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Dalal J, Dutta AL, Hiremath J, Iyengar SS, Mohan JC, Ooman A, Goswami B, Shenoy KT. Cardiovascular Compatibility of Proton Pump Inhibitors: Practice Recommendations. Cardiol Ther 2023; 12:557-570. [PMID: 37947939 DOI: 10.1007/s40119-023-00338-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/18/2023] [Indexed: 11/12/2023] Open
Abstract
This manuscript aims to critically evaluate the current evidence regarding adverse cardiovascular effects associated with proton pump inhibitors (PPIs) in patients with coronary artery disease (CAD). It also provides guidance for the selection of the most appropriate PPI within the context of cardiovascular polypharmacy and emphasizes the importance of establishing consensus among clinicians on the need to prescribe PPIs with limited cytochrome P450 (CYP450) enzyme inhibition to reduce the risk of drug interactions. PPIs are among the most widely used drugs for the treatment of gastroesophageal reflux disease (GERD) and the prevention of gastrointestinal (GI) bleeding. The manuscript reports the proceedings from the first practice recommendations meeting on the cardiovascular compatibility of PPIs in an Indian setting. A panel of eight Indian experts in cardiology and gastroenterology reviewed 14 consensus statements. Available literature was searched and summarized, and after multiple rounds of review, consensus was achieved for these statements. Based on the available evidence, the consensus panel highlights that a PPI with minimal drug-drug interaction (DDI) is recommended, especially in patients requiring clopidogrel or polypharmacy. Rabeprazole appears to be a good option in cases where co-prescription is indicated, owing to its optimal acid suppression and minimal drug interaction profile.
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Affiliation(s)
| | - Anjan Lal Dutta
- Peerless Hospital & B.K. Roy Research Center, 360 Panchasayar, Kolkata, India
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Rajput R, Mohan JC, Sawhney JPS, Dalal J, Mullasari A, Vasnawala H, Kumar A, Hs B, Sarda S. Prevalence of cardiac abnormalities and heart failure in unselected out-patients with type 2 diabetes mellitus and associated clinical factors: Real-world evidence from an Indian registry. Indian Heart J 2023; 75:436-442. [PMID: 37884126 PMCID: PMC10774570 DOI: 10.1016/j.ihj.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/05/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE Type 2 diabetes mellitus (T2DM) is known to be associated with development of left ventricular (LV) dysfunction and heart failure (HF). The study aimed to determine the prevalence of LV dysfunction and HF in unselected out-patients with T2DM with no previous cardiac history and to correlate LV dysfunction and HF with demographic and comorbid characteristics. METHODS This cross-sectional study conducted at 27 centers in India captured demographic and clinical data through electronic case record forms. B-type natriuretic peptide of >105 pg/mL was used to diagnose HF and two-dimensional echocardiography was used to assess LV dysfunction. RESULTS Of the 615 patients, 54.3 % (n = 334) were males; mean age was 57.4 ± 10.48 years. More than one-third of the patients had T2DM duration of >10 years (n = 238; 38.7 %), with hypertension as the most prevalent comorbidity (n = 372, 78.6 %). Approximately 61.3 % of the patients had LV hypertrophy. The mean LV mass was 135.0 ± 56.16 g (95 % CI 130.28, 139.70). The prevalence of any type of LV dysfunction, including systolic or diastolic dysfunction and HF was 55 % (95 % CI 51.0, 59.0) and 10 % (95 % CI 7.0, 12.0), respectively. A negligible but statistically significant correlation was observed between LV dysfunction and T2DM duration (p = 0.011), alongside HF and age (p < 0.0001). CONCLUSION Real-world data from this registry from India demonstrates a substantial burden of LV dysfunction and HF in individuals with T2DM in India. It is imperative to formulate strategies for early identification of LV dysfunction in individuals with T2DM for prevention and consequent management of HF.
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Affiliation(s)
| | - J C Mohan
- Institute of Heart & Vascular Diseases, Jaipur Golden Hospital, Sector 3, Rohini, New Delhi, India.
| | | | | | | | | | - Amit Kumar
- Medical Affairs, AstraZeneca Pharma India Ltd, India
| | - Bharath Hs
- Medical Affairs, AstraZeneca Pharma India Ltd, India
| | - Shital Sarda
- Medical Affairs, AstraZeneca Pharma India Ltd, India
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Hiremath J, Mohan JC, Hazra P, Sawhney JS, Mehta A, Shetty S, Oomman A, Shah MK, Bantwal G, Agarwal R, Karnik R, Jain P, Ray S, Das S, Jadhao V, Suryawanshi S, Barkate H. Bempedoic Acid for Lipid Management in the Indian Population: An Expert Opinion. Cureus 2023; 15:e35395. [PMID: 36987470 PMCID: PMC10040092 DOI: 10.7759/cureus.35395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2023] [Indexed: 03/30/2023] Open
Abstract
Lipid-lowering is a central theme in the management of patients with atherosclerotic cardiovascular disease (ASCVD) and heterozygous familial hypercholesterolemia (HeFH), with statins being currently used as the first-line lipid-lowering agent (LLAs). Bempedoic acid (BA) has been recently approved for lipid management in ASCVD/HeFH patients. This expert opinion paper brings out the essential concept to assess the current place of BA in the Indian population. Here we highlight that the majority of the patients with clinical ASCVD may not be receiving the optimal dose of statin, thereby failing to achieve their lipid targets. The addition of BA to statin results in a significant reduction in low-density lipoprotein cholesterol (LDL-C) along with substantial reductions in non-high-density lipoprotein cholesterol (non-HDL-C), apolipoprotein B (ApoB), and high-sensitivity C-reactive protein (hsCRP) levels. For patients who do not achieve LDL-C targets, BA can be an effective add-on alternative to choose among non-statin LLAs. BA is a good choice for statin-intolerant cases, especially in combination with ezetimibe. Given the lack of effect of worsening hyperglycemia or any increase in the occurrence of new-onset diabetes, BA can be used without hesitation in patients with diabetes. The small risk of hyperuricemia could be mitigated with appropriate patient selection and monitoring of serum uric acid levels in patients at high risk of hyperuricemia. We believe BA is an excellent non-statin therapy that is efficacious, well-tolerated, and cost-effective for lipid management in ASCVD, HeFH, and statin-intolerant patients in India.
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Affiliation(s)
| | - J C Mohan
- Cardiology, Jaipur Golden Hospital, Jaipur, IND
| | - Prakash Hazra
- Cardiology, Apollo Clinic Hospitals, Ballygunge, Kolkata, IND
| | - Jp S Sawhney
- Cardiology, Sir Ganga Ram Hospital, New Delhi, IND
| | | | - Sadanand Shetty
- Cardiology, Sadanand Healthy Living Center (P) Ltd. Sion (East), Mumbai, IND
| | | | - Mahesh K Shah
- Cardiology, MK's Heart Care, Vile Parle, Mumbai, IND
| | - Ganapathi Bantwal
- Endocrinology, Diabetes and Metabolism, St. John's Medical College and Hospital, Bengaluru, IND
| | | | - Rajiv Karnik
- Cardiology, Dr. Karnik's Cardiac Clinic, Mulund West, Mumbai, IND
| | - Peeyush Jain
- Cardiology, Fortis-Escorts Heart Institute and Research Centre, Delhi, IND
| | - Saumitra Ray
- Cardiology, Woodlands Multispeciality Hospital, Kolkata, IND
| | - Sambit Das
- Endocrinology, HiTech Medical College and Hospitals, Bhubaneshwar, IND
| | - Vibhuti Jadhao
- Global Medical Affairs, Glenmark Pharmaceuticals Limited, Mumbai, IND
| | | | - Hanmant Barkate
- Global Medical Affairs, Glenmark Pharmaceuticals Limited, Mumbai, IND
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Mohan JC, Sathyamurthy I, Panja M, Agarwala R, Ponde CK, Kumar AS, Mahala BK, Kolapkar V, Kumar RVL, Patel K. Expert Consensus on Ivabradine-based Therapy for Heart Rate Management in Chronic Coronary Syndrome and Heart Failure with Reduced Ejection Fraction in India. Curr Cardiol Rev 2023; 19:97-106. [PMID: 36941812 PMCID: PMC10518888 DOI: 10.2174/1573403x19666230320105623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 03/23/2023] Open
Abstract
Heart rate is an important indicator of health and disease and the modulation of heart rate can help to improve cardiovascular outcomes. Besides β-blockers, Ivabradine is a wellestablished heart rate modulating drug that reduces heart rate without any hemodynamic effects. This consensus document was developed with the help of expert opinions from cardiologists across India on effective heart rate management in routine clinical practice and choosing an appropriate Ivabradine-based therapy considering the available scientific data and guideline recommendations. Based on the discussion during the meetings, increased heart rate was recognized as a significant predictor of adverse cardiovascular outcomes among patients with chronic coronary syndromes and heart failure with reduced ejection fraction making heart rate modulation important in these subsets. Ivabradine is indicated in the management of chronic coronary syndromes and heart failure with reduced ejection fraction for patients in whom heart rate targets cannot be achieved despite guideline-directed β-blocker dosing or having contraindication/intolerance to β-blockers. A prolonged release once-daily dosage of Ivabradine can be considered in patients already stabilized on Ivabradine twice-daily. Ivabradine/β-blocker fixed-dose combination can also be considered to reduce pill burden. Two consensus algorithms have been developed for further guidance on the appropriate usage of Ivabradine-based therapies. Ivabradine and β-blockers can provide more pronounced clinical improvement in most chronic coronary syndromes and heart failure with reduced ejection fraction patients with a fixed-dose combination providing an opportunity to improve adherence.
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Affiliation(s)
- J C Mohan
- Head of Department & Senior Consultant Cardiology, Jaipur Golden Hospital, Delhi, India
| | - I Sathyamurthy
- Senior Interventional Cardiologist, Apollo Hospitals, Chennai, India
| | - Monotosh Panja
- Senior Interventional Cardiologist, AMRI Hospitals, Kolkata, India
| | - Rajeev Agarwala
- Head of Department and Consultant Cardiologist, Jaswant Rai Speciality Hospital, Meerut, India
| | - C K Ponde
- Head of Department and Consultant Cardiologist, P. D. Hinduja National Hospital & Medical Research Centre, Mumbai, India
| | - A Sreenivas Kumar
- Director Cardiology & Clinical Research, Apollo Health City, Hyderabad, India; Apollo Hospitals, Hyderabad, India
| | - Bijay Kumar Mahala
- Senior Consultant Cardiology, Narayana Institute of Cardiac Sciences, Bangalore, India
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Wander GS, McDonagh STJ, Rao MS, Alagesan R, Mohan JC, Bhagwat A, Pancholia AK, Viswanathan M, Chopda MB, Purnanand A, Kapardhi P, Vadavi AR, Selvaraj R, Aneja P, Hardas S, Bordoloi N, Sivakadaksham N, Goswami CE, Clark CE, Verberk WJ. Clinical relevance of double-arm blood pressure measurement and prevalence of clinically important inter-arm blood pressure differences in Indian Primary Care. J Clin Hypertens (Greenwich) 2022. [PMID: 36468352 DOI: 10.1111/jch.14456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 02/13/2022] [Accepted: 02/17/2022] [Indexed: 12/12/2022]
Abstract
Hypertension guidelines recommend measuring blood pressure (BP) in both arms at least once. However, this is seldom done due to uncertainties regarding measurement procedure and the implications of finding a clinically important inter-arm BP difference (IAD). This study aimed to provide insight into the prevalence of clinically important IADs in a large Indian primary care cohort. A number of 134678 (37% female) unselected Indian primary care participants, mean age 45.2 (SD 11.9) years, had BP measured in both arms using a standardized, triplicate, automated simultaneous measurement method (Microlife WatchBP Office Afib). On average, there were clinically minor differences in right and left arm BP values: systolic BP 134.4 vs. 134.2 mmHg (p<0.01) and diastolic BP 82.7 vs. 82.6 mmHg (p<0.01), respectively. Prevalence of significant mean systolic IAD between 10 and 15 mmHg was 7813 (5.8%). Systolic IAD ≥ 15 mmHg 2980 (2.2%) and diastolic IAD ≥ 10 mmHg 7151 (5.3%). In total, there were 7595 (5.6%) and 8548 (6.3%) participants with BP above the 140/90 mmHg threshold in only the left or right arm, respectively. Prevalence of participants with elevated BP on one arm only was highest in patients with a systolic IAD ≥ 15 mmHg; 19.1% and 13.7%, for left and right arm, respectively. This study shows that a substantial prevalence of IAD exist in Indian primary care patients. BP is above the diagnostic threshold for hypertension in one arm only for 6% of participants. These findings emphasise the importance of undertaking bilateral BP measurement in routine clinical practice. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Gurpreet S Wander
- Department of Cardiology, Hero DMC Heart Institute, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | - Sinead T J McDonagh
- Primary care research group, College of Medicine and Health, University of Exeter, UK
| | | | - R Alagesan
- G. A. Vasant compu cardiac scan centre, Chennai, India
| | - J C Mohan
- Jaipur Golden Hospital Rohini, Delhi, India
| | | | | | | | | | | | | | | | - R Selvaraj
- Preetham Cardiac Care, Coimbatore, India
| | | | - Suhas Hardas
- Poona Hospital and Research Center, Pune & Clinic: Hardas Heart Care, Pune, India
| | | | | | | | - Christopher E Clark
- Primary care research group, College of Medicine and Health, University of Exeter, UK
| | - Willem J Verberk
- CARIM School for Cardiovascular Diseases, Maastricht University, the Netherlands
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Mohan V, Singh AK, Zargar AH, Almeida A, Bhalla AK, Mohan JC, Dalal J, Sahay M, Mohanan PP, Maitra S, Ghosh S, Jeloka T, Kaul U, Sakhuja V, Das MK. Cardiorenal disease management in type 2 diabetes: An expert consensus. Diabetes Metab Syndr 2022; 16:102661. [PMID: 36375366 DOI: 10.1016/j.dsx.2022.102661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 09/28/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND AIM The interplay between cardiovascular disease (CVD), chronic kidney disease (CKD) and type 2 diabetes (T2D) is well established. We aim at providing an evidence-based expert opinion regarding the prevention and treatment of both heart failure (HF) and renal complications in people with T2D. METHOD ology: The consensus recommendations were developed by subject experts in endocrinology, cardiology, and nephrology. The criteria for consensus were set to statements with ≥80% of agreement among clinicians specialized in endocrinology, cardiology, and nephrology. Key expert opinions were formulated based on scientific evidence and clinical judgment. RESULTS Assessing the risk factors of CVD or CKD in people with diabetes and taking measures to prevent HF or kidney disease are essential. Known CVD or CKD among people with diabetes confers a very high risk for recurrent CVD. Metformin plus lifestyle modification should be the first-line therapy (unless contraindicated) for the management of T2D. Glucagon-like peptide 1 (GLP-1) agonists can be preferred in people with atherosclerotic cardiovascular disease (ASCVD) or with high-risk indicators, along with sodium-glucose cotransporter-2 inhibitors (SGLT2i), whereas SGLT2i are the first choice in HF and CKD. The GLP-1 agonists can be used in people with CKD if SGLT2i are not tolerated. CONCLUSION Current evidence suggests SGLT2i as preferred agents among people with T2D and HF, and for those with T2D and ASCVD. SGLT2i and GLP-1RA also lower CV outcomes in those with diabetes and ASCVD, and the treatment choice should depend on the patient profile.
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Affiliation(s)
- Viswanathan Mohan
- Madras Diabetes Research Foundation & Dr.Mohan's Diabetes Specialities Centre, Chennai, India. http://www.drmohans.com
| | - Awadhesh Kumar Singh
- Department of Endocrinology, G.D. Hospital and Diabetes Institute, Kolkata, India
| | | | - Alan Almeida
- Department of Nephrology, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, India
| | | | | | - Jamshed Dalal
- Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India
| | - Manisha Sahay
- Department of Nephrology, Osmania General Hospital & Osmania Medical College, Hyderabad, India
| | | | - Sanjay Maitra
- Department of Nephrology, Apollo Hospitals, Hyderabad, India
| | - Sujoy Ghosh
- Department of Endocrinology, IPGME&R and SSKM Hospital, Kolkata, India
| | | | | | - Vinay Sakhuja
- Department of Cardiology and Dean, Academics and Research, Batra Hospital and Medical Research Center, New Delhi, India
| | - Mrinal Kanti Das
- Department of Cardiology, C.K. Birla Hospitals (BMB/CMRI), Kolkata, India
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7
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Wander GS, McDonagh STJ, Rao MS, Alagesan R, Mohan JC, Bhagwat A, Pancholia AK, Viswanathan M, Chopda MB, Purnanand A, Kapardhi PLN, Vadavi AR, Selvaraj R, Aneja P, Hardas S, Bordoloi N, Sivakadaksham N, Goswami N, Clark CE, Verberk WJ. Clinical relevance of double-arm blood pressure measurement and prevalence of clinically important inter-arm blood pressure differences in Indian primary care. J Clin Hypertens (Greenwich) 2022; 24:993-1002. [PMID: 35811439 PMCID: PMC9380175 DOI: 10.1111/jch.14497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 11/29/2022]
Abstract
Hypertension guidelines recommend measuring blood pressure (BP) in both arms at least once. However, this is seldom done due to uncertainties regarding measurement procedure and the implications of finding a clinically important inter‐arm BP difference (IAD). This study aimed to provide insight into the prevalence of clinically important IADs in a large Indian primary care cohort. A number of 134 678 (37% female) unselected Indian primary care participants, mean age 45.2 (SD 11.9) years, had BP measured in both arms using a standardized, triplicate, automated simultaneous measurement method (Microlife WatchBP Office Afib). On average, there were clinically minor differences in right and left arm BP values: systolic BP 134.4 vs 134.2 mmHg (p < .01) and diastolic BP 82.7 vs 82.6 mmHg (p < .01), respectively. Prevalence of significant mean systolic IAD between 10 and 15 mmHg was 7,813 (5.8%). Systolic IAD ≥ 15 mmHg 2,980 (2.2%) and diastolic IAD ≥ 10 mmHg 7,151 (5.3%). In total, there were 7,595 (5.6%) and 8,548 (6.3%) participants with BP above the 140/90 mmHg threshold in only the left or right arm, respectively. Prevalence of participants with elevated BP on one arm only was highest in patients with a systolic IAD ≥ 15 mmHg; 19.1% and 13.7%, for left and right arm, respectively. This study shows that a substantial prevalence of IAD exists in Indian primary care patients. BP is above the diagnostic threshold for hypertension in one arm only for 6% of participants. These findings emphasize the importance of undertaking bilateral BP measurement in routine clinical practice.
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Affiliation(s)
- Gurpreet S Wander
- Department of Cardiology, Hero DMC Heart Institute, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | - Sinead T J McDonagh
- Primary care research group, College of Medicine and Health, University of Exeter, UK
| | | | - R Alagesan
- G. A. Vasant Compu Cardiac Scan Centre, Chennai, India
| | - J C Mohan
- Jaipur Golden Hospital Rohini, Delhi, India
| | | | | | | | | | | | | | | | - R Selvaraj
- Preetham Cardiac Care, Coimbatore, India
| | | | - Suhas Hardas
- Poona Hospital and Research Center, Pune & Clinic: Hardas Heart Care, Pune, India
| | | | | | | | - Christopher E Clark
- Primary care research group, College of Medicine and Health, University of Exeter, UK
| | - Willem J Verberk
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
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Puri R, Mehta V, Iyengar SS, Narasingan SN, Duell PB, Sattur GB, Vijayaraghavan K, Mohan JC, Wangnoo SK, Dalal J, Prabhakar D, Agarwal R, Bansal M, Yusuf J, Mukhopadhyay S, Shetty S, Manoria PC, Sabharwal A, Pradhan A, Mehrotra R, Mishra S, Puri S, Muruganathan A, Zargar AH, Patanwala RM, Kumar S, Bardoloi N, Pareek KK, Kapoor A, Rastogi A, Nair DR, Shaikh A, Adhikari CM, Majumder MSM, Kapoor D, Yadav M, Mubarak MR, Pancholia AK, Sahay RK, Nanda R, Wong ND. Apolipoprotein B as a Predictor of CVD. J Assoc Physicians India 2020; 68:50-53. [PMID: 33350616 DOI: pmid/33350616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Raman Puri
- Chairman, Expert Consensus Panel; Sr. Consultant Cardiologist, Indraprastha Apollo Hospitals, New Delhi
| | - Vimal Mehta
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - S S Iyengar
- Co-Chair, Expert Consensus Panel; Sr. Consultant and Head, Department of Cardiology, Manipal Hospital, Bangalore, Karnataka
| | - S N Narasingan
- Co-Chair, Expert Consensus Panel; Former Adjunct Professor of medicine, The Tamil Nadu Dr MGR Medical University and Managing Director, SNN Specialities Clinic, Chennai, Tamil Nadu
| | - P Barton Duell
- Professor of Medicine, Knight Cardiovascular Institute and Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health and Science University, Portland, OR, USA
| | - G B Sattur
- Sr. Consultant Physician and Diabetologist, Sattur Medical Care, Hubli, Karnataka
| | - Krishnaswami Vijayaraghavan
- Clinical Professor of Medicine, University of Arizona and Adjunct Professor of Medicine, Midwestern University, Glendale, Arizona, USA
| | - J C Mohan
- Consultant Cardiologist, Fortis Hospital, New Delhi
| | - S K Wangnoo
- Consultant Endocrinologist, Indraprastha Apollo Hospitals, New Delhi
| | - Jamshed Dalal
- Consultant Cardiologist, Kolilaben Ambani Hospital, Mumbai, Maharashtra
| | - D Prabhakar
- Sr. Consultant, Department of Cardiology, Apollo Hospitals, Chennai, Tamil Nadu
| | - Rajeev Agarwal
- Sr. Consultant Cardiologist, Jaswant Rai Speciality Hospital, Meerut, Uttar Pradesh
| | - Manish Bansal
- Associate Director, Department of Cardiology, Medanta Hospital, Gurugram, Haryana
| | - Jamal Yusuf
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - Saibal Mukhopadhyay
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - Sadanand Shetty
- Head of Department of Cardiology, K.J. Somaiya Super-speciality Institute, Mumbai, Maharashtra
| | | | | | - Akshayaya Pradhan
- Sr. Consultant, Department of Cardiology King George's Medical University, Lucknow, Uttar Pradesh
| | - Rahul Mehrotra
- Director and Head Non-Invasive Cardiology, Max Super speciality Hospital, Saket, New Delhi
| | | | - Sonika Puri
- Assistant Professor, Dept. of Nephrology/ Transplant, Rutgers Robert wood Johnson University, USA
| | - A Muruganathan
- Sr. Consultant Internal Medicine, AG Hospital, Tirupur, Tamil Nadu
| | - Abdul Hamid Zargar
- Medical Director, Center for Diabetes and Endocrine Care, National Highway, Gulshan Nagar, Srinagar, Jammu and Kashmir
| | | | - Soumitra Kumar
- Prof. and Head, Department of Cardiology, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal
| | - Neil Bardoloi
- Managing Director and HOD, Cardiology, Excel Care Hospital, Guwahati, Assam
| | - K K Pareek
- Head of Department of Medicine, SN Pareek Hospital, Kota, Rajasthan
| | - Aditya Kapoor
- Professor of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh
| | - Ashu Rastogi
- Assistant Professor, Department of Endocrinology and Metabolism, PGIMER Chandigarh, Punjab
| | - Devaki R Nair
- Sr. Consultant Department of Lipidology and Chemical pathologist, Royal Free Hospital, London, UK
| | - Altamash Shaikh
- Sr. Consultant, Endocrinology, Diabetology and Metabolic Physician, Mumbai, Maharashtra
| | | | | | - Dheeraj Kapoor
- Head of Department of Endocrinology, Artemis Hospital, Gurgaon, Haryana
| | - Madhur Yadav
- Director Professor of Medicine, Lady Harding Medical College, New Delhi
| | - M R Mubarak
- Consultant Cardiologist, Lanka Hospital, Colombo, Sri Lanka
| | - A K Pancholia
- Head of Department of Medicine, Clinical and Preventive Cardiology, Arihant Hospital and Research Center, Indore, Madhya Pradesh
| | - Rakesh Kumar Sahay
- Professor and Head of Department of Endocrinology, Osmania Medical College, Hyderabad
| | - Rashmi Nanda
- Consultant, Cardiac Care Centre, South Extension, New Delhi
| | - Nathan D Wong
- Professor and Director, Heart Disease Prevention Program, Division of Cardiology, University of California Irvine, USA
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9
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Puri R, Mehta V, Iyengar SS, Narasingan SN, Duell PB, Sattur GB, Vijayaraghavan K, Mohan JC, Wangnoo SK, Dalal J, Prabhakar D, Agarwal R, Bansal M, Yusuf J, Mukhopadhyay S, Shetty S, Manoria PC, Sabharwal A, Pradhan A, Mehrotra R, Mishra S, Puri S, Muruganathan A, Zargar AH, Patanwala RM, Kumar S, Bardoloi N, Pareek KK, Kapoor A, Rastogi A, Nair DR, Shaikh A, Adhikari CM, Majumder MSM, Kapoor D, Yadav M, Mubarak MR, Pancholia AK, Sahay RK, Nanda R, Wong ND. Triglycerides and Atherosclerotic Cardiovascular Disease. J Assoc Physicians India 2020; 68:35-41. [PMID: 33350613 DOI: pmid/33350613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Raman Puri
- Chairman, Expert Consensus Panel; Sr. Consultant Cardiologist, Indraprastha Apollo Hospitals, New Delhi
| | - Vimal Mehta
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - S S Iyengar
- Co-Chair, Expert Consensus Panel; Sr. Consultant and Head, Department of Cardiology, Manipal Hospital, Bangalore, Karnataka
| | - S N Narasingan
- Co-Chair, Expert Consensus Panel; Former Adjunct Professor of medicine, The Tamil Nadu Dr MGR Medical University and Managing Director, SNN Specialities Clinic, Chennai, Tamil Nadu
| | - P Barton Duell
- Professor of Medicine, Knight Cardiovascular Institute and Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health and Science University, Portland, OR, USA
| | - G B Sattur
- Sr. Consultant Physician and Diabetologist, Sattur Medical Care, Hubli, Karnataka
| | - Krishnaswami Vijayaraghavan
- Clinical Professor of Medicine, University of Arizona and Adjunct Professor of Medicine, Midwestern University, Glendale, Arizona, USA
| | - J C Mohan
- Consultant Cardiologist, Fortis Hospital, New Delhi
| | - S K Wangnoo
- Consultant Endocrinologist, Indraprastha Apollo Hospitals, New Delhi
| | - Jamshed Dalal
- Consultant Cardiologist, Kolilaben Ambani Hospital, Mumbai, Maharashtra
| | - D Prabhakar
- Sr. Consultant, Department of Cardiology, Apollo Hospitals, Chennai, Tamil Nadu
| | - Rajeev Agarwal
- Sr. Consultant Cardiologist, Jaswant Rai Speciality Hospital, Meerut, Uttar Pradesh
| | - Manish Bansal
- Associate Director, Department of Cardiology, Medanta Hospital, Gurugram, Haryana
| | - Jamal Yusuf
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - Saibal Mukhopadhyay
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - Sadanand Shetty
- Head of Department of Cardiology, K.J. Somaiya Super-speciality Institute, Mumbai, Maharashtra
| | | | | | - Akshayaya Pradhan
- Sr. Consultant, Department of Cardiology King George's Medical University, Lucknow, Uttar Pradesh
| | - Rahul Mehrotra
- Director and Head Non-Invasive Cardiology, Max Super speciality Hospital, Saket, New Delhi
| | | | - Sonika Puri
- Assistant Professor, Dept. of Nephrology/ Transplant, Rutgers Robert wood Johnson University, USA
| | - A Muruganathan
- Sr. Consultant Internal Medicine, AG Hospital, Tirupur, Tamil Nadu
| | - Abdul Hamid Zargar
- Medical Director, Center for Diabetes and Endocrine Care, National Highway, Gulshan Nagar, Srinagar, Jammu and Kashmir
| | | | - Soumitra Kumar
- Prof. and Head, Department of Cardiology, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal
| | - Neil Bardoloi
- Managing Director and HOD, Cardiology, Excel Care Hospital, Guwahati, Assam
| | - K K Pareek
- Head of Department of Medicine, SN Pareek Hospital, Kota, Rajasthan
| | - Aditya Kapoor
- Professor of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh
| | - Ashu Rastogi
- Assistant Professor, Department of Endocrinology and Metabolism, PGIMER Chandigarh, Punjab
| | - Devaki R Nair
- Sr. Consultant Department of Lipidology and Chemical pathologist, Royal Free Hospital, London, UK
| | - Altamash Shaikh
- Sr. Consultant, Endocrinology, Diabetology and Metabolic Physician, Mumbai, Maharashtra
| | | | | | - Dheeraj Kapoor
- Head of Department of Endocrinology, Artemis Hospital, Gurgaon, Haryana
| | - Madhur Yadav
- Director Professor of Medicine, Lady Harding Medical College, New Delhi
| | - M R Mubarak
- Consultant Cardiologist, Lanka Hospital, Colombo, Sri Lanka
| | - A K Pancholia
- Head of Department of Medicine, Clinical and Preventive Cardiology, Arihant Hospital and Research Center, Indore, Madhya Pradesh
| | - Rakesh Kumar Sahay
- Professor and Head of Department of Endocrinology, Osmania Medical College, Hyderabad
| | - Rashmi Nanda
- Consultant, Cardiac Care Centre, South Extension, New Delhi
| | - Nathan D Wong
- Professor and Director, Heart Disease Prevention Program, Division of Cardiology, University of California Irvine, USA
| |
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10
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Puri R, Mehta V, Iyengar SS, Narasingan SN, Duell PB, Sattur GB, Vijayaraghavan K, Mohan JC, Wangnoo SK, Dalal J, Prabhakar D, Agarwal R, Bansal M, Yusuf J, Mukhopadhyay S, Shetty S, Manoria PC, Sabharwal A, Pradhan A, Mehrotra R, Mishra S, Puri S, Muruganathan A, Zargar AH, Patanwala RM, Kumar S, Bardoloi N, Pareek KK, Kapoor A, Rastogi A, Nair DR, Shaikh A, Adhikari CM, Majumder MSM, Kapoor D, Yadav M, Mubarak MR, Pancholia AK, Sahay RK, Nanda R, Wong ND. Lifestyle Modification in the Prevention of Atherosclerotic Cardiovascular Disease. J Assoc Physicians India 2020; 68:10-20. [PMID: 33350611 DOI: pmid/33350611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Raman Puri
- Chairman, Expert Consensus Panel; Sr. Consultant Cardiologist, Indraprastha Apollo Hospitals, New Delhi
| | - Vimal Mehta
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - S S Iyengar
- Co-Chair, Expert Consensus Panel; Sr. Consultant and Head, Department of Cardiology, Manipal Hospital, Bangalore, Karnataka
| | - S N Narasingan
- Co-Chair, Expert Consensus Panel; Former Adjunct Professor of medicine, The Tamil Nadu Dr MGR Medical University and Managing Director, SNN Specialities Clinic, Chennai, Tamil Nadu
| | - P Barton Duell
- Professor of Medicine, Knight Cardiovascular Institute and Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health and Science University, Portland, OR, USA
| | - G B Sattur
- Sr. Consultant Physician and Diabetologist, Sattur Medical Care, Hubli, Karnataka
| | - Krishnaswami Vijayaraghavan
- Clinical Professor of Medicine, University of Arizona and Adjunct Professor of Medicine, Midwestern University, Glendale, Arizona, USA
| | - J C Mohan
- Consultant Cardiologist, Fortis Hospital, New Delhi
| | - S K Wangnoo
- Consultant Endocrinologist, Indraprastha Apollo Hospitals, New Delhi
| | - Jamshed Dalal
- Consultant Cardiologist, Kolilaben Ambani Hospital, Mumbai, Maharashtra
| | - D Prabhakar
- Sr. Consultant, Department of Cardiology, Apollo Hospitals, Chennai, Tamil Nadu
| | - Rajeev Agarwal
- Sr. Consultant Cardiologist, Jaswant Rai Speciality Hospital, Meerut, Uttar Pradesh
| | - Manish Bansal
- Associate Director, Department of Cardiology, Medanta Hospital, Gurugram, Haryana
| | - Jamal Yusuf
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - Saibal Mukhopadhyay
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - Sadanand Shetty
- Head of Department of Cardiology, K.J. Somaiya Super-speciality Institute, Mumbai, Maharashtra
| | | | | | - Akshayaya Pradhan
- Sr. Consultant, Department of Cardiology King George's Medical University, Lucknow, Uttar Pradesh
| | - Rahul Mehrotra
- Director and Head Non-Invasive Cardiology, Max Super speciality Hospital, Saket, New Delhi
| | | | - Sonika Puri
- Assistant Professor, Dept. of Nephrology/ Transplant, Rutgers Robert wood Johnson University, USA
| | - A Muruganathan
- Sr. Consultant Internal Medicine, AG Hospital, Tirupur, Tamil Nadu
| | - Abdul Hamid Zargar
- Medical Director, Center for Diabetes and Endocrine Care, National Highway, Gulshan Nagar, Srinagar, Jammu and Kashmir
| | | | - Soumitra Kumar
- Prof. and Head, Department of Cardiology, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal
| | - Neil Bardoloi
- Managing Director and HOD, Cardiology, Excel Care Hospital, Guwahati, Assam
| | - K K Pareek
- Head of Department of Medicine, SN Pareek Hospital, Kota, Rajasthan
| | - Aditya Kapoor
- Professor of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh
| | - Ashu Rastogi
- Assistant Professor, Department of Endocrinology and Metabolism, PGIMER Chandigarh, Punjab
| | - Devaki R Nair
- Sr. Consultant Department of Lipidology and Chemical pathologist, Royal Free Hospital, London, UK
| | - Altamash Shaikh
- Sr. Consultant, Endocrinology, Diabetology and Metabolic Physician, Mumbai, Maharashtra
| | | | | | - Dheeraj Kapoor
- Head of Department of Endocrinology, Artemis Hospital, Gurgaon, Haryana
| | - Madhur Yadav
- Director Professor of Medicine, Lady Harding Medical College, New Delhi
| | - M R Mubarak
- Consultant Cardiologist, Lanka Hospital, Colombo, Sri Lanka
| | - A K Pancholia
- Head of Department of Medicine, Clinical and Preventive Cardiology, Arihant Hospital and Research Center, Indore, Madhya Pradesh
| | - Rakesh Kumar Sahay
- Professor and Head of Department of Endocrinology, Osmania Medical College, Hyderabad
| | - Rashmi Nanda
- Consultant, Cardiac Care Centre, South Extension, New Delhi
| | - Nathan D Wong
- Professor and Director, Heart Disease Prevention Program, Division of Cardiology, University of California Irvine, USA
| |
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11
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Puri R, Mehta V, Iyengar SS, Narasingan SN, Duell PB, Sattur GB, Vijayaraghavan K, Mohan JC, Wangnoo SK, Dalal J, Prabhakar D, Agarwal R, Bansal M, Yusuf J, Mukhopadhyay S, Shetty S, Manoria PC, Sabharwal A, Pradhan A, Mehrotra R, Mishra S, Puri S, Muruganathan A, Zargar AH, Patanwala RM, Kumar S, Bardoloi N, Pareek KK, Kapoor A, Rastogi A, Nair DR, Shaikh A, Adhikari CM, Majumder MSM, Kapoor D, Yadav M, Mubarak MR, Pancholia AK, Sahay RK, Nanda R, Wong ND. Low Density Lipoprotein Cholesterol Targets in Secondary Prevention of Atherosclerotic Cardiovascular Disease. J Assoc Physicians India 2020; 68:21-34. [PMID: 33350612 DOI: pmid/33350612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Raman Puri
- Chairman, Expert Consensus Panel; Sr. Consultant Cardiologist, Indraprastha Apollo Hospitals, New Delhi
| | - Vimal Mehta
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - S S Iyengar
- Co-Chair, Expert Consensus Panel; Sr. Consultant and Head, Department of Cardiology, Manipal Hospital, Bangalore, Karnataka
| | - S N Narasingan
- Co-Chair, Expert Consensus Panel; Former Adjunct Professor of medicine, The Tamil Nadu Dr MGR Medical University and Managing Director, SNN Specialities Clinic, Chennai, Tamil Nadu
| | - P Barton Duell
- Professor of Medicine, Knight Cardiovascular Institute and Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health and Science University, Portland, OR, USA
| | - G B Sattur
- Sr. Consultant Physician and Diabetologist, Sattur Medical Care, Hubli, Karnataka
| | - Krishnaswami Vijayaraghavan
- Clinical Professor of Medicine, University of Arizona and Adjunct Professor of Medicine, Midwestern University, Glendale, Arizona, USA
| | - J C Mohan
- Consultant Cardiologist, Fortis Hospital, New Delhi
| | - S K Wangnoo
- Consultant Endocrinologist, Indraprastha Apollo Hospitals, New Delhi
| | - Jamshed Dalal
- Consultant Cardiologist, Kolilaben Ambani Hospital, Mumbai, Maharashtra
| | - D Prabhakar
- Sr. Consultant, Department of Cardiology, Apollo Hospitals, Chennai, Tamil Nadu
| | - Rajeev Agarwal
- Sr. Consultant Cardiologist, Jaswant Rai Speciality Hospital, Meerut, Uttar Pradesh
| | - Manish Bansal
- Associate Director, Department of Cardiology, Medanta Hospital, Gurugram, Haryana
| | - Jamal Yusuf
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - Saibal Mukhopadhyay
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - Sadanand Shetty
- Head of Department of Cardiology, K.J. Somaiya Super-speciality Institute, Mumbai, Maharashtra
| | | | | | - Akshayaya Pradhan
- Sr. Consultant, Department of Cardiology King George's Medical University, Lucknow, Uttar Pradesh
| | - Rahul Mehrotra
- Director and Head Non-Invasive Cardiology, Max Super speciality Hospital, Saket, New Delhi
| | | | - Sonika Puri
- Assistant Professor, Dept. of Nephrology/ Transplant, Rutgers Robert wood Johnson University, USA
| | - A Muruganathan
- Sr. Consultant Internal Medicine, AG Hospital, Tirupur, Tamil Nadu
| | - Abdul Hamid Zargar
- Medical Director, Center for Diabetes and Endocrine Care, National Highway, Gulshan Nagar, Srinagar, Jammu and Kashmir
| | | | - Soumitra Kumar
- Prof. and Head, Department of Cardiology, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal
| | - Neil Bardoloi
- Managing Director and HOD, Cardiology, Excel Care Hospital, Guwahati, Assam
| | - K K Pareek
- Head of Department of Medicine, SN Pareek Hospital, Kota, Rajasthan
| | - Aditya Kapoor
- Professor of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh
| | - Ashu Rastogi
- Assistant Professor, Department of Endocrinology and Metabolism, PGIMER Chandigarh, Punjab
| | - Devaki R Nair
- Sr. Consultant Department of Lipidology and Chemical pathologist, Royal Free Hospital, London, UK
| | - Altamash Shaikh
- Sr. Consultant, Endocrinology, Diabetology and Metabolic Physician, Mumbai, Maharashtra
| | | | | | - Dheeraj Kapoor
- Head of Department of Endocrinology, Artemis Hospital, Gurgaon, Haryana
| | - Madhur Yadav
- Director Professor of Medicine, Lady Harding Medical College, New Delhi
| | - M R Mubarak
- Consultant Cardiologist, Lanka Hospital, Colombo, Sri Lanka
| | - A K Pancholia
- Head of Department of Medicine, Clinical and Preventive Cardiology, Arihant Hospital and Research Center, Indore, Madhya Pradesh
| | - Rakesh Kumar Sahay
- Professor and Head of Department of Endocrinology, Osmania Medical College, Hyderabad
| | - Rashmi Nanda
- Consultant, Cardiac Care Centre, South Extension, New Delhi
| | - Nathan D Wong
- Professor and Director, Heart Disease Prevention Program, Division of Cardiology, University of California Irvine, USA
| |
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12
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Puri R, Mehta V, Iyengar SS, Narasingan SN, Duell PB, Sattur GB, Vijayaraghavan K, Mohan JC, Wangnoo SK, Dalal J, Prabhakar D, Agarwal R, Bansal M, Yusuf J, Mukhopadhyay S, Shetty S, Manoria PC, Sabharwal A, Pradhan A, Mehrotra R, Mishra S, Puri S, Muruganathan A, Zargar AH, Patanwala RM, Kumar S, Bardoloi N, Pareek KK, Kapoor A, Rastogi A, Nair DR, Shaikh A, Adhikari CM, Majumder MSM, Kapoor D, Yadav M, Mubarak MR, Pancholia AK, Sahay RK, Nanda R, Wong ND. Lipoprotein(a) and ASCVD risk. J Assoc Physicians India 2020; 68:42-46. [PMID: 33350614 DOI: pmid/33350614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Raman Puri
- Chairman, Expert Consensus Panel; Sr. Consultant Cardiologist, Indraprastha Apollo Hospitals, New Delhi
| | - Vimal Mehta
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - S S Iyengar
- Co-Chair, Expert Consensus Panel; Sr. Consultant and Head, Department of Cardiology, Manipal Hospital, Bangalore, Karnataka
| | - S N Narasingan
- Co-Chair, Expert Consensus Panel; Former Adjunct Professor of medicine, The Tamil Nadu Dr MGR Medical University and Managing Director, SNN Specialities Clinic, Chennai, Tamil Nadu
| | - P Barton Duell
- Professor of Medicine, Knight Cardiovascular Institute and Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health and Science University, Portland, OR, USA
| | - G B Sattur
- Sr. Consultant Physician and Diabetologist, Sattur Medical Care, Hubli, Karnataka
| | - Krishnaswami Vijayaraghavan
- Clinical Professor of Medicine, University of Arizona and Adjunct Professor of Medicine, Midwestern University, Glendale, Arizona, USA
| | - J C Mohan
- Consultant Cardiologist, Fortis Hospital, New Delhi
| | - S K Wangnoo
- Consultant Endocrinologist, Indraprastha Apollo Hospitals, New Delhi
| | - Jamshed Dalal
- Consultant Cardiologist, Kolilaben Ambani Hospital, Mumbai, Maharashtra
| | - D Prabhakar
- Sr. Consultant, Department of Cardiology, Apollo Hospitals, Chennai, Tamil Nadu
| | - Rajeev Agarwal
- Sr. Consultant Cardiologist, Jaswant Rai Speciality Hospital, Meerut, Uttar Pradesh
| | - Manish Bansal
- Associate Director, Department of Cardiology, Medanta Hospital, Gurugram, Haryana
| | - Jamal Yusuf
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - Saibal Mukhopadhyay
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - Sadanand Shetty
- Head of Department of Cardiology, K.J. Somaiya Super-speciality Institute, Mumbai, Maharashtra
| | | | | | - Akshayaya Pradhan
- Sr. Consultant, Department of Cardiology King George's Medical University, Lucknow, Uttar Pradesh
| | - Rahul Mehrotra
- Director and Head Non-Invasive Cardiology, Max Super speciality Hospital, Saket, New Delhi
| | | | - Sonika Puri
- Assistant Professor, Dept. of Nephrology/ Transplant, Rutgers Robert wood Johnson University, USA
| | - A Muruganathan
- Sr. Consultant Internal Medicine, AG Hospital, Tirupur, Tamil Nadu
| | - Abdul Hamid Zargar
- Medical Director, Center for Diabetes and Endocrine Care, National Highway, Gulshan Nagar, Srinagar, Jammu and Kashmir
| | | | - Soumitra Kumar
- Prof. and Head, Department of Cardiology, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal
| | - Neil Bardoloi
- Managing Director and HOD, Cardiology, Excel Care Hospital, Guwahati, Assam
| | - K K Pareek
- Head of Department of Medicine, SN Pareek Hospital, Kota, Rajasthan
| | - Aditya Kapoor
- Professor of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh
| | - Ashu Rastogi
- Assistant Professor, Department of Endocrinology and Metabolism, PGIMER Chandigarh, Punjab
| | - Devaki R Nair
- Sr. Consultant Department of Lipidology and Chemical pathologist, Royal Free Hospital, London, UK
| | - Altamash Shaikh
- Sr. Consultant, Endocrinology, Diabetology and Metabolic Physician, Mumbai, Maharashtra
| | | | | | - Dheeraj Kapoor
- Head of Department of Endocrinology, Artemis Hospital, Gurgaon, Haryana
| | - Madhur Yadav
- Director Professor of Medicine, Lady Harding Medical College, New Delhi
| | - M R Mubarak
- Consultant Cardiologist, Lanka Hospital, Colombo, Sri Lanka
| | - A K Pancholia
- Head of Department of Medicine, Clinical and Preventive Cardiology, Arihant Hospital and Research Center, Indore, Madhya Pradesh
| | - Rakesh Kumar Sahay
- Professor and Head of Department of Endocrinology, Osmania Medical College, Hyderabad
| | - Rashmi Nanda
- Consultant, Cardiac Care Centre, South Extension, New Delhi
| | - Nathan D Wong
- Professor and Director, Heart Disease Prevention Program, Division of Cardiology, University of California Irvine, USA
| |
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13
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Puri R, Mehta V, Iyengar SS, Narasingan SN, Duell PB, Sattur GB, Vijayaraghavan K, Mohan JC, Wangnoo SK, Dalal J, Prabhakar D, Agarwal R, Bansal M, Yusuf J, Mukhopadhyay S, Shetty S, Manoria PC, Sabharwal A, Pradhan A, Mehrotra R, Mishra S, Puri S, Muruganathan A, Zargar AH, Patanwala RM, Kumar S, Bardoloi N, Pareek KK, Kapoor A, Rastogi A, Nair DR, Shaikh A, Adhikari CM, Majumder MSM, Kapoor D, Yadav M, Mubarak MR, Pancholia AK, Sahay RK, Nanda R, Wong ND. Non-HDL Cholesterol and Atherosclerotic Cardiovascular Disease. J Assoc Physicians India 2020; 68:54-58. [PMID: 33350617 DOI: pmid/33350617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Raman Puri
- Chairman, Expert Consensus Panel; Sr. Consultant Cardiologist, Indraprastha Apollo Hospitals, New Delhi
| | - Vimal Mehta
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - S S Iyengar
- Co-Chair, Expert Consensus Panel; Sr. Consultant and Head, Department of Cardiology, Manipal Hospital, Bangalore, Karnataka
| | - S N Narasingan
- Co-Chair, Expert Consensus Panel; Former Adjunct Professor of medicine, The Tamil Nadu Dr MGR Medical University and Managing Director, SNN Specialities Clinic, Chennai, Tamil Nadu
| | - P Barton Duell
- Professor of Medicine, Knight Cardiovascular Institute and Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health and Science University, Portland, OR, USA
| | - G B Sattur
- Sr. Consultant Physician and Diabetologist, Sattur Medical Care, Hubli, Karnataka
| | - Krishnaswami Vijayaraghavan
- Clinical Professor of Medicine, University of Arizona and Adjunct Professor of Medicine, Midwestern University, Glendale, Arizona, USA
| | - J C Mohan
- Consultant Cardiologist, Fortis Hospital, New Delhi
| | - S K Wangnoo
- Consultant Endocrinologist, Indraprastha Apollo Hospitals, New Delhi
| | - Jamshed Dalal
- Consultant Cardiologist, Kolilaben Ambani Hospital, Mumbai, Maharashtra
| | - D Prabhakar
- Sr. Consultant, Department of Cardiology, Apollo Hospitals, Chennai, Tamil Nadu
| | - Rajeev Agarwal
- Sr. Consultant Cardiologist, Jaswant Rai Speciality Hospital, Meerut, Uttar Pradesh
| | - Manish Bansal
- Associate Director, Department of Cardiology, Medanta Hospital, Gurugram, Haryana
| | - Jamal Yusuf
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - Saibal Mukhopadhyay
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - Sadanand Shetty
- Head of Department of Cardiology, K.J. Somaiya Super-speciality Institute, Mumbai, Maharashtra
| | | | | | - Akshayaya Pradhan
- Sr. Consultant, Department of Cardiology King George's Medical University, Lucknow, Uttar Pradesh
| | - Rahul Mehrotra
- Director and Head Non-Invasive Cardiology, Max Super speciality Hospital, Saket, New Delhi
| | | | - Sonika Puri
- Assistant Professor, Dept. of Nephrology/ Transplant, Rutgers Robert wood Johnson University, USA
| | - A Muruganathan
- Sr. Consultant Internal Medicine, AG Hospital, Tirupur, Tamil Nadu
| | - Abdul Hamid Zargar
- Medical Director, Center for Diabetes and Endocrine Care, National Highway, Gulshan Nagar, Srinagar, Jammu and Kashmir
| | | | - Soumitra Kumar
- Prof. and Head, Department of Cardiology, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal
| | - Neil Bardoloi
- Managing Director and HOD, Cardiology, Excel Care Hospital, Guwahati, Assam
| | - K K Pareek
- Head of Department of Medicine, SN Pareek Hospital, Kota, Rajasthan
| | - Aditya Kapoor
- Professor of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh
| | - Ashu Rastogi
- Assistant Professor, Department of Endocrinology and Metabolism, PGIMER Chandigarh, Punjab
| | - Devaki R Nair
- Sr. Consultant Department of Lipidology and Chemical pathologist, Royal Free Hospital, London, UK
| | - Altamash Shaikh
- Sr. Consultant, Endocrinology, Diabetology and Metabolic Physician, Mumbai, Maharashtra
| | | | | | - Dheeraj Kapoor
- Head of Department of Endocrinology, Artemis Hospital, Gurgaon, Haryana
| | - Madhur Yadav
- Director Professor of Medicine, Lady Harding Medical College, New Delhi
| | - M R Mubarak
- Consultant Cardiologist, Lanka Hospital, Colombo, Sri Lanka
| | - A K Pancholia
- Head of Department of Medicine, Clinical and Preventive Cardiology, Arihant Hospital and Research Center, Indore, Madhya Pradesh
| | - Rakesh Kumar Sahay
- Professor and Head of Department of Endocrinology, Osmania Medical College, Hyderabad
| | - Rashmi Nanda
- Consultant, Cardiac Care Centre, South Extension, New Delhi
| | - Nathan D Wong
- Professor and Director, Heart Disease Prevention Program, Division of Cardiology, University of California Irvine, USA
| |
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14
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Puri R, Mehta V, Iyengar SS, Narasingan SN, Duell PB, Sattur GB, Vijayaraghavan K, Mohan JC, Wangnoo SK, Dalal J, Prabhakar D, Agarwal R, Bansal M, Yusuf J, Mukhopadhyay S, Shetty S, Manoria PC, Sabharwal A, Pradhan A, Mehrotra R, Mishra S, Puri S, Muruganathan A, Zargar AH, Patanwala RM, Kumar S, Bardoloi N, Pareek KK, Kapoor A, Rastogi A, Nair DR, Shaikh A, Adhikari CM, Majumder MSM, Kapoor D, Yadav M, Mubarak MR, Pancholia AK, Sahay RK, Nanda R, Wong ND. Lipid Association of India Expert Consensus Statement on Management of Dyslipidemia in Indians 2020: Part III. J Assoc Physicians India 2020; 68:8-9. [PMID: 33350610 DOI: pmid/33350610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Raman Puri
- Chairman, Expert Consensus Panel; Sr. Consultant Cardiologist, Indraprastha Apollo Hospitals, New Delhi
| | - Vimal Mehta
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - S S Iyengar
- Co-Chair, Expert Consensus Panel; Sr. Consultant and Head, Department of Cardiology, Manipal Hospital, Bangalore, Karnataka
| | - S N Narasingan
- Co-Chair, Expert Consensus Panel; Former Adjunct Professor of medicine, The Tamil Nadu Dr MGR Medical University and Managing Director, SNN Specialities Clinic, Chennai, Tamil Nadu
| | - P Barton Duell
- Professor of Medicine, Knight Cardiovascular Institute and Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health and Science University, Portland, OR, USA
| | - G B Sattur
- Sr. Consultant Physician and Diabetologist, Sattur Medical Care, Hubli, Karnataka
| | - Krishnaswami Vijayaraghavan
- Clinical Professor of Medicine, University of Arizona and Adjunct Professor of Medicine, Midwestern University, Glendale, Arizona, USA
| | - J C Mohan
- Consultant Cardiologist, Fortis Hospital, New Delhi
| | - S K Wangnoo
- Consultant Endocrinologist, Indraprastha Apollo Hospitals, New Delhi
| | - Jamshed Dalal
- Consultant Cardiologist, Kolilaben Ambani Hospital, Mumbai, Maharashtra
| | - D Prabhakar
- Sr. Consultant, Department of Cardiology, Apollo Hospitals, Chennai, Tamil Nadu
| | - Rajeev Agarwal
- Sr. Consultant Cardiologist, Jaswant Rai Speciality Hospital, Meerut, Uttar Pradesh
| | - Manish Bansal
- Associate Director, Department of Cardiology, Medanta Hospital, Gurugram, Haryana
| | - Jamal Yusuf
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - Saibal Mukhopadhyay
- Co-Chair, Expert Consensus Panel; Professor Department of Cardiology, GB Pant Hospital, New Delhi
| | - Sadanand Shetty
- Head of Department of Cardiology, K.J. Somaiya Super-speciality Institute, Mumbai, Maharashtra
| | | | | | - Akshayaya Pradhan
- Sr. Consultant, Department of Cardiology King George's Medical University, Lucknow, Uttar Pradesh
| | - Rahul Mehrotra
- Director and Head Non-Invasive Cardiology, Max Super speciality Hospital, Saket, New Delhi
| | | | - Sonika Puri
- Assistant Professor, Dept. of Nephrology/ Transplant, Rutgers Robert wood Johnson University, USA
| | - A Muruganathan
- Sr. Consultant Internal Medicine, AG Hospital, Tirupur, Tamil Nadu
| | - Abdul Hamid Zargar
- Medical Director, Center for Diabetes and Endocrine Care, National Highway, Gulshan Nagar, Srinagar, Jammu and Kashmir
| | | | - Soumitra Kumar
- Prof. and Head, Department of Cardiology, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal
| | - Neil Bardoloi
- Managing Director and HOD, Cardiology, Excel Care Hospital, Guwahati, Assam
| | - K K Pareek
- Head of Department of Medicine, SN Pareek Hospital, Kota, Rajasthan
| | - Aditya Kapoor
- Professor of Cardiology, Sanjay Gandhi PGIMS, Lucknow, Uttar Pradesh
| | - Ashu Rastogi
- Assistant Professor, Department of Endocrinology and Metabolism, PGIMER Chandigarh, Punjab
| | - Devaki R Nair
- Sr. Consultant Department of Lipidology and Chemical pathologist, Royal Free Hospital, London, UK
| | - Altamash Shaikh
- Sr. Consultant, Endocrinology, Diabetology and Metabolic Physician, Mumbai, Maharashtra
| | | | | | - Dheeraj Kapoor
- Head of Department of Endocrinology, Artemis Hospital, Gurgaon, Haryana
| | - Madhur Yadav
- Director Professor of Medicine, Lady Harding Medical College, New Delhi
| | - M R Mubarak
- Consultant Cardiologist, Lanka Hospital, Colombo, Sri Lanka
| | - A K Pancholia
- Head of Department of Medicine, Clinical and Preventive Cardiology, Arihant Hospital and Research Center, Indore, Madhya Pradesh
| | - Rakesh Kumar Sahay
- Professor and Head of Department of Endocrinology, Osmania Medical College, Hyderabad
| | - Rashmi Nanda
- Consultant, Cardiac Care Centre, South Extension, New Delhi
| | - Nathan D Wong
- Professor and Director, Heart Disease Prevention Program, Division of Cardiology, University of California Irvine, USA
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Kaul U, Das MK, Agarwal R, Bali H, Bingi R, Chandra S, Chopra VK, Dalal J, Jadhav U, Jariwala P, Jena A, Gupta R, Kerkar P, Guha S, Kumar D, Mashru M, Mehta A, Mohan JC, Nair T, Prabhakar D, Ray R, Rajani R, Sathe S, Sinha N, Vijayaraghavan G. Consensus and development of document for management of stabilized acute decompensated heart failure with reduced ejection fraction in India. Indian Heart J 2020; 72:477-481. [PMID: 33357634 PMCID: PMC7772598 DOI: 10.1016/j.ihj.2020.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/08/2020] [Accepted: 09/10/2020] [Indexed: 12/11/2022] Open
Abstract
Aim Ensuring adherence to guideline-directed medical therapy (GDMT) is an effective strategy to reduce mortality and readmission rates for heart failure (HF). Use of a checklist is one of the best tools to ensure GDMT. The aim was to develop a consensus document with a robust checklist for stabilized acute decompensated HF patients with reduced ejection fraction. While there are multiple checklists available, an India-specific checklist that is easy to fill and validated by regional and national subject matter experts (SMEs) is required. Methodology A total of 25 Cardiology SMEs who consented to participate from India discussed data from literature, current evidence, international guidelines and practical experiences in two national and four regional meetings. Results Recommendations included HF management, treatment optimization, and patient education. The checklist should be filled at four time points- (a) transition from intensive care unit to ward, (b) at discharge, (c) 1st follow-up and (d) subsequent follow-up. The checklist is the responsibility of the consultant or the treating physician which can be delegated to a junior resident or a trained HF nurse. Conclusion This checklist will ensure GDMT, simplify transition of care and can be used by all doctors across India. Institutions, associations, and societies should recommend this checklist for adaptability in public and private hospital. Hospital administrations should roll out policy for adoption of checklist by ensuring patient files have the checklist at the time of discharge and encourage practice of filling it diligently during follow-up visits.
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Affiliation(s)
- U Kaul
- Dept of Cardiology, Batra Hospital and Research Centre, 1, Mehrauli Badarpur Rd, Tughlakabad Institutional Area, New Delhi, India.
| | - M K Das
- Dept of Cardiology, CMRI Hospitals, 7/2 Diamond Harbour Road, Kolkata, West Bengal, India
| | - R Agarwal
- Dept of Cardiology, Jaswant Rai Speciality Hospital, Opp Sports Stadium, Civil Line Mawana Road Meerut, Uttar Pradesh, India
| | - H Bali
- Paras Hospital, Plot No. 2, HSIIDC Tech Park, Near NADA Sahib Gurudwara, Panchkula, Haryana, India
| | - R Bingi
- Vasavi Hospital, 15, 1st Stage, Opp. to 15E Bus Stop, 70th Cross Rd, Kumaraswamy Layout, Bengaluru, Karnataka, India
| | - S Chandra
- Dept of Cardiology, Virinchi Hospital, Virinchi Circle, Rd Number 1, Shyam Rao Nagar, Banjara Hills, Hyderabad, Telangana, India
| | - V K Chopra
- Max Superspeciality Hospital, 1, 2, Press Enclave Marg, Saket Institutional Area, Saket, New Delhi, India
| | - J Dalal
- Dept of Cardiology, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Rao Saheb, Achutrao Patwardhan Marg, Four Bungalows, Andheri West, Mumbai, Maharashtra, India
| | - U Jadhav
- MGM Hospital, Plot No.35, Atmashanti Society, Sector 3, Vashi, Navi Mumbai, Maharashtra, India
| | - P Jariwala
- Yashoda Hospital, Raj Bhavan Rd, Matha Nagar, Somajiguda, Hyderabad, Telangana, India
| | - A Jena
- Kalinga Institute of Medical Sciences, Kushabhadra Campus, KIIT Campus, 5, KIIT Road, Patia, Bhubaneswar, Odisha, India
| | - R Gupta
- Preventive Cardiology, RUHS Hospital, Kumbha Marg, Sector 11 Rd, Pratap Nagar, Jaipur, Rajasthan, India
| | - P Kerkar
- KEM Hospital, Acharya Donde Marg, Parel, Mumbai, Maharashtra, India; Asian Heart Institute, Bandra Kurla Complex, G/N, Bandra (E), Mumbai, Maharashtra, India
| | - S Guha
- Dept of Cardiology, Calcutta Medical College, 88, College St, Calcutta Medical College, College Square, Kolkata, West Bengal, India
| | - D Kumar
- MEDICA Superspeciality Hospital, 127, Eastern Metropolitan Bypass, Nitai Nagar, Mukundapur, Kolkata, West Bengal, India
| | - M Mashru
- Dept of Cardiology, Sir H N Reliance Foundation Hospital and Research Centre, Prarthana Samaj, Raja Rammohan Roy Rd, Charni Road East, Khetwadi, Girgaon, Mumbai, Maharashtra, India
| | - A Mehta
- Sir Ganga Ram Hospital and Research Centre, Sarhadi Gandhi Marg, Old Rajinder Nagar, Rajinder Nagar, New Delhi, Delhi, India
| | - J C Mohan
- Dept of Cardiology, Jaipur Golden Hospital, 2, Naharpur Village Rd, Institutional Area, Sector 3, Rohini, Delhi, India
| | - T Nair
- Dept of Cardiology, PRS Hospital, NH 47, Killipalam, Thiruvananthapuram, Kerala, India
| | - D Prabhakar
- Apollo First Med Hospital, Poonamallee High Rd, New Bupathy Nagar, Kilpauk, Chennai, Tamil Nadu, India
| | - R Ray
- AMRI Hospital, Block-A, Scheme-L11 P-4&5, Gariahat Rd, Dhakuria, Kolkata, West Bengal, India
| | - R Rajani
- P D Hinduja Hospital & Medical Research Centre, SVS Rd, Mahim West, Shivaji Park, Mumbai, Maharashtra, India
| | - S Sathe
- Deenanath Mangeshkar Hospital and Research Centre, Deenanath Mangeshkar Hospital Road, Near Mhatre Bridge, Erandwane, Pune, Maharashtra, India
| | - N Sinha
- Sahara India Medical Institute, Sahara India Medical Institute, Sahara Hospital Rd, Viraj Khand - 1, Viraj Khand, Gomti Nagar, Lucknow, Uttar Pradesh, India
| | - G Vijayaraghavan
- Kerala Institute of Medical Sciences, 1, Vinod Nagar Rd, Anayara, Thiruvananthapuram, Kerala, India
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Mishra S, Mohan JC, Nair T, Chopra VK, Harikrishnan S, Guha S, Ramakrishnan S, Ray S, Sethi R, Samal UC, Sarat Chandra K, Hiremath MS, Banerjee AK, Kumar S, Das MK, Deb PK, Bahl VK. Management protocols for chronic heart failure in India. Indian Heart J 2018; 70:105-127. [PMID: 29455764 PMCID: PMC5903070 DOI: 10.1016/j.ihj.2017.11.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Heart failure is a common clinical syndrome and a global health priority. The burden of heart failure is increasing at an alarming rate worldwide as well as in India. Heart failure not only increases the risk of mortality, morbidity and worsens the patient's quality of life, but also puts a huge burden on the overall healthcare system. The management of heart failure has evolved over the years with the advent of new drugs and devices. This document has been developed with an objective to provide standard management guidance and simple heart failure algorithms to aid Indian clinicians in their daily practice. It would also inform the clinicians on the latest evidence in heart failure and provide guidance to recognize and diagnose chronic heart failure early and optimize management.
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Affiliation(s)
- S Mishra
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - J C Mohan
- Department of Cardiology, Fortis Hospital, Shalimar Bagh, New Delhi, 110088, India
| | - Tiny Nair
- Department of Cardiology, PRS Hospital, Thiruvananthapuram, 695002, India
| | - V K Chopra
- Department of Clinical and Preventive Cardiology, Medanta - The Medicity, Gurugram, Haryana, 122001, India
| | - S Harikrishnan
- Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, 695011, India
| | - S Guha
- Department of Cardiology, Medical College, Kolkata, 700073, India
| | - S Ramakrishnan
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - S Ray
- Department of Cardiology, Vivekananda Institute of Medical Sciences, Kolkata, 70026, India
| | - R Sethi
- Department of Cardiology, King George's Medical University, Ludhiana, Uttar Pradesh, 226003, India
| | - U C Samal
- Heart Failure Subspecialty, Cardiological Society of India, Kolkata, India
| | - K Sarat Chandra
- Department of Cardiology, Institute of Post Graduate Medical Education & Research and Memorial Hospital, Kolkata, 700020, India
| | - M S Hiremath
- Department of Cardiology, Ruby Hall Clinic, Pune, 411001, India
| | - A K Banerjee
- Department of Cardiology, Institute of Post Graduate Medical Education & Research and Memorial Hospital, Kolkata, 700020, India
| | - S Kumar
- Cardiological Society of India, Kolkata, India
| | - M K Das
- Cardiological Society of India, Kolkata, India
| | - P K Deb
- Cardiological Society of India, Kolkata, India
| | - V K Bahl
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, 110029, India
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Dalal J, Mohan JC, Dasbiswas A, Kerkar P, Trivedi S, Thomas J. Cholesterol Management in Indians: Should We Treat the Targets or Treat the Risk? J Clin Diagn Res 2018. [DOI: 10.7860/jcdr/2018/32578.11249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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18
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Iyengar SS, Puri R, Narasingan SN, Wangnoo SK, Mohan V, Mohan JC, Misra A, Sriram U, Dalal JJ, Gupta R, Prabhakar D, Kerkar P, Zargar AH, Kasliwal RR, Mehrotra R, Kumar S, Chakraborty R, Chadha M, Daga MK, Seshadri K, Paul J, Kavalipati N, Kapoor D, Narain VS, Rastogi A, Muruganathan A, Gupta A, Murthy S, Bordoloi N, Sahoo PK, Agarwal RK, Chag M, Rajput R, Melinkeri RP. Lipid Association of India Expert Consensus Statement on Management of Dyslipidemia in Indians 2016: Part 1. J Assoc Physicians India 2016; 64:7-52. [PMID: 28762263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- S S Iyengar
- Chair, Sr. Consultant and Head, Department of Cardiology, Manipal Hospital, Bangalore, Karnataka
| | - Raman Puri
- Co-chair, Sr. Consultant Cardiology, Indraprastha Apollo Hospitals, New Delhi
| | - S N Narasingan
- Co-chair, Former Adjunct Professor of Medicine, The Tamil Nadu Dr MGR Medical University and Managing Director, SNN Specialties Clinic, Chennai, Tamil Nadu
| | - S K Wangnoo
- Prof. of Endocrinology, Department of Endocrinology, Indraprastha Apollo Hospitals, New Delhi
| | - V Mohan
- Chairman and Chief Diabetologist, Department of Diabetology, Madras Diabetes Research Foundation, Chennai, Tamil Nadu
| | - J C Mohan
- Sr. Consultant Cardiology, Fortis Hospital, Shalimar Bagh, New Delhi
| | - Anoop Misra
- Director, Department of Diabetes and Metabolic Diseases, Fortis Hospital, New Delhi
| | | | - Jamshed J Dalal
- Sr. Consultant Cardiology, Kokilaben Dhirubhai Ambani Hospital; Director, Centre for Cardiac Sciences, Mumbai, Maharashtra
| | - Rajeev Gupta
- Sr. Consultant, Department of Preventive Cardiology and Internal Medicine, Eternal Heart Care Center and Research Institute, Jaipur, Rajasthan
| | - D Prabhakar
- Sr. Consultant Cardiology, Apollo First Med and Apollo Hospitals, Chennai, Tamil Nadu
| | - Prafulla Kerkar
- Sr. Consultant Cardiology, Asian Heart Institute and Research Centre, Mumbai, Maharashtra
| | - Abdul Hamid Zargar
- Former Director and Ex. Officer Secretary to Govt., Shere-Kashmir Institute of Medical Sciences, Srinagar, Jammu Kashmir
| | - Ravi R Kasliwal
- Chairman, Clinical and Preventive Cardiology, Medanta the Medicity, Gurgaon, Haryana
| | - Rahul Mehrotra
- Sr. Consultant Cardiology, Medanta the Medicity, Gurgaon, Haryana
| | - Soumitra Kumar
- Prof. and Head, Department of Cardiology, Vivekanand Institute of Medical Sciences, Kolkata, West Bengal
| | - Rabin Chakraborty
- Sr. Consultant Cardiology, Apollo Glenagle Hospital, Kolkata, West Bengal
| | - Manoj Chadha
- Sr. Consultant Endocrinology, PD Hinduja Hospital and Medical Research Centre, Mumbai, Maharashtra
| | - Mradul Kumar Daga
- Director Professor, Department of Medicine, Maulana Azad Medical College and Attached Hospitals, New Delhi
| | - Krishna Seshadri
- Prof of Endocrinology and Metabolism, Shri Rama Chandra University, Chennai, Tamil Nadu
| | - Justin Paul
- Prof and Unit Head, Department of Cardiology, Madras Medical College, Chennai, Tamil Nadu
| | | | - Dheeraj Kapoor
- Sr. Consultant Endocrinologist, Artemis Hospital, Gurgaon, Haryana
| | - V S Narain
- Prof and Head, Department of Cardiology, King George Medical University, Lucknow, Uttar Pradesh
| | - Ashu Rastogi
- Assistant Prof, Department of Endocrinology, PGIMER, Chandigarh
| | - A Muruganathan
- Sr. Consultant Physician and Managing Director, AG Hospital, Thirupur, Tamil Nadu
| | - Ajay Gupta
- Sr. Consultant Endocrinology, CHL Group of Hospitals, Indore, Madhya Pradesh
| | - S Murthy
- Sr. Consultant Endocrinology, Chennai, Tamil Nadu
| | - Neil Bordoloi
- Head, Department of Cardiology, International Hospital and Excel Hospital, Guwahati, Assam
| | - Prasant Kumar Sahoo
- Sr. Consultant Cardiology and Director Interventional cardiology, Apollo Hospitals Bhubaneswar, Odisha
| | | | - Milan Chag
- Sr. Interventional Cardiologist and Managing Director, Care Institute of Medical Sciences, Ahmedabad, Gujarat
| | - Rajesh Rajput
- Sr. Prof. and Head, Department of Endocrinology, Pt. BDSPGIMS, Rohtak, Haryana
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19
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Mohan JC, Jain R, Chamle V, Bhargava A. Short Term Safety and Tolerability of a Fixed Dose Combination of Olmesartan, Amlodipine and Hydrochlorothiazide. J Clin Diagn Res 2015; 9:OC10-3. [PMID: 26435982 DOI: 10.7860/jcdr/2015/14054.6366] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 07/14/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To assess the short term safety and tolerability of a fixed dose combination (FDC) of olmesartan, amlodipine and hydrochlorothiazide (OAH) in real-world clinical setting in India. MATERIALS AND METHODS Physicians were requested to provide eight weeks observational clinical event data of the patients prescribed with FDC of Olmesartan (20/40mg), Amlodipine (5mg) and hydrochlorothiazide (12.5mg) in the prescription event monitoring (PEM) forms. Data on patients' demographics, indication for FDC, concomitant medication and other relevant history was also collected and was analysed with descriptive statistics. RESULTS Two hundred thirty eight physicians provided data of 4763 patients. Mean age of the population was 55±7 years and males were 59.3%. The commonest indication for the FDC was uncontrolled hypertension (60.7%). Diabetes and dyslipidemia were present in 37.9% and 35.1% respectively. Concomitant medications included statins (42.3%), oral anti-diabetic (33.7%) and antiplatelet agents (24.7%). Pedal oedema (0.29%) was the most common adverse event (AE) reported followed by headache (0.16%), giddiness (0.15%), light headedness (0.15) and stroke (0.15%). Other less common (0.04%) reported AEs were tiredness, dizziness, gastritis, hypersomnia, hypoglycaemia, lower respiratory tract infection (LRTI), weakness, diarrhea, labyrinthitis, urinary tract infection, hyponatremia and hypotension. Occurrence of AEs was more common in patients with uncontrolled hypertension (60.74%). CONCLUSION The FDC of olmesartan, amlodipine and hydrochlorothiazide prescribed most frequently for patients with uncontrolled hypertension and co-morbidities was found to be safe and well tolerated over a short period of observation.
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Affiliation(s)
- J C Mohan
- Director, Department of Cardiology, Fortis Hospital , New Delhi, India
| | - Rishi Jain
- Deputy General Manager, Department of Medical Services, Glenmark Pharmaceuticals , Mumbai, India
| | - Vijay Chamle
- Assistant Manager, Department of Medical Services, Glenmark Pharmaceuticals , Mumbai, India
| | - Amit Bhargava
- Head, Department of Medical Services, Glenmark Pharmaceuticals , Mumbai, India
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20
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Abstract
Despite recent advances, the diagnosis and management of heart failure evades the clinicians. The etiology of congestive heart failure (CHF) in the Indian scenario comprises of coronary artery disease, diabetes mellitus and hypertension. With better insights into the pathophysiology of CHF, biomarkers have evolved rapidly and received diagnostic and prognostic value. In CHF biomarkers prove as measures of the extent of pathophysiological derangement; examples include biomarkers of myocyte necrosis, myocardial remodeling, neurohormonal activation, etc. In CHF biomarkers act as indicators for the presence, degree of severity and prognosis of the disease, they may be employed in combination with the present conventional clinical assessments. These make the biomarkers feasible options against the present expensive measurements and may provide clinical benefits.
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Affiliation(s)
- I Satyamurthy
- Director, Cardiology, Department of Cardiology at Apollo Hospitals, Chennai, India.
| | - Jamshed J Dalal
- Director, Centre for Cardiac Sciences, Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
| | - J P S Sawhney
- Chairman, Department of Cardiology and Member, Board of Management at Sir Gangaram Hospital, New Delhi, India
| | - J C Mohan
- Prof., Chief of Cardiology, Jaipur Golden Hospital, New Delhi, India
| | | | - Nagaraj Desai
- Professor and Advisor of Cardiology, SS Medical College and Hospital, Mysore, India
| | - Shireesh P Sathe
- Consultant Cardiologist, Director - Cardiology, Deenanath Mangeshkar Hospital, Pune, India
| | - Alan S Maisel
- Director, Coronary Care Unit and Heart Failure Program, VA San Diego, USA
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21
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Sathyamurthy I, Dalal JJ, Sawhney JPS, Mohan JC, Chogle SA, Desai N, Sathe SP, Maisel AS. Cardiac Biomarkers for Better Management of Acute Coronary Syndromes. J Assoc Physicians India 2015; 63:46-50. [PMID: 26710400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Acute myocardial infarction (AMI) causes significant mortality and morbidity. Timely diagnosis allows clinicians to risk stratify their patients and select appropriate treatment. Biomarkers have been used to diagnose or rule out AMI. An increasing number of novel biomarkers have been identified to predict the outcome following AMI or acute coronary syndrome (ACS). This may facilitate tailoring of appropriate therapy to high-risk patients. This review focuses on a variety of promising biomarkers which provide diagnostic and prognostic information.
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Mohan JC, Shekhar C, Mohan V, Kaur B, Singh SK. Intramyocardial hematoma following primary percutaneous intervention in acute myocardial infarction: realtime 3D echocardiographic imaging. Indian Heart J 2011; 63:277-278. [PMID: 22734351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Affiliation(s)
- J C Mohan
- Department of Cardiology, Ridge Heart Centre, Sunder Lal Jain Hospital, New Delhi, India.
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Sengupta S, Alsi V, Mohan V, Kaur B, Mohan JC. Unique phenotypes of typical and inverted Takotsubo cardiomyopathy in young females. Indian Heart J 2010; 62:348-350. [PMID: 21280479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Takotsubo cardiomyopathy is an acute cardiac syndrome characterized by transient left ventricular regional wall motion abnormalities (with peculiar apical ballooning appearance), chest pain or dyspnea, electrocardiographic changes and minor elevations of cardiac enzyme level in the absence of coronary artery disease. We present 3 cases of a transient cardiomyopathy, noted in young women with associated emotional, physical or pharmacologic triggering events, that are distinct in that they all manifested initially with acute pulmonary edema with systolic akinesis involving different LV segments with rapid recovery. It is a reversible cardiac condition that should be differentiated from ischemic and peripartum cardiomyopathy.
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Mohan JC, Tomar D, Shekhar C, Aggarwal M. Prominent isovolumic relaxation velocities in mitral and tricuspid inflows in cardiac tamponade: normalisation after pericardiocentasis. Indian Heart J 2007; 59:366-369. [PMID: 19126946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Affiliation(s)
- J C Mohan
- Department of Cardiology, Metro Heart Institute, New Delhi.
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Kaul U, Iyengar SS, Kerkar PG, Mohan JC, Kumar S. Consensus development guidelines for the role of LMWHs in the management of unstable coronary artery disease: an Indian perspective. J Assoc Physicians India 2006; 54 Suppl:6-26. [PMID: 17357442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Affiliation(s)
- U Kaul
- Department of Cardiology, Fortis Hospital, Noida
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26
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Mohan JC, Nath LR. M-shaped doppler signal across ventricular septal defect: potential implications for estimation of right ventricuilar systolic pressure. Indian Heart J 2005; 57:158-60. [PMID: 16013356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
An 8-year-old child suffering from ventricular septal defect and severe valvular pulmonary stenosis was evaluated by echo-Doppler technique and cardiac catheterization. A peak instantaneous transventricular systolic gradient of 64 mmHg was recorded across the ventricular septal defect with an interesting M-shaped spectral pattern. However, cardiac catheterization revealed a peak-to-peak non-simultaneous gradient between the right and the left ventricle of only 14 mmHg. This discrepancy along with its implications are discussed in this report.
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Affiliation(s)
- J C Mohan
- Department of Interventional Cardiology, Metro Golden Heart Institute, New Delhi.
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Sengupta PP, Mohan JC, Arora R. Noncompaction of left ventricular myocardium in the presence of calcific aortic stenosis in an adult. Indian Heart J 2001; 53:766-8. [PMID: 11838932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
We describe an adult patient with a hitherto unreported association of severe aortic stenosis with extensive noncompaction of the left ventricular myocardium without any hypertrophy; however, there was severe left ventricular systolic dysfunction in the presence of a normal-sized left ventricular cavity on two-dimensional echocardiography. This condition was differentiated from persistence of embryonic intramyocardial sinusoids by selective coronary angiography.
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Affiliation(s)
- P P Sengupta
- Department of Cardiology, GB Pant Hospital, New Delhi.
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Mohan JC, Sengupta PP, Arora R. Congenitally unguarded tricuspid valve orifice with a giant right atrium and a massive clot in an asymptomatic adult. Indian Heart J 2001; 53:503-4. [PMID: 11759945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Congenitally unguarded tricuspid valve orifice, a variant of tricuspid valve dysplasia, is a rare malformation with protean manifestations. This report describes an asymptomatic adult who, on echocardiographic examination ordered in view of an abnormal 12-lead surface electrocardiogram and plain chest X-ray, was found to have an unguarded tricuspid valve orifice with a giant right atrium (12 x 10 cm), intense spontaneous echo contrast and a large right atrial clot.
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Affiliation(s)
- J C Mohan
- Department of Cardiology, GB Pant Hospital, New Delhi.
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30
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Abstract
A series of nine consecutive patients with unguarded tricuspid valve orifice as a result of partial or complete agenesis of the valvar tissue and patent right ventricular outflow tract is reported. Clinical manifestations were cyanosis, severe right ventricular failure and incidental echocardiographic detection in a young patient with dilated cardiomyopathy. This series contains the oldest reported patient with this malady, who was misdiagnosed as portal hypertension for 10 years. This study, with possibly the largest number of patients reported so far, sheds some light on the natural history of a rare entity.
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Affiliation(s)
- J C Mohan
- Department of Cardiology, G.B. Pant Hospital, 110002, New Delhi,
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31
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Shah PP, Nair M, Dhall A, Verman KK, Midha KK, Mohan JC, Kaul UA, Arora R. False-positive exercise stress electrocardiogram due to accessory pathway in the absence of manifest preexcitation. Pacing Clin Electrophysiol 2000; 23:1051-3. [PMID: 10879395 DOI: 10.1111/j.1540-8159.2000.tb00897.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
False-positive exercise testing in patients with an accessory pathway has been described only in patients with manifest preexcitation during exercise. We describe a patient in whom marked ST-segment changes were seen during an exercise test in the absence of any preexcitation of the QRS complexes. The role of the accessory pathway in producing the ST changes was reaffirmed by absence of this abnormality following catheter ablation of the accessory pathway.
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Affiliation(s)
- P P Shah
- Department of Cardiology, G.B. Pant Hospital, Jawahar Lal Nehru Marg, New Delhi, India
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32
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Panwar S, Banerjee A, Mohan JC, Tomar AS. Aortic leaflet injury caused by left ventricular myxoma: a hitherto unreported association. Indian Heart J 2000; 52:328-30. [PMID: 10976156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Affiliation(s)
- S Panwar
- Department of Cardiothoracic Surgery, GB Pant Hospital, New Delhi
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33
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Kaul UA, Singh S, Kalra GS, Nair M, Mohan JC, Nigam M, Arora R. Mitral regurgitation following percutaneous transvenous mitral commissurotomy: a single-center experience. J Heart Valve Dis 2000; 9:262-6; discussion 266-8. [PMID: 10772045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
BACKGROUND AND AIM OF THE STUDY Percutaneous transvenous mitral commissurotomy (PTMC) has revolutionized the treatment of patients with symptomatic mitral stenosis and is now established as the procedure of choice. Despite high technical expertise in PTMC using the Inoue balloon, mitral regurgitation (MR) remains a major procedure-related complication. We retrospectively analyzed our data of PTMC using the Inoue balloon with regard to the incidence of MR, its likely causative mechanism, and follow up of these patients. METHODS During the past ten years, PTMC was performed in 3,650 patients (median age 26 years; range: 8-76 years), of whom 910 (24.9%) were juveniles. Preprocedure mitral valve area (MVA) was 0.9 +/- 0.4 cm2 (range: 0.3-1.3 cm2); MR was mild in 1,396 cases (38.2%), moderate in 394 (10.8%) and severe in 22 (0.6%). None of the patients was rejected on the basis of echocardiographic score. RESULTS The procedure was successful in 3,276 (89.8%), with post-procedure MVA of 1.7 +/- 0.6 cm2 (range: 1.4-2.6 cm2), and without development of any major complication. Severe MR was seen in 120 patients (3.3%), of whom 66 (1.8%) required urgent mitral valve replacement (MVR). Echocardiography in these latter patients showed leaflet rupture in 48 (72.7%), chordal rupture in 12 (18.2%) and excessive commissural tear in six (9.1%). Fifty-four patients (1.5%) with severe MR post PTMC were followed with medical treatment; echocardiography in these patients revealed chordal rupture in 40 (74.1%) and excessive commissural tear in 14 (25.9%). Follow up data were available in 49 patients (1.3%); 30 (0.8%) required MVR and 19 (0.5%) were in NYHA class II at a median follow up of 24 months. Moderate MR was seen in 188 cases (5.1%), with predominant causative mechanisms of excessive commissural tear in 120 (63.8%) and chordal rupture in 68 (36.2%). Severity of MR worsened in 30 cases (0.8%), of which 20 (0.6%) required elective MVR on follow up. MR decreased in 58 patients (1.6%), in whom excessive commissural tear was the causative mechanism. CONCLUSION Significant MR (moderate or severe) after PTMC was seen in 308 patients (8.4%), of whom 116 (3.2%) required MVR urgently or on follow up. All patients with leaflet rupture during PTMC developed severe MR and required urgent MVR. There was a tendency for the severity of MR to decrease with time in cases where excessive commissural tear was the causative mechanism.
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Affiliation(s)
- U A Kaul
- Department of Cardiology and Cardiothoracic Surgery, GB Pant Hospital, New Delhi, India
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34
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Sinha SC, Nair M, Gambhir DS, Mohan JC, Kaul UA, Arora R. Genetically transmitted ventricular pre-excitation in a family with hypertrophic cardiomyopathy. Indian Heart J 2000; 52:76-8. [PMID: 10820940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Affiliation(s)
- S C Sinha
- Department of Cardiology, GB Pant Hospital, New Delhi
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35
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Shah PP, Singh S, Trehan V, Dubey S, Mohan JC, Kaul UA, Arora R. Surgical repair of pulmonary artery aneurysm following infective endocarditis in a patient with persistent ductus arteriosus. Indian Heart J 1999; 51:537-40. [PMID: 10721646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Affiliation(s)
- P P Shah
- Department of Cardiology, GB Pant Hospital, New Delhi
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36
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Mohan JC, Sengupta PP, Arora R. Immediate and delayed effects of successful percutaneous transvenous mitral commissurotomy on global right ventricular function in patients with isolated mitral stenosis. Int J Cardiol 1999; 68:217-23. [PMID: 10189011 DOI: 10.1016/s0167-5273(98)00358-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Global right ventricular function of the pressure-overloaded right ventricle in patients with mitral stenosis and pulmonary hypertension after successful percutaneous transvenous mitral commissurotomy (PTMC) has not been well-defined. With the use of a recently developed Doppler method for estimating right ventricular function in human beings, we studied 25 consecutive patients with isolated rheumatic mitral stenosis before, immediately after (mean, 40+/-12 h) and at a mean follow-up of 11.5 months after PTMC. Immediately after percutaneous mitral commissurotomy, there was a significant increase in mitral valve area (P = 0.000017) along with a decrease in mean pulmonary pressure (P = 0.001). The index was not affected immediately after successful PTMC (0.70+/-0.25 vs., 0.58+/-0.18; P = 0.06); however, at follow-up of about one year, the index showed a significant decrease (0.697+/-0.28 vs. 0.380+/-0.13; P = 0.0008, n = 24). The change in the index was characterised by a significant prolongation of the right ventricular ejection time, with a decrease in the isovolumic intervals. The Doppler index of combined right ventricular function was significantly correlated to the mean pulmonary artery pressure (r = 0.695, P<0.001) and systolic pulmonary artery pressure (r = 0.60, P = 0.007) before PTMC and also immediately after the procedure; however, at follow-up, the index had no correlation with the Doppler estimated pulmonary artery systolic pressure (r = 0.07). Despite a larger mitral valve area following PTMC, right ventricular isovolumic indices remain abnormal on mid-term follow-up, although global function tends to normalise in two-thirds of the patients.
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Affiliation(s)
- J C Mohan
- Department of Cardiology, G.B. Pant Hospital, New Delhi, India.
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37
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Tempe DK, Mehta N, Mohan JC, Tandon MS, Nigam M. Early hemodynamic changes following emergency mitral valve replacement for traumatic mitral insufficiency following balloon mitral valvotomy: report of six cases. Anesthesiology 1998; 89:1583-5. [PMID: 9856740 DOI: 10.1097/00000542-199812000-00043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- D K Tempe
- Department of Anesthesiology, G.B. Pant Hospital, New Delhi, India.
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38
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Abstract
A 14-year old asymptomatic boy was diagnosed as having a large calcified subaortic left ventricular aneurysm that was found to obstruct flow across the right pulmonary artery during systole. Surgical patch closure of the neck of the aneurysm resulted in relief of obstruction. The case is reported for its rarity, massive calcification, absence of aortic regurgitation and dynamic compression of the right pulmonary artery.
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Affiliation(s)
- J C Mohan
- Department of Cardiology, G.B. Pant Hospital, New Delhi, India.
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39
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Mohan JC, Passey R, Arora R. Unguarded tricuspid orifice and patent right ventricular outflow tract presenting with long-standing severe right heart failure in an adult. Int J Cardiol 1998; 66:85-7. [PMID: 9781793 DOI: 10.1016/s0167-5273(98)00150-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J C Mohan
- Department of Cardiology, G.B. Pant Hospital, New Delhi, India.
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40
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Mohan JC, Mishra B, Nair M, Arora R. Post-traumatic multilobated pseudoaneurysm of the left ventricle secondary to dissecting intramyocardial haematoma of the posterior wall: obstructive and fenestrated communication demonstrated by colour Doppler imaging. Indian Heart J 1998; 50:539-41. [PMID: 10052281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Affiliation(s)
- J C Mohan
- Department of Cardiology, GB Pant Hospital, New Delhi
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41
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Rao BH, Nair M, Mohan JC, Patnaik A, Kamal A, Batra R, Kaul UA, Arora R. Radiofrequency catheter ablation of common atrial flutter--acute and follow-up results. Indian Heart J 1998; 50:523-6. [PMID: 10052277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Atrial flutter with a structurally well-defined macro-reentrant circuit in the right atrium has recently become amenable to radiofrequency ablation with the recognition of isthmus as a narrow zone of slow conduction. This study describes 20 consecutive and symptomatic patients with atrial flutter (15 males, 5 females; mean age 38.5 +/- 10.2 years) who underwent radiofrequency ablation in our institute in the last 18 months. Fourteen patients had structurally normal hearts, while the remaining six patients had specific disorders (prior surgery for closure of atrial septal defect-2, idiopathic restrictive cardiomyopathy-1, primary sinus node dysfunction-2, tachycardiomyopathy-1). The endpoints of a complete isthmus block and conversion to sinus rhythm were achieved in 19 of the 20 patients. Total number of pulses needed to attain the endpoints was a mean of 4.2 (range 1-5), each pulse being delivered for 90 seconds. At a mean follow up of 9.4 +/- 3.2 months (range 6-12 months), recurrence of atrial flutter was seen in one patient, atrial fibrillation in two and sinus node reentrant tachycardia in one. These results are comparable to those reported in the literature. Achievement of a complete isthmus block appears to be an important endpoint in obtaining optimal results. The issues of alternative sites of ablation, long-term results and advantages of an 8 mm tip catheter need to be examined further. In conclusion, radiofrequency ablation appears to be the preferred mode of treatment for patients with atrial flutter with excellent short-term and mid-term results.
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Affiliation(s)
- B H Rao
- Department of Cardiology, GB Pant Hospital, New Delhi
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42
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Tempe DK, Mehta N, Mohan JC, Tandon MS, Nigam M. Emergency mitral valve replacement for traumatic mitral insufficiency following balloon mitral valvotomy: an early haemodynamic study. Ann Card Anaesth 1998; 1:49-55. [PMID: 17846466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
Acute severe mitral insufficiency may occur during percutaneous transvenous balloon mitarl valvotomy. Urgent surgical intervention in the form of mitral valve repair or replacement may be necessary in these patients. The haemodynamic measurements at various stages in these patients were obtained and compared with those of patients undergoing elective mitral valve replacement for chronic mitral regurgitation. Between September 1995 and December 1947, urgent mitral valve replacement was performed in 14 patients out of a total of 1688 patients who underwent balloon mitral valvotomy. Haemodynamic measurements could be obtained in 7 of these patients and they constituted group I. Eight other patients undergoing elective mitral valve replacement during the same period for chronic mitral regurgitation constituted group II. Standard haemodynamic measurements were obtained at the following stages: (1) Baseline- 20-30 min after endotracheal intubation; (2) stage 1- 20-30 min after termination of the cardiopulmonary bypass: (3) stage 2- four hours after the patient was transferred to ICU and (4) stage 3-30 min after extubation. All the patients were suffering from severe pulmonary hypertension. However, the indices of pulmonary artery hypertension such as mean pulmonary artery pressure, pulmonary capillary wedge pressure, pulmonary vascular resistance as well as right ventricular systolic and end-diastolic pressures did not decrease after surgery in group I. In contrast, in group II, there was significant decrease in mean pulmonary artery pressure (p<0.05), pulmonary capillary wedge pressure (p<0.05), right ventricular systolic (p<0.001) and end-diastolic pressures (p<0.05) at stage 1. These changes persisted throughout the study period. Pulmonary vascular resistance showed a decreasing trend, but attained statistical significance at stage 1 only. Two patients died; one of intractable cardiac failure and another from septicaemia and multiple organ failure in group I, but there were no deaths in group II. Reactive pulmonary hypertension secondary to acute mitral regurgitation may not recover immediately following mitral valve replacement and may be responsible for poor outcome in these patients.
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Affiliation(s)
- D K Tempe
- Departments of Anaesthesiology, Cardiac Surgery and Cardiology, GB Pant Hospital, New Delhi, India
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43
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Abstract
This study shows that patients with mitral stenosis have depressed left ventricular ejection performance and spherical remodeling of the left ventricular cavity, which is more marked in those with atrial fibrillation. These changes have important clinical implications regarding treatment strategy in patients with mitral stenosis and chronic atrial fibrillation.
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Affiliation(s)
- J C Mohan
- Department of Cardiology, G.B. Pant Hospital, New Delhi-2, India
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44
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Gambhir DS, Sudha R, Singh S, Batra R, Sethi KK, Mohan JC, Nair M, Kaul UA, Arora R. Coronary artery stenting for isolated proximal left anterior descending stenosis: immediate and follow-up results. Indian Heart J 1997; 49:493-6. [PMID: 9505015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Between February 1995 to August 1997, 120 patients underwent elective stent implantation for isolated proximal left anterior descending coronary artery stenosis. Their age ranged from 31 to 72 years (mean: 50.8 +/- 10.2) and the majority (89%) were males. All patients had angina, documented myocardial ischemia or both and 70 percent or more luminal diameter stenosis in the proximal left anterior descending before the origin of any branch. Majority (62.5%) of the treated lesions were type A. Successful deployment of the stent at the target site was achieved in all patients without any major in-hospital complications, including myocardial infarction, emergency bypass graft surgery or death. Clinical follow-up, ranging from 6 to 31 months (mean: 18.5 +/- 8.1, median: 20), was available in 87 out of 92 (94.5%) eligible patients who had completed at least six months after the procedure. Freedom from angina, myocardial infarction, target lesion revascularization and death was observed in 90.8, 100, 95.4 and 97.7 percent of patients, respectively. By the Kaplan-Meier estimate, an event-free survival (absence of death, myocardial infarction, recurrence of angina or revascularization) was 95.4 percent at six months, 89.5 percent at 12 and 18 months and 82.7 percent at 24 to 31 months of follow-up. Only 10 (11.5%) patients developed any event and TLR was required in 4.6 percent of patients. In conclusion, elective stenting for isolated proximal left anterior descending stenosis can be achieved safely and successfully in all patients without any adverse in-hospital events. This modality of treatment also provides long-term benefits in terms of reduction in major cardiovascular events and need for subsequent revascularization.
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Affiliation(s)
- D S Gambhir
- Department of Cardiology, GB Pant Hospital, New Delhi
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45
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Das DK, Gupta AK, Chowdhury V, Satsangi DK, Tyagi S, Mohan JC, Khan VA, Malhotra V. Fine-needle aspiration diagnosis of carotid body tumor: report of a case and review of experience with cytologic features in four cases. Diagn Cytopathol 1997; 17:143-7. [PMID: 9258623 DOI: 10.1002/(sici)1097-0339(199708)17:2<143::aid-dc11>3.0.co;2-g] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 45-yr-old female presented with a left upper cervical swelling of 4 yr duration. The clinical suspicion of carotid body tumor (CBT) was confirmed by imaging findings, fine-needle aspiration (FNA) cytology, and histology of the resected tumor. Review of our experience with four cases including the present one during 10 yr (1984-1994) showed that the age of the patients ranged from 35 to 45 yr with a mean of 40.8 yr. All four cases were females and had left-sided upper cervical swelling. Clinically one case was diagnosed as cervical lymphadenopathy and there was clinical suspicion of CBT in two cases. Findings of digital subtraction angiogram in four cases and ultrasonography including Doppler ultrasound vascular imaging in three cases were consistent with CBT. The cytodiagnosis was CBT in three cases and inadequate (blood only) in one case. The analysis of detailed cytologic features in three cases revealed blood-rich aspirate with poor to moderate cellularity, indistinct cell outline, and acinar formation. Giant bare nuclei, spindle-shaped tumor cells, and cytoplasmic granulations were observed in two cases each. Histopathology of the resected tumors in two cases confirmed the cytodiagnosis of CBT. FNA cytology played a useful role in arriving at a tissue diagnosis of this rare neoplasm.
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Affiliation(s)
- D K Das
- Institute of Cytology and Preventive Oncology (ICMR), New Delhi, India
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46
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Nair M, Kamal A, Dhal A, Mohan JC, Kaul UA, Arora R. Radiofrequency ablation of an unusual variant of atrial flutter. Indian Heart J 1997; 49:195-7. [PMID: 9231558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- M Nair
- Department of Cardiology, GB Pant Hospital, New Delhi
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47
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Gajra A, Aggarwal SK, Mohan JC. Age and intrinsic left ventricular myocardial contractility. Indian Heart J 1997; 49:155-8. [PMID: 9231546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The purpose of this study was to compare the left ventricular (LV) intrinsic contractile function in normal elderly (age > or = 60 years, mean age 66 +/- 4 years) and young (age < or = 35 years, mean 27 +/- 9 years) healthy volunteers by stress-shortening and stress-length relationship using a co-variate analysis. Echocardiographically determined meridional and circumferential wall stress were plotted against LV fractional shortening, velocity of circumferential fibre shortening, end-systolic volume and diameter. LV ejection fraction, preload (denoted by end-diastolic volume) and afterload (expressed as circumferential wall stress) were similar in the two groups. Stress-shortening and stress-length relationships using the circumferential wall stress showed no difference in the two groups, although meridional wall stress was greater in the elderly population. Our results suggest that circumferential wall stress is a better method to detect intrinsic contractile abnormality in the elderly. Intrinsic LV ejection performance is within the normal range in the elderly healthy individuals.
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Affiliation(s)
- A Gajra
- Department of Cardiology and Internal Medicine, G.B. Pant Hospital, New Delhi
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48
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Mohan JC, Sudha R, Sethi KK. Congenital aneurysm of the muscular interventricular septum with patent ductus arteriosus. Indian Heart J 1997; 49:83-4. [PMID: 9130434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- J C Mohan
- Department of Cardiology, GB Pant Hospital, New Delhi
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49
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Mohan JC, Chawla R, Arora R. Methodological variation and agreement in assessing mitral valve orifice area by echo-Doppler methods in mitral stenosis. Indian Heart J 1996; 48:653-7. [PMID: 9062012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Two-dimensional echocardiographic planimetry of the directly observed mitral valve orifice, pressure-half-time methods, continuity equation and the Gorlin formula are commonly used to calculate the mitral valve area. However, there have been few comparisons of the four methods. In this study, the mitral valve orifice area was determined by the above four methods using echo-Doppler data in 49 consecutive patients in sinus rhythm (mean area 0.87 to 1.26 cm2). The valve area estimated by these methods correlated well (r = 0.7 to 0.97) with excellent agreement between the continuity equation and the Gorlin formula (mean difference 0.4 cm2, r = 0.97, SEE = 0.26) and between the planimetric area and the pressure-half-time method (mean difference = 0.06 cm2, r = 0.87, SEE = 0.23). However, the limits of agreement were wide and exceeded 1 cm2 in planimetry versus the Gorlin, planimetry versus the continuity equation and pressure-half-time method versus the Gorlin formula. The standard error of estimate varied from 0.23 to 0.51 cm2 for various comparisons. Use of an empirical constant of 51.6 instead of 37.7 in the Gorlin formula provided excellent correlation between the valve area determined by the continuity equation and the modified hydraulic formula (mean difference 0.07 cm2, r = 0.95, SEE = 0.08). Estimates of the valve orifice area by any of the equations tested should be seen as a guide rather than a precise measure of actual orifice area.
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Affiliation(s)
- J C Mohan
- Department of Cardiology, GB Pant Hospital, New Delhi
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50
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Abstract
Effective orifice area of 3 different designs of prosthetic valves implanted in the aortic position was determined by the continuity equation and the Gorlin formula using Doppler hemodynamic data. The orifice area by the two methods correlated well in the case of tilting disc prostheses (r = 0.75, P = 0.0001, n = 37, SEE = 0.17 cm2) but poorly in the case of bileaflet mechanical valves (r = 0.40, P = 0.17, n = 13) and ball-in-cage prostheses (r = 0.58, P = 0.06, n = 11). Estimation of prosthetic aortic valve area by the Gorlin formula is inappropriate in the latter two types of prostheses because of design-related variable empiric constant.
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Affiliation(s)
- J C Mohan
- Department of Cardiology, G.B. Pant Hospital, New Delhi, India
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