Dr. Krishnananda Nayak

Associate Professor and Head

Department of Cardiovascular Technology

CURRENT ACADEMIC ROLE & RESPONSIBILITIES

    Dr. Krishnananda Nayak is the Associate Professor and Head of the Department of CVT – Manipal College of Health Professions, Manipal University, Manipal

    He is:

    • Head of the Department
    • Subject In-charge: Echocardiography, Cardiac Cath, Interventional technology and Clinical Cardiology
    • Clinical expertise –Fetal Echocardiography, Congenital, Valvular and Adult Echocardiography
    • Active team member in Interventional Cardiology especially in congenital heart diseases.
    • Clinical Supervisor: Master of Echocardiography

SUBJECTS CURRENTLY TEACHING

Subject Subject code Semester
Echocardiography III BSC CVT
Cardiac Cath and Intervention III BSC CVT
Clinical Cardiology III BSC CVT
Echo in Ischemic/Valvular heart disease I MSC Echocardiography and I MSC Cath and intervention technology
Clinical Cardiology I MSC Echocardiography
Basics in cardiac cath and intervention I MSC Cath and intervention technology
Congenital Heart Disease II MSC Echocardiography II MSC Cath and intervention technology
Miscellaneous Heart disease II MSC Echocardiography and II MSC Cath and intervention technology
Recent advances II MSC Echocardiography II MSC Cath and intervention technology

ACADEMIC QUALIFICATIONS

Degree Specialisation Institute Year of passing
PhD Cardiovascular Technology Manipal Academy of Higher Education y, Manipa March 2018
Certificate course in Biostatistics & Research Methodology Statistics Manipal Academy of Higher Education 2011
MSc Cardiovascular Technology Manipal Academy of Higher Education y, Manipal 2010
MSc Physics Kuvempu University, Shimoga 2007
Diploma Cardiovascular Technology Kasturba Medical College Manipal 2001
Bachelor of Science Physics, Chemistry, Mathematics Poorna Prajna College, Udupi 1997

Experience

Institution / Organisation Designation Role Tenure
Department of cardiovascular technology- Manipal College of Health Professions(MCHP) , Manipal Academy of Higher Education Associate Professor and Head Overall responsibility March 2018 till date
Department of cardiovascular technology- School of Allied Health Sciences ( SOAHS) ,Manipal Academy of Higher Education Assistant Professor- Selection Grade and Head of the department Overall responsibility July 2016 to March 2018
Department of cardiovascular technology- School of Allied Health Sciences ( SOAHS) , Manipal Academy of Higher Education Head of the Department Overall responsibility October 2015 till date
Department of cardiovascular technology- School of Allied Health Sciences ( SOAHS) , Manipal Academy of Higher Education Assistant Professor-Senior Grade Cordinator for UG & PG students July 2013 to September 2015
Department of cardiovascular technology- School of Allied Health Sciences ( SOAHS) , Manipal Academy of Higher Education Assistant Professor Cordinator for UG & PG students September 2010 to June 2013
Department of cardiovascular technology- School of Allied Health Sciences ( SOAHS) , Manipal Academy of Higher Education Assistant Lecturer Teaching UG students. Course coordinator September 2008 to August 2010

AREAS OF INTEREST, EXPERTISE AND RESEARCH

Area of Interest

Echocardiography, Electrophysiology and Interventional Cardiology , Research in Cardiology

Area of Expertise

Fetal Echocardiography

Area of Research

Fetal Echocardiography Tissue Doppler imaging echocardiography Speckle tracking echocardiography

Professional Affiliations & Contributions

Life Member of Indian academy of echocardiography (Karnataka)

Unilateral inverse moustache sign

2012-04-03 Inverse moustache sign, PAPVC Ranjan K Shetty G Vivek, Lorraine Simone Dias

Partial anomalous pulmonary venous drainage with intact interatrial septum associated with mitral stenosis is rare. Differential pulmonary vascular distribution (plethora) on chest radiograph is a subtle clue for the presence of anomalous venous drainage. BMJ Case Reports 2012; doi:10.1136/bcr.03.2012.6095

Satellite atrial septal vegetations

2011-04-03 Satellite vegetations, mitral regurgitation G Vivek Nitin Kansal Umesh Pai M , Lorraine Simone Dias

A 40-year-old lady was admitted with a week’s history of fever and dyspnoea. Transthoracic echocardiography revealed 0.5 × 0.5 cm vegetation on the posterior mitral leaflet with a severe eccentric mitral regurgitation (MR) hugging the left atrial aspect of anterior mitral leaflet and the interatrial septum (IAS) which was confirmed by a transoesophageal echocardiogram BMJ Case Reports 2011;10.1136/bcr.03.2011.3993

Pericardial cyst: a benign anomaly

2012-04-03 pericardial cyst, mediastinal mass Ranjan K Shetty G Vivek Umesh Pai M

A 40-year-old lady was admitted with a week’s history of fever and dyspnoea. Transthoracic echocardiography revealed 0.5 Pericardial cysts are rare benign mediastinal masses usually detected in asymptomatic individuals. Rare complications include compression of the bronchi, ventricular outflow tract, rupture with tamponade and sudden death. Treatment in symptomatic individuals includes surgical resection or percutaneous aspiration. BMJ Case Reports 2012;10.1136/bcr-03-2012-5984,

Fetal Ebstein’s anomaly

2012-04-03 fetal echo, ebsteins anomaly Ranjan K Shetty G Vivek Umesh Pai M

: Ebstein’s anomaly, a rare congenital cardiac malformation, is associated with a worse prognosis when it presents early as heart failure in the fetus and neonate. ▸ Targeted fetal echocardiography helps in risk stratification of such high-risk pregnancies towards more aggressive management. BMJ Case Reports 2012;10.1136/bcr-2012-006446,

Use of a coronary sinus guiding sheath for placement of right ventricular lead in abnormal venous anatomy: a report of 2 cases.

2012-04-03 coronary sinus guiding sheath, Right ventricular lead Vivek G Shetty RK Umesh Pai M

Techniques of implanting pacing leads in the right ventricle (RV) have evolved over time and involve the use of preshaped stylets. However, in the presence of venous abnormalities, it could be very challenging to do the same. We describe two cases with complex superior vena caval (SVC) anatomy which could be negotiated only with the use of a slittable coronary sinus guiding sheath and successful placement of pacing lead in the right ventricle. BMJ Case Reports 2012;10.1136/bcr-2012-007687

Carotid stenting in a nonagenarian patient with symptomatic carotid stenosis

2012-31-10 Carotid artery stenosis, nonagenarian, carotid artery stenting Ranjan Shetty K Vivek G Manoj K Gupta Umesh Pai M Lorraine Dias Kushal Naha Raviraj Acharya

Carotid artery stenosis is a disabling disease in all age groups. Elderly people are more prone to recurrent strokes due to advancing age and multiple co-morbidities. Treatment options for symptomatic carotid stenosis in the very elderly are the same as in younger patients although with a higher operative risk. We describe a successful case of carotid artery stenting in a nonagenarian with symptomatic carotid artery stenosis, a subgroup for whom treatment options are rarely discussed in guidelines. Australas Med J. 2012; 5(10): 528–530. doi: 10.4066/AMJ.2012.1278

Safety and efficacy of the frontrunner XP catheter for recanalization of chronic total occlusion of the femoropopliteal arteries.

2013-04-07 chronic total occlusions, recanalization, percutaneous transluminal angioplasty, fluoroscopy Shetty R Vivek G Thakkar A Prasad R Umesh Pai M

OBJECTIVE:The purpose of this study was to examine the safety and efficacy of the Frontrunner XP CTO (chronic total occlusion) catheter (Cordis Corporation) for recanalization of CTO of femoropopliteal arteries. METHODS:A retrospective analysis of consecutive patients with critical limb ischemia (CLI) who underwent femoropopliteal angioplasty for TransAtlantic Inter-Society Consensus (TASC) class D lesions between 2009 and 2011 was performed. Twenty-two patients were enrolled with a mean age of 58.9 ± 11.5 years. Patients were enrolled with totally occluded arteries (mean occlusion length, 18.0 ± 10.1 cm) that were treated with the Frontrunner XP CTO catheter. All lesions were complex (TASC D) and 86.4% of the lesions were mildly calcified. A Frontrunner catheter was used to treat 22 CTOs after guidewire failure. RESULTS:Twenty-two of the 33 cases (66.7%) had failed previous attempts of percutaneous intervention with conventional guidewire. The Frontrunner catheter was used to treat 22 CTOs after guidewire failure. The Frontrunner catheter successfully facilitated the placement of a guidewire into the distal true lumen in 21 cases (95.5%). Thrombolysis in Myocardial Infarction 3 flow was achieved in all target vessels after further balloon angioplasty or stenting. CONCLUSIONS:The Frontrunner XP CTO catheter is safe and effective for successful recanalization of CTO of femoropopliteal arteries and it should be an alternative method after guidewire failure. J Invasive Cardiol. 2013 Jul;25(7):344-7 Volume 25 - Issue 7 - July 2013

Multiple abscess, TAPVC, cyanotic congenital heart disease

2013-04-03 multiple abscess, TAPVC, cyanotic congenital heart disease Kushal Naha G Vivek Ranjan K Shetty

Summary: We report the case of a 24-year-old man, presenting with fever, headache, vomiting and seizures, subsequently diagnosed with cyanotic congenital heart disease. Evaluation revealed non-obstructive supracardiac total anomalous pulmonary venous connection (TAPVC) as the underlying disorder. Surprisingly, the patient denied any past cardiac symptoms. Presentation in adulthood is infrequent for TAPVC, and primary manifestation with cerebral abscesses is still more unusual. BMJ Case Reports 2013; doi:10.1136/bcr-2013-009778

Quadrivalvular heart disease of mixed congenital and rheumatic aetiology with concomitant ostium secundum atrial septal defect and Ebstein's anomaly of the tricuspid valve.

2013-03-05 quadripolar heart disease, rheumatic diseases, ebsteins anomaly Shetty RK Vivek G Naha K Rau NR

Abstract: We describe a 34-year-old man with an ostium secundum atrial septal defect, Ebstein's anomaly of the tricuspid valve with severe tricuspid regurgitation, congenital valvular pulmonary stenosis, rheumatic mitral stenosis and regurgitation with aortic regurgitation, who presented with decompensated heart failure after developing atrial fibrillation. The complex haemodynamic interplay of these lesions is also discussed. BMJ Case Rep. 2013 May 3;2013. pii: bcr2012008032. doi: 10.1136/bcr-2012-008032

Isolated pulmonary valve endocarditis in a patient with aplastic anaemia

2013-04-03 aplastic anaemia, pulmonary valve endocarditis K R Nishanth Shubha Seshadri Vinay Pandit

Summary: A 42-year-old female patient of aplastic anemia on maintenance blood transfusion presented with a 3-week history of fever, cough, dyspnoea and pedal oedema. Upon examination she was found to have severe pallor, temperature of 101°F, tachycardia, bilateral pitting pedal oedema, raised jugular venous pressure, ejection systolic murmur (grade 2/6) in pulmonary area and petechiae over extensor aspect of both lower limbs. Blood investigations revealed low haemoglobin, thrombocytopaenia and mild increase in serum creatine. Chest x-ray was normal. Initial 2D trans thoracic echocardiography performed after hospital admission was normal. Antibiotics were started empirically to treat a possible underlying infection. Subsequently, three sets of blood cultures grew Enterococcus faecalis. Upon searching for the source, repeat echocardiograph done showed 2×0.5 cm vegetation on both pulmonary leaflets with severe pulmonary regurgitation, all other valves were free of vegetations. She was treated with intravenous antibiotics for the endocarditis and improved. BMJ Case Reports 2013; doi:10.1136/bcr-2013-008769

Correlation of epicardial fat and anthropometric measurements in Asian-Indians: A community based study.

2012-04-10 Anthropometric measurements; epicardial fat; metabolic syndrome visceral fat Shetty R, Vivek G Naha K Goyal A Dias LS

Abstract BACKGROUND:It is increasingly evident that visceral adipose tissue plays a leading role in the pathogenesis of the metabolic syndrome. Unfortunately, accurate quantification of intra-abdominal visceral fat is cumbersome and expensive. Epicardial fat represents the component of visceral fat distributed around the heart, and is readily and non-invasively assessed by echocardiography. AIMS:To determine the correlation of epicardial fat with anthropometric parameters in a healthy population of Asian-Indians. MATERIALS AND METHODS:A prospective, cross-sectional study was conducted as part of a community outreach program from December to March 2011. Individuals over 18 years of age were included in the study. Anthropometric data was collected for all patients. Epicardial fat was assessed in parasternal long and short axes. RESULTS:350 healthy individuals were included in the study. Of them, 66.7% were males. Mean age was 42.7 ± 15.3 years (range 18-84). Mean body-mass index (BMI) and waist circumference were 23.3 ± 4.5 kg/m(2) (range 15.2-34.3) and 80.2 ± 13.3 cm (range 43-115) respectively. Mean epicardial fat in both axes was 2.6 ± 1.3 mm (range 0.3-7.0). Epicardial fat measured in both axes correlated well with weight (r = 0.399, P < 0.001), waist circumference (r = 0.522, P < 0.001) and BMI (r = 0.471, P < 0.001). Epicardial fat also correlated with age (r = 0.559, P < 0.001). CONCLUSIONS:There is an excellent correlation between epicardial fat measured by echocardiography and anthropometric parameters of metabolic syndrome. Avicenna J Med. 2012 Oct;2(4):89-93. doi: 10.4103/2231-0770.110739.

Cardiac Dysfunction in Patients with Sepsis, Severe Sepsis and Septic Shock

2014-04-07 Cardiac dysfunction; septic shock; sepsis; severe sepsis; echocardiography Tom Devasia Hashir Kareem Y. G. Ashok Kumar R. Padma Kumar Saumya Jose Sharmila Sadanand Prabhu, Umesh Pai M Tulsee Sitapara Ashok Thakkar

Abstract: Aims: Patients with severe sepsis and septic shock often exhibit significant cardiovascular dysfunction. We designed the study with an aim to determine the severity of cardiac dysfunction in the different group of sepsis patients. Study Design: Single-center, cross-sectional study Place and Duration of Study: The study was carried out at Department of Cardiology, Kasturba Medical College and Hospital, Manipal from June 2011 to December 2012. Methodology: A total of 74 patients who were diagnosed with sepsis were enrolled in the study. All patients were subjected to routine analysis, laboratory test and echocardiogrphic assessment. Results: The patients were divided into 3 groups: sepsis group (n = 11), severe sepsis group (n = 37) and septic shock group (n = 26). The mitral E/A value is significantly higher in patients with septic shock than that of the patients with sepsis (P = 0.04). The indices of right ventricular dysfunction did not show any significant difference in the patients with septic shock and that of sepsis. Conclusion: Left ventricular dysfunction may be considered prevalent in sepsis as per the significant E/A values. However, the other echocardiographic parameter should also be considered. This may even infer that cardiac dysfunction may not correlate with the severity of sepsis. July 2014; British Journal of Medicine and Medical Research, ISSN: 2231-0614,Vol.: 5, Issue

Unexplained extensive calcification of the venae cavae extending into the right atrium causing partial obstruction of the tricuspid valve

2014-05-06 calcification of IVC, Tricuspid valve obstruction Hashir Kareem Tom Devasia Sumit Agarwal

Description: Inferior vena caval (IVC) calcification is usually found in neonates and children and is extremely rare in adults. IVC calcification is usually benign and detected incidentally but may occasionally be associated with pulmonary embolism

Diabetic Cardiomyopathy: Tissue Doppler Imaging a Novel Insight.

2016-04-01 Diabetes mellitus, cardiomyopathy, Tissue Doppler, Strain rate Karthik N RAO Kirthinath BALLALA Jyothi SAMANTH Ranjan SHETTY Sudha VIDYASAGAR Arun G MAIYA Shashi KUMAR Usha NANDHINI

ABSTRACT Patients with diabetes mellitus (DM) are prone to develop heart failure even in the absence of evident hypertension and coronary artery disease. This entity is difficult to detect in early stages by conventional echocardiographic techniques. 32 asymptomatic TMT (tread mill stress test) negative DM patients compared with control subjects were screened and performed LV (left ventricle) strain, strain rate and tissue Doppler imaging. Tissue Doppler imaging revealed increased E/E’ of IVS (Inter ventricular septum) (p value<0.001) among DM suggestive of diastolic dysfunction. The tissue velocities E’ of both the LV lateral wall (p value=0.004) and RV (right ventricle) (p value =0.003) were reduced among DM. Similarly, the peak systolic strain (p value<0.001), and strain rate (p value<0.001) were significantly reduced among diabetic subjects. DM is an independent risk factor for myocardial dysfunction even in asymptomatic normotensive subjects. The changes that occur in the myocardium due to diabetic cardiomyopathy can be detected early, as the novel tissue Doppler is a noninvasive technique for early detection of Diabetic cardiomyopathy. Research Journal of Pharmaceutical, Biological and Chemical Sciences January – February 2016, ISSN: 0975-8585

Automated classification of patients with coronary artery disease using grayscale features from left ventricle echocardiographic images

2013-04-12 Coronary artery disease; Gaussian mixture model; Feature extraction; Classification U. Rajendra Acharya S. Vinitha Sree M. Muthu Rama Krishnan Shetty Ranjan Umesh Pai M Jasjit S. Suri

Abstract: Coronary Artery Disease (CAD), caused by the buildup of plaque on the inside of the coronary arteries, has a high mortality rate. To efficiently detect this condition from echocardiography images, with lesser inter-observer variability and visual interpretation errors, computer based data mining techniques may be exploited. We have developed and presented one such technique in this paper for the classification of normal and CAD affected cases. A multitude of grayscale features (fractal dimension, entropies based on the higher order spectra, features based on image texture and local binary patterns, and wavelet based features) were extracted from echocardiography images belonging to a huge database of 400 normal cases and 400 CAD patients. Only the features that had good discriminating capability were selected using t-test. Several combinations of the resultant significant features were used to evaluate many supervised classifiers to find the combination that presents a good accuracy. We observed that the Gaussian Mixture Model (GMM) classifier trained with a feature subset made up of nine significant features presented the highest accuracy, sensitivity, specificity, and positive predictive value of 100%. We have also developed a novel, highly discriminative HeartIndex, which is a single number that is calculated from the combination of the features, in order to objectively classify the images from either of the two classes. Such an index allows for an easier implementation of the technique for automated CAD detection in the computers in hospitals and clinics. Computer Methods and Programs in Biomedicine Elsevier: Volume 112, Issue 3, December 2013, Pages 624–632

Evaluation of Subtle Left Ventricular Systolic Abnormalities in Adult Patients with Hypertrophic Cardiomyopathy

2014-04-12 Global systolic dysfunction, Hypertrophic cardiomyopathy, Left-ventricular torsion, Strain imaging Ranjan Shetty Jyothi Samanth Arohi Sarang Ashok Thakkar

ABSTRACT Background: Hypertrophic cardiomyopathy (HCM), an auto-somal dominant disorder due to mutation of genes encoding sarcomeric proteins, leads to left ventricular diastolic dysfunction. Recently, the research in this area suggests that systolic dysfunction exists in the patients with HCM even though traditional measures of systolic dysfunction are normal. So, we carried out this study to determine global systolic dysfunction in patients with HCM. Materials and Methods: A total of 18 patients, diagnosed with HCM according to echocardiography parameters, that is thickness of interventricular septum/posterior wall thickness >1.3 or hypertrophy involving apex only with or without left ventricular outflow tract obstruction, were included in the study and were compared with normal age-matched controls. We measured torsion and strain imaging by 2-dimensional echocardiography as well as strain imaging by tissue Doppler echocardiography. Result: The results of the study showed that there was considerable increased torsion in patients with HCM as compared to normal subjects (16.61±7.43 vs. 10.42±4.73, p=0.006). Tissue Doppler indices—systolic annular velocity (7.7±0.7 vs. 8.7±1.00, p=0.012) and lateral wall E/E’ (12.52±5.27 vs. 6.66±1.67, p<0.001) were significantly different in patients with HCM and normal subjects. The average systolic strain and strain rate as well as diastolic strain rate were significantly different in both the groups when strain imaging was performed by tissue Doppler echocardiography. We also observed significantly reduced global longitudinal, circumferential and radial strain in patients with HCM when strain analysis was carried out with 2-dimensional speckle tracking echocardiography. Conclusion: The global subtle systolic dysfunction, as measured by left ventricular torsion and strain imaging, is present in patients with HCM even though traditional measure of systolic dysfunction is normal. Journal of Clinical and Diagnostic Research. 2014 Dec, Vol-8(12): MC05-MC09:DOI:10.7860/JCDR/2014/10185.5287

Percutaneous left atrial appendage closure in AF using Amplatzer Cardiac Plug: First single center experience from India

2015-04-12 Left atrial appendage; Atrial fibrillation; Amplatzer Cardiac Plug Shetty RK, Naveen Chandra GS Agarwal S Sudhakar Rao M

Abstract Background:Atrial fibrillation (AF) is one of the most common arrhythmias accounting for significant mortality and morbidity, especially in elderly. Though oral anticoagulation (OAC) is an effective mode of prevention of stroke in patients of AF, bleeding complication remains a major concern. Because of these issues, a significant proportion of patients either does not receive or receive suboptimal doses of OAC. Methods:In such patients, percutaneous left atrial appendage (LAA) closure remains an interesting option. Experience and literature of this procedure from India have been sparse. We report the first single center experience, from India, of percutaneous LAA closure with Amplatzer Cardiac Plug in 10 patients of non-valvular AF. These patients had contraindications for OAC or had high risk of bleeding or labile international normalized ratio (INR) on therapy. Results: We successfully deployed the devices in all of the cases with no major complications perioperatively and on short-term follow-up. We also report a comprehensive review on the technique of percutaneous LAA closure using Amplatzer Cardiac Plug, including some novel modification with our experience of doing percutaneous mitral balloon valvuloplasty. Indian Heart Journal: Volume 67, Supplement 2, December 2015, Pages S35–S39

Evaluation of fetal echocardiography as a routine antenatal screening tool for detection of congenital heart disease

2015-17-11 Congenital heart disease (CHD); fetal echocardiography; prenatal diagnosis Naveen Chandra G S Ranjan Shetty Pratap Kumar Narayan

Background: Fetal echocardiography plays a pivotal role in identifying the congenital heart defects (CHDs) in utero. Though foetal echocardiography is mostly reserved for high risk pregnant women, its role as a routine prenatal screening tool still needs to be defined. Performing foetal echocardiography based on only these indications can lead to a significant numbers of CHD cases going undetected who will be deprived of further management leading to increased early neonatal mortalities. The aim of this study is to assess the incidence of CHDs by fetal echocardiography in an unselected population of pregnant women in comparison with pregnant women with conventional high risk factors for CHD. Methods: This study enrolled consecutive pregnant women who attended antenatal clinic between 2008 and 2012 in a tertiary care hospital. These pregnant women were categorized into two groups: high risk group included pregnant women with traditional risk factors for CHD as laid down by Pediatric Council of the American Society of Echocardiography and low risk group. Detailed fetal 2 D echocardiography was done. Results: A total of 1,280 pregnant women were included in study.118 women were categorized as the high risk group while remaining 1,162 were included in the low risk group. Twenty six cases of CHDs were detected based on abnormal foetal echocardiography (20.3 per 1,000). Two of the 26 cases of CHD occurred in high risk group whereas the remaining 24 occurred in low risk pregnancy. The difference in the incidence of CHDs between the two groups was not significant statistically (P=0.76). Conclusions: Our study shows no difference in incidence of CHDs between pregnancies associated with high risk factors compared to low risk pregnancies. So we advocate foetal echocardiography should be included as a part of routine antenatal screening and all pregnant women irrespective of risk factors for CHDs. Cardiovascular Diagnosis and Therapy, Accepted for publication Nov 17, 2015. doi: 10.3978/j.issn.2223-3652.2015.12.01

Neonatal Tuberous Sclerosis Complex with Large and Multiple Cardiac Rhabdomyomas

2015-28-03 Ramesh Bhat Y Leslie E Lewis Jayashree P Prakashini K Ranjan S

Tuberous sclerosis complex (TSC) is most commonly diagnosed around the age of 5 years. Neonatal TSC is rare.The important neonatal manifestations include cardiacrhabdomyoma, central nervous system abnormalities and skin manifestations. We describe a neonate having TSC with large and multiple cardiac rhabdomyomas. The largest rhabdomyoma measured 3.6cm x 2cm almost filling the right ventricle. The neonate did not have any symptoms. She continued to remain asymptomatic until 8-months follow up. Discussion TSC is characterized by pleomorphic features involving brain,kidneys, heart, eyes, lungs and skin [1-4]. A mutation in either theTSC1 gene or the TSC2 gene causes this autosomal dominant disorder.The expression of the disease varies substantially. A family history of TSC is present in only 7 to 37 percent of newly diagnosed cases. About 60-70% cases occur sporadically [6]. In the present case the mother had asymptomatic TSC.Though the penetrance is complete in TSC, the range of phenotypic changes such as age of onset, severity of disease, and different signs Nearly all patients with TSC have one or more of the skin lesions characteristic of the disorder. The present case had multiple ash leaf macules. Renal manifestations are rare in neonates [2]. TSC is a progressive disorder. Hence a systematic follow up of all cases is suggested and which may include ophthalmology evaluations,renal scans, electroencephalography, echocardiography and brain MRI [10]. Some of recent research works being done on the treatment oftuberous sclerosis using mTOR inhibitors, such as sirolimus andeverolimus are promising [9,11]. Early mTOR inhibition in TSC patients may prevent the development of TSC lesions and alter the natural history of the disease. A significant decrease in brain tumor volume, prevention of facial angiofibromas and renal angiomyolipomas by using everolimus over 24-months period without significant side effects has been reported. Conclusion: In conclusion, cardiac rhabdomyomas of tuberous sclerosis complex are mostly silent despite being large and multiple in numbers. However, because of rare but serious consequences they warrant follow up and may need an early treatment. International Journal ofCardiovascular Research, Acc date: Mar 28, 2015 Pub date: Mar 30, 2015, Int J Cardiovasc Res 2015, 4:2, http://dx.doi.org/10.4172/2324-8602.1000204

A rare variant of single coronary artery presenting with angina

2012-12-06 angina, coronary anomaly, single coronary artery Ranjan Shetty G. Vivek Umesh Pai M

Description: Coronary artery anomalies, though rare, are extensively classified and categorized. The overall incidence of coronary artery anomalies is about 1% in the general population. Single coronary artery and its variants account for approximately 0.024% in the general population. Journal of Cardiovascular Disease Research 4 (2013) 74–75

Research paper: Molecular genetic study on heart septal defects

2016-01-04 Heart septal defects, genetic study, GATA4, NKX2-5 Yashawanthi Borker Ranjan Shetty Rajashekhar Moka

Abstract: Herat septal defects (HSD) are the common congenital malformation affecting over 1% of live births accounting for 50% of CHDs. HSD is a genetically heterogeneous defect and the genetic basis involved in the pathogenesis highly remains unknown. Three polymorphisms C.5434>A (rs7255428), C.63A>G (rs2277923) and C.606G>C (rs3729753) in NKX2-5 gene, three variations C.55G>A (rs1139240), C.419C>T (rs115372595) and intronic SNP at intronic/exonic boundaries of exon6c998-128T>C (rs3729853) in GATA4 gene. No notable variation was identified in TBX5 gene. These findings may be useful in understanding the mechanism and the prevalence of GATA4 (1%) and NKX2-5 (1-4%). Journal: Journal of Global Biosciences, ISSN 2320-1355, Volume 5, Number 1, 2016, pp. 3475-3482

Congenital Mitral Atresia: A Rare Anomaly Diagnosed in Fetal Echocardiography: A Case Study

2016-01-09 Sridevi Prabhu Jyothi S Ranjan Shetty K Pratap Kumar Kiran Shetty

Citation : Krishnananda N1*, Ranjan Shetty K2 , Pratap Kumar3 , Kiran Shetty4 , Sridevi Prabhu5 , Jyothi S 6; “Congenital Mitral Atresia: A Rare Anomaly Diagnosed in Fetal Echocardiography: A Case Study” Research Journal of Pharmaceutical, Biological and Chemical Sciences, 7(5), September – October 2016, Page No. 2506- 1939 URL: http://www.rjpbcs.com/7(5)/September – October 2016

Prediction of Intrauterine Growth Restriction (IUGR) using Novel Method of Noninvasive Doppler Ultrasound - A Systematic Review

2016-01-09 Pratap Kumar Ranjan Shetty Kiran Shetty Jyothi S, Shreemathi S Mayya Arun G Maiya

Citation: Krishnananda N, Pratap Kumar3, Ranjan Shetty, Kiran Shetty, Jyothi S, Shreemathi S Mayya, Arun G Maiya, ‘’Prediction of Intrauterine Growth Restriction (IUGR) using Novel Method of Noninvasive Doppler Ultrasound - A Systematic Review’’, Int. J. Pharm. Sci. Rev. Res., 41(1), November - December 2016; Article No. 26, Pages: 132-137 URL: Int. J. Pharm. Sci. Rev. Res., 41(1), November - December 2016; Article No. 26, Pages: 132-137

Assessment of left atrial function in patients with mitral valve diseases

2016-17-08 Alphonsa Mathew Ranjan Shetty Navin Patil Karthik Rao N Jyothi Samanth Balaji O Dipanjan B Rahul Kotian

Citation: Mathew et al,http://dx.doi.org/10.22159/ajpcr.2016.v9i6.14677 URL: http://dx.doi.org/10.22159/ajpcr.2016.v9i6.14677

Automated screening of congestive heart failure using variational mode decomposition and texture features extracted from ultrasound images

2017-05-01 U. Raghavendral U. Rajendra Acharya Anjan Gudigarl Ranjan Shetty Umesh pai, Jyothi Samanth Chaithra Nayak

Citation: U. Raghavendral, U. Rajendra Acharya, Anjan Gudigarl, Ranjan Shetty N, Krishnananda, Umesh pai, Jyothi Samanth, Chaithra Nayak; ‘’ Automated screening of congestive heart failure using variational mode decomposition and texture features extracted from ultrasound images’’ Neural comput & applic DOI 10.1007/s00521-017-2839-5 URL: http://link.springer.com/article/10.1007/s00521-017-2839-5

Altered arterial doppler flow pattern and perinatal outcome in intrauterine growth restriction

2017-01-03 Pratap Kumar Ranjan Shetty Kiran Shetty Jyothi Samanth Leslie Edward Lewis Shreemathi S Maiyya

Citation: Nayak K et al; DOI: http://dx.doi.org/10.22159/ajpcr.2017.v10i3.16422 URL: http://dx.doi.org/10.22159/ajpcr.2017.v10i3.16422

Gerbode Ventricular Septal Defect –A Rare Cardiac Anomaly Associated with Genetic Variants in Indian Population- A Case Series

2017-01-03 Yashvanthi Borkar Ranjan K. Shetty Gopalakrishna Bhat, Rajasekhar Moka

Citation: Yashvanthi Borkar et al., Gerbode Septal Defect, Journal of Clinical and Diagnostic Research. DOI: 10.7860/JCDR/2017/23820.9549; 2017 Mar, Vol-11(3): GR01-GR04 URL: http://dx.doi.org/DOI: 10.7860/JCDR/2017/23820.9549

Feasibility of Telecardiology Solution to Connect Rural Health Clinics to a Teaching Hospital

2017-01-08 Ranjan Shetty Jyothi Samant, Manjunatha Maiya Shankar Reddy

Citation: Shetty R, Samant J, Nayak K, Maiya M, Reddy S. Feasibility of telecardiology solution to connect rural health clinics to a teaching hospital. Indian J Community Med 2017;42:170-3 URL: http://www.ijcm.org.in/text.asp?2017/42/3/170/212066

Use of tissue doppler imaging to detect right ventricular myocardial dysfunction in patients with chronic obstructive pulmonary disease

2017-01-06 Jyothi Samanth Padmakumar R Ashwinikumar Mohapatra Navin Patil Karthik Rao N Vidya Nayak Balaji O Dipanjan B Rahul Kotian

Citation: Jyothi Samanth et al; Use of tissue doppler imaging to detect right ventricular myocardial dysfunction in patients with chronic obstructive pulmonary disease; Asian J Pharm Clin Res, Vol 10, Issue 6, 2017, 118-124 URL: http://dx.doi.org/10.22159/ajpcr.2017.v10i6.17517

Culprit or Companion-Foetal Right Ventricular Diverticulum: Role of M-mode Echocardiography in Distinguishing it from Ventricular Aneurysm

2018-01-01 Ashwal Adamane Jayaram Abdul Razak R Padmakumar Umesh Pai

Citation: Ashwal Adamane Jayaram et al., Culprit or Companion-Foetal Right Ventricular Diverticulum: Role of M-mode Echocardiography, Journal of Clinical and Diagnostic Research. 2018 Jan, Vol-12(1) URL: DOI: 10.7860/JCDR/2018/31277.11031

A study correlating angiographic result of patients with acute MI undergoing primary PCI and LV function

2011-01-01 Vidya

A study of ventricular function in angiographically proven slow flow/normal epicardial coronaries using newer indices of Echocardiography

2012-01-01 Thara Shetty

Comparison of bi-ventricular function bt pregnant and normal woman by Echo

2013-01-01 Priyanka Antony

A Comparative study of Left Ventricular torsion in normal and patients with chronic stable angina patients

2016-01-07 Nishal Ranjini Dr. Ranjan Shetty

Role: Co-Guide

Correlation of echo cardiographic dimensions in normal individuals with sugar, lipid and metabolic syndrome

2012-02-07 Sharmila, Dr. Ranjan Shetty,

Role: Co-Guide

Assessment of biventricular function in patients undergoing BMV- Pre and post procedure tissue Doppler imaging

2012-02-07 Priyanka Antony Dr. Ranjan Shetty

Role: Co-Guide

A Comparative study on left ventricular torsion in patients with Hypertrophic cardiomyopathy and controls

2016-09-09 Jyothi Dr. Ranjan Shetty

Role: Co-Guide

Assessment of LV dyssynchrony in patients with LBBB using tissue Doppler imaging

2013-01-07 Chaithra Nayak Dr. Ranjan Shetty

Role: Co-Guide

Assessment of biventricular function in patients undergoing BMV- Pre and post procedure using TDI

2016-09-09 Geethu Mary Raju Dr. Ranjan Shetty

Role: Co-Guide

Biventricular Function Assessment in Isolated Mitral Regurgitation By Using Newer Doppler Indices Of Echocardiography

2013-01-07 Roshini Thomas Dr. Ranjan Shetty

Role: Co-Guide

Biventricular Function Assessment in Isolated Aortic Stenosis By New Doppler Indices Echocardiography

2013-01-07 Kiran Rai Dr. Ranjan Shetty

Role: Co-Guide

A Follow up Study of prognosis of patients with renal artery stenosis after stenting

2013-01-07 Pema Wanchuk Lepcha Dr.Padmakumar R

Role: Co-Guide

Comparative study of biventricular function assessment in patients with AS and healthy controls

2014-01-07 Karthika Babu Dr. Ranjan Shetty

Role: Co-Guide

Comparative Study On Biventricular function In Pre & Post ASD Device Closure By Newer Doppler Indices

2014-01-07 Mohammed Safeer K K Dr. Ranjan Shetty

Role: Co-Guide

: Study of LV & RV Function In Pre & Post BMV Patients Using Newer Echo Technique

2014-01-07 Udaya Prabhu Dr. Ranjan Shetty

Role: Co-Guide

Assessment of Left Atrial Function in Patients with Mitral Valve Disease

2015-01-07 Alphonsa Mathew Dr. Ranjan Shetty

Role: Co-Guide

A study on time taken for PDA closure in preterm infants by Echocardiography

2015-01-07 Sahana Nayak Rachan Hegde Dr. Leslie Lewis Dr. Ranjan Shetty

Role: Co-Guide

Assessment of Right ventricular function in patients with pre and post cardiac surgery

2015-01-07 Tejaswi Jadhav Dr.Padmakumar R

Role: Co-Guide

Influence of vasodilators on global strain in angiographically proven coronary slow flow- Pre and post drug therapy

2015-01-07 Minnu Dr.Padmakumar R

Role: Co-Guide

A Study Correlating Angiographic Result Of Patients With Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention and Left Ventricular Function

2011-01-04 Vidya, Dr.Padmakumar R

Role: Co-Guide

Assessment of left ventricular dyssynchrony in patients with LBBB

2011-01-04 Sridevi Prabhu Dr.Padmakumar R

Role: Co-Guide

A study Of Ventricular Function In Angiographically Proven Slow Flow/normal Epicardial Coronaries using Newer Indices Of Echocardiography

2012-02-04 Thara S Shetty Dr.Padmakumar R

Role: Co-Guide

Comparison Of Biventricular Function Between Pregnant And Non-Pregnant Women By conventional And Newer Echocardiographic Indices

2014-02-06 Priyanka Antony Dr.Padmakumar R

Role: Co-Guide

Use Of Tissue Doppler Imaging To Detect Right Ventricular Myocardial Dysfunction In Patients With Chronic Obstructive Pulmonary Disease

2015-01-06 Jyothi Dr.Padmakumar R Dr.AshwiniKumar Mohapatra

Role: Co-Guide

Assessment Of Cardiac Structure And Function, Its Association With Anthropometric Values Among Neonates In Coastal Karnataka Region

2017-01-08 Annes Ishra Jyothi Samanth

Role: Guide

Myocardial Deformation Imaging Among Patients With Chronic Stable Angina

2017-01-08 Sharaa Shuhaib Mehek, Dr. Abdul Razak U K

Role: Co-guide

Left Ventricular Imaging In Left Bundle Branch Block Subjects

2017-01-08 Mathew Alina Dr. Ashwal A J

Role: Co-guide

Clinical Profile Of Infective Endocarditis

2017-01-08 Nimitha Sherol Vidya Nayak

Role: Guide

Assessment Of Left Ventricular Torsion In Pre And Pot ASD Device Closure Patients Using Speckle Tracking Echocardiography

2017-01-08 Maryam Al Hajri Dr. Ranjan Shetty K

Role: Co-guide