Indian Journal of Clinical Cardiology

To determine the prevalence of sarcopenia and sarcopenic obesity (SO) in patients with type-2 diabetes mellitus (T2DM) and established cardiovascular disease (CVD).

This cross-sectional study included 60 T2DM patients (30 with CVD and 30 without, aged 40-70 years, 80% males). Data collection included body composition analysis using bio-impedance, hand grip strength measurement and gait-speed assessment. Sarcopenia was defined using the Asian Working Group for Sarcopenia (AWGS-19) guidelines, while SO was defined using a body-mass index, waist circumference and percentage of body fat. SPSS software version 23.0 was used. P < .05 was significant.

Overall sarcopenia (including possible sarcopenia or sarcopenia) was found to be significantly higher in patients with CVD as compared to those without CVD (70% vs. 40%; P = .020). Although numerically greater (in patients with CVD), no statistically significant difference was found in the prevalence of SO (30% vs. 16.7%; P = .222).

Our study found that the prevalence of overall sarcopenia was significantly higher in patients with T2DM and CVD compared to those without CVD. Sarcopenia appears to be a potential independent risk factor in predicting risk of CVD in patients with T2DM.

Ischemic Heart Disease (IHD) is the leading cause of mortality among cardiovascular disorders. There is inadequate knowledge about the prevalence of IHD in Bangladesh, particularly in diabetes mellitus patients. This research aimed to ascertain the frequency of IHD in diabetic individuals and to identify risk factors for IHD in rural areas.

A cross-sectional survey was in a rural community in a diabetic cohort. Simple random sampling was used to select 150 diagnosed diabetic patients of both genders, aged 30 to 65, from registration numbers within the diabetic cohort. Diagnosis of IHD was based on the history of established IHD and ECG and echocardiography findings.

The results showed that the prevalence of IHD among diabetic patients is 4%. The univariate binary logistic regression analysis identified significant factors associated with IHD, including older age (OR 1.15; 95% CI 1.01-1.31), higher body mass index (BMI) (OR 1.30; 95% CI 1.07-1.52), increased duration of diabetes (OR 1.13; 95% CI 1.00-1.28), and smokeless tobacco use (OR 5.26; 95% CI 1.00-27.7). However, after adjustment in the logistic regression model, a significantly higher risk of IHD was found to be associated with patients having a higher BMI (AOR 1.43, 95% CI 1.14-1.80) and a longer duration of diabetes (AOR 1.26, 95% CI 1.07-1.48).

The present data indicate that the prevalence of IHD in Bangladesh is 4%, which is a significant issue for diabetic individuals. Regular screening and careful monitoring are necessary among diabetic patients to reduce the risk of cardiovascular diseases, including IHD.

Thyroid diseases are common in India. Both insufficient and excess thyroid hormones cause adverse cardiovascular events. Subclinical hypothyroidism and hyperthyroidism while undiagnosed can lead to derangement of cardiac functions. This study aimed to explore thyroid function abnormalities among heart failure patients of different severity (NYHA class).

A descriptive, cross-sectional study was undertaken on 492 heart failure patients (246 males and 246 females) of age greater than 18 years. Patients were classified according to NYHA. Serum TSH and FT4 were investigated. Data were analyzed by standard statistical software.

The mean age of participants was 54.2 ± 13.1 years. Mean FT4 and TSH were 1.36 ± 0.39 ng/dL and 2.89 ± 1.15 mIU/L, respectively. Patients belonged to NYHA class II (35.4%), III (52.4%) and IV (12.2%). Comorbidities included Hypertension (38%), Diabetes Mellitus (29%) and Dyslipidemia (52%). Hypothyroidism and hyperthyroidism were present in 27% and 5% patients respectively in overt or subclinical forms. The prevalence of thyroid disorders among NYHA class II, III and IV patients were 17%, 37%, and 50%, respectively.

Thyroid disorders were present in about one-third of the patients with heart failure. The prevalence of hypothyroidism was almost five times that of hyperthyroidism. The prevalence of thyroid disorders increased with the severity of heart failure.

Cardiomyopathy, a rare heart disease, is characterized by abnormalities in cardiac wall thickness and chamber size, leading to impaired contraction, relaxation, conduction, rhythm, and reduced pumping ability.

This review aims to provide a comprehensive understanding of cardiomyopathy by examining its various aspects

A literature survey was conducted using online databases such as PubMed, Google Scholar, and Web of Science, covering publications from January 1995 to July 2023.

Genetic mutations in key muscle contraction genes (MYH7, MYL2, MYL3, MYBPC3, TNNT2, TPM1, TNNI3, ACTC) contribute to cardiomyopathy. Additionally, epigenetic markers in genes like FKBP5, TBX5, HAND1, POLA2, PLAAT3, and CCDC88B, along with environmental factors such as alcohol addiction, smoking, and stress, significantly influence disease risk. Genetic testing, including whole exome/genome sequencing, has revolutionized diagnosis, enabling early detection and intervention. Familial genetic testing facilitates personalized management.

Cardiomyopathy is a complex disease with genetic and environmental influences. Various techniques, including genetic testing, aid in its identification and management. Furthermore, machine learning (ML) techniques have emerged as valuable tools in understanding and predicting cardiomyopathy outcomes.

Spontaneous coronary artery dissection (SCAD) often impacts young women who lack traditional risk factors. Diagnosing SCAD can be challenging due to its diverse angiographic presentations and resemblance to other conditions, such as organized thrombus.

We present two cases involving middle-aged male smokers, each experiencing chest pain lasting over 12 hours. Both patients exhibited ST-segment elevation in the anterior leads on ECG, anterior wall hypokinesia, and an LVEF of 40% on 2D echocardiography. Immediate coronary angiography revealed dye staining and multiple radiolucent lumens in the LAD, indicative of SCAD. Optical coherence tomography (OCT) identified an organized thrombus with a distinctive “Swiss cheese” pattern, differing from the usual radiolucent false lumen associated with SCAD. Both patients were successfully treated with PCI, including thrombus aspiration and stent placement.

Relying solely on angiography for SCAD diagnosis may overlook organized thrombus. Redefining SCAD criteria and utilizing multimodal imaging like OCT in all cases is essential.