Qualification: 
MD, DM
hishama@aims.amrita.edu

Dr. Hisham Ahamed currently serves as Assistant Professor at the Department of Cardiology, School of Medicine, Kochi.

Well respected consultant cardiologist with 7 years’ experience in treating patients for a wide variety of cardiovascular conditions. Fellowship trained in interventional cardiology ( 2013 ) and has performed a wide array of interventional procedures. Areas of special interest include hypertrophic cardiomyopathy and is currently the Project Lead for the Amrita Hypertrophic Cardiomyopathy Clinic and Registry which is the first and largest dedicated center of excellence for HCM in India.

Cardiovascular genomics is a key area of research and is the Clinical Lead for Amrita cardiovascular genomics. Co-guide for the Amrita Cardio-Oncology Clinic and established the very first cardio-oncology service in the region. Clinical focus on advanced heart failure management and heart failure epidemiology along with genetics of heart failure. Additional focus areas include advanced cardiovascular imaging including advanced echocardiography and cardiac MRI protocols.

Education

  • DM Cardiology

    Amrita Institute of Medical Sciences and Research, Kochi
    Dissertation: “Incidence of Sudden Cardiac Death in A Post MI Cohort in a tertiary care hospital 
    August 2012

  • MD Internal Medicine

    Sri Ramachandra University and Hospital, Chennai
    Thesis: “Prevalence of Secondary Bacterial Infection in Newly Diagnosed Pulmonary Tuberculosis
    May 2008

  • MBBS

    J.S.S Medical College, Mysore.
    April 2003

  • Fellowship in Interventional Cardiology

    Amrita Institute of Medical Sciences and Research
    August 2013

Honors and Awards

  • Awarded Gold Medal for "Best aggregate score in Pathology"  during the MBBS IInd year University Examination 1999  ( Rajiv Gandhi University of Health Sciences, Bangalore ).
  • Awarded the Gold Medal for "The Best Outgoing Candidate - Academic Performance" in the MD university examination in 2008 ( Internal Medicine – Sri Ramachandra University and Hospital , Chennai ).
  • Awarded the best-case presentation for "A case of reactive thrombocytosis " during monthly hospital multi-speciality meet ( 2005 ) at Department of Internal Medicine, Sri Ramachandra University and Hospital.
  • Awarded the Gold Medal for "The best academic performance in DM Cardiology" during the university examinations conducted in 2012 (Amrita Institute of Medical Sciences and Research).

Achievements

1. Amrita Hypertrophic Cardiomyopathy Registry and Clinic

Project Lead, Amrita Hypertrophic Cardiomyopathy Registry and Clinic

Founded the Amrita Hypertrophic Cardiomyopathy Registry and Clinic in 2013. This was the first comprehensive center of excellence for HCM care in India. This was established with mentorship under Dr Barry.J.Maron and Dr Martin.S. Maron from Tuft's HCM Center, Boston.

(References : Importance and feasibility of creating hypertrophic cardiomyopathy centers in developing countries: the experience in India. Maron BJ. Am J Cardiol. 2015 Jul 15;116(2):332-4. doi: 10.1016/j.amjcard.2015.04.027. Epub 2015 Apr 18. )

 

2. Hypertrophic Cardiomyopathy Summit VI, Boston, USA

Speaker: " HCM in the Developing World"

Was an invited speaker : International Summit VI: Hypertrophic cardiomyopathy – A Contemporary and Treatable Genetic Disease: Diagnosis, Heart Failure Management, and Prevention of Sudden Death, held in Boston, MA, October 27-29, 2017, at the Seaport Hotel & World Trade Center. Spoke on "HCM in the Developing World" and was the only invited speaker from the South Asian region.

3. Chapter Author : "Hypertrophic Cardiomyopathy" in Tandon's Textbook of Cardiology ( 2018 )

Co-authors : Dr. Barry J. Maron and Dr. Martin S. Maron

4. National Cardio-Oncology Summit, 2017

  1. Co-Founded India's first National Cardio- Oncology Society in 2017 (Secretary of the NCOS)
  2. Co-Founded India's first National Cardio-Oncology Summit in 2017 (Ramada Hotel, 2017) under the auspices of Canadian Cardio Oncology Society and International Cardio-Oncology Society
  3. Co-Director of the very first dedicated Cardio-Oncology service at Amrita Institute of Medical Sciences and Research, Kochi
  4. Organizing Secretary of India's first National Cardio-Oncology Summit at Ramada Hotel and Resorts, 2017 under the auspices of Canadian Cardio Oncology Society and International Cardio-Oncology Society

5. International Clinical Cardiovascular Genetics (ICCG) , Brisbane Australia 2018

Presented 3 cardiovascular genomics papers at the ICCG, 2018 held at Brisbane :

  1. Clinical outcome and phenotypic expression of PRKAG2 Cardiomyopathy
  2. Familial Non- Syndromic Thoracic Aortic Dissection and Thoracic Aneurysm with an MYH 11 mutation
  3. Clinical Profile of a Large Family with Familial HCM and Sudden Cardiac Death with an Alpha- Tropomyosin mutation

6. Annual Kerala State Echocardiography Meet , 2017

Organizing secretary of the Kerala Chapter of the Annual Indian Academy of Echocardiography Meet in 2017 ( Ramada Hotel, Kochi )

7. Annual Indian Academy of Echocardiography (2016) at Madurai

Best Case presentation - Award session

Won the award for best case presentation at Annual Indian Academy of Echocardiography meeting at Madurai ( 2016 ) for "Carcinoid Heart Disease : Flushing out the diagnosis"

8. Case Presentation : Awards Session ( CSI HFCON 2019 )

PRKAG2 Cardiomyopathy : A South Asian Cohort

Presented the paper : PRKAG2 Cardiomyopathy : A South Asian Cohort at National CSI HFCON, 2019 during the Awards Session.

9. Amrita Cardiovascular Genomics Service, 2015

Founded the Amrita Cardiovascular Genomics Service, the first dedicated cardiovascular genomics service in the region. The service addresses all aspects of evaluation of inherited cardiovascular disease of patients and family screening along with advanced next generation sequencing and genetic counseling.

Publications

Publication Type: Journal Article

Year of Publication Title

2019

M. Subramanian, Peravali, S., Dr. Hisham Ahamed, and Navin Mathew, “Arrhythmogenic right ventricular cardiomyopathy and sick sinus syndrome : a potential overlap syndrome”, European Heart Journal - Cardiovascular Imaging , vol. 20, Suppliment 2, p. ii53, 2019.[Abstract]


Introduction –

Abnormalities of desmosomes, more specifically mutations in the desmoplakin (DSP) gene, have been shown to cause not only arrhythmogenic right ventricular cardiomyopathy (ARVC) but also sick sinus syndrome (SSS) as well. Although various ARVC overlap syndromes have been described, its association with sinus node dysfunction is not documented. In this report, we describe an autosomal dominant missense mutation in the DSP gene in a proband with sick sinus syndrome and features of ARVC on cardiac MRI.

Clinical case –

A 70 year old man presented with a recurrent episodes of syncope, that were historically suggestive of an arrhythmic etiology. He had a history of systemic hypertension which was under adequate control with ACE inhibitors. His 2D Echocardiogram (ECHO) revealed a structurally normal heart. During his evaluation of syncope, his baseline electrocardiogram (ECG), head up tilt test, brain imaging, and electroencephalography were non-contributory. Cardiac MRI(CMR) examination was performed with 1.5-T MR Imager using a dedicated cardiac phase array coil. It revealed focal out-pouching in the right ventricular free wall that did not satisfy the major ARVD Task Force Criteria. The LV wall morphology and function was normal. No obvious late enhancement was noted. As extended 24 hour and 7 day ECG Holter monitoring also did not reveal any abnormalities, an implantable loop recorder was implanted. This revealed multiple sinus pauses (longest pause of 3.2 seconds) suggestive of sick sinus syndrome. The patient underwent a dual chamber implantable cardioverter defibrillator, and is doing well on follow up. In view of CMR findings suggestive of ARVC ,whole exome sequencing was done and it revealed a missense substitution affecting desmoplakin (DSP) gene on chromosome 6p24.3, previously described as ARVD8.

Family screening –

As shown in Figure 1, the entire family of the proband (I,1) was screened for both features of ARVD and sinus node dysfunction. All children of the proband were asymptomatic at the time of screening. An ECG, 2D ECHO, Exercise testing, CMR , as well as genetic screening was performed. All children were carriers for the same missense mutation (ARVD8) on the DSP gene. In one of the sons (II,1) of the proband, CMR revealed RV dilation and dyskinesia of the anterior right ventricular free wall, suggestive of ARVD. There were no features of sinus node dysfunction in any of the children of the proband.

Conclusion –

Autosomal dominant missense mutations on the desmoplakin (DSP) gene can cause a potential overlap syndrome of ARVC and sick sinus syndrome. Patients with this mutation are may be at higher risk for both cardiac conduction abnormalities and life-threatening ventricular arrhythmias, and hence both CMR and genetic screening are crucial in their risk stratification

More »»

2019

Dr. Hisham Ahamed and Subramanian, M., “Letter by Ahamed and Subramanian Regarding Article "Missense Mutations in the FLNC Gene Causing Familial Restrictive Cardiomyopathy".”, Circ Genom Precis Med, vol. 12, no. 7, p. e002587, 2019.

2018

P. Kerala Varma, Krishna, N., Dr. Hisham Ahamed, and Madassery, S., “Posterior mitral leaflet plication for hypertrophic obstructive cardiomyopathy.”, Asian Cardiovascular and Thoracic Annals, vol. 26, no. 5, pp. 400-403, 2018.[Abstract]


Anomalies of the mitral valve apparatus in hypertrophic cardiomyopathy are an important cause of systolic anterior motion. Patients with significant residual obstruction due to systolic anterior motion after myectomy and anterior mitral leaflet plication may end up having mitral valve replacement. We describe the case of a 52-year-old man who underwent posterior mitral leaflet plication to correct residual systolic anterior motion after anterior mitral leaflet plication.

More »»

2018

P. Kerala Varma and Dr. Hisham Ahamed, “Left Atrial Approach to Septal Myectomy: Word of Caution.”, Annals of Thoracic Surgery, vol. 106, no. 5, pp. 1591-1592, 2018.

2017

S. V., Subramaniam, M., Shanmugam, A., Philip, A., Susan, A., Prabhu, R., Unni, M., Sidharthan, N., Jose, W., V., S. N., Dr. Hisham Ahamed, Mathew, N., and Keechilat, P., “1025PIndependent predictors of one year mortality in patients with primary systemic immunoglobulin light chain cardiac amyloidosis”, Annals of Oncology, vol. 28, 2017.[Abstract]


Background: Immunoglobulin light chain amyloidosis (AL amyloidosis) is a monoclonal plasma cell proliferative disorder that is characterized by tissue deposits of misfolded insoluble κ and λ light chain derived amyloid fibrils, leading to organ dysfunction. The prognosis of patients depends on the number and severity of organ involvement, especially cardiac involvement. Nearly half of the patients with amyloidosis die within a year of diagnosis. We analysed factors predicting early mortality (within one year) in patients with systemic immunoglobulin light chain cardiac amyloidosis.Methods: Retrospective analysis of patients between January 2007 and January 2016 from our hospital database. In patients with AL cardiac amyloidosis, cardiac involvement was defined as per American society of echocardiography (ASE) criteria. We evaluated the clinical, ECG and ECHO parameters of early relapse (ER) within one year in these cardiac AL amyloidosis patients. Log rank test was done to identify independent predictors of one year all cause mortality.

More »»

2017

M. Subramanian, Dr. Hisham Ahamed, and Mathew, N., “Familial restrictive cardiomyopathy: A novel troponin mutation”, Indian Heart Journal, vol. 69, Suppliment 2, pp. S87 - S88, 2017.[Abstract]


Background: Although sporadic cases of familial restrictive cardiomyopathy (RCM) have been reported, there is limited data on whether a distinct genetic entity exists.

Methods: We recognized a large family in which 5 individuals died suddenly and several surviving relatives had symptoms of heart disease. Our index case was a 49-year-old male who had onset of heart failure symptoms since the age of 40 years. Echocardiography revealed bi-atrial enlargement accompanied by a restrictive filling pattern, and normal systolic function. He had recurrent admissions for heart failure and died within 1 month of initial admission. We applied a candidate gene approach to our index case and family members that were willing for genetic analysis.

Results: We identified a novel heterozygous missense mutation in exon 7 of the TNNI3 gene that results in the amino acid substitution of Tryptophan for Arginine at codon 145. The TNNI3 gene encodes a highly conserved region of the cardiac troponin I (cTnI) gene. Five other members of the family were detected to be carriers of the same mutation, among which two members had a similar restrictive filling pattern and biatrial dilation on echocardiography.

More »»

Publication Type: Book Chapter

Year of Publication Title

2018

Dr. Hisham Ahamed, J.Maron, D. Barry, and S.Maron, D. Martin, “Hypertrophic Cardiomyopathy”, in Tandon's Textbook of Cardiology , Wolters Kluwer India Pvt. Ltd., 2018.

Presentations and Invited Lectures

Year Title
2019 Presentation : “Managing hypertension and heart failure in COPD patients” at Indian Medical Association CME Update, Thodupuzha (2019) (Invited Lecture)
2019 Presentation : “Nitrates – Evolving usage and current clinical indications” at Cardiology Monthly CME Webinar at Karothukuzhi Hospital, Kochi (2019)
2019 Presentation : “Evolving trends in standard of care in ACS management” at Indian Medical Association CME Update, Cherthala (2019) (Invited Lecture)
2019 Presentation : “Chemotherapy induced cardiotoxicity” at CSI HFCON, Kochi (2019) (Invited Lecture)
2019 Presentation : “Role of SGLT2 inhibitors in modulating cardiovascular outcomes  in diabetes mellitus” at Diabetes Today Symposium, Trivandrum (2019) (Invited Lecture)
2018 Presentation : “Ivabradine : Early is better in heart failure” at Society for Heart Failure and Transplantation, 2018 (Coimbatore) (Invited Lecture)
2018 Presentation : “Genetic testing in HCM : Practical Considerations” at Cardiovascular Genomics Update, 2018 (Chennai) (Invited Lecture)
2018 Presentation : “Inotropes : Clinical indications and limitations” at AIMS Heart Failure Update for Clinicians, 2018 (Kochi) (Invited Lecture)
2018 Presentation : “ARNI – newer paradigms in cardiovascular and renal outcomes” at Indian Medical Association CME Update, Tirur (2018) (Invited Lecture)
2018 Presentation : “10 essential lessons from heart failure guidelines” at Heart Failure Symposium at AIMS, Kochi (2018)
2018 Presentation : “The concept of ARNI in heart failure management” at Heart Failure Symposium at Karothukuzhi Hospital, Kochi (2018) (Invited Lecture)
2018 Presentation : “SGLT2 inhibitors and cardiovascular outcomes” at Diabetes Update, Palghat (2018) (Invited Lecture)
2018 Presentation : “Advances in Diabetes Management : Cardiovascular outcome data” at Diabetes and Cardiovascular disease CME Update, Holiday Inn Kochi (2018) (Invited Lecture)
2018 Presentation : “Ticagrelor : Role in ACS and stable ischemic heart disease” : CAD Symposium at Karothukuzhi Hospital, Aluva (2018)
2018 Presentation : “Updates in ACS management” at ACS Symposium at AIMS, Kochi (2018) (Invited Lecture)
2018 Presentation : “Human beings – Prisoners of lifestyle diseases” at InQ, Kochi (2018) (Invited Lecture)
2018 Presentation : “10 lessons in lipid management” at Cochin Lives CME Update, Kochi (2018) (Invited Lecture)
2018 Presentation : “HCM – A contemporary treatable disease” at Indian Medical Association CME Update, Kollam (2018) (Invited Lecture)
2018 Presentation : “HCM – A contemporary treatable disease” at Indian Medical Association CME Update, Kodungalur (2018) (Invited Lecture)
2018 Presentation : “HCM – A contemporary treatable disease” at Indian Medical Association CME Update, Thiruvalla (2018) (Invited Lecture)
2018 Presentation : “HCM – Evolving trends and contemporary management” at Amrita HCM Conclave, Kochi (2018) (Invited Lecture)
2018 Presentation : “Highlights of preventive aspects of non-communicable diseases” at Amrita Community Medicine CME Update, Kochi (2018) (Invited Lecture)
2018 Presentation : “DPP-4 inhibitors : Current indications and cardiovascular outcome data” at Diabetes Care Symposium, Holiday Inn Kochi (2018) (Invited Lecture)
2017 Hypertrophic Cardiomyopathy Summit VI, Boston, USA 
He was an invited speaker at International Summit VI: Hypertrophic cardiomyopathy – A Contemporary and Treatable Genetic Disease: Diagnosis, Heart Failure Management, and Prevention of Sudden Death, being held in Boston, MA, October 27-29, 2017, at the Seaport Hotel & World Trade Center. Spoke on "HCM in the Developing World"and was the only invited speaker from the South Asian region
2017 Presentation : “SGLT2 inhibitors : Role in diabetes and heart failure” at Holiday Inn Diabetes Care Symposia, Kochi (2017) (Invited Lecture)
2017 Presentation : “Introduction to Cardio-Oncology : A New Sub-specialty” at National Cardio-Oncology Society, Kochi (2017)
2017 Presentation : “Unmet needs of current heart failure management” at Heart Failure Symposium, Marriott Kochi (2017) (Invited Lecture)
2017 Presentation : “ARNI – A new era in medical management of heart failure” at Indian Medical Association CME Update, Aluva (2017) (Invited Lecture)
2017 Presentation : “Updates in diabetes management – Role of SGLT2 inhibitors in modulating cardiovascular risk” at Diabetes and Heart Failure Update, Gokulam Hotel, Kochi (2017) (Invited Lecture)
2017 Presentation : “Pharmacoinvasive strategy for STEMI” at STEMI symposium, at Marriott Hotel, Kochi (2017) (Invited Lecture)
2017 Presentation : “Standards of ambulance care in STEMI and STEMI Network models” at STEMI Update at Marriott Hotel, Kochi (2017) (Invited Lecture)
2017 Presentation : “Newer P2Y12 inhibitors in clinical practice” at Indian Medical Association CME Update, Angamaly (2017) (Invited Lecture)
2017 Presentation : “Sudden Cardiac Death in the Young” at Indian Medical Association CME Update, Madhya Kerala IMA, Kochi (2017)
2017 Presentation : “HCM – A contemporary treatable disease” at Indian Medical Association CME Update, Kottayam (2017) (Invited Lecture)
2017 Presentation : “HCM – A contemporary treatable disease” at Indian Medical Association CME Update, Thodupuzha (2017) (Invited Lecture)
2016 Presentation : “Advances in antiplatelets : Focus on ACS management” Webinar at Holiday Inn, Kochi (2016) (Invited Lecture)
2016 Presentation : “Ticagrelor : Newer antiplatelet inhibition in ACS” at Physician Club Symposium Update, Thodupuzha (2016) (Invited Lecture)
2016 Presentation : “Indications and utility of vitamin K antagonist oral anticoagulation in the era of NOAC” at Anticoagulation Symposium at Karothukuzhi Hospital, Kochi (2016)
2016 Presentation : “Carcinoid heart disease” at Indian Academy of Echocardiography, 2016 (Madurai)
2016 Presentation : “Echo in the Emergency Room” at Annual Emergency Medicine update, AIMS, 2016 (Kochi) (Invited Lecture)
2016 Presentation : “Cost-effectiveness analysis of heart failure therapies” at Society for Heart Failure and Transplantation, 2016 (Kozhikode) (Invited Lecture)
2015 Presentation : “FFR guided intervention for side branch in bifurcation lesions” at CSI Kerala,2015 (Kochi) (Invited Lecture)
2015 Presentation : “A Right atrial surprise” at Indian Academy of Echocardiography, Kerala Chapter, 2015 ( Kozhikode )
2014 Presentation : “Aortic valve anatomy in the TAVR Era” at AIMS TAVR Symposium at Crowne Plaza, Kochi (2017)
2014 Presentation : “Assessment of Mitral Regurgitation by Echo” at CSI Kerala Meeting, 2014 ( Kozhikode ) (Invited Lecture)
2013 Presentation : “Flushing out the diagnosis” at CSI National CPC session, 2013 (Bangalore)

Professional Training

  • ACLS certified
  • ACLS instructor course – Certified ACLS instructor

Professional Affiliations

  • Cardiology Society of India (CSI)
  • Interventional Council Kerala (ICCK)
  • International Cardio-oncology Society (ICOS)
  • Society for Coronary Angiography and Interventions (SCAI)
  • European Society of Cardiology (ESC)