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Kostick-Quenet KM, Lang B, Dorfman N, Estep J, Mehra MR, Bhimaraj A, Civitello A, Jorde U, Trachtenberg B, Uriel N, Kaplan H, Gilmore-Szott E, Volk R, Kassi M, Blumenthal-Barby JS. Patients' and physicians' beliefs and attitudes towards integrating personalized risk estimates into patient education about left ventricular assist device therapy. Patient Educ Couns 2024; 122:108157. [PMID: 38290171 DOI: 10.1016/j.pec.2024.108157] [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] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 01/06/2024] [Accepted: 01/14/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Personalized risk (PR) estimates may enhance clinical decision making and risk communication by providing individualized estimates of patient outcomes. We explored stakeholder attitudes toward the utility, acceptability, usefulness and best-practices for integrating PR estimates into patient education and decision making about Left Ventricular Assist Device (LVAD). METHODS AND RESULTS As part of a 5-year multi-institutional AHRQ project, we conducted 40 interviews with stakeholders (physicians, nurse coordinators, patients, and caregivers), analyzed using Thematic Content Analysis. All stakeholder groups voiced positive views towards integrating PR in decision making. Patients, caregivers and coordinators emphasized that PR can help to better understand a patient's condition and risks, prepare mentally and logistically for likely outcomes, and meaningfully engage in decision making. Physicians felt it can improve their decision making by enhancing insight into outcomes, enhance tailored pre-emptive care, increase confidence in decisions, and reduce bias and subjectivity. All stakeholder groups also raised concerns about accuracy, representativeness and relevance of algorithms; predictive uncertainty; utility in relation to physician's expertise; potential negative reactions among patients; and overreliance. CONCLUSION Stakeholders are optimistic about integrating PR into clinical decision making, but acceptability depends on prospectively demonstrating accuracy, relevance and evidence that benefits of PR outweigh potential negative impacts on decision making quality.
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Affiliation(s)
| | - Benjamin Lang
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | - Natalie Dorfman
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | | | | | | | | | | | | | - Nir Uriel
- Columbia University Irving Medical Center, New York, NY, USA
| | - Holland Kaplan
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | - Eleanor Gilmore-Szott
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | - Robert Volk
- University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | | | - J S Blumenthal-Barby
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
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2
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Urey MA, Hibbert B, Jorde U, Eckman P, Simard T, Labinaz M, Nazer B, Wiley M, Gupta B, Sauer A, Shah H, Sorajja P, Pineda AM, Missov E, Mahmud E, Kahwash R, Lilly S, Latib A, Murthy S, Fam N, Garcia S, Chung ES, Klein L, Cheng R, Houston BA, Amoroso NS, Chang L, Gafoor S, Chaudhry SP, Hermiller J, Schwartz JG, Aldaia L, Koulogiannis K, Gray WA, Zahr F. Left atrial to coronary sinus shunting for treatment of heart failure with mildly reduced or preserved ejection fraction: The ALT FLOW Early Feasibility Study 1-year results. Eur J Heart Fail 2024. [PMID: 38606485 DOI: 10.1002/ejhf.3241] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 03/27/2024] [Accepted: 03/30/2024] [Indexed: 04/13/2024] Open
Abstract
AIMS Patients with heart failure and mildly reduced or preserved ejection fraction have limited therapeutic options. The ALT-FLOW Early Feasibility Study evaluated safety, haemodynamics and outcomes for the APTURE transcatheter shunt system, a novel left atrium to coronary sinus shunt in these patients. METHODS AND RESULTS Safety and shunt implantation success was evaluated for all 116 enrolled patients. An analysis population of implanted patients with a left ventricular ejection fraction (LVEF) >40% (n = 95) was chosen to assess efficacy via paired comparison between baseline and follow-up haemodynamic (3 and 6 months), and echocardiographic, clinical and functional outcomes (6 months and 1 year). Health status and quality of life outcomes were assessed using the Kansas City Cardiomyopathy Questionnaire overall summary score (KCCQ-OSS). The primary safety endpoint, major adverse cardiac, cerebral, and renal events, and reintervention through 30 days, occurred in 3/116 patients (2.6%). All implanted shunts were patent at 1 year. In patients with LVEF >40%, the mean (95% confidence interval) reduction in exercise pulmonary capillary wedge pressure (PCWP) at 20 W was -5.7 (-8.6, -2.9) mmHg at 6 months (p < 0.001). At baseline, 8% had New York Heart Association class I-II status and improved to 68% at 1 year (p < 0.001). KCCQ-OSS at baseline was 39 (35, 43) and improved at 6 months and 1 year by 25 (20-30) and 27 (22-32) points, respectively (both p < 0.0001). No adverse changes in haemodynamic and echocardiographic indices of right heart function were observed at 1 year. Overall, the reduction in PCWP at 20 W and improvement in KCCQ-OSS in multiple subgroups were consistent with those observed for the entire population. CONCLUSIONS In patients with heart failure and LVEF >40%, the APTURE shunt demonstrated an acceptable safety profile with significant sustained improvements in haemodynamic and patient-centred outcomes, underscoring the need for further evaluation of the APTURE shunt in a randomized trial.
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Affiliation(s)
- Marcus A Urey
- Division of Cardiovascular Medicine, University of California San Diego, La Jolla, CA, USA
| | - Benjamin Hibbert
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
- CAPITAL Research, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Ulrich Jorde
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, NY, USA
| | - Peter Eckman
- Department of Cardiology, Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Trevor Simard
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Marino Labinaz
- CAPITAL Research, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Babak Nazer
- Division of Cardiology, University of Washington Medical Center
| | - Mark Wiley
- Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Bhanu Gupta
- Virginia Mason Franciscan Health, Seattle, WA, USA
| | - Andrew Sauer
- Saint Luke's Mid America Heart Institute, Kansas City, MO, USA
| | - Hirak Shah
- Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Paul Sorajja
- Department of Cardiology, Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Andres M Pineda
- Division of Cardiology, Duke University Medical Center, Durham, NC, USA
| | - Emil Missov
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, USA
| | - Ehtisham Mahmud
- Division of Cardiovascular Medicine, University of California San Diego, La Jolla, CA, USA
| | - Rami Kahwash
- Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH, USA
| | - Scott Lilly
- Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH, USA
| | - Azeem Latib
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, NY, USA
| | - Sandhya Murthy
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, NY, USA
| | - Neil Fam
- St. Michael's Hospital Unity Health, Toronto, ON, Canada
| | - Santiago Garcia
- The Christ Hospital and The Carl and Edyth Lindner Center for Research and Education, Cincinnati, OH, USA
| | - Eugene S Chung
- Lindner Research Center at The Christ Hospital, Cincinnati, OH, USA
| | - Liviu Klein
- Advanced Heart Failure Comprehensive Care Center, Division of Cardiology, University of California San Francisco, San Francisco, CA, USA
| | - Richard Cheng
- Division of Cardiovascular Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Brian A Houston
- Division of Cardiology, Medical University of South Carolina, Charleston, SC, USA
| | - Nicholas S Amoroso
- Division of Cardiology, Medical University of South Carolina, Charleston, SC, USA
| | - Lee Chang
- Swedish Heart and Vascular, Seattle, WA, USA
| | - Sameer Gafoor
- Swedish Heart and Vascular, Seattle, WA, USA
- Cardiovascular Center Frankfurt, Frankfurt, Germany
| | - Sunit-Preet Chaudhry
- Ascension St. Vincent Heart Center, Indianapolis, Indiana and Ascension St. Vincent Cardiovascular Research Institute, Indianapolis, IN, USA
| | - James Hermiller
- Ascension St. Vincent Heart Center, Indianapolis, Indiana and Ascension St. Vincent Cardiovascular Research Institute, Indianapolis, IN, USA
| | | | - Lillian Aldaia
- Department of Cardiovascular Medicine, Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ, USA
| | - Konstantinos Koulogiannis
- Department of Cardiovascular Medicine, Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, NJ, USA
| | | | - Firas Zahr
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
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3
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Ovalle-Ramos JA, Díez-López C, Patel S, Jorde U, Rochlani Y. Challenges With Donor Selection: Inherited Channelopathy Unmasked by Drug Overdose. Can J Cardiol 2023; 39:1617-1619. [PMID: 37634648 DOI: 10.1016/j.cjca.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Julio A Ovalle-Ramos
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York, USA
| | - Carles Díez-López
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York, USA
| | - Snehal Patel
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York, USA
| | - Ulrich Jorde
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York, USA
| | - Yogita Rochlani
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York, USA.
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4
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Nunez JI, Uehara M, Mohamed A, Mellas N, Ashley JE, Rahmanian M, Carlese A, Forest SJ, Goldstein D, Jorde U, Saeed O. Lactate Dehydrogenase and Hemorrhagic Stroke During Extracorporeal Membrane Oxygenation for COVID-19. Lung 2023; 201:397-406. [PMID: 37401936 DOI: 10.1007/s00408-023-00630-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/21/2023] [Indexed: 07/05/2023]
Abstract
PURPOSE Hemorrhagic stroke (HS) is a devastating complication during extracorporeal membrane oxygenation (ECMO) but markers of risk stratification during COVID-19 are unknown. Lactate dehydrogenase (LDH) is a readily available biomarker of cell injury and permeability. We sought to determine whether an elevated LDH before ECMO placement is related to the occurrence of HS during ECMO for COVID-19. METHODS Adult patients with COVID-19 requiring ECMO between March 2020 and February 2022 were included. LDH values prior to ECMO placement were captured. Patients were categorized into high (> 750 U/L) or low (≤ 750 U/L) LDH groups. Multivariable regression modeling was used to determine the association between LDH and HS during ECMO. RESULTS There were 520 patients that underwent ECMO placement in 17 centers and 384 had an available LDH. Of whom, 122 (32%) had a high LDH. The overall incidence of HS was 10.9%, and patients with high LDH had a higher incidence of HS than those with low LDH level (17% vs 8%, p = 0.007). At 100 days, the probability of a HS was 40% in the high LDH group and 23% in those with a low LDH, p = 0.002. After adjustment for clinical covariates, high LDH remained associated with subsequent HS (aHR: 2.64, 95% CI 1.39-4.92). Findings were similar when restricting to patients supported by venovenous ECMO only. CONCLUSION Elevated LDH prior to ECMO cannulation is associated with a higher incidence of HS during device support. LDH can risk stratify cases for impending cerebral bleeding during ECMO.
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Affiliation(s)
- Jose I Nunez
- Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mayuko Uehara
- Departments of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Amira Mohamed
- Department of Medicine, Division of Critical Care Medicine and Pulmonology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Nicholas Mellas
- Departments of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Justin E Ashley
- Departments of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Marjan Rahmanian
- Department of Medicine, Division of Critical Care Medicine and Pulmonology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Anthony Carlese
- Department of Medicine, Division of Critical Care Medicine and Pulmonology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Stephen J Forest
- Departments of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Daniel Goldstein
- Departments of Cardiothoracic and Vascular Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ulrich Jorde
- Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Omar Saeed
- Department of Medicine, Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
- Department of Medicine, Division of Cardiovascular Medicine, Montefiore Medical Center, Albert Einstein College Of Medicine, Bronx, NY, USA.
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5
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Saeed D, Feldman D, Banayosy AE, Birks E, Blume E, Cowger J, Hayward C, Jorde U, Kremer J, MacGowan G, Maltais S, Maybaum S, Mehra M, Shah KB, Mohacsi P, Schweiger M, Schroeder SE, Shah P, Slepian M, Tops LF, Alvarez P, Arabia F, Aslam S, Benson-Louis L, Birati E, Buchholz HW, Cedars A, Christensen D, Ciarka A, Coglianese E, Cogswell R, Cook J, Copeland J, Costello JG, Drakos SG, Eghtesady P, Elliot T, Estep JD, Eulert-Grehn JJ, Fabrizio DR, Garbade J, Gelow J, Guglin M, Hernandez-Montfort J, Horstmanshof D, John R, Kanwar M, Khaliel F, Kim G, Kumar S, Lavee J, Leache M, Leprince P, Lim S, Loforte A, Maly J, Najjar S, Netuka I, Pamboukian SV, Patel SR, Pinney S, Pluym CV, Potapov E, Robson D, Rochlani Y, Russell S, Sandau K, Sandoval E, Sayer G, Schettle S, Schibilsky D, Schlöglhofer T, Schmitto J, Siddique A, Silvestry S, Slaughter MS, Sun B, Takayama H, Tedford R, Teuteberg JJ, Ton VK, Uriel N, Vierecke J, Zimpfer D, D'Alessandro D. The 2023 International Society for Heart and Lung Transplantation Guidelines for Mechanical Circulatory Support: A 10- Year Update. J Heart Lung Transplant 2023; 42:e1-e222. [PMID: 37245143 DOI: 10.1016/j.healun.2022.12.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/05/2022] [Indexed: 05/29/2023] Open
Affiliation(s)
- Diyar Saeed
- University Department for Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany..
| | - David Feldman
- University of Cincinnati & Cincinnati Childrens Hosptial, Cincinnati, Ohio, USA.
| | - Aly El Banayosy
- Integris Nazih Zuhdi Transplant Institute, Oklahoma City, OK, USA
| | - Emma Birks
- University of Louisville, Louisville, KY, USA
| | | | - Jennifer Cowger
- Department of Cardiology, Henry Ford Hospital, Detroit, MI, USA
| | - Christopher Hayward
- Faculty of Medicine, St Vincent's Hospital, University of New South Wales, Sydney, Australia
| | | | - Jamila Kremer
- Department of Cardiothoracic Surgery, Heidelberg University, Heidelberg, Germany
| | - Guy MacGowan
- Newcastle Upon Tyne Hospitals, and Newcastle University, Newcastle upon Tyne, UK
| | - Simon Maltais
- Department of cardiac Surgery, Mayo Clinic, Rochester, MN, USA
| | | | | | - Keyur B Shah
- Department of Cardiology, Virginia Commonwealth University, Virginia
| | - Paul Mohacsi
- CardioVascular Center Im Park, Seestrasse 247, CH-8038 Zürich
| | | | | | - Palak Shah
- Inova Heart and Vascular Institute, Falls Church VA, USA
| | | | - Laurens F Tops
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Paulino Alvarez
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Francisco Arabia
- Advanced Heart Program, Banner University Medical Group, Phoenix, AZ, USA
| | - Saima Aslam
- University of California, San Diego, San Diego, CA, USA
| | | | - Edo Birati
- Cardiovascular Division, Padeh-Poriya Medical Center, Bar Ilan University, Israel
| | | | - Ari Cedars
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | | | - Erin Coglianese
- Department of Medicine/Cardiology, Mass General Hospital, Harvard School of Medicine, Boston Massachusetts USA
| | | | - Jennifer Cook
- University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Jack Copeland
- Department of Surgery, Division of Cardiothoracic Surgery, University of Arizona, Tucson, AZ, USA
| | | | - Stavros G Drakos
- University of Utah Health and School of Medicine and Salt Lake VA Medical Center, Salt Lake City, Utah, USA
| | - Pirooz Eghtesady
- Department of Pediatrics, Washington University in St. Louis, USA
| | | | - Jerry D Estep
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | | | - De Rita Fabrizio
- Consultant in Congenital Heart Surgery, Adult and Paediatric Congenital Heart Unit Freeman Hospital, Newcastle Upon Tyne, UK
| | - Jens Garbade
- University Department for Cardiac Surgery, Leipzig Heart Center, Leipzg, Germany
| | - Jill Gelow
- Department of Pediatrics, Providence Heart Institute, Portland, Oregon, USA
| | | | | | | | - Ranjit John
- University of Minnesota, Minneapolis, MN, USA
| | | | - Feras Khaliel
- King Faisal Specialist Hospital & Research Center, Riyadh
| | - Gene Kim
- Department of Cardiology, University of Chicago, Illinois, USA
| | - Sachin Kumar
- Division of Cardiovascular Surgery, Advanced Heart Failure Program, University of Texas Medical Center, Houston, Texas, USA
| | - Jacob Lavee
- Department of Cardiac Surgery, Sheba Medical Center, Ramat Gan, Israel
| | - Marzia Leache
- Department of Cardiac Surgery, New Yok University Medical Center, New York, NY, USA
| | - Pascal Leprince
- Department of Thoracic and Cardiovascular Surgery, Sorbonne Université, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Sern Lim
- University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - Antonio Loforte
- Bologna University, Cardiothorac, Transplant and Vasc Surg Dept, Bologna, Italy
| | - Jiri Maly
- Department of Cardiac Surgery, Institute for Clinical and Experimental Medicine, Prague, Czeck Republic
| | - Samer Najjar
- Department of Medicine, MedStar Washington Hospital Center, Georgetown University, Wahington DC USA
| | - Ivan Netuka
- Dept. of Cardiac Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | | | - Snehal R Patel
- Cardiology Division, Montefiore Medical Center, Bronx, NY, USA
| | - Sean Pinney
- Mount Sinai Medical Center, New York, NY, USA
| | - Christina Vander Pluym
- Division of Cardiology, Boston Children's Hospital/Harvard School of Medicine, Boston, Massachusetts, USA
| | | | - Desiree Robson
- Department of Cardiology, Montefiore Medical Center, Bronx, NY, USA
| | | | | | | | | | - Gabriel Sayer
- University of Chicago Medical Center, Chicago, IL, USA
| | | | - David Schibilsky
- Department of Surgery, Universitats- Herzzentrum, Freiburg Germany
| | | | - Jan Schmitto
- Dept. of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Aleem Siddique
- Department of Surgery, University of Nebraska Medical Center, Omha, Nebraska, USA
| | - Scott Silvestry
- Department of Cardiac Surgery, Florida Hospital, Orlando, FL, USA
| | - Mark S Slaughter
- Department of Cardiovascular and Thoracic Surgery, University of Louisville, Kentucky, USA
| | - Benjamin Sun
- Cardiac Surgery department, Minneapolis Heart Institute, Minneapolis, MN, USA
| | - Hiroo Takayama
- Department of Cardiac Surgery, Columbia University Medical Center, New York, NY, USA
| | - Ryan Tedford
- Department of Medicine/Cardiology, Medical University of South Carolina, Charleston, South Carolina, USA
| | | | - Van-Khue Ton
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nir Uriel
- Department of Cardiology, Columbia University, New York, NY, USA
| | - Juliane Vierecke
- Department of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Daniel Zimpfer
- Department of Cardiac Surgery, Medical University Vienna, Vienna, Austria
| | - David D'Alessandro
- Massachusetts General Hospital, Boston, Harvard School of Medicine, Boston, MA, USA.
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6
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Sorajja P, Whisenant B, Hamid N, Naik H, Makkar R, Tadros P, Price MJ, Singh G, Fam N, Kar S, Schwartz JG, Mehta S, Bae R, Sekaran N, Warner T, Makar M, Zorn G, Spinner EM, Trusty PM, Benza R, Jorde U, McCarthy P, Thourani V, Tang GHL, Hahn RT, Adams DH. Transcatheter Repair for Patients with Tricuspid Regurgitation. N Engl J Med 2023; 388:1833-1842. [PMID: 36876753 DOI: 10.1056/nejmoa2300525] [Citation(s) in RCA: 144] [Impact Index Per Article: 144.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
BACKGROUND Severe tricuspid regurgitation is a debilitating condition that is associated with substantial morbidity and often with poor quality of life. Decreasing tricuspid regurgitation may reduce symptoms and improve clinical outcomes in patients with this disease. METHODS We conducted a prospective randomized trial of percutaneous tricuspid transcatheter edge-to-edge repair (TEER) for severe tricuspid regurgitation. Patients with symptomatic severe tricuspid regurgitation were enrolled at 65 centers in the United States, Canada, and Europe and were randomly assigned in a 1:1 ratio to receive either TEER or medical therapy (control). The primary end point was a hierarchical composite that included death from any cause or tricuspid-valve surgery; hospitalization for heart failure; and an improvement in quality of life as measured with the Kansas City Cardiomyopathy Questionnaire (KCCQ), with an improvement defined as an increase of at least 15 points in the KCCQ score (range, 0 to 100, with higher scores indicating better quality of life) at the 1-year follow-up. The severity of tricuspid regurgitation and safety were also assessed. RESULTS A total of 350 patients were enrolled; 175 were assigned to each group. The mean age of the patients was 78 years, and 54.9% were women. The results for the primary end point favored the TEER group (win ratio, 1.48; 95% confidence interval, 1.06 to 2.13; P = 0.02). The incidence of death or tricuspid-valve surgery and the rate of hospitalization for heart failure did not appear to differ between the groups. The KCCQ quality-of-life score changed by a mean (±SD) of 12.3±1.8 points in the TEER group, as compared with 0.6±1.8 points in the control group (P<0.001). At 30 days, 87.0% of the patients in the TEER group and 4.8% of those in the control group had tricuspid regurgitation of no greater than moderate severity (P<0.001). TEER was found to be safe; 98.3% of the patients who underwent the procedure were free from major adverse events at 30 days. CONCLUSIONS Tricuspid TEER was safe for patients with severe tricuspid regurgitation, reduced the severity of tricuspid regurgitation, and was associated with an improvement in quality of life. (Funded by Abbott; TRILUMINATE Pivotal ClinicalTrials.gov number, NCT03904147.).
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Affiliation(s)
- Paul Sorajja
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Brian Whisenant
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Nadira Hamid
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Hursh Naik
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Raj Makkar
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Peter Tadros
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Matthew J Price
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Gagan Singh
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Neil Fam
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Saibal Kar
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Jonathan G Schwartz
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Shamir Mehta
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Richard Bae
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Nishant Sekaran
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Travis Warner
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Moody Makar
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - George Zorn
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Erin M Spinner
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Phillip M Trusty
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Raymond Benza
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Ulrich Jorde
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Patrick McCarthy
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Vinod Thourani
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Gilbert H L Tang
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - Rebecca T Hahn
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
| | - David H Adams
- From Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis (P.S., N.H., R. Bae); Intermountain Medical Center, Murray, UT (B.W., N.S.); St. Joseph's Hospital and Integrated Medical Services, Phoenix, AZ (H.N., T.W.); Cedars-Sinai Medical Center, Los Angeles (R.M., M.M.), Scripps Clinic Green Hospital, La Jolla (M.J.P.), UC Davis Medical Center, Sacramento (G.S.), Los Robles Regional Medical Center, Thousand Oaks (S.K.), and Abbott Structural Heart, Santa Clara (E.M.S., P.M.T.) - all in California; Kansas University Medical Center, Kansas City (P.T., G.Z.); St. Michael's Hospital, Toronto (N.F.), and McMaster University, Hamilton, ON (S.M.) - both in Canada; Carolinas Medical Center, Charlotte, NC (J.G.S.); Ohio State University, Columbus (R. Benza); Montefiore Medical Center, Bronx (U.J.), and Mount Sinai Health System (G.H.L.T., D.H.A.) and New York-Presbyterian Columbia University Medical Center (R.T.H.), New York - all in New York; Northwestern University, Chicago (P.M.); and Marcus Valve Center, Piedmont Heart Institute, Atlanta (V.T.)
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Castagna F, Chalhoub G, Ippolito P, Saeed O, Sims D, Jorde U. Determinants of Cardiac Index Improvement after Intra-Aortic Balloon Pump Insertion. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.815] [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: 04/05/2023] Open
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Szymanski M, Mirza K, De Jonge N, Schmidt T, Brahmbhatt D, Billia F, Hsu S, MacGowan G, Jakovljevic D, Agostoni P, Trombara F, Jorde U, Rochlani Y, Vandersmissen K, Reiss N, Russell S, Meyns B, Gustafsson F. Prognostic Value of Repeated Peak Oxygen Uptake Measurements in LVAD Patients - Follow Up on PRO-VAD Study. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1644] [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: 04/05/2023] Open
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Alexy T, Patel S, Rochlani Y, Saeed O, Gjelaj C, Madan S, Shin J, Maharaj V, Goldstein D, Jorde U, Vukelic S. Risk of Acute Rejection in Heart Transplant Patients Treated with M-TOR Inhibitors. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.177] [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: 04/05/2023] Open
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Castagna F, Chalhoub G, Ippolito P, Saeed O, Sims D, Jorde U. Predictors of Poor Early Hemodyamic Response to Intra-Aortic Balloon Pump. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.817] [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: 04/05/2023] Open
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Takahashi T, Kobayashi Y, Saeed O, Vukelic S, Jorde U, Shin J, Patel S. Optical Coherence Tomography Evaluation of Donor Transmitted Coronary Atherosclerosis and Risk of Cardiac Allograft Vasculopathy. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.170] [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: 04/05/2023] Open
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Milwidsky A, Chan M, Travin M, Gjelaj C, Saeed O, Vukelic S, Rochlani Y, Madan S, Shin J, Sims D, Murthy S, Chavez P, Jorde U, Patel S. PET-CT Defined Micro-Vascular Dysfunction and Cardiac Allograft Vasculopathy Risk Factors in Heart Transplant Recipients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.172] [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: 04/05/2023] Open
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Mathai S, Krupad K, Sohal S, Mehta A, Montgomery M, Murthy S, Visveshwaran G, Sims D, Jorde U. Comparison of In-Hospital Outcomes in Acute Myocardial Infarction-Cardiogenic Shock (AMICS) versus Non-AMICS Following ECPELLA. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1530] [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: 04/05/2023] Open
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Kanwar M, Uriel N, Jorde U, Tian W, Pinney K, Shen L, Shah P. Impact of Rejection Surveillance Practices on Outcomes after Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.573] [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: 04/05/2023] Open
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Saeed D, Stark C, Loforte A, Zimpfer D, Bernhardt A, Schibilsky D, Riebandt J, Jawad K, Lichtenberg A, Haneya A, Potapov E, Albert A, Otto W, Huenges K, Aubin H, Lewin D, Raweh A, Morshuis M, Jorde U, Reichenspurner H, Borger M, Gummert J. Optimal Patient Selection on Extra-Corporeal Life Support for Durable Mechanical Circulatory Support: Validation Study on Behalf of Durable MCS after ECLS Study Group. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1532] [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: 04/05/2023] Open
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Hirsch E, Nnani D, Patel S, Rochlani Y, Vukelic S, Shin J, Chavez P, Madan S, Sims D, Jorde U, Saeed O. Tolerability and Effectiveness of Intensified Statin after Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.465] [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: 04/05/2023] Open
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Patel S, Knierim J, Goldstein D, Lamba H, Sun B, Schmitto J, Lowes B, Shah P, Kanwar M, Wald J, Ravichandran A, MacGowan G, Ton V, Silvestry S, Sera F, Farooq M, Jorde U, Stehlik J, Selzman C, Potapov E, Drakos S. Long-Term Clinical Trajectory after Durable Lvad Weaning: An International Registry Report. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1518] [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: 04/05/2023] Open
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Saeed O, Farooq M, Chinnadurai T, Ramos J, Patel S, Chavez P, Rochlani Y, Murthy S, Shin J, Vukelic S, Sims D, Goldstein D, Jorde U. Platelet Function and Sildenafil Use During Left Ventricular Assist Device Support. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.152] [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: 04/05/2023] Open
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Castagna F, Ippolito P, Chalhoub G, Saeed O, Sims D, Jorde U. Early Adverse Events Post-Iabp Discontinuation are Reduced with a Rapid Daily Structured Iabp Assessment. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.816] [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: 04/05/2023] Open
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Novakovic M, Nnani D, Saeed O, Vukelic S, Rochlani Y, Madan S, Sims D, Shin J, Murthy S, Bazarbachi A, Chavez P, Jorde U, Patel S. Does Switching from Bactrim to Atovaquone Result in Less Hyperkalemia? A Single-Center Retrospective Analysis in Heart Transplant Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1252] [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: 04/05/2023] Open
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Chauhan D, Patel S, Cohen S, Madan S, Goldstein D, Jorde U, Rochlani Y, Vukelic S, Shin J, Murthy S, Sims D, Forest S, Saeed O. Diminishing Effect of Blood Type on Waitlist and Heart Transplantation Outcomes in the Contemporary UNOS Allocation System. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1669] [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: 04/05/2023] Open
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Stehlik J, Schroder J, Pinney S, Patel C, D'Alessandro D, Goldstein D, Jorde U, Patel S, Mani D, Esmailian F, Kobashigawa J, Takeda K, Uriel N, Pham S, Patel P, Kai M, Sun B, Shah A, Ono M, Couper G, DeNofrio D, Vest A, Joyce D, DeVore A, Mallidi H, Itoh A, Mehra M, Givertz M, Milano C, Farr M. First Report of the Transmedics Organ Care System Heart Perfusion Registry. A Multi-Institutional Outcomes Analysis. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.634] [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: 04/05/2023] Open
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Rochlani Y, Madan S, Vukelic S, Saeed O, Murthy S, Shin J, Patel S, Latib M, Goldstein D, Jorde U, Sims D. Giant Cell Myocarditis with LVAD Presenting with Acute Severe AI Managed with Valve-In-Valve TAVI. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.487] [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: 04/05/2023] Open
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Madan S, Teitelbaum J, Saeed O, Sims D, Forest S, Goldstein D, Patel S, Jorde U. Outcomes of Heart Transplantation (HT) for Chagas Cardiomyopathy (CM) in US. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.560] [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: 04/05/2023] Open
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Milano C, Schroder J, Farr M, DeVore A, D'Alessandro D, Goldstein D, Jorde U, Patel S, Daneshmand M, Pinney S, Esmailian F, Kobashigawa J, Takeda K, Uriel N, Pham S, Patel P, Kai M, Sun B, Shah A, Ono M, Couper G, DeNofrio D, Vest A, Joyce D, Mallidi H, Itoh A, Mehra M, Givertz M, Patel C, Stehlik J. Demographics and Outcomes of Clinical Trial vs Initial Post-Approval Use of Transmedics Organ Care System Heart. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.135] [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: 04/05/2023] Open
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Szymanski M, Mirza K, De Jonge N, Schmidt T, Brahmbhatt D, Billia F, Hsu S, MacGowan G, Jakovljevic D, Agostoni P, Trombara F, Jorde U, Rochlani Y, Vandersmissen K, Reiss N, Russell S, Meyns B, Gustafsson F. Improvement in Peak Oxygen Uptake During First Year of Mechanical Circulatory Support in End-Stage Heart Failure Patients - Follow Up on PRO-VAD Study. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.780] [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: 04/05/2023] Open
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Madan S, Patel S, Saeed O, Sims D, Rochlani Y, Vukelic S, Forest S, Shin J, Goldstein D, Jorde U. Donor Cardiopulmonary Resuscitation (CPR) and Donation after Circulatory Death Heart Transplantations (HT). J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1605] [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: 04/05/2023] Open
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Hibbert B, Zahr F, Simard T, Labinaz M, Nazer B, Sorajja P, Eckman P, Pineda AM, Missov E, Mahmud E, Schwartz J, Gupta B, Wiley M, Sauer A, Jorde U, Latib A, Kahwash R, Lilly S, Chang L, Gafoor S, Chaudhry SP, Hermiller J, Aldaia L, Koulogiannis K, Gray WA. Left Atrial to Coronary Sinus Shunting for Treatment of Symptomatic Heart Failure. JACC Cardiovasc Interv 2023:S1936-8798(23)00571-X. [PMID: 36989271 DOI: 10.1016/j.jcin.2023.03.012] [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: 03/06/2023] [Revised: 03/09/2023] [Accepted: 03/09/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Heart failure (HF) is associated with both mortality and a significant decline in health status. Inter-atrial shunting is increasingly being investigated as a novel therapeutic option. OBJECTIVES The ALT FLOW Early Feasibility Study was designed to evaluate the safety of the Edwards left atrial to coronary sinus APTURETM Transcatheter Shunt System in patients with symptomatic HF. METHODS 18 centers enrolled patients with symptomatic HF with a pulmonary capillary wedge pressure (PCWP) >15mmHg at rest or 25mmHg during exercise. RESULTS Between May 2018 and September 2022, 87 patients underwent attempted APTURETM shunt implantation. Mean age was 71 years, and 53% were male. At baseline mean LVEF was 59% with 90% of the patients being NYHA III. Device success was achieved in 78 (90%) of patients with no device occlusions or associated adverse events identified after implantation. The primary safety outcome occurred in only 2 (2.3%) patients at 30 days. At 6 months health status improved: 68% of participants achieved NYHA I-II status, with a 23-point improvement (p<0.0001, 95% CI [17, 29]) in the Kansas City Cardiomyopathy Questionnaire overall summary score. Also at 6 months, 20-watt exercise pulmonary capillary wedge pressure was -7mmHg lower (p<0.0001, 95% CI [-11, -4]) without change in right atrial pressure or other right heart function indices. CONCLUSIONS In this single-arm experience, the APTURETM Transcatheter Shunt System in patients with symptomatic HF was observed to be safe and resulted in reduction in PCWP and clinically meaningful improvements in HF symptoms and quality of life indices.
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Affiliation(s)
- Benjamin Hibbert
- CAPITAL Research, Department of Medicine, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Firas Zahr
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon
| | - Trevor Simard
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Marino Labinaz
- CAPITAL Research, Department of Medicine, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Babak Nazer
- Division of Cardiology, University of Washington, Seattle, Washington
| | - Paul Sorajja
- Department of Cardiology, Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Peter Eckman
- Department of Cardiology, Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Andres M Pineda
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida
| | - Emil Missov
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida
| | - Ehtisham Mahmud
- Division of Cardiovascular Medicine, University of California San Diego, San Diego, California
| | - Jonathan Schwartz
- Sanger Heart & Vascular Institute, Carolinas Medical Center, Atrium Health, Charlotte, North Carolina
| | - Bhanu Gupta
- Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Mark Wiley
- Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Andrew Sauer
- Saint Luke's Mid America Heart Institute, Kansas City, Missouri
| | - Ulrich Jorde
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, New York
| | - Azeem Latib
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, New York
| | - Rami Kahwash
- Division of Cardiovascular Medicine, The Ohio State University, Columbus, Ohio
| | - Scott Lilly
- Division of Cardiovascular Medicine, The Ohio State University, Columbus, Ohio
| | - Lee Chang
- Swedish Heart and Vascular, Seattle, Washington
| | - Sameer Gafoor
- Swedish Heart and Vascular, Seattle, Washington; Cardiovascular Center Frankfurt, Frankfurt, Germany
| | - Sunit-Preet Chaudhry
- Department of Cardiology, Ascension St Vincent Heart Center of Indiana, Indianapolis, Indiana
| | - James Hermiller
- Department of Cardiovascular Medicine, Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey
| | - Lillian Aldaia
- Department of Cardiovascular Medicine, Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey
| | - Konstantinos Koulogiannis
- Department of Cardiovascular Medicine, Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey
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Coisne A, Scotti A, Taramasso M, Granada JF, Ludwig S, Rodés-Cabau J, Lurz P, Hausleiter J, Fam N, Kodali SK, Pozzoli A, Alessandrini H, Biasco L, Brochet E, Denti P, Estevez-Loureiro R, Frerker C, Ho EC, Monivas V, Nickenig G, Praz F, Puri R, Sievert H, Tang GHL, Andreas M, Von Bardeleben RS, Rommel KP, Muntané-Carol G, Gavazzoni M, Braun D, Lubos E, Kalbacher D, Connelly KA, Juliard JM, Harr C, Pedrazzini G, Philippon F, Schofer J, Thiele H, Unterhuber M, Himbert D, Alcázar MU, Wild MG, Jorde U, Windecker S, Maisano F, Leon MB, Hahn RT, Latib A. Prognostic Value of Tricuspid Valve Gradient After Transcatheter Edge-to-Edge Repair: Insights From the TriValve Registry. JACC Cardiovasc Interv 2023:S1936-8798(23)00452-1. [PMID: 36948892 DOI: 10.1016/j.jcin.2023.01.375] [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: 10/24/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND Data regarding the impact of the tricuspid valve gradient (TVG) after tricuspid transcatheter edge-to-edge repair (TEER) are scarce. OBJECTIVES This study sought to evaluate the association between the mean TVG and clinical outcomes among patients who underwent tricuspid TEER for significant tricuspid regurgitation. METHODS Patients with significant tricuspid regurgitation who underwent tricuspid TEER within the TriValve (International Multisite Transcatheter Tricuspid Valve Therapies) registry were divided into quartiles based on the mean TVG at discharge. The primary endpoint was the composite of all-cause mortality and heart failure hospitalization. Outcomes were assessed up to the 1-year follow-up. RESULTS A total of 308 patients were included from 24 centers. Patients were divided into quartiles of the mean TVG as follows: quartile 1 (n = 77), 0.9 ± 0.3 mm Hg; quartile 2 (n = 115), 1.8 ± 0.3 mm Hg; quartile 3 (n = 65), 2.8 ± 0.3 mm Hg; and quartile 4 (n = 51), 4.7 ± 2.0 mm Hg. The baseline TVG and the number of implanted clips were associated with a higher post-TEER TVG. There was no significant difference across TVG quartiles in the 1-year composite endpoint (quartiles 1-4: 35%, 30%, 40%, and 34%, respectively; P = 0.60) or the proportion of patients in New York Heart Association class III to IV at the last follow-up (P = 0.63). The results were similar after adjustment for clinical and echocardiographic characteristics (composite endpoint quartile 4 vs quartile 1-quartile 3 adjusted HR: 1.05; 95% CI: 0.52-2.12; P = 0.88) or exploring post-TEER TVG as a continuous variable. CONCLUSIONS In this retrospective analysis of the TriValve registry, an increased discharge TVG was not significantly associated with adverse outcomes after tricuspid TEER. These findings apply for the explored TVG range and up to the 1-year follow-up. Further investigations on higher gradients and longer follow-up are needed to better guide the intraprocedural decision-making process.
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Affiliation(s)
- Augustin Coisne
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Cardiovascular Research Foundation, New York, New York, USA; Universitè Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France
| | - Andrea Scotti
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Cardiovascular Research Foundation, New York, New York, USA
| | | | - Juan F Granada
- Cardiovascular Research Foundation, New York, New York, USA
| | - Sebastian Ludwig
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Cardiovascular Research Foundation, New York, New York, USA; Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
| | - Josep Rodés-Cabau
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Philipp Lurz
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Jörg Hausleiter
- Medical Clinic and Polyclinic I, University Hospital of Munich, Munich, Germany
| | - Neil Fam
- Division of Cardiology, Toronto Heart Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Susheel K Kodali
- Division of Cardiology, Columbia University Medical Center-NewYork Presbyterian Hospital, New York, New York, USA
| | - Alberto Pozzoli
- Division of Cardiac Surgery, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | | | - Luigi Biasco
- Azienda Sanitaria Locale Torino 4, Ciriè, Italy; Department of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland
| | - Eric Brochet
- Division of Cardiology, Bichat Hospital, Paris, France
| | - Paolo Denti
- Division of Cardiology and Department of Cardiac Surgery, San Raffaele University Hospital, Milan, Italy
| | | | - Christian Frerker
- University Heart Center, Schleswig-Holstein University, Lübeck, Germany
| | - Edwin C Ho
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Vanessa Monivas
- Division of Cardiology, Puerta de Hierro University Hospital, Madrid, Spain
| | - Georg Nickenig
- Division of Cardiology, Bonn University Hospital, Bonn, Germany
| | - Fabien Praz
- Division of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Rishi Puri
- Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Horst Sievert
- Division of Cardiology, Cardiovascular Center Frankfurt, Frankfurt am Main, Germany
| | - Gilbert H L Tang
- Department of Cardiovascular Surgery, Mount Sinai Health System, New York, New York, USA
| | - Martin Andreas
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | | | - Karl-Philipp Rommel
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | | | | | - Daniel Braun
- Medical Clinic and Polyclinic I, University Hospital of Munich, Munich, Germany
| | - Edith Lubos
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
| | - Daniel Kalbacher
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany; German Center for Cardiovascular Research, Partner Site Hamburg/Luebeck/Kiel, Germany
| | - Kim A Connelly
- Division of Cardiology, Toronto Heart Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | | | | | - Giovanni Pedrazzini
- Department of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland; Division of Cardiology, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - François Philippon
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | | | - Holger Thiele
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Matthias Unterhuber
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | | | | | - Mirjam G Wild
- Division of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Ulrich Jorde
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Stephan Windecker
- Division of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Francesco Maisano
- Division of Cardiology and Department of Cardiac Surgery, San Raffaele University Hospital, Milan, Italy
| | - Martin B Leon
- Cardiovascular Research Foundation, New York, New York, USA; Division of Cardiology, Columbia University Medical Center-NewYork Presbyterian Hospital, New York, New York, USA
| | - Rebecca T Hahn
- Cardiovascular Research Foundation, New York, New York, USA; Division of Cardiology, Columbia University Medical Center-NewYork Presbyterian Hospital, New York, New York, USA
| | - Azeem Latib
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
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Scotti A, Coisne A, Taramasso M, Granada JF, Ludwig S, Rodés-Cabau J, Lurz P, Hausleiter J, Fam N, Kodali SK, Rosiene J, Feinberg A, Pozzoli A, Alessandrini H, Biasco L, Brochet E, Denti P, Estévez-Loureiro R, Frerker C, Ho EC, Monivas V, Nickenig G, Praz F, Puri R, Sievert H, Tang GHL, Andreas M, Von Bardeleben RS, Rommel KP, Muntané-Carol G, Gavazzoni M, Braun D, Koell B, Kalbacher D, Connelly KA, Juliard JM, Harr C, Pedrazzini G, Russo G, Philippon F, Schofer J, Thiele H, Unterhuber M, Himbert D, Alcázar MU, Wild MG, Windecker S, Jorde U, Maisano F, Leon MB, Hahn RT, Latib A. Sex-related characteristics and short-term outcomes of patients undergoing transcatheter tricuspid valve intervention for tricuspid regurgitation. Eur Heart J 2023; 44:822-832. [PMID: 36445158 DOI: 10.1093/eurheartj/ehac735] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [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: 06/30/2022] [Revised: 11/04/2022] [Accepted: 11/25/2022] [Indexed: 12/02/2022] Open
Abstract
AIMS The impact of sexuality in patients with significant tricuspid regurgitation (TR) undergoing transcatheter tricuspid valve intervention (TTVI) is unknown. The aim of this study was to investigate sex-specific outcomes in patients with significant TR treated with TTVI vs. medical therapy alone. METHODS AND RESULTS The Transcatheter Tricuspid Valve Therapies (TriValve) registry collected data on patients with significant TR from 24 centres who underwent TTVI from 2016 to 2021. A control cohort was formed by medically managed patients with ≥severe isolated TR diagnosed in 2015-18. The primary endpoint was freedom from all-cause mortality. Secondary endpoints were heart failure (HF) hospitalization, New York Heart Association (NYHA) functional status, and TR severity. One-year outcomes were assessed for the TriValve cohort and compared with the control cohort with the inverse probability of treatment weighting (IPTW). A total of 556 and 2072 patients were included from the TriValve and control groups, respectively. After TTVI, there was no difference between women and men in 1-year freedom from all-cause mortality 80.9% vs. 77.9%, P = 0.56, nor in HF hospitalization (P = 0.36), NYHA Functional Classes III and IV (P = 0.17), and TR severity >2+ at last follow-up (P = 0.42). Multivariable Cox-regression weighted by IPTW showed improved 1-year survival after TTVI compared with medical therapy alone in both women (adjusted hazard ratio 0.45, 95% confidence interval 0.23-0.83, P = 0.01) and men (adjusted hazard ratio 0.42, 95% confidence interval 0.18-0.89, P = 0.03). CONCLUSION After TTVI in high-risk patients, there were no sex-related differences in terms of survival, HF hospitalization, functional status, and TR reduction up to 1 year. The IPTW analysis shows a survival benefit of TTVI over medical therapy alone in both women and men.
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Affiliation(s)
- Andrea Scotti
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.,Cardiovascular Research Foundation, New York, NY, USA
| | - Augustin Coisne
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.,Cardiovascular Research Foundation, New York, NY, USA.,University of Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, F-59000 Lille, France
| | | | | | - Sebastian Ludwig
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.,Cardiovascular Research Foundation, New York, NY, USA.,Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
| | - Josep Rodés-Cabau
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Philipp Lurz
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Jörg Hausleiter
- Medical Clinic and Polyclinic I, University Hospital of Munich, Munich, Germany
| | - Neil Fam
- Division of Cardiology, Toronto Heart Center, St Michael's Hospital, Toronto, Ontario, Canada
| | - Susheel K Kodali
- Division of Cardiology, Columbia University Medical Center, NewYork-Presbyterian Hospital, New York, NY, USA
| | - Joel Rosiene
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ari Feinberg
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Alberto Pozzoli
- Division of Cardiac Surgery, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Hannes Alessandrini
- Asklepios Clinic St Georg, Medical Care Center Prof. Mathey, Prof. Schofer, Hamburg, Germany
| | - Luigi Biasco
- Azienda Sanitaria Locale Torino 4. Via Battitore 7, 10071 Ciriè, Italy.,Department of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland
| | - Eric Brochet
- Division of Cardiology, Bichat Hospital, Paris, France
| | - Paolo Denti
- Division of Cardiology and Department of Cardiac Surgery, San Raffaele University Hospital, Milan, Italy
| | | | - Christian Frerker
- University Heart Center, Schleswig-Holstein University, Lübeck, Germany
| | - Edwin C Ho
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Vanessa Monivas
- Division of Cardiology, Puerta de Hierro University Hospital, Madrid, Spain
| | - Georg Nickenig
- Division of Cardiology, Bonn University Hospital, Bonn, Germany
| | - Fabien Praz
- Division of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Rishi Puri
- Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Horst Sievert
- Division of Cardiology, Cardiovascular Center Frankfurt, Frankfurt am Main, Germany
| | - Gilbert H L Tang
- Department of Cardiovascular Surgery, Mount Sinai Health System, New York, NY, USA
| | - Martin Andreas
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | | | - Karl-Philipp Rommel
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | | | | | - Daniel Braun
- Medical Clinic and Polyclinic I, University Hospital of Munich, Munich, Germany
| | - Benedikt Koell
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany
| | - Daniel Kalbacher
- Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany.,German Center for Cardiovascular Research, Partner Site Hamburg/Luebeck/Kiel, Germany
| | - Kim A Connelly
- Division of Cardiology, Toronto Heart Center, St Michael's Hospital, Toronto, Ontario, Canada
| | | | - Claudia Harr
- Asklepios Clinic St Georg, Medical Care Center Prof. Mathey, Prof. Schofer, Hamburg, Germany
| | - Giovanni Pedrazzini
- Department of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland.,Division of Cardiology, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Giulio Russo
- Cardiology Unit, Policlinico Tor Vergata, University of Rome, Rome, Italy
| | - François Philippon
- Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Joachim Schofer
- Asklepios Clinic St Georg, Medical Care Center Prof. Mathey, Prof. Schofer, Hamburg, Germany
| | - Holger Thiele
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | - Matthias Unterhuber
- Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Leipzig, Germany
| | | | | | - Mirjam G Wild
- Division of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Stephan Windecker
- Division of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Ulrich Jorde
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Francesco Maisano
- Division of Cardiology and Department of Cardiac Surgery, San Raffaele University Hospital, Milan, Italy
| | - Martin B Leon
- Cardiovascular Research Foundation, New York, NY, USA.,Division of Cardiology, Columbia University Medical Center, NewYork-Presbyterian Hospital, New York, NY, USA
| | - Rebecca T Hahn
- Cardiovascular Research Foundation, New York, NY, USA.,Division of Cardiology, Columbia University Medical Center, NewYork-Presbyterian Hospital, New York, NY, USA
| | - Azeem Latib
- Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
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Medranda GA, Rogers T, Modine T, Latib A, Jorde U, Bapat V, Sorajja P, Rowland M, Sutton JA, Baig S, Asch FM, Garcia-Garcia HM, Ben-Dor I, Satler LF, Waksman R. The Clinical Profile and Natural History of Patients Who Fail Screening for Transcatheter Mitral Valve Replacement: Rationale and Design of the Prospective Multicenter Mitral Valve Screening Survey (MVSS). Cardiovasc Revasc Med 2023; 47:72-75. [PMID: 36266153 DOI: 10.1016/j.carrev.2022.09.003] [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] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 09/06/2022] [Indexed: 01/25/2023]
Abstract
Mitral valve disease is insidious and associated with a decreased quality of life and survival over time. Despite surgery being the standard of care, many patients are at prohibitive surgical risk. Furthermore, a substantial proportion of patients with symptomatic mitral valve disease fail stringent screening criteria for transcatheter mitral valve replacement (TMVR). The natural history of patients who fail screening is not well-characterized, and data are limited on the reasons for screen failure in this population. The Mitral Valve Screening Survey (MVSS) seeks to detail the clinical profile and natural history of patients who fail screening for TMVR. The MVSS is a prospective, multicenter registry enrolling up to 1000 consecutive subjects who, after screening for TMVR, are deemed not to be candidates. Subjects will be followed for 30 days after failing screening for TMVR and annually for up to 5 years with clinical evaluations. The primary study endpoint of the MVSS registry is all-cause mortality at 1 year. Additional secondary endpoints include all-cause mortality, hospitalizations, subsequent mitral valve intervention (transcatheter or surgical), reason for screen failure, and quality-of-life assessments at 30 days and annually up to 5 years of follow-up. The MVSS registry is the first prospective multicenter study to characterize the clinical and anatomical profile of patients who fail screening for TMVR while providing longitudinal clarification on the natural history and outcomes of these patients. CLINICAL TRIAL REGISTRATION: Mitral Valve Screening Survey (MVSS), https://clinicaltrials.gov/ct2/show/NCT04736667, NCT04736667.
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Affiliation(s)
- Giorgio A Medranda
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Toby Rogers
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA; Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Thomas Modine
- Interventional Cardiology and Cardiovascular Surgery, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - Azeem Latib
- Department of Cardiology, Montefiore Einstein Center for Heart and Vascular Care, Bronx, NY, USA
| | - Ulrich Jorde
- Department of Cardiology, Montefiore Einstein Center for Heart and Vascular Care, Bronx, NY, USA
| | - Vinayak Bapat
- Department of Cardiothoracic Surgery, Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Paul Sorajja
- Department of Cardiology, Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Megan Rowland
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Joseph A Sutton
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Salman Baig
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Federico M Asch
- MedStar Health Research Institute at MedStar Washington Hospital Center, Washington, DC, USA
| | - Hector M Garcia-Garcia
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Itsik Ben-Dor
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Lowell F Satler
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Ron Waksman
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA.
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Kobashigawa JA, Hall S, Farr M, Blumberg E, Michael Borkon A, Colvin M, Copeland H, Eisen H, Johnson M, Jorde U, Khush K, Kirklin JK, Patel J, Pinney S, Saadaeijahromi H, Schold JD, Stehlik J. Proceedings from the metrics forum in heart transplantation for performance monitoring. Am J Transplant 2022; 22:1299-1306. [PMID: 34866328 DOI: 10.1111/ajt.16901] [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] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/09/2021] [Accepted: 11/19/2021] [Indexed: 01/25/2023]
Abstract
Regulatory oversight for heart transplant programs is currently under review by the United Network for Organ Sharing (UNOS). There is concern whether 1-year patient and graft survival truly represent heart transplant center performance. Thus, a forum was organized by the Thoracic and Critical Care Community of Practice (TCC COP) of the American Society of Transplantation (AST) for the heart transplant community to voice their opinions on matters involving program performance monitoring by UNOS. A TCC COP work group was formed to review outcome metrics for adult heart transplantation and culminated in a virtual community forum (72 participants representing 61 heart transplant programs) on November 12-13, 2020. One-year posttransplant survival is still considered an appropriate and important measure to assess program performance. Waitlist mortality and offer acceptance rate as pretransplant metrics could also be useful measures of program performance, recognizing that outside factors may influence these metrics. In depth discussion of these metrics and other issues including auditing thresholds, innovations to reduce risk-averse behavior and personally designed program scorecards are included in this meeting proceedings.
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Affiliation(s)
| | - Shelley Hall
- Baylor University Medical Center, Dallas, Texas, USA
| | | | - Emily Blumberg
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | - Hannah Copeland
- Lutheran Hospital, Indiana University Fort Wayne, Fort Wayne, Indiana, USA
| | - Howard Eisen
- Pennsylvania State University, State College, Pennsylvania, USA
| | | | - Ulrich Jorde
- Montefiore Medical Center, New York, New York, USA
| | - Kiran Khush
- Stanford University, Palo Alto, California, USA
| | - James K Kirklin
- University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jignesh Patel
- Cedars-Sinai Smidt Heart Institute, Los Angeles, California, USA
| | - Sean Pinney
- University of Chicago, Chicago, Illinois, USA
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Jahufar F, Majmudar U, Kim P, Parsi S, Murthy S, Saeed O, Shin JJ, Patel S, Jorde U, Sims D. Automatic Critical Care Consultation Does Not Improve Outcomes For Patients Receiving Mechanical Ventilation In A Cardiac Intensive Care Unit Staffed By A Dedicated Heart Failure Specialist. J Card Fail 2022. [DOI: 10.1016/j.cardfail.2022.03.118] [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: 10/18/2022]
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Kostick-Quenet K, Blumenthal-Barby J, Mehra M, Lang B, Dorfman N, Bhimaraj A, Civitello A, Jorde U, Trachtenberg B, Uriel N, Kaplan H, Gilmore-Szott E, Volk R, Estep J. Integrating Personalized Risk Scores in Decision Making About Left Ventricular Assist Device (LVAD) Therapy: Clinician and Patient Perspectives. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1714] [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: 10/18/2022] Open
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35
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Kataria R, Jorde U. Sex-Related Disparities In Atrial Functional Mitral Regurgitation. J Card Fail 2022. [DOI: 10.1016/j.cardfail.2022.03.288] [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]
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Mirza KK, Szymanski MK, Schmidt T, de Jonge N, Brahmbhatt DH, Billia F, Hsu S, MacGowan GA, Jakovljevic DG, Agostoni P, Trombara F, Jorde U, Rochlani Y, Vandersmissen K, Reiss N, Russell SD, Meyns B, Gustafsson F. Prognostic Value of Peak Oxygen Uptake in Patients Supported With Left Ventricular Assist Devices (PRO-VAD). JACC Heart Fail 2021; 9:758-767. [PMID: 34391745 DOI: 10.1016/j.jchf.2021.05.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The purpose of this study was to examine whether peak oxygen uptake (pVO2) and other cardiopulmonary exercise test (CPET)-derived variables could predict intermediate-term mortality in stable continuous flow LVAD recipients. BACKGROUND pVO2 is a cornerstone in the selection of patients for heart transplantation, but the prognostic power of pVO2 obtained in patients treated with a left ventricular assist device (LVAD) is unknown. METHODS We collected data for pVO2 and outcomes in adult LVAD recipients in a retrospective, multicenter study and evaluated cutoff values for pVO2 including: 1) values above or below medians; 2) grouping patients in tertiles; and 3) pVO2 ≤14 ml/kg/min if the patient was not treated with beta-blockers (BB) or pVO2 ≤12 ml/kg/min if the patient was taking BB therapy. RESULTS Nine centers contributed data from 450 patients. Patients were 53 ± 13 years of age; 78% were male; body mass index was 25 ± 5 kg/m2 with few comorbidities (stroke: 11%; diabetes: 18%; and peripheral artery disease: 4%). The cause of heart failure (HF) was most often nonischemic (66%). Devices included were the HeartMate II and 3 (Abbott); and Heartware ventricular assist devices Jarvik and Duraheart (Medtronic). The index CPET was performed at a median of 189 days (154 days-225 days) after LVAD implantation, and mean pVO2 was 14.1 ± 5 ml/kg/min (47% ± 14% of predicted value). Lower pVO2 values were strongly associated with poorer survival regardless of whether patients were analyzed for absolute pVO2 in ml/kg/min, pVO2 ≤12 BB/14 ml/kg/min, or as a percentage of predicted pVO2 values (P ≤ 0.001 for all). For patients with pVO2 >12 BB/14 and ventilation/carbon dioxide relationship (VE/VCO2) slope <35, the 1-year survival was 100%. CONCLUSIONS Even after LVAD implantation, pVO2 has prognostic value, similar to HF patients not supported by mechanical circulatory support devices. (PROgnostic Value of Exercise Capacity Measured as Peak Oxygen Uptake [pVO2] in Recipients of Left Ventricular Assist Devices [PRO-VAD]; NCT04423562).
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Affiliation(s)
- Kiran K Mirza
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.
| | | | - Thomas Schmidt
- Schüchtermann-Klinik Bad Rothenfelde, Institute for Cardiovascular Research, Bad Rothenfelde, Germany, and Institute for Cardiology and Sports Medicine, German Sports University Cologne, Cologne, Germany
| | | | - Darshan H Brahmbhatt
- Peter Munk Cardiac Centre, Division of Cardiology, Ted Rogers Centre for Heart Research, University Health Network, University of Toronto, Toronto, Ontario, Canada; Division of Cardiology, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Filio Billia
- Peter Munk Cardiac Centre, Division of Cardiology, Ted Rogers Centre for Heart Research, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Steven Hsu
- Advanced Heart Failure, Mechanical Circulatory Support, Transplant Cardiology, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Guy A MacGowan
- Department of Cardiology, Freeman Hospital and Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom; Faculty of Health and Life Sciences, Coventry University, University Hospital Coventry and Warwickshire, United Kingdom
| | - Djordje G Jakovljevic
- Department of Cardiology, Freeman Hospital and Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom; Faculty of Health and Life Sciences, Coventry University, University Hospital Coventry and Warwickshire, United Kingdom; Department of Cardiology, Freeman Hospital and Biosciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Piergiuseppe Agostoni
- Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milano, Italy; Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milano, Milano, Italy
| | - Filippo Trombara
- Montefiore Einstein Center for Heart and Vascular Care New York, New York City, New York, USA
| | - Ulrich Jorde
- Montefiore Einstein Center for Heart and Vascular Care New York, New York City, New York, USA
| | - Yogita Rochlani
- Montefiore Einstein Center for Heart and Vascular Care New York, New York City, New York, USA
| | | | - Nils Reiss
- Schüchtermann-Klinik Bad Rothenfelde, Institute for Cardiovascular Research, Bad Rothenfelde, Germany, and Institute for Cardiology and Sports Medicine, German Sports University Cologne, Cologne, Germany
| | - Stuart D Russell
- Department of Cardiology, Duke University Health System, Durham, North Carolina, USA
| | - Bart Meyns
- Department of Cardiac Surgery, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Finn Gustafsson
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Rigshospitalet, Copenhagen, Denmark. https://twitter.com/FinnGustafsson
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Hamza M, Doshi K, Harutyunyan M, Adhikari A, Nazeer H, Yager N, Torosoff M, Jorde U, Belov D. INCREASED MEAN PLATELET VOLUME IS ASSOCIATED WITH INCREASED MORTALITY IN CARDIOGENIC SHOCK PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION WITH CIRCULATORY SUPPORT. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)01996-3] [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: 10/21/2022]
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Milwidsky A, Haroun M, Saeed O, Goldstein D, Forest S, Uehara M, Chinnadurai T, Madan S, Jorde U. Post Left Ventricular Assist Device Implantation Platelets Count Alterations are Related to Gender, Race and Early Mortality. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Saeed D, Potapov E, Loforte A, Morshuis M, Schibilsky D, Zimpfer D, Riebandt J, Pappalardo F, Attisani M, Rinaldi M, Haneya A, Ramjankhan F, Donker D, Jorde U, Stein J, Tsyganenko D, Jawad K, Wieloch R, Ayala R, Cremer J, Borger M, Lichtenberg A, Gummert J. Neurological Complications in Patients Requiring Durable VAD Systems after ECLS Support. On Behalf of ECLS- Durable MCS Study Group. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Saeed D, Potapov E, Loforte A, Morshuis M, Schibilsky D, Zimpfer D, Riebandt J, Pappalardo F, Attisani M, Haneya A, Ramjankhan F, Donker D, Tsyganenko D, Jorde U, Jawad K, Wieloch R, Ayala R, Cremer J, Borger M, Lichtenberg A, Gummert J. Stroke Complications in Patients Requiring Durable VAD Systems after VA-ECMO Support. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - R. Ayala
- Freiburg im Breisgau, Deutschland
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Jorde U, Katz J, Colombo P, Stulak J, Crandall D, Franke A, Adamson R. Prevention of Non-Surgical Bleeding by Management of HeartMate II Patients without Antiplatelet Therapy. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Fauvel D, Castillo C, Taveras M, Oviedo J, Saeed O, Forest S, Goldstein D, Patel S, Jorde U. Advances in Driveline Technology Cures Some but Infects Others: Single Center's Experience with Driveline Infections in HeartMate 3 Patients. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Alvarez C, Nnani D, Patel S, Goldstein D, Saeed O, Sims D, Shin J, Murthy S, Vukelic S, Chavez P, Forest S, Jorde U. Post-Transplant Diabetes Mellitus and the Risk of Acute Rejection in Heart Transplant. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.923] [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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Chauhan D, Wetzler J, Phan D, Puius Y, Saeed O, Patel S, Sims D, Vukelic S, Shin J, Chavez P, Murthy S, Jorde U, Goldstein D, Forest S. Driveline Rerouting and Incision & Drainage for the Management of Chronic Driveline Infection in LVAD Recipients. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.065] [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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Harutyunyan M, Doshi K, Nazeer H, Joye E, Saeed O, Torosoff M, Jorde U, Belov D. Increased Mean Platelet Volume is Associated with Decreased Survival in Patients Supported with Impella. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Sun E, Diab K, Leyton C, Nnani D, Murthy S, Patricia C, Saeed O, Vukelic S, Patel S, Shin J, Garcia M, Jorde U, Sims D. ACUTE RATE CONTROL OF ATRIAL FIBRILLATION WITH RAPID VENTRICULAR RESPONSE USING INTRAVENOUS CALCIUM CHANNEL BLOCKERS OR INTRAVENOUS BETA BLOCKERS LEADS TO CARDIOGENIC SHOCK IN PATIENTS WITH UNDERLYING SYSTOLIC DYSFUNCTION. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31471-6] [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: 10/24/2022]
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Yarber C, Travin M, Vlismas P, Saeed O, Murthy S, Chavez P, Vukelic S, Patel S, Shin J, Jorde U, Sims D. CARDIAC PET GUIDED IMMUNOSUPPRESSION THERAPY IN THE TREATMENT OF CARDIAC SARCOIDOSIS. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31403-0] [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: 10/24/2022]
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Farr M, Truby LK, Lindower J, Jorde U, Taylor S, Chen L, Gass A, Stevens G, Reyentovich A, Mancini D, Arcasoy S, Delair S, Pinney S. Potential for donation after circulatory death heart transplantation in the United States: Retrospective analysis of a limited UNOS dataset. Am J Transplant 2020; 20:525-529. [PMID: 31529766 DOI: 10.1111/ajt.15597] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 03/27/2019] [Revised: 08/05/2019] [Accepted: 08/28/2019] [Indexed: 01/25/2023]
Abstract
Donation after Circulatory Death (DCD) is an alternative to Donation after Brain death (DBD), and is a growing strategy for organ procurement in the United States(US). The purpose of this analysis was to review the number and quality of hearts in one United Network for Organ Sharing (UNOS) Region that were not utilized as a potential consequence of nonheart DCD donation. We retrospectively identified all successful US DCD solid organ donors from 1/2011 to 3/1/2017, defined an ideal heart donor by age and left ventricular ejection fraction (LVEF), and then reviewed the donor charts of unused hearts in New York and Vermont (UNOS Region 9). Of 8302 successful DCD donors across the United States, 5033 (61%) were between 18 and 49 years of age, and 872 had a screening echocardiogram, with 573 (66%) measuring an EF >50%. Of these 573 potential donors, 44 (7.7%) were from Region 9. Detailed donor chart review identified 36 ideal heart donors, 24 (66.7%) with anoxic brain injury. Trends in Region 9 DCD donation increased from 4 unused hearts in 2011, to 13 in 2016. In the context of severe organ scarcity, these data indicate that implementation of DCD heart transplantation in the United States would improve overall donation rates and provide a pathway to utilize these ideal donor hearts.
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Affiliation(s)
- Maryjane Farr
- Heart and Lung Transplant Programs, Columbia University Irving Medical Center, New York, New York, USA
| | - Lauren K Truby
- Duke University Medical Center, Durham, North Carolina, USA
| | - Joel Lindower
- New York Cardiothoracic Transplant Consortium, Albany, New York, USA
| | - Ulrich Jorde
- Heart Transplant Program, Montefiore Medical Center, Bronx, New York, USA
| | - Samantha Taylor
- New York Cardiothoracic Transplant Consortium, Albany, New York, USA
| | - Leway Chen
- Heart Transplant Program, University of Rochester Medical Center, Rochester, New York, USA
| | - Alan Gass
- Heart Transplant Program, Westchester Medical Center, Valhalla, New York, USA
| | - Gerin Stevens
- Heart Transplant Program, Northwell Health, Manhasset, New York, USA
| | - Alex Reyentovich
- Heart Transplant Program, New York University, New York, New York, USA
| | - Donna Mancini
- United Network for Organ Sharing/Organ Procurement Transplant Network, Thoracic Committee, Region 9, Richmond, Virginia, USA.,Heart Transplant Program, Mt. Sinai Medical Center, New York, New York, USA
| | - Selim Arcasoy
- Heart and Lung Transplant Programs, Columbia University Irving Medical Center, New York, New York, USA
| | - Samantha Delair
- New York Cardiothoracic Transplant Consortium, Albany, New York, USA
| | - Sean Pinney
- Heart Transplant Program, Mt. Sinai Medical Center, New York, New York, USA
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Stehlik J, Mountis M, Haas D, Palardy M, Ambardekar AV, Estep JD, Ewald G, Russell SD, Robinson S, Jorde U, Taddei-Peters WC, Jeffries N, Richards B, Khalatbari S, Spino C, Baldwin JT, Mann D, Stewart GC, Aaronson KD. Quality of life and treatment preference for ventricular assist device therapy in ambulatory advanced heart failure: A report from the REVIVAL study. J Heart Lung Transplant 2019; 39:27-36. [PMID: 31822442 DOI: 10.1016/j.healun.2019.11.006] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 11/13/2019] [Accepted: 11/14/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The Registry Evaluation of Vital Information for Ventricular Assist Devices (VADs) in Ambulatory Life study is a prospective multicenter cohort of 400 ambulatory patients with advanced chronic systolic heart failure (HF). The aim of the study is to better understand disease trajectory and optimal timing of advanced HF therapies. We examined patient health-related quality of life (HRQOL) data collected at enrollment and their association with patient treatment preferences for VAD placement. METHODS Baseline assessment of HRQOL included the Kansas City Cardiomyopathy Questionnaire (KCCQ) and the EuroQol EQ-5D-3L Visual Analogue Scale (VAS), along with patient self-assessment of remaining life (PSARL). Descriptive statistics were used to present baseline HRQOL data and Spearman correlation tests to assess the association between KCCQ, VAS, and VAD treatment preference with patient clinical characteristics of interest. RESULTS The median age was 60 years, 75% were male, and the median left ventricular ejection fraction was 20%. The median (25th percentile, 75th percentile), baseline KCCQ summary score was 64 (48, 78), VAS score 65 (50, 75), and PSARL 7 years (5, 10). There were statistically significant associations of baseline KCCQ and VAS with New York Heart Association class and Interagency Registry of Mechanically Assisted Circulatory Support profile (p < 0.005 for all comparisons). Baseline KCCQ and VAS revealed a modest association with PSARL (correlation = 0.45 and 0.35, respectively; p < 0.001), and many patients were overly optimistic about their expected survival. VAD treatment preference was associated with KCCQ scores (p < 0.031), but the absolute differences were small. VAD treatment preference was independent of other key clinical characteristics such as subject age, VAS, and PSARL. CONCLUSIONS We found a lack of strong association between HRQOL and patient preference for VAD therapy. Better understanding of patients' perceptions of their illness and how this relates to HRQOL outcomes, clinician risk assessment, and patient decision-making is needed. This may in turn allow better guidance toward available HF therapies in this vulnerable population.
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Affiliation(s)
- Josef Stehlik
- University of Utah School of Medicine, Salt Lake City, Utah.
| | | | - Donald Haas
- Abington - Jefferson Health, Abington, Pennsylvania
| | - Maryse Palardy
- University of Michigan Medical School, Ann Arbor, Michigan
| | | | | | - Gregory Ewald
- Washington University School of Medicine, St. Louis, Missouri
| | | | | | - Ulrich Jorde
- Montefiore Medical Center, New York City, New York
| | | | - Neal Jeffries
- National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Blair Richards
- University of Michigan, Michigan Institute for Clinical and Health Research, Ann Arbor, Michigan
| | - Shokoufeh Khalatbari
- University of Michigan, Michigan Institute for Clinical and Health Research, Ann Arbor, Michigan
| | - Catherine Spino
- University of Michigan School of Public Health, Ann Arbor, Michigan
| | | | - Douglas Mann
- Washington University School of Medicine, St. Louis, Missouri
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50
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Vukelic S, Xu Q, Seidel-Rogol B, Faidley EA, Dikalova AE, Hilenski LL, Jorde U, Poole LB, Lassègue B, Zhang G, Griendling KK. NOX4 (NADPH Oxidase 4) and Poldip2 (Polymerase δ-Interacting Protein 2) Induce Filamentous Actin Oxidation and Promote Its Interaction With Vinculin During Integrin-Mediated Cell Adhesion. Arterioscler Thromb Vasc Biol 2019; 38:2423-2434. [PMID: 30354218 DOI: 10.1161/atvbaha.118.311668] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 12/22/2022]
Abstract
Objective- Actin cytoskeleton assembly and organization, as a result of focal adhesion (FA) formation during cell adhesion, are dependent on reactive oxygen species and the cellular redox environment. Poldip2 (polymerase δ-interacting protein 2), a novel regulator of NOX4 (NADPH oxidase 4), plays a significant role in reactive oxygen species production and cytoskeletal remodeling. Thus, we hypothesized that endogenous reactive oxygen species derived from Poldip2/NOX4 contribute to redox regulation of actin and cytoskeleton assembly during integrin-mediated cell adhesion. Approach and Results- Using vascular smooth muscle cells, we verified that hydrogen peroxide (H2O2) levels increase during integrin-mediated cell attachment as a result of activation of NOX4. Filamentous actin (F-actin) was oxidized by sulfenylation during cell attachment, with a peak at 3 hours (0.80±0.04 versus 0.08±0.13 arbitrary units at time zero), which was enhanced by overexpression of Poldip2. Depletion of Poldip2 or NOX4 using siRNA, or scavenging of endogenous H2O2 with catalase, inhibited F-actin oxidation by 78±26%, 99±1%, and 98±1%, respectively. To determine the consequence of F-actin oxidation, we examined the binding of F-actin to vinculin, a protein involved in FA complexes that regulates FA maturation. Vinculin binding during cell adhesion as well as migration capacity were inhibited after transfection with actin containing 2 oxidation-resistant point mutations (C272A and C374A). Silencing of Poldip2 or NOX4 also impaired actin-vinculin interaction, which disturbed maturation of FAs and inhibited cell migration. Conclusions- These results suggest that integrin engagement during cell attachment activates Poldip2/Nox4 to oxidize actin, which modulates FA assembly.
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Affiliation(s)
- Sasa Vukelic
- From the Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA (S.V., Q.X., B.S.-R., E.A.F., L.L.H., B.L., K.K.G.).,Division of Cardiology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY (S.V., U.J.)
| | - Qian Xu
- From the Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA (S.V., Q.X., B.S.-R., E.A.F., L.L.H., B.L., K.K.G.).,Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China (Q.X., G.Z.)
| | - Bonnie Seidel-Rogol
- From the Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA (S.V., Q.X., B.S.-R., E.A.F., L.L.H., B.L., K.K.G.)
| | - Elizabeth A Faidley
- From the Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA (S.V., Q.X., B.S.-R., E.A.F., L.L.H., B.L., K.K.G.)
| | - Anna E Dikalova
- Department of Medicine, Vanderbilt University, Nashville, TN (A.E.D.)
| | - Lula L Hilenski
- From the Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA (S.V., Q.X., B.S.-R., E.A.F., L.L.H., B.L., K.K.G.)
| | - Ulrich Jorde
- Division of Cardiology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY (S.V., U.J.)
| | - Leslie B Poole
- Department of Biochemistry, Center for Molecular Signaling, Center for Redox Biology and Medicine, Wake Forest School of Medicine, Winston-Salem, NC (L.B.P.)
| | - Bernard Lassègue
- From the Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA (S.V., Q.X., B.S.-R., E.A.F., L.L.H., B.L., K.K.G.)
| | - Guogang Zhang
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, China (Q.X., G.Z.)
| | - Kathy K Griendling
- From the Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA (S.V., Q.X., B.S.-R., E.A.F., L.L.H., B.L., K.K.G.)
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