Preface to the first issue of Heart India 2025

In this “Heart India” issue, we publish one review article, 11 original research articles, and one case report. Hypertension is the primary risk factor for both cardiovascular disease and death. Kunwar and Prasad[1] reviewed the literature correlating hypertensive retinopathy with coronary artery disease (CAD) in the first review article. They concluded that there exists a significant correlation between the severity of CAD as observed in coronary angiography and the greater grade of hypertensive retinopathy as observed on fundoscopic examination of the eyes. Comparing the burden of cardiac diseases in children, the availability of pediatric cardiac care (PCC) services is very dismal in our country. In the first original research article, Jain et al.[2] reported their initial 1000-day experience of newly established public-funded PCC center in Central India. The transradial approach has emerged as a preferred vascular access site for coronary angiography and percutaneous coronary interventions (PCIs) around the world owing to fewer vascular and bleeding complications. However, this approach has drawbacks such as radial artery occlusion, radial artery spasm, bleeding complications, and patient discomfort. In the second original research article, Gupta et al.[3] studied the feasibility and safety of the 5 Fr Glidesheath Slender (GSS) in female patients in a randomized controlled trial. Authors of this study have concluded that transradial coronary interventions of noncomplex lesions can be successfully performed with either 5 Fr or 6 Fr sheaths, with a tendency of higher procedural success rates in both the 5 Fr GSS and 6 Fr standard sheath (SS) groups and lower vascular access complications among 5 Fr GSS in comparison to 6 Fr SS. Cardiomyopathy is a group of heart disorders, in which there is a structural abnormality limited to the myocardium. In the third original research article, Shanya et al.[4] studied the psychological status and quality of life among patients with cardiomyopathy in a tertiary care hospital in Kochi. Authors of this study have concluded that psychological impairment decreases the quality of life, and prompt assessment and timely interventions will improve the quality of life of patients with cardiomyopathy. Mitral valve (MV) prosthetic dysfunction is a serious complication of mechanical prosthetic valve patients. In the fourth original research article, Sharma et al.[5] reported a comparative study of thrombolysis in cases of prosthetic MV replacement (MVR) dysfunction (thrombosis) between intravenous alteplase and intravenous urokinase. The authors of this study concluded that the use of alteplase and urokinase intravenously for thrombolysis in cases of prosthetic MV thrombosis dysfunction has equivalent therapeutic effects. Cardiovascular disease (CVD) is a highly common complication and the first cause of death in patients with end-stage renal disease (ESRD) on hemodialysis (HD), in the fifth original research article, Mohamed et al.[6] studied the early left ventricular dysfunction in patients with ESRD on HD by speckle-tracking echocardiography. The global longitudinal strain was significantly lower in diabetic ESRD patients and in ESRD patients with left ventricular hypertrophy (LVH) than nondiabetics and those without LVH. Authors of this study have concluded that speckle-tracking echocardiography can early detect left ventricle dysfunction in ESRD patients on HD, and global longitudinal strain is the most sensitive echocardiographic parameter to predict systolic dysfunction. The left ventricular end-diastolic pressure (LVEDP) is a crucial parameter that reflects left ventricular compliance and filling pressures, which are often compromised in patients with CAD. In the sixth original research article, Tandon et al.[7] have studied the acute changes in left ventricle end-diastolic pressure in patients undergoing nonprimary PCI. The mean LVEDP decreased by 2.49 mmHg in acute coronary syndrome (ACS) patients but increased by 0.96 mmHg in chronic coronary syndrome (CCS) patients. Authors of this study concluded that LVEDP decreases more significantly in ACS, compared to CCS, suggesting that acute myocardial ischemic damage is more reversible with PCI than chronic ischemic damage. The findings indicate that LVEDP is a useful parameter in assessing the success of PCI, particularly in ACS patients, and may help predict procedural outcomes. Rheumatic heart disease (RHD) is the most common cause of MV disease in developing countries like India. Among the available surgical options, MV repair (MVRe) is preferred over MVR. In the seventh original research article, Prashad et al.[8] reported the midterm outcomes of MVRe in RHD. The authors of this study have concluded that midterm outcome of MVRe is promising and encouraging in the rheumatic population. Dilated cardiomyopathy (DCM) is a heterogeneous condition with variable prevalence and outcomes worldwide. In the eighth original research article, Chaudhary et al.[9] have reported their finding of a comprehensive evaluation of clinical, echocardiographic, and cardiac magnetic resonance (CMR) findings in DCM. The authors of this study concluded that fibrosis on CMR and advanced LVDD are significant predictors of mortality in DCM, underscoring the importance of comprehensive imaging for the prognosis. Heart failure leads to ventricular stretch causing secretion of brain natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) from the ventricles into the circulation. In the ninth original research article, Pandey et al.[10] investigated the relationship between plasma BNP levels and chronic kidney disease (CKD) stages in patients with and without concurrent heart failure. Authors of this study have concluded that plasma concentration of NT-proBNP varies with the level of renal dysfunction and markedly elevation of concentration of NT-proBNP seen from CKD Stage 3 onward. The prevalence of heart failure increases as renal function deteriorates in individuals with CKD. The diagnosis of ACS is fundamental for the early detection and distinction of chest pain from alternative causes, as it is a common and life-threatening reason for emergency medicine department (EMD) admission. The history, electrocardiogram, age, risk factors, and initial troponin (HEART) score which was recently diagnosed is intended for early risk stratification of patients presenting with chest pain in EMD, and classify, them into low, intermediate, or high risk of experiencing major adverse cardiac events within 6 weeks, serves as an indicator of ACS. In the tenth original research article, Baskaran et al.[11] studied the role of the HEART score in patients presenting with chest pain to the EMD in Pudukkottai, southern Tamil Nadu. Authors of this study have concluded that if the HEART score is adopted for risk-stratifying patients presenting with chest pain to ED, half of the patients can be very well discharged from ED based on the clinical evaluation and prevent further complications in high-risk patients. DCM is a condition characterized by the enlargement of one or both ventricles of the heart, which impairs their pumping ability. In the eleventh original research article, Sachde et al.[12] studied the clinical and echocardiographic spectrum of DCM from their center. The authors of this study concluded that DCM is mainly found in the middle-aged male population and clinically presents with breathlessness and orthopnea. Echocardiography shows reduced mean left ventricular ejection fraction and mitral regurgitation in the majority of the patients. In the last, Nalawade et al.[13] reported an interesting case of giant left atrial myxoma neovascularization through the right coronary artery.