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Journal Of Shock And Hemodynamics, Vol 1., Iss. 1 (Print Version)

Journal of Shock and Hemodynamics

The print version of Volume I, Issue I of the Journal of Shock and Hemodynamics was published in September 2022. The PDF of the print version is downloadable here.

Transcatheter Atrial Septal Defect Closure Before Versus After Adulthood, Mohamed Saber Hafez, Mohamed Ibrahim Abdelrahman El-Sayed, Maiy Hamdy El Sayed

Journal of the Saudi Heart Association

Objectives: To evaluate the long term outcome of patients who underwent percutaneous transcatheter closure of secundum atrial septal defects during teenage life versus adulthood. Methods: The study included 100 patients with secundum type ASD who were treated by transcatheter closure of their defects 2-5 years before enrollment. The study population was subdivided into 2 equal groups: group 1 who underwent transcatheter closure during teenage life (13-19 years) and group 2 who underwent transcatheter closure after the age of 30 years. The two groups were compared according to resting 12 lead ECG, 24 hour Holter ECG and transthoracic echocardiographic findings (Right …

Persistent Left Superior Vena Cava, Connected To The Left Atrium Via The Left Superior Pulmonary Vein. An Unusual Cause Of Air Lock, Abdelkader Boukhmis, Mohamed El Amin Nouar

Journal of the Saudi Heart Association

The intraoperative diagnosis of a persistent left superior vena cava (LSVC) that drains into the left atrium (LA) via the left superior pulmonary vein may be difficult because of its extrapericardial pathway. We report here the case of a 48-year-old man, operated for a mitro-aortic endocarditis complicating a Laubry-Pezzi syndrome. The opening of the LA was followed immediately by a sudden air lock. It was only after opening of the left pleura that we were able to find and then ligate the LSVC. The patient underwent mitral valve repair, closure of the infundibular septal defect and aortic valve replacement.

The Lawnmower And The Pediatric Lower Extremity: A Catastrophic Combination, Alvaro Tamayo-Gutierrez, Hassan N Ibrahim

Faculty, Staff and Student Publications

Heart failure can lead to renal impairment, an interaction now termed "cardiorenal syndrome." The prevalent physiological explanation for the renal impairment that accompanies heart failure centers around the forward failure hypothesis, which emphasizes the role of left ventricular dysfunction in causing edema, and the backward failure hypothesis, which singles out venous congestion as the dominant mechanism of edema and reduced glomerular filtration rate. In this review, we provide an appraisal on venous congestion, an extremely important contributor that has received little attention. We also summarize the pharmacology of loop diuretics, explain current understanding of diuretic resistance, and address controversies regarding …

Hypertension Management In Patients With Chronic Kidney Disease, Sean A Hebert, Hassan N Ibrahim

Faculty, Staff and Student Publications

Hypertension and chronic kidney disease are closely linked. Patients with chronic kidney disease have hypertension almost universally and uncontrolled hypertension accelerates the decline in kidney function. The pathophysiology of hypertension in chronic kidney disease is complex, but is largely related to reduced nephron mass, sympathetic nervous system overactivation, involvement of the renin-angiotensin-aldosterone system, and generalized endothelial dysfunction. Consensus guidelines for blood pressure targets have adopted a blood pressure <120/80 mm Hg in native chronic kidney disease and <130/80 mm Hg in kidney transplant recipients. Guidelines also strongly advocate for renin-angiotensin-aldosterone system blockade as the first-line therapy.

Microrna Expression Levels Change In Neonatal Patients During And After Exposure To Cardiopulmonary Bypass., Lance Hsieh, Lan N. Tu, Alison Paquette, Quanhu Sheng, Shilin Zhao, Douglas C. Bittel, James O'Brien, Kasey Vickers, Peter Pastuszko, Vishal Nigam

Manuscripts, Articles, Book Chapters and Other Papers

Background The systemic inflammation that occurs after exposure to cardiopulmonary bypass (CPB), which is especially severe in neonatal patients, is associated with poorer outcomes and is not well understood. In order to gain deeper insight into how exposure to bypass activates inflammatory responses in circulating leukocytes, we studied changes in microRNA (miRNA) expression during and after exposure to bypass. miRNAs are small noncoding RNAs that have important roles in modulating protein levels and function of cells. Methods and Results We performed miRNA-sequencing on leukocytes isolated from neonatal patients with CPB (n=5) at 7 time points during the process of CPB, …

Recurrent Giant Cell Myocarditis After Heart Transplant: A Case Report, Eitan S. Frankel, Alexander G. Hajduczok, Indranee N. Rajapreyar, Yevgeniy Brailovsky

Division of Cardiology Faculty Papers

BACKGROUND: Giant cell myocarditis (GCM) is a rare but well-known cause of fulminant myocarditis. Despite optimal medical therapy, many patients progress to orthotopic heart transplant (OHT). We present a case of recurrent GCM following OHT, including complex considerations in patient management and infectious sequelae.

CASE SUMMARY: A 33-year-old previously healthy male presented with 2 months of worsening shortness of breath. Transthoracic echocardiogram (TTE) demonstrated a left ventricular ejection fraction of 30-35%. After ruling out an ischaemic aetiology, he was discharged on guideline-directed medical therapy and later presented with productive cough, worsening dyspnoea on exertion, and diarrhoea. He was found to …

Carfilzomib-Induced Cardiotoxicity: An Analysis Of The Fda Adverse Event Reporting System (Faers), Benjamin Buck, Eric Kellett, Daniel Addison, Ajay Vallakati

Journal of the Saudi Heart Association

Background: Carfilzomib and other proteasome inhibitors (PIs) have revolutionized treatment of multiple myeloma (MM). PIs have proven to be highly effective, but are associated with significant cardiovascular adverse events (AEs). No prior study has compared the cardiotoxicity of carfilzomib against other PI’s and all other classes of medications. Objectives: The purpose of this study is to characterize the cardiotoxicity of carfilzomib with respect to other PIs and all classes of medications using the US Food and Drug Administration Adverse Events Reporting System (FAERS) database and to define the observed cardiotoxicity profile. Methods: The FAERS database was queried between years 2017 …

Impact Of Social Determinants Of Health On Anticoagulant Use Among Patients With Atrial Fibrillation: Systemic Review And Meta-Analysis, Rasha Khatib, Nicole Glowacki, John Byrne, Peter Brady

Faculty, Staff and Student Publications

BACKGROUND: A growing body of literature now exists examining associations between social determinants of health (SDOH) and adverse outcomes in patients with atrial fibrillation; however, little is available on anticoagulant prescriptions and the impact of SDOH.

PURPOSE: Evaluate the impact of SDOH on anticoagulant prescriptions in patients with atrial fibrillation.

DATA SOURCES: Medline and Embase databases up to January 2021.

STUDY SELECTION: Noninterventional studies were included if they reported associations between at least 1 of 14 SDOH domains and anticoagulant prescription in patients with atrial fibrillation. Two investigators independently screened and collected data.

DATA EXTRACTION: Two investigators independently screened and …

Medical Autopsy For Sudden Unexplained Death In Saudi Arabia: A Call To Action, Wael Alqarawi, Abdulelah Alsaeed, Malak Alghamdi, Ahmed Hersi, Tarek Kashour, Khaldoon Aljerian

Journal of the Saudi Heart Association

Sudden unexplained death (SUD) is a sudden, unexpected, and unexplained death in an individual older than 1 year. It is one of the most devastating and tragic events to families and the community at large, particularly when it happens at a young age. Finding the cause of SUD is extremely important in order to prevent its recurrence in the family, and to help understand the epidemiology of SUD in the community. It has been well-established that the most effective way of finding the cause of SUD is by performing a medical autopsy. In many countries, medical autopsy is mandated in …

Tetrahydrocurcumin Improves Lipopolysaccharide-Induced Myocardial Dysfunction By Inhibiting Oxidative Stress And Inflammation Via Jnk/Erk Signaling Pathway Regulation, Hanzhao Zhu, Liyun Zhang, Hao Jia, Lu Xu, Yu Cao, Mengen Zhai, Kaifeng Li, Lin Xia, Liqing Jiang, Xiang Li, Yenong Zhou, Jincheng Liu, Shiqiang Yu, Weixun Duan

Chemistry Undergraduate Publications

Background

Acute myocardial dysfunction in patients with sepsis is attributed to oxidative stress, inflammation, and cardiomyocyte loss; however, specific drugs for its prevention are still lacking. Tetrahydrocurcumin (THC) has been proven to contribute to the prevention of various cardiovascular diseases by decreasing oxidative stress and inflammation. This study was performed to investigate the functions and mechanism of action of THC in septic cardiomyopathy.

Methods

After the oral administration of THC (120 mg/kg) for 5 consecutive days, a mouse model of sepsis was established via intraperitoneal lipopolysaccharide (LPS, 10 mg/kg) injection. Following this, cardiac function was assessed, pathological section staining was …

Impact Of Social Vulnerability On Comorbid Cancer And Cardiovascular Disease Mortality In The United States, Sarju Ganatra, Sourbha S. Dani, Ashish Kumar, Safi U. Khan, Rishi Wadhera, Tomas G. Neilan, Paaladinesh Thavendiranathan, Ana Barac, Joerg Hermann, Salim S. Virani

Office of the Provost

Background: Racial and social disparities exist in outcomes related to cancer and cardiovascular disease (CVD).
Objectives: The aim of this cross-sectional study was to study the impact of social vulnerability on mortality attributed to comorbid cancer and CVD.
Methods: The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database (2015-2019) was used to obtain county-level mortality data attributed to cancer, CVD, and comorbid cancer and CVD. County-level social vulnerability index (SVI) data (2014-2018) were obtained from the CDC's Agency for Toxic Substances and Disease Registry. SVI percentiles were generated for each county and aggregated to form …

Impact Of Remote Monitoring During The Interstage Period On Outcomes In Single Ventricle Patients Across Socioeconomic Groups, Bianca Cherestal, Lori Erickson, Janelle R. Noel-Macdonnell, Girish S. Shirali, Hayley S. Hancock, Doaa Aly, Natalie Jayaram

Posters

Background: Despite improvements in outcomes over time, morbidity and mortality for infants with single ventricle (SV) heart disease remains high. Among other risk factors for mortality, infants of low socioeconomic status (SES) are known to be particularly vulnerable following stage 1 palliation. We sought to determine whether use of a novel remote monitoring program, CHAMP (Cardiac High Acuity Monitoring Program), mitigates differences in outcomes by SES for infants with SV during the interstage period. Methods: Using the CHAMP database, we identified 607infants across 11 institutions enrolled in the program between 2014–2021. All enrolled patients’ families were provided with a Windows-based …

Impact Of Active And Historical Cancers On The Management And Outcomes Of Acute Myocardial Infarction Complicating Cardiogenic Shock, Sri Harsha Patlolla, Anusha G Bhat, Pranathi R Sundaragiri, Wisit Cheungpasitporn, Rajkumar P Doshi, Sudeep K Siddappa Malleshappa, Deepak K Pasupula, Wissam A Jaber, William J Nicholson, Saraschandra Vallabhajosyula

The Texas Heart Institute Journal

BACKGROUND: There are limited data on the outcomes of acute myocardial infarction-cardiogenic shock (AMI-CS) in patients with concomitant cancer.

METHODS: A retrospective cohort of adult AMI-CS admissions was identified from the National Inpatient Sample (2000-2017) and stratified by active cancer, historical cancer, and no cancer. Outcomes of interest included in-hospital mortality, use of coronary angiography, use of percutaneous coronary intervention, do-not-resuscitate status, palliative care use, hospitalization costs, and hospital length of stay.

RESULTS: Of the 557,974 AMI-CS admissions during this 18-year period, active and historical cancers were noted in 14,826 (2.6%) and 27,073 (4.8%), respectively. From 2000 to 2017, there …

Combined Disease Of The Quadricuspid Aortic Valve, Robert Blazekovic, Jasmina Catic, Stjepan Barisin, Marko Kusurin, Savica Gjorgjievska, Stanislav Glumbic

The Texas Heart Institute Journal

No abstract provided.

Subclavian Steal Phenomenon Associated With Vascular Ring In An Infant Who Had A Prenatally Diagnosed Right Aortic Arch With An Atretic Aberrant Left Subclavian Artery, Daiji Takajo, Jennifer Blake, Sanjeev Aggarwal

The Texas Heart Institute Journal

Vascular ring is a rare congenital anomaly in which the abnormal origin of the aorta or its branches and pulmonary arteries leads to encircling and compression of the trachea and esophagus. A right aortic arch (RAA) with an aberrant left subclavian artery is one of the most common forms of vascular ring. Here, we report a case of a prenatally diagnosed vascular ring resulting from an RAA with an aberrant left subclavian artery. When the infant was 7 months of age, the development of noisy breathing prompted further evaluation with cardiac magnetic resonance imaging that showed an atretic left subclavian …

Safety, Timing, And Outcomes Of Early Postoperative Cardiac Catheterization Following Congenital Heart Surgery, Karoline Krzywda, Jeremy Affolter, Darcie Al-Hassan, William Gibson, Ryan Romans, Kelly S. Tieves

Posters

Intro: Historically, early postoperative (<6weeks) cardiac catheterization (EPOCC) was considered high risk and often delayed. Recently, the safety of early postoperative cardiac catheterization has been demonstrated. The timing of catheterization in the struggling postoperative patient remains variable and optimal timing remains uncertain. There is limited data on the impact of EPOCC on outcomes such as length of stay, duration of mechanical ventilatory or extracorporeal support, and surgical or catheter- based interventions. The aim of this study was to describe our experience with EPOCC and its impact on management, length of stay, and duration of mechanical ventilatory support. Methods: This is a descriptive retrospective cohort study of patients who underwent cardiac surgery between 01/01/2010 and 12/31/2019 and cardiac catheterization within 30 days after surgery. Patients with catheterization for LA decompression on ECMO, endomyocardial biopsy, or BAS post hybrid procedure were excluded. We collected information surrounding timing, indication, and complications of catheterization, duration of mechanical ventilation/ECMO, and ICU/hospital LOS and compared these differences in patients who underwent EPOCC < 72hours (earlier) versus >72hours (later). Data was analyzed using IBM SPSS, version 28. Chi-square and Student’s t-test, or appropriate nonparametric tests were used to compare categorical and continuous variables, respectively. Results: There were 2542 surgeries performed during the study period with 167 patients undergoing cardiac catheterization within the defined 30 days. Twenty-six patients met exclusion criteria, leaving 141 patients for analyses. Median time from surgery to EPOCC was 10 days (1-30), with 26 patients(18.4%) having an earlier EPOCC. Interventions were performed in 70 patients (49.6%), not statistically different in those with earlier vs later EPOCC [n=9 (12.9%) vs …

Robotic Versus Conventional Sternotomy Mitral Valve Surgery: A Systematic Review And Meta-Analysis, Michael L. Williams, Bridget Hwang, Linna Huang, Ashley Wilson-Smith, John Brookes, Aditya Eranki, Tristan D. Yan, T. Sloane Guy, Johannes Bonatti

Department of Surgery Faculty Papers

Background: Robotic-assisted mitral valve surgery (RMVS) is becoming an increasingly performed procedure in cardiac surgery, however, its true safety and efficacy compared to the gold standard conventional sternotomy approach [conventional sternotomy mitral valve surgery (CSMVS)] remains debated. The aim of this meta-analysis was to provide a comprehensive analysis of all available literature comparing RMVS to CSMVS.

Methods: An electronic search of five databases was performed to identify all relevant studies comparing RMVS to CSMVS. Pre-defined primary outcomes of interest included all-cause mortality, cerebrovascular accidents (CVA) and re-operation for bleeding. Secondary outcomes of interest included cross clamp time, cardiopulmonary bypass (CPB) …

Assessment Of Cardiac, Vascular, And Pulmonary Pathobiology In Vivo During Acute Covid‐19, Shirjel R. Alam, Sudhir Vinayak, Adeel Shah, Jeilan Mohamed, Redemptar Kimeu, Felix Riunga, Sylvia Gachoka, Rodney Adam, Mariah Obino, Khalid Makhdomi, Kevin Ombati, Edward Nganga, Samuel Gitau

Imaging & Diagnostic Radiology, East Africa

Background: Acute COVID‐19–related myocardial, pulmonary, and vascular pathology and how these relate to each other remain unclear. To our knowledge, no studies have used complementary imaging techniques, including molecular imaging, to elucidate this. We used multimodality imaging and biochemical sampling in vivo to identify the pathobiology of acute COVID‐19. Specifically, we investigated the presence of myocardial inflammation and its association with coronary artery disease, systemic vasculitis, and pneumonitis.

Methods and Results: Consecutive patients presenting with acute COVID‐19 were prospectively recruited during hospital admission in this cross‐sectional study. Imaging involved computed tomography coronary angiography (identified coronary disease), cardiac 2‐deoxy‐2‐[fluorine‐18]fluoro‐D‐glucose positron emission …

Heterogeneity In The Prevalence Of Premature Hypertension Among Asian American Populations Compared With White Individuals: A National Health Interview Survey Study, Sina Kianoush, Mahmoud Al Rifai, Anwar T. Merchant, Xiaoming Jia, Zainab Samad, Aneil Bhalla, Ayesha Khan, Dongshan Zhu, Salim S. Virani

Section of Cardiology

Background: Differences in prevalence of risk factors such as hypertension may explain heterogeneity in cardiovascular risk across Asian American populations.
Methods: We used National Health Interview Survey (NHIS) data from 2006 to 2018 among White, Chinese, Asian Indian, Filipino, and 'other Asians' (Japanese, Korean, and Vietnamese). Unadjusted and adjusted odds ratios (aOR) with 95% confidence intervals were reported using logistic regression models for the association between race and self-reported premature hypertension (age old). Models were adjusted for sex, education, body mass index, smoking status, diabetes, and coronary heart disease.
Results: We studied 99,864 participants with history of hypertension (mean age, …