Clonal Haematopoiesis of Indeterminate potential and Cardiovascular diseases : A review.

Cardiovascular disease (CVD) is a major driver of mortality and declining health worldwide. Cardiovascular diseases (CVD) is the most common cause of morbidity and mortality globally. Although dyslipidemia, smoking, diabetes, hypertension and obesity are some well-known causes of CVD, the overlapping genetic pathways between other diseases and those affecting cardiovascular health have been overlooked.

SEVERITY OF MITRAL REGURGITATION AND ITS ASSOCIATION WITH LEFT VENTRICULAR DYSFUNCTION AND BRAIN-NATRIURETIC PEPTIDE LEVELS IN PATIENTS WITH ACUTE DECOMPENSATED HEART FAILURE.

Acute decompensated heart failure (ADHF) is greatly influenced by levels of brain-natriuretic peptides (BNP) and thereby may have strong correlation with severity of mitral regurgitation (MR) and left ventricular ejection fraction (LVEF). The available data on its association is limited which sought us to investigate correlations between type of ADHF, BNP levels and severity of MR. A single-center, cross-sectional, observational study was conducted at Sri Ramachandra Institute of Higher Education and Research, Chennai, India.

Systematic review and meta-analysis of early aortic valve replacement versus conservative therapy in patients with asymptomatic aortic valve stenosis with preserved left ventricle systolic function.

Background: A quarter of patients with severe aortic stenosis (AS) were asymptomatic, and only a third of them survived at the end of 4 years. Only a select subset of these patients was recommended for aortic valve replacement (AVR) by the current American College of Cardiology/American Heart Association guidelines. We intended to study the effect of early AVR (eAVR) in this subset of asymptomatic patients with preserved left ventricle function.

Safety and Efficacy of OPN Balloon in Patients With Calcified Coronary Artery Disease.

Background: Patients with symptomatic calcified coronary lesions have poor outcomes. Such lesions require additional atherectomy devices for bed preparation.

Aim: To assess the safety and efficacy of OPN balloon in patients with calcified coronary lesions.

Procedural Safety and Long-Term Clinical Outcomes in Patients Receiving Ultra-Long Everolimus-Eluting Stent: A Single-Center Real-World Experience.

Background: Diffuse long coronary lesions are difficult to treat percutaneously. The aim of the present study was to assess the procedural safety and long-term efficacy of the ultra-long (48-mm) drug-eluting stent Xience Xpedition.

Methods: This was an investigator-initiated, observational, all-comers study.

Clonal hematopoiesis of indeterminate potential (CHIP) and cardiovascular diseases-an updated systematic review.

Background: Cardiovascular diseases (CVDs) are the leading cause of mortality in India. Residual risk exists in patients receiving optimal guideline-directed medical therapy. Possession of certain somatic mutations, at a variant allele frequency of ≥ 2% in peripheral blood, driving clonal expansion in the absence of cytopenias and dysplastic hematopoiesis is defined as clonal hematopoiesis of indeterminate potential (CHIP).

Clinical profile and management of patients with acute pulmonary thromboembolism - a single centre, large observational study from India.

Acute pulmonary thromboembolism is associated with high mortality, similar to that of myocardial infarction and stroke. We studied the clinical presentation and management of pulmonary thromboembolism in the Indian population. An analysis of 140 patients who presented with acute pulmonary thromboembolism at a large volume center in India from June 2015 through December 2018 was performed.

Differentiating wide complex tachycardias: A historical perspective.

One of the most critical and challenging skills is the distinction of wide complex tachycardias into ventricular tachycardia or supraventricular wide complex tachycardia. Prompt and accurate differentiation of wide complex tachycardias naturally influences short- and long-term management decisions and may directly affect patient outcomes. Currently, there are many useful electrocardiographic criteria and algorithms designed to distinguish ventricular tachycardia and supraventricular wide complex tachycardia accurately; however, no single approach guarantees diagnostic certainty.

Comparison of the effect of Morphine and Fentanyl in patients with acute coronary syndrome receiving Ticagrelor - The COMET (Comparison Morphine, Fentayl and Ticagrelor) randomized controlled trial.

Introduction: Dual antiplatelet therapy (DAPT) remains the cornerstone of acute coronary syndrome (ACS) management, and ticagrelor is one of the commonly used second antiplatelet agents. There is some evidence to suggest that morphine may reduce the antiplatelet effect of ticagrelor.

Methods And Results: In a single-center, randomized controlled trial, we compared the effect of morphine and fentanyl on platelet aggregation (PA) among patients with ACS treated with ticagrelor.

Association of poor sleep quality with risk factors after coronary artery bypass graft surgery-A prospective cohort study.

Fragmented sleep is a daunting experience and a common health problem with high prevalence among patients 3 months after coronary artery bypass grafting (CABG). However, the potential predictors on poor seep quality remains unexplored. The main purpose of this study was to determine the predictors of poor sleep quality among patients 3 months after CABG.

Diagnostic accuracy of 64-slice multidetector computed tomography in evaluation of post-coronary artery bypass grafts in correlation with invasive coronary angiography.

64-slice multidetector computed tomography (MDCT) allows more reliable and non-invasive evaluation of the coronary artery bypass grafts for occlusion or stenosis both in symptomatic and asymptomatic patients and also progression of disease in native coronary vessels.

Can retinal changes predict coronary artery disease in elderly hypertensive patients presenting with angina?

Background: The prevalence of coronary artery disease (CAD) has been increasing in India, and so is the population of elderly patients with hypertension. In the predominantly resource-poor setting prevailing in India, this study is an effort to analyze the accuracy of retinal changes in predicting CAD among a cohort of elderly patients with hypertension presenting to the emergency department with angina.

Methods: A total of 72 elderly patients with hypertension older than 65 years presenting to the emergency department with acute angina were studied.

Correlation of anemia, secondary hyperparathyroidism with left ventricular hypertrophy in Chronic Kidney Disease patients.

Aims: To demonstrate the correlation of anemia and intact parathormone with left ventricular hypertrophy in a cohort of Chronic Kidney Disease (CKD) patients in a tertiary care centre.

Methods: A cross-sectional study was done over 2 years on 230 renal failure patients (160 males, 70 females), aged 15-75 years, who had elevated serum creatinine and reduced GFR. The patients were assessed based on clinical history and a number of laboratory parameters including serum creatinine, calcium, iPTH level, Hb, Hct, GFR and LVMI.

Comparison of target concentration intervention strategy with conventional dosing of digoxin.

Digoxin is a widely used drug in patients with congestive heart failure. The present study compared the quality of life of congestive heart failure patients on one year follow-up period with two different dosing of digoxin (5/7 therapy and 7/7 therapy in whom the target serum digoxin concentration is maintained). Quality of life significantly improved in intervention group thus emphasizing the need for continuous dosing of digoxin based on target concentration.

Plasma insulin levels in coronary artery disease.

Seventy two consecutive patients without a history of diabetes and normal fasting plasma glucose were included in this study of insulin levels. Standard oral glucose tolerance test with 75 gm glucose and fasting and two hour insulin levels were estimated in all patients. Coronary artery disease (CAD) was confirmed or excluded by selective coronary arteriography.

Proximal flow convergence method in the assessment of mitral stenosis.

Mitral valve area (MVA) was calculated using the proximal flow convergence method in 60 patients with severe mitral stenosis. Using the apical 4 chamber view, colour Doppler was used to measure the peak forward flow rate. From this, the mitral valve area was calculated according to the formula: mitral valve area = peak forward flow rate/peak mitral velocity.