Cardiology Commons^™

Revascularization Impact: Quality Of Life Enhancement In Chronic Limb-Threatening Ischemia, Cristian Traian Paius, Vlad Denis Constantin, Alexandru Carap, Andrei Tarus, Grigore Tinica

Journal of Mind and Medical Sciences

Introduction. Globally, over 230 million people have peripheral artery disease, often undiagnosed, leading to chronic limb-threatening ischemia. Revascularization is vital for preventing amputation and improving quality of life. While specific questionnaires for severe ischemia are lacking, the SF-36 questionnaire is widely used to assess quality of life, with variations like SF-12 and SF-8 for larger cohorts. Objectives. Our aim was to assess how different lower limb revascularization methods affect the postoperative quality of life in patients with chronic limb-threatening ischemia. Methods. This study was conducted at the St. Pantelimon Emergency Hospital of Bucharest, Romania. It included 166 adult patients with …

Coronary Artery Calcium Scoring In Asymptomatic Patients, Bilal Hussain, Ahmed Mahmood, Michael G. Flynn, Thomas Alexander

HCA Healthcare Journal of Medicine

Coronary artery calcium (CAC) scoring is an important prognostic tool for personalized cardiovascular preventive care and has recently been incorporated into American College of Cardiology/American Heart Association guidelines. CAC provides direct visualization and quantification of CAC burden for risk stratification and primary prevention of cardiovascular events in an asymptomatic population. CAC scoring is recommended for individuals with intermediate 10-year atherosclerotic cardiovascular disease (ASCVD) risk and selective populations with borderline ASCVD risk. In this review, we outline the interpretation of CAC scores for predicting the risk of cardiovascular events, and we highlight the guidelines for starting statin and potentially starting aspirin …

Contaminant Metals And Cardiovascular Health, Karl Kristian Lundin, Yusuf Kamran Qadeer, Zhen Wang, Salim S. Virani, Roman Leischik, Carl J. Lavie, Markus Strauss, Chayakrit Krittanawong

Office of the Provost

A growing body of research has begun to link exposure to environmental contaminants, such as heavy metals, with a variety of negative health outcomes. In this paper, we sought to review the current research describing the impact of certain common contaminant metals on cardiovascular (CV) health. We reviewed ten metals: lead, barium, nickel, chromium, cadmium, arsenic, mercury, selenium, zinc, and copper. After a literature review, we briefly summarized the routes of environmental exposure, pathophysiological mechanisms, CV health impacts, and exposure prevention and/or mitigation strategies for each metal. The resulting article discloses a broad spectrum of pathological significance, from relatively benign …

Left Ventricular Noncompaction Cardiomyopathy And Myocardial Bridging Association : A Coincidence Or A Usual Association ?, Abdessamad Couissi, Saleh Obeidat, Amine Mamoune Boutaleb, Rachida Habbal

Journal of the Saudi Heart Association

Left ventricular non compaction (LVNC) is a rare congenital disease. It occurs due to an arrest of the myocardial fibers compaction during embryogenesis. Myocardial bridge (MB) is a coronary anomaly in which the myocardium covers segments of the coronary arteries. We report a rare case of 62-year-old women who was diagnosed with the association of LVNC and MB revealed by chest pain and dyspnea. Some similar cases were reported in the last two decades suggesting that we may be in front of a usual yet underdiagnosed association. To our knowledge, this is the first case described in the Arab World.

Sustaining Care Team Engagement Using A Hierarchy Of Needs Framework, Katherine Skroski, Sam Canonico, Hailey Frager, Mary Beeaker, Natalia Johnson, Rebecca A. Brookes

Operations Transformation

Cardiology Intensive Care & Cardiovascular Interventional (CICU & R9 West) teams provide superb care to critically ill cardiac patients at Maine Medical Center. Covid Pandemic revealed the importance of physical and mental health wellbeing, as well as care team engagement in order to continue to provide outstanding care to patients. CICU/R9 West Leadership looked for ways to improve team engagement and ensure that care team members’ needs are met and sustained.

Defining High-Risk Percutaneous Coronary Intervention: Characteristics Of Patients Undergoing Contemporary Percutaneous Coronary Intervention With Axial-Flow Mechanical Support, Aditya S. Bharadwaj, Alexander G. Truesdell, Alejandro Lemor, Julia B. Thompson, Arsalan Abu-Much, Yiran Zhang, Simon R. Dixon

Conference Presentation Abstracts

No abstract provided.

Performance Of Existing Risk Models In Impella-Supported High-Risk Percutaneous Coronary Interventions: The Protect Iii Cvad Study, Tayyab Shah, Alejandro Lemor, Julia B. Thompson, Majd B. Prothy, Mamas Mamas, Tim Kinnaird, Simon R. Dixon

Conference Presentation Abstracts

No abstract provided.

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, 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 …

Localized Cardiac Small Molecule Trajectories And Persistent Chemical Sequelae In Experimental Chagas Disease, Zongyuan Liu, Rebecca Ulrich Vonbargen, April L Kendricks, Kate Wheeler, Ana Carolina Leão, Krithivasan Sankaranarayanan, Danya A Dean, Shelley S Kane, Ekram Hossain, Jeroen Pollet, Maria Elena Bottazzi, Peter J Hotez, Kathryn M Jones, Laura-Isobel Mccall

Faculty, Staff and Students Publications

Post-infectious conditions present major health burdens but remain poorly understood. In Chagas disease (CD), caused by Trypanosoma cruzi parasites, antiparasitic agents that successfully clear T. cruzi do not always improve clinical outcomes. In this study, we reveal differential small molecule trajectories between cardiac regions during chronic T. cruzi infection, matching with characteristic CD apical aneurysm sites. Incomplete, region-specific, cardiac small molecule restoration is observed in animals treated with the antiparasitic benznidazole. In contrast, superior restoration of the cardiac small molecule profile is observed for a combination treatment of reduced-dose benznidazole plus an immunotherapy, even with less parasite burden reduction. Overall, …

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, 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, 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, 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, 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.

Orthostatic Hypotension, Hypertension Treatment, And Cardiovascular Disease: An Individual Participant Meta-Analysis, Stephen P Juraschek, Jiun-Ruey Hu, Jennifer L Cluett, Anthony M Ishak, Carol Mita, Lewis A Lipsitz, Lawrence J Appel, Nigel S Beckett, Ruth L Coleman, William C Cushman, Barry R Davis, Greg Grandits, Rury R Holman, Edgar R Miller, Ruth Peters, Jan A Staessen, Addison A Taylor, Lutgarde Thijs, Jackson T Wright, Kenneth J Mukamal

Faculty, Staff and Students Publications

IMPORTANCE: There are ongoing concerns about the benefits of intensive vs standard blood pressure (BP) treatment among adults with orthostatic hypotension or standing hypotension.

OBJECTIVE: To determine the effect of a lower BP treatment goal or active therapy vs a standard BP treatment goal or placebo on cardiovascular disease (CVD) or all-cause mortality in strata of baseline orthostatic hypotension or baseline standing hypotension.

DATA SOURCES: Individual participant data meta-analysis based on a systematic review of MEDLINE, EMBASE, and CENTRAL databases through May 13, 2022.

STUDY SELECTION: Randomized trials of BP pharmacologic treatment (more intensive BP goal or active agent) with …

Hippo Pathway Knockdown Gene Therapy In The Heart, Todd R Heallen, James F Martin

The Texas Heart Institute Journal

No abstract provided.

Interruption Of The Tricuspid Regurgitant Jet: A Possible Consequence Of Reflected Waves, Saad Ngoga, Nicole Schulick, J. Christopher Bouwmeester, Jiun-Jr Wang, Gregg S. Pressman

Einstein Health Papers

Reflected pressure waves can impact central aortic pressure, and can cause notching of the pulmonic valve Doppler signal. However, reflected waves in the venous system usually do not achieve a high enough velocity to alter Doppler flow patterns. Herein we report a case of systolic notching of the tricuspid regurgitant signal that likely resulted from reflected venous waves.

Endothelial Dysfunction And Cardiometabolic Risk Factors In Mexican American Adults: The Cameron County Hispanic Cohort, Enrique Garcia-Sayan, Miryoung Lee, James R Stone, Danielle M Stone, Beverly Smulevitz, David D Mcpherson, Susan P Fisher-Hoch, Joseph B Mccormick, Susan T Laing

Faculty, Staff and Students Publications

Endothelial dysfunction assessed by impaired brachial flow-mediated dilation (FMD) predicts incident cardiovascular disease (CVD). We have previously shown that clustering of diabetes mellitus, obesity, and metabolic syndrome in young Hispanic patients was associated with subclinical atherosclerosis. This study aimed to assess determinants of impaired FMD response (%FMD), an earlier marker of atherosclerosis, in a population-based sample of asymptomatic Mexican Americans. Cardiometabolic biomarkers and FMD were obtained from 960 Cameron County Hispanic Cohort participants. Gender-specific median values of %FMD were used to categorize participants into those with %FMD below or above the median. The sample was further stratified into those younger …

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 …