Medical Specialties Commons^™

Predictors Of Incidence Of Candida Endocarditis In Patients With Candidemia: Insights From The National Inpatient Sample (2016-2020, Didien Meyahnwi Md, Tawanda Zinyandu, Ashraf Ahmed, Isaac Opoku Md

Posters

This study identifies critical predictors of CE incidence in patients with candidemia, including IV drug use, male gender, and the presence of prosthetic devices. These findings highlight the importance of targeted surveillance and management strategies in vulnerable populations.

A Rising Threat: Epidemiologic Trends In Incidence, Mortality, And Cost Of Candida Endocarditis In The United States, Didien Meyahnwi Md, Ashraf Ahmed, Tawanda Zinyandu, Isaac Opoku Md

Posters

Candida Endocarditis (CE) is a rare yet critical form of infective endocarditis (IE), accounting for approximately 1% of all IE cases. In light of the evolving epidemiology of candidemia, this study aims to elucidate any associated shifts in the epidemiology of CE within the United States.

Dual Circulatory Support With Ecmo And Mcs Devices Is Associated With Shorter Hospital Stay Without Compromising Heart Transplant Survival, Tawanda Zinyandu, Abhinav Aggarwal, Ashraf Ahmed, Isaac Opoku Md, Didien Meyahnwi Md, Yussuf Isaka Md, Stuart Zarich, Carlos Davila

Posters

• ECMO is commonly used as a bridge to heart transplantation in critically ill patients.
• Additional MCS devices (e.g., Impella, IABP) may be used alongside ECMO to enhance cardiac output.
• The effect of dual circulatory support vs. ECMO alone on post-transplant survival is unclear especially after 2018, when the heart allocation system was revised to reduce waitlist times for MCS patients.

Correction To: Active Versus Passive Learning In Large-Group Sessions In Medical School: A Randomized Cross-Over Trial Investigating Effects On Learning And The Feeling Of Learning, Peter Boedeker, Tobias Schlingmann, Joshua Kailin, Ajith Nair, Cara Foldes, David Rowley, Katherine Salciccioli, Ronald Maag, Nancy Moreno, Nadia Ismail

Faculty, Staff and Students Publications

This corrects the article "Active Versus Passive Learning in Large-Group Sessions in Medical School: A Randomized Cross-Over Trial Investigating Effects on Learning and the Feeling of Learning" on page 459.

Primary Prevention Of Cardiovascular Disease In Asia: Challenges: A Narrative Review, Mayank Dalakoti, Norman H Y Lin, Jonathan Yap, Aaysha Cader, Prajapati Dipanker, Derek Lee, Raja Ezman Raja Shariff, Lucky Cuenza, Satoshi Honda, Vorn Malis, Haowen Jiang, Anish Hirachan, Misato Chimura, Tee Joo Yeo, Khung Keong Yeo, Jack Wei Chieh Tan, Jasper Tromp, Poay Huan Loh, Nicholas W S Chew, Scott Wong, Ching-Hui Sia, Benjamin Y Q Tan, Sofian Johar, Gregory Y H Lip, Eugene Yang, Salim S Virani, Steven Hageman, Hueiming Liu, Emanuele Di Angelantonio, Prabhakaran Dorairaj, Angela S Koh, Calvin Chin, Wael Al Mahmeed, Mark Y Chan, Roger Foo

Faculty, Staff and Students Publications

Importance: Asia is home to 60% of the world's population, including the world's 2 most populous countries, India (1.1B) and China (1.2B). With cardiovascular disease burden and mortality increasing, the role of preventive cardiology is increasingly important.

Observations: The challenges in addressing the cardiovascular disease burden in Asia include unique cardiometabolic features of the different populations, heterogeneity of risk factors among Asian countries, differing levels of health literacy and socioeconomic status, suboptimal infrastructure to support preventive care especially in the primary care sector, high out-of-pocket costs, and environmental pollution.

Conclusions: Asia is a large continent that comprises diverse populations with …

The Association Between County-Level Social Determinants Of Health And Cardio-Kidney-Metabolic Disease Attributed All-Cause Mortality In The Us: A Cross Sectional Analysis, Antoinette Cotton, Pedro Rvo Salerno, Salil V Deo, Salim S Virani, Khurram Nasir, Ian Neeland, Sanjay Rajagopalan, Naveed Sattar, Sadeer Al-Kindi, Yakov E Elgudin

Faculty, Staff and Students Publications

Background: The American Heart Association recently defined cardio-kidney-metabolic (CKM) syndrome as the intersection between metabolic, renal, and cardiovascular disease. Understanding the contemporary estimates of CKM related mortality in the US is essential for developing targeted public interventions.

Methods: We analyzed state-level and county-level CKM-associated all-cause mortality data (2010-2019) from the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER). Median and interquartile (IQR) age-adjusted mortality rates (aaMR) per 100,000 were reported and linked with a multi-component metric for social deprivation: the Social Deprivation Index (SDI: range 0 - 100) grouped as: I: 0 - 25, II: 26 - 50, III: 51 …

Factors Associated With Shock At Presentation In Kawasaki Disease Versus Multisystem Inflammatory Syndrome In Children Associated With Covid-19., Supriya S. Jain, Ashraf S. Harahsheh, Simon Lee, Geetha Raghuveer, Nagib Dahdah, Michael Khoury, Michael A. Portman, Melissa Wehrmann, Arash A. Sabati, Marianna Fabi, Deepika Thacker, Nilanjana Misra, Mark D. Hicar, Nadine F. Choueiter, Matthew D. Elias, Audrey Dionne, William B. Orr, Jacqueline R. Szmuszkovicz, Seda Selamet Tierney, Luis Martin Garrido-Garcia, Frederic Dallaire, Balasubramanian Sundaram, Deepa Prasad, Tyler H. Harris, Elizabeth Braunlin, Elisa Fernandez Cooke, Cedric Manlhiot, Pedrom Farid, Brian W. Mccrindle, International Kawasaki Disease Registry

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: While clinical overlap between Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C) has been evident, information regarding those presenting with shock has been limited. We sought to determine associations with shock within and between diagnosis groups.

METHODS: The International KD Registry enrolled contemporaneous patients with either KD or MIS-C from 39 sites in 7 countries from January 1, 2020, to January 1, 2023. Demographics, clinical features and presentation, management, laboratory values, and outcomes were compared between the diagnosis and shock groups.

RESULTS: Shock at presentation was noted for 19 of 672 KD patients (2.8%) and 653 of …

Foamy Monocytes And Atherogenesis In Mice With Combined Hyperlipidemia And Effects Of Antisense Knockdown Of Apociii, Xueying Peng, Zeqin Lian, Veronica O'Brien, Jing Xiao, Benjamin A Litchfield, Xiao-Yuan Dai Perrard, Lu Xu, Jing Ni, Aparna Mukherjee, Timothy Simmons, Henry Dong, Adam E Mullick, Rosanne Crooke, Henry J Pownall, Scott I Simon, Christie M Ballantyne, Huaizhu Wu

Faculty, Staff and Students Publications

Hypertriglyceridemia (HTG), particularly in combined hyperlipidemia, increases risk for atherosclerotic cardiovascular disease, but the underlying mechanisms remain incompletely understood. We sought to determine contributions of circulating monocytes to atherosclerosis associated with HTG in combined hyperlipidemia, created by transgenic expression of human apoCIII in Ldlr−/− mice (Ldlr−/−ApoCIIItg) fed Western high-fat diet (WD). Tissue culture with THP-1 and primary human monocytes was used to examine effects of triglyceride (TG)-rich lipoproteins on monocytes. Ldlr−/−ApoCIIItg mice were also treated with apoCIII antisense oligonucleotide (ASO) and examined for foamy monocytes and atherosclerosis. Compared to Ldlr−/− mice, Ldlr−/−ApoCIIItg mice fed …

Importance Of Recognizing Hypertrophic Cardiomyopathy In The Preoperative Clinic., Anne Mcrae Botti, Edward Bope, Charles Botti, Marc Brower, Akira Wada, Meredith Arensman

Heart and Vascular Articles

BACKGROUND: Hypertrophic cardiomyopathy is a relatively common inherited disorder that may be asymptomatic. It is a common cause of sudden cardiac death and can lead to catastrophic cardiovascular collapse in the operating room if previously undiagnosed. This case report discusses the implications of unsuspected hypertrophic cardiomyopathy for anesthesia management.

CASE PRESENTATION: A veteran aged 55 years presented to the preadmission testing clinic prior to undergoing outpatient surveillance colonoscopy under anesthesia. His initial medical history was unremarkable. On physical examination, a murmur with benign characteristics was detected. However, further evaluation with echocardiography, revealed severe hypertrophic obstructive cardiomyopathy. The patient was ultimately …

Practices In Single Ventricle Repairs: Insights From Computational Fluid Dynamics On Cavopulmonary Connections – A Scoping Review, Olivia K. Osuch

Student Works

Abstract: Single-ventricle congenital heart defects require complex surgical strategies, with computation fluid dynamics (CFD) playing a growing role in optimizing cavopulmonary connections. This scoping review examines CFD-derived insights into power loss, hepatic flow distribution (HFD), and wall shear stress (WSS) across different Fontan geometries.

Methods: A search of available peer-reviewed literature (1995-2024) identified studies using CFD models to analyze hemodynamic performance in second and third-stage single-ventricle repairs. Studies were categorized based on surgical stage, anatomical variations, modeling assumptions, and key outcomes such as power loss, HFD, and WSS.

Results: Of 30 included studies, 28 analyzed power loss, 24 evaluated HFD, …

The Current State Of Redo Transcatheter Aortic Valve Replacement (Tavr) And Limitations: Why Tavr Explant Is Important As The Valve Reintervention Strategy, Grace S Lee, Gilbert Tang, Syed Zaid, Derrick Y Tam

Faculty, Staff and Students Publications

The rise of transcatheter aortic valve replacement (TAVR) over the past two decades has substantially changed the lifetime management of patients with aortic valve disease. As the indications for TAVR expand to include younger and lower-risk patients, the proportion of patients who subsequently require reintervention for failed transcatheter heart valves (THVs) will increase. The two primary options for reintervention are redo TAVR and TAVR explant followed by surgical aortic valve replacement (SAVR). The indications for redo TAVR in the short term include emergency “bailout” procedures due to malpositioning, embolization, or long-term device failure due to paravalvular leak (PVL) or valvular …

Successful Coaching Behaviors: Challenges And Opportunities In Relationships, Dustan Watkins, Madeline Rock, Elizabeth M Vaughan, Jessica M Kirschmann, Craig A Johnston

Faculty, Staff and Students Publications

Health and wellness coaching is a valuable intervention to help individuals improve their long-term physical, psychological, and social well-being. Coaches, individuals who employ motivational strategies through trusting relationships, have shown success in supporting individuals’ pursuit in creating and sustaining healthy lifestyle changes. We discuss the theoretical principles underlying coaching practices and present essential coaching behaviors that influence the quality and strength of the client–coach relationship. We acknowledge scenarios in which the client–coach relationship has grown stale or is incompatible; in these cases, we propose lateral referrals, which we define as identifying and redirecting clients to another coach possessing similar …

Left Ventricular And Aortic Pressures Measured With Fluid-Filled And Solid-State Pressure Catheters: Similarities And Differences, Priscilla Machado, Ira Cohen, Brian Osler, Maureen E. Mcdonald, Cara Esposito, Marguerite Davis, David Fischman, Michael P. Savage, Praveen Mehrotra, Flemming Forsberg, Jaydev K. Dave

Division of Cardiology Faculty Papers

Objective: To compare left ventricular (LV) and aortic (AO) pressures obtained using fluid-filled and high-fidelity solid-state pressure catheters in subjects undergoing left heart catheterization.

Materials and Methods: Twenty subjects scheduled for a left heart catheterization were enrolled and 18 subjects completed this IRB-approved study. LV and AO pressures were obtained using fluid-filled pressure catheter (standard-of-care) and high-fidelity solid-state pressure catheter synchronously. Pressure tracings were analyzed to measure LV systolic (LVSP), LV minimum-diastolic (LVMDP), LV end-diastolic (LVEDP), AO systolic (AOSP), and AO diastolic (AODP) pressures. Isovolumic contraction and relaxation rates (peak ± dp/dt) were derived from the pressure waveforms. Repeated measures …

The Future Direction Of Post-Transcatheter Aortic Valve Replacement Reinterventions: Insights From The Transcatheter Valve Therapy Registry, Edward Percy, Joseph E. Bavaria

Division of Cardiology Faculty Papers

No abstract provided.

Effects Of Intensive Blood Pressure Treatment On Orthostatic Hypertension: Individual Level Meta-Analysis, Stephen P Juraschek, Jiun-Ruey Hu, Jennifer L Cluett, Carol Mita, Lewis A Lipsitz, Lawrence J Appel, Nigel S Beckett, Barry R Davis, Rury R Holman, Edgar R Miller, Kenneth J Mukamal, Ruth Peters, Jan A Staessen, Addison A Taylor, Jackson T Wright, William C Cushman

Faculty, Staff and Students Publications

Objective: To determine the effects of intensive blood pressure treatment on orthostatic hypertension.

Design: Systematic review and individual participant data meta-analysis.

Data sources: MEDLINE, Embase, and Cochrane CENTRAL databases through 13 November 2023.

Inclusion criteria: Population: ≥500 adults, age ≥18 years with hypertension or elevated blood pressure; intervention: randomized trials of more intensive antihypertensive drug treatment (lower blood pressure goal or active agent) with duration ≥6 months; control: less intensive antihypertensive drug treatment (higher blood pressure goal or placebo); outcome: measured standing blood pressure.

Main outcomes: Orthostatic hypertension, defined as an increase in systolic blood pressure ≥20 mm Hg or …

"The Role Of Venous Excess Ultrasound Score In Optimizing Acute Heart Failure Diagnosis And Prognosis, Saoussen Antit, Sarra Romdhane, Imen Mtiri, Lilia Zakhama

Journal of the Saudi Heart Association

Acute heart failure (AHF) is a critical condition with significant morbidity and mortality, necessitating timely and accurate diagnosis for effective management.

The Venous Excess Ultrasound (VExUS) score has emerged as a non-invasive diagnostic tool, aimed at evaluating venous congestion through ultrasound. This scoring system integrates assessments of the inferior vena cava, hepatic veins, portal veins, and renal venous flow to quantify congestion severity. By providing a real-time assessment of venous pressure, the VExUS score has shown potential in optimizing early diagnosis of AHF and predicting outcomes and overall prognosis.

Recent studies suggest that incorporating the VExUS score into clinical practice …

Predictors Of Outcomes In Pediatric Pulmonary Arterial Hypertension, Aditya Doni Pradana

Journal of the Saudi Heart Association

There is no abstract for this article type.

Rare Damaging Ccr2 Variants Are Associated With Lower Lifetime Cardiovascular Risk, Marios K Georgakis, Rainer Malik, Omar El Bounkari, Natalie R Hasbani, Jiang Li, Jennifer E Huffman, Gabrielle Shakt, Reinier W P Tack, Tamara N Kimball, Yaw Asare, Alanna C Morrison, Noah L Tsao, Renae Judy, Braxton D Mitchell, Huichun Xu, May E Montasser, Ron Do, Eimear E Kenny, Ruth J F Loos, James G Terry, John Jeffrey Carr, Joshua C Bis, Bruce M Psaty, W T Longstreth, Kendra A Young, Sharon M Lutz, Michael H Cho, Jai Broome, Alyna T Khan, Fei Fei Wang, Nancy Heard-Costa, Sudha Seshadri, Ramachandran S Vasan, Nicholette D Palmer, Barry I Freedman, Donald W Bowden, Lisa R Yanek, Brian G Kral, Lewis C Becker, Patricia A Peyser, Lawrence F Bielak, Farah Ammous, April P Carson, Michael E Hall, Laura M Raffield, Stephen S Rich, Wendy S Post, Russel P Tracy, Kent D Taylor, Xiuqing Guo, Michael C Mahaney, Joanne E Curran, John Blangero, Shoa L Clarke, Jeffrey W Haessler, Yao Hu, Themistocles L Assimes, Charles Kooperberg, Jürgen Bernhagen, Christopher D Anderson, Scott M Damrauer, Ramin Zand, Jerome I Rotter, Paul S De Vries, Martin Dichgans

Faculty, Staff and Student Publications

BACKGROUND: Previous work has shown a role of CCL2, a key chemokine governing monocyte trafficking, in atherosclerosis. However, it remains unknown whether targeting CCR2, the cognate receptor of CCL2, provides protection against human atherosclerotic cardiovascular disease.

METHODS: Computationally predicted damaging or loss-of-function (REVEL > 0.5) variants within CCR2 were detected in whole-exome-sequencing data from 454,775 UK Biobank participants and tested for association with cardiovascular endpoints in gene-burden tests. Given the key role of CCR2 in monocyte mobilization, variants associated with lower monocyte count were prioritized for experimental validation. The response to CCL2 of human cells transfected with these variants was tested …

A Saudi Heart Association Position Statement On The Use Of Doacs In Patients With Arterial And Venous Thrombosis, Waleed Alhabeeb, Adel Tash, Ahmed Aljedai, Ayman Morsy, Feras Khaliel, Iman Alhazmi, Mohammed Alsheef, Mohammed Arafah, Owayed Alshammeri, Saeed Alahmari

Journal of the Saudi Heart Association

Background: Direct oral anticoagulants (DOACs) have emerged as non-inferior and effective alternatives to traditional anticoagulants in managing thromboembolic risks associated with various cardiovascular conditions. This position statement by the Saudi Heart Association (SHA) aims to provide guidance on the use of DOACs in the context of cardiovascular disease, particularly patients with arterial and venous thrombosis.

Methods: A multidisciplinary panel of experts reviewed current evidence and international guidelines on DOACs, considering the local healthcare context in Saudi Arabia. The statement addresses the initiation, maintenance, interruption, and re-initiation of DOAC therapy across different patient populations.

Results: DOACs are effective alternatives to traditional …

Characterization Of Novel Arrhythmogenic Patterns Arising Secondary To Heterogeneous Expression And Activation Of Nav1.8, Zhong-He Zhang, Hector Barajas-Martinez, Hong-Yi Duan, Guo-Hua Fan, Hong Jiang, Charles Antzelevitch, Hao Xia, Dan Hu

Department of Medicine Faculty Papers

Background: Previous studies suggested that SCN10A/Nav1.8 may influence cardiac electrophysiology and the susceptibility to cardiac arrhythmias. Notably, the expression of SCN10A is not uniform, showing variable expression in each cardiac chamber. The present study aims to explore the functional significance of Nav1.8 expression among different cell types present in the ventricular myocardium.

Methods: The effect of the specific Nav1.8 blocker, A-803467, on action potential was recorded from epicardial, mid-myocardial (M cells) and Purkinje tissue slices isolated from the canine left ventricle using standard microelectrode techniques and on late sodium current from Purkinje cells using patch-clamp techniques.

Results: A-803467 treatment …

Two-Dimensional Speckle Tracking Of The Ascending Aorta: A Novel Approach To Evaluate Arterial Stiffness In Pediatric Patients With Repaired Conotruncal Anomalies Using Echocardiography., Anmol Goyal, Anitha Parthiban, David A. White, Daniel Forsha, Doaa Aly

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Children with repaired conotruncal abnormalities (CTA) are at risk of progressive aortic dilation and deteriorating aortic elasticity even after surgical correction. Strain imaging, using a 2-dimensional speckle tracking echocardiography (2D-STE), has been used for arterial stiffness assessment, but pediatric data are still lacking. We investigated the feasibility, reproducibility, and clinical value of 2D-STE derived ascending aorta (AAo) stiffness in children with repaired CTA.

METHODS: 22 pediatric patients with repaired CTA were included along with 25 age- and sex- matched healthy controls (mean age 10.2 ± 4.5 years). Conventional 2D echocardiographic and 2D-STE assessment of AAo mechanics was performed. M-mode …

Perceptions Of Cardiac Surgeons Regarding The Integration Of Artificial Intelligence In Cardiac Surgery, Nada Alguizzani, Fareed Khouqeer, Rasha Alorini, Imtenan Oberi

Journal of the Saudi Heart Association

Background: After the surge of artificial intelligence in late 2022, researchers started exploring the idea of using artificial intelligence in the medical field. Considering the endless possibilities of artificial intelligence, there is still some hesitation toward its use in the medical field. This study aims to explore the attitudes of cardiac surgeons toward involving artificial intelligence in diagnosing cardiac conditions and planning cardiac operations.

Methodology: This study surveyed cardiac surgeons on AI integration in their field using a cross-sectional design and purposive sampling. Data were collected via a structured questionnaire and analyzed in IBM SPSS 29.0.

Results: Our study included …

Novel Valve-In-Valve Transcatheter Systemic Tricuspid Valve Replacement In Congenitally Corrected Transposition Of The Great Arteries, Aamer Naofal, Riyad Yazan Kherallah, Wilson W Lam, Dhaval R Parekh

Faculty, Staff and Students Publications

A 41-year-old woman with history of situs inversus totalis, dextrocardia, congenitally corrected transposition of the great arteries, and systemic tricuspid valve replacement presented with worsening of her baseline orthopnea and exertional dyspnea caused by stenosis of the tricuspid valve. Given her high risk for surgery, valve-in-valve transcatheter tricuspid valve replacement was pursued and performed successfully, leading to resolution of her symptoms. Previous valve-in-valve tricuspid interventions are rare. This case is notable as the first systemic atrioventricular valve-in-valve replacement in a patient with dextrocardia through a septal approach.

Using Ehr Reminders To Control Hypertension, Umme Kulsoom Ghous, Logan Mcculley, Danielle C. Hall, Linda Katherine Lambert, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

Hypertension is a significant risk factor for cardiovascular and kidney diseases but is often under-diagnosed and poorly managed. Electronic Health Records (EHR) can help by providing automated reminders to recheck elevated blood pressure (BP) readings, ensuring accurate measurements, and guiding clinical interventions. This study aims to determine if EHR-based reminders improve BP control in adult patients aged 21 and older, focusing on hypertension diagnosis accuracy and timely management.

Methods

After a literature review, the study took place in a primary care clinic and only included patients with an existing diagnosis of hypertension. Thirty patients were included in the study. …

Framework For Kidney Health Follow-Up Among Neonates With Critical Cardiac Disease: A Report From The Neonatal Kidney Health Consensus Workshop, Stephen M Gorga, Tara Beck, Paulomi Chaudhry, Marissa J Defreitas, Dana Y Fuhrman, Catherine Joseph, Catherine D Krawczeski, David M Kwiatkowski, Michelle C Starr, Matthew W Harer, Jennifer R Charlton, David J Askenazi, David T Selewski, Katja M Gist

Faculty, Staff and Students Publications

Acute kidney injury is common among neonates with critical cardiac disease. Risk factors and associations with kidney-related outcomes are heterogeneous and distinct from other neonates. As survival of children with critical cardiac disease increases to adulthood, the burden of chronic kidney disease is increasing. Thirty percent to 50% of adults with congenital heart disease have impaired kidney function, even in the absence of prior kidney injury episodes. This may be related to the current standardized acute kidney injury criteria, which may not fully capture clinically meaningful kidney injury and long-term kidney health risks. An improved understanding of which neonates with …

Appropriate International Normalized Ratio Follow-Up Interval In Patients With Atrial Fibrillation Taking Warfarin, Komsing Methavigul, Jirayu Sutasanasuang

Chulalongkorn Medical Journal

Background: The international normalized ratio (INR) is recommended to be followed up every four-week intervals in patients with atrial fibrillation (AF) taking warfarin. However, data about the appropriate INR follow-up interval are lacking in those patients.

Objective: We aimed to investigate the appropriate INR follow-up intervals in AF patients receiving warfarin between 6-week and 12-week intervals of follow-up appointments.

Methods: We retrospectively enrolled patients with AF taking warfarin at the Central Chest Institute of Thailand between January 2017 to May 2023. The primary outcome was time in therapeutic range (TTR) in each group of follow-up interval and secondary outcome …

Preoperative Brain Volume Loss Is Associated With Postoperative Delirium In Advanced Heart Failure Patients Supported By Left Ventricular Assist Device, Iván Murrieta-Álvarez, Jacob P Scioscia, José M Benítez-Salazar, Jason Uwaeze, Zicheng Xu, Guangyao Zheng, Shiyi Li, Vladimir Braverman, Carl P Walther, Alexis E Shafii, Camila Hochman-Mendez, Todd K Rosengart, Kenneth K Liao, Nandan K Mondal

Faculty, Staff and Students Publications

Delirium is a common neurological complication in patients with advanced heart failure (ADHF) following left ventricular assist device (LVAD) implantation, significantly impacting recovery. This study aimed to analyze non-contrast computed tomography (CT) scans of the brain in ADHF patients undergoing LVAD implantation to determine the association between pre-existing brain atrophy and postoperative delirium. A study involving 166 ADHF patients was conducted from March 2020 to July 2023. Non-contrast CT scans were analyzed using advanced quantitative neuroimaging techniques before implantation. The primary marker assessed was the lateral ventricle fraction (LVF), with secondary markers including cortical gray matter fraction (cGMF), white matter …

The Role Of Electrophysiologic Study In Device Selection For Leadless Atrial Pacing, Joshua R Hirsch, Jordan M Gales, Irakli Giorgberidze, Hamid Afshar

The Texas Heart Institute Journal

The AVEIR DR (Abbott Medical) was the first dual-chamber leadless pacing system approved by the US Food and Drug Administration. Many patients with sinus node dysfunction have physiologically normal atrioventricular conduction, so an atrial-only pacing system may be appropriate for them. Three patients with symptomatic sinus node dysfunction underwent device implantation with electrophysiologic study, including incremental atrial pacing until loss of 1:1 atrioventricular conduction (atrioventricular Wenckebach cycle length) and His-ventricular interval measurement. If the atrioventricular Wenckebach cycle length was no more than 400 milliseconds and the His-ventricular interval measurement was no more than 55 milliseconds, single-chamber atrial implantation was deemed …

Spontaneous Distal Middle Cerebral Artery Aneurysm In A Young Male With Full Mutation Of The Fragile X Syndrome With A High-Functioning Phenotype: Illustrative Case, Eleni Papadopoulos, Anna Abrimian, Hekmat Zarzour, Randi J Hagerman, Richard F Schmidt

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Fragile X syndrome (FXS) is a genetic disorder that typically presents with neurodevelopmental abnormalities. Patients with FXS can present with signs and symptoms of connective tissue disorder (CTD) and occasionally with vascular disease. However, cerebrovascular disease is not well documented in these patients, and it is unknown whether there is a direct link between abnormal levels of fragile X protein (FMRP) and its mRNA.

OBSERVATIONS: Here, the authors present a rare case of an adult male with full mutation FXS of a high-functioning phenotype who presented with syncope, and on further evaluation, a fusiform dissecting aneurysm of the distal …

Meta-Analysis On Sex Differences In Mortality And Neurodevelopment In Congenital Heart Defects, Alyssa K Crain, Zhia N Lim, Chloe J Sarfatis, Magela Arias, Travis Holder, Alvaro G Moreira, Antonio F Corno, Tina O Findley

Faculty, Staff and Student Publications

Given the increasing survival rates among congenital heart disease (CHD) patients and the growing emphasis on their quality of life, there is a need to comprehensively assess the impact of surgical interventions on neurodevelopmental outcomes. With increasing awareness in sex-related disparities in CHD, there is a need to explore potential differences in surgical mortality and neurodevelopmental outcomes between male and female patients. In this systematic review, we adhered to PRISMA guidelines and PROSPERO registration (#CRD42021225610). Articles published from 2015 to 2021 were searched using MeSH descriptors in three major databases (MEDLINE Ovid, Elsevier Embase, and Cochrane Library). Study selection criteria …