Cardiology Commons^™

Incident Aortic Stenosis In 49 449 Men And 42 229 Women Investigated With Routine Echocardiography, Simon Stewart, Yih-Kai Chan, David Playford, Geoffrey Strange

Medical Papers and Journal Articles

Objective

We addressed the paucity of data describing the characteristics and consequences of incident aortic stenosis (AS).

Methods

Adults undergoing echocardiography with a native aortic valve (AV) and no AS were studied. Subsequent age-specific and sex-specific incidence of AS were derived from echocardiograms conducted a median of 2.8 years apart. Progressive AV dysfunction and individually linked mortality were examined per AS category.

Results

49 449 men (53.9%, 60.9±15.8 years) and 42 229 women (61.6±16.9 years) with no initial evidence of AS were identified. Subsequently, 6293 (6.9%) developed AS—comprising 5170 (5.6%), 636 (0.7%), 339 (0.4%) and 148 (0.2%) cases of mild, …

Preoperative Atrial Fibrillation/Flutter Impact On Risk-Adjusted Repeat Aortic Intervention Patients[Protocol], Samantha Novotny, Julia Dokko, Xiaoyue Zhang, Sohaib Agha, Ashutosh Yaligar, Natalie Kolba, Vineet Tummala, Puja Parikh, Aurora Pryor, Henry Tannous, A. Laurie Shroyer, Thomas Bilfinger

Department of Surgery Faculty Publications

No abstract provided.

Predictors And Risk-Adjusted Outcomes Of New-Onset Postoperative Atrial Fibrillation In Surgical And Transcatheter Aortic Valve Replacement [Post-Af Ravr Protcol], Julia Dokko, Samantha Novotny, Xiaoyue Zhang, Sohaib Agha, Ashutosh Yaligar, Natalie Kolba, Vineet Tummala, Puja Parikh, Aurora Pryor, Henry Tannous, A. Laurie Shroyer, Thomas Bilfinger

Department of Surgery Faculty Publications

No abstract provided.

Covid-19 Presenting With Spontaneous Pneumothorax, Intisar Ahmed, Hunaina Shahab, Muhammad Arslan Ahmed, Muhammad Sohaib

Section of Cardiology

The coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease mainly affects respiratory system. Its common clinical findings include fever, cough and shortness of breath. Characteristic radiological features of the disease include peripherally distributed, bilateral ground-glass opacities, predominantly involving the lower lung zones. In this report, we present a case of COVID-19 disease presenting with spontaneous pneumothorax. A 26-year male patient was admitted to the Emergency Department with fever, dry cough, shortness of breath and right-sided chest pain. Radiographic imaging of the patient revealed pneumothorax on the right and peripherally distributed non-homogenous opacification. …

Pericardial Fluid Proteomic Label-Free Quantification Of Differentially Expressed Proteins In Ischemic Heart Disease Patients With Systolic Dysfunction By Nano-Lc-Esi-Ms/Ms Analysis, Junaid Ullah, Satwat Hashmi, Arslan Ali, Faisal Khan, Shahid Ahmed Sami, Nageeb Basir, Syedah Saira Bokhari, Hasanat Sharif, Hesham R. El-Seedi, Syed Ghulam Musharraf

Department of Biological & Biomedical Sciences

Left ventricular systolic dysfunction (LVSD) is common in patients with pre-existing ischemic heart disease (IHD) and myocardial infarction. An untargeted proteomic approach is used to improve the understanding of the molecular mechanisms associated with LVSD and to find out potential proteomic signatures in pericardial fluid. The pericardial fluid of IHD (n = 45) patients was grouped into two categories according to the left ventricular ejection fraction, LVEF ≥45 (n = 33) and LVEF <45 (n = 12), and analyzed by using nano-liquid chromatography–mass spectrometry (nano-LC-MS/MS) technique. The nano-LC-MS/MS analysis resulted in the identification of 709 pericardial fluid (PF) proteins …

Cardiac Resynchronization Therapy In Continuous Flow Left Ventricular Assist Device Recipients: A Systematic Review And Meta-Analysis From Electram Investigators, Kuldeep Shah, Vallabh Karpe, Mohit Turagam, Mahek Shah, Andrea Natale, Rakesh Gopinathannair, Dhanunjaya Lakkireddy, Jalaj Garg

Division of Cardiology Faculty Papers

Introduction: Whether cardiac resynchronization therapy (CRT) continues to augment left ventricular remodeling in patients with the continuous-flow left ventricular assist device (cf-LVAD) remains unclear. Methods: We performed a systematic review and meta-analysis of all clinical studies examining the role of continued CRT in end-stage heart failure patients with cf-LVAD reporting all-cause mortality, ventricular arrhythmias, and ICD shocks. Mantel-Haenszel risk ratio (RR) random-effects model was used to summarize data. Results: Eight studies (7 retrospective and 1 randomized) with a total of 1,208 unique patients met inclusion criteria. There was no difference in all-cause mortality (RR 1.08, 95% CI 0.86-1.35, p = …

In Silico Investigation Of Cardiac Arrhythmia Susceptibility In Long Qt Phenotype, Anthony Owusu-Mensah, Victoria Lam, Bright Tsevi, Michel Audette, Makarand Deo

Electrical & Computer Engineering Faculty Publications

Long QT Syndrome (LQTS) is associated with cardiac arrhythmia and sudden cardiac death. The Long QT Type 2 (LQT2) phenotype, which accounts for 35–40 % of all LQTS patients, is caused by mutations in HERG gene. The mechanisms of arrhythmia in presence of LQT2 conditions are not fully understood. We utilized anatomically and electrophysiologically realistic numerical simulations to elucidate the mechanisms of arrhythmia initiation in presence of blockade in rapid component of delayed rectifier potassium current, I_Kr. We utilized a 3D finite element model of rabbit ventricles integrated with His-purkinje network to simulate whole heart response to LQT2 …

Single-Dose Del Nido Cardioplegia Compared With Standard Cardioplegia During Coronary Artery Bypass Grafting At A Veterans Affairs Hospital, Michael R Reidy, Ernesto Jimenez, Shuab Omer, Lorraine D Cornwell, Sabrina X Runbeck, Ourania Preventza, Gabriel Loor, Todd K Rosengart, Joseph S Coselli

The Texas Heart Institute Journal

Del Nido cardioplegic solution (DNC), used chiefly in pediatric patients, rapidly induces prolonged cardiac arrest during cardiac surgery. To determine whether surgical outcomes after coronary artery bypass grafting in a United States military veteran population differed when DNC was used instead of our standard Plegisol cardioplegia, we retrospectively reviewed 155 consecutive operations performed from July 2016 through June 2017. Del Nido cardioplegia was used to induce cardiac arrest in 70 patients, and Plegisol in 85. Compared with the Plegisol group, the DNC group had a shorter mean cardiopulmonary bypass time (96.8 vs 117 min; P48 hours, atrial fibrillation, tracheostomy, reintubation, …

Cardio-Pulmonary Sequelae In Recovered Covid-19 Patients: Considerations For Primary Care, Zouina Sarfraz, Azza Sarfraz, Alanna Barrios, Radhika Garimella, Asimina Dominari, Manish Kc, Krunal Pandav, Juan C. Pantoja, Varadha Retnakumar, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Background: Current literature lacks characterization of the post-recovery sequelae among COVID-19 patients. This review characterizes the course of clinical, laboratory, radiological findings during the primary infection period, and the complications post-recovery. Primary care findings are presented for long-COVID care.
Methods: Adhering to PRISMA guidelines, 4 databases were searched (PubMed, Embase, CINAHL Plus, Scopus) through December 5, 2020, using the keywords "COVID-19 and/or recovered and/or cardiovascular and/or long-term and/or sequelae and/or sub-acute and/or complication." We included published peer-reviewed case reports, case series, and cross-sectional studies providing the clinical course of COVID-19 infection, and cardiopulmonary complications of patients who recovered from COVID-19, …

Chromosome Xq23 Is Associated With Lower Atherogenic Lipid Concentrations And Favorable Cardiometabolic Indices, Pradeep Natarajan, Akhil Pampana, Sarah E. Graham, Sanni Ruotsalainen, Paul S. De Vries, Jai G. Broome, Juan M. Peralta, John Blangero, Joanne E. Curran, James P. Pirruccello

School of Medicine Publications

Autosomal genetic analyses of blood lipids have yielded key insights for coronary heart disease (CHD). However, X chromosome genetic variation is understudied for blood lipids in large sample sizes. We now analyze genetic and blood lipid data in a high-coverage whole X chromosome sequencing study of 65,322 multi-ancestry participants and perform replication among 456,893 European participants. Common alleles on chromosome Xq23 are strongly associated with reduced total cholesterol, LDL cholesterol, and triglycerides (min P = 8.5 × 10-72), with similar effects for males and females. Chromosome Xq23 lipid-lowering alleles are associated with reduced odds for CHD among 42,545 cases and …

Papillary Fibroelastoma In Differential Diagnosis Of Left Atrial Appendage Masses, Anthony Alozie, Annette Zimpfer, Andreas Erbersdobler, Felix G Meinel, Pascal M Dohmen, Alper Öner

The Texas Heart Institute Journal

Papillary fibroelastomas are benign tumors that usually originate from cardiac valves but may have other endocardial origins. We report the cases of 2 patients in whom left atrial appendage masses were initially diagnosed as thrombus. They were treated for embolic stroke and their symptoms resolved; however, their left atrial appendage masses did not regress. After surgery, histologic analysis of the resected masses revealed papillary fibroelastoma in both cases. We discuss the diagnostic and therapeutic dilemmas encountered in patients with papillary fibroelastomas and cardiac masses other than thrombus.

Improper Use Of Temporary Epicardial Pacing Wires, Emre Kubat, Isil Tasoz, Kubilay Karabacak, Suat Doganci

The Texas Heart Institute Journal

No abstract provided.

Restoration Of Cardiac Function After Myocardial Infarction By Long-Term Activation Of The Cns Leptin-Melanocortin System, Sadia Ashraf, Xuan Li, John E Hall, Jussara M Do Carmo

Faculty, Staff and Student Publications

Heart failure has a high mortality rate, and current therapies offer limited benefits. The authors demonstrate that activation of the central nervous system leptin-melanocortin pathway confers remarkable protection against progressive heart failure following severe myocardial infarction. The beneficial cardiac-protective actions of leptin require activation of brain melanocortin-4 receptors and elicit improvements in cardiac substrate oxidation, cardiomyocyte contractility, Ca

Can Erythropoietin Reduce Hypoxemic Neurological Damages In Neonates With Congenital Heart Defects?, Rita Paroni

Faculty, Staff and Student Publications

Congenital heart defects (CHD), the most common cause of birth defects with increasing birth prevalence, affect nearly 1% of live births worldwide. Cyanotic CHD are characterized by hypoxemia, with subsequent reduced oxygen delivery to the brain, especially critical during brain development, beginning in the fetus and continuing through the neonatal period. Therefore, neonates with CHD carry a high risk for neurological comorbidities, even more frequently when there are associated underlying genetic disorders. We review the currently available knowledge on potential prevention strategies to reduce brain damage induced by hypoxemia during fetal development and immediately after birth, and the role of …

Endovascular Mechanical Thrombectomy Versus Thrombolysis In Patients With Iliofemoral Deep Vein Thrombosis - A Systematic Review And Meta-Analysis., Michael K W Lichtenberg, Stefan Stahlhoff, Katarzyna Młyńczak, Dominik Golicki, Paul Gagne, Mahmood K Razavi, Rick De Graaf, Raghu Kolluri, Katarzyna Kolasa

Heart and Vascular Articles

Background: This study sought to compare effectiveness and safety of percutaneous mechanical thrombectomy (PMT) and thrombolysis alone (THR) in patients with acute or subacute iliofemoral deep vein thrombosis (IfDVT). Patients and methods: Observational and randomized trials, published between January 2001 to February 2019 were identified by searching MEDLINE. Studies on deep venous thrombosis (DVT) treated with either THR or PMT adjunctive to conventional anticoagulation and compressive intervention were included. Meta-analysis of proportions was conducted to assess effectiveness outcomes of successful lysis and primary patency, post-thrombotic syndrome (PTS), valvular reflux, recurrent DVT, as well as safety outcomes of major bleeding, hematuria, …

Unusual Cardiac Presentation Of Covid-19 With Significant Sinus Pauses, Tarique S. Chachar, Salman K. Slais, Abdulrahman Almadani, Adel K. Hamad

Journal of the Saudi Heart Association

There is growing evidence of cardiac complications due to corona virus disease 2019 (COVID 19). Our case is a case of a young patient with COVID-19 and symptomatic sinus pauses.

A Multiloculated Left Ventricular Thrombus, Dinkar Bhasin, Gaurav K. Arora, Anunay Gupta, Hermohander S. Isser, Sandeep Bansal

Journal of the Saudi Heart Association

No abstract provided.

Integration Of Cardiovascular Risk Assessment With Covid-19 Using Artificial Intelligence., Jasjit S Suri, Anudeep Puvvula, Misha Majhail, Mainak Biswas, Ankush D Jamthikar, Luca Saba, Gavino Faa, Inder M Singh, Ronald Oberleitner, Monika Turk, Saurabh Srivastava, Paramjit S Chadha, Harman S Suri, Amer M Johri, Vijay Nambi, J Miguel Sanches, Narendra N Khanna, Klaudija Viskovic, Sophie Mavrogeni, John R Laird, Arindam Bit, Gyan Pareek, Martin Miner, Antonella Balestrieri, Petros P Sfikakis, George Tsoulfas, Athanasios Protogerou, Durga Prasanna Misra, Vikas Agarwal, George D Kitas, Raghu Kolluri, Jagjit Teji, Michele Porcu, Mustafa Al-Maini, Ann Agbakoba, Meyypan Sockalingam, Ajit Sexena, Andrew Nicolaides, Aditya Sharma, Vijay Rathore, Vijay Viswanathan, Subbaram Naidu, Deepak L Bhatt

Heart and Vascular Articles

Artificial Intelligence (AI), in general, refers to the machines (or computers) that mimic "cognitive" functions that we associate with our mind, such as "learning" and "solving problem". New biomarkers derived from medical imaging are being discovered and are then fused with non-imaging biomarkers (such as office, laboratory, physiological, genetic, epidemiological, and clinical-based biomarkers) in a big data framework, to develop AI systems. These systems can support risk prediction and monitoring. This perspective narrative shows the powerful methods of AI for tracking cardiovascular risks. We conclude that AI could potentially become an integral part of the COVID-19 disease management system. Countries, …

Entrapment Of A Partially Degloved Stent In The Radial Artery: Is There Any Way Out?, Nooraldaem Yousif, Husam A. Noor

Journal of the Saudi Heart Association

Stent loss during percutaneous coronary intervention (PCI) is uncommon but may lead to serious adverse events. Here we describe a challenging case of stent loss in the radial artery during primary PCI. There, a long stent failed to cross the culprit lesion, and an attempt to pull back the undeployed stent into the guiding catheter resulted in eversion of the stent, partially stripping it off the stent balloon and rendering the stent irretrievable. Retrieval of the stent at all costs might have led to major complications; hence stent deployment in the radial artery bailed us out of this precarious situation.

The Association Of Diurnal Blood Glucose Variability With Subclinical Cardiac Disease In Patients With Type 2 Diabetes Mellitus, Walid Shehab-Eldin, Ahmed Al-Ashmawy, Mahmoud Kamel, Nesrin Elhelbawy, Alaaeldin Dawood, Mostafa Elnajjar

Journal of the Saudi Heart Association

Background: The relationship between glycemic control and the risk of cardiac disease in patients with Type 2 Diabetes Mellitus (T2DM) is controversial. 1,5-Anhydroglucitol (1,5-AG) is a biomarker of Glucose Variability (GV) and has been associated with clinical cardiovascular disease. However, its association with Subclinical Cardiac Disease (SCD) is unknown. Aim of the work: Study the association between GV and SCD. Subjects and methods: A cross-sectional study was conducted on 46 asymptomatic patients with T2DM as T2DM individuals group. Another 46 non-diabetic age and sex matched subjects were included as the healthy group. 1,5-AG was measured for all subjects. M-mode echocardiography …

An Apical Mass Of The Left Ventricle After A Myocardial Infarction: Imaging Contribution, Selma Charfeddine, Wiem Feki, Imen Maaloul, Rania Hammami, Emna Daoud

Journal of the Saudi Heart Association

Intramyocardial dissecting hematoma (IDH) is a rare complication of myocardial infarction (MI). It can affect the left ventricular free wall, the right ventricle, or the interventricular septum.
We report a case of a 58-year-old man with an IDH following an acute anterior wall myocardial infarction detected by echocardiography and confirmed by Cardiac magnetic resonance (CMR).

Internal Medicine Point Of Care Ultrasound In The 21st Century: A ‘Focus’ On The Middle East, Arif Hussain, Irene W.Y. Ma

Journal of the Saudi Heart Association

No abstract provided.

Loss-Of-Function Genomic Variants Highlight Potential Therapeutic Targets For Cardiovascular Disease, Jonas B. Nielsen, Oren Rom, Ida Surakka, Sarah E. Graham, Wei Zhou, Tanmoy Roychowdhury, Lars G. Fritsche, Sarah A. Gagliano Taliun, Carlo Sidore, Yuhao Liu, Maiken E. Gabrielsen, Anne Heidi Skogholt, Brooke Wolford, William Overton, Ying Zhao, Jin Chen, He Zhang, Whitney E. Hornsby, Akua Acheampong, Austen Grooms, Amanda Schaefer, Gregory J. M. Zajac, Luis Villacorta, Jifeng Zhang, Ben Brumpton, Mari Løset, Vivek Rai, Pia R. Lundegaard, Morten S. Olesen, Kent D. Taylor, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Pharmaceutical drugs targeting dyslipidemia and cardiovascular disease (CVD) may increase the risk of fatty liver disease and other metabolic disorders. To identify potential novel CVD drug targets without these adverse effects, we perform genome-wide analyses of participants in the HUNT Study in Norway (n = 69,479) to search for protein-altering variants with beneficial impact on quantitative blood traits related to cardiovascular disease, but without detrimental impact on liver function. We identify 76 (11 previously unreported) presumed causal protein-altering variants associated with one or more CVD- or liver-related blood traits. Nine of the variants are predicted to result in loss-of-function of …

Transcatheter Vs. Surgical Aortic Valve Replacement In Patients At Intermediate Surgical Risk, Nichole M. Bonzano, David M. Milligram

Physician Assistant Capstones, 2020-current

Abstract

• Objective: To compare the safety and efficacy of transcatheter aortic valve replacement (TAVR) to surgical aortic valve replacement (SAVR) in patients with severe symptomatic aortic stenosis at intermediate surgical risk.
• Design: Systematic literature review.
• Methods Literature searches were done in PubMed and Scopus search engines using key terms: TAVR, trans-catheter aortic valve replacement, SAVR, surgical aortic valve replacement, severe aortic stenosis, and intermediate risk. Filters included primary research only. Inclusion criteria were articles which studied an intermediate risk patient population (STS-PROM 3-15%), primary research, and compared outcomes of TAVR and SAVR in patients with severe aortic stenosis requiring replacement. …

Watchman Compared To Warfarin In Reducing Risk Of Stroke In Patients With Non-Valvular Atrial Fibrillation, Peyton Parrish, Matt Isherwood

Physician Assistant Capstones, 2020-current

Objective: To determine if the WATCHMAN device is as efficacious as warfarin for stroke prevention in patients with non-valvular atrial fibrillation (NVAF) using a systematic review. Methods: Pubmed and Google Scholar databases were used to evaluate clinical trials using the search terms atrial fibrillation, watchman, warfarin, and stroke prevention. Results: Three studies met inclusion criteria, with 2 being randomized control trials (RCT), and 1 being a prospective cohort study. Reddy et al found that after 3.8 years of follow-up, patients with percutaneous closure of Left atrial appendage (LAA) met criteria for both non-inferiority and superiority, compared with warfarin for preventing …

A Case Of Carcinoid Heart Disease And Echocardiographic Findings, Brandon Alex, Jeffrey Songster, Helenmari L. Merritt, Rebecca A. Aron

Graduate Medical Education Research Journal

Abstract: Carcinoid heart disease occurs in approximately 50% of patients with carcinoid syndrome. Right heart involvement resulting in tricuspid regurgitation, tricuspid stenosis, pulmonic regurgitation and pulmonic stenosis is most common. We report a case of tricuspid heart disease resulting in tricuspid regurgitation, tricuspid stenosis, pulmonic regurgitation and pulmonic stenosis.

A Review Of Bleeding Risk With Impella-Supported High-Risk Percutaneous Coronary Intervention, George W. Vetrovec, Amir Kaki, Thom G. Dahle

Articles

Complex, high-risk percutaneous coronary intervention (HR-PCI) is increasingly being performed, often with mechanical circulatory support (MCS), though to date, there are limited randomised data on the efficacy of MCS for HR-PCI. The majority of MCS is provided by intra-aortic balloon pumps, but increasingly Impella® (Abiomed, Danvers, MA, USA) heart pumps are being used. While the Impella pumps provide greater increases in cardiac output, these devices require large bore access, which has been associated with an increased risk of bleeding and vascular complications. Decisions regarding the use of Impella are often based on risk–benefit considerations, with Impella-related bleeding risk being a …

Cardiac Electrophysiology: Exploring Racial And Gender Outcomes Of Treatment Of Paroxysmal And Persistent Atrial Fibrillation Using Sotalol And Dofetilide, Nicole Lanette Bradford-Love

Dissertations

Purpose

The purpose of this study is to explore the association between gender and racial lines in the conversion and sustainment of normal sinus rhythm (NSR) from paroxysmal atrial fibrillation (PAF) and persistent atrial fibrillation using the anti-arrhythmic drugs (AADs) sotalol and dofetilide.

Methods

A secondary data analysis was performed to assess the relationships of the independent and dependent variables listed above. Using SPSS v. 24 descriptive statistics were obtained and initially evaluated for accuracy with histograms. A cross-tabulation frequency table was produced to determine the number of variables that fell into each dependent category. Following this, the frequencies were …

Predicting In-Hospital Mortality After An In-Hospital Cardiac Arrest: A Multivariate Analysis, Talal Alnabelsi, Rahul Annabathula, Julie Shelton, Marc Paranzino, Sarah Price Faulkner, Matthew Cook, Adam J. Dugan, Sethabhisha Nerusu, Susan S. Smyth, Vedant A. Gupta

Gill Heart & Vascular Institute Faculty Publications

Aim of the study: Most survivors of an in-hospital cardiac arrest do not leave the hospital alive, and there is a need for a more patient-centered, holistic approach to the assessment of prognosis after an arrest. We sought to identify pre-, peri-, and post-arrest variables associated with in-hospital mortality amongst survivors of an in-hospital cardiac arrest.

Methods: This was a retrospective cohort study of patients ≥18 years of age who were resuscitated from an in-hospital arrest at our University Medical Center from January 1, 2013 to September 31, 2016. In-hospital mortality was chosen as a primary outcome and unfavorable discharge …

An Exploratory On Partial Anomalous Pulmonary Venous Return (Papvr), Gabriella Pitingaro

Honors Projects

This exploratory gives insight into Partial Anomalous Pulmonary Venous Return (PAPVR). The paper goes into depth explaining more detail about the congenital heart defect, the embryology surrounding it, and how much is still left to be discovered. With PAPVR's rarity (0.4-0.7% of the population), not much is known. Hypocritically, since PAPVR often goes undetected, our numbers for cases are estimated to be an underestimated value. The paper also goes into a specific case study regarding the celebrity Amy Grant and her experience with PAPVR and how it has affected her life and career.