An insight into the world of genomics in cardiac health and preventive cardiology | India News

Globally, World Heart Day (WHD) is celebrated on 29 th September to educate people about cardiac care and arm them with ways to maintain a healthy heart. With the aim of raising mass awareness about cardiac ailments, their treatments and prevention, TOI Medithon, organised a virtual conclave on the occasion of WHD. Titled TOI World Heart Day Symposium 2023: Every Beat Counts, the day-long webinar brought together stalwarts from the field of cardiology and came up with various panel discussions on an array of topics starting from genomics in cardiac health, principles of preventive cardiology and more. Here’s a peek into some of the most enriching sessions of TOI Medithon’s World Heart Day Symposium 2023.
Genomics in Cardiac Health: Latest advancements and preventive measures
Genomics is a game-changer in the realm of cardiac health, offering the latest advancements and highly effective preventive measures that have the potential to transform the landscape of cardiovascular disease management. The panellists for this TOI session on genomics included Dr. Vedam Ramprasad, CEO, MedGenome, India, Dr. Rajeev Gupta, President of Indian Society of Hypertension and Convenor of Prevention Council of Cardiological Society of India and Dr. Manish Bansal, Senior Director of Clinical and Preventive Cardiology at Medanta – The Medicity.
Kicking off the discussion, Dr. Ramprasad says, “Professor Paul Berg, a Nobel Laureate, had made a profound statement at one point of time. He said that almost every disease in humans has a genetic background. Depending upon the disease, the genetic component varies and we call it heritability in scientific terms.” There are ailments where genetics plays 20 to 30 per cent role while lifestyle and environment play a significant part. “However, there are diseases where the genes are the 100 per cent cause. Some common examples of such cardiac conditions would be hypertrophic cardiomyopathy, cardiac channelopathies and certain types of arrhythmias. Also, there are certain congenital heart anomalies (if not all) where significant changes in the genes are predominantly the cause and environment plays a lesser role,” he adds.
While the prevalence of genetic cardiac conditions may sound alarming, the good news is that many of them can be detected early on with the help of screening tests. Talking about this, another panellist, Dr. Bansal says, “There are various cardiac diseases which have a genetic basis and all of these can be diagnosed via DNA screenings. There are heart muscle disorders, cholesterol abnormalities, heart rhythm disturbances and diseases of the aorta, the main artery of the heart that supplies blood to the whole body—these are the common genetic cardiac conditions that we can diagnose using DNA screening. However, with the advancement of genomics, risk factors of quite a few other heart ailments can also be diagnosed with the help of genetic screening. These conditions include coronary artery disease (CAD), diabetes and hypertension.”
One big question that intrigues most of us is: Can genetic heart conditions be treated? Well, most of the genetic cardiac conditions are very rare. However, there are some common disorders like hypertrophic cardiomyopathy or other types of cardiomyopathy. “When we see patients with conditions like these, we diagnose the gene abnormalities. The genetic diagnosis tells us what gene causes them. Also, there have been various early-stage human trials for cardiomyopathies or channel disorders which have tried to provide some sort of gene therapies,” says Dr. Gupta. “Then there are cell-based therapies where healthy donor cells with protective genes are injected to improve the condition. This is a very old-fashioned technology though. CAR-T technology is a newer one which is evolving,” he adds.
Principles of preventive cardiology
At its core, cardiology revolves around the principle of optimal heart health through prevention, diagnosis, and treatment. It emphasizes the importance of a holistic approach, considering both lifestyle factors and medical interventions to mitigate cardiovascular risk factors. The panel discussion on this session dedicated to prevention of cardiac conditions had various luminaries from the field of cardiology including Dr. Y K Mishra, Chief Of Clinical Services, Head Of Cardiac Sciences And Chief Cardio Vascular Surgeon, Manipal Hospitals Dr. Tarlochan Singh Kler, Chairman, Fortis Heart & Vascular Institute at FMRI, Gurugram & Fortis Hospital, Vasant Kunj, Padma Bhushan Prof. Ambuj Roy, Professor of Cardiology, AIIMS, Delhi, Dr. Upendra Kaul, Chairman, Batra Heart Centre.
Sharing his insights on the subject, Dr. Kler says, “WHO data suggests that in 2021, about six million deaths occurred worldwide due to cardiovascular diseases. But the good news is that if we apply the information and technology available to us then 79 per cent of these premature deaths are avoidable.” According to him, lifestyle changes can go a long way in preventing cardiac disorders. “When I say lifestyle, I roughly refer to what our grandparents used to do some 50 years back. They used to work with their hands, they used to walk and cycle. So, what we essentially need to do is continue using our legs.”
Apart from lifestyle choices like exercise and diet management, another factor that is closely associated with cardiovascular health is mental health. Sharing his insights on the topic, Dr. Kaul, one of the distinguished panellists, says, “Stress in family leads to a lot of problems starting from obesity and uncontrolled high blood pressure. Hence, seeking professional help to manage stress is of utmost importance in the prevention of cardiac conditions.”
Talking about prevention, Dr. Mishra observes that there are two aspects of prevention: Primary and secondary. “Every year we do around 150 thousand coronary artery bypass surgeries. Cardiologists do around 4 lakhs of angioplasty. It’s the responsibility of the physicians, society and NGOs to ensure that these patients, who are already treated, do not get a secondary bout of coronary artery disease. Secondary prevention is extremely crucial,” he says. According to him, the surefire ways of preventing heart diseases are quitting smoking, controlling obesity and managing stress and cholesterol levels.
Caring for heart is a culture that needs to be inculcated at a very young age in order to ensure a lifelong cardiovascular health. Shedding light on this topic, Professor Roy says, “There’s a common saying that coronary artery disease begins from the womb to the tomb. You will be surprised to know that a heart attack doesn’t happen on the day that it occurs. It builds over the years and you need to intervene very early. Alongside regular lessons, introducing healthy behaviour in the curriculum is the need of the hour.”