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Appadurai V, Ayuba G, Flaherty JD, Malaisrie SC, Meng Z, Baldridge AS, Chen C, Slostad B, McCarthy P, Puthumana J, Davidson CJ, Narang A. Temporal Trends in Right Ventricular to Pulmonary Artery Coupling in Patients Undergoing Transcatheter Mitral Valve-in-Valve Replacement for Degenerated Mitral Bioprostheses. J Am Soc Echocardiogr 2024; 37:471-473. [PMID: 38237692 DOI: 10.1016/j.echo.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 12/27/2023] [Accepted: 12/30/2023] [Indexed: 02/23/2024]
Affiliation(s)
- Vinesh Appadurai
- Bluhm Cardiovascular Institute, Northwestern University, Feinberg Pavilion, Suite 8-503G, 201 E. Huron Street Chicago, IL 60611
| | - Gloria Ayuba
- Bluhm Cardiovascular Institute, Northwestern University, Feinberg Pavilion, Suite 8-503G, 201 E. Huron Street Chicago, IL 60611
| | - James D Flaherty
- Bluhm Cardiovascular Institute, Northwestern University, Feinberg Pavilion, Suite 8-503G, 201 E. Huron Street Chicago, IL 60611
| | - S Christopher Malaisrie
- Bluhm Cardiovascular Institute, Northwestern University, Feinberg Pavilion, Suite 8-503G, 201 E. Huron Street Chicago, IL 60611
| | - Zhiying Meng
- Bluhm Cardiovascular Institute, Northwestern University, Feinberg Pavilion, Suite 8-503G, 201 E. Huron Street Chicago, IL 60611
| | - Abigail S Baldridge
- Bluhm Cardiovascular Institute, Northwestern University, Feinberg Pavilion, Suite 8-503G, 201 E. Huron Street Chicago, IL 60611
| | - Chen Chen
- Bluhm Cardiovascular Institute, Northwestern University, Feinberg Pavilion, Suite 8-503G, 201 E. Huron Street Chicago, IL 60611
| | - Brody Slostad
- Bluhm Cardiovascular Institute, Northwestern University, Feinberg Pavilion, Suite 8-503G, 201 E. Huron Street Chicago, IL 60611
| | - Patrick McCarthy
- Bluhm Cardiovascular Institute, Northwestern University, Feinberg Pavilion, Suite 8-503G, 201 E. Huron Street Chicago, IL 60611
| | - Jyothy Puthumana
- Bluhm Cardiovascular Institute, Northwestern University, Feinberg Pavilion, Suite 8-503G, 201 E. Huron Street Chicago, IL 60611
| | - Charles J Davidson
- Bluhm Cardiovascular Institute, Northwestern University, Feinberg Pavilion, Suite 8-503G, 201 E. Huron Street Chicago, IL 60611
| | - Akhil Narang
- Bluhm Cardiovascular Institute, Northwestern University, Feinberg Pavilion, Suite 8-503G, 201 E. Huron Street Chicago, IL 60611.
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Gerçek M, Körber I, Narang A, Friedrichs K, Puthumana J, Thomas J, Pfister R, Davidson C, Rudolph V. TCT-532 Systolic Pulmonary Artery Derived From Echocardiography Is Not a Reliable Parameter in the Right Ventricular–Pulmonary Arterial Coupling in Patients Undergoing Transcatheter Tricuspid Valve Annuloplasty. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.627] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Ayuba G, Safder T, Goyal A, Meng Z, Baldridge A, Puthumana J, Malaisrie S, Thomas J, Flaherty J, Davidson C, Narang A. TCT-525 Cardiac Remodeling After Transcatheter Mitral Valve in Valve Implantation (MViV): Early Changes and Its Prognostic Significance. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.618] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Puthumana J, Vassallo P, Hoel A, Malaisrie SC, Mehta C. Surveillance Following Acute Type A Aortic Dissection: The Need for Long-Term Clinical Oversight. J Am Coll Cardiol 2022; 79:e205. [PMID: 35272806 DOI: 10.1016/j.jacc.2021.11.063] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 11/24/2021] [Indexed: 10/18/2022]
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Davidson CJ, Lim DS, Smith RL, Kodali SK, Kipperman RM, Eleid MF, Reisman M, Whisenant B, Puthumana J, Abramson S, Fowler D, Grayburn P, Hahn RT, Koulogiannis K, Pislaru SV, Zwink T, Minder M, Dahou A, Deo SH, Vandrangi P, Deuschl F, Feldman TE, Gray WA. Early Feasibility Study of Cardioband Tricuspid System for Functional Tricuspid Regurgitation: 30-Day Outcomes. JACC Cardiovasc Interv 2021; 14:41-50. [PMID: 33413863 DOI: 10.1016/j.jcin.2020.10.017] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/07/2020] [Accepted: 10/13/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The study reports for the first time the 30-day outcomes of the first U.S. study with the Cardioband tricuspid valve reconstruction system for the treatment of functional tricuspid regurgitation (TR). BACKGROUND Increasing severity of TR is associated with progressively higher morbidity and mortality; however, treatment options for isolated significant disease are limited. METHODS In this single-arm, multicenter, prospective Food and Drug Administration-approved early feasibility study (EFS), 30 patients with severe or greater symptomatic functional TR were enrolled who were deemed candidates for transcatheter tricuspid repair with the Cardioband tricuspid system by the local heart team and multidisciplinary screening committee. RESULTS The mean patient age was 77 years, 80% were women, 97% had atrial fibrillation, 70% were in New York Heart Association functional class III to IV with mean left ventricular ejection fraction of 58%, and 27% had severe, 20% massive, and 53% torrential TR. Device success was 93% and all patients were alive at 30 days. Between baseline and 30 days, septolateral tricuspid annular diameter was reduced by 13% (p < 0.001), 85% of patients had ≥1 grade TR reduction and 44% had ≤moderate TR, 75% were in New York Heart Association functional class I to II (p < 0.001), and overall Kansas City Cardiomyopathy Questionnaire score improved by 16 points (p < 0.001). CONCLUSIONS In patients with severe symptomatic functional TR, this is the first study in the United States with the Cardioband tricuspid system for direct transcatheter annular reduction. This early feasibility study demonstrates high procedural feasibility with no 30-day mortality. There is significant reduction of functional TR with clinically significant improvements in functional status and quality of life. (Edwards Cardioband Tricuspid Valve Reconstruction System Early Feasibility Study; NCT03382457).
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Affiliation(s)
- Charles J Davidson
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
| | - D Scott Lim
- Department of Medicine, University of Virginia Health System Hospital, Charlottesville, Virginia, USA
| | - Robert L Smith
- Department of Cardiothoracic Surgery, The Heart Hospital Baylor, Texas, USA
| | - Susheel K Kodali
- Department of Medicine, Columbia University Medical Center, New York, New York, USA
| | - Robert M Kipperman
- Department of Cardiovascular Surgery, Morristown Medical Center, Morristown, New Jersey, USA
| | - Mackram F Eleid
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Mark Reisman
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Brian Whisenant
- Division of Cardiovascular Diseases, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - Jyothy Puthumana
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sandra Abramson
- Division of Cardiology, Main Line Health, Lankenau Medical Center, Wynnewood, Pennsylvania, USA
| | - Dale Fowler
- Department of Medicine, University of Virginia Health System Hospital, Charlottesville, Virginia, USA
| | - Paul Grayburn
- Department of Cardiothoracic Surgery, The Heart Hospital Baylor, Texas, USA
| | - Rebecca T Hahn
- Department of Medicine, Columbia University Medical Center, New York, New York, USA
| | | | - Sorin V Pislaru
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Todd Zwink
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Michael Minder
- Division of Cardiovascular Diseases, Intermountain Healthcare, Salt Lake City, Utah, USA
| | | | | | | | | | | | - William A Gray
- Division of Cardiology, Main Line Health, Lankenau Medical Center, Wynnewood, Pennsylvania, USA
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Davidson CJ, Abramson S, Smith RL, Kodali SK, Kipperman RM, Eleid MF, Reisman M, Whisenant BK, Puthumana J, Fowler D, Grayburn PA, Hahn RT, Koulogiannis K, Pislaru SV, Zwink T, Minder M, Deuschl F, Feldman T, Gray WA, Lim DS. Transcatheter Tricuspid Repair With the Use of 4-Dimensional Intracardiac Echocardiography. JACC Cardiovasc Imaging 2021; 15:533-538. [PMID: 33744150 DOI: 10.1016/j.jcmg.2021.01.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Charles J Davidson
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
| | | | - Robert L Smith
- The Heart Hospital Baylor Scott & White, Plano, Texas, USA
| | | | | | | | - Mark Reisman
- University of Washington, Seattle, Washington, USA
| | | | - Jyothy Puthumana
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Dale Fowler
- University of Virginia Health System Hospital, Charlottesville, Virginia, USA
| | | | - Rebecca T Hahn
- Columbia University Medical Center, New York, New York, USA
| | | | | | - Todd Zwink
- University of Washington, Seattle, Washington, USA
| | | | | | - Ted Feldman
- Edwards Lifesciences, Irvine, California, USA
| | | | - D Scott Lim
- University of Virginia Health System Hospital, Charlottesville, Virginia, USA
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Ward A, Malaisrie SC, Andrei AC, Bonow RO, Thomas JD, Puthumana J, Pham DT, Churyla A, Kruse J, McCarthy PM. Fate of moderate aortic regurgitation after cardiac surgery. J Thorac Cardiovasc Surg 2021; 164:1784-1792.e1. [PMID: 33610367 DOI: 10.1016/j.jtcvs.2020.12.114] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 11/18/2020] [Accepted: 12/07/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To determine the prevalence of concomitant aortic regurgitation (AR) in cardiac surgery and the outcomes of treatment options. METHODS Between April 2004 and June 2018, 3289 patients underwent coronary artery bypass, mitral valve, or aortic aneurysm surgery without aortic stenosis. AR was graded none/trivial (score = 0), mild (score = 1+), or moderate (score = 2+). Patients with untreated 2+ AR were compared with those with 0 or 1+ AR, and to those with 2+ AR who had aortic valve surgery. Thirty-day and late survival, echocardiography, and clinical outcomes were compared using propensity score matching. RESULTS One hundred thirty-eight patients (4.2%) had 2+ AR; and 45 (33%) received aortic valve repair (n = 9) or replacement (n = 36) in the treated group and were compared with 2765 untreated patients with 0 AR and 386 patients with 1+ AR. Valve surgery was more common with anatomic leaflet abnormalities: bicuspid aortic valve (9% vs 0%; P < .01), rheumatic valve disease (16% vs 3%; P < .01), and calcification (47% vs 27%; P = .021). In unadjusted analysis, lower preoperative AR grade was associated with increased 10-year survival (P < .001). At year 10, progression to more-than-moderate AR among moderate AR patients was 2.6% and late intervention rate was 3.1%. In the untreated 2+ AR group, on last follow-up echocardiogram, 58% had improvement in AR, 41% remained 2+, and only 1% progressed to severe AR. CONCLUSIONS Aortic valve surgery in select patients with concomitant moderate AR can be added with minimal added risk, but untreated AR does not influence long-term survival after cardiac surgery and rarely required late intervention.
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Affiliation(s)
- Austin Ward
- Division of Cardiac Surgery, Department of Surgery, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine and Northwestern Medicine, Chicago, Ill
| | - S Chris Malaisrie
- Division of Cardiac Surgery, Department of Surgery, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine and Northwestern Medicine, Chicago, Ill.
| | - Adin-Cristian Andrei
- Division of Biostatistics, Department of Preventive Medicine, Northwestern University, Chicago, Ill
| | - Robert O Bonow
- Division of Cardiology, Department of Medicine, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine and Northwestern Medicine, Chicago, Ill
| | - James D Thomas
- Division of Cardiology, Department of Medicine, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine and Northwestern Medicine, Chicago, Ill
| | - Jyothy Puthumana
- Division of Cardiology, Department of Medicine, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine and Northwestern Medicine, Chicago, Ill
| | - Duc Thinh Pham
- Division of Cardiac Surgery, Department of Surgery, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine and Northwestern Medicine, Chicago, Ill
| | - Andrei Churyla
- Division of Cardiac Surgery, Department of Surgery, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine and Northwestern Medicine, Chicago, Ill
| | - Jane Kruse
- Division of Cardiac Surgery, Department of Surgery, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine and Northwestern Medicine, Chicago, Ill
| | - Patrick M McCarthy
- Division of Cardiac Surgery, Department of Surgery, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine and Northwestern Medicine, Chicago, Ill
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Gray W, Lim S, Smith R, Kodali S, Kipperman R, Eleid M, Reisman M, Whisenant B, Puthumana J, Abramson S, Fowler D, Grayburn P, Hahn R, Koulogiannis K, Pislaru S, Zwink T, Minder M, Dahou A, Davidson C. TCT CONNECT-1 Early Feasibility Study of the Cardioband Tricuspid System for Functional Tricuspid Regurgitation: 30-Day Outcomes. J Am Coll Cardiol 2020. [DOI: 10.1016/j.jacc.2020.09.016] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Cheema B, Kinno M, Gu D, Ryan J, Mitter S, Rigolin V, Thomas J, Puthumana J. Left atrial size and strain in elite athletes: A cross‐sectional study at the NBA Draft Combine. Echocardiography 2020; 37:1030-1036. [DOI: 10.1111/echo.14680] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/07/2020] [Accepted: 04/20/2020] [Indexed: 12/18/2022] Open
Affiliation(s)
- Baljash Cheema
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of Medicine Chicago IL USA
| | - Menhel Kinno
- Division of CardiologyLoyola University Chicago Stritch School of Medicine Maywood IL USA
| | - David Gu
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of Medicine Chicago IL USA
| | - Juliet Ryan
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of Medicine Chicago IL USA
| | - Sumeet Mitter
- Zena and Michael A. Weiner Cardiovascular InstituteIcahn School of Medicine at Mount Sinai New York NY USA
| | - Vera Rigolin
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of Medicine Chicago IL USA
| | - James Thomas
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of Medicine Chicago IL USA
| | - Jyothy Puthumana
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of Medicine Chicago IL USA
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Davidson C, Lim S, Smith R, Kodali S, Kipperman R, Eleid M, Reisman M, Puthumana J, Fowler D, Grayburn P, Hahn R, Koulogiannis KP, Abramson S, Pislaru S, Zwink T, Dahou A, Gray WA. EARLY FEASIBILITY STUDY OF CARDIOBAND TRICUSPID SYSTEM FOR FUNCTIONAL TRICUSPID REGURGITATION: 30 DAY OUTCOMES. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31759-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gray W, Lim S, Kodali S, Hahn R, Smith R, Grayburn P, Eleid M, Kipperman R, Abramson S, Fowler D, Pislaru S, Koulogiannis K, Puthumana J, Davidson C. TCT-93 Results From the Early Feasibility Study of Cardioband Tricuspid System for Functional Tricuspid Regurgitation. J Am Coll Cardiol 2019. [DOI: 10.1016/j.jacc.2019.08.136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kislitsina ON, Zareba KM, Bonow RO, Andrei AC, Kruse J, Puthumana J, Akhter N, Chris Malaisrie S, McCarthy PM, Rigolin VH. Is mitral valve disease treated differently in men and women? Eur J Prev Cardiol 2019; 26:1433-1443. [PMID: 30832507 DOI: 10.1177/2047487319833307] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study was performed to determine if there is a sex-based bias in referral practices, complexity of disease, surgical treatment, or outcomes in patients undergoing mitral valve surgery at our institution. METHODS Data were collected from the Cardiovascular Research Database of the Clinical Trial Unit of the Bluhm Cardiovascular Institute at Northwestern Memorial Hospital and they were defined according to the Society of Thoracic Surgeons National Database ( www.sts.org ). All patients who had mitral valve replacement, mitral valve repair with annuloplasty ring placement, and mitral valve annuloplasty alone were evaluated, including patients who underwent concomitant tricuspid valve surgery, atrial fibrillation ablation, patent foramen ovale closure, and coronary artery bypass grafting. An unmatched comparison was made between the 836 men and 600 women in the entire cohort (N = 1436) and propensity score-matching was performed in 423 pairs of men and women. Additional propensity score-matching for 219 pairs of men and women with Type II mitral valve functional class and no coronary artery disease and for 68 pairs of men and women with Type 1 or Type IIIb mitral valve functional class. Propensity score matching was used to compare sex differences involving a greedy algorithm with a caliper of size 0.1 logit propensity score standard deviation units. RESULTS Between 1 April 2004 and 30 June 2017, 1436 patients (41.8% women, mean age 61.1 ± 12.6 years (men), 62.9 ± 13.3 years (women)) underwent mitral valve surgery. The unmatched comparison for the entire cohort showed that, on average, at the time of surgery, women had higher Society of Thoracic Surgery risk scores, were older and had more heart failure, coronary artery disease, and mitral stenosis than men. Women received proportionately fewer mitral repairs and more atrial fibrillation ablation, and tricuspid valve surgery. Women had longer intensive care unit and hospital stays, required more dialysis, and suffered more transient ischemic attacks and cardiac arrests postoperatively, and 30-day mortality rate was higher for women. However, propensity score-matching of 846 of the patients (423 men; 423 women) indicated that both the surgical approaches and surgical outcomes were comparable for men and women who had similar levels of disease and co-morbidities. Additional propensity score-matching of only those patients with degenerative mitral regurgitation (DMR) (219 men; 219 women) and those with Type 1 or Type III mitral valve disease showed no differences in the surgical procedures performed or in 30-day mortality rates. CONCLUSIONS Women appear to be referred for mitral valve surgery later in the course of their disease, which could possibly be on the basis of sex bias, but they may also have a more aggressive form of mitral valve disease than men. Regardless of the reasons for the later referral of women for mitral valve surgery, the clinical outcomes are dependent upon the severity of the mitral disease and associated co-morbidities at the time of surgery, not on the basis of sex bias.
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Affiliation(s)
- Olga N Kislitsina
- Northwestern University Feinberg School of Medicine, Bluhm Cardiovascular Institute, Chicago, IL, USA
| | - Karolina M Zareba
- Northwestern University Feinberg School of Medicine, Bluhm Cardiovascular Institute, Chicago, IL, USA
| | - Robert O Bonow
- Northwestern University Feinberg School of Medicine, Bluhm Cardiovascular Institute, Chicago, IL, USA
| | - Adin-Cristian Andrei
- Northwestern University Feinberg School of Medicine, Bluhm Cardiovascular Institute, Chicago, IL, USA
| | - Jane Kruse
- Northwestern University Feinberg School of Medicine, Bluhm Cardiovascular Institute, Chicago, IL, USA
| | - Jyothy Puthumana
- Northwestern University Feinberg School of Medicine, Bluhm Cardiovascular Institute, Chicago, IL, USA
| | - Nausheen Akhter
- Northwestern University Feinberg School of Medicine, Bluhm Cardiovascular Institute, Chicago, IL, USA
| | - S Chris Malaisrie
- Northwestern University Feinberg School of Medicine, Bluhm Cardiovascular Institute, Chicago, IL, USA
| | - Patrick M McCarthy
- Northwestern University Feinberg School of Medicine, Bluhm Cardiovascular Institute, Chicago, IL, USA
| | - Vera H Rigolin
- Northwestern University Feinberg School of Medicine, Bluhm Cardiovascular Institute, Chicago, IL, USA
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Van Assche L, Vemulapalli S, Thomas J, Davidson C, Puthumana J, Malaisrie S, Stebbins A, Kosinski A, Rymer J, Kirtane AJ, Thourani V, Ricciardi M. TCT-46 Mitral Valve Gradient, Heart Failure Admissions and One Year Mortality Following MitraClip Repair in 5,378 Patients: Results from the ACC/STS TVT Registry. J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.1131] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Schafer D, Bavishi A, Andrei AC, Shi H, Kruse J, Crawford E, McCarthy P, Malaisrie SC, Thomas J, Puthumana J. PROGRESSION OF AORTIC STENOSIS BY SERIAL ECHOCARDIOGRAPHY AMONG SURGICAL BICUSPID AORTIC VALVE PATIENTS. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31107-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Sruthy KS, Nair A, Puthumana J, Antony SP, Singh ISB, Philip R. Molecular cloning, recombinant expression and functional characterization of an antimicrobial peptide, Crustin from the Indian white shrimp, Fenneropenaeus indicus. Fish Shellfish Immunol 2017; 71:83-94. [PMID: 28964865 DOI: 10.1016/j.fsi.2017.09.071] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 09/19/2017] [Accepted: 09/26/2017] [Indexed: 06/07/2023]
Abstract
Antimicrobial peptides (AMPs) comprise molecules that involve in the defense mechanism of various organisms towards pathogens such as bacteria, fungi, parasites and viruses. Crustins are generally defined as multi-domain cationic antimicrobial peptides containing one whey acidic protein (WAP) domain at the C-terminus as the functional unit. In this study, we identified and characterized a novel crustin homolog (Fi-Crustin2) with 354 bp fragment cDNA encoding 117 amino acids and an ORF of 100 amino acids with a net charge of +1 from the mRNA of F. indicus haemocytes. This study forms the second report of a crustin isoform from F. indicus. Blast analysis revealed that Fi-crustin2 exhibits similarity to shrimp crustins already reported. The active mature peptide has a molecular weight of 10.61 kDa and pI of 7.59 with a beta sheeted structure. The mature peptide was cloned into pET-32a(+) with a N-terminal hexa-histidine tag fused in-frame, and expressed in Escherichia coli, and the recombinant crustin, Fi-crustin2 inhibited the growth of Gram-negative bacteria with low MIC. All these features suggest that Fi-crustin2 is a potent antibacterial protein against Gram-negative bacteria and could play an important role in the innate immune mechanism of F. indicus.
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Affiliation(s)
- K S Sruthy
- Department of Marine Biology, Microbiology and Biochemistry, School of Marine Sciences, Cochin University of Science and Technology, Fine Arts Avenue, Kochi 682016, Kerala, India
| | - Aishwarya Nair
- Department of Marine Biology, Microbiology and Biochemistry, School of Marine Sciences, Cochin University of Science and Technology, Fine Arts Avenue, Kochi 682016, Kerala, India
| | - J Puthumana
- National Centre for Aquatic Animal Health, Cochin University of Science and Technology, Kochi 16, Kerala, India
| | - Swapna P Antony
- Department of Marine Biology, Microbiology and Biochemistry, School of Marine Sciences, Cochin University of Science and Technology, Fine Arts Avenue, Kochi 682016, Kerala, India
| | - I S Bright Singh
- National Centre for Aquatic Animal Health, Cochin University of Science and Technology, Kochi 16, Kerala, India
| | - Rosamma Philip
- Department of Marine Biology, Microbiology and Biochemistry, School of Marine Sciences, Cochin University of Science and Technology, Fine Arts Avenue, Kochi 682016, Kerala, India.
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Gajjar M, Yadlapati A, Van Assche LM, Puthumana J, Malaisrie SC, Davidson CJ, Thomas J, Ricciardi MJ. Real-Time Continuous Left Atrial Pressure Monitoring During Mitral Valve Repair Using the MitraClip NT System. JACC Cardiovasc Interv 2017; 10:1466-1467. [DOI: 10.1016/j.jcin.2017.05.053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 05/10/2017] [Accepted: 05/22/2017] [Indexed: 12/01/2022]
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Mansour SG, Puthumana J, Reese PP, Hall IE, Doshi MD, Weng FL, Schröppel B, Thiessen-Philbrook H, Bimali M, Parikh CR. Associations between Deceased-Donor Urine MCP-1 and Kidney Transplant Outcomes. Kidney Int Rep 2017; 2:749-758. [PMID: 28730184 PMCID: PMC5512592 DOI: 10.1016/j.ekir.2017.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Introduction Existing methods to predict recipient allograft function during deceased-donor kidney procurement are imprecise. Understanding the potential renal reparative role for monocyte chemoattractant protein-1 (MCP-1), a cytokine involved in macrophage recruitment after injury, might help to predict allograft outcomes. Methods We conducted a substudy of the multicenter prospective Deceased Donor Study cohort that evaluated deceased kidney donors from 5 organ procurement organizations from May 2010 to December 2013. We measured urine MCP-1 (uMCP-1) concentrations from donor samples collected at nephrectomy to determine associations with donor acute kidney injury (AKI), recipient delayed graft function (DGF), 6-month estimated glomerular filtration rate (eGFR), and graft failure. We also assessed perfusate MCP-1 concentrations from pumped kidneys for associations with DGF and 6-month eGFR. Results AKI occurred in 111 donors (9%). The median (interquartile range) uMCP-1 concentration was higher in donors with AKI compared with donors without AKI (1.35 [0.41–3.93] ng/ml vs. 0.32 [0.11–0.80] ng/ml, P < 0.001). DGF occurred in 756 recipients (31%), but uMCP-1 was not independently associated with DGF. Higher donor uMCP-1 concentrations were independently associated with a higher 6-month eGFR in those without DGF (0.77 [0.10–1.45] ml/min per 1.73 m2 per doubling of uMCP1). However, there were no independent associations between uMCP-1 and graft failure over a median follow-up of ∼2 years. Lastly, perfusate MCP-1 concentrations significantly increased during pump perfusion but were not associated with DGF or 6-month eGFR. Discussion Donor uMCP-1 concentrations were modestly associated with higher recipient 6-month eGFR in those without DGF. However, the results suggest that donor uMCP-1 has minimal clinical utility given no associations with graft failure.
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Affiliation(s)
- S G Mansour
- Program of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, CT.,Section of Nephrology, Yale University School of Medicine, New Haven, CT
| | - J Puthumana
- Program of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, CT
| | - P P Reese
- Renal-Electrolyte and Hypertension Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - I E Hall
- Division of Nephrology, Hypertension and Renal Transplantation, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT
| | | | - F L Weng
- Saint Barnabas Medical Center, Livingston, NJ
| | - B Schröppel
- Section of Nephrology, University Hospital, Ulm, Germany
| | - H Thiessen-Philbrook
- Program of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, CT
| | - M Bimali
- Program of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, CT
| | - C R Parikh
- Program of Applied Translational Research, Department of Medicine, Yale University School of Medicine, New Haven, CT.,Section of Nephrology, Yale University School of Medicine, New Haven, CT.,Veterans Affairs Connecticut Healthcare System, New Haven, CT
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Cheema B, Mitter S, Ryan J, Rigolin V, Puthumana J, Thomas J. DEFORMATION ANALYSIS CAN BE PERFORMED ON POST-EXERCISE IMAGES IN NATIONAL BASKETBALL ASSOCIATION DRAFT ELIGIBLE PLAYERS WITH GOOD REPRODUCIBILITY. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)34845-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Suma V, Seetharam K, Halazun H, Ziad S, Silbiger JJ, Bewley B, Bajwa F, Sookhu S, Puthumana J, Jivan A, Yadlapati A, Mikati IA, Argulian E, Bhinder J, Muthukumar L, Toole R, Gopal A, Chaudhry FA. SAFETY OF PERFLUTREN-BASED ECHOCARDIOGRAPHIC CONTRAST AGENT ADMINISTRATION IN THE SETTING OF A PATENT FORAMEN OVALE (PFO): A MULTICENTER STUDY CONDUCTED IN TERTIARY CARE CENTERS BASED IN THE NEW YORK/CHICAGO METROPOLITAN AREAS. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)34807-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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20
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Benck L, Schimmel D, Puthumana J, Freed B, Furiasse N. Right Ventricular Strain in Intermediate to High-Risk Pulmonary Embolism. Chest 2016. [DOI: 10.1016/j.chest.2016.08.1301] [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: 10/20/2022] Open
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21
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Garcia J, Barker AJ, van Ooij P, Schnell S, Puthumana J, Bonow RO, Collins JD, Carr JC, Markl M. Assessment of altered three-dimensional blood characteristics in aortic disease by velocity distribution analysis. Magn Reson Med 2014; 74:817-25. [PMID: 25252029 DOI: 10.1002/mrm.25466] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 08/27/2014] [Accepted: 08/28/2014] [Indexed: 01/15/2023]
Abstract
PURPOSE To test the feasibility of velocity distribution analysis for identifying altered three-dimensional (3D) flow characteristics in patients with aortic disease based on 4D flow MRI volumetric analysis. METHODS Forty patients with aortic (Ao) dilation (mid ascending aortic diameter MAA = 40 ± 7 mm, age = 56 ± 17 years, 11 females) underwent cardiovascular MRI. Four groups were retrospectively defined: mild Ao dilation (n = 10; MAA < 35 mm); moderate Ao dilation (n = 10; 35 < MAA < 45 mm); severe Ao dilation (n = 10; MAA > 45 mm); Ao dilation+aortic stenosis AS (n = 10; MAA > 35 mm and peak velocity > 2.5 m/s). The 3D PC-MR angiograms were computed and used to obtain a 3D segmentation of the aorta which was divided into four segments: root, ascending aorta, arch, descending aorta. Radial chart displays were used to visualize multiple parameters representing segmental changes in the 3D velocity distribution associated with aortic disease. RESULTS Changes in the velocity field and geometry between cohorts resulted in distinct hemodynamic patterns for each aortic segment. Disease progression from mild to Ao dilation + AS resulted in significant differences (P < 0.05) in flow parameters across cohorts and increased radial chart size for root and ascending aorta segments by 146% and 99%, respectively. CONCLUSION Volumetric 4D velocity distribution analysis has the potential to identify characteristic changes in regional blood flow patterns in patients with aortic disease.
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Affiliation(s)
- Julio Garcia
- Department of Radiology, Northwestern University, Chicago, USA
| | - Alex J Barker
- Department of Radiology, Northwestern University, Chicago, USA
| | - Pim van Ooij
- Department of Radiology, Northwestern University, Chicago, USA
| | - Susanne Schnell
- Department of Radiology, Northwestern University, Chicago, USA
| | - Jyothy Puthumana
- Department of Medicine - Cardiology, Northwestern University, Chicago, Illinois, USA
| | - Robert O Bonow
- Division of Cardiac Surgery, Northwestern University, Chicago, Illinois, USA
| | | | - James C Carr
- Department of Radiology, Northwestern University, Chicago, USA
| | - Michael Markl
- Department of Radiology, Northwestern University, Chicago, USA.,Biomedical Engineering, Northwestern University, Evanston, Illinois, USA
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Naro N, Taylor AP, Puthumana J, Carr JC, McCarthy PM, Markl M, Collins JD, Barker AJ. Baseline 2D PC-MRI hemodynamic markers correlate to aorta growth in serially monitored bicuspid aortic valve patients. J Cardiovasc Magn Reson 2014. [PMCID: PMC4044452 DOI: 10.1186/1532-429x-16-s1-p90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Kohli P, Rigolin V, Kott A, Bonow R, Lapin B, Akhter N, Puthumana J. EXERCISE TESTING ADDS PROGNOSTIC VALUE TO DOPPLER ECHOCARDIOGRAPHY IN ASYMPTOMATIC PATIENTS WITH SIGNIFICANT TYPE II MITRAL REGURGITATION. J Am Coll Cardiol 2012. [DOI: 10.1016/s0735-1097(12)61980-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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24
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Matkowskyj KA, Wiseman WR, Robin JC, Norvell JP, Puthumana J, Nelson B, Peterson L, McGarry TJ, Tourtellotte WG. Therapy-related myelodysplastic syndrome presenting as fulminant heart failure secondary to myeloid sarcoma. J Hematop 2010; 3:41-6. [PMID: 21544187 DOI: 10.1007/s12308-010-0058-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Accepted: 04/13/2010] [Indexed: 10/19/2022] Open
Abstract
Rapidly progressive heart failure is commonly caused by an extensive myocardial infarction, a mechanical complication of infarction, myocarditis, or acute valvular insufficiency. We present an unusual case that was caused by a diffuse infiltration of the myocardium with leukemic cells (myeloid sarcoma). The patient presented with episodic shortness of breath, he was anemic and thrombocytopenic, and his bone marrow biopsy revealed myelodysplastic syndrome from treatment for oligodendroglioma. His clinical course was characterized by a chronic leak of cardiac enzymes, a new right bundle branch block, and a large pericardial effusion causing tamponade and death from fulminant heart failure and ventricular arrhythmias within 2 weeks. At autopsy, the heart was massively infiltrated with myeloblasts and other immature myeloid cells. There was no evidence of acute leukemia in the bone marrow or peripheral blood. Cardiac infiltration in a patient with myelodysplastic syndrome is extremely rare, especially in the absence of bone marrow involvement by blasts. The recognition of this entity is becoming increasingly important as the incidence of cardiac myeloid sarcoma may be on the rise as the number of patients receiving chemotherapy increases.
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Zareba KM, Bonow RO, Ansari A, Puthumana J, Anjan VY, Lapin BR, Akhter N, McCarthy PM, Rigolin VH. GENDER BASED DIFFERENCES IN LEFT AND RIGHT VENTRICULAR SIZE AND FUNCTION IN PATIENTS UNDERGOING MITRAL VALVE SURGERY. J Am Coll Cardiol 2010. [DOI: 10.1016/s0735-1097(10)61392-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Palomares JFR, Wu E, Puthumana J. 2072 Rapid evaluation of left atrial volumes using CMR and its relation with left ventricular diastolic dysfunction. J Cardiovasc Magn Reson 2008. [DOI: 10.1186/1532-429x-10-s1-a341] [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: 11/10/2022] Open
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27
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Robin J, Meyers S, Nahlawi M, Puthumana J, Lomasney J, Mehlman D, Rigolin V, Davidson C. Accelerating restrictive cardiomyopathy after liver transplantation in a patient with familial amyloidotic polyneuropathy: a case report. J Med Case Rep 2008; 2:35. [PMID: 18241340 PMCID: PMC2248590 DOI: 10.1186/1752-1947-2-35] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2007] [Accepted: 02/01/2008] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Hereditary amyloidodis is a rare disease process with a propensity to cause polyneuropathies, autonomic dysfunction, and restrictive cardiomyopathy. It is transmitted in an autosomal dominant manner, with disease onset usually in the 20s-40s. The most common hereditary amyloidogenic protein, transthyretin, is synthesized in the liver and lies on Chromosome 18. Over 80 amyloidogenic transthyretin mutations have been described, the majority of which are neuropathic and hence the common name, Familial Amyloidotic Polyneuropathy. Until 1990, the disease was intractable with a 5-15 year survival after diagnosis. The prognosis changed after the implementation of orthotropic liver transplantation as a treatment strategy which halts the synthesis of amyloidogenic transthyretin. This has now has been performed over 1300 times in 67 centers. CASE PRESENTATION We describe the case of a man of Irish ancestry with Familial Amyloidotic Polyneuropathy and no clinical history of cardiac involvement. Shortly after orthotropic liver transplantation, he developed congestive heart failure. He was subsequently diagnosed with an accelerating post-transplant restrictive cardiomyopathy due to amyloid infiltration. CONCLUSION A liver transplant induced cardiomyopathy in Familial Amyloidotic Polyneuropathy can be observed in patients without any history of cardiac symptoms. All patients with Familial Amyloidotic Polyneuropathy should be followed after transplantation to assess for a deterioration in cardiac function.
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Affiliation(s)
- Jason Robin
- Department of Medicine, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sheridan Meyers
- Department of Medicine, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Maher Nahlawi
- Department of Medicine, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jyothy Puthumana
- Department of Medicine, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jon Lomasney
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - David Mehlman
- Department of Medicine, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Vera Rigolin
- Department of Medicine, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Charles Davidson
- Department of Medicine, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Reeves RR, Manuchehry A, Goonewardena SN, Blair JE, Price A, Rizvi K, Levy A, Gheorghiade M, Spencer KT, Puthumana J, Woodruff J. Non-Invasive Estimation of Cardiac Filling Pressures by Residents Using Tissue Doppler Imaging and Handcarried Ultrasound. J Card Fail 2007. [DOI: 10.1016/j.cardfail.2007.06.708] [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: 12/01/2022]
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Bangalore S, Yao SS, Puthumana J, Chaudhry FA. Incremental Prognostic Value of Stress Echocardiography Over Clinical and Stress Electrocardiographic Variables in Patients With Prior Myocardial Infarction: "Warranty Time" of a Normal Stress Echocardiogram. Echocardiography 2006; 23:455-64. [PMID: 16839382 DOI: 10.1111/j.1540-8175.2006.00261.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Patients with prior myocardial infarction (MI) are at increased risk of subsequent cardiac events (MI or cardiac death). The incremental prognostic value and warranty time of a normal stress echocardiogram in this high-risk population is not well defined. METHODS We evaluated 251 consecutive patients (62 +/- 11 years; 64% males) with remote history of MI (>6 weeks) undergoing stress echocardiography (83% dobutamine). Ischemia was defined as a new reversible wall motion abnormality and/or biphasic response. Follow-up for up to 4 years (mean 2.9 +/- 1.0 years) for confirmed MI (n = 7) and cardiac death (n = 15) were obtained. RESULTS Stress echocardiography effectively risk stratified patients into normal versus abnormal subgroups (Event rate 0.8% per year vs 4.2% per year; P = 0.01; RR = 5.6, 95% CI = 1.3-24.7). In patients with a normal stress echocardiogram, the event rate at the end of 6, 12, and 18 months were <1% per year. After 18 months the event rate in patients with a normal stress echocardiogram increased greatly (>1% per year). Stress echocardiography yields incremental prognostic value over clinical and stress electrocardiographic variables (Global chi-square increased from 12.4 to 25 to 31.1, P < 0.0001 both groups). CONCLUSIONS Stress echocardiography yields appropriate risk stratification and prognosis and provides incremental prognostic value over clinical and stress electrocardiographic variables even in patients with prior MI. A normal stress echocardiogram portends a benign prognosis (<1% event rate/year) for up to 18 months.
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Affiliation(s)
- Sripal Bangalore
- Department of Medicine, Division of Cardiology, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York 10025, USA
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Ferguson RP, Kohler FR, Chavez J, Puthumana J, Zaidi S, Shakil H. Discovering asymptomatic biochemical abnormalities on a Baltimore internal medicine service. Md Med J 1996; 45:543-546. [PMID: 8709833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
To assess the frequency of abnormalities that could be discovered through biochemical profile screening on patients admitted to a city hospital internal medicine ward service, we conducted a prospective cross-sectional chart and laboratory review. All unassigned patients admitted to the general medicine service during 1- to 2-month period in late 1993 and the spring of 1994 were eligible. The main outcome measures were frequency of abnormal test results and identification of significance. Admitted patients (N = 222) were evaluated with a 24-panel biochemical profile. Of 5,328 tests, 29% were outside the standard reference range. Of 3,851 tests classified as screening, 1,049 (27%) were outside the reference range. Of overall screening tests, 741 (19%) were judged potentially important by the predetermined criteria. The prevalence did not differ significantly when analyzed by age, race, gender, or history of substance abuse. Our experience indicates that asymptomatic biochemical abnormalities are common in patients admitted to a city hospital medical service and that admission biochemical screening is an effective method of identifying potential comorbidity. Further studies are needed to assess the impact of this approach.
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Affiliation(s)
- R P Ferguson
- Union Memorial Hospital, Baltimore, Maryland, USA
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