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1.  Are We Missing Hypertrophic Cardiomyopathy in Pregnancy? Experience of a Tertiary Care Hospital 
Background: Controversies persist regarding risks associated with pregnancy and delivery in women with hypertrophic cardiomyopathy (HCM). To date, pregnancy outcome data for these patients is scarce. We report the experience of pregnancies with HCM in a tertiary care hospital.
Materials and Methods: Data regarding cardiac illness and obstetric profile of all women attending the cardio-obstetrics clinic from January 1990 to December 2012 were studied. The records of cardiac illness of all women were checked and all patients with HCM were included in the study.
Results: Out of total 2016 patients booked in the cardio-obstetrics clinic between 1990 and 2012, only 4 women were found to have a diagnosis of HCM (0.2%). Of these, 2 women with left ventricular outflow tract obstruction and one with non-obstructive HCM had only mild symptoms and tolerated pregnancy and labour well. One patient had HCM with restrictive physiology developed heart failure and intra-uterine fetal death.
Conclusion: HCM is underdiagnosed and rarely identified in pregnancy. Most patients with HCM tolerated pregnancy well, howeverone patient with restrictive physiology developed heart failure during her first pregnancy.
doi:10.7860/JCDR/2014/9924.4803
PMCID: PMC4225939  PMID: 25386487
Hypertrophic cardiomyopathy; Pregnancy
2.  Left Ventricular Diastolic Parameters in Dilated Cardiomypoathy: Are We Missing Out on Something? 
Equilibrium radionuclide ventriculography is an established modality to assess the left ventricular (LV) systolic function in several clinical situations. Diastolic parameters can also be extracted from this investigation. The aim of our study is to assess the diastolic function of the left ventricle in cases of idiopathic dilated cardiomyopathy (IDCM) and ischemic cardiomyopathy, where systolic dysfunction has been considered of prime pathologic significance. We conducted a retrospective analysis of 89 patients who had undergone radionuclide ventriculography at our department with established diagnosis of IDCM in 59 patients and ischemic cardiomyopathy in remaining 30 patients. Peak filling rate (PFR) was assessed. The PFR was significantly lower in both patients with IDCM (median = 1.61 end diastolic volumes [EDV]/s) and ischemic cardiomyopathy (median = 2.005 EDV/s). 33% of the patients with ischemic cardiomyopathy and ejection fraction (EF) >45% had diastolic dysfunction while 25% of patients with IDCM and EF >45% had low PFR. Diastolic dysfunction can coexist in patients with dilated cardiomyopathy and even in patients with preserved LV EF. Routine evaluation of diastolic function in patients with heart failure can help in elucidation of pathogenesis and management of patients.
doi:10.4103/1450-1147.139136
PMCID: PMC4150164  PMID: 25191121
Cardiomyopathy; diastolic function; ejection fraction; multiple gated acquisition; radionuclide ventriculography; systolic function
4.  Former Heroin Addicts with or without a History of Cocaine Dependence are more Impulsive than Controls 
Drug and Alcohol Dependence  2012;124(1-2):113-120.
Background
Personality traits such as impulsivity and sensation seeking may contribute to the initiation and maintenance of illicit drug use. Since studies have reported higher impulsivity and sensation seeking traits in cocaine dependent subjects, we were interested in determining whether former heroin addicts in methadone pharmacotherapy with comorbid cocaine addiction have greater impulsivity than those without.
Methods
Instruments to assess impulsivity (Barratt Impulsiveness Scale version 11) and sensation seeking (Sensation Seeking Scale version V) were administered to former severe heroin addicts meeting Federal criteria for methadone maintenance pharmacotherapy with (n = 71) or without cocaine dependence (n = 31) and to 145 normal healthy (non-methadone-maintained) volunteers.
Results
The methadone-maintained without cocaine dependence and the methadone-maintained with cocaine dependence groups, both scored higher than did the normal volunteer group on the Barratt Impulsiveness Scale total score (p < 0.001). On the Barratt Impulsiveness Scale Attentional, Nonplanning, and Motor subscales, the methadone-maintained and methadone-maintained with cocaine dependence groups scored higher than did normal volunteers with no history of drug abuse or dependence (p < 0.001). There was no difference among groups on total score or any subscale of the Sensation Seeking Scale. However, males in all groups overall scored higher than did females on Disinhibition and Thrill and Adventure seeking subscales of the Sensation Seeking Scale version V (p < 0.001).
Conclusions
This study demonstrates higher impulsivity in former severe heroin addicts meeting criteria for or currently in stable methadone maintenance pharmacotherapy, irrespective of a positive or negative history of cocaine dependence.
doi:10.1016/j.drugalcdep.2011.12.022
PMCID: PMC3372650  PMID: 22265192
impulsiveness; sensation seeking; methadone maintenance; heroin addiction; cocaine dependence; gender differences
7.  Expression of coxsackievirus and adenovirus receptor and its cellular localization in myocardial tissues of dilated cardiomyopathy 
BACKGROUND:
Myocarditis and dilated cardiomyopathy (DCM) are common causes of morbidity and mortality in children and adults. Recently, the human coxsackievirus and adenovirus receptor (CAR), a common receptor for coxsackieviruses and adenoviruses, was discovered and its increased expression has been reported in patients with DCM and myocarditis.
OBJECTIVE:
To measure the expression of CAR in myocardial tissues of patients with DCM and its cellular localization in DCM cases.
METHODS:
Formalin-fixed myocardial tissues collected during autopsy from 26 cases of DCM, and 20 cases each of noncardiac disease and cardiac disease other than DCM were included as the test group, and control groups A and B, respectively. Expression of CAR was studied using immunohistochemical staining of myocardial tissue with a CAR-specific rabbit polyclonal antibody. CAR messenger RNA was semiquantified by reverse transcription polymerase chain reaction followed by agarose gel analysis and measurement of band intensity.
RESULTS:
CAR positivity in DCM cases was found to be 96% (25 of 26) compared with 30% in control group A and 40% in control group B. CAR was found to be expressed in myocytes, endothelial and interstitial cells; however, positivity in myocytes was significantly higher than in other cells in all groups. The site of CAR expression was predominantly the sarcolemma along with cytoplasm in cardiomyocytes.
CONCLUSIONS:
The present study highlighted the increased expression of CAR in DCM cases, with localization in myocytes and endothelial cells.
PMCID: PMC3627271  PMID: 23592932
Autopsy; CAR; Dilated cardiomyopathy; Myocarditis
9.  Alcohol septal ablation – An evolving procedure 
Indian Heart Journal  2012;64(6):591-593.
doi:10.1016/j.ihj.2012.10.002
PMCID: PMC3861222  PMID: 23253413
10.  A common MYBPC3 (cardiac myosin binding protein C) variant associated with cardiomyopathies in South Asia 
Nature genetics  2009;41(2):187-191.
Heart failure is a leading cause of mortality in South Asians. However, its genetic etiology remains largely unknown1. Cardiomyopathies due to sarcomeric mutations are a major monogenic cause for heart failure (MIM600958). Here, we describe a deletion of 25 bp in the gene encoding cardiac myosin binding protein C (MYBPC3) that is associated with heritable cardiomyopathies and an increased risk of heart failure in Indian populations (initial study OR = 5.3 (95% CI = 2.3–13), P = 2 × 10−6; replication study OR = 8.59 (3.19–25.05), P = 3 × 10−8; combined OR = 6.99 (3.68–13.57), P = 4 × 10−11) and that disrupts cardiomyocyte structure in vitro. Its prevalence was found to be high (~4%) in populations of Indian subcontinental ancestry. The finding of a common risk factor implicated in South Asian subjects with cardiomyopathy will help in identifying and counseling individuals predisposed to cardiac diseases in this region.
doi:10.1038/ng.309
PMCID: PMC2697598  PMID: 19151713

Results 1-10 (10)