|Year : 2021 | Volume
| Issue : 1 | Page : 1-2
Preface to the first issue of Heart India 2021
Alok Kumar Singh
Department of Cardiology, Opal Hospital, Varanasi, Uttar Pradesh, India
|Date of Submission||23-Mar-2021|
|Date of Decision||25-Mar-2021|
|Date of Acceptance||25-Mar-2021|
|Date of Web Publication||30-Mar-2021|
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 2021. Heart India 2021;9:1-2
In this issue of “Heart India,” we are publishing two review articles, 12 original research articles and one case report.
Resistant hypertension (RH) is defined as uncontrolled blood pressure despite the use of at least three different antihypertensive agents (including angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, calcium channel blocker, and a diuretic) at their optimal doses. In the first review article, the authors have discussed the role of spironolactone in the management of RH.
Postoperative junctional ectopic tachycardia (JET) usually occurs within 72 h after pediatric cardiac surgery., On the basis of etiology, JET is classified into congenital, postoperative, focal paroxysmal, focal nonparoxysmal, and JET associated with digitalis toxicity. In the second review article, Sharma et al. have discussed the role of Ivabradine in the management of JET.
Troponin I (Trop 1) and N-terminal pro–B-type natriuretic peptide (NT-ProBNP) can be a discerning marker for the patients presenting with the symptoms of acute cardiac ischemia and risk of death. In the first original research article, Pansuriya et al. have studied the correlation between Trop 1, NT-ProBNP, and left ventricular ejection fraction (LVEF) in acute coronary syndrome patients with mortality. The authors of this study have concluded that, Trop I, NT-ProBNP, and LVEF at the time of admission are the strong predictors of 1-month mortality in ACS.
Junctional rhythm (JR) is a rescue rhythm where the upstream impulse generators fail to pace the heart and atrioventricular (AV) junction takes up that function. The presentation is variable ranging from totally asymptomatic cases, where it is a manifestation of heightened vagal tone, to life-threatening bradycardia, resulting from some serious underlying pathology. In the second original research article, Sinha et al. have studied the hospitalized patients of JR with reference to the prevalence of different underlying etiologies. The most common etiology was acute myocardial infarction (AMI) responsible in 28% of patients followed by hyperkalemia (24%), sick sinus syndrome (20%), and medication drug use (16%) as the principal causes of JR. Myocarditis, toxin, and hypothyroidism were uncommon association.
Aortic valve (AV) stenosis is a congenital or acquired disease that causes a decrease in AV area resulting in an impaired outflow of blood from the left ventricle (LV) into the aorta and increased end-diastolic pressure in LV. In the third original research article, Prajapati et al. have studied the acute- and short-term outcomes of balloon aortic valvuloplasty in patients with significant aortic stenosis. Cardiac perforation by pacemaker/automatic implantable cardioverter-defibrillator (AICD) lead can be a life-threatening emergency. Delayed cardiac perforation by pacemaker/AICD lead is defined as perforation occurring after a period of 1 month following pacemaker/AICD insertion. Delayed perforation is often difficult to identify at first and needs active intervention to prevent complications and death. In the fourth original research article, Kumar et al. have studied the management of delayed perforation of the right ventricle (RV) by pacemaker/automated implantable cardioverter-defibrillator lead. The magnitude of risk factor clustering for coronary artery disease (CAD), as well as the CAD, is increasing in developing countries, especially in the young. In the fifth original research article, Desai et al. have studied the socioclinical characteristics of young patients presenting for coronary angiography at Goa medical college.
Dilated cardiomyopathy (DCM) represents alteration in ventricular morphology and function secondary to various pathological conditions of the cardiac muscle. In the sixth original research article, Khan et al. have studied the role of cardiac magnetic resonance (CMR) imaging in the evaluation of idiopathic DCM. The authors of this study have concluded that CMR is an accurate tool to determine the phenotype of DCM by identifying the presence, location, and pattern of late gadolinium enhancement (LGE) which has a prognostic value and is used to guide management.
Cardiac resynchronization therapy (CRT) is an important treatment option in patients with progressive heart failure. The ideal position for stimulation is the posterolateral region of the LV, since this is the site where maximum contractile delay is seen. However, this ideal site of LV lead placement is not possible in many patients due to anatomical limitations. In the seventh original research article, Pande et al. evaluated the feasibility of the middle cardiac vein (MCV) as an alternative target for LV lead placement with short-term outcomes result in a small cohort of patients. The authors of this study have concluded, that when usual posterolateral or lateral target veins cannot be accessed for LV lead placement, as an alternative approach utilizing MCV collateral circulation to reach as close possible to the lateral surface may be considered in CRT. RV leads to be positioned at the outflow tract or upper septum in those cases.
Cardiomyopathy is defined as a heterogeneous group of disorders of the myocardium, usually with inappropriate ventricular hypertrophy or dilatation. In the eighth original research article, Jawahirani et al. have studied the clinical features and treatment outcomes of cardiomyopathy in Indian patients in a retrospective manner.
Congenital absence of pericardium is a very rare condition, with an incidence of <1 in 10,000 and occurs in isolation or associated with various congenital cardiac or systemic disorders.
In the ninth original research article, Tewarson et al. have reported the out of 2193 cardiac surgeries at their center, 478 patients got operated for congenital heart disease, out of which 2 were found with pericardial defects intraoperatively. No surgical intervention for pericardial defects was done. Both patients did well after surgery for their primary disease.
Infective endocarditis (IE) is an infection affecting the endocardial lining and contributed to socioeconomic burden due to prolonged admission, invasive procedure, and expensive treatment. The high prevalence of intravenous drug users (IVDU) shifts the paradigm of the disease. In the tenth original research article, Mohd Said et al. have studied the recent trends, clinical characteristics, and outcome of IE among IVDUs of a tertiary hospital in the east region of Malaysia.
In patients with rheumatic heart disease (RHD), left atrial appendage (LAA) dilation and thrombus formation are widely known. LAA thrombus formation is a risk factor for stroke even in patients with sinus rhythm. In the eleventh original research article, Natarajan et al. have studied the Association of Structure and Function of LAA with LAA thrombus formation in patients with RHD. The authors of this study have concluded that LAA contractility is reduced in RHD with LAA thrombus, and loss of both contractility and LAA dilation is associated with increased risk of thrombus formation and hence the risk of stroke.
The clinical manifestations of acute pulmonary embolism (PE) are highly variable, ranging from pulseless electrical activity to mild dyspnea, which can mislead the diagnosis. In the twelfth original research article, Patel et al. have studied the clinical profile, risk stratification of patients with acute PE in a prospective manner. The authors of this study have concluded, PE can present with unexplained dyspnea and atypical chest pain, so for making a diagnosis high index of suspicion is required. Early diagnosis, risk stratification, and guideline-directed prompt management can lead to a favorable outcome. In the last Rai et al. have reported a case of Brugada syndrome presenting as atrial flutter with sick sinus syndrome.
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