Finerenone: Will It Be a Game-changer?

Heart failure (HF) is a major contributor to hospitalisations and accounts for 7% of cardiovascular-related deaths, with patients who have chronic kidney disease and type 2 diabetes at heightened risk. Existing treatment guidelines inadequately address these comorbidities. Steroidal mineralocorticoid receptor antagonists (MRAs) are commonly used in HF with reduced ejection fraction but pose risks, such as hyperkalaemia and acute kidney injury.

Conduction system metastasis in a patient with carcinoma oesophagus.

A young man in his 30s presented to us with multiple episodes of syncope and exertional dyspnoea for the last 2 weeks. He was diagnosed with squamous cell carcinoma of the lower one-third of the oesophagus in 2021 for which he was treated with neoadjuvant chemoradiotherapy, followed by McKeown oesophagectomy. At 2-year follow-up, he had developed a soft tissue swelling in the scalp, which was diagnosed as a tumour recurrence and radiotherapy was initiated.

Lerodalcibep and evolocumab for the treatment of homozygous familial hypercholesterolaemia with PCSK9 inhibition (LIBerate-HoFH): a phase 3, randomised, open-label, crossover, non-inferiority trial.

Background: Lerodalcibep, a small binding anti-PCSK9 protein (adnectin), showed effective LDL cholesterol reduction in heterozygous familial hypercholesterolaemia. We aimed to assess the safety and efficacy of lerodalcibep and evolocumab in a globally diverse homozygous familial hypercholesterolaemia population.

Methods: This phase 3, randomised, open-label, crossover, non-inferiority study consisted of two 24-week treatment periods separated by an 8-week washout.

Doxorubicin-induced phosphorylation of lamin A/C enhances DNMT1 and activates cardiomyocyte death via suppressing GATA-4 and Bcl-xL in rat heart.

Cardiotoxic effect of Doxorubicin (Dox) limits its clinical application. Previously, we reported that Dox induces phosphorylation of lamin A/C (pS22 lamin A/C), increased nuclear size, damage to the nuclear membrane, and cell death. However, the activation of signalling pathway during this event remains elusive, and it is unclear whether increased phospho-lamin A/C activates the cell death pathway in heart.

Penicillin Allergy Management in India and Sri Lanka: Current Challenges.

Data regarding Penicillin allergy labels (PALs) from India and Sri Lanka are sparse. Emerging data suggests that the proportion of patients declaring an unverified PAL in secondary care in India and Sri Lanka (1%-4%) is lesser than that reported in High Income Countries (15%-20%). However, even this relatively small percentage translates into a large absolute number, as this part of the world accounts for approximately 25% of the global population.

Neurodevelopmental outcomes after infant heart surgery for congenital heart disease: a hospital-based multicentre prospective cohort study from India.

Background: Neurodevelopmental disability is a common long-term concern following surgery for congenital heart disease (CHD). Little information is available from low-resource environments where the majority of children with CHD are born. Several challenges in the CHD care continuum exist in such environments.

Long-acting nifedipine in the management of essential hypertension: a review for cardiologists.

Calcium channel antagonists, specifically long-acting nifedipine formulations, play a crucial role in treating hypertension and angina. Originally used for angina, nifedipine has been widely employed as an antihypertensive medication for over 40 years. It offers rapid action and oral bioavailability with minimal maternal or fetal side effects, making it suitable for treating hypertensive crises during pregnancy.

Isolated absent pulmonary valve with intact ventricular septum in a young child: A rare case report.

Absent pulmonary valve syndrome, commonly linked with tetralogy of Fallot and ventricular septal defect, is a rare congenital condition. It is exceedingly rare to have an isolated absent pulmonary valve with an intact ventricular septum without cardiovascular shunt lesions, such as an atrial/ventricular septal defect or patent ductus arteriosus. This report presents a case of such rarity involving a young child with recurrent lower respiratory tract infections.

Efficacy of early enteral feeding with supplemented mother's milk on postoperative outcomes of cardiac surgical infants: A randomized controlled trial.

Introduction: Congenital heart disease (CHD)-associated malnutrition is a systemic consequence of CHD. Dietary recommendations to fulfill nutritional requirements are lacking. This randomized controlled trial (RCT) was conducted to determine the efficacy of early enteral feeding with supplemented expressed breast milk (suppl-EBM) versus expressed breast milk (EBM) in improving the weight of postoperative cardiac surgical infants.

Sleep Stewardship.

Sleep stewardship is a systematic effort to ensure relaxed and restorative sleep, by optimizing pre-sleep, intra-sleep and post-sleep environment and ambience, in a rational manner. It includes not only sleep hygiene and prevention of sleeping pill abuse, but also macro- and meso-level interventions to improve sleep quality. The person living with sleep disorder, their family, members of society, health care professionals, and policy makers: all have a role to play in sleep stewardship.

Recent development in CRISPR-Cas systems for cardiac disease.

The CRISPR-Cas system has emerged as a revolutionary tool in genetic research, enabling highly precise gene editing and significantly advancing the field of cardiovascular science. This chapter provides a comprehensive overview of the latest developments in utilizing CRISPR-Cas technologies to investigate and treat heart diseases. It delves into the application of CRISPR-Cas9 for creating accurate models of complex cardiac conditions, such as hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), and various arrhythmias, which are essential for understanding disease mechanisms and testing potential therapies.

Giant pulmonary vein aneurysm.

We report a case of a 14-year-old girl with complex congenital heart disease where computed tomography (CT) angiography demonstrated a giant aneurysm of the right inferior pulmonary vein, in the absence of any downstream obstruction. The case highlights the developmental aspects of this rare anomaly in addition to the role of CT angiography in anatomical depiction of structures which are difficult to visualize on transthoracic echocardiography.

Computed tomography dataset virtual dissection for sternal re-entry in congenital cardiac surgery.

Unlabelled: In congenital heart surgery, redo-sternotomies are very common. In most cases, sternal re-entry is achieved without serious complications. However, sometimes elective institution of peripheral cardiopulmonary bypass is needed for safe sternotomy, albeit with a long cardio-pulmonary bypass time.

Identifying Drug Prescription in Newly Diagnosed Hypertension Patients in India.

This study evaluated initial antihypertensive drug prescription patterns in Indian healthcare settings. An observational, cross-sectional, prospective prescription registry analyzed prescriptions for 4723 newly diagnosed hypertension patients. Additionally, it investigated the extent to which physicians adhered to either European or Indian hypertension guidelines.

Correlation Between Cardiac Autonomic Dysfunction and Severity of Coronary Artery Lesions in Patients With Chronic Coronary Syndrome.

Background Autonomic dysfunction is associated with adverse outcomes in patients with coronary artery disease. Cardiac autonomic dysfunction parameters such as heart rate variability (HRV) and heart rate recovery (HRR) have been studied individually and have been linked to the presence or likelihood of coronary artery disease. In this study, the cardiac autonomic function was assessed in terms of HRR and HRV.

Rare cause of angina: mechanical compression from hydatid cyst.

A young man presented with complaints of angina on exertion and dyspnoea on exertion for the last 3 months. On evaluation, he was found to have a cystic mass in the left ventricle with severe left ventricular systolic dysfunction. A cardiac MRI revealed a multiloculated mass in the left ventricle with multiple septa with internal enhancement and CT coronary angiography revealed compression of a coronary artery by the cystic mass.

Real-World Evidence of the Impact of CanAssist Breast on Physician's Decision About the Use of Adjuvant Chemotherapy in Early Breast Cancer.

Background Clinicians use prognostic biomarker/multi-gene-based tests for predicting recurrence in hormone receptor-positive/HER2-negative (HR+/HER2-) early-stage breast cancer (EBC). CanAssist Beast (CAB) uses the expression of five protein biomarkers in combination with tumor-specific parameters such as tumor size, histopathological grade, and lymph node status to predict the risk of distant recurrence within five years of diagnosis for patients with HR+/HER2-, EBC. The current study aimed to evaluate the impact of prognostic tests on adjuvant chemotherapy decisions by assessing the agreement between clinical and CAB risk stratification as low-risk (LR) or high-risk (HR) for distant recurrence.

Asian Pacific Society of Cardiology Position Statement on the Use of Transcatheter Aortic Valve Implantation in the Management of Aortic Stenosis.

Transcatheter aortic valve implantation (TAVI) has been established as an effective treatment modality in patients with severe aortic stenosis (AS) and the uptake of TAVI is rapidly growing in the Asia-Pacific region. However, there exist a heterogeneity in the management of aortic stenosis and the use of TAVI among countries in the region. Reasons for these differences include anatomic variations, disparity in healthcare resources and infrastructure, and the lack of consensus on the optimal management of AS in the Asia-Pacific region.

The interplay of heart rate variability and ventricular repolarization parameters in the obese state: a review.

The impact of obesity on heart rate variability (HRV) and ventricular repolarization, both vital indicators of cardiovascular health, is the focus of this review. Obesity, measured by BMI, waist circumference, and waist-to-hip ratio, significantly increases cardiovascular disease (CVD) risk due to structural and autonomic heart changes. Findings show that obese individuals exhibit prolonged QT and Tpeak-to-Tend (Tpe) intervals, suggesting delayed ventricular recovery and greater arrhythmia risk.

Study of pattern of lipid profile amongst type II diabetic patients of two major tribal populations of Tripura.

Background: Diabetic population are at an increased risk of developing dyslipidemia and other cardiovascular complications. The study was performed to evaluate the lipid profile parameter in the diabetic population among the ethnic tribal community of Tripura and calculate the risk of cardiovascular events. The tribal community was chosen as the study population because their lifestyle, food habits, culture and housing practices are different from people living on the plains.