Cardiac diseases remain a prevalent health issue across the world, though with increased morbidity and mortality due to lifestyle changes, stress, and a bad diet. Therefore, there has been widespread advancement in developing modern and sophisticated cardiac care solutions that prevent and treat heart conditions more effectively. India has pioneered the front-line adoption of state-of-the-art technology and medical procedures in heart care. This blog discusses the latest advances in cardiac treatment in India, which provides insight into innovations that are improving patient outcomes and offering new hope for healthier lives:
1. Recent Breakthroughs in Formulating Treatments to Suppress the Protein Linked to Hypertension Development
Hypertension affects nearly half of the population in adults, many of whom are not even aware of having it. If left untreated, it greatly increases the chances of having a heart attack, stroke or other serious health problems. It also can reduce the life expectancy of the patient.
A high Blood Pressure is persistently 130/80 mmHg or greater. In spite of advances in medications that should be able to control hypertension in most people, less than 25% of those being treated keep BP levels within the targeted range.
A protein secreted by the liver is called Angiotensinogen. It is believed to play a key role in increasing blood pressure. Previous research shows the more angiotensinogen produced, the higher the BP.
Zilebesiran is an investigational drug that reduces the production of angiotensinogen.
New classes of drugs, such as SGLT2 inhibitors and Novel anticoagulants, have shown promise in managing heart failure and reducing Stroke risk.
2. Advances in Imaging.
Advances in imaging help to guide stent placement in patients with complex coronary artery lesions.
Percutaneous Coronary Intervention (PCI) is a procedure in which a stent is placed in the blood vessels in the heart that are blocked or that have become too narrow due to plaque buildup along the arterial walls. But sometimes, placing a stent can be difficult because of the position of the plaque build-up or lesion. For example, it might be located at a branch point of the artery, making it difficult to access, or it could be too close to the aorta, the main blood vessel of the heart.
PCI does not work well in such patients or diabetic patients, who instead might need surgery to restore blood flow to and from their hearts. Initially, PCI was only used for patients with simple coronary artery disease. Advances in the type of imaging used to guide stent selection and placements have led to long-term treatment benefits with PCI. Because of this, cardiologists now use the procedure on people with more complex heart problems.
Cardiologists use intravascular imaging to see what is inside the artery, like artery walls and features of plaque, but it is used less often. There are two types: intravascular ultrasonography (which uses sound waves to see inside blood vessels) and optical coherence tomography (which uses light waves to look more closely at plaque in the arteries). By using high-resolution images, physicians can determine the right location for the stent to be placed and the right size to be used.
Enhanced imaging technologies, like cardiac MRI and 3D echocardiography, offer more detailed insights into Heart conditions, improving diagnosis and treatment planning.
3. Leadless Pacemaker defibrillator system and Pulsed-field Ablation for Atrial fibrillation.
Pacemakers help people with Bradyarrhythmia (slow heart rates). These slow heart rhythms can occur as a result of disease in the heart's conduction system. A leadless pacemaker is a small, one-piece device that a cardiac surgeon inserts into your heart to prevent slow heart rates. A leadless pacemaker can be used with a Subcutaneous Implantable cardioverter-defibrillator to provide anti-tachycardia pacing for ventricular Tachycardia (fast heart rhythms).
Pulsed Field Ablation is a new method for treating Atrial Fibrillation that uses Microsecond high-voltage electric pulses to cause localised cell death.
4. Gene Therapy.
Gene therapy aims to treat inherited cardiac conditions at the cellular level. Moreover, personalised medicine approaches tailor treatments based on individual genetic profiles. This therapy is for heart diseases wherein selective genes associated with the disease are altered or substituted permitting smooth functioning of the cardiac cells. By addressing the root cause rather than merely the symptoms, gene therapy holds the potential to cure, if not all, then at least some inherited heart diseases.
An area that holds promise is gene silencing therapy with specific relevance to cardiac amyloidosis where amyloid protein deposits occur in the heart, affecting its functioning. The goal of gene silencing is to eliminate the genetic production of factors that are responsible for creating these toxic proteins, therefore, avoiding or alleviating the heart from additional injury.
5. Moderate Hypothermia during Aortic Arch surgery
Moderate hypothermia is now preferred over deep hypothermia during Aortic Arch Surgery when antegrade cerebral perfusion is used. Hypothermic cardioprotection reduces the temperature (deep hypothermia) to a level of less than 20C in order to slow down physiological activities and hence buy more working time for the surgeon. A recent trial, done in March 2024 suggests that moderate (20.1 to 28.0 C) rather than deep hypothermia is reasonable during Aortic arch surgery when ACP is also used.
6. Palliative care telehealth
Palliative care telehealth is an innovative approach that significantly enhances the management of patients with advanced cardiopulmonary diseases like heart failure using modern technology in compassionate care. It facilitates access to remote monitoring and management of symptoms, adjustment of treatment plans, and real-time emotional support that leads to a better quality of life for the patient.
Frequent visits to the hospital are minimised by telehealth. This is a major benefit for immobile patients or those living in rural areas. Continuous monitoring of heart rate, blood pressure, and oxygen levels is possible, thus having the capacity to note potential complications early and allow medical intervention before they become full-blown complications.
7. Coronary Sinus Reduction (CSR) device for Angina
The coronary sinus reducer is an hourglass-shaped instrument that is inserted below the skin in the Coronary sinus to reduce the chances of angina. CSR is currently used for patients with angina, and no further options for antianginal medication, percutaneous coronary intervention (PCI), or coronary artery bypass grafting.
Conclusion
To summarise, these new developments in cardiac interventions are a huge step in dealing with different types of heart diseases, giving patients better hope and outcomes. From Zilebesiran medicine developed for hypertension to additional imaging techniques to place the stent more accurately, these and many other advanced treatment approaches are helping improve the management of heart disease.
Better personalised approaches such as gene therapy, leadless pacemakers, and moderate hypothermia are less invasive. Moreover, the provision of such surgeries becomes easier and more effective with the help of telehealth integration and devices such as coronary sinus reducers. These innovations are paving the way toward a future of cardiovascular disease therapy wherein even more efficacy, safety, and most importantly patient-centeredness can be emphasised.
