Cardiology Commons^™

Challenges In Diagnosing And Treating Fungal Endocarditis: A Case Report Of Recurrent Candida Endocarditis In A Hemodialysis Patient, Ghaidaa Almuhammadi, Rawia Alzughaibi, Lamar Amer, Talal Alzahrani

Journal of the Saudi Heart Association

Fungal endocarditis (FE) is a rare yet life-threatening condition, especially in hemodialysis (HD) patients with indwelling long-term catheters. Symptoms often overlap with non-fungal infective endocarditis, making diagnosis difficult. As FE incidence increases, healthcare providers face challenges in diagnosing and managing this severe condition. Early suspicion of FE is crucial for patients with long-term catheters. We reported a 23-year-old male with end-stage renal disease (ESRD) on HD that developed FE affecting the tricuspid valve, requiring valve replacement and anti-fungal medication. Despite these interventions, he had recurrent Candida prosthetic endocarditis(CPE). Currently, he is receiving anti-fungal medication, with plans for a third surgery.

The Safety Of Ramadan Fasting In Chronic Heart Failure Patients With Reduced Ejection Fraction, Ahmed Farouk Alaarag, Mahmoud Abd Elkhalek Abou-Omar, Osama Ahmed Amin

Journal of the Saudi Heart Association

Objectives: Even though Islam excludes the sick from Ramadan Fasting (RF), countless Muslims choose to fast throughout this holy month. So, it is of paramount importance to review how RF influences patients with chronic Heart Failure with reduced Ejection Fraction (HFrEF). Our study intended to check the safety of RF in these patients.

Methods: We selected patients under 75 years old with compensated chronic HFrEF. After applying all the exclusion conditions, those who insisted on fasting during the coming Ramadan were enrolled in fasting Group I (90 patients). Those who decided not to fast were listed as control Group …

Effect On Cardiovascular Outcome Of Sodium-Glucose Co-Transporter-2 (Sglt2) Inhibitors Among Cancer Patients Treated With Anthracycline: A Systematic Review And Meta-Analysis, Chalothorn Wannaphut, Phuuwadith Wattanachayakul, Sakditad Saowapa, Ben Ponvilawan, Manasawee Tanariyakul, Jakrin Kewcharoen, Pitchaporn Yingchoncharoen, Thanathip Suenghataiphorn, Noppawit Aiumtrakul, Jared Acoba

Department of Medicine Faculty Papers

Background/objectives: Sodium-glucose-co-transporter-2 (SGLT2) inhibitors have shown benefit in reducing cardiovascular disease outcomes in diabetes patients. Anthracycline therapy is associated with a risk of cardiomyopathy. However, the impact of SGLT2 inhibitors in the prevention of cardiomyopathy and heart failure in cancer patients undergoing anthracycline treatment remains unclear. Thus, we conducted a systematic review and meta-analysis to explore the effect of the prevention of cardiovascular outcomes in patients with cancer and diabetes who had received anthracycline therapy.

Methods: We systematically reviewed Medline and EMBASE databases from inception to January 2024 for studies focusing on cancer patients with a history of anthracycline therapy. …

Red Meat Consumption And Hypertension: An Updated Review, Tara S Allen, Michael Najem, Alexis C Wood, Danielle J Lee, Lorena S Pacheco, Lori B Daniels, Matthew A Allison

Faculty, Staff and Students Publications

PURPOSE OF REVIEW: Hypertension (HTN) is a major risk factor for cardiovascular diseases (CVD). The global prevalence of HTN and related CVD mortality continues to rise. The development of HTN is influenced by genetic predisposition and modifiable risk factors, including diet. One area of ongoing debate is the relationship between red meat consumption and risk of HTN.

RECENT FINDINGS: Processed red meat has become increasingly implicated in the pathogenesis and morbidity of HTN, though randomized control trials comparing HTN-related outcomes associated with red meat subtypes have yielded heterogenous results. This review summarizes the existing relevant literature and highlights the methodological …

Contrast-Enhanced Magnetic Resonance Imaging Based Calf Muscle Perfusion And Machine Learning In Peripheral Artery Disease, Bijen Khagi, Tatiana Belousova, Christina M Short, Addison A Taylor, Jean Bismuth, Dipan J Shah, Gerd Brunner

Faculty, Staff and Students Publications

Peripheral artery disease (PAD) remains underdiagnosed and undertreated and is associated with an increased risk for adverse cardiovascular outcomes. Imaging provides an approach to identifying patients with PAD. However, the role of integrating imaging with machine learning to identify PAD patients and potentially assess disease severity remains understudied. A total of 56 participants, including 36 PAD patients with intermittent claudication and 20 matched controls, underwent contrast-enhanced magnetic resonance imaging (CE-MRI) calf muscle perfusion scanning. CE-MRI-derived dynamic muscle perfusion maps were developed to quantify alterations of the microvascular circulation in the calf muscles based on voxel contrast enhancement. These dynamic muscle …

Effectiveness Of Empagliflozin In Treating Patients With Heart Failure With Preserved Ejection Fraction: A Systematic Review, Sara Abou Al-Saud

Journal of the Saudi Heart Association

Aim

The goal of this systematic review is to determine the effectiveness of empagliflozin in managing patients with heart failure with preserved ejection fraction (HFpEF) as compared with a placebo

Methods

Web of Science, Cochrane, PubMed, and Scopus databases were searched for articles from 2000 to 2023. Reference lists of articles were manually screened. Trials that recruited patients with HFpEF and reported the effects of empagliflozin were included. Endnote X9 software was used for the study screening process.

Results

1029 non-duplicate articles were identified from the literature and 9 were selected for inclusion in this review. The included papers were …

The Usefulness Of 3d Heart Models As A Tool Of Congenital Heart Disease Education: A Narrative Review, Raghad Abdulaziz Alhojailan, Reghd Husain M Alkhalifah, Bana Albani, Majed Wadi

Journal of the Saudi Heart Association

Objectives: The objective of this review is to evaluate the effectiveness of three-dimensional (3D) heart models as teaching tools for congenital heart disease (CHD), addressing the limitations of traditional medical education methods. Methods: A thorough literature review was conducted using PubMed, Google Scholar, Scientific Direct and Scopus databases. Relevant articles were screened and selected based on their discussion of the application of 3D models in CHD education. Results: The comprehensive review of 19 studies revealed that 3D heart models provide students, healthcare professionals, and patients with meaningful experiences that significantly enhance understanding and learning outcomes. These models improve …

Murder Mystery Solved! Unmasking Multi-Generational Familial Death As A Result Of Brugada Syndrome, Ryan Tam, Sandres Aodish, Jeremiah Tom, Mohammad Jawish

Advances in Clinical Medical Research and Healthcare Delivery

Brugada syndrome is an inherited condition that has an increased risk of developing ventricular arrhythmias and sudden cardiac death. This condition can be diagnosed by using the Shanghai Scoring System. Here, we present a patient with an incidental finding of Type 1 Brugada pattern on electrocardiogram amidst atypical neurological findings on presentation to the emergency department and a history of cardiac-related familial deaths of uncertain etiology.

Prediction Of Obstructive Coronary Artery Disease Using Coronary Calcification And Epicardial Adipose Tissue Assessments From Ct Calcium Scoring Scans, Juhwan Lee, Tao Hu, Ammar Hoori, Hao Wu, Justin N. Kim, Robert Gilkeson, Sanjay Rajagopalan, David L. Wilson

Faculty Scholarship

Background: Low-cost/no-cost non-contrast CT calcium scoring (CTCS) exams can provide direct evidence of coronary atherosclerosis. In this study, using features from CTCS images, we developed a novel machine learning model to predict obstructive coronary artery disease (CAD), as defined by the coronary artery disease-reporting and data system (CAD-RADS). Methods: This study analyzed 1324 patients from the SCOT-HEART trial who underwent both CTCS and CT angiography. Obstructive CAD was defined as CAD-RADS 4A-5, while CAD-RADS 0–3 were considered non-obstructive CAD. We analyzed clinical, Agatston-score-derived, and epicardial fat-omics features to predict obstructive CAD. The most predictive features were selected using elastic net …

Infection-Related Hospitalization And Incident Heart Failure: The Atherosclerosis Risk In Communities Study, Rebecca L Molinsky, Amil Shah, Melana Yuzefpolskaya, Bing Yu, Jeffrey R Misialek, Bruno Bohn, David Vock, Richard Maclehose, Barry A Borlaug, Paolo C Colombo, Chiadi E Ndumele, Junichi Ishigami, Kunihiro Matsushita, Pamela L Lutsey, Ryan T Demmer

Faculty, Staff and Student Publications

Background: The immune response to infections may become dysregulated and promote myocardial damage contributing to heart failure (HF). We examined the relationship between infection-related hospitalization (IRH) and HF, HF with preserved ejection fraction, and HF with reduced ejection fraction.

Methods and results: We studied 14 468 adults aged 45 to 64 years in the ARIC (Atherosclerosis Risk in Communities) Study who were HF free at visit 1 (1987-1989). IRH was identified using select International Classification of Diseases (ICD) codes in hospital discharge records and was treated as a time-varying exposure. HF incidence was defined as the first occurrence …

The Association Between Online Health Information Characteristics And Appropriate Trust In Informational Quality Among Patients With High Cardiovascular Risk, Lim Woei Xian

Student Works (2020-2029)

More patients are turning to the Internet to understand their health and make health decisions. However, the quality of online health information (OHI) is highly variable, and it may contain misinformation. Patients who lack the necessary skills to appraise OHI may trust poor-quality OHI. Thus, this study aims to examine the association between OHI characteristics and appropriate trust in patients with high cardiovascular (CV) risk. This is a secondary analysis from a quantitative cohort study of 270 patients from a primary care clinic in Kuala Lumpur, Malaysia. Patients recorded each OHI encountered over two months in a digital information diary …

Large-Bore Mechanical Thrombectomy Versus Catheter-Directed Thrombolysis In The Management Of Intermediate-Risk Pulmonary Embolism: Primary Results Of The Peerless Randomized Controlled Trial., Wissam A Jaber, Carin F Gonsalves, Stefan Stortecky, Samuel Horr, Orestis Pappas, Ripal T Gandhi, Keith Pereira, Jay Giri, Sameer J Khandhar, Khawaja Afzal Ammar, David M Lasorda, Brian Stegman, Lucas Busch, David J Dexter, Ezana M Azene, Nikhil Daga, Fakhir Elmasri, Chandra R Kunavarapu, Mark E Rea, Joseph S Rossi, Joseph Campbell, Jonathan Lindquist, Adam Raskin, Jason C Smith, Thomas M Tamlyn, Gabriel A Hernandez, Parth Rali, Torrey R Schmidt, Jeffrey T Bruckel, Juan C Camacho, Jun Li, Samy Selim, Catalin Toma, Sukhdeep Singh Basra, Brian A Bergmark, Bhavraj Khalsa, David M Zlotnick, Jordan Castle, David J O'Connor, C Michael Gibson

Heart and Vascular Articles

BACKGROUND: There are a lack of randomized controlled trial data comparing outcomes of different catheter-based interventions for intermediate-risk pulmonary embolism.

METHODS: PEERLESS is a prospective, multicenter, randomized controlled trial that enrolled 550 patients with intermediate-risk pulmonary embolism with right ventricular dilatation and additional clinical risk factors randomized 1:1 to treatment with large-bore mechanical thrombectomy (LBMT) or catheter-directed thrombolysis (CDT). The primary end point was a hierarchal win ratio composite of the following (assessed at the sooner of hospital discharge or 7 days after the procedure): (1) all-cause mortality, (2) intracranial hemorrhage, (3) major bleeding, (4) clinical deterioration and/or escalation to …

Cardiovascular Disease In Adults With Osteogenesis Imperfecta: Clinical Characteristics, Care Recommendations, And Research Priorities Identified Using A Modified Delphi Technique, Lars Folkestad, Siddharth K Prakash, Sandesh C S Nagamani, Niels Holmark Andersen, Erin Carter, Jannie Dahl Hald, Riley J Johnson, Bente Langdahl, Eleanor M Perfetto, Cathleen Raggio, Stuart H Ralston, Robert A Sandhaus, Oliver Semler, Laura Tosi, Eric Orwoll

Faculty, Staff and Student Publications

Osteogenesis imperfecta (OI) is a multisystem disorder most often caused by pathogenic variants in genes that encode type I collagen. Type I collagen is abundant not only in bone but also in multiple tissues including skin, tendons, cornea, blood vessels, and heart. Thus, OI can be expected to affect cardiovascular system, and there are numerous reports of cardiovascular disease (CVD) in people with OI. However, there is no consensus on how CVD in OI should be assessed or managed. To fill this gap, a multidisciplinary group was convened to develop clinical guidance. The work included a systematic review of the …

A Case Of Heterotaxy And Common Atrioventricular Canal With Bradycardia, Mohamed Aashiq Abdul Ghayum, Jenna Schermerhorn, Hayley S. Hancock, Kelsey Brattrud, Melanie Kathol, Maria Kiaffas

Posters

Background: Heterotaxy-polysplenia syndrome (otherwise known as left atrial isomerism) should be suspected in the presence of complete atrioventricular canal defect (CAVC) with interruption of the inferior vena cava (IVC), atrioventricular block (AVB), and viscero-cardiac heterotaxy. The prognosis remains dismal for the fetus with such entity, especially in the presence of major structural heart disease and high-grade atrioventricular block. Early diagnosis, close follow up, and appropriate delivery planning, allows for effective stabilization of the baby after birth and might improve survival. Methods: A 26-year-old mother at 26 weeks gestational age was referred for cardiac evaluation of cardiomegaly, suspected CAVC and bradycardia. …

Common Pulmonary Vein Atresia: A Diagnostic And Management Distinction, Adenike Adenikinju, Jenna Schermerhorn, Anmol Goyal, William Douglas, Sanket Shah

Posters

Common pulmonary vein atresia (CPVA) is an extremely rare congenital heart disease (CHD) characterized by a pulmonary vein confluence with no connection to the left atrium (LA) and no large decompressing vessel. We present a rare case of CPVA prognosticated with multimodal imaging.

Synergistic Effects Of Plasma S100b And Mri Measures Of Cerebrovascular Disease On Cognition In Older Adults, Colleen A. Pappas, Christopher E. Bauer, Valentinos Zachariou, Timothy Justin Libecap, Beatriz Rodolpho, Tiffany L. Sudduth, Peter T. Nelson, Gregory Jicha, Anika M. S. Hartz, Xingfeng Shao, Danny J. J. Wang, Brian T. Gold

Neurology Faculty Publications

There is growing interest in studying vascular contributions to cognitive impairment and dementia (VCID) and developing biomarkers to identify at-risk individuals. A combination of biofluid and neuroimaging markers may better profile early stage VCID than individual measures. Here, we tested this possibility focusing on plasma levels of S100 calcium-binding protein B (S100B), which has been linked with blood– brain-barrier (BBB) integrity, and neuroimaging measures assessing BBB function (water exchange rate across the BBB (kw)) and cerebral small vessel disease (white matter hyperintensities (WMHs)). A total of 74 older adults without dementia had plasma samples collected and underwent cognitive assessment. A …

D-Transposition Of The Great Arteries With Right Aortic Arch, Bilateral Ductus With Ductal Origin Of The Left Subclavian Artery And Abnormal Aortic Origin Of The Left Coronary Artery, Jenna Schermerhorn, Anmol Goyal, Param Vora, Braidyn Wells, Edo Bedzra, Sanket Shah

Posters

We present a case of prenatally diagnosed d-transposition of the great arteries (d-TGA) with intact ventricular septum (IVS), postnatally found to have bilateral patent ductus arteriosus (PDA) with potential for isolation of the left subclavian artery (LSA) and an abnormal left coronary artery (LCA) course. Isolation of the LSA is a rare occurrence and defined as an anomalous origin from the pulmonary artery via PDA and apparent discontinuation from the arch following PDA closure. It is exceedingly rare in association with d-TGA. Coronary artery anatomy is particularly important in d-TGA given most patients undergo the arterial switch operation (ASO).

Duration Of Labor And Umbilical Artery Acidosis In Critical Congenital Heart Disease, Sarah Gwazdacz, Teresa Nguyen, Henry Yeh, Mary T. Donofrio, Timothy Bennett, Amanda Mcintosh

Posters

• Background (83 words): Standard delivery protocols for most prenatally diagnosed CCHD is induction of labor at 39 weeks with aims of a vaginal delivery (VD) near a tertiary care center. There is no benefit to planned Cesarean delivery (CD) over VD for most infants with CCHD. However, longer durations of labor (DOL) in CCHD have been described as a risk factor for umbilical artery (UA) acidosis. We aim to describe the relationship between DOL and UA pH and neonatal outcomes in those with prenatally diagnosed CCHD. • Methods (150 words): Retrospective chart review of prenatally diagnosed with CCHD born …

Sudden Cardiac Death Associated With Fatty Liver Disease, Jonathan Vo, Thien T T T Truyen, Audrey Uy-Evanado, Arayik Sargsyan, Harpriya Chugh, Christopher Young, Sean Hurst, Christina Y Miyake, Kyndaron Reinier, Sumeet S Chugh

Faculty, Staff and Students Publications

BACKGROUND: Fatty liver disease or steatotic liver disease (SLD) affects 25% of the global population and has been associated with heart disease. However, there is a lack of postmortem studies in the context of sudden cardiac death (SCD).

OBJECTIVES: To investigate the relationship between SLD and SCD.

METHODS: A post-mortem case-case study was conducted in victims of SCD from an ongoing community-based study in Southern California (Ventura, CA, 2015-2023). Diagnosis of SLD was determined from post-mortem liver histopathology reports. For each patient, demographic variables, laboratory values, and presence of co-morbidities were ascertained from medical records and were compared between patients …

Analyzing The Creation And Use Of Abbreviations In Cardiology And Cardiac Imaging Society Guidelines, Christopher R Green, Rui Zhang, Raymond F Stainback, Sofia W Ye, Daniel E Forsha, Enrique Garcia-Sayan, Jeffrey C Hill, Carol Mitchell, Vera H Rigolin, Vandana Sachdev, Partho P Sengupta, Vincent L Sorrell, Jordan B Strom, Alexander M Ye, Cynthia C Taub

Faculty, Staff and Students Publications

BACKGROUND: Abbreviation use in clinical and academic cardiology is widespread, yet there are few guidelines regulating the creation and utilization of abbreviations. Inconsistent abbreviations can introduce ambiguity and pose challenges to practice and research.

OBJECTIVES: The authors aimed to analyze how abbreviations are created and utilized in general cardiology and cardiac imaging society guidelines in order to assess whether ambiguities and discrepancies exist between societies.

METHODS: Abbreviation data were collected from 7 national and international societies of general cardiology and cardiac imaging over a 6-year span (2018-2023). Data were linguistically coded for abbreviation type, unique occurrence, meaning or sense count, …