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We conclude there can be spurious elevation of LA mean pressure
in spite of successful BMV in AF.
Profile of patients of coronary artery disease (CAD)
in a tertiary care hospital in central India
Y. Varma, P. Singh, R.S. Meena, B.S. Yadav, R. Gupta, G. Singh
Gandhi Medical College &Hamidia Hospital, Bhopal, India
Aims: To assess the extent and severity of CAD in patients of
established or suspected CAD in tertiary care hospital.
Methods: The study was conducted on 1218 patients of estab-
lished or suspected CAD. Coronary Angiography (CAG) was
performed.
Results:
Extent of disease Number of patients Percentage
Single vessel disease (SVD) 452 37.11
Double vessel disease (DVD) 507 41.63
Triple vessel disease (TVD) 139 11.41
Recanalised 39 3.2
Normal 81 6.65
Total 1218 100
Conclusions: Coronary Angiographic profile in Central Indian
population, irrespective of risk factors, revealed an occurence of
11.41 percentage of significant CAD. The data thus collected would
be helpful not only for preventive measures but also for revas-
cularization procedures as may be indicated depending on the
extent and severity of the disease.
Coronary angiographic profile of young patients
(aged 40 years or less) in a tertiary care hospital in
central India
Y. Varma, P. Singh, B.S. Yadav, R. Gupta, Gurmeet Singh
Gandhi Medical College &Hamidia Hospital, Bhopal, India
Aims: To assess the extent and severity of Coronary Artery Dis-
ease (CAD) in patients aged 40 years or less having established or
suspected CAD in tertiary care hospital.
Methods: The study was conducted on 152 patients of established
or suspected CAD. Coronary Angiography (CAG) was performed
through radial and femoral routes.
Results:
Extent of
Disease
Number
of male
patients
Percentage Number
of female
patients
Percentage
Single vessel
disease (SVD)
64 52.03 13 44.82
Double vessel
disease (DVD)
36 29.27 4 13.8
Triple vessel
disease (TVD)
2 1.63 1 3.44
Recanalised 1 0.81 2 6.9
Normal 20 16.26 9 31.03
Total 123 29
Conclusions: Patients aged 40 years or less who underwent CAG
for established or suspected CAD, 1.63 percent of males and 3.44
percent of females had significant CAD which warrants extremes
of preventive steps and also revascularization to prevent reoc-
currence and fatalities due to CAD.
Disparity in coronary artery diameter in diabetic
and non-diabetic subjects undergoing
percutaneous coronary intervention in
Bangladesh: A 2 years retrospective analysis
C.M.S. Kabir, M.M. Haq
Ibrahim Cardiac Hospital and Research Institute, Dhaka, Bangladesh
Background: To compare the coronary arteries diameter between
diabetic and non-diabetic patients undergoing percutaneous
coronary intervention (PCI) using stent diameter for more
accuracy.
Methods: This was a single centre &exclusively single operator
randomized observational study. From a dedicated database, we
retrospectively analyzed all consecutive patients of both genders
who underwent PCI from January 2011 to December 2012. Patients
with left main coronary artery stenting and patients where
optimal results were not achieved excluded from this study. Pa-
tients were divided into two groups; diabetics and non-diabetics.
We calculated the coronary artery diameter according to the
diameter the stent achieved at the final pressure at which the
stent was deployed. The diameter which was achieved at a given
atmospheric pressure was taken from the attached booklet given
with stent packet. If post dilatation was required then the diam-
eter achieved by the balloon after post dilatation was taken as the
reference diameter of the artery.
Results: A total of 571 patients, 333 in diabetic and 238 in non-
diabetic group were included. Proximal segments of LAD in di-
abetics and non-diabetics were 2.99±0.44 vs 3.18±0.50 mm
(p¼0.00) while mid and distal segments were 2.90±0.38 vs
3.10±0.42 mm (p¼0.00) and 2.25±0.39 vs 2.42±0.45 mm (p¼0.00)
respectively. Various segments of proximal LCx in diabetics and
non-diabetics were 2.98±0.21 vs 3.02±0.25 mm (p¼0.37) while
distal circumflex were 2.45±0.40 vs 2.69±0.43 mm (p¼0.00)
respectively. Proximal segments of RCA in diabetic and non-di-
abetics were 3.0±0.28 vs 3.28±0.25 mm (p¼0.00) while mid and
distal segments were 2.97±0.26 vs 3.19±0.25 mm (p¼0.00) and
2.53±0.51 vs 2.87±0.32 mm (p¼0.00) respectively.
Conclusions: The LAD, distal circumflex and right coronary ar-
teries were significantly narrower in diabetics than in non-dia-
betic subjects.
Is there a shift in the demography of heart disease
complicating pregnancy? An observational
studyfrom a tertiary care hospital
G. Selvarani, M.S. Ravi, K. Meenakshi, D. Muthukumar,
N. Swaminathan, G. Ravishankar, G. Justin Paul,
G. Prathapkumar, S. Venkatesan
Rajiv Gandhi General Hospital, Madras Medical College, Chennai, India
Background: Heart diseases complicating pregnancy accounts for
about 0.2-4% of pregnant women. The spectrum of cardiac disease
indian heart journal 66 (2014) s1es143 S115
in pregnancy is changing and differs between countries. It is
believed that Rheumatic heart disease is more common than
other heart diseases in India. We found in our registry of antenatal
mothers that RHD is second most common heart disease.
Methods: We registered 1,125 antenatal mothers in outpatient
department who are referred to undergo cardiac evaluation from
Jan 2014 to June 2014. All were asymptomatic except few who had
NYHA class II symptoms. Echocardiogram done and those with
heart disease are classified.
Results:
Category Number (total 1125) Percentage%
RHD-total 17 1.511
RHD-MS 13 1.155
RHD MS/MR 1 0.088
RHD-S/P IV1VR 2 0.177
RHD S/P CIVIC 1 0.088
Congenital total 24 2.133
ASD-OS 6 0.533
ASD dIVC 1 0.088
VSD 2 0.177
PDA 0 0
S/P ASD closure 5 0.444
S/P VSD closure 1 0.088
S/P PDA ligation 2 0.177
MVP eAML 3 0.266
BCAV-AR 1 0.088
BCAV -AR 2 0.177
S /P ICR for DORV VSD PS 1 0.088
CAD OLD AWMI 1 0.088
DCM 1 0.088
Normal 1082 96.09
Total 1125 100.00
43(3.8%) out of 1,125 had heart disease. Among heart diseases,
the relative proportions were CHD 56%, RHD 40%, CAD and CMY
2%. Median age was 23 years 151(13.42%) .14 yrs was the youngest
age and 47 yrs was the oldest age . Among them , primi
627(55.73%), second gravida 448(39.82%), third gravida 50(4.44%).
Conclusions: There has been varied reports about the incidence
and prevalence of RHD in Indian population .However among
heart disease complicating pregnancy from we have found a
definite decline in the prevalence of RHD while CHD has surged
ahead over RHD. This may be attributable to the changing socio-
economic, environmental factors and reduction in family size.
The role of thrombolytic therapy in the treatment
of acute sub massive pulmonary embolism: A
single center observational study from India
Soumya Patra, C.M. Nagesh, Babu Reddy, B.C. Srinivas,
C.N. Manjunath
Sri Jayadeva Institute of Cardiovascular Sciences &Research, Bangalore,
India
Background: Routine use of thrombolytic therapy in hemody-
namically stable patients with sub massive pulmonary embolism
is controversial.
Rationale: To observe the safety &efficacy of thrombolytic ther-
apy in acute pulmonary embolism patients with normal blood
pressure and right ventricular dysfunction.
Methods: In this study, 130 patients with sub-massive pulmonary
embolism who had right ventricular (RV) dysfunction, were
included and treated with thrombolytic therapy.
Results: Mean age of our study patients was 43 +/- 14. 9 years.
Fifty-three (41%) patients in our study were within forty years of
age. Hundredeeight (83%) patients had clinical improvement in
NYHA class and it was statistically significant (p<0.001). Both RV
dysfunction and pulmonary artery systolic pressure (PASP)
improved significantly following thrombolytic therapy from
baseline (mean PASP 49 mm of Hg vs 28 mm of Hg; p¼0.01; 95% CI
¼-13 to e56). Twelve (9%) patients died and two patients (1.5%)
developed intra cerebral haemorrhage.
Conclusion: Thrombolytic therapy is helpful in improving clinical
course following sub-massive acute pulmonary embolism.
Thrombolysis with single bolus tenecteplase
compared with streptokinase infusion in the
treatment of acute pulmonary embolism eA pilot
study
Soumya Patra, C.M. Nagesh, Babu Reddy, B.C. Srinivas,
C.N. Manjunath, Madhav Hegde
Sri Jayadeva Institute of Cardiovascular Sciences &Research, Bangalore,
India
Objective: This study was planned to compare the efficacy of bolus
regimens of tenecteplase and 24 hours infusion of streptokinase
in acute pulmonary embolism in resource poor setting.
Methods: Design: It was a comparative study. Setting: It was done
in a single tertiary cardiac care centre. Patients: One-hundred
patients with acute pulmonary embolism were included and
divided according to their treatment received. Interventions:
Twenty-five patients received injection Tenecteplase as a single
bolus injection according to their body weight. Seventy-five pa-
tients received infusion of Streptokinase over 24-48 hours. Main
outcome measures: The outcome in this study was to determine
the reduction of RV dysfunction and/ or PASP seen at echocardi-
ography performed 24 hours after treatment given.
Results: Fifty-six percent patients in our study were within forty
years of age. Forty-three percent of total patients had normal
blood pressure in presence of right ventricular dysfunction. Pul-
monary artery systolic pressure was improved separately in both
the study groups of patients from baseline at 24 hours or at 7th
day, but was comparable among the TNK and STK group of pa-
tients. Mean duration of stay in ICU was significantly less in TNK
group (2.2 +/- 0.8 vs 3.2 +/- 1.3 days; p¼0.04) though the cost of
therapy was three times more than STK group (USD 800 vs USD
275; p¼0.01).
Conclusion: These results suggest that a 24-h infusion regimen of
streptokinase is as effective as bolus tenecteplase in the treatment
of patients with acute pulmonary embolism in countries with
limited resources.
Pulmonary embolism in young: Prevalence and
practice
Soumya Patra, A.C. Nagamani, C.N. Manjunath,
K.S. Ravindranath, B. Ramesh, Navin Agrawal
Sri Jayadeva Institute of Cardiovascular Sciences &Research, Bangalore,
India
indian heart journal 66 (2014) s1es143S116
