Lekhya Raavi, Pankaj Garg, Mohammad Alomari, Mostafa Ali, Ishaq Wadiwala, Magdy M El-Sayed Ahmed
{"title":"Patent Foramen Ovale-Related Hypoxemia After Bilateral Lung Transplant.","authors":"Lekhya Raavi, Pankaj Garg, Mohammad Alomari, Mostafa Ali, Ishaq Wadiwala, Magdy M El-Sayed Ahmed","doi":"10.14503/THIJ-23-8229","DOIUrl":"10.14503/THIJ-23-8229","url":null,"abstract":"<p><p>A 64-year-old man with interstitial pulmonary fibrosis and a small patent foramen ovale with right-to-left shunting underwent bilateral lung transplant without closure of the patent foramen ovale. Postoperatively, the patient remained persistently hypoxemic with partial response to high-flow oxygen. Investigations revealed the presence of a large patent foramen ovale with right-to-left shunting on echocardiography and a shunt fraction of 21% on cardiac catheterization. Two months after the lung transplantation, primary surgical repair of the patent foramen ovale was performed with immediate improvement in oxygenation. Three years postoperatively, the patient remained oxygen independent.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Orlando R Suero, Sri Kartik Valluri, Mario H Farias-Kovac, Leo Simpson, Gabriel Loor, Diana M Guerra, Jose L Diaz-Gomez, Subhasis Chatterjee
{"title":"Recovery of Lung Function After 149 Days on Extracorporeal Membrane Oxygenation for COVID-19.","authors":"Orlando R Suero, Sri Kartik Valluri, Mario H Farias-Kovac, Leo Simpson, Gabriel Loor, Diana M Guerra, Jose L Diaz-Gomez, Subhasis Chatterjee","doi":"10.14503/THIJ-23-8132","DOIUrl":"10.14503/THIJ-23-8132","url":null,"abstract":"<p><p>This report highlights survival and the patient's perspective after prolonged venovenous extracorporeal membrane oxygenation (ECMO) for COVID-19-related respiratory failure. A 36-year-old man with COVID-19 presented with fever, anosmia, and hypoxia. After respiratory deterioration necessitating intubation and lung-protective ventilation, he was referred for ECMO. After 3 days of conventional venovenous ECMO, he required multiple creative cannulation configurations. Adequate sedation and recurrent bradycardia were persistent challenges. After 149 consecutive days of ECMO, he recovered native lung function and was weaned from mechanical ventilation. This represents the longest-duration ECMO support in a survivor of COVID-19 yet reported. Necessary strategies included unconventional cannulation and flexible anticoagulation.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Milos Matkovic, Nemanja Aleksic, Ilija Bilbija, Ana Antic, Jelena Milin Lazovic, Marko Cubrilo, Aleksandar Milojevic, Igor Zivkovic, Svetozar Putnik
{"title":"Clinical Impact of Patient-Prosthesis Mismatch After Aortic Valve Replacement With a Mechanical or Biological Prosthesis.","authors":"Milos Matkovic, Nemanja Aleksic, Ilija Bilbija, Ana Antic, Jelena Milin Lazovic, Marko Cubrilo, Aleksandar Milojevic, Igor Zivkovic, Svetozar Putnik","doi":"10.14503/THIJ-22-8048","DOIUrl":"10.14503/THIJ-22-8048","url":null,"abstract":"<p><strong>Background: </strong>Patient-prosthesis mismatch (PPM) may impair functional capacity and survival after aortic valve replacement. This study aimed to investigate the impact of PPM on long-term survival and quality of life after mechanical and biological aortic valve replacement.</p><p><strong>Methods: </strong>This study included 595 consecutive patients who had undergone isolated aortic valve replacement. Patients were divided into 2 groups according to prosthesis type. The baseline and operative characteristics, survival rates, complications, and quality of life of the groups with and without PPM were compared for up to 6 years. The PPM calculation was performed using the effective orifice area value provided by the manufacturer divided by the patient's body surface area.</p><p><strong>Results: </strong>The moderate to severe PPM rates were 69.8% and 3.7% after biological and mechanical prosthesis implantation, respectively. Mean survival for patients in the biological group who had PPM was statistically significantly shorter (50.2 months [95% CI, 45.2-55.3]) than for patients in the biological group without PPM (60.1 months [95% CI, 55.7-64.4]; P = .04). In the mechanical prosthesis group, there was no difference in mean survival between the subgroup with PPM (66.6 months [95% CI, 58.3-74.9]) and the subgroup without PPM (64.9 months [95% CI, 62.6-67.2]; P = .50). A quality-of-life questionnaire's scores did not differ between the groups.</p><p><strong>Conclusion: </strong>Mismatch is common after biological valve implantation and statistically significantly affects long-term survival and quality of life. If the risk of PPM after implantation of a biological prosthesis is suspected, adopting strategies to avoid PPM at the time of surgery is warranted.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Inflammatory Pathways and Their Implications in Heart Failure With Preserved Ejection Fraction.","authors":"Matthew W Segar, Stephanie A Coulter","doi":"10.14503/THIJ-23-8223","DOIUrl":"10.14503/THIJ-23-8223","url":null,"abstract":"","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Science Is a Self-Correcting Discipline: Revisiting the Biological Potential of Adult Cardiac Progenitors.","authors":"Daniele Torella, Eleonora Cianflone","doi":"10.14503/THIJ-23-8241","DOIUrl":"10.14503/THIJ-23-8241","url":null,"abstract":"","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Olga Vriz, Ali Hassan Mushtaq, Ahmed Nahid Elshaer, Abdullah Shaik, Irene Landi, Talal Alzahrani
{"title":"Takotsubo Syndrome in Black Americans: Insights From the National Inpatient Sample.","authors":"Olga Vriz, Ali Hassan Mushtaq, Ahmed Nahid Elshaer, Abdullah Shaik, Irene Landi, Talal Alzahrani","doi":"10.14503/THIJ-22-8055","DOIUrl":"10.14503/THIJ-22-8055","url":null,"abstract":"<p><strong>Background: </strong>Data on race-related differences in the clinical outcomes of Takotsubo syndrome are limited, particularly for Black patients. This study aimed to assess whether race and sex may have an additional impact on the inpatient mortality of patients with Takotsubo syndrome.</p><p><strong>Methods: </strong>A total of 4,628 patients from the United States' National Inpatient Sample from 2012 to 2016 were identified; propensity score analysis revealed a similar propensity score between Black patients (n = 2,314) and White patients (n = 2,314), which was used to balance observed covariates. Sex and age distributions were identical between the 2 groups. The groups were also similar in baseline characteristics, including cardiovascular risk factors. White patients were compared with Black patients on in-hospital outcomes and inpatient mortality. A logistic regression analysis was conducted to measure the difference in mortality based on race and sex.</p><p><strong>Results: </strong>Compared with White patients, Black patients had a higher percentage of in-hospital complications, including cerebrovascular accidents (4.9% vs 2.5%, P ≤ .01), acute kidney injury (25% vs 19%, P ≤ .01); longer lengths of stay (8 vs 7 days, P ≤ .01); and higher inpatient mortality (6.1% vs 4.5%, P < .01). When analysis was conducted with race and sex combined, inpatient mortality was higher among Black men than among White women (odds ratio, 2.7 [95% CI, 1.80-3.95]; P ≤ .01).</p><p><strong>Conclusion: </strong>This study showed that Black patients with Takotsubo syndrome have higher in-hospital complications and inpatient mortality rates. When race and sex were combined, inpatient mortality was significantly higher among Black men than among either White men and women or Black women.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Targeting Cell Senescence to Improve Cardiac Regeneration.","authors":"Georgina M Ellison-Hughes","doi":"10.14503/THIJ-23-8262","DOIUrl":"10.14503/THIJ-23-8262","url":null,"abstract":"phenotype (","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eliana Rosenzweig, Gerson Antonio Valencia Villeda, Sarah Crook, Fatima Koli, Erika B Rosenzweig, Usha S Krishnan
{"title":"Efficacy of a Commercial Physical Activity Monitor in Longitudinal Tracking of Patients With Pulmonary Hypertension: A Pilot Study.","authors":"Eliana Rosenzweig, Gerson Antonio Valencia Villeda, Sarah Crook, Fatima Koli, Erika B Rosenzweig, Usha S Krishnan","doi":"10.14503/THIJ-22-7866","DOIUrl":"10.14503/THIJ-22-7866","url":null,"abstract":"<p><strong>Background: </strong>Patients with pulmonary arterial hypertension have quality-of-life limitations, decreased exercise capacity, and poor prognosis if the condition is left untreated. Standard exercise testing is routinely performed to evaluate patients with pulmonary arterial hypertension but may be limited in its ability to monitor activity levels in daily living.</p><p><strong>Objective: </strong>To evaluate the validity of the commercial Fitbit Charge HR as a tool to assess real-time exercise capacity as compared with standard exercise testing.</p><p><strong>Methods: </strong>Ambulatory pediatric and adult patients were enrolled and given a Fitbit with instructions to continuously wear the device during waking hours. Patients underwent a 6-minute walk test, cardiopulmonary exercise test, and a 36-Item Short Form Health Survey on the day of enrollment and follow-up. Twenty-seven ambulatory patients with pulmonary arterial hypertension were enrolled, and 21 had sufficient data for analyses (median age, 25 years [range, 13-59 years]; 14 female participants).</p><p><strong>Results: </strong>Daily steps measured by the Fitbit had a positive correlation with 6-minute walk distance (r = 0.72, P = .03) and an inverse trend with World Health Organization functional class. On the 36-Item Short Form Health Survey, 77% of patients reported improvement in vitality (P = .055). At follow-up, there was a strong correlation between number of steps recorded by Fitbit and role limitations because of physical problems (r = 0.88, P = .02) and weaker correlations with other quality-of-life markers.</p><p><strong>Conclusion: </strong>The findings of this pilot study suggest activity monitors may have potential as a simple and novel method of assessing longitudinal exercise capacity and activity levels in patients with pulmonary hypertension. Further study in larger cohorts of patients is warranted to determine which accelerometer measures correlate best with outcomes.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hippo Pathway Knockdown Gene Therapy in the Heart.","authors":"Todd R Heallen, James F Martin","doi":"10.14503/THIJ-23-8272","DOIUrl":"10.14503/THIJ-23-8272","url":null,"abstract":"","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49683846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephanie J Kim, Fernanda C P Mesquita, Camila Hochman-Mendez
{"title":"New Biomarkers for Cardiovascular Disease.","authors":"Stephanie J Kim, Fernanda C P Mesquita, Camila Hochman-Mendez","doi":"10.14503/THIJ-23-8178","DOIUrl":"10.14503/THIJ-23-8178","url":null,"abstract":"<p><p>Cardiovascular disease is the leading cause of death and disability worldwide. Early detection and treatment of cardiovascular disease are crucial for patient survival and long-term health. Despite advances in cardiovascular disease biomarkers, the prevalence of cardiovascular disease continues to increase worldwide as the global population ages. To address this problem, novel biomarkers that are more sensitive and specific to cardiovascular diseases must be developed and incorporated into clinical practice. Exosomes are promising biomarkers for cardiovascular disease. These small vesicles are produced and released into body fluids by all cells and carry specific information that can be correlated with disease progression. This article reviews the advantages and limitations of existing biomarkers for cardiovascular disease, such as cardiac troponin and cytokines, and discusses recent evidence suggesting the promise of exosomes as cardiovascular disease biomarkers.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"50 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}