Rajesh Rajan

Indian Association of Clinical Cardiologists · Clinical Cardiology

Across the world, heart failure is one of the leading cause of frequent hospitalizations.1 The etiology of heart failure may differ in various ethnic groups,2 and may be due to multiple factors like non-adherence of the patient to medications, endstage heart failure, or a lack of proper follow-up.3 We encounter many ambulatory heart failure patient...

Objective The purpose of this study was to evaluate the impact of R-heart failure (R-hf) risk score on all-cause mortality in acute heart failure (AHF) patients in the Middle East. Methods Data was analyzed from 776 consecutive patients. R-hf risk score were derived by multiplying (eGFR (mL/min), left ventricular ejection fraction (%) and hemoglob...

Background The aim of this study was to validate R-heart failure (R-hf) risk score in ischemic heart failure patients. Methods We prospectively recruited a cohort of 179 ischemic and 107 non-ischemic heart failure patients. This study mainly focused on ischemic heart failure patients. Non-ischemic heart failure patients were included for the purpo...

We recently published a case report in European Heart Journal Case Reports. We proposed a modified version of Lipton’s classification, a new classification for single coronary artery (SCA), named Rajan’s and Kotevski’s TYPE-IV (R-IV-C) modified Lipton’s classification, which we describe in detail.

Tricuspid regurgitation (TR) is a common finding. Any changes to the components of the tricuspid valve (TV), such as the tricuspid annulus, valve leaflets, papillary muscles, and chordae tendinae can lead to TR. This valvular disease has recently sparked interest after it was long forgotten. This paper examines the anatomy of the TV, etiology of TR...

Background: Systemic congestion is the leading pathophysiological mechanism of decompensated heart failure (HF), and hospitalization and poor prognosis. Unfortunately, patients are discharged with residual congestion, possibly due to the lack of a clear strategy for its assessment. The existing criteria for discharge of patients from the hospital a...

Introduction: Healthcare resource utilisation and costs are important metrics of healthcare burden, but they have rarely been explored in the setting of cardiac ion channelopathies. Purpose: The aim of this study is to compare HCRUs and costs between patients with Brugada syndrome (BrS) and congenital long QT syndrome (LQTS) in a single city of Chi...

Objectives: Initial reports indicate a high incidence of abnormal aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in patients with COVID-19 and possible association with acute kidney injury (AKI). We aimed to investigate clinical features of elevated transaminases on admission, its association with AKI, and outcomes in p...

Аbstrасt Objectives This study aimed to investigate in-hospital mortality rates in patients with coronavirus disease (COVID-19) according to enoxaparin and heparin use. Methods This retrospective cohort study included 962 patients admitted to two hospitals in Kuwait with a confirmed diagnosis of COVID-19. Cumulative all-cause mortality rate was t...

The goal of this study was to investigate in-hospital mortality in patients suffering from acute respiratory syndrome coronavirus 2 (SARS-CoV-2) relative to the neutrophil to lymphocyte ratio (NLR) and to determine if there are gender disparities in outcome. Between February 26 and September 8, 2020, patients having SARS-CoV-2 infection were enroll...

The present work deals with the design of a cylinder-piston arrangement to deliver the required tidal volume (TV) of air to the patient through the respiratory tract especially in the setting of severe acute respiratory syndrome corona virus 2 (SARS CoV-2) or corona virus disease (COVID-19). The design ensures that only the desired volume of air is...

Click here to view optimized website for mobile devices Table of Contents ORIGINAL ARTICLE Year : 2022 | Volume : 4 | Issue : 1 | Page : 9-14 Clinical characteristics, incidence, and outcomes of transcatheter aortic valve implantation stratified by new-onset left bundle branch block: A single-center pilot study Fajer Alabdulrazzaq1, Mohammed Al...

Background The aim of this study was to determine in-hospital mortality in patients presenting with acute respiratory syndrome corona virus 2 (SARS-CoV-2) and to evaluate for any differences in outcome according to sex differences. Methods Patients with SRS-CoV-2 infection were recruited into this retrospective cohort study between February 26 and...

Аbstrасt Objective To investigate COVID-19 related mоrtаlity according to the use of corticosteroid therapy. Design Retrospective cohort study. Setting Two tertiary hospitals in Kuwait. Participants Overall, 962 patients with confirmed SARS-CoV-2 infection, were stratified according to whether they were treated with corticosteroids (dexamethaso...

Funding Acknowledgements Type of funding sources: None. Background Meditation can induce changes in autonomic balance, which can benefit cardiovascular health. The present meta-analysis evaluated changes in heart rate variability (HRV) in meditators. Methods PubMed and Embase were searched for primary prospective studies using the search terms ‘h...

Introduction To define baseline echocardiographic, electrocardiographic (ECG) and computed tomographic (CT) findings of patients with heart failure undergoing transcatheter aortic valve replacement (TAVR) and analyze their overall procedural outcomes. Methods Between 2018 and 2021, patients with severe aortic stenosis (AS) who performed transcathe...

Brugada syndrome (BrS) is a rare disorder characterized by coved or saddle-shaped ST-segment elevation in the right precordial leads on the electrocardiogram. Risk stratification in BrS remains challenging. A number of clinical, electrocardiographic, programmed ventricular stimulation and genetic risk factors have been identified as important predi...

Background: This study investigates in-hospital mortality amongst patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its relation to serum levels of gamma-glutamyl transferase (GGT). Methods: Patients were stratified according to serum levels of gamma-glutamyl transferase (GGT) (GGT<50 IU/L or GGT≥50 IU/L). Results:...

Background: Chronic coronary syndrome (CCS) is a recently defined entity that necessitates evaluating individual clinical risk factors in this cohort. Objective: The objective of the present study was to evaluate patients with CCS and examine their coronary profiles in order to delineate differences between genders. Methods: A cross‐sectional analy...

Аbstrасt Introduction This study aims to investigate in-hоsрitаl mоrtаlity in severe асute resрirаtоry syndrоme соrоnаvirus 2 раtients strаtified by serum ferritin levels. Methods Patients were stratified based on ferritin levels (ferritin levels ≤ 1000 or >1000). Results Approximately 89% (118) of the patients with ferritin levels > 1000 had pn...

Background: Lung ultrasound (LUS) is a bedside imaging tool that has proven useful in identifying and assessing the severity of pulmonary pathology. The aim of this study was to determine LUS patterns, their clinical significance, and how they compare to CT findings in hospitalized patients with coronavirus infection. Methods: This observational...

Background: The aim of this study was to determine in-hospital mortality in patients presenting with acute respiratory syndrome corona virus 2 (SARS-CoV-2) and to evaluate for any differences in outcome according to gender. Methods: Patients with SRS-CoV-2 infection were recruited into this retrospective cohort study between February 26 and Septemb...

Аbstrасt This study is to estimаte in-hоsрitаl mоrtаlity in severe асute resрirаtоry syndrоme соrоnаvirus 2 (SАRS-СоV-2) раtients strаtified by Vitamin-D (Vit-D) levels. Раtients were strаtified ассоrding tо by serum 25-Hydroxy-Vitamin D (25(OH)Vit-D) levels intо twо grоuрs, i.e., 25(OH)Vit-D less thаn 40 nmol/L аnd 25(OH)Vit-D greаter thаn 40 nmol...

Background: The impact of mineralocorticoid receptor antagonist (MRA) use in acute heart failure (AHF) patients in the Middle East is not well studied. Objective: The objective of this study was to examine the impact of MRA therapy on all-cause mortality in AHF patients in the Middle East stratified by left ventricular ejection fraction. Methods:...

This study is to estimate in-hospital mortality in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients stratified by hemoglobin (Hb) level. Patients were stratified according to hemoglobin level into two groups, that is, Hb <100 g/L and Hb >100 g/L. A total of 6931 patients were included. Of these, 6377 (92%) patients had hemoglob...

Background: Heart failure (HF) burden in the developing world is not well quantified. Objectives: The objective is to evaluate the demographics and outcomes of acute HF patients with reduced ejection fraction (EF) (<40%) (HFrEF), HF with midrange EF (40%-49%) (HFmrEF) and HF with preserved EF (≥50%) (HFpEF) in the Arabian Gulf. Methods: Gulf CARE r...

Chronic coronary syndrome (CCS) is a newly proposed entity by the European Society of Cardiology that replaces stable coronary artery disease (CAD), which is defined as a progressive process of plaque accumulation in coronary circulation with associated functional changes. CCS has replaced stable CAD to raise awareness that despite the clinically s...

The scope of this journal will be broadly based in order to realize three objectives. First and foremost the objective is to publish high quality research which deals with problems which are of universal relevance but with greater focus on work targeting locally relevant problems. Secondly, the journal will be a forum for cardiologists and other sp...

Novel Wuhan Coronavirus (COVID-19) induced atypical viral pneumonia was first reported in Wuhan city, China in December 2019. As reported earlier, severe acute respiratory syndrome coronavirus (SARS-CoV) is a milder version of coronavirus with 10% mortality rate whereas Middle East respiratory syndrome coronavirus (MERS-CoV) has a mortality rate of...

Objectives: We sought to estimate the mortality and morbidity in diabetic acute heart failure (AHF) patients stratified by left ventricular ejection fraction. Methods: We analyzed the data of patients with AHF from seven Middle Eastern countries (Bahrain, Oman, Yemen, Kuwait, UAE, Qatar, and Saudi Arabia) from February to November 2012, who were...

In the United States, 30% of cardiovascular disease-related mortality is due to Tobacco smoking [1]. Electronic (e) cigarettes have nicotine content ranging between 16 and 24 mg/ml. The adverse impact of e-cigarettes can affect the respiratory tract, central nervous system and, immune system [2]. Most of the flavoring chemicals used in e-cigarettes...

Background and Objectives: The use of digoxin in acute heart failure (AHF) is not without controversy. The aim of this study was to examine the impact of digoxin therapy on all-cause mortality and re-hospitalizations for heart failure (HF) at 3 months and 12 months in AHF patients in the Arabian Gulf stratified by left ventricular ejection fraction...

A 24‑year‑old female presented to the emergency room with sudden‑onset palpitations and shortness of breath for 4 h. We report a rare cause of anterior fascicular ventricular tachycardia. Keywords: Anterior fascicular ventricular tachycardia, palpitations, wide QRS complex tachycardia

Abstract Aims The aim of this study is to determine the impact of diabetes mellitus on all‐cause mortality and rehospitalization rates at 3 months and at 1 year in patients admitted with acute heart failure (AHF) stratified by left ventricular ejection fraction (EF). Methods and results We analysed consecutive patients admitted to 47 hospitals in s...

Background Quadfurcation of single coronary artery (SCA) from the right is an extremely rare anomaly and acute coronary syndrome in such patients is catastrophic. Case summary We report a 56-year-old Bangladeshi male who presented with an acute inferior wall ST-elevation myocardial infarction. He was taken to the Cath lab for primary percutaneous...

Objective: We aimed to determine the mortality and re-hospitalization rates in diabetic heart failurepatients with HFrEF, HFmrEF and HFpEF. Methods: We analysed 5005 patients with acute heart failure (AHF) who were enrolled in Gulf CARE, amultinational registry of patients with HF. We compared the the mortality and re-hospitalization rates in diab...

Objective: The purpose of this study was to describe the clinical characteristics and outcomes of the cardiorenal anemia syndrome (CRAS) patients from the Gulf acute heart failure registry (Gulf CARE) stratified by left ventricular ejection fraction (LVEF) (≤35% vs >35%). Methods: Data was analyzed from 1,190 consecutive patients admitted to 47 h...

Objective: The purpose of this study was to describe the clinical characteristics and outcomes of the cardiorenal anemia syndrome (CRAS) patients from the Gulf acute heart failure registry (Gulf CARE) stratified by admission diagnosis. Methods: Data was analyzed from 1,319 consecutive patients admitted to 47 hospitals in 7 Middle Eastern countrie...

A 54-year-old Kuwaiti male presented an inferior wall ST elevation myocardial infarction (STEMI). Clopidogrel 600mg was administered by the first medical contact and Ticagrelor 180 mg with intravenous (IV) glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitor infusion for 24 hours after primary percutaneous intervention. Despite this, several episodes of s...

Atrial fibrillation is the most common arrhythmia in the elderly population and is an important cause of stroke. The role of antiplatelet therapy remains controversial. Treatment with aspirin and clopidogrel significantly reduced the rate of stroke in randomised clinical trials. Dual antiplatelet therapy (DAPT) could be an alternative treatment opt...

Objective: The clinical features, treatment and outcomes in patients with EF ≥40% (HFmrEF/HFpEF) have been shown to vary by geographical region. We aimed to determine the characteristics of HFmrEF/HFpEF in the Arabian Gulf region, which have not been previously reported. Methods: We analysed the features of 4577 patients with HF who were enrolled...

Aims This study aims to evaluate the incidence and impact of cardiorenal anaemia syndrome (CRAS) on all‐cause mortality in acute heart failure (AHF) patients stratified by left ventricular ejection fraction (LVEF) status in the Middle East. Methods and results Data were analysed from 4934 consecutive patients admitted to 47 hospitals in seven Midd...

Aim To evaluate the prevalence, clinical associations and outcomes of anemia in patients with chronic heart failure (CHF). Material and methods We studied 170 patients with CHF, including 137 males, at the average age of 53.1±12.5 years. Arterial hypertension was present in 56.5% of patients, previous myocardial infarction with ST-segment elevatio...

Background: To Study the coronary artery profile in young Kuwaiti patients who are using anabolic steroids for bodybuilding. Subjects and methods: We have done a retrospective analysis of all young Kuwaiti male patients ≤ 30 years who underwent coronary angiogram in Sabah Al Ahmed Cardiac Center, Al Amiri Hospital during the period of 2014 to 2017...

Coronary artery disease is one of the major cause of death in human immunodeficiency virus (HIV) positive patients. It can be due to endothelial dysfunction, hypercoagulability and inflammatory changes associated with HIV and highly active antiretroviral therapy (HAART) induced metabolic complications. This is one of the first reported deferred ste...

Aim: To study the impact of digoxin in acutely decompensated chronic heart failure (ADCHF). Subjects & methods: Data was analyzed from 5005 consecutive patients admitted to 47 hospitals in 7 Middle Eastern countries with AHF from February to November, 2012. Patients were categorized into ADCHF patients off digoxin therapy (A1) and ADCHF patient...

Aim: To study the impact of Cardio renal anemia syndrome (CRAS) in de novo acute heart failure (de novo-AHF) and acutely decompensated chronic heart failure (ADCHF). Subjects & methods: Data was analyzed from 5005 consecutive patients admitted to 47 hospitals in 7 Middle Eastern countries with AHF from February to November, 2012. Patients were...

Aim: Cardio renal anemia syndrome (CRAS) in acute heart failure (AHF) is considered to be a high risk group. We have limited data available for the significance of CRAS in acute heart failure in the Middle East population. Subjects & Methods: Gulf Acute Heart Failure Registry (Gulf-CARE) study analyzed 5005 consecutive patients admitted with AHF to...

Introduction Perivalvular abscess in native valve infective endocarditis (IE) is associated with significantly increased mortality. Case description Herein, we report a 29 year old Indian male who presented with culture negative IE with perivalvular abscess and severe mitral regurgitation requiring mitral valve replacement. Discussion Initial app...

Case Report: A 64 year old male presented to the emergency room as a case of cardiogenic shock. He had history of previous percutaneous coronary intervention (PCI) to left anterior descending artery (LAD) two years ago.ECG taken at emergency room (ER) showed acute inferolateral ST elevation myocardial infarction (STEMI). Coronary angiogram (CAG) re...

Background: Coronary Artery Disease (CAD) is increasingly becoming the disease of the young. Not much is known regarding the incidence, degree and pattern of CAD in pre-menopausal Indian women. Our aim was to study the prevalence and pattern of CAD among pre-menopausal women undergoing CAG.

Abstract Aims: Cardio renal anemia syndrome is a condition (CRAS) where heart failure, anemia and renal failure co-exist. The purpose of this article is to measure and analyze the role of CRAS in acute heart failure in terms of left ventricular (LV) systolic function. Subjects & Methods: Gulf aCute heArt failuRe rEgistry (Gulf-CARE) study analyze...

Ruptured noncoronary sinus of Valsalva is a rare condition which was first reported in 1974. The majority of RSOV drains into right‑sided chambers and rarely to the left. RSOV is an anatomical defect due to failure of fusion between heart and aortic media with an aneurysmal enlargement which ruptures due to elevated pressures at the aortic root, in...

Coronary artery fistula is a rare anomaly of the coronary artery. Majority are congenital, rarely, acquired. Large proportions of these are detected incidentally during evaluation of the coronary artery disease. Most of them remain asymptomatic and do not need any active management, for those who are symptomatic both surgical closure and transcathe...

Congenital coronary arteriovenous fistula (CAVF) is a rare and its incidence during coronary angiogram is estimated about 0.1% to 0.2%. In 1908 Maude Abbott described the first CAVF. Majority of coronary artery fistulas are identified during echocardiography or coronary arteriography. They are usually small and clinically difficult to detect. Most...

Background: Diseases and conditions related to myocardial infarction are frequent causes of emergency visits and lead to delayed diagnosis of other common conditions. Case Report: This is a case of a 23-year-old Bangladeshi young man who was working on an offshore oil rig based in Kuwaitas a manual labour. He had a cardiac arrest associated with ma...