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Novel genetic risk factors cause heart failures in India, says CCMB

by Vaishali Sharma
written by Vaishali Sharma

India has one of the highest rates of cardiovascular disease and related fatalities in the world. Heart failure is widespread in disorders such as severe cardiomyopathy, which is one of various cardiovascular diseases. Because this illness alters the essential structure of the heart muscle, the heart is unable to pump blood normally, resulting in cardiac arrest and death.

The Centre for Cellular and Molecular Biology (CCMB) has discovered that this disorder is caused by unique genetic alterations.

A team of CCMB scientists, led by K Thangaraj, have found novel genetic mutations in the beta myosin heavy chain gene (β-MYH7) gene are responsible for causing dilated cardiomyopathy among Indians.

This gene is one of the major genes that are found to be causing cardiac diseases globally.

“However, not many genetic studies were carried out in Indian cardiomyopathy patients. Hence, we sequenced β-MYH7 gene of 137 dilated cardiomyopathy patients along with 167 ethnically matched healthy controls to identify the mutation(s), if any, that are associated with dilated cardiomyopathy in Indian patients,” K Thangaraj, senior author of this study and presently Director, Centre for DNA Fingerprinting and Diagnostics (CDFD), said.

These findings have been published in the Canadian Journal of Cardiology last week.

“Our study revealed 27 variations, of which 7 mutations were novel, and were detected exclusively in Indian dilated cardiomyopathy patients,” he said.

“We for first time demonstrated how these mutations uniquely disrupt a critical network of non-bonding interactions at the molecular level, and may contribute to the development of disease phenotype,” Deepa Selvi Rani, the lead author of this study, said.

“This study can help in developing gene editing methods that may rescue cardiac contractility of failing hearts among Indians with the novel mutations,” Vinay Kumar Nandicoori, Director of CCMB, said in a statement.

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Cardiology NewsDietetics News

Second heart attack or stroke can be seen as result of Ultra-processed foods

by Pragati Singh
written by Pragati Singh

To qualify as UPF, a food must include a minimum of five whole food components and at least five — frequently many more affordable, industrially manufactured ingredients.

Overconsumption of UPF has long been advised by scientists, who have linked it to a variety of health problems. According to recent studiesTrusted Source, they can cause cardiovascular disease (CVD) and all-cause death.

“We saw,” says first author of the study Dr. Marialaura Bonaccio, “that people with a higher consumption of ultra-processed foods have a two-thirds increased risk of a second heart attack or stroke, this time fatal, compared with participants eating these foods less frequently. The probability of dying from any cause is also 40% higher.”

Worryingly, consumption of UPF is growing, particularly in the United States, where nearly 60% of the average person’s diet is likely to be made up of highly processed foods.

The Department of Epidemiology and Prevention of the I.R.C.C.S. Neuromed in Pozzilli, Italy, conducted the study, which appears in European Heart Journal.

Recognizing ultra-processed foods

Dr. Bonaccio told Medical News Today, “It is important to underline that the definition of ultra-processed food is not linked to the nutritional content, but rather to the process used for its preparation and storage. In other words, even if a food is nutritionally balanced, it might still be considered ultra-processed.”

Cardiology dietician Michelle Routhenstein, MS RD CDE CDN, who was not involved in the study, told MNT:

“I find that many people are hyper-focused on calories, so when they read the food label, if the nutritional facts panel satisfies what they are assessing it for, they can easily dismiss the processing element of the food. I, therefore, like to direct the attention of the consumer to read the actual ingredient list first.”

Routhenstein adds, “When looking at the food label, it may be helpful to understand at a glance the NOVA classification scale.”

The NOVA classification system assigns foods to one of four categories based on the amount of processing they involve:

  • Group 1 — Unprocessed or minimally processed foods. These are either unprocessed foods or foods that have undergone minimal processing, such as cooking or pasteurization.
  • Group 2 — Processed culinary ingredients. These derive from nature or group 1 foods. They include olive oil, salt, maple syrup, and other items which people may use to prepare group 1 foods.
  • Group 3 — Processed foods. These are foods created using items from groups 1 and 2, such as bread and cheese.
  • Group 4 — Ultra-processed food and drink products. Manufacturers have formulated these food products to be tasty, cheap to buy, and easy to prepare. They include few to no products from group 1 and often contain fats, salt, preservatives, stabilizers, food coloring, artificial flavoring, and refined grains.

 

 

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Cardiology NewsCovid News and Updates

Changes in the blood, not the heart, may underlie cardiac thrombosis in COVID-19 patients

by Pragati Singh
written by Pragati Singh

“My laboratory has a long history of defining endothelial cell alterations that produce pathologies, including thrombosis, and we expected to confirm the widely held assumption that local endothelial cell alterations were responsible for thrombosis of the cardiac vessels in COVID-19 patients,” explained lead investigator Jordan S. Pober, MD, PhD, Department of Immunobiology, Yale University School of Medicine, New Haven, CT, USA. “Instead, we found that the cardiac thrombi contained neutrophils that expressed changes known to promote coagulation, including changes that are associated with cell death and inflammation.”

Hospitalized patients with SARS-CoV-2 infection have an increased risk of developing myocardial injury. However, numerous studies have rarely detected viral protein or RNA within the hearts of patients who died from COVID-19, despite evidence of abundant virus presence in the lungs of the same patients. Thrombosis of micro and macro coronary vessels has most consistently characterized the hearts of individuals who succumbed to COVID-19, but the underlying cause remains unknown.

Dr. Pober and his colleagues examined heart tissue from seven autopsies of COVID-19 patients performed early in the pandemic, before anticoagulation treatment was commonly administered, and compared these specimens to autopsy tissue from 12 COVID-19-negative controls, with and without heart disease, using multiparameter fluorescence microscopy to analyze the composition of the thrombosed vessels. All patients in the COVID-19 group had severe pneumonia. One patient experienced a sudden cardiac arrest outside of the hospital, two patients developed sepsis, and one patient had recurrent acute leukemia with thrombocytopenia. The COVID-19-negative controls included six patients with pre-existing cardiac disease.

Thrombosis was the most common pathological finding in the COVID-19 group with a greatly elevated frequency of microthrombi and total number of macrothrombi compared to the COVID-19-negative controls. Despite the widespread evidence of thrombosis, no evidence of myocyte death or acute inflammation typically associated with myocardial infarction was detected in the COVID-19 group.

The vessels of the heart were examined for signs of endothelial cell injury, which can promote thrombosis through release of microparticles containing procoagulative tissue factor, or by endothelial cell sloughing that can expose platelet activating collagen. The investigators failed to find such endothelial changes at sites of thrombosis. Instead, they saw that the cardiac thrombi in four of the six COVID-19 patients contained neutrophils that expressed procoagulant changes in the blood, such as citrullination of histones associated with formation of neutrophil extracellular traps (NETs). Some images suggest NETS that appear to be directly associated with platelets. Neutrophil-rich macrothrombi composed of 30% or more neutrophils were common in the COVID-19 group but not in control tissue specimens.

Dr. Pober commented, “Our data challenge the view that alterations in the heart vessel wall are the primary cause of COVID-19 cardiac thrombosis. Current treatments of severe COVID-19 include anticoagulation, but the best strategy is still not clear. In light of our findings, reducing neutrophil responses could be an important target for therapeutic intervention. This and many other advances in the understanding of disease continue to be provided by autopsies, and I am grateful to the pathologists who performed them for this study at both Brigham and Women’s Hospital and Yale.”

Peter Libby, MD, a cardiologist and vascular biologist at Boston’s Brigham and Women’s Hospital and the Harvard Medical School, a long-time collaborator of Dr. Pober’s, stated: “For several years we have studied neutrophils and their prothrombotic products known as NETs in the context of clots that form in the larger coronary arteries. The finding of neutrophil involvement in the smaller blood vessels that course through the heart muscle in COVID-19 extends our understanding of cardiac injury that we often see in patients with severe SARS-CoV-2 infection. Brigham pathologists Robert F. Padera, Jr., MD, PhD, and Richard N. Mitchell, MD, PhD, helped us enormously by providing tissue samples for these analyses early on in our experience with this pandemic.”

Source: Elsevier

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Cardiology News

Women Experience a Heart Attack Differently From Men

by Vaishali Sharma
written by Vaishali Sharma

Anyone can die from a heart attack. Women, on the other hand, require a lengthier hospital stay and are more likely to die after a heart attack than males. Furthermore, evidence suggests that women are more likely than males to have a second heart attack within a year of the first.

A heart attack occurs when the blood circulation to the heart is compromised due to plaque deposition in the blood vessels supplying the heart. However, heart attacks differ noticeably in women in terms of risk factors, presentation and prognosis as compared to men due to differences in their physiology and body functioning. Women as compared to men are also less likely to seek immediate medical attention as they are unable to recognise early symptoms and often tend to ignore their health, putting their family’s needs first.

Heart attacks in women may be difficult to recognise as the symptoms are milder and sometimes mimics acid refluxes. Chest pain or discomfort is less prominent in women. Instead, they may experience other symptoms such as breathlessness, abdominal discomfort, dizziness, fainting, pressure in the upper back area and extreme fatigue more frequently as compared to men.

This difference in presentation is because of the type of coronary arteries being affected in the two sexes. While men more commonly tend to develop a block in the major coronary artery, in women the smaller blood vessels supplying the heart are more affected.

In general obesity, pre-existing heart conditions, diabetes, hypertension, high cholesterol levels, use of contraceptive pills, alcohol abuse and smoking are key drivers of high heart attacks in women. For example, a study including 450,000 patients showed diabetes in women as compared to men are associated with a 50% higher risk of dying from heart disease.

Elderly women are at a higher risk of heart attack as compared to their male counterparts. In younger women, the hormone oestrogen is thought to play a crucial role in affording protection against heart diseases. Post-menopause, the level of oestrogen production decreases, increasing the risk of heart diseases. As compared to males, pre-menopausal women tend to have a 14% higher prevalence of hypertension and a more adverse lipid profile. Other female-specific risk factors include hysterectomy and pregnancy complications such as gestational diabetes or pre-eclampsia.

Regular heart health check-ups in high-risk patients coupled with lifestyle modifications are the keys to reducing morbidity and mortality associated with heart attacks in women. Some of the crucial lifestyle changes include maintaining the ideal weight for height through diet and regular 30 minutes of moderate-intensity exercise.

Important dietary considerations should include a high intake of vegetables and fruits, complex carbohydrates and the inclusion of food rich in omega-3-fatty acids such as oily fish or seeds. Intake of saturated fats, trans fat and cholesterol in the form of fried and processed food should be limited. Smoking cessation is encouraged and alcohol should be limited to a few drinks a week. The use of hormonal medications should be taken only under medical supervision to avoid unnecessary harm to heart health. Last but not the least, all prescribed medications for diabetes, hypertension and other pre-existing medical conditions should be taken as recommended by one’s physician.

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Cardiology News

Jaslok Hospital in Mumbai has announced the beginning of a ‘heart transplant’ programme

by Pragati Singh
written by Pragati Singh

Jaslok Hospital & Research Centre, one of Mumbai’s major hospitals, has announced the commencement of a ‘Heart transplant’ programme and division at its Mumbai location. The initiative will be directed by Dr. K R Balakrishnan, a famous cardiac surgeon and pioneer in the field of heart transplants in the nation. Jaslok Hospital will collaborate with MGM Hospital in Chennai to bring this concept to life in a first-of-its-kind cooperation. According to official data, the city has witnessed a total of 163 heart transplants in the previous five years.

Speaking on the occasion Jitendra Haryan, CEO Jaslok Hospital said, “We are thrilled to be expanding our transplant services and offerings to include heart transplants as well. Dr. K R Balakrishnan is a well-known cardiac surgeon in the country, and we are happy to bring his services and expertise to our patients in Mumbai and the larger western region. It is heartening to see the increase in the number of organ donations that happen in the city giving a new lease of life to many. ”

While the program will be led by Dr. K R Balakrishnan, he will be supported by the prestigious cardiac surgeons and cardiologists’ team at Jaslok Hospital. The programme will provide outstanding quality and outcome, comprehensive support services, easily accessible care, team consisting of transplant surgeons, critical care experts, infectious diseases Consultants, specially trained support nursing & other paramedical staff for ICU and wards, liaison officers, transplant coordinators, dedicated beds in ICU,cardiac rehab, and specialized post op care.

Dr. K R Balakrishnan is known as the pioneer of heart transplants in the country. A graduate of KEM Hospital, University of Bombay, he is one of the most awarded healthcare practitioners, who is known for his work in end-stage heart failure management, pediatric cardiac transplants and liver and heart transplants. In a career spanning more than 30 years, he has successfully performed over 329 transplants in the country.

MGM Healthcare CEO, Harish Manian said, “MGM Healthcare Chennai is very happy to associate with Jaslok Hospital Mumbai to provide Heart & Lung Transplant service under the leadership of Dr. K R Balakrishnan and team. The association with Jaslok is strategic in nature, which will help knowledge sharing and on-site transplant support from the team of experts from MGM Healthcare Chennai. Dr. K R Balakrishnan and team will be having a dedicated Heart Failure Clinic to evaluate the patients. This association also strengthens our relationship with Jaslok Hospital and enhances our commitment to get closer to our patients in Western India.”

As per recent estimates, heart disease is the number one cause of mortality and a silent epidemic among Indians. Data from Brihanmumbai Municipal Corporation (BMC) indicates that around 90 people die because of heart attacks every day in the city. All the speakers at the event stressed on the importance of organ donation to make any transplant programme successful and urged people to donate their organs.

The launch event was presided by dignitaries such as Dr. S K Mathur, President ZTCC, Dr. Suresh Rao, Cardiologist, MGM Hospital Chennai, Dr. A B Mehta, Director Cardiology Dr. Hemant Pathare, Additional Director of Heart & Lung transplant at Jaslok Hospital, along with others from the Jaslok Hospital team.

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Cardiology NewsUttar Pradesh

Noida: Govt hospital performs invasive cardiac surgery on 16-yr-old

by Vaishali Sharma
written by Vaishali Sharma

A 16-year-old girl with congenital heart disease had minimally invasive cardiac surgery at the Postgraduate Institute of Child Health (PGICH), often known as Child PGI, in Noida’s Sector 30. While the procedure is commonly performed on adults, experts claim this is the first time it has been performed on a child in a government facility in Uttar Pradesh.

The girl, an Azamgarh inhabitant, had been born with an Atrial Septal Disease (ASD), a kind of heart defect. She was sent to Child PGI in April of this year as part of the National Health Mission’s Rashtra Bal Suraksha Kalyan programme, which provides free treatment to infants born with congenital abnormalities.

“The girl is 16-years-old but the structure of her body was that of a 12-year-old. Her weight was just 34kg. She is from a poor family, her family’s humble financial condition prevented them from seeking consultation from private hospitals,” said Dr. Mukesh Kumawat , head of the paediatric cardiac surgery department at PGICH.

The girl’s surgery was postponed due to a crippling second wave of Covid-19 that ravaged the country in April and May. Doctors said she also had antibodies against Covid-19, which meant she had been infected with the viral infection but was unaware of it.

“Unlike conventional sternal (mid chest bone] approach, where an incision is made in the middle of the chest and the chest bone has to be opened to operate on the heart, minimal invasive surgery involves operating on the heart by making an incision on the side of the patient’s chest. Minimal invasive cardiac surgeries have been practised on adults but in paediatric cases, they are extremely expensive and are rarely done in government institutes,” said Dr Dheeraj Sharma, associate professor of cardiac surgery, PGICH.

He added such a procedure is not performed on paediatric patients due to unavailability of necessary equipment that can be used on children of different age groups and body types.

“This procedure has an advantage in terms of early post-operative recovery, less requirement of blood transfusion and freedom from sterna (chest bone) non-union. A special advantage is that there is no chest scar peeping out of clothes. It has often been seen that cardiac patients, especially children, may develop low self-esteem due to the presence of a visible scar on their body. This was the first such paediatric surgery conducted at a government institute in Uttar Pradesh,” said Dr Kamawat.

He added that the surgery was conducted successfully on October 15 and the patient was off ventilator after two hours of surgery. “The patient was able to move and walk the next morning without any chest discomfort. It has been a month now and the child has not reported any discomfort after the surgery,” said Dr Sharma.

Dr Kamawat added that the provision of performing minimally invasive cardiac surgery (MICS) at Child PGI will help more children with congenital heart diseases which are life-threatening.

“The Child PGI will be able to cater to more paediatric patients with heart diseases in western Uttar Pradesh. We hope this surgical approach is promoted at more government institutes so that the underprivileged can avail the facilities. In the future, MICS is expected to substitute the conventional approach of heart surgeries among paediatric patients in more than 80% of the cardiac procedures for its cosmetic advantages,” he said.

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Cardiology NewsDoctor NewsKarnataka

Dr B M Hegde a Cardiologist, conferred Padma Vibhushan

by Pragati Singh
written by Pragati Singh

MANGALURU: On Tuesday, President of India Ram Nath Kovind bestowed the Padma Vibhushan, India’s second-highest civilian award, on Dr Belle Monappa Hegde, 83, popularly known as Dr B M Hegde, cardiologist, Professor of Medicine, scientist, and author.

He was chosen for the Padma Vibhushan award, under the medical category, given for exceptional and distinguished service.Known to most as the ‘people’s doctor,’ Dr Hegde is a physician with a humane approach, stress on holistic medicine and giving importance to minimum use of medicines. Presently, he resides at Chilimbi Gudde in Mangaluru. Hegde, former Vice Chancellor of Manipal University, was honoured with the Padma Bhushan in 2010. He is also the recipient of Dr BC Roy Award in 1999.Dr Hegde studied up to SSLC at Hiriyadka in Udupi and later completed his intermediate from MGM College, Udupi. He completed his MBBS from Stanley Medical College, Madras in 1960. He received a gold medal from Madras University for MBBS.Stanley Medical College, Madras in 1960. He received a gold medal from Madras University for MBBS.

Dr Hegde, who was the Dean of Kasturba Medical College from July 13, 1992, served as the Vice Chancellor of Manipal Academy of Higher Education (Deemed University) from June 18, 1999 to August 30, 2003. A recipient of Karnataka Rajyotsava Award in1997, he authored `What Doctors Don’t Get to Study in a Medical School Board book,’ a book that provides part of the important and formative reading a medical student must do outside the prescribed requirements for a degree Dr Hegde, who was the Dean of Kasturba Medical College from July 13, 1992, served as the Vice Chancellor of Manipal Academy of Higher Education (Deemed University) from June 18, 1999 to August 30, 2003. A recipient of Karnataka Rajyotsava Award in1997, he authored `What Doctors Don’t Get to Study in a Medical School Board book,’ a book that provides part of the important and formative reading a medical student must do outside the prescribed requirements for a degree.

 

 

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Cardiology NewsExclusives

We will have nearly 1 mn CPR trained people by November end: Indian Resuscitation Council

by Vaishali Sharma
written by Vaishali Sharma

80% of cardiac arrests happen outside a hospital, claims Indian Resuscitation Council and by learning CPR, one can save a life at home, at work or elsewhere. According to IRC, about 4280 people per 1 lac population in India every year are subjected to Sudden Cardiac Arrests and in these circumstances, the council has framed unique guidelines and to discuss the same, Medically Speaking invited a panel of experts from the IRC that included: Dr SSC Chakra Rao, Chairman, IRC; Dr Mukul Kapoor, Scientific Director, IRC; Dr Rakesh Garg, Honorary Director, IRC; Aditya Kumar, Honorary Director, IRC.

Here are a few excerpts from the interview:

 

Why do we need to have a continued dialogue and discussion on CPR, why is it that so little is talked about such a significant topic?

Dr SSC Rao: As per the survey done in 2016, less than 2% of people in India know about CPR, and about 4280 people per 1 lakh population in India every year are subjected to sudden cardiac arrest, and 90% of those people die because of lack of knowledge and not being revived. So, in these circumstances, IRC has thought that we should have our own guidelines and start giving CPR drives pan India. We have written our own guidelines with people like Dr Rakesh Garg and Dr Mukul Kapoor, and our guidelines are unique because we have certain issues in India. We have a very vast population, and the majority are literate, but there are barriers like superstition, myths, unapproachable and water-logged areas, language barriers, vivid religions, etc.

Could you elaborate on the same sir? That what these guidelines are about and how are you reaching out to people?

Dr Mukul Kapoor: These guidelines are simplified ones. We have AHA guidelines which are generally followed across the country but are very complex. They were meant for the western world, but not for the Indian world. In India, we have literate and illiterate people. We are literate, supposedly, but we are not being taught the right things, so we needed simple guidelines that were understandable by the general public, so we made algorithms and explained every step in a very simplified manner, not only in English but in other languages as well.

 

How are you reaching out to people who are in remote areas? 

Aditya Kumar: We just have 2% of the people in our country aware of basic CPR. We are doing our best through social media like Facebook Live, regional newspapers, local-virtual programs, electronic media, and time to time, paper advertisements also. Due to Covid times, we are not allowed to hold public meetings, but we are doing them through virtual mode.

 

What these guidelines entail and what are you telling people?

Dr Rakesh Garg: When we talk about the guidelines, these need to reach the people and users, and here we are targeting the layman. The guidelines should be simplified, which Dr Kapoor was mentioning and we have released them in very simple languages. Let me take a simple example: a person is jogging in the park and suddenly collapses and is no more all of a sudden. This is called a cardiac arrest. But when we say cardiac arrest, we just have a few golden minutes for that. We cannot wait for minutes or hours because the chances of survival decrease by 7 to 10% with each minute that passes. it means if a patient gets treatment after 15-20 minutes, they might have a brain injury or a dead brain. So this means we have to immediately become the layman, and that is what we want to say. Each person can become a life saver. So it is very simple. Check if the person is responding; if not, it means he has a cardiac arrest and then start CPR. When we say the heart has stopped functioning, how to start it? If you try to compress the heart externally, it will pump blood. We have to keep both our hands on our chest and compress at a certain speed, which is two compressions per second, and then this will help the pumping of blood, and this is called manual chest compression. That’s why this whole guideline is called “Compression Only Life Support”. We are in talks about activating emergency medical services.

 

Where can one get these courses for free or understand these guidelines perhaps virtually or online if they want to access, sitting at the comfort of their home from their laptop?

Dr SSC Chakra Rao: So we have our own YouTube channel and our own website called www.cprindia.in which they can visit. The most important thing is that we are accessible and we teach for free to all the school children, including laypeople. Our charges are very minimal, even for doctors. All surgeons at AP Medical University are required to complete this training or their MBBS certificate will be revoked. Prior to this, there was no curriculum in MBBS to teach CPR, but now NMC has introduced it as a foundation course for the same. For the compression, we have to keep both hands on the chest and pump the heart, and this will pump the blood to the brain. Actually, cardiac arrest does not mean the heart immediately stops, it might be contracting but at a very slow rate. Majorly, it means there is no blood supply to the brain. That’s why the person suddenly collapses.

 

What is the need for people to learn this technique of CPR?

Dr Mukul Kapoor: When a person has a cardiac arrest, the person needs resuscitation within minutes because it is the golden time. The brain cells die within five minutes of the cardiac arrest. If the blood flow is not resumed to the brain in that period, the person is not likely to survive, and even if the person survives, he will be brain dead. So whoever is with the patient should take immediate action and start the activity of chest compression only then. The patient is likely to survive. That is why it is important for each person to be aware of this and, most importantly, follow the correct algorithm.

 

Is there hesitancy among people due to Covid?

Dr Rakesh Garg: I believe this is a concern nowadays because covid can come up and that’s why if you see the guidelines for the layman, they are not providing mouth to mouth breathing because these are not a part of the layman resuscitation. These are only kept for healthcare workers and they have proper precautions for HCW’s with all the safety measures. Therefore, the layperson should not worry about getting covid-19 because as I mentioned, they just have to do chest compression. If the patients cover their faces with a mask, they will be absolutely safe. The other aspect which you raised is lack of awareness. If you do not know something and someone asks you to do it for the first time, you will be heightened to do it, and that’s why the significance of the day is that we observe October 16th as World Restart a Heart Day, just to create awareness and sensitization.

 

Why us there so much lack of awareness among people regarding the topic?

Aditya Kumar: Other countries, such as the United States, Japan, and Singapore, have long included basic CPR in their curricula, and in our country, thanks to the efforts of the Indian Resuscitation Council, CBSE has recently included it in the syllabus, and we are working to include it in local boards as well, so that more and more people are aware of its importance. More than 80% of cardiac arrest cases happen outside the hospital area. How can we help our own people if you don’t know basic CPR?

 

Do you think in India, it’s the carried the approach which could work or maybe we need to make it mandatory in every school in every college only then can we reach out large number of people and create awareness since voluntary awareness clearly doesn’t seem to be reaching the knowledge which is needed?

Dr SSC Chakra Rao: Training should be made mandatory. Not only that, in cinema halls, swimming pools, gyms, and many other places like railway stations, people trained in CPR must be hired. We must know when somebody is getting a cardiac arrest and when they will be taken to the hospital. But not only that, even in our houses, all our family members and neighbours should be trained. I want to ask all the municipal commissioners of the smart cities to make a law for this under which the CPR trained fellows should be kept as watchmen.

 

Latest studies suggest that if children go into cardiac arrest, mouth to mouth breathing. is that true it all? is the CPR technique different for adults and young children?

Dr Mukul Kapoor: Yes, it is very different for children and adults, but it’s just not respiration that helps in children, it is a combination of both. The techniques depend on the size of the case and whether it is a neonatal or a paediatric case. We have different guidelines for different age groups also. The one that requires more awareness and more dissemination is the one for adults.

 

What would be as closing comment, what would be your message on this World Restart a Heart Day?

Dr Rakesh Garg: I agree. I think it’s time to create awareness so that each citizen can be a life saver. Let’s have this sensitization programme on World Restart a Heart Day, and coincidentally, it’s also World Anesthesia Day today. So I will urge everybody to join together and save our citizens. It’s a doable technique, and each one of us can learn it. Let’s learn and save our citizens.

 

What would you say to the people today?

Aditya Kumar: Our two hands can save lives. Life donation is a very big donation. We must make the people realize that is common men will be involved, success will be achieved.

 

Why should we talk about it today when everyone is discussing Covid and third wave? What will you say to the naysayers?

Dr Mukul Kapoor: I would like to say that COVID is important, but we have had too much hype about it. People are dying, other than Covid, from incidences like cardiac arrest. So why not make people aware of that? And I would also like to add that the media can have a social responsibility. When you put ads in between programs, you can put some fillers on CPR.

 

How will you convince people to actually take the training sir?

Dr SSC Rao: This is really a make-in-India initiative, and our recommendations are saving us about Rs. 80 crores in foreign money since everyone is being drawn to the American Heart Association, and they are paying their own way. We’ve reduced the cost of training to only Rs 500, which includes a certificate. We are providing it for free to school pupils. We’re excited to teach people everywhere, and my idea is that we start with vaccine booths, but people are afraid. Nonetheless, I am certain that by the end of November, we will have trained one million life savers.

 

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Cardiology News

A new study confirms the IDEAL blood sugar range for avoiding repeat heart attacks and strokes

by Pragati Singh
written by Pragati Singh

Key Highlights

• Diabetes increases your chances of having your first stroke.

• An ideal blood sugar level can help reduce the risk of a second stroke or heart attack.

• When people with A1C levels higher than 7% were admitted to the hospital, their chances of having another stroke increased by 28%.

According to new research, perfect blood sugar levels may exist for diabetics who suffer a stroke in order to reduce the risk of later vascular disorders such as a stroke or heart attack.

The study’s findings were published in the medical journal “Neurology.”

“We know that having diabetes may be associated with an increased risk of having a first stroke,” said study author Moon-Ku Han, MD, PhD, of Seoul National University College of Medicine in Korea.

“But our results indicate that there is an optimal blood sugar level that may start to minimize the risk of having another stroke, a heart attack or other vascular problems, and it’s right in the 6.8 per cent to 7.0 per cent range,” Han added.

There were 18,567 diabetics in the research, with an average age of 70. A blood clot produced an ischemic stroke in all of the subjects; therefore they were all brought to the hospital. Researchers utilized a test called hemoglobin A1C to evaluate people’s average blood sugar level over the previous two to three months after they were admitted.

This test determines the percentage of sugar-coated hemoglobin proteins in the blood. A level of less than 5.7 percent is considered normal, while a level of 6.5 percent or greater implies diabetes. The average A1C of the subjects was 7.5 percent.

The researchers then followed up a year later to see if A1C levels were linked to the risk of having another stroke, a heart attack, or dying from these or other vascular causes.

Within a year of commencing the trial, 1,437 people, or about 8%, had a heart attack or died from vascular illness, and 954, or 5%, had another stroke.

People brought to the hospital with A1C levels above 6.8% to 7.0 percent had a higher risk of having a vascular event, such as a heart attack, as well as having another stroke, according to the study.

After controlling for characteristics such as age and gender, researchers discovered that those brought to the hospital with A1C levels above 7.0 percent had a 27 percent higher risk of a heart attack or other vascular disease than those hospitalized with A1C values below 6.5 percent.

When people with A1C levels above 7.0 percent were admitted to the hospital, their chance of having another stroke was 28 percent higher than when they had A1C levels below 6.5 percent.

 “Our findings highlight the importance of keeping a close eye on your blood sugar if you’re diabetic and have had a stroke,” Han said.

The study’s main weakness is that participants’ blood sugar levels were only assessed once at the start of the study.

 

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Cardiology News

Researchers develop low-cost sensor that detects heart attack in less than 30 minutes

by Vaishali Sharma
written by Vaishali Sharma

Researchers from the University of Notre Dame and the University of Florida have developed a sensor that could diagnose a heart attack in less than 30 minutes, according to a study published in Lab on a Chip.

Currently, it takes health care professionals hours to diagnose a heart attack. Initial results from an echocardiogram can quickly show indications of heart disease, but to confirm a patient is having a heart attack, a blood sample and analysis is required. Those results can take up to eight hours.

“The current methods used to diagnose a heart attack are not only time intensive, but they also have to be applied within a certain window of time to get accurate results,” said Pinar Zorlutuna, the Sheehan Family Collegiate Professor of Engineering at Notre Dame and lead author of the paper. “Because our sensor targets a combination of miRNA, it can quickly diagnose more than just heart attacks without the timeline limitation.”

By targeting three distinct types of microRNA or miRNA, the newly developed sensor can distinguish between an acute heart attack and a reperfusion — the restoration of blood flow, or reperfusion injury, and requires less blood than traditional diagnostic methods to do so. The ability to differentiate between someone with inadequate blood supply to an organ and someone with a reperfusion injury is an unmet, clinical need that this sensor addresses.

“The technology developed for this sensor showcases the advantage of using miRNA compared to protein-based biomarkers, the traditional diagnostic target,” said Hsueh-Chia Chang, the Bayer Professor of Chemical and Biomolecular Engineering at Notre Dame and co-author of the paper. “Additionally, the portability and cost efficiency of this device demonstrates the potential for it to improve how heart attacks and related issues are diagnosed in clinical settings and in developing countries.”

A patent application has been filed for the sensor and the researchers are working with Notre Dame’s IDEA Center to potentially establish a startup company that would manufacture the device.

Bioengineers Chang and Zorlutuna are both affiliated with Notre Dame’s Institute for Precision Health. Additional co-authors from Notre Dame are Stuart Ryan Blood, Cameron DeShetler, Bradley Ellis, Xiang Ren, George Ronan and Satyajyoti Senapati. Co-authors from the University of Florida are David Anderson, Eileen Handberg, Keith March and Carl Pepine. The study was funded by the National Institutes of Health National Heart, Lung, and Blood Institute.

Source:University of Notre Dame

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