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Introduction: Coronary heart disease (CAD) is the leading cause of morbidity and mortality worldwide, with India being the top cause. The Asian subcontinent accounts for 20% of the world's population, but 60% of the cardiovascular disease burden is due to genetic predisposition and environmental factors. Arterial stiffness increases with aging, accelerated by cardiovascular risk factors like hypertension and diabetes. Endothelial dysfunction in coronary arteries affects arterial stiffness and potentially reversible in atherogenesis. Pressure wave velocity (PWV) is a useful index for assessing endothelial status and large artery stiffness. Large artery stiffening can increase systolic blood pressure, left ventricular afterload, and left ventricular hypertrophy, potentially limiting coronary perfusion. Material and Methods: A prospective cross-sectional study was conducted at Sri Jayadeva Institute of Cardiovascular Sciences and Research Centre in Bangalore, India, from 1/6/2018 to 31/01/2019. Thirty patients with triple vessel disease and 30 age-matched controls underwent angiography at the institute. Echocardiography and Doppler evaluation assessed heart carotid pulse wave velocity and transit time. The study included patients with triple vessel disease and normal epicardial coronary arteries. The study excluded patients over 70 years old, having a heart rate above 100, having severe LV dysfunction below 30%, having chronic kidney disease, or having coronary artery stenosis. Demographic details, family history, medical history, clinical presentation, diagnostic tests, and blood tests were collected from patients. The study used descriptive and inferential statistical analysis, with continuous measurements presented as Mean ± SD and categorical measurements as Number (%). Results: The study involved 30 cases and 30 controls, with the majority of patients aged 50-70 years and controls aged 40-60 years. The gender distribution was predominantly males. Diagnosis distribution was similar between the two groups, with patients with EA, UA, or TMT positive being more likely to undergo angiography. BMI (kg/m2) distribution was similar between the two groups, with the majority of patients still overweight or obese but having normal BMIs. Pulse transit time (PTT) was significantly lower in the triple vessel disease case group compared to the control group with normal coronary angiography. Pulse wave velocity (PWV) increased in the case group compared to the control group. In contrast to the control group, 66% of the patients in the case group showed some kind of LV dysfunction due to more patients with myocardial infarction. Pulse wave velocity was significantly lower in the case group, with 20% and 63% shorter. LMCA distribution was also similar between the two groups, with patients with LMCA having lower pulse transit time (20%) and (63% shorter) compared to the control group. The study highlights the importance of assessing patients' angiography and LMCA distribution in determining the appropriate treatment for patients with LV dysfunction. Conclusion: Aortic PWV predicts future cardiovascular risk by accounting for known risk variables. It could be a valuable biomarker for intermediate risk, but randomized controlled studies are needed to prove its therapeutic utility before implementation. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases (CVDs) are the most prevalent cause of death and disability worldwide; more people die annually from CVDs than from any other cause. An estimated 17.7 million people died from CVDs in 2015, representing 31% of all global deaths. This transition is characterized by rapid urbanization and its accompanying adverse lifestyle changes (e.g., drug and alcohol addictions, unhealthy diet, physical inactivity and increasing psychosocial ailments) and by increasing longevity. India is experiencing an alarming increase in heart disease, which seems to be linked to changes in lifestyle and diet, rapid urbanization, and possibly an underlying genetic component. Objectives and Aims: To evaluate application of Doppler echocardiography in determining left ventricular diastolic dysfunction in primary hypertension. Proportions of hypertensive patients having left ventricular diastolic dysfunction. Materials and Methods: This study was carried out in the Department of General Medicine at Swami Dayan and Hospital, Delhi. This is the Cross sectional Observational Study. Study of diastolic function in hypertensives in tertiary care centre was observed. The study observed that 44% had abnormal diastolic function in hypertensive patients. Taking this value as reference, the minimum required sample size with 10% margin of error and 5% level of significance is 95 patients. So total sample size taken was 100. Observations and Results: Sample size was of 100 cases, the variable Age (Years) was not normally distributed (p = <0.001). The Age ranged from 26-67 years. The mean Age was 49.64 years (11.45). The median Age was 50 years (15.50). Maximum patients were between age of 50-59 years (comprises 30%) followed by age group 40-49 year (comprises 26%).Only 10.0% of the patients had age less than 30 Years. Diastolic Dysfunction was present in 56 patients out of 100 (56%). Majority of patients (42%) had mild diastolic dysfunction and only 4% had severe diastolic dysfunction. Conclusion: The prevalence of diastolic dysfunction is high among the population of patients with hypertension as reported in this study. There is a linear increase in the prevalence of DD with the increase in age. There is no difference in the prevalence of DD among males and females. LV diastolic dysfunction is significantly correlated with presence of high blood pressure, LVH and high BMI. The higher prevalence of left ventricular diastolic dysfunction and left ventricular hypertrophy among hypertensives in our study support the need for improved attainment of blood pressure goals in these patients. Every effort needs to be put in for early detection of LVDD as it has important diagnostic, prognostic and therapeutic implications. [ABSTRACT FROM AUTHOR]

Introduction: Anemia is a very common disease worldwide with even more prevalence in developing countries like India. Prevalence of anemia among women of reproductive age (% of women ages 15-49) in India was 51.40% as of 2016, compared to 9% prevalence in developed countries. It is also the second most common cause of maternal mortality in India. Anemia leads to hyperdynamic state of heart at rest leading to impaired oxygen supply to myocardium. This ultimately leads to supply-demand myocardial mismatch causing myocardial ischemia or infarction. Long standing hyperdynamic state due to anemia may lead to cardiac dilatation and hypertrophy as well. These changes in heart cause cardiac disturbances. Electrocardiography is used to detect ischemic heart diseases, hypertensive heart diseases and asymptomatic arrhythmias. The abnormalities may be proportional to the severity of anemia or show no correlation to hemoglobin levels. The studies which show the effect of iron deficiency anaemia on ECG changes in females are few in India. Hence in the present study we decided to study the electrocardiographic changes in female anemic population. Materials and methods: It is the cross section observation study of 100 female patients of age group between 19-49 years those who were admitted with Hb less than 12 gm/dl. We excluded the patients with pregnancy, diabetes, hypertension, fever, renal disease, liver disease, COPD, cardiac disease and who not giving consent. Results: In the present Cross sectional observational study ECG changes in female anemic patents was studied. In the present study, anemia prevalence was higher in age group 20-40. Studies have shown reduced triglyceride levels in patients with anaemia. In the present study, 31 patients out of the 100 had shown cardiomegaly in chest X-ray. In the present study 45% of the patients presented with sinus tachycardia in ECG. Left axis deviation and left ventricular hypertrophy are seen 30% of the patients in the present study. Lower the hemoglobin values higher is the frequency of left axis deviation In the present study there were no changes in the P wave and QRS complexes. In the present study, 26% of the patients had ST segment depression and 18% of the patients had inverted T wave in the ECG. Conclusion: Anemia is more prevalent in India. Anemia has major effect on heart due to hyperdynamic state. ECG is the basic tool to identify various cardiac diseases. The studies which show the effect of iron deficiency anaemia on ECG changes in females are few in India. Hence in the present study we decided to study the ECG changes in female anemic population. [ABSTRACT FROM AUTHOR]