|Year : 2020 | Volume
| Issue : 1 | Page : 1-2
Preface to the first issue of Heart India 2020
Alok Kumar Singh
Department of Cardiology, Opal Hospital, Varanasi, Uttar Pradesh, India
|Date of Submission||24-Mar-2020|
|Date of Acceptance||24-Mar-2020|
|Date of Web Publication||03-Apr-2020|
Dr. Alok Kumar Singh
Department of Cardiology, Opal Hospital, Varanasi, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Singh AK. Preface to the first issue of Heart India 2020. Heart India 2020;8:1-2
In This issue of “Heart India,” we are publishing one review article and six original research articles. Coronary revascularization is required in significantly obstructed coronary arteries. Initially, percutaneous coronary intervention (PCI) was indicated only in discrete and noncalcified coronary obstruction. In the current era, it has emerged as the primary treatment modality even in a diffuse, triple-vessel, and left main disease and even chronic total occlusions. However, calcified and fibrotic lesions have remained a major challenge in coronary interventions. Conventionally, cutting balloon and rotational atherectomy have been utilized for plaque modification/debulking of such lesions. In the first review article, Pradhan et al. have discussed the in-depth role of different techniques of laser in the management of complex obstructive coronary artery diseases.
Over the past century, blood pressure has conventionally been measured, diagnosed, and treated through the brachial artery. However, recent technological breakthroughs have allowed routine assessment of blood pressure at central arteries. Central blood pressure directly reflects pressure on the target organs and therefore varies from peripheral blood pressure. In the first original research article, Chandra et al. have evaluated the central-to-peripheral blood pressure ratio in patients undergoing invasive coronary angiography. Authors of this study have concluded that the novel ratio of central to peripheral blood pressure may serve as a precursor of cardiovascular risk. This ratio may give a clue to the relationship between central and peripheral blood pressure.
Pericardiocentesis is the most useful therapeutic procedure for the early management and diagnosis of large, symptomatic pericardial effusion, and cardiac tamponade. In 1911, Marfan first described the subxiphoid approach, which had been used for the blind pericardiocentesis procedure for decades despite the significant morbidity and mortality rates (50% and 6%, respectively). In the second original research article, Manvi et al. have studied the safety and efficacy of inserting double-lumen catheter under echo guidance for pericardial fluid tapping.
Hyperuricemia is an abnormally high level of uric acid in the blood. It is a prevalent condition in chronic heart failure, describing increased oxidative stress and inflammation. Uric acid is the end product of purine metabolism, and its levels are often elevated in patients with chronic heart failure, as a consequence of increased production and probably smaller renal excretion. In the third original research article, George et al. have studied the role of uric acid in stratifying the high-risk population in acute heart failure population.
Functional flow reserve (FFR) is used to determine the functional significance of coronary artery stenosis. FFR demonstrated discrepancy between angiographic and functional significance of jailed side branches (JSBs) as well as moderate in-stent restenosis (ISR), with only minority of such lesions having functional significance. An attempt was made to study the utility of FFR and comparison of FFR with single-photon emission computed tomographymyocardial perfusion imaging (SPECT-MPI) in native coronary artery stenoses. In the fourth original research article, Jadhav et al. have studied the utility of fractional flow reserve in moderate ISR and JSBs and comparison of fractional flow reserve with SPECT-MPI in native coronary artery stenosis. Authors of this study have observed significant negative correlation between FFR and sum difference score (SPECTMPI). Sensitivity and specificity of SPECTMPI did not differ much when FFR value cutoff was taken as 0.75 or 0.80.
Heterotaxy syndrome is a disorder that involves abnormal lateralization of the abdominal viscera, thoracic organs, and cardiac atria. In the fifth original research article, Champaneri et al. have compared the frequency of morphologic profile of congenital heart defects associated with the right isomerism and left isomerism in the Western Indian population. Asian Indians differ from Caucasians in total anomalous pulmonary venous connection being intracardiac in nature when associated with heterotaxy. Right atrial isomerism (RAI) in Asian Indians is more common with atrioventricular cushion defect please do correction (AVCD) and pulmonary artery/stenosis, while left atrial isomerism (LAI) was more often associated with univentricular heart. There is a fair degree of overlap between defects associated with RAI and LAI.
Reperfusion therapy for patients with acute myocardial infarction using primary PCI has shown to improve the clinical outcome compared with thrombolysis. However, despite the achievement of optimal epicardial coronary artery patency, 30%–40% of patients show the no-reflow phenomenon. In the sixth original research article, Bhatia et al. have studied the correlation between NT-PROBNAP in predicting no-reflow phenomenon in patients undergoing coronary angioplasty in ischemic heart disease (IHD) among Asian Indians. Authors of this study have concluded that higher NT-proBNP levels in patients with acute coronary syndrome who undergo PCI have higher likelihood of developing no-flow phenomenon during PCI.
| References|| |
Payne RA, Webb DJ. Peripheral augmentation index: Shouldering the central pressure load. Hypertension 2008;51:37-8.
Krikorian JG, Hancock EW. Pericardiocentesis. Am J Med 1978;65:808-14.