Digital Commons Network^™

The Interplay Between Osteosarcopenia And Intrinsic Capacity: Insights And Associations With All-Cause Mortality In The Toledo Study For Healthy Aging, Ivan Baltasar-Fernandez, Pedro L. Valenzuela, Irene Rodríguez-Gómez, Fabio Quiñonez-Bareiro, Luis M. Alegre, Konstantinos Prokopidis, Leocadio Rodriguez-Mañas, Ignacio Ara, Oscar Rosas-Carrasco, Lana J. Williams, Robinson Ramirez-Vélez, Julie A. Pasco, Guy Hajj-Boutros, Raman Agnihotram, Marc Sim, Wayne Lok Ok Choo, Mahdi Imani, Ana M. Ayala-Copete, Julia Chabot, Miguel G. Borda, Nailton J. Neto, Claire Godard-Sebillotte, Howard Bergman, Anna Andrianova, Hidenori Arai, Pierrette Gaudreau

Research outputs 2022 to 2026

Background: Osteosarcopenia—the coexistence of osteopenia/osteoporosis and sarcopenia—is associated with numerous adverse health outcomes, but its association with intrinsic capacity (IC) remains unknown. We aimed to explore the associations of osteosarcopenia with IC and all-cause mortality in older adults. Methods: We conducted a cross-sectional analysis of IC and a prospective analysis of all-cause mortality in 1142 participants from the Toledo Study for Healthy Aging (75.1 ± 6.0 years, 53.1% women). Participants were classified as having no musculoskeletal disorders, osteopenia/osteoporosis, sarcopenia, or osteosarcopenia (DXA- and EWGSOP2-based criteria). IC was operationalized as a composite score integrating locomotion, cognition, psychological, vitality, and sensory domains. …

Triple Tracer Heterogeneity In Dual Neoplasia: The "Three Musketeers" In Discerning Squamous Cell Carcinoma And Paraganglioma In The Same Patient, Shyam Kumar Ravada, Gaurav Malhotra, Aaditya Daga, Anurag R Lila, Saba Memon, Tushar Bandgar

Faculty, Staff and Student Publications

Head and neck squamous cell carcinoma of unknown primary (HNSCCUP) comprises 2%-5% of head and neck squamous cell cancers (HNSCC). Its coexistence with abdominal paraganglioma is exceedingly rare. We report a unique case of a 48-year-old male with HNSCCUP presenting as cervical lymphadenopathy and a coexisting abdominal paraganglioma. 18 F-FDG showed uptake in both lesions, while 68 Ga-DOTATATE was avid only in paraganglioma, and 68 Ga-DOTA-FAPI-04 was avid only in cervical nodes. These differential uptake patterns reflect distinct tumor biology and underscore the potential for tailoring theranostic treatment strategies with 177 Lu/ 90 Y isotopes for FAPI-avid squamous cell cancers …

Impacts Of The Early Collaborative Intervention On Mother-Preterm Infant Interaction At One Month Of Age: Secondary Analysis Of A Randomized Controlled Trial, Charlotte Sahlén Helmer, Ulrika Birberg Thornberg, Thomas Abrahamsson, Evalotte Mörelius

Research outputs 2022 to 2026

Background A sensitive, well-functioning maternal interaction is vital for healthy infant development. For moderate to late preterm infants, this is even more important as this group of infants are at increased risk of facing neurodevelopmental disorders. The Early Collaborative Intervention supports parent-preterm infant interaction and includes three sessions, two in the hospital and one after discharge. Objective To investigate the impact of the Early Collaborative Intervention, compared with standard care, on mother-preterm infant interaction at one month corrected age. Design A longitudinal randomized controlled trial, reporting secondary outcomes from the first follow-up. Setting The intervention was conducted at a pediatric …

Occupational Therapy Intervention For Children With Developmental Coordination Disorder: A Survey Of Occupational Therapists In Australia, Jacqui Hunt, Jill G. Zwicker, Annette Raynor, Erin Godecke

Research outputs 2022 to 2026

Introduction: Developmental coordination disorder (DCD), a common neurodevelopmental condition, is associated with persistent motor and psychosocial difficulties impacting participation and quality of life. International guidelines recommend activity-/participation-focused, task-specific interventions; however, little is known about how Australian occupational therapists translate these recommendations into clinical practice. This study aimed to describe current Australian occupational therapy intervention for children with (or suspected to have) DCD and identify factors that shape occupational therapists' intervention choices. Methods: A cross-sectional online survey was distributed to Australian occupational therapists via professional organisations/social media September–October 2020. Eligible participants were registered occupational therapists with ≥15% children in their caseload. …

Multi-Sensory Information And Simulator Immersion: Impact On Decision-Making Performance, Presence, And Cognitive Load, Zachariah G. Hoyne, Khaya Morris-Binelli, Sean Müller, Benjamin Piggott, Paola Chivers, Evan Dekker

Research outputs 2022 to 2026

Immersive technologies such as 360-degree video virtual reality (360VR) provide unique opportunities to simulate representative environments to investigate decision-making in a safe and cost-effective manner. Inclusion of multi-sensory visual, contextual, and auditory information is important to enhance simulator psychological fidelity. Yet, the influence of increased sensory information on decision-making, presence, and cognitive load in 360VR compared to less immersive two-dimensional video simulators is unknown. This study investigated multi-sensory information, presence, and cognitive load across immersion conditions (360VR and two-dimensional video) in an exemplar sport-specific decision-making task. Fifteen higher-skilled and 15 lesser-skilled Australian Rules Football players completed a decision-making task which …

Detecting Cognitive Impairment Early In Hispanic And Black Older Adults: Community Voices From South Central Texas, Robin C. Hilsabeck, Stephanie Santiago-Mejias, Tara L. Fletcher, Shanae L. Rhodes, Gladys Maestre, Sudha Seshadri, Neela K. Patel, Fayron R. Epps

School of Medicine Publications

Background: Alzheimer disease and related dementias (ADRD) are more prevalent in Black and Hispanic older adults and are also more likely to be undetected and misdiagnosed. The purpose of this study was to engage with Black and Hispanic communities about interest in and support needed for memory screening.

Methods: Participants were recruited from established community partners of the South Texas Alzheimer's Disease Research Center to engagein a 90-minute listening session. The session was recorded with participants' permission, and a thematic analysis was conducted by 2 independent coders.

Results: Sixteen individuals (81% female, 88% Hispanic or Black) from various perspectives participated …

Global, Regional And National Burden Of Maternal Haemorrhage (2000–2021) And Projections To 2050 In 204 Countries And Territories, Mulat Ayele, Bereket Duko, Tenaw Tiruye, Paul R. Ward, Lillian Mwanri, Gavin Pereira, Tegene Atamenta Kitaw, Biruk Beletew Abate, Eyob Shitie Lake, Abebaw Alamrew, Aynalem Yetwale, Gizachew Yilak, Befkad Derese Tilahun, Chalie Mulugeta, Tadele Emagneneh, Amanuel Tesfay Gebremedhin

Research outputs 2022 to 2026

Objective: To estimate the global, regional and national burden of maternal haemorrhage (2000–2021) and its 2050 projections in 204 countries and territories. Design: This study systematic analysis of the burden of maternal haemorrhage sourced data from the Global Burden of Disease (GBD) 2021 study. We estimated the incidence, mortality, disability-adjusted life years (DALYs), years lived with disability (YLDs) and years of life lost (YLLs) due to maternal haemorrhage. Changes in the burden from 2000 to 2021 were computed using AAPC. To detect statistically notable changes in the trends of maternal haemorrhage metrics between 2000 and 2021, Joinpoint regression analysis using …

Ig–Microbiota Binding Patterns In Mothers And Infants: A Scoping Review, Alicia Tan Yi Jia, Christopher S. Peacock, Danielle E. Dye, Claus T. Christophersen

Research outputs 2022 to 2026

Studies characterising the immunoglobulin (Ig)-bound microbiota apply varying methodologies, making comparisons difficult. This scoping review synthesised evidence on Ig–microbiota binding patterns in maternal and infant contexts, identified recurrent Ig-bound and -unbound bacteria across studies, and highlighted knowledge gaps for further study. Nine articles investigating Ig–microbiota binding patterns in stool or breastmilk samples in mothers or infants were included. Ig–microbiota associations were influenced by sample type, Ig-subclass, genetics, and diet. The most important antibody was IgA, with partial functional redundancy with IgM, while IgG appeared more selective for pathobionts. Ig-bound taxa in early life included important commensals and pathobionts, with high …

Defining Varus Thrust Assessment And Measurement: A Scoping Review, Haonan Shen, Nicole D'Souza, Claire E. Hiller, Marnee J. Mckay, Kun Hu, Zhiyong Wang, Milena Simic

Research outputs 2022 to 2026

Objective: The primary aim of this scoping review was to identify and evaluate the methodologies used for classifying and quantifying varus thrust of the knee during walking. The secondary aim was to report outcomes of reliability, validity, prevalence, and quantitative cutoffs of varus thrust in existing studies. Methods: A systematic literature search was conducted across five electronic databases from inception to April 2024. Studies that reported varus thrust during gait in adults were included. Two independent reviewers extracted data, and data were synthesized based on thrust classification methods, prevalence, reliability, and validity results. Results: A total of 59 studies were …

The Effect Of Vigorous Physical Activity On The Incidence Of Kidney Cancer, Lawrence H. Kim, Bang, Daniel Galvao, David P. Smith, Manish I. Patel

Research outputs 2022 to 2026

Background: Kidney cancer incidence is increasing. While physical activity can reduce the risk of several cancers, the role of vigorous physical activity (VPA) in kidney cancer prevention remains unclear. We examined associations between physical activity intensity and kidney cancer incidence in a large Australian cohort. Methods: Data were obtained from 267,357 adults aged ≥ 45 years in the New South Wales 45 and Up Study. Physical activity, including walking, moderate physical activity (MPA), and VPA, was self-reported at baseline using the validated Active Australia Survey and categorised according to WHO guidelines. Multivariable Cox proportional hazards models estimated hazard ratios and …

Factors Impacting Western Australian Midwives' Intention To Stay: A Mixed Methods Study, Christine Atkinson, Dianne Bloxsome, Zoe Bradfield, Kate Buchanan, Sarah Dawson, Frances Finch, Sadie Geraghty, Sara Bayes

Research outputs 2022 to 2026

Problem Midwifery workforce sustainability remains a critical concern for maternity services. Existing literature predominantly focuses on burnout and attrition, offering limited insight into what influences midwives’ decisions to remain within specific workplaces. Background Midwives consistently report strong professional commitment alongside growing workforce instability. National data indicate that uncertainty about current roles does not necessarily reflect disengagement from the profession. Understanding workplace-level influences on retention is therefore essential for targeted workforce strategy. Aim To examine how workplace stress and satisfaction with the practice environment are associated with Western Australian midwives’ intention to stay in their current job and in the profession. …

The Impact Of A Single Session Of Sprint Interval Training (Sit) On Pain Pressure Threshold (Ppt) In Healthy Adults, Francesco Pacenza, Gary Brickley, Umberto Crainich, Francesco Bettariga, Anthony Turner, Luca Maestroni

Research outputs 2022 to 2026

Different forms of aerobic exercise lead to Exercise-Induced Hypoalgesia (EIH). The aim of this study was to investigate the acute effect of a single session of Sprint Interval Training (SIT) on EIH. A total of 44 recreationally active young adults participated in a single SIT session on a cycle ergometer, consisting of a 2 min warm-up, 3 × 20 s “all-out” cycling bouts interspersed with 2 min of active recovery, and a 3 min cool-down. Pain Pressure Threshold (PPT) measurements were taken on the quadriceps (working muscle) and thenar eminence (resting muscle) before and after the session. Additionally, average power …

A Scoping Review Of Force Plates In Female Soccer: The Utility, Existing Practice And Identification Of Knowledge Gaps, Jack T. Fahey, Francisco Javier Robles-Palazón, Paul Comfort, Nichoals Ripley

Research outputs 2022 to 2026

Female soccer has grown exponentially with increasing funding, participation and competition. Force plates enable high resolution force-time assessment using isometric and dynamic tasks for acute or longitudinal monitoring, and profiling performance and injury risk. However, more research has been conducted in male soccer players compared to females with the utility of force plates in female soccer yet to be reviewed. The purpose of this scoping review is to review existing research using force plates in female soccer describing the utility of force plates, methods used, reported metrics and to identify gaps in our current understanding. A literature search was conducted …

Exploring The Fidelity Of Resistance Training Interventions In Regional, Rural, And Remote Cancer Care: A Systematic Scoping Review, Christopher W. Rowe, Nicolas H. Hart, Julia Carlino, James Murray

Research outputs 2022 to 2026

Resistance-based exercise interventions are an integral part of supportive cancer care, though their high quality and high-fidelity implementation with people with cancer living in non-metropolitan locations is challenging. This systematic scoping review aimed to identify how exercise prescription principles and measures of fidelity are reported in resistance-based exercise interventions delivered to people with cancer living in regional, rural and remote areas. A systematic scoping review was conducted in accordance with the PRISMA-ScR guidelines. Five electronic databases were searched (MEDLINE/PubMed, Embase, CINAHL, SCOPUS and SportDiscus) for peer-reviewed studies published in English, that delivered a resistance-based exercise intervention to adult cancer survivors …

Aviation Accident Investigation Analysis Methodologies Used By 12 Government Safety Investigation Authorities, Kym Bills, Leesa Costello, Marcus Cattani

Research outputs 2022 to 2026

Introduction: Leading government Safety Investigation Authorities (SIAs) that investigate major aviation accidents are members of the International Transportation Safety Association (ITSA). Investigation analysis methodology details are rarely included on SIA websites, in final accident reports, shared with peers, or specified by the International Civil Aviation Organization (ICAO). Some ‘New View’ safety researchers assume SIAs don't use systemic methodologies and that accident investigation has little value. Because of the sensitivity of SIA work and need to prioritize safety value from available investigation funding, there has been little academic research on choice and use of investigation analysis methodologies to address these issues …

Higher Sodium Intake Is Associated With Episodic Memory Decline In Cognitively Unimpaired Older Males: A 6-Year Longitudinal Study, Francisca Chuwa, Stephanie R. Rainey-Smith, Hilal Salim Said Al Shamsi, Hamid Sohrabi, Kevin Taddei, Colin L. Masters, Ralph N. Martins, Samantha L. Gardener

Research outputs 2022 to 2026

Recent evidence has suggested an association between high sodium intake and development of cognitive impairment. However, while animal studies demonstrate consistent relationships between sodium intake and cognitive impairment, this relationship remains less clear in humans. Our aim was to investigate the relationship between self-reported baseline sodium intake and cognitive decline over 72 months. Cognitively unimpaired participants (n = 1208) from the Australian Imaging, Biomarkers and Lifestyle study were included (70.87 years of age; 41 % male). Participants completed a food frequency questionnaire to quantify sodium intake and underwent comprehensive neuropsychological assessment at baseline and four additional timepoints, 18 months apart. …

Protective Potential Of Minimally Processed, Plant-Derived Foods Against Steatotic Liver Disease In Early Adulthood, Yasmina Tashkent, Jocelyn M. Choo, Steven L. Taylor, Therese A. O'Sullivan, Dujinthan Jayabalan, Sophie J. Miller, Richard Woodman, Luis Calzadilla-Bertot, Oyekoya T. Ayonrinde, Lawrence J. Beilin, Trevor A. Mori, John K. Olynyk, Alan J. Wigg, Kate R. Muller, Leon A. Adams, Geraint B. Rogers

Research outputs 2022 to 2026

Background & aims: The incidence of steatotic liver disease (SLD) among younger adults is increasing globally. While poor diet is a recognised risk factor, the impact of specific dietary components is unclear. We investigated associations between dietary patterns and SLD markers in younger adults. Methods: Analysis involved 887 members of the Raine Study Generation 2 cohort, assessed at age 27. SLD was defined using a validated MRI volumetric liver fat fraction equation. Dietary intake, assessed by food frequency questionnaires, was summarised using a modified Overall Diet Score (ODS) that classified foods as “healthy” or “unhealthy.” Associations between diet and SLD …

Mitigating Disparities In Diagnosis Of Dementia, Lycia Tramujas Vasconcellos Neumann, Simin Mahinrad, Erin L. Abner, Soo Borson, Goldie S. Byrd, Maria Carrillo, Lindsay Clark, Anthony N. Correro Ii, Kacie D. Deters, Gladys E. Maestre

School of Medicine Publications

The field of Alzheimer's disease and related dementias (AD/ADRD) is undergoing a transformative shift with a better understanding of disease biology, biomarker-based diagnostics, and disease-modifying therapies. Yet, these advancements risk exacerbating existing disparities in diagnosis and care. The 2024 Alzheimer's Association International Conference (AAIC) Advancements: Exploring Equity in Diagnosis convened interdisciplinary experts to address these inequities and chart a path toward population-generalizable research and practice. This article synthesizes key insights from the conference, highlighting considerations for inclusive and representative research design, ethical approaches in diagnostic disclosure, as well as challenges and solutions at individual, community, and systemic levels to advance …

Calcium Signaling And Postsynaptic Density Dynamics: The Roles Of Calmodulin In Synaptic Protein Regulation, Keyaa Dilip Shah, Yonghong Zhang

School of Integrative Biological & Chemical Sciences Faculty Publications

Calcium signaling in neuronal cells is the principal mechanism underlying learning and synaptic plasticity, whereas the postsynaptic density (PSD) is an important center where calcium-dependent processes are organized and regulated. This review explores the roles of calmodulin (CaM) in facilitating calcium-dependent modulation of the activities of synaptic proteins in the PSD. We focus on the molecular processes through which CaM interacts with calcium signals to regulate the function, localization, and interactions of central synaptic proteins, including calcium/calmodulin-dependent protein kinase II (CaMKII), membrane-associated guanylate kinases (MAGUKs), and N-methyl-D-aspartate (NMDA) receptors. We aim to summarize recent advances in structural, biochemical, and imaging …

Response To Kodali Et Al., “Hailey-Hailey Disease: A Review And An Approach To Management”, Christina Tolete, Teresa Duong, Adam Friedman, Leonardo Tjahjono

Department of Medicine Faculty Papers

No abstract provided.

Alara+: Summit On Radiation And Orthopedic Risks In Fluoroscopic Laboratories: Endorsed By Acc, Acvp, Ase, Hrs, Scai, Sir, Snis, Svin, And Svs, Arash Salavitabar, Amit N. Vora, Dorothea Altschul, J. Fritz Angle, Chelsea Ballinger, Andrew Bojanowski, Anna E. Bortnick, Kyle Bugg, Emily Carpenter, Robert E. Foster, Joanna Ghobrial, Matthew Glogoza, Atul Gupta, James B. Hermiller, A. Kyle Jones, Summer L. Kaplan, Steven J. Kraus, Omar Khalique, Andrea Klein, Nick Morse, Preethi Ramchand, David G. Rizik, Lucy M. Safi, Cheryl C. Schultz, Kamala P. Tamirisa, R. Jay Widmer, Kristi Wilson, Jonathan X. Fang, Arnold Seto, Robert F. Riley

Department of Neurosurgery Faculty Papers

Occupational radiation exposure has a clear association with long-term health effects and has a particular impact on women, trainees, and supporting staff. There is a reliance on limited, traditional radiation protection and nonergonomic equipment, which carries associated orthopedic injury rates with adverse impacts on both individual career trajectories and health systems, and with significant challenges to widespread implementation of enhanced radiation protection devices. During the 2025 Society for Cardiovascular Angiography & Interventions Scientific Sessions in Washington, DC, a multidisciplinary Think Tank summit was convened and included representatives from multiple stakeholders, including other professional societies, advocacy groups, and industry partners. The …

Genetic Ancestry-Concordant Ceramide Metabolism And Response To Androgen Receptor Pathway Inhibition In Metastatic Castration-Resistant Prostate Cancer, Sean Piwarski, Lauren Howard, Morgan Paul, Nick Bachelder, Bonnie Lacroix, Angela Clayton, Donna Allen, Julie Kephart, Andrew Armstrong, Steven Patierno, Daniel George, Terry Hyslop, Jennifer Freedman

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

BACKGROUND: The authors observed differences in response between Black and White patients with metastatic castration-resistant prostate cancer (mCRPC) who were treated prospectively with androgen receptor pathway inhibition (ARPI) in the Abi Race and PANTHER studies. In addition, genetic ancestry-related single nucleotide variants in ceramide metabolism genes were associated with the time to prostate-specific antigen progression in the Abi Race study. For this report, the authors analyzed ceramide metabolites and their association with response to ARPI treatment in the Abi Race and PANTHER studies.

METHODS: Fasting serum levels were obtained from 22 Black patients and 22 White patients in the Abi …

Routine Transfusion Of Rh(D)-Positive Rbcs To Rh(D)-Negative Patients Designated As Do Not Resuscitate Conserves Rh(D)-Negative Red Blood Cell Inventory, Julie Katz Karp, Jovanna Everetts, Juliana Guarente, Angelica Vivero, Tiffany Bohr, Mary Harach

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background: A minority of blood donors are Rh(D)-negative, and Rh(D)-negative red blood cell (RBC) products are often overutilized. As such, Rh(D)-negative RBCs may be difficult to maintain in blood bank inventory.

Study design and methods: We changed our blood bank laboratory policy to approve non-alloimmunized Rh(D)-negative patients to receive Rh(D)-positive RBCs for routine transfusion under defined criteria. Those criteria included Rh(D)-negative males (all ages) and females (aged >50 years) who were designated as do not resuscitate (DNR), either with or without intubation, in the electronic medical record.

Results: From August 15, 2024 through August 15, 2025, a total of 204 …

Variation In Chronic Automated Red Cell Exchange Practices For Sickle Cell Disease: Insights Into Isovolemic Hemodilution Use, Jennifer M. Jones, Fatima Aldarweesh, Nicole Aqui, Aleh Bobr, Patricia Brunker, Mischa L. Covington, Juliana Guarente, Robert Hagar, Matthew Karafin, Divjot Singh Lamba, Grace Lee, Wen Lu, Ethan A. Mack, Gagan Muthur, Saadiya Nazli, Halima Olaniyan, Chinelo P. Onyenekwu, Jay S. Raval, Divya Setya, Yvette C. Tanhehco, Mamie Thant, Angelica Vivero, Yanyun Wu, Edward C. C. Wong, Nalan Yurtsever, Yan Zheng, Patricia A. Shi, Jennifer Webb

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Prior surveys of chronic automated red blood cell exchange (RCE) for patients with sickle cell disease (SCD) have identified considerable procedural variability, especially with the use of isovolemic hemodilution red blood cell exchange (IHD-RCE). We conducted a survey of chronic RCE practices among American Society for Apheresis (ASFA) members to identify opportunities for practice harmonization and future studies. The ASFA SCD Research Subcommittee developed a 72-item survey of chronic RCE practices, with a focus on IHD-RCE. The survey was validated internally and distributed by email to all ASFA members from September 2024 to February 2025. One survey response from each …

Dean's Update, June 2026, Neil W. Schluger

SOM Dean's Research Newsletter

No abstract provided.

Rethinking Ethics For An Era Of Trusted Computational Tools, Kristin M Kostick-Quenet, Meghan Hurley, John Herrington, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Computer perception (CP) technologies are poised to deliver near real-time behavioral insights with high precision. As technical barriers recede, our field's ethical focus must shift from "Can we trust the data?" to "Should we use it here, and how?" We propose a contextual ethics framework that: (1) defines the appropriate scope of CP integration; (2) advocates codesigned roadmaps to manage expectations and epistemic conflict; (3) expands evaluation beyond performance metrics to humanistic outcomes; and (4) anticipates future high performance systems to safeguard dignity, empathy, and shared decision-making in clinical care.

Public Attitudes Toward Cascade Genetic Screening In The United States, Hadley Stevens Smith, Emilie S Zoltick, Madison R Hickingbotham, Emily S Bonkowski, Stacey Pereira, Tara A Lavelle, David L Veenstra, Amy L Mcguire, Katherine E Bonini, Leila Jamal

Center for Medical Ethics and Health Policy Staff Publications

Introduction: After a patient receives genetic test results that indicate an actionable health condition, cascade genetic screening (CGS) is the process of evaluating the patient's relatives for a potentially elevated genetic risk of disease. The United States primarily relies on patients to communicate with their relatives, resulting in suboptimal rates of risk communication, familial genetic testing uptake, and risk-reducing interventions. There is ongoing debate about whether and how best to inform relatives of a potentially increased genetic risk.

Methods: We conducted a nationally representative survey of US adults to assess attitudes toward informing at-risk relatives, acceptability of system-mediated communication, and …

Prognostic Value Of Stress Perfusion Cardiac Magnetic Resonance Imaging In Kawasaki Disease With Coronary Artery Aneurysms: A 10-Year Retrospective Cohort Study, Alexander J Kiener, S Kristen Sexson Tejtel, Aimee Liou, Carolyn A Altman, Tam T Doan

Faculty, Staff and Students Publications

Background: Kawasaki disease (KD) with coronary artery aneurysms (CAA) places patients at risk for myocardial ischemia and major cardiac events (MCE). While stress perfusion cardiac magnetic resonance imaging (spCMR) is used for surveillance, its prognostic value has not been established.

Methods: We conducted a retrospective cohort study of KD patients (AHA risk levels 3-5) who underwent clinically indicated vasodilator spCMR at a tertiary pediatric center between October 2014 and December 2024. We evaluated inducible perfusion defects, late gadolinium enhancement (LGE), ventricular function, and MCE (myocardial infarction, ventricular dysfunction, arrhythmia, revascularization, transplant, or death). We performed Cox regression and Kaplan-Meier analyses …

A Phase 4, Open-Label, Non-Randomized, Multicenter Study To Evaluate Efficacy (And Safety) Of Intravenous Administration Of Optison For Contrast-Enhanced Echocardiography In Pediatric Patients, Arash Sabati, Shuo Wang, Pushpa Shivaram, Joshua Hawley, David Thompson, Francine Erenberg, Shelby Kutty, Aparna Kulkarni, Tam T Doan, Joshua D Robinson

Faculty, Staff and Students Publications

Contrast-enhanced echocardiography (CE-echo) is commonly used in adult patients to optimize endocardial border delineation (EBD) but there is limited experience in children. A prospective, open-label, non-randomized, multicenter study was performed to evaluate the efficacy of intravenous Optison for CE-echo in pediatric patients and determine the optimal dose of Optison. Subjects ≥ 9 and <  18 years with suboptimal echocardiograms (defined as ≥ 2 contiguous segments that could not be adequately visualized) were enrolled. After a baseline non-contrast echocardiogram (NC-echo), CE-echo was performed with 2 dose levels of Optison based on patient weight. The primary endpoint was visualization of the LV wall segments (LVWS) in apical 2- and 4-chamber views. An EBD score was calculated by assigning a value from 0 (no visualization) to 3 (optimal visualization) for 12 LVWS. 37 subjects across 8 sites completed the study. 30 had complete echocardiograms at both dose levels. 2 patients had usable images at dose 2 only. Mean age was 13.4 years (± 2.6) with 23 males (62%). Mean weight was 73.9 kg (± 36.8) with wide distribution of weight (interquartile range of 42-102 kg). There were 8 patients under 40 kg. Most subjects had a prior medical/surgical history (n = 33, 89%). Both dose levels of Optison CE-echo improved the number of LVWS visualized from 3.7 ± 1.1 on NC-echo to 10.0 ± 0.1 with dose 1 (p <  0.001) and 10.5 ± 0.1 with dose 2 (p <  0.001). EBD score also improved at both dose levels from 11.9 ± 2.5 for NC-echo to 28.5 ± 1.7 for dose 1 (p <  0.001) and 30.2 ± 8.4 for dose 2 (p <  0.001). The number of suboptimal echocardiograms improved from 92.3% ± 10.7 in NC-echo to 26.2% ± 9 with dose 1 (p <  0.001) and 30.8% ± 4.5 with dose 2 (p <  0.001). CE-echo with intravenous Optison in pediatric patients improved the number of LVWS visualized, improved EBD score, and reduced the number of suboptimal echocardiograms at both dosages used in this study. Intravenous Optison can improve LV visualization in pediatric patients with suboptimal echocardiograms.

Myocardial T1 And T2 Values Are Associated With Patient Age In Healthy Pediatric Heart Transplant Recipients, Andrew A Lawson, Robyn G Lottes, Defne Magnetta, Andrada Popescu, Kae Watanabe, Cynthia K Rigsby, Michael Markl, Nazia Husain

Faculty, Staff and Students Publications

Background: In pediatric heart transplant recipients (PHTR), myocardial T1 and T2 values are elevated in the setting of acute rejection and with cardiac allograft vasculopathy. In normal, healthy children, T1 and T2 values vary with patient age. Our goal was to identify associations between T1, extracellular volume fraction (ECV), and T2 values and patient- and donor-characteristics in PHTR without history of significant graft pathology.

Methods: We performed a single-center, retrospective chart review of consecutive cardiac magnetic resonance (CMR) studies in PHTR from 2017 to 2023. Exclusion criteria were a prior CMR during the study period, history of any prior antibody-mediated …