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Ramonfaur D, Salto-Quintana JN, Aguirre-García GM, Hernández-Mata NM, Villanueva-Lozano H, Torre-Amione G, Martínez-Reséndez MF. Cumulative steroid dose in hospitalized patients and COVID-19-associated pulmonary aspergillosis. J Hosp Infect 2023; 142:26-31. [PMID: 37499762 DOI: 10.1016/j.jhin.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/04/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Severe COVID-19 elicits a hyperimmune response frequently amenable to steroids, which in turn increase the risk for opportunistic infections. COVID-19 associated pulmonary aspergillosis (CAPA) is a complication known to be associated with immunomodulatory treatment. The role of cumulative steroid dose in the development of CAPA is unclear. This study evaluates the relationship between cumulative steroid dose in hospitalized individuals with COVID-19 pneumonia and the risk for CAPA. METHODS This retrospective cohort study includes 135 hospitalized patients with PCR-confirmed COVID-19 pneumonia at a tertiary centre in north Mexico. Patients who developed CAPA were matched by age and gender to two controls with COVID-19 pneumonia who did not develop CAPA defined and classified as possible, probable, or proven according to 2020 ECMM/ISHAM criteria. Cumulative steroid dose in dexamethasone equivalents was obtained from admission until death, discharge, or diagnosis of CAPA (whichever occurred first). The risk of CAPA by the continuous cumulative steroid dose was assessed using a logistic regression model. RESULTS Forty-five patients were diagnosed with CAPA and matched to 90 controls. Mean age was 61 ± 14 years, and 72% were male. Mean cumulative steroid dose was 66 ± 75 mg in patients without CAPA vs 195 ± 226 mg in patients with CAPA (P<0.001). The risk for CAPA increased with higher cumulative dose of steroids (OR 1.0075, 95% CI: 1.0033-1.0116). CONCLUSIONS Patients who developed CAPA had a history of higher cumulative steroid dose during hospitalization. The risk for CAPA increases ∼8% for every 10 mg of dexamethasone used.
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Affiliation(s)
- D Ramonfaur
- Division of Postgraduate Medical Education, Harvard Medical School, Boston, MA, USA
| | - J N Salto-Quintana
- School of Medicine and Health Sciences, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico
| | - G M Aguirre-García
- School of Medicine and Health Sciences, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico
| | - N M Hernández-Mata
- School of Medicine and Health Sciences, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico
| | - H Villanueva-Lozano
- Department of Infectious Diseases, ISSSTE Regional Monterrey, Monterrey, Nuevo Leon, Mexico
| | - G Torre-Amione
- School of Medicine and Health Sciences, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico; The Methodist Hospital, Cornell University, Houston, TX, USA
| | - M F Martínez-Reséndez
- School of Medicine and Health Sciences, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, Nuevo Leon, Mexico; Epidemiological Surveillance Unit, Hospital San Jose-Tec Salud, Monterrey, Nuevo Leon, Mexico.
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2
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Aguirre-García GM, Ramonfaur D, Torre-Amione G, Ramírez-Elizondo MT, Lara-Medrano R, Moreno-Hoyos JF, Velázquez-Ávila ES, Diaz-Garza CA, Sanchez-Nava VM, Castilleja-Leal F, Rhoades GM, Martínez-Reséndez MF. Stratifying risk outcomes among adult COVID-19 inpatients with high flow oxygen: The R4 score. Pulmonology 2021; 29:200-206. [PMID: 34728168 PMCID: PMC8506226 DOI: 10.1016/j.pulmoe.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/03/2021] [Accepted: 10/03/2021] [Indexed: 11/22/2022] Open
Abstract
Background High flow oxygen therapy (HFO) is a widely used intervention for pulmonary complications. Amid the coronavirus infectious disease 2019 (COVID-19) pandemic, HFO became a popular alternative to conventional oxygen supplementation therapies. Risk stratification tools have been repurposed –and new ones developed– to estimate outcome risks among COVID-19 patients. This study aims to provide a simple risk stratification system to predict invasive mechanical ventilation (IMV) or death among COVID-19 inpatients on HFO. Methods Among 529 adult inpatients with COVID-19 pneumonia, we selected unadjusted clinical risk factors for developing the composite endpoint of IMV or death. The risk for the primary outcome by each category was estimated using a Cox proportional hazards model. Bootstrapping was used to validate the results. Results Age above 62, eGFR under 60 ml/min, room air SpO2 ≤89 % upon admission, history of hypertension, history of diabetes, and any comorbidity (cancer, cardiovascular disease, COPD/ asthma, hypothyroidism, or autoimmune disease) were considered for the score. Each of the six criteria scored 1 point. The score was further simplified into 4 categories: 1) 0 criteria, 2) 1 criterion, 3) 2-3 criteria, and 4) ≥4 criteria. Taking the first category as the reference, risk estimates for the primary endpoint were HR; 2.94 [1.67 – 5.26], 4.08 [2.63 – 7.05], and 6.63 [3.74 – 11.77], respectively. In ROC analysis, the AUC for the model was 0.72. Conclusions Our score uses simple criteria to estimate the risk for IMV or death among COVID-19 inpatients with HFO. Higher category reflects consistent increases in risk for the endpoint.
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Affiliation(s)
- G M Aguirre-García
- Instituto Tecnologico y de Estudios Superiores de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico
| | - D Ramonfaur
- Harvard Medical School, Division of Postgraduate Medical Education, 25 Shattuck St, Boston, MA 02115, United States
| | - G Torre-Amione
- Instituto Tecnologico y de Estudios Superiores de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico
| | - M T Ramírez-Elizondo
- Instituto Tecnologico y de Estudios Superiores de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico
| | - R Lara-Medrano
- Instituto Tecnologico y de Estudios Superiores de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico
| | - J F Moreno-Hoyos
- Instituto Tecnologico y de Estudios Superiores de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico
| | - E S Velázquez-Ávila
- Hospital San Jose-Tec Salud, Epidemiological Surveillance Unit, Monterrey, Nuevo Leon, Mexico
| | - C A Diaz-Garza
- Instituto Tecnologico y de Estudios Superiores de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico
| | - V M Sanchez-Nava
- Instituto Tecnologico y de Estudios Superiores de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico
| | - F Castilleja-Leal
- Instituto Tecnologico y de Estudios Superiores de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico
| | - G M Rhoades
- Instituto Tecnologico y de Estudios Superiores de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico
| | - M F Martínez-Reséndez
- Instituto Tecnologico y de Estudios Superiores de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico; Hospital San Jose-Tec Salud, Epidemiological Surveillance Unit, Monterrey, Nuevo Leon, Mexico.
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Cruz-Solbes A, Hussain I, Trachtenberg B, Bhimaraj A, Guha A, Park M, Torre-Amione G, Kaleekal T, Estep J. Combined Heart and Lung Transplant: Improved Survival After Implementation of Exclusion and Inclusion Criteria. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Ali A, Hannawi B, Waxali N, Cruz-Solbes A, Trachtenberg B, Estep J, Park M, Hussain I, Torre-Amione G, Bhimaraj A, Guha. A. Schematic Evaluation and Conservative Management of the Short-To-Shield Phenomenon Circumventing Pump Exchange. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Cruz-Solbes A, Hannawi B, Achi M, Amione-Guerra J, Karanja E, Trachtenberg B, Bhimaraj A, Estep J, Torre-Amione G, Hussain I, Park M, Bruckner B, Guha A. Feasibility, Efficacy and Safety of Fibrinogen Guided Very Low Dose Multi-Day Thrombolytics in the Management of LVAD Thrombosis. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Cruz-Solbes A, Uribe C, Youker K, Amione-Guerra J, Hanawi B, Estep J, Trachtenberg B, Guha A, Torre-Amione G, Suarez E, Bhimaraj A. Mesenchymal to Endothelial Transition (MET) Occurs Secondary to Cardiac Unloading Through LVAD Support. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Amione-Guerra J, Ali A, Cruz-Solbes A, Araujo-Gutierrez R, Trachtenberg B, Bhimaraj A, Guha A, Park M, Estep J, Torre-Amione G. Very Low Incidence of Clinically Significant Thrombocytopenia After Extended Intra Aortic Balloon Pump Support. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Oropeza-Almazán Y, Silva-Platas C, Youker K, Torre-Amione G, García-Rivas G. PT169 The Mitochondrial Calcium Uniporter Is a Therapeutic Target in the Hypoxia/Reoxygenation Injury. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Cruz-Solbes A, Uribe C, Youker K, Cordero-Reyes A, Amione-Guerra J, Ashrith G, Trachtenberg B, Estep J, Torre-Amione G, Cooke J, Bhimaraj A. Temporal Assessment of Endothelial to Mesenchymal Transition as a Contributor to Fibrosis in a Mouse Model of Heart Failure. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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10
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Amione-Guerra J, Cordero-Reyes A, Cruz-Solbes A, Bhimaraj A, Trachtenberg B, Ashrith G, Lin C, Bruckner B, Suarez E, Torre-Amione G, Park M, Estep J. Expanded Experience with Percutaneous Placement of Axillary-Subclavian Intra-Aortic Balloon Pump that Permits Sitting Upright and Ambulation in Patients with Advanced Heart Failure. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Araujo-Gutierrez R, Ibarra-Cortez S, Park M, Estep J, Ashrith G, Torre-Amione G, Bhimaraj A, Trachtenberg B. Utility of Wireless Pulmonary Artery Pressure Measurement System (CardioMEMS®) in Heart Failure Patients with Non-Cardiac Advanced Organ Failure or Organ Replacement. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Uribe C, Cruz-Solbes A, Youker K, Cordero-Reyes A, Amione-Guerra J, Trachtenberg B, Ashrith G, Estep J, Torre-Amione G, Suarez E, Cooke J, Bhimaraj A. Presence of Endothelial to Mesenchymal Transition in End Stage Human Myocardial Samples-Documentation in Human Heart Failure for the First Time. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Segura-Ibarra V, Amione-Guerra J, Cruz-Solbes A, Youker K, Torre-Amione G, Ashrith G, Blanco E. Polymer Based Nanotherapeutics Prevent the Progression of Pulmonary Hypertension in a Rat Model. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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14
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Cruz-Solbes A, Uribe C, Youker K, Trachtenberg B, Ashrith G, Estep J, Torre-Amione G, Bruckner B, Cooke J, Bhimaraj A. Vascular Reactivity Analysis in Patients with Continuous Flow Left Ventricular Assist Devices (CF-LVADs) - The Role of Endothelial Function in Continuous Flow Physiology. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.1128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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15
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Ashrith G, Daoud A, Teeter L, Amione-Guerra J, Cordero-Reyes A, Graviss E, Trachtenberg B, Bhimaraj A, Gaber A, Scheinin S, Torre-Amione G, Estep J. Impact of Cytomegalovirus on Survival after Heart Transplant: Analysis of 20,000 Patients from the UNOS Registry Data. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Amione-Guerra J, Cordero-Reyes A, Fida N, Bhimaraj A, Trachtenberg B, Loebe M, Torre-Amione G, Estep J, Ashrith G. Anemia After Continuous Flow Left Ventricular Assist Device (CF-LVAD) Implantation Is Associated With Morbidity and Mortality. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Ashrith G, Fida N, Cordero-Reyes A, Amione-Guerra J, Bhimaraj A, Trachtenberg B, Torre-Amione G, Nagueh S, Estep J. Echocardiographic Predictors of Combined Pre- and Post-Capillary Pulmonary Hypertension in a Population of Systolic Heart Failure With WHO Group II Pulmonary Hypertension. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Amione-Guerra J, Cordero-Reyes A, Bhimaraj A, Ashrith G, Loebe M, Suarez E, Loza L, Torre-Amione G, Estep J, Trachtenberg B. MELDing a High Risk Patient for Continuous Flow Left Ventricular Assist Device (CF-LVAD) into a Low Risk Patient. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Rao P, Hong L, Gjertson D, Balaz I, Fishbein M, Deng M, Harre N, Leuchter R, Banchs H, DeNofrio D, Eisen H, Ewald G, Kfoury A, Kobashigawa J, Starling R, Torre-Amione G, Van Bakel A, Reed E. Effect of Everolimus Immunotherapy on HLA Antibody Production in Heart Transplantation. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Kassi M, Adigun R, Choi S, Cordero-Reyes A, Bhimaraj A, Trachtenberg B, Ashrith G, Loebe M, Torre-Amione G, Chang S, Estep J. Utility of Cardiac Computed Tomography in Detecting Malposition of Left Ventricular Assist Devices Associated With Pump Thrombosis. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Eshelbrenner C, Cordero-Reyes A, Bhimaraj A, Trachtenberg B, Ashrith G, Elias B, Loebe M, Torre-Amione G, Estep J. Absolute Reduction in Left Ventricular End Diastolic Diameter (Greater Than 0.65cm) in Patients With Continuous Flow Left Ventricular Assist Devices (CF-LVAD) Reflects Complete LV Unloading Defined By Invasive Hemodynamics. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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22
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Eshelbrenner C, Cordero-Reyes A, Bhimaraj A, Trachtenberg B, Ashrith G, Loebe M, Torre-Amione G, Estep J. Large Incremental Changes in Pump Speed Are Required in Order to See Meaningful Changes in Invasively Measured Hemodynamics in Patients With HeartMate II Continuous Flow Left Ventricular Assist Devices (CF-LVADs). J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Fernández-Sada E, Silva-Platas C, Villegas CA, Rivero SL, Willis BC, García N, Garza JR, Oropeza-Almazán Y, Valverde CA, Mazzocchi G, Zazueta C, Torre-Amione G, García-Rivas G. Cardiac responses to β-adrenoceptor stimulation is partly dependent on mitochondrial calcium uniporter activity. Br J Pharmacol 2014; 171:4207-21. [PMID: 24628066 DOI: 10.1111/bph.12684] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 02/06/2014] [Accepted: 03/01/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND PURPOSE Despite the importance of mitochondrial Ca(2+) to metabolic regulation and cell physiology, little is known about the mechanisms that regulate Ca(2+) entry into the mitochondria. Accordingly, we established a system to determine the role of the mitochondrial Ca(2+) uniporter in an isolated heart model, at baseline and during increased workload following β-adrenoceptor stimulation. EXPERIMENTAL APPROACH Cardiac contractility, oxygen consumption and intracellular Ca(2+) transients were measured in ex vivo perfused murine hearts. Ru360 and spermine were used to modify mitochondrial Ca(2+) uniporter activity. Changes in mitochondrial Ca(2+) content and energetic phosphate metabolite levels were determined. KEY RESULTS The addition of Ru360 , a selective inhibitor of the mitochondrial Ca(2+) uniporter, induced progressively and sustained negative inotropic effects that were dose-dependent with an EC50 of 7 μM. Treatment with spermine, a uniporter agonist, showed a positive inotropic effect that was blocked by Ru360 . Inotropic stimulation with isoprenaline elevated oxygen consumption (2.7-fold), Ca(2+) -dependent activation of pyruvate dehydrogenase (5-fold) and mitochondrial Ca(2+) content (2.5-fold). However, in Ru360 -treated hearts, this parameter was attenuated. In addition, β-adrenoceptor stimulation in the presence of Ru360 did not affect intracellular Ca(2+) handling, PKA or Ca(2+) /calmodulin-dependent PK signalling. CONCLUSIONS AND IMPLICATIONS Inhibition of the mitochondrial Ca(2+) uniporter decreases β-adrenoceptor response, uncoupling between workload and production of energetic metabolites. Our results support the hypothesis that the coupling of workload and energy supply is partly dependent on mitochondrial Ca(2+) uniporter activity.
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Affiliation(s)
- E Fernández-Sada
- Cátedra de Cardiología y Medicina Vascular, Escuela de Medicina, Tecnológico de Monterrey, Monterrey, Nuevo León, México
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Bhimaraj A, Bellera R, Martinez D, Cordero-Reyes A, Elias B, Trachtenberg B, Ashrith G, Torre-Amione G, Loebe M, Estep J. Interaction of Pulse Perception, Blood Pressure Measurements (By Doppler and Standard Cuff Techniques) and Visual Assessment of Aortic Valve Opening in Continuous Flow LVAD Patients in the Outpatient Setting. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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25
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Bhimaraj A, Cordero-Reyes A, Trachtenberg B, Ashrith G, Loza L, Loebe M, Suarez E, Bruckner B, Torre-Amione G, Estep J. Use of Various Mechanical Circulatory Support Strategies in End Stage Amyloidosis - A Single Center Experience From an Amyloid Heart Transplant Center. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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26
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Ashrith G, Kotun F, Cordero-Reyes A, Bhimaraj A, Trachtenberg B, Loebe M, Torre-Amione G, Estep J. Cerebrovascular Accidents and End of Life Admissions Contribute Most to the Cost in Patients With Continuous Flow Left Ventricular Assist Devices. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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27
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Trachtenberg B, Aldeiri M, Cordero-Reyes A, Alvarez P, Bhimaraj A, Elias B, Suarez E, Bruckner B, Loebe M, Harris R, Zhang Y, Torre-Amione G, Estep J. Persistent Blood Stream Infections Are Associated with Cerebrovascular Accidents in Patients with Continuous Flow LVADs. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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28
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Aldeiri M, Vivo R, Hall D, Cordero-Reyes A, Soliman A, El-Beheary M, Bhimaraj A, Bruckner B, Loebe M, Trachtenberg B, Torre-Amione G, Estep J. Incidence and Pre-Implant Predictors of Late Right Ventricular Failure in Patients Supported with Contineous-Flow LVADs. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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29
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Vivo R, Aldeiri M, Cordero-Reyes A, Krim S, Trachtenberg B, Bhimaraj A, Torre-Amione G, Bruckner B, Loebe M, Estep J. Echocardiographic Parameters Associated with Clinical Heart Failure Due to Partial Left Ventricular Unloading in Patients with Continuous-Flow LVAD. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Orrego C, Cordero-Reyes A, Estep J, Loebe M, Torre-Amione G. 257 An Intensive Endomyocardial Biopsy (EMB) Surveillance Strategy Is Not Superior to a Conservative Strategy To Reduce Post Transplant Events: A 5-Year Follow-Up Study. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Estep J, Cordero-Reyes A, Bhimaraj A, Loebe M, Bruckner B, Scheinin S, Ramlawi B, Torre-Amione G. 10 Successful Use of Percutaneously Placed Axillary-Subclavian Intra-Aortic Balloon Pumps That Permit Ambulation as a Bridge to Heart and Multi-Organ Transplantation. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Medina D, Cordero-Reyes A, Mosele B, Fry K, Estep J, Bhimaraj A, Loebe M, Torre-Amione G. 753 Low Psychosocial and Financial Assessment Scores Are Not Predictive of Poor Outcomes among Ventricular Assist Device Patients. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Estep J, Vivo R, Flores-Arredondo J, Krim S, Aldeiri M, Elias B, Kurchock B, Loebe M, Bruckner B, Torre-Amione G, Bhimaraj A. 119 Proposed Echocardiographic Algorithm To Predict Elevated Left Ventricular Filling Pressures in Patients Supported with Continuous-Flow Left Ventricular Assist Devices. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Bhimaraj A, Hall D, Vivo R, Cordero-Reyes A, Aldieri M, Torre-Amione G, Loebe M, Bruckner B, Ramlawri B, Scheinin S, Estep J. 561 Maintaining Pulsatility or Not with Intermittent Aortic Valve Opening Does Not Appear To Contribute to Formation of AV Malformation in Patients with Continuous-Flow Left Ventricular Assist Devices. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Cordero-Reyes A, Gupte A, Youker K, Estep J, Loebe M, Hamilton D, Hsueh W, Torre-Amione G. 795 Evidence for Restoration of Glucose Metabolism in Failing Myocardium Following Prolonged Mechanical Circulatory Support. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Orrego C, Cordero-Reyes A, Estep J, Seethamraju H, Kesavan R, Torre-Amione G. 616 Are the Risk Factors and Underlying Mechanisms for Atrial Fibrillation and Atrial Flutter Post Lung Transplant the Same? J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Orrego C, Cordero-Reyes A, Estep J, Torre-Amione G. 79 Routine Use of Surveillance Endomyocardial Biopsy (EMB) Is Only Useful within the Six Months Post-Transplant: Its Routine Use Thereafter Should Be Abandoned. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Barbandi M, Cordero-Reyes A, Malaty A, Krim S, Vivo R, Torre-Amione G, Estep J. 124 Echocardiographic Predictors of Adverse Outcome in Patients Referred for End Stage Heart Failure. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Orrego C, Florez J, Youker K, Torre-Amione G. 205: Cardiac Resynchronization Therapy (CRT) Induced Cellular Reverse Cardiac Remodeling Similar to Left Ventricular Assist Devices. J Heart Lung Transplant 2010. [DOI: 10.1016/j.healun.2009.11.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Khalil N, Orrego C, Assad-Kottner C, Leveque C, Youker K, Torre-Amione G. 104: Plasmapheresis: Quality of Life and Clinical Improvements in Chronic Heart Failure. J Heart Lung Transplant 2009. [DOI: 10.1016/j.healun.2008.11.782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Vrtovec B, Poglajen G, Sebestjen M, Okrajsek R, Bunc M, Cernelc P, Sever M, Domanovic D, Torre-Amione G. 157: Early Benefits of Intracoronary CD34+ Stem Cell Transplantation in Patients with Dilated Cardiomyopathy Are Sustained over Time. J Heart Lung Transplant 2009. [DOI: 10.1016/j.healun.2008.11.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Loebe M, Zade Asfahani WH, Petrov GP, Kleiman NS, Torre-Amione G. Surgical considerations on the use of the percutaneous ventricular assist device TandemHeart in critical aortic valve stenosis. Thorac Cardiovasc Surg 2009; 57:50-2. [PMID: 19169999 DOI: 10.1055/s-2008-1038407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Decompensated aortic valve stenosis is a life-threatening condition. Aortic valve replacement in patients with cardiogenic shock due to critical aortic stenosis is a high-risk procedure and is associated with increased operative mortality. We describe the clinical course of a patient who was transferred to our institution in cardiogenic shock and with multiple organ failure, due to decompensated aortic valve stenosis. The patient received the percutaneous left ventricular assist device TandemHeart which has been developed for short-term cardiac support. After hemodynamic improvement the patient underwent successful aortic valve replacement. The device was left in place until the patient had recovered from surgery. The excellent outcome suggests that a perioperative mechanical support might greatly improve the safety of aortic valve replacement in the presence of cardiogenic shock.
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Affiliation(s)
- M Loebe
- Methodist DeBakey Heart Center, Houston, TX 77030, United States.
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Jahanyar J, Loebe M, Orrego C, Goss J, Bruckner B, Celis R, Koerner M, Youker K, Noon G, Torre-Amione G. 247: Decreased Incidence of Acute Cardiac Allograft Rejection in Combined Heart and Liver Transplant Recipients. J Heart Lung Transplant 2008. [DOI: 10.1016/j.healun.2007.11.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Jahanyar J, Peterson L, Loebe M, Joyce D, Bruckner B, Torre-Amione G, Koerner M, Noon G, Youker K. 377: Differences in Gene Expression after Mechanical Circulatory Support with Pulsatile and Non-Pulsatile Left Ventricular Assist Devices Utilizing Gene Arrays. J Heart Lung Transplant 2008. [DOI: 10.1016/j.healun.2007.11.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Lin L, Kim SC, Wang Y, Gupta S, Davis B, Simon SI, Torre-Amione G, Knowlton AA. HSP60 in heart failure: abnormal distribution and role in cardiac myocyte apoptosis. Am J Physiol Heart Circ Physiol 2007; 293:H2238-47. [PMID: 17675567 DOI: 10.1152/ajpheart.00740.2007] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Heat shock protein (HSP) 60 is a mitochondrial and cytosolic protein. Previously, we reported that HSP60 doubled in end-stage heart failure, even though levels of the protective HSP72 were unchanged. Furthermore, we observed that acute injury in adult cardiac myocytes resulted in movement of HSP60 to the plasma membrane. We hypothesized that the inflammatory state of heart failure would cause translocation of HSP60 to the plasma membrane and that this would provide a pathway for cardiac injury. Two models were used to test this hypothesis: 1) a rat model of heart failure and 2) human explanted failing hearts. We found that HSP60 localized to the plasma membrane and was also found in the plasma early in heart failure. Plasma membrane HSP60 localized to lipid rafts and was detectable on the cell surface with the use of both flow cytometry and confocal microscopy. Localization of HSP60 to the cell surface correlated with increased apoptosis. In heart failure, HSP60 is in the plasma membrane fraction, on the cell surface, and in the plasma. Membrane HSP60 correlated with increased apoptosis. Release of HSP60 may activate the innate immune system, promoting a proinflammatory state, including an increase in TNF-alpha. Thus abnormal trafficking of HSP60 to the cell surface may be an early trigger for myocyte loss and the progression of heart failure.
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Affiliation(s)
- Li Lin
- Molecular and Cellular Cardiology, Cardiovascular Division, University of California, Davis, California 95616, USA
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Rasmusson K, Stehlik J, Brown R, Renlund D, Wagoner L, Torre-Amione G, Folsom J, Silber D, Kirklin J. 435: Long-term outcomes of transplantation for peripartum cardiomyopathy. A multiinstitutional analysis. J Heart Lung Transplant 2007. [DOI: 10.1016/j.healun.2006.11.457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Jahanyar J, Youker K, Noon G, Torre-Amione G, Loebe M. 6: Cathepsin G is co-localized in tryptase/chymase positive human cardiac mast cells (MCTC) during heart failure and mechanical circulatory support. J Heart Lung Transplant 2007. [DOI: 10.1016/j.healun.2006.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Jahanyar J, Youker K, Loebe M, Chai H, Assad-Kottner C, Torre-Amione G, Noon G. 384: Stem cell factor mRNA expression during mechanical circulatory support with left ventricular assist devices correlates with cardiac mast cell populations in the failing human heart. J Heart Lung Transplant 2007. [DOI: 10.1016/j.healun.2006.11.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Oliveira G, Thohan V, Koerner M, Loebe M, Noon G, Nasir N, Torre-Amione G. 168. J Heart Lung Transplant 2006. [DOI: 10.1016/j.healun.2005.11.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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