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Biomedical subjects

I Sathyamurthy

Publications and source records attributed to I Sathyamurthy.

At least 19 recordsLinked to original sources
PubMed2003

Profile of female patients undergoing coronary angiogram at a tertiary centre.

OBJECTIVE: To study clinical profile, risk factors and pattern of coronary artery involvement in females. MATERIAL AND METHOD: Female patients undergoing coronary angiography at Apollo Hospitals, Chennai during 1996-1998 for angina were analysed for risk factors. RESULTS: Out of 5997 angiograms, 660 (11%) were females of which 574 (88%) post-menopausal. 48% had atypical chest pain, 11% had unstable angina, 1% had acute myocardial infarction (MI). Past history of MI was present in 48%. Risks factors were hypertension in 60%, diabetes in 52%, obesity in 41%, dyslipidemia in 32%, family history in 36%. 71% patients used oral contraceptive. None of the patients were smoker, 34.8% pre-menopausal and 72.2% post-menopausal had coronary artery disease. Single vessel disease 33% vs 22.1% two vessel disease 43.3 vs 31.2%. Triple vessel 22.3 vs 46.6% and diffuse disease 10% vs 38.7% was seen in pre-menopausal vs post-menopausal females, respectively. CONCLUSIONS: Family history was the predominant risk factor in pre-menopausal and diabetes mellitus and hypertension in post-menopausal females. Diffuse and triple vessel disease were significantly common in post-menopausal females.

Adult↗
PubMed2003

Adenosine myocardial SPECT--its efficacy and safety and correlation with coronary angiogram.

OBJECTIVE: The aim of this study was to determine the safety and efficacy of adenosine Tc99m sestamibi myocardial perfusion study under controlled conditions and to correlate the adenosine Tc99m sestamibi perfusion defects and the coronary angiography in patients investigated for coronary artery disease. METHODS: This prospective study included 122 consecutive patients who underwent adenosine Tc99m sestamibi single photon emission computed tomography (SPECT) myocardial perfusion study. Seventy two patients had coronary angiographic correlation. All the patients who were referred by the cardiologists for stress myocardial perfusion scan who could not be stressed physiologically for one reason or the other were included in the study. RESULTS: Among the coronary angiography group the overall sensitivity, specificity, positive predictive value and negative predictive value of adenosine Tc99m sestamibi single photon emission computed tomography myocardial perfusion study for detecting significant coronary obstruction (diameter > or = 50%) were 94.4%, 79%, 85% and 92% respectively. The side effects were transient and required no treatment. CONCLUSION: We conclude adenosine Tc99m sestamibi single photon emission computed tomogram myocardial perfusion study is a reliable test with high sensitivity and specificity for the detection of coronary artery disease.

Adenosine↗
PubMed2002

Is increased apolipoprotein B-A major factor enhancing the risk of coronary artery disease in type 2 diabetes?

OBJECTIVES: An association of Apolipoprotein B (Apo B) with coronary artery disease (CAD) independent of LDL cholesterol (LDLc) concentrations has been reported in white population. This analysis was taken up to study whether the higher CAD risk in Asian Indians with diabetes could be explained by possible alterations in Apo B and Apolipoprotein A1 (Apo A1) concentrations. METHODS: The study group consisted of four hundred and forty seven men aged > or = 25 years, 167 with CAD and 280 with no CAD, classified by coronary angiography. Plasma lipid profile including total cholesterol, LDLc, Apo A1 and Apo B were done. Glucose tolerance was evaluated in all. RESULTS: Age, BMI, Apo B, and Apo A1 were significantly associated with CAD in a multiple regression analysis. Hyper Apo B was more common than hyper LDLc in CAD (73.6% vs 20.4%, chi2 = 157, P < 0.001). Apo B concentrations were increased in diabetic subjects even in the presence of normal levels of LDLc and in the absence of CAD. CONCLUSIONS: The study has shown that the apolipoproteins B and A1 provide better information regarding the risk of CAD. Apo B abnormalities exist in large percentages of CAD subjects despite having normal levels of LDLc. Diabetes per se enhances the Apo B concentrations and this could probably be one of the mechanisms of accelerated CAD in diabetes. Hyper Apo B may be an index of CAD risk.

Adult↗
PubMed2002

Plasma homocysteine concentration and coronary artery disease in Asian Indians.

OBJECTIVE: This study was done (a) to evaluate the relationship between the plasma total homocysteine (tHcy) levels and coronary artery disease (CAD) in Asian Indians and (b) to see the relationship between tHcy and glucose intolerance. METHODS: Fasting concentrations of plasma tHcy was measured in 137 men, aged > or = 25 years who underwent coronary angiography while investigating for chest pain. Among them 71 had no CAD and 66 had CAD. Fasting plasma glucose (FPG) and glycosylated haemoglobin (HbA1c) were estimated. Total Hcy was measured using the Elisa method (Axis Biochemicals ASA-Oslo, Norway) in fasting EDTA plasma. RESULTS: The subjects with CAD were significantly older but had similar body mass index (BMI), waist-hip ratio (WHR), FPG and HbA1c values compared with the non-CAD subjects (P < 0.001). The median tHcy and the percentages of abnormal values were similar in non-CAD and CAD groups. No significant differences were seen in the four subgroups with respect to the mean tHcy or the percentage of abnormal values. The highest tHcy values were seen in the non-diabetic, non-CAD group (group 1--control). CONCLUSION: This preliminary data indicates that tHcy concentrations are not elevated in subjects with CAD and probably there is no association between total homocysteine and CAD in Indians. Homocysteine values were not influenced by the glucose tolerance status. Measurement of homocysteine concentrations may be more appropriate when the blood levels of vitamin B12 and folate are also measured.

Adult↗
PubMed2001

Risk variables for coronary artery disease in Asian Indians.

No large study from India has addressed the association of risk variables with coronary artery disease (CAD) in angiographically proved cases. In this study, we analyzed the association of anthropometric variables, lipoproteins, and coagulation parameters with CAD in those cases proved by coronary angiography. A cross-sectional study of 447 men > or = 25 years old, classified as with CAD or without CAD, was performed. Men treated with aspirin or lipid-lowering agents, and those with renal, hepatic, or thyroid diseases were excluded. Associations of these variables with CAD were evaluated by univariate and multiple logistic regression analyses. The effect of diabetes on the CAD profile was also analyzed. Prevalences of diabetes and hypertension were significantly higher among those with CAD (p <0.001 for both). Lipid profile abnormalities, except lipoprotein (Lp(a)), were associated with CAD. Antibodies to oxidized low-density lipoprotein was higher in patients with CAD. Fibrinogen levels were higher in CAD, but plasminogen activator inhibitor-1 did not show an association with CAD. In the multiple logistic regression analysis, age, body mass index, very-low-density lipoprotein cholesterol, total to high-density lipoprotein cholesterol ratio, and fibrinogen showed significant independent association with CAD. Several lipid abnormalities were associated with CAD in Asian Indians, but no significant association was seen with Lp(a) levels.

Adult↗
PubMed1998

Left ventricular mural thrombus following myocardial infarction--a follow up study.

Left Ventricular mural thrombus detected by echocardiography in 41 patients after myocardial infarction (MI) were followed up for 4 years. Thirty eight patients were males and mean age of study population was 52.4 years. Echocardiography revealed predominant mural type of thrombi (38 patients) and none showed mobility. All of them showed regional wall motion abnormality (RWMA) and Left Ventricular (LV) aneurysm was found in 28 patients. Embolic events were observed in 6 patients and 1 patient died following embolic stroke. Follow up study revealed persistent left ventricular thrombus in 19 patients and risk factors detected were severe LV dysfunction and LV aneurysm. Six patients had spontaneous resolution and 6 had resolution of the thrombus after anticoagulants. While anticoagulant therapy was very effective in preventing embolism after recent MI (within 3 weeks), it was found not useful in chronic LV thrombi. We observed ongoing embolic risk in chronic LV thrombi with LV aneurysms but a randomised trial is needed to decide the role of anticoagulants in such situation.

Adult↗
PubMed1993

Pseudocoarctation of the aorta: a magnetic resonance imaging correlation.

We present here the clinical and angiographic features in a patient with pseudocoarctation of the aorta and aortic valvular stenosis. An MRI study performed to delineate the aorta provided valuable correlations and highlighted the potential of this noninvasive modality for the diagnosis of pseudocoarctation of the aorta.

Aorta↗
PubMed1980

Ajmaline in WPW syndrome: an electrophysiologic study.

Six patients including three females with WPW syndrome (three with type A and three with type B) presenting with recurrent paroxysmal tachyarrhythmia were subject to electrophysiological studies. Apart from basal parameters, rapid atrial and ventricular pacing was done which confirmed electrophysiological characteristics of bundle of Kent operation. A single intravenous bolus of ajmaline 50 mg. was effective in blocking the bundle of Kent in all patients within 30 seconds of injection with the effect persisting for 15 minutes in one and from 25 to 60 minutes in the others. The most dramatic effect was prolongation of the HV interval with normalization of QRS complex with a marginal effect on the AH interval. The drug was also effective in breaking narrow QRS tachycardia in two patients and broad QRS tachycardia in one patient. Long-term oral therapy with ajmaline has proved effective in preventing recurrent tachyarrhythmias. We conclude that ajmaline is specifically effective and safe in the treatment of the WPW syndrome.

Adult↗
PubMedDate not supplied

Hemangioma of the pericardium: a case report.

A 52-year-old male presented with dyspnoea on exertion. He was found to have a clinically normal cardiac status and a mass lesion in the anterior mediastinum, probably arising from the pericardium near the right atrium, as shown by both echocardiography and a computerized tomographic scan of the chest. He was successfully operated. The histopathology of the mass revealed it to be a hemangioma of the pericardium. This is one of the rare tumors of the pericardium and only a few cases have been reported in the literature.

Heart Neoplasms↗
PubMedDate not supplied

Surgical repair of left ventricular aneurysms: a comparative evaluation of linear versus Dor's repair.

BACKGROUND: Resection and linear repair of aneurysms of the left ventricle alter its geometry and thereby reduce its performance over the long term. Hence, Dor's circular patch repair was advocated to maintain the geometry of the left ventricle. However, the superiority of this procedure over linear repair is debatable. METHODS AND RESULTS: We retrospectively analyzed 95 cases of left ventricular aneurysm repair--28 cases by Dor's procedure and 67 by linear repair. The age group, symptoms, risk-factor profile and severity of coronary artery disease were comparable in both the groups, but the cardiopulmonary bypass and mean aortic cross-clamp time were longer in those treated with Dor's procedure. The left internal mammary artery could be grafted to the left anterior descending artery or diagonal branch in 13 cases in the group undergoing Dor's procedure (group I) versus 14 cases in the group undergoing linear repair (group II). There was no mortality in group I while there were 7 deaths in group II. Patients in group I were followed up for up to 2 years and those in group II for up to 13 years. During follow-up, 16/2 8 remained in NYHA functional class I or II in group I versus 24/67 in group II. The mean preoperative left ventricular ejection fraction was 34.9% in group I which improved to 39.7% during follow-up. In group II, the mean preoperative left ventricular ejection fraction was 37.2% which improved to 41.5% during follow-up. This difference was not statistically significant. CONCLUSIONS: In our retrospective study, we did not observe any superiority of Dor's repair over linear repair for left ventricular aneurysm as regards NYHA functional class and left ventricular ejection fraction. However, follow-up with Dor's repair was short (up to 2 years). Hence, no definite conclusions can be drawn.

Adult↗