Department of Cardiology

Permanent URI for this collectionhttp://10.0.2.71:4000/handle/123456789/395

Browse

Now showing 1 - 5 of 5

Circular RNAs as Biomarkers and Therapeutic Targets in Diabetic Cardiovascular Complications
(Wiley, 2026) Beniwal, Shreya Singh; Jeong,Yujin; Rawat, Akash et al
Background: The global prevalence of diabetes mellitus (DM) is rising rapidly and is projected to reach unprecedented levels by 2035 and 2050, with a disproportionate burden among elderly populations and in low- and middle- income countries. Diabetes- related cardiovascular complications remain a leading cause of morbidity and mortality despite advances in glycaemic control and pharmacotherapy. There is an urgent need for novel molecular biomarkers and therapeutic targets to improve early detec tion, risk stratification, and personalised management. Methods: A comprehensive narrative review of the current literature was conducted to summarise emerging evidence on the biological roles of circular RNAs (circRNAs) in diabetes and its cardiovascular complications. Published experimental, trans lational, and clinical studies investigating circRNA expression, mechanisms of action, and therapeutic potential were critically analysed. Results: CircRNAs have emerged as key regulators in the pathophysiology of diabetes- associated cardiovascular disorders, in cluding diabetic cardiomyopathy, endothelial dysfunction, and vascular inflammation, as well as related microvascular compli cations. Mechanistically, circRNAs act through diverse pathways such as microRNA sponging, modulation of gene transcription, interaction with RNA- binding proteins, and regulation of cellular processes including apoptosis, fibrosis, oxidative stress, and inflammation. Their covalently closed structure confers exceptional stability, while their tissue- and disease- specific expression profiles support their utility as sensitive biomarkers for early diagnosis, prognosis, and therapeutic monitoring. Advances in synthetic circRNA design further highlight their promise as novel therapeutic agents, although challenges related to delivery efficiency, specificity, and off- target effects remain.
Diagnostic Accuracy of a Smartphone-based 12-lead ECG for Detection of Common Bradycardias, Tachycardias, and Ectopic Arrhythmias
(Galenos Publishing House, 2026-02-24) Mohan, Chandra; Gururani, Kunal et al.
Background and Aim: Electrocardiography (ECG) remains the cornerstone for diagnosing cardiac arrhythmias. The purpose of this study was to assess the diagnostic performance of a smartphone-based ECG device (Spandan Ultra 12-lead) compared with a standard 12-lead ECG device for detecting common cardiac arrhythmias (bradycardias, tachycardias, and ectopic arrhythmias), with a cardiologist as the reference standard. Materials and Methods: The study was a prospective, cross-sectional, single-blind, observational, comparative diagnostic accuracy study conducted in 321 patients aged ≥20 years who exhibited signs of arrhythmias. For analysis of diagnostic performance, sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), accuracy, F-score, positive and negative likelihood ratios [(positive likelihood ratio (PLR) and negative likelihood ratio (NLR)], Matthews correlation coefficient (MCC), and the Farrington-Manning score were used to provide a comprehensive evaluation. Results: The mean age was 51.95±14.51 years; 50.47% were male. The smartphone-based ECG demonstrated higher sensitivity (86.54% vs. 77.80%), specificity (93.68% vs. 91.38%), PPV (72.58% vs. 64.61%), NPV (97.29% vs. 95.31%), accuracy (92.52% vs. 89.09%), F1 score (0.79 vs. 0.70), PLR (13.7 vs. 9.05), MCC (0.75 vs. 0.64), area under the curve (0.851 vs. 0.846), and lower NLR (0.14 vs. 0.24) compared with the standard 12-lead ECG. The Farrington-Manning non-inferiority test demonstrates that the smartphone-based ECG was non-inferior to the standard 12-lead ECG on all validation parameters. Conclusion: The Spandan Ultra 12-lead smartphone-based ECG is a reliable diagnostic tool for detecting common bradycardias, tachycardias, and ectopic arrhythmias. Its simultaneous multichannel recording enables rapid and accurate rhythm assessment, demonstrating comparable diagnostic performance to that of the standard 12-lead ECG and serving as a complementary diagnostic tool for detecting common arrhythmias.
Diagnostic agreement of smartphone-based electrocardiogram with coronary angiography in identifying vessel involvement in patients with myocardial infarction
(Elsevier, 2026-02-11) Mohan, Chandra; Gururani, Kunal
Background: Acute myocardial infarction (MI) remains one of the major causes of morbidity and mortality throughout the world. The objectives of this study were to determine the diagnostic agreement between the findings from Portable (Spandan Pro) and Conventional Electrocardiogram with coronary angiography (CAG) regarding vessel involvement in MI patients, and to assess related risk factors. Methodology: This study was an Observational, Single-arm, Cross-sectional study performed on 109 subjects at a local hospital in Dehradun. The study was approved by the Institutional Ethics Committee, and informed consent was obtained from all the participants. For diagnostic agreement, Statistical analyses such as Cohen's κ, weighted κ, prevalence- and bias-adjusted κ (PABAK), and Jaccard index were used. Results: The mean age of the included patients was 58 ± 11.96 years, with a significant male predominance (88.07%). For overall vessel involvement of ECGs with CAG, portable ECG showed a higher sensitivity (84.76 vs. 78.10%), and for LAD artery, it also showed higher sensitivity (88.46% vs. 82.05%) compared to the conven tional ECG. Diagnostic agreement showed substantial agreement with CAG (PABAK 0.68), and according to the Jaccard Index, there was a moderate agreement (approximately 50%) between the ECG-derived findings with CAG across all types of vessel diseases. The most prevalent confounding factor among the participants was smoking (41.9%), followed by Hypertension (39.0%) and diabetes (34.3%). Conclusion: This study indicates that Portable ECG performed comparably to conventional ECG and had a moderate level of diagnostic agreement with CAG in the detection of vessel involvement in patients with MI.
One substrate, two tachycardias and multiple QRS morphologies
(Elsevier, 2026-05-28) Singh, Vatsal; Gulati, Parakh; Pandit, Bhagya Narayan; Nath, Ranjit Kumar
Prevalence of silent brain lesions in rheumatic mitral valve disease
(Elsevier, 2026-05-19) Singh, Vatsal; Chaudhari, Lokesh et al.
Background: Patients with rheumatic heart disease (RHD) are at high risk of stroke. Silent brain lesions (SBL) on brain MRI represent subclinical neurological injury, but their prevalence and predictors in RHD are not well defined. Methods: We conducted a prospective, single-center study of consecutive adults with RHD and moderate-to- severe mitral valve disease. Patients with a history of stroke, hypertension, diabetes, smoking, or ventricular dysfunction were excluded. All participants underwent a standardized protocol including clinical assessment, electrocardiography, echocardiography, and 3T brain MRI. Results: Among 79 patients (mean age 44.3 ± 11.4 years, 69.6% female), SBL were present in 14 (17.7%). Most patients (81%; n = 64) had atrial fibrillation (AF). The prevalence of SBL was similar between those with AF and those in sinus rhythm (17.2% vs. 20%). There were no significant differences in age, gender, valve lesion type (stenosis vs. regurgitation), left atrial size, or the presence of LAA thrombus between patients with and without SBL. The majority of SBL (85.7%) were located in cortical regions. Conclusions: Silent brain lesions on MRI were detectable in 17.7% RHD patients with significant mitral valve disease, even in the absence of traditional stroke risk factors. We did not find any association between occurrence of these brain lesions and atrial fibrillation or left atrial enlargement. Alternative mechanisms like pro- thrombotic states or atrial cardiomyopathy may be responsible. These findings warrant further investigation into the clinical significance and management of subclinical brain injury in RHD