Cardiology Commons^™

Role Of Multimodal Cardiac Imaging In Diagnosing A Primary Intimal Sarcoma Of The Left Atrial Appendage, Kara L Raphael, Anthony P Martinez, Stephen D Clements, Ijeoma Isiadinso

The Texas Heart Institute Journal

Primary cardiac tumors are rare, and most are benign. Intimal sarcomas are among the rarest of the malignant cardiac tumors; they are aggressive and associated with a poor prognosis. Whereas transesophageal echocardiography has been instrumental in evaluating cardiac masses, other imaging methods, such as cardiac magnetic resonance, have proved invaluable in accurately characterizing these masses. We present the case of a 49-year-old woman in whom we diagnosed a primary intimal sarcoma of the left atrial appendage, and we discuss the importance of multimodal imaging in the evaluation and diagnosis of cardiac masses.

Association Of Cyp2c19*17 Allele And Choice Of P2y12 Inhibitor On Cardiovascular Outcomes Following Percutaneous Coronary Intervention, Yash Varma, Bs, Craig R. Lee, Phd, Pharmd, Joseph S. Rossi, Md, George A. Stouffer, Md

Phase 1

Introduction: The CYP2C19*17 allele variant is a gain-of-function polymorphism which increases levels of the active metabolite of clopidogrel.

Objective: *17 is associated with increased bleeding risk during clopidogrel therapy, but it is unclear whether alternative P2Y12 inhibitors, prasugrel and ticagrelor, produce better clinical outcomes in patients undergoing percutaneous coronary intervention (PCI).

Methods: A single-center observational study was conducted in 928 PCI patients who received CYP2C19 testing and dual anti-platelet therapy (DAPT). Risk of major adverse cardiovascular or cerebrovascular events (MACCE) and clinically significant bleeding over 12 months were compared across genotype and DAPT groups by proportional hazards regression.

Results: 584 …

Rapid 5 Lb Weight Gain Is Not Associated With Readmission In Patients With Heart Failure, Jill Howie-Esquivel, Kathleen Dracup, Mary A. Whooley, Charles Mcculloch, Chengshi Jin, Debra K. Moser, Robyn A. Clark, Michele M. Pelter, Martha J. Biddle, Linda G. Park

Nursing Faculty Publications

Aims Heart failure (HF) patients are taught to identify a rapid 5 lb body‐weight gain for early detection of cardiac decompensation. Few data support this common advice. The study aim was to determine whether a 5 lb weight gain in 1 week and signs and symptoms of HF increased risk for unplanned physician or emergency department (ED) visits or hospital admission in rural HF patients.

Methods and results This was a secondary analysis of a randomized trial. Patients tracked body weight and HF symptoms using diaries. We included patients adherent to daily diaries > 50% over 24 months (N = …

Atrial Myxoma Presenting With Palpitations: A Case Report, George Prousi Md, Joseph Moran Do, Ross Biggs Do

Department of Medicine

Abstract

Atrial myxomas are a rare phenomenon and although benign, primary neoplasms of the heart can be burdensome depending on their location. Clinical symptoms are caused through a variety of mechanisms including conduction disturbances, obstruction, and valvular interference. Size and symptom development are strongly correlated and can almost always be detected by the use of echocardiography, magnetic resonance imaging or computed tomography. This is a case of a 62-year-old female with no significant past medical history presented to our facility with complaints of palpitations and associated dizziness for three months.

Introduction

Atrial myxomas are the most common benign primary neoplasm …

Clinical And Procedural Effects Of Transitioning To Contact Force Guided Ablation For Atrial Fibrillation., Daniel R. Frisch, Sean J. Dikdan

Division of Cardiology Faculty Papers

Background: A major innovation in atrial fibrillation (AF) ablation has been the introduction of contact force (CF) sensing catheters.

Objective: To evaluate procedural and clinical effects of transitioning to CF-guided AF ablation.

Methods: Consecutive AF ablation patients were studiedduring the period of time of transitioning from a non-CF to CF sensing catheter. Procedural data recorded was total radiofrequency time, time to isolate the left pulmonary veins (LPVs), and time to isolate the right pulmonary veins (RPVs). Clinically, the 3 and 12-month maintenance of sinus rhythm was noted and compared by: paroxysmal vs. persistent AF; CT scan LA volume more or …

Waiting For Test Results, Herbert L Fred

The Texas Heart Institute Journal

No abstract provided.

Chicken-Fried Steak Changed My Outlook On Medicine, Michael J Lehner

The Texas Heart Institute Journal

No abstract provided.

Penetrating Atherosclerotic Ulcer Of The Ascending Aorta Found Incidentally In A 71-Year-Old Man, Antonino M Grande, Dario Di Perna, Adele Valentini, Eloisa Arbustini

The Texas Heart Institute Journal

No abstract provided.

Cardiac Replacement In Our Lifetime, Jack G Copeland

The Texas Heart Institute Journal

No abstract provided.

Preventing A Catastrophe: Increasing Awareness Of Loeys-Dietz Syndrome, Bradley S Kane, Kamran Shamsa

The Texas Heart Institute Journal

Loeys-Dietz syndrome is a genetic disorder that predisposes patients to aortic aneurysms. If left untreated, the natural history of the associated aortopathy often culminates in fatal aortic dissection. We describe the case of a 21-year-old man who was diagnosed with Loeys-Dietz syndrome after 2 family members died of aortic dissection. This case highlights the importance of increased physician awareness of this syndrome, which can play a crucial role in preventing premature sudden cardiac death caused by aortic catastrophe.

The Future Of Tissue Engineering In Heart Transplantation, Doris A Taylor

The Texas Heart Institute Journal

No abstract provided.

Percutaneous Transluminal Balloon Venoplasty: A Less Invasive Technique For Implantation Of Cardiac Leads In Patients With Limited Venous Access To The Heart, Waiel Abusnina, Zachary O. Curtis, Emilia C. Leigh, Eric Y. Auyoung, Dr. Mehiar El-Hamdani, Esam Baryun

Marshall Journal of Medicine

Since its inception, cardiac pacing has made a significant advancement in cardiology. As new therapies and devices emerge, the number of implantations is steadily increasing which requires up-to-date clinical guidelines for management. Although advanced, these mechanical devices often require maintenance and revisions to achieve optimal performance. One of the most common deteriorations is the lead failure.

In the case of lead failure requiring revision, new lead implant, or upgrading to a more advanced pacing system, venous stenosis resulting in partial or complete obstruction of the vessel can pose a real problem. This case series report introduces the technique of percutaneous …

Hemodynamic, Therapeutic, And Clinical Outcomes Of Ambulatory Pressure-Guided Heart Failure Management, Jacob Abraham, Lian Wang, Rebecca Lewis, Katherine Callis, Joshua Remick, Kateri J. Spinelli

The VAD Journal

Background: Heart failure (HF) management guided by CardioMEMS™ pulmonary artery pressure (PAP) monitoring reduces PAP and HF hospitalizations. The objective of this project was to characterize the relationship between medication adjustments, PAP change, and outcomes for all patients at an advanced HF center.

Methods: We retrospectively analyzed medication changes and hospitalizations for 32 consecutive patients implanted with the CardioMEMS™ sensor at a single HF center and related these outcomes to PAP data from the Merlin.net (Abbott) database. Absolute change in PAP from baseline was estimated using area under the curve normalized to days monitored.

Results: Patients had an average change …

Temporal Trends And Inequalities In Coronary Angiography Utilization In The Management Of Non-St-Elevation Acute Coronary Syndromes In The U.S., Muhammad Rashid, David L. Fischman, Martha Gulati, Khalid Tamman, Jessica Potts, Chun Shing Kwok, Joie Ensor, Ahmad Shoaib, Hossam Mansour, Azfar Zaman, Michael P. Savage, Mamas A. Mamas

Division of Cardiology Faculty Papers

Coronary angiography (CA) is the basis of an invasive management strategy in non-ST elevation acute coronary syndromes (NSTEACS). There are limited contemporary data on national temporal trends in utilization of CA in different patient subgroups. We sought to investigate temporal trends, predictors and clinical outcomes associated with the use of CA in the US. Using the Nationwide Inpatient Sample (NIS) from 2004–2014, we identified all inpatient admissions, age ≥18, with a primary diagnosis of NSTEACS. Descriptive statistics and multivariable logistic regression models were used to investigate temporal trends, predictors and clinical outcomes associated with CA. From a total of 4,380,827 …

Antisense Oligonucleotides Targeting Angiotensinogen: Insights From Animal Studies, Chia-Hua Wu, Ya Wang, Murong Ma, Adam E. Mullick, Rosanne M. Crooke, Mark J. Graham, Alan Daugherty, Hong S. Lu

Saha Cardiovascular Research Center Faculty Publications

Angiotensinogen (AGT) is the unique substrate of all angiotensin peptides. We review the recent preclinical research of AGT antisense oligonucleotides (ASOs), a rapidly evolving therapeutic approach. The scope of the research findings not only opens doors for potentially new therapeutics of hypertension and many other diseases, but also provides insights into understanding critical physiological and pathophysiological roles mediated by AGT.

Peak Left Atrial Strain As A Single Measure For The Non-Invasive Assessment Of Left Ventricular Filling Pressures, A. Singh, D. Medvedofsky, A. Mediratta, B. Balaney, E. Kruse, B. Ciszek, A. P. Shah, J. E. Blair, F. Maffessanti, R. M. Lang, +2 Additional Authors

Journal Articles

No abstract provided.

A Prospective, Single-Arm, Multicenter Trial Of Catheter-Directed Mechanical Thrombectomy For Intermediate-Risk Acute Pulmonary Embolism The Flare Study, T. Tu, C. Toma, V. F. Tapson, C. Adams, W. A. Label, M. Silver, S. Khandhar, R. Amin, M. Weinberg, K. Rosenfield, +8 Additional Authors

Journal Articles

No abstract provided.

Management And 1-Year Outcomes Of Patients With Newly Diagnosed Atrial Fibrillation And Chronic Kidney Disease: Results From The Prospective Garfield-Af Registry, S. Goto, P. Angchaisuksiri, J. P. Bassand, A. John Camm, H. Dominguez, L. Illingworth, H. Gibbs, S. Z. Goldhaber, A. Spyropoulos, X. S. Hu, +90 Additional Authors

Journal Articles

© 2019 The Authors. Background-—Using data from the GARFIELD-AF (Global Anticoagulant Registry in the FIELD–Atrial Fibrillation), we evaluated the impact of chronic kidney disease (CKD) stage on clinical outcomes in patients with newly diagnosed atrial fibrillation (AF). Methods and Results-—GARFIELD-AF is a prospective registry of patients from 35 countries, including patients from Asia (China, India, Japan, Singapore, South Korea, and Thailand). Consecutive patients enrolled (2013–2016) were classified with no, mild, or moderate-to-severe CKD, based on the National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative guidelines. Data on CKD status and outcomes were available for 33 024 of 34 854 patients …

World Health Organization Cardiovascular Disease Risk Charts: Revised Models To Estimate Risk In 21 Global Regions, S. Kaptoge, L. Pennells, D. De Bacquer, M. T. Cooney, M. Kavousi, G. Stevens, L. M. Riley, S. Savin, K. W. Davidson, J. Danesh, +90 Additional Authors

Journal Articles

© 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: To help adapt cardiovascular disease risk prediction approaches to low-income and middle-income countries, WHO has convened an effort to develop, evaluate, and illustrate revised risk models. Here, we report the derivation, validation, and illustration of the revised WHO cardiovascular disease risk prediction charts that have been adapted to the circumstances of 21 global regions. Methods: In this model revision initiative, we derived 10-year risk prediction models for fatal and non-fatal cardiovascular disease (ie, myocardial infarction and stroke) using individual …

The Utilization Of Telehealth/ Telemedicine In Cardiology In Rural Areas, Sophia Noplis, Jocelyn Stout

Theses, Dissertations and Capstones

Introduction: Telecardiology has been defined as a way of practicing cardiology through the utilization of telecommunications and a more cost-effective way to deliver cardiac care. As a subset of telemedicine, telecardiology has functioned to bring providers to underserved communities through technological mechanisms. Rural regions have turned to telemedicine and tapped into a network of clinical institutions exchanging practitioners and patients to emphasize value-based instead of volume-based care.

Methodology: The methodology of this qualitative study was a literature review having used mixed methodologies. Five electronic databases and government websites were utilized, and one semi-structured interview with an expert in …