Noninvasive Point Of Care Device For Assessing Cardiac Response To Acute Volume Changes, 2023 Thomas Jefferson University
Noninvasive Point Of Care Device For Assessing Cardiac Response To Acute Volume Changes, Harry A. Silber, Nisha A. Gilotra, Thomas L. Miller
Department of Pediatrics Faculty Papers
Purpose: The change in the amplitude of a peripheral pulse in response to a Valsalva maneuver has diagnostic utility for assessing volume status at the bedside. We have developed a device to automatically quantify the Valsalva pulse response (VPR) to a standardized Valsalva maneuver that the device guides a user to perform. In this study, we sought to determine whether VPR by the device, Indicor, is sensitive enough to detect the acute increase in central pressure and volume load that occurs with a passive leg raise (PLR) in healthy volunteers.
Methods: Healthy volunteers were tested semirecumbently at 45 degrees, then …
Comorbidity Clusters And In-Hospital Outcomes In Patients Admitted With Acute Myocardial Infarction In The Usa: A National Population-Based Study, 2023 Thomas Jefferson University
Comorbidity Clusters And In-Hospital Outcomes In Patients Admitted With Acute Myocardial Infarction In The Usa: A National Population-Based Study, Salwa Zghebi, Martin Rutter, Louise Sun, Waqas Ullah, Muhammad Rashid, Darren Ashcroft, Douglas Steinke, Stephen Weng, Evangelos Kontopantelis, Mamas Mamas
Division of Cardiology Faculty Papers
BACKGROUND: The prevalence of multimorbidity in patients with acute myocardial infarction (AMI) is increasing. It is unclear whether comorbidities cluster into distinct phenogroups and whether are associated with clinical trajectories.
METHODS: Survey-weighted analysis of the United States Nationwide Inpatient Sample (NIS) for patients admitted with a primary diagnosis of AMI in 2018. In-hospital outcomes included mortality, stroke, bleeding, and coronary revascularisation. Latent class analysis of 21 chronic conditions was used to identify comorbidity classes. Multivariable logistic and linear regressions were fitted for associations between comorbidity classes and outcomes.
RESULTS: Among 416,655 AMI admissions included in the analysis, mean (±SD) age …
Concept Of Health-Related Quality Of Life Among People With Heart Failure In Karachi, Pakistan, 2023 Aga Khan University
Concept Of Health-Related Quality Of Life Among People With Heart Failure In Karachi, Pakistan, Anny Ashiq Ali
Theses & Dissertations
Background: Non-communicable diseases (NCDs), including cardiovascular diseases, are a leading cause of global mortality. The mortality rate for cardiovascular diseases is on the rise, with 80 % to 86 % of fatalities, particularly in low- and middle-income countries, including Pakistan. Among NCDs, heart failure (HF) is a condition for which there is no cure, and patients rely on supportive treatments to maintain their quality of life. HF not only affects physical well-being but also has far-reaching consequences on the emotional, social, and cognitive aspects of life. In the context of Pakistan, where unique healthcare, sociocultural, and economic factors prevail, the …
Lower Versus Higher Oxygen Targets For Out-Of-Hospital Cardiac Arrest: A Systematic Review And Meta-Analysis, 2023 Thomas Jefferson University
Lower Versus Higher Oxygen Targets For Out-Of-Hospital Cardiac Arrest: A Systematic Review And Meta-Analysis, Xin Cheng, Yu Zhang, Haidong Deng, Yuning Feng, Weelic Chong, Yang Hai, Pengfei Hao, Jialing He, Tiangui Li, Liyuan Peng, Peng Wang, Yangchun Xiao, Fang Fang
Student Papers, Posters & Projects
BACKGROUND: Supplemental oxygen is commonly administered to patients after out-of-hospital cardiac arrest. However, the findings from studies on oxygen targeting for out-of-hospital cardiac arrest are inconclusive. Thus, we conducted a systematic review and meta-analysis to evaluate the impact of lower oxygen target compared with higher oxygen target on patients after out-of-hospital cardiac arrest.
METHODS: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, from inception to February 6, 2023, for randomized controlled trials comparing lower and higher oxygen target in adults (aged ≥ 18 years) after out-of-hospital cardiac arrest. We screened studies and extracted data independently. The primary …
Evaluation Of Telephone Cardiopulmonary Resuscitation Performance In Current Practice In Saudi Arabia, 2023 School of Health Sciences, University of Southampton, Southampton, United Kingdom
Evaluation Of Telephone Cardiopulmonary Resuscitation Performance In Current Practice In Saudi Arabia, Meshary Binhotan, Joanne Turnbull, Graham Petley, Nawfal Aljerian, Mohammad Altuwaijri
Journal of the Saudi Heart Association
Objectives: Out-of-hospital cardiac arrest (OHCA) is a global health problem with a low survival rate. Telephone cardiopulmonary resuscitation (T-CPR) guidance by emergency medical services (EMS) dispatchers can improve CPR performance and, consequently, survival rates. Accordingly, the American Heart Association (AHA) has released performance standards for T-CPR in current practice to improve its quality. However, no study has examined T-CPR performance in Saudi Arabia. Therefore, this study aims to evaluate T-CPR performance in the Saudi Arabian EMS system.
Methods: A retrospective observation of OHCA calls in current practice was conducted in Riyadh, Saudi Arabia. OHCA calls were reviewed to identify those …
Cardiac Rehabilitation In Abu Dhabi: A Retrospective Investigation Of Program Delivery, Participants, And Factors Associated With Program Completion Utilizing A Hospital Registry, 2023 Cardiovascular and Pulmonary Physical Therapy Specialist Cleveland Clinic Abu Dhabi Inpatient Therapies and Rehabilitation Abu Dhabi, United Arab Emirates
Cardiac Rehabilitation In Abu Dhabi: A Retrospective Investigation Of Program Delivery, Participants, And Factors Associated With Program Completion Utilizing A Hospital Registry, Aaron Heisey Thrush
Journal of the Saudi Heart Association
Objectives: Investigations into the provision of cardiac rehabilitation from the Arabian Gulf countries are rare, despite suffering from an unusually high prevalence of cardiovascular disease. This study reports patient and program characteristics from an exercise-based cardiac rehabilitation program in Abu Dhabi, and factors associated with program completion. Methods: Data was drawn from the institution’s cardiac rehabilitation registry, populated from the electronic medical record of patients enrolled in the hospital-based cardiac rehabilitation program, from 2015 to 2022. The program was administered by physical therapist and nurse specialists and guided by individualized exercise parameters. Completion of the program was defined as attendance …
Left Pulmonary Artery Occlusion Following Device Closure Of Patent Ductus Arteriosus In Premature Infants, 2023 LSU Health Sciences Center - New Orleans
Left Pulmonary Artery Occlusion Following Device Closure Of Patent Ductus Arteriosus In Premature Infants, Jesus C. Jaile, Ernest Siwik, Sergio Bartakian
School of Medicine Faculty Publications
Background: Device closure of a patent ductus arteriosus (PDA) is rapidly evolving, with the Amplatzer Piccolo Occluder (Abbott) receiving US Food and Drug Administration approval and becoming the first device approved for PDA closure in patients ≥700 g. We report on the first known cases of complete left pulmonary artery (LPA) occlusion following Piccolo closure of a PDA in premature infants. Methods: Retrospective chart analysis of PDA closures. Results: We have performed over 50 cases of Piccolo device closure of the PDA in preterm neonates in the past 2 years, with these 2 cases representing our only complications (4%). This …
Recognizing A “Hot Phase” Of An Arrhythmogenic Left Ventricular Cardiomyopathy: A Case Report, 2023 Cardiology department, Leiria Hospital Centre, Leiria, Portugal
Recognizing A “Hot Phase” Of An Arrhythmogenic Left Ventricular Cardiomyopathy: A Case Report, Margarida Cabral, Sara Fernandes, Catarina Ruivo, Hélia Martins, João Morais
Journal of the Saudi Heart Association
A 35-year-old male, with a medical history of acute myocarditis, presented with palpitations. Further investigation revealed non-sustained ventricular tachycardia and a slightly reduced left ventricular systolic function. Cardiac magnetic resonance showed extended late gadolinium enhancement of the left ventricle and fat infiltration. Genetic testing was positive for a pathogenic desmoplakin mutation, fulfilling the criteria of arrhythmogenic left ventricular cardiomyopathy. In conclusion, the authors described a case of a mimicked acute myocarditis at a young age in a patient with an arrhythmogenic left ventricular cardiomyopathy. Therefore, the genetic study is essential for both diagnosis and management.
A Rare Case Of Takotsubo Cardiomyopathy In An Elderly Lady During Hospital Stay, 2023 The University of Texas Rio Grande Valley
A Rare Case Of Takotsubo Cardiomyopathy In An Elderly Lady During Hospital Stay, Himabindu Kolli, Ashika A. Chacko, Pooja Maknoor, Nazish Khan, Timothy Heath
Research Colloquium
Introduction: Takotsubo Cardiomyopathy (TTC) is an acute, reversible form of left ventricular systolic dysfunction, most often triggered by a sudden physical, or less commonly emotional event. Here, we describe a patient who developed Takotsubo Cardiomyopathy during her hospital stay.
Case Description: 74-year-old Hispanic lady, a nursing home resident presented to the ED with altered mental status. She was admitted for septic shock due to UTI. Echocardiogram demonstrated normal systolic function, with 60-65% LV ejection fraction. After initiation of antibiotic therapy, she showed clinical improvement with resolution of shock.
On day 8 of hospitalization, patient became emotionally upset and her clinical …
A Case Of Device Lead Induced Severe Tricuspid Regurgitation And Right-Sided Heart Failure, 2023 The University of Texas Rio Grande Valley
A Case Of Device Lead Induced Severe Tricuspid Regurgitation And Right-Sided Heart Failure, Nina Shyama Appareddy, Michaela Iglesia, Ayman Khaddam, Henry Kwang, Eduardo D. Flores
Research Colloquium
Background: Interference of device leads with closure of the tricuspid leaflets can cause severe tricuspid regurgitation (TR) and right-sided heart failure, as can heart failure with reduced LV function (HfrEF), and left sided valve disease.
Case Presentation: A 78-year-old male with history of coronary artery disease s/p remote coronary bypass, ischemic cardiomyopathy with left ventricular ejection fraction 35-40%, and inducible ventricular tachycardia status post defibrillator presented with worsening dyspnea on exertion, easy fatigue, lower extremity pitting edema, anasarca, abdominal bloating and new systolic murmurs at the right upper and left lower sternal borders. An Echocardiogram demonstrated severe aortic stenosis with …
A Simple Case Of Viral Myopericarditis Or A Complication Of Monoclonal Antibody Infusion?, 2023 The University of Texas Rio Grande Valley
A Simple Case Of Viral Myopericarditis Or A Complication Of Monoclonal Antibody Infusion?, Jose A. Rivera, Michael Menowsky
Research Colloquium
Background: Myocarditis has been a rare, but well-documented side effect of the mRNA-based vaccines against SARS-CoV-2 as well as a complication of viral infections including SARS-CoV-2. However, myopericarditis as a complication of monoclonal antibody infusion or as complication of allergic reaction to antibody infusions might be and underreported.
Case presentation: In this case, we report a 30-year-old man with a previous diagnosis of COVID infection 1 week prior to presentation, unvaccinated for SARS-CoV-2 who was referred from a monoclonal infusion center where he received casirivimab and imdevimab and 15 minutes after infusion began to complain of chills, chest pain, shortness …
Appropriateness Of Inpatient Transthoracic Echocardiography In A Community Hospital With A New Cardiology Fellowship Program, 2023 The University of Texas Rio Grande Valley
Appropriateness Of Inpatient Transthoracic Echocardiography In A Community Hospital With A New Cardiology Fellowship Program, Christian D. Avalos, Y. Wady Aude
Research Colloquium
Background: The 2011 Appropriate Use Criteria (AUC) for echocardiography was developed to guide in the rational use of high quality cardiovascular imaging. Transthoracic echocardiography (TTE) orders with seemingly inappropriate indications were repeatedly identified at our hospital. Our goals were to identify the percentage of inappropriate TTEs, find a correlation between ordering physicians and appropriateness of TTEs, and reduce the inappropriate use of TTEs in the inpatient setting.
Methods: After implementing a required free-text indication for TTE orders, the indications of 100 random TTEs were retrospectively categorized as appropriate, inappropriate, and uncertain based on the AUC. TTEs for cardiac evaluation prior …
Using Noninvasive Calibrated Cuff Plethysmography To Observe The Effects Of Cold-Water Immersion On Arterial Compliance, 2023 California Polytechnic State University, San Luis Obispo
Using Noninvasive Calibrated Cuff Plethysmography To Observe The Effects Of Cold-Water Immersion On Arterial Compliance, Rita M. Grigorian
Master's Theses
As the prevalence of cardiovascular diseases continues to exponentially grow in populations across the globe, the necessity of determining underlying factors, effective methods of diagnoses, and universally available preventive measures also grows. Early detection of endothelial dysfunction, a proven precursor of cardiovascular diseases, can be extremely impactful in encouraging preventative measures and early intervention before medical conditions become chronic. In recent years, ice plunging, a form of cryotherapy involving full body immersion in cold water, has gained popularity within circles of fitness and health practitioners, gaining the interest of people of all backgrounds. Certain parallels observed between the human physiological …
3-Year Follow-Up Of A Prospective, Multicenter Study Of The Amplatzer Piccolo™ Occluder For Transcatheter Patent Ductus Arteriosus Closure In Children ≥ 700 Grams., 2023 Children's Mercy Hospital
3-Year Follow-Up Of A Prospective, Multicenter Study Of The Amplatzer Piccolo™ Occluder For Transcatheter Patent Ductus Arteriosus Closure In Children ≥ 700 Grams., Brian H. Morray, Shyam K. Sathanandam, Thomas Forbes, Matthew Gillespie, Darren Berman, Aimee K. Armstrong, Shabana Shahanavaz, Thomas Jones, Toby A. Rockefeller, Henri Justino, David Nykanen, Courtney Weiler, Dan Gutfinger, Evan M. Zahn
Manuscripts, Articles, Book Chapters and Other Papers
OBJECTIVE: This study describes 3-year follow-up of 200 infants weighing ≥ 700 grams who underwent transcatheter patent ductus arteriosus (PDA) closure with the Amplatzer Piccolo™ Occluder.
STUDY DESIGN: Between June 2017 and February 2019, 200 children were enrolled in this U.S. study (NCT03055858). PDA closure, survival, and device- or procedure-related events were evaluated. A total of 156 of the available 182 patients (86%) completed the study.
RESULTS: The implant success rate was 95.5% (191/200). At 3 years, PDA closure was observed in 100% (33/33) of patients. Survival was >95% with 9 reported deaths. No deaths were adjudicated as device- or …
Predictors Of Coronary Artery Disease In Heart Failure With Reduced Ejection Fraction At The Aga Khan University Hospital In Nairobi, 2023 Aga Khan University
Predictors Of Coronary Artery Disease In Heart Failure With Reduced Ejection Fraction At The Aga Khan University Hospital In Nairobi, Redemptar Kimeu, Jeilan Mohamed, Mzee Ngunga
Internal Medicine, East Africa
There appears to be an epidemiological transition in the etiology of heart failure in sub-Saharan Africa (SSA) in parallel with a steady increase in risk factors for coronary artery disease (CAD). SSA has limited access to heart failure and CAD diagnostics, limiting the number of patients who receive optimal care. Our objectives were to study the predictors of coronary artery disease among patients with heart failure with reduced ejection fraction (HFrEF) and develop a model to assist clinicians in determining the likelihood of CAD before cardiac catheterization.
Methodology: This was a retrospective study at the Aga Khan University Hospital, …
Outcomes And Discriminatory Accuracy Of The Cha2ds2vasc Score In Atrial Fibrillation And Cancer, 2023 Thomas Jefferson University
Outcomes And Discriminatory Accuracy Of The Cha2ds2vasc Score In Atrial Fibrillation And Cancer, Waqas Ullah, Mathew Dimeglio, Daniel Frisch, Rodrigo Bagur, Louise Sun, David Fischman, Andrija Matetic, Bonnie Ky, Mamas Mamas
Division of Cardiology Faculty Papers
Background: Atrial fibrillation (AF) is highly prevalent among cancer patients. The role of traditional risk stratification scores in the context of different cancer types in these patients remains unknown. Objectives: The purpose of this study was to determine the discriminative accuracy of the CHA2DS2VASc score for ischemic stroke using receiver operating characteristic and area under the curve. Methods: The National Readmission Database (2015-2019) was used to identify all AF patients stratified by the cancer diagnosis, type, and CHA2DS2VASc category (low; moderate; high risk). Outcomes at 30-day readmission were compared between cancer and …
Heart Failure Readmissions After Cardiac Surgeries: Navigating The High-Risk Terrain, 2023 Thomas Jefferson University
Heart Failure Readmissions After Cardiac Surgeries: Navigating The High-Risk Terrain, Waqas Ullah, Indranee Rajapreyar, Yevgeniy Brailovsky
Division of Cardiology Faculty Papers
No abstract provided.
Arrhythmogenic Right Ventricular Cardiomyopathy: Is Coxsackie The Criminal?, 2023 The University of Texas Rio Grande Valley
Arrhythmogenic Right Ventricular Cardiomyopathy: Is Coxsackie The Criminal?, Areeb Masood, Lily Chen, Paulina Vega, Henry Kwang
Research Symposium
Introduction: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiomyopathy characterized by right ventricular dysfunction, which can precipitate sudden cardiac death in young adults.
Case Presentation: A 22-year-old Hispanic male with PMH of hypertriglyceridemia and exertional syncopal episodes was brought to the ED after experiencing a sudden cardiac arrest while on the treadmill. On arrival, the patient was intubated and placed on a defibrillator which detected Vfib with torsade de pointes. On arrival to ED, initial ECG revealed 1-2 mm ST depressions in leads II, III, and aVF and incomplete RBBB. Chest XR showed water-bottle-shaped cardiac silhouette. Coronary angiography demonstrated …
Acute Exacerbation Of Heart Failure In A 35-Year-Old Hispanic Female With Premature Coronary Artery Disease Status Post Cabg X 4 And Multiple Comorbidities: A Case Report, 2023 The University of Texas Rio Grande Valley
Acute Exacerbation Of Heart Failure In A 35-Year-Old Hispanic Female With Premature Coronary Artery Disease Status Post Cabg X 4 And Multiple Comorbidities: A Case Report, Nelson D. Gonzalez, Bhargavi Akkineni
Research Symposium
Background: Coronary artery disease (CAD) is the leading cause of death in adults worldwide.1 Although CHD prevalence is highest in adults of middle age and above, it is important to be aware of risk factors in young adults that predispose them to premature CAD and its complications. We present a case of a young Hispanic female with acute exacerbation of heart failure (HF), CAD, and multiple comorbidities.
Case: A 35-year-old Hispanic female with past medical history of CAD status post coronary artery bypass graft (CABG) X 4, HF with reduced ejection fraction (EF) of 40-45%, chronic kidney disease stage …
A Case Of Minoca In A Patient With Recent History Of Covid-19 Infection, 2023 The University of Texas Rio Grande Valley
A Case Of Minoca In A Patient With Recent History Of Covid-19 Infection, Don C. Rajan, Nghia Nguyen, Nevin A. Varghese
Research Symposium
Background: Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a syndrome of myocardial ischemia resulting from microvascular dysfunction and with < 50% stenosis of major epicardial vessels. The incidence of MINOCA is 6% among patients with acute myocardial infarction. We present a case of MINOCA in a patient with a recent history of COVID-19 infection.
Case presentation: A 22-year-old man with recent history of Covid 19 infection presented with 3 days history of typical cardiac chest pain. He was not taking any medications or illicit drugs. EKG revealed sinus rhythm with ST elevations in leads II, V5, V6. Troponin I was elevated to 5.3ng/ml. He underwent coronary angiography which was reported as normal with no signs of obstructive coronary artery disease. Further workup including viral panel, ESR, CRP, HIV, hepatitis panel were negative. He was …