Cardiology Commons^™

Use Of Impella Devices For Acute Cardiogenic Shock In The Perioperative Period Of Cardiac Surgery, Serge Sicouri, Vishal N Shah, Meghan Buckley, Nicholas Imperato, Jacqueline Mcgee, Elena Casanova, Eric Gnall, Konstadinos A Plestis

Division of Cardiology Faculty Papers

Introduction: The Impella ventricular support system is a device that can be inserted percutaneously or directly across the aortic valve to unload the left ventricle. The purpose of this study is to determine the role of Impella devices in patients with acute cardiogenic shock in the perioperative period of cardiac surgery.

Methods: A retrospective single-surgeon review of 11 consecutive patients who underwent placement of Impella devices in the perioperative period of cardiac surgery was performed. Patient records were evaluated for demographics, indications for placement, and postoperative outcomes.

Results: Impella devices were placed for refractory cardiogenic shock preoperatively in 6 patients, …

Trapped Heart With Overlying Chest Wall Deformity And Sternal Defect, Muniraju Maralakunte, Arun Sharma, Neelam Dahiya, Manphool Singhal

Journal of the Saudi Heart Association

No abstract provided.

The Rsph4a Gene In Primary Ciliary Dyskinesia, Ron Nates, Mattan Arazi, Liza Grosman-Rimon, Roy Israel, Jacob Gohari, Leonid Sternik, Erez Kachel

Faculty, Staff and Student Publications

INTRODUCTION: There is no consensus as to which patients should undergo Non-Contrast Chest Computerized Tomography (NCCCT) and carotid arteries Doppler (CD) prior to cardiac surgery. The objective of this study was to examine whether preoperative imaging modalities provide clinical benefits and a change in surgical strategy.

METHODS: We routinely performed NCCCT and CD in all non-urgent cardiac surgery patients. Major NCCCT/CD findings related to cardiovascular findings (aortic calcification/atherosclerosis, carotid artery plaque/stenosis), or other incidental findings (lung kidney, thyroid, adrenal, gastrointestinal sites etc.) were documented. The results were divided into 3 categories: (A) findings requiring both changes in surgical strategy and …

Sirpα Mediates Igf1 Receptor In Cardiomyopathy-Induced By Chronic Kidney Disease, Sandhya S Thomas, Jiao Wu, Giovanni Davogustto, Michael W Holliday, Kristin Eckel-Mahan, Daniela Verzola, Giacomo Garibotto, Zhaoyong Hu, William E Mitch, Heinrich Taegtmeyer

Faculty, Staff and Student Publications

BACKGROUND: Chronic kidney disease (CKD) is characterized by increased myocardial mass despite near-normal blood pressure, suggesting the presence of a separate trigger. A potential driver is SIRPα (signal regulatory protein alpha)-a mediator impairing insulin signaling. The objective of this study is to assess the role of circulating SIRPα in CKD-induced adverse cardiac remodeling.

METHODS: SIRPα expression was evaluated in mouse models and patients with CKD. Specifically, mutant, muscle-specific, or cardiac muscle-specific SIRPα KO (knockout) mice were examined after subtotal nephrectomy. Cardiac function was assessed by echocardiography. Metabolic responses were confirmed in cultured muscle cells or cardiomyocytes.

RESULTS: We demonstrate that …

Association Of U.S. Birth, Duration Of Residence In The U.S., And Atherosclerotic Cardiovascular Disease Risk Factors Among Asian Adults, Mahmoud Al Rifai, Sina Kianoush, Vardhmaan Jain, Parag H. Joshi, Miguel Cainzos-Achirica, Khurram Nasir, Anwar T. Merchant, Sunita Dodani, Zainab Samad, Salim S. Virani

Section of Cardiology

Introduction: Prior studies have shown a direct association between U.S. birth and duration of residence with atherosclerotic cardiovascular disease (ASCVD) though, few have specifically focused on Asian Americans.
Methods: We utilized cross-sectional data from the 2006 to 2015 National Health Interview Survey. We compared prevalent cardiovascular risk factors and ASCVD among Asian American individuals by U.S. birth and duration of time spent in the U.S.
Results: The study sample consisted of 18,150 Asian individuals of whom 20.5 % were Asian Indian, 20.5 % were Chinese, 23.4 % were Filipino, and 35.6 % were of other Asian ethnic groups. The mean …

Tuberculous Pericarditis, Chun Kit Wong, Yeuk Chi Choi

Journal of the Hong Kong College of Cardiology

Tuberculous (TB) pericarditis, a severe extrapulmonary manifestation of Mycobacterium tuberculosis, is notorious for its challenging presentation. We report a case of effusive-constrictive pericarditis due to tuberculosis infection.

Right Atrial Mass With Inflow Obstruction In A Patient With Igg4-Related Disease, Shek Joyce, Wu Lok Yi, Wong Chun Kit, Lu Jianlin, Lam Wai Lung William, Mak Wai Man Vivien, Chan Ngai Yin

Journal of the Hong Kong College of Cardiology

Cardiac tumour is a rare cause of heart failure. We report a case of right atrial mass found in a patient with known immunoglobulinG4-related disease (IgG4-RD), who presented with right heart failure, renal impairment and thrombocytopenia. Multimodal investigations were performed to reach the diagnosis of diffuse large B-cell lymphoma with cardiac involvement. Chemotherapy was initiated in an attempt for disease control. We highlight the potential link between IgG4-related disease and lymphoma.

Cardiac Involvement Related To Covid-19 Infection And Vaccination In Children And Adolescents – Hong Kong’S Perspective, Sabrina Tsao, Gilbert T. Chua, Mike Yw Kwan, Ian Chi Kei Wong, Kelvin Kai Wang To, Janette Kwok, Bill H Chan, Joshua Sung Chih Wong, Patrick Ip, Yu Lung Lau

Journal of the Hong Kong College of Cardiology

Myocarditis and Pericarditis have many virological and immunological causes. This article described the SARS-CoV involvement to the heart in children and adolescents, also the entity Multisystem Inflammatory Syndrome in Children (MIS-C), a rare but severe consequence of SARS-CoV2 infection. Hong Kong case definition of MIS-C was listed. The consensus from overseas experts was that MIS-C should be managed by multidisciplinary team with a structured long-term follow-up to monitor the functioning of various organs and ascertain the prognosis. The side effect mRNA vaccination causing myocarditis and pericarditis is also concern of paediatricians worldwide. Hong Kong published local epidemiology of acute myocarditis …

The Utility Of Has-Bled Score In Predicting The Bleeding Risk Of Atrial Fibrillation Patients Undergoing Percutaneous Coronary Intervention Receiving Anticoagulation And Dual Anti-Platelet Therapy: A Single Center Retrospective Cohort Study, Luk Yin Cheung Adrian, Chan Chi Lin Jaclyn

Journal of the Hong Kong College of Cardiology

Background The Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly and Drugs/alcohol (HAS-BLED) score is a validated bleeding risk prediction tool in patients with atrial fibrillation taking oral anticoagulation. Its predictive value in patients with atrial fibrillation undergoing percutaneous coronary intervention receiving combination of anticoagulation and antiplatelet therapy is unknown. This retrospective cohort study sought to validate the accuracy of HAS-BLED score in predicting the bleeding risk in patients with atrial fibrillation who underwent percutaneous coronary intervention receiving both anticoagulation and dual antiplatelet therapy. Method We calculated HAS-BLED score in 186 patients with AF …

Prognostic Nutritional Index As A Predictor Of Prognosis In Patients With Chronic Limb Threatening Ischemia Who Underwent Endovascular Revascularization Therapy, Wai Kin Chi, Gm Tan, Bryan Py Yan

Journal of the Hong Kong College of Cardiology

BACKGROUND/INTRODUCTION: Patients with chronic limb-threatening ischemia (CLTI) have poor prognosis. Prognostic nutritional index (PNI) is an established independent predictor of adverse outcome in various chronic illnesses. The use of PNI in patients with CLTI has not been studied.

PURPOSE: To evaluate the impact of PNI on 12-month adverse cardiovascular and limb outcomes in CLTI patients after endovascular revascularization therapy (ERT).

METHODS: 270 consecutive patients with CLTI (mean age 73.7±11.9 years; 53% male) who underwent ERT at a single tertiary referral hospital between January 2009 and October 2016 were prospectively enrolled and analyzed. Patients were grouped by tertiles of PNI (lowest …

Usefulness Of Computed Tomography Parameters In Predicting The Clinical Outcomes Of Acute Aortic Dissection, Eleanor Wei Sze Lee, Kwok Hin Yiu, Willis Chun Wai Lam, Cyrus Yiu Kwan Ko, Sung Yee Wong, Kin Wing Chan

Journal of the Hong Kong College of Cardiology

Background

Acute aortic dissection is a potentially life-threatening condition among patients presenting with chest pain to emergency department. Without a prompt diagnosis and treatment, it carries high mortality and morbidity. Computed tomography (CT) of thorax and abdomen is one of the commonly used non-invasive investigation modalities for diagnosis of acute aortic dissection. Apart from making a diagnosis, there are a number of parameters in the CT images that may be helpful in providing prognostic information. In this study, prognostic values of these parameters in predicting both short term and intermediate term clinical outcomes of acute aortic dissection will be evaluated. …

Effect Of Low Body Mass Index In Outcome Of Micra Leadless Pacemaker Implantation, Mark Tsz Kin Tam, Anna Kin Yin Chan, Alex Chi Kin Au, Lily Cheung, Gary Chin Pang Chan, Joseph Yat Sun Chan

Journal of the Hong Kong College of Cardiology

Background

Implantation of Micra transcatheter pacing system (TPS) requires introduction of a large caliber delivery catheter into patient’s venous system and right heart. While the investigational device exemption study population had a mean body mass index (BMI) of 27.6kg/m2, implantation outcome in patients with small body size requires further investigation. This study sort to evaluate the effect of low BMI in outcome of Micra TPS implantation Method

Consecutive patients undergoing Micra TPS implantation between 19 September 2015 and 24 May 2018 in a single tertiary referral center were studied. Procedure efficacy outcome was defined as successful implantation with threshold being …

The Risk Is Small: Implant Complications Of Leadless Pacemakers Are Related To Body Size, Chu-Pak Lau

Journal of the Hong Kong College of Cardiology

No abstract provided.

Cardiac Metastasis After Curative Treatment Of Hepatocellular Carcinoma: Risk Factors, Treatment Options, And Prognosis, Gaurav Jain, Mathew Otto, Mubeen Khan Mohammed Abdul, Manpreet Chadha, Ajay Sahajpal

Journal of Patient-Centered Research and Reviews

Hepatocellular carcinoma (HCC) is primary hepatic malignancy with a high incidence of recurrence. The risk of recurrence directly correlates to patient’s overall prognosis. Management of advanced HCC involves a combination of surgical resection, locoregional therapy, and systemic treatment. Distant metastases are rare, and intraventricular cardiac metastases are even more infrequent. This brief review details an illustrative case of cardiac metastasis after curative treatment of primary HCC and then summarizes the literature on risk factors, treatment options, and patient prognosis in the setting of distant metastases from HCC. Prognosis of metastasis to the heart is generally poor, and available evidence emphasizes …

Is Home Blood Pressure Monitoring Effective At Controlling Hypertension In African American Patients? A Clin-Iq, Rebecca Nye, Wilhelm Lehmann, Deborah Simpson

Journal of Patient-Centered Research and Reviews

African Americans are disproportionately affected by hypertension, a modifiable contributor to multiple chronic diseases and premature death. Primary care physicians play an important role in hypertension control. Home blood pressure monitoring (HBPM) is an evidence-based method for confirming diagnosis and monitoring hypertension over time. Some studies have found that HBPM may lead to clinically relevant reductions in blood pressure when combined with additional interventions, but few studies have focused specifically on African American populations. Evidence of effectiveness could increase clinical recommendation of HBPM. This clinical inquiry examined whether HBPM improves blood pressure control in African Americans with uncontrolled hypertension. Reviewed …

Echocardiographic Predictors Of Symptomatic Cardiotoxicity Among Patients Undergoing Chemotherapy: A Systematic Review And Meta-Analysis, Muhammad Umer Siddiqui, Youssef Yaacoub, Heidi-Anne Hanson, Joey Junarta, Ahmed K Pasha, Mahek Shah

Division of Internal Medicine Faculty Papers & Presentations

BACKGROUND: Chemotherapeutic agents have been associated with cardiotoxicity; thus, they require close monitoring. Several echocardiographic variables have been investigated as early predictors of symptomatic cardiotoxicity in patients undergoing chemotherapy.

OBJECTIVE: To identify if global longitudinal strain (GLS) is a better predictor of symptomatic cardiotoxicity compared to left ventricular ejection fraction (LVEF) in patients receiving chemotherapy.

METHODS: MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials were searched from inception through December 2020. Adults who developed symptomatic cardiotoxicity (New York Heart Association [NYHA] Class III-IV heart failure, cardiac arrest, or cardiac death) after undergoing chemotherapy with pre- and postchemotherapy echocardiographic measures …

Describing Characteristics Of Adults With And Without Congenital Heart Defects Hospitalized With Covid-19, Perla Diaz, Will Coughlin, Wilson Lam, Peter Ermis, David Aguilar, Cecilia M Ganduglia Cazaban, A J Agopian

Faculty, Staff and Student Publications

BACKGROUND: We sought to describe patient characteristics in adults with and without congenital heart defects (CHDs) during hospitalization for COVID-19.

METHODS: We analyzed data collected by Optum®, a nationally representative database of electronic medical records, for 369 adults with CHDs and 41,578 without CHDs hospitalized for COVID-19 between January 1, 2020, and December 10, 2020. We used Poisson regression to describe and compare epidemiologic characteristics, heart-related conditions, and severe outcomes between these two groups.

RESULTS: The distributions of many epidemiologic characteristics were similar between the two groups, but patients with CHDs were significantly more likely to be current or former …

Editorial: Physiologic Signals In Neonatal Intensive Care, Eric W Reynolds

Faculty, Staff and Student Publications

No abstract provided.

Concomitant Myocardial And Coronary Injury In Systemic Lupus Erythematosus, Amal Elouarradi, Ilham Bensahi, Marwa Ghayate, Fatimazahra Merzouk, Mohamed Sabry

Journal of the Saudi Heart Association

No abstract provided.

Association Of Cardiovascular Health Through Young Adulthood With Genome-Wide Dna Methylation Patterns In Midlife: The Cardia Study, Yinan Zheng, Brian T Joyce, Shih-Jen Hwang, Jiantao Ma, Lei Liu, Norrina B Allen, Amy E Krefman, Jun Wang, Tao Gao, Drew R Nannini, Haixiang Zhang, David R Jacobs, Myron D Gross, Myriam Fornage, Cora E Lewis, Pamela J Schreiner, Stephen Sidney, Dongquan Chen, Philip Greenland, Daniel Levy, Lifang Hou, Donald M Lloyd-Jones

Faculty, Staff and Student Publications

Background: Cardiovascular health (CVH) from young adulthood is strongly associated with an individual's future risk of cardiovascular disease (CVD) and total mortality. Defining epigenomic biomarkers of lifelong CVH exposure and understanding their roles in CVD development may help develop preventive and therapeutic strategies for CVD.

Methods: In 1085 CARDIA study (Coronary Artery Risk Development in Young Adults) participants, we defined a clinical cumulative CVH score that combines body mass index, blood pressure, total cholesterol, and fasting glucose measured longitudinally from young adulthood through middle age over 20 years (mean age, 25-45). Blood DNA methylation at >840 000 methylation markers was …

Pulsatility Is A Predictive Marker Of Improved Cardiac Function In Patients With Liquid Matrix-Treated Left Ventricular Assist Devices, Philemon Mikail, Rinku Skaria, Marvin Slepian, Janny Garcia, Richard Smith, Zain Khalpey

The VAD Journal

Objective: Left ventricular assist devices (LVADs) are utilized as a bridge to transplant or as destination therapy for patients with end-stage heart failure. Although cardiac offloading from these devices rarely leads to complete remodeling and functional recovery, the use of mesenchymal cells to modulate heart failure has been explored in recent years due to its intrinsic regenerative properties. Current methods of evaluating cardiac function have too much variability, difficulty of access, or require too frequent follow up to create universal weaning protocols. We hypothesized that the administration of amniotic allograft liquid matrix (LM) containing amnion-derived mesenchymal stem cells (aMSCs) in …

Case Report On Peri-Operative Surgical And Anaesthetic Management Of Ruptured Humongous Lung Abscess, Khalid Maudood Siddiqui, Akbar Azizullah, Muhammad Saad Yousuf

Department of Anaesthesia

Introduction: Early thoracic empyema is usually treated through video-assisted thoracoscopic (VATS) decortication. Patient selection is important for decortication if an effective surgical outcome is required. Lung isolation techniques are required to provide anesthesia for these patients to facilitate the surgeon while operating on the affected lung. The ultimate target is to protect the non-diseased contra-lateral lung from contamination.
Presentation of case: We are presenting a unique case of 20-year-old female, resident of Karachi, who was brought to the emergency room (ER) with signs of sepsis, hypotension, and multi-organ failure. She was brought to the operating room to undergo video-assisted thoracoscopy …

No Mental Illness Impact On Post-Aortic Valve Replacement Patients’ New-Onset Atrial Fibrillation, Natalie Kolba, Julia Dokko, Samantha Novotny, Sohaib Agha, Ashutosh Yaligar, Puja Parikh, Aurora Pryor, Henry Tannous, Laurie Shroyer, Thomas Bilfinger

Department of Surgery Faculty Publications

No abstract provided.

Role Of Myocardial Strain Imaging By Echocardiography For The Early Detection Of Anthracyclines-Induced Cardiotoxicity, Reham Selmy Rasheed, Hatem El Sokkary, Mahmoud Zaki El Amrosy, Mohammed El Setiha, Mai Mohammed Abd El Moneim Salama

Journal of the Saudi Heart Association

Objective: To investigate the role of myocardial strain imaging by echocardiogram for detecting anthracycline-induced cardiotoxicity early. Methods: Fifty patients had transthoracic echocardiogram and/or cardiological consultation before, during, and after taking anthracyclines. GE Vivid E9 Ultrasound System was used for echocardiographic examination and myocardial strain imaging. All patients were assessed three times: on the first visit; before starting anthracycline medication, on the second visit; three months later and on the third visit; six months later. Results: Cardiotoxicity occurred in 4 patients at the end of the research. There was a statistically significant association between percentage change in left ventricular global longitudinal …

Assessment Of Value Of Three Dimensional Transesophageal Echocardiography Versus Conventional Two Dimensional Transesophageal Echocardiography In Guiding Transcatheter Closure Of Atrial Septal Defects And Patent Foramen Ovale, Eman H. El Doklah, Sahar A. Elshedoudy, Ayman M. El Saied, Hanan K. Kassem, Magdy M. El Masry

Journal of the Saudi Heart Association

Objective: To evaluate the benefit of using three-dimensional transesophageal echocardiography (3DTEE) over conventional two-dimensional transesophageal echocardiography (2DTEE) in evaluation of various morphological features of atrial septal defect (ASD) and patent foramen ovale (PFO) during transcatheter closure. Methods: This is an observational cross sectional study including 115 patients (45 PFO and 70 ASD patients) who underwent 2D/3DTEE guided transcatheter closure from April 2019 to October 2021 in cardiology department, Tanta university hospital. Results: 70 ASD patients were divided into two groups; the pediatric age group (18 patients, mean age 9.05± 3.51 years) and the adult group (52 patients, mean age 39.3±10.15 …

Utility Of Av Nodal Characteristics In Identification Of Atrioventricular Nodal Reentrant Tachycardia And Risk Of Recurrence, Kimberly M. Decarr

Longitudinal Scholar's Project

Background: Catheter ablation of the slow atrioventricular (AV) nodal pathway is a safe and effective treatment for atrioventricular nodal reentrant tachycardia (AVNRT). While AVNRT occurs frequently in both children and adults, pediatric patients experience higher rates of AVNRT recurrence.

Objective: The purpose of this study was to characterize changes in AV nodal conduction properties following catheter ablation and correlate these properties with AVNRT recurrence in pediatric patients.

Methods: This was a retrospective review of patients aged(AVRT) at a single tertiary care center between January 01, 2010 and September 01, 2021. Demographics, pre- and post-ablation ECG intervals, and AV nodal conduction …

Global Think Tank On The Clinical Considerations And Management Of Lipoprotein(A): The Top Questions And Answers Regarding What Clinicians Need To Know, Salim S. Virani, Marlys L. Koschinsky, Lisa Maher, Anurag Mehta, Carl E. Orringer, Raul D. Santos, Michael D. Shapiro, Joseph J. Saseen

Office of the Provost

Evidence from Mendelian randomization studies suggest that lipoprotein(a) (Lp(a)) has a causal role in the development of atherosclerotic cardiovascular disease risk. However, guidelines and consensus statement recommendations vary regarding how clinicians should incorporate Lp(a) into patient care. To provide practical answers to key questions pertaining to Lp(a) that clinicians will find useful when assessing and treating patients, a global think tank was convened. Representatives from seven national and international stakeholder organizations answered questions that were focused on: Lp(a) measurement; ethnic, gender, and age considerations; factoring Lp(a) into risk assessment; and current and emerging treatment options for elevated Lp(a). This manuscript …

Heart Transplant Recipient 1-Year Outcomes During The Covid-19 Pandemic, Gabriel Esmailian, Nikhil Patel, Jignesh K Patel, Lawrence Czer, Matthew Rafiei, Dominick Megna, Dominic Emerson, Danny Ramzy, Alfredo Trento, Joanna Chikwe, Fardad Esmailian, Jon A Kobashigawa

Faculty, Staff and Student Publications

The COVID-19 pandemic initially brought forth considerable challenges to the field of heart transplantation. To prevent the spread of the virus and protect immunocompromised recipients, our center made the following modifications to post-transplant outpatient management: eliminating early coronary angiograms, video visits for postoperative months 7, 9, and 11, and home blood draws for immunosuppression adjustments. To assess if these changes have impacted patient outcomes, the current study examines 1-year outcomes for patients transplanted during the pandemic. Between March and September 2020, we assessed 50 heart transplant patients transplanted during the pandemic. These patients were compared to patients who were transplanted …

The Curious Case Of An Isolated Right Coronary Artery Aneurysm Complicated By Thrombosis And Distal Embolization, Hussam Al Hennawi, Mohammad F. Mathbout, Katrina Bidwell, Christopher D. Nielsen

Abington Jefferson Health Papers

No abstract provided.

The Undesirable Communication: A Case Of Cerebral Air Emboli In The Setting Of Atrio-Esophageal Fistula Following Atrial Fibrillation Catheter Ablation, Momin Islam, Hussam Al Hennawi, Anwar Khedr, Khaled Harmouch, Mohammad F. Mathbout

Abington Jefferson Health Papers

Atrial-esophageal fistula is an extremely rare condition but is often a deleterious complication following catheter ablation for atrial fibrillation. The associated iatrogenic communication acts as a conduit for air and bacterial translocation, which may lead to cerebral air embolism and polymicrobial sepsis, respectively. Coupled with a history of invasive procedures, the diagnosis is largely based on the accompanying neurological symptoms. In this report, we present the case of a 73-year-old female who presented with neurological deficits attributed to cerebral vascular emboli three weeks after catheter ablation for the treatment of chronic atrial fibrillation.