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11. Poster session Thursday 12 December - PM: 12/12/2013, 14:00-18:00 * Location: Poster area

Author

Garcia Martin, A, Fernandez Golfin, C, Salido Tahoces, L, Fernandez Santos, S, Jimenez Nacher, JJ, Moya Mur, JL, Velasco Valdazo, E, Hernandez Antolin, R, Zamorano Gomez, JL, Veronesi, F, Corsi, C, Caiani, EG, Lamberti, C, Tsang, W, Holmgren, C, Guo, X, Bateman, M, Iaizzo, P, Vannier, M, Lang, RM, Patel, AR, Adamayn, KG, Tumasyan, L R, Chilingaryan, AL, Nasr, G, Eleraki, A, Farouk, N, Axelsson, A, Langhoff, L, Jensen, MK, Vejlstrup, N, Iversen, K, Bundgaard, H, Watanabe, T, Iwai-Takano, M, Attenhofer Jost, C H, Pfyffer, M, Seifert, B, Scharf, C, Candinas, R, Medeiros-Domingo, A, Chin, J-Y, Yoon, HJ, Vollbon, W, Singbal, Y, Rhodes, K, Wahi, S, Katova, T M, Simova, I I, Hristova, K, Kostova, V, Pauncheva, B, Bircan, A, Sade, LE, Eroglu, S, Pirat, B, Okyay, K, Bal, U, Muderrisoglu, H, Heggemann, F, Buggisch, H, Welzel, G, Doesch, C, Hansmann, J, Schoenberg, S, Borggrefe, M, Wenz, F, Papavassiliu, T, Lohr, F, Roussin, I, Drakopoulou, M, Rosen, S, Sharma, R, Prasad, S, Lyon, AR, Carpenter, JP, Senior, R, Breithardt, O-A, Razavi, H, Arya, A, Nabutovsky, Y, Ryu, K, Gaspar, T, Kosiuk, J, Eitel, C, Hindricks, G, Piorkowski, C, Pires, S, Nunes, A, Cortez-Dias, N, Belo, A, Zimbarra Cabrita, I, Sousa, C, Pinto, F, Baron, T, Johansson, K, Flachskampf, FA, Christersson, C, Pires, S, Cortez-Dias, N, Nunes, A, Belo, A, Zimbarra Cabrita, I, Sousa, C, Pinto, F, Santoro, A, Federico Alvino, FA, Giovanni Antonelli, GA, Raffaella De Vito, RDV, Roberta Molle, RM, Sergio Mondillo, SM, Gustafsson, M, Alehagen, U, Johansson, P, Tsukishiro, Y, Onishi, T, Chimura, M, Yamada, S, Taniguchi, Y, Yasaka, Y, Kawai, H, Souza, J R M, Zacharias, L G T, Pithon, K R, Ozahata, T M, Cliquet, A JR, Blotta, M H, Nadruz, W JR, Fabiani, I, Conte, L, Cuono, C, Liga, R, Giannini, C, Barletta, V, Nardi, C, Delle Donne, MG, Palagi, C, Di Bello, V, Glaveckaite, S, Valeviciene, N, Palionis, D, Laucevicius, A, Hristova, K, Bogdanova, V, Ferferieva, V, Shiue, I, Castellon, X, Boles, U, Rakhit, R, Shiu, M F, Gilbert, T, Papachristidis, A, Henein, M Y, Westholm, C, Johnson, J, Jernberg, T, Winter, R, Ghosh Dastidar, A, Augustine, D, Cengarle, M, Mcalindon, E, Bucciarelli-Ducci, C, Nightingale, A, Onishi, T, Watanabe, T, Fujita, M, Mizukami, Y, Sakata, Y, Nakatani, S, Nanto, S, Uematsu, M, Saraste, A, Luotolahti, M, Varis, A, Vasankari, T, Tunturi, S, Taittonen, M, Rautakorpi, P, Airaksinen, J, Ukkonen, H, Knuuti, J, Boshchenko, A, Vrublevsky, A, Karpov, R, Yoshikawa, H, Suzuki, M, Hashimoto, G, Kusunose, Y, Otsuka, T, Nakamura, M, Sugi, K, Rosner, SJ, Orban, M, Lesevic, H, Karl, M, Hadamitzky, M, Sonne, C, Panaro, A, Martinez, F, Huguet, M, Moral, S, Palet, J, Oller, G, Cuso, I, Jornet, A, Rodriguez Palomares, J, Evangelista, A, Stoebe, S, Tarr, A, Pfeiffer, D, Hagendorff, A, Gilmanov, DSH, Baroni, MB, Cerone, EC, Galli, EG, Berti, SB, Glauber, MG, Soesanto, A, Yuniadi, Y, Mansyur, M, Kusmana, D, Venkateshvaran, A, Dash, P K, Sola, S, Govind, S C, Shahgaldi, K, Winter, R, Brodin, L A, Manouras, A, Dokainish, H, Sadreddini, M, Nieuwlaat, R, Lonn, E, Healey, J, Nguyen, V, Cimadevilla, C, Dreyfus, J, Codogno, I, Vahanian, A, Messika-Zeitoun, D, Lim, Y-J, Kawamura, A, Kawano, S, Polte, CL, Gao, S, Lagerstrand, KM, Cederbom, U, Bech-Hanssen, O, Baum, J, Beeres, F, Van Hall, S, Boering, YC, Zeus, T, Kehmeier, ES, Kelm, M, Balzer, JC, Della Mattia, A, Pinamonti, B, Abate, E, Nicolosi, GL, Proclemer, A, Bassetti, M, Luzzati, R, Sinagra, G, Hlubocka, Z, Jiratova, K, Dostalova, G, Hlubocky, J, Dohnalova, A, Linhart, A, Palecek, T, Sonne, C, Lesevic, H, Karl, M, Rosner, S, Hadamitzky, M, Ott, I, Malev, E, Reeva, S, Zemtsovsky, E, Igual Munoz, B, Alonso Fernandez Pau, PAF, Miro Palau Vicente, VMP, Maceira Gonzalez Alicia, AMG, Estornell Erill, JEE, Andres La Huerta, AALH, Donate Bertolin, LDB, Valera Martinez, FVM, Salvador Sanz Antonio, ASS, Montero Argudo Anastasio, AMA, Nemes, A, Kalapos, A, Domsik, P, Chadaide, S, Sepp, R, Forster, T, Onaindia, JJ, Arana, X, Cacicedo, A, Velasco, S, Rodriguez, I, Capelastegui, A, Sadaba, M, Gonzalez, J, Salcedo, A, Laraudogoitia, E, Archontakis, S, Gatzoulis, K, Vlasseros, I, Arsenos, P, Tsiachris, D, Vouliotis, A, Sideris, S, Karistinos, G, Kalikazaros, I, Stefanadis, C, Ancona, R, Comenale Pinto, S, Caso, P, Coppola, MG, Arenga, F, Cavallaro, C, Vecchione, F, Donofrio, A, Calabro, R, Correia, C E, Moreira, D, Cabral, C, Santos, JO, Cardoso, JS, Igual Munoz, B, Maceira Gonzalez, AMG, Estornell Erill Jordi, JEE, Jimenez Carreno, RJC, Arnau Vives, MAV, Monmeneu Menadas, JVMM, Domingo-Valero, DDV, Sanchez Fernandez, ESF, Montero Argudo Anastasio, AMA, Zorio Grima, EZG, Cincin, A, Tigen, K, Karaahmet, T, Dundar, C, Sunbul, M, Guler, A, Bulut, M, Basaran, Y, Mordi, I, Carrick, D, Berry, C, Tzemos, N, Cruz, I, Ferreira, A, Rocha Lopes, L, Joao, I, Almeida, AR, Fazendas, P, Cotrim, C, Pereira, H, Ochoa, J P, Fernandez, A, Filipuzzi, JM, Casabe, JH, Salmo, JF, Vaisbuj, F, Ganum, G, Di Nunzio, HJ, Veron, LF, Guevara, E, Salemi, VMC, Nerbass, FB, Portilho, N, Ferreira Filho, JCA, Pedrosa, RP, Arteaga-Fernandez, E, Mady, C, Drager, LF, Lorenzi-Filho, G, Marques, JS, Almeida, A M G, Menezes, M, Silva, GL, Placido, R, Amaro, C, Brito, D, Diogo, AN, Lourenco, M R, Azevedo, O, Moutinho, J, Nogueira, I, Machado, I, Portugues, J, Quelhas, I, Lourenco, A, Calore, C, Muraru, D, Melacini, P, Badano, LP, Mihaila, S, Puma, L, Peluso, D, Casablanca, S, Ortile, A, Iliceto, S, Kang, M-K, Yu, SH, Park, JJ, Kim, SH, Park, TY, Mun, H-S, C, S, Cho, S-R, Han, SW, Lee, N, Khalifa, E A, Hamodraka, E, Kallistratos, M, Zacharopoulou, I, Kouremenos, N, Mavropoulos, D, Tsoukas, A, Kontogiannis, N, Papanikolaou, N, Tsoukanas, K, Manolis, A, Villagraz Tecedor, L, Jimenez Lopez Guarch, C, Alonso Chaterina, S, Blazquez Arrollo, L, Lopez Melgar, B, Veitia Sarmiento, AL, Mayordomo Gomez, S, Escribano Subias, MP, Lichodziejewska, B, Kurnicka, K, Goliszek, S, Dzikowska Diduch, O, Kostrubiec, M, Krupa, M, Grudzka, K, Ciurzynski, M, Palczewski, P, Pruszczyk, P, Sakata, K, Ishiguro, M, Kimura, G, Uesugo, Y, Takemoto, K, Minamishima, T, Futuya, M, Matsue, S, Satoh, T, Yoshino, H, Signorello, MC, Gianturco, L, Colombo, C, Stella, D, Atzeni, F, Boccassini, L, Sarzi-Puttini, PC, Turiel, M, Kinova, E, Deliiska, B, Krivoshiev, S, Goudev, A, De Stefano, F, Santoro, C, Buonauro, A, Schiano-Lomoriello, V, Muscariello, R, De Palma, D, Galderisi, M, Ranganadha Babu, B, Chidambaram, SUNDAR, Sangareddi, V, Dhandapani, VE, Ravi, MS, Meenakshi, K, Muthukumar, D, Swaminathan, N, Ravishankar, G, Bruno, R M, Giardini, G, Catizzo, B, Brustia, R, Malacrida, S, Armenia, S, Cauchy, E, Pratali, L, Resamont2, Cesana, F, Alloni, M, Vallerio, P, De Chiara, B, Musca, F, Belli, O, Ricotta, R, Siena, S, Moreo, A, Giannattasio, C, Magnino, C, Omede, P, Avenatti, E, Presutti, D, Sabia, L, Moretti, C, Bucca, C, Gaita, F, Veglio, F, Milan, A, Eichhorn, JG, Springer, W, Helling, A, Alarajab, A, Loukanov, T, Ikeda, M, Kijima, Y, Akagi, T, Toh, N, Oe, H, Nakagawa, K, Tanabe, Y, Watanabe, N, Ito, H, Hascoet, S, Hadeed, K, Marchal, P, Bennadji, A, Peyre, M, Dulac, Y, Heitz, F, Alacoque, X, Chausseray, G, Acar, P, Kong, WILL, Ling, LH, Yip, JAMES, Poh, KK, Vassiliou, V, Rekhraj, S, Hoole, SP, Watkinson, O, Kydd, A, Boyd, J, Mcnab, D, Densem, C, Shapiro, LM, Rana, BS, Potpara, TS, Djikic, D, Polovina, M, Marcetic, Z, Peric, V, Lip, GYH, Gaudron, P, Niemann, M, Herrmann, S, Hu, K, Strotmann, J, Beer, M, Bijnens, B, Liu, D, Ertl, G, Weidemann, F, Peric, V, Jovanovic, A, Djikic, D, Otasevic, P, Kochanowski, J, Piatkowski, R, Scislo, P, Grabowski, M, Marchel, M, Opolski, G, Bandera, F, Guazzi, M, Arena, R, Corra, U, Ghio, S, Forfia, P, Rossi, A, Dini, F, Cahalin, LP, Temporelli, L, Rallidis, L, Tsangaris, I, Makavos, G, Anthi, A, Pappas, A, Orfanos, S, Lekakis, J, Anastasiou-Nana, M, Kuznetsov, V A, Krinochkin, D V, Yaroslavskaya, E I, Zaharova, E H, Pushkarev, G S, Mizia-Stec, K, Wita, K, Mizia, M, Loboz-Grudzien, K, Szwed, H, Kowalik, I, Kukulski, T, Gosciniak, P, Kasprzak, J, Plonska-Gosciniak, E, Cimino, S, Pedrizzetti, G, Tonti, G, Cicogna, F, Petronilli, V, De Luca, L, Iacoboni, C, Agati, L, Hoffmann, R, Barletta, G, Von Bardeleben, S, Kasprzak, J, Greis, C, Vanoverschelde, J, Becher, H, Galrinho, A, Moura Branco, L, Fiarresga, A, Cacela, D, Ramos, R, Cruz Ferreira, R, Van Den Oord, SCH, Akkus, Z, Bosch, JG, Renaud, G, Sijbrands, EJG, Verhagen, HJM, Van Der Lugt, A, Van Der Steen, AFW, Schinkel, AFL, Mordi, I, Tzemos, N, Stanton, T, Delgado, D, Yu, E, Drakopoulou, M, Gonzalez-Gonzalez, AM, Karonis, T, Roussin, I, Babu-Narayan, S, Swan, L, Senior, R, Li, W, Parisi, V, Pagano, G, Pellegrino, T, Femminella, GD, De Lucia, C, Formisano, R, Cuocolo, A, Perrone Filardi, P, Leosco, D, Rengo, G, Unlu, S, Farsalinos, K, Amelot, K, Daraban, A, Ciarka, A, Delcroix, M, Voigt, JU, Miskovic, A, Poerner, TD, Goebel, B, Stiller, CH, Moritz, A, Sakata, K, Uesugo, Y, Kimura, G, Ishiguro, M, Takemoto, K, Minamishima, T, Futuya, M, Satoh, T, Yoshino, H, Miyoshi, T, Tanaka, H, Kaneko, A, Matsumoto, K, Imanishi, J, Motoji, Y, Mochizuki, Y, Minami, H, Kawai, H, Hirata, K, Wutthimanop, A, See, O, Vathesathokit, P, Yamwong, S, Sritara, P, Rosner, A, Kildal, AB, Stenberg, TA, Myrmel, T, How, OJ, Capriolo, M, Frea, S, Giustetto, C, Scrocco, C, Benedetto, S, Grosso Marra, W, Morello, M, Gaita, F, Garcia-Gonzalez, P, Cozar-Santiago, P, Chacon-Hernandez, N, Ferrando-Beltran, M, Fabregat-Andres, O, De La Espriella-Juan, R, Fontane-Martinez, C, Jurado-Sanchez, R, Morell-Cabedo, S, Ridocci-Soriano, F, Mihaila, S, Piasentini, E, Muraru, D, Peluso, D, Casablanca, S, Puma, L, Naso, P, Iliceto, S, Vinereanu, D, Badano, LP, Tarzia, P, Villano, A, Figliozzi, S, Russo, G, Parrinello, R, Lamendola, P, Sestito, A, Lanza, GA, Crea, F, Sulemane, S, Panoulas, VF, Bratsas, A, Frankel, AH, Nihoyannopoulos, P, Dores, H, Andrade, MJ, Almeida, MS, Goncalves, PA, Branco, P, Gaspar, A, Gomes, A, Horta, E, Carvalho, MS, Mendes, M, Yue, WS, Li, XY, Chen, Y, Luo, Y, Gu, P, Yiu, KH, Siu, CW, Tse, HF, Cho, EJ, Lee, SH, Hwang, BH, Kim, DB, Jang, SW, Jeon, HK, Youn, HJ, and Kim, JH

Abstract

Background: Progress in the technique of TAVR requires good knowledge of the aortic root. With this aim new specialized software appears, with the ability of automated quantitative modeling of the AV and root from 3D TEE.The purpose of this study was to validate this model with the measurements made manually. Methods: Eight patients undergoing TAVR in our center where included. The diameters of the aortic annulus, sinotubular union (STU) and sinus of valsalva (SV) were measured by 2D TEE; diameters and areas of aortic annulus, STU and SV as well as anatomic aortic valve area were measured by 3D TEE. Afterwards, the images were analyzed using the new software (Figure 1). Results. We showed good correlation with aortic annulus diameter measured by 2D TEE (r:,832 p:,01) and excellent correlation with one of the aortic annulus diameter measured by 3D TEE (r:,941 p:,00). The same happened with the area (r:,720 p:,04). Regarding the measurements at SV level, the correlations between the diameters by 2D TEE and 3D TEE with the measurements obtained with the new model were the following (r:,771;p:,025) and (r:,797;p:,018). The correlation of the area was also good (r:,812 p:,014).An excellent correlation was found between the measurements at UST level. UST diameter by 2D TEE (r:,818;P:,013), by ETE3D (r:,800;p:,017) and area (r:,844;p:,008).Finally, the anatomic aortic valve area measured by the new model showed significant correlation with the 3D TTE (r:,830 p:,011). Conclusions. There is a proper correlation between manual and automated measurements analyzed by the new model. The feasibility of determine the TAVR results with geometric models based on image, prior to procedure, is one of the possibilities of this new software. Prospective studies are necessary to define its applicability. Figure 1

Published
2013
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12. Factors which Influence the Levels of ST-2, Galectin-3 and MMP-9 in Acute Coronary Syndrome.

Author

Goenka L, Jha D, Sharma M, Dhandapani VE, and George M

Subjects
Acute Coronary Syndrome enzymology, Age Factors, Aged, Biomarkers blood, Blood Proteins, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Acute Coronary Syndrome blood, Galectins blood, Interleukin-1 Receptor-Like 1 Protein blood, Matrix Metalloproteinase 9 blood
Abstract

Background: Several cardiac biomarkers are being studied to explore their potential in the prognostication of Acute Coronary Syndrome (ACS). However, there are limited studies exploring the relationship between these biomarkers and clinical, laboratory and demographic characteristics., Objective: We sought to determine the factors which influence the concentration of novel cardiac biomarkers such as Galectin-3, suppression of tumorigenicity-2 (ST-2) and Matrix Metallopeptidase-9 (MMP-9) in patients with ACS., Methods: A total of 122 patients with ACS were enrolled in the study. The study patients were categorized into two groups namely: STEMI (n=58) and NSTEMI/UA (n=64). Plasma samples were used to determine the level of biomarkers, Galectin-3 and ST-2, and serum samples were used to determine the levels of MMP-9 using the Enzyme-linked immunosorbent assay (ELISA). The association between the plasma and serum levels of biomarkers and, demographic, clinical and laboratory variables were determined. Statistical analyses for the study were performed using SPSS 16.0 software (SPSS Inc., Chicago, IL, USA)., Results: Elderly aged [0.107 (0.012-0.969); p=0.047] patients had higher ST-2. Galectin-3 was higher among female patients [3.693(1.253-10.887); p=0.018] and patients with low left ventricular ejection fraction [2.882 (1.041-7.978); p=0.042]. Patients with lower body mass index [3.385 (1.241-9.231); p=0.017], diabetes [3.650 (1.302-10.237); p=0.014] and high total leukocyte count [2.900 (1.114-7.551; p=0.029] had higher MMP-9 levels., Conclusion: The concentration of galectin-3, ST-2 and MMP-9 are independently influenced by demographic, clinical and laboratory characteristics. It is estimated that these factors should be accounted for when interpreting the results of the biomarker assays., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Published
2020
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13. Prognostic role of soluble ST2 in acute coronary syndrome with diabetes.

Author

Jha D, Goenka L, Ramamoorthy T, Sharma M, Dhandapani VE, and George M

Subjects
Acute Coronary Syndrome complications, Acute Coronary Syndrome diagnostic imaging, Acute Coronary Syndrome mortality, Adult, Aged, Case-Control Studies, Coronary Angiography, Diabetes Mellitus, Type 2 complications, Enzyme-Linked Immunosorbent Assay, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Non-ST Elevated Myocardial Infarction complications, Non-ST Elevated Myocardial Infarction diagnostic imaging, Non-ST Elevated Myocardial Infarction mortality, Prognosis, Proportional Hazards Models, ROC Curve, ST Elevation Myocardial Infarction complications, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction mortality, Acute Coronary Syndrome blood, Diabetes Mellitus, Type 2 blood, Interleukin-1 Receptor-Like 1 Protein blood, Non-ST Elevated Myocardial Infarction blood, ST Elevation Myocardial Infarction blood
Abstract

Background: Acute coronary syndrome (ACS) patients are at an increased risk of major adverse cardiovascular events (MACE). The objective of our study was to assess whether cardiac biomarker like soluble ST2 (sST2) can predict MACE among ACS patients with diabetes., Materials and Methods: A total of 122 patients with ACS were included in the study. sST2 level in blood plasma samples was quantified using enzyme-linked immunosorbent assay (ELISA). Prognostic utility of sST2 for the primary outcome of MACE which included mortality, rehospitalization due to chest pain, unstable angina, recurrent myocardial infarction (MI) and stroke, was assessed during follow-up., Results: The median follow-up period was of 180 days. ROC (receiver operating characteristic) curve demonstrated that elevated levels of sST2 were able to predict mortality, and MACE in ACS patients, along with increased risk of occurrence of MACE and mortality in ACS patients having diabetes. Kaplan-Meier plots revealed a significant increase in the occurrence of MACE in diabetic ACS patients (P = 0.006; by log-rank test). Cox regression analysis revealed that sST2 is not an independent predictor of mortality and MACE in ACS patients having diabetes; however, high sST2 level was found to be a predictor of MACE in all ACS subjects in the fully adjusted model with a hazard ratio (HR) of 5.8 (P = 0.032)., Conclusion: The current study indicates that elevated levels of sST2 might be a suitable biomarker to evaluate the risk of future adverse cardiovascular events in ACS patients with diabetes., (© 2018 Stichting European Society for Clinical Investigation Journal Foundation.)

Published
2018
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14. Evaluation of Endothelial and Platelet Derived Microparticles in Patients with Acute Coronary Syndrome.

Author

George M, Ganesh MR, Sridhar A, Jena A, Rajaram M, Shanmugam E, and Dhandapani VE

Abstract

Background: Microparticles (MP) are a nuclear fragments of membrane released by the damaged cell during stress. Elevated levels of MP have been found in patients with acute coronary syndrome (ACS) owing to the damage in the endothelium., Aim: To determine if the levels of endothelial and platelet microparticles (EMP & PMP) in patients with ACS influenced the severity of the disease., Materials and Methods: This was a prospective cohort study performed in 63 ACS patients (ST elevation myocardial infarction- STEMI-28, non ST elevation myocardial infarction -NSTEMI-35). After obtaining consent, blood samples were collected from the patients and processed by flow cytometry., Results: The NSTEMI group had higher levels of EMP {792.11(327.59-1661.49) vs 300.35 (176.3-550.46), p=0.001} and PMP {218.87(86.65-439.77) vs 114.45(50.34-196.75), p= 0.007} as compared to the STEMI group. However, it was found that the EMP (r=-0.438, p=0.001) and PMP (r= -0.316, p=0.024) negatively correlated with Global Registry of Acute Coronary Events score (GRACE in-hospital score) for the entire cohort., Conclusion: The levels of microparticles are elevated in ACS patients and may reflect a protective effect in patients with acute coronary syndrome.

Published
2015
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15. Normal limits of ECG measurements related to atrial activity using a modified limb lead system.

Author

Sivaraman J, Uma G, Venkatesan S, Umapathy M, and Dhandapani VE

Subjects
Adult, Electrodes, Extremities, Humans, Male, Middle Aged, Posture, Atrial Function physiology, Electrocardiography, Heart Atria
Abstract

Objective: The present study was designed to derive the normal limits of a new ECG lead system aimed at enhancing the amplitude of atrial potentials through the use of bipolar chest leads., Methods: Sixty healthy male subjects, mean age 38.85±8.76 years (range 25 to 58 years) were included in this study. In addition to a standard 12-lead ECG, a modified limb lead (MLL) ECG was recorded for 60 sec with the RA electrode placed in the 3rd right intercostal space slightly to the left of the mid-clavicular line, the LA electrode placed in the 5th right intercostal space slightly to the right of the mid-clavicular line and the LL electrode placed in the 5th right intercostal space on the mid- clavicular line., Results: In the frontal plane, the modification of limb electrode positions produced significant changes compared to standard limb lead I and II. The mean P wave amplitude was 111±17μV in MLL I and 64±16μV in standard limb lead (SLL) I (p<0.001). Similarly it was 118±22μV in MLL II and 100±27μV in SLL II. No statistically significant changes were seen in V1-V6 due to modification of the Wilson central terminal electrode positions., Conclusion: The modification of limb electrode placement leads to changes in the amplitude of the P waves in the MLL leads I and II compared to SLL leads I and II in healthy subjects. These changes may be of importance in the detection of atrial electrical activity.

Published
2015
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16. A Rare Association of Parachute Mitral Valve with Double Outlet Right Ventricle and Severe Pulmonary Hypertension in an Adult.

Author

Meenakshi K, Chidambaram S, Dhandapani VE, and Rameshwar R

Subjects
Double Outlet Right Ventricle complications, Echocardiography, Humans, Hypertension, Pulmonary diagnosis, Male, Middle Aged, Mitral Valve Stenosis complications, Mitral Valve Stenosis congenital, Radiography, Thoracic, Abnormalities, Multiple, Double Outlet Right Ventricle diagnosis, Hypertension, Pulmonary etiology, Mitral Valve abnormalities, Mitral Valve Stenosis diagnosis
Abstract

Congenital mitral stenosis (MS) is a rare congenital cardiac malformation and the obstruction to the flow across the mitral valve can be caused by supramitral ring, commissural fusion, short chordae, anomalous mitral arcade, anomalous position of the papillary muscles and the so-called'parachute mitral valve'. We describe here the case of a 47 year old male diagnosed to have a double outlet right ventricle (DORV), subaortic ventricular septal defect (VSD) with no pulmonary stenosis, severe pulmonary hypertension and congenital MS due to parachute mitral valve.

Published
2014

17. An echocardiographic assessment of cardiovascular hemodynamics in patients with large pleural effusion.

Author

Chidambaram S, Sangareddi V, Ganesan G, Dhandapani VE, Ravi MS, Meenakshi K, Muthukumar D, Swaminathan N, and Ravishankar G

Subjects
Adolescent, Adult, Cardiac Tamponade etiology, Cohort Studies, Echocardiography methods, Female, Follow-Up Studies, Humans, India, Male, Middle Aged, Pericardiocentesis methods, Pleural Effusion complications, Radiography, Thoracic methods, Risk Assessment, Severity of Illness Index, Tertiary Care Centers, Treatment Outcome, Young Adult, Cardiac Tamponade diagnostic imaging, Cardiac Tamponade surgery, Cardiovascular System physiopathology, Hemodynamics physiology, Pleural Effusion diagnostic imaging
Abstract

Background: The close relationship between pleural space and pericardial space and the dependence of their pressure kinetics are well known. This study evaluates the effects of increased intra pleural pressure due to pleural effusion on cardiovascular system., Methods: Forty patients above the age of 12 who had massive unilateral/bilateral pleural effusion due to non-cardiac etiology were included in the study. Therapeutic thoracocentesis was done for massive pleural effusion. The echocardiographic parameters measured before and after thoracocentesis were compared., Results: Mean age of the patients 46.6 years. Out of 40 patients 8 were females (20%). 7 patients had right atrial collapse on echo. 85% of patients had significant flow velocity changes across both tricuspid valve and mitral valve during phases of respiration.11 patients (47.82%) had IVC compressibility of <50% during inspiration. Mean flow velocity respiratory variations across tricuspid valve before thoracocentesis and after thoracocentesis E 45.04 ± 10.3,32 ± 11.3% (p value <0.001), A 53.71 ± 28%, 32.08 ± 12.5% (p < 0.001) across mitral valve E 32.30 ± 12%, 19.78 ± 7.8% (p < 0.001), A 26 ± 11.2%, 21 ± 9.3% (p 0.006) across pulmonary artery 42.63 ± 31.3%, 17.70 ± 6.2% (p < 0.001), across aorta 21.57 ± 11.4%, 14.08 ± 7.6% (p < 0.001)., Conclusion: Large pleural effusion has a potential to cause adverse impact on the cardiovascular hemodynamics, which could manifest as tamponade physiology. Altered cardiac hemodynamics could be an important contributor in the mechanism of dyspnea in patients with large pleural effusion., (Copyright © 2013 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.)

Published
2013
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18. Large free-floating left atrial thrombus with normal mitral valve.

Author

Chidambaram S, Rajkumar A, Ganesan G, Sangareddi V, Ramasamy A, Dhandapani VE, and Ravi MS

Subjects
Adult, Diagnosis, Differential, Echocardiography, Electrocardiography, Fatal Outcome, Female, Humans, Heart Atria diagnostic imaging, Mitral Valve diagnostic imaging, Thrombosis diagnostic imaging
Abstract

Left atrial thrombus in the presence of diseased mitral valve and atrial fibrillation is a well known entity. But it is very rare to occur in the presence of normal mitral valve apparatus. We report the case of a 36 year old female who presented with left atrial ball valve thrombus and normal mitral valve apparatus and underwent surgery. This patient with gangrene of right lower limb came for cardiac evaluation. She had infarct in left middle cerebral artery territory- ten months prior to this admission and was on treatment for infertility. She had atrial fibrillation. Emergency surgery to remove the thrombus should be considered given its potential life threatening embolic nature., (Copyright © 2013 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.)

Published
2013
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