Medical Specialties Commons^™

Adults With Preexisting Diagnosis Of Heart Failure In The Environment Of Coronavirus Disease 2019, Ronald Phillips

Dissertations

Background: Heart disease continues to be the leading cause of death among adults in the United States and other industrialized countries. Heart failure (HF) is a form of heart disease and has become an epidemic with complications and medical care costs increasing at an alarming rate. HF affects more than 5.7 million adults in the United States with an incidence between 550,000 to 670,000 annually, primarily affecting females, African Americans, and adults aged 55 years and older. HF is also associated with a high rate of mortality, estimated to increase, with a risk rate of 13%, 32%, and 64% among …

The Immune Response To Airway Mycosis, Wei Ruan, Xinxin Ma, In Hyuk Bang, Yafen Liang, Jochen Daniel Muehlschlegel, Kuang-Lei Tsai, Tingting W Mills, Xiaoyi Yuan, Holger K Eltzschig

Faculty, Staff and Student Publications

Despite increasing availability and more successful interventional approaches to restore coronary reperfusion, myocardial ischemia-reperfusion injury is a substantial cause of morbidity and mortality worldwide. During myocardial ischemia, the myocardium becomes profoundly hypoxic, thus causing stabilization of hypoxia-inducible transcription factors (HIF). Stabilization of HIF leads to a transcriptional program that promotes adaptation to hypoxia and cellular survival. Transcriptional consequences of HIF stabilization include increases in extracellular production and signaling effects of adenosine. Extracellular adenosine functions as a signaling molecule via the activation of adenosine receptors. Several studies implicated adenosine signaling in cardioprotection, particularly through the activation of the Adora2a and Adora2b …

Extracorporeal Membrane Oxygenation Therapy In Covid-19 Patients With Acute Respiratory Distress Syndrome, Joseph B. Zwischenberger, Katherine Breetz

Journal of Shock and Hemodynamics

Patients with coronavirus disease of 2019 (COVID-19) may present with a wide range of symptoms ranging from asymptomatic to critically ill. Approximately 10-14% of patients require hospitalization. Those individuals requiring hospitalization can deteriorate rapidly with worsening hypoxemia or new-onset pneumonia, resulting in 20-30% of patients developing acute respiratory distress syndrome (ARDS).

When refractory to medical management, severe ARDS secondary to other illnesses has been successfully treated with extracorporeal membrane oxygenation (ECMO). We completed a comprehensive literature review of ECMO utilization for patients with severe COVID-19 who were unresponsive to critical care management. Of the 1419 patients with a reported diagnosis …

Development Of The Centrifugal Blood Pump For A Hybrid Continuous Flow Pediatric Total Artificial Heart: Model, Make, Measure, Carson S Fox, Thomas Palazzolo, Matthew Hirschhorn, Randy M Stevens, Joseph Rossano, Steven W Day, Vakhtang Tchantchaleishvili, Amy L Throckmorton

Department of Medicine Faculty Papers

Clinically-available blood pumps and total artificial hearts for pediatric patients continue to lag well behind those developed for adults. We are developing a hybrid, continuous-flow, magnetically levitated, pediatric total artificial heart (TAH). The hybrid TAH design integrates both an axial and centrifugal blood pump within a single, compact housing. The centrifugal pump rotates around the separate axial pump domain, and both impellers rotate around a common central axis. Here, we concentrate our development effort on the centrifugal blood pump by performing computational fluid dynamics (CFD) analysis of the blood flow through the pump. We also conducted transient CFD analyses (quasi-steady …

Impact Of Atrial Fibrillation On Outcomes After Left Ventricular Assist Device Implantation: Systematic Review And Meta-Analysis, Chandan Buttar, Sofia Lakhdar, Mahmood Nassar, Nso Nso, Giovina Collura, Most Sirajum Munira

The VAD Journal

Background: Atrial fibrillation (AF) is a common finding in patients with heart failure and is well-known for its deleterious effects on cardiac function and hemodynamics; however, there are gaps in knowledge regarding the impact of AF on patients with left ventricular assist devices (LVADs).

Methods: In this study, we searched PubMed/Medline, Embase, and Cochrane Library databases through September 2021 to find articles that assessed the outcomes of AF in patients with LVADs.

Results: A total of 12 studies that underwent systematic review evaluated the outcomes of 7853 adult patients. The meta-analysis analyzed findings from a total of 1003 patients. Pooled …

Giant Left Atrial Myxoma Revealed By Syncopal Attacks, Nour El Houda Snoussi, Youssra Serroukh, Fatima-Zahra El Hattab, Mohamed Cherti

Journal of the Saudi Heart Association

No abstract provided.

Identifying Differences: A Key Step In Precision Cardiovascular Disease Prevention, Mahmoud Al Rifai, Salim S. Virani, Vijay Nambi

Office of the Provost

No abstract provided.

Association Between Social Vulnerability Index And Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Study, Vardhmaan Jain, Mahmoud Al Rifai, Safi U. Khan, Safi U. Khan, Ankur Kalra, Fatima Rodriguez, Zainab Samad, Yashashwi Pokharel, Arunima Misra, Laurence S. Sperling

Section of Cardiology

Background Social and environmental factors play an important role in the rising health care burden of cardiovascular disease. The Centers for Disease Control and Prevention developed the Social Vulnerability Index (SVI) from US census data as a tool for public health officials to identify communities in need of support in the setting of a hazardous event. SVI (ranging from a least vulnerable score of 0 to a most vulnerable score of 1) ranks communities on 15 social factors including unemployment, minoritized groups status, and disability, and groups them under 4 broad themes: socioeconomic status, housing and transportation, minoritized groups, and …

Association Between Social Vulnerability Index And Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Study, Vardhmaan Jain, Mahmoud Al Rifai, Safi U Khan, Ankur Kalra, Fatima Rodriguez, Zainab Samad, Yashashwi Pokharel, Arunima Misra, Laurence S Sperling, Jamal S Rana, Waqas Ullah, Ankit Medhekar, Salim S Virani

Division of Cardiology Faculty Papers

Background Social and environmental factors play an important role in the rising health care burden of cardiovascular disease. The Centers for Disease Control and Prevention developed the Social Vulnerability Index (SVI) from US census data as a tool for public health officials to identify communities in need of support in the setting of a hazardous event. SVI (ranging from a least vulnerable score of 0 to a most vulnerable score of 1) ranks communities on 15 social factors including unemployment, minoritized groups status, and disability, and groups them under 4 broad themes: socioeconomic status, housing and transportation, minoritized groups, and …

Polygenic Risk, Midlife Life's Simple 7, And Lifetime Risk Of Stroke, Emy A Thomas, Nitesh Enduru, Adrienne Tin, Eric Boerwinkle, Michael E Griswold, Thomas H Mosley, Rebecca F Gottesman, Myriam Fornage

Faculty, Staff and Student Publications

Background

Recent genetic discoveries in stroke have unleashed the potential of using genetic information for risk prediction and health interventions aimed at disease prevention. We sought to estimate the lifetime risk of stroke (LTRS) by levels of genetic risk and to investigate whether optimal cardiovascular health can offset the negative impact of high genetic risk on lifetime risk of stroke.

Methods and Results

Study participants were 11 568 middle‐aged adults (56% women, 23% Black adults), who were free of stroke at baseline and were followed up for a median of 28 years. The remaining LTRS was estimated according to levels …

Association Between Social Vulnerability Index And Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Study, Vardhmaan Jain, Mahmoud Al Rifai, Safi U Khan, Ankur Kalra, Fatima Rodriguez, Zainab Samad, Yashashwi Pokharel, Arunima Misra, Laurence S Sperling, Jamal S Rana, Waqas Ullah, Ankit Medhekar, Salim S Virani

Faculty, Staff and Students Publications

Background Social and environmental factors play an important role in the rising health care burden of cardiovascular disease. The Centers for Disease Control and Prevention developed the Social Vulnerability Index (SVI) from US census data as a tool for public health officials to identify communities in need of support in the setting of a hazardous event. SVI (ranging from a least vulnerable score of 0 to a most vulnerable score of 1) ranks communities on 15 social factors including unemployment, minoritized groups status, and disability, and groups them under 4 broad themes: socioeconomic status, housing and transportation, minoritized groups, and …

Development Of A Cardiac Anesthesia Tool (Cat) To Predict Intensive Care Unit (Icu)Admission For Pediatric Cardiac Patients Undergoing Non-Cardiac Surgery: A Retrospective Cohort Study, Ahmed Mounir A. Metwally, Ahmed Haroun M. Mahmoud, Abdulrahman A. Alwakeel, Abdulrahman M. Aljamous, Rayan S. Aldusari, Faisal Hijji, Fouzia A. Al Tuwaijri, Saad Eldin M. Hassan, Mohamed Ebid, Abdullah A. Alghamdi

Journal of the Saudi Heart Association

Background and aim of the work: Pediatric cardiac patients often undergo non-cardiac surgical procedures and many of these patients would require intensive care unit admission, but can we predict the need for ICU admission in pediatric cardiac patients undergoing non-cardiac procedures. Numerous preoperative and intraoperative variables were strongly associated with ICU admission. Given the variations in the underlying cardiac physiology and the diversity of non-cardiac surgical procedures along with the scarce predictive clinical tools, we aimed to develop a simple and practical tool to predict the need for ICU admission in pediatric cardiac patients undergoing non-cardiac procedures. Material and Methods: …

Synchronized Diaphragmatic Stimulation For Heart Failure Using The Visone System: A First-In-Patient Study., Ana Jorbendaze, Robin Young, Tamaz Shaburishvili, Vitaly Demyanchuk, Roman Buriak, Borys Todurov, Kostyantyn Rudenko, Michel Zuber, Simon F Stämpfli, Felix C Tanner, Paul Erne, Michael Mirro Md, Facc, Fhrs, Faha, Marat Fudim, Lee R Goldberg, John G F Cleland

Parkview Heart Institute

AIMS: Synchronized diaphragmatic stimulation (SDS) modulates intrathoracic and intra-abdominal pressures with favourable effects on cardiac function for patients with a reduced left ventricular ejection fraction (LVEF) and heart failure (HFrEF). VisONE-HF is a first-in-patient, observational study assessing the feasibility and 1 year effects of a novel, minimally invasive SDS device.

METHODS AND RESULTS: The SDS system comprises a pulse generator and two laparoscopically delivered, bipolar, active-fixation leads on the inferior diaphragmatic surface. Fifteen symptomatic men with HFrEF and ischaemic heart disease receiving guideline-recommended therapy were enrolled (age 60 [56, 67] years, New York Heart Association class II [53%] /III [47%], …

Statins: Masked Anti-Epileptic Warriors, Govinda Khatri, Priya Kotak, Ayush Kumar, Mohammad Mehedi Hasan

Medical College Documents

No abstract provided.

Cardiac Magnetic Resonance Features And Outcomes Of Patients With Non-Compaction Cardiomyopathy - A Retrospective Follow-Up From Pakistan, Pirbhat Shams, Fateh Ali Tipoo Sultan

Section of Cardiology

Background: The exact prevalence of left ventricle non-compaction cardiomyopathy (LVNC) in south Asians is not known and phenotypic CMR characteristics, clinical features, and outcomes of LVNC remain unknown for the SA population.
Objective: To evaluate clinical characteristics, cardiac magnetic resonance imaging features, and outcomes of patients with left ventricle non-compaction.
Methods: This was a retrospective study of 294 patients undergoing cardiac MRI (CMR) for evaluation of cardiomyopathy from 2011 to 2020. Patients were stratified based on the presence or absence of left ventricle non-compaction (LVNC). Clinical characteristics, CMR features, and outcomes were evaluated.
Results: Out of 294 patients, 18 patients …

Endovascular Management Of A Congenital Hepatic Arterioportal Malformation In A Low Resource Setting, Poonamjeet Loyal, Ravjit Sagoo

Imaging & Diagnostic Radiology, East Africa

Background: Arterioportal malformations, a rare type of vascular malformation, have significant associated morbid- ity and mortality. Management requires a carefully thought out approach by a multidisciplinary team. Low resource settings have an added challenge of limited treatment options and consumables.

Case presentation: We report a case of a 14-month-old male with failure to thrive due to a congenital hepatic arte- rioportal fistula. He was successfully treated via an endovascular approach with metallic coil embolization.

Conclusion: Hepatoportal fistula, a rare hepatic vascular malformation, has limited treatment options which can further be restricted by overall patient wellness. Minimally invasive …

Association Of Acute Anti-Inflammatory Treatment With Medium-Term Outcomes For Coronary Artery Aneurysms In Kawasaki Disease., Kevin G. Friedman, Brian W. Mccrindle, Kyle Runeckles, Nagib Dahdah, Ashraf S. Harahsheh, Michael Khoury, Sean Lang, Cedric Manlhiot, Adriana H. Tremoulet, Geetha Raghuveer, Elif Seda Selamet Tierney, Pei-Ni Jone, Jennifer S. Li, Jacqueline R. Szmuszkovicz, Kambiz Norozi, Supriya S. Jain, Angela T. Yetman, Jane W. Newburger, International Kawasaki Disease Registry

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The impact of adjunctive anti-inflammatory treatment on outcomes for patients with Kawasaki disease (KD) and coronary artery aneurysms (CAAs) is unknown.

METHODS: Using data from the International KD Registry in patients with ≥ medium CAA we evaluate associations of treatment with outcomes and major adverse cardiac events (MACE).

RESULTS: Medium or large CAA was present in 527 (32%) patients. All were treated with intravenous immunoglobulin (IVIG), 70% were male, and the median age was 1.3 years (interquartile range: 0.4-4.0 years). The most common acute therapies included single IVIG alone in 243 (46%), multiple IVIG in 100 (19%), multiple IVIG …

Rationale And Design Of Savi-Aos: A Physiologic Study Of Patients With Symptomatic Moderate Aortic Valve Stenosis And Preserved Left Ventricular Ejection Fraction, Rob Eerdekens, Pim Tonino, Jo Zelis, Rik Adrichem, Jung-Min Ahn, Jesse Demandt, Ashkan Eftekhari, Mohamed El Farissi, Phillip Freeman, Abdul Rahman Ihdayhid, Nikolaos Kakouros, Dae-Hee Kim, Seung-Ah Lee, Nicolas M Van Mieghem, Waqas Qureshi, Nils P Johnson

Faculty, Staff and Student Publications

Background: Moderate aortic valve stenosis occurs twice as often as severe aortic stenosis (AS) and carries a similarly poor prognosis. Current European and American guidelines offer limited insight into moderate AS (MAS) patients with unexplained symptoms. Measuring valve physiology at rest while most patients experience symptoms during exertion might represent a conceptual limitation in the current grading of AS severity. The stress aortic valve index (SAVI) may delineate hemodynamically significant AS among patients with MAS.

Objectives: To investigate the diagnostic value of SAVI in symptomatic MAS patients with normal left ventricular ejection fraction (LVEF ≥ 50%): aortic valve area (AVA) …

Anesthesia For Echocardiography And Magnetic Resonance Imaging In The African Clawed Frog (Xenopus Laevis), Antonio F Corno, Noelia E Flores, Wen Li, Thomas H Gomez, Jorge D Salazar

Faculty, Staff and Student Publications

This report describes an anesthesia technique that we used to study cardiovascular anatomy and physiology with echocardiography and cardiac magnetic resonance (CMR) in 46 African clawed frogs (Xenopus laevis) (n = 24 for electrocardiography and n = 22 for CMR). For administration of anesthesia, 3 holding tanks, one each for transportation, sedation, and recovery, were filled with filtered water, with 0.05% buffered tricaine methasulfonate solution (MS-222) added into the sedation tank. Fifteen minutes after the frog was placed in the sedation tank, a paper towel was soaked in MS-222 solution, and the frog was placed in a …

Geriatric Cardiology: Coming Of Age, Parag Goyal, Min Ji Kwak, Christina Al Malouf, Manish Kumar, Namit Rohant, Abdulla A Damluji, Quin E Denfeld, Kim K Bircher, Ashok Krishnaswami, Karen P Alexander, Daniel E Forman, Michael W Rich, Nanette K Wenger, James N Kirkpatrick, Jerome L Fleg

Faculty, Staff and Student Publications

Older adults with cardiovascular disease (CVD) contend with deficits across multiple domains of health due to age-related physiological changes and the impact of CVD. Multimorbidity, polypharmacy, cognitive changes, and diminished functional capacity, along with changes in the social environment, result in complexity that makes provision of CVD care to older adults challenging. In this review, we first describe the history of geriatric cardiology, an orientation that acknowledges the unique needs of older adults with CVD. Then, we introduce 5 essential principles for meeting the needs of older adults with CVD: 1) recognize and consider the potential impact of multicomplexity; 2) …

A Case Report Of Successful Physiological Pacing In A Patient With Lamin A/C Cardiomyopathy, Nitin Chandra Mohan, Paul Foley, Badrinathan Chandrasekaran

Faculty, Staff and Student Publications

BACKGROUND: Lamin A/C (LMNA) mutations account for 5-8% of familial dilated cardiomyopathies, and can manifest with conduction abnormalities and ventricular arrhythmias in 78% of patients. Therefore, when suspected, it is important to implant the correct type of device.

CASE SUMMARY: A 52-year-old gentleman with a family history of cardiomyopathy, presented with asymptomatic atrial fibrillation and complete atrioventricular block associated with a narrow QRS interval. Investigations confirmed dilated and severely impaired left ventricular systolic function. He underwent successful conduction system pacing in combination with a primary prevention defibrillator. Genetic screening confirmed LMNA cardiomyopathy. During 3 years follow up, his left ventricular …

Acquired Hemophilia A: A Possibly Fatal Complication Of Sars-Cov-2 Infection, Hasan Fareed Siddiqui, Taymmia Ejaz, Aisha Fareed Siddiqui, Fahd Niaz Shaikh

Department of Medicine

No abstract provided.

A Sensor-Controlled Digital Game For Heart Failure Self-Care Based On Behavioral Change Frameworks, Kavita Radhakrishnan, Atami Sagna Demain, Christine Julien, Katelyn Leggio, Matthew O'Hair, Emily T Hebért Arsers, Grace Lee, Tom Baranowski

Faculty, Staff and Students Publications

Self-care behaviors are critical to manage the adverse impact of heart failure disease. However, engaging in self-care behaviors such as physical activity or daily weight-monitoring can be difficult due to lack of knowledge or motivation. Digital games can serve as an alternative to traditional patient education to provide information and motivate engagement in critical self-care behaviors. In this paper, we describe a sensor-controlled digital game (SCDG) in which game play is driven by the player's real life self-care behaviors. We also present the design and development of the next iteration of the SCDG based on playtesting results and behavioral theoretical …

Use Of Point-Of-Care Ultrasound And Focus-Assessed Transthoracic Echocardiography To Diagnose Acute Right Heart Failure Due To Fat Emboli In A Parturient, Stephanie O Ibekwe, Varun Potluri, Raja Palvadi, Gavin T Best

Faculty, Staff and Students Publications

Fat embolism syndrome (FES), causing right heart dysfunction, is a rare disease that is often difficult to diagnose with imaging modalities such as computed tomography (CT). FES is the clinical presentation that follows the entry of fat globules into the systemic circulation, which typically results in respiratory failure, scattered petechiae, cardiovascular collapse, and neurological sequelae. It is mostly observed in the cases of orthopedic trauma but may occur in any circumstance where fat can enter the circulatory system. In this case report, the authors describe an atypical presentation of FES in a 24-week parturient. The use of bedside point-of-care ultrasonography …

Integrated Multi-Omic Characterization Of Congenital Heart Disease, Matthew C Hill, Zachary A Kadow, Hali Long, Yuka Morikawa, Thomas J Martin, Emma J Birks, Kenneth S Campbell, Jeanne Nerbonne, Kory Lavine, Lalita Wadhwa, Jun Wang, Diwakar Turaga, Iki Adachi, James F Martin

Faculty, Staff and Students Publications

The heart, the first organ to develop in the embryo, undergoes complex morphogenesis that when defective results in congenital heart disease (CHD). With current therapies, more than 90% of patients with CHD survive into adulthood, but many suffer premature death from heart failure and non-cardiac causes1. Here, to gain insight into this disease progression, we performed single-nucleus RNA sequencing on 157,273 nuclei from control hearts and hearts from patients with CHD, including those with hypoplastic left heart syndrome (HLHS) and tetralogy of Fallot, two common forms of cyanotic CHD lesions, as well as dilated and hypertrophic cardiomyopathies. We …

Aspirin Use Is Associated With Decreased Inpatient Mortality In Patients With Covid-19: A Meta-Analysis, Aswin Srinivasan, Jonathan Brown, Pavitra Parimala Krishnamani, Brendon Cornett, Ramesh Babu Kesavan, Siva T Sarva, Syed Arman Raza, Waleed Tallat Kayani

Faculty, Staff and Students Publications

Thromboembolism is a major cause of death in patients who suffer from COVID-19. Studies examining the effects of aspirin (ASA) on mortality relating to this phenomenon have showed conflicting results with varying degrees and certainties of evidence. We performed an aggregate data meta-analysis of fourteen studies encompassing 164,539 COVID-19 patients, which showed a reduced risk of in-hospital mortality associated with ASA use in eight studies that reported risk ratios (RR 0.90; 95 % CI 0.82–0.98; I2 = 27.33 %, P = 0.01), six studies that reported hazard ratios (HR 0.56; 95 % CI 0.41–0.76, P ≤ 0.01; I2 = 85.92 …

Icsm 3rd Annual Scientific Meeting Plenary Lectures

Journal of the Hong Kong College of Cardiology

No abstract provided.

Icsm 3rd Annual Scientific Meeting Abstracts For Oral Presentation

Journal of the Hong Kong College of Cardiology

No abstract provided.

Icsm 3rd Annual Scientific Meeting Scientific Programme

Journal of the Hong Kong College of Cardiology

No abstract provided.

Icsm 3rd Annual Scientific Meeting Abstracts For Poster Presentation

Journal of the Hong Kong College of Cardiology

No abstract provided.