Cardiology Commons^™

Sphingosine-1-Phosphate-Mediated Mobilization Of Hematopoietic Stem/Progenitor Cells During Intravascular Hemolysis Requires Attenuation Of Sdf-1-Cxcr4 Retention Signaling In Bone Marrow, Kasia Mierzejewska, Yuri M. Klyachkin, Janina Ratajczak, Ahmed Abdel-Latif, Magda Kucia, Mariusz Z. Ratajczak

Saha Cardiovascular Research Center Faculty Publications

Sphingosine-1-phosphate (S1P) is a crucial chemotactic factor in peripheral blood (PB) involved in the mobilization process and egress of hematopoietic stem/progenitor cells (HSPCs) from bone marrow (BM). Since S1P is present at high levels in erythrocytes, one might assume that, by increasing the plasma S1P level, the hemolysis of red blood cells would induce mobilization of HSPCs. To test this assumption, we induced hemolysis in mice by employing phenylhydrazine (PHZ). We observed that doubling the S1P level in PB from damaged erythrocytes induced only a marginally increased level of mobilization. However, if mice were exposed to PHZ together with the …

Sevoflurane Induces Cardioprotection Through Reactive Oxygen Species-Mediated Upregulation Of Autophagy In Isolated Guinea Pig Hearts., Mayumi Shiomi, Masami Miyamae, Genzou Takemura, Kazuhiro Kaneda, Yoshitaka Inamura, Anna Onishi, Shizuka Koshinuma, Yoshihiro Momota, Toshiaki Minami, Vincent M. Figueredo

Division of Cardiology Faculty Papers

PURPOSE: Sevoflurane increases reactive oxygen species (ROS), which mediate cardioprotection against myocardial ischemia-reperfusion injury. Emerging evidence suggests that autophagy is involved in cardioprotection. We examined whether reactive oxygen species mediate sevoflurane preconditioning through autophagy.

METHODS: Isolated guinea pigs hearts were subjected to 30 min ischemia followed by 120 min reperfusion (control). Anesthetic preconditioning was elicited with 2 % sevoflurane for 10 min before ischemia (SEVO). The ROS-scavenger, N-(2-mercaptopropionyl) glycine (MPG, 1 mmol/l), was administered starting 30 min before ischemia to sevoflurane-treated (SEVO + MPG) or non-sevoflurane-treated (MPG) hearts. Infarct size was determined by triphenyltetrazolium chloride stain. Tissue samples were obtained …

Invited Commentary On: Orthotopic Heart Transplantation In Patients With Metabolic Risk Factors, Nicholas Cavarocchi, Paul Mather

Nicholas C Cavarocchi MDJ

This is invited commentary to the following article: Kilic, A., Conte, J. V., Shah, A. S., & Yuh, D. D. (2012). Orthotopic heart transplantation in patients with metabolic risk factors. Annals of Thoracic Surgery, 93(3), 718-724.

Ecmo-State Of The Art, Nicholas Cavarorocchi, Md

Nicholas C Cavarocchi MDJ

Dr. Cavarocchi is an Associate Professor of Surgery who holds a faculty appointment in the Department of Surgery at Thomas Jefferson University Hospital in Philadelphia, PA. He is also the Director of Cardiac Critical Care and Surgical Care Unit at Jefferson. In 2007, he was names as one of the countries top surgeons. He specializes in cardiothoracic surgery.

Presentation runs for 1 hour and 2 minutes.

Peripartum Cardiomyopathy: Ten Year Experience At A Tertiary Care Hospital In Pakistan., Abid Laghari, Aamir Hameed, K. Kazmi

Department of Medicine

Background: There is very little literature regarding peripartum cardiomyopathy from the Asian countries. We conducted this study to determine demographic details, clinical presentations, complications and recovery of left ventricular (LV) systolic function in peripartum cardiomyopathy (PPCMP) patients of Pakistani origin.

Method: A ten year retrospective case series of PPCMP was conducted at the Aga Khan University Hospital. Patients were also followed up for six months after presentation, with special regard to improvement in the LV function.

Results: Total 45 patients were included, 25 (55.5%) primigravida and 8 (17.7%) gravida 2 and the remaining 12 (26.6%) were multigravida. Fourteen patients (31.1%) …

Clinically Significant Contrast Induced Acute Kidney Injury After Non-Emergent Cardiac Catheterization--Risk Factors And Impact On Length Of Hospital Stay., Waqar Kashif, Ali Khawaja, Syed Ather Hussain

Department of Medicine

Objective: To evaluate the frequency and risk factors associated with clinically significant contrast-induced nephropathy(CIN) in patients undergoing non-emergent coronary angiography.

Study Design: Descriptive study.

Place and Duration of Study: The Aga Khan University Hospital, Karachi, from January 2005 to December 2007.

Methodology: Case records of patients who underwent coronary angiography with a serum creatinine of ≥ 1.5 mg/dl atthe time of procedure were evaluated. Clinically significant contrast induced nephropathy (CSCIN) was defined as either doubling of serum creatinine from baseline value within a week following the procedure or need for emergency hemodialysis after the procedure.Results: One hundred …

Single Nucleotide Polymorphisms Linked To Essential Hypertension In Kasigau, Kenya, Julia Carol Freeman

Masters Theses & Specialist Projects

Hypertension, or high blood pressure (BP), is an ever-growing epidemic in the developing world. Understanding the genetics behind essential hypertension (EH), or hypertension with no known cause, is especially important. In this study, three single nucleotide polymorphisms (SNPs) known to be linked to an increase in susceptibility to EH were quantified from a cohort of Kenyans living in the Kasigau region. The SNPs are located in three genes that are part of the renin angiotensin system, the primary regulatory pathway in humans controlling BP. They include: AGT (rs699), AGTR1 (rs5186), and HSD11β2 (rs5479). Overall, by using a fluorescent-based RT-PCR technique, …

Anthracycline-Induced Cardiotoxicity: Prospective Cohort Study From Pakistan, Abdul Sattar Shaikh, Ali Faisal Saleem, Shazia Samad Mohsin, Muhammad Matloob Alam, Mehnaz Atiq Ahmed

Department of Paediatrics and Child Health

Objectives: To identify anthracycline-induced acute (within 1 month) and early-onset chronic progressive (within 1 year) cardiotoxicity in children younger than 16 years of age with childhood malignancies at a tertiary care centre of Pakistan.

Design: Prospective cohort study.

Setting: Aga Khan University, Karachi, Pakistan.

Participants: 110 children (aged 1 month–16 years).

Intervention: Anthracycline (doxorubicin and/or daunorubicin).

Outcome measurements: All children who received anthracycline as chemotherapy and three echocardiographic evaluations (baseline, 1 month and 1 year) between July 2010 and June 2012 were prospectively analysed for cardiac dysfunction. Statistical analysis including systolic and diastolic functions at baseline, 1 month and 1 …

Amlodipine Reduces Angii-Induced Aortic Aneurysms And Atherosclerosis In Hypercholesterolemic Mice, Xiaofeng Chen, Debra L. Rateri, Deborah A. Howatt, Anju Balakrishnan, Jessica J. Moorleghen, Andrew J. Morris, Richard Charnigo, Lisa A. Cassis, Alan Daugherty

Saha Cardiovascular Research Center Faculty Publications

BACKGROUND: The purpose of this study was to determine effects of amlodipine, a dihydropyridine calcium channel blocker, on development of angiotensin II (AngII)-induced vascular pathologies.

METHODS AND RESULTS: Male LDL receptor -/- mice were infused with vehicle, amlodipine (5 mg/kg/d), AngII (1,000 ng/kg/min), or AngII + amlodipine for 4 weeks through osmotic pumps (n=10/group). Mice were fed a saturated fat-enriched diet for 1 week prior to pump implantation and during 4 weeks of infusion. Infusion of amlodipine resulted in plasma concentrations of 32 ± 2 ng/ml and 27 ± 2 ng/ml for mice in saline + amlodipine and AngII + …

Multicenter Study Comparing Shunt Type In The Norwood Procedure For Single-Ventricle Lesions: Three-Dimensional Echocardiographic Analysis., Gerald R. Marx, Girish S. Shirali, Jami C. Levine, Lin T. Guey, James F. Cnota, Jeanne M. Baffa, William L. Border, Steve Colan, Gregory Ensing, Mark K. Friedberg, David J. Goldberg, Salim F. Idriss, J Blaine John, Wyman W. Lai, Minmin Lu, Shaji C. Menon, Richard G. Ohye, David Saudek, Pierre C. Wong, Gail D. Pearson, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The Pediatric Heart Network's Single Ventricle Reconstruction (SVR) trial randomized infants with single right ventricles (RVs) undergoing a Norwood procedure to a modified Blalock-Taussig or RV-to-pulmonary artery shunt. This report compares RV parameters in the 2 groups using 3-dimensional echocardiography.

METHODS AND RESULTS: Three-dimensional echocardiography studies were obtained at 10 of 15 SVR centers. Of the 549 subjects, 314 underwent 3-dimensional echocardiography studies at 1 to 4 time points (pre-Norwood, post-Norwood, pre-stage II, and 14 months) for a total of 757 3-dimensional echocardiography studies. Of these, 565 (75%) were acceptable for analysis. RV volume, mass, mass:volume ratio, ejection fraction, …

Predictors Of Disease Progression In Pediatric Dilated Cardiomyopathy., Kimberly M. Molina, Peter Shrader, Steven D. Colan, Seema Mital, Renee Margossian, Lynn A. Sleeper, Girish S. Shirali, Piers Barker, Charles E. Canter, Karen Altmann, Elizabeth Radojewski, Elif Seda Selamet Tierney, Jack Rychik, Lloyd Y. Tani, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

Background: Despite medical advances, children with dilated cardiomyopathy (DCM) remain at high risk of death or need for cardiac transplantation. We sought to identify predictors of disease progression in pediatric DCM.

Methods and results: The Pediatric Heart Network evaluated chronic DCM patients with prospective echocardiographic and clinical data collection during an 18-month follow-up. Inclusion criteria were age <22 years and DCM disease duration >2 months. Patients requiring intravenous inotropic/mechanical support or listed status 1A/1B for transplant were excluded. Disease progression was defined as an increase in transplant listing status, hospitalization for heart failure, intravenous inotropes, mechanical support, or death. Predictors of disease progression were identified using …

New Oral Anticoagulants Are Not Superior To Warfarin In Secondary Prevention Of Stroke Or Transient Ischemic Attacks, But Lower The Risk Of Intracranial Bleeding: Insights From A Meta-Analysis And Indirect Treatment Comparisons, Partha Sardar, Saurav Chatterjee, Wen-Chih Wu, Edgar Lichstein, Joydeep Ghosh, Shamik Aikat, Debabrata Mukherjee

Internal Medicine Faculty Publications

PURPOSE: Patients with Atrial Fibrillation (AF) and prior stroke are classified as high risk in all risk stratification schemes. A systematic review and meta-analysis was performed to compare the efficacy and safety of New Oral Anticoagulants (NOACs) to warfarin in patients with AF and previous stroke or transient ischemic attack (TIA).

METHODS: Three randomized controlled trials (RCTs), including total 14527 patients, comparing NOACs (apixaban, dabigatran and rivaroxaban) with warfarin were included in the analysis. Primary efficacy endpoint was ischemic stroke, and primary safety endpoint was intracranial bleeding. Random-effects models were used to pool efficacy and safety data across RCTs. RevMan …

One Year Outcomes Of A Pre-Hospital Myocardial Infarction Alert 3 Process, Gerald Coleman Do, Andrew C. Miller Do, David Richardson Md, David A. Cox Md, Nainesh Patel Md, J Patrick Kleaveland Md, Bruce Feldman Do, Ron Freudenberger Md, Richard S. Mackenzie Md

Ronald S Freudenberger MD

No abstract provided.

St-Segment Elevation (Stemi) Real Time Data Feedback –A Process Of Care Initiative, Orlando E. Rivera Rn, Nainesh Patel Md, Bruce Feldman Do, Mercedes Rios-Scott Bs, David M. Richardson Md, J Patrick Kleaveland Md, David A. Cox Md, Ronald S. Freudenberger Md

Ronald S Freudenberger MD

No abstract provided.

Pre-Operative Angiotensin Converting Enzyme Inhibitors And Angiotensin Receptor Blockers On The Occurrence Of Post Operative Atrial Fibrillation After Cardiac Valve Department Of Surgery, Nasir Shariff, Matthew W. Martinez Md, Ravi V. Desai Md, Michael J. Weiss, Vadim Levin Md, Larry E. Jacobs Md, Martin E. Matsumura Md, Ronald S. Freudenberger Md

Ronald S Freudenberger MD

No abstract provided.

Impact Of Pre-Hospital Myocardial Infarction Alert Process Education On Door To Balloon Times At Sites Within A Regional Heart Center, Gerald Coleman Do, Andrew C. Miller Do, David Richardson Md, David Cox Md, Nainesh C. Patel Md, J Patrick Kleaveland Md, Bruce Feldman Do, Ron Freudenberger Md, Richard S. Mackenzie Md

Ronald S Freudenberger MD

No abstract provided.

Comparison Of Chronic Persistent And Post-Operative Atrial Fibrillation On Long Term Survival In Patients Undergoing Cardiac Valve Surgery, Nasir Shariff, Ravi V. Desai Md, Sherrine Eid, Michael J. Weiss, Matthew W. Martinez, Sultan M. Siddique, Ronald S. Freudenberger Md

Ronald S Freudenberger MD

No abstract provided.

Aldosterone Antagonism With Eplerenone Does Not Adversely Affect Plasma Glucose Levels In Patients With Diabetes Mellitus: Findings From A Post Hoc Analysis Of The Ephesus Trial, Prakash Deedwania Md, Bertram Pitt, Ravi V. Desai Md, Marjan Mujib Md, Mph, Inmaculada B. Aban Phd, J Vincent, E Turgonyi, Ali Ahmed Md, Mph

Ravi V Desai MD

No abstract provided.

Relationship Between Plasma Glucose And Mortality In Non-Diabetic Patients With Acute Coronary Syndrome And Systolic Heart Failure: Insights From The Ephesus Trial, Prakash Deedwania Md, Ravi V. Desai Md, Marjan Mujib Md, Mph, Bertram Pitt, Ali Ahmed Md, Mph

Ravi V Desai MD

No abstract provided.

Treatment Of Acute Aortic Dissection At A Community Hospital: A 10 Year Review Of Outcomes., Timothy Misselbeck Md, Stephen Deturk, Matthew Wilson, Theodore Phillips Md, Michael Szwerc Md, Sanjay Mehta Md, Gary Szydlowski Md, Raymond Singer Md, James Wu Md

James K. Wu, M.D.

No abstract provided.

Critical Assessment Of Outcomes In Acute Aortic Dissection (Type A) At A Community Hospital: A 10 Year Review, Tim S. Misselbeck Md, James K. Wu Md, Stephen Deturk Ba, Michael F. Szwerc Md, Sanjay M. Mehta Md, Theodore G. Phillips Md, Gary W. Szydlowski Md, Raymond L. Singer Md

James K. Wu, M.D.

No abstract provided.

Conventional Isolated Aortic Valve Replacement In Octogenarians: A 10-Year Single Center Experience, James K. Wu Md, Justin D. Roberts Do, Gregory S. Troutman Bs, Michael J. Weiss Mph, Sanjay M. Mehta Md, Theodore G. Phillips Md, Michael F. Szwerc Md, Gary W. Szydlowski Md, Tim S. Misselbeck Md, Raymond L. Singer Md

James K. Wu, M.D.

No abstract provided.

De-Branching Of The Aortic Arch During Thoracic Endovascular Aortic Repair, James K. Wu Md, Caitlin O'Connor Bs, Tim S. Misselbeck Md, Theodore G. Phillips Md

James K. Wu, M.D.

No abstract provided.

Critical Assessment Of Outcomes In Acute Aortic Dissection (Type A) At A Community Hospital: A 10 Year Review, Tim S. Misselbeck Md, James K. Wu Md, Stephen Deturk Ba, Michael F. Szwerc Md, Sanjay M. Mehta Md, Theodore G. Phillips Md, Gary W. Szydlowski Md, Raymond L. Singer Md

James K Wu MD

No abstract provided.

Anomalous Right Coronary Artery Arising From The Pulmonary Artery, Ashish Kabra, James Wu, Matthew Martinez

James K Wu MD

No abstract provided.

Fabry's Disease With Lvot Obstruction: Diagnosis And Management, Jacob Blount, James Wu, Matthew Martinez

James K Wu MD

A 46-year-old male was diagnosed with hypertrophic cardiomyopathy (HCM) and severe left ventricular outflow tract (LVOT) obstruction. Genetic testing revealed that this was a "mimic of HCM" and the true diagnosis was Fabry's disease, although there were no other clinical features of Fabry's. Despite maximal medical therapy he remained symptomatic from the outflow tract gradient and required surgical myectomy for symptom relief. This case illustrates the diagnosis of an HCM mimic by genetic testing.

Risk Factors Affecting Surgical Outcomes In Patients Undergoing Hypothermic Circulatory Arrest During Aortic Surgeries: A 10-Year Study, Bree Ann Young, James K. Wu, Martin E. Matsumura Md, Sanjay M. Mehta Md, Theodore G. Phillips Md, Michael F. Szwerc Md, Gary W. Szydlowski Md, Raymond L. Singer Md

James K. Wu, M.D.

No abstract provided.

Treatment Of Acute Aortic Dissection At A Community Hospital: A 10 Year Review Of Outcomes., Timothy Misselbeck Md, Stephen Deturk, Matthew Wilson, Theodore Phillips Md, Michael Szwerc Md, Sanjay Mehta Md, Gary Szydlowski Md, Raymond Singer Md, James Wu Md

James K Wu MD

No abstract provided.

Outcome Of Traumatic Aortic Rupture: A 14-Year Experience, Matthew Wilson, James K. Wu, Sanjay M. Mehta Md, Theodore G. Phillips Md, Raymond L. Singer Md, Michael F. Szwerc Md, Gary W. Szydlowski Md

James K. Wu, M.D.

No abstract provided.

Risk Factors Affecting Outcomes In Patients Undergoing Hypothermic Circulatory Arrest During Aortic Surgeries, Bree Ann Young, James K. Wu Md, Martin E. Matsumura Md, Tim S. Misselbeck Md, Sanjay M. Mehta Md, Theodore G. Phillips Md, Michael F. Szwerc Md, Gary W. Szydlowski Md, Raymond L. Singer Md

James K. Wu, M.D.

No abstract provided.