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Harold JG. C. Richard Conti and Chinese cardiology 1989–2022. Clin Cardiol 2022; 45:1089-1093. [DOI: 10.1002/clc.23905] [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: 07/14/2022] [Accepted: 08/08/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
- John Gordon Harold
- Department of Cardiology Cedars‐Sinai Smidt Heart Institute Los Angeles California USA
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Backman WD, Levine SA, Wenger NK, Harold JG. Shared decision-making for older adults with cardiovascular disease. Clin Cardiol 2019; 43:196-204. [PMID: 31580493 PMCID: PMC7021653 DOI: 10.1002/clc.23267] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 08/30/2019] [Accepted: 09/06/2019] [Indexed: 12/12/2022] Open
Abstract
Shared decision‐making is appropriate for clinical decisions involving multiple reasonable options, which occur frequently in the cardiovascular care of older adults. The process includes the communication of relevant factual information between the patient and the clinician, elicitation of patient preferences, and a mutual agreement on the best course of action to meet the patient's personal goals. For older adults, there are common challenges and considerations with regard to shared decision‐making, some of which (eg, cognitive impairment) may be biologically linked to cardiovascular disease. There are tools designed to facilitate the shared decision‐making process, known as decision aids, which are broadly effective although have shortcomings when applied to older adults. Novel approaches in clinical research and health systems changes will go some way toward improving shared decision‐making for older adults, but the greatest scope for improvement may be within the grass roots areas of communication skills, interdisciplinary teamwork, and simply asking our patients what matters most.
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Affiliation(s)
- Warren D Backman
- Veterans Affairs New England Geriatric Research Education and Clinical Center, Boston, Massachusetts.,Section of Geriatrics, Boston University and Boston Medical Center, Boston, Massachusetts
| | - Sharon A Levine
- Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Nanette K Wenger
- Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia.,Emory Heart and Vascular Center, Atlanta, Georgia.,Emory Women's Heart Center, Atlanta, Georgia
| | - John Gordon Harold
- Cedars-Sinai Smidt Heart Institute and UCLA David Geffen School of Medicine, Los Angeles, California
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Bell SP, Orr NM, Dodson JA, Rich MW, Wenger NK, Blum K, Harold JG, Tinetti ME, Maurer MS, Forman DE. What to Expect From the Evolving Field of Geriatric Cardiology. J Am Coll Cardiol 2015; 66:1286-1299. [PMID: 26361161 DOI: 10.1016/j.jacc.2015.07.048] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 07/24/2015] [Accepted: 07/26/2015] [Indexed: 11/20/2022]
Abstract
The population of older adults is expanding rapidly, and aging predisposes to cardiovascular disease. The principle of patient-centered care must respond to the preponderance of cardiac disease that now occurs in combination with the complexities of old age. Geriatric cardiology melds cardiovascular perspectives with multimorbidity, polypharmacy, frailty, cognitive decline, and other clinical, social, financial, and psychological dimensions of aging. Although some assume that a cardiologist may instinctively cultivate some of these skills over the course of a career, we assert that the volume and complexity of older cardiovascular patients in contemporary practice warrants a more direct approach to achieve suitable training and a more reliable process of care. We present a rationale and vision for geriatric cardiology as a melding of primary cardiovascular and geriatrics skills, thereby infusing cardiology practice with expanded proficiencies in diagnosis, risks, care coordination, communications, end-of-life, and other competences required to best manage older cardiovascular patients.
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Affiliation(s)
- Susan P Bell
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee; Center for Quality Aging, Division of Geriatric Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Nicole M Orr
- Division of Cardiology and the Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts
| | - John A Dodson
- Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York
| | - Michael W Rich
- Division of Cardiology, Washington University School of Medicine, St. Louis, Missouri
| | - Nanette K Wenger
- Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia
| | - Kay Blum
- Geriatric Cardiology Section, American College of Cardiology, Washington, DC
| | - John Gordon Harold
- Cedars-Sinai Heart Institute and David Geffen School of Medicine, University of California, Los Angeles, California
| | - Mary E Tinetti
- Departments of Internal Medicine and Public Health and Epidemiology, Yale School of Medicine, New Haven, Connecticut
| | - Mathew S Maurer
- Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, New York
| | - Daniel E Forman
- Geriatric Cardiology Section, Department of Medicine, University of Pittsburgh Medical Center, and Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.
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Affiliation(s)
- John Gordon Harold
- From the Cedars-Sinai Heart Institute and David Geffen School of Medicine at UCLA, Los Angeles, CA
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Affiliation(s)
- Patrick T O'Gara
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA 02115, USA.
| | - John Gordon Harold
- Division of Cardiology, Cedars-Sinai Heart Institute, Los Angeles, CA, USA
| | - William A Zoghbi
- Department of Cardiology, Houston Methodist Hospital, Houston, TX, USA
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Affiliation(s)
| | - John Gordon Harold
- Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | | | - Frank T Flannery
- Center for Legal Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland
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Harold JG. President's Page: Heart Month and the American College of Cardiology: A Lesson in Partnerships, Member Values, and Patient Education. J Am Coll Cardiol 2014; 63:373-4. [DOI: 10.1016/j.jacc.2013.12.009] [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: 11/28/2022]
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Affiliation(s)
- Gary H Gibbons
- Office of the Director of the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland
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Harold JG, O'Gara PT, Hill JA, Konstam MA. President's page: an urgent call to action: graduate medical education funding and the future of health care. J Am Coll Cardiol 2013; 62:1394-5. [PMID: 24091224 DOI: 10.1016/j.jacc.2013.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Harold JG, O'Gara P, Hill JA, Konstam MA. President's Page: The Perfect Storm Part 2: A Rally Cry for Medical Research Funding. J Am Coll Cardiol 2013; 62:1811-2. [DOI: 10.1016/j.jacc.2013.10.001] [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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Affiliation(s)
- John Gordon Harold
- American College of Cardiology, 2400 N Street NW, Washington, DC 20037, USA.
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Bass TA, Harold JG. President's page: The mandate for quality: An invitation to be part of the solution. Catheter Cardiovasc Interv 2013; 82:501-2. [DOI: 10.1002/ccd.25142] [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] [Indexed: 11/10/2022]
Affiliation(s)
- Ted A. Bass
- President, Society for Cardiovascular Angiography and Interventions
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Harold JG, Rumsfeld JS. President's Page: Honoring Those Who Have Served With High Quality Cardiovascular Care. J Am Coll Cardiol 2013; 61:2389-90. [DOI: 10.1016/j.jacc.2013.05.005] [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: 11/24/2022]
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Harold JG. President's Page: The Future of Cardiology Starts With Mentors. J Am Coll Cardiol 2013; 61:1459-60. [DOI: 10.1016/j.jacc.2013.02.008] [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: 11/27/2022]
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Harold JG. Maintenance of Certification: American College of Cardiology and American Board of Internal Medicine. Rev Cardiovasc Med 2009; 10:165-6. [DOI: 10.3909/ricm0515] [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: 11/05/2022] Open
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Harold JG. The Year of the Patient: the BCS and the CA ACC. Introduction. Rev Cardiovasc Med 2009; 10:38-39. [PMID: 19367231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
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Abstract
Penetrating aortic ulcers and intramural hematomas cannot always be differentiated by transesophageal echocardiography. We suggest that color and pulsed-wave Doppler flow can be used for identifying penetrating aortic ulcers.
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Affiliation(s)
- S Atar
- Cardiac Non-Invasive Laboratory, Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA
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Carroll BJ, Chandra M, Phillips EH, Harold JG. Laparoscopic cholecystectomy in the heart transplant candidate with acute cholecystitis. J Heart Lung Transplant 1992; 11:831-3. [PMID: 1386754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
We report the first successful laparoscopic cholecystectomy for treatment of acute cholecystitis in a heart transplant candidate with end-stage heart disease. Eight successful cases of conventional cholecystectomy in heart transplant candidates have been reported, but convalescence after the conventional procedure is prolonged, and morbidity often interferes with a timely heart transplantation. Laparoscopic cholecystectomy is a less-invasive method for treatment of symptomatic cholelithiasis and cholecystitis and may be better tolerated in this patient population. Although further study is needed, we believe laparoscopic cholecystectomy will have applications in patients with end-stage heart disease.
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Affiliation(s)
- B J Carroll
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif. 90048
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Harold JG, Siegel RJ, FitzGerald GA, Satoh P, Fishbein MC. Differential prostacyclin production by human umbilical vasculature. Arch Pathol Lab Med 1988; 112:43-6. [PMID: 3276285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Using the avidin-biotin immunohistochemical technique with rabbit antihuman 6-keto-prostaglandin (PG)-F1 alpha (6KPGF), we studied the distribution of the stable prostacyclin metabolite, 6KPGF, in 14 formaldehyde-fixed human umbilical cords. All umbilical veins demonstrated intense endothelial cell staining. None of the arteries stained. To corroborate the immunohistochemical findings, three fresh umbilical cords were dissected to separate arteries from veins and then were incubated in oxygenated tissue baths containing Ringer's lactate (37 degrees C) for 30 minutes. Cumulative 6KPGF production as measured by radioimmunoassay of tissue effluents was markedly different between arteries and veins with the umbilical vein producing the largest quantity of 6KPGF. Thus, immunohistochemistry and ex vivo capacitance studies suggest that there is a differential distribution of 6KPGF in human umbilical arteries and veins.
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Affiliation(s)
- J G Harold
- Division of Cardiology, Cedars-Sinai Medical Center, UCLA School of Medicine 90048
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Harold JG, Bateman TM, Czer LS, Chaux A, Matloff JM, Gray RJ. Mitral valve replacement early after myocardial infarction: attendant high risk of left ventricular rupture. J Am Coll Cardiol 1987; 9:277-82. [PMID: 3492523 DOI: 10.1016/s0735-1097(87)80375-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Between 1969 and 1983, 608 patients underwent mitral valve replacement surgery at Cedars-Sinai Medical Center. Perioperative rupture of the left ventricular myocardium complicated seven operations (1.2%), five of them in the 247 patients with concomitant ischemic heart disease. Six ruptures were fatal. Relative incidences of seven previously hypothesized predisposing factors were determined for patients with and without myocardial rupture. In addition, because of the apparent frequency of association with ischemic heart disease and because all ruptures were posterior or posterolateral, patients were also categorized by prior history of posterior myocardial infarction: 177 patients had none, whereas 49 patients had a remote and 21 patients a recent (less than or equal to 1 month) posterior wall infarct. Four ruptures (accounting for 57% of all ruptures) occurred in the 21 patients (19% incidence) with a recent posterior infarct, compared with only three ruptures in the 587 patients (0.5%) without a recent posterior wall infarct (p = 0.000). None of the factors of age, sex, valve pathology, etiology of valve lesion, concomitant coronary disease, valve substitute or intraoperative myocardial preservation were associated with perioperative rupture. These data establish a low overall incidence of ventricular rupture after mitral valve replacement, high fatality and possible etiologic association with recent posterior wall infarction.
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Lopez JA, Harold JG, Rosenthal MC, Oseran DS, Schapira JN, Peter T. QT prolongation and torsades de pointes after administration of trimethoprim-sulfamethoxazole. Am J Cardiol 1987; 59:376-7. [PMID: 3492908 DOI: 10.1016/0002-9149(87)90824-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Harold JG, Siegel RJ, Edwalds GM, Satoh P, Fishbein MC. Immunohistochemical localization of 6-keto-PGF1-alpha in canine coronary vasculature. Prostaglandins 1985; 29:19-23. [PMID: 3883429 DOI: 10.1016/0090-6980(85)90147-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The localization of the prostacyclin metabolite, 6-keto-PGF1-alpha, in canine coronary vasculature was accomplished using immunohistochemical techniques (avidin-biotin method of immunoperoxidase staining). Six-keto-PGF1-alpha was localized to the intimal endothelial cell layer of epicardial and intramyocardial arteries and veins. No specific staining was seen in the the media or adventitia of canine coronary vasculature, or in capillaries, or myocardial fibers. To our knowledge these studies represent the first immunohistochemical demonstration of the endothelial cell localization of the prostacyclin metabolite, 6-keto-PGF1-alpha. The described technique allows the cellular localization of prostaglandin metabolites in histologic sections.
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