Cardiology Commons^™

Association Of Estimated Plasma Volume Status With Invasive Hemodynamics And Adverse Clinical Outcomes In Patients With Pulmonary Hypertension And Chronic Kidney Disease, Andrew Geller, Jose Manuel Martinez Manzano, Esteban Kosak Lopez, Phuuwadith Wattanachayakul, John Malin, Raul Leguizamon, Tara John, Rasha Khan, Ian Mclaren, Alexander Prendergast, Simone Jarrett, Kevin Bryan Lo, Christian Witzke

Einstein Health Papers

Identifying noninvasive measures to assess intravascular volume status and risk stratify patients with pulmonary hypertension (PH) and chronic kidney disease (CKD) is needed. We assessed the predictive value of estimated plasma volume status (ePVS) using the Strauss-derived Duarte formula in PH-CKD patients. This single-center retrospective cohort analysis included patients with PH and CKD Stage 3b (CKD3b), Stage 4 (CKD4), or Stage 5 (CKD5) who underwent right heart catheterization from 2018 to 2023. Patients were categorized into low ePVS (< 6.2) and high ePVS (≥ 6.2) using Youden's J statistics. We used the Cox-proportional hazards model, adjusting for age, sex, and body mass index, to investigate the association between …

Heart Failure Devices: Treatment Options, Underutilization, And A Proposed Trigger System For Patient Referral And Evaluation, Marat Fudim, Dmitry M Yaranov, Richa Gupta, Laurie Letarte, Samuel F Sears, Brian G Howard, Nir Uriel, Vikram Raje, Kiran Mahmood, Sean P Pinney, Amin Yehya, Amit Alam, Pujan Patel, Albert Hicks, Amarinder Bindra, Steve M Antoine, Jason Feliberti, Allman Rollins, Vishal N Rao, Patrick Mccann, Nirav Raval, Rachel A Garcia, Ahmed Sayed

Faculty, Staff and Students Publications

The use of guideline-directed medical therapy (GDMT) has substantially prolonged and improved the lives of patients with heart failure (HF). Nevertheless, adherence rates remain suboptimal. Even when successfully maximized and adhered to, there is a substantial residual risk of recurrent HF hospitalization and death. In light of this, there is a strong need for effective interventions that can decrease the high residual risk seen in patients with HF. Several device options exist that are approved by the US Food and Drug Administration and that have been shown to decrease morbidity and/or mortality in patients among whom GDMT is maximized. These …

Fetal Congenital Complete Heart Block: 2 Success Stories Through Multidisciplinary Care., Mohamed Aashiq Abdul Ghayum, Jenna Schermerhorn, Hayley S. Hancock, Lindsey Malloy-Walton, Steven Olsen, Laura Vricella, Kelsey Brattrud, Melanie Kathol, Rita France, Maria Kiaffas

Manuscripts, Articles, Book Chapters and Other Papers

Congenital complete heart block (CCHB) is a rare condition associated with significant fetal and neonatal mortality. It may present as an isolated conduction abnormality in association with autoimmune disease, or in conjunction with congenital heart defects including heterotaxy-polysplenia syndrome. Early prenatal diagnosis and coordinated perinatal care are critical for improving outcomes. We present 2 cases of prenatally diagnosed CCHB. The first occurred in a fetus with heterotaxy-polysplenia syndrome, and the second in the setting of maternal anti-SSA antibody exposure. Both fetuses developed progressive bradycardia, with heart rates declining to < 50 beats/min, necessitating close fetal surveillance and individualized perinatal management. Preterm delivery and prompt placement of temporary pacing wires allowed initial stabilization before eventual definitive management, resulting in survival. The successful outcomes in these neonates highlight the critical role of multidisciplinary prenatal care, timely delivery planning, and early postnatal intervention in improving survival in fetuses diagnosed with CCHB.

Purulent Pericarditis: Treating A Medically-Complex Patient With Intrapericardial Antibiotics, Meryem Guler, Sudheshna Vemula, Matthew Hart, Josh Wiener, Darius Farzad, Mark Decaro, Gregary D. Marhefka, Devin Weber, John W.C. Entwistle, Jacqueline Urtecho

Division of Cardiology Faculty Papers

OBJECTIVE: Purulent pericarditis is a rare, lethal complication of a bacterial pericardial infection. This case report outlines the protocol for instilling intrapericardial antibiotics for methicillin-sensitive Staphylococcus aureus (MSSA) pericarditis without fibrinolytics in a 51-year-old man.

KEY STEPS: An appropriately sized percutaneous pericardial drain was placed. Then, a 3-day course of intrapericardial infusions of 50 mL vancomycin was begun. Drainage of all accessible fluid was performed before each infusion. The daily infusions each had an 8-hour dwell time. The prior drainage protocol continued after each infusion.

POTENTIAL PITFALLS: Strict dosage and infusion length management are required to prevent direct toxicity. Potential …

Long-Term Survival In Lung Cancer With Brain Metastases And Coronary Artery Stenosis: A Case Report, Raghad O. Alharbi, Shahad J. Alshammary, Nasser E. Alotaibi, Ruba M. Aljohani, Bader A. Alotaibi, Ihab F. Suliman

Journal of the Saudi Heart Association

Lung cancer is among the most diagnosed cancers worldwide, and its co-occurrence with coronary heart disease is life-threatening. Osimertinib is the standard treatment for epidermal growth factor receptor (EGFR) mutations in advanced non-small cell lung cancer (NSCLC). The addition of pemetrexed and carboplatin increases not only the efficacy but also the cardiotoxicity risk. We report a 59-year-old woman with NSCLC alongside brain, liver, and spleen metastases, who developed cardiovascular events following cancer therapy. With advanced imaging and multidisciplinary intervention, remarkable remission was achieved over two years. Reporting this case contributes to the understanding of its presentation and diagnostic challenges.

Artificial Intelligence-Enhanced Electrocardiography For Hypertrophic Cardiomyopathy: Bridging The Gap Between Innovation And Clinical Implementation, Muhammad Nabeel Saddique, Alina Jamshed

Journal of the Saudi Heart Association

No abstract for this article type

Improving Outcomes In Pediatric Congenital Heart Disease: The Integration Of Wearable Technology And Ai-Driven Analysis, Sophia Moon, Melissa Cruz, Pad Renga

Research Colloquium

Background: Wearable devices such as biosensors and smartwatches have demonstrated clinical utility in arrhythmia detection in adult populations, but their integration into pediatric congenital heart disease (CHD) care remains limited. Despite advances in CHD management, challenges persist in the timely identification of arrhythmias in children. The use of wearables in pediatrics is constrained by research gaps, adherence issues, and complex data interpretation. Traditional tools like Holter monitors and event recorders face limitations in detecting intermittent arrhythmias and ensuring compliance. These devices cannot leverage artificial intelligence (AI) and machine learning (ML) to enhance ECG interpretation. This study analysis evaluates the potential …

Deprescribing And Polypharmacy In Heart Failure Patients Aged 80 Years And Older: A Case Report, Learsi R. De Hoyos, Elizabeth Mills-Reyes, Chelsea Chang

Research Colloquium

Background: Since 2004, the number of adults aged 65 and older has increased by 5.6%. With a growing geriatric population, medical management should maximize benefits and minimize risks. Polypharmacy, defined as the concurrent use of 5 or more medications, is a common concern in older adults. In adults 80 years and older, the prevalence of polypharmacy is 67.1%. Among adults with heart disease, the prevalence of polypharmacy increased from 40.6% to 61.7% between 2000 and 2018. In the context of heart failure, guideline-directed medical therapy (GDMT) includes beta-blockers, renin-angiotensin-aldosterone system (RAAS) inhibitors, mineralocorticoid receptor antagonists (MRAs), and sodium-glucose cotransporter 2 …

Semilunar Valve Replacement With A Telescoping Arterial Trunk Valve, Edo Bedzra, Herra Javed, James E. O'Brien, Taufiek Konrad Rajab

Manuscripts, Articles, Book Chapters and Other Papers

A bicuspid aortic valve, from autologous tissue, with growth potential can be constructed using the simple, and reproducible telescoping arterial trunk technique.

Impact Of Tricuspid Regurgitation On The Clinical Outcomes Of Patients With Heart Failure, Muhammad U. Almani, Rasha Khan, Noor Fatima, Muhammad Yousuf, Aman Amanullah

Einstein Health Papers

BACKGROUND: Tricuspid regurgitation (TR) is a common occurrence in patients with heart failure (HF), and its role in disease progression has gained attention in recent years. Although TR can worsen clinical outcomes in HF patients, the impact of gender, racial, and socioeconomic factors remains largely unexplored. With growing evidence supporting the role of percutaneous interventions for the treatment of significant TR, understanding these disparities is more crucial than ever.

METHODS: Data were extracted from the National Inpatient and National Readmission 2016-2020 Databases. We used ICD-10 code I50 to identify the patients primarily admitted for HF and subdivided the cohort into …

Bilateral Pulmonary Embolism With Bi-Atrial Cardiac Thrombi Entrapped In A Patent Foramen Ovale, Denise Mourad, Fahd Eissa Mohamed, Yashi Ballal, Elie Mrad, Natasa Petreska, Sachin Singh, Paritharsh Ghantasala

Journal of Community Hospital Internal Medicine Perspectives

Bi-atrial thrombi with bilateral pulmonary embolism (PE) through a patent foramen ovale (PFO) is rare and life-threatening, requiring urgent management due to embolization risk. We present a 53-year-old female with left lower extremity extensive deep vein thrombosis (DVT), bilateral PE, and bi-atrial thrombi straddling a PFO. She underwent thrombectomy, PFO closure, and pulmonary embolectomy but later experienced recurrent DVT and PE. Anticoagulation was limited due to bleeding risk given a recent neurosurgery. Literature lacks clear guidelines for managing such cases necessitating individualized treatment. This case highlights the complexity of bi-atrial thrombi with PFO and the need for further research to …

Erratum To “Cardiac Screening Findings And Referral Patterns In Male African-American Basketball Players: Analysis Of The Heartbytes Registry”[The American Journal Of Cardiology 243 (2025) 73-80], Douglas Corsi, Avinash Saraiya, Maggie Doyle, Vacha Shah, Blaise O’Malley, Grace Qiu, Renee Lanstaff, Imran Masood, Brian Osler, Alexander Hajduczok, Drew Johnson, David Shipon

Division of Cardiology Faculty Papers

No abstract provided.

The Hidden Link Between Hiv And Cardiomyopathy: Unraveling Hiv's Impact On The Heart, Toluwalase Awoyemi, Oluwaremilekun Zeth Tolu-Akinnawo, Andrew Greek, Oluwakemi Adenuga, Chukwuebuka Asogwa, Isaac Ekundayo, Olamide Odusola, Oyinlola O. Fasehun, Mercy Ajayi, Onyinye Ugoala

School of Medicine Publications

This comprehensive review examines the complex relationship between human immunodeficiency virus (HIV) and cardiomyopathy, focusing on the underlying molecular mechanisms, clinical manifestations, diagnostic approaches, and treatment strategies. It highlights the significant global health burden posed by HIV and its potential to cause long-term cardiovascular complications. The review investigates the pathogenesis of HIV-associated cardiomyopathy. It elucidates the intricate cellular and molecular pathways involved, including the actions of neutrophils, monocytes, macrophages, and lymphocytes in cardiac inflammation. Key signaling pathways such as TNF-NF-κB and the caspase-1 inflammasome are detailed, as they contribute to cardiac infection and injury. The clinical manifestations of HIV-associated cardiomyopathy …

Challenging Case: Acute Type A Aortic Dissection With Multi-Organ Malperfusion, Rishab Agarwal, Allebelle Bradshaw Md, Jennifer S. Lawton Md

Cardiovascular Research Symposium

Description of case: A 57-year-old male with hypertension and obesity presented with acute, severe chest pain. He developed a cold, numb right leg with motor deficits. He was hypotensive with a lactate of 7.4. CT imaging revealed an acute Type A aortic dissection (TAAD) with malperfusion involving the right internal carotid, right subclavian, and right coronary arteries, as well as the superior mesenteric artery, and right iliac artery (Fig 1A/B). He was transferred to our tertiary center for emergent surgery.

Five hours after presentation, he underwent emergent ascending aortic replacement, deep hypothermic circulatory arrest, and retrograde cerebral perfusion. The …

Association Between Cardiovascular Risk And Kidney Function In A Real-World Peruvian Cohort, Juan Munoz-Moreno, Gina Sanchez, Johanna Contreras

Cardiovascular Research Symposium

Background: Cardiovascular risk and kidney function are interrelated, with variations by sex and age. Middle-aged women often have slightly lower kidney function than men, increasing susceptibility to early renal effects of elevated cardiovascular risk, but data from Latin America remain limited.

Methods: Cross-sectional study of adults aged 40-79 years evaluated at a tertiary hospital in Peru between January and June 2024. We excluded individuals with established cardiovascular disease, statin use, LDL >190 mg/dL, or incomplete ASCVD risk data. Ten-year ASCVD risk was estimated using the 2013 Pooled Cohort Equations with race set as “Other” and classified as low, borderline, intermediate, …

Six-Year Survival Following Liver Transplant In Val30met Hereditary Transthyretin Amyloidosis, Juan Munoz-Moreno, Johanna Contreras

Cardiovascular Research Symposium

Background: Hereditary transthyretin amyloidosis (ATTRv) is a progressive, multisystem disorder caused by pathogenic TTR mutations affecting the heart and peripheral nerves. While disease-modifying agents such as tafamidis are available, liver transplantation (LTx) remains an option in selected genotypes, with over 50% of Val30Met carriers surviving up to 20 years post-transplant.

Case: A 53-year-old male with a permanent pacemaker for complete atrioventricular block presented with NYHA class II dyspnea, syncope, and lower extremity paresthesias. ECG showed atrial fibrillation. Transthoracic echocardiography revealed preserved ejection fraction, biventricular wall thickening with granular appearance, moderate left atrial dilation, and moderate mitral regurgitation. Speckle-tracking echocardiography demonstrated …

Mechanical Circulatory Support As A Bridge To Early Recovery Of Left Ventricular Function In Fulminant Myocarditis, Juan Munoz-Moreno, Gina Sanchez, Johanna Contreras

Cardiovascular Research Symposium

Background: Fulminant myocarditis (FM) is a rare cause of acute heart failure that can lead to a rapid left ventricular ejection fraction (LVEF) decline within four weeks. With in-hospital mortality up to 18.2%, timely mechanical circulatory support (MCS) is essential to stabilize hemodynamics and bridge to recovery or transplantation.

Case: A 49-year-old Japanese man with hypertension and diabetes presented with two weeks of dyspnea and angina after a flu-like illness. On admission, he developed ventricular fibrillation requiring advanced CPR. Physical exam revealed pulmonary congestion. ECG showed repolarization abnormalities. TTE demonstrated severe biventricular dysfunction (LVEF 9%, RVFAC 9%). Labs showed elevated …

Periprocedural Results And Right Ventricular Outcomes Of Computer Assisted Vacuum Thrombectomy Treatment Of Acute Pulmonary Embolism: Interim Analysis Of 300 Patients From The Strike-Pe Study, John M. Moriarty, Brian J. Schiro, Suhail Y. Dohad, Houman Tamaddon, Hugh C. Davis, David M. Shavelle, George S. Chrysant, Elias A. Iliadis, David J. Dexter, Juan J. Ciampi Dopazo, Andrew Holden, Frances M. West, Brent Keeling, Andrew S. P. Sharp, Ido Weinberg

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

BACKGROUND: Pulmonary embolism (PE) can be a life-threatening condition. Endovascular treatment is emerging as a promising treatment to restore hemodynamic stability and reverse right ventricular (RV) dysfunction in PE; however, more studies are needed to elucidate the effects on the right ventricle after endovascular treatment. This analysis reports the effects of computer assisted vacuum thrombectomy on RV function.

METHODS: Eligible patients for the single-arm, prospective, international, multicenter STRIKE-PE (A Prospective, Multicenter Study of the Indigo Aspiration System Seeking to Evaluate the Long-Term Safety and Outcomes of Treating Pulmonary Embolism) cohort study are adults with acute PE with symptoms for ≤14 …

What Next? A Challenging Case Of Refractory Hypertension With End-Organ Dysfunction In A 33-Year-Old Male, Rezane Miftari Md, Shaun Abid, Anton Stolear, Irma Fotjhadi

Posters

We present a challenging case of a 33-year-old male with history of longstanding hypertension since high school, which progressed to RH complicated by severe left ventricular hypertrophy and hypertensive nephrosclerosis.

International Accreditation For Acute Stroke Care: Lessons Learnt From A Kenyan Stroke Centre, Dilraj Sokhi

Internal Medicine, East Africa

Background: The prevalence of stroke is increasing in Africa, yet resources remain limited in managing the disease. Whilst there are international guidelines on how to set up and manage stroke services, even in resource-limited settings, the uptake remains low. We describe here the opportunities and challenges we faced whilst setting up a stroke care pathway of international standards in a regional referral hospital in East Africa.

Methods: We describe how we adapted international stroke care guidelines for acute primary stroke (including both ischemic and hemorrhagic stroke), and used these to inform our stroke care pathway. We highlight opportunities of leveraging …