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Namkoong J. The Currency of Time vs Energy: An Interventional Cardiology Fellow's Reflections on Thriving in the Uncertainties Within Medical Training and Beyond. Can J Cardiol 2024; 40:730-731. [PMID: 38103866 DOI: 10.1016/j.cjca.2023.12.010] [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: 09/05/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023] Open
Affiliation(s)
- Jenny Namkoong
- Cardiac Sciences, St. Boniface Hospital, Winnipeg, Manitoba, Canada.
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Namkoong J, Andraweera PH, Pathirana M, Munawar D, Downie M, Edwards S, Averbuj P, Arstall MA. A systematic review and meta-analysis of the diagnosis and surgical management of carcinoid heart disease. Front Cardiovasc Med 2024; 11:1353612. [PMID: 38572311 PMCID: PMC10987853 DOI: 10.3389/fcvm.2024.1353612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/11/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction Carcinoid heart disease (CHD), a complication of carcinoid syndrome (CS), is a rare condition that can lead to right sided valvular heart disease and has been traditionally associated with a poor prognosis. We conducted a systematic review and meta-analysis to explore the accuracy of biomarkers and echocardiography in diagnosing CHD amongst patients who are already known to have neuroendocrine tumours and to assess whether surgical management of CHD leads to a reduction in mortality. Methods A systematic literature search of MEDLINE, EMBASE, EBM Reviews, Google Scholar, ClinicalTrials.gov was conducted. All studies on patients with carcinoid heart disease (CHD) reporting on biomarkers, echocardiographic and surgical outcomes were included. The National Heart, Lung, and Blood Institute quality assessment tool was used to assess the methodological study quality. Data analysis was performed using Stata Statistical Software and R Studio, and individual meta-analyses were performed for biomarkers, echocardiographic findings, and surgical outcomes. Results A total of 36 articles were included in the systematic review analysis. N terminal pro-brain natriuretic peptide (NTproBNP) and 5-hydroxyindole acetate (5-HIAA) levels were higher in patients with CHD compared with those without CHD. 32% of CS patients had echocardiographic evidence of cardiac involvement, of which 79% involved tricuspid valve abnormalities. Moderate-severe tricuspid regurgitation was the most common echocardiographic abnormality (70% of patients). However, these analyses had substantial heterogeneity due to the high variability of cardiac involvement across studies. Pooled surgical mortality for CHD was 11% at 1 month, 31% at 12 months and 56% at 24 months. When assessing surgical outcomes longitudinally, the one-month surgical results showed a trend towards more recent surgeries having lower mortality rates than those reported in earlier years, however this was not statistically significant. Discussion There is not enough data in current literature to determine a clear cut-off value of NTproBNP and 5-HIAA to help diagnose or determine CHD severity. Surgical management of CHD is yet to show significant mortality benefit, and there are no consistent comparisons to medical treatment in current literature.
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Affiliation(s)
- Jenny Namkoong
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
| | - Prabha H. Andraweera
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
- Adelaide Medical School, The University of Adelaide, North Terrace Adelaide, SA, Australia
| | - Maleesa Pathirana
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
- Adelaide Medical School, The University of Adelaide, North Terrace Adelaide, SA, Australia
| | - Dian Munawar
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
| | - Michael Downie
- SA Health Library Service, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
| | - Suzanne Edwards
- Adelaide Medical School, The University of Adelaide, North Terrace Adelaide, SA, Australia
| | - Paula Averbuj
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
| | - Margaret A. Arstall
- Department of Cardiology, Lyell McEwin Hospital, SA Health, Elizabeth Vale, SA, Australia
- Adelaide Medical School, The University of Adelaide, North Terrace Adelaide, SA, Australia
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Cook B, Namkoong J, Riggs M, Holley K, Kern D, Knaggs H. 496 Evaluation of extracts containing red clover using dermal papilla cells in the development of a scalp treatment system targeting hair loss and hair damage. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.505] [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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Namkoong J, Nadar G, Pati P. 497 If the Clinical Outcome of a NSTEMI With Acute Total Occlusion (ATO) is the Same as a STEMI, Why Treat Them Differently? Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.504] [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: 10/23/2022]
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Namkoong J, Chia V, Sultana F, Earl D, Arstall M. 542 Review of Efficacy and Outcomes of Preventing Hospital Admissions by Use of Quick-Access Chest Pain Clinic for Low-Moderate Risk Chest Pain Presentations. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.549] [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: 11/16/2022]
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Pati P, Pati A, Namkoong J, Yongcheng Chia V, Arstall M. 818 Distal Radial Artery Access is as Safe and Feasible as Proximal Radial Artery Access for Coronary Interventions. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.825] [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: 10/23/2022]
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Namkoong J, Nadar G, Pati P. 837 If the Clinical Outcome of a NSTEMI With Acute Total Occlusion (ATO) is the Same as a STEMI, Why Treat Them Differently? Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.844] [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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Namkoong J, Kern D, Riggs M, Holley K, Knaggs H. 667 A facial treatment cleansing device enhanced delivery of topical skin care products. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.676] [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: 10/17/2022]
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Kern D, Namkoong J, Riggs M, Cook B, Draelos Z, Knaggs H. 698 A novel device for skin type-based treatment while cleansing. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.375] [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: 11/26/2022]
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Namkoong J, Kern D, Knaggs H. 254 Preliminary evaluation of gene expression changes from tape stripping. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.270] [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: 10/19/2022]
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Jones S, Hart D, Blythe A, Ronsky J, Namkoong J, Kern D. 536 The influence of a novel mechanical loading regimen on the molecular response of human facial skin cells. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.557] [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: 10/19/2022]
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Allahwala U, Namkoong J, Gray B, Soo Hoo S, Choong C, Bhindi R, Tofler G. Acute Pericarditis: Predictors of the Presence of a Pericardial Effusion – The Experience in a Tertiary Centre. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.170] [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: 11/15/2022]
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Wood S, Gray R, Hester S, Mastaloudis A, Kern D, Namkoong J, Draelos Z. 581 Nutritional supplement improves skin health. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.620] [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: 11/16/2022]
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Goydos J, Gorski D, Schell S, Namkoong J, Chen S. Metabotropic glutamate receptor 1 activates the mitogen activated protein kinase (MAPK) pathway in breast cancer and melanoma. J Surg Res 2006. [DOI: 10.1016/j.jss.2005.11.010] [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: 11/25/2022]
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