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Articles 151 - 180 of 535

Full-Text Articles in Cardiology

Diagnostic And Therapeutic Challenge: A Case Of Right Ventricular Thrombus, Angad Bedi, Muhammad Sabri, Prerana Sevella, Hussam Al Hennawi, Gregory Pirolli Feb 2024

Diagnostic And Therapeutic Challenge: A Case Of Right Ventricular Thrombus, Angad Bedi, Muhammad Sabri, Prerana Sevella, Hussam Al Hennawi, Gregory Pirolli

Abington Jefferson Health Papers

Right ventricular thrombus is a rare finding found in 4% of people diagnosed with pulmonary embolism. Although right ventricular thrombi are usually associated with atrial fibrillation, deep venous vein thrombi, or intracardiac procedures, isolated right ventricular thrombi are rare. Right ventricular thrombus has also been reported in patients with right ventricular infarction, as hypokinesis of the right ventricle causes blood stasis and promotes thrombosis as per Virchow’s triad. However, we present a case of isolated RV thrombus in a patient without evidence of deep vein thrombosis or right ventricular hypokinesis who presented with dyspnea on exertion.


The Curious Case Of Kounis Syndrome: Exploring Clinical Manifestations And Management In The Presence Of Nonobstructive Coronary Arteries, Darren Drittel, Dylan Deyar, Eric Boxer, Hussam Al Hennawi, Margaret Mack Feb 2024

The Curious Case Of Kounis Syndrome: Exploring Clinical Manifestations And Management In The Presence Of Nonobstructive Coronary Arteries, Darren Drittel, Dylan Deyar, Eric Boxer, Hussam Al Hennawi, Margaret Mack

Abington Jefferson Health Papers

Kounis syndrome, an allergic hypersensitivity coronary disorder, is a rare but potentially life-threatening condition triggered by various allergens, including medications. We present the case of a 41-year-old male with no prior cardiac history, who developed Kounis syndrome following vancomycin administration for suspected cellulitis. The patient initially presented with rash, fever, and malaise, which progressed to chest discomfort associated with diaphoresis and elevated troponin levels. Diagnostic evaluations, including electrocardiographic changes and coronary angiography, confirmed a diagnosis of type I Kounis syndrome. This case adds to the limited literature on vancomycin-induced Kounis syndrome, and underscores the importance of considering this diagnosis in …


Transcatheter Aortic Valve Replacement Across Hemodynamic Subtypes Of Severe Aortic Valve Stenosis: A Network Meta-Analysis, Waqas Ullah, Muhammad Khawar Sana, Maryam Mukhtar, Sohaib Hasan Syed, Salman Zahid, Mohamad Alkhouli, Alec Vishnevsky Feb 2024

Transcatheter Aortic Valve Replacement Across Hemodynamic Subtypes Of Severe Aortic Valve Stenosis: A Network Meta-Analysis, Waqas Ullah, Muhammad Khawar Sana, Maryam Mukhtar, Sohaib Hasan Syed, Salman Zahid, Mohamad Alkhouli, Alec Vishnevsky

Division of Cardiology Faculty Papers

Background: Studies assessing outcomes of transcatheter aortic valve replacement (TAVR) in patients with severe aortic valve stenosis (AS) with hemody- namic subtypes have demonstrated mixed results with respect to outcomes and periprocedural complications. This study aimed to assess the outcomes of TAVR in patients across various hemodynamic subtypes of severe AS. Methods: PubMed, Embase, and Cochrane databases were searched through September 2023 to identify all observational studies comparing outcomes of TAVR in patients with paradoxical low flow low gradient (pLFLG), classic LFLG, and high gradient AS (HGAS). The primary outcome was major adverse cardiovascular events (MACE). The secondary outcomes were …


Development Of Angiotensin Ii Type 1 Receptor Antibodies In Patients With Temporary Mechanical Circulatory Support, Maria T. Gamero, Mark Liotta, Md, Yevgeniy Brailovsky, Gregory T. Gibson, René J Alvarez, Patricia Uber, Yanping Huang, Indranee Rajapreyar Feb 2024

Development Of Angiotensin Ii Type 1 Receptor Antibodies In Patients With Temporary Mechanical Circulatory Support, Maria T. Gamero, Mark Liotta, Md, Yevgeniy Brailovsky, Gregory T. Gibson, René J Alvarez, Patricia Uber, Yanping Huang, Indranee Rajapreyar

Department of Medicine Faculty Papers

Angiotensin II type 1 receptor antibodies (AT1R-Ab) are among the most investigated type of non-human leukocyte antigen antibodies in solid organ transplantation, particularly given its association with allograft dysfunction. Some prior studies have described the development of AT1R antibodies in patients with durable mechanical circulatory support (MCS); however, the role of temporary MCS in autoantibody development is still uncertain. Given that the current United Network For Organ Sharing (UNOS) allocation system prioritizes heart transplant recipients in cardiogenic shock requiring temporary MCS, we investigated the development of these antibodies in 10 patients with temporary MCS (Impella 5.5 n = 8, Intra-aortic …


Social And Psychosocial Determinants Of Racial And Ethnic Differences In Cardiovascular Health: The Masala And Mesa Studies, Nilay S. Shah, Xiaoning Huang, Lucia C. Petito, Michael P. Bancks, Alka M. Kanaya, Sameera Talegawkar, Saaniya Farhan, Mercedes R. Carnethon, Donald M. Lloyd-Jones, Norrina B. Allen, Namratha R. Kandula, Sadiya S. Khan Jan 2024

Social And Psychosocial Determinants Of Racial And Ethnic Differences In Cardiovascular Health: The Masala And Mesa Studies, Nilay S. Shah, Xiaoning Huang, Lucia C. Petito, Michael P. Bancks, Alka M. Kanaya, Sameera Talegawkar, Saaniya Farhan, Mercedes R. Carnethon, Donald M. Lloyd-Jones, Norrina B. Allen, Namratha R. Kandula, Sadiya S. Khan

Student Papers, Posters & Projects

BACKGROUND: Social and psychosocial determinants are associated with cardiovascular health (CVH).

OBJECTIVES: To quantify the contributions of social and psychosocial factors to racial/ethnic differences in CVH.

METHODS: In the Multi-Ethnic Study of Atherosclerosis and Mediators of Atherosclerosis in South Asians Living in America cohorts, Kitagawa-Blinder-Oaxaca decomposition quantified the contributions of social and psychosocial factors to differences in mean CVH score (range 0-14) in Black, Chinese, Hispanic, or South Asian compared with White participants.

RESULTS: Among 7,978 adults (mean age 61 [SD 10] years, 52 % female), there were 1,892 Black (mean CVH score for decomposition analysis 7.96 [SD 2.1]), 804 …


Echocardiographic Parameters Associated With Less Reverse Left Ventricular Remodeling After Transcatheter Aortic Valve Implant In Subjects With Prosthesis Patient Mismatch, Andrew C. Peters, Fei Fei Gong, Ashvita Ramesh, Adin Andrei, Madeline Jankowski, Eric Cantey, Vincent Chen, James D. Thomas, James D. Flaherty, S. Christopher Malaisrie, Kameswari Maganti Jan 2024

Echocardiographic Parameters Associated With Less Reverse Left Ventricular Remodeling After Transcatheter Aortic Valve Implant In Subjects With Prosthesis Patient Mismatch, Andrew C. Peters, Fei Fei Gong, Ashvita Ramesh, Adin Andrei, Madeline Jankowski, Eric Cantey, Vincent Chen, James D. Thomas, James D. Flaherty, S. Christopher Malaisrie, Kameswari Maganti

Division of Cardiology Faculty Papers

BACKGROUND: Transaortic valve implant (TAVI) is the treatment of choice for severe aortic stenosis (AS). Some patients develop prosthesis patient mismatch (PPM) after TAVI. It is challenging to determine which patients are at risk for clinical deterioration.

METHODS: We retrospectively measured echocardiographic parameters of left ventricular (LV) morphology and function, prosthetic aortic valve effective orifice area (iEOA) and hemodynamics in 313 patients before and 1 year after TAVI. Our objective was to compare the change in echocardiographic parameters associated with left ventricular reverse modeling in subjects with and without PPM. Our secondary objective was to evaluate echo parameters associated with …


Post-Capillary Pulmonary Hypertension: Clinical Review, Joshua Riley, James Fradin, Douglas Russ, Eric Warner, Yevgeniy Brailovsky, Indranee Rajapreyar Jan 2024

Post-Capillary Pulmonary Hypertension: Clinical Review, Joshua Riley, James Fradin, Douglas Russ, Eric Warner, Yevgeniy Brailovsky, Indranee Rajapreyar

Department of Medicine Faculty Papers

Pulmonary hypertension (PH) caused by left heart disease, also known as post-capillary PH, is the most common etiology of PH. Left heart disease due to systolic dysfunction or heart failure with preserved ejection fraction, valvular heart disease, and left atrial myopathy due to atrial fibrillation are causes of post-capillary PH. Elevated left-sided filling pressures cause pulmonary venous congestion due to backward transmission of pressures and post-capillary PH. In advanced left-sided heart disease or valvular heart disease, chronic uncontrolled venous congestion may lead to remodeling of the pulmonary arterial system, causing combined pre-capillary and post-capillary PH. The hemodynamic definition of post-capillary …


Correlation Between Melphalan Chemotherapy With Longitudinal Global Strain Indices Of The Left Ventricle In Multiple Myeloma Patients: A Velocity Vector Imaging (Vvi) Echocardiography Study, Liaosadat Mirsafaee, Mohammad Dehghani Firouzabadi, Sayeh Parkhideh, Hassan Vahidnezhad, Fatemeh Dehghani Firouzabadi, Maryam Arab, David M. Yousem, Mersedeh Karvandi Jan 2024

Correlation Between Melphalan Chemotherapy With Longitudinal Global Strain Indices Of The Left Ventricle In Multiple Myeloma Patients: A Velocity Vector Imaging (Vvi) Echocardiography Study, Liaosadat Mirsafaee, Mohammad Dehghani Firouzabadi, Sayeh Parkhideh, Hassan Vahidnezhad, Fatemeh Dehghani Firouzabadi, Maryam Arab, David M. Yousem, Mersedeh Karvandi

Jefferson Institute of Molecular Medicine Papers and Presentations

Multiple myeloma (MM) is characterized by the neoplastic proliferation of plasma cells, leading to the production of monoclonal immunoglobulins. High-dose chemotherapy with autologous stem cell transplant has been used in the treatment of patients with MM (1). Melphalan (L-phenylalanine nitrogen mustard) is one of the most effective chemotherapeutic drugs in the treatment of MM (2). The side effects of melphalan include anemia, nausea, vomiting, allergic reactions, oral ulcers, nephrotoxicity, and arrhythmia at high doses (3). The effect of this drug on cardiac mechanics and heart damage is not well established, as previous studies have only focused on the electrocardiographic and …


Effect Of Flecainide And Ibutilide Alone And In Combination To Terminate And Prevent Recurrence Of Atrial Fibrillation, Alexander Burashnikov, José M. Di Diego, Bence Patocskai, Debra S. Echt, Luiz Belardinelli, Charles Antzelevitch Dec 2023

Effect Of Flecainide And Ibutilide Alone And In Combination To Terminate And Prevent Recurrence Of Atrial Fibrillation, Alexander Burashnikov, José M. Di Diego, Bence Patocskai, Debra S. Echt, Luiz Belardinelli, Charles Antzelevitch

Division of Cardiology Faculty Papers

BACKGROUND: There is a need for improved approaches to rhythm control therapy of atrial fibrillation (AF).

METHODS: The effectiveness of flecainide (1.5 µmol/L) and ibutilide (20 nmol/L), alone and in combination, to cardiovert and prevent AF recurrence was studied in canine-isolated coronary-perfused right atrioventricular preparations. We also examined the safety of the combination of flecainide (1.5 µmol/L) and ibutilide (50 nmol/L) using canine left ventricular wedge preparations.

RESULTS: Sustained AF (>1 hour) was inducible in 100%, 60%, 20%, and 0% of atria in the presence of acetylcholine alone, acetylcholine+ibutilide, acetylcholine+flecainide, and acetylcholine+ibutilide+flecainide, respectively. When used alone, flecainide and ibutilide …


Impact Of Comorbid Heart Failure Among Hospitalized Patients With Sarcoidosis: A United States Population-Based Cohort Study, Bruce Adrian Casipit, Kevin Bryan Lo, Carlo Gabriel Casipit, Abdiodun Idowu, Aman Amanullah Dec 2023

Impact Of Comorbid Heart Failure Among Hospitalized Patients With Sarcoidosis: A United States Population-Based Cohort Study, Bruce Adrian Casipit, Kevin Bryan Lo, Carlo Gabriel Casipit, Abdiodun Idowu, Aman Amanullah

Einstein Health Papers

BACKGROUND: There is paucity of data regarding the impact of concomitant heart failure (HF) on the in-hospital outcomes among hospitalized sarcoidosis patients. We aim to investigate the factors associated with concomitant HF and its impact on in-hospital outcomes among hospitalized sarcoidosis patients.

METHODS: We utilized the 2018-2020 National Inpatient Sample (NIS) Database in conducting this study. Multivariable logistic and linear regression models were used to examine the factors associated with HF and hospital-associated outcomes among patients with sarcoidosis.

RESULTS: A total of 36,864 hospitalized patients with sarcoidosis were identified, of which 24.78 % (n = 9135/36,864) had concomitant HF. Factors …


Clinical Trials In Cardiogenic Shock: Challenges And Solutions For The Future, Anju Bhardwaj, Sahoor Khan, Shashank Sinha, Preethi Pirlamarla, Rajiv Sankaranarayanan, Alexander Hajduczok, Holger Thiele, Navin Kapur Dec 2023

Clinical Trials In Cardiogenic Shock: Challenges And Solutions For The Future, Anju Bhardwaj, Sahoor Khan, Shashank Sinha, Preethi Pirlamarla, Rajiv Sankaranarayanan, Alexander Hajduczok, Holger Thiele, Navin Kapur

Division of Cardiology Faculty Papers

No abstract provided.


Nonlinear Model Predictive Control Of Vagal Nerve Stimulation To Regulate Hemodynamic Variables, Oluwasanmi Adeodu, Michelle Gee, Babak Mahmoudi, Rajanikanth Vadigepalli, Mayuresh Kothare Nov 2023

Nonlinear Model Predictive Control Of Vagal Nerve Stimulation To Regulate Hemodynamic Variables, Oluwasanmi Adeodu, Michelle Gee, Babak Mahmoudi, Rajanikanth Vadigepalli, Mayuresh Kothare

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Various pre-clinical investigations indicate that the electrical stimulation of the cervical branch of the vagus that innervates the heart has therapeutic value in the management of various cardiac diseases. In theory, the design of a closed-loop control mechanism that automatically adjusts vagal nerve stimulation (VNS) parameters based on real-time physiological feedback can eliminate intra-patient variability in VNS outcomes and therefore represents a major step towards patient-specific therapy. This study develops a nonlinear model predictive control (NMPC) approach for VNS of a pulsatile, human cardio-baroreflex system. The manipulated variables are the frequency and amplitude of a charge-balanced biphasic current. The effects …


Relationship Of Race With Functional And Clinical Outcomes With The Rehab-Hf Multidomain Physical Rehabilitation Intervention For Older Patients With Acute Heart Failure, Olivia N. Gilbert, Robert J. Mentz, Alain G. Bertoni, Dalane W. Kitzman, David J. Whellan, Gordon R. Reeves, Pamela W. Duncan, Michael Benjamin Nelson, Vanessa Blumer, Haiying Chen, Shelby D. Reed, Bharathi Upadhya, Christopher M. O'Connor, Amy M. Pastva Nov 2023

Relationship Of Race With Functional And Clinical Outcomes With The Rehab-Hf Multidomain Physical Rehabilitation Intervention For Older Patients With Acute Heart Failure, Olivia N. Gilbert, Robert J. Mentz, Alain G. Bertoni, Dalane W. Kitzman, David J. Whellan, Gordon R. Reeves, Pamela W. Duncan, Michael Benjamin Nelson, Vanessa Blumer, Haiying Chen, Shelby D. Reed, Bharathi Upadhya, Christopher M. O'Connor, Amy M. Pastva

Department of Medicine Faculty Papers

Background

The REHAB‐HF (Rehabilitation Therapy in Older Acute Heart Failure Patients) randomized trial demonstrated that a 3‐month transitional, tailored, progressive, multidomain physical rehabilitation intervention improves physical function, frailty, depression, and health‐related quality of life among older adults with acute decompensated heart failure. Whether there is differential intervention efficacy by race is unknown.

Methods and Results

In this prespecified analysis, differential intervention effects by race were explored at 3 months for physical function (Short Physical Performance Battery [primary outcome], 6‐Minute Walk Distance), cognition, depression, frailty, health‐related quality of life (Kansas City Cardiomyopathy Questionnaire, EuroQoL 5‐Dimension‐5‐Level Questionnaire) and at 6 months for …


Systemic Emboli And Biventricular Hypertrophy Due To Glycogen Storage Disease: Clinical, Imaging, And Pathologic Predicament, Amirhossein Esmaeeli, Prashant Nagpal, Jefree J. Schulte, Sofia C. Masri, Peter S. Rahko Nov 2023

Systemic Emboli And Biventricular Hypertrophy Due To Glycogen Storage Disease: Clinical, Imaging, And Pathologic Predicament, Amirhossein Esmaeeli, Prashant Nagpal, Jefree J. Schulte, Sofia C. Masri, Peter S. Rahko

Division of Cardiology Faculty Papers

Glycogen storage disease cardiomyopathy is being recognized increasingly as a mimicker of hypertrophic cardiomyopathy. It is important to diagnose these diseases, as there are prognostic and treatment ramifications. This case report discusses a patient who presented with cardioembolic renal infarction and was ultimately diagnosed with glycogen storage disease XV (which is extremely rare). The diagnosis was made by pursuing multimodality imaging, endomyocardial biopsy, and genetic testing.


Utilization And Short-Term Outcomes Of Percutaneous Left Atrial Appendage Occlusion In Patients With Cancer, Yaqi Zhang, Zhuoran Yang, Muhammad Usman Almani, Raquel Soon-Shiong, Bolun Liu Nov 2023

Utilization And Short-Term Outcomes Of Percutaneous Left Atrial Appendage Occlusion In Patients With Cancer, Yaqi Zhang, Zhuoran Yang, Muhammad Usman Almani, Raquel Soon-Shiong, Bolun Liu

Einstein Health Papers

Background

Percutaneous left atrial appendage occlusion (LAAO) has been rapidly evolving since FDA’s approval in 2015 and has become more of a same-day-discharge procedure. Cancer patient with atrial fibrillation/flutter (AF) population can benefit from the procedure but the in-hospital outcomes and readmission data were rarely studied.

Objectives

We investigated the utilization, in-hospital and readmission outcomes in cancer patients with AF who underwent LAAO.

Methods

Data were derived from the National Inpatient Sample and National Readmissions Database from 2016 to 2019. Patients with primary diagnosis of AF admitted for LAAO (ICD-10 code 02L73DK) were grouped by cancer as a secondary diagnosis. …


Atrial Shunt Therapy For Heart Failure: An Update, William Gray Nov 2023

Atrial Shunt Therapy For Heart Failure: An Update, William Gray

Department of Medicine Faculty Papers

Transcatheter atrial shunt therapies, designed to dynamically lower left atrial (LA) pressure by shunting blood into the larger reservoir of the right atrium and central veins, have been developed as a novel treatment for heart failure (HF) over the past 10+ years. Several atrial shunt devices and procedures are currently in development with several pivotal randomized clinical trials (RCT) underway; however, only 2 sham-controlled RCT (both with the Atrial Shunt Device [Corvia Medical] in HF with EF ≥ 40%) have been reported thus far; a mechanistic RCT (n = 44) that demonstrated a reduction in exercise LA pressure at …


Breaking Down Barriers In Pursuit Of Thrombolytic Perfection, Yevgeniy Brailovsky, Waqas Ullah Nov 2023

Breaking Down Barriers In Pursuit Of Thrombolytic Perfection, Yevgeniy Brailovsky, Waqas Ullah

Division of Cardiology Faculty Papers

No abstract provided.


Noninvasive Point Of Care Device For Assessing Cardiac Response To Acute Volume Changes, Harry A. Silber, Nisha A. Gilotra, Thomas L. Miller Oct 2023

Noninvasive Point Of Care Device For Assessing Cardiac Response To Acute Volume Changes, Harry A. Silber, Nisha A. Gilotra, Thomas L. Miller

Department of Pediatrics Faculty Papers

Purpose: The change in the amplitude of a peripheral pulse in response to a Valsalva maneuver has diagnostic utility for assessing volume status at the bedside. We have developed a device to automatically quantify the Valsalva pulse response (VPR) to a standardized Valsalva maneuver that the device guides a user to perform. In this study, we sought to determine whether VPR by the device, Indicor, is sensitive enough to detect the acute increase in central pressure and volume load that occurs with a passive leg raise (PLR) in healthy volunteers.

Methods: Healthy volunteers were tested semirecumbently at 45 degrees, then …


Comorbidity Clusters And In-Hospital Outcomes In Patients Admitted With Acute Myocardial Infarction In The Usa: A National Population-Based Study, Salwa Zghebi, Martin Rutter, Louise Sun, Waqas Ullah, Muhammad Rashid, Darren Ashcroft, Douglas Steinke, Stephen Weng, Evangelos Kontopantelis, Mamas Mamas Oct 2023

Comorbidity Clusters And In-Hospital Outcomes In Patients Admitted With Acute Myocardial Infarction In The Usa: A National Population-Based Study, Salwa Zghebi, Martin Rutter, Louise Sun, Waqas Ullah, Muhammad Rashid, Darren Ashcroft, Douglas Steinke, Stephen Weng, Evangelos Kontopantelis, Mamas Mamas

Division of Cardiology Faculty Papers

BACKGROUND: The prevalence of multimorbidity in patients with acute myocardial infarction (AMI) is increasing. It is unclear whether comorbidities cluster into distinct phenogroups and whether are associated with clinical trajectories.

METHODS: Survey-weighted analysis of the United States Nationwide Inpatient Sample (NIS) for patients admitted with a primary diagnosis of AMI in 2018. In-hospital outcomes included mortality, stroke, bleeding, and coronary revascularisation. Latent class analysis of 21 chronic conditions was used to identify comorbidity classes. Multivariable logistic and linear regressions were fitted for associations between comorbidity classes and outcomes.

RESULTS: Among 416,655 AMI admissions included in the analysis, mean (±SD) age …


Lower Versus Higher Oxygen Targets For Out-Of-Hospital Cardiac Arrest: A Systematic Review And Meta-Analysis, Xin Cheng, Yu Zhang, Haidong Deng, Yuning Feng, Weelic Chong, Yang Hai, Pengfei Hao, Jialing He, Tiangui Li, Liyuan Peng, Peng Wang, Yangchun Xiao, Fang Fang Oct 2023

Lower Versus Higher Oxygen Targets For Out-Of-Hospital Cardiac Arrest: A Systematic Review And Meta-Analysis, Xin Cheng, Yu Zhang, Haidong Deng, Yuning Feng, Weelic Chong, Yang Hai, Pengfei Hao, Jialing He, Tiangui Li, Liyuan Peng, Peng Wang, Yangchun Xiao, Fang Fang

Student Papers, Posters & Projects

BACKGROUND: Supplemental oxygen is commonly administered to patients after out-of-hospital cardiac arrest. However, the findings from studies on oxygen targeting for out-of-hospital cardiac arrest are inconclusive. Thus, we conducted a systematic review and meta-analysis to evaluate the impact of lower oxygen target compared with higher oxygen target on patients after out-of-hospital cardiac arrest.

METHODS: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, from inception to February 6, 2023, for randomized controlled trials comparing lower and higher oxygen target in adults (aged ≥ 18 years) after out-of-hospital cardiac arrest. We screened studies and extracted data independently. The primary …


Interruption Of The Tricuspid Regurgitant Jet: A Possible Consequence Of Reflected Waves, Saad Ngoga, Nicole Schulick, J. Christopher Bouwmeester, Jiun-Jr Wang, Gregg S. Pressman Oct 2023

Interruption Of The Tricuspid Regurgitant Jet: A Possible Consequence Of Reflected Waves, Saad Ngoga, Nicole Schulick, J. Christopher Bouwmeester, Jiun-Jr Wang, Gregg S. Pressman

Einstein Health Papers

Reflected pressure waves can impact central aortic pressure, and can cause notching of the pulmonic valve Doppler signal. However, reflected waves in the venous system usually do not achieve a high enough velocity to alter Doppler flow patterns. Herein we report a case of systolic notching of the tricuspid regurgitant signal that likely resulted from reflected venous waves.


Outcomes And Discriminatory Accuracy Of The Cha2ds2vasc Score In Atrial Fibrillation And Cancer, Waqas Ullah, Mathew Dimeglio, Daniel Frisch, Rodrigo Bagur, Louise Sun, David Fischman, Andrija Matetic, Bonnie Ky, Mamas Mamas Oct 2023

Outcomes And Discriminatory Accuracy Of The Cha2ds2vasc Score In Atrial Fibrillation And Cancer, Waqas Ullah, Mathew Dimeglio, Daniel Frisch, Rodrigo Bagur, Louise Sun, David Fischman, Andrija Matetic, Bonnie Ky, Mamas Mamas

Division of Cardiology Faculty Papers

Background: Atrial fibrillation (AF) is highly prevalent among cancer patients. The role of traditional risk stratification scores in the context of different cancer types in these patients remains unknown. Objectives: The purpose of this study was to determine the discriminative accuracy of the CHA2DS2VASc score for ischemic stroke using receiver operating characteristic and area under the curve. Methods: The National Readmission Database (2015-2019) was used to identify all AF patients stratified by the cancer diagnosis, type, and CHA2DS2VASc category (low; moderate; high risk). Outcomes at 30-day readmission were compared between cancer and …


Heart Failure Readmissions After Cardiac Surgeries: Navigating The High-Risk Terrain, Waqas Ullah, Indranee Rajapreyar, Yevgeniy Brailovsky Oct 2023

Heart Failure Readmissions After Cardiac Surgeries: Navigating The High-Risk Terrain, Waqas Ullah, Indranee Rajapreyar, Yevgeniy Brailovsky

Division of Cardiology Faculty Papers

No abstract provided.


Pericardial Effusions And Cardiac Tamponade In Hospitalized Systemic Sclerosis Patients: Analysis Of The National Inpatient Sample, Bikash Basyal, Waqas Ullah, Chris T. Derk Sep 2023

Pericardial Effusions And Cardiac Tamponade In Hospitalized Systemic Sclerosis Patients: Analysis Of The National Inpatient Sample, Bikash Basyal, Waqas Ullah, Chris T. Derk

Abington Jefferson Health Papers

Introduction

Clinically significant pericardial effusions and cardiac tamponade in systemic sclerosis (SSc) patients is uncommon and the factors that contribute to progression of pericardial involvement in SSc patients have not been well established.

Methods

A review of the national inpatient sample database was performed looking SSc related hospitalizations between 2002 and 2019. Data was collected on patients with pericardial effusions and cardiac tamponade and analyzed to identify and describe patient characteristics and comorbidities.

Results

Out of a total of 523,410 SSc hospitalizations, with an overall inpatient mortality rate of 4.7% (24,764 patients), pericardial effusion was identified in 3.1% of all …


Camkii: A Link Between Metabolic Disorders And Cardiac Arrhythmias, Marilen Federico, C.A. Valverde, L.A. Gonano, J. Palomeque, A. Matiazzi Aug 2023

Camkii: A Link Between Metabolic Disorders And Cardiac Arrhythmias, Marilen Federico, C.A. Valverde, L.A. Gonano, J. Palomeque, A. Matiazzi

Center for Translational Medicine Faculty Papers

The prevalence of metabolic diseases -such as obesity, prediabetes, metabolic syndrome or diabetes-has increased globally over the years. These diseases, mainly diabetes mellitus (DM), are among the leading causes of mortality and morbidity worldwide, with increased risk of diabetic cardiomyopathy (DC), cardiac arrhythmias, and heart failure (HF). In metabolic diseases several steps and proteins involved in excitation-contraction coupling (ECC) are compromised, precluding an efficient and rhythmic cardiac contraction; moreover, calcium/calmodulin-dependent protein kinase II (CaMKII) a kinase involved in ECC, is upregulated in several metabolic maladies and significantly contributes to cardiac remodeling and arrhythmias, among which are calcium (Ca2+)-triggered arrhythmias. CaMKII …


The Value Of Right Heart Catheterization: Case Series Showing Benefits In A Variety Of Diagnoses, Max Ruge, David Fischman, Indranee Rajapreyar, Yevgeniy Brailovsky Aug 2023

The Value Of Right Heart Catheterization: Case Series Showing Benefits In A Variety Of Diagnoses, Max Ruge, David Fischman, Indranee Rajapreyar, Yevgeniy Brailovsky

Division of Cardiology Faculty Papers

Although the right heart catheterization (RHC) was first introduced in 1945, its use in the quantitative hemodynamic assessment of patients has remained of questionable benefit. With recent advances in pharmacotherapies and mechanical support devices, RHC has been increasingly used to assess and help tailor the management of more complex patient scenarios. We present a case series in which the use of the RHC was helpful in making complex medical decisions.


Protein-Energy Malnutrition Is Associated With Worse Outcomes In Patients With Atrial Fibrillation: A Nationwide Analysis, Favour Markson, Emmanuel Akuna, Iriagbonse Asemota, Gabriel Areoye, Anoz Shahi, Praise Nwachukwu, Kenneth Ong Aug 2023

Protein-Energy Malnutrition Is Associated With Worse Outcomes In Patients With Atrial Fibrillation: A Nationwide Analysis, Favour Markson, Emmanuel Akuna, Iriagbonse Asemota, Gabriel Areoye, Anoz Shahi, Praise Nwachukwu, Kenneth Ong

Einstein Health Papers

Protein–energy malnutrition (PEM), which leads to a reduced ability of tissues to regenerate and repair themselves, may exacerbate many chronic diseases, including atrial fibrillation (AF), which occurs as a response of the heart to chronic inflammation. However, population-based studies examining the association between PEM and the prevalence and health care burden of AF are lacking. The aim of this retrospective cohort study was to estimate the impact of PEM on the prevalence and clinical outcomes of hospitalization for AF. The National Inpatient Sample (NIS) 2016 and 2017 datasets were searched for data on hospitalized adult patients with AF as a …


Tav-In-Tav And Beyond: How Far Can We Go?, Taramasso Maurizio, Ana Paula Tagliari, David L. Fischman Aug 2023

Tav-In-Tav And Beyond: How Far Can We Go?, Taramasso Maurizio, Ana Paula Tagliari, David L. Fischman

Division of Cardiology Faculty Papers

No abstract provided.


Characteristics And Outcomes Of Patients Who Underwent Coronary Atherectomy In Centers With And Without On-Site Cardiac Surgery, Mohamed Dafaalla, Muhammad Rashid, Saadiq Moledina, Tim Kinnaird, Peter Ludman, Nick Curzen, Sarah Zaman, James Nolan, Mamas A. Mamas Aug 2023

Characteristics And Outcomes Of Patients Who Underwent Coronary Atherectomy In Centers With And Without On-Site Cardiac Surgery, Mohamed Dafaalla, Muhammad Rashid, Saadiq Moledina, Tim Kinnaird, Peter Ludman, Nick Curzen, Sarah Zaman, James Nolan, Mamas A. Mamas

Department of Medicine Faculty Papers

We aimed to describe the clinical characteristics and outcomes of patients who underwent atherectomy at the time of percutaneous coronary intervention in centers with on-site surgical centers (SCs) versus nonsurgical centers (NSCs). Patients treated with coronary atherectomy between January 1, 2006, to December 31, 2019, from the British Cardiovascular Society Intervention (BCIS) registry were included. Primary outcomes were in-hospital all-cause mortality and major adverse cardiovascular and cerebrovascular events. A total of 20,833 patients were treated with coronary atherectomy, of which 7,983 (38%) were performed at NSC. The proportion of coronary atherectomies performed in NSC increased from 12.5% in 2006 to …


Major Cardiovascular Events After Covid-19, Event Rates Post-Vaccination, Antiviral Or Anti-Inflammatory Therapy, And Temporal Trends: Rationale And Methodology Of The Corona-Vte-Network Study, Behnood Bikdeli, Candrika D Khairani, Darsiya Krishnathasan, Antoine Bejjani, Andre Armero, Anthony Tristani, Julia Davies, Nicole Porio, Ali A Assi, Victor Nauffal, Umberto Campia, Zaid Almarzooq, Eric Wei, Aditya Achanta, Sirus J Jesudasen, Bruce C Tiu, Geno J. Merli, Orly Leiva, John Fanikos, Aditya Sharma, Alec Vishnevsky, Judith Hsia, Mark R Nehler, James Welker, Marc P Bonaca, Brett J Carroll, Zhou Lan, Samuel Z Goldhaber, Gregory Piazza Aug 2023

Major Cardiovascular Events After Covid-19, Event Rates Post-Vaccination, Antiviral Or Anti-Inflammatory Therapy, And Temporal Trends: Rationale And Methodology Of The Corona-Vte-Network Study, Behnood Bikdeli, Candrika D Khairani, Darsiya Krishnathasan, Antoine Bejjani, Andre Armero, Anthony Tristani, Julia Davies, Nicole Porio, Ali A Assi, Victor Nauffal, Umberto Campia, Zaid Almarzooq, Eric Wei, Aditya Achanta, Sirus J Jesudasen, Bruce C Tiu, Geno J. Merli, Orly Leiva, John Fanikos, Aditya Sharma, Alec Vishnevsky, Judith Hsia, Mark R Nehler, James Welker, Marc P Bonaca, Brett J Carroll, Zhou Lan, Samuel Z Goldhaber, Gregory Piazza

Division of Cardiology Faculty Papers

BACKGROUND: Coronavirus disease 2019 (COVID-19) is associated with excess risk of cardiovascular and thrombotic events in the early post-infection period and during convalescence. Despite the progress in our understanding of cardiovascular complications, uncertainty persists with respect to more recent event rates, temporal trends, association between vaccination status and outcomes, and findings within vulnerable subgroups such as older adults (aged 65 years or older), or those undergoing hemodialysis. Sex-informed findings, including results among pregnant and breastfeeding women, as well as adjusted comparisons between male and female adults are similarly understudied.

METHODS: Adult patients, aged ≥18 years, with polymerase chain reaction-confirmed COVID-19 …