Journal of cardiovascular disease research (J Cardiovasc Dis Res)

Publications in this journal

• Article: Prevalence of rheumatic and congenital heart disease in school children of Andhra Pradesh, South India

  N. Rama Kumari, I. Bhaskara Raju, Amar N. Patnaik, Ramachandra Barik, Amarpal Singh, A. Pushpanjali, V. Laxmi, L. Satya Ramakrishna
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  ABSTRACT: Objective To determine the prevalence of rheumatic heart disease (RHD) and congenital heart disease (CHD) using clinical and echocardiographic criteria in rural and urban school children in Andhra Pradesh, South India. Materials and methods A total of 4213 school children between 5 and 16 years of age were screened. 1177 were from rural schools and 3036 from urban schools. Prevalence of RHD and CHD was estimated. Results Clinically RHD was present in 3 (prevalence 0.7/1000). Using echocardiography RHD was detected in 32 (7.6/1000), 11 (7.3/1000) from rural and 21 (7/1000) from urban schools. (P = 0.000, O.R = 0.093 and C.I. = 0.023–0.317). Total prevalence of RHD is 8.3/1000. Clinically CHD was present in 39 (9.2/1000) children, rural 9 (7.6/1000) and urban 30 (9.9/1000). Using echocardiography CHD was detected in 44 (10.4/1000) children, rural 11 (9.3/1000) and urban 33 (10.8/1000). Conclusion RHD was detected several fold using echocardiographic screening than by clinical examination alone. Longitudinal follow-up of children with echocardiographically diagnosed subclinical RHD is needed.
  Journal of cardiovascular disease research 03/2013; Volume 4(Issue 1):Pages 11-14.
• Article: Kawasaki's disease: An unusual presentation.

  I Shah
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  ABSTRACT: Atypical presentations of Kawasaki's disease have been described in the form of intestinal pseudo-obstruction, tonsillitis, hemorrhagic serous effusions, thrombocytopenia, and non-fulfillment of all criteria for diagnosis of Kawasaki's disease. However, presentation of Kawasaki's disease with shock and need for ionotropic support have been rarely described. We present a 4-year-old girl with Kawasaki's disease who presented with anasarca, oliguria, shock, and presence of dilated coronary arteries within 5 days of fever and responded to intravenous immunoglobulin (IVIG) and inotropic support.
  Journal of cardiovascular disease research 07/2012; 3(3):240-1.
• Article: Aged garlic extract and coenzyme Q10 have favorable effect on inflammatory markers and coronary atherosclerosis progression: A randomized clinical trial.

  Irfan Zeb, Naser Ahmadi, Khurram Nasir, Jigar Kadakia, Vahid Nabavi Larijani, Ferdinand Flores, Dong Li, Matthew J Budoff
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  ABSTRACT: Aged garlic extract (AGE) and coenzyme Q10 (CoQ10) have been shown to affect multiple cardiovascular risk factors. The current study evaluates the effect of AGE combined with CoQ10 on inflammatory markers and progression of coronary atherosclerosis compared with placebo. In this placebo-controlled, double-blind, randomized trial, 65 intermediate risk firefighters (age 55 ± 6 years) were treated with a placebo capsule or a capsule containing AGE and CoQ10 (AGE+CoQ10, 1200 and 120 mg, respectively) daily for 1 year. All participants underwent coronary artery calcium (CAC) scanning and C-reactive protein (CRP) at baseline and at 12 months. At 1 year, mean CAC progression was significantly lower in AGE+CoQ10 (32 ± 6 vs. 58 ± 8, P = 0.01) than placebo. Similarly, CRP were significantly decreased in AGE+CoQ10 compared with placebo (-0.12 ± 0.24 vs. 0.91 ± 0.56 mg/L, P < 0.05). After adjustment for age, gender, conventional cardiac risk factors, and statin therapy, AGE+CoQ10 was associated with 3.99 fold (95% 1.3-12.2, P = 0.01) lack of CAC progression compared with the placebo. AGE+CoQ10 are associated with beneficial effects on inflammatory markers and reduced progression of coronary atherosclerosis.
  Journal of cardiovascular disease research 07/2012; 3(3):185-90.
• Article: Impact of urbanization and gender on frequency of metabolic syndrome among native Abuja settlers in Nigeria.

  O Adediran, A A Akintunde, A E Edo, O G Opadijo, A M Araoye
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  ABSTRACT: Metabolic syndrome (MetS) is an important cause of morbidity and mortality. Nigeria is currently undergoing rapid epidemiological transition. The objective was to study whether urbanization is associated with increased prevalence of MetS between native rural Abuja settlers and genetically related urban dwellers. It was a cross-sectional study. Three hundred and forty-two urban native Abuja settlers and 325 rural dwellers were used for the study. Fasting blood lipid, glucose, waist circumference, blood pressure, and body mass index were determined. MetS was defined according to three standard criteria. SPSS 16.0 was used for statistical analysis. P<0.05 was used as statistically significant. Obesity, hypertriglyceridemia, and hypertension were commoner among urban dwellers than rural dwellers. MetS was associated more with the female gender. Urbanization significantly increases the frequency of MetS using the three standard definitions. The prevalence of MetS using International Diabetes Federation, World Health Organization, and National Cholesterol Education Program Adult Treatment Panel III among rural versus urban dwellers were 7.7% vs. 14.9%, P<0.05; 0% vs. 0.9%, P>0.05; and 3.7% vs. 13.7%, P<0.05, respectively. This study shows that MetS is a major health condition among rural and urban Nigerians and that urbanization significantly increases the prevalence of MetS. This can be explained on the basis of higher prevalence of dyslipidemia, obesity, and hypertension in urban setting, possibly as a result of stress, diet, and reduction in physical activity. Effective preventive strategy is therefore required to stem the increased risk associated with urbanization to reduce the cardiovascular risk associated with MetS among Nigerians.
  Journal of cardiovascular disease research 07/2012; 3(3):191-6.
• Article: ABO-Rh blood groups distribution in cardiac syndrome X patients.

  Fatemeh Kheradmand, Yousef Rasmi, Mohaddeseh Nemati, Mir Hossein Seyed Mohammadzad
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  ABSTRACT: Data on frequency distribution of ABO-Rh blood groups in cardiac syndrome X (CSX) patients are not available. We aimed to investigate the distribution of ABO-Rh blood groups in these patients. A total of 247 CSX patients' records were reviewed in a cross-sectional study from 2006 to 2010. One hundred forty six patients (59.1%) were female, and the mean patient age was 52 ± 11 years. The frequency of ABO-Rh blood groups was compared to the frequency of these blood groups in the West-Azerbaijan province, Iran; general population. Blood groups distribution among CSX patients showed phenotypes A, B, AB, O and Rh negative as 33.1%, 21.9%, 9.3%, 35.8%, and 7.9%, respectively. According to our results, there were no differences in ABO-Rh blood groups distribution between CSX patients and normal population. These data suggest that ABO-Rh blood groups might be unassociated with CSX.
  Journal of cardiovascular disease research 07/2012; 3(3):197-9.
• Article: Prevalence and risk factors for metabolic syndrome in Asian Indians: A community study from urban Eastern India.

  D S Prasad, Z Kabir, A K Dash, B C Das
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  ABSTRACT: To determine the prevalence of metabolic syndrome and to identify predictors for the same, specific to an underdeveloped urban locale of Eastern India. Study design: Population-based cross-sectional study, with multistage random sampling technique. Setting: Urban city-dwellers in Orissa one of the poorest states of Eastern India bordering a prosperous state of Andhra Pradesh of Southern India. Participants: 1178 adults of age 20-80 years randomly selected from 37 electoral wards of the urban city. Definition of Metabolic Syndrome: We followed a unified definition of the metabolic syndrome by joint interim statement of five major scientific organizations - the International Diabetes Federation, the National Heart, Lung, and Blood Institute, the American Heart Association, the World Heart Federation, the International Atherosclerosis Society, and the International Association of the Study of Obesity. Individuals who meet at least three of five clinical criteria of abdominal obesity, hypertriglyceredimia, low HDL, hypertension, and hyperglycemia are diagnosed as having the condition; presence of none of these criteria is mandatory. Explicit cut points are defined for all criteria, except elevated waist circumference, which must rely on population and country-specific definitions. Main Outcome Measure: Prevalence and significant predictors of metabolic syndrome. Statistical Analysis: Both descriptive and multivariable logistic regression analyses. Age-standardized prevalence rates of metabolic syndrome were 33.5% overall, 24.9 % in males and 42.3% in females. Older age, female gender, general obesity, inadequate fruit intake, hypercholesterolemia, and middle-to-high socioeconomic status significantly contributed to increased risk of metabolic syndrome. Metabolic syndrome is a significant public health problem even in one of the poorest states of India that needs to be tackled with proven strategies.
  Journal of cardiovascular disease research 07/2012; 3(3):204-11.
• Article: Hemodynamic effect of atrioventricular and interventricular dyssynchrony in patients with biventricular pacing: Implications for the pacemaker syndrome.

  R Mollazadeh, L Mohimi, M Zeighami, A Fazelifar, M Haghjoo
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  ABSTRACT: Pacemaker syndrome was mainly described as the sequel of atrioventricular (AV) dyssynchrony. The role of interventricular (VV) dyssynchrony has not been studied yet. The aims of this study were to noninvasively assess the hemodynamic effects of different ventricular pacing sites with and without AV and VV dyssynchrony and to observe the patients for clinical symptoms of the pacemaker syndrome during the AV sequential and ventricular-only pacing modes. Between March 2009 and February 2010, 40 patients (28 men; mean age, 61 ± 15 years) with biventricular (BiV) device were enrolled. Mean systolic and diastolic blood pressures (BP) of 5 beats were measured 5 minutes after each mode change using fingertip plethysmography. The patients were also observed for the occurrence of symptoms suggestive of the pacemaker syndrome, including dyspnea, palpitations, dizziness, presyncope, and syncope. There was no difference in mean systolic BP among different ventricular-only pacing modes (all P = NS). However, mean systolic BP was significantly higher in AV sequential biventricular pacing (DDD-BiV) compared with ventricular-only pacing modes (all P<0.05). In addition, there was no difference in terms of pacemaker syndrome-related symptoms following mode change from DDD-BiV to DDD-RV or DDD-LV (all P>0.05). The present study showed that the non-AV sequential BiV and LV pacing may have no significant benefit compared with RV pacing in terms of systolic blood pressure. However, there was marked hemodynamic improvement following mode change to AV sequential BiV pacing. This study may have important implications for pathogenesis of pacemaker syndrome.
  Journal of cardiovascular disease research 07/2012; 3(3):200-3.
• Article: Reverse Wenckebach "pseudo-supernormal" conduction or paroxysmal atrioventricular block.

  M Zahid, S Arora
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  ABSTRACT: Paroxysmal atrioventricular-block is a poorly-recognized cause of atrioventricular conduction abnormality leading to syncope and can be fatal. Here we report a case of paroxysmal atrioventricular-block presenting as syncope treated effectively with pacemaker implantation and review the current literature on prevalence, known mechanisms and treatment for it. Importantly we provide the diagnostically important differentiating points between vagally mediated block and paroxysmal atrioventricular-block as well as the highlight the vastly varying prognosis between the two.
  Journal of cardiovascular disease research 07/2012; 3(3):225-7.
• Article: A case of double right coronary artery with bifurcation stenosis in association with complete heart block.

  A K Singh, A K Pandey
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  ABSTRACT: Congenital coronary artery anomalies are present at birth, but most anomalies are discovered as incidental findings during coronary angiography or at autopsy. Double right coronary artery (RCA) is a rare coronary anomaly. Double RCA with bifurcation stenosis in association with degenerative complete heart block (CHB) have never been reported in literature to the best of our knowledge. We therefore report an interesting case of a patient with double RCA and degenerative CHB.
  Journal of cardiovascular disease research 07/2012; 3(3):242-4.
• Article: Screening for risk of cardiovascular disease among officer grade bank employees of Gulbarga city.

  R K Vinod, M Pastapur, K P Suresh
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  ABSTRACT: The risk of cardiovascular disease was assessed among officer grade bank employees of Gulbarga city, as they face a large of amount of work related stress. (1) To assess the risk of cardiovascular disease among the study group. (2) To propose a similar population based heart disease screening strategy for other groups. Out of the 242 officers in 26 banks in Gulbarga city (nationalized and private), 59 officers were willing to be a part of the study. This population was initially screened by a self-assessment scale, consisting of 10 questions relating to past history, family history, and lifestyle practices. Scoring system was used for the analysis. The initial part of this cross-sectional study was conducted during April 2006. Forty nine officers who scored ≥3 were recruited for preliminary assessment, which consists of physical examination, Electrocardiogram (ECG) and some invasive investigations (fasting blood sugar and cholesterol). Those found at further risk, were recruited for detailed assessment. 15 officers who qualified were screened for specific cardiac markers using advanced investigations Lipoprotein (Lp) a, homocysteine, C reactive protein (CRP), lipid profile measurements, Treadmill test (TMT) / Echocardiogram (ECHO), and Glucose tolerance test (GTT). All the five officers who were found at the highest level of risk were referred to the tertiary health care centre. Microsoft excel was used to compute the frequencies and percentages. Among the 59 employees examined in the study, 49 were found to be at risk for cardiovascular diseases (comprising ~83% of the assessed population) and thus qualified to the second round of assessment. Only 31 officers underwent the second round of assessment, out of whom 15 (48.4%) were found to be at higher risk and thus were subjected to the third round. Only five officers (of the 15) underwent the third round of assessment and all were found to be utmost at risk for CVDs and were duly referred to a tertiary health care centre. The study shows the application of a risk assessment model, towards predicting the risk for cardiovascular diseases among a group of high risk population. Similar models could be used for the risk assessment of other population groups.
  Journal of cardiovascular disease research 07/2012; 3(3):218-24.
• Article: Behavioral risk factors of coronary artery disease: A paired matched case control study.

  Rohit V Ram, Atul V Trivedi
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  ABSTRACT: Cardiovascular diseases are becoming the major cause of morbidity and mortality in most of the developing countries including India. Various behavioral risk factors are the major risk factors for coronary artery disease. Present study was carried out to study the role of various behavioral risk factors in the occurrence of coronary artery disease. Present study was a hospital-based paired-matched case-control study, carried out at civil hospital, Ahmedabad. A total of 135 newly-diagnosed cases of coronary artery disease and 135 controls were studied after taking an informed written consent. Data was analyzed by using Epi-info version 3.5.1 computer package, Chi -square test, Z test and Odds ratio was calculated. Among the total 135 cases, 70.4% were male and 29.6% were female, most of the cases (40%) belong to the age group of 51-60 years. Smokers, smokeless tobacco users, and alcoholic were significantly higher among the cases as compared to controls. Significant association was also observed between current smokers, smokeless tobacco users, and coronary artery disease. Dose-response relationship was observed between the frequency of smoking per day and coronary artery disease (OR = 3.72). Significant association was also observed between obesity, physical inactivity, and coronary artery disease. Salt and oil intake per day were significantly higher among the cases as compared to controls. Modifiable and preventable behavioral risk factors are major etiology behind the occurrence of coronary artery disease, which highlights the need of appropriate control strategies and measures.
  Journal of cardiovascular disease research 07/2012; 3(3):212-7.
• Article: Preface to the Journal of Cardiovascular Disease Research, third issue 2012.

  Xiaolun Sun, Zhenquan Jia
  Journal of cardiovascular disease research 07/2012; 3(3):183-4.
• Article: Acute thrombosis of mechanical bi-leaflet aortic valve prosthesis.

  Theodor Tirilomis
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  ABSTRACT: Thrombosis of mechanical aortic valve prosthesis is a rare but life-threatening complication. In most reported cases, inadequate anticoagulation or cessation of anticoagulation is the cause of prosthesis thrombosis. The case of a 70-year-old male patient hospitalized for severe dyspnoea is presented. Although the patient was under continuous anticoagulation, thrombosis of the 16 years previously implanted mechanical 31-sized aortic valve prosthesis was diagnosed. Emergency surgery was performed and postoperative course was uneventful. Patients with large size prostheses should have closer anticoagulation monitoring, even after many years of event-free postimplant course.
  Journal of cardiovascular disease research 07/2012; 3(3):228-30.
• Article: Slow ventricular response atrial fibrillation related to mad honey poisoning.

  A Osken, S Yaylacı, E Aydın, I Kocayigit, M A Cakar, A Tamer, H Gündüz
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  ABSTRACT: Mad honey poisoning which is induced by Grayanotoxin (Andromedotoxin), is also known to have adverse effects in the cardiovascular system leading to different clinical entities. This toxin is produced by a member of the Rhododendron genus of plants of two R. Luteum and R. Panticum. In this article, we presented a case of slow ventricular response atrial fibrillation complaints with nausea, vomiting, dizziness and chest pain about an hour after eating honey produced in the Black Sea Region.
  Journal of cardiovascular disease research 07/2012; 3(3):245-7.
• Article: Rare variant of mixed total anomalous pulmonary venous connection.

  Jitendeep Singh, Prashant N Mohite, Sandip Singh Rana
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  ABSTRACT: Mixed variety of Total anomalous pulmonary venous connection is a rare congenital heart disorder with a wide variation of pulmonary venous anatomy and their drainage. Present article depicts "3+1" variant of mixed TAPVC treated by rechannelizing all pulmonary veins to left atrium using a Polytetrafleuroethylene patch.
  Journal of cardiovascular disease research 07/2012; 3(3):248-50.
• Article: fatal thrombocytopenia: a rare case with possible explanation

  Ramachandra Barik, AS gulati, amar narayan patnaik
  Journal of cardiovascular disease research 04/2012; 3(2-2):147.
• Article: Cardiorenal syndrome: Resistant to diuretics, sensitive to ultraflitration.

  Swati C Aundhakar, Sanket K Mahajan, Makarand B Mane, Akshay N Lakhotia, Vikrant V Mahajani
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  ABSTRACT: Cardiac and renal diseases are becoming increasingly common today, and are seen to frequently coexist, thus causing a significant increase in the mortality rate, morbidity, complexity of treatment and cost of care. Syndromes describing the interaction between heart and kidney have been defined and classified; however, never as a result of a consensus process. Though the incidence of cardiorenal syndrome is increasing, the associated pathophysiology and effective management are still not well understood. For many years, diuretics and ultrafiltration, have been the mainstay of treatment for cardiorenal syndrome, although a significant proportion of patients develop resistance to diuretics, and even deteriorate while on diuretics. Here, we will discuss one such patient who failed to respond to the optimum doses of diuretics; however, his blood urea and serum creatinine touched the baseline levels post-ultrafiltration.
  Journal of cardiovascular disease research 04/2012; 3(2):173-5.
• Article: The prevalence of hypertension and hypertension risk factors in a rural Indian community: A prospective door-to-door study.

  Sushil K Bansal, Vartika Saxena, Sunil D Kandpal, William K Gray, Richard W Walker, Deepak Goel
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  ABSTRACT: The aim of this study was to identify the prevalence and risk factors for hypertension in a rural community in north-east India. A door-to-door survey was conducted amongst all residents of a village in Uttarakhand province. All residents were interviewed and data were was relating to the demographics of the individuals, dietary habits, alcohol consumption, tobacco use, psychosocial stress, past medical history and drug history. Blood pressure (BP) and anthropometric data was recorded and blood samples taken. We identified 1348 people living in the village. Assessment was carried out on all those aged 15 years and over (n=968, 71.8%). Hypertension, defined as BP ≥ 140/90 mmHg or cases of known hypertensive on medication, were present in 30.9% (95% CI 25.6 to 36.0) of males and 27.8% (95% CI 23.4 to 32.2) of females. Standardisation to the World Health Organization (WHO) world population gives an overall prevalence of 32.3% (95% confidence interval, CI 28.9 to 35.8). Increasing age and higher body mass index (BMI) were independent predictors of hypertension in both sexes, with psychosocial stress an additional independent predictor in males. Rates of hypertension in the rural community under study are similar to those seen in high-income countries and in urban India. With the exception of age, all the risk factors identified were potentially modifiable.
  Journal of cardiovascular disease research 04/2012; 3(2):117-23.
• Article: Fatal thrombocytopenia: A rare case with possible explanation.

  Ramachandra Barik, A N Patnaik, A S Gulati
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  ABSTRACT: A 22 year old male presented with breathlessness on exertion, ecchymosis, jaundice and features of worsening right heart failure for the last fifteen days. On physical examination, he had a mid diastolic murmur in the tricuspid area and an ejection systolic murmur in the pulmonary area. Bone marrow histopathology report showed an increased in megakaryocytes count. Routine investigations reports were normal. Echocardiography and computerized tomography (CT) revealed a single mobile large intra cardiac mass originating from the right atrium and causing dynamic obstruction of the right ventricular inflow and outflow tract. Associated fatal thrombocytopenia did not respond to intravenous steroids or platelet transfusion. Patient could not be operated because of very low platelet count, and died during hospital stay before excision biopsy could be done. Pathological autopsy was not done. This is a rare case, as the fatal thrombocytopenia observed here was the result of mechanical effects like frictional and shear force, which can be attributed to the physical presence of a large intra cardiac mass resulting in obstruction to flow.
  Journal of cardiovascular disease research 04/2012; 3(2):147-9.