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Isaza N, Alashi A, Faulx J, Popovic ZB, Menon V, Ellis SG, Faulx M, Kapadia SR, Griffin BP, Desai MY. Impact of Temporal Changes in Left Ventricular Systolic Function on Outcomes in Takotsubo Cardiomyopathy. JACC Cardiovasc Imaging 2020; 14:1273-1274. [PMID: 33341418 DOI: 10.1016/j.jcmg.2020.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 11/30/2022]
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Griffin BP, Chandler JL, Andersen JC, Havill NP, Elkinton JS. The Reliability of Genitalia Morphology to Monitor the Spread of the Invasive Winter Moth (Lepidoptera: Geometridae) in Eastern North America. ENVIRONMENTAL ENTOMOLOGY 2020; 49:1492-1498. [PMID: 33080009 DOI: 10.1093/ee/nvaa122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Indexed: 06/11/2023]
Abstract
Winter moth, Operophtera brumata L. (Lepidoptera: Geometridae), causes widespread defoliation in both its native and introduced distributions. Invasive populations of winter moth are currently established in the United States and Canada, and pheromone-baited traps have been widely used to track its spread. Unfortunately, a native species, the Bruce spanworm, O. bruceata (Hulst), and O. bruceata × brumata hybrids respond to the same pheromone, complicating efforts to detect novel winter moth populations. Previously, differences in measurements of a part of the male genitalia called the uncus have been utilized to differentiate the species; however, the accuracy of these measurements has not been quantified using independent data. To establish morphological cutoffs and estimate the accuracy of uncus-based identifications, we compared morphological measurements and molecular identifications based on microsatellite genotyping. We find that there are significant differences in some uncus measurements, and that in general, uncus measurements have low type I error rates (i.e., the probability of having false positives for the presence of winter moth). However, uncus measurements had high type II error rates (i.e., the probability of having false negatives for the presence of winter moth). Our results show that uncus measurements can be useful for performing preliminary identifications to monitor the spread of winter moth, though for accurate monitoring, molecular methods are still required. As such, efforts to study the spread of winter moth into interior portions of North America should utilize a combination of pheromone trapping and uncus measurements, while maintaining vouchers for molecular identification.
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Wang TKM, Brizneda MV, Kwon DH, Popovic ZB, Flamm SD, Hanna M, Griffin BP, Xu B. Reference Ranges, Diagnostic and Prognostic Utility of Native
T1
Mapping and Extracellular Volume for Cardiac Amyloidosis: A Meta‐Analysis. J Magn Reson Imaging 2020; 53:1458-1468. [DOI: 10.1002/jmri.27459] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 12/29/2022] Open
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Wiegers SE, Ryan T, Arrighi JA, Brown SM, Canaday B, Damp JB, Diaz-Gomez JL, Figueredo VM, Garcia MJ, Gillam LD, Griffin BP, Kirkpatrick JN, Klarich KW, Lui GK, Maffett S, Naqvi TZ, Patel AR, Poulin MF, Rose GA, Swaminathan M, Arrighi JA, Mendes LA, Adams JE, Brush JE, Dec GW, Denktas A, Fernandes S, Freeman R, Hahn RT, Halperin JL, Housholder-Hughes SD, Khan SS, Klarich KW, Lin CH, Marine JE, McPherson JA, Niazi K, Ryan T, Solomon MA, Spicer RL, Tam M, Wang A, Weissman G, Weitz HH, Williams ES. 2019 ACC/AHA/ASE Advanced Training Statement on Echocardiography (Revision of the 2003 ACC/AHA Clinical Competence Statement on Echocardiography): A Report of the ACC Competency Management Committee. J Am Soc Echocardiogr 2020; 32:919-943. [PMID: 31378259 DOI: 10.1016/j.echo.2019.04.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Chahine J, Montane B, Alzubi J, Alnajjar H, Fiore A, mutti J, Verma B, Gad MM, Reznicek E, Grimm RA, Griffin BP, Xu B. Abstract 13434: Improved Diagnostic Performance of Contemporary Transesophageal Echocardiography With Three-dimensional Imaging for Infective Endocarditis. Circulation 2020. [DOI: 10.1161/circ.142.suppl_3.13434] [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: 01/05/2023]
Abstract
Introduction:
Infective endocarditis (IE) is associated with high morbidity and mortality. Conventionally, a repeat transesophageal echocardiogram (TEE) is necessary if the first TEE is negative, and there is high clinical suspicion. We aimed to investigate the diagnostic performance of contemporary TEE for IE.
Hypothesis:
We hypothesize that with advancements in TEE imaging, including three-dimensional (3D) imaging, the diagnostic performance of TEE for IE would be improved.
Methods:
Patients who had two or more TEEs at our center, within 6 months, for evaluation of IE in 2011 (pre-3D imaging) and 2019 (post-3D imaging) were included. Patients not meeting the Duke criteria for IE (n=899) were excluded. The primary endpoint was the sensitivity of TEE to detect IE. TEE sensitivity was also compared among the different subtypes of IE (native valve, prosthetic valve, device-related, central line-related, and aortic prosthetic graft-related).
Results:
242 patients were included: 70 in 2011 and 172 in 2019. In 2011, there were more smokers and a lower rate of pacing devices; otherwise, there were no significant differences in baseline characteristics, including intravenous drug use. The sensitivity of the initial TEE for IE was 85.7% in 2011, improving significantly to 95.3% in 2019 (p=0.01). The improved diagnostic performance in 2019 was mainly driven by the improved detection of prosthetic valve IE (70.8% vs. 93.7%, p=0.009). There were no significant differences for the other subtypes of IE
(Figure).
In 2019, patients had a higher rate of IE diagnosis within 15 days of index admission, which did not reach statistical significance (n=161, 93.6% vs. n=62, 88.6% in 2011, p=0.19). Kaplan Meier analysis demonstrated that patients in 2019 had a higher rate of procedures for endocarditis (p=0.01).
Conclusions:
Contemporary TEE imaging including 3D technology improved the detection of IE on the initial TEE, mainly driven by improved detection of prosthetic valve IE.
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Gwiazdowski RA, Andersen JC, Knisley CB, Griffin BP, Elkinton JS. First Account of Phylogeographic Variation, Larval Characters, and Laboratory Rearing of the Endangered Cobblestone Tiger Beetle Cicindelidia marginipennis , Dejean, 1831 with Observations of Their Natural History. INSECTS 2020; 11:insects11100708. [PMID: 33081250 PMCID: PMC7650647 DOI: 10.3390/insects11100708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/09/2020] [Accepted: 10/13/2020] [Indexed: 11/16/2022]
Abstract
Simple Summary Tiger beetles (Coleoptera: Cicindelidae) are highly predatory and colorful insects of long-standing fascination by entomologists. Most species in this group are in decline from range-wide habitat loss, including those with wide ranges such as the cobblestone tiger beetle (Cicindelidia marginipennis (Dejean, 1831)). This species is considered threatened and/or endangered range-wide, and conservation activities are hindered by a lack of basic information about this species’ biology. Here, we describe new aspects of this species’ basic biology in the lab and the field and use the mitochondrial locus cytochrome oxidase I (COI) to examine biogeographic patterns. We present larval descriptions with detailed drawings and find genetic evidence for geographically structured populations, suggesting that further conservation genetic research is warranted for this species. We expect the new tools and information presented in this paper will allow specialists to test further hypotheses about this species, advance survey methods, and guide proactive tiger beetle conservation. Abstract The cobblestone tiger beetle, Cicindelidia marginipennis (Dejean, 1831) is a North American species specializing in riparian habitats from New Brunswick, Canada, to Alabama in the United States. In the United States, this species is state-listed as threatened or endangered range-wide and periodically receives consideration for federal listing, mostly due to habitat decline. Despite its conservation status, intraspecific genetic diversity for this species has not been explored and little is known about its natural history. To support further inquiry into the biology of C. marginipennis, this study provides the first look at range-wide genetic diversity using mitochondrial DNA (mtDNA), describes all three larval instars, and describes natural history characteristics from captive rearing and field observation. Based on mtDNA analyses, our results suggest that geographically based population structure may exist throughout the range, with individuals from Alabama possessing haplotypes not found elsewhere in our sampling. Further genetic analyses, particularly multi-locus analyses, are needed to determine whether the Alabama population represents a separate cryptic species. Our morphological analysis and descriptions of larval instars reveal a combination of characteristics that can be used to differentiate C. marginipennis from closely related and co-occurring species. Based on our field observations, we find that the larval “throw pile” of soil excavated from burrows is a key search image for locating larvae, and we provide descriptions and detailed photographs to aid surveys. Lastly, we find that this species can be successfully reared in captivity and provide guidelines to aid future recovery efforts.
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Dunn AN, Donnellan E, Johnston DR, Alashi A, Reed GW, Jellis C, Krishnaswamy A, Gillinov AM, Svensson LG, Ellis S, Griffin BP, Kapadia SR, Pettersson GB, Desai MY. Long-Term Outcomes of Patients With Mediastinal Radiation-Associated Coronary Artery Disease Undergoing Coronary Revascularization With Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting. Circulation 2020; 142:1399-1401. [PMID: 33017210 DOI: 10.1161/circulationaha.120.046575] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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83
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Riaz H, Alashi A, Lang R, Seballos R, Feinleib S, Sukol R, Cho L, Cremer P, Jaber W, Griffin BP, Desai MY. Exaggerated blood pressure response on exercise treadmill testing and longer term outcomes in primary prevention. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2020; 6:343-344. [PMID: 32514546 DOI: 10.1093/ehjqcco/qcaa043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 04/30/2020] [Indexed: 11/12/2022]
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Hussain M, Hanna M, Griffin BP, Conic J, Patel J, Fava AM, Watson C, Phelan DM, Jellis C, Grimm RA, Rodriguez LL, Schoenhagen P, Hachamovitch R, Jaber WA, Cremer PC, Collier P. Aortic Valve Calcium in Patients With Transthyretin Cardiac Amyloidosis. Circ Cardiovasc Imaging 2020; 13:e011433. [DOI: 10.1161/circimaging.120.011433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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85
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Wang TKM, Griffin BP, Xu B, Rodriguez LL, Popovic ZB, Gillinov MA, Pettersson GB, Desai MY. Relationships between mitral annular calcification and cardiovascular events: A meta‐analysis. Echocardiography 2020; 37:1723-1731. [DOI: 10.1111/echo.14861] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/25/2020] [Accepted: 08/25/2020] [Indexed: 11/29/2022] Open
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Ramanathan A, Witten JC, Gordon SM, Griffin BP, Pettersson GB, Shrestha NK. Factors associated with local invasion in infective endocarditis: a nested case-control study. Clin Microbiol Infect 2020; 27:1011-1014. [PMID: 32919070 DOI: 10.1016/j.cmi.2020.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/24/2020] [Accepted: 09/01/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE A substantial proportion of infective endocarditis (IE) cases are complicated by local invasion. The purpose of this study was to identify patient and disease characteristics associated with local invasion in surgically treated IE patients. METHODS This was a nested case-control study. All episodes of IE for patients admitted to Cleveland Clinic from 1 January 2013 to 30 June 2016 were identified from the Cleveland Clinic IE Registry. Patients ≥18 years of age who underwent surgery for IE were included. Among these, cases were those with local invasion, controls were those without. Local invasion, defined as periannular extension, paravalvular abscess, intracardiac fistula or pseudoaneurysm, was ascertained from the surgical operative note. Associations of selected factors with local invasion were examined in a multivariable logistic regression model. RESULTS Among 511 patients who met inclusion criteria, 215 had local invasion. Mean age was 56 years; 369 were male. Overall 345 (68%) had aortic valve, 228 (45%) mitral valve, and 66 (13%) tricuspid or pulmonic valve involvement. Aortic valve involvement (OR 6.23, 95% CI 3.55-11.44), bioprosthetic valve (OR 3.88, 95% CI 2.36-6.44), significant paravalvular leak (OR 3.80, 95% CI 1.60-9.89), new atrioventricular nodal block (OR 3.77, 95% CI 1.87-7.90), infection with streptococci other than viridans group streptococci (OR 7.54, 95% CI 2.42-24.87) and presence of central nervous system emboli (OR 1.85, 95% CI 1.13-3.04) were associated with local invasion. DISCUSSION Intracardiac and microorganism factors, but not comorbid conditions, are associated with local invasion in IE.
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Wang TKM, Bin Saeedan M, Chan N, Obuchowski NA, Shrestha N, Xu B, Unai S, Cremer P, Grimm RA, Griffin BP, Flamm SD, Pettersson GB, Popovic ZB, Bolen MA. Complementary Diagnostic and Prognostic Contributions of Cardiac Computed Tomography for Infective Endocarditis Surgery. Circ Cardiovasc Imaging 2020; 13:e011126. [PMID: 32900226 DOI: 10.1161/circimaging.120.011126] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cardiac computed tomography (CT) is emerging as an adjunctive modality to echocardiography in the evaluation of infective endocarditis (IE) and surgical planning. CT studies in IE have, however, focused on its diagnostic rather than prognostic utility, the latter of which is important in high-risk diseases like IE. We evaluated the associations between cardiac CT and transesophageal echocardiography (TEE) findings and adverse outcomes after IE surgery. METHODS Of 833 consecutive patients with surgically proven IE during May 1, 2014 to May 1, 2019, at Cleveland Clinic, 155 underwent both preoperative ECG-gated contrast-enhanced CT and TEE. Multivariable analyses were performed to identify CT and TEE biomarkers that predict adverse outcomes after IE surgery, adjusting for EuroSCORE II (European System for Cardiac operative Risk Evaluation II). RESULTS CT and TEE were positive for IE in 123 (75.0%) and 124 (75.6%) of patients, respectively. Thirty-day mortality occurred in 3 (1.9%) patients and composite mortality or morbidities in 72 (46.5%). Pseudoaneurysm or abscess detected on TEE was the only imaging biomarker to show independent association with composite mortality or morbidities in-hospital, with odds ratio (95% CI) of 3.66 (1.76-7.59), P=0.001. There were 17 late deaths, and both pseudoaneurysm or abscess detected on CT and fistula detected on CT were the only independent predictors of total mortality during follow-up, with hazards ratios (95% CI) of 3.82 (1.25-11.7), P<0.001 and 9.84 (1.89-51.0), P=0.007, respectively. CONCLUSIONS We identified cardiac CT and TEE features that predicted separate adverse outcomes after IE surgery. Imaging biomarkers can play important roles incremental to conventional clinical factors for risk stratification in patients undergoing IE surgery.
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Alashi A, Isaza N, Faulx J, Popovic ZB, Menon V, Ellis SG, Faulx M, Kapadia SR, Griffin BP, Desai MY. Characteristics and Outcomes of Patients With Takotsubo Syndrome: Incremental Prognostic Value of Baseline Left Ventricular Systolic Function. J Am Heart Assoc 2020; 9:e016537. [PMID: 32755253 PMCID: PMC7660826 DOI: 10.1161/jaha.120.016537] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background We sought to determine (1) long‐term outcomes in patients presenting with documented Takotsubo syndrome (TS), (2) whether left ventricular global longitudinal strain (LV‐GLS) provides incremental prognostic value, and (3) prognostic cutoffs of LV ejection fraction (LVEF) and LV‐GLS during an acute TS episode. Methods and Results We studied 650 patients with TS (aged 66±14 years, 88% women) who were diagnosed clinically and angiographically between 2006 and 2018. Baseline LVEF and LV‐GLS (using velocity vector imaging) were recorded. The primary end point was all‐cause mortality. TS triggers were unknown (34%), emotional (16%), physical (41%), and neurologic (10%). Mean LVEF and LV‐GLS were 36±10% and −11.6±0.4%; in addition, 94% patients had LVEF <52%, and 80% had apical ballooning. No patient had obstructive coronary artery disease. At a median of 2.2 years (interquartile range, 0.7–4.4), 175 (27%) had died (9% in‐hospital deaths). Multivariate Cox survival analysis revealed that higher age (hazard ratio [HR], 1.35), male sex (HR, 1.75), lower baseline LVEF (HR, 1.02), worse LV‐GLS (HR, 1.04), neurologic trigger (HR, 2.66), and physical trigger (HR, 2.64) were associated with mortality, whereas aspirin (HR, 0.70) and β‐blockers (HR, 0.73) improved survival (all P<0.049). The addition of LVEF and LV‐GLS to clinical markers (age, sex, cardiogenic shock at presentation, and peak troponin I) significantly increased log‐likelihood ratios: clinical (−521.48), clinical plus LVEF (−511.32, P<0.001), and clinical plus LVEF and LV‐GLS (−500.68, P<0.001). On penalized spline analysis, LVEF of 38% and LV‐GLS of −10% were cutoffs below which survival was significantly worse. Conclusions Patients with TS with a neurologic or physical trigger had significantly worse survival than those without such a trigger, with baseline LVEF and LV‐GLS providing incremental prognostic value.
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Sato K, Sankaramangalam K, Kandregula K, Bullen JA, Kapadia SR, Krishnaswamy A, Mick S, Rodriguez LL, Grimm RA, Menon V, Desai MY, Svensson LG, Griffin BP, Popović ZB. Contemporary Outcomes in Low-Gradient Aortic Stenosis Patients Who Underwent Dobutamine Stress Echocardiography. J Am Heart Assoc 2020; 8:e011168. [PMID: 30879370 PMCID: PMC6475055 DOI: 10.1161/jaha.118.011168] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Detection of flow reserve (FR) by dobutamine stress echocardiography is used for risk stratification in low‐gradient aortic stenosis (AS). Prognostic significance of dobutamine stress echocardiography in the transcatheter aortic valve replacement era is unclear. We aimed to assess the current relevance of FR. Methods and Results We studied 235 patients with low‐gradient severe AS (rest aortic valve area ≤1.0 cm2 or indexed aortic valve area ≤0.60 cm2/m2; mean aortic valve gradient <40 mm Hg) and left ventricular ejection fraction <50%) with dobutamine stress echocardiography done September 2010 through July 2016. FR was defined by ≥20% stroke volume increase. We diagnosed “true‐severe AS” if peak aortic valve velocity ≥4 m/s occurred with aortic valve area ≤1.0 cm2 (or indexed aortic valve area ≤0.6 cm2/m2). At a median time of 51 days, 128 patients underwent aortic valve replacement,either surgical aortic valve replacement (n=42) or transcatheter aortic valve replacement (n=86). FR was observed in 138 patients, while 86 patients had true‐severe AS. During median follow‐up of 2.3 years, 138 patients died. In a multivariable model, aortic valve replacement (hazard ratio 0.41, 95% CI: 0.29–0.58, P <0.001) and lower Society of Thoracic Surgeons score (hazard ratio 1.06, 95% CI: 1.04–1.09, P<0.001) were associated with better survival, while FR was not predictive. aortic valve replacement was associated with survival regardless of the presence or absence of FR or AS severity stratification. Conclusions In low‐gradient AS with reduced ejection fraction, FR or AS severity stratification by dobutamine stress echocardiography was not associated with survival. Aortic valve replacement was associated with better survival in low‐gradient AS independent of FR. See Editorial by Annabi et al
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Isaza N, Shrestha NK, Gordon S, Pettersson GB, Unai S, Vega Brizneda M, Witten JC, Griffin BP, Xu B. Contemporary Outcomes of Pulmonary Valve Endocarditis: A 16-Year Single Centre Experience. Heart Lung Circ 2020; 29:1799-1807. [PMID: 32616369 DOI: 10.1016/j.hlc.2020.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/11/2019] [Accepted: 04/28/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Limited data exist regarding the clinical characteristics and contemporary outcomes of patients with pulmonary valve (PoV) infective endocarditis (IE). METHODS This is a retrospective cohort study of patients with a confirmed diagnosis of IE affecting the PoV at our centre between January 2002 and October 2018. Electronic medical records were reviewed to gather the clinical and echocardiographic variables. The population was subdivided according to risk factor profiles: group 1: miscellaneous risk factors; group 2: patients with congenital heart disease (CHD); and group 3: patients who inject drugs (PWID). The primary outcome was all-cause mortality. RESULTS Out of 2,124 cases of IE during the study period, 24 (1.1%) patients had PoV IE. The majority of cases of PoV IE occurred in patients with prosthetic valves (54.2%). Coagulase-negative Staphylococci species were the most common micro-organisms. Seventy-five per cent (75%) of the patients required surgical management. The median follow-up was 2.8 years (interquartile range: 0.2-5.3 years). Patients with miscellaneous risk factors were older (p<0.01), and had higher rates of hypertension (p=0.01) and hyperlipidaemia (p=0.04). There was a statistically significant difference in survival between the groups (p=0.03), mainly driven by better outcomes of patients with CHD, compared to those with miscellaneous risk factors. CONCLUSIONS In a contemporary 16-year series, a high proportion of patients with PoV IE required surgical management. Patients with PoV IE and CHD had better survival, compared to patients with miscellaneous risk factors at a median follow-up of 2.8 years.
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Kaur S, Misbah Rameez R, Jaber W, Griffin BP, Xu B. Transcatheter Aortic Valve Replacement Associated Infective Endocarditis: A Clinical Update. STRUCTURAL HEART-THE JOURNAL OF THE HEART TEAM 2020. [DOI: 10.1080/24748706.2020.1733718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Isaza N, Desai MY, Kapadia SR, Krishnaswamy A, Rodriguez LL, Grimm RA, Conic JZ, Saijo Y, Roselli EE, Gillinov AM, Johnston DR, Svensson LG, Griffin BP, Popović ZB. Long-Term Outcomes in Patients With Mixed Aortic Valve Disease and Preserved Left Ventricular Ejection Fraction. J Am Heart Assoc 2020; 9:e014591. [PMID: 32204665 PMCID: PMC7428636 DOI: 10.1161/jaha.119.014591] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Background Concurrent presence of aortic stenosis and aortic regurgitation is termed mixed aortic valve disease (MAVD). Although multiple articles have addressed patients with “isolated” aortic stenosis or aortic regurgitation, the natural history, impact, and outcomes of MAVD are not well defined. Here, we evaluate long‐term outcomes in patients with MAVD and cardiovascular adaptations to chronic MAVD. Methods and Results This observational cohort study evaluated 862 adult patients (56.8% male) with preserved left ventricular ejection fraction and at least moderate aortic regurgitation and moderate aortic stenosis. Primary outcome was all‐cause mortality. Subgroup analysis was based on treatment modality (aortic valve replacement [AVR] versus medical management). A regression analysis of longitudinal echocardiographic parameters was performed to assess the natural history of MAVD. Mean age was 68±15 years, and mean left ventricular ejection fraction was 58±5%. At 4.6 years (25th–75th percentile range, 1.0–8.7), 58.6% of patients underwent an AVR and 48.8% patients died. In both unadjusted and adjusted Cox survival analysis, AVR was associated with improved survival (hazard ratio, 0.41; 95% CI, 0.34–0.51, P<0.001). Impact of AVR persisted when stratifying the cohort by symptom status and baseline aortic valve area (log rank, P<0.001 for both) and after propensity‐score matching (hazard ratio, 0.40; 95% CI, 0.32–0.50; P<0.001). In the longitudinal analysis, there were statistically significant changes over time in aortic valve peak gradient (P<0.001) and aortic valve area (P<0.001) and only mild increases in left ventricular end‐diastolic (P<0.007) and ‐systolic (P<0.001) volumes. Conclusions MAVD confers a high risk of all‐cause mortality. However, AVR significantly reduces this risk independent of aortic valve area, symptom status, and after controlling for confounding variables.
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Wang TKM, Griffin BP, Miyasaka R, Xu B, Popovic ZB, Pettersson GB, Gillinov AM, Desai MY. Isolated surgical tricuspid repair versus replacement: meta-analysis of 15 069 patients. Open Heart 2020; 7:e001227. [PMID: 32206317 PMCID: PMC7078937 DOI: 10.1136/openhrt-2019-001227] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/30/2020] [Accepted: 02/17/2020] [Indexed: 11/14/2022] Open
Abstract
Objectives Tricuspid valve disease is increasingly encountered, but surgery is rarely performed in isolation, in part because of a reported higher operative risk than other single-valve operations. Although guidelines recommend valve repair, there is sparse literature for the optimal surgical approach in isolated tricuspid valve disease. We performed a meta-analysis examining outcomes of isolated tricuspid valve repair versus replacement. Methods We searched Pubmed, Embase, Scopus and Cochrane from January 1980 to June 2019 for studies reporting outcomes of both isolated tricuspid valve repair and replacement, excluding congenital tricuspid aetiologies. Data were extracted and pooled using random-effects models and Review Manager 5.3 software. Results There were 811 article abstracts screened, from which 52 full-text articles reviewed and 16 studies included, totalling 6808 repairs and 8261 replacements. Mean age ranged from 36 to 68 years and females made up 24%–92% of these studies. Pooled operative mortality rates and odds ratios (95% confidence intervals) for isolated tricuspid repair and replacement surgery were 8.4% vs 9.9%, 0.80 (0.64 to 1.00). Tricuspid repair was also associated with lower in-hospital acute renal failure 12.4% vs 15.6%, 0.82 (0.72 to 0.93) and pacemaker implantation 9.4% vs 21.0%, 0.37 (0.24 to 0.58), but higher stroke rate 1.5% vs 0.9%, 1.63 (1.10 to 2.41). There were no differences in rates of prolonged ventilation, mediastinitis, return to operating room or late mortality. Conclusion Isolated tricuspid valve repair was associated with significantly reduced in-hospital mortality, renal failure and pacemaker implantation compared with replacement and is therefore recommended where feasible for isolated tricuspid valve disease, although its higher stroke rate warrants further research.
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94
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Kocyigit D, Shah N, Bullen J, Downey S, Obuchowski N, Lee N, Tang WW, Griffin BP, Flamm SD, Kwon D. INFLUENCE OF SEX ON THE PROGNOSTIC IMPACT OF CARDIAC MAGNETIC RESONANCE IMAGING QUANTIFICATION OF FUNCTIONAL MITRAL REGURGITATION IN PATIENTS WITH NON-ISCHEMIC CARDIOMYOPATHY. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)32196-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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95
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Wang TKM, Sanchez A, Igbinomwanhia E, Cremer P, Griffin BP, Xu B. DIAGNOSIS OF NATIVE VALVE, PROSTHETIC VALVE AND IMPLANTABLE CARDIAC DEVICE LEAD INFECTIVE ENDOCARDITIS USING 18F-FLUORODEOXYGLUCOSE POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY: A CONTEMPORARY META-ANALYSIS. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)32271-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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96
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Kocyigit D, Milinovich A, Lee CM, Hanna M, Gabrovesk A, Jin J, Silverman M, Ahmad M, Tang WW, Grimm RA, Cho L, Griffin BP, Flamm SD, Kwon D. THE ADDITIONAL VALUE OF NATURAL LANGUAGE PROCESSING TO IDENTIFY DISEASE PREVALENCE BASED ON ELECTRONIC MEDICAL RECORD IMAGING REPORTS. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)34269-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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97
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Ramchand J, Podugu P, Chetrit M, Harb S, Milinovich A, Griffin BP, Cho L, Flamm SD, Tang WHW, Kwon D. REAPPRAISAL OF CARDIAC MAGNETIC RESONANCE IN LEFT VENTRICULAR NON-COMPACTION: NEW INSIGHTS FROM A LARGE, LONGITUDINAL STUDY. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)32198-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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98
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Kocyigit D, Milinovich A, Lee CM, Silverman M, Ahmad M, Hanna M, Gabrovesk A, Jin J, Tang WW, Grimm RA, Cho L, Griffin BP, Flamm SD, Kwon D. PERFORMANCE AND ACCURACY OF NATURAL LANGUAGE PROCESSING TO IDENTIFY DISEASE ETIOLOGY FROM NON-STRUCTURED CARDIAC MAGNETIC RESONANCE IMAGING ELECTRONIC MEDICAL RECORD REPORTS. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)34266-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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99
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Donnellan E, Wazni O, Kanj M, Cantillon D, Patel D, Trulock K, Elshazly M, Kochar A, Cohen J, Hussein A, Baranowski B, Griffin BP, Jaber WA, Saliba WI. IMPACT OF NONALCOHOLIC FATTY LIVER DISEASE ON ARRHYTHMIA RECURRENCE FOLLOWING ATRIAL FIBRILLATION ABLATION. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31135-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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100
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Wang TKM, Popovic Z, Flamm SD, Grimm RA, Rodriguez LL, Bolen M, Moennich LA, Rutkowski K, Griffin BP, Kwon D. PROSPECTIVE ECHOCARDIOGRAPHY AND MAGNETIC RESONANCE IMAGING VALIDATION STUDY OF A GEOMETRIC MODEL FOR CALCULATING LEFT VENTRICULAR EJECTION FRACTION FROM STRAIN IN VALVULAR HEART DISEASE. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)32362-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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