Cardiology Commons^™

Hemodialysis Access-Related High-Output Heart Failure: From Mechanisms To Multidisciplinary Management, Chukwuemezie Mamanu, Estefania Oliveros, Yevgeniy Brailovsky

Department of Medicine Faculty Papers

No abstract provided.

Same Day Discharge Can Be Performed Safely After Atrial Fibrillation Catheter Ablation Using A Wide-Footprint Lattice-Tip Dual-Energy System., Tyler L Taigen, Devi G Nair, Dinesh Sharma, Erich L Kiehl, Jose Osorio, Petr Neuzil, Josef Kautzner, Stavros E Mountantonakis, Andrea Natale, John D Hummel, Shephal K Doshi, Anish K Amin, Usman R Siddiqui, Kelly A Van Bragt, Jeffrey Cerkvenik, Khaldoun G Tarakji, Vivek Y Reddy, Moussa Mansour, Elad Anter

Heart and Vascular Articles

BACKGROUND: Same-day discharge (SDD) after atrial fibrillation (AF) ablation is generally considered safe, since most complications are identified during (or immediately) after the procedure.

OBJECTIVE: This study aimed to evaluate SDD in the SPHERE Persistent-Atrial Fibrillation trial.

METHODS: Patients with persistent AF were randomized to the dual-energy lattice-tip mapping and ablation catheter (investigational) vs a conventional contact-force radiofrequency ablation system (control). SDD and timing of 30-day procedure- or device-related serious adverse events (SAEs) were assessed in the full cohort. In a subset of centers that performed SDD in the trial, predictors of SDD, 30-day readmissions, and mortality rates were assessed. …

Leadless Pacing And The Emerging Era Of Combined Procedures In Adult Congenital Heart Disease, Srikant Das, Brock A Karolcik, Taylor S Howard

Faculty, Staff and Students Publications

No abstract provided.

Protocol For Non-Invasive Assessment Of Skeletal Muscle Structure And Function In Adolescents With Single Ventricle Heart Disease: A Cross-Sectional, Case-Control Study., Tyler A. Fick, Trent J. Herda, Emily Cramer, David A. White, Daniel Forsha

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Congenital heart disease (CHD) is the most common congenital malformation, and the most severe type, single ventricle (SV) heart disease, requires the Fontan surgical palliation. Fontan palliation minimizes hypoxemia and volume overload by separating systemic and pulmonary circulations, resulting in the absence of a sub-pulmonary pump. Skeletal muscle health may have a greater relative contribution to overall functional capacity of those with SV physiology, via the skeletal muscle (SkM) pump mechanism and oxidative capacity. The purpose of this study is to comprehensively evaluate multiple domains of SkM in this population compared to those with normal cardiac anatomy.

METHODS: Forty …

Sequential Presentation Of Diabetic Ketoacidosis, Acute Ischemic Stroke, And St-Elevation Myocardial Infarction: A Case Report, Ichlasul Mahdi Fardhani, Putu Aditya Darmawan Kuntadi, Hammam Arif Shabri, Muhammad Isra Rafidin Rayyan, Zarrah Yuniar Qolbi Harris, Tristi Lukita Wening, Azham Purwandhono

Chulalongkorn Medical Journal

Cardio-cerebral infarction (CCI), the simultaneous occurrence of acute ischemic stroke (AIS) and acute myocardial infarction (AMI), is a rare and life-threatening emergency. Management becomes even more challenging when accompanied by metabolic complications like diabetic ketoacidosis (DKA). We report a case of a 45-year-old man with hypertension and a chronic smoking history, found unresponsive with right-sided hemiparesis. He was last seen well six hours before arrival. On examination, he was hypertensive, tachypneic, had a ketotic breath odor, GCS 12, and NIHSS 15. Laboratory results confirmed DKA, with a random blood glucose of 412 mg/dL and metabolic acidosis. Non-contrast brain CT revealed …

Superior Mediastinal Cut-Off Measurements In Chest Radiographs For Screening Of Silent Thoracic Aortic Diseases, Kantheera Leesmidt, Boonyarit Sintuvikaiwong, Apichaya Sripariwuth

Chulalongkorn Medical Journal

Objective: To determine cut-off values for superior mediastinal width and the mediastinal width-to-thoracic cage ratio from chest radiographs for the early detection of unrecognized thoracic aortic diseases. Additionally, this study aims to enhance diagnostic strategies for identifying aortic abnormalities.

Materials and Methods: This retrospective analysis included 152 subjects who underwent both computed tomography angiography (CTA) of the thoracic aorta and chest radiograph between April 2007 and January 2021. Superior mediastinal width was measured at 3 levels on chest radiographs. Thoracic CTA findings were categorized into normal and abnormal groups, the latter comprising aortic dissection, intramural hematoma, penetrating atherosclerotic …

Faktor Risiko Perdarahan Gastrointestinal Pada Pasien Dengan Sindrom Koroner Akut: Sebuah Tinjauan Sistematis, Assyadilla Kirana Setyobudi, Amie Vidyani, Jonathan Christianto Sutadji, Lady Aqnes Kurniawati, Kevin Fernando Suhardi

Jurnal Penyakit Dalam Indonesia

Introduction. Gastrointestinal bleeding (GIB) is a serious but potentially preventable condition. Its symptoms include hematemesis, hematochezia, and melena. Risk factors for GIB include medications such as antiplatelets and anticoagulants, which are standard treatments for acute coronary syndrome (ACS). GIB is strongly associated with ACS and represents the most common bleeding complication in these patients. This study aimed to systematically review the factors contributing to GIB in patients with ACS.

Methods. Relevant articles were retrieved from PubMed, ScienceDirect, Springer, and EBSCO databases, covering studies on GIB risk factors in ACS patients published between March 31, 2003, and March 31, …

Free Versus In Situ Right Internal Mammary Artery As A Conduit In Coronary Artery Bypass Surgery: A Meta-Analysis, Yuta Kikuchi, Tomoki Sakata, Tomonari Shimoda, Shinichi Fukuhara, Junichi Shimamura, Makoto Hibino, Tsuyoshi Kaneko, Hiroo Takayama, Hisato Takagi, Michel Pompeu Sa, Toshiki Kuno

Department of Medicine Faculty Papers

OBJECTIVES: There is debate regarding the optimal choice for a second conduit in coronary artery bypass grafting. The right internal mammary artery (RIMA) is commonly employed as a second conduit; however, it is unclear whether the free (fRIMA) or in situ (isRIMA) configuration yields superior outcomes. We performed a systematic review and meta-analysis to compare clinical outcomes between fRIMA and isRIMA as the second conduit.

METHODS: A comprehensive search of PubMed (MEDLINE), EMBASE, and CENTRAL was performed through May 2025 to identify studies comparing outcomes in patients undergoing coronary artery bypass grafting with either fRIMA or isRIMA as a second …

2025 Novel Drug Approvals, Katherine Ghattas Pharmd, Amanda Rawa Pharmd

Transformative Medicine

The year 2025 marked another strong chapter in pharmaceutical innovation, with multiple novel therapies gaining approval from the U.S. Food and Drug Administration (FDA). These approvals reflect continued progress in addressing unmet medical needs across a wide range of disease states. This article reviews the FDA’s 2025 novel drug approvals, spotlighting a few therapeutic advancements and emerging trends. A comprehensive table of all approved agents is provided, along with a focused discussion of four particularly impactful therapies: donidalorsen (Dawnzera), taletrectinib (Ibtrozi), delgocitinib (Anzupgo), gepotidacin (Blujepa), etripamil (Cardamyst). Each of these agents represents a step forward in its respective field and …

The Forgotten Ecg Clues Of Pulmonary Embolism, Badri Aryal, Devi Parvathy Jyothi Ramachandran Nair

Transformative Medicine

No abstract provided.

Evaluation Of Radial Artery Anatomy With Various Anatomical Variants In Patients Undergoing Transradial Catheterization, Nisarg Desai, Sharadkumar Jain, Kunal Parwani, Pooja Vyas, Yaqub Sidatar

Journal of the Saudi Heart Association

Objectives: This study aimed to determine the incidence of radial artery anomalies in a large cohort of patients undergoing TRA and to evaluate their specific impact as predictors of procedural failure and access site complications.

Methods: This prospective, observational, single-center study enrolled 1000 consecutive patients undergoing coronary angiography or intervention via TRA between 2022 and 2024. Radial artery anatomy was assessed using retrograde radial arteriography immediately following sheath insertion. Anatomical variants were categorized into high bifurcation (origin proximal to the cubital fossa), Radial artery loops (full 360-degree curvature), Tortuosity (curve of more than 45 degrees in the vessel), Narrow calliber, …

Artificial Intelligence-Enhanced Cardiac Point-Of-Care Ultrasound: A Prospective Single-Arm Study, Lior Fisher, Michael Fiman, Yuval Yarkoni, Ella Segal, Boris Fishman, Kobi Faierstein, Noa Rubin, Adiel Am-Shalom, Howard Amital, Qiong Zhao, Smadar Kort, Praveen Mehrotra, Ehud Schwammenthal, Robert Klempfner, Eyal Zimlichman, Ehud Raanani, Elad Maor

Division of Cardiology Faculty Papers

OBJECTIVE: To evaluate the clinical utility of combining artificial intelligence (AI) with handheld focused cardiac ultrasound (FoCUS) performed by noncardiologist physicians in clinical care settings.

PATIENTS AND METHODS: In this prospective, single-arm study conducted from July 1, 2022, through December 31, 2023 (ClinicalTrials.gov NCT05455541), 660 adult patients presenting to the emergency department or internal medicine wards were assessed with handheld ultrasound devices enhanced by AI algorithms. These algorithms provided automated analysis of ventricular function, valvular disease, pericardial effusion, and inferior vena cava size. Participating physicians received focused training and performed examinations either in response to clinical suspicion or as part …

Incidental Left Ventricular Fibroma Detected During Pre-Participation Screening In A Young Athlete, Alya J. Al Hashmi, Meetha S. Al Ameri, Asna Ayoob, Hafsa Maryam, Fiza Halima

Journal of the Saudi Heart Association

Primary cardiac fibromas are rare benign tumors that may carry arrhythmic risk. We report a case of cardiac fibroma that was incidentally detected in an 18-year-old athlete with echocardiography and MRI during routine pre-championship screening. Following multidisciplinary heart team discussion and shared decision-making, surgical excision was performed due to potential arrhythmic risk in the setting of high-intensity athletic activity.

Socioeconomic Disparities In Readmission Outcomes And Cardiac Procedures Among Atrial Fibrillation Hospitalizations, Muhammad U. Almani, Muhammad Yousuf, Noor Fatima, Muhammad Q. Ullah, Muhammed Arshad

Einstein Health Papers

Introduction: Atrial fibrillation (AF) remains one of the leading dysrhythmias incurring hospitalization. We set out to determine the impact of socioeconomic status (SES) on in-hospital cardiac procedures and the readmission outcomes in patients with AF. Methods: The National Readmission Database (NRD) was searched for adults with a primary diagnosis of AF between 2010 and 2019. We determined unplanned AF-specific readmission within 30 days. Median neighborhood household income was assessed by patient zip code as quartiles: low income (Q1), middle income (Q2), upper-middle income (Q3), and high income (Q4). Differences in in-hospital cardiac procedures during the index hospitalization and probability of …

Influenza B Viral Infection Complicated By Acute Fulminant Myocarditis Requiring Mechanical Support: A Case Report., Tareef Hesham Kannout, Muhammad Azam Shah, Fahmi Abdullah Alkaf, Faisal A. Alghamdi, Mohammed Alreshidan

Journal of the Saudi Heart Association

Acute fulminant myocarditis represents a severe complication of myocarditis, necessitating early suspicion and intervention for improved patient outcomes. Influenza B-induced myocarditis remains a relatively rare entity. A young lady presented to the emergency department with symptoms of heart failure and cardiogenic shock, requiring inotropes without significant improvement. For the continued deterioration of her hemodynamics, she underwent mechanical circulatory support, including Extracorporeal Membrane Oxygenation (ECMO) and Intra-aortic balloon pump (IABP).  The follow-up investigations showed positive influenza B. She was treated with antiviral therapy and steroids, resulting in gradual improvement in hemodynamics and left ventricular ejection fraction

A Hemorheological Perspective On Coronary Microvascular Dysfunction: Association Of Erythrocyte Parameters With Angiography-Derived Coronary Microcirculatory Resistance, Abdulrahman Alqazzaz, Yanfeng Lu, Jasmine Bao, Gary S. Mintz, Jiahao Feng, Yong Zhang, Shanshan Gao, Qiang Song, Feifei Ning, Hytham H. Al-Samawi, Mohsen Al-Manj, Mohammed Al-Asadi, Xin Huang, Ning Guo

Student Papers, Posters & Projects

BACKGROUND: Coronary microvascular dysfunction (CMD) contributes to myocardial ischemia in patients both without obstructive coronary artery disease (e.g., MINOCA/INOCA) and in those with co-existing epicardial stenosis. While its etiology includes structural and functional causes. hematologic parameters have been linked to cardiovascular outcomes. However, the relationship between red blood cell (RBC) markers and microvascular resistance remains poorly characterized. We aim to evaluate whether RBC parameters are correlated with the angiography-derived index of microcirculatory resistance (angio-IMR).

METHODS: This retrospective study evaluated the association between red blood cell (RBC) parameters and angio-IMR in patients with intermediate coronary artery disease (30%-70% stenosis). Data were …

Atrial Fibrillation In Athletes: Mechanisms, Management, And Future Directions, Ibrahim Alameh, Ghina Al Fout, Michael D. Ezekowitz, Mohammed Kamareddine

Department of Medicine Faculty Papers

BACKGROUND: High-volume endurance training may shift exercise from cardioprotective to arrhythmogenic, increasing the risk of atrial fibrillation (AF) in healthy athletes.

CASE SUMMARY: A 38-year-old marathon runner with a 15-year history of high-intensity endurance training presented with episodic palpitations and reduced athletic performance. Electrocardiogram showed paroxysmal AF; echocardiography revealed mild left atrial enlargement without structural heart disease. Symptoms worsened during the recovery phase after runs, suggesting vagally mediated AF. After unsuccessful flecainide therapy, he underwent pulmonary vein isolation. Twelve months later, he remained free of recurrent AF on Holter monitoring and successfully resumed endurance training following an 8-week recovery period. …

Visual-Physiological Concordance And Target Vessel Outcomes: A Μqfr-Based Real-World Cohort Study, Yanfeng Lu, Abdulrahman Alqazzaz, Jasmine Bao, Gary S Mintz, Jiahao Feng, Yong Zhang, Shanshan Gao, Qiang Song, Feifei Ning, Wangge Ma, Haoyu Wu, Yuejiao Wei, Jiaying Li, Ning Guo, Xin Huang

Student Papers, Posters & Projects

BACKGROUND AND OBJECTIVES: Quantitative flow ratio (QFR) offers a non-interventional alternative for evaluating ischemia, yet its concordance with real-world treatment and clinical outcomes remains unclear. This study aimed to assess the alignment between Murray law-based QFR (μQFR) physiological assessment and treatment strategies, evaluate the association between treatment concordance and clinical outcomes, and explore factors influencing concordance.

METHODS: In this retrospective cohort, 242 patients with angiographically intermediate coronary stenosis and μQFR values adjacent to the grey-zone (low: 0.70-0.74; high: 0.86-0.90) were included. Treatment concordance was defined as PCI for low μQFR and medication for high μQFR. The primary endpoint was target …

Whole-Blood, Concentrated, And Micro–Dose Del Nido Cardioplegia In Adult Cardiac Surgery: A Scoping Review, Christian Iulianelli

Student Works

1. A.     Background/Introduction: Del Nido cardioplegia was originally developed for pediatric cardiac surgery to provide prolonged myocardial protection with a single-dose strategy. Its adoption in adult cardiac surgery has led to multiple modified formulations, including whole-blood, concentrated, and bloodless strategies. Given expanding clinical use and variation in technique, a structured mapping of the adult evidence base is warranted.
2. B.     Methodology: This scoping review followed PRISMA-ScR guidance. PubMed and CINAHL were searched, yielding 88 records. After duplicate removal and screening, 18 studies met inclusion criteria. Data were charted on study design, cardioplegia formulation, patient population, myocardial biomarkers, arrhythmias, renal outcomes, transfusion requirements, …

2. Impact Of Gum Chewing On Postoperative Ileus Following Open Heart Surgery, Jacinta Smith

Providence Nursing Research Conference 2023 – Present

No abstract provided.