Cardiology Commons^™

Chylopericardium And Superior Vena Cava Syndrome Caused By Central Venous Occlusion From Indwelling Hemodialysis Catheters, Daniel Underberg, Nicholas Demario, Sebastian Rodriguez, Khulkar Mirzozoda, Mark Decaro, Gregary Marhefka

Division of Cardiology Faculty Papers

Chylopericardium is a rare condition. Causes include superior vena cava syndrome resulting from indwelling catheters. We present a case of this condition in a 42-year-old man with end-stage renal disease treated with hemodialysis through a right subclavian vein catheter. He underwent successful endovascular stenting with resolution of his symptoms and chylopericardium.

Residual Stroke Risk Among Patients With Atrial Fibrillation Prescribed Oral Anticoagulants: A Patient-Level Meta-Analysis From Combine Af, Linda Johnson, Alexander Benz, Ashkan Shoamanesh, John W Eikelboom, Michael Ezekowitz, Robert Giugliano, Lars Wallentin, Christian Ruff, Renato Lopes, Sanjit Jolly, Richard Whitlock, Christopher Granger, Stuart Connolly, Jeffrey Healey

Division of Cardiology Faculty Papers

Background: Despite oral anticoagulation, patients with atrial fibrillation (AF) remain at risk of ischemic stroke and systemic embolism (SE) events. For patients whose residual risk is sufficiently high, additional therapies might be useful to mitigate stroke risk.

Methods and results: Individual patient data from 5 landmark trials testing oral anticoagulation in AF were pooled in A Collaboration Between Multiple Institutions to Better Investigate Non-Vitamin K Antagonist Oral Anticoagulant Use in AF (COMBINE AF). We calculated the rate of ischemic stroke/SE among oral anticoagulation-treated patients with a CHA₂DS₂-VASc score≥2, across strata of CHA₂DS₂-VASc …

The Discover In-Hospital Cardiac Arrest (Discover Ihca) Study: An Investigation Of Hospital Practices After In-Hospital Cardiac Arrest, Luke Andrea, Nathaniel S Herman, Jacob Vine, Katherine M Berg, Saiara Choudhury, Mariana Vaena, Jordan E Nogle, Saleem M Halablab, Aarthi Kaviyarasu, Jonathan Elmer, Gabriel Wardi, Alex K Pearce, Conor Crowley, Micah T Long, J Taylor Herbert, Kipp Shipley, Brittany D Bissell Turpin, Michael J Lanspa, Adam Green, Shekhar A Ghamande, Akram Khan, Siddharth Dugar, Aaron M Joffe, Michael Baram, Cooper March, Nicholas J Johnson, Alexander Reyes, Krassimir Denchev, Michael Loewe, Ari Moskowitz

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

IMPORTANCE: In-hospital cardiac arrest (IHCA) is a significant public health burden. Rates of return of spontaneous circulation (ROSC) have been improving, but the best way to care for patients after the initial resuscitation remains poorly understood, and improvements in survival to discharge are stagnant. Existing North American cardiac arrest databases lack comprehensive data on the post-resuscitation period, and we do not know current post-IHCA practice patterns. To address this gap, we developed the Discover In-Hospital Cardiac Arrest (Discover IHCA) study, which will thoroughly evaluate current post-IHCA care practices across a diverse cohort.

OBJECTIVES: Our study collects granular data on post-IHCA …

Milvexian Vs Apixaban For Stroke Prevention In Atrial Fibrillation: The Librexia Atrial Fibrillation Trial Rationale And Design, Sneha S Jain, Kenneth W Mahaffey, Karen S Pieper, Wataru Shimizu, Tatjana Potpara, Christian T Ruff, Hooman Kamel, Basil S Lewis, Jan H Cornel, Peter R. Kowey, Jay Horrow, John Strony, Alexei N Plotnikov, Danshi Li, Stephen Weng, Julia Donahue, C Michael Gibson, P Gabriel Steg, Roxana Mehran, Jeffrey I Weitz, S Claiborne Johnston, Graeme J Hankey, Robert A Harrington, Carolyn S P Lam

Department of Medicine Faculty Papers

BACKGROUND: Direct oral anticoagulants are the standard of care for stroke prevention in eligible patients with atrial fibrillation and atrial flutter; however, bleeding remains a significant concern, limiting their use. Milvexian is an oral Factor XIa inhibitor that may offer similar anticoagulant efficacy with less bleeding risk.

METHODS: LIBREXIA AF (NCT05757869) is a global phase III, randomized, double-blind, parallel-group, event-driven trial to compare milvexian with apixaban in participants with atrial fibrillation or atrial flutter. Participants are randomly assigned to milvexian 100 mg or apixaban (5 mg or 2.5 mg per label indication) twice daily. The primary efficacy objective is to …

Utilization Of A Novel Scoring System In Predicting 30-Day Mortality In Acute Pulmonary Embolism, The Clot-5 Pilot Study, Alexandru Marginean, Punit Arora, Kevin Walsh, Elizabeth Bruno, Cathryn Sawalski, Riya Gupta, Frances Greathouse, Jacob Clarke, Quinn Mallery, Myoung Hyun Choi, Waddah Malas, Parth Shah, David Sutherland, Amudha Kumar, Igor Wroblewski, Ahmed Elkaryoni, Parth Desai, Yevgeniy Brailovsky, Amir Darki

Division of Cardiology Faculty Papers

OBJECTIVES: To construct a new scoring system utilizing biomarkers, vitals, and imaging data to predict 30-day mortality in acute pulmonary embolism (PE).

BACKGROUND: Acute PE, a well-known manifestation of venous thromboembolic disease, is responsible for over 100,000 deaths worldwide yearly. Contemporary management algorithms rely on a multidisciplinary approach to care via PE response teams (PERT) in the identification of low, intermediate, and high-risk patients. The PESI and sPESI scores have been used as cornerstones of the triage process in assigning risk of 30-day mortality for patients presenting with acute PE; however, the specificity of these scoring systems has often come …

The Michigan Procedure: Mass Extraction From The Heart Facilitated By Onocor Global Embolic Protection Device, Hussam Al Hennawi, Shaurya Srivastava, Ahmad Abulshamat, Mohammed Qintar

Abington Jefferson Health Papers

Intracardiac masses present a challenging diagnostic and therapeutic dilemma and are associated with an increased risk of complications, such as embolic events and obstructive symptoms. We report a novel procedure using an ŌNŌCOR device through subclavian access that acted as a full-body protection device as well as a retrieval device.

A Case Of Propafenone Toxicity In The Setting Of Dehydration And Acute Kidney Injury, Enad Haddad, Matthew Collins

Abington Jefferson Health Papers

Propafenone is a class 1C antiarrhythmic and is one of the first-line drugs used in the management of atrial fibrillation. Its toxicity is rare, yet potentially life-threatening. Common clinical findings could range from hypotension, dysrhythmias, and conduction disturbances to cardiac arrest. We present a case of an 80-year-old male who presented with generalized weakness and polyuria secondary to over-diuresis leading to dehydration. Electrocardiogram on admission showed a first-degree atrioventricular block, QRS complex widening, and QTC interval prolongation. These findings were attributed to propafenone toxicity in the setting of dehydration and increased serum propafenone concentration. In the case described the optimization …

National Estimates For The Percentage Of All Readmissions With Demographic Features, Morbidity, Overall And Gender-Specific Mortality Of Transcutaneous Versus Open Surgical Tricuspid Valve Replacement/Repair, Muhammad Shayan Khan, Abdul Baqi, Ayesha Tahir, Ghulam Mujtaba Ghumman, Waqas Ullah, Jay Shah, Yasar Sattar, Tanveer Mir, Zain Sheikh, Fnu Salman, Moaaz Baghal, Kritika Luthra, Vinod Khatri, Zainulabedin Waqar, Malik Waleed Zeb Khan, Mohammed Taleb, Syed Sohail Ali

Abington Jefferson Health Papers

BACKGROUND: The aim of the study was to determine national estimates for the percentage of all readmissions with demographic features, length of stay (LOS), cost analysis, comorbidities, complications, overall and gender-specific mortality and complications of transcutaneous tricuspid valve replacement/repair (TTVR) vs. open surgical tricuspid valve replacement/repair (open TVR).

METHODS: Data were extrapolated from the Nationwide Readmissions Database (NRD) 2015-19. Of the 75,266,750 (unweighted) cases recorded in the 2015 - 2019 dataset, 429 had one or more of the percutaneous approach codes as per the ICD-10 dataset, and 10,077 had one or more of the open approach codes.

RESULTS: Overall, the …

Cardiovascular Disease In Adults With A History Of Out-Of-Home Care During Childhood: A Systematic Review And Meta-Analysis Of Prospective Cohort Studies, G. David Batty, Mika Kivimäki, Ylva B. Almquist, Johan G. Eriksson, Mika Gissler, Emmanuel S. Gnanamanickam, Mark Hamer, Josephine Jackisch, Hee-Soon Juon, Markus Keski-Säntti, Chaiquan Li, Tuija M. Mikkola, Emily Murray, Amanda Sacker, Leonie Segal, Philipp Frank

Department of Medical Oncology Faculty Papers

Background

While individuals who were separated from their biological family and placed into the care of the state during childhood (out-of-home care) are more prone to developing selected adverse health problems in adulthood, their risk of cardiovascular disease is uncertain. Our aim was to explore this association by pooling published and unpublished results from prospective cohort studies.

Methods

We used two approaches to identifying relevant data on childhood care and adult cardiovascular disease (PROSPERO registration CRD42021254665). First, to locate published studies, we searched PubMed (Medline) until November 2023. Second, with the objective of identifying unpublished studies with the potential to …

What Constitutes Adequate Control Of High Blood Pressure? Current Considerations, Donald E. Casey, Alexander J. Blood, Stephen D. Persell, Daniel Pohlman, Jeff D. Williamson

College of Population Health Faculty Papers

An estimated 45% of adult Americans currently have high blood pressure (HBP). Effective blood pressure (BP) control is essential for preventing major adverse events from cardiovascular and other vascular-related diseases, such as chronic kidney disease, stroke and dementia. A large and growing number of medical professional societies, health care organizations, and governmental agencies have now endorsed a clinical practice guideline-based target for adequate control of HBP to a systolic BP of less than 130 mm Hg. However, adequate BP control to this goal has been recently estimated to be as low as 30%. The first and most important steps to …

Neutrophil To Lymphocyte Ratio As A Prognostic Marker For Cardiovascular Outcomes In Patients With St-Segment Elevation Myocardial Infarction After Percutaneous Coronary Intervention: A Systematic Review And Meta-Analysis, Hassan Ul Hussain, Kanwal Ashok Kumar, Marium Zahid, Muhammad Husban Burney, Zayeema Khan, Muqaddus Asif, Syeda Tayyaba Rehan, Huzaifa Ahmad Cheema, Sarya Swed, Farah Yasmin, Waqas Ullah, M. Chadi Alraies

Abington Jefferson Health Papers

BACKGROUND: Neutrophil to lymphocyte ratio (NLR) has been considered a prognostic biomarker of mortality and other major cardiac events. This study investigates NLR's efficacy in predicting in-hospital and long-term outcomes in patients with ST-segment elevated myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI).

METHODS: Electronic databases (PUBMED, Cochrane CENTRAL, ERIC, Embase, Ovid, and Google Scholar) were searched till June 2022 to identify studies having STEMI patients who underwent PCI. Risk ratios and mean differences (MDs), along with their corresponding 95% confidence intervals (Cis) and standard deviations (SDs), were pooled using a random-effect model. This meta-analysis has been registered on Prospero …

Combining Novel Thrombectomy Devices For Intracardiac Mass Extraction: The Kong And Godzilla Of Mass Extraction, Hussam Al Hennawi, Ahmad Abulshamat, Ali Sheikh, Hisham Qandeel, Kiril Zakharov, Appa Bandi, Mohammed Qintar

Abington Jefferson Health Papers

Transcatheter extraction of an intracardiac mass is a newer approach that may lead to nonsurgical treatment of complex cardiac masses. We present a case in which thrombectomy devices were combined to extract a right atrial mass, which highlights new frontiers in the treatment of complex transcatheter mass extraction. The combined use of two transcatheter thrombectomy devices (Kong and Godzilla) may provide a powerful addition to the existing armamentarium.

Polymer-Based Drug-Eluting Stent Treatment Extends The Time To Reintervention For Patients With Symptomatic Femoropopliteal Artery Disease: Clinical Evidence And Potential Economic Value, William Gray, Yoshimitsu Soga, Masahiko Fujihara, Osamu Iida, Anvar Babaev, Daizo Kawasaki, Thomas Zeller, David O'Connor, Michael Jaff, Anna Chavez, Stefan Müller-Hülsbeck

Department of Medicine Faculty Papers

Aim: Use long-term follow-up data from the IMPERIAL study to determine whether drug-eluting polymer-based nitinol stent treatment can delay the time to repeat intervention for femoropopliteal artery disease and how such a delay may result in cost savings in a value-based episode of care. Patients & methods: The IMPERIAL randomized controlled trial was an international study of a paclitaxel-eluting polymer-coated stent (Eluvia, Boston Scientific, MA, USA) versus a polymer-free paclitaxel-coated stent (Zilver PTX, Cook Corporation, IN, USA) for treating lesions of the femoropopliteal arterial segment. Study patients (n = 465) had symptomatic lower limb ischemia. Safety and efficacy assessments were …

Invasive Hemodynamic Changes Associated With Sodium-Glucose Cotransporter-2 Inhibitors: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Abiodun Idowu, Olayinka Adebolu, Casipit Bruce, Bede Nriagu, Endurance Evbayekha, Kevin Bryan Lo, Olayinka Afolabi-Brown, Janani Rangaswami

Einstein Health Papers

Sodium-glucose cotransporter-2 inhibitors (SGLT2is) have been shown to lower incident heart failure (HF) and HF hospitalizations, but the mechanisms of benefit in relation to invasive hemodynamics remain unclear. Using PRISMA guidelines, we systematically reviewed multiple online databases for randomized trials evaluating the effect of SGLT2i on invasive hemodynamics. Rest and peak exercise invasive hemodynamics were measured via right heart catheterization pre- and postintervention. Random effects model meta-analysis at a 95% confidence interval was done using RevMan 5.0. A total of 3 studies with a total of 145 patients were included in the meta-analysis. SGLT2i was significantly associated with a reduction …

Heart Rate Variability Applications In Strength And Conditioning: A Narrative Review, Jennifer Addleman, Nicholas Lackey, Justin Deblauw, Alexander Hajduczok

Division of Cardiology Faculty Papers

Heart rate variability (HRV) is defined as the fluctuation of time intervals between adjacent heartbeats and is commonly used as a surrogate measure of autonomic function. HRV has become an increasingly measured variable by wearable technology for use in fitness and sport applications. However, with its increased use, a gap has arisen between the research and the application of this technology in strength and conditioning. The goal of this narrative literature review is to discuss current evidence and propose preliminary guidelines regarding the application of HRV in strength and conditioning. A literature review was conducted searching for HRV and strength …

The Impact Of The Optn Policy Change On Patients With A Durable Left Ventricular Assist Device And Chronic Kidney Disease: Analysis Of The Unos Database, Eric D. Warner, Christopher Pritting, Sawan Dutta, Matt Bierowski, Waqas Ullah, Yevgeniy Brailovsky, Michelle Kittleson, René J. Alvarez, J. Eduardo Rame, Alexander Hajduczok, Vineeta Kumar, Danial Ahmad, Vakhtang Tchantchaleishvili, Indranee N. Rajapreyar

Division of Cardiology Faculty Papers

BACKGROUND: The Organ Procurement and Transplantation Network (OPTN) implemented modifications in 2018 to the adult heart transplant allocation system to better stratify the most medically urgent transplant candidates. We evaluated the impact of these changes on patients supported by a durable left ventricular assist device (LVAD) with chronic kidney disease (CKD).

OBJECTIVE: To evaluate the impact of the OPTN policy change on patients supported by durable left ventricular assist devices (LVAD) with chronic kidney disease (CKD).

METHODS: We performed an analysis of patients from the United Network of Organ Sharing Database supported by durable LVAD listed for a heart transplant …

Beyond The Task: Developing A Tool To Measure Workplace Characteristics That Affect Cognitive Load And Learning, Sarah Blissett, Sebastian Rodriguez, Atif Qasim, Patricia O'Sullivan

Department of Medicine Faculty Papers

PURPOSE: Educators lack tools to measure the workplace characteristics that learners perceive to affect learning. Without a tool that encompasses the social, organizational, and physical components of workplace learning environments (WLEs), it is challenging to identify and improve problematic workplace characteristics. Using echocardiography WLE, this study developed a tool to measure workplace characteristics that cardiology fellows perceive to affect learning.

METHOD: The Workplace-Cognitive Load Tool (W-CLT) was developed, which encompasses 17 items to measure workplace characteristics that could affect perceived cognitive load and learning. Exploratory factor analysis was used to identify the most parsimonious structure. A total of 646 cardiology …

Incidental Coronary Artery Calcification: A Low-Hanging Fruit With Life-Prolonging Potential, Ryan Gardner, Md, Youssef Elfatatry, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem Statement:

Incidental coronary artery calcium (CAC) seen on ungated computerized tomography (CT) scans obtained for various clinical reasons can serve as an excellent opportunity for screening of patients with previously undiagnosed coronary artery disease (CAD). Despite this, studies have shown that these findings are rarely reported in final impressions of radiology reports.

Project AIM:

To propose the use of a natural language processing (NLP) algorithm to identify incidental CAC noted in radiology reports and an electronic alert to notify primary care clinicians of such findings.

Cardiology Referrals For African-American Basketball Players Falls Below Expectation, Vacha Shah, Blaise O'Malley, Douglas Corsi, Avinash Saraiya, Margaret Doyle, I. Masood, Brian Osler, A. Hajduczok, David Shipon

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem Statement:

• Rates of sudden cardiac death due to hypertrophic cardiomyopathy are higher in male African American basketball players compared with White players (Maron, 2003)
• Male African American NCAA Division I basketball players have the highest incidence of sudden cardiac arrest and death between the ages of 11 and 29 (Peterson, 2020)
• Retrospective analysis of the HeartBytes Registry collected by Simon’s Heart Organization identified multiple risk factors, such as asthma and sickle cell anemia, higher in this population than in the general population
• Increased murmurs and EKG abnormalities such as ST-segment depressions and other nonspecific changes are present in …

Racial Disparities In Transcatheter And Surgical Aortic Valve Replacement, Maggie Doyle, Svenja Schneider, Md, Kashka Mallari, Md, Nicholas Ruggiero, Md, Rebecca Marcantuono, Crnp, Alec Vishnevsky, Md, Yevgeniy Brailovsky, Do

Health Equity and Quality Improvement (HEQI) Summit

Background

• Transcatheter and surgical aortic valve replacement (TAVR, SAVR) is disproportionately distributed across racial and ethnicity groups.^{1, 2}
• Nationally, 87-91% of individuals undergoing AVR are White, despite making up approximately 60% of the US population.^1-4
• Jefferson’s AVR demographic data is consistent with national trends.
• Further studies have found that zip codes associated with lower socioeconomic status (SES) have lower rates of TAVR.⁵
• Although this disparity is widely recognized, there lacks understanding of contributing factors and potential interventions.

Project Aim:

• Investigate additional demographic data of Thomas Jefferson University Hospital (TJUH) patients undergoing TAVR to isolate targets for future …

Importance Of The Assessment Of Left Ventricular Function Following A Diagnosis Of Left Bundle Branch Block, Samuel Dyer, Bs, Benjamin Mass, Bs, Alyson Owen, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• Left bundle branch block (LBBB) is a diagnosis often encountered in clinical practice.
• It can be seen as a harbinger of decreased left ventricular function in the future. LBBB has been associated with new onset congestive heart failure (CHF) and death from cardiovascular diseases.¹

Problem Statement

• LBBB in and of itself is given inadequate follow-up and attention by clinicians. Project AIM: bring to light the delay in follow-up after diagnosis of LBBB.

Ventilation Method During Intensive Care Unit Transport After Cardiac Surgeries; When Should We Use A Ventilator?, Francis Anderson, Do, Kent Berg, Md, Marc Torjman, Phd, Yoshihisa Morita, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem Statement: Manual ventilation with AMBU bag is utilized mostly for transporting post cardiac surgery patients to the intensive care unit, but some patients need mechanical ventilation due to concern for oxygenation, ventilation, and cardiac function.

Also, transport can be a critical moment because of limited hemodynamic information and suboptimal environment for therapeutic intervention.

Thus, risk stratification for appropriate ventilation is necessary for safe transport. •

Project AIM: We assessed biventricular function (with a hand-held echocardiography), arterial blood gas, and hemodynamics pre and post transport in manual and mechanical ventilation groups.

Low Absolute Risk Of Thrombotic And Cardiovascular Events In Outpatient Pregnant Women With Covid-19, Behnood Bikdeli, Darsiya Krishnathasan, Candrika Khairani, Antoine Bejjani, Julia Davies, Nicole Porio, Anthony Tristani, Andre Armero, Ali Assi, Victor Nauffal, Umberto Campia, Zaid Almarzooq, Eric Wei, Marcos Ortiz-Rios, Valeria Zuluaga-Sánchez, Aditya Achanta, Sirus Jesudasen, Bruce Tiu, Geno Merli, Orly Leiva, John Fanikos, Elvira Grandone, Aditya Sharma, Samantha Rizzo, Mariana Pfeferman, Ruth Morrison, Alec Vishnevsky, Judith Hsia, Mark Nehler, James Welker, Marc Bonaca, Brett Carroll, Samuel Goldhaber, Zhou Lan, Gregory Piazza

Division of Cardiology Faculty Papers

INTRODUCTION: Pregnancy may contribute to an excess risk of thrombotic or cardiovascular events. COVID-19 increases the risk of these events, although the risk is relatively limited among outpatients. We sought to determine whether outpatient pregnant women with COVID-19 are at a high risk for cardiovascular or thrombotic events.

MATERIALS & METHODS: We analyzed pregnant outpatients with COVID-19 from the multicenter CORONA-VTE-Network registry. The main study outcomes were a composite of adjudicated venous or arterial thrombotic events, and a composite of adjudicated cardiovascular events. Events were assessed 90 days after the COVID-19 diagnosis and reported for non-pregnant women ≤45 years, and …

Outcomes Of Drug-Eluting Stents In Comparison To Bare Metal Stents In Cancer Patients With Percutaneous Coronary Intervention: A Systematic Review And Meta-Analysis, Muhammad Siddiqui, Eric Warner, Joey Junarta, Parker O’Neill, David Signarovitz, Eyad Kanawati, Mohammed Murtaza, David Fischman

Division of Cardiology Faculty Papers

Background: Studies have demonstrated poor prognosis in cancer patients who undergo percutaneous coronary intervention (PCI) for coronary artery disease (CAD). Cancer patients receiving PCI are at increased risk of in-stent thrombosis, bleeding, hospital readmissions, and cardiovascular and noncardiovascular mortality when compared to patients without cancer. It is unclear if the poor outcomes in cancer patients are related to the stent type utilized for PCI. This meta-analysis attempts to identify differences in efficacy and safety outcomes when comparing drug-eluting stents (DESs) with bare metal stents (BMSs) in cancer patients.

Methods: This meta-analysis is reported according to the Preferred Reporting Items for …

Endocarditis: A Review Of Recent Literature, Scott Dale, Zaid Tayyem, Steven Maceyko

Jefferson Hospital Staff Papers and Presentations

Purpose of Review

Endocarditis remains a challenging diagnosis, with significant implications for early identification and initiation of therapy. In this review, we examine the evolution in the epidemiology and presentation of infectious endocarditis (IE), the role of new diagnostic tools, and the approach to therapy.

Recent Findings

Staphylococcus and Streptococcus species remain the most common causative organisms, but the prevalence of IE caused by enterococcus and non-HACEK organisms is increasing. While newer antibiotics such as dalbavancin have shown promise, treatment must still be tailored on an individual basis. Evidence suggests that antibiotic prophylaxis to prevent IE be limited to high-risk …

Swiss Cheese Heart: A Tale Of Multiple Valve Perforations, Hussam Al Hennawi, Shayan I. Khan, Aamna Khan, Usama Sadiq, Sung-Hae Cho

Abington Jefferson Health Papers

Gerbode defect, an anomalous connection between the left ventricle and right atrium, is often congenital but can be acquired or iatrogenically formed. We present an exceedingly rare case of this defect associated with multiple valve perforation in an otherwise healthy patient with bicuspid aortic valve and endocarditis.

Association Of Multiple Metabolic And Cardiovascular Markers With The Risk Of Cognitive Decline And Mortality In Adults With Alzheimer’S Disease And Ad-Related Dementia Or Cognitive Decline: A Prospective Cohort Study, Longjian Liu, Edward Gracely, Xiaopeng Zhao, Gediminas Gliebus, Nathalie May, Stella Volpe, Jingyi Shi, Rose Ann Dimaria-Ghalili, Howard Eisen

Division of Cardiology Faculty Papers

BACKGROUND AND OBJECTIVES: There is a scarcity of data stemming from large-scale epidemiological longitudinal studies focusing on potentially preventable and controllable risk factors for Alzheimer's disease (AD) and AD-related dementia (ADRD). This study aimed to examine the effect of multiple metabolic factors and cardiovascular disorders on the risk of cognitive decline and AD/ADRD.

METHODS: We analyzed a cohort of 6,440 participants aged 45-84 years at baseline. Multiple metabolic and cardiovascular disorder factors included the five components of the metabolic syndrome [waist circumference, high blood pressure (HBP), elevated glucose and triglyceride (TG) concentrations, and reduced high-density lipoprotein cholesterol (HDL-C) concentrations], C-reactive …

Discordance Interpretation Of Left Ventricular Size Between Echocardiography And Cardiac Magnetic Resonance In Pediatric Patients With Aortic/Mitral Regurgitation, Anastasia Barros, Michelle Udine, Chris Spurney, Laura Olivieri, Yue-Hin Loke

Jefferson Hospital Staff Papers and Presentations

PURPOSE: This study investigated discordance between echocardiography (echo) and cardiac magnetic resonance (CMR) measurements of the left ventricle (LV) in pediatric patients with aortic and/or mitral regurgitation (AR/MR).

METHODS: Retrospective cohort study of pediatric patients. The cohorts were comprised of patients with AR/MR vs. non-AR/MR. Left ventricular end diastolic volume (LVEDV) by CMR and left ventricular internal diameter diastolic (LVIDd) by echo were obtained from clinical reports then echo images were reviewed to remeasure LVEDV by bullet method. Left ventricular internal diameter systolic (LVIDs) and left ventricular ejection fraction (LVEF) measurements by echo and LVEF by CMR were obtained from …

Microcurrent-Mediated Modulation Of Myofibroblasts For Cardiac Repair And Regeneration, Dipthi Bachamanda Somesh, Karsten Jürchott, Thomas Giesel, Thomas Töllner, Alexander Prehn, Jan-Peter Richters, Dragana Kosevic, J. Eduardo Rame, Peter Göttel, Johannes Müller

Division of Cardiology Faculty Papers

Cardiovascular diseases are a significant cause of illness and death worldwide, often resulting in myofibroblast differentiation, pathological remodeling, and fibrosis, characterized by excessive extracellular matrix protein deposition. Treatment options for cardiac fibrosis that can effectively target myofibroblast activation and ECM deposition are limited, necessitating an unmet need for new therapeutic approaches. In recent years, microcurrent therapy has demonstrated promising therapeutic effects, showcasing its translational potential in cardiac care. This study therefore sought to investigate the effects of microcurrent therapy on cardiac myofibroblasts, aiming to unravel its potential as a treatment for cardiac fibrosis and heart failure. The experimental design involved …

Microvascular Vasoregulatory Dysfunction In African Americans - An Enhanced Opportunity For Early Prevention And Treatment Of Atherosclerotic Cardiovascular Disease, Renee Bullock-Palmer, Panithaya Chareonthaitawee, Ervin Fox, Garth Beache

Division of Cardiology Faculty Papers

Atherosclerotic cardiovascular disease and its risk factors and precursors are a major driver of disparities in cardiovascular health. This review examines reported evidence that vascular endothelial dysfunction, and its manifestation as coronary microvascular dysfunction, underlies observed excess morbidity and mortality in African Americans. Advanced imaging insights that reveal patho-mechanisms, along with population evidence from the Jackson Heart Study, and the growing evidence emanating from national and international clinical trials and registries are presented. We examine a physiological framework that recognizes insulin-resistant cardiometabolic underpinnings of the conditions of the American Heart Associations' Life's Essential Eight construct of cardiovascular health as a …