1
|
Brown SA, Beavers C, Bauer B, Cheng RK, Berman G, Marshall CH, Guha A, Jain P, Steward A, DeCara JM, Olaye IM, Hansen K, Logan J, Bergom C, Glide-Hurst C, Loh I, Gambril JA, MacLeod J, Maddula R, McGranaghan PJ, Batra A, Campbell C, Hamid A, Gunturkun F, Davis R, Jefferies J, Fradley M, Albert K, Blaes A, Choudhuri I, Ghosh AK, Ryan TD, Ezeoke O, Leedy DJ, Williams W, Roman S, Lehmann L, Sarkar A, Sadler D, Polter E, Ruddy KJ, Bansal N, Yang E, Patel B, Cho D, Bailey A, Addison D, Rao V, Levenson JE, Itchhaporia D, Watson K, Gulati M, Williams K, Lloyd-Jones D, Michos E, Gralow J, Martinez H. Advancing the care of individuals with cancer through innovation & technology: Proceedings from the cardiology oncology innovation summit 2020 and 2021. Am Heart J Plus 2024; 38:100354. [PMID: 38510746 PMCID: PMC10945974 DOI: 10.1016/j.ahjo.2023.100354] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 12/10/2023] [Accepted: 12/12/2023] [Indexed: 03/22/2024]
Abstract
As cancer therapies increase in effectiveness and patients' life expectancies improve, balancing oncologic efficacy while reducing acute and long-term cardiovascular toxicities has become of paramount importance. To address this pressing need, the Cardiology Oncology Innovation Network (COIN) was formed to bring together domain experts with the overarching goal of collaboratively investigating, applying, and educating widely on various forms of innovation to improve the quality of life and cardiovascular healthcare of patients undergoing and surviving cancer therapies. The COIN mission pillars of innovation, collaboration, and education have been implemented with cross-collaboration among academic institutions, private and public establishments, and industry and technology companies. In this report, we summarize proceedings from the first two annual COIN summits (inaugural in 2020 and subsequent in 2021) including educational sessions on technological innovations for establishing best practices and aligning resources. Herein, we highlight emerging areas for innovation and defining unmet needs to further improve the outcome for cancer patients and survivors of all ages. Additionally, we provide actionable suggestions for advancing innovation, collaboration, and education in cardio-oncology in the digital era.
Collapse
Affiliation(s)
- Sherry-Ann Brown
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Craig Beavers
- University of Kentucky College of Pharmacy, Lexington, KY, USA
| | - Brenton Bauer
- COR Healthcare Associates, Torrance Memorial Medical Center, Torrance, CA, USA
| | - Richard K. Cheng
- Cardio-Oncology Program, Division of Cardiology, University of Washington, Seattle, WA, USA
| | | | - Catherine H. Marshall
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Avirup Guha
- Cardio-Oncology Program, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Prantesh Jain
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | | | - Jeanne M. DeCara
- Section of Cardiology, Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Iredia M. Olaye
- Division of Clinical Epidemiology, Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | | | - Jim Logan
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Carmen Bergom
- Department of Radiation Oncology, Washington University in St. Louis, St. Louis, MO, USA
- Cardio-Oncology Center of Excellence, Washington University in St. Louis, St. Louis, MO, USA
| | - Carri Glide-Hurst
- Department of Human Oncology, University of Wisconsin, Madison, WI, USA
| | - Irving Loh
- Ventura Heart Institute, Thousand Oaks, CA, USA
- Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - John Alan Gambril
- Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA
| | | | | | - Peter J. McGranaghan
- Department of Cardiothoracic Surgery, German Heart Center, Berlin, Germany
- Department of Internal Medicine and Cardiology, Charité Campus Virchow-Klinikum, Berlin, Germany
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | - Akshee Batra
- Department of Medicine, University of Vermont Medical Center, Burlington, VT, USA
| | - Courtney Campbell
- Cardio-Oncology Center of Excellence, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Fatma Gunturkun
- Center for Biomedical Informatics, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Robert Davis
- Center for Biomedical Informatics, University of Tennessee Health Science Center, Memphis, TN, USA
- St. Jude Children's Research Hospital, Memphis, TN, USA
| | - John Jefferies
- Center for Biomedical Informatics, University of Tennessee Health Science Center, Memphis, TN, USA
- St. Jude Children's Research Hospital, Memphis, TN, USA
- The Heart Institute at Le Bonheur Children's Hospital, University of Tennessee Health and Science Center, Memphis, TN, USA
| | - Michael Fradley
- Cardio-Oncology Center of Excellence, Division of Cardiology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Katherine Albert
- Helen and Arthur E. Johnson Beth-El College of Nursing and Health Sciences, University of Colorado at Colorado Springs, Denver, CO, USA
| | - Anne Blaes
- Division of Hematology/Oncology, University of Minnesota, Minneapolis, MN, USA
| | - Indrajit Choudhuri
- Department of Electrophysiology, Froedtert South Hospital, Milwaukee, WI, USA
| | - Arjun K. Ghosh
- Cardio-Oncology Service, Barts Heart Centre and University College London Hospital, London, UK
| | - Thomas D. Ryan
- Department of Pediatrics, University of Cincinnati College of Medicine; Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Ogochukwu Ezeoke
- Department of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Douglas J. Leedy
- Division of Cardiology, University of Washington, Seattle, WA, USA
| | | | - Sebastian Roman
- Department of Internal Medicine III: Cardiology, Angiology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany
| | - Lorenz Lehmann
- Department of Internal Medicine III: Cardiology, Angiology and Pulmonology, Heidelberg University Hospital, Heidelberg, Germany
| | - Abdullah Sarkar
- Department of Medicine, Cleveland Clinic Florida, Weston, FL, USA
| | - Diego Sadler
- Department of Medicine, Cleveland Clinic Florida, Weston, FL, USA
| | - Elizabeth Polter
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | | | - Neha Bansal
- Division of Pediatric Cardiology, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Eric Yang
- Cardio-Oncology Program, University of California, Los Angeles, Los Angeles, CA, USA
| | - Brijesh Patel
- Division of Cardiology, West Virginia University Heart and Vascular Institute, West Virginia University, Morgantown, WV, USA
| | - David Cho
- Division of Cardiovascular Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Alison Bailey
- Center for Heart, Lung, and Vascular Health at Parkridge, HCA Healthcare, Chattanooga, TN, USA
| | - Daniel Addison
- Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA
| | - Vijay Rao
- Indiana Heart Physicians, Franciscan Health, Indianapolis, IN, USA
| | - Joshua E. Levenson
- Division of Cardiology, UPMC Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dipti Itchhaporia
- Cardiology, University of California Irvine, Hoag Hospital Newport Beach, Newport Beach, CA, USA
| | - Karol Watson
- Division of Cardiovascular Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Martha Gulati
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Kim Williams
- Division of Cardiology, Rush University Medical Center, Chicago, IL, USA
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Erin Michos
- Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Julie Gralow
- American Society of Clinical Oncology, Alexandria, VA, USA
| | - Hugo Martinez
- St. Jude Children's Research Hospital, Memphis, TN, USA
- The Heart Institute at Le Bonheur Children's Hospital, University of Tennessee Health and Science Center, Memphis, TN, USA
| |
Collapse
|
2
|
Summey R, Aliani R, McAlarnen LA, Sequeira N, Shaik T, Uyar D, Brown SA. Syndromes of Concurrent Hypertension, Diastolic Dysfunction, and Pulmonary or Peripheral Edema in Cardio-Oncology: Case Studies, Literature Review, and New Classification System. Curr Treat Options Oncol 2023; 24:1917-1934. [PMID: 38091185 DOI: 10.1007/s11864-023-01141-9] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2023] [Indexed: 01/11/2024]
Abstract
OPINION STATEMENT Individuals who have ever been diagnosed with cancer are at increased risk for cardiovascular conditions during and after cancer treatment. Especially during cancer treatment, cardiovascular conditions can manifest in many ways, including peripheral or pulmonary edema. Edema can indicate volume overload affecting the heart even without other unequivocal evidence of apparent diastolic or systolic left ventricular dysfunction, particularly at rest. We propose a novel algorithm to streamline the diagnostic evaluation and cardiovascular classification for cancer patients with edema. We initially advise prompt evaluation with a chest X-ray and echocardiogram. We then suggest classification into one of five categories based on the timing of presentation of edema relative to cancer treatment, as well as echocardiography results and the presence or absence of hypertension or lymphatic causes of edema. This classification tool can then be utilized to guide further cardiovascular management suggestions. These concurrent syndromes presenting as edema may indicate the development or aggravation of undiagnosed diastolic dysfunction with or without hypertension, even if transiently present only while on cancer treatment.
Collapse
Affiliation(s)
- Rebekah Summey
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
| | - Rana Aliani
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Lindsey A McAlarnen
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
| | - Nicole Sequeira
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
| | - Tahseen Shaik
- Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Denise Uyar
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
| | - Sherry-Ann Brown
- Cardio-oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
- Preventive Cardio-Oncology LLC, Miami, FL, USA.
| |
Collapse
|
3
|
Brown SA, Hamid A, Pederson E, Bs AH, Maddula R, Goodman R, Lamberg M, Caraballo P, Noseworthy P, Lukan O, Echefu G, Berman G, Choudhuri I. Simplified rules-based tool to facilitate the application of up-to-date management recommendations in cardio-oncology. Cardiooncology 2023; 9:37. [PMID: 37891699 PMCID: PMC10605976 DOI: 10.1186/s40959-023-00179-w] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 05/24/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Millions of cancer survivors are at risk of cardiovascular diseases, a leading cause of morbidity and mortality. Tools to potentially facilitate implementation of cardiology guidelines, consensus recommendations, and scientific statements to prevent atherosclerotic cardiovascular disease (ASCVD) and other cardiovascular diseases are limited. Thus, inadequate utilization of cardiovascular medications and imaging is widespread, including significantly lower rates of statin use among cancer survivors for whom statin therapy is indicated. METHODS In this methodological study, we leveraged published guidelines documents to create a rules-based tool to include guidelines, expert consensus, and medical society scientific statements relevant to point of care cardiovascular disease prevention in the cardiovascular care of cancer survivors. Any overlap, redundancy, or ambiguous recommendations were identified and eliminated across all converted sources of knowledge. The integrity of the tool was assessed with use case examples and review of subsequent care suggestions. RESULTS An initial selection of 10 guidelines, expert consensus, and medical society scientific statements was made for this study. Then 7 were kept owing to overlap and revisions in society recommendations over recent years. Extensive formulae were employed to translate the recommendations of 7 selected guidelines into rules and proposed action measures. Patient suitability and care suggestions were assessed for several use case examples. CONCLUSION A simple rules-based application was designed to provide a potential format to deliver critical cardiovascular disease best-practice prevention recommendations at the point of care for cancer survivors. A version of this tool may potentially facilitate implementing these guidelines across clinics, payers, and health systems for preventing cardiovascular diseases in cancer survivors. TRIAL REGISTRATION ClinicalTrials.Gov Identifier: NCT05377320.
Collapse
Affiliation(s)
- Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
| | | | | | | | | | | | | | | | - Peter Noseworthy
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Opeoluwa Lukan
- Department of Internal Medicine, Baton Rouge General Medical Center, Baton Rouge, LA, USA
| | - Gift Echefu
- Department of Internal Medicine, Baton Rouge General Medical Center, Baton Rouge, LA, USA
| | | | | |
Collapse
|
4
|
Prousi GS, Joshi AM, Atti V, Addison D, Brown SA, Guha A, Patel B. Vascular Inflammation, Cancer, and Cardiovascular Diseases. Curr Oncol Rep 2023; 25:955-963. [PMID: 37261651 DOI: 10.1007/s11912-023-01426-0] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 06/02/2023]
Abstract
PURPOSE OF REVIEW Cancer and cardiovascular disease are among the leading causes of morbidity and mortality in the USA. Cancer and cardiovascular disease have inflammatory underpinnings that have been associated with both the development and progression of these disease states. RECENT FINDINGS Inflammatory signaling has been found to be a critical event in both cardiovascular disease and cancer formation and progression. Further, many chemotherapeutic agents potentiate inflammation exacerbating existing cardiovascular disease or leading to its presence. The exact mechanisms of these interactions remain poorly understood. The proinflammatory milieu observed in both cancer and cardiovascular disease likely plays an important role in the development and potentiation of both conditions. Further evaluation of this relationship will be critical in the development of new diagnostic and therapeutic modalities.
Collapse
Affiliation(s)
| | - Amogh M Joshi
- Department of Cardiology, Lehigh Valley Health Network, Allentown, PA, USA
| | - Varun Atti
- Heart and Vascular Institute, West Virginia University, 1 Medical Center Dr, Morgantown, WV, 26505, USA
| | - Daniel Addison
- Department of Cardiology, Ohio State University, Columbus, OH, USA
| | - Sherry-Ann Brown
- Department of Cardiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Avirup Guha
- Department of Cardiology, Medical College of Georgia, Augusta, GA, USA
| | - Brijesh Patel
- Heart and Vascular Institute, West Virginia University, 1 Medical Center Dr, Morgantown, WV, 26505, USA.
| |
Collapse
|
5
|
Brown SA, Sparapani R, Osinski K, Zhang J, Blessing J, Cheng F, Hamid A, MohamadiPour MB, Lal JC, Kothari AN, Caraballo P, Noseworthy P, Johnson RH, Hansen K, Sun LY, Crotty B, Cheng YC, Echefu G, Doshi K, Olson J. Team principles for successful interdisciplinary research teams. Am Heart J Plus 2023; 32:100306. [PMID: 38510201 PMCID: PMC10946054 DOI: 10.1016/j.ahjo.2023.100306] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/26/2023] [Accepted: 05/28/2023] [Indexed: 03/22/2024]
Abstract
Interdisciplinary research teams can be extremely beneficial when addressing difficult clinical problems. The incorporation of conceptual and methodological strategies from a variety of research disciplines and health professions yields transformative results. In this setting, the long-term goal of team science is to improve patient care, with emphasis on population health outcomes. However, team principles necessary for effective research teams are rarely taught in health professional schools. To form successful interdisciplinary research teams in cardio-oncology and beyond, guiding principles and organizational recommendations are necessary. Cardiovascular disease results in annual direct costs of $220 billion (about $680 per person in the US) and is the leading cause of death for cancer survivors, including adult survivors of childhood cancers. Optimizing cardio-oncology research in interdisciplinary research teams has the potential to aid in the investigation of strategies for saving hundreds of thousands of lives each year in the United States and mitigating the annual cost of cardiovascular disease. Despite published reports on experiences developing research teams across organizations, specialties and settings, there is no single journal article that compiles principles for cardiology or cardio-oncology research teams. In this review, recurring threads linked to working as a team, as well as optimal methods, advantages, and problems that arise when managing teams are described in the context of career development and research. The worth and hurdles of a team approach, based on practical lessons learned from establishing our multidisciplinary research team and information gleaned from relevant specialties in the development of a successful team are presented.
Collapse
Affiliation(s)
- Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Rodney Sparapani
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kristen Osinski
- Clinical Science and Translational Institute, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jun Zhang
- Department of Electrical Engineering and Computer Science, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jeffrey Blessing
- Department of Computer Science, Milwaukee School of Engineering, USA
| | - Feixiong Cheng
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | | | - Mehri Bagheri MohamadiPour
- Department of Electrical Engineering and Computer Science, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jessica Castrillon Lal
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Anai N. Kothari
- Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Peter Noseworthy
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | - Louise Y. Sun
- Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Bradley Crotty
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Yee Chung Cheng
- Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Gift Echefu
- Department of Internal Medicine, Baton Rouge General Medical Center, Baton Rouge, LA, USA
| | - Krishna Doshi
- Department of Internal Medicine, Advocate Lutheran General Hospital, Park Ridge, IL, USA
| | - Jessica Olson
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - for the Cardio-Oncology Artificial Intelligence Informatics & Precision (CAIP) Research Team Investigators
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
- Clinical Science and Translational Institute, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Electrical Engineering and Computer Science, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
- Department of Computer Science, Milwaukee School of Engineering, USA
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Medical College of Wisconsin, Milwaukee, WI, USA
- Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
- Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
- Green Bay, WI, USA
- Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Internal Medicine, Baton Rouge General Medical Center, Baton Rouge, LA, USA
- Department of Internal Medicine, Advocate Lutheran General Hospital, Park Ridge, IL, USA
| |
Collapse
|
6
|
Mallinson JB, Heywood ZE, Daniels RK, Arnold MD, Bones PJ, Brown SA. Reservoir computing using networks of memristors: effects of topology and heterogeneity. Nanoscale 2023. [PMID: 37211815 DOI: 10.1039/d2nr07275k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Reservoir computing (RC) has attracted significant interest as a framework for the implementation of novel neuromorphic computing architectures. Previously attention has been focussed on software-based reservoirs, where it has been demonstrated that reservoir topology plays a role in task performance, and functional advantage has been attributed to small-world and scale-free connectivity. However in hardware systems, such as electronic memristor networks, the mechanisms responsible for the reservoir dynamics are very different and the role of reservoir topology is largely unknown. Here we compare the performance of a range of memristive reservoirs in several RC tasks that are chosen to highlight different system requirements. We focus on percolating networks of nanoparticles (PNNs) which are novel self-assembled nanoscale systems that exhibit scale-free and small-world properties. We find that the performance of regular arrays of uniform memristive elements is limited by their symmetry but that this symmetry can be broken either by a heterogeneous distribution of memristor properties or a scale-free topology. The best perfomance across all tasks is observed for a scale-free network with uniform memistor properties. These results provide insight into the role of topology in neuromorphic reservoirs as well as an overview of the computational performance of scale-free networks of memristors in a range of benchmark tasks.
Collapse
Affiliation(s)
- J B Mallinson
- The MacDiarmid Institute for Advanced Materials and Nanotechnology, School of Physical and Chemical Sciences, University of Canterbury, Christchurch, New Zealand.
| | - Z E Heywood
- The MacDiarmid Institute for Advanced Materials and Nanotechnology, School of Physical and Chemical Sciences, University of Canterbury, Christchurch, New Zealand.
- Electrical and Computer Engineering, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand
| | - R K Daniels
- The MacDiarmid Institute for Advanced Materials and Nanotechnology, School of Physical and Chemical Sciences, University of Canterbury, Christchurch, New Zealand.
| | - M D Arnold
- School of Mathematical and Physical Sciences, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia
| | - P J Bones
- The MacDiarmid Institute for Advanced Materials and Nanotechnology, School of Physical and Chemical Sciences, University of Canterbury, Christchurch, New Zealand.
- Electrical and Computer Engineering, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand
| | - S A Brown
- The MacDiarmid Institute for Advanced Materials and Nanotechnology, School of Physical and Chemical Sciences, University of Canterbury, Christchurch, New Zealand.
| |
Collapse
|
7
|
Hamid A, MacLeod J, Erb S, Berman G, Martinez HR, Scherrer-Crosbie M, Cheng RK, Brown SA. Editorial: Leveraging digital and technological innovations in cardio-oncology: building collaborative networks, implementing education and improving the cardiac outcomes of patients. Front Cardiovasc Med 2023; 10:1184988. [PMID: 37180799 PMCID: PMC10169814 DOI: 10.3389/fcvm.2023.1184988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/12/2023] [Indexed: 05/16/2023] Open
Affiliation(s)
| | - James MacLeod
- Medical College of Wisconsin, Milwaukee, WI, United States
| | - Samuel Erb
- Medical College of Wisconsin, Green Bay, WI, United States
| | | | - Hugo R. Martinez
- Department of Pediatric Cardiology, University of Tennessee Health Science Center, Memphis, TN, United States
- Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Marielle Scherrer-Crosbie
- Division of Cardiovascular Diseases, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, United States
| | - Richard K. Cheng
- Cardio-Oncology Program, Division of Cardiology, University of Washington, Seattle, WA, United States
| | - Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States
| |
Collapse
|
8
|
Cohen JB, Brown NJ, Brown SA, Dent S, van Dorst DCH, Herrmann SM, Lang NN, Oudit GY, Touyz RM. Cancer Therapy-Related Hypertension: A Scientific Statement From the American Heart Association. Hypertension 2023; 80:e46-e57. [PMID: 36621810 PMCID: PMC10602651 DOI: 10.1161/hyp.0000000000000224] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Contemporary anticancer drugs have significantly improved cancer survival at the expense of cardiovascular toxicities, including heart disease, thromboembolic disease, and hypertension. One of the most common side effects of these drugs is hypertension, especially in patients treated with vascular endothelial growth factor inhibitors, as well as tyrosine kinase inhibitors and proteasome inhibitors. Adjunctive therapy, including corticosteroids, calcineurin inhibitors, and nonsteroidal anti-inflammatories, as well as anti-androgen hormone therapy for prostate cancer, may further increase blood pressure in these patients. Cancer therapy-induced hypertension is often dose limiting, increases cardiovascular mortality in cancer survivors, and is usually reversible after interruption or discontinuation of treatment. The exact molecular mechanisms underlying hypertension are unclear, but recent discoveries indicate an important role for reduced nitric oxide generation, oxidative stress, endothelin-1, prostaglandins, endothelial dysfunction, increased sympathetic outflow, and microvascular rarefaction. In addition, genetic polymorphisms in vascular endothelial growth factor receptors are implicated in vascular endothelial growth factor inhibitor-induced hypertension. Diagnosis, management, and follow-up of cancer therapy-induced hypertension follow national hypertension guidelines because evidence-based clinical trials specifically addressing patients who develop hypertension as a result of cancer therapy are currently lacking. Rigorous baseline assessment of patients before therapy is started requires particular emphasis on assessing and treating cardiovascular risk factors. Hypertension management follows guidelines for the general population, although special attention should be given to rebound hypotension after termination of cancer therapy. Management of these complex patients requires collaborative care involving oncologists, cardiologists, hypertension specialists, primary care professionals, and pharmacists to ensure the optimal therapeutic effect from cancer treatment while minimizing competing cardiovascular toxicities.
Collapse
|
9
|
Brown SA, Chung BY, Doshi K, Hamid A, Pederson E, Maddula R, Hanna A, Choudhuri I, Sparapani R, Bagheri Mohamadi Pour M, Zhang J, Kothari AN, Collier P, Caraballo P, Noseworthy P, Arruda-Olson A. Patient similarity and other artificial intelligence machine learning algorithms in clinical decision aid for shared decision-making in the Prevention of Cardiovascular Toxicity (PACT): a feasibility trial design. Cardiooncology 2023; 9:7. [PMID: 36691060 PMCID: PMC9869606 DOI: 10.1186/s40959-022-00151-0] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 12/26/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND The many improvements in cancer therapies have led to an increased number of survivors, which comes with a greater risk of consequent/subsequent cardiovascular disease. Identifying effective management strategies that can mitigate this risk of cardiovascular complications is vital. Therefore, developing computer-driven and personalized clinical decision aid interventions that can provide early detection of patients at risk, stratify that risk, and recommend specific cardio-oncology management guidelines and expert consensus recommendations is critically important. OBJECTIVES To assess the feasibility, acceptability, and utility of the use of an artificial intelligence (AI)-powered clinical decision aid tool in shared decision making between the cancer survivor patient and the cardiologist regarding prevention of cardiovascular disease. DESIGN This is a single-center, double-arm, open-label, randomized interventional feasibility study. Our cardio-oncology cohort of > 4000 individuals from our Clinical Research Data Warehouse will be queried to identify at least 200 adult cancer survivors who meet the eligibility criteria. Study participants will be randomized into either the Clinical Decision Aid Group (where patients will use the clinical decision aid in addition to current practice) or the Control Group (current practice). The primary endpoint of this study is to assess for each patient encounter whether cardiovascular medications and imaging pursued were consistent with current medical society recommendations. Additionally, the perceptions of using the clinical decision tool will be evaluated based on patient and physician feedback through surveys and focus groups. This trial will determine whether a clinical decision aid tool improves cancer survivors' medication use and imaging surveillance recommendations aligned with current medical guidelines. TRIAL REGISTRATION ClinicalTrials.Gov Identifier: NCT05377320.
Collapse
Affiliation(s)
- Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
| | - Brian Y Chung
- Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Krishna Doshi
- Department of Internal Medicine, Advocate Lutheran General Hospital, Park Ridge, IL, USA
| | | | | | | | - Allen Hanna
- University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | | | - Rodney Sparapani
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Jun Zhang
- Department of Computer Science, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Anai N Kothari
- Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Patrick Collier
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA
| | | | - Peter Noseworthy
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | |
Collapse
|
10
|
Sun LY, Echefu G, Doshi K, Roberts ML, Hamid A, Cheng RK, Olson J, Brown SA. Commentary: "Multimodality advanced cardiovascular and molecular imaging for early detection and monitoring of cancer therapy-associated cardiotoxicity and the role of artificial intelligence and big data". Front Cardiovasc Med 2023; 10:982028. [PMID: 36923958 PMCID: PMC10009261 DOI: 10.3389/fcvm.2023.982028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 01/31/2023] [Indexed: 03/02/2023] Open
Affiliation(s)
- Louise Y Sun
- Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Gift Echefu
- Department of Internal Medicine, Baton Rouge General Medical Center, Baton Rouge, LA, United States
| | - Krishna Doshi
- Department of Internal Medicine, Advocate Lutheran General Hospital, Park Ridge, IL, United States
| | - Michelle L Roberts
- Division of Cardiovascular Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | | | - Richard K Cheng
- Cardio-Oncology Program, Division of Cardiology, University of Washington, Seattle, WA, United States
| | - Jessica Olson
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States
| |
Collapse
|
11
|
Holt JM, Cusatis R, Mortensen N, Wolfrath N, Hyun N, Winn AN, Brown SA, Somai MM, Crotty BH. Twenty-first century house calls: a survey of ambulatory care providers to inform organisational telehealth strategy. BMJ Health Care Inform 2022; 29:bmjhci-2022-100626. [PMID: 36564094 PMCID: PMC9791455 DOI: 10.1136/bmjhci-2022-100626] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/13/2022] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES While patient interest in telehealth increases, clinicians' perspectives may influence longer-term adoption. We sought to identify facilitators and barriers to continued clinician incorporation of telehealth into practice. METHODS A cross-sectional 24-item web-based survey was emailed to 491 providers with ≥50 video visits (VVs) within an academic health system between 1 March 2020 and 31 December 2020. We quantitatively summarised the characteristics and perceptions of respondents by using descriptive and test statistics. We used systematic content analysis to qualitatively code open-ended responses, double coding at least 25%. RESULTS 247 providers (50.3%) responded to the survey. Seventy-nine per cent were confident in their ability to deliver excellent clinical care through VV. In comparison, 48% were confident in their ability to troubleshoot technical issues. Most clinicians (87%) expressed various concerns about VV. Providers across specialties generally agreed that VV reduced infection risk (71%) and transportation barriers (71%). Three overarching themes in the qualitative data included infrastructure and training, usefulness and expectation setting for patients and providers. DISCUSSION As healthcare systems plan for future delivery directions, they must address the tension between patients' and providers' expectations of care within the digital space. Telehealth creates new friction, one where the healthcare system must fit into the patient's life rather than the usual dynamic of the patient fitting into the healthcare system. CONCLUSION Telehealth infrastructure and patient and clinician technological acumen continue to evolve. Clinicians in this survey offered valuable insights into the directions healthcare organisations can take to right-size this healthcare delivery modality.
Collapse
Affiliation(s)
- Jeana M Holt
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA,Family and Community Medicine, Medical College of Wisconsin Department of Family and Community Medicine, Milwaukee, Wisconsin, USA
| | - Rachel Cusatis
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Natalie Mortensen
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Nathan Wolfrath
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Noorie Hyun
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente, Seattle, Washington, USA
| | - Aaron N Winn
- School of Pharmacy, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Sherry-Ann Brown
- Cardio-Oncology, Medical College of Wisconsin Cardiovascular Center, Milwaukee, Wisconsin, USA
| | - Melek M Somai
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Bradley H Crotty
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| |
Collapse
|
12
|
Ibrahim ESH, Sosa A, Brown SA, An D, Klawikowski S, Baker J, Bergom C. Myocardial Contractility Pattern Characterization in Radiation-Induced Cardiotoxicity Using Magnetic Resonance Imaging: A Pilot Study with ContractiX. Tomography 2022; 9:36-49. [PMID: 36648991 PMCID: PMC9844312 DOI: 10.3390/tomography9010004] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/13/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
Radiation therapy (RT) plays an integral role in treating thoracic cancers, despite the risk of radiation-induced cardiotoxicity. We hypothesize that our newly developed magnetic resonance imaging (MRI)-based contractility index (ContractiX) is a sensitive marker for early detection of RT-induced cardiotoxicity in a preclinical rat model of thoracic cancer RT. Adult salt-sensitive rats received image-guided heart RT and were imaged with MRI at 8 weeks and 10 weeks post-RT or sham. The MRI exam included cine and tagging sequences to measure left-ventricular ejection fraction (LVEF), mass, myocardial strain, and ContractiX. Furthermore, ventricular torsion, diastolic strain rate, and mechanical dyssynchrony were measured. Statistical analyses were performed between the sham, 8 weeks post-RT, and 10 weeks post-RT MRI parameters. The results showed that both LVEF and myocardial mass increased post-RT. Peak systolic strain and ContractiX significantly decreased post-RT, with a more relative reduction in ContractiX compared to strain. ContractiX showed an inverse nonlinear relationship with LVEF and continuously decreased with time post-RT. While early diastolic strain rate and mechanical dyssynchrony significantly changed post-RT, ventricular torsion changes were not significant post-RT. In conclusion, ContractiX measured via non-contrast MRI is a sensitive early marker for the detection of subclinical cardiac dysfunction post-RT, and it is superior to other MRI cardiac measures.
Collapse
Affiliation(s)
- El-Sayed H. Ibrahim
- Department of Radiology, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA
- Correspondence:
| | - Antonio Sosa
- Department of Radiology, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - Sherry-Ann Brown
- Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - Dayeong An
- Department of Biomedical Engineering, Marquette University, 1250 W Wisconsin Ave, Milwaukee, WI 53233, USA
| | - Slade Klawikowski
- Department of Radiation Oncology, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - John Baker
- Department of Surgery, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA
| | - Carmen Bergom
- Department of Radiation Oncology, Washington University, 1 Brookings Dr, St. Louis, MO 63130, USA
| |
Collapse
|
13
|
Sadler D, Okwuosa T, Teske AJ, Guha A, Collier P, Moudgil R, Sarkar A, Brown SA. Cardio oncology: Digital innovations, precision medicine and health equity. Front Cardiovasc Med 2022; 9:951551. [PMID: 36407451 PMCID: PMC9669068 DOI: 10.3389/fcvm.2022.951551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
The rapid emergence of cardio-oncology has resulted in a rapid growth of cardio-oncology programs, dedicated professional societies sections and committees, and multiple collaborative networks that emerged to amplify the access to care in this new subspecialty. However, most existing data, position statements and guidelines are limited by the lack of availability of large clinical trials to support these recommendations. Furthermore, there are significant challenges regarding proper access to cardio-oncology care and treatment, particularly in marginalized and minority populations. The emergence and evolution of personalized medicine, artificial intelligence (AI), and machine learning in medicine and in cardio-oncology provides an opportunity for a more targeted, personalized approach to cardiovascular complications of cancer treatment. The proper implementation of these new modalities may facilitate a more equitable approach to adequate and universal access to cardio-oncology care, improve health related outcomes, and enable health care systems to eliminate the digital divide. This article reviews and analyzes the current status on these important issues.
Collapse
Affiliation(s)
- Diego Sadler
- Cardio Oncology Section, Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic Florida, Weston, FL, United States
- *Correspondence: Diego Sadler
| | - Tochukwu Okwuosa
- Division of Cardiology, Department of Medicine, Rush University Medical Center, Chicago, IL, United States
| | - A. J. Teske
- Division of Heart and Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Avirup Guha
- Division of Cardiology, Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Patrick Collier
- Cleveland Clinic, Cardio Oncology, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland, OH, United States
| | - Rohit Moudgil
- Cleveland Clinic, Cardio Oncology, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland, OH, United States
| | - Abdullah Sarkar
- Cardio Oncology Section, Department of Cardiovascular Medicine, Heart Vascular and Thoracic Institute, Cleveland Clinic Florida, Weston, FL, United States
| | - Sherry-Ann Brown
- Division of Cardiology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| |
Collapse
|
14
|
MacLeod J, Abdelrahim M, Painter S, Maddula R, Steward A, Hamid A, Cheng RK, Zaha V, Addison D, Bauer B, Brown SA. Ten step academic-industry digital health collaboration methodology: A case-based guide for digital health research teams with the example of cardio-oncology. Front Cardiovasc Med 2022; 9:982059. [PMID: 36247469 PMCID: PMC9562627 DOI: 10.3389/fcvm.2022.982059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- James MacLeod
- Medical College of Wisconsin, Milwaukee, WI, United States
| | | | - Sabrina Painter
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | | | - Austin Steward
- Medical College of Wisconsin, Milwaukee, WI, United States
| | | | - Richard K. Cheng
- Division of Cardiovascular Medicine, University of Washington, Seattle, WA, United States
| | - Vlad Zaha
- Cardiology Division, University of Texas Southwestern, Dallas, TX, United States
| | - Daniel Addison
- Cardio-Oncology Program, Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH, United States
| | - Brenton Bauer
- COR Healthcare Associates, Torrance Memorial Medical Center, Torrance, CA, United States
| | - Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
- *Correspondence: Sherry-Ann Brown
| |
Collapse
|
15
|
Brown SA, Berman G, Logan J, Sadler D, Moudgil R, Patel B, Scherrer-Crosbie M, Addison D, Cheng RK, Teske AJ. Leveraging innovation, education, and technology for prevention and health equity: Proceedings from the cardiology oncology innovation ThinkTank 2021. Front Cardiovasc Med 2022; 9:982021. [PMID: 36247476 PMCID: PMC9557098 DOI: 10.3389/fcvm.2022.982021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | | | - Jim Logan
- University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Diego Sadler
- Cardio-Oncology Section, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Florida, Weston, FL, United States
| | - Rohit Moudgil
- Section of Clinical Cardiology, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Brijesh Patel
- Section of Cardiology, Department of Medicine, West Virginia University, Morgantown, WV, United States
| | - Marielle Scherrer-Crosbie
- Division of Cardiology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, United States
| | - Daniel Addison
- Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, United States
| | - Richard K. Cheng
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, United States
| | - Arco J. Teske
- Division of Heart and Lungs, Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands
| |
Collapse
|
16
|
Ganatra S, Dani SS, Kumar A, Khan SU, Wadhera R, Neilan TG, Thavendiranathan P, Barac A, Hermann J, Leja M, Deswal A, Fradley M, Liu JE, Sadler D, Asnani A, Baldassarre LA, Gupta D, Yang E, Guha A, Brown SA, Stevens J, Hayek SS, Porter C, Kalra A, Baron SJ, Ky B, Virani SS, Kazi D, Nasir K, Nohria A. Impact of Social Vulnerability on Comorbid Cancer and Cardiovascular Disease Mortality in the United States. JACC CardioOncol 2022; 4:326-337. [PMID: 36213357 PMCID: PMC9537091 DOI: 10.1016/j.jaccao.2022.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 11/23/2022] Open
Abstract
Background Racial and social disparities exist in outcomes related to cancer and cardiovascular disease (CVD). Objectives The aim of this cross-sectional study was to study the impact of social vulnerability on mortality attributed to comorbid cancer and CVD. Methods The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database (2015-2019) was used to obtain county-level mortality data attributed to cancer, CVD, and comorbid cancer and CVD. County-level social vulnerability index (SVI) data (2014-2018) were obtained from the CDC's Agency for Toxic Substances and Disease Registry. SVI percentiles were generated for each county and aggregated to form SVI quartiles. Age-adjusted mortality rates (AAMRs) were estimated and compared across SVI quartiles to assess the impact of social vulnerability on mortality related to cancer, CVD, and comorbid cancer and CVD. Results The AAMR for comorbid cancer and CVD was 47.75 (95% CI: 47.66-47.85) per 100,000 person-years, with higher mortality in counties with greater social vulnerability. AAMRs for cancer and CVD were also significantly greater in counties with the highest SVIs. However, the proportional increase in mortality between the highest and lowest SVI counties was greater for comorbid cancer and CVD than for either cancer or CVD alone. Adults <45 years of age, women, Asian and Pacific Islanders, and Hispanics had the highest relative increase in comorbid cancer and CVD mortality between the fourth and first SVI quartiles, without significant urban-rural differences. Conclusions Comorbid cancer and CVD mortality increased in counties with higher social vulnerability. Improved education, resource allocation, and targeted public health interventions are needed to address inequities in cardio-oncology.
Collapse
Affiliation(s)
- Sarju Ganatra
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital & Medical Center, Burlington, Massachusetts, USA
- Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital & Medical Center, Burlington, Massachusetts, USA
| | - Sourbha S. Dani
- Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital & Medical Center, Burlington, Massachusetts, USA
| | - Ashish Kumar
- Department of Medicine, Cleveland Clinic Akron General, Akron, Ohio, USA
| | - Safi U. Khan
- Department of Cardiovascular Medicine, Houston Methodist, Houston, Texas, USA
| | - Rishi Wadhera
- Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Tomas G. Neilan
- Cardiovascular Imaging Research Center and Cardio-Oncology Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Paaladinesh Thavendiranathan
- Ted Rogers Program in Cardiotoxicity Prevention, Division of Cardiology and Joint Division of Medical Imaging, Peter Munk Cardiac Center, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Ana Barac
- Cardio-Oncology Program, Department of Cardiology, MedStar Washington Hospital Center, MedStar Heart and Vascular Institute, Washington, District of Columbia, USA
| | - Joerg Hermann
- Cardio-Oncology Program, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Monika Leja
- Cardio-Oncology Program, Department of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Anita Deswal
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, MD Anderson Cancer Center, Houston, Texas, USA
| | - Michael Fradley
- Cardio-Oncology Translational Center of Excellence, Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jennifer E. Liu
- Cardiology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Diego Sadler
- Cardio-Oncology Program, Department of Cardiovascular Medicine, Cleveland Clinic Florida, Weston, Florida, USA
| | - Aarti Asnani
- Cardio-Oncology Program, Department of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Lauren A. Baldassarre
- Cardio-Oncology Program, Department of Cardiovascular Medicine, Yale New Haven Hospital, Yale University, New Haven, Connecticut, USA
| | - Dipti Gupta
- Cardiology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Eric Yang
- Cardio-Oncology Program, Department of Cardiovascular Medicine, University of California-Los Angeles, Los Angeles, California, USA
| | - Avirup Guha
- Cardio-Oncology Program, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jennifer Stevens
- Center for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Salim S. Hayek
- Cardio-Oncology Program, Department of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Charles Porter
- Cardio-Oncology Program, Department of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, Missouri, USA
| | - Ankur Kalra
- Department of Cardiovascular Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Suzanne J. Baron
- Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital & Medical Center, Burlington, Massachusetts, USA
| | - Bonnie Ky
- Cardio-Oncology Translational Center of Excellence, Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Salim S. Virani
- Health Policy and Quality Program, Michael E. DeBakey VA Medical Center, Health Services Research and Development Center of Excellence and Section of Health Services Research, Baylor College of Medicine, Houston, Texas, USA
| | - Dhruv Kazi
- Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Khurram Nasir
- Department of Cardiovascular Medicine, Houston Methodist, Houston, Texas, USA
| | - Anju Nohria
- Cardio-Oncology Program, Department of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| |
Collapse
|
17
|
Maddula R, MacLeod J, Painter S, McLeish T, Steward A, Rossman A, Hamid A, Ashwath M, Martinez HR, Guha A, Patel B, Addison D, Blaes A, Choudhuri I, Brown SA. Connected Health Innovation Research Program (C.H.I.R.P.): A bridge for digital health and wellness in cardiology and oncology. Am Heart J Plus 2022; 20:100192. [PMID: 37800118 PMCID: PMC10552440 DOI: 10.1016/j.ahjo.2022.100192] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Study objective Cancer and heart disease are leading causes of mortality, and cardio-oncology is emerging as a new field addressing the cardiovascular toxicities related to cancer and cancer therapy. Interdisciplinary research platforms that incorporate digital health to optimize cardiovascular health and wellness in cancer survivors are therefore needed as we advance in the digital era. Our goal was to develop the Connected Health Innovation Research Program (C.H.I.R.P.) to serve as a foundation for future integration and assessments of adoption and clinical efficacy of digital health tools for cardiovascular health and wellness in the general population and in oncology patients. Design/setting/participants Partner companies were identified through the American Medical Association innovation platform, as well as LinkedIn and direct contact by our team. Company leaders met with our team to discuss features of their technology or software. Non-disclosure agreements were signed and data were discussed and obtained for descriptive or statistical analysis. Results A suite of companies with technologies focused on wellness, biometrics tracking, audio companions, oxygen saturation, weight trends, sleep patterns, heart rate variability, electrocardiogram patterns, blood pressure patterns, real-time metabolism tracking, instructional video modules, or integration of these technologies into electronic health records was collated. We formed an interdisciplinary research team and established an academia-industry collaborative foundation for connecting patients with wellness digital health technologies. Conclusions A suite of software and device technologies accessible to the cardiology and oncology population has been established and will facilitate retrospective, prospective, and case research studies assessing adoption and clinical efficacy of digital health tools in cardiology/oncology.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Hugo R. Martinez
- The Heart Institute at Le Bonheur Children’s Hospital, Memphis, TN, USA
- St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Avirup Guha
- Cardio-Oncology Program, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | | | - Daniel Addison
- Cardio-Oncology Program, Ohio State University, Columbus, OH, USA
| | - Anne Blaes
- Division of Hematology, Oncology and Transplantation, University of Minnesota Medical School, MN, USA
| | | | - Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
18
|
Daniels RK, Mallinson JB, Heywood ZE, Bones PJ, Arnold MD, Brown SA. Reservoir computing with 3D nanowire networks. Neural Netw 2022; 154:122-130. [PMID: 35882080 DOI: 10.1016/j.neunet.2022.07.001] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/27/2022] [Accepted: 07/06/2022] [Indexed: 10/17/2022]
Abstract
Networks of nanowires are currently being explored for a range of applications in brain-like (or neuromorphic) computing, and especially in reservoir computing (RC). Fabrication of real-world computing devices requires that the nanowires are deposited sequentially, leading to stacking of the wires on top of each other. However, most simulations of computational tasks using these systems treat the nanowires as 1D objects lying in a perfectly 2D plane - the effect of stacking on RC performance has not yet been established. Here we use detailed simulations to compare the performance of perfectly 2D and quasi-3D (stacked) networks of nanowires in two tasks: memory capacity and nonlinear transformation. We also show that our model of the junctions between nanowires is general enough to describe a wide range of memristive networks, and consider the impact of physically realistic electrode configurations on performance. We show that the various networks and configurations have a strikingly similar performance in RC tasks, which is surprising given their radically different topologies. Our results show that networks with an experimentally achievable number of electrodes perform close to the upper bounds achievable when using the information from every wire. However, we also show important differences, in particular that the quasi-3D networks are more resilient to changes in the input parameters, generalizing better to noisy training data. Since previous literature suggests that topology plays an important role in computing performance, these results may have important implications for future applications of nanowire networks in neuromorphic computing.
Collapse
Affiliation(s)
- R K Daniels
- The MacDiarmid Institute for Advanced Materials and Nanotechnology, School of Physical and Chemical Sciences, Te Kura Matū, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand
| | - J B Mallinson
- The MacDiarmid Institute for Advanced Materials and Nanotechnology, School of Physical and Chemical Sciences, Te Kura Matū, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand
| | - Z E Heywood
- Electrical and Computer Engineering, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand
| | - P J Bones
- Electrical and Computer Engineering, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand
| | - M D Arnold
- School of Mathematical and Physical Sciences, University of Technology Sydney, PO Box 123 Broadway NSW 2007, Australia
| | - S A Brown
- The MacDiarmid Institute for Advanced Materials and Nanotechnology, School of Physical and Chemical Sciences, Te Kura Matū, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand.
| |
Collapse
|
19
|
Hidde M, Beyer AM, Beyer KMM, Durand MJ, Phillips SA, Grigoriadis G, Jankowski C, Berendt M, Canales B, Norwood Toro L, Kong AL, Hoskins K, Brown SA, Gutterman D, Stolley M. Take charge during treatment: A planned exercise protocol to evaluate disparities and cardiovascular outcomes in Black and White patients with breast cancer undergoing treatment. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.tps12138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS12138 Background : Cardiotoxicity is a significant challenge associated with common first-line breast cancer (BC) chemotherapy (CTx) treatments including anthracyclines (AC) and targeted therapies, such as anti-Her-2 therapy. For targeted therapies, cardiac complications typically resolve once treatment is completed or stopped. For ACs, treatment may lead to permanent long term cardiac damage, and elevated risk for major adverse cardiovascular events (MACE). Black/African American (B/AA) women are at higher risk for AC-based cardiotoxicity compared to Non-Hispanic White (NHW) women. To date, most efforts have targeted managing and defining mechanisms of large vessels and cardiac damage. However, impaired microvascular function, a powerful but clinically underused predictor of future MACE, may also be implicated. Extensive evidence shows that exercise interventions reduce systemic inflammation and possibly MACE. However, few cardio-oncology studies have utilized exercise to mitigate cardiotoxicity, and none have quantified microvascular endothelial function. A further gap in cardio-oncology research is a paucity of studies focused on understanding and addressing disparities. This research project aims to 1) test the feasibility and efficacy of an exercise intervention designed to mitigate the effects of CTx, Take Charge during Treatment (TCT) and 2) examine the influence of socio-ecological factors on endothelial function in response to an exercise intervention. Methods: B/AA (n=50) and NHW (n=50) women diagnosed with non-metastatic BC, scheduled to receive AC and/or anti-HER-2 therapy, will be recruited and randomized to participate in the TCT intervention or usual care (NCT05223322). TCT is a virtual exercise coaching program with weekly coaching sessions, six of which include supervised exercise. Assessments to assess socio-ecologic and vascular outcomes are presented in the Table. Assessments will be completed prior to treatment (T1), after treatment completion (18-24 weeks, T2), and 12-months post treatment (T3). Clinical trial information: NCT05223322. [Table: see text]
Collapse
Affiliation(s)
- Mary Hidde
- Medical College of Wisconsin, Milwaukee, WI
| | | | | | | | | | | | | | | | | | | | - Amanda L. Kong
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI
| | | | | | | | | |
Collapse
|
20
|
Brown SA. Introduction to "Artificial intelligence and health informatics in learning health systems in cardio-oncology". Am Heart J Plus 2022; 18:100156. [PMID: 38559419 PMCID: PMC10978357 DOI: 10.1016/j.ahjo.2022.100156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 06/14/2022] [Indexed: 04/04/2024]
Affiliation(s)
- Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
21
|
Lamberg M, Rossman A, Bennett A, Painter S, Goodman R, MacLeod J, Maddula R, Rayan D, Doshi K, Bick A, Bailey S, Brown SA. Next Generation Risk Markers in Preventive Cardio-oncology. Curr Atheroscler Rep 2022; 24:443-456. [PMID: 35441347 PMCID: PMC10026729 DOI: 10.1007/s11883-022-01021-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Cardiovascular disease (CVD) and cancer are the first and second most common causes of death within the USA. It is well established that a diagnosis of cancer increases risk and predisposes the patient to CVD, and vice versa. Despite these associations, cancer is not yet incorporated into current CVD risk calculators, necessitating additional CV risk markers for improved stratification in this at-risk population. In this review, we consider the utility of breast arterial calcification (BAC), coronary artery calcification (CAC), clonal hematopoiesis of indeterminate potential (CHIP), and cancer and cancer treatment in CVD risk assessment. RECENT FINDINGS There is evidence supporting the use of BAC, CAC, CHIP, and cancer and cancer treatment for improved CV risk stratification in patients with cancer and those who are being screened for cancer. BAC has been shown to predict CAC, coronary atherosclerotic plaque on coronary CTA, coronary artery stenosis on coronary angiography, and CVD events and accordingly enhances CVD risk stratification beyond the atherosclerotic CVD (ASCVD) risk pooled cohort equation. Additionally, CAC visualized on CT utilized for lung cancer screening, radiation planning, and cancer staging is predictive of coronary artery disease (CAD). Furthermore, CHIP can also be utilized in risk stratification, as the presence of CHIP carries a 40% increase in CV risk independent of traditional CV risk factors. Finally, cancer and many oncologic therapies confer a lifelong increased risk of CVD. We propose an emerging set of tools to be incorporated into the routine continuum of CVD risk assessment in individuals who have been treated for cancer or who are being screened for cancer development. In this review, we discuss BAC, CAC, CHIP, and cancer and cancer treatment as emerging risk markers in cardiovascular health assessment. Their effectiveness in predicting and influencing the burden of CVD will be discussed, along with suggestions on their incorporation into preventive cardio-oncology practice. Future research will focus on short- and long-term CVD outcomes in these populations.
Collapse
Affiliation(s)
- Morgan Lamberg
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, USA
| | | | | | - Sabrina Painter
- Department of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Rachel Goodman
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, USA
| | | | | | - David Rayan
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, USA
| | - Krishna Doshi
- Department of Medicine, Advocate Lutheran General Hospital, Park Ridge, IL, USA
| | - Alexander Bick
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Simone Bailey
- Preventive Cardiology, Rochester Regional Health, Rochester, MN, USA
| | - Sherry-Ann Brown
- Cardio-Oncology & Preventive Cardiology Programs, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
| |
Collapse
|
22
|
Sinha A, Bavishi A, Hibler EA, Yang EH, Parashar S, Okwuosa T, DeCara JM, Brown SA, Guha A, Sadler D, Khan SS, Shah SJ, Yancy CW, Akhter N. Interconnected Clinical and Social Risk Factors in Breast Cancer and Heart Failure. Front Cardiovasc Med 2022; 9:847975. [PMID: 35669467 PMCID: PMC9163546 DOI: 10.3389/fcvm.2022.847975] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022] Open
Abstract
Breast cancer and heart failure share several known clinical cardiovascular risk factors, including age, obesity, glucose dysregulation, cholesterol dysregulation, hypertension, atrial fibrillation and inflammation. However, to fully comprehend the complex interplay between risk of breast cancer and heart failure, factors attributed to both biological and social determinants of health must be explored in risk-assessment. There are several social factors that impede implementation of prevention strategies and treatment for breast cancer and heart failure prevention, including socioeconomic status, neighborhood disadvantage, food insecurity, access to healthcare, and social isolation. A comprehensive approach to prevention of both breast cancer and heart failure must include assessment for both traditional clinical risk factors and social determinants of health in patients to address root causes of lifestyle and modifiable risk factors. In this review, we examine clinical and social determinants of health in breast cancer and heart failure that are necessary to consider in the design and implementation of effective prevention strategies that altogether reduce the risk of both chronic diseases
Collapse
Affiliation(s)
- Arjun Sinha
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Avni Bavishi
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Elizabeth A. Hibler
- Department of Preventive Medicine, Division of Cancer Epidemiology and Prevention, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Eric H. Yang
- UCLA Cardio-Oncology Program, Division of Cardiology, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Susmita Parashar
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, GA, United States
| | - Tochukwu Okwuosa
- Division of Cardiology, Department of Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Jeanne M. DeCara
- Section of Cardiology, Department of Medicine, University of Chicago Medicine, Chicago, IL, United States
| | - Sherry-Ann Brown
- Division of Cardiology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Avirup Guha
- Cardio-Oncology Program, Division of Cardiology, Medical College of Georgia at Augusta University, Augusta, GA, United States
- Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, United States
| | - Diego Sadler
- Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic Florida, Weston, FL, United States
| | - Sadiya S. Khan
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Sanjiv J. Shah
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Clyde W. Yancy
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Nausheen Akhter
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
- *Correspondence: Nausheen Akhter
| |
Collapse
|
23
|
Suero-Abreu GA, Hamid A, Akbilgic O, Brown SA. Trends in cardiology and oncology artificial intelligence publications. Am Heart J Plus 2022; 17:100162. [PMID: 38559882 PMCID: PMC10978330 DOI: 10.1016/j.ahjo.2022.100162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Received: 02/05/2022] [Revised: 05/26/2022] [Accepted: 05/28/2022] [Indexed: 04/04/2024]
Abstract
Study objective To determine whether there has been growth in publications on the use of artificial intelligence in cardiology and oncology, we assessed historical trends in publications related to artificial intelligence applications in cardiology and oncology, which are the two fields studying the leading causes of death worldwide. Upward trends in publications may indicate increasing interest in the use of artificial intelligence in these crucial fields. Design/setting To evaluate evidence of increasing publications on the use of artificial intelligence in cardiology and oncology, historical trends in related publications on PubMed (the biomedical repository most frequently used by clinicians and scientists in these fields) were reviewed. Results Findings indicated that research output related to artificial intelligence (and its subcategories) generally increased over time, particularly in the last five years. With some initial degree of vacillation in publication trends, a slight qualitative inflection was noted in approximately 2015, in general publications and especially for oncology and cardiology, with subsequent consistent exponential growth. Publications predominantly focused on "machine learning" (n = 20,301), which contributed to the majority of the accelerated growth in the field, compared to "artificial intelligence" (n = 4535), "natural language processing" (n = 2608), and "deep learning" (n = 4459). Conclusion Trends in the general biomedical literature and particularly in cardiology and oncology indicated exponential growth over time. Further exponential growth is expected in future years, as awareness and cross-disciplinary collaboration and education increase. Publications specifically on machine learning will likely continue to lead the way.
Collapse
Affiliation(s)
| | | | - Oguz Akbilgic
- Section of Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Wake Forest, NC, USA
| | - Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
24
|
Brown SA, Hudson C, Hamid A, Berman G, Echefu G, Lee K, Lamberg M, Olson J. The pursuit of health equity in digital transformation, health informatics, and the cardiovascular learning healthcare system. Am Heart J Plus 2022; 17:100160. [PMID: 38559893 PMCID: PMC10978355 DOI: 10.1016/j.ahjo.2022.100160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Received: 02/01/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 04/04/2024]
Abstract
African Americans have a higher rate of cardiovascular morbidity and mortality and a lower rate of specialty consultation and treatment than Caucasians. These disparities also exist in the care and treatment of chemotherapy-related cardiovascular complications. African Americans suffer from cardiotoxicity at a higher rate than Caucasians and are underrepresented in clinical trials aimed at preventing cardiovascular injury associated with cancer therapies. To eliminate racial and ethnic disparities in the prevention of cardiotoxicity, an interdisciplinary and innovative approach will be required. Diverse forms of digital transformation leveraging health informatics have the potential to contribute to health equity if they are implemented carefully and thoughtfully in collaboration with minority communities. A learning healthcare system can serve as a model for developing, deploying, and disseminating interventions to minimize health inequities and maximize beneficial impact.
Collapse
Affiliation(s)
- Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | | | | | - Gift Echefu
- Baton Rouge General Medical Center, Department of Internal Medicine, Baton Rouge, LA, USA
| | - Kyla Lee
- Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Morgan Lamberg
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jessica Olson
- Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| |
Collapse
|
25
|
Foss L, Brown SA, Sutherland S, Miller CJ, Philliber S. A randomized controlled trial of the impact of the Teen Council peer education program on youth development. Health Educ Res 2022; 37:36-47. [PMID: 35134906 DOI: 10.1093/her/cyac001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 01/07/2022] [Accepted: 01/24/2022] [Indexed: 06/14/2023]
Abstract
This paper presents results of an impact evaluation of Teen Council, a program that trains youth as peer educators. Teen Council is designed to help peer educators make healthy sexual and reproductive decisions, increase their confidence and abilities to educate their peers and inspire them to advocate for just sexual policies. The program's impact on these educators was evaluated using a randomized controlled trial. Over 5 years, interested high school students in seven states were randomly assigned to a study condition. An intent-to-treat framework using ordinary least square (OLS) regression was employed to measure program effects. Relative to control, Teen Council youth showed enhanced comfort with their own sexuality, greater comfort with and more frequent communication with parents about sexuality and more positive sexual health behaviors, including accessing reproductive health care and adopting more effective means of contraception. Teen Council youth also reported greater confidence in talking with peers about sexuality and more confidence in their civic engagement skills.
Collapse
Affiliation(s)
- L Foss
- Philliber Research & Evaluation, 16 Main Street, Accord, NY 12404, USA
| | - S A Brown
- Philliber Research & Evaluation, 16 Main Street, Accord, NY 12404, USA
| | - S Sutherland
- Planned Parenthood of the Great Northwest and the Hawaiian Islands, 2001 E. Madison, Seattle, WA 98122, USA
| | - C J Miller
- Planned Parenthood of the Great Northwest and the Hawaiian Islands, 2001 E. Madison, Seattle, WA 98122, USA
| | - S Philliber
- Philliber Research & Evaluation, 16 Main Street, Accord, NY 12404, USA
| |
Collapse
|
26
|
Goodman RE, Thordsen SE, Sridhar N, Calderon A, Weil E, Chaudhary LN, Kamaraju S, Retseck J, Charlson J, Burfeind J, Chitambar CR, Cheng YC, Brown SA. CHANGE IN LEFT VENTRICULAR END DIASTOLIC INDEX OR GLOBAL LONGITUDINAL STRAIN MAY PREDICT DEVELOPMENT OF CANCER THERAPY RELATED CARDIAC DYSFUNCTION IN HER2 POSITIVE BREAST CANCER PATIENTS RECEIVING TRASTUZUMAB. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)02878-9] [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: 10/18/2022]
|
27
|
Martinez DSL, Noseworthy PA, Akbilgic O, Herrmann J, Ruddy KJ, Hamid A, Maddula R, Singh A, Davis R, Gunturkun F, Jefferies JL, Brown SA. Artificial intelligence opportunities in cardio-oncology: Overview with spotlight on electrocardiography. Am Heart J Plus 2022; 15:100129. [PMID: 35721662 PMCID: PMC9202996 DOI: 10.1016/j.ahjo.2022.100129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 01/21/2023]
Abstract
Cardiovascular disease is a leading cause of death among cancer survivors, second only to cancer recurrence or development of new tumors. Cardio-oncology has therefore emerged as a relatively new specialty focused on prevention and management of cardiovascular consequences of cancer therapies. Yet challenges remain regarding precision and accuracy with predicting individuals at highest risk for cardiotoxicity. Barriers such as access to care also limit screening and early diagnosis to improve prognosis. Thus, developing innovative approaches for prediction and early detection of cardiovascular illness in this population is critical. In this review, we provide an overview of the present state of machine learning applications in cardio-oncology. We begin by outlining some factors that should be considered while utilizing machine learning algorithms. We then examine research in which machine learning has been applied to improve prediction of cardiac dysfunction in cancer survivors. We also highlight the use of artificial intelligence (AI) in conjunction with electrocardiogram (ECG) to predict cardiac malfunction and also atrial fibrillation (AF), and we discuss the potential role of wearables. Additionally, the article summarizes future prospects and critical takeaways for the application of machine learning in cardio-oncology. This study is the first in a series on artificial intelligence in cardio-oncology, and complements our manuscript on echocardiography and other forms of imaging relevant to cancer survivors cared for in cardiology clinical practice.
Collapse
Affiliation(s)
- Daniel Sierra-Lara Martinez
- Coronary Care Unit, National Institute of Cardiology/Instituto Nacional de Cardiologia, Ciudad de Mexico, Mexico
| | | | - Oguz Akbilgic
- Department of Health Informatics and Data Science, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL, USA
- Section of Cardiovascular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Wake Forest, NC, USA
| | - Joerg Herrmann
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Ashima Singh
- Institute of Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Robert Davis
- Center for Biomedical Informatics, University of Tennessee Health Sciences Center, USA
| | - Fatma Gunturkun
- Center for Biomedical Informatics, University of Tennessee Health Sciences Center, USA
| | - John L. Jefferies
- Division of Cardiovascular Diseases, University of Tennessee Health Sciences Center, USA
- Department of Epidemiology, St. Jude Children's Research Hospital, USA
| | - Sherry-Ann Brown
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| |
Collapse
|
28
|
Madan N, Lucas J, Akhter N, Collier P, Cheng F, Guha A, Zhang L, Sharma A, Hamid A, Ndiokho I, Wen E, Garster NC, Scherrer-Crosbie M, Brown SA. Artificial intelligence and imaging: Opportunities in cardio-oncology. Am Heart J Plus 2022; 15:100126. [PMID: 35693323 PMCID: PMC9187287 DOI: 10.1016/j.ahjo.2022.100126] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 12/29/2022]
Abstract
Cardiovascular disease is a leading cause of death in cancer survivors. It is critical to apply new predictive and early diagnostic methods in this population, as this can potentially inform cardiovascular treatment and surveillance decision-making. We discuss the application of artificial intelligence (AI) technologies to cardiovascular imaging in cardio-oncology, with a particular emphasis on prevention and targeted treatment of a variety of cardiovascular conditions in cancer patients. Recently, the use of AI-augmented cardiac imaging in cardio-oncology is gaining traction. A large proportion of cardio-oncology patients are screened and followed using left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS), currently obtained using echocardiography. This use will continue to increase with new cardiotoxic cancer treatments. AI is being tested to increase precision, throughput, and accuracy of LVEF and GLS, guide point-of-care image acquisition, and integrate imaging and clinical data to optimize the prediction and detection of cardiac dysfunction. The application of AI to cardiovascular magnetic resonance imaging (CMR), computed tomography (CT; especially coronary artery calcium or CAC scans), single proton emission computed tomography (SPECT) and positron emission tomography (PET) imaging acquisition is also in early stages of analysis for prediction and assessment of cardiac tumors and cardiovascular adverse events in patients treated for childhood or adult cancer. The opportunities for application of AI in cardio-oncology imaging are promising, and if availed, will improve clinical practice and benefit patient care.
Collapse
Affiliation(s)
- Nidhi Madan
- Division of Cardiology, Rush University Medical Center, Chicago, IL, USA
| | | | - Nausheen Akhter
- Division of Cardiology, Northwestern University, Chicago, IL, USA
| | - Patrick Collier
- Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Feixiong Cheng
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Avirup Guha
- Harrington Heart and Vascular Institute, Cleveland, OH, USA
| | - Lili Zhang
- Cardio-Oncology Program, Division of Cardiology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Abhinav Sharma
- Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Imeh Ndiokho
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ethan Wen
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Noelle C. Garster
- Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| |
Collapse
|
29
|
Brown SA, Beavers C, Martinez HR, Marshall CH, Olaye IM, Guha A, Cho D, Bailey A, Bergom C, Bansal N, Bauer B, Cheng RK. Bridging the gap to advance the care of individuals with cancer: collaboration and partnership in the Cardiology Oncology Innovation Network (COIN). Cardiooncology 2022; 8:2. [PMID: 35139920 PMCID: PMC8827263 DOI: 10.1186/s40959-022-00129-y] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/05/2022] [Indexed: 01/21/2023]
Abstract
Cardiovascular diseases and cancer continue to be the two leading causes of death in the United States. While innovations in artificial intelligence, digital health, and telemedicine may revolutionize cardio-oncology clinical practice, barriers to widespread adoption continue to exist. The most effective way to advance these technologies is through a broad range of stakeholders sharing a common vision. Additionally, as we enter the digital era in healthcare, we must help lead this charge for the benefit of our cardiology and oncology patients. Bolstering collaborations in cardiology and oncology is key, in partnership with technology firms, industry, academia, and private practice, with an emphasis on various forms of innovation. The ultimate goal is to connect our patients and their health to informatics-based opportunities to advance cardiovascular disease prevention in cancer patients. We have established the Cardiology Oncology Innovation Network in accordance with this vision, to develop new care delivery options through the use of innovative technological strategies. Our tripartite mission - innovation, collaboration, and education - aims to increase access to and expertise in digital transformation to prevent cardiovascular diseases in cancer patients. Here we describe network initiatives, early accomplishments, and future milestones.
Collapse
Affiliation(s)
- Sherry-Ann Brown
- grid.30760.320000 0001 2111 8460Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226 USA
| | - Craig Beavers
- grid.266539.d0000 0004 1936 8438University of Kentucky College of Pharmacy, Lexington, KY USA
| | - Hugo R. Martinez
- grid.267301.10000 0004 0386 9246The Heart Institute at Le Bonheur Children’s Hospital, University of Tennessee Health and Science Center, Memphis, TN USA ,grid.240871.80000 0001 0224 711XSt. Jude Children’s Research Hospital, Memphis, TN USA
| | - Catherine H. Marshall
- grid.21107.350000 0001 2171 9311Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD USA ,grid.21107.350000 0001 2171 9311Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Iredia M. Olaye
- grid.5386.8000000041936877XDivision of Clinical Epidemiology, Department of Medicine, Weill Cornell Medicine, New York, NY USA
| | - Avirup Guha
- grid.410427.40000 0001 2284 9329Cardio-Oncology Program, Division of Cardiology, Department of Internal Medicine, Medical College of Georgia at Augusta University, Augusta, GA USA
| | - David Cho
- grid.19006.3e0000 0000 9632 6718University of California, Los Angeles, Division of Cardiovascular Medicine, Los Angeles, CA USA
| | - Alison Bailey
- Center for Heart, Lung, and Vascular Health at Parkridge, HCA Healthcare, Chattanooga, TN USA
| | - Carmen Bergom
- grid.4367.60000 0001 2355 7002Department of Radiation Oncology, Washington University in St. Louis, St. Louis, MO USA ,grid.4367.60000 0001 2355 7002Cardio-Oncology Center of Excellence, Washington University in St. Louis, St. Louis, MO USA
| | - Neha Bansal
- grid.251993.50000000121791997Division of Pediatric Cardiology, Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY USA
| | - Brenton Bauer
- grid.431038.d0000 0004 0474 1180COR Healthcare Associates, Torrance Memorial Medical Center, Torrance, CA USA
| | - Richard K. Cheng
- grid.34477.330000000122986657Cardio-oncology Program, Division of Cardiology, University of Washington, Seattle, WA USA
| |
Collapse
|
30
|
Prasad P, Branch M, Asemota D, Elsayed R, Addison D, Brown SA. Correction to: Cardio-oncology Preventative Care: Racial and Ethnic Disparities. Curr Cardiovasc Risk Rep 2022. [DOI: 10.1007/s12170-022-00688-w] [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: 11/03/2022]
|
31
|
Brown SA, Sparapani R, Osinski K, Zhang J, Blessing J, Cheng F, Hamid A, Berman G, Lee K, BagheriMohamadiPour M, Castrillon Lal J, Kothari AN, Caraballo P, Noseworthy P, Johnson RH, Hansen K, Sun LY, Crotty B, Cheng YC, Olson J. Establishing an interdisciplinary research team for cardio-oncology artificial intelligence informatics precision and health equity. Am Heart J Plus 2022; 13:100094. [PMID: 35434676 PMCID: PMC9012235 DOI: 10.1016/j.ahjo.2022.100094] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/01/2022] [Indexed: 11/23/2022]
Abstract
Study objective A multi-institutional interdisciplinary team was created to develop a research group focused on leveraging artificial intelligence and informatics for cardio-oncology patients. Cardio-oncology is an emerging medical field dedicated to prevention, screening, and management of adverse cardiovascular effects of cancer/ cancer therapies. Cardiovascular disease is a leading cause of death in cancer survivors. Cardiovascular risk in these patients is higher than in the general population. However, prediction and prevention of adverse cardiovascular events in individuals with a history of cancer/cancer treatment is challenging. Thus, establishing an interdisciplinary team to create cardiovascular risk stratification clinical decision aids for integration into electronic health records for oncology patients was considered crucial. Design/setting/participants Core team members from the Medical College of Wisconsin (MCW), University of Wisconsin-Milwaukee (UWM), and Milwaukee School of Engineering (MSOE), and additional members from Cleveland Clinic, Mayo Clinic, and other institutions have joined forces to apply high-performance computing in cardio-oncology. Results The team is comprised of clinicians and researchers from relevant complementary and synergistic fields relevant to this work. The team has built an epidemiological cohort of ~5000 cancer survivors that will serve as a database for interdisciplinary multi-institutional artificial intelligence projects. Conclusion Lessons learned from establishing this team, as well as initial findings from the epidemiology cohort, are presented. Barriers have been broken down to form a multi-institutional interdisciplinary team for health informatics research in cardio-oncology. A database of cancer survivors has been created collaboratively by the team and provides initial insight into cardiovascular outcomes and comorbidities in this population.
Collapse
Affiliation(s)
- Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Rodney Sparapani
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kristen Osinski
- Clinical Science and Translational Institute, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jun Zhang
- Department of Electrical Engineering and Computer Science, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jeffrey Blessing
- Department of Computer Science, Milwaukee School of Engineering, USA
| | - Feixiong Cheng
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | | | | | - Kyla Lee
- Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Mehri BagheriMohamadiPour
- Department of Electrical Engineering and Computer Science, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jessica Castrillon Lal
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Anai N. Kothari
- Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Peter Noseworthy
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | - Louise Y. Sun
- Division of Cardiac Anesthesiology, University of Ottawa Heart Institute and School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Bradley Crotty
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Yee Chung Cheng
- Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jessica Olson
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Cardio-Oncology Artificial Intelligence Informatics & Precision (CAIP) Research Team Investigators
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
- Clinical Science and Translational Institute, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Electrical Engineering and Computer Science, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
- Department of Computer Science, Milwaukee School of Engineering, USA
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Medical College of Wisconsin, Milwaukee, WI, USA
- Medical College of Wisconsin, Green Bay, WI, USA
- Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
- Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
- Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
- Green Bay, WI, USA
- Division of Cardiac Anesthesiology, University of Ottawa Heart Institute and School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| |
Collapse
|
32
|
Batra A, Patel B, Addison D, Baldassarre LA, Desai N, Weintraub N, Deswal A, Hussain Z, Brown SA, Ganatra S, Agarwala V, Parikh PM, Fradley M, Ghosh A, Guha A. Cardiovascular safety profile of taxanes and vinca alkaloids: 30 years FDA registry experience. Open Heart 2021; 8:openhrt-2021-001849. [PMID: 34952868 PMCID: PMC8710909 DOI: 10.1136/openhrt-2021-001849] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 09/07/2021] [Accepted: 11/29/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Antimicrotubular agents are among the most commonly used classes of chemotherapeutic agents, but the risk of cardiovascular adverse events (CVAEs) remains unclear. Our objective was to study the CVAEs associated with antimicrotubular agents. METHODS The Food and Drug Administration's Adverse Event Reporting System was used to study CVAEs in adults from 1990 to 2020. Reported single-agent (only taxane or vinca alkaloid) CVAEs were compared with combination therapy (with at least one of the four major cardiotoxic drugs: anthracycline, HER2Neu inhibitors, tyrosine kinase inhibitors and checkpoint inhibitors) using adjusted polytomous logistic regression. RESULTS Over 30 years, 134 398 adverse events were reported, of which 18 426 (13.4%) were CVAEs, with 74.1% due to taxanes and 25.9% due to vinca alkaloids. In 30 years, there has been a reduction in the proportion of reported CVAEs for taxanes from 15% to 11.8% (Cochran-Armitage P-trends <0.001) with no significant change in the proportion of reported CVAEs for vinca alkaloids (9.2%-11.7%; P-trends=0.06). The proportion of reported CVAEs was lower in both taxane and vinca alkaloid monotherapy versus combination therapy (reporting OR=0.50 and 0.55, respectively). Anthracyclines and HER2Neu inhibitor combinations with taxanes or vinca alkaloids primarily drove the higher burden of combination CVAEs. Hypertension requiring hospitalisation and heart failure was significantly lower in monotherapy versus combination antimicrotubular agent therapy. CONCLUSIONS Antimicrotubular agents are associated with CVAEs, especially in combination chemotherapy regimens. Based on this study, we suggest routine cardiovascular assessment of patients with cancer before initiating antimicrotubular agents in combination therapy.
Collapse
Affiliation(s)
- Akshee Batra
- Department of Medicine, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Brijesh Patel
- Department of Cardiology, West Virginia University, Morgantown, West Virginia, USA
| | - Daniel Addison
- Cardio-Oncology Program, Division of Cardiology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | | | - Nihar Desai
- Department of Cardiology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Neal Weintraub
- Cardio-Oncology Program, Division of Cardiology, Department of Internal Medicine, Augusta University Medical College of Georgia, Augusta, Georgia, USA
| | - Anita Deswal
- Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Zeeshan Hussain
- Harrington Heart and Vascular Institute, University Hospitals, Cleveland, Ohio, USA
| | | | - Sarju Ganatra
- Department of Cardiovascular Medicine, Lahey Clinic Medical Center, Burlington, Massachusetts, USA
| | - Vivek Agarwala
- Department of Medical Oncology, Narayana Superspeciality Hospital-Howrah, Howrah, West Bengal, India
| | | | - Michael Fradley
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Avirup Guha
- Cardio-Oncology Program, Division of Cardiology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA .,Cardio-Oncology Program, Division of Cardiology, Department of Internal Medicine, Augusta University Medical College of Georgia, Augusta, Georgia, USA.,Department of Internal Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| |
Collapse
|
33
|
Jordan CG, Brown SA, Schrager S. Health Equity Tourism: The WMJ Editorial Board Responds. WMJ 2021; 120:258-259. [PMID: 35025170 PMCID: PMC8986421] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- C Greer Jordan
- Institute of Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Sherry-Ann Brown
- Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Sarina Schrager
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin,
| |
Collapse
|
34
|
Infante MA, Eberson SC, Zhang Y, Brumback T, Brown SA, Colrain IM, Baker FC, Clark DB, De Bellis MD, Goldston D, Nagel BJ, Nooner KB, Zhao Q, Pohl KM, Sullivan EV, Pfefferbaum A, Tapert SF, Thompson WK. Adolescent Binge Drinking Is Associated With Accelerated Decline of Gray Matter Volume. Cereb Cortex 2021; 32:2611-2620. [PMID: 34729592 DOI: 10.1093/cercor/bhab368] [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: 04/13/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 11/12/2022] Open
Abstract
The age- and time-dependent effects of binge drinking on adolescent brain development have not been well characterized even though binge drinking is a health crisis among adolescents. The impact of binge drinking on gray matter volume (GMV) development was examined using 5 waves of longitudinal data from the National Consortium on Alcohol and NeuroDevelopment in Adolescence study. Binge drinkers (n = 166) were compared with non-binge drinkers (n = 82 after matching on potential confounders). Number of binge drinking episodes in the past year was linked to decreased GMVs in bilateral Desikan-Killiany cortical parcellations (26 of 34 with P < 0.05/34) with the strongest effects observed in frontal regions. Interactions of binge drinking episodes and baseline age demonstrated stronger effects in younger participants. Statistical models sensitive to number of binge episodes and their temporal proximity to brain volumes provided the best fits. Consistent with prior research, results of this study highlight the negative effects of binge drinking on the developing brain. Our results present novel findings that cortical GMV decreases were greater in closer proximity to binge drinking episodes in a dose-response manner. This relation suggests a causal effect and raises the possibility that normal growth trajectories may be reinstated with alcohol abstinence.
Collapse
Affiliation(s)
- M A Infante
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - S C Eberson
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Y Zhang
- Division of Biostatistics, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, USA.,Population Neuroscience and Genetics Lab, University of California, San Diego, USA
| | - T Brumback
- Department of Psychological Science, Northern Kentucky University, Kentucky, USA
| | - S A Brown
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.,Department of Psychology, University of California, San Diego, La Jolla, CA, USA
| | - I M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - F C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, USA
| | - D B Clark
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - M D De Bellis
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
| | - D Goldston
- Department of Psychiatry & Behavioral Sciences, Duke University, Durham, NC, USA
| | - B J Nagel
- Departments of Psychiatry and Behavioral Neuroscience, Oregon Health & Sciences University, Portland, OR, USA
| | - K B Nooner
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC, USA
| | - Q Zhao
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - K M Pohl
- Center for Health Sciences, SRI International, Menlo Park, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - E V Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - A Pfefferbaum
- Center for Health Sciences, SRI International, Menlo Park, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - S F Tapert
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - W K Thompson
- Division of Biostatistics, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, USA.,Population Neuroscience and Genetics Lab, University of California, San Diego, USA.,Department of Radiology, University of California, San Diego, USA
| |
Collapse
|
35
|
Kobo O, Brown SA, Nafee T, Mohamed MO, Sharma K, Istanbuly S, Roguin A, Cheng RK, Mamas MA. Impact of malignancy on In-hospital mortality, stratified by the cause of admission: An analysis of 67 million patients from the National Inpatient Sample. Int J Clin Pract 2021; 75:e14758. [PMID: 34490963 PMCID: PMC8983059 DOI: 10.1111/ijcp.14758] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/26/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To describe the patient characteristics and the reason for admission of patients with malignancy by malignancy, and to study mortality rates for the different causes of admissions among the different types of cancer. PATIENTS AND METHODS Using the nationwide Inpatient Sampling (2015-2017) we examined the cause of admission and associated in-hospital mortality, stratified by presence and type of malignancy. Multivariable logistic regression models were used to examine the association between in-hospital mortality and malignancy sites for different primary admission causes. RESULTS Out of 67 819 693 inpatient admissions, 8.8% had malignancy. Amongst those with malignancy, haematological malignancy was the most common (20.2%). The most common cause of admission amongst all cancers were malignancy-related admissions, where up to 57% of all colorectal admissions were malignancy-related. The most common non-malignancy cause of admission was infectious causes, which were most frequent among patients with haematological malignancy (18.4%). Patients with malignancy had higher crude mortality rates (5.7% vs 1.9%). Mortality rates were highest among patients with lung cancer (8.7%). Among all admissions, the adjusted rates of mortality were higher for patients with lung (OR 3.65, 95% CI [3.59-3.71]), breast (OR 2.06, 95% CI [1.99-2.13]), haematological (OR 1.79, 95% CI [1.76-1.82]) and colorectal (OR 1.71, 95% CI [1.66-1.76]) malignancies compared with patients with no malignancy. CONCLUSION Our work highlights the need to consider the burden of cancer on our hospital services and consider how the prognostic impact of different types of admissions may relate to the type of cancer diagnosis and understand whether these differences relate to disparities in clinical care/treatments.
Collapse
Affiliation(s)
- Ofer Kobo
- Department of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel
- Keele Cardiovascular Research Group, Keele University, Stoke on Trent, United Kingdom
| | - Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Tarek Nafee
- Department of Medicine, Roger Williams Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Mohamed O. Mohamed
- Keele Cardiovascular Research Group, Keele University, Stoke on Trent, United Kingdom
| | - Kamal Sharma
- U.N. Mehta ICRC, B. J. Medical College, Ahmedabad, India
| | | | - Ariel Roguin
- Department of Cardiology, Hillel Yaffe Medical Center, Hadera, Israel
- Keele Cardiovascular Research Group, Keele University, Stoke on Trent, United Kingdom
| | - Richard K. Cheng
- Division of Cardiology, University of Washington Heart Institute, Seattle, WA, USA
| | - Mamas A. Mamas
- Keele Cardiovascular Research Group, Keele University, Stoke on Trent, United Kingdom
- Institute of Population Health, University of Manchester, Manchester, United Kingdom
| |
Collapse
|
36
|
Affiliation(s)
- Samuel B Jackson
- Department of Medicine, David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, California, USA
| | - Michael Tanoue
- Division of Cardiology, Department of Medicine, Queens Medical Center, University of Hawaii, Honolulu, Hawaii, USA
| | - Negeen Shahandeh
- Division of Cardiology, David Geffen School Medicine at the University of California-Los Angeles, Los Angeles, California, USA
| | - Juan Lopez-Mattei
- Departments of Cardiology and Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Disease, Medical College of Wisconsin, Wauwatosa, Wisconsin, USA
| | - Janet K Han
- Division of Cardiology, David Geffen School Medicine at the University of California-Los Angeles, Los Angeles, California, USA
| | - Eric H Yang
- Division of Cardiology, David Geffen School Medicine at the University of California-Los Angeles, Los Angeles, California, USA.,UCLA Cardio-Oncology Program, Division of Cardiology, Department of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| |
Collapse
|
37
|
Lisdahl KM, Tapert S, Sher KJ, Gonzalez R, Nixon SJ, Ewing SWF, Conway KP, Wallace A, Sullivan R, Hatcher K, Kaiver C, Thompson W, Reuter C, Bartsch H, Wade NE, Jacobus J, Albaugh MD, Allgaier N, Anokhin AP, Bagot K, Baker FC, Banich MT, Barch DM, Baskin-Sommers A, Breslin FJ, Brown SA, Calhoun V, Casey BJ, Chaarani B, Chang L, Clark DB, Cloak C, Constable RT, Cottler LB, Dagher RK, Dapretto M, Dick A, Do EK, Dosenbach NUF, Dowling GJ, Fair DA, Florsheim P, Foxe JJ, Freedman EG, Friedman NP, Garavan HP, Gee DG, Glantz MD, Glaser P, Gonzalez MR, Gray KM, Grant S, Haist F, Hawes S, Heeringa SG, Hermosillo R, Herting MM, Hettema JM, Hewitt JK, Heyser C, Hoffman EA, Howlett KD, Huber RS, Huestis MA, Hyde LW, Iacono WG, Isaiah A, Ivanova MY, James RS, Jernigan TL, Karcher NR, Kuperman JM, Laird AR, Larson CL, LeBlanc KH, Lopez MF, Luciana M, Luna B, Maes HH, Marshall AT, Mason MJ, McGlade E, Morris AS, Mulford C, Nagel BJ, Neigh G, Palmer CE, Paulus MP, Pecheva D, Prouty D, Potter A, Puttler LI, Rajapakse N, Ross JM, Sanchez M, Schirda C, Schulenberg J, Sheth C, Shilling PD, Sowell ER, Speer N, Squeglia L, Sripada C, Steinberg J, Sutherland MT, Tomko R, Uban K, Vrieze S, Weiss SRB, Wing D, Yurgelun-Todd DA, Zucker RA, Heitzeg MM. Substance use patterns in 9-10 year olds: Baseline findings from the adolescent brain cognitive development (ABCD) study. Drug Alcohol Depend 2021; 227:108946. [PMID: 34392051 PMCID: PMC8833837 DOI: 10.1016/j.drugalcdep.2021.108946] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 01/15/2021] [Revised: 06/03/2021] [Accepted: 06/05/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND The Adolescent Brain Cognitive Development ™ Study (ABCD Study®) is an open-science, multi-site, prospective, longitudinal study following over 11,800 9- and 10-year-old youth into early adulthood. The ABCD Study aims to prospectively examine the impact of substance use (SU) on neurocognitive and health outcomes. Although SU initiation typically occurs during teen years, relatively little is known about patterns of SU in children younger than 12. METHODS This study aims to report the detailed ABCD Study® SU patterns at baseline (n = 11,875) in order to inform the greater scientific community about cohort's early SU. Along with a detailed description of SU, we ran mixed effects regression models to examine the association between early caffeine and alcohol sipping with demographic factors, externalizing symptoms and parental history of alcohol and substance use disorders (AUD/SUD). PRIMARY RESULTS At baseline, the majority of youth had used caffeine (67.6 %) and 22.5 % reported sipping alcohol (22.5 %). There was little to no reported use of other drug categories (0.2 % full alcohol drink, 0.7 % used nicotine, <0.1 % used any other drug of abuse). Analyses revealed that total caffeine use and early alcohol sipping were associated with demographic variables (p's<.05), externalizing symptoms (caffeine p = 0002; sipping p = .0003), and parental history of AUD (sipping p = .03). CONCLUSIONS ABCD Study participants aged 9-10 years old reported caffeine use and alcohol sipping experimentation, but very rare other SU. Variables linked with early childhood alcohol sipping and caffeine use should be examined as contributing factors in future longitudinal analyses examining escalating trajectories of SU in the ABCD Study cohort.
Collapse
Affiliation(s)
- Krista M Lisdahl
- University of Wisconsin, Milwaukee, WI, United States; Medical College of Wisconsin, Milwaukee, WI, United States.
| | - Susan Tapert
- University of California, San Diego, CA, United States
| | | | - Raul Gonzalez
- Florida International University, Miami, FL, United States
| | - Sara Jo Nixon
- University of Florida, Gainesville, FL, United States
| | | | - Kevin P Conway
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - Alex Wallace
- University of Wisconsin, Milwaukee, WI, United States
| | - Ryan Sullivan
- University of Wisconsin, Milwaukee, WI, United States
| | - Kelah Hatcher
- University of Wisconsin, Milwaukee, WI, United States
| | | | - Wes Thompson
- University of California, San Diego, CA, United States
| | - Chase Reuter
- University of California, San Diego, CA, United States
| | - Hauke Bartsch
- University of California, San Diego, CA, United States
| | | | | | - M D Albaugh
- University of Vermont, Burlington, VT, United States
| | - N Allgaier
- University of Vermont, Burlington, VT, United States
| | - A P Anokhin
- Washington University, St. Louis, MO, United States
| | - K Bagot
- University of California, San Diego, CA, United States; Icahn School of Medicine at Mount Sinai, United States
| | - F C Baker
- SRI International, Menlo Park, CA, United States
| | - M T Banich
- University of Colorado Boulder, CO, United States
| | - D M Barch
- Washington University, St. Louis, MO, United States
| | | | - F J Breslin
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - S A Brown
- University of California, San Diego, CA, United States
| | - V Calhoun
- Georgia State University, Atlanta, GA, United States
| | - B J Casey
- Yale University, New Haven, CT, United States
| | - B Chaarani
- University of Vermont, Burlington, VT, United States
| | - L Chang
- University of Maryland School of Medicine, Baltimore, MD, United States
| | - D B Clark
- University of Pittsburgh, Pittsburgh, PA, United States
| | - C Cloak
- University of Maryland School of Medicine, Baltimore, MD, United States
| | | | - L B Cottler
- University of Florida, Gainesville, FL, United States
| | - R K Dagher
- National Institute of Minority Health and Health Disparities, Bethesda, MD, United States
| | - M Dapretto
- University of California, Los Angeles, CA, United States
| | - A Dick
- Florida International University, Miami, FL, United States
| | - E K Do
- Virginia Commonwealth University, Richmond, VA, United States
| | | | - G J Dowling
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - D A Fair
- University of Minnesota, Minneapolis, MN, United States
| | - P Florsheim
- University of Wisconsin, Milwaukee, WI, United States
| | - J J Foxe
- University of Rochester, Rochester, NY, United States
| | - E G Freedman
- University of Rochester, Rochester, NY, United States
| | - N P Friedman
- University of Colorado Boulder, CO, United States
| | - H P Garavan
- University of Vermont, Burlington, VT, United States
| | - D G Gee
- Yale University, New Haven, CT, United States
| | - M D Glantz
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - P Glaser
- Washington University, St. Louis, MO, United States
| | - M R Gonzalez
- Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - K M Gray
- Medical University of South Carolina, Charleston, SC, United States
| | - S Grant
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - F Haist
- University of California, San Diego, CA, United States
| | - S Hawes
- Florida International University, Miami, FL, United States
| | - S G Heeringa
- University of Michigan, Ann Arbor, MI, United States
| | - R Hermosillo
- Oregon Health & Science University, Portland, OR, United States
| | - M M Herting
- University of Southern California, Los Angeles, CA, United States
| | - J M Hettema
- Virginia Commonwealth University, Richmond, VA, United States
| | - J K Hewitt
- University of Colorado Boulder, CO, United States
| | - C Heyser
- University of California, San Diego, CA, United States
| | - E A Hoffman
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - K D Howlett
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - R S Huber
- University of Utah, Salt Lake City, UT, United States
| | - M A Huestis
- University of California, San Diego, CA, United States; Thomas Jefferson University, Philadelphia, PA, United States
| | - L W Hyde
- University of Michigan, Ann Arbor, MI, United States
| | - W G Iacono
- University of Minnesota, Minneapolis, MN, United States
| | - A Isaiah
- University of Maryland School of Medicine, Baltimore, MD, United States
| | - M Y Ivanova
- University of Vermont, Burlington, VT, United States
| | - R S James
- American Psychistric Association, United States
| | - T L Jernigan
- University of California, San Diego, CA, United States
| | - N R Karcher
- Washington University, St. Louis, MO, United States
| | - J M Kuperman
- University of California, San Diego, CA, United States
| | - A R Laird
- Florida International University, Miami, FL, United States
| | - C L Larson
- University of Wisconsin, Milwaukee, WI, United States
| | - K H LeBlanc
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - M F Lopez
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - M Luciana
- University of Minnesota, Minneapolis, MN, United States
| | - B Luna
- University of Pittsburgh, Pittsburgh, PA, United States
| | - H H Maes
- Virginia Commonwealth University, Richmond, VA, United States
| | - A T Marshall
- Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - M J Mason
- University of Tennessee, Knoxville, TN, United States
| | - E McGlade
- University of Utah, Salt Lake City, UT, United States
| | - A S Morris
- Laureate Institute for Brain Research, Tulsa, OK, United States; Oklahoma State University, Stillwater, OK, United States
| | - C Mulford
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - B J Nagel
- Oregon Health & Science University, Portland, OR, United States
| | - G Neigh
- Virginia Commonwealth University, Richmond, VA, United States
| | - C E Palmer
- University of California, San Diego, CA, United States
| | - M P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - D Pecheva
- University of California, San Diego, CA, United States
| | - D Prouty
- SRI International, Menlo Park, CA, United States
| | - A Potter
- University of Vermont, Burlington, VT, United States
| | - L I Puttler
- University of Michigan, Ann Arbor, MI, United States
| | - N Rajapakse
- National Institute of Minority Health and Health Disparities, Bethesda, MD, United States
| | - J M Ross
- University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - M Sanchez
- Florida International University, Miami, FL, United States
| | - C Schirda
- University of Pittsburgh, Pittsburgh, PA, United States
| | - J Schulenberg
- University of Michigan, Ann Arbor, MI, United States
| | - C Sheth
- University of Utah, Salt Lake City, UT, United States
| | - P D Shilling
- University of California, San Diego, CA, United States
| | - E R Sowell
- Children’s Hospital Los Angeles, Los Angeles, CA, United States
| | - N Speer
- University of Colorado Boulder, CO, United States
| | - L Squeglia
- Medical University of South Carolina, Charleston, SC, United States
| | - C Sripada
- University of Michigan, Ann Arbor, MI, United States
| | - J Steinberg
- Virginia Commonwealth University, Richmond, VA, United States
| | - M T Sutherland
- Florida International University, Miami, FL, United States
| | - R Tomko
- Medical University of South Carolina, Charleston, SC, United States
| | - K Uban
- University of California, Irvine, CA, United States
| | - S Vrieze
- University of Minnesota, Minneapolis, MN, United States
| | - S R B Weiss
- National Institute on Drug Abuse, NIH, Bethesda, MD, United States
| | - D Wing
- University of California, San Diego, CA, United States
| | | | - R A Zucker
- University of Michigan, Ann Arbor, MI, United States
| | | | | |
Collapse
|
38
|
Brown SA, Yang EH, Reza N, Guha A, Ismail-Khan R, Pemmaraju N, Fradley MG, Lopez-Mattei J. #JACCCardioOnc: Evolution of a Dedicated Social Media Strategy for JACC: CardioOncology. JACC CardioOncol 2021; 3:461-464. [PMID: 34604810 PMCID: PMC8463728 DOI: 10.1016/j.jaccao.2021.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Eric H. Yang
- UCLA Cardio-Oncology Program, Division of Cardiology, Department of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Nosheen Reza
- Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Avirup Guha
- Harrington Heart and Vascular Institute, Case Western Reserve University, Cleveland, Ohio, USA
| | - Roohi Ismail-Khan
- Cardio-Oncology Program, H. Lee Moffitt Cancer Center and University of South Florida, Tampa, Florida, USA
| | - Naveen Pemmaraju
- Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michael G. Fradley
- CardioOncology Center of Excellence, Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Juan Lopez-Mattei
- Departments of Cardiology and Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| |
Collapse
|
39
|
Brown SA, Campbell C, Fradley M, Volgman AS. Social media for cardiovascular journals: State of the art review. Am Heart J Plus 2021; 8:100041. [PMID: 34604825 PMCID: PMC8486169 DOI: 10.1016/j.ahjo.2021.100041] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 07/27/2021] [Indexed: 12/02/2022]
Abstract
In cardiovascular (CV) medicine, the use of social media (SoMe) has increased the dissemination of scientific knowledge, including the sharing of scientific journal articles. With the rapid growth of online methods for communicating scientific research, the critical question is whether online attention correlates with citations in academic journal articles. Traditionally, the performance of a scientific journal article has been determined by the number of times it has been cited. The impact factor and the number of citations in peer-reviewed journals are widely accepted measures of scientific impact. Social media platforms such as Twitter (Twitter.com) enable the development of novel article- or journal-level metrics for assessing effect and influence. Indeed, "alternative metrics" for journal article impact have been proposed, with the most frequently used being the Altmetric Attention Score (AAS; Altmetric.com). The relationship between these new metrics and established indicators such as citations has not been thoroughly investigated. We summarize numerous studies investigating associations between social media posts about journal articles and journal article citations. We then describe our own journal's social media strategy in light of these findings.
Collapse
Affiliation(s)
- Sherry-Ann Brown
- Division of Cardiovascular Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Courtney Campbell
- Cardio-Oncology Center of Excellence, Washington University in St. Louis, St. Louis, MO, USA
- Cardio-Oncology Program, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Michael Fradley
- CardioOncology Center of Excellence, Division of Cardiovascular Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | | |
Collapse
|
40
|
de Boer RA, Aboumsallem JP, Bracun V, Leedy D, Cheng R, Patel S, Rayan D, Zaharova S, Rymer J, Kwan JM, Levenson J, Ronco C, Thavendiranathan P, Brown SA. A new classification of cardio-oncology syndromes. Cardiooncology 2021; 7:24. [PMID: 34154667 PMCID: PMC8218489 DOI: 10.1186/s40959-021-00110-1] [Citation(s) in RCA: 11] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/30/2021] [Indexed: 12/21/2022]
Abstract
Increasing evidence suggests a multifaceted relationship exists between cancer and cardiovascular disease (CVD). Here, we introduce a 5-tier classification system to categorize cardio-oncology syndromes (COS) that represent the aspects of the relationship between cancer and CVD. COS Type I is characterized by mechanisms whereby the abrupt onset or progression of cancer can lead to cardiovascular dysfunction. COS Type II includes the mechanisms by which cancer therapies can result in acute or chronic CVD. COS Type III is characterized by the pro-oncogenic environment created by the release of cardiokines and high oxidative stress in patients with cardiovascular dysfunction. COS Type IV is comprised of CVD therapies and diagnostic procedures which have been associated with promoting or unmasking cancer. COS Type V is characterized by factors causing systemic and genetic predisposition to both CVD and cancer. The development of this framework may allow for an increased facilitation of cancer care while optimizing cardiovascular health through focused treatment targeting the COS type.
Collapse
Affiliation(s)
- Rudolf A de Boer
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Joseph Pierre Aboumsallem
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Valentina Bracun
- Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Douglas Leedy
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Richard Cheng
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Sahishnu Patel
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - David Rayan
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Svetlana Zaharova
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA
| | | | - Jennifer M Kwan
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Joshua Levenson
- Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Claudio Ronco
- Department of Medicine, University of Padova, Padova, Italy.,International Renal Research Institute of Vicenza, Vicenza, Italy.,Department of Nephrology, San Bortolo Hospital, Vicenza, Italy
| | | | - Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
| |
Collapse
|
41
|
Kwok CS, Wong CW, Kontopantelis E, Barac A, Brown SA, Velagapudi P, Hilliard AA, Bharadwaj AS, Chadi Alraies M, Mohamed M, Bhatt DL, Mamas MA. Percutaneous coronary intervention in patients with cancer and readmissions within 90 days for acute myocardial infarction and bleeding in the USA. Eur Heart J 2021; 42:1019-1034. [PMID: 33681960 DOI: 10.1093/eurheartj/ehaa1032] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [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: 12/19/2019] [Revised: 04/13/2020] [Accepted: 12/14/2020] [Indexed: 01/04/2023] Open
Abstract
AIMS The post-discharge outcomes of patients with cancer who undergo PCI are not well understood. This study evaluates the rates of readmissions within 90 days for acute myocardial infarction (AMI) and bleeding among patients with cancer who undergo percutaneous coronary intervention (PCI). METHODS AND RESULTS Patients treated with PCI in the years from 2010 to 2014 in the US Nationwide Readmission Database were evaluated for the influence of cancer on 90-day readmissions for AMI and bleeding. A total of 1 933 324 patients were included in the analysis (2.7% active cancer, 6.8% previous history of cancer). The 90-day readmission for AMI after PCI was higher in patients with active cancer (12.1% in lung, 10.8% in colon, 7.5% in breast, 7.0% in prostate, and 9.1% for all cancers) compared to 5.6% among patients with no cancer. The 90-day readmission for bleeding after PCI was higher in patients with active cancer (4.2% in colon, 1.5% in lung, 1.4% in prostate, 0.6% in breast, and 1.6% in all cancer) compared to 0.6% among patients with no cancer. The average time to AMI readmission ranged from 26.7 days for lung cancer to 30.5 days in colon cancer, while the average time to bleeding readmission had a higher range from 38.2 days in colon cancer to 42.7 days in breast cancer. CONCLUSIONS Following PCI, patients with cancer have increased risk for readmissions for AMI or bleeding, with the magnitude of risk depending on both cancer type and the presence of metastasis.
Collapse
Affiliation(s)
- Chun Shing Kwok
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, UK.,Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Chun Wai Wong
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, UK
| | - Evangelos Kontopantelis
- Division of Population Health, Health Services Research and Primary Care, University of Manchester, UK
| | - Ana Barac
- Department of Cardiology, MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington DC, USA
| | - Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Poonam Velagapudi
- Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Anthony A Hilliard
- Department of Medicine, Division of Cardiology, Linda University School of Medicine, Loma Linda, CA, USA
| | - Aditya S Bharadwaj
- Department of Medicine, Division of Cardiology, Linda University School of Medicine, Loma Linda, CA, USA
| | - M Chadi Alraies
- Department of Cardiology, Wayne State University, Detroit Medical Center, Detroit Heart Hospital, MI, USA
| | - Mohamed Mohamed
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, UK.,Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| | - Deepak L Bhatt
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute for Primary Care and Health Sciences, Keele University, Stoke-on-Trent, UK.,Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK
| |
Collapse
|
42
|
Batra A, Patel B, Addison D, Baldassarre L, Desai N, Weintraub N, Deswal A, Hussain Z, Brown SA, Ganatra S, Agarwala V, Parikh P, Fradley M, Ghosh A, Guha A. CARDIOVASCULAR SAFETY PROFILE OF TAXANES AND VINCA ALKALOIDS: 30-YEARS FDA REGISTRY EXPERIENCE. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)04638-6] [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]
|
43
|
Sadler D, Arnold A, Herrmann J, Daniele A, Silva CMPDC, Ghosh AK, Szmit S, Khan RI, Raez L, Blaes A, Brown SA. Reaching Across the Aisle: Cardio-Oncology Advocacy and Program Building. Curr Oncol Rep 2021; 23:64. [PMID: 33855620 PMCID: PMC8045572 DOI: 10.1007/s11912-021-01059-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2021] [Indexed: 11/30/2022]
Abstract
Purpose of Review This study aims to assess the current state of cardio-oncology in reference to advocacy efforts, access to care, and perspective of stakeholders in their ability to provide patient care as well as development of “across the aisle” synergy among cardiologists and oncologists and academic and non-academic centers in various worldwide locations. Recent Findings During the last decade, there has been a significant and diverse growth in cardio-oncology. We reviewed the experience from cardiologists and oncologists across different healthcare systems, the global trends, the role of collaborative networks, and the importance of advocacy efforts. Summary Cardio-oncology will continue to grow, but there is an unmet need to increase awareness, improve education, and expand access to care to larger segments of the cancer population in order to have a more significant impact on their health. The growing collaboration through professional societies and collaborative networks provides an opportunity to advance the cardiovascular care of cancer patients to meet the projected needs in a growing and more diverse population.
Collapse
Affiliation(s)
- Diego Sadler
- Heart and Vascular Center, Cleveland Clinic Florida, Weston, FL, USA.
| | - Anita Arnold
- Lee Health, Florida State University, Ft. Myers, FL, USA
| | - Joerg Herrmann
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Andres Daniele
- Angel H. Roffo Institute of the University of Buenos Aires, Buenos Aires, Argentina
| | | | - Arjun K Ghosh
- Barts Heart Centre, St. Bartholomew's Hospital and University College London's Hospital, London, UK
| | | | - Roohi Ismail Khan
- H. Lee Moffitt Cancer Center & Research Institute, University of South Florida, Tampa, FL, USA
| | - Luis Raez
- Memorial Health Care, Florida International University, Miami, FL, USA
| | - Anne Blaes
- University of Minnesota, Minneapolis, MN, USA
| | | |
Collapse
|
44
|
Cain MT, Smith NJ, Barash M, Simpson P, Durham LA, Makker H, Roberts C, Falcucci O, Wang D, Walker R, Ahmed G, Brown SA, Nanchal RS, Joyce DL. Extracorporeal Membrane Oxygenation with Right Ventricular Assist Device for COVID-19 ARDS. J Surg Res 2021; 264:81-89. [PMID: 33789179 PMCID: PMC7969863 DOI: 10.1016/j.jss.2021.03.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/02/2021] [Accepted: 03/10/2021] [Indexed: 01/08/2023]
Abstract
Background: Right ventricular failure is an underrecognized consequence of COVID-19 pneumonia. Those with severe disease are treated with extracorporeal membrane oxygenation (ECMO) but with poor outcomes. Concomitant right ventricular assist device (RVAD) may be beneficial. Methods: A retrospective analysis of intensive care unit patients admitted with COVID-19 ARDS (Acute Respiratory Distress Syndrome) was performed. Nonintubated patients, those with acute kidney injury, and age > 75 were excluded. Patients who underwent RVAD/ECMO support were compared with those managed via invasive mechanical ventilation (IMV) alone. The primary outcome was in-hospital mortality. Secondary outcomes included 30-d mortality, acute kidney injury, length of ICU stay, and duration of mechanical ventilation. Results: A total of 145 patients were admitted to the ICU with COVID-19. Thirty-nine patients met inclusion criteria. Of these, 21 received IMV, and 18 received RVAD/ECMO. In-hospital (52.4 versus 11.1%, P = 0.008) and 30-d mortality (42.9 versus 5.6%, P= 0.011) were significantly lower in patients treated with RVAD/ECMO. Acute kidney injury occurred in 15 (71.4%) patients in the IMV group and zero RVAD/ECMO patients (P< 0.001). ICU (11.5 versus 21 d, P= 0.067) and hospital (14 versus 25.5 d, P = 0.054) length of stay were not significantly different. There were no RVAD/ECMO device complications. The duration of mechanical ventilation was not significantly different (10 versus 5 d, P = 0.44). Conclusions: RVAD support at the time of ECMO initiation resulted in the no secondary end-organ damage and higher in-hospital and 30-d survival versus IMV in specially selected patients with severe COVID-19 ARDS. Management of severe COVID-19 ARDS should prioritize right ventricular support.
Collapse
Affiliation(s)
- Michael T Cain
- Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Nathan J Smith
- Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - Mark Barash
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Pippa Simpson
- Department of Pediatrics, Division of Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Lucian A Durham
- Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Hemanckur Makker
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Christopher Roberts
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Octavio Falcucci
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Dong Wang
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Rebekah Walker
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin; Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Gulrayz Ahmed
- Department of Medicine, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Rahul S Nanchal
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - David L Joyce
- Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
| |
Collapse
|
45
|
Abstract
PURPOSE OF REVIEW Cancer and heart disease are the leading causes of mortality in the USA. Advances in cancer therapies, namely, the development and use of chemotherapeutic agents alone or in combination, are becoming increasingly prevalent. RECENT FINDINGS Many chemotherapeutic agents have been associated with adverse cardiovascular manifestations. The mechanisms of these sequelae remain incompletely understood. In particular, microtubule inhibitor (MTI) agents have been related to the development of heart failure, myocardial ischemia, and conduction abnormalities. At present, there are no guidelines for patients undergoing MTI therapy as it pertains to both preventative and mitigatory strategies for cardiovascular complications. We conducted a literature review focusing on content related to the use of MTIs and their effect on the cardiovascular system. MTIs have been associated with various forms of cardiotoxicity, and fatal cardiotoxicities are rare. The most well-described cardiotoxicities are brady- and tachyarrhythmias. The co-administration of anthracycline-based agents with MTIs can increase the risk of cardiotoxicity.
Collapse
Affiliation(s)
- Amogh M Joshi
- Department of Internal Medicine, Lehigh Valley Health Network, Allentown, PA, USA
| | - George S Prousi
- Department of Cardiology, University of South Carolina, Columbia, SC, USA
| | - Christopher Bianco
- Heart and Vascular Institute, West Virginia University, 1 Medical Center Dr., Morgantown, WV, 26505, USA
| | - Midhun Malla
- Hematology and Oncology, West Virginia University, Morgantown, WV, USA
| | - Avirup Guha
- Department of Cardiology, Case Western University, Cleveland, OH, USA
| | - Mahek Shah
- Department of Cardiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Sherry-Ann Brown
- Cardio-Oncology Program, Department of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Brijesh Patel
- Heart and Vascular Institute, West Virginia University, 1 Medical Center Dr., Morgantown, WV, 26505, USA.
| |
Collapse
|
46
|
Affiliation(s)
- Carmen Bergom
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri
| | - David Rayan
- Division of Internal Medicine, Medical College of Wisconsin, Milwaukee
| | - Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee
| |
Collapse
|
47
|
Brown SA, Patel S, Rayan D, Zaharova S, Lin M, Nafee T, Sunkara B, Maddula R, MacLeod J, Doshi K, Meskin J, Marks D, Saucedo J. A virtual-hybrid approach to launching a cardio-oncology clinic during a pandemic. Cardiooncology 2021; 7:2. [PMID: 33441188 PMCID: PMC7803880 DOI: 10.1186/s40959-020-00088-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Received: 10/06/2020] [Accepted: 12/08/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND As cardiovascular disease is a leading cause of death in cancer survivors, the new subspecialty of Cardio-Oncology has emerged to address prevention, monitoring, and management of cardiovascular toxicities to cancer therapies. During the coronavirus disease of 2019 (COVID-19) pandemic, we developed a Virtual-Hybrid Approach to build a de novo Cardio-Oncology Clinic. METHODS We conceptualized a Virtual-Hybrid Approach including three arms: information seeking in locations with existing Cardio-Oncology clinics, information gathering at the location for a new clinic, and information sharing to report clinic-building outcomes. A retrospective review of outcomes included collection and synthesis of data from our first 3 months (at pandemic peak) on types of appointments, cancers, drugs, and cardiotoxicities. Data were presented using descriptive statistics. RESULTS A de-novo Cardio-Oncology clinic was developed structured from the ground up to integrate virtual and in-person care in a hybrid and innovative model, using the three arms of the Virtual-Hybrid Approach. First, we garnered in-person and virtual preparation through hands-on experiences, training, and discussions in existing Cardio-Oncology Clinics and conferences. Next, we gleaned information through virtual inquiry and niche-building. With partners throughout the institution, a virtual referral process was established for outpatient referrals and inpatient e-consult referrals to actualize a hybrid care spectrum for our patients administered by a multidisciplinary hybrid care team of clinicians, ancillary support staff, and clinical pharmacists. Among the multi-subspecialty clinic sessions, approximately 50% were in Cardio-Oncology, 20% in Preventive Cardiology, and 30% in General Cardiology. In the hybrid model, the Heart & Vascular Center had started to re-open, allowing for 65% of our visits to be in person. In additional analyses, the most frequent cardiovascular diagnosis was cardiomyopathy (34%), the most common cancer drug leading to referral was trastuzumab (29%), and the most prevalent cancer type was breast cancer (42%). CONCLUSION This Virtual-Hybrid Approach and retrospective review provides guidance and information regarding initiating a brand-new Cardio-Oncology Clinic during the pandemic for cancer patients/survivors. This report also furnishes virtual resources for patients, virtual tools for oncologists, cardiologists, and administrators tasked with starting new clinics during the pandemic, and innovative future directions for this digital pandemic to post-pandemic era.
Collapse
Affiliation(s)
- Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, 8701 W Watertown Plank Road, Wauwatosa, WI, 53226, USA.
| | - Sahishnu Patel
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - David Rayan
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Svetlana Zaharova
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, 8701 W Watertown Plank Road, Wauwatosa, WI, 53226, USA
| | - Mingqian Lin
- Medical College of Wisconsin, Milwaukee, WI, USA
| | - Tarek Nafee
- Department of Medicine, Roger Williams Medical Center, Boston University School of Medicine, Providence, RI, USA
| | - Bipin Sunkara
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | | | | | - Joshua Meskin
- Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - David Marks
- Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jorge Saucedo
- Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| |
Collapse
|
48
|
Iacopo F, Branch M, Cardinale D, Middeldorp M, Sanders P, Cohen JB, Achirica MC, Jaiswal S, Brown SA. Preventive Cardio-Oncology: Cardiovascular Disease Prevention in Cancer Patients and Survivors. Curr Treat Options Cardio Med 2021. [DOI: 10.1007/s11936-020-00883-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
49
|
Kwan JM, Henry ML, Christophers B, Tamirisa K, Thamman R, Sadler D, Aggarwal NR, Cheng R, Parwani P, Dent S, Ismail-Khan R, Fradley MG, Brown SA. The Role and Impact of Social Media in Cardio-oncology During the COVID-19 Pandemic. Curr Oncol Rep 2021; 23:99. [PMID: 34259950 PMCID: PMC8278372 DOI: 10.1007/s11912-021-01081-3] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW To give an overview of the role of social media (SoMe) in cardio-oncology during the COVID-19 pandemic. RECENT FINDINGS SoMe has been critical in fostering education, outreach, awareness, collaboration, dissemination of information, and advocacy in cardio-oncology. This has become increasingly evident during the COVID-19 pandemic, during which SoMe has helped share best practices, community, and research focused on the impact of COVID-19 in cardiology and hematology/oncology, with cardio-oncology at the interface of these two subspecialty fields. A strength of SoMe is the ability to amplify a message in real-time, globally, with minimal investment of resources. This has been particularly beneficial for the emerging field of cardio-hematology/cardio-oncology, a field focused on the interplay of cancer and cardiovascular disease. SoMe field especially during the COVID-19 pandemic. We illustrate how social media has supported innovation (including telemedicine), amplification of healthcare workers' voice, and illumination of pre-existing and continued health disparities within the field of cardio-oncology during the pandemic.
Collapse
Affiliation(s)
- Jennifer M Kwan
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | - Briana Christophers
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD program, New York, NY, USA
| | | | | | | | - Niti R Aggarwal
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Richard Cheng
- Division of Cardiology, University of Washington, Seattle, WA, USA
| | | | - Susan Dent
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Roohi Ismail-Khan
- Cardio-Oncology Program, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL, USA
| | - Michael G Fradley
- Cardio-Oncology Center of Excellence, Division of Cardiology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
| |
Collapse
|
50
|
Tuzovic M, Brown SA, Yang EH, West BH, Bassi NS, Park S, Guha A, Ghosh AK, Ganatra S, Hayek SS, Moslehi J, Jahangir E. Implementation of Cardio-Oncology Training for Cardiology Fellows. JACC CardioOncol 2020; 2:795-799. [PMID: 34396296 PMCID: PMC8352041 DOI: 10.1016/j.jaccao.2020.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Mirela Tuzovic
- Division of Cardiovascular Medicine, Department of Medicine, Stanford Medical Center, Stanford, California, USA
| | - Sherry-Ann Brown
- Cardio-oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Eric H Yang
- University of California Los Angeles Cardio-oncology Program, Division of Cardiology, Department of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Brian H West
- Division of Cardiovascular Medicine, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California, USA
| | - Nikhil S Bassi
- University of California Los Angeles Cardio-oncology Program, Division of Cardiology, Department of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Sandy Park
- University of California Los Angeles Cardio-oncology Program, Division of Cardiology, Department of Medicine, University of California at Los Angeles, Los Angeles, California, USA
| | - Avirup Guha
- Cardio-oncology Program, Division of Cardiology, Department of Medicine, The Ohio State University, Columbus, Ohio, USA.,Harrington Heart and Vascular Institute, Case Western Reserve University, Cleveland, Ohio, USA
| | - Arjun K Ghosh
- Cardio-oncology Services, Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom.,University College London Hospital, London, United Kingdom.,Hatter Cardiovascular Institute, University College London, London, United Kingdom
| | - Sarju Ganatra
- Cardio-Oncology Program, Landsman Heart and Vascular Center, Division of Cardiology, Department of Medicine, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA
| | - Salim S Hayek
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Javid Moslehi
- Cardio-oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Eiman Jahangir
- Cardio-oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|