Browsing by Author "Arjun Tandon"

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Acute changes in left ventricle end-diastolic pressure in patients undergoing nonprimary percutaneous coronary intervention
(Wolters Kluwer Medknow Publications, 2025) Arjun Tandon; Salini Mukhopadhyay; Soumik Ghosh; A. Lavakumar; Kumar Amit; Vikas Agrawal
Background: Percutaneous coronary intervention (PCI) is a critical procedure for managing coronary artery disease (CAD), with nonprimary PCI being increasingly used in elective revascularization. Left ventricular end-diastolic pressure (LVEDP) is an essential marker of ventricular function, often compromised in CAD patients. While its acute changes have been widely studied in primary PCI, research on nonprimary PCI remains limited. This study investigates the acute changes in LVEDP during nonprimary PCI. Materials and Methods: The study was conducted on 100 patients undergoing nonprimary PCI at a tertiary hospital. Baseline LVEDP measurements were taken before the procedure, and post-PCI LVEDP changes were recorded. Patients were categorized based on acute coronary syndrome (ACS) or chronic coronary syndrome (CCS), as well as subcategorized on the type of ACS. Statistical analysis included Mann-Whitney and Kruskal-Wallis tests, with P < 0.05 considered statistically significant. Results: The mean LVEDP decreased by 2.49 mmHg in ACS patients but increased by 0.96 mmHg in CCS patients. ST-segment elevation myocardial infarction (STEMI) patients showed the most significant reduction in LVEDP post-PCI, while non-STEMI (NSTEMI) and unstable angina exhibited smaller decreases. A significant negative correlation was found between LVEDP change and left ventricular ejection fraction. No significant correlation was found between LVEDP change and type and quantity of contrast agent used, number of stents used, serum creatinine level, or coexisting comorbidities such as hypertension and diabetes mellitus. Conclusion: The study highlights that LVEDP decreases more significantly in acute ischemic conditions, such as STEMI, compared to chronic conditions, suggesting that acute myocardial ischemic damage is more reversible with PCI than chronic ischemic damage. The findings indicate that LVEDP is a useful parameter in assessing the success of PCI, particularly in ACS patients, and may help predict procedural outcomes. © 2025 Heart India.
Echoes of Recovery: Echocardiographic and Quality of Life Transformations after Percutaneous Atrial Septal Defect Closure
(Wolters Kluwer Medknow Publications, 2025) Arjun Tandon; Pratibha Rai; Soumik Ghosh; Manish Kumar; Vikas Agrawal
Background: Atrial septal defects (ASDs) are among the most common congenital heart diseases in adults and may lead to right heart dilation, pulmonary hypertension, and arrhythmias if left untreated. This study aims to evaluate the short and mid term effects of percutaneous transcatheter closure of secundum ASDs on right ventricular (RV) structure and function, as well as on patient reported quality of life (QoL). Materials and Methods: This prospective observational study was conducted at a tertiary care center and included 60 adult patients (mean age: 38.26 ± 12.58 years; 80% female) who underwent transcatheter closure of secundum ASDs. Eligible patients demonstrated significant left to right shunting (pulmonary to systemic flow ratio >1.5) with suitable septal anatomy. Exclusion criteria included severe pulmonary arterial hypertension, Eisenmenger physiology, and complex congenital heart disease. Comprehensive transthoracic echocardiography and the 12 item Short Form Health Survey (SF 12) were administered at baseline, 24 h, and 90 days post-procedure. The primary endpoints were echocardiographic indicators of RV remodeling; secondary endpoints focused on changes in QoL domains. Results: The mean ASD diameter was 21.85 ± 4.72 mm. By Day 90, RV basal diameter decreased from 45.00 mm to 36.93 mm (P < 0.001), and RV outflow tract diameter reduced from 28.82 mm to 23.23 mm (P < 0.001). RV fractional area change improved (32.75% to 35.20%, P = 0.022), and myocardial performance index declined from 0.52 to 0.36 (P < 0.001). QoL significantly improved across physical, emotional, and social domains. Conclusions: Percutaneous ASD closure leads to significant right heart remodeling and improved functional and psychosocial outcomes within 3 months. © 2025 Journal of the Indian Academy of Echocardiography & Cardiovascular Imaging.
Ironing Out the Link: Ferritin and Coronary Artery Disease- a Two-year Perspective on Disease Burden and Prognosis
(Sciendo, 2025) Soumik Ghosh; Rajpal Prajapati; Chandra Kishore; Amit K. Gauraw; Arjun Tandon
Purpose: This study evaluates the association between serum ferritin levels, coronary artery disease (CAD) severity, and survival outcomes over two years. It also examines correlations between ferritin and clinical parameters, including age and creatinine. Methods: A total of 300 CAD patients underwent coronary angiography (CAG). Serum ferritin levels were categorized as low (<30 μg/L), normal (30-300 μg/L for males and 30-200 μg/L for females), and high (>300 μg/L for males and >200 μg/L for females). CAD severity was classified into non-critical, single-vessel, dual-vessel, and triple-vessel disease. Survival outcomes were recorded as alive, deceased, or lost to follow-up. Statistical analyses included Pearson's correlation, Chi-square tests, and Kaplan-Meier survival curves. Results: The mean age was 59.03 ± 9.42 years, with 71.66% males. Hypertension and diabetes were present in 51.66% and 35.33% of patients, respectively. Ferritin levels showed a weak negative correlation with age (r = -0.122, P = 0.035) and a positive correlation with creatinine (r = 0.281, P = 0.001). Elevated ferritin levels were significantly associated with dual-vessel disease (50%) and mortality (P = 0.001). Deceased patients had higher ferritin levels (142.0 μg/L vs. 90.45 μg/L in survivors; P = 0.001). Conclusions: Ferritin is strongly associated with CAD severity and mortality, particularly in dual-vessel disease. Its potential role in early risk stratification suggests clinical relevance. Further research should explore ferritin's mechanistic link to CAD progression and its integration into prognostic models. © 2025 Soumik Ghosh et al., published by Sciendo.
Low-tech, high-value: Electrocardiographic markers of left ventricular dysfunction in non-ischemic cardiomyopathy
(Brawijaya University, 2025) Soumik Ghosh; Arjun Tandon; A. Lava Kumar; Srashti Kulshreshtha; Kumar Amit; Vikas Agrawal
Background: Electrocardiography (ECG) is a widely accessible, cost-effective diagnostic tool, particularly valuable in resource-limited settings where echocardiography is unavailable. Identifying ECG parameters that reflect left ventricular (LV) systoli c dysfunction could enable earlier detection and intervention in patients with non-ischemic cardiomyopathy (NICM). Objective: To evaluate the correlation between ECG parameters—QTc duration, QRS duration, morphology, voltage, and axis— and left ventricular ejection fraction (LVEF) in NICM patients with reduced ejection fraction (REF), and to assess their potential as surrogate markers of LV systolic function. Methods: A cross-sectional study was conducted on 140 NICM patients (LVEF ≤40%) confirmed by echocardiography and angiography. Clinical, biochemical, and ECG data were collected. Pearson’s correlation and ANOVA were used to assess associations between ECG variables, mitral regurgitation (MR) severity, hemoglobin levels, and LVEF. Result: QTc duration showed a significant inverse correlation with LVEF (r = –0.428, p = 0.001). Hemoglobin levels were positively correlated with LVEF (r = 0.175, p = 0.039). The presence of mitral regurgitation was associated with lower LVEF (p = 0.029), with a trend toward further decline as severity increased. Conclusion: Prolonged QTc was strongly associated with reduced LVEF in patients with non-ischemic cardiomyopathy. As ECG is inexpensive and widely available, QTc may provide a simple surrogate marker to aid in identifying LV dysfunction, especial ly in resource-limited settings. Larger prospective studies with outcome data are needed to validate its prognostic role. © 2025, Brawijaya University. All rights reserved.
Navigating risks and rewards in percutaneous transcatheter mitral commissurotomy: A multicenter hemodynamic analysis of safety and efficacy in symptomatic mitral stenosis
(Slovak Society of Cardiology, 2025) Soumik Ghosh; Tusharkanti Patra; Arjun Tandon; Vikas Agrawal
Aims: This study evaluates the safety and efficacy of Percutaneous Transcatheter Mitral Commissurotomy (PTMC) in treating symptomatic rheumatic mitral stenosis (MS), using invasive hemodynamic parameters. PTMC, a less invasive alternative to surgical mitral valvotomy, is widely used for severe MS but involves risks like mitral regurgitation (MR) and procedural complications. We aimed to assess PTMC’s safety through changes in left ventricular end-diastolic pressure (LVEDP) and efficacy via reductions in left atrial pressure (LAP) in a multicenter cohort. Methods: This prospective, two-year study included 328 patients undergoing PTMC at IPGIMER- SSKM, Kolkata, and IMS-BHU, Varanasi, India. Patients were symptomatic, over 18 years old, and had severe MS (MVA ≤1.5 cm2) with favorable valve morphology. Exclusions included left atrial thrombus, significant MR, and additional valve disease. PTMC was performed with a 24-28 mm Accura balloon catheter. Outcomes were grouped by procedural safety (LVEDP increase <50%) and efficacy (LAP reduction ≥50%). Results: The mean participant age was 37.92 years, with 72.2% female. Procedures were both safe and efficacious in 26.83% of cases, and safe but inefficacious in 32.32%. Older patients were more likely to have unfavorable outcomes (p=0.0012), with no significant gender-based differences. Conclusion: PTMC effectively reduces LAP in severe MS but involves risks, particularly for older patients with complex valve morphology. PTMC is beneficial when performed in experienced centers, but careful patient selection and further long-term studies are essential to enhance procedural outcomes. Fig. 1, Tab. 3, Ref. 15, on-line full text (Free, PDF), www.cardiologyletters.sk © 2025, Slovak Society of Cardiology. All rights reserved.
Survival and Clinical Outcomes After Single-vessel Percutaneous Coronary Intervention Using Drug-eluting Stent: An Observational and Follow-up Study in a Tertiary Care Center in the Gangetic Plains of North India
(Journal of Association of Physicians of India, 2025) Soumik Ghosh; Rajpal Prajapati; Arjun Tandon; Amit K. Gauraw; Kumar Amit; Om Shankar
Introduction: Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) has transformed the management of coronary artery disease (CAD), particularly for single-vessel disease (SVD), by reducing restenosis rates. However, long-term survival data following PCI in North Indian populations are limited. This study aimed to evaluate survival and clinical outcomes after PCI with DES and identify factors associated with mortality and adverse events, such as chest pain, dyspnea, and bleeding. Materials and methods: This observational cohort study at Sir Sunder Lal Hospital, Banaras Hindu University, included 1,112 adult patients undergoing single-vessel PCI with DES. Patients were followed for 18 months via outpatient assessments and telephonic interviews to assess survival, chest pain, dyspnea, and bleeding. Data were analyzed using IBM SPSS Statistics (Version 25.0). Continuous variables were reported as mean ± SD, and categorical data as frequencies and percentages. Chi-square and independent t-tests were used, with a 5% significance level. Results: Of the 782 patients who were successfully followed up after 18 months, 740 (94.62%) were alive, and 42 (5.38%) had died. Significant factors associated with mortality included older age (p = 0.013), history of hospitalization (p < 0.001), chest pain (p < 0.001), dyspnea (p < 0.001), and bleeding (p < 0.001). Acute coronary syndrome (ACS) was the leading cause of death (52.3%), followed by post-PCI complications. Conclusion: PCI with DES demonstrated a high survival rate in North Indian patients with SVD. Key predictors of mortality were age, history of hospitalization, and post-PCI symptoms, emphasizing the need for long-term follow-up and aggressive management of symptoms to improve outcomes. ©The Author(s).