Cardiology Commons^™

Utility Of The Qt Interval In Predicting Outcomes In Patients Presenting To The Emergency Department With Chest Pain., Toni A De Venecia, Marvin Y Lu, Chinualumogu C Nwakile, Vincent M. Figueredo, M.D.

Division of Cardiology Faculty Papers

OBJECTIVES: The aim of this study was to investigate whether prolongation of the heart rate-corrected QT interval (QTc) is an independent risk factor for predicting future acute coronary syndrome (ACS) occurrence or mortality in patients with at least one cardiac risk factor presenting with chest pain to the emergency department (ED).

METHODS: This is a single-center, retrospective study of patients presenting with chest pain to the ED of Einstein Medical Center, Philadelphia, between 2011 and 2012. Proportional hazards models were used to calculate hazard ratios (HRs) for occurrence of ACS or death within 1 year. Kaplan-Meier curves were used to …

Lipid-Induced Epigenomic Changes In Human Macrophages Identify A Coronary Artery Disease-Associated Variant That Regulates Ppap2b Expression Through Altered C/Ebp-Beta Binding, Michael E. Reschen, Kyle J. Gaulton, Da Lin, Elizabeth J. Soilleux, Andrew J. Morris, Susan S. Smyth, Christopher A. O'Callaghan

Gill Heart & Vascular Institute Faculty Publications

Genome-wide association studies (GWAS) have identified over 40 loci that affect risk of coronary artery disease (CAD) and the causal mechanisms at the majority of loci are unknown. Recent studies have suggested that many causal GWAS variants influence disease through altered transcriptional regulation in disease-relevant cell types. We explored changes in transcriptional regulation during a key pathophysiological event in CAD, the environmental lipid-induced transformation of macrophages to lipid-laden foam cells. We used a combination of open chromatin mapping with formaldehyde-assisted isolation of regulatory elements (FAIRE-seq) and enhancer and transcription factor mapping using chromatin immuno-precipitation (ChIP-seq) in primary human macrophages before …

Transient Cardiovascular Hemodynamics In A Patient-Specific Arterial System, Jr Rodward Hewlin

Dissertations

The ultimate goal of the present study is to aid in the development of tools to assist in the treatment of cardiovascular disease. Gaining an understanding of hemodynamic parameters for medical implants allow clinicians to have some patient-specific proposals for intervention planning. In the present study a full cardiovascular experimental phantom and digital phantom (CFD model) was fabricated to study: (1) the effects of local hemodynamics on global hemodynamics, (2) the effects of transition from bed-rest to upright position, and (3) transport of dye (drug delivery) in the arterial system. Computational three dimensional (3-D) models (designs A, B, and C) …

Successful Tricuspid Valvectomy In A Septic Patient With Tricuspid Valve Endocarditis, Taimur Asif Ali, Saulat Hasnain Fatimi, Syed Saad Naeem, Wasiq Faraz Rawasia

Department of Surgery Docs

Abstract

Endocarditis is characterized by vegetations, which is a mass of platelets, fibrin, micro-colonies of micro-organisms, and inflammatory cells, in the endocardium. Over the past three decades, the incidence of right-sided endocarditis has risen dramatically in Pakistan. We report a 36-year woman with a history of repeated intravenous analgesic injections for low back pain, presenting with high grade fever, sepsis and a white cell count of 44,000 with 90% neutrophils. Echocardiography showed large mobile vegetations on TricuspidValve (TV). Tricuspid Valve Endocarditis (TVE) is generally responsive to medical treatment; however, about 25% of TVE patients require surgical intervention. Long-term survival of …

Prenatal Diagnosis Of Left Pulmonary Artery-To-Pulmonary Vein Fistula And Its Successful Surgical Repair In A Neonate, Oleksii Ostras, Andrii Kurkevych, Lyubomyr Bohuta, Tetyana Yalynska, Tammo Raad, Mark Lewin, Illya Yemets

The Texas Heart Institute Journal

Pulmonary arteriovenous fistula is a rare disease. To the best of our knowledge, prenatal diagnosis of a fistula between the left pulmonary artery and the left pulmonary vein has not been described in the medical literature. We report a case of the prenatal diagnosis of a left pulmonary artery-to-pulmonary vein fistula, followed by successful neonatal surgical repair.

Transcatheter Aortic Valve Implantation Despite Challenging Vascular Access, Angelo Nascimbene, Federico Azpurua, James J Livesay, R David Fish, Zvonimir Krajcer

The Texas Heart Institute Journal

We describe transcatheter aortic valve implantation in a patient who had severe peripheral artery disease. The patient's vascular condition required additional preliminary peripheral intervention to enable adequate vascular access.

A 78-year-old man with severe aortic stenosis, substantial comorbidities, and severe heart failure symptoms was referred for aortic valve replacement. The patient's 20-mm aortic annulus necessitated the use of a 23-mm Edwards Sapien valve inserted through a 22F sheath, which itself needed a vessel diameter of at least 7 mm for percutaneous delivery. The left common femoral artery was selected for valve delivery. The left iliac artery and infrarenal aorta underwent …

When The Chief Complaint Tells It All, Herbert L Fred

The Texas Heart Institute Journal

No abstract provided.

Regression Of Left Ventricular Mass After Implantation Of The Sutureless 3f Enable Aortic Bioprosthesis, Giovanni Concistrè, Antonio Miceli, Federica Marchi, Francesca Chiaramonti, Mattia Glauber, Marco Solinas

The Texas Heart Institute Journal

Left ventricular hypertrophy in aortic stenosis is considered a compensatory response for the maintenance of systolic function but a risk factor for cardiac morbidity and death. We investigated the degree of left ventricular mass regression after implantation of the sutureless Medtronic 3f Enable® Aortic Bioprosthesis.

We studied 19 patients who, from May 2010 through July 2011, underwent isolated aortic valve replacement with the 3f Enable bioprosthetic valve, with clinical and echocardiographic follow-up at 6 months. The mean age was 77.1 ± 5.1 years (range, 68–86 yr); 14 patients were women (73.7%); and the mean logistic EuroSCORE was 15.4% ± 11.8%. …

Pathways Involved In Interleukin-1Β-Mediated Murine Cardiomyocyte Apoptosis, Yi Shen, Jie Qin, Peili Bu

The Texas Heart Institute Journal

Accumulating evidence suggests that interleukin-1 (IL-1) signaling plays an essential role in the pathogenesis of heart failure by inducing cardiomyocyte apoptosis, but the mechanisms of this process are poorly defined. We further explored these molecular pathways.

We isolated cardiomyocytes from neonatal mice and then cultured and stimulated them with murine IL-1β in vitro. Cell apoptotic ratios were measured by means of flow cytometry. Expression of effector molecules was analyzed by means of enzyme-linked immunosorbent assay, Western blotting, and real-time quantitative polymerase chain reaction. The results showed that IL-1β induced murine cardiomyocyte apoptosis through a release of cytochrome c into cytoplasm …

Surgical Considerations Of Lvad Implantation In Patients With Prosthetic Valves, Igor D. Gregoric

The VAD Journal

No abstract provided.

Cost-Effectiveness Of Coronary Artery Calcium Testing For Coronary Heart And Cardiovascular Disease Risk Prediction To Guide Statin Allocation: The Multi-Ethnic Study Of Atherosclerosis (Mesa), Khurram Nasir

All Publications

BACKGROUND: The Multi-Ethnic Study of Atherosclerosis (MESA) showed that the addition of coronary artery calcium (CAC) to traditional risk factors improves risk classification, particularly in intermediate risk asymptomatic patients with LDL cholesterol levels /dL. However, the cost-effectiveness of incorporating CAC into treatment decision rules has yet to be clearly delineated.OBJECTIVE: To model the cost-effectiveness of CAC for cardiovascular risk stratification in asymptomatic, intermediate risk patients not taking a statin. Treatment based on CAC was compared to (1) treatment of all intermediate-risk patients, and (2) treatment on the basis of United States guidelines.METHODS: We developed a Markov model of first coronary …

Risk Of Stent Thrombosis In Cardiac Arrest Patients With St- Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention And Therapeutic Hypothermia: International Cardiac Arrest Registry, Nainesh Patel Md, Sanjeev U. Nair Md, Michael R. Mooney Md, John Mcpherson Md, David B. Seder Md, Paul Hsu Md, Michael Cash Md, Michael Young Md, Barbara Unger Rn, Karl B. Kern Md

Department of Medicine

No abstract provided.

Catheter Ablation Of Wolff-Parkinson White Syndrome: 14-Year Trends In Utilization And Complications In The United States, Jalaj Garg Md, Neeraj Shah Md, Kathan Mehta, Parasuram Krishnamoorthy Md, Babak Bozorgnia Md

Department of Medicine

No abstract provided.

Effect Of Beta-Blockers On Progressive Aortic Dilatation In Patients With Marfan Syndrome, Parasuram Krishnamoorthy Md, Jalaj Garg Md, Neeraj Shah Md, Abhishek Sharma Md, Larry E. Jacobs Md, Matthew W. Martinez Md

Department of Medicine

No abstract provided.

Stent Thrombosis Is Not Increased In Cardiac Arrest Patients Undergoing Therapeutic Hypothermia: An Analysis Of 15,079 Procedures, Neeraj Shah Md, Jalaj Garg Md, Vratika Agarwal Md, Kathan Mehta, Larry E. Jacobs Md, Nainesh C. Patel Md, Ronald Freudenberger Md

Department of Medicine

No abstract provided.

Underutilization Of Therapeutic Hypothermia After Sudden Cardiac Arrest In United States: A 10 Year Perspective, Neeraj Shah Md, Vratika Agarwal Md, Jalaj Garg Md, Kathan Mehta, Nainesh C. Patel Md, Ronald Freudenberger Md, Larry E. Jacobs Md

Department of Medicine

No abstract provided.

2015 Spctpd/Acc/Aap/Aha Training Guidelines For Pediatric Cardiology Fellowship Programs (Revision Of The 2005 Training Guidelines For Pediatric Cardiology Fellowship Programs)., R D. Ross, M Brook, J A. Feinstein, P Koenig, P Lang, R Spicer, J A. Vincent, A B. Lewis, G R. Martin, P J. Bartz, P S. Fischbach, D R. Fulton, G P. Matherne, B Reinking, S Srivastava, B Printz, T Geva, Girish S. Shirali, P Weinberg, P C. Wong, L B. Armsby, R N. Vincent, S R. Foerster, R J. Holzer, J W. Moore, A C. Marshall, L Latson, A M. Dubin, E P. Walsh, W Franklin, R J. Kanter, J P. Saul, M J. Shah, G F. Van Hare, T F. Feltes, S J. Roth, M C. Almodovar, D B. Andropoulos, D J. Bohn, J M. Costello, R J. Gajarski, A R. Mott, K Stout, A M. Valente, S Cook, M Gurvitz, A Saidi, S A. Webber, D T. Hsu, D D. Ivy, T J. Kulik, E Pahl, D N. Rosenthal, R Morrow, W T. Mahle, A M. Murphy, J S. Li, Y M. Law, J W. Newburger, S R. Daniels, D Bernstein, B S. Marino

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Is Metabolic Syndrome Predictive Of Prevalence, Extent, And Risk Of Coronary Artery Disease Beyond Its Components? Results From The Multinational Coronary Ct Angiography Evaluation For Clinical Outcome: An International Multicenter Registry (Confirm), Ricardo Cury

All Publications

No abstract provided.

Changes In Speckle Tracking Echocardiography Measures Of Ventricular Function After Percutaneous Implantation Of The Edwards Sapien Transcatheter Heart Valve In The Pulmonary Position., Shahryar M. Chowdhury, Ziyad M. Hijazi, John F. Rhodes, Saibal Kar, Raj Makkar, Michael Mullen, Qi-Ling Cao, Lazar Mandinov, Jason Buckley, Nicholas P. Pietris, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Patients with free pulmonary regurgitation or mixed pulmonary stenosis and regurgitation and severely dilated right ventricles (RV) show little improvement in ventricular function after pulmonary valve replacement when assessed by traditional echocardiographic markers. We evaluated changes in right and left ventricular (LV) function using speckle tracking echocardiography in patients after SAPIEN transcatheter pulmonary valve (TPV) placement.

METHODS: Echocardiograms were evaluated at baseline, discharge, 1 and 6 months after TPV placement in 24 patients from 4 centers. Speckle tracking measures of function included peak longitudinal strain, strain rate, and early diastolic strain rate. RV fractional area change, tricuspid annular plane …

Are Bp Readings Taken After A Patient-Physician Encounter In A Real-World Clinic Scenario The Lowest Of All The Readings In A Clinic Visit., Hunaina Shahab, Hamza Sohail Kan2 Khan, Aysha Almas, Sohail Abrar Khan, Aamir Hameed Khan

Department of Medicine

Objective: To determine the difference in Blood Pressure (BP) readings taken before, during and after the clinic encounter.

Study Design: Descriptive study.

Place and Duration of Study: Cardiology Clinic, The Aga Khan University Hospital, Karachi, from January to August 2013.

Methodology: Hypertensive and normotensive participants aged ≥ 18 years were recruited. Pre-clinic BP was measured by a nurse and in-clinic BP by a physician. After 15 minutes, two post-clinic BP readings were taken at 1 minute interval. All readings were taken using Omron HEM7221-E.

Results: Out of 180 participants, males were 57% and 130 (71%) were hypertensive. Mean SBP (Systolic …