This editorial highlights recent advances in assessing diastolic heart function, identifying dyssynchrony for CRT using echocardiography, and managing coronary events in diabetic patients.
Although rapid advances have occurred in pharmacotherapy and intervention, precise diagnosis of the underlying pathophysiology remains a key factor. This issue of the journal examines newer modalities for assessing diastolic heart function. This is relevant, as heart failure with preserved ejection fraction is becoming an increasingly problematic global issue. A thorough assessment of diastolic function is often overlooked, and El-Dosouky et al. highlighted the essential clues to improve diagnostic accuracy.1,2 Similarly, one of the best advances in heart failure has been cardiac resynchronization therapy (CRT). Of course, the criteria are well defined.3 All the same, there are many occasions where the option for CRT is missed in resting electrocardiogram (ECG). The article by Bhyravavajhala et al. in this issue is an eye-opener for assessing dyssynchrony on echo, even when the ECG width is normal.4 However, the QRS width remains a vital decision tool for therapy. Diabetic patients are more prone to coronary events, and the results following the percutaneous intervention (PCI) may not be as good as in nondiabetic patients. Insights into the metabolic milieu and addressing this abnormality would further help us in tackling this problem.5 The study by Shanmuganathan et al. analyzed HbA1C in the right direction, though many other important comorbidities, such as lipid abnormalities, also need to be assessed.6 Diabetic patients have small-caliber vessels, and the outcome following PCI is not really well studied.7 Smaller stents are more prone to restenosis, and in the contemporary era of Drug Coated Balloon (DCB), it is only appropriate that mid- and long-term follow-up of these patients is published. This will further advance our knowledge of the best practice in this subset. The paper by Ajinkya Mahorkar et al. gives contemporary data in India.8 I am sure the case report would be an interesting read. I take this opportunity to wish all our readers a happy and prosperous New Year.
Jayagopal Pathiyil Balagopalan (Wed,) conducted a editorial in Cardiovascular diseases (Heart failure, Diabetes, Coronary artery disease). This editorial highlights recent advances in assessing diastolic heart function, identifying dyssynchrony for CRT using echocardiography, and managing coronary events in diabetic patients.