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Kassi M, Agrawal T, Xu J, Marcos-Abdala HG, Araujo-Gutierrez R, Macgillivray T, Suarez EE, Yousefzai R, Fida N, Kim JH, Hussain I, Guha A, Trachtenberg B, Bhimaraj A, Chang SM, Estep J. Outflow cannula alignment in continuous flow left ventricular devices is associated with stroke. Int J Artif Organs 2023; 46:226-234. [PMID: 36895175 DOI: 10.1177/03913988231154284] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
We sought to evaluate whether differences in left ventricular assist device (LVAD) canula alignment are associated with stroke. There is a paucity of clinical data on contribution of LVAD canulae alignment to strokes. We conducted a retrospective analysis of patients who underwent LVAD implantation at Houston Methodist hospital from 2011 to 2016 and included those who had undergone cardiac computed tomography (CT) with contrast. LVAD graft alignment using X-ray, echocardiography, and cardiac CT was evaluated. The primary outcome was stroke within 1 year of LVAD implantation. Of the 101 patients that underwent LVAD Implantation and cardiac CT scan during the study period, 78 met inclusion criteria. The primary outcome occurred in 12 (15.4%) patients with a median time to stroke of 77 days (interquartile range: 42-132 days). Of these, 10 patients had an ischemic and two had hemorrhagic strokes. The predominant device type was Heart Mate II (94.8%). Patients with LVAD outflow cannula to aortic angle lesser than 37.5° and those with outflow graft diameter of anastomosis less than 1.5 cm (assessed by cardiac CT) had significantly higher stroke risk (p < 0.001 and p = 0.01 respectively). In HMII patients, a lower LVAD speed at the time of CT scan was associated with stroke. Further studies are needed to identify optimal outflow graft configuration to mitigate stroke risk.
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Affiliation(s)
| | - Tanushree Agrawal
- Houston Methodist Hospital DeBakey Cardiology Associates, Houston, TX, USA
| | - Jiaqiong Xu
- Houston Methodist Research Institute, Houston, TX, USA
| | | | | | | | - Erik E Suarez
- Houston Methodist Research Institute, Houston, TX, USA
| | | | - Nadia Fida
- Houston Methodist Hospital, Houston, TX, USA
| | - Ju H Kim
- Houston Methodist Hospital, Houston, TX, USA
| | - Imad Hussain
- Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
| | - Ashrith Guha
- Houston Methodist Hospital DeBakey Cardiology Associates, Houston, TX, USA
| | - Barry Trachtenberg
- Houston Methodist Hospital DeBakey Cardiology Associates, Houston, TX, USA
| | - Arvind Bhimaraj
- Houston Methodist Hospital DeBakey Cardiology Associates, Houston, TX, USA
| | - Su Min Chang
- Houston Methodist Hospital DeBakey Cardiology Associates, Houston, TX, USA
| | - Jerry Estep
- Cleveland Clinic Foundation, Cleveland, OH, USA
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2
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Liu J, Lane S, Lall R, Russo M, Farrell L, Debreli Coskun M, Curtin C, Araujo-Gutierrez R, Scherrer-Crosbie M, Trachtenberg BH, Kim J, Tolosano E, Ghigo A, Gerszten RE, Asnani A. Circulating hemopexin modulates anthracycline cardiac toxicity in patients and in mice. Sci Adv 2022; 8:eadc9245. [PMID: 36563141 PMCID: PMC9788780 DOI: 10.1126/sciadv.adc9245] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 11/29/2022] [Indexed: 05/28/2023]
Abstract
Anthracyclines such as doxorubicin (Dox) are effective chemotherapies, but their use is limited by cardiac toxicity. We hypothesized that plasma proteomics in women with breast cancer could identify new mechanisms of anthracycline cardiac toxicity. We measured changes in 1317 proteins in anthracycline-treated patients (n = 30) and replicated key findings in a second cohort (n = 31). An increase in the heme-binding protein hemopexin (Hpx) 3 months after anthracycline initiation was associated with cardiac toxicity by echocardiography. To assess the functional role of Hpx, we administered Hpx to wild-type (WT) mice treated with Dox and observed improved cardiac function. Conversely, Hpx-/- mice demonstrated increased Dox cardiac toxicity compared to WT mice. Initial mechanistic studies indicate that Hpx is likely transported to the heart by circulating monocytes/macrophages and that Hpx may mitigate Dox-induced ferroptosis to confer cardioprotection. Together, these observations suggest that Hpx induction represents a compensatory response during Dox treatment.
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Affiliation(s)
- Jing Liu
- Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Sarah Lane
- Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Rahul Lall
- Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Michele Russo
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, "Guido Tarone," University of Torino, Torino, Italy
| | - Laurie Farrell
- Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Melis Debreli Coskun
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Casie Curtin
- Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Raquel Araujo-Gutierrez
- Division of Advanced Heart Failure and Transplantation, Houston Methodist Heart and Vascular Center, Houston, TX, USA
| | - Marielle Scherrer-Crosbie
- Division of Cardiovascular Diseases, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Barry H. Trachtenberg
- Division of Advanced Heart Failure and Transplantation, Houston Methodist Heart and Vascular Center, Houston, TX, USA
| | - Jonghan Kim
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Emanuela Tolosano
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, "Guido Tarone," University of Torino, Torino, Italy
| | - Alessandra Ghigo
- Department of Molecular Biotechnology and Health Sciences, Molecular Biotechnology Center, "Guido Tarone," University of Torino, Torino, Italy
| | - Robert E. Gerszten
- Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Aarti Asnani
- Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Kenneth Sims R, Srour N, El Nihum LI, Hannawi B, Araujo-Gutierrez R, Cruz-Solbes AS, Trachtenberg BH, Hussain I, Kim JH, Kassi M, Graviss EA, Nguyen DT, Estep J, Bhimaraj A, Guha A. Tissue plasminogen activator in left ventricular assist device-related intravascular hemolysis after failed augmented anticoagulation. Int J Artif Organs 2022; 45:911-918. [PMID: 35941752 DOI: 10.1177/03913988221115445] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVES We sought to examine the efficacy and safety of adding fibrinogen-guided low-dose multi-day Alteplase™ tissue plasminogen activator (tPA) in the management of intravascular hemolysis (IVH) in patients with the HeartMate II (HM-II) continuous flow (CF) left ventricular assist device (LVAD) who failed to achieve IVH resolution with conventional augmented anticoagulation (AAC). BACKGROUND IVH in patients with LVAD is often treated with AAC, failing which pump exchange is considered. We hypothesized that a trial of low-dose tPA after failed AAC therapy could resolve IVH and prevent pump exchange in some patients. METHODS We performed a retrospective study of 31 HM-II CF LVAD patients admitted to our center from January 2015 to January 2020 for IVH management who received tPA following failed AAC. Primary 6-month outcomes included successful IVH resolution, unsuccessful IVH resolution requiring pump exchange, gastrointestinal bleeding, ischemic and hemorrhagic cerebrovascular accident (CVA), and death. RESULTS Thirty-one patients with IVH were treated with tPA following failed AAC. Successful resolution of IVH occurred in 22/31 (71%) patients. Pump exchange occurred in 9/31 (29%) patients. Gastrointestinal bleeding occurred in 7/31 (22.6%) patients. Ischemic CVA occurred in 6/31 (19.4%) patients. CONCLUSIONS Management of IVH with administration of low-dose tPA after failed AAC is feasible and may prevent pump exchange in some patients.
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Affiliation(s)
- Robert Kenneth Sims
- Texas A&M College of Medicine, Bryan, TX, USA
- DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Nina Srour
- DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Lamees I El Nihum
- Texas A&M College of Medicine, Bryan, TX, USA
- DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | | | | | | | | | - Imad Hussain
- DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Ju H Kim
- DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Mahwash Kassi
- DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Edward A Graviss
- DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Duc T Nguyen
- DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | | | - Arvind Bhimaraj
- DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Ashrith Guha
- DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA
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Araujo-Gutierrez R, Van Eps JL, Scherba JC, Anastasio AT, Cabrera F, Vatsaas CJ, Youker K, Fernandez Moure JS. Platelet rich plasma concentration improves biologic mesh incorporation and decreases multinucleated giant cells in a dose dependent fashion. J Tissue Eng Regen Med 2021; 15:1037-1046. [PMID: 34551456 DOI: 10.1002/term.3247] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 08/19/2021] [Accepted: 08/31/2021] [Indexed: 11/09/2022]
Abstract
Platelet rich plasma (PRP) has been shown to improve incorporation and reduce inflammation in ventral hernia repair (VHR) with acellular dermal matrix (ADM). The concentration of platelets in PRP varies in clinical studies and an ideal concentration has yet to be defined. The effects of varied concentrations of PRP on ADM incorporation and inflammatory cell infiltration in a rat model of VHR. We hypothesized that increasing concentration of PRP would lead to improved incorporation, decreased CD8+ and multinucleated giant cell (MNGC) infiltrate. Lewis rats underwent ventral hernia creation and repair 30 days later with porcine non-crosslinked ADM. PRP was applied to the mesh prior to skin closure at concentrations of 1 × 104 plt/μL (PRP-LOW), 1 × 106 plt/μL (PRP-MID), or 1 × 107 plt/μL (PRP-HIGH) and tissue harvested at 2 and 4 weeks. Cellularization, tissue deposition, and mesh thickness using hematoxylin and eosin and Masson's trichrome, and neovascularization was assessed with VVG staining, to establish the relationship of PRP concentration to metrics of incorporation. MNGC and CD8+ T-cell infiltration were quantified to establish the relationship of inflammatory cell infiltration in response to PRP concentration. Lymphocyte infiltration was assessed using immunohistochemical staining for CD8. PRP-HIGH treated had significantly greater tissue deposition at 4 weeks. PRP-MID showed increasing mesh thickness at 2 weeks. Cell infiltration was significantly higher with PRP-HIGH at both 2 and 4 weeks while PRP-LOW showed increased cell infiltration only at 4 weeks. At both time points there was a trend towards a dose dependent response in cell infiltration to PRP concentration. Neovascularization was highest with MID-plt at 2 weeks, yet no significant differences were noted compared to controls. CD8+ cell infiltrate was significantly decreased at 2 and 4 weeks in PRP-LOW and PRP-MID treated groups. PRP at all concentrations significantly decreased MNGC infiltration at 2 weeks while only PRP-HIGH and PRP-MID had significant reductions in MNGC at 4 weeks. Both MNGC and CD8+ cell infiltration demonstrated dose dependent reduction in relation to PRP concentration. Increasing platelet concentrations of PRP correlated with improved incorporation, tissue deposition, and decreased scaffold degradation. These findings were associated with a blunted foreign body response. These findings suggest PRP reduces inflammation which may be beneficial for ADM incorporation in VHR.
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Affiliation(s)
| | - Jeffrey L Van Eps
- Department of Surgery, Section of Colon & Rectal Surgery, UTHealth at McGovern Medical School, Houston, Texas, USA
| | - Jacob C Scherba
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
| | - Albert Thomas Anastasio
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Fernando Cabrera
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas, USA
| | - Cory J Vatsaas
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Keith Youker
- Department of Cardiovascular Science, Houston Methodist Hospital, Houston, Texas, USA
| | - Joseph S Fernandez Moure
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas, USA
- Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA
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El Rafei A, Trachtenberg BH, Schultz J, John R, Estep JD, Araujo-Gutierrez R, Suarez TEE, Goodwin K, Cogswell R. Association between digoxin use and gastrointestinal bleeding in contemporary continuous flow left ventricular assist device support. J Heart Lung Transplant 2021; 40:671-676. [PMID: 33875331 DOI: 10.1016/j.healun.2021.03.005] [Citation(s) in RCA: 5] [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: 10/06/2020] [Revised: 02/21/2021] [Accepted: 03/02/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Assess the association between digoxin use and gastrointestinal bleeding (GIB) in a multicenter continuous flow left ventricular assist device (LVAD) cohort. METHODS Patients implanted with continuous flow LVADs with data on GIB and digoxin use from two centers were included in the analysis (n = 649). GIB events were captured up to 2 years of follow-up. Digoxin use was defined as digoxin prescribed at discharge or within the first 3 months after LVAD implantation. A negative binomial regression model was performed to determine the association between digoxin use and number of GIB events over the follow-up period. RESULTS Mean age of the cohort was 57 years (±14) and 45% (293/649) were bridge to transplant (BTT). Digoxin was prescribed in 33% of patients. Digoxin use was associated with an unadjusted 32% reduction in the incidence of rate of all cause GIB (IRR 0.68, 95% CI 0.46-0.99, p = 0.049). After adjusting for age, sex, Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile, renal function, and implanting center there was still a 34% reduction in the incidence rate (IRR 0.67, 95% CI 0.45-0.99, p = 0.048). When limiting the analysis to those with likely arteriovenous malformation associated GIB, the association strengthened (unadjusted: IRR 0.48, 95 % CI 0.26-0.89, p = 0.02, adjusted: IRR 0.47, 95 % CI 0.25-0.9, p = 0.022). CONCLUSIONS In this multicenter study, inclusive of contemporary devices, digoxin use was associated with reduced GIB events. Prospective data will be required to confirm this association.
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Affiliation(s)
- Abdelghani El Rafei
- Department of Medicine, Division of Internal Medicine, University of Minnesota, Minneapolis, Minnesota.
| | - Barry H Trachtenberg
- Department of Heart Failure & Transplant Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Research Institute, Houston, Texas
| | - Jessica Schultz
- Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, Minnesota
| | - Ranjit John
- Department of Surgery, Division of Cardiothoracic Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Jerry D Estep
- Department of Cardiovascular Medicine, Cleveland Clinic Sydell and Arnold Miller Family, Cleveland, Ohio
| | - Raquel Araujo-Gutierrez
- Department of Heart Failure & Transplant Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Research Institute, Houston, Texas
| | - T Eric E Suarez
- Department of Cardiovascular Surgery, Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas
| | - Kevin Goodwin
- Department of Cardiothoracic Surgery, Stanford University, Palo Alto, California
| | - Rebecca Cogswell
- Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, Minnesota
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Araujo-Gutierrez R, Chitturi KR, Xu J, Wang Y, Kinder E, Senapati A, Chebrolu LB, Kassi M, Trachtenberg BH. Baseline global longitudinal strain predictive of anthracycline-induced cardiotoxicity. Cardiooncology 2021; 7:4. [PMID: 33517910 PMCID: PMC7849080 DOI: 10.1186/s40959-021-00090-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 01/19/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Cancer therapy-related cardiac dysfunction (CTRD) is a major source of morbidity and mortality in long-term cancer survivors. Decreased GLS predicts decreased left ventricular ejection fraction (LVEF) in patients receiving anthracyclines, but knowledge regarding the clinical utility of baseline GLS in patients at low-risk of (CTRD) is limited. OBJECTIVES The purpose of this study was to investigate whether baseline echocardiographic assessment of global longitudinal strain (GLS) before treatment with anthracyclines is predictive of (CTRD) in a broad cohort of patients with normal baseline LVEF. METHODS Study participants comprised 188 patients at a single institution who underwent baseline 2-dimensional (2D) speckle-tracking echocardiography before treatment with anthracyclines and at least one follow-up echocardiogram 3 months after chemotherapy initiation. Patients with a baseline LVEF <55% were excluded from the analysis. The primary endpoint, (CTRD), was defined as an absolute decline in LVEF > 10% from baseline and an overall reduced LVEF <50%. Potential and known risk factors were evaluated using univariable and multivariable Cox proportional hazards regression analysis. RESULTS Twenty-three patients (12.23%) developed (CTRD). Among patients with (CTRD), the mean GLS was -17.51% ± 2.77%. The optimal cutoff point for (CTRD) was -18.05%. The sensitivity was 0.70 and specificity was 0.70. The area under ROC curve was 0.70. After adjustment for cardiovascular and cancer therapy related risk factors, GLS or decreased baseline GLS ≥-18% was predictive of (CTRD) (adjusted hazards ratio 1.17, 95% confidence interval 1.00, 1.36; p = 0.044 for GLS, or hazards ratio 3.54; 95% confidence interval 1.34, 9.35; p = 0.011 for decreased GLS), along with history of tobacco use, pre-chemotherapy systolic blood pressure, and cumulative anthracycline dose. CONCLUSIONS Baseline GLS or decreased baseline GLS was predictive of (CTRD) before anthracycline treatment in a cohort of cancer patients with a normal baseline LVEF. This data supports the implementation of strain-protocol echocardiography in cardio-oncology practice for identifying and monitoring patients who are at elevated risk of (CTRD).
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Affiliation(s)
- Raquel Araujo-Gutierrez
- Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St., Suite 1901, Houston, Texas 77030 USA
| | - Kalyan R. Chitturi
- Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St., Suite 1901, Houston, Texas 77030 USA
- Department of Medicine, Division of Cardiovascular Medicine, University of Missouri-Columbia, Columbia, Missouri USA
| | - Jiaqiong Xu
- Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St., Suite 1901, Houston, Texas 77030 USA
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, Texas USA
| | - Yuanchen Wang
- Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St., Suite 1901, Houston, Texas 77030 USA
| | - Elizabeth Kinder
- Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St., Suite 1901, Houston, Texas 77030 USA
| | - Alpana Senapati
- Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St., Suite 1901, Houston, Texas 77030 USA
| | - L. Bindu Chebrolu
- Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St., Suite 1901, Houston, Texas 77030 USA
| | - Mahwash Kassi
- Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St., Suite 1901, Houston, Texas 77030 USA
| | - Barry H. Trachtenberg
- Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St., Suite 1901, Houston, Texas 77030 USA
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Araujo-Gutierrez R, Potter L, Teigen L, Schultz J, Estep J, John R, Martin C, Cogswell R, Trachtenberg B. Pre-Operative Pectoralis Muscle Quantity and Attenuation by Computed Tomography are Predictive of Recurrent Gastrointestinal Bleeding on Left Ventricular Assist Device Support: A Multicenter Analysis. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.530] [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: 10/24/2022] Open
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8
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Araujo-Gutierrez R, Bhimaraj A, Guha A, Hussain I, Kassi M, Kim J, Trachtenberg B. No Increase in Infections or Readmissions in Al Amyloid Patients Who Undergo Heart Transplant. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.629] [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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9
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Cogswell R, Trachtenberg B, Murray T, Schultz J, Teigen LEVI, Allen T, Araujo-Gutierrez R, John R, Martin CM, Estep J. A Novel Model Incorporating Pectoralis Muscle Measures to Predict Mortality After Ventricular Assist Device Implantation. J Card Fail 2020; 26:308-315. [DOI: 10.1016/j.cardfail.2019.11.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 10/29/2019] [Accepted: 11/19/2019] [Indexed: 01/14/2023]
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10
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Singhvi A, Araujo-Gutierrez R, Bhimaraj A, Park M, Trachtenberg B, Hussain I, Guha A. Influence of HLA-DR Mismatches on Long Term Outcomes Following Heart Transplant. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.653] [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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11
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Chitturi KR, Xu J, Araujo-Gutierrez R, Bhimaraj A, Guha A, Hussain I, Kassi M, Bernicker EH, Trachtenberg BH. Immune Checkpoint Inhibitor-Related Adverse Cardiovascular Events in Patients With Lung Cancer. JACC CardioOncol 2019; 1:182-192. [PMID: 34396181 PMCID: PMC8352266 DOI: 10.1016/j.jaccao.2019.11.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [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] [Received: 08/26/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES The purpose of this study was to evaluate whether immune checkpoint inhibitors (ICIs) are associated with an increased risk of major adverse cardiovascular events (MACE) compared with non-ICI therapies in patients with lung cancer. BACKGROUND ICIs activate the host immune system to target cancer cells. Though uncommon, cardiovascular immune-related adverse events can be life-threatening. METHODS A retrospective single-institution cohort study of 252 patients with pathologically confirmed lung cancer who received ICI or non-ICI therapy was analyzed. The primary endpoint was MACE, defined as a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and hospitalization for heart failure. RESULTS During a median follow-up of 6 months, MACE occurred in 13.3% of ICI-treated patients, with a median time to event of 51 days, compared with 10.3% and 64 days in non-ICI patients. ICIs were not associated with MACE (hazard ratio [HR]: 1.18; 95% confidence interval [CI]: 0.57 to 2.43; p = 0.66) in a univariable Fine-Gray regression analysis incorporating noncardiovascular death as a competing risk. Multivariable regression analyses determined that patients treated with ICIs with elevated serum troponin I >0.01 ng/ml (HR: 7.27; 95% CI: 2.72 to 19.43; p < 0.001) and B-type natriuretic peptide (BNP) >100 pg/ml (HR: 2.65; 95% CI: 1.01 to 6.92; p = 0.047) had an increased risk of MACE. Patients pre-treated or receiving combined immunotherapy with ICIs and vascular endothelial growth factor inhibitors (VEGFIs) or tyrosine kinase inhibitors (TKIs) had an increased risk of MACE (HR: 2.15; 95% CI: 1.05 to 4.37; p = 0.04). CONCLUSIONS ICIs were not independently associated with an increased risk of MACE in patients with lung cancer, although power is an important limitation in these analyses. ICI-associated cardiotoxicity was associated with elevations in serum troponin and BNP, and combined immunotherapy with VEGFIs or TKIs. Future studies are needed to further define the role of cardiac biomarkers as a monitoring strategy with ICI therapy.
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Key Words
- BNP
- BNP, B-type natriuretic peptide
- CI, confidence interval
- HR, hazard ratio
- ICI, immune checkpoint inhibitor
- IQR, interquartile range
- LVEF, left ventricular ejection fraction
- MACE
- MACE, major adverse cardiovascular events
- PD, programmed cell death protein
- PD-L1, programmed cell death-ligand 1
- TKI, tyrosine kinase inhibitor
- TnI, troponin I
- VEGFI, vascular endothelial growth factor inhibitor
- cardiotoxicity
- immune checkpoint inhibitors
- lung cancer
- troponin
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Affiliation(s)
| | - Jiaqiong Xu
- Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, Texas, USA
| | | | - Arvind Bhimaraj
- Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA
| | - Ashrith Guha
- Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA
| | - Imad Hussain
- Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA
| | - Mahwash Kassi
- Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA
| | - Eric H. Bernicker
- Department of Medical Oncology, Houston Methodist Cancer Center, Houston, Texas, USA
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Trachtenberg BH, Kamble RT, Rice L, Araujo-Gutierrez R, Bhimaraj A, Guha A, Park MH, Hussain I, Bruckner BA, Suarez EE, Victor DW, Adrogue HE, Baker KR, Estep JD. Delayed autologous stem cell transplantation following cardiac transplantation experience in patients with cardiac amyloidosis. Am J Transplant 2019; 19:2900-2909. [PMID: 31152491 DOI: 10.1111/ajt.15487] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 12/23/2018] [Revised: 04/30/2019] [Accepted: 05/08/2019] [Indexed: 01/25/2023]
Abstract
This study sought to retrospectively investigate the outcomes of patients with light-chain amyloidosis (AL) with advanced cardiac involvement who were treated with a strategy of heart transplantation (HT) followed by delayed autologous stem cell transplantation (ASCT) at 1-year posttransplant. Patients with AL amyloidosis with substantial cardiac involvement have traditionally had very poor survival (eg, several months). A few select centers have reported their outcomes for HT followed by a strategy of early ASCT (ie, 6 months) for CA. The outcomes of patients undergoing a delayed strategy have not been reported. All patients with AL amyloidosis at a single institution undergoing evaluation for HT from 2004-2018 were included. Retrospective analyses were performed. Sixteen patients underwent HT (including two combined heart-kidney transplant) for AL amyloidosis. ASCT was performed in a total of nine patients to date at a median 13.5 months (12.8-32.9 months) post-HT. Survival was 87.5% at 1 year and 76.6% at 5 years, comparable to institutional outcomes for nonamyloid HT recipients. In addition to these 16 patients, two patients underwent combined heart-lung transplantation. A strategy of delayed ASCT 1-year post-HT for patients with AL amyloidosis is feasible, safe, and associated with comparable outcomes to those undergoing an earlier ASCT strategy.
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Affiliation(s)
- Barry H Trachtenberg
- Division of Cardiology, JC Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas
| | - Rammurti T Kamble
- Center for Cell and Gene Therapy, Baylor College of Medicine and Houston Methodist Hospital, Houston, Texas
| | - Lawrence Rice
- Division of Hematology, Department of Medicine, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas
| | - Raquel Araujo-Gutierrez
- Division of Cardiology, JC Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas
| | - Arvind Bhimaraj
- Division of Cardiology, JC Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas
| | - Ashrith Guha
- Division of Cardiology, JC Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas
| | - Myung H Park
- Division of Cardiology, JC Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas
| | - Imad Hussain
- Division of Cardiology, JC Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas
| | - Brian A Bruckner
- Division of Cardiothoracic Surgery, JC Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas
| | - Erik E Suarez
- Division of Cardiothoracic Surgery, JC Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas
| | - David W Victor
- Division of Hepatology, JC Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas
| | - Horacio E Adrogue
- Division of Nephrology, JC Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas
| | - Kelty R Baker
- Division of Hematology, Baylor College of Medicine, Houston, Texas
| | - Jerry D Estep
- Division of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio
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13
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Araujo-Gutierrez R, Chitturi KR, Wang Y, Bhimaraj A, Guha A, Hussain I, Kassi M, Kim J, Trachtenberg B. Pre-Treatment Global Longitudinal Strain Predicts Left Ventricular Systolic Dysfunction in Patients Undergoing Anthracycline-Based Chemotherapy. J Card Fail 2019. [DOI: 10.1016/j.cardfail.2019.07.112] [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: 10/26/2022]
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14
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Chitturi KR, Araujo-Gutierrez R, McLean ET, Xu J, Bhimaraj A, Guha A, Hussain I, Trachtenberg BH. Cardiotoxicity of Immune Checkpoint Inhibitors in Patients with Lung Cancer. J Card Fail 2019. [DOI: 10.1016/j.cardfail.2019.07.141] [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: 10/26/2022]
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15
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Agrawal T, Marcos-Abdala HG, Araujo-Gutierrez R, Thaker R, Fida N, Kassi M. Association of LVAD Outflow Cannula Position with Stroke Risk. J Card Fail 2019. [DOI: 10.1016/j.cardfail.2019.07.037] [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: 10/26/2022]
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16
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Trachtenberg B, Hussain F, Mukherjee A, Araujo-Gutierrez R, Pingali SRK. Immune Checkpoint Inhibitor-Related Cardiotoxicity. Methodist Debakey Cardiovasc J 2019; 14:e1-e4. [PMID: 30410661 DOI: 10.14797/mdcj-14-3-e1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
| | - Fahd Hussain
- HOUSTON METHODIST RESEARCH INSTITUTE, HOUSTON METHODIST HOSPITAL, HOUSTON, TEXAS
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Thaker R, Araujo-Gutierrez R, Marcos-Abdala HG, Agrawal T, Fida N, Kassi M. Innovative Modeling Techniques and 3D Printing in Patients with Left Ventricular Assist Devices: A Bridge from Bench to Clinical Practice. J Clin Med 2019; 8:E635. [PMID: 31075841 PMCID: PMC6572374 DOI: 10.3390/jcm8050635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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] [Received: 04/03/2019] [Revised: 04/24/2019] [Accepted: 05/01/2019] [Indexed: 02/07/2023] Open
Abstract
Left ventricular assist devices (LVAD) cause altered flow dynamics that may result in complications such as stroke, pump thrombosis, bleeding, or aortic regurgitation. Understanding altered flow dynamics is important in order to develop more efficient and durable pump configurations. In patients with LVAD, hemodynamic assessment is limited to imaging techniques such as echocardiography which precludes detailed assessment of fluid dynamics. In this review article, we present some innovative modeling techniques that are often used in device development or for research purposes, but have not been utilized clinically. Computational fluid dynamic (CFD) modeling is based on computer simulations and particle image velocimetry (PIV) employs ex vivo models that helps study fluid characteristics such as pressure, shear stress, and velocity. Both techniques may help elaborate our understanding of complications that occur with LVAD and could be potentially used in the future to troubleshoot LVAD-related alarms. These techniques coupled with 3D printing may also allow for patient-specific device implants, lowering the risk of complications increasing device durability.
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Affiliation(s)
- Rishi Thaker
- Touro College of Osteopathic Medicine, Middletown, New York, NY 10940, USA.
| | - Raquel Araujo-Gutierrez
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX 77030, USA.
| | - Hernan G Marcos-Abdala
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX 77030, USA.
| | - Tanushree Agrawal
- Department of Internal Medicine, Houston Methodist Hospital, Houston, TX 77030, USA.
| | - Nadia Fida
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX 77030, USA.
| | - Mahwash Kassi
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX 77030, USA.
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18
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Marcos-Abdala H, Karmouty-Quintana H, Youker K, Cruz-Solbes A, Amione-Guerra J, Ali A, Araujo-Gutierrez R, Thandavarayan R, Ashrith G. Platelet Derived Growth Factor (PDGF) and Bone Morphogenic Protein 4 (BMP4) Levels May Indicate Presence of Combined Pre and Post Capillary WHO Group II Pulmonary Hypertension. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1251] [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: 10/27/2022] Open
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19
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Araujo-Gutierrez R, Van Eps JL, Kirui D, Bryan NS, Kang Y, Fleming JB, Fernandez-Moure JS. Enhancement of gemcitabine cytotoxicity in pancreatic adenocarcinoma through controlled release of nitric oxide. Biomed Microdevices 2019; 21:23. [PMID: 30790060 DOI: 10.1007/s10544-019-0375-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Gemcitabine (GEM) is the first-line treatment for pancreatic adenocarcinoma (PAC) yet chemoresistance is common. Nitric oxide (NO) is the predominant species responsible for the cytotoxic action of macrophages against cancer cells yet localized delivery is difficult given the short half-life. We sought to study the effect of locally delivered NO on GEM mediated PAC cytotoxicity and the potential role of SMAD4 in this effect. We hypothesized that NO would enhance the cytotoxicity of GEM in a SMAD4 dependent manner. NO-Silica nanoparticles (NO-Si) were synthesized via a co-condensation of tetraethoxysilane with aminoalkoxysilane under high-pressure nitrous oxide. NO release was measured using chemiluminescence. A SMAD4 negative PAC cell line (SMAD4-) was made using retroviral knockdown of Panc1 PAC cells. Panc1 and SMAD4- cells were treated with gemcitabine (100 nm (hi) to 30 μm (lo)), 30 mg NOSi particles, or both (NOSihi or NOSilo) and cell viability assessed. NoSi reduced cell viability by 25.99% in Panc1 and 24.38% in SMAD4-. When combined with gemcitabine, further reductions were seen in a dose dependent manner for both cell lines. We have demonstrated the in-vitro dose dependent cytotoxic effects of NOSi. When combined with GEM there is a synergistic effect resulting in improved cytotoxicity seen in both Panc1 and SMAD4- PAC cells with a differential pattern of cell death seen at high concentrations of NO. These findings suggest not only that NO is useful chemosensitizing agent but that SMAD4- may play a role in its synergism with GEM.
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Affiliation(s)
- R Araujo-Gutierrez
- Department of Heart Failure & Transplant Cardiology, Houston Methodist Research Institute, 6565 Fannin St. F657, Houston, TX, 77030, USA
| | - J L Van Eps
- Department of Surgery, Houston Methodist Hospital, 6550 Fannin St. Sm1661, Houston, TX, 77030, USA
| | - D Kirui
- Department of Maxillofacial Injury and Disease US Navy Medical Research Center, 3650 Chambers Pass, Fort Sam Houston, San Antonio, TX, 78234, USA
| | - N S Bryan
- Department of Molecular and Human Genetics, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA
| | - Y Kang
- Department of Gastrointestinal Oncology, H Lee Moffitt Cancer Center, Tampa, FL, USA
| | - J B Fleming
- Department of Gastrointestinal Oncology, H Lee Moffitt Cancer Center, Tampa, FL, USA
| | - J S Fernandez-Moure
- Department of Surgery, Division of Traumatology, Critical Care, and Emergency Surgery, University of Pennsylvania, 51N 39th St. MOB Suite 120, Philadelphia, PA, 19104, USA.
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20
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Trachtenberg B, Hussain F, Mukherjee A, Araujo-Gutierrez R, Pingali SRK. Immune Checkpoint Inhibitor-Related Cardiotoxicity. Methodist Debakey Cardiovasc J 2018. [DOI: 10.14797/mdcvj.842] [Citation(s) in RCA: 1] [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: 11/08/2022] Open
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21
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Araujo-Gutierrez R, Gardner J, Trachtenberg B, Bhimaraj A, Park M, Hussain I, Ashrith G, Suarez E, Bruckner B, Estep J. Safety and Efficacy of Mechanical Circulatory Support as a Bridge to Heart-Kidney Transplant. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1105] [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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22
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Trachtenberg B, Araujo-Gutierrez R, Rammurti K, Rice L, Bhimaraj A, Guha A, Park M, Hussain I, Suarez E, Bruckner B, Estep J. Cardiac Transplantation with Delayed Autologous Stem Cell Transplant in Patients with Cardiac Amyloidosis. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.216] [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: 10/17/2022] Open
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23
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Araujo-Gutierrez R, Gardner J, Trachtenberg B, Bhimaraj A, Hussain I, Park M, Ashrith G, Suarez E, Bruckner B, Estep J. Simultaneous Heart-Liver Transplant is Associated with Excellent Outcomes Independent of MELD Score. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1106] [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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24
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Araujo-Gutierrez R, Ibarra-Cortez SH, Estep JD, Bhimaraj A, Guha A, Hussain I, Park MH, Torre-Amione G, Trachtenberg BH. Incidence and outcomes of cancer treatment-related cardiomyopathy among referrals for advanced heart failure. Cardiooncology 2018; 4:3. [PMID: 32154004 PMCID: PMC7048122 DOI: 10.1186/s40959-018-0029-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 02/21/2018] [Indexed: 12/21/2022]
Abstract
Background Approximately 2-3% of patients undergoing advanced heart failure therapies such as left ventricular assist devices (LVAD) and orthotropic heart transplantation (OHT) have chemotherapy-related cardiomyopathy, according to analyses of large databases such as United Network for Organ Sharing (UNOS) or Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) registries. While these studies have shown similar survival outcomes post-interventions, these databases by definition exclude patients referred for advanced therapies but do not receive them, and thus there is little data on overall outcomes of such patients. Given the lack of nuance in the diagnoses in large registries and the possibility that many cancer treatment-related cardiomyopathy (CCMP) patients might be misclassified by the generic "non-ischemic" or "dilated" cardiomyopathies, we investigated the incidence and clinical outcomes of CCMP patients among advanced heart failure (HF) referrals at a single high volume institution. Methods All referrals from 2013 to 2016 were evaluated for type of cardiomyopathy, with careful chart review. Outcomes such as LVAD, OHT and death were compared between CCMP and other cardiomyopathies. Results Of 553 referrals for advanced HF, 19 (3.4%) were for CCMP. There was a higher percentage of patients receiving advanced therapies in the CCMP vs. non-ischemic cardiomyopathy (NICMP) and ischemic cardiomyopathy (ICMP) (42.1% vs 30.2% vs 33.6%, not significant). Of the CCMP patients, 3 had OHT directly, 2 had LVAD followed by OHT, and 3 had LVADs as bridge to candidacy or destination therapy. Fifty-eight percent of the CCMP did not receive LVAD or OHT compared to 69.8% and 66.3 of the NICMP and ICMP, respectively (p = 0.0388). Independent of type of advanced therapy, survival was significantly higher in the CCMP group compared to NICMP and ICMP (93.3% vs 84.8% vs 73.8%, respectively P = 0.0021 for 1 year, 93.3% vs 76.2% vs 58.3%, respectively, P = < 0.0001 for 3 year). Conclusions In a single institution, CCMP accounts for more than 3% of all referrals for advanced HF therapies and almost 8% of NICMP. Contrary to concerns for previous cancer and sequelae of cancer treatment excluding patients for advanced therapies, a higher percentage of CCMP underwent advanced HF therapies and with similar outcomes. This is the first study to show that among patients referred for advanced therapies, CCMP patients do not have inferior outcomes compared to other cardiomyopathies regardless of the selected management strategy.
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Affiliation(s)
- Raquel Araujo-Gutierrez
- 1Department of Heart Failure & Transplant Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Research Institute, 6565 Fannin St, F657, Houston, TX 77030 USA
| | - Sergio H Ibarra-Cortez
- 2Department of Structural Heart Disease, Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Research Institute, 6565 Fannin St. F766, Houston, TX 77030 USA
| | - Jerry D Estep
- 3Department of Heart Failure & Transplant Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, 6550 Fannin St. Suite 1901, Houston, TX 77030 USA
| | - Arvind Bhimaraj
- 3Department of Heart Failure & Transplant Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, 6550 Fannin St. Suite 1901, Houston, TX 77030 USA
| | - Ashrith Guha
- 3Department of Heart Failure & Transplant Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, 6550 Fannin St. Suite 1901, Houston, TX 77030 USA
| | - Imad Hussain
- 3Department of Heart Failure & Transplant Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, 6550 Fannin St. Suite 1901, Houston, TX 77030 USA
| | - Myung H Park
- 3Department of Heart Failure & Transplant Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, 6550 Fannin St. Suite 1901, Houston, TX 77030 USA
| | - Guillermo Torre-Amione
- 3Department of Heart Failure & Transplant Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, 6550 Fannin St. Suite 1901, Houston, TX 77030 USA
| | - Barry H Trachtenberg
- 3Department of Heart Failure & Transplant Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, 6550 Fannin St. Suite 1901, Houston, TX 77030 USA
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25
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Ibarra-Cortez S, Araujo-Gutierrez R, Cruz-Solbes A, Bruckner B, Estep J, Suarez E, Bhimaraj A. (1323) Single Center Experience of Long Term Outcomes of Severe Cardiogenic Shock Patients Needing IMPELLA 5.0 Placement. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1235] [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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26
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Ali A, Araujo-Gutierrez R, Cruz-Solbes A, Uribe C, Youker K, Bhimaraj A. Endothelial Dysfunction in Heart Failure. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.584] [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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27
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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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28
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Mao R, Meng S, Gu Q, Araujo-Gutierrez R, Kumar S, Yan Q, Almazan F, Youker KA, Fu Y, Pownall HJ, Cooke JP, Miller YI, Fang L. AIBP Limits Angiogenesis Through γ-Secretase-Mediated Upregulation of Notch Signaling. Circ Res 2017; 120:1727-1739. [PMID: 28325782 DOI: 10.1161/circresaha.116.309754] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 03/15/2017] [Accepted: 03/21/2017] [Indexed: 12/22/2022]
Abstract
RATIONALE Angiogenesis improves perfusion to the ischemic tissue after acute vascular obstruction. Angiogenesis in pathophysiological settings reactivates signaling pathways involved in developmental angiogenesis. We showed previously that AIBP (apolipoprotein A-I [apoA-I]-binding protein)-regulated cholesterol efflux in endothelial cells controls zebra fish embryonic angiogenesis. OBJECTIVE This study is to determine whether loss of AIBP affects angiogenesis in mice during development and under pathological conditions and to explore the underlying molecular mechanism. METHODS AND RESULTS In this article, we report the generation of AIBP knockout (Apoa1bp-/-) mice, which are characterized of accelerated postnatal retinal angiogenesis. Mechanistically, AIBP triggered relocalization of γ-secretase from lipid rafts to nonlipid rafts where it cleaved Notch. Consistently, AIBP treatment enhanced DLL4 (delta-like ligand 4)-stimulated Notch activation in human retinal endothelial cells. Increasing high-density lipoprotein levels in Apoa1bp-/- mice by crossing them with apoA-I transgenic mice rescued Notch activation and corrected dysregulated retinal angiogenesis. Notably, the retinal vessels in Apoa1bp-/- mice manifested normal pericyte coverage and vascular integrity. Similarly, in the subcutaneous Matrigel plug assay, which mimics ischemic/inflammatory neovascularization, angiogenesis was dramatically upregulated in Apoa1bp-/- mice and associated with a profound inhibition of Notch activation and reduced expression of downstream targets. Furthermore, loss of AIBP increased vascular density and facilitated the recovery of blood vessel perfusion function in a murine hindlimb ischemia model. In addition, AIBP expression was significantly increased in human patients with ischemic cardiomyopathy. CONCLUSIONS Our data reveal a novel mechanistic connection between AIBP-mediated cholesterol metabolism and Notch signaling, implicating AIBP as a possible druggable target to modulate angiogenesis under pathological conditions.
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Affiliation(s)
- Renfang Mao
- From the Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences (R.M., S.M., Q.G., R.A.-G., Q.Y., J.P.C., L.F.), Houston Methodist DeBakey Heart and Vascular Center, Department of Cardiology (R.A.-G., K.A.Y.), Department of Bioenergetics (H.J.P.), Houston Methodist Research Institute, TX; Department of Ophthalmology, Baylor College of Medicine, Houston, TX (S.K., Y.F.); and Department of Medicine, University of California, San Diego, La Jolla (F.A., Y.I.M.)
| | - Shu Meng
- From the Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences (R.M., S.M., Q.G., R.A.-G., Q.Y., J.P.C., L.F.), Houston Methodist DeBakey Heart and Vascular Center, Department of Cardiology (R.A.-G., K.A.Y.), Department of Bioenergetics (H.J.P.), Houston Methodist Research Institute, TX; Department of Ophthalmology, Baylor College of Medicine, Houston, TX (S.K., Y.F.); and Department of Medicine, University of California, San Diego, La Jolla (F.A., Y.I.M.)
| | - Qilin Gu
- From the Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences (R.M., S.M., Q.G., R.A.-G., Q.Y., J.P.C., L.F.), Houston Methodist DeBakey Heart and Vascular Center, Department of Cardiology (R.A.-G., K.A.Y.), Department of Bioenergetics (H.J.P.), Houston Methodist Research Institute, TX; Department of Ophthalmology, Baylor College of Medicine, Houston, TX (S.K., Y.F.); and Department of Medicine, University of California, San Diego, La Jolla (F.A., Y.I.M.)
| | - Raquel Araujo-Gutierrez
- From the Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences (R.M., S.M., Q.G., R.A.-G., Q.Y., J.P.C., L.F.), Houston Methodist DeBakey Heart and Vascular Center, Department of Cardiology (R.A.-G., K.A.Y.), Department of Bioenergetics (H.J.P.), Houston Methodist Research Institute, TX; Department of Ophthalmology, Baylor College of Medicine, Houston, TX (S.K., Y.F.); and Department of Medicine, University of California, San Diego, La Jolla (F.A., Y.I.M.)
| | - Sandeep Kumar
- From the Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences (R.M., S.M., Q.G., R.A.-G., Q.Y., J.P.C., L.F.), Houston Methodist DeBakey Heart and Vascular Center, Department of Cardiology (R.A.-G., K.A.Y.), Department of Bioenergetics (H.J.P.), Houston Methodist Research Institute, TX; Department of Ophthalmology, Baylor College of Medicine, Houston, TX (S.K., Y.F.); and Department of Medicine, University of California, San Diego, La Jolla (F.A., Y.I.M.)
| | - Qing Yan
- From the Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences (R.M., S.M., Q.G., R.A.-G., Q.Y., J.P.C., L.F.), Houston Methodist DeBakey Heart and Vascular Center, Department of Cardiology (R.A.-G., K.A.Y.), Department of Bioenergetics (H.J.P.), Houston Methodist Research Institute, TX; Department of Ophthalmology, Baylor College of Medicine, Houston, TX (S.K., Y.F.); and Department of Medicine, University of California, San Diego, La Jolla (F.A., Y.I.M.)
| | - Felicidad Almazan
- From the Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences (R.M., S.M., Q.G., R.A.-G., Q.Y., J.P.C., L.F.), Houston Methodist DeBakey Heart and Vascular Center, Department of Cardiology (R.A.-G., K.A.Y.), Department of Bioenergetics (H.J.P.), Houston Methodist Research Institute, TX; Department of Ophthalmology, Baylor College of Medicine, Houston, TX (S.K., Y.F.); and Department of Medicine, University of California, San Diego, La Jolla (F.A., Y.I.M.)
| | - Keith A Youker
- From the Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences (R.M., S.M., Q.G., R.A.-G., Q.Y., J.P.C., L.F.), Houston Methodist DeBakey Heart and Vascular Center, Department of Cardiology (R.A.-G., K.A.Y.), Department of Bioenergetics (H.J.P.), Houston Methodist Research Institute, TX; Department of Ophthalmology, Baylor College of Medicine, Houston, TX (S.K., Y.F.); and Department of Medicine, University of California, San Diego, La Jolla (F.A., Y.I.M.)
| | - Yingbin Fu
- From the Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences (R.M., S.M., Q.G., R.A.-G., Q.Y., J.P.C., L.F.), Houston Methodist DeBakey Heart and Vascular Center, Department of Cardiology (R.A.-G., K.A.Y.), Department of Bioenergetics (H.J.P.), Houston Methodist Research Institute, TX; Department of Ophthalmology, Baylor College of Medicine, Houston, TX (S.K., Y.F.); and Department of Medicine, University of California, San Diego, La Jolla (F.A., Y.I.M.)
| | - Henry J Pownall
- From the Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences (R.M., S.M., Q.G., R.A.-G., Q.Y., J.P.C., L.F.), Houston Methodist DeBakey Heart and Vascular Center, Department of Cardiology (R.A.-G., K.A.Y.), Department of Bioenergetics (H.J.P.), Houston Methodist Research Institute, TX; Department of Ophthalmology, Baylor College of Medicine, Houston, TX (S.K., Y.F.); and Department of Medicine, University of California, San Diego, La Jolla (F.A., Y.I.M.)
| | - John P Cooke
- From the Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences (R.M., S.M., Q.G., R.A.-G., Q.Y., J.P.C., L.F.), Houston Methodist DeBakey Heart and Vascular Center, Department of Cardiology (R.A.-G., K.A.Y.), Department of Bioenergetics (H.J.P.), Houston Methodist Research Institute, TX; Department of Ophthalmology, Baylor College of Medicine, Houston, TX (S.K., Y.F.); and Department of Medicine, University of California, San Diego, La Jolla (F.A., Y.I.M.)
| | - Yury I Miller
- From the Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences (R.M., S.M., Q.G., R.A.-G., Q.Y., J.P.C., L.F.), Houston Methodist DeBakey Heart and Vascular Center, Department of Cardiology (R.A.-G., K.A.Y.), Department of Bioenergetics (H.J.P.), Houston Methodist Research Institute, TX; Department of Ophthalmology, Baylor College of Medicine, Houston, TX (S.K., Y.F.); and Department of Medicine, University of California, San Diego, La Jolla (F.A., Y.I.M.)
| | - Longhou Fang
- From the Center for Cardiovascular Regeneration, Department of Cardiovascular Sciences (R.M., S.M., Q.G., R.A.-G., Q.Y., J.P.C., L.F.), Houston Methodist DeBakey Heart and Vascular Center, Department of Cardiology (R.A.-G., K.A.Y.), Department of Bioenergetics (H.J.P.), Houston Methodist Research Institute, TX; Department of Ophthalmology, Baylor College of Medicine, Houston, TX (S.K., Y.F.); and Department of Medicine, University of California, San Diego, La Jolla (F.A., Y.I.M.).
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Araujo-Gutierrez R, Ibarra-Cortez SH, Park MH, Estep JD, Guha A, Trachtenberg BH, Torre-Amione G, Bhimaraj A. Reduction in Healthcare Utilization in Patients with Remote Hemodynamic Pulmonary Artery Pressure Monitoring Device: A Real-World, Post Clinical Trial Single Center Experience. J Card Fail 2016. [DOI: 10.1016/j.cardfail.2016.06.334] [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]
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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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