1
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Garg G, Appadurai V, Cheema B, Gruca M, Kinno M, Ryan J, Bavishi A, Baldridge AS, Rigolin VH, Thomas JD, Zielinski A, Puthumana JJ. Right Ventricular Remodeling in Elite Basketball Athletes. J Am Soc Echocardiogr 2023; 36:1120-1125. [PMID: 37364756 DOI: 10.1016/j.echo.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 06/28/2023]
Affiliation(s)
- Gaurang Garg
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Vinesh Appadurai
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Baljash Cheema
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Martin Gruca
- Department of Medicine, Section of Cardiology, University of Chicago Medicine, Chicago, Illinois
| | - Menhel Kinno
- Division of Cardiology, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois
| | - Juliet Ryan
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Aakash Bavishi
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Abigail S Baldridge
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Vera H Rigolin
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - James D Thomas
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Allison Zielinski
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jyothy J Puthumana
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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2
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Nagueh SF, Klein AL, Scherrer-Crosbie M, Fine NM, Kirkpatrick JN, Forsha DE, Nicoara A, Mackensen GB, Tilkemeier PL, Doukky R, Cheema B, Adusumalli S, Hill JC, Tanguturi VK, Ouyang D, Bdoyan SB, Strom JB. A Vision for the Future of Quality in Echocardiographic Reporting: The American Society of Echocardiography ImageGuideEcho Registry, Current and Future States. J Am Soc Echocardiogr 2023:S0894-7317(23)00250-X. [PMID: 37256252 DOI: 10.1016/j.echo.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/05/2023] [Accepted: 05/01/2023] [Indexed: 06/01/2023]
Affiliation(s)
- Sherif F Nagueh
- Department of Cardiology, Houston Methodist Hospital, Weill Cornell Medical College, Houston, Texas
| | - Allan L Klein
- Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Marielle Scherrer-Crosbie
- Cardiovascular Medicine Division, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nowell M Fine
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - James N Kirkpatrick
- Division of Cardiology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Daniel E Forsha
- Ward Family Heart Center, Children's Mercy Kansas City, Missouri; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Alina Nicoara
- Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - G Burkhard Mackensen
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington
| | - Peter L Tilkemeier
- Department of Medicine, Prisma Health and the University of South Carolina School of Medicine Greenville, Greenville, South Carolina
| | - Rami Doukky
- Division of Cardiology, Cook County Health, Chicago, Illinois
| | - Baljash Cheema
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Srinath Adusumalli
- Cardiovascular Medicine Division, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; CVS Health, Woonsocket, Rhode Island
| | - Jeffrey C Hill
- School of Medical Imaging and Therapeutics, Massachusetts College of Pharmacy and Health Sciences University, Worcester, Massachusetts
| | - Varsha K Tanguturi
- Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - David Ouyang
- Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California
| | | | - Jordan B Strom
- Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
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3
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Cheema B, Mutharasan RK, Sharma A, Jacobs M, Powers K, Lehrer S, Wehbe FH, Ronald J, Pifer L, Rich JD, Ghafourian K, Tibrewala A, McCarthy P, Luo Y, Pham DT, Wilcox JE, Ahmad FS. Augmented Intelligence to Identify Patients With Advanced Heart Failure in an Integrated Health System. JACC Adv 2022; 1:100123. [PMID: 36643021 PMCID: PMC9838119 DOI: 10.1016/j.jacadv.2022.100123] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Timely referral for specialist evaluation in patients with advanced heart failure (HF) is a Class 1 recommendation. However, the transition from stage C HF to advanced or stage D HF often goes undetected in routine care, resulting in delayed referral and higher mortality rates. OBJECTIVES The authors sought to develop an augmented intelligence-enabled workflow using machine learning to identify patients with stage D HF and streamline referral. METHODS We extracted data on HF patients with encounters from January 1, 2007, to November 30, 2020, from a HF registry within a regional, integrated health system. We created an ensemble machine learning model to predict stage C or stage D HF and integrated the results within the electronic health record. RESULTS In a retrospective data set of 14,846 patients, the model had a good positive predictive value (60%) and low sensitivity (25%) for identifying stage D HF in a 100-person, physician-reviewed, holdout test set. During prospective implementation of the workflow from April 1, 2021, to February 15, 2022, 416 patients were reviewed by a clinical coordinator, with agreement between the model and the coordinator in 50.3% of stage D predictions. Twenty-four patients have been scheduled for evaluation in a HF clinic, 4 patients started an evaluation for advanced therapies, and 1 patient received a left ventricular assist device. CONCLUSIONS An augmented intelligence-enabled workflow was integrated into clinical operations to identify patients with advanced HF. Endeavors such as this require a multidisciplinary team with experience in design thinking, informatics, quality improvement, operations, and health information technology, as well as dedicated resources to monitor and improve performance over time.
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Affiliation(s)
- Baljash Cheema
- Bluhm Cardiovascular Institute Center for Artificial Intelligence, Northwestern Medicine, Chicago, Illinois, USA,Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - R. Kannan Mutharasan
- Bluhm Cardiovascular Institute Center for Artificial Intelligence, Northwestern Medicine, Chicago, Illinois, USA,Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Aditya Sharma
- Bluhm Cardiovascular Institute Center for Artificial Intelligence, Northwestern Medicine, Chicago, Illinois, USA,Northwestern Medicine, Chicago, Illinois, USA
| | - Maia Jacobs
- Department of Computer Science, Northwestern University McCormick School of Engineering, Evanston, Illinois, USA
| | | | | | - Firas H. Wehbe
- Bluhm Cardiovascular Institute Center for Artificial Intelligence, Northwestern Medicine, Chicago, Illinois, USA,Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | | | - Jonathan D. Rich
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kambiz Ghafourian
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Anjan Tibrewala
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Patrick McCarthy
- Bluhm Cardiovascular Institute Center for Artificial Intelligence, Northwestern Medicine, Chicago, Illinois, USA,Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Yuan Luo
- Division of Health and Biomedical Informatics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Duc T. Pham
- Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jane E. Wilcox
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Faraz S. Ahmad
- Bluhm Cardiovascular Institute Center for Artificial Intelligence, Northwestern Medicine, Chicago, Illinois, USA,Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA,Division of Health and Biomedical Informatics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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4
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Gruca MM, Cheema B, Garg G, Ryan J, Thomas JD, Rigolin VH, Zielinski AR, Puthumana JJ. Strain echocardiography to describe left ventricular function pre- and postexercise in elite basketball athletes: A feasibility study. Echocardiography 2021; 38:1165-1172. [PMID: 34028863 DOI: 10.1111/echo.15121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 03/04/2021] [Revised: 04/15/2021] [Accepted: 05/07/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Elite athletes show structural cardiac changes as an adaptation to exercise. Studies examining strain in athletes have largely analyzed images at rest only. There is little data available regarding the change in strain with exercise. Our objectives were: to investigate the feasibility of strain analysis in athletes at peak exercise, to determine the normal range of left ventricular (LV) global longitudinal strain (GLS) within this population postexercise, to describe how LV GLS changes with exercise, and to determine whether any clinical characteristics correlate with the change in GLS that occurs with exercise. METHODS We conducted a cross-sectional study on elite athletes who participated in the 2016-2018 National Basketball Association Draft Combines. Echocardiograms were obtained at rest and after completing a treadmill stress test to maximal exertion or completion of Bruce protocol. Primary outcomes included GLS obtained at rest and peak exercise. Secondary outcome was the change in GLS between rest and exercise. Univariate relationships between various clinical characteristics and our secondary outcome were analyzed. RESULTS Our final cohort (n = 111) was all male and 92/111 (82.9%) were African American. Mean GLS magnitude increased in response to exercise (-17.6 ± 1.8 vs -19.2 ± 2.6, P < .0001). Lower resting heart rates (r = .22, P = .02) and lower heart rates at peak exercise (r = .21, P = .03) correlated with the increase in LV GLS from exercise. CONCLUSIONS Strain imaging is technically feasible to obtain among elite basketball athletes at peak exercise. Normative strain response to exercise from this study may help identify abnormal responses to exercise in athletes.
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Affiliation(s)
- Martin M Gruca
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Baljash Cheema
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gaurang Garg
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Juliet Ryan
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - James D Thomas
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Vera H Rigolin
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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5
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Cheema B, Kinno M, Gu D, Ryan J, Mitter S, Rigolin V, Thomas J, Puthumana J. Left atrial size and strain in elite athletes: A cross‐sectional study at the NBA Draft Combine. Echocardiography 2020; 37:1030-1036. [DOI: 10.1111/echo.14680] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/07/2020] [Accepted: 04/20/2020] [Indexed: 12/18/2022] Open
Affiliation(s)
- Baljash Cheema
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of Medicine Chicago IL USA
| | - Menhel Kinno
- Division of CardiologyLoyola University Chicago Stritch School of Medicine Maywood IL USA
| | - David Gu
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of Medicine Chicago IL USA
| | - Juliet Ryan
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of Medicine Chicago IL USA
| | - Sumeet Mitter
- Zena and Michael A. Weiner Cardiovascular InstituteIcahn School of Medicine at Mount Sinai New York NY USA
| | - Vera Rigolin
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of Medicine Chicago IL USA
| | - James Thomas
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of Medicine Chicago IL USA
| | - Jyothy Puthumana
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of Medicine Chicago IL USA
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6
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Abstract
Vasospastic angina is an uncommon cause of cardiac arrest. We describe a patient who presented with sudden cardiac arrest due to severe coronary vasospasm. Telemetry during the event revealed ventricular arrhythmias and asystole followed by spontaneous self-conversion back to normal sinus rhythm. The patient underwent implantable cardioverter-defibrillator therapy. (Level of Difficulty: Beginner.)
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7
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Volpe N, Connolly S, Cheema B, Angarone M. A Curious Case of Endocarditis and Liver Abscess in a Previously Healthy Man. Am J Med 2020; 133:186-190. [PMID: 31421067 DOI: 10.1016/j.amjmed.2019.07.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/09/2019] [Accepted: 07/09/2019] [Indexed: 11/20/2022]
Affiliation(s)
- Nicholas Volpe
- Northwestern University, Feinberg School of Medicine, Chicago, Ill
| | - Sean Connolly
- Northwestern Medicine, Feinberg School of Medicine, Chicago, Ill.
| | - Baljash Cheema
- Northwestern Medicine, Feinberg School of Medicine, Chicago, Ill
| | - Michael Angarone
- Northwestern Medicine, Feinberg School of Medicine, Chicago, Ill
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8
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Njoroge JN, Cheema B, Ambrosy AP, Greene SJ, Collins SP, Vaduganathan M, Mebazaa A, Chioncel O, Butler J, Gheorghiade M. Expanded algorithm for managing patients with acute decompensated heart failure. Heart Fail Rev 2019; 23:597-607. [PMID: 29611010 DOI: 10.1007/s10741-018-9697-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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] [Indexed: 12/11/2022]
Abstract
Heart failure is a complex disease process, the manifestation of various cardiac and noncardiac abnormalities. General treatment approaches for heart failure have remained the same over the past decades despite the advent of novel therapies and monitoring modalities. In the same vein, the readmission rates for heart failure patients remain high and portend a poor prognosis for morbidity and mortality. In this context, development and implementation of improved algorithms for assessing and treating HF patients during hospitalization remains an unmet need. We propose an expanded algorithm for both monitoring and treating patients admitted for acute decompensated heart failure with the goal to improve post-discharge outcomes and decrease rates of rehospitalizations.
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Affiliation(s)
- Joyce N Njoroge
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | - Baljash Cheema
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Andrew P Ambrosy
- Duke Clinical Research Institute and Division of Cardiology, Duke University Medical Center, Durham, NC, USA
| | - Stephen J Greene
- Duke Clinical Research Institute and Division of Cardiology, Duke University Medical Center, Durham, NC, USA
| | - Sean P Collins
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Muthiah Vaduganathan
- Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA, USA
| | - Alexandre Mebazaa
- Department of Anesthesia and Critical Care, Inserm U942, Hôpitaux Universitaires Saint-Louis-Lariboisière, Paris, France.,University Paris Diderot, Paris, France
| | - Ovidiu Chioncel
- Institute of Emergency for Cardiovascular Diseases "Prof C.C.Iliescu", Bucharest, Romania.,University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Javed Butler
- Department of Medicine, University of Mississippi, Oxford, MS, USA
| | - Mihai Gheorghiade
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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9
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Vaduganathan M, Cheema B, Cleveland E, Sankar K, Subacius H, Fonarow GC, Solomon SD, Lewis EF, Greene SJ, Maggioni AP, Böhm M, Zannad F, Butler J, Gheorghiade M. Plasma renin activity, response to aliskiren, and clinical outcomes in patients hospitalized for heart failure: the ASTRONAUT trial. Eur J Heart Fail 2017; 20:677-686. [PMID: 29143416 DOI: 10.1002/ejhf.973] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 06/03/2017] [Revised: 07/25/2017] [Accepted: 07/26/2017] [Indexed: 11/09/2022] Open
Abstract
AIMS The direct renin inhibitor, aliskiren, is known to reduce plasma renin activity (PRA), but whether the efficacy of aliskiren varies based on an individual's baseline PRA in patients hospitalized for heart failure (HF) is presently unknown. We characterized the prognostic value of PRA and determined if this risk is modifiable with use of aliskiren. METHODS AND RESULTS This pre-specified neurohormonal substudy of ASTRONAUT analysed all patients hospitalized for HF with ejection fraction (EF) ≤40% with available baseline PRA data (n = 1306, 80.9%). Risk associated with baseline PRA and short-term changes in PRA from baseline to 1 month was modelled with respect to 12-month clinical events. Median baseline PRA was 3.0 (interquartile range 0.6-16.4) ng/mL/h. Aliskiren significantly reduced PRA early after treatment initiation through 12-month follow-up compared with placebo (P < 0.001). The lowest baseline PRA quartile (<0.6 ng/mL/h) was independently predictive of lower all-cause mortality [adjusted hazard ratio (HR) 0.50, 95% confidence interval (CI) 0.31-0.81] and the composite of cardiovascular mortality and HF hospitalization (adjusted HR 0.57, 95% CI 0.40-0.79). Delta log-normalized PRA (from baseline to 1 month) was not predictive of either primary endpoint at 12 months (P ≥ 0.43). The prognostic value of baseline PRA and short-term changes in PRA did not vary by randomization to aliskiren or placebo (interaction P ≥ 0.13). CONCLUSIONS Plasma renin activity is reduced early and durably by aliskiren, but this did not translate into improved clinical outcomes in ASTRONAUT. Baseline PRA or short-term reduction in PRA do not identify a subgroup who may preferentially benefit from direct renin inhibition. Clinical Trial Registration ClinicalTrials.gov Unique Identifier: NCT00894387.
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Affiliation(s)
- Muthiah Vaduganathan
- Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, MA, USA
| | - Baljash Cheema
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Erin Cleveland
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Kamya Sankar
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Haris Subacius
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Gregg C Fonarow
- Ahmanson-UCLA Cardiomyopathy Center, University of California Los Angeles, Los Angeles, CA, USA
| | - Scott D Solomon
- Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, MA, USA
| | - Eldrin F Lewis
- Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, MA, USA
| | - Stephen J Greene
- Division of Cardiology, Duke University Medical Center, Durham, NC, USA
| | | | - Michael Böhm
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Faiez Zannad
- INSERM, CHRU Nancy, Université de Lorraine, Centre d'Investigation Clinique CIC1433, Nancy, France
| | | | - Mihai Gheorghiade
- Center for Cardiovascular Innovation, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
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10
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Cheema B, Ambrosy AP, Kaplan RM, Senni M, Fonarow GC, Chioncel O, Butler J, Gheorghiade M. Lessons learned in acute heart failure. Eur J Heart Fail 2017; 20:630-641. [PMID: 29082676 DOI: 10.1002/ejhf.1042] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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: 11/11/2016] [Revised: 09/18/2017] [Accepted: 09/20/2017] [Indexed: 12/11/2022] Open
Abstract
Acute heart failure (HF) is a global pandemic with more than one million admissions to hospital annually in the US and millions more worldwide. Post-discharge mortality and readmission rates remain unchanged and unacceptably high. Although recent drug development programmes have failed to deliver novel therapies capable of reducing cardiovascular morbidity and mortality in patients hospitalized for worsening chronic HF, hospitalized HF registries and clinical trial databases have generated a wealth of information improving our collective understanding of the HF syndrome. This review will summarize key insights from clinical trials in acute HF and hospitalized HF registries over the last several decades, focusing on improving the management of patients with HF and reduced ejection fraction.
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Affiliation(s)
- Baljash Cheema
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Andrew P Ambrosy
- Duke University Medical Center, Durham, NC, USA.,Duke Clinical Research Institute, Durham, NC, USA
| | - Rachel M Kaplan
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Michele Senni
- Cardiovascular Department, Papa Giovannni XXIII Hospital, Bergamo, Italy
| | - Gregg C Fonarow
- Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center, Los Angeles, CA, USA
| | - Ovidiu Chioncel
- Institute of Emergency for Cardiovascular Diseases 'Prof. C.C. Iliescu', Cardiology 1, UMF Carol Davila, Bucharest, Romania
| | | | - Mihai Gheorghiade
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
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11
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Cheema B, Mitter S, Ryan J, Rigolin V, Puthumana J, Thomas J. DEFORMATION ANALYSIS CAN BE PERFORMED ON POST-EXERCISE IMAGES IN NATIONAL BASKETBALL ASSOCIATION DRAFT ELIGIBLE PLAYERS WITH GOOD REPRODUCIBILITY. J Am Coll Cardiol 2017. [DOI: 10.1016/s0735-1097(17)34845-3] [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: 11/25/2022]
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12
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Davies FC, Cheema B, Carley SD. Innovation in the field of medical-conference-based education: a new marketplace. Emerg Med J 2015; 32:756-8. [PMID: 26101405 DOI: 10.1136/emermed-2015-204718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 06/05/2015] [Indexed: 11/03/2022]
Affiliation(s)
- F C Davies
- Emergency Department, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - B Cheema
- Division of Emergency Medicine, University of Cape Town, South Africa
| | - S D Carley
- Department of Emergency Medicine, Central Manchester & Manchester Children's Foundation Trust, UK
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13
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Deng Y, Chu J, Ren Y, Fan Z, Ji X, Mundy-Bosse B, Yuan S, Hughes T, Zhang J, Cheema B, Camardo AT, Xia Y, Wu LC, Wang LS, He X, Kinghorn AD, Li X, Caligiuri MA, Yu J. The natural product phyllanthusmin C enhances IFN-γ production by human NK cells through upregulation of TLR-mediated NF-κB signaling. J Immunol 2014; 193:2994-3002. [PMID: 25122922 DOI: 10.4049/jimmunol.1302600] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Natural products are a major source for cancer drug development. NK cells are a critical component of innate immunity with the capacity to destroy cancer cells, cancer-initiating cells, and clear viral infections. However, few reports describe a natural product that stimulates NK cell IFN-γ production and unravel a mechanism of action. In this study, through screening, we found that a natural product, phyllanthusmin C (PL-C), alone enhanced IFN-γ production by human NK cells. PL-C also synergized with IL-12, even at the low cytokine concentration of 0.1 ng/ml, and stimulated IFN-γ production in both human CD56(bright) and CD56(dim) NK cell subsets. Mechanistically, TLR1 and/or TLR6 mediated PL-C's activation of the NF-κB p65 subunit that in turn bound to the proximal promoter of IFNG and subsequently resulted in increased IFN-γ production in NK cells. However, IL-12 and IL-15Rs and their related STAT signaling pathways were not responsible for the enhanced IFN-γ secretion by PL-C. PL-C induced little or no T cell IFN-γ production or NK cell cytotoxicity. Collectively, we identify a natural product with the capacity to selectively enhance human NK cell IFN-γ production. Given the role of IFN-γ in immune surveillance, additional studies to understand the role of this natural product in prevention of cancer or infection in select populations are warranted.
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Affiliation(s)
- Youcai Deng
- Division of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210; Institute of Materia Medica, College of Pharmacy, Third Military Medical University, Chongqing 400038, China
| | - Jianhong Chu
- The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210
| | - Yulin Ren
- Division of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, OH 43210
| | - Zhijin Fan
- The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210; State Key Laboratory of Elemento-Organic Chemistry, Nankai University, Tianjin 300071, China
| | - Xiaotian Ji
- State Key Laboratory of Elemento-Organic Chemistry, Nankai University, Tianjin 300071, China
| | | | - Shunzong Yuan
- The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210; Department of Lymphoma, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China
| | - Tiffany Hughes
- The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210
| | - Jianying Zhang
- Center for Biostatistics, The Ohio State University, Columbus, OH 43210
| | - Baljash Cheema
- Division of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, OH 43210
| | - Andrew T Camardo
- The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210
| | - Yong Xia
- Department of Molecular and Cellular Biochemistry, The Ohio State University College of Medicine, Columbus, OH 43210
| | - Lai-Chu Wu
- Department of Molecular and Cellular Biochemistry, The Ohio State University College of Medicine, Columbus, OH 43210
| | - Li-Shu Wang
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI 53226; and
| | - Xiaoming He
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH 43210
| | - A Douglas Kinghorn
- Division of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, OH 43210
| | - Xiaohui Li
- Institute of Materia Medica, College of Pharmacy, Third Military Medical University, Chongqing 400038, China;
| | - Michael A Caligiuri
- Division of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210; The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210;
| | - Jianhua Yu
- Division of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH 43210; The Ohio State University Comprehensive Cancer Center, Columbus, OH 43210;
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14
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Urroz P, Colagiuri B, Smith C, Cheema B. Effect of acupuncture and instruction on post-exercise recovery: A balanced-placebo controlled trial. J Sci Med Sport 2013. [DOI: 10.1016/j.jsams.2013.10.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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15
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Melville G, Chang D, Colagiuri B, Marshall P, Cheema B. P02.16. Fifteen minutes of yoga postures or guided meditation in the office can elicit psychological and physiological relaxation. Altern Ther Health Med 2012. [PMCID: PMC3373908 DOI: 10.1186/1472-6882-12-s1-p72] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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16
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Melville G, Chang D, Colagiuri B, Marshall P, Cheema B. Fifteen minutes of yoga postures or guided meditation in the office can elicit psychological and physiological relaxation. J Sci Med Sport 2011. [DOI: 10.1016/j.jsams.2011.11.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Esan MO, Phiri KS, Molyneux EM, Mukaka M, Cheema B, Boele van Hensbroek M. High transfusion failure rates in Malawian children with severe anaemia following a standard blood transfusion regimen. Br J Haematol 2011; 154:783-5. [PMID: 21671896 DOI: 10.1111/j.1365-2141.2011.08779.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M O Esan
- MLW Clinical Research Programme, Blantyre, MalawiGlobal Child Health Group - AIGHD, AMC, Amsterdam, The NetherlandsLiverpool School of Tropical Medicine, Liverpool, UKCollege of Medicine, University of Malawi, Blantyre, Malawi Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa E-mail:
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18
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Cheema B, Molyneux EM, Emmanuel JC, M'baya B, Esan M, Kamwendo H, Kalilani-Phiri L, Boele van Hensbroek M. Development and evaluation of a new paediatric blood transfusion protocol for Africa. Transfus Med 2010; 20:140-51. [DOI: 10.1111/j.1365-3148.2010.00989.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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19
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Raschke V, Oltersdorf U, Elmadfa I, Wahlqvist ML, Kouris-Blazos A, Cheema B. Investigation of the Dietary Intake and Health Status in East Africa in the 1960s: A Systematic Review of the HistoricOltersdorf Collection. Ecol Food Nutr 2008. [DOI: 10.1080/03670240701454683] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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20
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Cheema B, Grant CC, Mahadevan M, Beca J. An infant with a persistent empyema. Acta Paediatr 1999; 88:1168-71. [PMID: 10565471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- B Cheema
- Starship Children's Hospital, Auckland Healthcare Limited, New Zealand
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