Cardiology Commons^™

Advantages Of Bridging To Durable Left Ventricular Assist Device With The Impella 5.0, Manish K. Patel

The VAD Journal

The mainstay therapy for patients in critical cardiogenic shock (CS) is temporary mechanical circulatory support. Although there is a trend toward use of durable left ventricular assist devices (LVAD) in patients that are less ill, we present our experience with using the Impella 5.0 (Abiomed) to illustrate the potential benefits of supporting patients with critical CS before durable LVAD implantation. Since 2012, our use of the Impella has increased from 5 to 38 per year. Mortality is highest early after LVAD implantation, but our long-term survival is better than data reported to the INTERMACS registry. Use of an Impella 5.0 …

A "Blinking" Left Ventricular Assist Device, Maya Guglin, Roopa Rao

The VAD Journal

A 61-year-old male with history of coronary artery disease and end stage ischemic cardiomyopathy underwent a successful implantation of a HeartMate 3 device with an uneventful recovery. However, after 6 months, he complained of increased fatigue, intermittent dizziness, and weakness after minor exertion. The pulsatility index was increased to 8, but the left ventricular assist device (LVAD) was otherwise functioning properly. No major changes in either medications or laboratory results were noted. The patient started getting low flow alarms seven months after the procedure and the dizziness increased. On the controller, a continuously changing (“blinking”) speed was noted (Supplemental Video …

Shear Stress Associated With Cardiopulmonary Bypass Induces Expression Of Inflammatory Cytokines And Necroptosis In Monocytes., Lan N. Tu, Lance Hsieh, Masaki Kajimoto, Kevin Charette, Nataliya Kibiryeva, Adriana Forero, Sarah Hampson, Jennifer A. Marshall, James O'Brien, Marta Scatena, Michael A. Portman, Ram Savan, Chris Benner, Alberto Aliseda, Muhammad Nuri, Douglas Bittel, Peter Pastuzsko, Vishal Nigam

Manuscripts, Articles, Book Chapters and Other Papers

Cardiopulmonary bypass (CPB) is required during most cardiac surgeries. CBP drives systemic inflammation and multiorgan dysfunction that is especially severe in neonatal patients. Limited understanding of molecular mechanisms underlying CPB-associated inflammation presents a significant barrier to improve clinical outcomes. To better understand these clinical issues, we performed mRNA sequencing on total circulating leukocytes from neonatal patients undergoing CPB. Our data identify myeloid cells, particularly monocytes, as the major cell type driving transcriptional responses to CPB. Furthermore, IL-8 and TNF-α were inflammatory cytokines robustly upregulated in leukocytes from both patients and piglets exposed to CPB. To delineate the molecular mechanism, we …

Predictive Value Of Blood N-Terminal Pro-Brain Natriuretic Peptide Concentrations For Early Patent Ductus Closure In Very Preterm Infants, Solomiia Potsiurko, Dmytro Dobryanskyy, Lesya Sekretar

Journal of the Saudi Heart Association

Objectives. It has been shown that blood concentrations of NT-proBNP may be useful in identifying preterm infants at risk of hemodynamically significant patent ductus arteriosus and its complications. The aim of the study was to assess predictive value of serum NT-proBNP levels for early ductus arteriosus (DA) closure in very preterm newborns.
Methods. Fifty-two infants weeks’ gestation aged (PDA) diameter >1.5 mm were involved in a randomized study. Twenty-seven (52%) of them were treated with ibuprofen or paracetamol starting within the first 3 days of life. Expectant management was applied to 25 (48%) infants. All patients underwent planned echocardiographic (daily) …

Right Atrial Volume Index As A Predictor Of Persistent Right Ventricular Dysfunction In Patients With Acute Inferior Myocardial Infarction And Proximal Right Coronary Artery Occlusion Treated With Primary Percutaneous Coronary Intervention, Mohamed Naseem, Sameh Samir

Journal of the Saudi Heart Association

Objectives: Patients with right ventricular (RV) infarctions associated with inferior infarctions have higher rates of adverse events than isolated inferior infarctions. Right atrial volume index (RAVI) has recently been described as a predictor of clinical outcome in patients with chronic systolic heart failure and pulmonary hypertension. The aim of this study is to assess the ability of RAVI to predict the persistent RV dysfunction after acute inferior STEMI due to occlusion of proximal RCA. To the best of our knowledge, this is the first study to investigate the relation between RAVI and persistent RV dysfunction in such group of patients. …

Office Blood Pressure Measurement: A Comprehensive Review, Saulat Siddique, Aamir Hameed Khan, Hunaina Shahab, Yu-Qing Zhang, Jam Chin Tay, Peera Buranakitjaroen, Yuda Turana, Narsingh Verma, Chen-Huan Chen, Hao-Min Cheng

Section of Cardiology

The conventional auscultatory methods for measuring blood pressure have been used to screen, diagnose, and manage hypertension since long. However, these have been found to be prone to errors especially the white coat phenomena which cause falsely high blood pressure readings. The Mercury sphygmomanometer and the Aneroid variety are no longer recommended by WHO for varying reasons. The Oscillometric devices are now recommended with preference for the Automated Office Blood Pressure measurement device which was found to have readings nearest to the Awake Ambulatory Blood Pressure readings. The downside for this device is the cost barrier. The alternative is to …

Disparities In Cardiovascular Disease Outcomes Among Pregnant And Post-Partum Women, Mohamed M Gad, Islam Y Elgendy, Ahmed N Mahmoud, Anas M Saad, Toshiaki Isogai, Isadora Sande Mathias, Rabel Misbah Rameez, Johnny Chahine, Hani Jneid, Samir R Kapadia

Faculty, Staff and Students Publications

Background

The incidence of cardiovascular disease among pregnant women is rising in the United States. Data on racial disparities for the major cardiovascular events during pregnancy are limited.

Methods and Results

Pregnant and post‐partum women hospitalized from January 2007 to December 2017 were identified from the Nationwide Inpatient Sample. The outcomes of interest included: in‐hospital mortality, myocardial infarction, stroke, pulmonary embolism, and peripartum cardiomyopathy. Multivariate regression analysis was used to assess the independent association between race and in‐hospital outcomes. Among 46 700 637 pregnancy‐related hospitalizations, 21 663 575 (46.4%) were White, 6 302 089 (13.5%) were Black, and 8 914 …

Highlights From Studies Presented At The American Heart Association Scientific Session 2020: Navigating New Roads In Prevention, Aliza Hussain, Mahmoud Al Rifai, Dhruv Mahtta, Jing Liu, Vardhmaan Jain, Salim S Virani

Faculty, Staff and Students Publications

PURPOSE OF THE REVIEW: This review highlights late-breaking science presented at the American Heart Association Scientific Session 2020 that demonstrated advancements in preventative cardiology and introduced novel treatment approaches for the management of chronic kidney disease, type 2 diabetes, and/or heart failure.

RECENT FINDINGS: The studies reviewed include clinical trials that assessed the use of omecamtiv in the treatment of heart failure with reduced heart failure (GALACTIC-HF); effects of sotagliflozin in patients with diabetes and recent heart failure exacerbation; cardiovascular outcomes with the use of omega-3 carboxylic acids in patients with high vascular risk and atherogenic dyslipidemia (STRENGTH) and omega-3 …

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.

Contemporary Treatment Options For Pulmonary Embolism, Tanya Glenz, Teresa Jahn

Nursing Posters

Purpose:

Provide RNs education on the classifications of PEs and new catheter directed treatment options.

Significance:

• PE remains a common and lethal entity
• PE is the 3rd leading cause of cardiovascular death in hospitalized patients (60,000-1000,000 per year)
• 150,000-250,000 PE related hospitalizations per year
• RNs must be knowledgeable of the classifications of PEs and catheter directed therapies to promote positive patient outcomes
• Prior to catheter directed therapies, submassive PEs had a mortality rate up to 20% at 3 months and were traditionally treated with IV heparin, or oral anticoagulant therapy

Atrial Fibrillation In Covid-19: A Descriptive Study Of Incidence, Mortality And Related Factors, Diana L. Taylor

DNP Research Projects

Abstract

This scholarly project determined the relationship of atrial fibrillation (AF) occurrences in COVID-19, as it is the most frequent arrhythmia in the U.S. and is driven by inflammatory pathology. In COVID-19 positive patients with AF occurrences understanding the relationship between these conditions could help identify patients with poor prognosis, higher morality, and other factors earlier in the hospital course.

This single-center scholarly project was a retrospective descriptive chart review to determine the relationship between AF and COVID-19 over a 6-month timeline in Chattanooga, TN. Of the 565 hospitalized COVID-19 positive patients included, 82 (14.5%) had AF occurrences. A higher …

Atrial Fibrillation Is An Independent Predictor For In-Hospital Mortality In Patients Admitted With Sars-Cov-2 Infection., S. E. Mountantonakis, M. Saleh, J. Fishbein, A. Gandomi, M. Lesser, J. Chelico, J. Gabriels, M. Qiu, L. M. Epstein, Northwell Covid-19 Research Consortium

Journal Articles

Background

Atrial fibrillation (AF) is the most encountered arrhythmia and has been associated with worse in-hospital outcomes.

Objective

This study was to determine the incidence of AF in patients hospitalized with coronavirus disease 2019 (COVID-19) as well as its impact on in-hospital mortality.

Methods

Patients hospitalized with a positive COVID-19 polymerase chain reaction test between March 1 and April 27, 2020, were identified from the common medical record system of 13 Northwell Health hospitals. Natural language processing search algorithms were used to identify and classify AF. Patients were classified as having AF or not. AF was further classified as new-onset …

Should Covid-19 Patients > 75 Years Be Ventilated? An Outcome Study., H. Raheja, N. Chukwuka, C. Agarwal, D. Sharma, A. Munoz-Martinez, J. Fogel, M. Khalid, A. T. Hashmi, S. Ehrlich, G. R. Rojas-Marte, +11 Additional Authors

Journal Articles

Background

Elderly patients with COVID-19 disease are at increased risk for adverse outcomes. Current data regarding disease characteristics and outcomes in this population is limited.

Aim

To delineate the adverse factors associated with outcomes of COVID- 19 patients ≥75 years of age.

Design

Retrospective cohort study.

Methods

Patients were classified into mild/moderate, severe/very severe, and critical disease (intubated) based on oxygen requirements. The primary outcome was in-hospital mortality.

Results

355 patients aged ≥75 years hospitalized with COVID-19 between March 19th and April 25th, 2020 were included. Mean age was 84.3 years. One-third of the patients developed critical disease. Mean length …

Outcomes In Patients With Covid-19 Disease And High Oxygen Requirements., G. Rojas-Marte, A. T. Hashmi, M. Khalid, N. Chukwuka, J. Fogel, A. Munoz-Martinez, S. Ehrlich, M. Akbar Waheed, D. Sharma, J. Shani, +6 Additional Authors

Journal Articles

Background

Approximately 19% of people infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) progress to severe or critical stages of the coronavirus disease 2019 (COVID-19) with a mortality rate exceeding 50%. We aimed to examine the characteristics, mortality rates, intubation rate, and length of stay (LOS) of patients hospitalized with COVID-19 disease with high oxygen requirements (critically ill).

Methods

We conducted a retrospective analysis in a single center in Brooklyn, New York. Adult hospitalized patients with confirmed COVID-19 disease and high oxygen requirements were included. We performed multivariate logistic regression analyses for statistically significant variables to reduce any …

Commentary: Covid 19: Don't Throw Caution To The Wind Nor Air Leak. Use Ppe!, R. S. Lazzaro, M. L. Inra, B. Patton

Journal Articles

No abstract provided.

Mitral Valve-In-Valve And Valve-In-Ring: Tips, Tricks, And Outcomes, L Pirelli, E Hong, R Steffen, T P. Vahl, S K. Kodali, V Bapat

Journal Articles

No abstract provided.

Association Between Regional Distributions Of Sars-Cov-2 Seroconversion And Out-Of-Hospital Sudden Death During The First Epidemic Outbreak In New York., K. M. Coleman, M. Saleh, S. E. Mountantonakis

Journal Articles

Background

Increased incidence of out-of-hospital sudden death (OHSD) has been reported during the coronavirus 2019 (COVID-19) pandemic. New York City (NYC) represents a unique opportunity to examine the epidemiologic association between the two given the variable regional distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in its highly diverse neighborhoods.

Objective

The purpose of this study was to examine the association between OHSD and SARS-CoV-2 epidemiologic burden during the first COVID-19 pandemic across the highly diverse neighborhoods of NYC.

Methods

The incidences of OHSD between March 20 and April 22, 2019, and between March 20 and April 22, 2020, …

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.

Transcatheter Aortic Valve Replacement (Tavr), Emily Wentzel

Student Research Poster Presentations 2021

Transcatheter Aortic Valve Replacement (TAVR)

Emily Wentzel

Lynn Blazaskie

Abstract

Transcatheter Aortic Valve Replacement, or TAVR, is a procedure that is performed when a patient is in need of a new aortic valve. This is a procedure done to relieve symptoms of aortic stenosis. TAVR first began in France in 2002 and came to the United States in 2005. Cardiac Catheterization is the modality that is utilized in order to perform this procedure along with a cardiac catheterization team. The team includes cardiac catheterization technologists, doctors, nurses, cardiovascular surgeons, and ultrasound technologists. Cardiac Catheterization is a minor surgical procedure that …

Statins And Women, Debra Schulte

Rural Health Professions Projects

Low-density lipoprotein (LDL) elevation is a primary risk factor for atherosclerotic cardiovascular problems such as heart disease and stroke. Heart disease is the leading cause of death in the United States and stroke is the fifth leading. Earlier LDL reduction improves morbidity and mortality. Literature indicates fewer women start statin medications compared to men.