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Gaudino M, Lemma M, Sandner S, Boening A, Harik L, Albert M, Martin JA, Alcocer J, Alexander JH, Bhatt DL, Bonaros N, Borger M, Danner BC, Davierwala P, Deja MA, De Paulis R, Deutsch MA, Flather M, Kappetein P, Kurlansky P, Lamy A, Lorusso R, Mannam GC, Marzouk M, Creber RM, Milojevic M, Nasso G, Patel N, Petrovic I, Quintana E, Sajja LR, Rinaldi M, Rong L, Rudez I, Ruel M, Ruttmann-Ulmer E, Voisine P, Zhao Q, Zheng Z, Fremes SE. The ROMA trial: 7 years of trial activities and the development of the ROMA trial network. Eur J Cardiothorac Surg 2024; 65:ezae188. [PMID: 38758192 PMCID: PMC11099650 DOI: 10.1093/ejcts/ezae188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/26/2024] [Accepted: 05/01/2024] [Indexed: 05/18/2024] Open
Affiliation(s)
- Mario Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Massimo Lemma
- Department of Cardiac Surgery, Jilin Heart Hospital, Changchun, China
| | - Sigrid Sandner
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Andreas Boening
- Department of Cardiovascular Surgery, University Hospital Giessen, Giessen, Germany
| | - Lamia Harik
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Marc Albert
- Department of Cardiovascular Surgery, Robert-Bosch Hospital, Stuttgart, Germany
| | - Jose Albors Martin
- Department of Cardiac Surgery, Hospital Universitario del Vinalopo, Alicante, Spain
| | - Jorge Alcocer
- Department of Cardiac Surgery, Hospital Clinic de Barcelona, Barcelona, Spain
| | - John H Alexander
- Duke Clinical Research Institute, Division of Cardiology, Duke University, Durham, NC, USA
| | - Deepak L Bhatt
- Department of Medicine, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nikolaos Bonaros
- Department of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Borger
- Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany
| | - Bernhard C Danner
- Department of Thoracic and Cardiovascular Surgery, University Hospital of Goettingen, Goettingen, Germany
| | - Piroze Davierwala
- Department of Surgery, Division of Cardiac Surgery, Toronto General Hospital, Toronto, ON, Canada
| | - Marek A Deja
- Department of Cardiac Surgery, Medical University of Silesia-Katowice, Katowice, Poland
| | - Ruggero De Paulis
- Department of Cardiac Surgery, European Hospital, Unicamillus University, Rome, Italy
| | - Marcus-Andre Deutsch
- Department of Thoracic and Cardiovascular Surgery, HDZ NRW, University Hospital Ruhr-University Bochum, Bad Oeynhausen, Germany
| | - Marcus Flather
- Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - Paul Kurlansky
- Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Andre Lamy
- Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Roberto Lorusso
- Department of Cardio-Thoracic Surgery, Maastricht University Medical Center and Cardiovascular Research Maastricht, Maastricht, Netherlands
| | - Gopi Chand Mannam
- Department of Cardiothoracic Surgery, Star Hospitals, Hyderabad, India
| | - Mohamed Marzouk
- Department of Cardiovascular Surgery, IUCPQ, Universite Laval, Quebec City, QC, Canada
| | | | - Milan Milojevic
- Department of Cardiac Surgery and Cardiovascular Research, Dedinje Cardiovascular Institute, Belgrade, Serbia
- Department of Cardiothoracic Surgery, Erasmus MC, Rotterdam, Netherlands
| | - Giuseppe Nasso
- Department of Cardiac Surgery, Anthea Hospital, Bari, Italy
| | - Nirav Patel
- Department of Cardiovascular and Thoracic Surgery, Northwell Health, New Hyde Park, NY, USA
| | - Ivana Petrovic
- Department of Cardiosurgery, Center of Excellence, Dedinje Cardiovascular Institute, Belgrade, Serbia
| | - Eduard Quintana
- Department of Cardiac Surgery, Hospital Clinic de Barcelona, Barcelona, Spain
| | | | - Mauro Rinaldi
- Department of Cardiac Surgery, University of Turin, Turin, Italy
| | - Lisa Rong
- Department of Anesthesia, Weill Cornell Medicine, New York, NY, USA
| | - Igor Rudez
- Department of Cardiac and Transplant Surgery, Dubrava University Hospital, Zagreb, Croatia
| | - Marc Ruel
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | | | - Pierre Voisine
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Qiang Zhao
- Department of Cardiac Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhe Zheng
- Department of Cardiac Surgery, Fuwai Hospital, Beijing, China
| | - Stephen E Fremes
- Division of Cardiac Surgery, Schulich Heart Centre, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
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Elkind MSV, Arnett DK, Benjamin IJ, Eckel RH, Grant AO, Houser SR, Jacobs AK, Jones DW, Robertson RM, Sacco RL, Smith SC, Weisfeldt ML, Wu JC, Jessup M. The American Heart Association at 100: A Century of Scientific Progress and the Future of Cardiovascular Science: A Presidential Advisory From the American Heart Association. Circulation 2024; 149:e964-e985. [PMID: 38344851 DOI: 10.1161/cir.0000000000001213] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
In 1924, the founders of the American Heart Association (AHA) envisioned an international society focused on the heart and aimed at facilitating research, disseminating information, increasing public awareness, and developing public health policy related to heart disease. This presidential advisory provides a comprehensive review of the past century of cardiovascular and stroke science, with a focus on the AHA's contributions, as well as informed speculation about the future of cardiovascular science into the next century of the organization's history. The AHA is a leader in fundamental, translational, clinical, and population science, and it promotes the concept of the "learning health system," in which a continuous cycle of evidence-based practice leads to practice-based evidence, permitting an iterative refinement in clinical evidence and care. This advisory presents the AHA's journey over the past century from instituting professional membership to establishing extraordinary research funding programs; translating evidence to practice through clinical practice guidelines; affecting systems of care through quality programs, certification, and implementation; leading important advocacy efforts at the federal, state and local levels; and building global coalitions around cardiovascular and stroke science and public health. Recognizing an exciting potential future for science and medicine, the advisory offers a vision for even greater impact for the AHA's second century in its continued mission to be a relentless force for longer, healthier lives.
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Muhyieddeen A, Cheng S, Mamas MA, Beasley D, Weins GC, Gulati M. Racial Disparities in Mortality Associated With Acute Myocardial Infarction and COVID-19 in the United States: A Nationwide Analysis. Curr Probl Cardiol 2023; 48:101798. [PMID: 37178989 PMCID: PMC10174333 DOI: 10.1016/j.cpcardiol.2023.101798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 05/07/2023] [Indexed: 05/15/2023]
Abstract
This study assessed the COVID-19 pandemic's impact on racial disparities in acute myocardial infarction (AMI) management and outcomes. We reviewed AMI patient management and outcomes in the pandemic's initial nine months, comparing COVID-19 and non-COVID-19 cases using 2020's National Inpatient Sample data. Our findings revealed that patients with concurrent AMI and COVID-19 had higher in-hospital mortality (aOR 3.19, 95% CI 2.63-3.88), increased mechanical ventilation (aOR 1.90, 95% CI 1.54-2.33), and higher initiation of hemodialysis (aOR 1.38, 95% CI 1.05-1.89) compared to those without COVID-19. Moreover, Black and Asian/Pacific Islander patients had higher in-hospital mortality than White patients, (aOR 2.13, 95% CI 1.35-3.59; aOR 3.41, 95% CI 1.5-8.37). Also, Black, Hispanic, and Asian/Pacific Islander patients showed higher odds of initiating hemodialysis (aOR 5.48, 95% CI 2.13-14.1; aOR 2.99, 95% CI 1.13-7.97; aOR 7.84, 95% CI 1.55-39.5), and were less likely to receive PCI for AMI (aOR 0.71, 95% CI 0.67-0.74; aOR 0.81, 95% CI 0.77-0.86; aOR 0.82, 95% CI 0.75-0.90). Black patients also showed less likelihood of undergoing CABG (aOR 0.55, 95% CI 0.49-0.61). Our study highlights elevated mortality and complications in COVID-19 AMI patients, emphasizing significant racial disparities. These findings underscore the pressing need for initiatives addressing healthcare disparities, enhancing access, and promoting culturally sensitive care to boost health equity.
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Affiliation(s)
- Amer Muhyieddeen
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center Los Angeles, CA
| | - Susan Cheng
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center Los Angeles, CA
| | - Mamas A Mamas
- Keele Cardiac Research Group, Centre for Prognosis Research, Keele University, Stoke-on-Trent, UK
| | | | - Galen Cook Weins
- Bioststatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Martha Gulati
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center Los Angeles, CA.
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Diaz DM, Orton EC, de Rezende ML, Zersen K, Guillaumin J. Assessment of microcirculation variables and endothelial glycocalyx using sidestream dark field videomicroscopy in anesthetized dogs undergoing cardiopulmonary bypass. Front Vet Sci 2023; 10:1189738. [PMID: 37671279 PMCID: PMC10476349 DOI: 10.3389/fvets.2023.1189738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 07/06/2023] [Indexed: 09/07/2023] Open
Abstract
Introduction To evaluate microcirculation and endothelial glycocalyx (eGC) variables using sidestream darkfield (SDF) videomicroscopy in canine cardiopulmonary bypass (CPB). Methods Dogs undergoing CPB for surgical correction of naturally-occurring cardiac disease were prospectively included. Variables collected included patient demographics, underlying cardiac disease, red blood cell flow (Flow), 4-25 μm vessel density (Density), absolute capillary blood volume (CBVabs), relative capillary blood volume (CBVrel) and eGC width assessed by perfused boundary region (PBR). Anesthetized healthy dogs were used as control. Microcirculation and eGC variables were compared at baseline under anesthesia (T0), on CPB prior to cross clamping (T1), after cross clamp removal following surgical correction (T2) and at surgical closure (T3). Results Twelve dogs were enrolled, including 10 with a complete dataset. Median Flow was 233.9, 79.9, 164.3, and 136.1 μm/s at T0, T1, T2, and T3, respectively, (p = 1.00). Median Density was 173.3, 118.4, 121.0 and 155.4 mm/mm2 at T0, T1, T2, and T3, respectively, (p = 1.00). Median CBVabs decreased over time: 7.4, 6.6, 4.8 and 4.7 103μm3 at T0, T1, T2, and T3, respectively, (p < 0.01). Median CBVrel increased over time: 1.1, 1.5,1.1, and 1.3 103μm3 at T0, T1, T2, and T3, respectively, (p < 0.001). Median PBR increased over time: 1.8, 2.1, 2.4, 2.1 μm at T0, T1, T2, and T3, respectively, (p < 0.001). Compared to control dogs (n = 8), CPB dogs had lower CBVabs at T0. Conclusion Alterations in eGC thickness and microvascular occur in dogs undergoing CPB for naturally-occurring cardiac disease.
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Affiliation(s)
| | | | | | | | - Julien Guillaumin
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
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5
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Koupenova M, Chung MK, Bristow MR. COVID-19 and the Cardiovascular System: Requiem for a Medical Minotaur. Circ Res 2023; 132:1255-1258. [PMID: 37167357 PMCID: PMC10171293 DOI: 10.1161/circresaha.123.322935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Affiliation(s)
| | - Mina K. Chung
- Heart and Vascular Institute and Lerner Research Institute at Cleveland Clinic, Lerner College of Medicine of Case Western Reserve University, Cleveland, OH (M.K.C.)
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Boulos PK, Freeman SV, Henry TD, Mahmud E, Messenger JC. Interaction of COVID-19 With Common Cardiovascular Disorders. Circ Res 2023; 132:1259-1271. [PMID: 37167359 PMCID: PMC10171313 DOI: 10.1161/circresaha.122.321952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The onset and widespread dissemination of the severe acute respiratory syndrome coronavirus-2 in late 2019 impacted the world in a way not seen since the 1918 H1N1 pandemic, colloquially known as the Spanish Flu. Much like the Spanish Flu, which was observed to disproportionately impact young adults, it became clear in the early days of the coronavirus disease 2019 (COVID-19) pandemic that certain groups appeared to be at higher risk for severe illness once infected. One such group that immediately came to the forefront and garnered international attention was patients with preexisting cardiovascular disease. Here, we examine the available literature describing the interaction of COVID-19 with a myriad of cardiovascular conditions and diseases, paying particular attention to patients diagnosed with arrythmias, heart failure, and coronary artery disease. We further discuss the association of acute COVID-19 with de novo cardiovascular disease, including myocardial infarction due to coronary thrombosis, myocarditis, and new onset arrhythmias. We will evaluate various biochemical theories to explain these findings, including possible mechanisms of direct myocardial injury caused by the severe acute respiratory syndrome coronavirus-2 virus at the cellular level. Finally, we will discuss the strategies employed by numerous groups and governing bodies within the cardiovascular disease community to address the unprecedented challenges posed to the care of our most vulnerable patients, including heart transplant recipients, end-stage heart failure patients, and patients suffering from acute coronary syndromes, during the early days and height of the COVID-19 pandemic.
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Affiliation(s)
- Peter K. Boulos
- University of Colorado School of Medicine, Division of Cardiology, Aurora (P.K.B., S.V.F., J.C.M.)
| | - Scott V. Freeman
- University of Colorado School of Medicine, Division of Cardiology, Aurora (P.K.B., S.V.F., J.C.M.)
| | - Timothy D. Henry
- The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, OH (T.D.H.)
| | - Ehtisham Mahmud
- Sulpizio Cardiovascular Center, University of California San Diego, La Jolla (E.M.)
| | - John C. Messenger
- University of Colorado School of Medicine, Division of Cardiology, Aurora (P.K.B., S.V.F., J.C.M.)
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Bailey D, Stewart A. On changes, challenges and collaboration: Introducing a new Editor-in-Chief and moving to Open Access. Exp Physiol 2022; 107:1381-1382. [PMID: 36218081 DOI: 10.1113/ep090859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Damian Bailey
- University of South Wales, Neurovascular Research Laboratory, Pontypridd, UK
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Rihan M, Sharma SS. Role of Pyruvate Kinase M2 (PKM2) in Cardiovascular Diseases. J Cardiovasc Transl Res 2022; 16:382-402. [PMID: 36178660 DOI: 10.1007/s12265-022-10321-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 09/07/2022] [Indexed: 11/29/2022]
Abstract
Cardiovascular diseases (CVDs) are the world's leading cause of death, accounting for 32% of all fatalities. Although therapeutic agents are available for CVDs, however, most of them have significant limitations such as the time-dependency effect, hypotension, and bradycardia. To overcome the limitations of current pharmacological therapies, new molecular targets and pathways need to be identified and investigated to provide better treatment options for CVDs. Recent evidence suggested the involvement of pyruvate kinase M2 (PKM2) and targeting PKM2 by its modulators (inhibitors and activators) has shown promising results in several CVDs. PKM2 regulates gene activation in the context of apoptosis, mitosis, hypoxia, inflammation, and metabolic reprogramming. PKM2 modulators might have a significant impact on the molecular pathways involved in CVD pathogenesis. Therefore, PKM2 modulators can be one of the therapeutic options for CVDs. This review provides an insight into PKM2 involvement in various CVDs along with their therapeutic potential.
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Affiliation(s)
- Mohd Rihan
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Sector 67, S.A.S. Nagar, Punjab, India
| | - Shyam Sunder Sharma
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Sector 67, S.A.S. Nagar, Punjab, India.
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Hudson MF. Short‐ and
long‐term
strategies for navigating
research‐ambivalent
organizational cultures besetting embedded researchers. Learn Health Syst 2022; 7:e10329. [PMID: 37066096 PMCID: PMC10091197 DOI: 10.1002/lrh2.10329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/19/2022] [Accepted: 07/04/2022] [Indexed: 12/23/2022] Open
Abstract
Many health systems may host embedded researchers (ERs) and provide fiscal resources to encourage health service research. However, ERs may remain challenged to initiate research in these settings. This discussion examines how health system culture may impede research initiation, thereby exposing a paradox for embedded researchers immersed in research-ambivalent health systems. The discussion ultimately describes potential short-term and long-term strategies embedded researchers may employ to initiate scholarly inquiry in research-ambivalent health systems.
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Affiliation(s)
- Matthew F. Hudson
- Department of Medicine Prisma Health Cancer Institute Greenville South Carolina USA
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Cao F, Guo N, Yuan Z. Reports from the 2021 Great Wall International Congress of Cardiology in China. Eur Heart J 2021:ehab852. [PMID: 34922357 DOI: 10.1093/eurheartj/ehab852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Feng Cao
- National Clinical Research Center for Geriatric Diseases & 2nd Medical Center, Chinese PLA General Hospital, 28 Fuxing Street, Haidian District, Beijing 100853, China
| | - Ning Guo
- Department of cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, China
| | - Zuyi Yuan
- Department of cardiology, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi 710061, China
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