Cardiology Commons^™

Double-Inlet Left Ventricle, P Syamasundar Rao

Faculty, Staff and Student Publications

Double-inlet left ventricle (DILV) is most frequent among univentricular atrioventricular connections. In DILV, there is a single functioning ventricle, most commonly with left ventricular structure. This chamber receives both atrioventricular valves and is connected to an outlet chamber with morphologic features of the right ventricle. The great vessels are often transposed, and pulmonary stenosis is seen in two-thirds of patients. The anatomy and pathophysiology can be defined by echo-Doppler studies with a rare need for other imaging studies. The management is mostly related to the nature of associated heart defects and the degree of pathophysiological abnormality. When the infants present …

Cardiovascular Outcomes Of Transradial Versus Transfemoral Percutaneous Coronary Intervention In End-Stage Renal Disease: A Regression-Based Comparison, Yasar Sattar, Mohammed Faisaluddin, Talal Almas, Noora Alhajri, Rajendra Shah, Mohamed Zghouzi, Fnu Zafrullah, Prasana M Sengodon, Muhammad Zia Khan, Waqas Ullah, Mahboob Alam, Sudharshan Balla, Nasser Lakkis, Akram Kawsara, Ramesh Daggubati, M Chadi Alraies

Division of Cardiology Faculty Papers

Background: Limited data is available on the comparison of outcomes of transradial (TR) and transfemoral (TF) access for percutaneous coronary intervention (PCI) in patients with end-stage stage renal disease (ESRD).

Methods: Online databases were queried to compare cardiovascular outcomes among TR. and TF in ESRD patients. The outcomes assessed included differences in mortality, cerebrovascular accidents (CVA), periprocedural myocardial infarction (MI), bleeding, transfusion, and periprocedural cardiogenic shock (CS). Unadjusted odds ratios (OR) were calculated using a random-effect effect model.

Results: A total of 6 studies including 7,607 patients (TR-PCI = 1,288; TF-PCI = 6,319) were included. The overall mean age was …

Cardiovascular Outcomes Of Transradial Versus Transfemoral Percutaneous Coronary Intervention In End-Stage Renal Disease: A Regression-Based Comparison, Yasar Sattar, Mohammed Faisaluddin, Talal Almas, Noora Alhajri, Rajendra Shah, Mohamed Zghouzi, Fnu Zafrullah, Prasana M Sengodon, Muhammad Zia Khan, Waqas Ullah, Mahboob Alam, Sudharshan Balla, Nasser Lakkis, Akram Kawsara, Ramesh Daggubati, M Chadi Alraies

Faculty, Staff and Students Publications

Background: Limited data is available on the comparison of outcomes of transradial (TR) and transfemoral (TF) access for percutaneous coronary intervention (PCI) in patients with end-stage stage renal disease (ESRD).

Methods: Online databases were queried to compare cardiovascular outcomes among TR. and TF in ESRD patients. The outcomes assessed included differences in mortality, cerebrovascular accidents (CVA), periprocedural myocardial infarction (MI), bleeding, transfusion, and periprocedural cardiogenic shock (CS). Unadjusted odds ratios (OR) were calculated using a random-effect effect model.

Results: A total of 6 studies including 7,607 patients (TR-PCI = 1,288; TF-PCI = 6,319) were included. The overall mean age was …

Evaluation Of Ecg Repolarization Parameters In A Worker Cohort Working The Night Shift, Sezen Baglan Uzunget, Kader Eliz Sahin

Journal of the Saudi Heart Association

Objectives: Night Shift work is an increasingly common working order that affects human well-being and it is little known about its arrhythmic role in the cardiovascular system. We aimed to investigate the effect of working at night shifts on P-wave dispersion (Pd), QT and QTc dispersions (QTd, QTcd resp) on surface electrocardiography. Methods: We included 286 foundry workers who work at night shift and 100 foundry workers who work on day time only. The night shift workers were divided into three subgroups according to the length of time they worked at night shift. Surface electrocardiography and blood tests were applied …

Leveraging Clinical Digitized Data To Understand Temporal Characteristics And Outcomes Of Acute Myocardial Infarctions At A Tertiary Care Medical Centre In Pakistan From 1988-2018 - Methods And Results, Zainab Samad, Ali Aahil Noorali, Awais Farhad, Safia Awan, Nada Qaiser Qureshi, Mushyada Ali, Laiba Masood, Ghurfan Adnan, Zulfiqar Ahmed Bhutta, Javed Tai

Section of Cardiology

Background and objective: Few data exist on trends in acute myocardial infarction (AMI) patterns spanning recent epidemiological shifts in low middle-income countries (LMICs). To understand temporal disease patterns of AMI characteristics and outcomes between 1988-2018, we used digitized legacy clinical data at a large tertiary care centre in Pakistan.
Methods: We reviewed digital health information capture systems maintained across the Aga Khan University Hospital and obtained structured elements to create a master dataset. We included index admissions of patients >18 years that were discharged between January 1, 1988, and December 31, 2018, with a primary discharge diagnosis of AMI (using …

Vascular Implications Of Covid-19: Role Of Radiological Imaging, Artificial Intelligence, And Tissue Characterization: A Special Report., Narendra N Khanna, Mahesh Maindarkar, Anudeep Puvvula, Sudip Paul, Mrinalini Bhagawati, Puneet Ahluwalia, Zoltan Ruzsa, Aditya Sharma, Smiksha Munjral, Raghu Kolluri, Padukone R Krishnan, Inder M Singh, John R Laird, Mostafa Fatemi, Azra Alizad, Surinder K Dhanjil, Luca Saba, Antonella Balestrieri, Gavino Faa, Kosmas I Paraskevas, Durga Prasanna Misra, Vikas Agarwal, Aman Sharma, Jagjit Teji, Mustafa Al-Maini, Andrew Nicolaides, Vijay Rathore, Subbaram Naidu, Kiera Liblik, Amer M Johri, Monika Turk, David W Sobel, Gyan Pareek, Martin Miner, Klaudija Viskovic, George Tsoulfas, Athanasios D Protogerou, Sophie Mavrogeni, George D Kitas, Mostafa M Fouda, Manudeep K Kalra, Jasjit S Suri

Heart and Vascular Articles

The SARS-CoV-2 virus has caused a pandemic, infecting nearly 80 million people worldwide, with mortality exceeding six million. The average survival span is just 14 days from the time the symptoms become aggressive. The present study delineates the deep-driven vascular damage in the pulmonary, renal, coronary, and carotid vessels due to SARS-CoV-2. This special report addresses an important gap in the literature in understanding (i) the pathophysiology of vascular damage and the role of medical imaging in the visualization of the damage caused by SARS-CoV-2, and (ii) further understanding the severity of COVID-19 using artificial intelligence (AI)-based tissue characterization (TC). …

An Ebp Approach To Managing Post Cardiac Arrest Interdisciplinary Care, Mary Kay Bader, Teresa Wavra, Tauseef Qureshi, Jon Cline, Marne Andersen

2022 Southern California Nursing Research Conference

The Joint Commission (TJC) published new performance standards on Post Cardiac Arrest (PCA) care that went into effect on Jan 1, 2022. The new standards encourage hospitals to review and synthesize current scientific literature on Post Cardiac Arrest Syndrome (PCAS) and analyze current hospital practice. Following a review of the evidence, hospitals are guided to create a multidisciplinary protocol and education that facilitates training of personnel, implementation of the evidence into clinical practice, data collection, and case review processes. The intent of the standard is to bring hospital based clinical practice in line with the established standards to improve patient …

Saudi Heart Association Position Statement On The Use Of Biomarkers For The Management Of Heart Failure And Acute Coronary Syndrome, Waleed Alhabeeb, Adel Abdulkader Tash, Fawaz Almutari, Kamal Al Ghalayini, Maryam Alqaseer, Mostafa Alshamiri, Suleiman Kharabsheh, Wail Alkashkari

Journal of the Saudi Heart Association

Background: The burden of acute coronary syndrome (ACS) and heart failure (HF) remains high in Saudi Arabia. Biomarkers can greatly improve the management and outcomes of these conditions, but no official guidance is available on their use in Saudi Arabia. Consensus panel: An expert panel of cardiologists, interventional cardiologists and cardiac surgeon reviewed available evidence and formulated recommendations relevant to clinical practice in Saudi Arabia. Consensus findings: high-sensitivity cardiac troponins play a major role in the diagnosis of ACS and the exclusion of myocardial infarction in patients with HF. Natriuretic Peptides are recommended to determine the likelihood of a diagnosis …

Adults With Preexisting Diagnosis Of Heart Failure In The Environment Of Coronavirus Disease 2019, Ronald Phillips

Dissertations

Background: Heart disease continues to be the leading cause of death among adults in the United States and other industrialized countries. Heart failure (HF) is a form of heart disease and has become an epidemic with complications and medical care costs increasing at an alarming rate. HF affects more than 5.7 million adults in the United States with an incidence between 550,000 to 670,000 annually, primarily affecting females, African Americans, and adults aged 55 years and older. HF is also associated with a high rate of mortality, estimated to increase, with a risk rate of 13%, 32%, and 64% among …

The Immune Response To Airway Mycosis, Wei Ruan, Xinxin Ma, In Hyuk Bang, Yafen Liang, Jochen Daniel Muehlschlegel, Kuang-Lei Tsai, Tingting W Mills, Xiaoyi Yuan, Holger K Eltzschig

Faculty, Staff and Student Publications

Despite increasing availability and more successful interventional approaches to restore coronary reperfusion, myocardial ischemia-reperfusion injury is a substantial cause of morbidity and mortality worldwide. During myocardial ischemia, the myocardium becomes profoundly hypoxic, thus causing stabilization of hypoxia-inducible transcription factors (HIF). Stabilization of HIF leads to a transcriptional program that promotes adaptation to hypoxia and cellular survival. Transcriptional consequences of HIF stabilization include increases in extracellular production and signaling effects of adenosine. Extracellular adenosine functions as a signaling molecule via the activation of adenosine receptors. Several studies implicated adenosine signaling in cardioprotection, particularly through the activation of the Adora2a and Adora2b …

Extracorporeal Membrane Oxygenation Therapy In Covid-19 Patients With Acute Respiratory Distress Syndrome, Joseph B. Zwischenberger, Katherine Breetz

Journal of Shock and Hemodynamics

Patients with coronavirus disease of 2019 (COVID-19) may present with a wide range of symptoms ranging from asymptomatic to critically ill. Approximately 10-14% of patients require hospitalization. Those individuals requiring hospitalization can deteriorate rapidly with worsening hypoxemia or new-onset pneumonia, resulting in 20-30% of patients developing acute respiratory distress syndrome (ARDS).

When refractory to medical management, severe ARDS secondary to other illnesses has been successfully treated with extracorporeal membrane oxygenation (ECMO). We completed a comprehensive literature review of ECMO utilization for patients with severe COVID-19 who were unresponsive to critical care management. Of the 1419 patients with a reported diagnosis …

Development Of The Centrifugal Blood Pump For A Hybrid Continuous Flow Pediatric Total Artificial Heart: Model, Make, Measure, Carson S Fox, Thomas Palazzolo, Matthew Hirschhorn, Randy M Stevens, Joseph Rossano, Steven W Day, Vakhtang Tchantchaleishvili, Amy L Throckmorton

Department of Medicine Faculty Papers

Clinically-available blood pumps and total artificial hearts for pediatric patients continue to lag well behind those developed for adults. We are developing a hybrid, continuous-flow, magnetically levitated, pediatric total artificial heart (TAH). The hybrid TAH design integrates both an axial and centrifugal blood pump within a single, compact housing. The centrifugal pump rotates around the separate axial pump domain, and both impellers rotate around a common central axis. Here, we concentrate our development effort on the centrifugal blood pump by performing computational fluid dynamics (CFD) analysis of the blood flow through the pump. We also conducted transient CFD analyses (quasi-steady …

Impact Of Atrial Fibrillation On Outcomes After Left Ventricular Assist Device Implantation: Systematic Review And Meta-Analysis, Chandan Buttar, Sofia Lakhdar, Mahmood Nassar, Nso Nso, Giovina Collura, Most Sirajum Munira

The VAD Journal

Background: Atrial fibrillation (AF) is a common finding in patients with heart failure and is well-known for its deleterious effects on cardiac function and hemodynamics; however, there are gaps in knowledge regarding the impact of AF on patients with left ventricular assist devices (LVADs).

Methods: In this study, we searched PubMed/Medline, Embase, and Cochrane Library databases through September 2021 to find articles that assessed the outcomes of AF in patients with LVADs.

Results: A total of 12 studies that underwent systematic review evaluated the outcomes of 7853 adult patients. The meta-analysis analyzed findings from a total of 1003 patients. Pooled …

Giant Left Atrial Myxoma Revealed By Syncopal Attacks, Nour El Houda Snoussi, Youssra Serroukh, Fatima-Zahra El Hattab, Mohamed Cherti

Journal of the Saudi Heart Association

No abstract provided.

Identifying Differences: A Key Step In Precision Cardiovascular Disease Prevention, Mahmoud Al Rifai, Salim S. Virani, Vijay Nambi

Office of the Provost

No abstract provided.

Association Between Social Vulnerability Index And Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Study, Vardhmaan Jain, Mahmoud Al Rifai, Safi U. Khan, Safi U. Khan, Ankur Kalra, Fatima Rodriguez, Zainab Samad, Yashashwi Pokharel, Arunima Misra, Laurence S. Sperling

Section of Cardiology

Background Social and environmental factors play an important role in the rising health care burden of cardiovascular disease. The Centers for Disease Control and Prevention developed the Social Vulnerability Index (SVI) from US census data as a tool for public health officials to identify communities in need of support in the setting of a hazardous event. SVI (ranging from a least vulnerable score of 0 to a most vulnerable score of 1) ranks communities on 15 social factors including unemployment, minoritized groups status, and disability, and groups them under 4 broad themes: socioeconomic status, housing and transportation, minoritized groups, and …

Association Between Social Vulnerability Index And Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Study, Vardhmaan Jain, Mahmoud Al Rifai, Safi U Khan, Ankur Kalra, Fatima Rodriguez, Zainab Samad, Yashashwi Pokharel, Arunima Misra, Laurence S Sperling, Jamal S Rana, Waqas Ullah, Ankit Medhekar, Salim S Virani

Division of Cardiology Faculty Papers

Background Social and environmental factors play an important role in the rising health care burden of cardiovascular disease. The Centers for Disease Control and Prevention developed the Social Vulnerability Index (SVI) from US census data as a tool for public health officials to identify communities in need of support in the setting of a hazardous event. SVI (ranging from a least vulnerable score of 0 to a most vulnerable score of 1) ranks communities on 15 social factors including unemployment, minoritized groups status, and disability, and groups them under 4 broad themes: socioeconomic status, housing and transportation, minoritized groups, and …

Polygenic Risk, Midlife Life's Simple 7, And Lifetime Risk Of Stroke, Emy A Thomas, Nitesh Enduru, Adrienne Tin, Eric Boerwinkle, Michael E Griswold, Thomas H Mosley, Rebecca F Gottesman, Myriam Fornage

Faculty, Staff and Student Publications

Background

Recent genetic discoveries in stroke have unleashed the potential of using genetic information for risk prediction and health interventions aimed at disease prevention. We sought to estimate the lifetime risk of stroke (LTRS) by levels of genetic risk and to investigate whether optimal cardiovascular health can offset the negative impact of high genetic risk on lifetime risk of stroke.

Methods and Results

Study participants were 11 568 middle‐aged adults (56% women, 23% Black adults), who were free of stroke at baseline and were followed up for a median of 28 years. The remaining LTRS was estimated according to levels …

Association Between Social Vulnerability Index And Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Study, Vardhmaan Jain, Mahmoud Al Rifai, Safi U Khan, Ankur Kalra, Fatima Rodriguez, Zainab Samad, Yashashwi Pokharel, Arunima Misra, Laurence S Sperling, Jamal S Rana, Waqas Ullah, Ankit Medhekar, Salim S Virani

Faculty, Staff and Students Publications

Background Social and environmental factors play an important role in the rising health care burden of cardiovascular disease. The Centers for Disease Control and Prevention developed the Social Vulnerability Index (SVI) from US census data as a tool for public health officials to identify communities in need of support in the setting of a hazardous event. SVI (ranging from a least vulnerable score of 0 to a most vulnerable score of 1) ranks communities on 15 social factors including unemployment, minoritized groups status, and disability, and groups them under 4 broad themes: socioeconomic status, housing and transportation, minoritized groups, and …

Development Of A Cardiac Anesthesia Tool (Cat) To Predict Intensive Care Unit (Icu)Admission For Pediatric Cardiac Patients Undergoing Non-Cardiac Surgery: A Retrospective Cohort Study, Ahmed Mounir A. Metwally, Ahmed Haroun M. Mahmoud, Abdulrahman A. Alwakeel, Abdulrahman M. Aljamous, Rayan S. Aldusari, Faisal Hijji, Fouzia A. Al Tuwaijri, Saad Eldin M. Hassan, Mohamed Ebid, Abdullah A. Alghamdi

Journal of the Saudi Heart Association

Background and aim of the work: Pediatric cardiac patients often undergo non-cardiac surgical procedures and many of these patients would require intensive care unit admission, but can we predict the need for ICU admission in pediatric cardiac patients undergoing non-cardiac procedures. Numerous preoperative and intraoperative variables were strongly associated with ICU admission. Given the variations in the underlying cardiac physiology and the diversity of non-cardiac surgical procedures along with the scarce predictive clinical tools, we aimed to develop a simple and practical tool to predict the need for ICU admission in pediatric cardiac patients undergoing non-cardiac procedures. Material and Methods: …