Browsing by Author "Nair, K"

Now showing 1 - 16 of 16
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    ACE I/D polymorphism in Indian patients with hypertrophic cardiomyopathy and dilated cardiomyopathy
    (MOLECULAR AND CELLULAR BIOCHEMISTRY, 2008) Rai, TS; Dhandapany, PS; Ahluwalia, TS; Bhardwaj, M; Bahl, A; Talwar, KK; Nair, K; Rathinavel, A; Khullar, M
    Aim The study was carried to determine the association of angiotensin converting enzyme (ACE) insertion/deletion (I/D) polymorphism with the risk of hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), and restrictive cardiomyopathy (RCM). Methods and results A total of 174 patients diagnosed with cardiomyopathy (118 with HCM, 51 with DCM, and 5 with RCM) and 164 ethnically, age- and gender-matched controls were included in the study. ACE I/D genotyping was performed by PCR. In total, 25.86% of the patients were in New York Heart Association (NYHA) class III and IV at presentation. A total of 67.24% patients had dyspnea, 56.89% had angina pectoris, and 25.28% of the patients had at least one event of syncope. Frequency of occurrence of the disease was more in male patients compared to female patients (P < 0.05). After adjustment for age, sex, body mass index (BMI), and smoking habit, the prevalence of ACE DD genotype, and ACE 'D' allele was significantly higher in patients as compared to controls and was associated with increased risk (DD: OR 2.11, 95% CI 1.27-3.52, P < 0.05; 'D': OR 1.91, 95% CI 1.08-3.35, P < 0.05). The mean septal thickness was higher for DD and ID genotypes (20.40 +/- 3.73 mm and 21.82 +/- 5.35 mm, respectively) when compared with II genotype (18.63 +/- 6.69 mm) in HCM patients, however, the differences were not significant statistically (P > 0.05). The DCM patients with ID genotype showed significantly decreased left ventricular ejection fraction (LVEF) at enrolment (26.50 +/- 8.04%) (P = 0.04). Conclusion Our results suggest that D allele of ACE I/D polymorphism significantly influences the HCM and DCM phenotypes.
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    Developments in mechanical heart valve prosthesis
    (SADHANA-ACADEMY PROCEEDINGS IN ENGINEERING SCIENCES, 2003) Nair, K; Muraleedharan, CV; Bhuvaneshwar, GS
    Artificial heart valves are engineered devices used for replacing diseased or damaged natural valves of the heart. Most commonly used for replacement are mechanical heart valves and biological valves. This paper briefly outlines the evolution, designs employed, materials being used,. and important factors that affect the performance of mechanical heart valves. The clinical performance of mechanical heart valves is also addressed. Efforts made in India in the development of mechanical heart valves are also discussed.
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    Double right coronary artery with anomalous origin of septal arteries from the right coronary sinus
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 2005) Nair, K; Krishnamoorthy, KM; Tharakan, JA
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    Hutchinson-Gilford progeria syndrome with severe calcific aortic valve stenosis and calcific mitral valve
    (JOURNAL OF HEART VALVE DISEASE, 2004) Nair, K; Ramachandran, P; Krishnamoorthy, KM; Dora, S; Achuthan, TJ
    The case of a 12-year-old girl with clinical features of progeria with severe calcific valvar aortic stenosis is presented. The mitral valve showed the presence of calcium, and peripheral vascular disease was also present, though there was no family history of this. Aortic valve replacement was deferred because of insufficient data relating to this condition. The genetics and phenotypic mechanisms of the disease are reviewed. In view of the association of progeria with valve disease, all patients should undergo electrocardiography and echocardiography as part of their routine work-up.
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    Native vessel angioplasty as treatment strategy for left internal mammary artery to pulmonary vasculature fistula producing coronary steal phenomenon
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 2009) Bijulal, S; Namboodiri, N; Nair, K; Ajitkumar, VK
    Formation of fistulous connection between internal mammary graft and pulmonary vasculature after coronary artery bypass graft (CABG) is a rare event, which can result in recurrence of symptoms ranging from stable angina to myocardial infarction related to coronary steal. We hereby report a case of a 56-year-old man who was detected to have such a fistulous communication leading to coronary steal as the cause of effort angina 3 years after CABG. Coronary angioplasty and stenting of left anterior descending artery resulted in resolution of symptoms. Native vessel percutaneous coronary intervention as a treatment strategy for internal mammary artery to pulmonary artery fistula has not been reported previously. (c) 2007 Elsevier Ireland Ltd. All rights reserved.
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    Oblique vein of Marshall.
    (Heart (British Cardiac Society), 2005)
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    Origin of three coronary arteries from the right sinus; ramus intermedius from the left sinus and hybrid distribution
    (CANADIAN JOURNAL OF CARDIOLOGY, 2005)
    A 72-year-old hypertensive man with diabetes. had a previously undiagnosed pattern of coronary artery. distribution: the ramus intermedius from the left sinus, and the separate origin of the left anterior descending artery, left circumflex artery and right coronary artery from the right sinus. A unique form of branching, a hybrid distribution, was also noted: the left anterior descending artery giving off a right ventricular branch and septals arising from the ramus. No intervention was planned due to the minimal disease observed with angiography and the absence of an interarterial course.
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    Percutaneous transmitral commissurotomy in juvenile mitral stenosis - Comparison of long term results of inoue balloon technique and metallic commissurotomy
    (CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2006)
    Objectives: To compare the immediate and long term results of percutaneous mitral valvotomy using metallic commissurotome and Inoue balloon in juvenile mitral stenosis. Background: Inoue balloon technique for mitral commissurotomy (IBMC) is well established and carried out worldwide in the treatment of juvenile mitral stenosis. Percutaneous mitral metallic commissurotomy (PMMC) is reported to be a cheaper and effective alternative to balloon mitral commissurotomy. Methods: Thirty-three patients aged less than 20 years, who underwent PMMC, were compared with 33 age and sex matched control patients who underwent IBMC. Success of valvotomy, procedure related complications, and follow-up events of the two techniques were compared. Results: Basal echocardiographic and hemodynamic data were similar in both groups. Procedural success was similar in both groups, 31/33. Complications like cardiac tamponade and mitral regurgitation (requiring or not requiring mitral valve replacement) were similar in both groups. On follow-up of more than 3 years, both groups had comparable hemodynamic parameters and restenosis rates. Conclusions: Both IBMC and PMMC are successful in providing relief from severe juvenile mitral stenosis in terms of gain in valve area and reduction in transmitral gradient. Both techniques have similar procedural success and complication rates. The long term follow-up results are comparable at follow-up of more than 3 years. (c) 2006 Wiley-Liss, Inc.
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    Polymorphic ventricular tachycardia after radiofrequency maze procedure: Report of two cases
    (JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2005)
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    Rebuttal: Percutaneous Valvuloplasty for Mitral Valve Restenosis
    (CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2011) Nair, K; Sivadasanpillai, H; Sivasubramonium, P; Ramachandran, P; Tharakan, JA; Kumar, A; Sivasubramonian, S; Krishnamoorthy, KM; Dora, S
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    Retrieval of friable catheter fragments
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 2006)
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    Role of left atrial compliance in determination of left atrial pressures in pure mitral stenosis and the effect of age on it - A hemodynamic study in patients undergoing balloon mitral valvotomy
    (AMERICAN JOURNAL OF CARDIOLOGY, 2006) Namboodiri, NKK; Thomas, V; Tharakan, JA; Krishnamoorthy, KM; AjithKumar, VK; Harikrishnan, S; Dora, KSK; Nair, K; Sivasankaran, S; Titus, T
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    Role of statins in acute coronary syndromes
    (ACTA CARDIOLOGICA, 2004)
    Statins reduce major coronary events and all-cause mortality in patients with coronary artery disease. Statin therapy has a proven track record for the secondary prevention of coronary artery disease. The extension of the benefit to patients with acute coronary syndromes can be expected. Apart from their lipid-lowering effects, statins significantly and favourably alter the natural history of acute coronary syndromes. Promotion of plaque stability, improvement of endothelial dysfunction and reversal of coagulation and platelet abnormalities are only some of the effects which are beneficial in the management of these patients. Early potential clinical benefits further strengthen the rationale for starting statin treatment as soon as possible after acute coronary events particularly in patients in whom invasive intervention is planned. This review examines their role in acute coronary syndromes and emphasizes the benefits of early statin therapy.
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    Spontaneous automaticity of an atriofascicular accessory pathway
    (EUROPACE, 2006) Dora, SK; Tharakan, JA; Valaparambil, A; Namboodiri, N; Nair, K; Peter, T
    In a 12-year-old girt with history of recurrent palpitation, an ambulatory 24 h Hotter electrocardiogram showed a wide QRS complex rhythm with atrioventricular dissociation. During an electrophysiology study, an atriofascicular pathway was diagnosed with an inducible antidromic atrioventricutar re-entrant tachycardia. At slower heart rates, the patient had a wide QRS complex escape rhythm similar to the tachycardia and the pre-excited QRS complex morphology. This indicates the presence of pacemaker-like cells in the atriofascicular accessory pathway giving rise to the wide QRS complex escape rhythm at a slower heart rate.
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    Ventricular septal rupture following myocardial infarction. Long-term survival of patients who did not undergo surgery. Single-centre experience
    (ACTA CARDIOLOGICA, 2005) Pillai, HS; Tharakan, J; Titus, T; Kumar, A; Sivasubramonian, S; Mahadevan, KK; Dora, S; Nair, K; Namboodiri, N
    Long-term survival is rare in patients not undergoing surgery after post-myocardial infarction ventricular septal rupture. We report our experience of seven patients out of 27, who did not undergo surgery and were followed up for a mean period of 2.8years. They were evaluated after a mean period of 2.2 months after infarction in our centre. The septal defects measured 9.8 mms on average and the mean left-to-right shunt ratio was 1.98: L The mean pulmonary artery, right atrial and left ventricular end diastolic pressures were 28.3 +/- 10.6, 4 +/- 3 and 15.8 +/- 4.8 mm Hg, respectively. Only three out of seven patients had LV aneurysm and all patients had single-vessel disease. Smaller defect size, minimal left-to-right shunt and preserved right ventricular function may be the factors responsible for long-term survival.