Sanjay Prasad

Devi Ahilya Vishwavidyalaya, Indore (DAVV) · School of Commerce

ARTIFICIAL INTELLIGENCE AND AUTOMATION IN ACCOUNTING: OPPORTUNITIES AND CHALLENGES FOR THE FUTURE Dr. Sanjay Prasad 1 ISBN: 978-81-981898-4-4 | DOI: 10.25215/819818984X.33 Abstract: This paper explores the transformative impact of Artificial Intelligence (AI) and automation on the accounting profession, highlighting the opportunities and challenges...

Background In the TRED-HF randomized trial, withdrawal of therapy for patients with recovered dilated cardiomyopathy (DCM) resulted in a 40% relapse rate by 6 months. Predicting which patients are likely to relapse would be useful. An abnormal LV volumetric response to isometric hand grip exercise (IHGE) might reflect the fragility of recovery. Ob...

Introduction Dilated cardiomyopathy (DCM) is characterised by left ventricular or biventricular systolic dysfunction and dilatation, in the absence of abnormal loading conditions or coronary artery disease. Up to 30% of cases have an identified monogenic cause, usually with an autosomal dominant (AD) inheritance. The prevalence amongst males appear...

Introduction Obesity is a common comorbidity and a risk factor for developing heart failure (HF). However, more data is required to understand the association between obesity and prognosis in specific patient subgroups. We sought to evaluate the effect of obesity on clinical phenotype and cardiovascular mortality in patients with non-ischaemic dila...

Introduction Many patients with dilated cardiomyopathy (DCM) undergo improvement in left ventricular ejection fraction (LVEF). Although DCM with improved LVEF (DCMimpEF) is associated with favourable clinical outcomes, cases of sudden cardiac death (SCD) have been reported in this population. Myocardial fibrosis, detected by late gadolinium enhance...

Background: Recent data have suggested that global longitudinal strain (GLS) could be useful for risk stratification of patients with severe aortic stenosis (AS). In this study, we aimed to investigate the prognostic role of GLS in patients with AS and also its incremental value in relation to left ventricular ejection fraction (LVEF) and late gado...

Background Rare truncating variants in the genes Filamin C (FLNC) and Desmoplakin (DSP) are increasingly recognised causes of Dilated Cardiomyopathy and Arrhythmogenic Cardiomyopathy (1,2). They are often grouped together due to an assumed similar phenotype of marked left ventricular fibrosis and life threatening ventricular arrhythmias (3). A dire...

Importance: Cardiac dysfunction and myocarditis have emerged as serious complications of multisystem inflammatory syndrome in children (MIS-C) and vaccines against SARS-CoV-2. Understanding the role of autoantibodies in these conditions is essential for guiding MIS-C management and vaccination strategies in children. Objective: To investigate th...

Understanding the penetrance of pathogenic variants identified as secondary findings (SFs) is of paramount importance with the growing availability of genetic testing. We estimated penetrance through large-scale analyses of patients referred for diagnostic sequencing for hypertrophic cardiomyopathy (HCM; 10,400 cases, 1,340 variants) and dilated ca...

Introduction Predictive genetic testing allows the identification of at-risk first-degree relatives of patients with genetic cardiomyopathies. Data on the penetrance of genetic variants associated with cardiomyopathies is limited. The aim of this study was to investigate disease penetrance in asymptomatic carriers of familial cardiomyopathy variant...

Background: Endomyocardial biopsy (EMB) is the gold standard method for surveillance of acute cardiac allograft rejection (ACAR) despite its invasive nature. Cardiovascular magnetic resonance (CMR)-based myocardial tissue characterization allows detection of myocarditis. The feasibility of CMR-based surveillance for ACAR-induced myocarditis in the...

Objectives: The management of severe aortic stenosis mandates consideration of aortic valve intervention for symptomatic patients. However, for asymptomatic patients with severe aortic stenosis, recent randomised trials supported earlier intervention. We conducted a systematic review and meta-analysis to evaluate all the available data comparing t...

Background Although coronavirus disease 2019 (COVID-19) is primarily a respiratory illness, myocardial injury is increasingly reported and associated with adverse outcomes. However, the pathophysiology, extent of myocardial injury and clinical significance remains unclear. Methods COVID-HEART is a UK, multicentre, prospective, observational, longi...

Background Quantitative cardiovascular magnetic resonance T1-mapping is increasingly used for myocardial tissue characterization. However, the lack of standardization limits direct comparability between centers and wider roll-out for clinical use or trials. Purpose To develop a quality assurance (QA) program assuring standardized T1 measurements f...

Mediastinal lymphadenopathy and auto-antibodies are clinical phenomena during ischemic heart failure pointing to an autoimmune response against the heart. T and B cells have been convincingly demonstrated to be activated after myocardial infarction, a prerequisite for the generation of mature auto-antibodies. Yet, little is known about the immunogl...

Objective: Interstitial fibrosis is a pathological expansion of the heart's inter-cellular collagen matrix. It is a potential complication of nonischemic cardiomyopathy (NICM), a class of diseases involving electrical and or mechanical dysfunction of cardiac tissue not caused by atherosclerosis. Patients with NICM and interstitial fibrosis often s...

In previous studies of septal heart muscle from HCM patients with hypertrophic obstructive cardiomyopathy (HOCM, LVOT gradient 50–120 mmHg) we found that the level of phosphorylation of troponin I (TnI) and myosin binding protein C (MyBP-C) was extremely low yet samples from hearts with HCM or DCM mutations that did not have pressure overload were...

Objective: Interstitial fibrosis is a pathological expansion of the heart's inter-cellular collagen matrix. It is a potential complication of nonischemic cardiomyopathy (NICM), a class of diseases involving electrical and or mechanical dysfunction of cardiac tissue not caused by atherosclerosis. Patients with NICM and interstitial fibrosis often su...

Background: Left ventricular (LV) diastolic dysfunction (DD) carries worse prognosis in childhood. 2-dimensional (2-D) left atrial (LA) strain accurately categorizes DD in adults but its role in children is unknown. Thus, the aim of this study is to investigate whether LA strain and strain rate could diagnose and classify DD in children with dilat...

Objectives: This study aimed to determine the role of T1 mapping in identifying cardiac allograft rejection. Background: Endomyocardial biopsy (EMBx), the current gold standard to diagnose cardiac allograft rejection, is associated with potentially serious complications. Cardiac magnetic resonance (CMR)-based T1 mapping detects interstitial edem...

Introduction Dilated cardiomyopathy (DCM) is genetically heterogeneous, with >100 purported disease genes tested in clinical laboratories. However, many genes were originally identified based on candidate-gene studies that did not adequately account for background population variation. Here we define the frequency of rare variation in 2538 DCM pati...

Aortic valve stenosis is the commonest form of valvular heart disease in the Western world, currently affecting about 7% of the population over the age of 60, while 3% of people over the age of 75 have severe stenosis. With an aging population, its prevalence is expected to increase dramatically in the next few decades with major financial implicat...

Background: Left ventricular noncompaction cardiomyopathy (LVNC) is associated with poor clinical outcome in childhood. Standard diagnostic criteria are still controversial, especially in young patients. Recent studies in adults demonstrated that left ventricular (LV) twist is abnormal in LVNC, but it has not been investigated in pediatric patient...

Background: PRKAG2 is a rare autosomal dominant syndrome that mainly presents with hypertrophic cardiomyopathy, ventricular preexcitation, and conduction abnormalities. This case report demonstrates that the PRKAG2 mutation presents with various phenotypes already in pediatric patients. Case summary: We describe the clinical and investigative fi...

Background: The optimal timing of aortic valve replacement in asymptomatic patients with aortic stenosis is uncertain. Replacement fibrosis, as assessed by midwall (nonischemic) late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging, is an irreversible marker of left ventricular decompensation in aortic stenosis. Once establ...

Dilated cardiomyopathy (DCM) is defined as a disease of the myocardium characterized by left ventricular dilatation and systolic impairment that cannot be exclusively explained by abnormal loading conditions (such as hypertension or valvular heart disease) or coronary artery disease. The true prevalence is debated because of a lack of large contemp...

BACKGROUND: Hemorrhagic myocarditis is a potentially fatal complication of excessive levels of systemic inflammation. It has been reported in viral infection, but is also possible in systemic autoimmunity. Cardiac magnetic resonance (CMR) imaging is the current gold standard for non-invasive detection of suspected inflammatory damage to the heart a...

Purpose: Increasing numbers of genes are being implicated in Mendelian disorders and incorporated into clinical test panels. However, lack of evidence supporting the gene-disease relationship can hinder interpretation. We explored the utility of testing 51 additional genes for hypertrophic cardiomyopathy (HCM), one of the most commonly tested Mend...

Alterations in the geometry and function of the heart define well-established causes of cardiovascular disease. However, current approaches to the diagnosis of cardiovascular diseases often rely on subjective human assessment as well as manual analysis of medical images. Both factors limit the sensitivity in quantifying complex structural and funct...

Alterations in the geometry and function of the heart define well-established causes of cardiovascular disease. However, current approaches to the diagnosis of cardiovascular diseases often rely on subjective human assessment as well as manual analysis of medical images. Both factors limit the sensitivity in quantifying complex structural and funct...

Background: Alcoholic cardiomyopathy (ACM) is defined by a dilated and impaired left ventricle due to chronic excess alcohol consumption. It is largely unknown which factors determine cardiac toxicity on exposure to alcohol. Objectives: This study sought to evaluate the role of variation in cardiomyopathy-associated genes in the pathophysiology...

Introduction Hypertrophic cardiomyopathy (HCM) is characterised by great phenotypic diversity and broad spectrum of clinical courses. The genetic, environmental and phenotypic determinants of outcome remain poorly understood. We integrated machine-learning analysis of cardiovascular magnetic resonance (CMR) with computational modelling to define th...

To evaluate the relationship between sex, age and outcome in dilated cardiomyopathy (DCM). We used proportional hazard modelling to examine the association between sex, age and all-cause mortality in consecutive patients with DCM. Overall, 881 patients (290 women, median age 52 years) were followed for a median of 4.9 years. Women were more likely...

Background: With the increasing utilisation of cardiovascular magnetic resonance (CMR), increasing numbers of patients are identified with normal left ventricular (LV) volumes and function but with non-ischaemic (mid-wall and subepicardial) patterns of late gadolinium enhancement (LGE). The underlying aetiology is often unclear and clinical signifi...

The aim of the present study was to compare cardiac structure as well as global and regional cardiac function in athletes with and without myocardial fibrosis (MF). Cardiac magnetic resonance imaging with late gadolinium enhancement was used to detect MF and global cardiac structure in nine lifelong veteran endurance athletes (58 ± 5 years, 43 ± 5...

Background: Predictive genetic testing is important for risk stratification in inherited cardiac conditions, yet may cause psychological distress. The aim of this study was to determine the healthcare needs of young adults undergoing predictive testing for inherited cardiomyopathies. Method: In this qualitative study, 11 young adults (aged 16–25 y...

Background Hypertrophic cardiomyopathy (HCM) is characterised by increased left ventricular wall thickness leading to exercise intolerance and heart failure. Peak oxygen consumption (peak VO2) on cardiopulmonary exercise testing (CPET) is often used as a functional marker alongside B-type natriuretic peptide (BNP). However, CPET is complex and time...

Background Titin truncating variants (TTNtv), found in~10%–20% of dilated cardiomyopathy (DCM), are notable for variable penetrance and expressivity. We evaluated whether TTNtv DCM patients had distinct phenotypic features, which may influence disease outcomes. Methods Prospectively recruited DCM patients underwent comprehensive clinical evaluatio...

Background The prevalence of underlying cardiovascular disease in those who die suddenly varies with age (Finocchiaro et al 2016). Cardiovascular magnetic resonance (CMR) imaging can provide incremental in-vivo diagnostic value in those resuscitated from sudden cardiac arrest (SCA) but this practice is not yet supported by guideline recommendations...

Objectives: The goal of this study was to assess the independent and collective diagnostic value of various modalities in cardiac sarcoidosis, delineate the role of cardiac magnetic resonance (CMR), and identify patients at risk. Background: Cardiac sarcoidosis is associated with increased morbidity and mortality. CMR is a key modality in the ev...

Heart failure is a major health burden, affecting 40 million people globally. One of the main causes of systolic heart failure is dilated cardiomyopathy (DCM), the leading global indication for heart transplantation. Our understanding of the genetic basis of both DCM and systolic heart failure has improved in recent years with the application of ne...

Aim: Hypertrophic cardiomyopathy (HCM) exhibits genetic heterogeneity that is dominated by variation in eight sarcomeric genes. Genetic variation in a large number of non-sarcomeric genes has also been implicated in HCM but not formally assessed. Here we used very large case and control cohorts to determine the extent to which variation in non-sar...

Variants in NDUFB11, which encodes a structural component of complex I of the mitochondrial respiratory chain (MRC), were recently independently reported to cause histiocytoid cardiomyopathy (histiocytoid CM) and microphthalmia with linear skin defects syndrome (MLS syndrome). Here we report an additional case of histiocytoid CM, which carries a de...

Background: There is increasing evidence that the Brugada ECG pattern is a marker of subtle structural heart disease. Objective: We characterised Brugada syndrome (BrS) patients using cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE). Methods: BrS was diagnosed according to international guidelines. 26% BrS patient...

Background: The relative diagnostic and prognostic value of cardiac magnetic resonance imaging (CMR) and positron emission tomography (PET) has not been evaluated when performed concurrently in suspected cardiac sarcoidosis patients. Methods: We retrospectively studied 359 suspected cardiac sarcoidosis patients that underwent contrast enhanced CMR...

Background The clinical course of dilated cardiomyopathy (DCM) is variable: while 20% of patients die within 5 years of diagnosis, up to 15% recover fully. DNA variants that truncate the sarcomeric protein titin (TTNtv) are found in up to 20% of DCM. We sought to characterise the phenotype of TTNtv DCM and evaluate the effect of TTNtv on left ventr...

Introduction Percutaneous transcatheter aortic valve implantation (TAVI) is gaining significant popularity as an alternative to conventional aortic valve replacement surgery for patients with aortic stenosis (AS), especially in high operative risk patients. We investigated outcome prediction using a cohort of patients undergoing TAVI and utilising...

Introduction The European System for Cardiac Operative Risk Evaluation II (EuroSCORE) and Society of Thoracic Surgeons (STS) risk models provide a method of predicating mortality of patients undergoing cardiac surgery. However, their validity in transcatheter aortic valve implantation (TAVI) remains controversial with some studies supporting its us...

Background Up to fifty percent of idiopathic dilated cardiomyopathy (DCM) has a familial basis. Variants can occur in over 40 genes, though truncating variants in the sarcomeric gene titin account for the largest proportion (~20%). At least half of familial DCM cases are genetically orphan. We sought to study whether familial DCM was associated wit...

Introduction Elevated NT-pro BNP is associated with worse outcome in patients with cardiomyopathy. Hypothesis We hypothesized that a mild elevation in NT-pro BNP may be associated with a worse outcome in patients with Aortic Stenosis (AS). Methods Between 2011 and 2015, consecutive consenting patients with moderate (1.0–1.5 cm2) or severe (<1 cm2)...

Mutations in NDUFB11, which encodes a component of the Mitochondrial Respiratory Chain (MRC) were recently reported to cause both Histiocytoid Cardiomyopathy (Histiocytoid CM) and Microphthalmia with Linear Skin Defects Syndrome (MLS syndrome). Histiocytoid CM is a rare, distinctive form of cardiomyopathy with ˜ 150 cases reported worldwide, that p...

Introduction and objectives Sudden cardiac death (SCD) in the paediatric population is an uncommon event. No clear information is available regarding the prevalence of the various causes in the entire population and studies usually reflect the accumulation of autopsy cases in a single centre. We performed a retrospective study from the SCD database...

Introduction: There are few data on heart failure (HF) burden and none available on the community prevalence of HF in India. We conducted a study aimed at determining the HF prevalence in a rural community as well as tertiary hospital care setting in North India. We also reviewed the existing literature regarding the estimated and projected prevale...

Introduction: Constrictive pericarditis is characterized by constriction of the heart secondary to pericardial inflammation. Cardiovascular magnetic resonance (CMR) imaging is useful imaging modality for addressing the challenges of confirming this diagnosis. It can be used to exclude other causes of right heart failure, such as pulmonary hyperten...

The REGENERATE-DCM trial is the first phase II randomized, placebo-controlled trial aiming to assess if granulocyte colony-stimulating factor (G-CSF) administration with or without adjunctive intracoronary (IC) delivery of autologous bone marrow-derived cells (BMCs) improves global left ventricular (LV) function in patients with dilated cardiomyopa...