Cardiology Commons^™

Fetal Myocardial Performance Index In The Late Third Trimester For The Prediction Of Intrapartum Cardiotocographic Abnormalities, Sikolia Wanyonyi, Ingrid Gichere

Obstetrics and Gynaecology, East Africa

Objective

We sought to determine whether fetal myocardial performance index (MPI) performed in the late third trimester could predict abnormal intrapartum cardiotocographic (CTG) patterns.

Methods

A prospective observational study including women presenting for fetal growth ultrasound from 32 weeks. Three consecutive measurements of the left ventricular MPI were obtained and averaged. The patients’ intrapartum CTG events were later observed.

Results

A total of 299 women were analyzed. The fetal MPI across the population were 0.41, 0.50 and 0.63, representing 10th, 50th and 90th centiles, respectively. A one-way analysis of variance (ANOVA) did not show a significant difference in MPI values …

Patients´ Characteristics And Six-Month Outcomes Of Patients With Atrial Fibrillation In Kenya: A Retrospective Observational Cohort Study From The National Cardiovascular Registry, Salim Abdallah, Jasmit Shah, Anders Barasa, Felix Barasa, Benard Gitura, Mzee Ngunga

Internal Medicine, East Africa

Introduction: atrial fibrillation is increasingly diagnosed in Kenya due to the persistence of rheumatic heart disease and the rising burden of cardiovascular risk factors. We aim to describe the baseline, clinical, treatment characteristics, and six-month outcomes of patients diagnosed with atrial fibrillation in Kenya.

Methods: a retrospective observational cohort study design was employed. Data were obtained from three Kenyan referral hospitals, including public and private institutions. Baseline and six-month data were collected. Depending on the type of variable, data were summarized descriptively.

Results: two hundred forty participants were enrolled, with a median age of 59.0 (IQR: 42.0-75.8). …

Cardiogenic Shock With Acute Myocardial Infarction Among Older Adults In The United States, Taha Mansoor, Ali Bin Jabbar, Mahmoud Ismayl, Dylan Yu, Kartik Gupta, Sachin Parikh, Austin Brubaker, Abdul Minhas, Dmitry Abramov, Salim S. Virani

Population Health, East Africa

Background: Characteristics and outcomes associated with cardiogenic shock (CS) with acute myocardial infarction (AMI) in older patients have not been well characterized.

Objectives: The purpose of this study was to investigate characteristics and outcomes of older patients admitted with CS with AMI.

Methods: We used the National Inpatient Sample database to evaluate clinical characteristics of hospitalizations, clinical outcomes, and health care utilization of hospitalizations of older patients ≥80 years with CS and AMI from 2003 to 2021. We also compared data from older patients with a reference relatively younger patient population (18-79 years).

Results: During the study period, …

Ideal Navitor Implant Depth For Redo-Tavr Feasibility And Coronary Access: A Ct Simulation Study, Sahil Khera, Syed Zaid, Parasuram Krishnamoorthy, Anoop N Koshy, Sneha Gudibendi, Megan Berdan, Lucy M Safi, Stamatios Lerakis, George D Dangas, Samin K Sharma, Annapoorna S Kini, Gilbert H L Tang

Faculty, Staff and Students Publications

Background: The impact of implant depth of the Abbott Navitor intra-annular, self-expanding valve on redo-transcatheter aortic valve replacement (TAVR) feasibility is unknown.

Objectives: The authors sought to determine the feasibility of redo-TAVR and coronary access with Edwards Sapien 3 (S3) valve after initial Navitor valve, based on various implant depths on computed tomography (CT) simulation.

Methods: Using 2050 pre-TAVR CTs of patients with native aortic stenosis, initial Navitor TAVR simulations were done at 3 implant depths (0 mm, 3 mm, and 5 mm), with frame expansion assumed at native annular dimensions and commissural alignment not achievable. Redo-TAVR with S3 was …

Association Between Chd And Cerebral Abscess: Insights From A National Database., Keats Ewing, Rohit Seath Loomba, Saul Flores, Enrique G. Villarreal, Juan S. Farias, Matthew Taylor Coghill

Manuscripts, Articles, Book Chapters and Other Papers

CHD has been historically associated with the development of cerebral abscess. This retrospective cohort study examines the association of CHD with the occurrence of cerebral abscess in an inpatient paediatric population. We analysed data from the Pediatric Health Information System database, an administrative database that captures data from participating children's hospitals in the United States. We included all patients admitted to participating paediatric ICUs between 2016 and 2021 for a total of 426,029 admissions. Including all admissions, 1,387 (0.3%) patients experienced a cerebral abscess, and of 80,927 (19%) patients with CHD, only 88 (0.1%) experienced a cerebral abscess (odds ratio …

Cardiogenic Shock With Acute Myocardial Infarction Among Older Adults In The United States, Taha Mansoor, Ali Bin Abdul Jabbar, Mahmoud Ismayl, Dylan Yu, Kartik Gupta, Sachin Parikh, Austin Brubaker, Abdul Mannan Khan Minhas, Dmitry Abramov, Jagadeesh Kalavakunta, Vishal Gupta, Salim S Virani, Santhosh K G Koshy

Faculty, Staff and Students Publications

Background: Characteristics and outcomes associated with cardiogenic shock (CS) with acute myocardial infarction (AMI) in older patients have not been well characterized.

Objectives: The purpose of this study was to investigate characteristics and outcomes of older patients admitted with CS with AMI.

Methods: We used the National Inpatient Sample database to evaluate clinical characteristics of hospitalizations, clinical outcomes, and health care utilization of hospitalizations of older patients ≥80 years with CS and AMI from 2003 to 2021. We also compared data from older patients with a reference relatively younger patient population (18-79 years).

Results: During the study period, 207,333 hospitalizations …

Whole-Genome Sequence-Based Association Analysis Of African American Individuals With Bipolar Disorder And Schizophrenia, Runjia Li, Sarah A Gagliano Taliun, Kevin Liao, Matthew Flickinger, Janet L Sobell, Giulio Genovese, Adam E Locke, Rebeca Rothwell Chiu, Jonathon Lefaive, Jiongming Wang, Taylor Martins, Sinéad Chapman, Anna Neumann, Robert E Handsaker, Donna K Arnett, Kathleen C Barnes, Eric Boerwinkle, David Braff, Brian E Cade, Myriam Fornage, Richard A Gibbs, Karin F Hoth, Lifang Hou, Charles Kooperberg, Ruth J F Loos, Ginger A Metcalf, Courtney G Montgomery, Alanna C Morrison, Zhaohui S Qin, Susan Redline, Alexander P Reiner, Stephen S Rich, Jerome I Rotter, Kent D Taylor, Karine A Viaud-Martinez, National Heart, Lung, And Blood Institute Trans-Omics For Precision Medicine (Topmed) Consortium;, Genomic Psychiatry Cohort Investigators, Tim B Bigdeli, Stacey Gabriel, Sebastian Zollner, Albert V Smith, Goncalo Abecasis, Steve A Mccarroll, Michele T Pato, Carlos N Pato, Michael Boehnke, James Knowles, Hyun Min Kang, Roel A Ophoff, Jason Ernst, Laura J Scott

Faculty, Staff and Students Publications

In studies of individuals of primarily European genetic ancestry, common and low-frequency variants and rare coding variants have been found to be associated with the risk of bipolar disorder (BD) and schizophrenia (SZ). However, less is known for individuals of other genetic ancestries or the role of rare non-coding variants in BD and SZ risk. We performed whole-genome sequencing (∼27X) of African American individuals: 1,598 with BD, 3,295 with SZ, and 2,651 unaffected controls (InPSYght study). We increased power by incorporating 14,812 jointly called psychiatrically unscreened ancestry-matched controls from the Trans-Omics for Precision Medicine (TOPMed) Program for a total of …

Multi-Center Survey Of Medicine Residents And Self-Assessment On Cardiac Complications In Obstetric Patients, Kevyn Niu, Christie A. Tran, Robert J. Subbiondo Md, Olubenga Oyesanmi

HCA Healthcare Journal of Medicine

Background

Internal medicine (IM) residents receive significant cardiology training, and previous surveys have evaluated IM resident competency on obstetric (OB)-related subjects. However, there is minimal literature on self-reported competence of cardiac-specific complications in OB patients. Our study assessed self-reported comfort and competency regarding cardiovascular complications in OB patients with medical residents across several specialties.

Methods

We surveyed 207 residents across 3 specialties and 3 teaching hospitals on 10 questions regarding their self-reported confidence in managing cardiovascular complications in OB patients, including practice setting, specific cardiac issues, and stages of labor. We received 42 responses. Results were obtained using Google Sheets …

Nondominant Right Coronary Artery Occlusion Leading To An Anterior St-Segment Elevation Myocardial Infarction, Taha Ahmed, Taylor Wood, Austin Harris, Rajan Desai, Garima Handa, Naoki Misumida, Amartya Kundu

HCA Healthcare Journal of Medicine

Background

A nondominant right coronary artery supplies a small portion of the myocardium. Albeit rare, an acute occlusion of a nondominant right coronary artery is believed to be inconsequential with minimal clinical relevance.

Case Presentation

We present a case of a middle-aged man who presented with chest pain and an electrocardiogram demonstrating anterior ST-segment elevation. An emergent coronary angiogram revealed acute thrombotic occlusion of the proximal nondominant right coronary artery with no significant obstructive atherosclerotic disease in the dominant left coronary circulation. Balloon angioplasty of the occluded vessel followed by implantation of a drug-eluting stent resulted in the resolution of …

Characteristics And Outcomes Of Axillary And Subclavian Artery Injuries, Benjamin Samberg, Nicholas Bandy, Michael Martyak

Cardiovascular Research Symposium

INTRODUCTION: Subclavian and axillary artery injuries are rare but life-threatening. Optimal management strategies remain debated. This study compares injury characteristics and outcomes.

METHODS: Retrospective analysis was conducted on 181 PROOVIT Database patients categorized by injury location, mechanism, and treatment (open, endovascular, nonoperative). Collected data includes ISS, PRBC, mortality, hospital and ICU LOS, and hard signs.

RESULTS: Subclavian injuries had higher ISS (μ=25, 19; p=0.004) and mortality (18%, 3.4%; p=0.004), but fewer hard signs (41%, 63%; p=0.004) than axillary. Axillary injuries were more frequently treated with open repair (51%, 32%; p=0.016), while subclavian injuries were more often managed nonoperatively (45%, 29%; …

B Cell Subset Specific Regulation Via Desmosterol In An Atherosclerotic Environment, Shelby Ma, Alina Morty, Kathleen Coleman, Basudha Habisyasi, Elena Galkina

Cardiovascular Research Symposium

No abstract provided.

New Onset Heart Failure Of Sodium-Glucose Cotransporter 2 (Sglt2) Inhibitors In Patients With End-Stage Renal Disease (Esrd) And Dialysis, Daiwik Munjwani, Amin Yehya

Cardiovascular Research Symposium

Introduction: Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated cardioprotective and renoprotective benefits in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). However, the effects of these agents in patients with end-stage renal disease (ESRD) or on dialysis remain underexplored, as previous clinical trials often excluded this population. With the recent removal of ESRD as a contraindication by the U.S. Food and Drug Administration, understanding the cardiovascular risks of SGLT2 inhibitors in this group is imperative. This study aimed to assess the incidence of new onset heart failure (HF), including HF with reduced ejection fraction (HFrEF) and …

"Lost To Follow Up:" A Case Of An Adult Congenital Heart Defect Patient Who Faced Morbidity In Adulthood After Lacking Transitional Care Following Medical Intervention In Childhood, Mackenzie Kelley, Ashish Saini

Cardiovascular Research Symposium

CASE PRESENTATION: This patient is a 40 y.o. male with a BMI of 46.2 kg/m2 who presented to the ED with fluid overload, shortness of breath, and orthopnea. The patient was tachycardic and physical exam revealed anasarca and ascites. The patient reported chronic lower extremity and scrotal edema so severe that he had been unable to walk and was mainly homebound for the past two years. The patient’s past medical history was significant for hypertension, alcohol use disorder with history of withdrawal, and a cardiac murmur which the patient attributed to a “hole in the heart” for which he had …

Ice Guided Percutaneous Pseudoaneurysm Coil Embolization, Moudar Jano, Amir M. Hassani, Matthew R. Summers

Cardiovascular Research Symposium

Background: Pseudoaneurysm formation following cardiac procedures can be a significant complication due to the high risk of rupture. Traditionally managed through sternotomy and cardiac surgery, innovative percutaneous interventions have shown promise for high-risk patients. This case report highlights the successful application of ICE-guided percutaneous coil embolization for the treatment of aortic pseudoaneurysms, presenting a less invasive alternative for patients for whom traditional surgery poses significant risks.

Case Summary: A patient with a complex cardiovascular history, including aortic root and ascending aorta replacement and CABG x2, developed two pseudoaneurysms below the right coronary button and at the distal aortic graft-native aorta …

Using Atrial Pacing Trials After Tavr To Assess Conduction Abnormalities And Predict Need For Pacemaker Implantation, Hemish M. Philip, Matthew R. Summers, Shirish R. Yasa, Hasani Amir, Daiwik P. Munjwani, Thomas A. Cook, Matthew G. Jackson

Cardiovascular Research Symposium

Abstract:

Background: Transcatheter Aortic Valve Replacement (TAVR) is the standard of care for many patients with severe aortic stenosis who cannot undergo surgical intervention. However, conduction disturbances remain a frequent complication, particularly with self-expanding valves. This often leads to permanent pacemaker implantation (PPI). At Sentara Heart Hospital, atrial pacing at 140 bpm is standard practice during TAVR to assess AV conduction.

Objective: This study aims to evaluate whether preserved 1:1 atrioventricular (AV) conduction during routine atrial pacing at 140 bpm after self-expanding TAVR predicts a low likelihood of requiring PPI, thus yielding a high negative predictive value (NPV).

Methods: We …

Development Of Overt Hypo-Attenuated Leaflet Thickening Following Transcatheter Aortic Valve Replacement, Stephonda Lewis, Hemish M. Philip, Matthew Summers

Cardiovascular Research Symposium

Background: Transcatheter aortic valve replacement (TAVR) is a cornerstone therapy for severe aortic stenosis. Up to one-third of patients develop hypoattenuated leaflet thickening (HALT) within the first year post-TAVR. HALT, a form of leaflet thrombosis, can progress to leaflet immobility and structural deterioration. Despite its significance, no unified approach exists for screening or management of HALT after TAVR.

Case Presentation: A 64-year-old woman presented with shortness of breath on exertion. Exam revealed a 3/6 systolic murmur, and echocardiogram confirmed severe aortic stenosis. She underwent TAVR with resolution of symptoms and was discharged on clopidogrel (Plavix) as single antiplatelet therapy. Two …

Novel Guidewire Technique For Paravalvular Leak Repair Following Tavr: A Case Report, Daiwik Munjwani, Bharadwaj Chintalapati, Casey Barry, Matthew R. Summers

Cardiovascular Research Symposium

Background:

Paravalvular leak (PVL) is a recognized complication following transcatheter aortic valve replacement (TAVR), associated with increased mortality, heart failure symptoms, and hemolytic anemia. Standard percutaneous PVL closure relies on crossing the defect with a 0.035-inch hydrophilic guidewire, followed by exchange for a stiffer wire to enable device delivery. However, traversing the defect can be technically challenging due to decreased maneuverability of the guidewire. We report a case of PVL repair using a modified 0.014-inch polymer-jacketed coronary guidewire and aspiration guidewire strategy that facilitated stable device deployment and complete leak closure.

Case Presentation and Management:

An 86-year-old woman with prior …

Vcd-Induced Model Of Menopause To Study Effects Of Sleep Fragmentation On Atherogenesis, Sarah Shackelford B.S, Alina Moriarty M.S., Basudha Habisyasi M.S., Kathleen Coleman B.S., Pavla Brachova Phd, Diane Duffy Phd, Elena Galkina Phd

Cardiovascular Research Symposium

Introduction: Atherosclerosis is a chronic disease characterized by plaque buildup within arteries, leading to cardiovascular diseases. Sleep fragmentation (SF), defined as less than seven hours of uninterrupted sleep, is a recognized risk factor and is commonly observed in menopausal women. Menopause causes a decline in estrogen and ovarian follicles, resulting in the loss of estrogen’s protective anti-atherogenic effects. SF exacerbates atherosclerosis by promoting oxidative stress and inflammation. Since SF contributes to atherosclerosis, and menopausal women are particularly affected by disturbed sleep, we aim to examine how menopause affects atherogenesis in the conditions of disturbed sleep.

Methods: We used the 4-vinylcyclohexene …

Transcatheter Pulmonary Valve Replacement (Tpvr): A Saudi Consensus Statement, Khalid Alnajashi, Ahmed Al Zahrani, Atif Al Qabani, Mohamed Al Humaid, Mishael Binobaidan, Ahmed Krimley, Ahmed Al Omrani, Dhafer Al Shahrani, Ahmed Al Samman, Abdullah Al Quei, Khalid Al Twirqi, Wail Alkashkari, Adel Tash

Journal of the Saudi Heart Association

Objectives: To provide an expert consensus on the appropriate use of transcatheter pulmonary valve replacement (TPVR) in managing chronic pulmonary regurgitation (PR), particularly in patients with congenital heart defects such as Tetralogy of Fallot (TOF). The consensus aims to address current practices, patient selection criteria, procedural planning, and device-specific considerations to guide clinicians in optimizing outcomes. Methods: A multidisciplinary panel reviewed existing literature, clinical guidelines, and real-world practices. Key domains covered include epidemiology, anatomical and hemodynamic evaluation, pre- and post-procedural imaging, device characteristics, and patient selection. Imaging modalities such as echocardiography, cardiac magnetic resonance (CMR), and computed tomography (CT) were …

Aorto-Septal Angle As A Predictor Of Left Ventricular Outflow Tract Obstruction In Pediatric Patients With Subaortic Stenosis And Subaortic Membrane Development: A Study At Prince Sultan Cardiac Center, Buraydah, Saudi Arabia 2023, Rehab N. Alharbi, Ali A. Alakhfash, Abdullah M. Alqwaiee, Abdulrahman A. Almesned, Abdulrahman O. Alharbi

Journal of the Saudi Heart Association

Background: The angle between the interventricular septum and the anterior aortic wall is shallow and measured at 120 degrees in normal individuals. In patients with LVOT narrowing, aortic valve anomalies, and a subaortic membrane, this angle is more acute. This will change the flow hemodynamics and might lead to the formation or progression of the subaortic membrane. Objectives: This study aims to assess the IVS/Anterior Aortic wall angle in patients with abnormal aortic valves and/or LVOT obstruction and its association with SAM development. Methodology: A one-year prospective observational study (September 2022 to June 2023) at PSCC-Qassim's pediatric cardiology department included …