Ejection fraction at the first attack of myocardial infarction and postinfarction survival in south Indian population.

Ischemic heart disease is estimated to be the most important cause of mortality by the end of 2020 world wide despite sufficient improvement in health care. It has several modifiable and few non modifiable prognostic variables. Therefore, we analyzed the data of all patients admitted for the first time for acute myocardial infarction (MI) and evaluated the long term modifiable prognostic variables retrospectively. We did not find any difference in the age, blood pressure, hematological and several biochemical parameters between patients who survived and those who expired in 4 years of follow up. Our study revealed that in the expired group patients, the mean admission heart rate, ejection fraction, serum urea and creatinine levels were higher and bicarbonate level was lower compared to survived group patients at the first attack of MI. Also, despite the less incidence of myocardial infarction in females, the percentage of cardiac death was higher in female MI patients. We suggest from our retrospective analysis that MI patients with higher heart rate, altered renal function and metabolic acidosis should be rigorously followed up and special counseling should be provided to old age female patients for better prognosis and survival.

Inflammation and oxidative stress in hypothyroids: Additive effects on cardiovascular risk.

Cardiovascular disease is one of the major complications of hypothyroidism which is one of the most common endocrine disorders in India. In the present study, we have analyzed the link among oxidative stress, C reactive protein which is an inflammatory marker and the cardiovascular lipid risk factors in hypothyroid patients which has not been analyzed before. Sixty seven untreated hypothyroid patients were recruited consecutively for the study. Their ultrasensitive C reactive protein level and oxidative stress profile were measured apart from various lipid risk factors of cardiovascular disease. Ultra sensitive C reactive protein was significantly correlated with increased lipid risk factors of cardiovascular disease, thyroid stimulating hormone level and indices of oxidative stress in these patients. Low grade inflammation in hypothyroidism plausibly acts as the link between higher oxidative stress and the underlying cardiovascular risk among hypothyroid patients.

Association of albumin-globulin ratio with sympathovagal imbalance in pregnancy-induced hypertension.

The early prediction of pregnancy-induced hypertension (PIH) is based on the demonstration of increased sympathetic activity in early part of pregnancy. However, the mechanisms that increase sympathetic activity in PIH have not yet been fully elucidated. Therefore, in the present study we have investigated the link of albumin-globulin ratio (AGR) to sympathovagal imbalance in PIH patients. Spectral analysis of HRV was performed in three groups of subjects (Group I: normal pregnant women; Group II: pregnant women with risk factors for PIH, but did not develop PIH; Group III: pregnant women with risk factors and developed PIH) and their biochemical parameters including AGR were recorded. It was observed that LF-HF ratio, the most sensitive indicator of sympathovagal balance was significantly high (P<0.01) since early pregnancy in group III compared to other groups, which was considerably correlated with AGR in group III (PIH subjects). It was suggested that alteration in AGR could have direct contribution to the sympathovagal imbalance that plays a critical role in the genesis of PIH.

Myocardial infarction in prediabetic patients: Role of blood pressure dyshomeostasis.

Male gender and fasting sugar level at pre diabetic range are two of the recognized risk factors associated with coronary artery disease. Recently it was found that although males are at increased incidence of myocardial infarction (MI), the severity of disease is same for both genders among pre-diabetic myocardial infarction cases. In this study, we have retrospectively analyzed various biochemical and physiological parameters and cardiac markers of patients admitted for the first instance of myocardial infarction. We found an evidence of impairment in blood pressure homeostasis in female patients which could be one of the factors responsible for the equal degree of severity in myocardial infarction among females compared to males, despite lower incidence of MI in them.

Gender difference in the effect of short-term calorie restriction on body weight and immunological parameters in albino rats.

In the present study, we have assessed the effect of gender on short-term calorie restriction influencing body weight and immunological parameters in albino rats. Adult albino rats (12 females, 12 males) were taken for the study and randomly divided into control and experimental groups of both the genders (n=6 in each). Following the recording of their basal 24 h food intake and body weight, rats of experimental groups were allowed to undergo food restriction (eat every alternate day) for 21 days, whereas control rats were allowed to eat normally. 7 days before the completion of food restriction, all animals were immunized and different immunological parameters such as: –log2 of anti-SRBC titer (Ab titer), liver weight/body weight ratio (LWBWR), spleen weight/body weight ratio (SWBWR), total globulin (Tg) and albumin/globulin ratio (AGR) were assessed. Following three weeks of intermittent calorie restriction, LWBWR was increased in both male (p<0.05) and female (p<0.001) experimental rats compared to their respective controls. Though the increase in SWBWR was not statistically significant in male rats, the increase was significant in female rats (p<0.05). The SRBC titer and total globulin concentration were increased significantly in both male (p<0.01) and female (p<0.001) experimental rats. The decrease AGR was more in female compared to male rats (p<0.01). The decrease in body weight following calorie restriction was significantly correlated with alteration in their immunological parameters. Short-term intermittent calorie restriction was found to facilitate immunity, especially in female rats, which promises future research on health promoting effects of calorie control.

Myocardial infarction in nondiabetic and prediabetic population : A retrospective analysis.

Diabetes mellitus (DM) is one of the important risk factors for cardiac diseases. Type 2 DM is the commonest form of diabetes, which is characterized by insulin resistance. Insulin resistance can be preceded by long term abnormality in glucose homeostasis which is called pre-diabetes. Recently, pre-diabetes has been suggested to have an increased risk of cardiovascular disease. Considering that India has been declared as a diabetic capital of the world it deemed pertinent to assess the exact load of pre diabetics and non diabetics landing in myocardial infarction. We analyzed retrospectively the data of all patients admitted for the first time for acute myocardial infarction (MI) and evaluated the load of non diabetics, pre diabetics and diabetics among them. We found difference in the severity of diseases and degree of biochemical alterations among the three groups suggesting that abnormal glucose homeostasis has no role on the severity of MI. No previous studies have investigated the difference in male and female MI patients with respect to their glucose metabolism and its impact on the severity of the disease. Our study reveals that males even with normal glucose level are at increased risk to develop MI. Males on the other hand have increased risk for MI when compared to females with normal glucose homeostasis.

Sympathovagal imbalance in thyroid dysfunctions in females: Correlation with thyroid profile, heart rate and blood pressure.

The aim of the study was to investigate the role of spectral analysis of heart rate variability (HRV) for assessing the type and degree of sympathovagal imbalance (SVI) and their link to cardiovascular morbidities in thyroid dysfunctions. Forty-five female subjects (15 control subjects and freshly diagnosed untreated 15 hypothyroid and 15 hyperthyroid patients) were recruited for the study. Thyroid profile, body mass index (BMI), basal heart rate (BHR), blood pressure (BP) and spectral indices of HRV (TP, LFnu, HFnu and LF-HF ratio, mean RR, SDNN and RMSSD) were assessed in all the three groups. LF-HF ratio was correlated with thyroid profile, BMI, BHR and BP. SVI was more prominent in hyperthyroid (P<0.001) compared to hypothyroid (P<0.05) subjects. LF-HF ratio was correlated with thyroid profile in both hypo and hyperthyroid subjects; but correlation with BHR and BP was significant only in hyperthyroidism. Though the SVI was found to be due to both vagal withdrawal and sympathetic activation, especially in hyperthyroidism, contribution by vagal inhibition was prominent. Vagal inhibition contributes significantly to SVI in thyroid dysfunctions, especially in hyperthyroidism. As the present study indicates poor cardiovascular health due to vagal inhibition in patients suffering from thyroid dysfunctions, attempt should be made to improve vagal tone especially in hyperthyroid subjects to attain a stable sympathovagal and cardiovascular homeostasis.