|Year : 2022 | Volume
| Issue : 3 | Page : 111-112
Preface to the third issue of Heart India 2022
Alok Kumar Singh
Department of Cardiology, Life Line Hospital, Varanasi, Uttar Pradesh, India
|Date of Submission||07-Dec-2022|
|Date of Acceptance||07-Dec-2022|
|Date of Web Publication||14-Dec-2022|
Alok Kumar Singh
Department of Cardiology, Life Line Hospital, Varanasi, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Singh AK. Preface to the third issue of Heart India 2022. Heart India 2022;10:111-2
In this issue of “Heart India,” we are publishing one systematic review and meta-analysis, six original research articles, three case reports, and one short communication. Inflammations resulting from cardiac surgical procedures have traditionally been controlled with corticosteroids such as dexamethasone. However, the use of these medications to attenuate the inflammatory responses from cardiac surgery remains contentious. In the first review and meta-analysis, Madkaiker et al. have done the systemic review and meta-analysis of the impact of administering intraoperative dexamethasone versus placebo on major complications and mortality in patients undergoing cardiac surgery. According to this review, dexamethasone does not result in a significant decrease in incidences of mortality, myocardial infarction, and stroke. However, the medication was associated with decreased incidences of renal failure and atrial fibrillation in a majority of the studies.
Coronary artery disease (CAD) has reached epidemic proportions in low- and middle-income countries such as India, affecting the rural population. Indian population is more prone to develop early CAD due to rapid changes in lifestyle and existing conventional risk factors. In first original research article, Ashida et al. have studied the angiographic profile of acute coronary syndrome (ACS) and its risk factors among young individuals (≤45 years). Authors of this study have concluded that, the main risk factors for young ACS were dyslipidemia, smoking, and type 2 diabetes mellitus. STelevation myocardial infarction (STEMI) and NSTEACS had almost equal proportions with preserved left ventricular function in the majority of patients with young ACS. Single vessel disease with left anterior descending (LAD) involvement was the most common lesion and majority of the patients had a low syntax score and 47.7% of patients with young ACS needed revascularization. Short-term prognosis (1 year) is favorable in young patients with ACS.
Coronary endarterectomy (CE) is performed adjacent to coronary artery bypass grafting (CABG) grafting to aid complete revascularization. In second original research article, Patel et al. have studied the usefulness of CE in achieving complete revascularization in patient undergoing CABG. Authors of this study have concluded that, CE helps in complete revascularization in patients with diffuse CAD. CE should be given due consideration in an era where it has been neglected due to its complexities and accompanying myths. CE is an important and integral weapon in a surgeon's armamentarium.
Coarctation of the aorta (CoA) is a rare congenital heart disease for which ballooning or surgery is recommended in the early stages of life, however, in adult patients, stenting has emerged as the treatment of choice. In third original research article Vijay et al. have studied the periprocedural and short-term outcomes of stenting of CoA in adults. The authors of this study have concluded that stenting for native CoA with the use of Cheathamplatinum stents in adult patients is a highly effective and safe therapy. Longer-term follow-up studies are required to show the exact incidence of stent fracture and aneurysm formation after stenting.
Tetralogy of Fallot (TOF) is a form of congenital anomaly characterized by pulmonary stenosis, an interventricular defect, biventricular aortal origin, and right ventricular hypertrophy. It is the most common cyanotic congenital heart disease; affecting 3–5 in 10,000 live births making 7%–10% of congenital defects. In fourth original research article, Buchade et al. have studied the anatomic variations in the pulmonary vasculature and associated cardiac defects in patients with TOF by angiography. They have concluded that subvalvular stenosis, confluence of pulmonary artery (PA), discrete, disconnected, and diffuse stenosis of left pulmonary artery and right pulmonary artery were the most common PA abnormalities found in patients with TOF. Significant-associated cardiac lesions including communicating MAPCA, PDA, and coronary anomaly were more commonly observed in these patients.
Atrioventricular (AV) heart block refers to an interruption or delay in electrical conduction from the atria to the ventricles. This occurs when the atrial impulse is either delayed or not conducted to the ventricles. The block may occur at the AV node, a bundle of HIS, or the bundle branches. In fifth original research article Sharma et al. have studied the safety and efficacy profile of an indigenous developed CHARAK DDDR 747R dual chamber rateresponsive pacemaker. Authors of this study have concluded that, the Charak DDDR 747R, an indigenous pacemaker, is safe and effective in the Indian population. Durable lead parameters were obtained during the study which remained stable over time referring the same. Future larger studies are needed to confirm the preliminary data obtained from our study.
Thrombolytic therapy in the appropriate window period remains the most commonly used therapy in STEMI patients, despite the advantage of primary percutaneous coronary intervention over it. The use of newer more potent antiplatelets agents early after thrombolysis carries the chance of increasing bleeding complications. In sixth original research article, Agrawal et al. have studied the clinical outcomes with the use of ticagrelor or clopidogrel after fibrinolytic therapy in patients with STEMI. Authors of this study have concluded that ticagrelor can be safely administered in post thrombolytic patients similar to clopidogrel albeit at the cost of slightly increased minor bleeding events in short-term follow-up.
Coronary arteriovenous fistula (CVAF) is the most frequent congenital coronary anomaly disorder comprising 14% of all congenital coronary abnormalities (0.2%–0.4% of all congenital cardiac defects. In first case report, Dadarwal et al. reporting a case of a small CVAF presenting with inferior wall myocardial infarction. Endocarditis is the inflammation of the innermost lining of the heart including the valves. It can be of infective or noninfective etiology. It is a relatively uncommon disease with high morbidity and mortality. In second case report, Radha et al. reporting a case of aspergillus endocarditis in a patient with chronic rheumatic heart disease, which was incidentally diagnosed during surgery.
Myxomas are the most common primary tumors of the heart constituting around 10% of all cardiac tumors. Left atrium is the common site involving around 50%–70%. Biatrial myxomas are extremely rare. In third case report, Asotra et al. reporting a case of large biatrial myxoma in a young male who underwent successful surgical correction. In the last under short communication category, Mr Jariwala is reporting a case of hyperdominant LAD coronary artery.
| References|| |
Institute of Medicine (US) Committee on Preventing the Global Epidemic of Cardiovascular Disease: Meeting the Challenges in Developing Countries. In: Fuster V, Kelly BB, editors. Promoting Cardiovascular Health in the Developing World: A Critical Challenge to Achieve Global Health. Washington (DC): National Academies Press (US); 2010.
Prajapati J, Joshi H, Sahoo S, Virpariya K, Parmar M, Shah K. AGE-related differences of novel atherosclerotic risk factors and angiographic profile among Gujarati acute coronary syndrome patients. J Clin Diagn Res 2015;9:C05-9.