Cardiology Commons^™

Rapid Access Chest Pain Assessment Clinic: An Australian Virtual Care Experience, Marwan Shawki, Thalys Sampaio Rodrigues, Hussein Al-Fiadh, Karen Sanders Mnursing, Ali H. Al-Fiadh

Journal of the Saudi Heart Association

Background: The Rapid Access Chest Pain Assessment Clinic (RACPAC) streamlines the evaluation of low to intermediate-risk chest pain patients, reducing hospitalisation and healthcare costs. However, there is limited data on the virtual model of care for RACPAC.

Aim: We sought to evaluate the structure, cost-effectiveness, and imaging modalities performance of face-to-face and virtual RACPAC in an Australian setting.

Methods:A retrospective analysis of patients attending the RACPAC within a large Australian quaternary hospital between 2012 and 2021. We described the clinic parameters and imaging modality utilisation with parametric and non-parametric descriptive statics. Patterns of diagnostic modality utilisation were assessed with …

Leveraging A Randomized Trial To Assess Relationships Between Transeptal Puncture, Brain Emboli, And Migraine Symptoms, Adi Elias, Roderick Tung, Edward P Gerstenfeld, Trisha F Hue, Feng Lin, Jing Cheng, J Peter Weiss, Wendy S Tzou, Henry Hsia, Ashkan Ehdaie, Daniel H Cooper, T Jared Bunch, Jeffrey Arkles, Babak Nazer, Adam Lee, Alexios Hadjis, Duy T Nguyen, Mihail G Chelu, Joshua D Moss, Jonathan C Hsu, Miguel Valderrábano, Prashant D Bhave, Gabrielle Montenegro, Anthony S Kim, William P Dillon, Gregory M Marcus

Faculty, Staff and Students Publications

Background: Catheter ablation procedures with transseptal punctures (usually for atrial fibrillation) are often associated with migraine-related visual auras, but the mechanism remains unknown. Whether this phenomenon is mediated by the creation of an atrial septal defect from transseptal puncture or by silent acute brain emboli detected on magnetic resonance imaging related to the procedure remains to be investigated.

Objective: This study aimed to evaluate whether randomization to a transseptal puncture during catheter ablation for ventricular arrhythmias is associated with postprocedural visual auras and assess the relationship between occipital and parietal lobes acute brain emboli and migraine-related visual auras.

Methods: In …

Incidence, Associated Abnormalities, And Outcomes Of Dextrocardia: A Registry-Based Study In Saudi Arabia, Naif Saad Alghasab, Bandar Alshehri, Sulaman Almesned, Hassan Harbi, Reem Alameer, Fahad Alshehri, Ahmad Alzeid, Meshari Alzhrani, Ghazi T. Almutiri, Sara Abou Al-Saud, Fahad Alobaid, Khalid S. Alnajashi, Federica Fogacci, Arrigo F.G. Cicero, Suleiman M. Kharabsheh

Journal of the Saudi Heart Association

Objective: The right-sided positioning of heart during embryonic development is termed dextrocardia, and it may be isolated or associated with visceral dextroposition or malformation. However, there are few studies on the condition. This study aimed to determine the incidence of cardiac and non-cardiac malformations, long-term follow-up, and survival analysis of patients with dextrocardia. Methods: This was a retrospective chart review of dextrocardia cases at King Faisal Specialist Hospital & Research Centre in Riyadh, Saudi Arabia from April 22, 1975, to December 31, 2016. A total of 259,246 transthoracic echocardiograms from that period were reviewed, and 357 patients were included in …

From Aortic Stenosis To Cardiomyopathy: The Hidden Impact Of Undiagnosed Acommissural Unicuspid Aortic Valve, Muhammad Sabri, Hamza Muhammadzai, Angad Bedi, Eddy Mizrahi, Matthew Collins

Abington Jefferson Health Papers

Unicuspid aortic valve (UAV) is a rare congenital anomaly, diagnosed in individuals aged 30 to 50. It is associated with aortic stenosis or aortic regurgitation, potentially leading to heart failure. We report a case of a 28-year-old male with an acommissural UAV, aortopathy, critical aortic stenosis, and heart failure with reduced ejection fraction, presenting with shortness of breath. This case is notable for late presentation of an acommissural UAV, which typically manifests in childhood.

Novel Aspiration Thrombectomy And Blood Reinfusion System For Acute Intermediate-Risk Pulmonary Embolism: Aventus Trial Results., Saher Sabri, Samuel Horr, Brian Stegman, Wissam A Jaber, Michael A Jolly, Christopher M Huff, David O'Connor, Ahmad Younes, Nora E Tabori, Peter P Monteleone, Raghu Kolluri, Mehdi H Shishehbor, Jun Li

OhioHealth Research Institute Articles

BACKGROUND: Mechanical thrombectomy has become a first-line adjunctive therapy for anticoagulation in patients with acute intermediate-risk pulmonary embolism (PE). This prospective study evaluated the safety and efficacy of percutaneous mechanical aspiration thrombectomy with autologous blood reinfusion using the next-generation AVENTUS Thrombectomy System (Inquis Medical) in subjects with acute intermediate-risk PE.

METHODS: Subjects with acute intermediate-risk PE with symptoms ≤14 days were enrolled in this prospective, multicenter, single-arm study. Primary efficacy (defined as the change in the right ventricle to left ventricle [RV/LV] ratio from baseline) and safety defined as a composite rate of device-related major adverse events were both assessed …

Corrigendum To 'Scai Expert Consensus Statement On Alternative Access For Transcatheter Aortic Valve Replacement' [Journal Of The Society For Cardiovascular Angiography & Interventions 4 (2025) 102514]., Matthew Sherwood, Keith B Allen, Thom G Dahle, Chandan M Devireddy, Jeffrey Gaca, Santiago Garcia, Kendra J Grubb, Tsuyoshi Kaneko, Chad A Kliger, Robert J Lederman, John C Messenger, Puja B Parikh, Marie-France Poulin, Carlos Sanchez, Anene Ukaigwe, James J Yun, Paul D Mahoney

Heart and Vascular Articles

[This corrects the article DOI: 10.1016/j.jscai.2024.102514.].

Fibroblast-Restricted Inflammasome Activation Promotes Atrial Fibrillation And Heart Failure With Diastolic Dysfunction, Luge Li, Cristian Coarfa, Yue Yuan, Issam Abu-Taha, Xiaolei Wang, Jia Song, Yuying Zeng, Xiaohui Chen, Amrit Koirala, Sandra L Grimm, Markus Kamler, Lisa K Mcclendon, Michelle Tallquist, Stanley Nattel, Dobromir Dobrev, Na Li

Faculty, Staff and Students Publications

Atrial fibrillation (AF) often coexists with heart failure, both involving inflammatory signaling and cardiac fibroblasts. To understand the role of fibroblast NLR family pyrin domain containing 3 (NLRP3) inflammasome in cardiac function, we found that NLRP3 was up-regulated in atrial fibroblasts from AF patients. Fibroblast-specific activation of NLRP3 in mice induced AF-promoting atrial myopathy and heart failure with diastolic dysfunction, accompanied by increased fibrosis, and reduced conduction velocity. Knockdown of NLRP3 prevented the AF-promoting atrial substrate and cardiomyopathy in the context of NLRP3 activation in fibroblasts. We identify the fibroblast NLRP3 inflammasome as a key pathway governing the promotion of …

Cardiac Rhythm Devices In Heart Failure With Reduced Ejection Fraction – Role, Timing, And Optimal Use In Contemporary Practice European Journal Of Heart Failure Expert Consensus Document, Biykem Bozkurt, Wilfried Mullens, Christophe Leclercq, Andrea M Russo, Gianluigi Savarese, Michael Böhm, Loreena Hill, Koichiro Kinugawa, Naoki Sato, William T Abraham, Antoni Bayes-Genis, Alexandre Mebazaa, Giuseppe M C Rosano, Shelley Zieroth, Cecilia Linde, Javed Butler

Faculty, Staff and Students Publications

Guidelines for management of heart failure with reduced ejection fraction (HFrEF) emphasize personalized care, patient engagement, and shared decision-making. Medications and cardiac rhythm management (CRM) devices are recommended with a high level of evidence. However, there are significant disparities: patients who could benefit from devices are frequently referred too late or not at all. Misconceptions about device therapy and the notion that the needs of patients (especially the prevention of sudden cardiac death) can now be met by expanding drug therapies may play a role in these disparities. This state-of-the-art review is produced by members of the DIRECT HF initiative, …

Daily Physical Activity And Cardiorespiratory Fitness In Adults With Down Syndrome With And Without Congenital Heart Disease., Julianne G. Clina, David A. White, Joseph R. Sherman, Jessica C. Danon, Daniel Forsha, Brian C. Helsel, Richard A. Washburn, Joseph E. Donnelly, Lauren T. Ptomey

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Individuals with Down syndrome (DS) typically exhibit lower cardiorespiratory fitness and reduced moderate-to-vigorous physical activity (MVPA) compared to persons without disability. Approximately 50-55 % of individuals with DS have congenital heart disease (CHD), which is associated with cardiopulmonary deficiencies and reduced MVPA participation in non-DS populations. It is unknown if CHD related comorbidities compound with DS associated deficits in physical activity and fitness.

OBJECTIVE: To compare physical activity, cardiorespiratory fitness, and cardiovascular function, of persons with DS with and without CHD.

METHODS: Baseline data were used from a 12-month randomized controlled physical activity intervention of adults with DS. Participants …

Impacts Of Radiation On Metabolism And Vascular Cell Senescence, Junichi Abe, Khanh Chau, Anahita Mojiri, Guangyu Wang, Masayoshi Oikawa, Venkata S K Samanthapudi, Abigail M Osborn, Keila C Ostos-Mendoza, Karla N Mariscal-Reyes, Tammay Mathur, Abhishek Jain, Joerg Herrmann, Syed Wamique Yusuf, Sunil Krishnan, Anita Deswal, Steven H Lin, Sivareddy Kotla, John P Cooke, Nhat-Tu Le

Faculty, Staff and Student Publications

Significance: This review investigates how radiation therapy (RT) increases the risk of delayed cardiovascular disease (CVD) in cancer survivors. Understanding the mechanisms underlying radiation-induced CVD is essential for developing targeted therapies to mitigate these effects and improve long-term outcomes for patients with cancer.

Recent Advances: Recent studies have primarily focused on metabolic alterations induced by irradiation in various cancer cell types. However, there remains a significant knowledge gap regarding the role of chronic metabolic alterations in normal cells, particularly vascular cells, in the progression of CVD after RT.

Critical Issues: This review centers on RT-induced metabolic alterations in vascular cells …

Clinical Outcomes After Hospitalization For Acute Coronary Syndrome In Patients Treated With Semaglutide Versus Bariatric Surgery: A Retrospective Multicenter Analysis, Nameer Ascandar, Charles Boadu, Gauthier Stepman, George Skaf, Olugbenga Oyesanmi, Sabry Omar, Rias Ali, Michael Schandorf-Lartey

HCA Healthcare Journal of Medicine

Background

Obesity is a chronic medical condition with a rising prevalence in the United States. A wide range of morbidity and mortality is associated with obesity, with coronary artery disease being among the most common. Ischemic heart disease continues to be the primary cause of death in the United States. Taken together, interventions to minimize the detrimental effects of obesity on patients at risk of heart disease will not only benefit the patient, but the health care system as well.

Methods

In this retrospective study, we used the HCA Healthcare enterprise data warehouse to identify all adult patients who were …

Intermittent Fasting For Metabolic Syndrome Management, Tony Laborde

Lynchburg Journal of Medical Science

This paper reviews the potential of intermittent fasting as a non-pharmacological therapeutic approach to the treatment of metabolic syndrome (MetS). MetS is a global health problem with risk factors that include obesity, hypertension, hyperglycemia, low high-density lipoprotein (HDL) cholesterol, and high triglycerides that predispose to cardiovascular disease and type 2 diabetes. Traditional treatment approaches, including pharmacological agents and lifestyle modification, are typically of short-term benefit. Intermittent fasting, with its scheduled cycles of eating and fasting, presents another strategy for improving weight control, insulin sensitivity, lipid profiles, and blood pressure. Various intermittent fasting regimens, including time-restricted feeding and alternate-day fasting, have …

Pharmacogenetic-Guided Antiplatelet Therapy For Personalized Medicine In Patients With Stroke And Transient Ischemic Attack Without Cardioembolic Stroke: A Systematic Review Of Economic Evaluations, Nathapol Samprasit, Chamipa Phanudulkitti, Nattanichcha Kulthanachairojana, Jatapat Hemapanpairoa

The Thai Journal of Pharmaceutical Sciences

Background: Stroke is a major global public health burden. Ischemic stroke is the most common type of all stroke cases worldwide. Antiplatelet therapy is a key strategy for secondary prevention in patients with stroke and transient ischemic attacks (TIAs) without cardioembolic stroke. Dual antiplatelet therapy (DAPT) with clopidogrel is recommended in patients with early mild stroke or high-risk TIA, followed by long-term single antiplatelet therapy (SAPT). Clopidogrel is often used as an alternative for patients with aspirin resistance or intolerance. However, clopidogrel is a prodrug metabolized by the CYP2C19 enzyme, leading to variability in its effectiveness.

Objectives: This study aims …

Incidence, Risk Factors And Clinical Outcomes Of Pericardial Effusion In Left Ventricular Assist Device Patients, Muhammad Zubair Khan, Yevgeniy Brailovsky, Mohammad Alfrad Nobel Bhuiyan, Gregary D. Marhefka, Abu S. M. Faisal, Adrija Sircar, Parker O'Neill, J. Eduardo Rame, Sona Franklin, Muhammad Waqas, Hadia Shah, Indranee Rajapreyar, René J. Alvarez

Division of Cardiology Faculty Papers

BACKGROUND: Development of pericardial effusion in patients with left ventricular assist devices (LVADs) can be detrimental to health outcomes. This study aims to elucidate the prevalence and risk factors for pericardial effusion in patients with LVADs.

AIM: To elucidate risk factors associated with the presence of pericardial effusion in patients with LVADs and compare the clinical outcomes of those with and without pericardial effusion. The secondary goal is to determine the incidence of pericardiocentesis and pericardial window placement in patients with LVADs experiencing pericardial effusion.

METHODS: Data were obtained from the National Inpatient Sample database between 2016 and 2018. Statistical …

Successful Primary Coronary Intervention During Prolonged Mechanical Cardiopulmonary Resuscitation For Acute Myocardial Infarction-Related Cardiac Arrest, Sadeq Tabatabai, Mosaad Abushabana, Ahmed Najah, Prasad Padmakar Kulkarni, Jasem Mohammed Alhashmi

Journal of the Saudi Heart Association

We report a case of a male patient with an acute inferior myocardial infarction who underwent successful primary coronary intervention during prolonged cardiac arrest (220 minutes) and continuous resuscitation using a mechanical chest compression device. He achieved full neurological recovery. Mechanical compression devices may help maintain perfusion and improve outcomes in such scenarios.

Demographics, Clinical Features And Genetics Of Common Inherited Arrhythmias In Oman, Kadhiya Al Azri, Ismail Al Abri, Maryam Al Shehhi, Maria Al Hinai, Tahlil Al Amri, Narjis Al Sheala, Ammar Al Shabibi

Journal of the Saudi Heart Association

Objectives:

Inherited arrhythmia syndromes (IAS) are a group of rare disorders that result from genetic mutations in several genes including congenital long QT syndrome, Brugada syndrome (BrS), short QT syndrome, and Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT). Affected individuals may have various symptoms including sudden cardiac death (SCD). Few reports have highlighted long QT syndrome from the Arbian Gulf region. The current study aims to describe demographics of children and adults with inherited arrhythmia syndromes; report the presenting clinical features, genetic mutations and management strategies.

Material and Method:

This is a descriptive retrospective study that included Omani children and adults with …

Efficacy And Safety Of Olezarsen In Dyslipidemia: A Systematic Review And Dose-Response Meta-Analysis Of Randomized Controlled Trials, Christopher D. Tristan, Risalina Myrtha, Matthew A. Wijayanto, Erlangga M. Kynaya, Muhammad F. Hamka, Nathania E. Sudiono, Muhammad A. Rusyidi, Muhana F. Ilyas

Journal of the Saudi Heart Association

Olezarsen emerged as a novel promising Apo-C3 inhibitor for dyslipidemia. However, its dose-response relationship remains uncertain. This review aims to evaluate the lipid-lowering effect of olezarsen, safety measures, and dose-response effects to determine the optimal dose. A systematic search was conducted across Scopus, PubMed, ScienceDirect, and CENTRAL on January 2, 2025. Randomized controlled trial (RCT) comparing olezarsen with placebo in dyslipidemia was included. The Rob 2.0 tool was implemented to assess quality. R-studio and STATA were used to conduct statistical analysis. From a total of 194 documents at initial search, four RCTs involving 361 patients were included in the present …

Potential Strategies For Reducing Mortality And Morbidity In Acute Ischemic Cardiogenic Shock, Richard Smalling, James Mccarthy, Tim Henry, Ali Denktas

Journal of Shock and Hemodynamics

Cardiogenic shock is predominantly caused by acute ischemic myocardial injury. Despite advancements in reperfusion strategies, outcomes remain poor, with the duration of ischemia before reperfusion playing a crucial role in the development of irreversible damage. This review synthesizes insights from animal models and human studies, highlighting the limited myocardial salvage beyond 90 minutes of ischemia. In light of the high mortality rates associated with cardiogenic shock, this review proposes re-evaluating pre-hospital fibrinolysis, exploring left ventricular unloading strategies before reperfusion, and assessing the potential role of endothelin antagonists. These approaches aim to improve outcomes in this high-risk population.

Unmasking Myocardial Bridging: Multimodal Imaging And Tailored Medical Approach In Exercise-Induced Angina – A Case Report, M.A. Amico, M. Casini, E.N. Costanzo, M. Moroni, N. Carrabba

Journal of the Saudi Heart Association

Myocardial bridging (MB) is a congenital coronary anomaly in which a segment of a coronary artery runs intramyocardially. We present the case of a 38-year-old male with myocardial bridging in the mid-left anterior descending artery who developed exerciseinduced angina. This case underscores the importance of recognizing MB as a cause of ischemia that should not be overlooked in the diagnostic workup of patients with angina, especially in younger individuals. A comprehensive diagnostic approach, including multimodality imaging, is essential to uncover the pathology. A tailored pharmacological strategy is recommended. Long-term clinical follow-up is crucial for optimizing symptom management and reducing complications.

Assessment Of The Relationship Between Serum Vitamin D Levels And Its Cardiovascular Outcomes: A Systematic Review And Meta-Analysis Study, Reza Madadi, Sina Bakhshaei, Arian Tavasol, Mahmood Gorjizad, Rouhollah Hemmati, Masood Zangi

Journal of the Saudi Heart Association

Introduction: Cardiovascular events are the most common cause of mortality worldwide. Various studies have shown the relationship between serum 25- hydroxyvitamin D [25(OH) D] levels and cardiovascular events. The purpose of this study is to investigate the meta-analysis of the relationship between serum 25(OH) D levels and the risk of cardiovascular diseases (CVD), including stroke, coronary heart disease, peripheral arterial disease, and aortic disease in the population. Method: Using valid keywords and searching the Medline, Science Direct, Scopus, and web of sciences databases, 22 papers were compiled. Data analysis was performed in the group of people with low serum 25(OH)D …