Cardiology Commons^™

Association Of Cardiovascular Risk Factor Profile And Financial Hardship From Medical Bills Among Non-Elderly Adults In The United States, Gowtham R. Grandhi, Javier Valero-Elizondo, Reed Mszar Reed Mszar, Eric J. Brandt, Amarnath Annapureddy, Rohan Khera, Anshul Saxena, Salim S. Virani, Ron Blankstein, Nihar R. Desai

Office of the Provost

Background: While optimal cardiovascular risk factor (CRF) profile is associated with lower mortality, morbidity, and healthcare expenditures among individuals with atherosclerotic cardiovascular disease (ASCVD), less is known regarding its impact on financial hardship from medical bills. Therefore, we assessed whether an optimal CRF profile is associated with a lower burden of financial hardship from medical bills and a reduction in cost-related barriers to health.
Methods: We used a nationally representative sample of adults between 18 and 64 years from the National Health Interview Survey between 2013 and 2017. We assessed ASCVD status and the number of risk factors to categorize …

Fatal Heart Failure Induced By Pazopanib In A Sarcoma Patient Previously Treated With Gemcitabine, Daniela Di Lisi, Girolamo Manno, Clarissa Filorizzo, Tommaso Guarino, Giulia Santanelli, Monica Lunetta, Giuseppe Badalamenti, Antonio Russo, Giuseppina Novo

Journal of the Saudi Heart Association

Gemcitabine is commonly used for various solid organ malignancies with rarely reported cardiac side effects such as cardiomyopathy. Pazopanib usually can cause arterial hypertension but cases of heart failure have recently been reported. We describe a case of fatal heart failure after treatment with gemcitabine and pazopanib in a 55-year-old female with sarcoma. Patient developed left ventricular dysfunction after gemcitabine treatment and acute heart failure after 22 days of pazopanib treatment which led to death. Physicians should be aware of the cardiotoxicity risk when managing the use of pazopanib especially in patients previously treated with other cardiotoxic drugs.

Anomalous Drainage Of Persistent Left Superior Vena Cava To The Left Atrium: Case Series And Literature Review, Mustafa Abdulwahab, Abdulhameed Ali Alnajja, Ali Edris Jelly, Aitizaz Eldien Syed, Mohamed Mofeed Fawaz Morsy, Mansour Bader Al-Mutairi, Alassal Ahmad Alkodami

Journal of the Saudi Heart Association

Persistent left superior vena cava (PLSVC) draining into the coronary sinus is not uncommon, but to the left atrium is a rare condition. Such anomaly may be a cause of unexplained hypoxia in all age groups. It is often diagnosed accidentally during cardiovascular diagnostic work-up or in a contest of other cardiac investigations. We report two cases of these rare PLSVC associations with subsequent medical and surgical management.

Endocrine Significance Of Sars-Cov-2'S Reliance On Ace2, Eric Lazartigues, Mirza Muhammad Fahd Qadir, Franck Mauvais-Jarvis

School of Medicine Faculty Publications

The current COVID-19 pandemic is the most disruptive event in the past 50 years, with a global impact on health care and world economies. It is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a coronavirus that uses angiotensin-converting enzyme 2 (ACE2) as an entry point to the cells. ACE2 is a transmembrane carboxypeptidase and member of the renin-angiotensin system. This mini-review summarizes the main findings regarding ACE2 expression and function in endocrine tissues. We discuss rapidly evolving knowledge on the potential role of ACE2 and SARS coronaviruses in endocrinology and the development of diabetes mellitus, hypogonadism, and pituitary and …

Catastrophic Cardiac Complications Of Takayasu's Arteritis., Sara Godil Md, Bilal Saqi Md, Kareem Godil Md, Syed Rafay Ali Sabzwari, Yasotha Rajeswaran Md

Department of Medicine

Takayasu's arteritis (TA) causes inflammation and necrosis of vessel walls, leading to aneurysm formation, extensive coronary damage and valvular abnormalities. We review a case of recurrent coronary, aortic and mitral valve involvement in a patient with TA and discuss the various treatment options available for such patients.

Acute Effusive Pericarditis: A Late Complication Of Covid-19., Kelli Fox, Jessica A Prokup, Kyle Butson, Kim Jordan

Heart and Vascular Articles

As the COVID-19 pandemic evolves, the medical community continues to discover novel clinical manifestations of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Often, extrapulmonary manifestations occur simultaneously with pulmonary disease. However, there is a paucity of literature describing the cardiac manifestations of COVID-19 in the absence of pulmonary findings. We report a rare case of acute pericarditis presenting with pericardial effusion and cardiac tamponade in a 43-year-old man diagnosed with COVID-19. This case emphasizes the importance of continued investigation regarding diagnosis and treatment of COVID-19 and its related symptoms.

A Complication Of Acute Myocardial Infarction, Nakeya Dewaswala, Robert Dean Chait

HCA Healthcare Journal of Medicine

Ventricular septal rupture (VSR) is a rare complication after acute myocardial infarction (MI). The case presents an apical four chamber echocardiogram showing mid-septal discontinuity with lateral to medial movement of the transected ventricular septum during systole and diastole. Color Doppler demonstrates flow across the septum with extensive anatomic destruction of the ventricular septum.

Association Of Palliative Care Consultation With Advance Directive Completion For Patients Admitted With An Acute Heart Failure Exacerbation, Michelle Crispo, Doug Sawyer, Kathleen Fairfield, Rebecca N. Hutchinson

Journal of Maine Medical Center

No abstract for research letter

Switching Warfarin To Direct Oral Anticoagulants In Atrial Fibrillation: Insights From The Ncdr Pinnacle Registry, Christopher T. Sciria, Thomas M. Maddox, Lucas Marzec, Benjamin Rodwin, Salim S. Virani, Amarnath Annapureddy, James V. Freeman, Ali O'Hare, Yuyin Liu

Office of the Provost

Background: Previous studies examining the use of direct oral anticoagulants (DOACs) in atrial fibrillation (AF) have largely focused on patients newly initiating therapy. Little is known about the prevalence/patterns of switching to DOACs among AF patients initially treated with warfarin.
Hypothesis: To examine patterns of anticoagulation among patients chronically managed with warfarin upon the availability of DOACs and identify patient/practice-level factors associated with switching from chronic warfarin therapy to a DOAC.
Methods: Prospective cohort study of AF patients in the NCDR PINNACLE registry prescribed warfarin between May 1, 2008 and May 1, 2015. Patients were followed at least 1 year …

Major Septal Defects: Comparative Study Of Down Syndrome And Non-Down Syndrome Infants, Before And After Surgery, Saleha Aziz, Maaha Ayub, Laiba Masood, Muneer Amanullah, Rukhsana Hameed, Shiraz Hashmi, Waris Ahmad

Medical College Documents

Objective: To compare pre-operative, intra-operative, and post-operative parameters in Down syndrome (DS) and non-DS patients with atrioventricular septal defects (AVSD) and inlet ventricular septal defects (VSD) in a tertiary care hospital in Pakistan.
Methods: We conducted a retrospective study at Aga Khan University, Pakistan. All complete atrioventricular septal defect (CAVSD), partial atrioventricular septal defect (PAVSD), and VSD with inlet extension surgical cases from January 2007 to January 2019 were included. Patients with congenital heart diseases other than those listed above were excluded.
Results: In 61 cases, 18 had DS. Median age, mean body surface area (BSA), and height were lower …

Postoperative Myocardial Injury In A Patient With Left Ureteric Stone And Asymptomatic Covid-19 Disease, Nadeem Kassam, Omar Aziz, Ally Zain Ismail, Rodgers Swai, Samina Somji, Robert Mvungi, Mustaafa Bapumia, Ali Akbar Zehri, Salim Surani

Internal Medicine, East Africa

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first identified on 8thDecember 2019 in Wuhan, Hubei, China, and has since spread globally to become an emergency of international concern. Patients infected with SARS-CoV-2 may be asymptomatic or present with symptoms ranging from mild clinical manifestations: such as fever, cough, and sore throat to moderate and severe form of the disease such as pneumonia and acute respiratory distress syndrome (ARDS). In some patients, SARS-CoV-2 can affect the heart and cause myocardial injury which is evidenced either by electrocardiographic (ECG) changes …

Practice Gap In Atrial Fibrillation Oral Anticoagulation Prescribing At Emergency Department Home Discharge, Bory Kea, Bethany T. Waites, Amber Lynn, Merritt H. Raitt, David R. Vinson, Niroj Ari, Luke Welle, Andrew Sill, Dana Button, Benjamin C. Sun

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: Current U.S. cardiology guidelines recommend oral anticoagulation (OAC) to reduce stroke risk in selected patients with atrial fibrillation (AF), but no formal AF OAC recommendations exist to guide emergency medicine clinicians in the acute care setting. We sought to characterize emergency department (ED) OAC prescribing practices after an ED AF diagnosis.

Methods: This retrospective study included index visits for OAC-naive patients ≥18 years old who were discharged home from the ED at an urban, academic, tertiary hospital with a primary diagnosis of AF from 2012-2014. Five hypothesis-blinded, chart reviewers abstracted data from patient problem lists and medical history in …

Efficacy Of A Novel Mitochondrial-Derived Peptide In A Porcine Model Of Myocardial Ischemia/Reperfusion Injury, Thomas E. Sharp, Zhenwei Gong, Amy Scarborough, Eric S. Goetzman, Murtuza J. Ali, Pablo Spaletra, David J. Lefer, Radhika H. Muzumdar, Traci T. Goodchild

School of Medicine Faculty Publications

With the complexities that surround myocardial ischemia/reperfusion (MI/R) injury, therapies adjunctive to reperfusion that elicit beneficial pleiotropic effects and do not overlap with standard of care are necessary. This study found that the mitochondrial-derived peptide S14G-humanin (HNG) (2 mg/kg), an analogue of humanin, reduced infarct size in a large animal model of MI/R. However, when ischemic time was increased, the infarct-sparing effects were abolished with the same dose of HNG. Thus, although the 60-min MI/R study showed that HNG cardioprotection translates beyond small animal models, further studies are needed to optimize HNG therapy for longer, more patient-relevant periods of cardiac …

In Response To Letter Title "Immediate Hemodynamic And Gaseous Exchange Effect Of Bi-Level Positive Airway Pressure After Cardiac Surgery: Our Insight To Hamid Et Al.'S Study", Mohammad Hamid, Mohammad Irfan Akhtar, Saba Ahmed

Department of Anaesthesia

No abstract provided.

Oral Anticoagulants For Nonvalvular Atrial Fibrillation In Frail Elderly Patients: Insights From The Aristophanes Study, G. Y. H. Lip, A. V. Keshishian, A. L. Kang, A. D. Dhamane, X. Luo, X. Li, N. Balachander, L. Rosenblatt, J. Mardekian, X. Pan, M. Di Fusco, A. B. Garcia Reeves, Huseyin Yuce, S. Deitelzweig

Publications and Research

Background

Patient frailty amongst patients with nonvalvular atrial fibrillation (NVAF) is associated with adverse health outcomes and increased risk of mortality. Additional evidence is needed to evaluate effective and safe NVAF treatment in this patient population.

Objectives

This subgroup analysis of the ARISTOPHANES study compared the risk of stroke/systemic embolism (S/SE) and major bleeding (MB) amongst frail NVAF patients prescribed nonvitamin K antagonist oral anticoagulants (NOACs) or warfarin.

Methods

This comparative retrospective observational study of frail, older NVAF patients who initiated apixaban, dabigatran, rivaroxaban or warfarin from 01JAN2013‐30SEP2015 was conducted using Medicare and 3 US commercial claims databases. To compare …

Editorial Management Of Cardiac Patients During The Covid-19 Pandemic, Günter Breithardt, Hani K. Najm, Marko Turina, Ahmed A. Arifi

Journal of the Saudi Heart Association

No abstract provided.

Health Care Delivery For Heart Failure Patients During The Covid-19 Pandemic; A Consensus Of The Saudi Heart Failure Working Group (Saudi-Hf), Abeer Bakhsh, Maryam Alqaseer, Fakhr Alayoubi, Rima S. Bader, Kamal Alghalayini, Abdelfatah Elasfar, Waleed Alhabeeb

Journal of the Saudi Heart Association

The Coronavirus disease 2019 (COVID-19) pandemic led to global and national rapid health system changes to treat the affected patients and prevent the spread of the virus. The social distancing, redirecting resources, and nationwide lockdown led to the cancellation of non-urgent hospital visits and interruption of continuity of care for patients with chronic cardiac conditions such as heart failure (HF). This consensus document addresses the domains of health care delivery that are affected by the pandemic. It explains the current situation of health care delivery to heart failure patients and further recommendation on how to overcome this. Thus, maintaining quality …

A Predictive Analytics Model For Differentiating Between Transient Ischemic Attacks (Tia) And Its Mimics, Alia C. Stanciu, Mihai Banciu, Alireza Sadighi, Kyle A. Marshall, Neil Holland, Vida Abedi, Ramin Zand

Faculty Journal Articles

Transient ischemic attack (TIA) is a brief episode of neurological dysfunction resulting from cerebral ischemia not associated with permanent cerebral infarction. TIA is associated with high diagnostic errors because of the subjective nature of findings and the lack of clinical and imaging biomarkers. The goal of this study was to design and evaluate a novel multinomial classification model, based on a combination of feature selection mechanisms coupled with logistic regression, to predict the likelihood of TIA, TIA mimics, and minor stroke.

What Is A Vad Social Worker? A National Perspective, Pamela Combs, William Cohen, Umar Siddiqi, Valluvan Jeevanandam

The VAD Journal

Ventricular Assist Device Social Workers (VAD SWs) are mandated members of VAD care teams and contribute to the psychosocial aspect of patient care within the United States. However, the contributions and methods of the VAD SW are relatively undefined. This article reports the results of two national surveys regarding VAD SWs. One survey ascertains the VAD SW’s views of their work and their role in the VAD care team. The other survey assesses the VAD SWs involvement with care, through the perspective of the VAD team. Our results indicate that SWs are not only routinely involved in VAD patient selection …

Same-Day Discharge After Subcutaneous Implantable Cardioverter-Defibrillator Implantation Is Safe And Cost-Effective., Jill Swinning, Kelli Fox, Sreedhar Billakanty, Shannon Brown, Nagesh Chopra, Eugene Fu, Jennifer James, Gregory Kidwell, James Kleman, Victoria Murnane, Steven Nelson, Allan Nichols, S Kay Nichols, Andrea Robinson, Anish Amin

Heart and Vascular Articles

The feasibility and safety of same-day discharge after transvenous implantable cardioverter-defibrillator implantation is well-established. However, subcutaneous ICDs (S-ICDs) are now increasingly being implanted, and the feasibility, safety, and potential cost savings associated with same-day discharge after S-ICD placement has not been widely investigated. In a small cohort of patients (n = 24) who underwent S-ICD implantation at our institution, 54% were successfully discharged on the same day as their implant procedure. Procedure-related complications were not apparent in this sampling and the reduction in health care costs was high, suggesting this protocol has immense benefit in today's health care environment. As …