Population Study of Urban, Rural, and Semiurban Regions for the Detection of Endovascular Disease and Prevalence of Risk Factors and Holistic Intervention Study: Rationale, Study Design, and Baseline Characteristics of PURSE-HIS.

We designed and implemented the PURSE-HIS (Population Study of Urban, Rural and Semiurban Regions for the Detection of Endovascular Disease and Prevalence of Risk Factors and Holistic Intervention Study) to understand the prevalence and progression of subclinical and overt endovascular disease (EVD) and its risk factors in urban, semiurban, and rural communities in South India. The study is also designed to generate clinical evidence for effective, affordable, and sustainable community-specific intervention strategies to control risks factors for EVD. As of June 2012, 8,080 (urban: 2,221; semiurban: 2,821; rural: 3,038) participants >20 years of age were recruited using 2-stage cluster sampling. Baseline measurements included standard cardiovascular disease risk factors, sociodemographic factors, lifestyle habits, psychosocial factors, and nutritional assessment. Fasting blood samples were assayed for putative biochemical risk factors and urine samples for microalbuminuria. All nondiabetic participants underwent oral glucose tolerance test with blood and urine samples collected every 30 min for 2 h. Additional baseline measurements included flow-mediated brachial artery endothelial vasodilation, assessment of carotid intimal medial wall thickness using ultrasonography, screening for peripheral vascular disease using ankle and brachial blood pressures, hemodynamic screening using a high-fidelity applanation tonometry to measure central blood pressure parameters, and aortic pulse wave velocity. To assess prevalence of coronary artery disease, all participants underwent surface electrocardiography and documentation of ventricular wall motion abnormality and function using echocardiography imaging. To detect subclinical lesions, all eligible participants completed an exercise treadmill test. Prospectively, the study will assess progression of subclinical and overt EVD, including risk factor-outcome relation differences across communities. The study will also evaluate community-specific EVD prevention using traditional Indian system of medicine versus recognized allopathic (mainstream) systems of medicine.

Diagnostic accuracy of 64-slice multidetector computed tomography in evaluation of post-coronary artery bypass grafts in correlation with invasive coronary angiography.

64-slice multidetector computed tomography (MDCT) allows more reliable and non-invasive evaluation of the coronary artery bypass grafts for occlusion or stenosis both in symptomatic and asymptomatic patients and also progression of disease in native coronary vessels.

Catheter intervention in valvular obstruction and long-term results.

Percutaneous balloon mitral valvuloplasty has been established as an effective alternative to surgery for the treatment of mitral stenosis. The authors describe their experience in percutaneous mitral commissurotomy with a detailed discussion of the procedures and a brief review of literature.

A Case of Ball Valve Thrombus.

Ball valve thrombus is a very rare cardiac pathological entity; most case reports are postmortem. It is always associated with a very tight rheumatic mitral stenosis. The antemortem diagnosis of ball valve thrombus has become easy with the advent of echocardiography and even easier with biplane or multiplane transesophageal echocardiography, including the three-dimensional acquisition of images. We present the case of a patient with a ball valve thrombus diagnosed during routine echocardiographic examination as a prelude to surgery.