|Year : 2016 | Volume
| Issue : 1 | Page : 1-2
Preface to first issue of Heart India 2016
Alok Kumar Singh
Department of Cardiology, Heritage Hospital, Varanasi, Uttar Pradesh, India
|Date of Web Publication||4-Mar-2016|
Alok Kumar Singh
Department of Cardiology, Heritage Hospital, Varanasi, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Singh AK. Preface to first issue of Heart India 2016. Heart India 2016;4:1-2
In this issue, we are publishing an editorial commentary, four original article, six case reports, one journal watch and one book review. From this issue, we are starting regular column with the name of journal watch. In editorial commentary, Dr. Pradhan have emphasized the role of cardiovascular screening in general population. The role of percutaneous coronary intervention in the treatment of multivessel coronary artery disease (CAD) is still controversial and widely discussed. Polavarapuet al., in first original article, studied a total of 151 patients, exclusively treated with Indolimus sirolimus-eluting stent in multivessel (≥2 vessels), were examined in the retrospective, nonrandomized, observational, multicenter MULTIDES study. A total of 314 Indolimus stents were implanted. Clinical follow-up was performed at 30-day, at 6-month, and at 9-month. The primary endpoint, major adverse cardiac events (MACEs) at 9-month follow-up, occurred in 5 (3.3%) patients, consisting of 1 (0.7%) cardiac death, 2 (1.3%) myocardial infarction (MI), 2 (1.3%) target lesion revascularization, 0 (0%) target vessel revascularization, and 0 (0%) stent thrombosis. Authors of the present study have demonstrated Indolimus implantation is safe and effective treatment in multivessel CAD, showing low rates of MACEs during 9-month follow-up.
Revascularization strategy in acute coronary syndrome (ACS) is based on the ST segment deviation in the presenting electrocardiogram (ECG). ST segment elevation denotes total occlusion of culprit vessel and mandates early revascularization. Gerogeet al. have studied 89 consecutive patients with chest pain and angiogram evidence of at least one totally occluded epicardial coronary vessel. Culprit artery prediction was attempted according to the available algorithms and correlated with the angiogram finding., All patients with total occlusion of left anterior descending (LAD) and right coronary artery had ST segment elevation whereas only 50% of patients with circumflex artery occlusions had classical ST segment elevation in respective territories. In this study, authors found that half of total circumflex artery occlusions were classified as non-ST elevation ACS when using the current 12-lead ECG criteria. This emphasizes the need for the incorporation of routine posterior leads in cases of suspected ACS if classical ST elevation is not present in 12-lead ECG. Otherwise, many patients with totally occluded culprit arteries may be denied, the revascularization procedures in their golden hour. In third original research article, Savitharaniet al. have screened a total of 900 supporting staff of a Tertiary Care Hospital, Mysuru, were screened for CVD risks by utilizing WHO-ISH 10-year CVD Risk Prediction Chart. Out of them, 30 (3.3%) had hypertension, 20 (2.2%) had diabetes mellitus (DM), and 18 (1.99%) consumed tobacco. The proportion of newly detected diabetes cases was 8 (0.9%) and of prediabetics was 32 (3.7%). The proportion of newly detected prehypertensives were 292 (39.08%), and 27 (3.61%) were hypertensives. Out of 175 individuals aged above 40 years, the WHO-ISH risk prediction chart predicted that 1.7% of them had >10% risk of CVD event within 10 years.
The role of glycosylated hemoglobin (HbA1c) in predicting the outcome of ACS remains largely controversial. In fourth original research article, Singhet al. have studied the impact of higher HbA1c in predicting outcome of ACS patients. This observational cross-sectional study included 100 patients without DM, who were admitted to the coronary care unit with symptoms suggestive of ACS. This study shows that ACS patients without known DM are associated with poorer outcomes if they have higher levels of HbA1c. High normal HbA1c is associated with more complications such as left ventricular function and arrhythmia. High normal HbA1c is also associated with more severe ACS in terms of higher levels of troponin T, lower EF, presence of regional wall motion abnormalities on ECHO.
Srinivasa et al., in first case report of this issue, reported a series of two case of high altitude pulmonary edema (HAPE) with pulmonary embolism. Authors have concluded that the possibility of pulmonary embolism should be considered in cases of HAPE with persistent radiographic opacities despite oxygen therapy or descent. In second case report, Jain et al. reported a case of direct type Gerbode defect with the cleft of the anterior mitral leaflet in a 15-year-old boy. Ocular myasthenia gravis is an autoimmune disorder of the neuromuscular junction. Diplopia and ptosis are common symptoms at the onset of ocular myasthenia gravis. It may occur due to the antibodies developed against various drugs. Modiet al., in third case report of this issue, reported a case of ocular myasthenia gravis which was developed in a patient postangiography which may be due to antibody developed against the dye used in angiography. Chest trauma has a high rate of mortality. Coronary dissection causing MI following blunt chest trauma is rare. Agrawalaet al., in fourth case report, describing a case of an anterior MI following blunt chest trauma because of dissection in the left anterior coronary artery, which was successfully treated with stenting. In fifth case report, Somanet al. reported a case of rare branching pattern of left main coronary artery. Patient had type I dual LAD artery in addition to a fairly large ramus intermedius (RI) and a nondominant left circumflex arising from the LCA. Awareness and recognition of dual LAD is of importance to surgeons and interventionalists alike in planning the revascularization strategy. In last case report, Jain et al. reported a rare combination of atrial fibrillation with idiopathic right ventricular outflow tract ventricular tachycardia.
At last, in Journal Watch, I have discussed the salient finding of five landmark study which will impact the future cardiovascular practice. In this issue we are publishing for the first time a book review by Prof. Arora on a book titled “A Treatise on Health Management” edited by well known expert Prof. S. C. Mohapatra.
| References|| |
Wagner GS, Macfarlane P, Wellens H, Josephson M, Gorgels A, Mirvis DM, et al.
AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: Part VI: Acute ischemia/infarction: A scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol 2009;53:1003-11.
Fiol M, Carrillo A, Cygankiewicz I, Velasco J, Riera M, Bayés-Genis A, et al.
Anew electrocardiographic algorithm to locate the occlusion in left anterior descending coronary artery. Clin Cardiol 2009;32:E1-6.