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Prabhakar Y, Goyal A, Khalid N, Sharma N, Nayyar R, Spodick DH, Chhabra L. Pericardial decompression syndrome: A comprehensive review. World J Cardiol 2019; 11:282-291. [PMID: 31908728 PMCID: PMC6937413 DOI: 10.4330/wjc.v11.i12.282] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/25/2019] [Accepted: 11/21/2019] [Indexed: 02/06/2023] Open
Abstract
Pericardial decompression syndrome (PDS) is an infrequent, life-threatening complication following pericardial drainage for cardiac tamponade physiology. PDS usually develops after initial clinical improvement following pericardiocentesis and is significantly underreported and may be overlooked in the clinical practice. Although the precise mechanisms resulting in PDS are not well understood, this seems to be highly associated with patients who have some underlying ventricular dysfunction. Physicians performing pericardial drainage should be mindful of the risk factors associated with the procedure including the rare potential for the development of PDS.
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Affiliation(s)
- Yougeesh Prabhakar
- Department of Cardiology, Heartland Regional Medical Center, Marion, IL 62959, United States
| | - Amandeep Goyal
- Department of Medicine, Marietta Memorial Hospital, Marietta, OH45750, United States
| | | | - Nitish Sharma
- Department of Interventional Cardiology, Medstar Washington Hospital Center, Washington, DC 20010, United States
- Department of Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Raj Nayyar
- Department of Cardiology, Heartland Regional Medical Center, Marion, IL 62959, United States
| | - David H Spodick
- Department of Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
| | - Lovely Chhabra
- Department of Cardiology, Heartland Regional Medical Center, Marion, IL 62959, United States
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Chhabra L, Spodick DH. ¿Es hora de revertir el paradigma en el tratamiento de la pericarditis aguda idiopática? Rev Esp Cardiol (Engl Ed) 2019. [DOI: 10.1016/j.recesp.2019.02.016] [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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Chhabra L, Spodick DH. Is It Time for a "Reverse Paradigm Shift" in the Treatment of Acute Idiopathic Pericarditis? Rev Esp Cardiol (Engl Ed) 2019; 72:703-704. [PMID: 30948264 DOI: 10.1016/j.rec.2019.02.011] [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] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 02/26/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Lovely Chhabra
- Department of Cardiology, Heartland Regional Medical Center, Marion, IL, United States.
| | - David H Spodick
- Department of Medicine, Saint Vincent Hospital, Worcester, MA, United States
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Chhabra L, Spodick DH. Hospitalized elderly patients for acute pericarditis deserve more clinical attention and a closer follow-up monitoring. Eur Heart J Qual Care Clin Outcomes 2018; 4:73-75. [PMID: 29309548 DOI: 10.1093/ehjqcco/qcx050] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Lovely Chhabra
- Heartland Regional Medical Center, 3331 W. DeYoung Street, Suite 100, Marion, IL 62959, USA
- Division of Cardiovascular Medicine, Southern Illinois University, 1263 Lincoln Dr, Carbondale, 62901 IL, USA
| | - David H Spodick
- Saint Vincent Hospital, Worcester, 123 Summer St, Worcester, 01608 MA, USA
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Chhabra L, Kowlgi NG, Spodick DH. Colchicine In Epistenocardiac Pericarditis. Conn Med 2016; 80:549-551. [PMID: 29772141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Epistenocardiac pericarditis (EP) is a rare form of pericarditis which occurs in the early period after a myocardial infarction (MI) and is commonly regionalized to the area of infarction. The preferred treatment for EP is high-dose oral aspirin, given the compelling indication for aspirin use in the post-MI setting; however, high-dose aspirin use may be prohibitive in certain clinical situations such as with concomitant use of newer antiplatelet agents like ticagrelor. The treatment option with colchicine remains an alternative; however the efficacy of colchicine in EP is not well established. We herewith describe a case series of 11 patients with EP who were treated with colchicine.
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Spodick DH. Book Review: Cardiac Arrhythmias: A Clinical Approach. J Intensive Care Med 2016. [DOI: 10.1177/0885066605275617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- David H. Spodick
- University of Massachusetts Medical School, Cardiovascular Division, Worcester, MA
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Sider RC, Ram CVS, Egger RL, Filer LJ, Rovelstad RA, Spodick DH. The Medical Bookshelf. Postgrad Med 2016. [DOI: 10.1080/00325481.1979.11715292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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8
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Spodick DH. Book Review: Cardiac Electrophysiology: From Cell to Bedside, Fourth Edition. J Intensive Care Med 2016. [DOI: 10.1177/0885066605284593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Spodick DH. Intensive Management of Pericardial Disease. J Intensive Care Med 2016. [DOI: 10.1177/088506668700200103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- David H. Spodick
- Department of Medicine Section of Cardiology University of Massachusetts Medical School Cardiology Division St Vincent Hospital Worcester, MA 01604
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Chhabra L, Chaubey VK, Spodick DH. Pericardial Involvement in Mediastinal Disease: A Contiguous Association! J Emerg Med 2016; 50:e173. [PMID: 26794453 DOI: 10.1016/j.jemermed.2014.12.098] [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] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 12/22/2014] [Indexed: 06/05/2023]
Affiliation(s)
- Lovely Chhabra
- Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford
| | - Vinod K Chaubey
- Department of Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester
| | - David H Spodick
- Department of Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester
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Chhabra L, Gowd BMP, Spodick DH. Hypothermia Can Masquerade as Pericarditis: Yet Another Possibility to be Considered in the Differential Diagnosis. J Emerg Med 2016; 50:e171-e172. [PMID: 26794456 DOI: 10.1016/j.jemermed.2014.07.065] [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] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 07/28/2014] [Indexed: 06/05/2023]
Affiliation(s)
- Lovely Chhabra
- Department of Cardiology, Hartford Hospital, University of Connecticut, Hartford
| | - B M Pamapana Gowd
- Department of Cardiology, Hartford Hospital, University of Connecticut, Hartford
| | - David H Spodick
- Department of Cardiology, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester
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Umer A, Khalid N, Chhabra L, Spodick DH. Role of Pericardiectomy in Postcardiac Transplant Constrictive Pericarditis. Ann Thorac Surg 2015; 100:2420. [PMID: 26652564 DOI: 10.1016/j.athoracsur.2015.06.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 06/05/2015] [Accepted: 06/09/2015] [Indexed: 10/22/2022]
Affiliation(s)
- Affan Umer
- Department of Surgery, Saint Francis Hospital, University of Connecticut Health Center, Hartford, CT.
| | - Nauman Khalid
- Hartford Hospital, University of Connecticut Health Center, Hartford, CT
| | - Lovely Chhabra
- Hartford Hospital, University of Connecticut Health Center, Hartford, CT
| | - David H Spodick
- Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA
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Chhabra L, Bhattad VB, Memon S, Spodick DH. Arrhythmogenic Potential of Acute Idiopathic Pericarditis. Card Electrophysiol Clin 2015; 7:xix-xx. [PMID: 26596822 DOI: 10.1016/j.ccep.2015.08.021] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Lovely Chhabra
- Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut School of Medicine, 80 Seymour Street, Hartford, CT 06102, USA.
| | - Venugopal Brijmohan Bhattad
- Department of Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA 01608, USA
| | - Sarfaraz Memon
- Department of Cardiovascular Medicine, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102, USA
| | - David H Spodick
- Department of Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA 01608, USA
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Affiliation(s)
- Nauman Khalid
- Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut Health Center, Hartford
| | - Lovely Chhabra
- Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford
| | - Sarah Aftab Ahmad
- Department of Cardiovascular Medicine, Texas Tech University Health Sciences Center, Lubbock
| | - Pooja Sareen
- Department of Cardiovascular Medicine, Baystate Medical Center, Springfield, Mass
| | - David H Spodick
- Department of Cardiovascular Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester
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Khalid N, Chhabra L, Ahmad SA, Umer A, Spodick DH. Case Report: Autoimmune Polyglandular Syndrome Type 2 Complicated by Acute Adrenal Crisis and Pericardial Tamponade in the Setting of Normal Thyroid Function. Methodist Debakey Cardiovasc J 2015; 11:250-252. [PMID: 28451060 DOI: 10.14797/mdcj-11-4-250] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
We describe herein a 48-year-old Caucasian woman with a history of autoimmune polyglandular syndrome type 2 who presented with pericarditis, pericardial effusion, and pericardial tamponade preceded by acute adrenal crisis in the setting of normal thyroid function. The case highlights the importance of a rare yet important complication of autoimmune polyglandular syndrome type 2 that mandates early recognition and intervention.
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Affiliation(s)
| | - Lovely Chhabra
- University of Connecticut School of Medicine, Hartford, Connecticut
| | | | - Affan Umer
- University of Connecticut School of Medicine, Hartford, Connecticut
| | - David H Spodick
- University of Massachusetts Medical School, Worcester, Massachusetts
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Chhabra L, Bhattad VB, Sareen P, Khalid N, Spodick DH. Atrial fibrillation in acute pericarditis: an overblown association. Heart 2015; 101:1518. [DOI: 10.1136/heartjnl-2015-308265] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Umer A, Khalid N, Chhabra L, Memon S, Spodick DH. Constrictive pericarditis complicating cardiac transplantation. J Cardiothorac Surg 2015; 10:109. [PMID: 26302865 PMCID: PMC4549104 DOI: 10.1186/s13019-015-0314-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 08/03/2015] [Indexed: 11/18/2022] Open
Abstract
Constrictive pericarditis is a disease characterized by progressive pericardial fibrosis. If left untreated it can lead to progressive heart failure and can be severely disabling. Medical management with non-steroidal anti-inflammatory drugs in combination with colchicine is promising in the acute phase of the disease but for more chronic cases pericardiectomy offers the best chance for hemodynamic recovery. Constrictive pericarditis after cardiac transplantation is a rare phenomenon. Current literature suggests that early pericardiectomy may be the most effective treatment in this subset of patients as well.
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Affiliation(s)
- Affan Umer
- Department of Surgery, Saint Francis Hospital and Medical Center, University of Connecticut Health Center, Hartford, CT, USA.
| | - Nauman Khalid
- Hartford Hospital, University of Connecticut Health Center, Hartford, CT, USA
| | - Lovely Chhabra
- Hartford Hospital, University of Connecticut Health Center, Hartford, CT, USA
| | - Sarfaraz Memon
- Hartford Hospital, University of Connecticut Health Center, Hartford, CT, USA
| | - David H Spodick
- Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA, USA
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Umer A, Khalid N, Chhabra L, Spodick DH. Important Treatment Modalities for Symptomatic Malignant Pericardial Effusions. World J Surg 2015; 40:480-1. [PMID: 26246113 DOI: 10.1007/s00268-015-3170-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Affan Umer
- Department of Surgery, Saint Francis Hospital and Medical Center, University of Connecticut Health Center, Hartford, CT, USA.
| | - Nauman Khalid
- Hartford Hospital, University of Connecticut Health Center, Hartford, CT, USA
| | - Lovely Chhabra
- Hartford Hospital, University of Connecticut Health Center, Hartford, CT, USA
| | - David H Spodick
- Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA, USA
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Affiliation(s)
- Puneet Gupta
- Dept. of Cardiology, Hartford Hospital, University of Connecticut School of Medicine, Hartford, CT 06102, USA
| | - Lovely Chhabra
- Dept. of Cardiology, Hartford Hospital, University of Connecticut School of Medicine, Hartford, CT 06102, USA.
| | - Brett Hiendlmayr
- Dept. of Cardiology, Hartford Hospital, University of Connecticut School of Medicine, Hartford, CT 06102, USA
| | - David H Spodick
- Dept. of Cardiology, Hartford Hospital, University of Connecticut School of Medicine, Hartford, CT 06102, USA
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Abstract
BACKGROUND The prognosis of pericarditis with concomitant myocarditis, especially in the setting of troponin elevation, is a reason for concern because it could imply an adverse outcome. METHODS We performed a comprehensive Medline search of all publications from 2000 to 2013 with the MeSH terms 'pericarditis', 'myocarditis' and 'prognosis'. Additional publications were sought using the reference lists of identified papers, the published reviews on this topic, and a search of abstracts from the American Heart Association, American College of Cardiology, and European Society of Cardiology scientific sessions. RESULTS We identified eight major clinical series evaluating the prognosis of myopericarditis. Studies included a total of 389 patients with myopericarditis (mean age 31.7 years, men-to-women ratio 4.0). After a mean follow-up of 31 months, residual left-ventricular dysfunction was reported in 3.5% without cases of heart failure. Recurrences occurred in 13.0% of cases mainly as recurrent pericarditis (>90%), cardiac tamponade and constrictive pericarditis in less than 1% of cases. The overall prognosis seems good (no mortality), with only one single discordant study reporting three deaths: one related to cardiac tamponade and two sudden cardiac deaths during hospitalization, but no out-of-hospital deaths during follow-up. CONCLUSION Myopericarditis has a good overall prognosis. Troponin elevation in this setting does not predict an adverse outcome in most cases. Thus it is important to reassure the patients on their prognosis, explaining the nature of the disease and the likely course. Diagnostic and therapeutic choices should take into account the overall good outcome of these patients, including less invasive diagnostic tools and toxic drugs.
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Affiliation(s)
- Massimo Imazio
- aCardiology Department, Maria Vittoria Hospital, Torino bInternal Medicine Division, Ospedale Papa Giovanni XXIII, Bergamo, Italy cSt Vincent Hospital, Worcester, Massachusetts, USA dChaim Sheba Medical Centre, Tel Hashomer, Israel
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Chhabra L, Spodick DH. Did Colchicine Prove Useful in the Prevention of Postoperative Atrial Fibrillation? Am J Cardiol 2015; 116:165. [PMID: 25960380 DOI: 10.1016/j.amjcard.2015.04.008] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 04/12/2015] [Indexed: 11/25/2022]
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Khalid N, Chhabra L, Spodick DH. Response to Role of a 12-Lead Electrocardiogram in the Diagnosis of Cardiac Tamponade as Diagnosed by Transthoracic Echocardiography in Patients With Malignant Pericardial Effusion. Clin Cardiol 2015. [DOI: 10.1002/clc.22416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Nauman Khalid
- Department of Cardiovascular Medicine, Hartford Hospital; University of Connecticut Health Center; Hartford Connecticut
| | - Lovely Chhabra
- Hartford Hospital; University of Connecticut School of Medicine; Hartford Connecticut
| | - David H. Spodick
- Saint Vincent Hospital; University of Massachusetts Medical School; Worcester Massachusetts
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Chhabra L, Khalid N, Spodick DH. Persistent J-ST Changes: Suspect Ongoing Pericardial Irritation! Can J Cardiol 2015; 31:1074.e3. [PMID: 26051621 DOI: 10.1016/j.cjca.2015.02.032] [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] [Received: 02/22/2015] [Revised: 02/24/2015] [Accepted: 02/24/2015] [Indexed: 10/23/2022] Open
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Khalid N, Chhabra L, Ahmad SA, Spodick DH. Symptomatic malignant pericardial effusion due to advanced pericardial malignancies: a palliative approach. J Thorac Dis 2015; 7:E102-3. [PMID: 25973248 DOI: 10.3978/j.issn.2072-1439.2015.04.05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 03/11/2015] [Indexed: 11/14/2022]
Affiliation(s)
- Nauman Khalid
- 1 Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut Health Center, Hartford, CT, USA ; 2 Hartford Hospital, University of Connecticut School of Medicine, Hartford, CT, USA ; 3 Texas Tech University Health Sciences Center, Lubbock, TX, USA ; 4 Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA, USA
| | - Lovely Chhabra
- 1 Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut Health Center, Hartford, CT, USA ; 2 Hartford Hospital, University of Connecticut School of Medicine, Hartford, CT, USA ; 3 Texas Tech University Health Sciences Center, Lubbock, TX, USA ; 4 Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA, USA
| | - Sarah Aftab Ahmad
- 1 Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut Health Center, Hartford, CT, USA ; 2 Hartford Hospital, University of Connecticut School of Medicine, Hartford, CT, USA ; 3 Texas Tech University Health Sciences Center, Lubbock, TX, USA ; 4 Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA, USA
| | - David H Spodick
- 1 Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut Health Center, Hartford, CT, USA ; 2 Hartford Hospital, University of Connecticut School of Medicine, Hartford, CT, USA ; 3 Texas Tech University Health Sciences Center, Lubbock, TX, USA ; 4 Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA, USA
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Chhabra L, Chaubey VK, Spodick DH. Recurrent Myocardial Infarction or Epistenocardiac Pericarditis: How Can the Surface ECG Be Useful in Clinical Decision Making? Hellenic J Cardiol 2015; 56:269-270. [PMID: 26021253] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Affiliation(s)
- Lovely Chhabra
- Dept. of Cardiovascular Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford, CT, USA
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Chhabra L, Spodick DH. Pyopericarditis in diabetes mellitus: some worthy considerations. Diabet Med 2015; 32:569. [PMID: 25640692 DOI: 10.1111/dme.12690] [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] [Accepted: 01/12/2015] [Indexed: 11/26/2022]
Affiliation(s)
- L Chhabra
- Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford, CT, USA
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Chhabra L, Chaubey VK, Spodick DH. Letter by Chhabra et al regarding article, "Prevalence and prognostic significance of abnormal P terminal force in lead V1 of the electrocardiogram in the general population". Circ Arrhythm Electrophysiol 2015; 8:243. [PMID: 25691561 DOI: 10.1161/circep.114.002646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Lovely Chhabra
- Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford
| | - Vinod K Chaubey
- Department of Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester
| | - David H Spodick
- Department of Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester
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Chhabra L, Kowlgi NG, Spodick DH. Age as a factor to predict postpericardiotomy syndrome. Am J Cardiol 2015; 115:554-5. [PMID: 25527281 DOI: 10.1016/j.amjcard.2014.11.015] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 11/18/2014] [Accepted: 11/18/2014] [Indexed: 10/24/2022]
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Affiliation(s)
- Lovely Chhabra
- Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford, Connecticut
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Proietti R, Russo V, Sagone A, Viecca M, Spodick DH. [Interatrial block: an under-recognized electrocardiographic diagnosis with important clinical-therapeutic implications]. G Ital Cardiol (Rome) 2015; 15:561-8. [PMID: 25424020 DOI: 10.1714/1672.18308] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Interatrial blocks, characterized by P-wave duration ≥120 ms, are a well described but poorly recognized cardiac rhythm disorder. They are caused by a conduction delay between the right and left atria and occur in pandemic proportions in unselected patients. Interatrial blocks correlate with atrial dysfunction and are a predictor of significant atrial arrhythmias, particularly atrial fibrillation, as well as embolic stroke, all-cause and cardiovascular mortality. Special attention to this cardiac rhythm disorder is required because of its pathologic implications.
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Kowlgi NG, Chhabra L, Spodick DH. Refined nine-lead total QRS voltage with body mass index might offer a better diagnostic accuracy! Am J Cardiol 2015; 115:279-80. [PMID: 25465927 DOI: 10.1016/j.amjcard.2014.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 10/21/2014] [Indexed: 11/16/2022]
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Abstract
We describe herein a 61-year-old African American woman who presented with takotsubo cardiomyopathy preceded by lupus myopericarditis. The case highlights the importance of the association between pericarditis and takotsubo cardiomyopathy. This new stressor adds to the existing evidence that these two entities may coexist and do not have to be mutually exclusive.
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Affiliation(s)
- Lovely Chhabra
- Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford, Connecticut
| | - Nauman Khalid
- Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford, Connecticut
| | - Jeffrey Kluger
- Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford, Connecticut
| | - David H Spodick
- Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford, Connecticut
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Chhabra L, Khalid N, Spodick DH. [Letter on the article "Pericardial effusion: an unknown expression of Graves' disease"]. Presse Med 2014; 43:1407. [PMID: 25443638 DOI: 10.1016/j.lpm.2014.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 08/27/2014] [Indexed: 10/24/2022] Open
Affiliation(s)
- Lovely Chhabra
- Hartford hospital, university of Connecticut school of medicine, département de médecine cardiovasculaire, 80, Seymour street, Hartford, CT (06102), États-Unis.
| | - Nauman Khalid
- Hartford hospital, university of Connecticut school of medicine, département de médecine cardiovasculaire, 80, Seymour street, Hartford, CT (06102), États-Unis
| | - David H Spodick
- Hôpital Saint-Vincent, Massachusetts medical school university, département de médecine cardiovasculaire, Worcester, MA, États-Unis
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Affiliation(s)
- Lovely Chhabra
- Department of Cardiovascular Medicine Hartford Hospital University of Connecticut School of Medicine Hartford, CT
| | - David H. Spodick
- Department of Cardiovascular Medicine Saint Vincent Hospital University of Massachusetts Medical School Worcester, MA
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Chhabra L, Khalid N, Spodick DH. Pericardial manifestations in autoimmune encounters: some worthy facts for consideration! Int J Prev Med 2014; 5:1632-3. [PMID: 25709803 PMCID: PMC4336998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 09/27/2014] [Indexed: 10/26/2022] Open
Affiliation(s)
- Lovely Chhabra
- Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut, School of Medicine, Hartford, CT, USA,Correspondence to: Dr. Lovely Chhabra, 80, Seymour Street, Hartford, CT 06102, USA. E-mail:
| | - Nauman Khalid
- Department of Internal Medicine, Hartford Hospital, University of Connecticut, School of Medicine, Hartford, CT, USA
| | - David H. Spodick
- Department of Cardiovascular Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA, USA
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Affiliation(s)
- Lovely Chhabra
- Dept. of Cardiovascular Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford, CT 06102, USA.
| | - David H Spodick
- Saint Vincent Hospital, University of Massachusetts Medical School, Worcester MA 01608, USA
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Chhabra L, Khalid N, Spodick DH. Pericarditis recurrente: ¿la anakinra puede aportar un tratamiento prometedor para adultos con síntomas refractarios? Rev Esp Cardiol (Engl Ed) 2014. [DOI: 10.1016/j.recesp.2014.05.019] [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: 11/17/2022]
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Chhabra L, Khalid N, Spodick DH. Recurrent pericarditis: can anakinra offer a promising therapy in adults with refractory symptoms? Rev Esp Cardiol (Engl Ed) 2014; 67:963. [PMID: 25239182 DOI: 10.1016/j.rec.2014.05.019] [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] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 05/30/2014] [Indexed: 06/03/2023]
Affiliation(s)
- Lovely Chhabra
- Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford, Connecticut, United States.
| | - Nauman Khalid
- Department of Internal Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford, Connecticut, United States
| | - David H Spodick
- Department of Cardiovascular Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, Massachusetts, United States
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Chhabra L, Spodick DH. Letter by Chhabra and Spodick regarding article, "Influence of steroid therapy on the incidence of pericarditis and atrial fibrillation after percutaneous epicardial mapping and ablation for ventricular tachycardia" by Dyrda et al. Circ Arrhythm Electrophysiol 2014; 7:991. [PMID: 25336374 DOI: 10.1161/circep.114.002063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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] [Indexed: 12/23/2022]
Affiliation(s)
- Lovely Chhabra
- Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford, CT
| | - David H Spodick
- Department of Cardiovascular Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA
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Imazio M, Brucato A, Ferrazzi P, Pullara A, Adler Y, Barosi A, Caforio AL, Cemin R, Chirillo F, Comoglio C, Cugola D, Cumetti D, Dyrda O, Ferrua S, Finkelstein Y, Flocco R, Gandino A, Hoit B, Innocente F, Maestroni S, Musumeci F, Oh J, Pergolini A, Polizzi V, Ristic A, Simon C, Spodick DH, Tarzia V, Trimboli S, Valenti A, Belli R, Gaita F. Colchicine for prevention of postpericardiotomy syndrome and postoperative atrial fibrillation: the COPPS-2 randomized clinical trial. JAMA 2014; 312:1016-23. [PMID: 25172965 DOI: 10.1001/jama.2014.11026] [Citation(s) in RCA: 222] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Postpericardiotomy syndrome, postoperative atrial fibrillation (AF), and postoperative effusions may be responsible for increased morbidity and health care costs after cardiac surgery. Postoperative use of colchicine prevented these complications in a single trial. OBJECTIVE To determine the efficacy and safety of perioperative use of oral colchicine in reducing postpericardiotomy syndrome, postoperative AF, and postoperative pericardial or pleural effusions. DESIGN, SETTING, AND PARTICIPANTS Investigator-initiated, double-blind, placebo-controlled, randomized clinical trial among 360 consecutive candidates for cardiac surgery enrolled in 11 Italian centers between March 2012 and March 2014. At enrollment, mean age of the trial participants was 67.5 years (SD, 10.6 years), 69% were men, and 36% had planned valvular surgery. Main exclusion criteria were absence of sinus rhythm at enrollment, cardiac transplantation, and contraindications to colchicine. INTERVENTIONS Patients were randomized to receive placebo (n=180) or colchicine (0.5 mg twice daily in patients ≥70 kg or 0.5 mg once daily in patients <70 kg; n=180) starting between 48 and 72 hours before surgery and continued for 1 month after surgery. MAIN OUTCOMES AND MEASURES Occurrence of postpericardiotomy syndrome within 3 months; main secondary study end points were postoperative AF and pericardial or pleural effusion. RESULTS The primary end point of postpericardiotomy syndrome occurred in 35 patients (19.4%) assigned to colchicine and in 53 (29.4%) assigned to placebo (absolute difference, 10.0%; 95% CI, 1.1%-18.7%; number needed to treat = 10). There were no significant differences between the colchicine and placebo groups for the secondary end points of postoperative AF (colchicine, 61 patients [33.9%]; placebo, 75 patients [41.7%]; absolute difference, 7.8%; 95% CI, -2.2% to 17.6%) or postoperative pericardial/pleural effusion (colchicine, 103 patients [57.2%]; placebo, 106 patients [58.9%]; absolute difference, 1.7%; 95% CI, -8.5% to 11.7%), although there was a reduction in postoperative AF in the prespecified on-treatment analysis (placebo, 61/148 patients [41.2%]; colchicine, 38/141 patients [27.0%]; absolute difference, 14.2%; 95% CI, 3.3%-24.7%). Adverse events occurred in 21 patients (11.7%) in the placebo group vs 36 (20.0%) in the colchicine group (absolute difference, 8.3%; 95% CI; 0.76%-15.9%; number needed to harm = 12), but discontinuation rates were similar. No serious adverse events were observed. CONCLUSIONS AND RELEVANCE Among patients undergoing cardiac surgery, perioperative use of colchicine compared with placebo reduced the incidence of postpericardiotomy syndrome but not of postoperative AF or postoperative pericardial/pleural effusion. The increased risk of gastrointestinal adverse effects reduced the potential benefits of colchicine in this setting. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01552187.
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Affiliation(s)
- Massimo Imazio
- Cardiology Department, Maria Vittoria Hospital, Torino, Italy2University of Torino, Torino, Italy
| | | | | | - Alberto Pullara
- University of Torino, Torino, Italy4AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Yehuda Adler
- Chaim Sheba Medical Center, Tel Hashomer and Sacker University, Tel Aviv, Israel
| | - Alberto Barosi
- Department of Internal Medicine and Cardiac Surgery, Ospedale Niguarda, Milano, Italy
| | - Alida L Caforio
- Department of Cardiological Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Roberto Cemin
- Cardiology Department, Ospedale Regionale San Maurizio, Bolzano, Italy
| | - Fabio Chirillo
- Department of Cardiology and Cardiac Surgery, Ca Foncello Hospital, Treviso, Italy
| | - Chiara Comoglio
- Department of Cardiac Surgery and Rehabilitation, Villa Maria Pia Hospital, Torino, Italy
| | | | | | - Oleksandr Dyrda
- Department of Cardiac Surgery and Rehabilitation, Villa Maria Pia Hospital, Torino, Italy
| | - Stefania Ferrua
- Department of Cardiology, Ospedale degli Infermi, Rivoli, Italy
| | - Yaron Finkelstein
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | | | - Anna Gandino
- Department of Internal Medicine and Cardiac Surgery, Ospedale Niguarda, Milano, Italy
| | - Brian Hoit
- Case Western Reserve University, Cleveland, Ohio15University Hospitals Case Medical Center, Cleveland, Ohio
| | | | | | | | - Jae Oh
- Division of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota
| | - Amedeo Pergolini
- Department of Cardiac Surgery, Ospedale San Camillo, Roma, Italy
| | - Vincenzo Polizzi
- Department of Cardiac Surgery, Ospedale San Camillo, Roma, Italy
| | - Arsen Ristic
- Department of Cardiology, Belgrade University School of Medicine and Clinical Centre of Serbia, Belgrade, Serbia
| | | | | | - Vincenzo Tarzia
- Department of Cardiological Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - Stefania Trimboli
- Department of Cardiac Surgery and Rehabilitation, Villa Maria Pia Hospital, Torino, Italy
| | | | - Riccardo Belli
- Cardiology Department, Maria Vittoria Hospital, Torino, Italy
| | - Fiorenzo Gaita
- University of Torino, Torino, Italy4AOU Città della Salute e della Scienza di Torino, Torino, Italy
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Mehrzad R, Rajab M, Spodick DH. The three integrated phases of left atrial macrophysiology and their interactions. Int J Mol Sci 2014; 15:15146-60. [PMID: 25167138 PMCID: PMC4200839 DOI: 10.3390/ijms150915146] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 08/17/2014] [Accepted: 08/21/2014] [Indexed: 11/24/2022] Open
Abstract
Our understanding of the left atrium is growing, although there are many aspects that are still poorly understood. The left atrium size as an imaging biomarker has been consistently shown to be a powerful predictor of outcomes and of different cardiovascular disorders, such as, but not limited to, atrial fibrillation, congestive heart failure, mitral regurgitation and stroke. Left atrial function has been conventionally divided into three integrated phases: reservoir, conduit and booster-pump. The highly dynamic left atrium and its response to the stretch and secretion of atrial neuropeptides leaves the left atrium far from being a simple transport chamber. The aim of this review is to provide an understanding of the left atrial physiology and its relation to disorders within the heart.
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Affiliation(s)
- Raman Mehrzad
- Department of Medicine, Steward Carney Hospital, Tufts University School of Medicine, 2100 Dorchester Avenue, Boston, MA 02124, USA.
| | - Mohammad Rajab
- Department of Medicine, Division of Cardiology, Virginia Commonwealth University Medical Center, Richmond, VA 23298, USA.
| | - David H Spodick
- Department of Medicine, Division of Cardiology, St. Vincent Hospital, University of Massachusetts Medical School, Worcester, MA 02124, USA.
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Abstract
Interatrial block (IAB; P-wave duration ≥ 110 ms), which represents a delay in the conduction between the atria, is a pandemic conduction abnormality that is frequently underappreciated in clinical practice. Despite its comprehensive documentation in the medical literature, it has still not received adequate attention and also not adequately described and discussed in most cardiology textbooks. IAB can be of varying degrees and classified based on the degree of P-duration and its morphology. It can transform into a higher degree block and can also manifest transiently. IAB may be a preceding or causative risk factor for various atrial arrhythmias (esp. atrial fibrillation) and also be associated with various other clinical abnormalities ranging from left atrial dilation and thromboembolism including embolic stroke and mesenteric ischemia. IAB certainly deserves more attention and prospective studies are needed to formulate a standard consensus regarding appropriate management strategies.
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Chhabra L, Chaubey VK, Spodick DH. A case of seasonal recurrent myopericarditis? Tough to say! J Osteopath Med 2014; 114:532. [PMID: 25002442 DOI: 10.7556/jaoa.2014.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Lovely Chhabra
- Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut School of Medicine
| | - Vinod K Chaubey
- Department of Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester
| | - David H Spodick
- Department of Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester
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Imazio M, Belli R, Brucato A, Cemin R, Ferrua S, Beqaraj F, Demarie D, Ferro S, Forno D, Maestroni S, Cumetti D, Varbella F, Trinchero R, Spodick DH, Adler Y. Efficacy and safety of colchicine for treatment of multiple recurrences of pericarditis (CORP-2): a multicentre, double-blind, placebo-controlled, randomised trial. Lancet 2014; 383:2232-7. [PMID: 24694983 DOI: 10.1016/s0140-6736(13)62709-9] [Citation(s) in RCA: 222] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Colchicine is effective for the treatment of acute pericarditis and first recurrences. However, conclusive data are lacking for the efficacy and safety of colchicine for treatment of multiple recurrences of pericarditis. METHODS We did this multicentre, double-blind trial at four general hospitals in northern Italy. Adult patients with multiple recurrences of pericarditis (≥two) were randomly assigned (1:1) to placebo or colchicine (0·5 mg twice daily for 6 months for patients weighing more than 70 kg or 0·5 mg once daily for patients weighing 70 kg or less) in addition to conventional anti-inflammatory treatment with aspirin, ibuprofen, or indometacin. Permuted block randomisation (size four) was done with a central computer-based automated sequence. Patients and all investigators were masked to treatment allocation. The primary outcome was recurrent pericarditis in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT00235079. FINDINGS 240 patients were enrolled and 120 were assigned to each group. The proportion of patients who had recurrent pericarditis was 26 (21·6%) of 120 in the colchicine group and 51 (42·5%) of 120 in the placebo group (relative risk 0·49; 95% CI 0·24-0·65; p=0·0009; number needed to treat 5). Adverse effects and discontinuation of study drug occurred in much the same proportions in each group. The most common adverse events were gastrointestinal intolerance (nine patients in the colchicine group vs nine in the placebo group) and hepatotoxicity (three vs one). No serious adverse events were reported. INTERPRETATION Colchicine added to conventional anti-inflammatory treatment significantly reduced the rate of subsequent recurrences of pericarditis in patients with multiple recurrences. Taken together with results from other randomised controlled trials, these findings suggest that colchicine should be probably regarded as a first-line treatment for either acute or recurrent pericarditis in the absence of contraindications or specific indications. FUNDING Azienda Sanitaria 3 of Torino (now ASLTO2).
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Affiliation(s)
- Massimo Imazio
- Cardiology Department, Maria Vittoria Hospital, Turin, Italy.
| | - Riccardo Belli
- Cardiology Department, Maria Vittoria Hospital, Turin, Italy
| | - Antonio Brucato
- Internal Medicine Department, Papa Giovanni XXIII Hospital, ex-Ospedali Riuniti, Bergamo, Italy
| | - Roberto Cemin
- Cardiology Department, San Maurizio Regional Hospital, Bolzano, Italy
| | - Stefania Ferrua
- Cardiology Department, Ospedale degli Infermi, Rivoli, Italy
| | | | - Daniela Demarie
- Cardiology Department, Maria Vittoria Hospital, Turin, Italy
| | - Silvia Ferro
- Cardiology Department, Maria Vittoria Hospital, Turin, Italy
| | - Davide Forno
- Cardiology Department, Maria Vittoria Hospital, Turin, Italy
| | - Silvia Maestroni
- Internal Medicine Department, Papa Giovanni XXIII Hospital, ex-Ospedali Riuniti, Bergamo, Italy
| | - Davide Cumetti
- Internal Medicine Department, Papa Giovanni XXIII Hospital, ex-Ospedali Riuniti, Bergamo, Italy
| | | | - Rita Trinchero
- Cardiology Department, Maria Vittoria Hospital, Turin, Italy
| | - David H Spodick
- Internal Medicine Department, St Vincent Hospital, Worcester, MA, USA
| | - Yehuda Adler
- Chaim Sheba Medical Center, Tel Hashomer and Sacker Faculty of Medicine, Tel Aviv, Israel
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Abstract
Hypothermia is a common environmental emergency encountered by physicians and is associated with a variety of electrocardiographic (ECG) abnormalities. The classic and well-known ECG manifestations of hypothermia include the presence of J (Osborn) waves, interval (PR, QRS, QT) prolongation, and atrial and ventricular arrhythmias. There are less well defined and known ECG signs of hypothermia, which in fact may simulate findings of acute coronary ischemia, Brugada syndrome, or even pericarditis. Although classical ECG changes seen in hypothermia certainly serve as an important clinical clue for prompt identification and management of this easily curable life-threatening entity, physicians should, however, be able to maintain a high suspicion for recognition and differentiation of less common ECG abnormalities encountered in hypothermia. This article aims to provide a detailed review of all the potential ECG abnormalities that may be encountered in accidental and iatrogenic hypothermia.
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Affiliation(s)
- Lovely Chhabra
- 1 Department of Internal Medicine, Saint Vincent Hospital, University of Massachusetts Medical School , Worcester, Massachusetts
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Chhabra L, Spodick DH. Role of epicardial fat in atrial fibrillation after coronary artery bypass surgery. Am J Cardiol 2014; 113:2090. [PMID: 24878138 DOI: 10.1016/j.amjcard.2014.04.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Accepted: 04/09/2014] [Indexed: 10/25/2022]
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Imazio M, Belli R, Beqaraj F, Giammaria M, Lestuzzi C, Hoit B, LeWinter M, Spodick DH, Adler Y. DRainage Or Pericardiocentesis alone for recurrent nonmalignant, nonbacterial pericardial effusions requiring intervention. J Cardiovasc Med (Hagerstown) 2014; 15:510-4. [DOI: 10.2459/jcm.0b013e3283621d26] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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