51
|
Shami A, Edsfeldt A, Shore A, Natali A, Khan F, Nilsson J, Lutgens E, Goncalves I. CD40 levels in plasma are associated with cardiovascular disease and in carotid plaques with a vulnerable plaque phenotype and remodelling. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and purpose
CD40 and CD40 ligand (CD40L) are costimulatory molecules and members of the TNF receptor superfamily well known for their involvement in inflammatory and autoimmune diseases. This study uses two large human cohorts – the SUrrogate markers for Micro- and Macro-vascular hard endpoints for Innovative diabetes Tools (SUMMIT) and the Carotid Plaque Imaging Project (CPIP) – to explore the potential of plasma or intra-plaque expression of CD40 and CD40L as biomarkers and to locally affect plaque stability.
Methods
Proximity Extension Assay (PEA) technique was used to measure soluble CD40 and CD40L (sCD40 and sCD40L) in plasma from 1437 subjects from the SUMMIT cohort, the majority of which (80%) with pre-existing cardiovascular disease, and in atherosclerotic plaque homogenates from 199 subjects of the CPIP cohort undergoing carotid endarterectomy. The Mann-Whitney U test was used to compare groups and Spearman's rank correlation/the Chi-square test was used to assess correlations. Multiple comparisons were corrected for using the Holm-Šídák test. A logistic regression model was used to test for associations with future cardiovascular events and mortality.
Results
In the SUMMIT cohort both plasma CD40 and CD40L levels were elevated in individuals with a history of stroke (p=0.000030 and p=0.020, respectively), while sCD40 levels also were higher in individuals with a prior acute myocardial infarction (p=0.016). Plasma levels of sCD40 correlated with carotid plaque burden (as measured by ultrasound imaging, r=0.355, p<1x10–16) and were associated with future cardiovascular events over a three year-follow up period (p=0.02, hazard ratio 1.3, 95% C.I: 1.042–1.625).
sCD40 and sCD40L were associated with a plaque phenotype characterized by the strong presence of features both of vulnerability such as high content oxidized low-density lipoprotein (LDL; r=0.236, p=0.004 and r=0.259, p=0.0037, respectively) and pro-inflammatory cytokines (e.g. tumour necrosis factor-α: p=3.1x10–7 and p=0.0006, respectively) and low calcium content (r=−0.208, p=0.012 and r=0.268, p=0.00034, respectively).
Conclusion
High plasma CD40 and CD40L levels are associated with symptomatic cardiovascular disease. Plasma CD40 levels correlate with the severity of carotid atherosclerosis and are associated with an increased risk for future cardiovascular events. Additionally, intra-plaque levels are associated with a vulnerable plaque phenotype. Our findings thus support the value of sCD40 and sCD40L both as biomarkers and therapeutic targets for cardiovascular disease.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): The Swedish Heart and Lung Foundation (1) and the Swedish Research Council (2)
Collapse
|
52
|
Mittauer K, Herrera R, Yu J, Khan F, Romaguera T, Alvarez D, Gutierrez A, Mehta M, Chuong M. Comparison of Cardiopulmonary Sparing and Dose Conformality in Distal Esophageal Cancer: Intensity Modulated Proton Therapy (IMPT), MR-guided Radiotherapy (MRgRT), and Volumetric Modulated Arc Therapy (VMAT). Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
53
|
Khan F, Inoue K, Remme E, Andersen O, Gude E, Skulstad H, Chetrit M, Garcia-Izquierdo Jaen E, Ha J, Klein A, Kikuchi S, Ohte N, Nagueh S, Smiseth O. Assessment of left ventricular filling pressure: left atrial reservoir strain is an excellent replacement for missing tricuspid regurgitation velocity. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
When evaluating left ventricular filling pressure (LVFP) according to current guidelines, tricuspid regurgitation (TR) velocity is often not available.
Purpose
In the present study we investigate if left atrial (LA) reservoir strain may be used instead of TR velocity for evaluation of LVFP.
Methods
We performed a prospective, multicenter, multinational and multivendor study in an all comer population of 322 patients with suspected heart failure or other cardiovascular disease where LVFP was measured by right- or left heart catheterization, as pulmonary capillary wedge pressure or pre-A LV diastolic pressure, respectively. Echocardiography was performed within 1 day of catheterization.
101 patients classified as special populations in the 2016 ASE/EACVI recommendations (i.e. non-cardiac pulmonary hypertension, atrial fibrillation, hypertrophic and restrictive cardiomyopathies) were excluded. Of the remaining 221 patients, 118 patients had EF ≥50% and 103 patients had EF <50%. Regression analysis was performed for LA reservoir strain and TR velocity against LVFP. LA reservoir strain at a cut-off value of <18% was applied instead of TR velocity in the 2016 ASE/EACVI algorithm and compared with the current algorithm.
Results
LA reservoir strain correlated better with LVFP than TR velocity, r=0.62 vs 0.40 (p<0.01) (Figure 1). When replacing TR velocity with LA reservoir strain, the feasibility of the ASE/EACVI 2016 algorithm increased from 91.8% to 98.1%. The accuracy of the algorithm was not significantly altered (80% vs 79%).
An accuracy of 80% for the algorithm is lower than what has been reported in earlier publications, this may be due to inclusion of patients without suspected heart failure and no assessment of clinical data, which in turn may have influenced the accuracy of the algorithm.
Conclusion
LA reservoir strain has better correlation to LVFP than TR velocity, and can be used in the ASE/EACVI 2016 algorithm for estimation of LVFP as a replacement when TR velocity is missing.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): South-Eastern Norway Regional Health Authority
Collapse
|
54
|
Khan F, Inoue K, Remme E, Andersen O, Gude E, Skulstad H, Chetrit M, Garcia-Izquierdo Jaen E, Ha J, Klein A, Kikuchi S, Ohte N, Nagueh S, Smiseth O. Which single echo parameter is the best marker of left ventricular filling pressure? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Estimation of left ventricular filling pressure (LVFP) is highly relevant in clinical practice. Invasive pressure remains the gold standard, but a number of echocardiographic parameters that correlate with LVFP are used as non-invasive markers of pressure.
Purpose
We investigated how different echocardiographic parameters correlated with invasively measured LVFP, and how accurately those parameters could differentiate between normal or elevated LVFP.
Method
We performed a prospective, multicenter, multinational and multivendor study in an all comer population of 322 patients with suspected heart failure or other cardiovascular disease. 194 patients had EF ≥50% and 129 had EF <50%. LVFP was measured by right- or left heart catheterization, as pulmonary capillary wedge pressure or pre-A LV diastolic pressure, respectively.
When excluding all special patient populations defined in the 2016 recommendations for echocardiographic evaluation of LV diastolic function, 213 patients remained. Of these 135 had EF ≥50% and 74 had EF <50%.
Echocardiography was performed within 1 day of catheterization. Previously recommended cut-off values for established parameters were used to determine the accuracy of classifying LVFP as normal or elevated. For left atrial (LA) reservoir strain, based on ROC analysis, a cut-off value of <18% was used as marker of elevated LVFP.
Results
LA reservoir strain and the ratio of peak mitral early flow velocity (E) and LA reservoir strain (E/LA strain) showed the best correlations to LVFP (Table 1, Figure 1). They also had the highest accuracy, 75% for both, in classifying LVFP as normal or elevated in the whole patient population. E/LA reservoir strain provided no additional diagnostic value to using LA reservoir strain alone.
In HFpEF patients accuracy was essentially similar for LA strain, E/LA strain and E/e', whereas in HFrEF patients the two former tended to be better than E/e'.
Conclusion
Parameters containing LA reservoir strain showed the best correlation to LVFP. This indicates that LA reservoir strain may have a role in evaluation of LVFP.
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): South-Eastern Norway Regional Health Authority
Collapse
|
55
|
Dhawan R, Selim A, Jhand A, Lundgren S, Zolty R, Khan F. Impact of perioperative right ventricular assist device on ventricular arrhythmias in patients with continuous flow left ventricular assist device. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Patients with continuous flow left ventricular assist device (LVAD) may develop right ventricular failure in perioperative period of LVAD implantation. Some of these patients require temporary support with right ventricular assist device (RVAD). There is paucity of data regarding the impact of RVAD support on incidence of ventricular arrhythmias (VA) in LVAD patients.
Purpose
To assess the impact of perioperative RVAD support on the incidence of VA in the first 6 months after LVAD implant.
Methods
This is a retrospective study including 316 patients undergoing LVAD implantation at the University of Nebraska Medical Center, USA since 2012. Patients were divided into 2 groups- those who required perioperative RVAD support (BiVAD group) and those who did not require it (LVAD only group). VA was defined as any sustained ventricular tachyarrhythmia lasting more than 30 seconds or requiring therapy from implantable cardioverter-defibrillator. Incidence of VA in the first 6 months post-LVAD implantation was analyzed and compared between the groups using Cox proportional hazards regression analysis.
Results
Out of 316 total patients, 52 (16%) patients required RVAD support. The difference in age, gender, race and medications between the two groups was not statistically significant. The patients in BiVAD group had a higher incidence of post-LVAD VA (35%) as compared to LVAD only group (21%). On Cox proportional hazards regression analysis, the difference was found to be statistically significant even after adjusting for history of pre-LVAD VAs (HR: 2.27; p=0.02) (Figure 1).
Conclusion
In this large single center cohort of LVAD patients, we noticed a statistically higher incidence of VA in subgroup of patients requiring perioperative RVAD support.
Figure 1
Funding Acknowledgement
Type of funding source: None
Collapse
|
56
|
Haque S, Jawed A, Akhter N, Dar SA, Khan F, Mandal RK, Areeshi MY, Lohani M, Wahid M. Acetylsalicylic acid (Aspirin): a potent medicine for preventing COVID-19 deaths caused by thrombosis and pulmonary embolism. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2020; 24:9244-9245. [PMID: 33015764 DOI: 10.26355/eurrev_202009_23005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
57
|
Schmitt H, Erber W, Khan F. Response to: ‘Patients with breakthrough tick‐borne encephalitis suffer a more severe clinical course and display extensive MRI changes’. Eur J Neurol 2020; 27:e86-e87. [DOI: 10.1111/ene.14449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/16/2020] [Indexed: 11/29/2022]
|
58
|
Dalli J, O'Keeffe DA, Khan F, Traynor O, Cahill RA. Powered Air Purifying Respirators (PAPR) for the protection of surgeons during operative tasks: a user perspective assessment. Br J Surg 2020; 107:e328-e330. [PMID: 32671824 PMCID: PMC7405207 DOI: 10.1002/bjs.11782] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 05/18/2020] [Indexed: 02/06/2023]
|
59
|
Ahluwalia N, Graham A, Orini M, Williams S, Ahsan S, Khan F, Ezzat V, Sporton S, Earley M, Chow A, Lambiase P, Dhinoja M. P504VT ablation outcomes and predictors in a UK population- validating existing predictors and novel markers. Europace 2020. [DOI: 10.1093/europace/euaa162.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Radiofrequency catheter ablation (CA) can reduce ventricular tachycardia (VT) burden and registry data suggests an improvement in mortality. However, there is significant heterogeneity in patient morbidity and VT phenotype. A risk prediction model derived from observational data has suggested pre-procedural left ventricular (LV) function, age and underlying ischaemic cardiomyopathy are associated with greater post-procedural mortality. Validation of proposed factors in clinical practice is required to facilitate comprehensive pre-procedural risk stratification and inform decision making.
Purpose
To determine whether proposed pre-procedural predictors of mortality after VTCA are valid in a UK population and explore any association with other predictors.
Method
Patients undergoing VTCA at a tertiary electrophysiology centre between 06/07/16 and 31/07/19 were included. Pre-specified characteristics and mortality follow-up data were analysed from electronic health records. Cox regression analysis was undertaken to determine association with mortality.
Results
161 patients with mean age of 63 ±15.9 years underwent VTCA of whom 133 (83%) were male. During the follow-up period (16 months, 13-24; median, 1st-3rd quartile) 16 patients died. No deaths occured in the 27 (16%) patients with structurally normal hearts. Chronic kidney disease (CKD) stage III-IV (HR 14.73 [4.9-44.4]), LV ejection fraction <35% (HR 7.13 [1.59-31.88]), underlying ischaemic cardiomyopathy (HR 6.17 [1.37-27.85]), LV internal diameter (LVID) (1.08 [1.02-1.15]) and age (HR 1.08 [1.02-1.14]) were associated with significantly greater mortality risk (Table 1) (Figure 1).
Conclusion
Proposed risk stratifying factors are validated in our UK centre’s experience. Additionally, CKD and baseline LVID appear to be associated with mortality in our population and warrant further study.
Risk factor Hazard ratio Lower confidence interval Upper confidence interval P-value Atrial fibrillation (yes/no) 0.14 0.02 1.11 0.06 Age (years) 1.08 1.02 1.14 <0.01 Diabetes (yes/no) 2.43 0.85 6.92 0.10 Chronic kidney disease (yes/no) 14.73 4.88 44.41 <0.01 Ischaemic cardiomyopathy (yes/no) 6.17 1.37 27.85 0.02 LV EF <35% (yes/no) 7.13 1.59 31.88 <0.01 LV internal diameter (mm) 1.08 1.02 1.15 <0.01 Procedural urgency (urgent/elective) 1.12 0.57 2.20 0.75 Table 1: Association between baseline risk factors and mortality risk after VT catheter ablation
Abstract Figure 1: Kaplan-Meier survival curves
Collapse
|
60
|
Akram M, Khalid U, Ashraf M, Butt F, Khan F. INDICATIONS AND CLINICAL OUTCOMES OF INDWELLING PLEURAL CATHETER PLACEMENT IN PATIENTS WITH MALIGNANT PLEURAL EFFUSION IN A CANCER SETTING HOSPITAL. Chest 2020. [DOI: 10.1016/j.chest.2020.05.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
61
|
Omara M, Abdelgadir E, Khan F, Latif MF, Alawadi F, Koury M, Elshourbagy D, Hamza D, Kumar S, Das K, Malik Q, Tirmazy SH. Incidence of Immune Related Adverse Events in Patients Treated with Immune Checkpoint Inhibitors, Case Series from Two Tertiary Care Centeers in Dubai, UAE. TUMORI JOURNAL 2020. [DOI: 10.1177/0300891620914156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction: Immune checkpoint inhibitors (ICI) represent a major component of systemic therapy in advanced malignancy. Studies have reported unique spectrum of toxicity profile of ICI as compared to systemic chemotherapy. Aim of this study is to evaluate toxicities of ICI in our population and to compare this with published data. Material and Methods: We retrospectively reviewed medical records of patients treated with ICI at Dubai hospital and American hospital Dubai from November 2015 to April 2019. After patient identification from hospitals cancer registry, data regarding patients’ demographics, cancer type, type of ICI, adverse events, and duration of treatment were collected. Results: Forty-Five patients were identified with median age of 60 (27-80) years. 27 (60%) patients were male and 18 (40%) were female. Underlying diagnosis was lung cancer (n=25), renal cell cancer (n=6), melanoma (n=5), bladder cancer (n=3), Hodgkins lymphoma (n=3) and other malignancies (n=3). Majority of patients received Nivolumab (n=20, 44%) followed by Pembrolizumab (n=19, 42%), Atezolizumab (n=4, 9%) and Durvalumab (n=2, 5%) respectively. Thyroid dysfunction was the most common side effect observed in 17 (38%) patients including hypothyroidism (n=12, 27%) and hyperthyroidism (n=5, 11%). 53 % patients treated with Nivolumab developed thyroid dysfunction as compared to Pembrolizumab (22%). 7 patients (16%) had elevated liver enzymes. Grade II and III hepatotoxicity was noted in 1 patient (2.2 %) each. One patient (2.2 %) developed grade II skin toxicity. One patient (2.2 %) developed grade III colitis. Grade II, III and IV pneumonitis was observed in 2 (4.4 %), 1 (2.2%) and 1 (2.2%) patient respectively. Immune mediated adverse events were managed according to standard guidelines and 2 patients (4.4 %) had treatment discontinuation due to grade IV Pneumonitis and grade III Colitis. Conclusion: Our study reports relatively higher incidence of thyroid adverse events in patients treated with ICI. The incidence of grade III-IV immune related toxicity remains low. Overall treatment with ICI was tolerated reasonably well and toxicity was manageable.
Collapse
|
62
|
Khan F, Keenan R, Keyes A, Cahill RA. Intra-operative visualization of the ureter by near-infrared fluorescence during robotic-assisted laparoscopic sigmoidectomy for diverticulitis - a video vignette. Colorectal Dis 2020; 22:354-355. [PMID: 31713979 DOI: 10.1111/codi.14908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 10/18/2019] [Indexed: 12/19/2022]
|
63
|
Devane LA, Khan F, Murphy E, McCaul C, Cahill RA. Laparoscopic guided transversus abdominis plane block for abdominal surgery - a video vignette. Colorectal Dis 2020; 22:221-222. [PMID: 31487430 DOI: 10.1111/codi.14848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 08/27/2019] [Indexed: 02/08/2023]
|
64
|
Khan F, Amatya B. Medical Rehabilitation in Pandemics: Towards a New Perspective. J Rehabil Med 2020; 52:jrm00043. [DOI: 10.2340/16501977-2676] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
65
|
Ahmad Z, Ghramh HA, Khan KA, Pandey K, Khan F. Chelonine (Hymenoptera: Braconidae: Cheloninae) Parasitoids of Lepidopteran Leafminers in the Indian Subcontinent, with Notes on Taxonomic Character. PAK J ZOOL 2020. [DOI: 10.17582/journal.pjz/20191204091259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
66
|
Ahmad Z, Ghramh HA, Khan KA, Khan F, Shujauddin S. Impact of Two Attending Ants, Crematogaster subnuda and Camponotus compressus (Hymenoptera: Formicidae), on the Parasitism of Sugarcane Aphid Melanaphis sacchari (Zehnt.). PAK J ZOOL 2020. [DOI: 10.17582/journal.pjz/20200309190337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
67
|
Ghramh HA, Ahmad Z, Khan KA, Khan F. Three New Species of the Genus Microplitis Förster, 1862 (Hymenoptera: Braconidae: Microgastrinae) from Saudi Arabia. PAK J ZOOL 2020. [DOI: 10.17582/journal.pjz/20191003111027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
68
|
Amatya B, Cofré Lizama LE, Elmalik A, Bastani A, Galea MP, Khan F. Multidimensional evaluation of changes in limb function following botulinum toxin injection in persons with stroke. NeuroRehabilitation 2019; 45:67-78. [PMID: 31403954 DOI: 10.3233/nre-192722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There are limited evidence of instrumented measures of gait and balance to determine the functional effects of botulinum toxin injections (BoNT-A) in spasticity after stroke. OBJECTIVE To evaluate the functional changes in gait and balance following upper limb and lower limb BoNT-A in persons with stroke. METHODS A pre-post prospective study of 35 stroke patients with upper and/or lower limb spasticity after focal treatment with BoNT-A. Assessments were at baseline (T0), 6-weeks (T1) and 12-weeks (T2), using validated subjective and objective physical activity measures. RESULTS After BoNT-A injections, significant improvements in most measures of impairments, activity and participation domains were found at T1 (p < 0.05, effect sizes (r) = 0.5-0.9). There was a significant increase in low intensity physical activity (at T1) and sedentary time reductions at both follow-up periods. Instrumented gait/balance measures showed a significant increase in cadence and turn velocity, but no changes in sway measures were found using posturography. Improvements in most outcome measures were maintained at 12-weeks. CONCLUSION BONT-A improved scores in most clinical measures but only in some of the objective gait/balance and physical activity measures. Further robust studies should utilize a larger sample size to better determine the benefits of BoNT-A for stroke-related spasticity.
Collapse
|
69
|
Sangshetti J, Chivte DK, Anees MI, Langade M, Khan F, Zainuddin R, Zaheer Z, Mahaparale P. DEVELOPMENT OF HPLC METHOD FOR DETERMINATION OF TAMSULOSIN USING QUALITY BY DESIGN (QBD) APPROACH. EUROPEAN CHEMICAL BULLETIN 2019. [DOI: 10.17628/ecb.2019.8.409-415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
|
70
|
Naz A, Khan Q, Khan T, Gul A, Khan F, Humayun M. An Analysis of Community Perceptions Towards Migration, Economic Development and Family Well-Being in Khyber Pakhtunkhwa Pakistan. CLINICAL SOCIAL WORK AND HEALTH INTERVENTION 2019. [DOI: 10.22359/cswhi_10_3_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
71
|
Dabbous O, Sproule D, Feltner D, Ogrinc F, Menier M, Droege M, Maru B, Khan F, Arjunji R. P.209Event-free survival and motor milestone achievement following onasemnogene abeparvovec and nusinersen interventions contrasted to natural history for spinal muscular atrophy t1 (SMA1) patients. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
72
|
Dabbous O, Sproule D, Feltner D, Ogrinc F, Menier M, Droege M, Maru B, Khan F, Novack A, Arjunji R. CM4 TIME TO TREATMENT EFFECT, EVENT-FREE SURVIVAL, AND MOTOR MILESTONE ACHIEVEMENT IN TYPE I SPINAL MUSCULAR ATROPHY PATIENTS TREATED WITH ONASEMNOGENE ABEPARVOVEC (AVXS-101) OR NUSINERSEN CONTRASTED TO NATURAL HISTORY. Value Health Reg Issues 2019. [DOI: 10.1016/j.vhri.2019.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
73
|
Arjunji R, Dean R, Jensen I, Miller B, Menier M, Sproule D, Feltner D, Droege M, Khan F, Dabbous O. P.357Type I spinal muscular atrophy patients treated with AVXS-101 have greater health outcome improvements and lower use of ventilatory support, hospitalization, and associated costs contrasted to those treated with nusinersen. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
74
|
Servais L, Day J, De Vivo D, Kirschner J, Mercuri E, Muntoni F, Shieh P, Tizzano E, Droege M, Dabbous O, Khan F, Anderson F, Finkel R. PND18 THE RESTORE REGISTRY: A RESOURCE FOR MEASURING AND IMPROVING SPINAL MUSCULAR ATROPHY OUTCOMES. Value Health Reg Issues 2019. [DOI: 10.1016/j.vhri.2019.08.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
75
|
Okuno T, Asami M, Praz F, Heg D, Lanz J, Kassar M, Hoeller R, Khan F, Raeber L, Stortecky S, Windecker S, Pilgrim T. 98Mitral annular calcification, mitral valve diseases and clinical outcomes in patients undergoing transcatheter aortic valve replacement for severe aortic stenosis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Mitral annular calcification (MAC) and mitral valve diseases (MVD) have been identified as strong predictors of mortality in patients undergoing transcatheter aortic valve replacement (TAVR). However, the association between MAC and MVD, and the prognostic implications in these patients remain unclear.
Purpose
This study sought to investigate the association between severity of MAC and the prevalence of MVD as well as to assess the prognostic impact of MAC depending on the presence or absence of MVD in patients undergoing TAVR.
Methods
We identified 967 patients who have comprehensive echocardiographic and computed tomographic assessment of MVD and MAC from our institutional registry that is a part of the Swiss TAVI registry (NCT01368250) between August 2007 and June 2017.
Results
Among these patients, mild or moderate MAC was present in 45.2% and severe MAC was present in 17.8%. The prevalence of MVD was significantly higher in severe MAC patients, while the prevalence in patients with mild and moderate MAC was similar to patients without MAC. Compared to patients without severe MAC and MVD, an increased risk of all-cause death at 1 year was observed in patients with severe MAC and MVD (hazard ratio [HR]: 2.81, 95% confidence interval [CI]: 1.72–4.59, p<0.001) as well as in patients with non-severe MAC and MVD (HR: 2.80, 95% CI: 1.87–4.20, p<0.001) but not in patients with severe MAC and non-MVD (HR: 0.68, 95% CI: 0.27–1.70, p=0.409). In a multivariable analysis, severe MAC concomitant with MVD was found to be an independent predictor of new permanent pacemaker implantation after TAVR (Odds ratio: 2.08, 95% CI: 1.27–3.41, p=0.004).
Conclusions
Severe MAC was associated with higher prevalence of MVD. Severe MAC concomitant with MVD was associated with increased risks of mortality at 1 year and conduction abnormalities after TAVR, whereas severe MAC without MVD was not.
Collapse
|