Transcatheter aortic valve implantation (TAVI) is the treatment of choice in elderly patients with severe symptomatic aortic stenosis. Though trials have shown positive results in low-risk patients, we should be cautious...Transcatheter aortic valve implantation (TAVI) is the treatment of choice in elderly patients with severe symptomatic aortic stenosis. Though trials have shown positive results in low-risk patients, we should be cautious, as these trials were not all comer. Studies have also shown that early intervention helps in patients with asymptomatic severe aortic stenosis as well. The first device introduced was a balloon expandable (Edward Sapien), and a self-expanding (Medtronic CoreValve) device soon followed. Presently, multiple devices are available in both balloon expandable and self-expanding categories. This review provides a brief review of balloon expandable TAVI valves and stepwise approach for performing TAVI.
Shock is a life-threatening condition of circulatory failure. Mixed shock is observed in approximately 24.5 % of patients with cardiogenic shock. In cases of out-of-hospital cardiac arrest, outcomes are worse when the pr...Shock is a life-threatening condition of circulatory failure. Mixed shock is observed in approximately 24.5 % of patients with cardiogenic shock. In cases of out-of-hospital cardiac arrest, outcomes are worse when the predominant shock type is distributive rather than cardiogenic. Thus, distinguishing between cardiogenic and distributive phenotypes is crucial for appropriate management. A dysregulated immune response has been observed in both. This review article details the pathophysiology, diagnostic challenges, and management of distributive shock when encountered in a cardiac intensive care unit.
• IVI is a critical component of DCB angioplasty to ensure optimal lesion preparation for effective drug transfer and long-term patency. • DCB has demonstrated excellent outcomes in specific subset of lesions, like ISR (...• IVI is a critical component of DCB angioplasty to ensure optimal lesion preparation for effective drug transfer and long-term patency. • DCB has demonstrated excellent outcomes in specific subset of lesions, like ISR (particularly ISR with homogeneous or layered neointima) and de novo small vessel disease, where it has often shown comparable or even superior results to DES. • In bifurcation lesions an approach of using DES in the main vessel and DCB for the side branch is highly effective, promoting positive remodelling and reducing adverse events. • DCB offers an attractive "leave no metal behind" option for high bleeding risk patients, allowing for abbreviated dual antiplatelet or single antiplatelet therapy.
BACKGROUND: Although the mechanism of coronary artery ectasia (CAE) shares the common pathophysiologic steps resembling those of atherosclerosis, there are certain discrepancies or aspects incompatible with atheroscleros...BACKGROUND: Although the mechanism of coronary artery ectasia (CAE) shares the common pathophysiologic steps resembling those of atherosclerosis, there are certain discrepancies or aspects incompatible with atherosclerosis. Therefore, we hypothesize that the pathophysiology of CAE might differ from that of atherosclerosis in terms of inflammatory parameters, infectious agents and the read out of protein electrophoresis. MATERIALS AND METHODS: Seventy patients with coronary artery disease (CAD) and 30 patients with both CAD and CAE comprised the study populations. Blood samples were centrifuged for the measurement of IgG antibodies against C.pneumoniae and H.Pylori, alongside with total IgE, IgG levels and protein electrophoresis. RESULTS: There were not statistically significant differences between patients with and without CAE regarding the complete blood counting and routine biochemical laboratory parameters except hemoglobin levels. Among other studied laboratory parameters, IgE, Alpha 2 macroglobulin, Beta-1 globulin levels were found to be higher in patients with CAE + CAD than those of CAD alone. Logistic regression analysis by including the variables IgE, Hb, Alpha 2 macroglobulin, beta-1 globulin, and gender, revealed that Ig E (Odd ratio:1.004 85 % CI: 1.000-1.008, p = 0.01) and alpha 2 macroglobulin (Odds ratio: 9.41, 95 %CI: 1.69-52.28, p = 0.028) were independently and positively associated with the presence of CAE. CONCLUSION: Independent association of serum IgE levels and alpha2 globulins with the presence of CAE underlines the divergent features of pathophysiology of CAE compared with atherosclerosis or CAD alone. Comparable activity of humoral immunity measured by IgG antibody against C.Pneumoniae, and H. Pylori has suggested that these infectious agents do not play an additional role in the pathogenesis of CAE.
OBJECTIVE: Ductal stenting (DS) has emerged as a critical intervention for neonates with duct-dependent pulmonary circulation (DDPC), offering a less invasive alternative to surgical shunts. METHODS: This retrospective s...OBJECTIVE: Ductal stenting (DS) has emerged as a critical intervention for neonates with duct-dependent pulmonary circulation (DDPC), offering a less invasive alternative to surgical shunts. METHODS: This retrospective study evaluates the procedural and mid-term outcomes of neonatal DS at a high-volume tertiary cardiac centre between January 2018 and August 2023. RESULTS: The study involved 124 symptomatic neonates. Primary outcomes included procedural success, defined as achieving post-procedural oxygen saturation (SpO2) ≥85 %, and survival to planned surgical repair. Secondary outcomes assessed included unplanned re-interventions, pulmonary artery growth, and all-cause mortality within 6 months. Success rate was 98.5 %. Total hospital stay was 3.17 ± 4 days. All-cause mortality was 8.9 %. Branch PA origin stenosis was found in 42 % cases on follow up. CONCLUSION: The study concludes that DS is a feasible and effective strategy in a variety of different cases of DDPC. Further research is needed to explore long-term outcomes and optimal stent selection based on individual patient characteristics.
BACKGROUND AND AIMS: Accurate prediction of incident heart failure (HF), risk of recurrent HF or hospitalization are essential for optimizing patient outcomes. Seeing the rising trends of HF in Indians, the present study...BACKGROUND AND AIMS: Accurate prediction of incident heart failure (HF), risk of recurrent HF or hospitalization are essential for optimizing patient outcomes. Seeing the rising trends of HF in Indians, the present study assessed the applicability of 5 different HF risk scores in these patients. METHODS AND RESULTS: Of the 280 patients recruited, 159 (55.7 %) had HF Stage A, B while 121 (44.3 %) had asymptomatic or symptomatic HF (HF Stage C, D). At 30 ± 7.5 months, new onset HF occurred in 32.07 % and in Stage C/D HF patients, rehospitalization was noted in 37.1 % and 8.9 % died. The incidence of new-onset HF increased incrementally with higher Health ABC scores (13.7, 31.4 and 52.9 % in score 5-10 %, 10-20 %, >20 % respectively). Amongst diabetic patients, TRS-HFDM score strongly predicted new-onset HF (16.7, 30 and 43.3 % in score 1,2 and ≥ 3 respectively). LACE index also accurately predicted events in those with Stage C/D HF: rehospitalization for recurrent HF was 6.6, 44.5 and 48.9 % while mortality was 4, 36 and 60 % in those with LACE index 0-4, 5-9, >9 respectively. Patients without any events had a lower MAGGIC score (19.25 ± 9.56) vs those who died (29.33 ± 8.32). H2FPEF score also performed well: re-hospitalization for HF was 22.2 vs 57.7 % and mortality was 20 vs 72 % in score <2 vs score >2. CONCLUSION: These easily available risk scores can accurately predict events in Indian patients with HF and should be part of clinical workflow.
BACKGROUNDS AND OBJECTIVES: This study aims to evaluate the presence and prognostic significance of myocardial fibrosis in subjects with and without HFpEF, using Cardiac MRI. METHODS: This was an ambidirectional observat...BACKGROUNDS AND OBJECTIVES: This study aims to evaluate the presence and prognostic significance of myocardial fibrosis in subjects with and without HFpEF, using Cardiac MRI. METHODS: This was an ambidirectional observational study [mean follow-up: 25 months], selecting HFpEF patients and comparing them with an age and sex-matched control arm without HF. Late gadolinium-enhanced (LGE) imaging and T1 mapping were used to assess fibrosis. RESULTS: LGE (27 % vs 0 %, p = 0.005) and mid-segment (1062 ± 64 ms vs 1020±8 ms, p < 0.001) or total average (1057 ± 70 ms vs 1020±4 ms, p = 0.006) T1 values were significantly higher in HFpEF group (N = 30) compared to the control group. However, there was no significant difference in T2 values (p = 0.657). 53.3 % of our patients with HFpEF had a clinical event (HF hospitalization, stroke or all-cause mortality) during the follow-up. It was found that average mid-segment (1099 ± 67 ms vs 1019 ± 17 ms, p<0.001) and total average (1101 ± 70 ms vs 1007 ± 15 ms, p<0.001) T1 values were significantly higher in the event group compared to the no-event group. There were no differences in LGE prevalence between event and no-event groups. However, LGE negative cases had significantly increased T1 values in all segments compared to the healthy control group (p<0.001). CONCLUSIONS: Higher T1 values but not T2 values , were associated with the HFpEF group compared to the age and sex-matched control group. Focal fibrosis, as evident by LGE, was significantly more in HFpEF. Among HFpEF patients, high T1 myocardial values were associated with a higher rate of all-cause death, stroke, and HF hospitalization in short-term follow-up.
BACKGROUND: An inward force is experienced by the guide catheter during device retrieval resulting in potential risk of deep engagement into the ostio-proximal coronary segment. This undesired movement can result in coro...BACKGROUND: An inward force is experienced by the guide catheter during device retrieval resulting in potential risk of deep engagement into the ostio-proximal coronary segment. This undesired movement can result in coronary injury. There is no systematic data or reports of techniques to prevent such inadvertent guide movement during difficult retrieval of devices. METHODS: In 25 patients undergoing percutaneous coronary intervention, where the conventional methods of guide stabilization failed to prevent deep engagement of guide catheter during device retrieval we used 'floating aortic wire' technique and reattempted retrieval. The primary endpoint was the successful retrieval of the device without deep engagement of the guide. RESULTS: Successful retrieval was seen without deep engagement of guide in 23(92 %) patients. Left anterior descending(n = 15, 60 %) artery was the most common coronary artery. The XB guide(n = 14, 70 %) was the most commonly used guide for left coronary intervention while Judgkins right and Amplatz left were used most commonly for right coronary intervention. Stent balloon(n = 15, 60 %) was the most common device which required using floating aortic wire for retrieval. Other devices were jailed wire(n = 5,20 %), non-compliant balloon(n = 4,16 %) and cutting balloon(n = 1,4 %). Intravascular ultrasound did not show any guide related vessel injury(dissection or intramural hematoma) in any cases. The floating aortic wire failed to prevent deep engagement in two patients because of longer segment of jailed wire and long stent balloon in distal right coronary artery. CONCLUSION: Floating aortic wire assisted retrieval of coronary devices is a simple, reliable and safe technique that prevents deep guide engagement during difficult retrieval.
BACKGROUND: Atrial fibrillation (AF), affects around 2 % of the global population and is projected to rise over the next 50 years. Catheter ablation (CA) is the primary treatment for symptomatic AF resistant to drug ther...BACKGROUND: Atrial fibrillation (AF), affects around 2 % of the global population and is projected to rise over the next 50 years. Catheter ablation (CA) is the primary treatment for symptomatic AF resistant to drug therapy. Despite its widespread use, CA has a failure rate of 20 %-50 %, often requiring repeat procedures, due to significant long-term recurrence rates. Combining CA with renal denervation (RDN) or ganglion plexus ablation (GPA) may effectively reduce the recurrence rates of AF. METHODS: Quality assessment was done using the Cochrane ROB 2.0 tool, network meta-analysis using RStudio, and comparative meta-analysis using RevMan 5.4. RESULTS: A thorough search across seven databases resulted in 13 articles for analysis, with eight classified as low-risk and five as moderate-risk of bias. The network meta-analysis found that RDN + CA had the highest freedom from AF episodes at 12 and 24 months (OR 2.28 [1.34-3.86] and OR 1.61 [0.89-2.89]), followed by GPA + CA (OR 1.88 [0.91-3.89] and OR 1.36 [0.91-2.03]), compared to CA alone. RDN + CA also showed fewer procedure-related complications (OR 0.78 [0.30-2.02]), while GPA + CA was more prevalent (OR 3.60 [1.72-7.55]), compared to CA alone. Additionally, RDN + CA significantly reduced systolic blood pressure (SBP) (MD -5.22 [-9.91 to -0.53]), diastolic blood pressure (DBP) (MD -3.61 [-7.98 to -0.76]), and creatinine levels (MD -0.25 [-0.34 to -0.15]), while increasing estimated glomerular filtration rate (eGFR) (MD 7.98 [-1.16-17.11]) compared to the control group. CONCLUSION: Remarkable success in preventing AF recurrence was observed when CA was combined with RDN or GPA. However, it is noteworthy that GPA + CA was associated with a higher incidence of procedural-related complications, while RDN + CA demonstrated additional advantages by improving blood pressure regulation and renal function.
This retrospective observational study was conducted in a tertiary care hospital to assess the challenges involved in the diagnosis of cardiac sarcoidosis. The study included a total of 42 patients with primary cardiac m...This retrospective observational study was conducted in a tertiary care hospital to assess the challenges involved in the diagnosis of cardiac sarcoidosis. The study included a total of 42 patients with primary cardiac manifestation of sarcoidosis and imaging evidence of patchy myocardial inflammation. Ventricular tachycardia(20) was the most common cardiac manifestation, followed by heart failure(12) and complete heart block(10). Histopathological evidence of sarcoidosis was found only in 12 patients (one endocardial biopsy, 11 extracardiac source). We could not find evidence of extracardiac involvement in the majority of patients. As the diagnostic criteria mainly stress upon the evidence of extracardiac sarcoidosis, diagnosis remains uncertain in many patients.
OBJECTIVE: The lack of data related to the prevalence of rheumatic heart disease (RHD) in Meghalaya, India prompted us to assess the prevalence of RHD in school-going children of Meghalaya aged 5-15 years and risk factor...OBJECTIVE: The lack of data related to the prevalence of rheumatic heart disease (RHD) in Meghalaya, India prompted us to assess the prevalence of RHD in school-going children of Meghalaya aged 5-15 years and risk factors associated with it. METHODS: A cross-sectional epidemiological study was performed using World Heart Federation (WHF) echocardiographic criteria with a portable echo machine. RESULTS: 4039 children (mean age 10.18 ± 2.87 years) underwent 2D echocardiographic screening. Among them, 2100 (52.0 %) were aged 5-10 years and 1939 (48.0 %) were aged 11-15 years. Of them, 2066 (51.1 %) were female and 2488 (61.6 %) resided in rural areas. 652 (16.1 %) children were in government-run schools, 1836 (45.5 %) in private institutions. The cohort's mean BMI was 16.94 ± 2.52. Ethnically, 3818 children (94.5 %) belonged to indigenous tribes-Khasi (61.9 %), Jaintia (21.7 %), and Garo (10.9 %)-while 221 (5.5 %) were from non-native groups. Echocardiography identified subclinical RHD in 19 children (4.7 per 1000) and clinical RHD in 2 children (0.49 per 1000). Among subclinical cases, 8 were classified as definite RHD (1.98 per 1000) and 11 as borderline RHD (2.72 per 1000). RHD risk increased with age (OR = 1.16; 95 % CI: 0.98-1.37), was approximately twofold higher in females (OR = 2.07; 95 % CI: 0.79-5.47), and was more prevalent among rural children and those attending government schools. CONCLUSION: Subclinical RHD prevalence in Meghalaya's children is significantly higher than clinical RHD. These findings highlight the need for a national registry to monitor subclinical cases and evaluate the impact of future interventions.
BACKGROUND: Cardiovascular disease (CVD) risk significantly increases in women after menopause. However, the cardiovascular (CV) outcomes in women who undergo bilateral oophorectomy remain unclear. This study aimed to ev...BACKGROUND: Cardiovascular disease (CVD) risk significantly increases in women after menopause. However, the cardiovascular (CV) outcomes in women who undergo bilateral oophorectomy remain unclear. This study aimed to evaluate the CV outcomes associated with bilateral oophorectomy. METHODS: A systematic search was conducted across 4 databases, including PubMed, Embase, Web of Science, and Cochrane CENTRAL, from inception to March 25, 2025, without language restrictions. Studies comparing CV outcomes in women who underwent bilateral oophorectomy versus those who did not were included. A random-effects model was used for meta-analysis. RESULTS: A total of 18 studies, comprising a total of 2,414,600 participants, were included. Bilateral oophorectomy was associated with a marginally increased risk of CVD compared to control (pooled HR 1.05, 95 %CI 1.00-1.11, p = 0.05). Bilateral oophorectomy was also associated with a higher risk of heart failure (pooled HR 2.25, 95 %CI 1.15-4.41, p = 0.02). When stratified by age at surgery, bilateral oophorectomy performed at a premenopausal age was associated with a higher risk of CVD (pooled HR 1.15, 95 %CI 1.02-1.30, p = 0.03) and coronary artery disease (pooled HR 1.26, 95 %CI 1.15-1.39, p < 0.01). In contrast, bilateral oophorectomy performed at postmenopausal age was not associated with an increased risk of CV events. CONCLUSIONS: Bilateral oophorectomy is associated with an increased risk of CV events, particularly when performed at a premenopausal age. Further research is warranted to determine appropriate prevention strategies and risk stratification in this population.
BACKGROUND: Hypertrophic cardiomyopathy (HCM) is an autosomal dominant genetic disorder characterized by left ventricular hypertrophy and variable clinical manifestations, including asymptomatic states and sudden cardiac...BACKGROUND: Hypertrophic cardiomyopathy (HCM) is an autosomal dominant genetic disorder characterized by left ventricular hypertrophy and variable clinical manifestations, including asymptomatic states and sudden cardiac death (SCD). Data on its phenotype and genotype in the Indian population remain limited. METHODS: We studied 113 patients diagnosed with HCM. All underwent clinical assessment, 24-h Holter monitoring, echocardiography, and cardiac MRI. Genetic testing was performed in 80 patients. Clinical and imaging features were compared between genotype-positive and genotype-negative groups. RESULTS: The mean age was 47 ± 10.8 years, with 82.6 % being males. Dyspnoea and chest pain were the most frequent symptoms. Obstructive HCM was seen in 70 (61.9 %) patients. Cardiac MRI showed late gadolinium enhancement >15 % in 13 (23.2 %) and apical aneurysms in 2 (3.5 %). Genetic mutations were detected in 40 (50 %) patients, with MYBPC3 (33 %) and MYH7 (26.8 %) being most common. Genotype-positive individuals more frequently had chest pain, a family history of SCD, and more severe hypertrophy. CONCLUSION: In this Indian HCM cohort, the condition predominantly affected males. Genotype-positive patients exhibited more severe hypertrophy and adverse clinical profiles, underscoring the importance of genetic screening in risk stratification.
INTRODUCTION: Despite the burden of Takayasu's arteritis (TA) in India, data on LA, LV and RV strain and aortic stiffness is scanty. AIMS: We assessed these in 100 TA patients (mean age 29.8 years, 70 % females) and corr...INTRODUCTION: Despite the burden of Takayasu's arteritis (TA) in India, data on LA, LV and RV strain and aortic stiffness is scanty. AIMS: We assessed these in 100 TA patients (mean age 29.8 years, 70 % females) and correlated with disease activity and duration. METHODS AND RESULTS: Mean illness duration was 6.34 years, Numano V and III angiographic type was seen in 42 and 20 %. Global LVEF was normal and 6 % had LVEF <50 %. TA patients had significantly lower LVGLS (-16.09 vs -18.9 %), peak atrial longitudinal strain (PALS: 25.03vs 27.1 %), RV-FWS (23.42 vs 25.2 %), and higher mean aortic stiffness (8.39 vs 7.44 m/s) vs controls. The % of patients with LV GLS > -16 %, PALS < -25 %, RV-FWS > -23 % and aortic stiffness (>12 m/s) was 32, 26, 14 and 17 % respectively. Those with LVGLS > -16 % had longer symptom duration (7.02 vs 5.66 years), higher ITAS score (4.96 vs 4.44), higher % prevalence of impaired RV strain (28 % vs 7 %) and impaired PALS (29 % vs 18 %). Those with abnormal aortic stiffness had higher mean ITAS scores (5.58 vs 3.62), higher chance of active disease (ITAS-2010 ≥ 2, 64 % vs 40 %) and longer disease duration. CONCLUSION: Despite normal global LVEF, 15-32 % patients with TA had impaired LVGLS, RVFWS, PALS and aortic stiffness. Impaired LVGLS and Aortic stiffness correlated with longer disease duration and higher disease activity. These preliminary findings suggest that strain and aortic stiffness evaluation in TA may help in early identification of subclinical ventricular dysfunction.
Patients of Eisenmenger syndrome are a heterogeneous group of subjects with varying underlying cardiac defects, longevity, and quality of life. The optimal transplantation strategy, ie, single lung, bilateral lung with i...Patients of Eisenmenger syndrome are a heterogeneous group of subjects with varying underlying cardiac defects, longevity, and quality of life. The optimal transplantation strategy, ie, single lung, bilateral lung with intra-cardiac repair, or combined heart-lung transplantation remains a matter of debate, requiring careful consideration of the specific cardiac defect, age at presentation, ventricular function, organ availability, and resources available at the treating centre. The introduction of pulmonary vasodilator therapy has improved the survival curves and led to better quality of life even without transplantation. This review aims to discuss the merits, demerits, optimal timing, and type of transplantation options for adult patients with ES, particularly in countries with resource limitations such as ours (India).
BACKGROUND: Few cohort studies examine the association of cardiovascular risk scores with cardiovascular mortality in India. This study assessed the association of baseline Framingham Risk Scores (FRS) with 10-year incid...BACKGROUND: Few cohort studies examine the association of cardiovascular risk scores with cardiovascular mortality in India. This study assessed the association of baseline Framingham Risk Scores (FRS) with 10-year incidence of fatal CVD events in rural Tamil Nadu, India. METHODS: Using a retrospective cohort study design, we analysed the association of baseline FRS categories assessed in 2011-12 through a STEPS risk factor survey, with CVD deaths over 10 years. Causes of death for the survey participants aged 30-64 years at baseline (2011-12), were obtained through established vital event surveillance, while baseline FRS CVD scores were calculated using original and published recalibration equations. RESULTS: 3418 participants (1480 males, 1938 females), free of CVD at baseline, were followed up for mortality for 10.22 years (median). The CVD mortality rate was 3.01 per 1000 person-years among males and 1.36 in females. Those with baseline original lipid-based FRS ≥20 % had higher CVD mortality risk (Hazard Ratio males: 11.18, 95 % CI: 4.67-26.79; females: 17.51, 95 % CI: 6.07-50.55) compared to those with scores <10 %, with similar results using recalibrated scores. Discrimination statistics (Harrell's C) were 0.755 and 0.751 for original and recalibrated lipid-based scores in males, compared to 0.734 and 0.842 in females. CONCLUSIONS: FRS had good predictive validity for cardiovascular mortality in a rural Indian population, confirming its clinical usefulness.
Arava S, Goswami A, Pandit JN
… +13 more, Jain S, Dagar S, Mallick SK, Harisha K, Alam N, Srinivasamurthy A, Rijal R, Behera C, Yadav A, Bodwal J, Katiyar A, Roy A, Ray R
INTRODUCTION: Sudden cardiac death in young (SCDY) is a rare and important public health concern which needs to be addressed and documented. The present study was undertaken to identify the various cardiovascular causes...INTRODUCTION: Sudden cardiac death in young (SCDY) is a rare and important public health concern which needs to be addressed and documented. The present study was undertaken to identify the various cardiovascular causes and genetic factors leading to sudden cardiac death (SCD) in young individuals in North India. METHODOLOGY: All the suspected SCD cases meeting the inclusion criteria in the age group between 18 and 45 years, received at the forensic mortuary were studied over a period of four years (October 2019-November 2023). Detailed verbal and conventional autopsy, gross and microscopic examination of the heart with whole-exome genetic sequencing (WEGS) was performed to identify all the possible causes of death in these individuals. RESULTS: A total of 59 cases were included. Mean age was 33.7 years with male predominance. Sudden unexplained death (SUD)/negative autopsy was the commonest (n = 21, 35.6 %), followed by coronary artery disease (CAD) with myocardial infarction (MI) (n = 17, 28.8 %) and structural cardiomyopathies (n = 15, 25.4 %). Hypertrophic cardiomyopathy (HCM) was the commonest structural cardiomyopathy. Congenital anomalies constituted 5 %. Isolated cases include myopericarditis, severe aortic stenosis, arrhythmogenic cardiomyopathy, post-partum cardiomyopathy, and cardiac rupture. Molecular yield in SUDs was 42.8 %. Sarcomeric genes (30.4 %) and Z-disk protein genes (21.7 %) constituted the most significant proportion, followed by genes associated with channelopathies and junctional proteins. CONCLUSION: Negative autopsy/SUD constituted the most common observation in sudden young deaths, followed by CAD/MI. Molecular autopsy in sudden unexplained deaths in young will give a definitive molecular yield of 14.3 %.
BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a prevalent genetic cardiac disorder with variable clinical expression. While global data are available, phenotypic characterization of Indian HCM patients remains limited...BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a prevalent genetic cardiac disorder with variable clinical expression. While global data are available, phenotypic characterization of Indian HCM patients remains limited. Speckle-tracking echocardiography (STE)-derived global longitudinal strain (GLS) may serve as a surrogate marker of myocardial fibrosis in settings with limited access to cardiac magnetic resonance (CMR). OBJECTIVES: To characterize the clinical and imaging features of Indian patients with HCM and evaluate the correlation of GLS with CMR-derived late gadolinium enhancement (LGE) and electrocardiographic abnormalities. METHODS: This cross-sectional study enrolled 150 consecutive adult HCM patients at a tertiary care center in North India. All patients underwent detailed clinical evaluation, standard transthoracic echocardiography including STE-derived GLS, electrocardiography, and 24-h Holter monitoring. CMR was performed in 74 patients based on physician discretion. GLS was quantified using vendor-specific semi-automated software. LGE was quantified as a percentage of total left ventricular mass. Correlations were assessed using Spearman's coefficient (ρ). RESULTS: The mean age of the cohort was 46.7 ± 13.5 years, with 80 % males. Asymmetric septal hypertrophy (76 %) and obstructive HCM (53 %) were the predominant phenotypes. GLS was reduced (<-20 %) in 89 % of patients (mean GLS: -12.1 % ± 4.1 %). CMR revealed LGE in 92 % of patients, with ≥15 % LGE in 40 %. Peak GLS showed a strong positive correlation with percent LGE (ρ = 0.739). GLS was significantly lower in patients with CMR-detected perfusion deficits (p = 0.04), but not significantly associated with non-sustained ventricular tachycardia (p = 0.18). Modest inverse correlations were noted between GLS and tissue doppler indices (medial e': -0.55; lateral e': -0.60). CONCLUSION: Indian HCM patients exhibit a distinct clinical profile with high fibrosis burden. STE-derived GLS correlates strongly with myocardial fibrosis on CMR and may serve as a practical risk stratification tool in resource-limited settings. Further multicentric studies are needed to validate these findings.