Background: Diastolic dysfunction is the cause in nearly half of cases of heart failure, the hemodynamic equivalent of which is elevated cardiac filling pressures. However, owing to its ubiquity, it is often diagnosed as an incidental finding, but an association with symptoms is not established in many of the patients. Most patients with hypertension or left ventricular (LV) hypertrophy have evidence of impaired diastolic function as a finding on Doppler echocardiography, but do not have any symptoms of heart failure at rest. However, these patients do have symptoms related to diastolic dysfunction only during exercise. In this study, we have contemplated to assess invasively, left ventricular filling pressures in patients with unexplained shortness of breath with normal systolic and diastolic function on echocardiography, on exercise and compare the level of rise in patients with established diastolic dysfunction. Methods: This is an observational prospective study, done over a span of 3 months, wherein patients with typical symptoms such as chest pain and shortness of breath, after ruling out systemic causes, and were subjected to coronary angiogram. If no coronary lesion identified, patients were subjected to invasive cardiac catheterization during coronary angiogram. Patients were divided into two groups, one without diastolic dysfunction and the other with established diastolic dysfunction. Simultaneous left ventricular end diastolic pressures (LVEDP) were measured at rest and after 3-minute manual handgrip exercise and readings were noted. Results: The mean age of the population (n = 30) was 55.8 ± 7.538 and 20 were males. The mean value of LVEDP in patients with no diastolic dysfunction at resting was 4.4 ± 3.169 and after exercise was 8.40 ± 4.169. The mean value of LVEDP in patients with established diastolic dysfunction at resting was 5.30 ± 3.948 and after exercise was 8.75 ± 4.506. Paired t-test among two groups revealed a significant p-value of 0.001 after exercise among both groups, suggesting a significant increase in LVEDP in patients with exercise. Unpaired t-test comparing both groups revealed that the elevation of LVEDP in no diastolic dysfunction group was comparable with patients with diastolic dysfunction (p = 0.432). Conclusion: The increase in LVEDP with exercise is a well-established fact in patients with diastolic dysfunction. Our study adds to the fact that patients with unexplained shortness of breath can have raised LVEDP after exercise, thereby unmasking the underlying diastolic dysfunction. Our study stresses the importance of inclusion of exercise as a provocative test for the assessment of diastolic function, either invasively or non-invasively, in patients presenting with exertional dyspnea.
{"title":"Unmasking of Exercise-Induced Diastolic Dysfunction in Symptomatic Post Coronary Angiogram Patients with Normal Coronaries","authors":"M. Harish Reddy, J. Maddury, A. Panda","doi":"10.1055/s-0042-1744277","DOIUrl":"https://doi.org/10.1055/s-0042-1744277","url":null,"abstract":"\u0000 Background: Diastolic dysfunction is the cause in nearly half of cases of heart failure, the hemodynamic equivalent of which is elevated cardiac filling pressures. However, owing to its ubiquity, it is often diagnosed as an incidental finding, but an association with symptoms is not established in many of the patients. Most patients with hypertension or left ventricular (LV) hypertrophy have evidence of impaired diastolic function as a finding on Doppler echocardiography, but do not have any symptoms of heart failure at rest. However, these patients do have symptoms related to diastolic dysfunction only during exercise. In this study, we have contemplated to assess invasively, left ventricular filling pressures in patients with unexplained shortness of breath with normal systolic and diastolic function on echocardiography, on exercise and compare the level of rise in patients with established diastolic dysfunction.\u0000 Methods: This is an observational prospective study, done over a span of 3 months, wherein patients with typical symptoms such as chest pain and shortness of breath, after ruling out systemic causes, and were subjected to coronary angiogram. If no coronary lesion identified, patients were subjected to invasive cardiac catheterization during coronary angiogram. Patients were divided into two groups, one without diastolic dysfunction and the other with established diastolic dysfunction. Simultaneous left ventricular end diastolic pressures (LVEDP) were measured at rest and after 3-minute manual handgrip exercise and readings were noted.\u0000 Results: The mean age of the population (n = 30) was 55.8 ± 7.538 and 20 were males. The mean value of LVEDP in patients with no diastolic dysfunction at resting was 4.4 ± 3.169 and after exercise was 8.40 ± 4.169. The mean value of LVEDP in patients with established diastolic dysfunction at resting was 5.30 ± 3.948 and after exercise was 8.75 ± 4.506. Paired t-test among two groups revealed a significant p-value of 0.001 after exercise among both groups, suggesting a significant increase in LVEDP in patients with exercise. Unpaired t-test comparing both groups revealed that the elevation of LVEDP in no diastolic dysfunction group was comparable with patients with diastolic dysfunction (p = 0.432).\u0000 Conclusion: The increase in LVEDP with exercise is a well-established fact in patients with diastolic dysfunction. Our study adds to the fact that patients with unexplained shortness of breath can have raised LVEDP after exercise, thereby unmasking the underlying diastolic dysfunction. Our study stresses the importance of inclusion of exercise as a provocative test for the assessment of diastolic function, either invasively or non-invasively, in patients presenting with exertional dyspnea.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86303574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Narayanam Srikanth, M. Jyotsna, P. Durga, Achukatla Kumar
Prevalence of pulmonary thromboembolism (PTE) is very high when we compare the coronavirus disease 2019 positive patients with the other patients who are admitted in intensive care unit for other different infection. Thorough evaluation of the different causative factors for PTE should be better evaluated and prevention can be tried accordingly. Incidence of subclinical PTE that can give rise to future cardiac disease needs to be studied and plan of action can be done accordingly. Newer modalities of detecting PTE using non-invasive or simple invasive techniques need to be investigated to cope up in pandemic situation.
{"title":"Incidence of Cardiovascular Events and Mortality in COVID-19 Patients Admitted in NIMS Intensive Care Unit during Second Wave","authors":"Narayanam Srikanth, M. Jyotsna, P. Durga, Achukatla Kumar","doi":"10.1055/s-0041-1742215","DOIUrl":"https://doi.org/10.1055/s-0041-1742215","url":null,"abstract":"Prevalence of pulmonary thromboembolism (PTE) is very high when we compare the coronavirus disease 2019 positive patients with the other patients who are admitted in intensive care unit for other different infection. Thorough evaluation of the different causative factors for PTE should be better evaluated and prevention can be tried accordingly. Incidence of subclinical PTE that can give rise to future cardiac disease needs to be studied and plan of action can be done accordingly. Newer modalities of detecting PTE using non-invasive or simple invasive techniques need to be investigated to cope up in pandemic situation.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74307524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vasanth Kataria Anilet, I. Tammiraju, Meena Koduri
Background Brucellosis is a zoonotic bacterial infection caused by a gram-negative aerobic coccobacillus. It can have varied presentation. Most severe complications include neurological and cardiovascular involvement (most commonly in the form of infective endocarditis). Aortic valve is most commonly involved (75%). Blood culture is highly specific, while serologic tests are more sensitive for diagnosing brucellosis. Transthoracic and transesophageal echocardiography plays a major role in diagnosing infective endocarditis. Treatment of Brucella endocarditis includes combination of antibiotic therapy and surgical valve replacement. We are presenting here a case series of seven cases of B. endocarditis with different presentations and varied underlying cardiac conditions. Materials and Methods Total seven cases of B. endocarditis were reported. The age group ranges from 22 to 45 years. Majority of them were from agriculture and dairy industry. All have presented with fever and three patients had severe breathlessness. Three cases were rheumatic valve diseases, one was bicuspid aortic valve, and one was congenital heart disease with prosthetic valve. Six patients had native valve endocarditis (four had predisposing cardiac condition with diseased valves, two had normal valves), whereas one had prosthetic valve endocarditis. Four had aortic valve involvement and three had mitral involvement. All cases were diagnosed using blood culture, serology, and echocardiography. Conclusion All were treated initially with antibiotics and valve replacement was done in five cases. Mortality was the outcome in two cases on conservative treatment and before surgery. Other five patients recovered after surgery.
{"title":"Clinical Characteristics of a Zoonotic Occupational Disease—Brucella endocarditis with Review of Literature","authors":"Vasanth Kataria Anilet, I. Tammiraju, Meena Koduri","doi":"10.1055/s-0041-1742213","DOIUrl":"https://doi.org/10.1055/s-0041-1742213","url":null,"abstract":"\u0000 Background Brucellosis is a zoonotic bacterial infection caused by a gram-negative aerobic coccobacillus. It can have varied presentation. Most severe complications include neurological and cardiovascular involvement (most commonly in the form of infective endocarditis). Aortic valve is most commonly involved (75%). Blood culture is highly specific, while serologic tests are more sensitive for diagnosing brucellosis. Transthoracic and transesophageal echocardiography plays a major role in diagnosing infective endocarditis. Treatment of Brucella endocarditis includes combination of antibiotic therapy and surgical valve replacement. We are presenting here a case series of seven cases of B. endocarditis with different presentations and varied underlying cardiac conditions.\u0000 Materials and Methods Total seven cases of B. endocarditis were reported. The age group ranges from 22 to 45 years. Majority of them were from agriculture and dairy industry. All have presented with fever and three patients had severe breathlessness. Three cases were rheumatic valve diseases, one was bicuspid aortic valve, and one was congenital heart disease with prosthetic valve. Six patients had native valve endocarditis (four had predisposing cardiac condition with diseased valves, two had normal valves), whereas one had prosthetic valve endocarditis. Four had aortic valve involvement and three had mitral involvement. All cases were diagnosed using blood culture, serology, and echocardiography.\u0000 Conclusion All were treated initially with antibiotics and valve replacement was done in five cases. Mortality was the outcome in two cases on conservative treatment and before surgery. Other five patients recovered after surgery.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85376009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background The aim of this study was to study the prognostic implications of minimal coronary artery disease (CAD) in patients with dilated cardiomyopathy (DCMP) in terms of mortality and hospitalization due to heart failure. Methods One-hundred sixty-three patients with DCMP were recruited for this study. Out of these, 61.9% (n = 101; 62.4% men) patients were without associated minimal CAD and 38% (n = 62; 66.1% men) with associated minimal CAD (stenosis < 50%), and their risk factor profile was noted. These patients were followed for 30 months, with mortality being the primary endpoint, and hospitalization secondary to cardiac decompensation in the form of heart failure was denoted as the secondary endpoint. Results In our study, independent significant predictors of CAD were age (p = 0.002), hypertension (p = 0.001), diabetes (p < 0.001), and smoking (p = 0.023). The presence of minimal CAD in DCMP patients as a predictor of mortality was not significant (odds ratio [OR]: 1.69, 95% confidence interval [CI]: 0.62–4.62, p = 0.303); however, it was a significant predictor of hospitalization secondary to cardiac decompensation (OR: 6.78, 95% CI: 2.28–20.13, p = 0.001). Conclusions Minimal CAD was observed in 38% of DCMP patients. The risk factor profile predicting CAD in DCMP patients was the same as that of the general population. The presence of minimal CAD in DCMP patients was not associated with mortality. However, it was associated with hospitalization secondary to cardiac decompensation in the form of heart failure.
{"title":"Case Series: Is Minimal Coronary Artery Disease a Prognostic Indicator in Dilated Cardiomyopathy?","authors":"S. Kakroo, Y. Kishore","doi":"10.1055/s-0041-1739127","DOIUrl":"https://doi.org/10.1055/s-0041-1739127","url":null,"abstract":"\u0000 Background The aim of this study was to study the prognostic implications of minimal coronary artery disease (CAD) in patients with dilated cardiomyopathy (DCMP) in terms of mortality and hospitalization due to heart failure.\u0000 Methods One-hundred sixty-three patients with DCMP were recruited for this study. Out of these, 61.9% (n = 101; 62.4% men) patients were without associated minimal CAD and 38% (n = 62; 66.1% men) with associated minimal CAD (stenosis < 50%), and their risk factor profile was noted. These patients were followed for 30 months, with mortality being the primary endpoint, and hospitalization secondary to cardiac decompensation in the form of heart failure was denoted as the secondary endpoint.\u0000 Results In our study, independent significant predictors of CAD were age (p = 0.002), hypertension (p = 0.001), diabetes (p < 0.001), and smoking (p = 0.023). The presence of minimal CAD in DCMP patients as a predictor of mortality was not significant (odds ratio [OR]: 1.69, 95% confidence interval [CI]: 0.62–4.62, p = 0.303); however, it was a significant predictor of hospitalization secondary to cardiac decompensation (OR: 6.78, 95% CI: 2.28–20.13, p = 0.001).\u0000 Conclusions Minimal CAD was observed in 38% of DCMP patients. The risk factor profile predicting CAD in DCMP patients was the same as that of the general population. The presence of minimal CAD in DCMP patients was not associated with mortality. However, it was associated with hospitalization secondary to cardiac decompensation in the form of heart failure.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74298772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Alasnag, Z. Dakhil, I. Sukmawati, Sarita Rao, Shazia T. Hussain
Several studies have examined the efficacy of drug-eluting stents in acute and chronic coronary syndromes and demonstrated benefit in both men and women. However, the effect of gender on percutaneous coronary intervention (PCI) outcomes in more complex disease including bifurcation disease is less well-known. In particular, a two-stent or provisional strategy, for both left Main and non-Left Main bifurcation lesions, has been variable across the different studies. In addition, there is a notable geographic preference whereby a stepwise provisional strategy with culotte as a bailout technique is preferred in Europe while in Asia there is a predilection to DK Crush for a 2-stent strategy. Many of these trials, however, are underpowered to conduct subgroup analysis for outcomes in women. To date, the evidence suggests women have better outcomes with coronary artery bypass grafting in complex disease. The higher events in women undergoing PCI are largely driven by bleeding. Studies dedicated to evaluating outcomes after complex revascularization in women are desperately needed with long-term follow-up. This review examines the current landmark trials as they pertain to outcomes in women.
{"title":"Summary of Bifurcation Stenting Strategies and Outcomes in Women","authors":"M. Alasnag, Z. Dakhil, I. Sukmawati, Sarita Rao, Shazia T. Hussain","doi":"10.1055/s-0042-1748979","DOIUrl":"https://doi.org/10.1055/s-0042-1748979","url":null,"abstract":"Several studies have examined the efficacy of drug-eluting stents in acute and chronic coronary syndromes and demonstrated benefit in both men and women. However, the effect of gender on percutaneous coronary intervention (PCI) outcomes in more complex disease including bifurcation disease is less well-known. In particular, a two-stent or provisional strategy, for both left Main and non-Left Main bifurcation lesions, has been variable across the different studies. In addition, there is a notable geographic preference whereby a stepwise provisional strategy with culotte as a bailout technique is preferred in Europe while in Asia there is a predilection to DK Crush for a 2-stent strategy. Many of these trials, however, are underpowered to conduct subgroup analysis for outcomes in women. To date, the evidence suggests women have better outcomes with coronary artery bypass grafting in complex disease. The higher events in women undergoing PCI are largely driven by bleeding. Studies dedicated to evaluating outcomes after complex revascularization in women are desperately needed with long-term follow-up. This review examines the current landmark trials as they pertain to outcomes in women.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90521394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I read with interest the article 1 about therapeutic anticoagulation in patients with coronavirus disease 2019 (COVID-19) and considerations in women. I applaud the authors for performing rigorous review to address this important clinical concern in COVID-19. High prevalence of venous thromboembolism (VTE) was observed in 22.7% of patients in intensive care units. 2 Observational studies and initial autopsy series showed high rates of both venous and arterial thrombosis as well as prominent pulmonary microvascular thrombosis. Patients with COVID-19 were reported to have 6% more risk to develop VTE as compared to non-COVID-19 patients. 3 In addition, COVID-19-associated coagulopathy was recognized as a marker of disease severity and poor prognosis. Contrasting results have been reported about the pre-ferred anticoagulation therapy in patients with COVID-19 infection. As evident in the given article, 1 the recommenda-tions by various societies and guidelines kept on changing as the evidence emerged. Elevated D-dimer levels were reported as predictive for breakthrough thrombosis 4 despite standard deep vein thrombosis prophylaxis. Some institu-tions started risk-stratifying patients for VTE based on the D-dimer cutoff points and started intermediate-dose prophy-laxis in critically ill patients with COVID-19. 5 Follow-up studies have con fi rmed signi fi cant coagulopathy associated with severe COVID-19, characterized by marked elevation of fi brinogen, von Willebrand factor, and platelet and profound endothelia
{"title":"Letter to the Editor: Venous Thromboembolism in COVID-19: Are Women Different?","authors":"A. Kapoor","doi":"10.1055/s-0042-1746420","DOIUrl":"https://doi.org/10.1055/s-0042-1746420","url":null,"abstract":"I read with interest the article 1 about therapeutic anticoagulation in patients with coronavirus disease 2019 (COVID-19) and considerations in women. I applaud the authors for performing rigorous review to address this important clinical concern in COVID-19. High prevalence of venous thromboembolism (VTE) was observed in 22.7% of patients in intensive care units. 2 Observational studies and initial autopsy series showed high rates of both venous and arterial thrombosis as well as prominent pulmonary microvascular thrombosis. Patients with COVID-19 were reported to have 6% more risk to develop VTE as compared to non-COVID-19 patients. 3 In addition, COVID-19-associated coagulopathy was recognized as a marker of disease severity and poor prognosis. Contrasting results have been reported about the pre-ferred anticoagulation therapy in patients with COVID-19 infection. As evident in the given article, 1 the recommenda-tions by various societies and guidelines kept on changing as the evidence emerged. Elevated D-dimer levels were reported as predictive for breakthrough thrombosis 4 despite standard deep vein thrombosis prophylaxis. Some institu-tions started risk-stratifying patients for VTE based on the D-dimer cutoff points and started intermediate-dose prophy-laxis in critically ill patients with COVID-19. 5 Follow-up studies have con fi rmed signi fi cant coagulopathy associated with severe COVID-19, characterized by marked elevation of fi brinogen, von Willebrand factor, and platelet and profound endothelia","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83737360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Microcatheters are commonly used hardware during complex coronary and cerebral interventional therapies. With increasing operator experience, more and more complex coronary interventions are beingdone in day-to-day practice and especially with chronic total occlusions. Various types of micro catheters are available in the market with each manufacturer having unique design and purpose. This review summarizes the various available and commonly used microcatheters in interventional cardiology
{"title":"Micro Catheters in Interventional Cardiology","authors":"Arramraj Sreenivas Kumar, R. Janapati","doi":"10.1055/s-0042-1748949","DOIUrl":"https://doi.org/10.1055/s-0042-1748949","url":null,"abstract":"Microcatheters are commonly used hardware during complex coronary and cerebral interventional therapies. With increasing operator experience, more and more complex coronary interventions are beingdone in day-to-day practice and especially with chronic total occlusions. Various types of micro catheters are available in the market with each manufacturer having unique design and purpose. This review summarizes the various available and commonly used microcatheters in interventional cardiology","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87073441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ganesh Anjani Sharma, S. Bala, Arun Guddeti, S. Katkuri, Suneeth Jogi, Jahnavi Dharmana
Background Association of type-2 diabetes mellitus with cardiovascular morbidity and mortality is a well-known fact. The measurement of associated risk factors among diabetics gives a better idea for further management and prevention of complications, especially among those with high risk. Objectives The objective of our study was to compare the cardiovascular risk profile and estimate the 10-year cardiovascular risk using the World Health Organization (WHO) risk chart among diabetic patients as per their gender. Methods Hospital-based cross-sectional study was undertaken among type 2 diabetic patients attending our tertiary care hospital using a semi-structured questionnaire based on WHO-STEPwise approach to surveillance questionnaire consisting of socio-demographic variables, personal habits, and lifestyle (physical and biochemical measurements). Carotid intima–media thickness (CIMT) was assessed through ultrasonography. Ten-year cardiovascular disease (CVD) risk assessment was also done using WHO/International Society of Hypertension (ISH) charts. Results One hundred and thirteen male and 144 female subjects were included in the study. On comparison of cardiovascular risk factors, a statistically significant difference among males and females was found in tobacco and alcohol consumption, systolic blood pressure (BP), diastolic BP, and high-density lipoprotein (HDL). CIMT measurements revealed statistically significant differences, with males being significantly at higher risk. A 10-year CVD risk assessment revealed higher risk among males and was statistically significant. It was found that a significant association between increased 10-year CVD risk and HbA1c, HDL, systolic BP, diastolic BP, and CIMT existed. Conclusions Comparison within gender among diabetic patients revealed that the cardiovascular risk factors were statistically higher among males as per 10-year risk assessment using the WHO/ISH chart.
{"title":"Estimation of Cardiovascular Risk Profile among Diabetic Patients Attending Tertiary Care Hospital","authors":"Ganesh Anjani Sharma, S. Bala, Arun Guddeti, S. Katkuri, Suneeth Jogi, Jahnavi Dharmana","doi":"10.1055/s-0042-1746418","DOIUrl":"https://doi.org/10.1055/s-0042-1746418","url":null,"abstract":"\u0000 Background Association of type-2 diabetes mellitus with cardiovascular morbidity and mortality is a well-known fact. The measurement of associated risk factors among diabetics gives a better idea for further management and prevention of complications, especially among those with high risk.\u0000 Objectives The objective of our study was to compare the cardiovascular risk profile and estimate the 10-year cardiovascular risk using the World Health Organization (WHO) risk chart among diabetic patients as per their gender.\u0000 Methods Hospital-based cross-sectional study was undertaken among type 2 diabetic patients attending our tertiary care hospital using a semi-structured questionnaire based on WHO-STEPwise approach to surveillance questionnaire consisting of socio-demographic variables, personal habits, and lifestyle (physical and biochemical measurements). Carotid intima–media thickness (CIMT) was assessed through ultrasonography. Ten-year cardiovascular disease (CVD) risk assessment was also done using WHO/International Society of Hypertension (ISH) charts.\u0000 Results One hundred and thirteen male and 144 female subjects were included in the study. On comparison of cardiovascular risk factors, a statistically significant difference among males and females was found in tobacco and alcohol consumption, systolic blood pressure (BP), diastolic BP, and high-density lipoprotein (HDL). CIMT measurements revealed statistically significant differences, with males being significantly at higher risk. A 10-year CVD risk assessment revealed higher risk among males and was statistically significant. It was found that a significant association between increased 10-year CVD risk and HbA1c, HDL, systolic BP, diastolic BP, and CIMT existed.\u0000 Conclusions Comparison within gender among diabetic patients revealed that the cardiovascular risk factors were statistically higher among males as per 10-year risk assessment using the WHO/ISH chart.","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90317130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Despite the challenges posed by coronavirus disease 2019 (COVID-19) on all fields of life including healthcare and academics, Indian Journal of Cardiovascular Disease inWomen(IJCDW) has successfully completed its 6th consecutive years with four complete issues. Each issue brings forth original articles centered onwomen cardiac health, interesting case reports, and review articles on latest topics of the time. The other interesting sections in the journal include intervention rounds, practice in medicine, short communications, and expert opinions where the appropriate topics have been described at their best. Velam etal study on lifestyle patterns and well-being status among healthcare employees at their tertiary care hospital showed that the overall well-being was good, with males scoring over female employees.1 Female employees experienced risks with regard to their physical health. An interesting study by Fatima etal on circadian rhythm as risk factor for cardiovascular disease in shift-working nurses emphasized that work shift in which sleep is disturbed leads to mental stress and is a direct risk factor for cardiovascular disease.2 Both theses original studies highlight the need to address life stylemodifications that include regular adequate sleep. There were several original studies on heart failure patients. The get with the guidelines (GWTG) risk score based on seven parameters was developed to predict inhospital mortality in acute heart failure patients. Bodicherla etal study aimed to clarify its prognostic impact in south Indian patients admitted with acute heart failure, predicted adverse outcomes with higher GWTG score (average score of 39 predicting complications and hospitalization and 45 predicting death).3Kishore etal study on prognosis after revascularization in patients with severe left ventricular (LV) dysfunction showed that severe LV dysfunction alone was the cause for mortality with no confounding factors.4 Presence of minimal coronary artery disease (CAD) is an adverse prognostic marker for morbidity not mortality in dilated cardiomyopathy as shown by Kakroo and Kishore.5 There were new insights on CAD with gender differences. According to Swaminathan and Prasath angiographic severity measured by SYNTAX score 1 increasedwith duration and number of risk factors.6 Irrespective of gender, recanalized and thrombotic coronaries are common in the young with premature CAD.7 In a single-center experience by Harini etal, women had higher bleeding incidence following percutaneous coronary intervention (PCI), though there was no difference in mortality.8 Women who underwent PCI tend to be older with higher rates of hypertension diabetes and obesity. E2/T ratio may be used as a predictor of CAD in postmenopausal women according to study by Khanna et al.9 According to the study by Madaka et al, high white blood cell to mean platelet volume ratio predicted worse outcome and short-term major adverse cardiac events in patients with acute c
{"title":"Progress of IJCDW in 2021","authors":"M. Jyotsna, Lalita Nemani","doi":"10.1055/s-0042-1748956","DOIUrl":"https://doi.org/10.1055/s-0042-1748956","url":null,"abstract":"Despite the challenges posed by coronavirus disease 2019 (COVID-19) on all fields of life including healthcare and academics, Indian Journal of Cardiovascular Disease inWomen(IJCDW) has successfully completed its 6th consecutive years with four complete issues. Each issue brings forth original articles centered onwomen cardiac health, interesting case reports, and review articles on latest topics of the time. The other interesting sections in the journal include intervention rounds, practice in medicine, short communications, and expert opinions where the appropriate topics have been described at their best. Velam etal study on lifestyle patterns and well-being status among healthcare employees at their tertiary care hospital showed that the overall well-being was good, with males scoring over female employees.1 Female employees experienced risks with regard to their physical health. An interesting study by Fatima etal on circadian rhythm as risk factor for cardiovascular disease in shift-working nurses emphasized that work shift in which sleep is disturbed leads to mental stress and is a direct risk factor for cardiovascular disease.2 Both theses original studies highlight the need to address life stylemodifications that include regular adequate sleep. There were several original studies on heart failure patients. The get with the guidelines (GWTG) risk score based on seven parameters was developed to predict inhospital mortality in acute heart failure patients. Bodicherla etal study aimed to clarify its prognostic impact in south Indian patients admitted with acute heart failure, predicted adverse outcomes with higher GWTG score (average score of 39 predicting complications and hospitalization and 45 predicting death).3Kishore etal study on prognosis after revascularization in patients with severe left ventricular (LV) dysfunction showed that severe LV dysfunction alone was the cause for mortality with no confounding factors.4 Presence of minimal coronary artery disease (CAD) is an adverse prognostic marker for morbidity not mortality in dilated cardiomyopathy as shown by Kakroo and Kishore.5 There were new insights on CAD with gender differences. According to Swaminathan and Prasath angiographic severity measured by SYNTAX score 1 increasedwith duration and number of risk factors.6 Irrespective of gender, recanalized and thrombotic coronaries are common in the young with premature CAD.7 In a single-center experience by Harini etal, women had higher bleeding incidence following percutaneous coronary intervention (PCI), though there was no difference in mortality.8 Women who underwent PCI tend to be older with higher rates of hypertension diabetes and obesity. E2/T ratio may be used as a predictor of CAD in postmenopausal women according to study by Khanna et al.9 According to the study by Madaka et al, high white blood cell to mean platelet volume ratio predicted worse outcome and short-term major adverse cardiac events in patients with acute c","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"115 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79096645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Women Power","authors":"M. Jyotsna","doi":"10.1055/s-0042-1748955","DOIUrl":"https://doi.org/10.1055/s-0042-1748955","url":null,"abstract":"","PeriodicalId":92905,"journal":{"name":"Indian journal of cardiovascular disease in women WINCARS","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77527677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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