Cardiology Commons^™

Utilization Of Evidence-Based Secondary Preventive Therapies Post-Acute Coronary Syndrome: A Heart Registry Cohort Study In Kenya, Anthony Ochola, Jasmit Shah, Jeilan Mohamed, Harun Otieno, Anders Barasa, Felix Barasa, Constantine Akwanalo, Benard Gitura, Mzee Ngunga

Internal Medicine, East Africa

Introduction: cardiovascular disease is a growing concern in Africa, with coronary artery disease emerging as a leading cause of mortality. Despite strong evidence and international guidelines recommending secondary prevention therapy post-acute coronary syndrome (ACS)-including antiplatelet agents, statins, beta blockers, and angiotensin-converting enzyme (ACE) inhibitors-suboptimal use remains a concern, especially in low- and middle-income countries. This study aimed to quantify the use of guideline-recommended secondary prevention medications after ACS in Kenya using the data from the Kenya Heart Registry study.

Methods: a cohort study was conducted using data from the Kenya Heart Registry across three hospitals in Kenya from …

Artificial Intelligence In Cardiology: An Updated Systematic Review With Ethical Considerations And Challenges In Implementing Artificial Intelligence Models, Dev Patel, Reshmitha Kantamneni, Jabez David John, Tirath Patel, Arnesh Shukla, Ayesha Salma, Nikhilesh Anand

School of Medicine Publications

The integration of artificial intelligence (AI) in cardiovascular medicine presents a transformative opportunity to enhance diagnostic accuracy and improve patient outcomes. This systematic review evaluates the impact of AI on cardiovascular diagnostics with a focus on its ability to surpass traditional methods in accuracy, efficiency, and predictive capabilities. Machine learning and deep learning have demonstrated significant advancements in areas such as echocardiography, electrocardiography, computed tomography angiography, and predictive analytics.

AI algorithms have demonstrated superior performance in identifying subtle patterns and anomalies. Additionally, AI has shown promise in predictive analytics, forecasting disease progression and tailoring treatment plans, thereby improving patient outcomes. …

Patient Wait Time And Throughput Interventions In The Cardiology Outpatient Setting, Chioma Ohiri Tawose

Electronic Theses and Dissertations

Healthcare collaboration and patient care require effective communication. Poor communication impacts wait time. Inadequate communication in the outpatient cardiology clinic can lead to disruptive patient throughput, or workflow, and extend patient length of visit. The purpose of this project was to implement a means of communication for clinicians and healthcare assistants to improve patient flow and cut down idleness, ultimately reducing patient wait time. The project established the incorporation of a built-in electronic health record communication notification system, the Event Button, for asynchronous communication between staff. A quantitative quality improvement design was used to conduct this project. Inferential and descriptive …

Right Ventricular Thrombus Presenting With Right Ventricular Failure In Septic Shock: A Case Report., Micah Harris

Heart and Vascular Articles

We present a case report of refractory multifactorial shock initially managed as septic shock, requiring multidisciplinary collaboration when the diagnostic pathway was limited by acute kidney injury; the primary learning objective is to highlight clinical decision-making in shock when standard contrast imaging is contraindicated. Echocardiography revealed right ventricular failure with right ventricular thrombus, and pulmonary embolism was strongly suspected but could not be confirmed due to the inability to obtain contrast imaging. Persistent shock prompted a transition from a septic shock-directed strategy to cardiogenic and obstructive shock management. The patient was treated with anticoagulation but was not a candidate for …

Longitudinal Peripheral Blood Transcriptomics Reveal Novel Signatures During Cardiac Allograft Rejection., Rachad Ghazal, Min Wang, Akshatha N. Srinivas, Jenny J. Cao, Hridyanshu Vyas, Duan Liu, Asha Nair, Byron H. Smith, Li Wang, Daniel S. Yip, Parag C. Patel, David E. Steidley, Brian W. Hardaway, Alfredo L. Clavell, Sudhir S. Kushwaha, Walter D. Park, Mark D. Stegall, Howard Eisen, Naveen L. Pereira

Division of Cardiology Faculty Papers

Background: Acute cellularrejection (ACR) remains a major cause of morbidity afterhearttransplantation despite advances in immunosuppression. Whole genometranscriptomicprofiling offers a systems-based, unbiased approach to elucidate the molecular mechanisms underlying ACR. However, noninvasive,longitudinal biomarker assessments capable of capturing the temporal dynamics ofrejection biology remain scarce.

Methods: RNA sequencing ofperipheralblood fromheart transplant recipients before, during, and after ACR was compared with nonrejection controls. Pathway analysis was conducted using differentially expressed genes (DEGs), and a machine learning approach was applied to assessgene-based prediction of ACR.

Results: A total of 235 rejection-specific significant DEGs and 863 postrejection DEGs (false discovery rate < 0.05) were identified. During ACR, DEGs were enriched for T-cell activation/differentiation, apoptosis, and B-cell receptor signaling pathways. By combining the 2 sets of DEGs, a panel of 71 common genes was identified that reflected the significant, longitudinal transcriptomic dynamics of ACR. In an elastic net machine learning-based classifier, DYNLL1 and SERF2 were …

Diagnostic Challenges Of Anomalous Left Coronary Artery From The Right Pulmonary Artery., Lavina Desai, Sanket Shah, Edo Bedzra, Christopher Mathis

Manuscripts, Articles, Book Chapters and Other Papers

• ALCAPA is a rare congenital heart defect seen in about one in 300,000 live births. • ALCARPA is an even rarer subset of ALCAPA with the LCA originating from the RPA. • Few cases report ALCARPA associated with coarctation of the aorta. • Coarctation and VSD may cause PH with antegrade LCA flow. • These defects are hard to diagnose and require coronary imaging before surgery.

Clinical Outcomes Of Patients Hospitalized For Conventional Pacemaker Implantation With Protein-Energy Malnutrition, Phuuwadith Wattanachayakul, Pojsakorn Danpanichkul, Chalothorn Wannaphut, Hamza Tahir, John Malin, Thanathip Suenghataiphorn, Kanokphong Suparan, Aman Amanullah

Einstein Health Papers

INTRODUCTION: The impact of protein-energy malnutrition (PEM) on patients hospitalized for conventional pacemaker implantation remains poorly understood.

METHODS: We utilized the 2020 U.S. National Inpatient Sample (NIS) database to evaluate the impact of PEM on the in-hospital outcomes of patients who underwent conventional pacemaker implantation. Patients aged 18 and older were identified by ICD-10 CM and PCS codes. Multivariable survey logistic and linear regression analyses were employed to examine in-hospital outcomes, including in-patient mortality, system-based outcomes, and post-procedural complications.

RESULTS: A total of 108 020 patients were identified with 4315 (3.99%) diagnosed with PEM. The mean age of the cohort …

Use Of Electrocardiograms To Identify Coronary Artery Disease: Cross-Validation Of An Artificial Intelligence Model, Michael Leasure, Indu Poornima, Adam Butchy, Utkars Jain, Devin Vasoya, Michael Warnick, Brent Williams, John Rehder, Prahlad Menon, Veronica A. Covalesky, Gary S. Mintz

Department of Medicine Faculty Papers

BACKGROUND: The current gold standard for the diagnosis of coronary artery disease (CAD) is invasive angiography; however, it is an invasive procedure. Therefore, we developed an artificial intelligence model designed to predict significant CAD from a resting digital 12-lead electrocardiogram (ECG).

OBJECTIVES: This retrospective study assessed the model's ability to predict clinically significant CAD in a patient population presenting for coronary angiography.

METHODS: From 2019 to 2021, 16,476 patients had a resting 12-lead digital ECG recorded within 90 days prior to coronary angiography. The artificial intelligence model was developed using 10-fold cross-validation methodology. Clinically significant disease was defined as angiographic …

Race And Patient-Physician Communication On Blood Pressure Management: Helping Improve Care, Samar A. Nasser, Ashley Pender, Ayan Ali, Kardie Tobb, Keith C. Ferdinand

Division of Cardiology Faculty Papers

PURPOSE OF REVIEW: To provide an overview of the relationship of race and ethnicity and patient-physician/clinician communication on blood pressure management.

RECENT FINDINGS: The suboptimal interactions experienced by patients from underrepresented racial and ethnic populations may be improved by enriching relationships among clinicians, population health scientists, policymakers, and community members/leaders. Current care communication and policies for managing hypertension appear to be insufficient. Implementing and disseminating effective strategies to efficiently improve the quality of hypertension care and recognize social determinants of health among minoritized populations is intertwined with enhanced communication.

SUMMARY: Approaches such as self-affirmation—encouraging patients to reflect on their strengths …

Health Plan-Based Atherosclerosis Imaging For Members With Diabetics: Utilization And Impact On Subsequent Episodes Of Care., Subha V Raman, Alexander V Smolensky, Juhi Ramchandani, Purva Patel, Xin He, Tarek Aridi, John Salvas, Wasi Khatri, Jack Tiahnybik, Nihanth Damera, Keyur Vora, Rohan Dharmakumar

Heart and Vascular Articles

BACKGROUND: Quantitative coronary CT angiography plaque analysis (QCCTA) is a novel tool for atherosclerosis detection.

OBJECTIVES: The authors examined utilization of a health plan offering of QCCTA to diabetic members and the impact of utilization on health plan costs.

METHODS: Diabetic health plan members ≥40 years without prior myocardial infarction were offered QCCTA as a pilot benefit. Benefit utilizers were compared to eligible nonutilizers for incident cardiovascular episodes of care post-notification of eligibility.

RESULTS: Over 14 months, 2,064 of 38,079 health plan members were identified as eligible. Utilizers (19.1%) were predominantly White (76.4%) and female (72.6%) residing in communities with …

Real-Time Hemodynamic Deterioration Following Polymorphic Ventricular Tachycardia In A Patient With Preexisting Aicd Implanted With Lvad, Dhruvil Patel, Maya Guglin, Deepa Iyer, Chonyang Albert, Jagpreet Grewal, Kenneth Dulnuan

The VAD Journal

Ventricular arrhythmias (VAs) are common in patients with a left ventricular assist device (LVAD), but the literature remains inconclusive regarding the benefits of an automatic implantable cardioverter-defibrillator (AICD) in this population, especially in those with a preexisting device before LVAD implantation. Here, we report the acute hemodynamic consequences of polymorphic ventricular tachycardia in a patient with a preexisting biventricular AICD who was implanted with an LVAD (HeartMate 3). This case underscores the importance of considering AICD placement on a case-by-case basis and highlights the need for a well-designed study to establish its benefit in this population.

Leadless Versus Transvenous Dual-Chamber Pacemakers: Real-World Evidence From Aveir Dr Coverage With Evidence Development Study., Monica Lo, Anish K Amin, Marcin Kowalski, Anne Kroman, Dilip Mathew, Valay Parikh, Stanislav Weiner, Jennifer M Joseph, Leonard Ganz, Mohammed Mortada

Heart and Vascular Articles

BACKGROUND: AVEIR DR, an industry-first dual-chamber leadless pacemaker (LP), provides continuous atrioventricular synchrony through implant-to-implant (i2i) communication between atrial and ventricular LP devices. It is important to evaluate the early real-world comparative safety of AVEIR DR LP.

OBJECTIVE: To compare complications and mortality between AVEIR DR LP and dual-chamber transvenous pacemakers (TP).

METHODS: De novo LP and TP patients were identified in Medicare Fee-for-Service claims (October 2023 and December 2024). Outcomes were 30-day and 6-month complications, reinterventions, heart failure hospitalizations, and all-cause mortality. Comparisons were adjusted for demographics, comorbidities, and hospital encounter characteristics.

RESULTS: Compared to TP (N = 77 …

Chiari Network Identified By Ct Imaging: An Uncommon Modality For A Common Incidental Finding, Kyle Admire, Denis Yusupov, Xian Qiao

Eastern Virginia Medical Journal

Chiari networks are anatomical variants that result from incomplete resorption of embryologic tissues and are often discovered incidentally on echocardiography. We describe the case of a large Chiari network we discovered after independent review of the patient’s computed tomography scan showed an unexpected filling defect within the right atrium, prompting further investigation. We also conducted a review of the literature for this anatomic variant of unclear clinical significance.

Prognostic Value Of Baseline Qfr In Single-Vessel Intermediate Coronary Stenosis, Yanfeng Lu, Abdulrahman Alqazzaz, Jasmine Bao, Gary S. Mintz, Jiahao Feng, Yong Zhang, Shanshan Gao, Qiang Song, Feifei Ning, Xin Huang, Ning Guo

Student Papers, Posters & Projects

BACKGROUND AND OBJECTIVES: The prognostic value of baseline Quantitative Flow Ratio (QFR) in real-world patients remains unclear. This study aimed to evaluate the prognostic value of baseline QFR and its three-tier model-low, grey-zone, and high QFR-in patients with single-vessel intermediate stenosis.

METHODS: This retrospective study included 478 patients with QFR between 0.70 and 0.90 who underwent coronary angiography between May and June 2023. Patients were stratified into Low (0.70-0.74), Grey-Zone (0.75-0.85), and High (0.86-0.90) QFR groups. The primary endpoint was major adverse cardiac events (MACE); the key secondary endpoint was target vessel failure (TVF). Kaplan-Meier and Cox proportional hazards models …

End Point–Based Threshold For The Ambulatory Arterial Stiffness Index, Yi-Bang Cheng, De-Wei An, Dong-Yan Zhang, Yu-Ling Yu, Jesus D. Melgarejo, José Boggia, Dries S. Martens, Tine W. Hansen, Kei Asayama, Gladys E. Maestre

School of Medicine Publications

Background: The ambulatory arterial stiffness index (AASI) is increasingly used in clinical research and practice. This individual-participant meta-analysis aims to consolidate the prognostic accuracy of AASI in the general population and to derive an end point-based AASI risk threshold.

Methods: In 12 558 individuals enrolled in 14 population studies (48.8% women; mean age, 59.3 years), AASI was derived by regressing 24-hour diastolic on systolic blood pressure (mm Hg/mm Hg). Using Cox regression, the risk-carrying AASI threshold was established by examining stepwise increasing AASI levels and by determining the AASI level, yielding a 10-year risk similar to an office systolic pressure …

Acute Stemi In A Young Adult On Therapeutic Anticoagulation Following Diclofenac Use, Naeem Hasanfatta, Naveed Ahmed, Debabrata Dash

Journal of the Saudi Heart Association

Background: Acute coronary syndrome (ACS) in young adults is uncommon. The case of a 34-year-old male, post mechanical mitral valve replacement (MVR), who developed anterior ST-elevation myocardial infarction (STEMI) despite therapeutic anticoagulation (INR 3.17), shortly after the initiation of diclofenac, highlights an important clinical scenario.

Case Presentation: The patient presented with atypical upper back pain and was diagnosed with anterior STEMI. Coronary angiography revealed a 100% thrombotic occlusion in the mid left anterior descending (LAD) artery. Percutaneous transluminal coronary angioplasty (PTCA) was successfully performed. Importantly, the patient had no history of hypercoagulable states or atherosclerosis and had been compliant with …

Saudi Heart Association Position Statement On Early Detection Of Subclinical Atherosclerosis In Clinical Practice, Waleed Alhabeeb, Abdelrahaman Almoghairi, Abdulhalim Kinsara, Abdullah Khoja

Journal of the Saudi Heart Association

Background: Atherosclerosis is the leading underlying cause of cardiovascular disease (CVD), which remains the primary cause of mortality in Saudi Arabia. Saudi patients experience CVD events nearly a decade earlier than their Western counterparts. Given the limitations of traditional risk assessment tools, there is a growing need to detect subclinical atherosclerosis to refine risk stratification and improve primary prevention strategies, particularly in younger and asymptomatic individuals.

Methods: The Saudi Heart Association (SHA) developed this position statement through a structured, multistep process that included a comprehensive literature review and two expert panel meetings. Recommendations were formulated based on current evidence, expert …

After Hours, Faster Reperfusion: A Multidisciplinary Quality Improvement Initiative To Reduce Stemi Door-To-Balloon Time, Suhas Tatapudi, Aarohi Parikh, Jeffrey Lesser, Alexander Rhodes, M Daniel

Gulf Coast Division GME Research Day 2026

No abstract provided.

A Case Report: Successful Treatment Of Clot In Transit In The Ra And Rv, Venkata Kalyan Byrapogu, Garret D. Olsen, Rati Shirodkar, Brett Hiendylmayr, Pratik Saha

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Ai-Powered Chatbot For Structural Valve Education And Shared Decision-Making: A Pilot Simulation Study, Yves Najm Mrad, Ahmad Al-Taweel, Bahaeddin Shabaneh

Gulf Coast Division GME Research Day 2026

No abstract provided.