One of the common negative impacts in the management of acute myocardial infarction is cognitive decline. Using the rat model of isoproterenol (ISO)-induced myocardial infarction, we assessed the cardioprotective effect of sodium thiosulfate (STS) and its influence on cognition. STS treatment reduced the cardiac infarct size

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The above results suggest that mitochondrial changes associated with diabetes and cardiomyopathy significantly contribute to the adverse outcome of I/R injury.

BACKGROUND Coronary Artery Disease (CAD) is the leading cause of morbidity and mortality worldwide. The prevalence of CAD and the incidence of Acute Coronary Syndrome (ACS) are very high among Indians. ST Elevation Myocardial Infarction (STEMI) is one of the major presentations of Acute Coronary Syndrome. The data regarding the clinical presentations of STEMI is still lacking in the majority rural population of INDIA. MATERIALS AND METHODS All patients who were admitted with features of Acute ST Elevation myocardial infarction (STEMI) from 1 st January to 30 th September 2018 were included and analysed retrospectively in this study. The demographic features, Cardiovascular risk factors, Clinical presentation, Serial E.C.G findings & the 2-D Echocardiographic features were analysed and correlated with the clinical and E.C.G findings. RESULTS Out of 236 patients admitted with features of Acute STEMI 184 (77.97%) patients were male and 52(22.03%) were female. The commonly affected age group was 40-60years of age (51.27%). The female patients with STEMI increased with advancing age. Type II diabetes mellitus was the most common modifiable risk factor (36.01%). Smoking (9.75%) and alcoholism (7.63%) contributed as significant risk factors for male. Chest pain was the most common presenting symptom (72.88%). Majority of patients 98(41.53%) presented between 12-24hours after the onset of chest pain. AWMI (51.27%) was more common than IWMI (46.19%). RV infarction occurred in 33% of patients with Acute IWMI. There were more patients with LVEF <40% in AWMI group (64.46%) and in non-thrombolysed patients (66.67%). CONCLUSION Most of the patients with STEMI were male in the 40-60years of age. There were more female patients with STEMI with advancing age (>65years). Diabetes mellitus and systemic hypertension were the most common risk factors for STEMI. AWMI was more common than IWMI. 33% of patients with IWMI had RVMI. LV dysfunction with LVEF < 40% was more common in AWMI and in non-thrombolysed patients. The mortality is high among elderly female with multiple risk factors and more extensive STEMI.

BACKGROUNDRheumatic heart disease (RHD) is a major contributor to morbidity and premature death in poor and developing countries like India. RHD predominantly affects young and working age group. Objective-To evaluate relative frequency of the various cardiac valvular lesions in Rheumatic heart disease (RHD) in patients who underwent Echocardiogram in the Department of Cardiology, Thanjavur Medical College, Thanjavur, Tamilnadu. MATERIALS AND METHODSThis retrospective descriptive study was conducted at Cardiology Department based on transthoracic two dimensional echocardiogram reports, diagnosed as RHD (Rheumatic heart disease) from January 2016 to December 2016. The reports were retrieved from computerised database and demographic features like age, sex, type of valvular lesion were analysed. RESULTSOut of 17,625 patients who underwent echocardiogram in the Department of Cardiology, 428 patients (2.4 %) were diagnosed with rheumatic heart disease. The commonly affected age group was 21 to 40 years. The distribution being 120 males (28%), 288 females (67.2%) and 20 children (4.6%). Mitral Regurgitation was the predominant valvular lesion affecting 328 (76.6%) patients with female preponderance of 239 (72.8%) patients. The second most common valvular lesion was Mitral Stenosis. It was diagnosed in 287 patients constituting 67.05%. The incidence was most common in females (205 cases, 71%) when compared to males (82 cases 29%). Of those 287 patients, 139 (48.4%) patients had severe MS and 92 (32.0%) had moderate MS. Aortic Regurgitation (AR) was present in 126 (29.4%) patients and almost always (99 %) in combination. Mixed valvular lesions (MS with MR) were present in 117 (27.3%) of patients. The least common lesion was Aortic stenosis (AS) noted in 24 (5.6%) patients. Out of 118 patients with multivalvular lesions, MS with MR with AR were found in 65 (55.08%) patients. CONCLUSIONThe most common valvular lesion reported in our study was multivalvular lesion. The predominant pure lesion was Mitral regurgitation followed by Mitral stenosis, Aortic regurgitation and MS with MR.

BACKGROUND Coronary Artery Disease (CAD) is the leading cause of morbidity and mortality among elderly. The clinical features of Acute ST Elevation Myocardial Infarction (STEMI) in elderly are different from those in young patients in many aspects. The elderly STEMI patients are often less aggressively treated than younger ones due to advanced age, co-morbidities and delayed admission to the hospital. The epidemiological data regarding STEMI in elderly in India are mainly from urban centres. Hence, we conducted a study on the clinical presentation, risk factors and complications of elderly STEMI (> 60 years) patients admitted in the ICCU of Department of Cardiology, Thanjavur Medical College, Tamilnadu which caters to the needs of largely rural population. MATERIALS AND METHODS Our retrospective descriptive study was conducted on patients > 60 years of age, who were admitted with the features of acute STEMI from 1 st January 2018 to 30 th September 2018. The demographic features, cardiovascular risk factors, clinical presentations, serial ECG changes and 2D-Echo features were analysed and correlated. RESULTS Out of 87 patients studied, 58 (66.67%) were Male and 29 (33.33%) were Female with Male-to-Female ratio of 2:1. However, above 80 years of age, there were more Females (20.69%) than Males (1.72%). Majority of the patients belonged to 60-70 years' age group (66.67%). Type II Diabetes Mellitus (28.74%) and Systemic Hypertension (25.29%) were the common risk factors. Though 50.57% of patients presented with chest pain, atypical symptoms were present in significant number of patients. Majority were in Killip's class II (47.13%) on admission. IWMI occurred slightly more (49.42%) than AWMI (48.28%). RVMI occurred in 37.21% of patients with acute IWMI. LVEF < 40% was more common in AWMI (64.28%) group and in non-thrombolysed (50%) patients. Mitral regurgitation was present in 57 (65.52%) cases, while cardiogenic shock was present in 14.95% of cases. 5 patients (5.74%) died during their hospital stay. CONCLUSION STEMI in the elderly presented commonly between 60-70 years of age. Female patients with STEMI increased with increasing age (>70 yrs.). Diabetes Mellitus and Systemic Hypertension were the common risk factors. More patients presented with atypical symptoms and in Killip's class II. IWMI was more common than AWMI. 37.21% of patients with IWMI had RVMI. LV systolic dysfunction with LVEF < 40% was more common in AWMI and in non-thrombolysed patients. Advanced age, female gender, multiple risk factors, co-morbid conditions, extensive infarction and severe LV systolic dysfunction were the major contributors of in-hospital mortality.

BACKGROUNDPulmonary hypertension is a progressive disease with high morbidity and mortality. The W.H.O. Group II Pulmonary hypertension (Pulmonary hypertension due to left heart disease) is the most prevalent form of PHT worldwide. There is paucity of data regarding Group II Pulmonary hypertension from developing countries including India. This retrospective descriptive study was carried out at a tertiary care institute with an objective of establishing the epidemiological data of Group II Pulmonary hypertension by Echocardiography. MATERIALS AND METHODSAll patients who were referred for the first time echo between January 2016 and December 2016 were included and analysed in this study. Echocardiogram was performed by consultant cardiologist using Philips HD11XE and ALOKA SSD-4000 echo machines following ASE Guidelines. Pulmonary artery systolic pressure was derived from tricuspid regurgitation jet velocity by modified Bernoulli equation with the addition of estimated right atrial pressure. The standard echo doppler techniques were applied to diagnose the presence of left sided valvular diseases and left ventricular dysfunction by following ASE guidelines. RESULTSIn our study of 17,625 cases, 282 (16%) patients were diagnosed as pulmonary hypertension. The WHO Group II pulmonary hypertension (pulmonary hypertension caused by left heart disease) is the commonest echo group (72.7%) present in our study. Among the patients with Group II pulmonary hypertension 51.71% had rheumatic left sided valvular heart disease and 48.29% had LV dysfunction due to CAD and cardiomyopathy. RHD was more common in female (71.70%) while LV dysfunction was more common in male (67.68%). The mean age Group in our study was 35-45 years. Patients with combined mitral stenosis and mitral regurgitation (42.45%) commonly presented with significant pulmonary hypertension. Among the Group II PHT patients with LV dysfunction, 80.81% had LV systolic dysfunction with reduced ejection fraction and 19.91% had LV diastolic dysfunction with normal EF. The functional mitral regurgitation was present in 67.68% of patients with LV systolic dysfunction. CONCLUSIONThe Group II pulmonary hypertension (PHT due to left heart disease) is the leading cause of pulmonary hypertension. The rheumatic left sided valvular heart disease and LV dysfunction due to CAD and cardiomyopathy are the major causes of Group II pulmonary hypertension. The early diagnosis of the underlying left heart disease by echocardiography and its timely correction may improve the survival of the patients with Group II pulmonary hypertension.