Browsing by Author "Kumar Amit"

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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.
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.
Qualitative and quantitative estimation of a polyherbal compound dashang lepa
(2013) Soni Ashish; S.J. Gupta; Kumar Amit; Y.B. Tripathi
In Ayurvedic system of medicine mainly polyherbal compounds are used for the treatment of various infections. Dashang lepa is one of the polyherbal compound which contain mixture of ten indigenous drugs. It is used to treat inflammatory swellings like as cellulitis by external application. As several study show qualitative and quantitative estimation of individual drug but none of the estimation involves combined study of Dashang lepa. Qualitative phytochemical, thin layer chromatography and quantitative loss on drying, ash value, pH value analysis were studied for polyherbal drug Dashang lepa. Methanolic extraction was carried out by hot percolation method through soxhlet apparatus. Phytochemical study was performed using various standard methods and TLC analysis was done with four type of solvent system. Determination of moisture content (loss on drying), measurement of ash value and pH value were also carried out as per standard guidelines of Ayurvedic Pharmacopoeia of India. The phytochemical analysis showed the presence of alkaloid, saponin, tannins, terpenoids, steroids, glycosides, phenols and flavonoids. TLC analysis shows six spots using chloroform: ethyl acetate: methanol (6: 3: 1) and toluene: chloroform: methanol (6: 3:1) two different solvent system. Loss on drying, ash value and pH were obtained 9 %, 8 % and 5.5 respectively.
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).