Cardiology Commons^™

Predictors And Impact Of Prolonged Vasoplegia After Continuous-Flow Left Ventricular Assist Device Implantation, Harveen K Lamba, Mary Kim, Meng Li, Andrew B Civitello, Ajith P Nair, Leo Simpson, J Patrick Herlihy, O H Frazier, Joseph G Rogers, Gabriel Loor, Kenneth K Liao, Alexis E Shafii, Subhasis Chatterjee

Faculty, Staff and Students Publications

BACKGROUND: Vasoplegia after cardiac surgery is associated with adverse outcomes. However, the clinical effects of vasoplegia and the significance of its duration after continuous-flow left ventricular assist device (CF-LVAD) implantation are less known.

OBJECTIVES: This study aimed to identify predictors of and outcomes from transient vs prolonged vasoplegia after CF-LVAD implantation.

METHODS: The study was a retrospective review of consecutive patients who underwent CF-LVAD implantation between January 1, 2005, and December 31, 2017. Vasoplegia was defined as the presence of all of the following: mean arterial pressure ≤65 mm Hg, vasopressor (epinephrine, norepinephrine, vasopressin, or dopamine) use for >6 hours …

Chlorthalidone Vs Hydrochlorothiazide For Hypertension Treatment After Myocardial Infarction Or Stroke: A Secondary Analysis Of A Randomized Clinical Trial, Areef Ishani, Cynthia Hau, William C Cushman, Sarah M Leatherman, Robert A Lew, Peter A Glassman, Addison A Taylor, Ryan E Ferguson

Faculty, Staff and Students Publications

IMPORTANCE: Patients with prior myocardial infarction (MI) or stroke have a greater risk of recurrent cardiovascular (CV) events.

OBJECTIVE: To evaluate the association of chlorthalidone (CTD) vs hydrochlorothiazide (HCTZ) with CV outcomes and noncancer deaths in participants with and without prior MI or stroke.

DESIGN, SETTING, AND PARTICIPANTS: This was a prespecified secondary analysis of the Diuretic Comparison Project (DCP), a pragmatic randomized clinical trial conducted within 72 participating Veterans Affairs health care systems from June 2016 to June 2021, in which patients aged 65 years or older with hypertension taking HCTZ at baseline were randomized to continue HCTZ or …

Early Life Cardiovascular Risk Factors And Midlife Epigenetic Aging: An Enduring Legacy, Paul S De Vries, Anthony S Zannas

Faculty, Staff and Student Publications

No abstract provided.

Low Absolute Risk Of Thrombotic And Cardiovascular Events In Outpatient Pregnant Women With Covid-19, Behnood Bikdeli, Darsiya Krishnathasan, Candrika Khairani, Antoine Bejjani, Julia Davies, Nicole Porio, Anthony Tristani, Andre Armero, Ali Assi, Victor Nauffal, Umberto Campia, Zaid Almarzooq, Eric Wei, Marcos Ortiz-Rios, Valeria Zuluaga-Sánchez, Aditya Achanta, Sirus Jesudasen, Bruce Tiu, Geno Merli, Orly Leiva, John Fanikos, Elvira Grandone, Aditya Sharma, Samantha Rizzo, Mariana Pfeferman, Ruth Morrison, Alec Vishnevsky, Judith Hsia, Mark Nehler, James Welker, Marc Bonaca, Brett Carroll, Samuel Goldhaber, Zhou Lan, Gregory Piazza

Division of Cardiology Faculty Papers

INTRODUCTION: Pregnancy may contribute to an excess risk of thrombotic or cardiovascular events. COVID-19 increases the risk of these events, although the risk is relatively limited among outpatients. We sought to determine whether outpatient pregnant women with COVID-19 are at a high risk for cardiovascular or thrombotic events.

MATERIALS & METHODS: We analyzed pregnant outpatients with COVID-19 from the multicenter CORONA-VTE-Network registry. The main study outcomes were a composite of adjudicated venous or arterial thrombotic events, and a composite of adjudicated cardiovascular events. Events were assessed 90 days after the COVID-19 diagnosis and reported for non-pregnant women ≤45 years, and …

Illness Perceptions And Health-Promoting Behaviors: The Buffering Role Of Resilience In Adults With Congenital Heart Disease, Taylor Rose Eldridge

Electronic Theses and Dissertations

Congenital heart defects (CHD) are one of the most prevalent genetic abnormalities, impacting the lives of millions of children, teens, and young adults. Conservative diagnoses estimate that 2.4 million children and adults are living with CHD in the United States (Gilboa et al., 2016). CHD requires consistent cardiac support with multiple surgeries and hospitalizations expected throughout the lifetime, which significantly impacts psychological health. Specifically, patients present with a host of extra-cardiac conditions that impact their quality of life. With advancements in medical technology, mortality rates continue to improve for this population; however, individuals face a number of consequences that impact …

Cardiac Conduction Diseases: Understanding The Molecular Mechanisms To Uncover Targets For Future Treatments, Tingting Li, Qussay Marashly, Jitae A Kim, Na Li, Mihail G Chelu

Faculty, Staff and Students Publications

Introduction: The cardiac conduction system (CCS) is crucial for maintaining adequate cardiac frequency at rest and modulation during exercise. Furthermore, the atrioventricular node and His-Purkinje system are essential for maintaining atrioventricular and interventricular synchrony and consequently maintaining an adequate cardiac output.

Areas covered: In this review article, we examine the anatomy, physiology, and pathophysiology of the CCS. We then discuss in detail the most common genetic mutations and the molecular mechanisms of cardiac conduction disease (CCD) and provide our perspectives on future research and therapeutic opportunities in this field.

Expert opinion: Significant advancement has been made in understanding the molecular …

Piezo1 Regulates Meningeal Lymphatic Vessel Drainage And Alleviates Excessive Csf Accumulation, Dongwon Choi, Eunkyung Park, Joshua Choi, Renhao Lu, Jin Suh Yu, Chiyoon Kim, Luping Zhao, James Yu, Brandon Nakashima, Sunju Lee, Dhruv Singhal, Joshua P Scallan, Bin Zhou, Chester J Koh, Esak Lee, Young-Kwon Hong

Faculty, Staff and Students Publications

Piezo1 regulates multiple aspects of the vascular system by converting mechanical signals generated by fluid flow into biological processes. Here, we find that Piezo1 is necessary for the proper development and function of meningeal lymphatic vessels and that activating Piezo1 through transgenic overexpression or treatment with the chemical agonist Yoda1 is sufficient to increase cerebrospinal fluid (CSF) outflow by improving lymphatic absorption and transport. The abnormal accumulation of CSF, which often leads to hydrocephalus and ventriculomegaly, currently lacks effective treatments. We discovered that meningeal lymphatics in mouse models of Down syndrome were incompletely developed and abnormally formed. Selective overexpression of …

Multimodal Neurologic Monitoring In Patients Undergoing Extracorporeal Membrane Oxygenation, Khwaja Siddiqui, Muhammad U Hafeez, Ali Ahmad, Syed O Kazmi, Subhasis Chatterjee, Eric Bershad, Mohammad Hirzallah, Chethan Rao, Rahul Damani

Faculty, Staff and Students Publications

Introduction Extracorporeal membrane oxygenation (ECMO) is associated with a high rate of neurologic complications. Multimodal neurologic monitoring (MNM) has the potential for early detection and intervention. We examined the safety and feasibility of noninvasive MNM during ECMO. We hypothesized that survivors and non-survivors would have meaningful differences in transcranial Doppler (TCD) sonography and electroencephalographic (EEG) characteristics, which we aimed to identify. We also investigated adverse neurologic events and attempted to identify differences in EEG and TCD characteristics among patients based on the type of ECMO and the occurrence of these events. Material and methods We performed an observational study on …

Head-To-Head Comparison Of Relevant Cell Sources Of Small Extracellular Vesicles For Cardiac Repair: Superiority Of Embryonic Stem Cells, Hernán González-King, Patricia G Rodrigues, Tamsin Albery, Benyapa Tangruksa, Ramya Gurrapu, Andreia M Silva, Gentian Musa, Dominika Kardasz, Kai Liu, Bengt Kull, Karin Åvall, Katarina Rydén-Markinhuhta, Tania Incitti, Nitin Sharma, Cecilia Graneli, Hadi Valadi, Kasparas Petkevicius, Miguel Carracedo, Sandra Tejedor, Alena Ivanova, Sepideh Heydarkhan-Hagvall, Phillipe Menasché, Jane Synnergren, Niek Dekker, Qing-Dong Wang, Karin Jennbacken

Faculty, Staff and Student Publications

Small extracellular vesicles (sEV) derived from various cell sources have been demonstrated to enhance cardiac function in preclinical models of myocardial infarction (MI). The aim of this study was to compare different sources of sEV for cardiac repair and determine the most effective one, which nowadays remains limited. We comprehensively assessed the efficacy of sEV obtained from human primary bone marrow mesenchymal stromal cells (BM-MSC), human immortalized MSC (hTERT-MSC), human embryonic stem cells (ESC), ESC-derived cardiac progenitor cells (CPC), human ESC-derived cardiomyocytes (CM), and human primary ventricular cardiac fibroblasts (VCF), in in vitro models of cardiac repair. ESC-derived sEV (ESC-sEV) …

Coronary Stenosis And Cardiogenic Shock Secondary To Aortitis Following Aortic Root Support Procedure, Alexander Carpenter, Stephanie Connaire, Nitin Chandra Mohan, Stephanie L Curtis, Serban C Stoica, Massimo Caputo, Julian W Strange

Faculty, Staff and Student Publications

A woman with recent personalized external aortic root support implant presented in cardiogenic shock with bilateral coronary ostial occlusion and aortic inflammation requiring emergency coronary angioplasty. Subsequent computed tomography with positron emission tomography scanning demonstrated aortitis with extensive inflammation adjacent to the personalized external aortic root support mesh, the first report of this important complication.

The Impact Of Severe Obesity On Image Quality And Ventricular Function Assessment In Echocardiography And Cardiac Mri., Akash Goyal, Christopher D Crabtree, Bryan C Lee, Thura T Harfi, Saurabh Rajpal, Vedat O Yildiz, Orlando P Simonetti, Matthew S Tong

Heart and Vascular Articles

This study sought to evaluate the impact of severe obesity on image quality and ventricular function assessment in cardiovascular magnetic resonance (MRI) and trans-thoracic echocardiography (TTE). We studied 100 consecutive patients who underwent clinically indicated cardiac MRI and TTE studies within 12 months between July 2017 and December 2020; 50 (28 females and 22 males; 54.5 ± 18.7 years) with normal body mass index (BMI) (18.5-25 kg/m

Three-Year Outcomes Of The Abre Venous Self-Expanding Stent System In Patients With Symptomatic Iliofemoral Venous Outflow Obstruction., Stephen Black, Marc Sapoval, David J Dexter, Kathleen Gibson, Raghu Kolluri, Mahmood Razavi, Dorian J Defreitas, Hong Wang, Stephanie Brucato, Erin Murphy

Heart and Vascular Articles

PURPOSE: To report 36-month outcomes and subgroup analysis of the ABRE study evaluating the safety and effectiveness of the Abre venous self-expanding stent system for the treatment of symptomatic iliofemoral venous outflow obstruction disease.

METHODS: The ABRE study was a prospective, multicenter, nonrandomized study that enrolled and implanted Abre venous stents in 200 participants (mean age 51.5 years [SD ± 15.9], 66.5% women) with symptomatic iliofemoral venous outflow obstruction at 24 global sites. Outcomes assessed through 36 months included patency, major adverse events, stent migration, stent fracture, and quality-of-life changes. Adverse events and imaging studies were adjudicated by independent clinical …

Management Of Macrovascular Diabetic Complications: A Single-Center Case Series Analysis Of Consecutively Attending Patients In Primary Care, Sanda Maria Crețoiu, Mihaela Adela Iancu, Laura Maria Condur, Teodor Salmen, Andreea Steriu, Ana Maria Alexandra Stănescu, Irina Anca Eremia, Cristina Mihaela Olariu, Eliza Elena Cinteză, Camelia Cristina Diaconu

Journal of Mind and Medical Sciences

Introduction. The prevalence of diabetes mellitus is increasing, with type 2 diabetes (T2DM) being a major health priority for any public health system. Increased arterial stiffness in patients with diabetes will lead to the appearance of vascular complications. Increased arterial stiffness in patients with diabetes usually leads to vascular complications. Any earlier diagnosis of impaired macrovascular evidence may lead to improved outcomes in patient care. The objective of our study was to assess and evaluate the finger-toe pulse wave velocity (ftPWV), as a measure of arterial stiffness, in order to assist with early detection of macrovascular diabetic complications. Materials and …

Venous Thrombosis Associated With Pancreatic Cancer, Vlad Buică, Camelia Diaconu, Octavian Andronic

Journal of Mind and Medical Sciences

Introduction. Cancer-associated thrombosis is a significant prognostic marker in pancreatic neoplasia, with a venous thromboembolism incidence of 17-34%. This study focuses on cancer-associated thrombosis risk factors, screening scores, and treatment options. Materials and Methods. Comprehensive database searches were conducted across Web of Science, PubMed, Reaxys, ScienceDirect, and Scopus. Results. Of the 37 articles reviewed, findings include splanchnic vein thrombosis correlating with pancreatic complications and survival rates. Gender differences in cancer-associated thrombosis risk were inconclusive, while African Americans showed a higher incidence of pulmonary embolism. Various cancer-associated thrombosis staging scores were evaluated, with ONKOTEV score outperforming Khorana. Direct oral anticoagulants were …

Dronedarone For The Treatment Of Atrial Arrhythmias In Adults With Congenital Heart Disease, Mahdi S Agha, Peter R Ermis, Wayne J Franklin, Dhaval R Parekh, Angeline D Opina, Jeffrey J Kim, Christina Y Miyake, Santiago O Valdes, Wilson W Lam

The Texas Heart Institute Journal

Background: Atrial tachyarrhythmias are common and difficult to treat in adults with congenital heart disease. Dronedarone has proven effective in patients without congenital heart disease, but data are limited about its use in adults with congenital heart disease of moderate to great complexity.

Methods: A single-center, retrospective chart review of 21 adults with congenital heart disease of moderate to great complexity who were treated with dronedarone for atrial tachyarrhythmias was performed.

Results: The median (IQR) age at dronedarone initiation was 35 (27.5-39) years. Eleven patients (52%) were male. Ten patients (48%) had New York Heart Association class I disease, 10 …

Dronedarone For The Treatment Of Atrial Arrhythmias In Adults With Congenital Heart Disease, Mahdi S Agha, Peter R Ermis, Wayne J Franklin, Dhaval R Parekh, Angeline D Opina, Jeffrey J Kim, Christina Y Miyake, Santiago O Valdes, Wilson W Lam

The Texas Heart Institute Journal

BACKGROUND: Atrial tachyarrhythmias are common and difficult to treat in adults with congenital heart disease. Dronedarone has proven effective in patients without congenital heart disease, but data are limited about its use in adults with congenital heart disease of moderate to great complexity.

METHODS: A single-center, retrospective chart review of 21 adults with congenital heart disease of moderate to great complexity who were treated with dronedarone for atrial tachyarrhythmias was performed.

RESULTS: The median (IQR) age at dronedarone initiation was 35 (27.5-39) years. Eleven patients (52%) were male. Ten patients (48%) had New York Heart Association class I disease, 10 …

What Is The Additive Value Of Nutritional Deficiency To Va-Fi In The Risk Assessment For Heart Failure Patients?, Seulgi Erica Kim, Mehrnaz Azarian, Aanand D Naik, Catherine Park, Molly J Horstman, Salim S Virani, Orna Intrator, Christopher I Amos, Ariela Orkaby, Javad Razjouyan

Faculty, Staff and Student Publications

OBJECTIVES: to assess the impact of adding the Prognostic Nutritional Index (PNI) to the U.S. Veterans Health Administration frailty index (VA-FI) for the prediction of time-to-death and other clinical outcomes in Veterans hospitalized with Heart Failure.

METHODS: A retrospective cohort study of veterans hospitalized for heart failure (HF) from October 2015 to October 2018. Veterans ≥50 years with albumin and lymphocyte counts, needed to calculate the PNI, in the year prior to hospitalization were included. We defined malnutrition as PNI ≤43.6, based on the Youden index. VA-FI was calculated from the year prior to the hospitalization and identified three groups: …

Outcomes Of Drug-Eluting Stents In Comparison To Bare Metal Stents In Cancer Patients With Percutaneous Coronary Intervention: A Systematic Review And Meta-Analysis, Muhammad Siddiqui, Eric Warner, Joey Junarta, Parker O’Neill, David Signarovitz, Eyad Kanawati, Mohammed Murtaza, David Fischman

Division of Cardiology Faculty Papers

Background: Studies have demonstrated poor prognosis in cancer patients who undergo percutaneous coronary intervention (PCI) for coronary artery disease (CAD). Cancer patients receiving PCI are at increased risk of in-stent thrombosis, bleeding, hospital readmissions, and cardiovascular and noncardiovascular mortality when compared to patients without cancer. It is unclear if the poor outcomes in cancer patients are related to the stent type utilized for PCI. This meta-analysis attempts to identify differences in efficacy and safety outcomes when comparing drug-eluting stents (DESs) with bare metal stents (BMSs) in cancer patients.

Methods: This meta-analysis is reported according to the Preferred Reporting Items for …

Association Between Monosodium Glutamate Consumption With Changes In Gut Microbiota And Related Metabolic Dysbiosis—A Systematic Review, Hossein Ahangari, Behnam Bahramian, Arezou Khezerlou, Milad Tavassoli, Narges Kiani-Salmi, Vahideh Tarhriz, Ali Ehsani

School of Medicine Faculty Publications

Monosodium glutamate (MSG) is used as a common food additive in some foods. However, based on our search and knowledge, no comprehensive study discussed the effect of MSG on the human gut microbiome. In this study, the effects of MSG on the gut microbiome, liver, and kidney were performed. Data were collected from databases including PubMed, Scopus, Web of Science, and ScienceDirect using the search strategy and keywords. Finally, 14 eligible studies were selected for systematic review. This study provides a new perspective on the effects of MSG on the gut flora, shedding light on the potential relationship between MSG …

Acute Mitral Valve Regurgitation Caused By Left Ventricular Pacing Wire During Transcatheter Aortic Valve Replacement, Byeng-Ju Son, Ung Kim, Jong-Ho Nam, Kang-Un Choi, Jong-Il Park, Jang-Won Son

The Texas Heart Institute Journal

Transcatheter aortic valve replacement is quickly becoming the standard of care for patients with severe aortic stenosis thanks to its minimally invasive nature and favorable outcomes. Recently, left ventricular pacing has been proposed as a safer alternative to traditional right heart pacing, which could simplify the transcatheter aortic valve replacement procedure overall, although procedural complications may still occur. This report describes a rare case of left ventricular pacing wire-induced acute severe mitral valve regurgitation during transcatheter aortic valve replacement.