Cardiology Commons^™

The 2023 Society For Vascular Surgery, American Venous Forum, And American Vein And Lymphatic Society Clinical Practice Guidelines For The Management Of Varicose Veins Of The Lower Extremities. Part Ii: Endorsed By The Society Of Interventional Radiology And The Society For Vascular Medicine., Peter Gloviczki, Peter F Lawrence, Suman M Wasan, Mark H Meissner, Jose Almeida, Kellie R Brown, Ruth L Bush, Michael Di Iorio, John Fish, Eri Fukaya, Monika L Gloviczki, Anil Hingorani, Arjun Jayaraj, Raghu Kolluri, M Hassan Murad, Andrea T Obi, Kathleen J Ozsvath, Michael J Singh, Satish Vayuvegula, Harold J Welch

Heart and Vascular Articles

The Society for Vascular Surgery, the American Venous Forum, and the American Vein and Lymphatic Society recently published Part I of the 2022 clinical practice guidelines on varicose veins. Recommendations were based on the latest scientific evidence researched following an independent systematic review and meta-analysis of five critical issues affecting the management of patients with lower extremity varicose veins, using the patients, interventions, comparators, and outcome system to answer critical questions. Part I discussed the role of duplex ultrasound scanning in the evaluation of varicose veins and treatment of superficial truncal reflux. Part II focuses on evidence supporting the prevention …

Rare Genomic Copy Number Variants Implicate New Candidate Genes For Bicuspid Aortic Valve, Steven G Carlisle, Hasan Albasha, Hector I Michelena, Anna Sabate-Rotes, Lisa Bianco, Julie De Backer, Laura Muiño Mosquera, Anji T Yetman, Malenka M Bissell, Maria Grazia Andreassi, Ilenia Foffa, Dawn S Hui, Anthony Caffarelli, Yuli Y Kim, Dongchuan Guo, Rodolfo Citro, Margot De Marco, Justin T Tretter, Kim L Mcbride, Dianna M Milewicz, Simon C Body, Siddharth K Prakash, Ebav Investigators, Bavcon Investigators

Faculty, Staff and Student Publications

Bicuspid aortic valve (BAV), the most common congenital heart defect, is a major cause of aortic valve disease requiring valve interventions and thoracic aortic aneurysms predisposing to acute aortic dissections. The spectrum of BAV ranges from early onset valve and aortic complications (EBAV) to sporadic late onset disease. Rare genomic copy number variants (CNVs) have previously been implicated in the development of BAV and thoracic aortic aneurysms. We determined the frequency and gene content of rare CNVs in EBAV probands (n = 272) using genome-wide SNP microarray analysis and three complementary CNV detection algorithms (cnvPartition, PennCNV, and QuantiSNP). Unselected control …

Suppression Of Il-1Β Promotes Beneficial Accumulation Of Fibroblast-Like Cells In Atherosclerotic Plaques In Clonal Hematopoiesis, Trevor P Fidler, Andrew Dunbar, Eunyoung Kim, Brian Hardaway, Jessica Pauli, Chenyi Xue, Sandra Abramowicz, Tong Xiao, Kavi O'Connor, Nadja Sachs, Nan Wang, Lars Maegdefessel, Ross Levine, Muredach Reilly, Alan R Tall

Faculty, Staff and Student Publications

Clonal hematopoiesis (CH) is an independent risk factor for atherosclerotic cardiovascular disease. Murine models of CH suggest a central role of inflammasomes and IL-1β in accelerated atherosclerosis and plaque destabilization. Here we show using single-cell RNA sequencing in human carotid plaques that inflammasome components are enriched in macrophages, while the receptor for IL-1β is enriched in fibroblasts and smooth muscle cells (SMCs). To address the role of inflammatory crosstalk in features of plaque destabilization, we conducted SMC fate mapping in Ldlr-/- mice modeling Jak2VF or Tet2 CH treated with IL-1β antibodies. Unexpectedly, this treatment minimally affected SMC differentiation, …

Mediation By Fatalism Of The Association Between Symptom Burden And Self-Care Management In Patients With Heart Failure, Ashmita Thapa, Misook L. Chung, Jia-Rong Wu, Abigail Latimer, Terry A. Lennie, Gia Mudd-Martin, Chin-Yen Lin, Jessica Harman Thompson, Junghee Kang, Debra K. Moser

UK CARES Faculty Publications

Background: Clinicians and researchers often assume that symptom burden is associated with self-care management (SCM) in patients with heart failure (HF). However, that association is often not borne out in simple regression analyses and may be because another variable mediates the association. Fatalism is an appropriate candidate for mediation and is the belief that circumstances are predetermined without opportunity for control by individuals.

Objective: Our objective was to determine whether fatalism mediated the relationship of symptom burden with SCM among adults with HF.

Methods: We conducted a secondary analysis (N = 95) from a clinical trial. We used Self-care of …

Mediators Of The Association Between Cognitive Function And Self-Care Behaviors In Patients Hospitalized With An Exacerbation Of Heart Failure, Jia-Rong Wu, Chin-Yen Lin, Abigail Latimer, Muna Hassan Hammash, Debra K. Moser

UK CARES Faculty Publications

Background: Patients with heart failure (HF) must engage in self-care, yet their self-care is often poor. Cognitive function commonly is impaired in HF and is associated with poor self-care. Heart failure knowledge and self-care confidence also are needed to preform self-care. Few investigators have examined mediators of the association of cognitive function with self-care.

Objectives: The aim of this study was to determine whether HF knowledge and self-care confidence mediated the association of cognitive function with self-care maintenance and management among patients with HF.

Methods: This was a cross-sectional observational study of 164 patients with HF. Cognitive function was assessed …

Impact Of Covid Status And Blood Group On Complications In Patients In Hemorrhagic Shock, Jason Bradley Brill, Krislynn M Mueck, Madeline E Cotton, Brian Tang, Mariela Sandoval, Lillian S Kao, Bryan A Cotton

Faculty, Staff and Student Publications

OBJECTIVE: Among critically injured patients of various blood groups, we sought to compare survival and complication rates between COVID-19-positive and COVID-19-negative cohorts.

BACKGROUND: SARS-CoV-2 infections have been shown to cause endothelial injury and dysfunctional coagulation. We hypothesized that, among patients with trauma in hemorrhagic shock, COVID-19-positive status would be associated with increased mortality and inpatient complications. As a secondary hypothesis, we suspected group O patients with COVID-19 would experience fewer complications than non-group O patients with COVID-19.

METHODS: We evaluated all trauma patients admitted 4/2020-7/2020. Patients 16 years or older were included if they presented in hemorrhagic shock and received …

Navigating P2y12 Inhibition In The Labyrinth Of Cardio-Oncology Care: Cangrelor Bridging In Patients With Cancer, Abdelrahman Ali, Poonam Jewani, Max Bourdillon, Efstratios Koutroumpakis, Shaden Khalaf, Konstantinos Charitakis, Kara Thompson, Konstantinos Marmagkiolis, Anita Deswal, Cezar Iliescu

Faculty, Staff and Student Publications

Cangrelor, a potent intravenous P2Y12 platelet inhibitor, has demonstrated effectiveness in reducing ischemic events without a corresponding increase in severe bleeding during percutaneous coronary intervention, as evidenced by the CHAMPION-PHOENIX trial. Its off-label role as a bridging antiplatelet agent for patients facing high thrombotic risks who must temporarily stop oral P2Y12 inhibitor therapy further underscores its clinical utility. This is the first case series to shed light on the application of cangrelor in cancer patients needing to pause dual antiplatelet therapy for a range of medical interventions, marking it as a pioneering effort in this domain. The inclusion of patients …

The 2018 World Cancer Research Fund (Wcrf)/American Institute For Cancer Research (Aicr) Score And Diabetes Risk In The Diabetes Prevention Program Outcomes Study (Dppos), Danny Ramzy, Nicholas Ray

Faculty, Staff and Student Publications

No abstract provided.

A Frequent Diagnostic Pitfall: Dermatological Clinical Features And Pathological Results In Diagnosing Pagetoid Squamous Cell Carcinoma In Situ (Case Series), Sheng-Kai Wang, Jia-Wei Cai, Yu Zhang, Ya-Jing Lin, Yi-Hui Yang

Faculty, Staff and Student Publications

Squamous cell carcinoma (SCC) in situ can occur on any skin or mucus surface and is more commonly found in elderly patients on areas of skin that have been sunburnt. Most previous case reports are from dermatologists, with few published reports from pathologists. In this study, three patients underwent pathological routine and auxiliary immunohistochemical (IHC) examination and were ultimately diagnosed with pagetoid SCC in situ - a different diagnosis from the initial clinical assessment. All three patients received a complete resection of the skin mass. After follow-up, as of June 2023, the patients had no tumour recurrence or metastasis. Pagetoid …

Risk Stratification And Prediction Of Severity Of Covid-19 Infection In Patients With Preexisting Cardiovascular Disease, Stanislava Matejin, Igor D Gregoric, Rajko Radovancevic, Slobodan Paessler, Vladimir Perovic

Faculty, Staff and Student Publications

Introduction: Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 is a highly contagious viral disease. Cardiovascular diseases and heart failure elevate the risk of mechanical ventilation and fatal outcomes among COVID-19 patients, while COVID-19 itself increases the likelihood of adverse cardiovascular outcomes.

Methods: We collected blood samples and clinical data from hospitalized cardiovascular patients with and without proven COVID-19 infection in the time period before the vaccine became available. Statistical correlation analysis and machine learning were used to evaluate and identify individual parameters that could predict the risk of needing mechanical ventilation and patient survival.

Results: Our results confirmed that COVID-19 …

Differentiating Origins Of Outflow Tract Ventricular Arrhythmias: The Correction Of Transitional Zone Index Is Not Superior To The Original One, Ming Liu, Zhuoqiao He, Pengxiang Ying, Dong Lin, Min Yu, Xuerui Tan

Research outputs 2022 to 2026

Introduction: Our team once proposed a correction of transitional zone index (CTZI) based on the transitional zone index (TZI) in view of achieving a more precise prediction of outflow tract ventricular arrhythmia (OTVA). The predictive accuracy of these two electrocardiogram (ECG) algorithms has not been validated and compared. The purpose of this study was to compare the predictive accuracy of TZI and CTZI in a much larger population with idiopathic OTVA. Methods: The predictive accuracy of TZI and CTZI was compared in 695 individuals with idiopathic premature ventricular complex or ventricular tachycardia which exhibited a left bundle branch block pattern …

Coronary Artery Bypass Grafting In A Patient With Multivessel Disease And Dextrocardia With Situs Inversus Totalis, Rohit Shahani, Adham Ahmed, Frank M Rosell, Alexander Iribarne

The Texas Heart Institute Journal

Dextrocardia with situs inversus totalis is a rare hereditary condition characterized by reversed orientation of the major thoracic and abdominal organs. Though dextrocardia itself is not believed to increase the risk of coronary artery disease, the workup and surgical management of patients with this condition may be technically challenging to heart team clinicians. This report describes the case management of a high-risk 56-year-old man with dextrocardia who presented with multivessel coronary artery disease.

Does Serum Uric Acid To Creatinine Ratio Predict Mortality Risk In Patients With Heart Failure, Xiaoqing Xi, Jinfeng Cai, Chen Zhang, Xuefei Wang

The Texas Heart Institute Journal

BACKGROUND: Previous studies have established a positive correlation between serum uric acid to creatinine (SUA/Cr) ratio and cardiovascular disease, but the relationship between SUA/Cr ratio and the prognosis of heart failure (HF) remains unknown. This study investigated the potential of SUA/Cr ratio as a prognostic predictor for patients with HF.

METHODS: This single-center prospective cohort study enrolled 2,122 patients with HF between March 2013 and June 2017. All patients were divided into 3 groups according to SUA/Cr ratio tertiles and were followed up with until December 31, 2022. The association between SUA/Cr ratio and the prognosis of HF was assessed …

Use Of Extracorporeal Membrane Oxygenation-Facilitated Large-Bore Catheter Embolectomy In The Treatment Of Acute Pulmonary Embolism Complicated By Shock, Hugh A Glazier, Amir Kaki

The Texas Heart Institute Journal

This article reports the case of a 42-year-old man who presented with a saddle pulmonary embolus complicated by normotensive cardiogenic shock. The patient was first stabilized with venoarterial extracorporeal membrane oxygenation. Then, while the patient was still on extracorporeal membrane oxygenation, thrombectomy with a large-bore catheter device was performed that resulted in a large decrease in pulmonary artery pressures and a clinically significant increase in cardiac index, with rapid clinical improvement. Complete recovery of the patient's cardiopulmonary status has been maintained at intermediate-term follow-up. This treatment strategy should be considered favorably in the treatment of patients presenting with pulmonary embolism …

Positive Airway Pressure And Mask Factors Affective Adherence In Patients With Obstructive Sleep Apnea, Rutvi Sheth, Michel Audette, Soham Sheth

Electrical & Computer Engineering Faculty Publications

Purpose: Sleep apnea is a major risk factor for cardiovascular disorders. CPAP (Continuous Positive Airway Pressure) therapy is the main treatment for sleep apnea. However, adherence with CPAP remains a concern. Although there are various factors attributed to failure of CPAP therapy, mask related factors are not well studied.

Methods: The study recruited patients with obstructive sleep apnea using CPAP from neurology outpatient clinic at Progressive Neurology and Sleep Center. An IRB (Institutional Review Board) approved questionnaire was administered to evaluate factors affecting CPAP compliance.

Results: The study recruited 24 patients. It showed that almost 50% of the patients did …

Comparison Of Primary Percutaneous Coronary Intervention (Ppci) Vs. Pharmacoinvasive Strategy As Reperfusion Strategies In Patients With St-Elevation Myocardial Infarction (Stemi), Siu Wai For

Journal of the Hong Kong College of Cardiology

Background – Guidelines recommended primary percutaneous coronary intervention (PPCI) as the preferred reperfusion strategy in the treatment of patients with ST-elevation myocardial infarction (STEMI). However, PPCI might not be readily available in the real-world situations due to the limitation of resources. A pharmacoinvasive strategy consisting of early thrombolytic therapy followed by PCI was suggested as an alternative reperfusion approach. Prior studies had shown that clinical outcomes of pharmacoinvasive strategy were comparable to PPCI. The purpose of this retrospective study was to assess the outcomes of reperfusion strategies in patients with STEMI in the North Territories East of Hong Kong, comparing …

Traumatic Tricuspid Regurgitation And Right Coronary Artery Dissection, Kan Chung Yan Joyce, Wong Chun Kit Martin

Journal of the Hong Kong College of Cardiology

Traumatic tricuspid valve regurgitation and coronary artery dissection are rare complications of blunt chest trauma. We report a case of acute severe traumatic tricuspid valve regurgitation and right coronary artery dissection in a young male patient with unremarkable medical history after a road traffic accident.

Atorvastatin In Preventing Anthracycline-Induced Cardiotoxicity In Low-Risk Breast Cancer Patients: A Randomized Controlled Trial (Atopact-Low), Chonthicha Tanking, Chanwit Wuttichaipradit, Chayanee Samdaengpan, Jomtana Siripaibun, Siriwan Manahwan,R.N, Bundhitwong Trikesornnopamas, Phakawan Budchala, Viroj Muangsillapasart

Journal of the Hong Kong College of Cardiology

Background: According to the current guideline, statins should be provided to prevent anthracycline cardiotoxicity in high-risk cancer patients. This study aims to investigate the role of atorvastatin in preventing anthracycline-induced cardiac dysfunction among low-risk breast cancer patients. Methods: In this randomized, double-blinded, placebo-controlled trial, newly diagnosed breast cancer patients with low risk of cancer therapy-related cardiac dysfunction (CTRCD) were assigned to receive atorvastatin 40 mg or placebo. Echocardiography was performed before, at 3 and 6 months after the anthracycline treatment to determine changes in LVEF as a primary outcome. The secondary outcome included changes in global longitudinal strain (GLS), LV …

Effects Of Bioprosthetic Valve Fracturing On Valve-In-Valve Transcatheter Aortic Valve Implantation Transvalvular Gradients, Osama Hallak, Karley Fischer, Shaina Ailawadi, Damian Valencia, Yan Yatsynovich, Raja Nazir, Brian Schwartz

The Texas Heart Institute Journal

BACKGROUND: Valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) is quickly becoming a routine and effective means by which to treat degenerated bioprosthetic valves. A known complication of ViV-TAVI is patient-prosthesis mismatch, which substantially affects survival. Bioprosthetic valve fracture is a method by which to reduce the risk of patient-prosthesis mismatch and post-ViV-TAVI transvalvular gradients. This study sought to determine the safety and efficacy of post-ViV-TAVI bioprosthetic valve fracture.

METHODS: Patients with a history of surgical aortic valve replacement undergoing ViV-TAVI bioprosthetic valve fracture (N = 25) at the corresponding institution from 2015 to 2022 were cataloged for a retrospective analysis. …

Stroke Survivors’ Telemedicine Experiences During The Covid-19 Pandemic: A Phenomenological Investigation, Barbara Kimmel, Annette Walder, Anette Ovalle, Chethan P Venkatasubba Rao, Sean I Savitz, Mark Goldberg, Steven Warach, Salvador Cruz-Flores, Daiwai M Olson, Jane A Anderson

Faculty, Staff and Student Publications

PURPOSE: This study aimed to describe stroke survivors' experiences receiving telemedicine visits at the Lone Star Stroke Consortium during the COVID-19 pandemic.

MATERIALS AND METHODS: A qualitative descriptive phenomenological design was applied to gather patients' telemedicine experiences through in-depth interviews, using a study guide. Audio-recorded interviews were conducted via ZOOM and transcribed verbatim. Two independent reviewers used the Giorgi descriptive method to analyze the data and search for the essence of stroke survivors' follow-up telemedicine experiences during the COVID-19 pandemic.

RESULTS: Fifteen underserved patients were recruited: mean age, 51.8 (15.7), and 9 (60%) females. Three themes emerged: (1) vivid memory …

Mitral Valve Regurgitation In Klippel-Feil Syndrome With Related Thoracic Deformity, Yuki Endo, Yoshiei Shimamura, Hiroshi Niinami

The Texas Heart Institute Journal

Klippel-Feil syndrome, characterized by congenital fusion of any 2 or more cervical vertebrae, is a rare disorder in which skeletal and other organ system-related abnormalities have been reported. This article reports a case of mitral valve regurgitation in a patient with Klippel-Feil syndrome and related thoracic deformity who underwent mitral valvuloplasty. Postoperatively, the mitral valve regurgitation disappeared, and there has been no recurrence for 3 years. This case highlights mitral valvuloplasty via median sternotomy as an excellent treatment for mitral valve regurgitation in a patient with thoracic deformity related to Klippel-Feil syndrome.