Cardiology Commons^™

Electrophysiologic Mechanism Of Conversion Of Atrial Fibrillation To Sinus Rhythm, Kazuo Moroe, Tadayuki Hiroki, Kei Miyoshi, Tetsushi Wakiyama

Journal of the Hong Kong College of Cardiology

We investigated the validity of the circulating wavelet hypothesis as an explanation of the mechanism of termination of atrial fibrillation in 11 patients with atrial fibrillation.

Brachytherapy In The New Millennium Scientific Programme

Journal of the Hong Kong College of Cardiology

No abstract provided.

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, …

Heart Failure In General And Cardiac Transplant Patients With Covid-19, Munish Sharma, Gowthami Sai Kogilathota Jagirdhar, Kalpalatha K Guntupalli, Rahul Kashyap, Salim Surani

Faculty, Staff and Students Publications

Coronavirus disease 2019 (COVID-19) is primarily an infection of the respiratory tract, but it can have multisystem manifestations. Cardiac complications of COVID-19 can range from acute myocardial injury, cardiac arrhythmias, or heart failure, amongst others. Heart failure (HF) in COVID-19 can be a de novo process or due to worsening of pre-existing cardiovascular ailment. HF in a patient with COVID-19 not only poses challenges in clinical presentation and management of COVID-19 but also affect prognosis of the patient. This article aims to succinctly revisit the implications of this pandemic regarding pre-existing HF or new-onset HF based on prevailing data. It …

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 …

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 …

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 …

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 …

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 …

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 …