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Stinis CT, Abbas AE, Teirstein P, Makkar RR, Chung CJ, Iyer V, Généreux P, Kipperman RM, Harrison JK, Hughes GC, Lyons JM, Rahman A, Kakouros N, Walker J, Roberts DK, Huang PH, Kar B, Dhoble A, Logsdon DP, Khanna PK, Aragon J, McCabe JM. Real-World Outcomes for the Fifth-Generation Balloon Expandable Transcatheter Heart Valve in the United States. JACC Cardiovasc Interv 2024; 17:1032-1044. [PMID: 38456883 DOI: 10.1016/j.jcin.2024.02.015] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/14/2024] [Accepted: 02/14/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND The fifth-generation SAPIEN 3 Ultra Resilia valve (S3UR) incorporates several design changes as compared with its predecessors, the SAPIEN 3 (S3) and SAPIEN 3 Ultra (S3U) valves, including bovine leaflets treated with a novel process intended to reduce structural valve deterioration via calcification, as well as a taller external skirt on the 29-mm valve size to reduce paravalvular leak (PVL). The clinical performance of S3UR compared with S3 and S3U in a large patient population has not been previously reported. OBJECTIVES The aim of this study was to compare S3UR to S3/S3U for procedural, in-hospital, and 30-day clinical and echocardiographic outcomes after transcatheter aortic valve replacement (TAVR). METHODS Patients enrolled in the STS/ACC TVT (Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy) Registry between January 1, 2021, and June 30, 2023, who underwent TAVR with S3UR or S3U/S3 valve platforms were propensity-matched and evaluated for procedural, in-hospital, and 30-day clinical and echocardiographic outcomes. RESULTS 10,314 S3UR patients were propensity matched with 10,314 patients among 150,539 S3U/S3 patients. At 30 days, there were no statistically significant differences in death, stroke, or bleeding, but a numerically higher hospital readmission rate in the S3UR cohort (8.5% vs 7.7%; P = 0.04). At discharge, S3UR patients exhibited significantly lower mean gradients (9.2 ± 4.6 mm Hg vs 12.0 ± 5.7 mm Hg; P < 0.0001) and larger aortic valve area (2.1 ± 0.7 cm2 vs 1.9 ± 0.6 cm2; P < 0.0001) than patients treated with S3/S3U. The 29-mm valve size exhibited significant reduction in mild PVL (5.3% vs 9.4%; P < 0.0001). CONCLUSIONS S3UR TAVR is associated with lower mean gradients and lower rates of PVL than earlier generations of balloon expandable transcatheter heart valve platforms.
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Affiliation(s)
- Curtiss T Stinis
- Division of Cardiology, Scripps Clinic, La Jolla, California, USA.
| | - Amr E Abbas
- Corewell Health East, William Beaumont University Hospital, Royal Oak, Michigan, USA
| | - Paul Teirstein
- Division of Cardiology, Scripps Clinic, La Jolla, California, USA
| | - Raj R Makkar
- Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Christine J Chung
- University of Washington Medical Center, Department of Medicine, Division of Cardiology, Seattle, Washington, USA
| | - Vijay Iyer
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, New York, USA
| | - Philippe Généreux
- Gagnon Cardiovascular Institute at Morristown Medical Center, Morristown, New Jersey, USA
| | - Robert M Kipperman
- Atlantic Health System Morristown Medical Center, Morristown, New Jersey, USA
| | - John K Harrison
- Division of Cardiology, Department of Medicine, Duke University Hospital, Durham, North Carolina, USA
| | - G Chad Hughes
- Division of Cardiology, Department of Medicine, Duke University Hospital, Durham, North Carolina, USA
| | | | - Ayaz Rahman
- Cardiology Associates of East Tennessee, Knoxville, Tennessee, USA
| | - Nikolaos Kakouros
- Division of Cardiology, University of Massachusetts School of Medicine, Worcester, MA, USA
| | - Jennifer Walker
- Department of Medicine, Division of Cardiology, University of North Carolina at Chapel Hill, North Carolina, USA
| | | | | | - Biswajit Kar
- Division of Cardiology, Department of Internal Medicine, University of Texas Health Science Center, Houston, Texas, USA
| | - Abhijeet Dhoble
- Division of Cardiology, Department of Internal Medicine, University of Texas Health Science Center, Houston, Texas, USA
| | | | | | - Joseph Aragon
- Santa Barbara Cottage Hospital, Santa Barbara, California, USA
| | - James M McCabe
- Division of Cardiology, University of Washington Medical Center, Seattle, Washington, USA
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Kapadia SR, Krishnaswamy A, Whisenant B, Potluri S, Iyer V, Aragon J, Gideon P, Strote J, Leonardi R, Agarwal H, Larrain G, Sanchez C, Panaich SS, Harvey J, Vahl T, Menon V, Wolski K, Wang Q, Leon MB. Concomitant Left Atrial Appendage Occlusion and Transcatheter Aortic Valve Replacement Among Patients With Atrial Fibrillation. Circulation 2024; 149:734-743. [PMID: 37874908 DOI: 10.1161/circulationaha.123.067312] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 10/19/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) is common in patients undergoing transcatheter aortic valve replacement (TAVR) and is associated with increased risk of bleeding and stroke. While left atrial appendage occlusion (LAAO) is approved as an alternative to anticoagulants for stroke prevention in patients with AF, placement of these devices in patients with severe aortic stenosis, or when performed at the same time as TAVR, has not been extensively studied. METHODS WATCH-TAVR (WATCHMAN for Patients with AF Undergoing TAVR) was a multicenter, randomized trial evaluating the safety and effectiveness of concomitant TAVR and LAAO with WATCHMAN in AF patients. Patients were randomized 1:1 to TAVR + LAAO or TAVR + medical therapy. WATCHMAN patients received anticoagulation for 45 days followed by dual antiplatelet therapy until 6 months. Anticoagulation was per treating physician preference for patients randomized to TAVR + medical therapy. The primary noninferiority end point was all-cause mortality, stroke, and major bleeding at 2 years between the 2 strategies. RESULTS The study enrolled 349 patients (177 TAVR + LAAO and 172 TAVR + medical therapy) between December 2017 and November 2020 at 34 US centers. The mean age of patients was 81 years, and the mean scores for CHA2DS2-VASc and HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile INR, Elderly, Drugs/alcohol concomitantly) were 4.9 and 3.0, respectively. At baseline, 85.4% of patients were taking anticoagulants and 71.3% patients were on antiplatelet therapy. The cohorts were well-balanced for baseline characteristics. The incremental LAAO procedure time was 38 minutes, and the median contrast volume used for combined procedures was 119 mL versus 70 mL with TAVR alone. At the 24-month follow-up, 82.5% compared with 50.8% of patients were on any antiplatelet therapy, and 13.9% compared with 66.7% of patients were on any anticoagulation therapy in TAVR + LAAO compared with TAVR + medical therapy group, respectively. For the composite primary end point, TAVR + LAAO was noninferior to TAVR + medical therapy (22.7 versus 27.3 events per 100 patient-years for TAVR + LAAO and TAVR + medical therapy, respectively; hazard ratio, 0.86 [95% CI, 0.60-1.22]; Pnoninferiority<0.001). CONCLUSIONS Concomitant WATCHMAN LAAO and TAVR is noninferior to TAVR with medical therapy in severe aortic stenosis patients with AF. The increased complexity and risks of the combined procedure should be considered when concomitant LAAO is viewed as an alternative to medical therapy for patients with AF undergoing TAVR. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT03173534.
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Affiliation(s)
- Samir R Kapadia
- Cleveland Clinic, Cleveland, OH (S.R.K., A.K., V.M., K.W., Q.W.)
| | | | | | | | | | | | - Philip Gideon
- Banner University Medical Center, Phoenix, AZ (P.G.)
| | | | - Robert Leonardi
- Lexington Medical Heart and Vascular Center, West Columbia, SC (R.L.)
| | | | | | | | | | | | - Torsten Vahl
- Columbia University Medical Center, New York, NY (T.V., M.B.L.)
| | - Venu Menon
- Cleveland Clinic, Cleveland, OH (S.R.K., A.K., V.M., K.W., Q.W.)
| | - Kathy Wolski
- Cleveland Clinic, Cleveland, OH (S.R.K., A.K., V.M., K.W., Q.W.)
| | - Qiuqing Wang
- Cleveland Clinic, Cleveland, OH (S.R.K., A.K., V.M., K.W., Q.W.)
| | - Martin B Leon
- Columbia University Medical Center, New York, NY (T.V., M.B.L.)
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Iyer V, Faza NN, Pfeiffer M, Kozak M, Peterson B, Wyler von Ballmoos M, Mollenkopf S, Mancilla M, Latibeaudiere-Gardner D, Reardon MJ. Understanding Treatment Preferences for Patients with Tricuspid Regurgitation. MDM Policy Pract 2024; 9:23814683231225667. [PMID: 38250668 PMCID: PMC10798093 DOI: 10.1177/23814683231225667] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/14/2023] [Indexed: 01/23/2024] Open
Abstract
Background. Tricuspid regurgitation (TR) is a high-prevalence disease associated with poor quality of life and mortality. This quantitative patient preference study aims to identify TR patients' perspectives on risk-benefit tradeoffs. Methods. A discrete-choice experiment was developed to explore TR treatment risk-benefit tradeoffs. Attributes (levels) tested were treatment (procedure, medical management), reintervention risk (0%, 1%, 5%, 10%), medications over 2 y (none, reduce, same, increase), shortness of breath (none/mild, moderate, severe), and swelling (never, 3× per week, daily). A mixed logit regression model estimated preferences and calculated predicted probabilities. Relative attribute importance was calculated. Subgroup analyses were performed. Results. An online survey was completed by 150 TR patients. Shortness of breath was the most important attribute and accounted for 65.8% of treatment decision making. The average patients' predicted probability of preferring a "procedure-like" profile over a "medical management-like" profile was 99.7%. This decreased to 78.9% for a level change from severe to moderate in shortness of breath in the "medical management-like" profile. Subgroup analysis confirmed that patients older than 64 y had a stronger preference to avoid severe shortness of breath compared with younger patients (P < 0.02), as did severe or worse TR patients relative to moderate. New York Heart Association class I/II patients more strongly preferred to avoid procedural reintervention risk relative to class III/IV patients (P < 0.03). Conclusion. TR patients are willing to accept higher procedural reintervention risk if shortness of breath is alleviated. This risk tolerance is higher for older and more symptomatic patients. These results emphasize the appropriateness of developing TR therapies and the importance of addressing symptom burden. Highlights This study provides quantitative patient preference data from clinically confirmed tricuspid regurgitation (TR) patients to understand their treatment preferences.Using a targeted literature search and patient, physician, and Food and Drug Administration feedback, a cross-sectional survey with a discrete-choice experiment that focused on 5 of the most important attributes to TR patients was developed and administered online.TR patients are willing to accept higher procedural reintervention risk if shortness of breath is alleviated, and this risk tolerance is higher for older and more symptomatic patients.
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Affiliation(s)
- Vijay Iyer
- Division of Cardiology, Buffalo General Medical Center, Buffalo, NY, USA
| | - Nadeen N. Faza
- Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX, USA
| | - Michael Pfeiffer
- Division of Cardiology, Penn State Heart and Vascular Institute, Hershey, PA, USA
| | - Mark Kozak
- Division of Cardiology, Penn State Heart and Vascular Institute, Hershey, PA, USA
| | - Brandon Peterson
- Division of Cardiology, Penn State Heart and Vascular Institute, Hershey, PA, USA
| | | | | | | | | | - Michael J. Reardon
- Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX, USA
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4
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Albakry MF, Alkhatib I, Alonso D, Amaral DWP, Aralis T, Aramaki T, Arnquist IJ, Ataee Langroudy I, Azadbakht E, Banik S, Bathurst C, Bhattacharyya R, Brink PL, Bunker R, Cabrera B, Calkins R, Cameron RA, Cartaro C, Cerdeño DG, Chang YY, Chaudhuri M, Chen R, Chott N, Cooley J, Coombes H, Corbett J, Cushman P, Das S, De Brienne F, Rios M, Dharani S, di Vacri ML, Diamond MD, Elwan M, Fascione E, Figueroa-Feliciano E, Fink CW, Fouts K, Fritts M, Gerbier G, Germond R, Ghaith M, Golwala SR, Hall J, Harms SAS, Hassan N, Hines BA, Hong Z, Hoppe EW, Hsu L, Huber ME, Iyer V, Kashyap VKS, Kelsey MH, Kubik A, Kurinsky NA, Lee M, Litke M, Liu J, Liu Y, Loer B, Lopez Asamar E, Lukens P, MacFarlane DB, Mahapatra R, Mast N, Mayer AJ, Meyer Zu Theenhausen H, Michaud É, Michielin E, Mirabolfathi N, Mohanty B, Nebolsky B, Nelson J, Neog H, Novati V, Orrell JL, Osborne MD, Oser SM, Page WA, Pandey L, Pandey S, Partridge R, Pedreros DS, Perna L, Podviianiuk R, Ponce F, Poudel S, Pradeep A, Pyle M, Rau W, Reid E, Ren R, Reynolds T, Tanner E, Roberts A, Robinson AE, Saab T, Sadek D, Sadoulet B, Sahoo SP, Saikia I, Sander J, Sattari A, Schmidt B, Schnee RW, Scorza S, Serfass B, Poudel SS, Sincavage DJ, Sinervo P, Speaks Z, Street J, Sun H, Terry GD, Thasrawala FK, Toback D, Underwood R, Verma S, Villano AN, von Krosigk B, Watkins SL, Wen O, Williams Z, Wilson MJ, Winchell J, Wykoff K, Yellin S, Young BA, Yu TC, Zatschler B, Zatschler S, Zaytsev A, Zeolla A, Zhang E, Zheng L, Zheng Y, Zuniga A, An P, Barbeau PS, Hedges SC, Li L, Runge J. First Measurement of the Nuclear-Recoil Ionization Yield in Silicon at 100 eV. Phys Rev Lett 2023; 131:091801. [PMID: 37721818 DOI: 10.1103/physrevlett.131.091801] [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] [Received: 03/21/2023] [Revised: 07/07/2023] [Accepted: 07/26/2023] [Indexed: 09/20/2023]
Abstract
We measured the nuclear-recoil ionization yield in silicon with a cryogenic phonon-sensitive gram-scale detector. Neutrons from a monoenergetic beam scatter off of the silicon nuclei at angles corresponding to energy depositions from 4 keV down to 100 eV, the lowest energy probed so far. The results show no sign of an ionization production threshold above 100 eV. These results call for further investigation of the ionization yield theory and a comprehensive determination of the detector response function at energies below the keV scale.
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Affiliation(s)
- M F Albakry
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - I Alkhatib
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - D Alonso
- Instituto de Física Teórica UAM/CSIC, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Instituto de Física Teórica UAM-CSIC, Campus de Cantoblanco, 28049 Madrid, Spain
| | - D W P Amaral
- Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
| | - T Aralis
- Division of Physics, Mathematics, & Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - T Aramaki
- Department of Physics, Northeastern University, 360 Huntington Avenue, Boston, Massachusetts 02115, USA
| | - I J Arnquist
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - I Ataee Langroudy
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - E Azadbakht
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - S Banik
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni - 752050, India
| | - C Bathurst
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - R Bhattacharyya
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - P L Brink
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - R Bunker
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - B Cabrera
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - R Calkins
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - R A Cameron
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - C Cartaro
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - D G Cerdeño
- Instituto de Física Teórica UAM/CSIC, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Instituto de Física Teórica UAM-CSIC, Campus de Cantoblanco, 28049 Madrid, Spain
| | - Y-Y Chang
- Division of Physics, Mathematics, & Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - M Chaudhuri
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni - 752050, India
| | - R Chen
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - N Chott
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - J Cooley
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - H Coombes
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - J Corbett
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - P Cushman
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - S Das
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni - 752050, India
| | - F De Brienne
- Département de Physique, Université de Montréal, Montréal, Québec H3C 3J7, Canada
| | - M Rios
- Instituto de Física Teórica UAM/CSIC, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Instituto de Física Teórica UAM-CSIC, Campus de Cantoblanco, 28049 Madrid, Spain
| | - S Dharani
- Institute for Astroparticle Physics (IAP), Karlsruhe Institute of Technology (KIT), 76344 Eggenstein-Leopoldshafen, Germany
- Institut für Experimentalphysik, Universität Hamburg, 22761 Hamburg, Germany
| | - M L di Vacri
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - M D Diamond
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - M Elwan
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - E Fascione
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - E Figueroa-Feliciano
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - C W Fink
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - K Fouts
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - M Fritts
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - G Gerbier
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - R Germond
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - M Ghaith
- College of Natural and Health Sciences, Zayed University, Dubai, 19282, United Arab Emirates
| | - S R Golwala
- Division of Physics, Mathematics, & Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - J Hall
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
- Laurentian University, Department of Physics, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - S A S Harms
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - N Hassan
- Département de Physique, Université de Montréal, Montréal, Québec H3C 3J7, Canada
| | - B A Hines
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
| | - Z Hong
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - E W Hoppe
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - L Hsu
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M E Huber
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
- Department of Electrical Engineering, University of Colorado Denver, Denver, Colorado 80217, USA
| | - V Iyer
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - V K S Kashyap
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni - 752050, India
| | - M H Kelsey
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - A Kubik
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - N A Kurinsky
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - M Lee
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - M Litke
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - J Liu
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - Y Liu
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - B Loer
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - E Lopez Asamar
- Instituto de Física Teórica UAM/CSIC, Universidad Autónoma de Madrid, 28049 Madrid, Spain
- Instituto de Física Teórica UAM-CSIC, Campus de Cantoblanco, 28049 Madrid, Spain
| | - P Lukens
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D B MacFarlane
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - R Mahapatra
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - N Mast
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - A J Mayer
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - H Meyer Zu Theenhausen
- Institute for Astroparticle Physics (IAP), Karlsruhe Institute of Technology (KIT), 76344 Eggenstein-Leopoldshafen, Germany
| | - É Michaud
- Département de Physique, Université de Montréal, Montréal, Québec H3C 3J7, Canada
| | - E Michielin
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - N Mirabolfathi
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - B Mohanty
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni - 752050, India
| | - B Nebolsky
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - J Nelson
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - H Neog
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - V Novati
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - J L Orrell
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - M D Osborne
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - S M Oser
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - W A Page
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - L Pandey
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - S Pandey
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - R Partridge
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - D S Pedreros
- Département de Physique, Université de Montréal, Montréal, Québec H3C 3J7, Canada
| | - L Perna
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - R Podviianiuk
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - F Ponce
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - S Poudel
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - A Pradeep
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - M Pyle
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - W Rau
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - E Reid
- Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
| | - R Ren
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - T Reynolds
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - E Tanner
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - A Roberts
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
| | - A E Robinson
- Département de Physique, Université de Montréal, Montréal, Québec H3C 3J7, Canada
| | - T Saab
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - D Sadek
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - B Sadoulet
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - S P Sahoo
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - I Saikia
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - J Sander
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - A Sattari
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - B Schmidt
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - R W Schnee
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - S Scorza
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
- Laurentian University, Department of Physics, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - B Serfass
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - S S Poudel
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - D J Sincavage
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - P Sinervo
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - Z Speaks
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - J Street
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - H Sun
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - G D Terry
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - F K Thasrawala
- Institut für Experimentalphysik, Universität Hamburg, 22761 Hamburg, Germany
| | - D Toback
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - R Underwood
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - S Verma
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - A N Villano
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
| | - B von Krosigk
- Institute for Astroparticle Physics (IAP), Karlsruhe Institute of Technology (KIT), 76344 Eggenstein-Leopoldshafen, Germany
| | - S L Watkins
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - O Wen
- Division of Physics, Mathematics, & Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - Z Williams
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - M J Wilson
- Institute for Astroparticle Physics (IAP), Karlsruhe Institute of Technology (KIT), 76344 Eggenstein-Leopoldshafen, Germany
| | - J Winchell
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - K Wykoff
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - S Yellin
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - B A Young
- Department of Physics, Santa Clara University, Santa Clara, California 95053, USA
| | - T C Yu
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - B Zatschler
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - S Zatschler
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - A Zaytsev
- Institute for Astroparticle Physics (IAP), Karlsruhe Institute of Technology (KIT), 76344 Eggenstein-Leopoldshafen, Germany
| | - A Zeolla
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - E Zhang
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - L Zheng
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - Y Zheng
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - A Zuniga
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - P An
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - P S Barbeau
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - S C Hedges
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - L Li
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
| | - J Runge
- Department of Physics, Duke University, Durham, North Carolina 27708, USA
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Baig A, Manion C, Khawar W, Donnelly B, Monteiro A, Iyer V, Levy EI, Siddiqui AH. 554 Cerebral Emboli Detection Using Robotic Transcranial Doppler With Artificial Intelligence During Transcatheter Aortic Valve Replacement - A Novel and Autonomous Neuromonitoring Tool. Neurosurgery 2023. [DOI: 10.1227/neu.0000000000002375_554] [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: 03/18/2023] Open
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Johal G, Jonnala V, Pourafkari L, Sedghi S, Jafarsis S, Fernandez S, Iyer V, Nader ND. Energy loss index as a predictor of all-cause mortality after transcatheter aortic valve replacement: A long-term follow-up. Echocardiography 2023; 40:327-334. [PMID: 36859692 DOI: 10.1111/echo.15545] [Citation(s) in RCA: 1] [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: 08/10/2022] [Revised: 01/21/2023] [Accepted: 02/06/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND As transcatheter aortic valve replacement (TAVR) procedures become more widely available, there is a growing need to monitor and evaluate postoperative outcomes accurately. The energy loss index (ELI) of the ascending aorta has been commonly used to examine the agreement between the echocardiographic and Gorlin measurement of the aortic valve area. OBJECTIVES This project aims to demonstrate a link between ELI values and mortality following implanted TAVR valves and determine an ELI cutoff value associated with post-TAVR events. METHOD We retrospectively reviewed patients undergoing TAVR from 2012 to 2017. We calculated ELI values for patients immediately postoperative after a TAVR procedure. Using Receiver-Operator Characteristic and Cox Regression analyses, we identified a cutoff value to distinguish between "High ELI" (≥ 1.34) and "Low ELI" (< 1.34) patients. RESULTS This study showed low ELI (hazard ratio, 2.30; 95% confidence interval 1.57-3.36, p < .001) as representative of patients with a high risk of mortality post-TAVR. Additionally, post-TAVR, ejection fraction increased by 3.6% (p < .001), and the aortic valve effective orifice area increased by 1.41 cm squared (p < .001) while the mean transvalvular gradient decreased by 32.8 mmHg (p < .001) and the peak transvalvular gradient decreased by 49.0 mmHg (p < .001). CONCLUSION ELI is an additional prognostic factor that should be considered during risk assessment before TAVR. This study shows that patients with Low ELI had decreased cumulative survival post-TAVR. These patients almost had a fivefold increased risk of death following TAVR.
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Affiliation(s)
- Gurkaran Johal
- Department of Anaesthesiology, University at Buffalo, Jacob's School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Vinesh Jonnala
- Department of Medicine, Rutgers University Newark, New Jersey, USA
| | - Leili Pourafkari
- Department of Anaesthesiology, University at Buffalo, Jacob's School of Medicine and Biomedical Sciences, Buffalo, New York, USA.,Cardiac Imaging, The Lundquist Institute, Harbor-UCLA, Medical Center, Torrance, California, USA
| | - Siavash Sedghi
- Department of Anaesthesiology, University at Buffalo, Jacob's School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Samira Jafarsis
- Department of Anaesthesiology, University at Buffalo, Jacob's School of Medicine and Biomedical Sciences, Buffalo, New York, USA.,Department of Medicine, Division of Cardiology, Jacob's School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Stanley Fernandez
- Department of Medicine, Division of Cardiology, Jacob's School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Vijay Iyer
- Department of Medicine, Division of Cardiology, Jacob's School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Nader D Nader
- Department of Anaesthesiology, University at Buffalo, Jacob's School of Medicine and Biomedical Sciences, Buffalo, New York, USA
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7
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Zafar MR, Sharma A, Sunder SS, Karthikeyan B, Nagahama M, Atia A, Bahuva R, Pokharel S, Iyer V, Kattel S, Sharma UC. Left atrial appendage volume as a prognostic Indicator of long-term mortality in Cancer survivors treated with thoracic radiation. Cardiooncology 2023; 9:2. [PMID: 36641509 PMCID: PMC9840329 DOI: 10.1186/s40959-023-00155-4] [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: 01/24/2022] [Accepted: 01/09/2023] [Indexed: 01/16/2023]
Abstract
BACKGROUND Cancer survivors with prior chest radiation therapy (CXRT) frequently present with atrial fibrillation, heart failure, and have higher overall long-term mortality. There are no data examining the utility of left atrial (LA) and LA appendage (LAA) volume-indices to predict clinical outcomes in these patients. OBJECTIVES We examined the prognostic value of cardiac phase-dependent 3-D volume-rendered cardiac computerized tomography (CT)-derived LA and LAA volume-indices to predict mortality and major adverse cardiac events (MACE) in cancer survivors treated with thoracic irradiation. METHOD We screened 625 consecutive patients with severe aortic stenosis who had undergone transcatheter aortic valve replacement from 2012 to 2017. Based on the gated cardiac CT image quality, we included 184 patients (CXRT:43, non-CXRT:141) for further analysis. We utilized multiplane-3D-reconstructed cardiac CT images to calculate LA and LAA volume-indices, and examined the prognostic role of CCT-derived LA and LAA volume-indices in predicting the all-cause mortality, cardiovascular (CV) mortality, and MACE. We used multivariate cox-proportional hazard analysis to identify the clinical predictors of survival. RESULTS Overall, the CXRT group had significantly elevated LAA volume-index compared to non-CXRT group (CXRT:11.2 ± 8.9 ml/m2; non-CXRT:8.6 ± 4.5 ml/m2, p = 0.03). On multivariate cox-proportional hazard analysis, the elevated LAA volume and LAA volume-index were the strongest predictors of reduced survival in CXRT group compared to non-CXRT group (LAA volume: RR = 1.03,95% CI 1.0-1.01, p = 0.01; and LAA volume index: RR = 1.05, 95% CI 1.0-1.01, p = 0.03). LAA volume > 21.9 ml was associated with increased mortality. In contrast, LA volume was not a significant predictor of mortality. CONCLUSION We describe a novel technique to assess LA and LAA volume using 3-D volume-rendered cardiac CT. This study shows enlarged LAA volume rather than LA volume carries a poor prognosis in cancer-survivors treated with prior CXRT. Compared to conventionally reported markers, LAA volume of > 21.9 ml was incremental to that of other risk factors.
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Affiliation(s)
- Meer R. Zafar
- grid.273335.30000 0004 1936 9887Department of Medicine, Division of Cardiology, Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
| | - Ashutosh Sharma
- grid.273335.30000 0004 1936 9887Department of Medicine, Division of Cardiology, Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
- grid.425214.40000 0000 9963 6690Department of Medicine at the Icahn School of Medicine, Mount Sinai Health System, New York, NY USA
| | - Sunitha Shyam Sunder
- grid.273335.30000 0004 1936 9887Department of Medicine, Division of Cardiology, Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
| | - Badri Karthikeyan
- grid.273335.30000 0004 1936 9887Department of Medicine, Division of Cardiology, Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
| | - Makoto Nagahama
- grid.273335.30000 0004 1936 9887Department of Medicine, Division of Cardiology, Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
- grid.415875.a0000 0004 0368 6175Division of Cardiology, Lehigh Valley Health Network, Allentown, PA USA
| | - Andrew Atia
- grid.273335.30000 0004 1936 9887Department of Medicine, Division of Cardiology, Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
| | - Ronak Bahuva
- grid.273335.30000 0004 1936 9887Department of Medicine, Division of Cardiology, Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
| | - Saraswati Pokharel
- grid.240614.50000 0001 2181 8635Department of Pathology and Laboratory Medicine, Roswell Park Comprehensive Cancer Centre, Buffalo, NY USA
| | - Vijay Iyer
- grid.273335.30000 0004 1936 9887Department of Medicine, Division of Cardiology, Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
| | - Sharma Kattel
- grid.273335.30000 0004 1936 9887Department of Medicine, Division of Cardiology, Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
- grid.47100.320000000419368710Department of Medicine, Division of Cardiology, Yale School of Medicine, New Haven, CT USA
| | - Umesh C. Sharma
- grid.273335.30000 0004 1936 9887Department of Medicine, Division of Cardiology, Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
- Advanced Cardiovascular Imaging, Division of Cardiovascular Medicine, 875 Ellicott Street, Buffalo, New York, 14203 USA
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Farooq W, Iyer V. Hemoperitoneum, Hepatic Laceration, and Hepatic Artery Pseudoaneurysm as a Complication of Emergent Pericardiocentesis. JACC Case Rep 2022; 5:101686. [PMID: 36523950 PMCID: PMC9745653 DOI: 10.1016/j.jaccas.2022.101686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/10/2022] [Accepted: 10/21/2022] [Indexed: 12/02/2022]
Abstract
Emergent pericardiocentesis is a potentially life-saving therapeutic procedure. We report a case of hemoperitoneum, a rare but known complication of pericardiocentesis; due to hepatic artery laceration and hepatic artery pseudoaneurysm formation resulting in delayed hemorrhagic shock as a complication of emergent pericardiocentesis. (Level of Difficulty: Intermediate.).
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Affiliation(s)
- Waseem Farooq
- Address for correspondence: Dr. Waseem Farooq, University at Buffalo, 2780 Main Street, Rear Upper Carriage House, Buffalo, New York 14214, USA. @waseemfarooqmd
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Baig A, Manion C, Khawar W, Donnelly B, Iyer V, Levy E, Siddiqui A. TCT-330 Cerebral Emboli Detection Using Robotic Transcranial Doppler With Artificial Intelligence During Transcatheter Aortic Valve Replacement—A Novel and Autonomous Neuromonitoring Tool. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.387] [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: 10/14/2022]
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10
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Kapur N, Moses J, Faraz H, George Z, Iyer V, Karas R, Kimmelstiel C, Koenig G, Madder R, Meraj P, Kim R, Schreiber T, Wohns D, Udelson J, Stone G, O’Neill W. TCT-34 Reduction of Infarct Size in Anterior ST-Segment Elevation Myocardial Infarction (STEMI) With LAD Occlusion and LV Unloading Using a Micro-axial Pump for 30 Minutes Before PCI: Per-Protocol Analysis of the STEMI Door to Unload (DTU) Pilot Study. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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11
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Di Florio M, Iyer V, Rajhans A, Buccelli S, Chiappalone M. Model-based online implementation of spike detection algorithms for neuroengineering applications. Annu Int Conf IEEE Eng Med Biol Soc 2022; 2022:736-739. [PMID: 36086269 DOI: 10.1109/embc48229.2022.9871444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Traditional methods for the development of a neuroprosthesis to perform closed-loop stimulation can be complex and the necessary technical knowledge and experience often present a high barrier for adoption. This paper takes a novel Model-Based Design approach to simplifying such closed-loop system development, and thereby lowering the adoption barrier. This work implements a computational model of different spike detection algorithms in Simulink® and compares their performances by taking advantage of synthetic neural signals to evaluate suitability for the intended embedded implementation. Clinical Relevance--- Closed-loop systems have been demonstrated to be suitable for brain repair strategies. Coupling two different brain areas by means of a neuroprosthesis can potentially lead to restoration of communication by inducing activity-dependent plasticity.
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12
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Sommer KN, Bhurwani MMS, Iyer V, Ionita CN. Comparison of fluid dynamics changes due to physical activity in 3D printed patient specific coronary phantoms with the Windkessel equivalent model of coronary flow. 3D Print Med 2022; 8:10. [PMID: 35389117 PMCID: PMC8988414 DOI: 10.1186/s41205-022-00138-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 03/29/2022] [Indexed: 11/11/2022] Open
Abstract
Background 3D printing (3DP) used to replicate the geometry of normal and abnormal vascular pathologies has been demonstrated in many publications; however, reproduction of hemodynamic changes due to physical activities, such as rest versus moderate exercise, need to be investigated. We developed a new design for patient specific coronary phantoms, which allow adjustable physiological variables such as coronary distal resistance and coronary compliance in patients with coronary artery disease. The new design was tested in precise benchtop experiments and compared with a theoretical Windkessel electrical circuit equivalent, that models coronary flow and pressure using arterial resistance and compliance. Methods Five phantoms from patients who underwent clinically indicated elective invasive coronary angiography were built from CCTA scans using multi-material 3D printing. Each phantom was used in a controlled flow system where patient specific flow conditions were simulated by a programmable cardiac pump. To simulate the arteriole and capillary beds flow resistance and the compliance for various physical activities, we designed a three-chamber outlet system which controls the outflow dynamics of each coronary tree. Benchtop pressure measurements were recorded using sensors embedded in each of the main coronary arteries. Using the Windkessel model, patient specific flow equivalent electrical circuit models were designed for each coronary tree branch, and flow in each artery was determined for known inflow conditions. Local flow resistances were calculated through Poiseuille’s Law derived from the radii and lengths of the coronary arteries using CT angiography based multi-planar reconstructions. The coronary stenosis flow rates from the benchtop and the electrical models were compared to the localized flow rates calculated from invasive pressure measurements recorded in the angio-suites. Results The average Pearson correlations of the localized flow rates at the location of the stenosis between each of the models (Benchtop/Electrical, Benchtop/Angio, Electrical/Angio) are 0.970, 0.981, and 0.958 respectively. Conclusions 3D printed coronary phantoms can be used to replicate the human arterial anatomy as well as blood flow conditions. It displays high levels of correlation when compared to hemodynamics calculated in electrically-equivalent coronary Windkessel models as well as invasive angio-suite pressure measurements.
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Affiliation(s)
- Kelsey N Sommer
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY, USA. .,Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, USA. .,QAS.AI Incorporated, Buffalo, NY, 14203, USA.
| | - Mohammad Mahdi Shiraz Bhurwani
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY, USA.,Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, USA
| | - Vijay Iyer
- University at Buffalo Cardiology, University at Buffalo Jacobs School of Medicine, Buffalo, NY, USA
| | - Ciprian N Ionita
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY, USA.,Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, USA.,QAS.AI Incorporated, Buffalo, NY, 14203, USA
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El Sabbagh A, Al-Hijji M, Wang DD, Eleid M, Urena M, Himbert D, Chakravarty T, Holzhey D, Pershad A, Fang HK, Nejjari M, Zahr F, Dvir D, Sardar MR, Cheema AN, Alnasser S, Iyer V, Kaddissi G, Webb J, Makkar R, Vahanian A, O'Neill W, Rihal C, Guerrero M. Predictors of Left Ventricular Outflow Tract Obstruction After Transcatheter Mitral Valve Replacement in Severe Mitral Annular Calcification: An Analysis of the Transcatheter Mitral Valve Replacement in Mitral Annular Calcification Global Registry. Circ Cardiovasc Interv 2021; 14:e010854. [PMID: 34665654 DOI: 10.1161/circinterventions.121.010854] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Abdallah El Sabbagh
- Department of Cardiovascular Diseases, Mayo Clinic, Jacksonville, FL (A.E.S.)
| | - Mohammed Al-Hijji
- Division of Cardiovascular Diseases, Heart Hospital, Hamad Medical Corporation, Doha, Qatar (M.A.-H)
| | - Dee Dee Wang
- Division of Cardiology, Henry Ford Hospital, Detroit, MI (D.D.W., W.O.)
| | - Mackram Eleid
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (M.E., C.R., M.G.)
| | - Marina Urena
- Department of Cardiology, Bichat Hospital, Paris, France (M.U., D.H.)
| | - Dominique Himbert
- Department of Cardiology, Bichat Hospital, Paris, France (M.U., D.H.)
| | - Tarun Chakravarty
- Division of Cardiology, Cedars Sinai Medical Center, Los Angeles, CA (T.C., R.M.)
| | - David Holzhey
- Division of Cardiac Surgery, Leipzig Heart Center, Germany (D.H.)
| | - Ashish Pershad
- Division of Cardiology, Chandler Regional and Mercy Gilbert Medical Center, AZ (A.P.)
| | - H Kenith Fang
- Division of Cardiac Surgery, Banner University Medical Center, Phoenix, AZ (H.K.F.)
| | - Mohammed Nejjari
- Division of Cardiology, Centre Cardiologique du Nord, St. Denis, France (M.N.)
| | - Firas Zahr
- Division of Cardiology, Oregon Health & Science University, Portland, OR (F.Z.)
| | - Danny Dvir
- Division of Cardiology, University of Washington, Seattle (D.D.).,Jesselson Integrated Heart Center, Shaare Zedek Medical Centre, Hebrew University, Jerusalem, Israel (D.D.)
| | | | - Asim N Cheema
- Division of Cardiology, St. Michael's Hospital, Toronto, Canada (A.N.C., S.A.)
| | - Sami Alnasser
- Division of Cardiology, St. Michael's Hospital, Toronto, Canada (A.N.C., S.A.)
| | - Vijay Iyer
- Division of Cardiology, Buffalo General Medical Center, Buffalo, NY (V.I.)
| | - Georges Kaddissi
- Division of Cardiology, Cooper University Hospital, Camden, NJ (G.K.)
| | - John Webb
- Division of Cardiology, St. Paul's Hospital, Vancouver, Canada (J.W.)
| | - Raj Makkar
- Division of Cardiology, Cedars Sinai Medical Center, Los Angeles, CA (T.C., R.M.)
| | - Alec Vahanian
- Division of Cardiology, University of Paris, Paris, France (A.V.)
| | - William O'Neill
- Division of Cardiology, Henry Ford Hospital, Detroit, MI (D.D.W., W.O.)
| | - Charanjit Rihal
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (M.E., C.R., M.G.)
| | - Mayra Guerrero
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (M.E., C.R., M.G.)
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Iyer V, Enthoven CA, van Dommelen P, Samkar AV, Groenewoud JH, Reijneveld SA, Jaddoe VWV, Klaver CCW. Spectacle wear and refractive errors in Dutch children. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.787] [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: 11/13/2022] Open
Abstract
Abstract
Background
Myopia is a refractive error that is increasing dramatically all over the world. Early onset is associated with a significant visual burden later in life, but little is known about refractive errors in preschool children. The aim of this study was to assess prevalence of spectacle wear, visual acuity and refractive errors in young Dutch children and to make global comparisons.
Methods
We analyzed data of three prospective population-based studies: 99,660 3- to 5-year-olds undergoing vision screening at preventive child healthcare organizations, 6,934 6-year-olds from the Generation R study, and 2,974 7-year-olds from the RAMSES study. Visual acuity was measured with Landolt-C or LEA charts, spectacle wear was assessed, and refractive errors at age 6 and 7 were measured with cycloplegic refraction. Spectacle wear was compared with international studies.
Results
The prevalence of spectacle wear was 1.5%, 2.3%, 6.6%, 8.2% and 11.8% at 36, 45, 60, 72 and 84 months, respectively, with no major sex differences. Among children with spectacle wear at 72 months (N = 583) and 84 months (N = 351) 29.8% and 34.6% had myopia respectively, of which 21.1% and 21.6% combined with astigmatism, 19.6% and 6.8% had hyperopia, 37.2% and 11.1% hyperopia and astigmatism, and 12.5% and 33.3% astigmatism only. The prevalence of spectacle wear globally varied between 1.5% to 21%.
Conclusions
Spectacle wear in these European children started early in preschool and increased to substantial figures at school age. Among children with spectacle wear, >30% were already myopic, illustrating the urgency to implement myopia prevention strategies in child health centers.
Key messages
Early onset myopia is a public health issue. Of the 6- to 7-year-olds with spectacles 30-34% were already myopic. Monitoring of refractive errors and preventive lifestyle interventions are warranted.
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Affiliation(s)
- V Iyer
- Child Health/Education, TNO, Leiden, Netherlands
| | - CA Enthoven
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - A van Samkar
- Resident Geriatric Medicine, Omring, Lutjebroek, Netherlands
| | - JH Groenewoud
- University of Applied Sciences, Rotterdam, Netherlands
| | - SA Reijneveld
- Department of Health Sciences, University Medical Center, Groningen, Netherlands
| | - VWV Jaddoe
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, Netherlands
| | - CCW Klaver
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands
- Department of Ophthalmology, Radboud Medical Center, Nijmegen, Netherlands
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
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15
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Anwaar O, Carrillo M, Welch SB, Iyer V. Obturator abscess in children: a delayed diagnosis. Arch Dis Child 2021; 106:974. [PMID: 33785531 DOI: 10.1136/archdischild-2020-321132] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/29/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Osama Anwaar
- Paediatrics Department, Birmingham Heartlands Hospital, Birmingham, UK .,Paediatric, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Maria Carrillo
- Radiology Department, Birmingham Heartlands Hospital, Birmingham, West Midlands, UK
| | - Steven B Welch
- Paediatrics Department, Birmingham Heartlands Hospital, Birmingham, UK
| | - Vijay Iyer
- Paediatrics Department, Birmingham Heartlands Hospital, Birmingham, UK.,Paediatric, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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16
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Alkhatib I, Amaral DWP, Aralis T, Aramaki T, Arnquist IJ, Ataee Langroudy I, Azadbakht E, Banik S, Barker D, Bathurst C, Bauer DA, Bezerra LVS, Bhattacharyya R, Bowles MA, Brink PL, Bunker R, Cabrera B, Calkins R, Cameron RA, Cartaro C, Cerdeño DG, Chang YY, Chaudhuri M, Chen R, Chott N, Cooley J, Coombes H, Corbett J, Cushman P, De Brienne F, di Vacri ML, Diamond MD, Fascione E, Figueroa-Feliciano E, Fink CW, Fouts K, Fritts M, Gerbier G, Germond R, Ghaith M, Golwala SR, Harris HR, Hines BA, Hollister MI, Hong Z, Hoppe EW, Hsu L, Huber ME, Iyer V, Jardin D, Jastram A, Kashyap VKS, Kelsey MH, Kubik A, Kurinsky NA, Lawrence RE, Li A, Loer B, Lopez Asamar E, Lukens P, MacFarlane DB, Mahapatra R, Mandic V, Mast N, Mayer AJ, Meyer Zu Theenhausen H, Michaud ÉM, Michielin E, Mirabolfathi N, Mohanty B, Morales Mendoza JD, Nagorny S, Nelson J, Neog H, Novati V, Orrell JL, Oser SM, Page WA, Partridge R, Podviianiuk R, Ponce F, Poudel S, Pradeep A, Pyle M, Rau W, Reid E, Ren R, Reynolds T, Roberts A, Robinson AE, Saab T, Sadoulet B, Sander J, Sattari A, Schnee RW, Scorza S, Serfass B, Sincavage DJ, Stanford C, Street J, Toback D, Underwood R, Verma S, Villano AN, von Krosigk B, Watkins SL, Wilson JS, Wilson MJ, Winchell J, Wright DH, Yellin S, Young BA, Yu TC, Zhang E, Zhang HG, Zhao X, Zheng L. Constraints on Lightly Ionizing Particles from CDMSlite. Phys Rev Lett 2021; 127:081802. [PMID: 34477436 DOI: 10.1103/physrevlett.127.081802] [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] [Received: 11/18/2020] [Revised: 06/11/2021] [Accepted: 07/27/2021] [Indexed: 06/13/2023]
Abstract
The Cryogenic Dark Matter Search low ionization threshold experiment (CDMSlite) achieved efficient detection of very small recoil energies in its germanium target, resulting in sensitivity to lightly ionizing particles (LIPs) in a previously unexplored region of charge, mass, and velocity parameter space. We report first direct-detection limits calculated using the optimum interval method on the vertical intensity of cosmogenically produced LIPs with an electric charge smaller than e/(3×10^{5}), as well as the strongest limits for charge ≤e/160, with a minimum vertical intensity of 1.36×10^{-7} cm^{-2} s^{-1} sr^{-1} at charge e/160. These results apply over a wide range of LIP masses (5 MeV/c^{2} to 100 TeV/c^{2}) and cover a wide range of βγ values (0.1-10^{6}), thus excluding nonrelativistic LIPs with βγ as small as 0.1 for the first time.
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Affiliation(s)
- I Alkhatib
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - D W P Amaral
- Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
| | - T Aralis
- Division of Physics, Mathematics, & Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - T Aramaki
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - I J Arnquist
- Pacific Northwest National Laboratory, Richland, Washington, D.C. 99352, USA
| | - I Ataee Langroudy
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - E Azadbakht
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - S Banik
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni-752050, India
| | - D Barker
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - C Bathurst
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - D A Bauer
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - L V S Bezerra
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - R Bhattacharyya
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - M A Bowles
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - P L Brink
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - R Bunker
- Pacific Northwest National Laboratory, Richland, Washington, D.C. 99352, USA
| | - B Cabrera
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - R Calkins
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - R A Cameron
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - C Cartaro
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - D G Cerdeño
- Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
- Instituto de Física Teórica UAM/CSIC, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Y-Y Chang
- Division of Physics, Mathematics, & Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - M Chaudhuri
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni-752050, India
| | - R Chen
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - N Chott
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - J Cooley
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - H Coombes
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - J Corbett
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - P Cushman
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - F De Brienne
- Département de Physique, Université de Montréal, Montréal, Quebec H3C 3J7, Canada
| | - M L di Vacri
- Pacific Northwest National Laboratory, Richland, Washington, D.C. 99352, USA
| | - M D Diamond
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - E Fascione
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - E Figueroa-Feliciano
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - C W Fink
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - K Fouts
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - M Fritts
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - G Gerbier
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - R Germond
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - M Ghaith
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - S R Golwala
- Division of Physics, Mathematics, & Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - H R Harris
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, Texas 77843, USA
| | - B A Hines
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
| | - M I Hollister
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - Z Hong
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - E W Hoppe
- Pacific Northwest National Laboratory, Richland, Washington, D.C. 99352, USA
| | - L Hsu
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M E Huber
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
- Department of Electrical Engineering, University of Colorado Denver, Denver, Colorado 80217, USA
| | - V Iyer
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni-752050, India
| | - D Jardin
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - A Jastram
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - V K S Kashyap
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni-752050, India
| | - M H Kelsey
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - A Kubik
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - N A Kurinsky
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R E Lawrence
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - A Li
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - B Loer
- Pacific Northwest National Laboratory, Richland, Washington, D.C. 99352, USA
| | - E Lopez Asamar
- Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
| | - P Lukens
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D B MacFarlane
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - R Mahapatra
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - V Mandic
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - N Mast
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - A J Mayer
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - É M Michaud
- Département de Physique, Université de Montréal, Montréal, Quebec H3C 3J7, Canada
| | - E Michielin
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - N Mirabolfathi
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - B Mohanty
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni-752050, India
| | - J D Morales Mendoza
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - S Nagorny
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - J Nelson
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - H Neog
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - V Novati
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - J L Orrell
- Pacific Northwest National Laboratory, Richland, Washington, D.C. 99352, USA
| | - S M Oser
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - W A Page
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - R Partridge
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - R Podviianiuk
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - F Ponce
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - S Poudel
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - A Pradeep
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - M Pyle
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - W Rau
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - E Reid
- Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
| | - R Ren
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - T Reynolds
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - A Roberts
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
| | - A E Robinson
- Département de Physique, Université de Montréal, Montréal, Quebec H3C 3J7, Canada
| | - T Saab
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - B Sadoulet
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J Sander
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - A Sattari
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - R W Schnee
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - S Scorza
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
- Laurentian University, Department of Physics, 935 Ramsey Lake Road, Sudbury, Ontario P3E 2C6, Canada
| | - B Serfass
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - D J Sincavage
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - C Stanford
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - J Street
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - D Toback
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - R Underwood
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - S Verma
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - A N Villano
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
| | - B von Krosigk
- Institut für Experimentalphysik, Universität Hamburg, 22761 Hamburg, Germany
| | - S L Watkins
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - J S Wilson
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - M J Wilson
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
- Institut für Experimentalphysik, Universität Hamburg, 22761 Hamburg, Germany
| | - J Winchell
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - D H Wright
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - S Yellin
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - B A Young
- Department of Physics, Santa Clara University, Santa Clara, California 95053, USA
| | - T C Yu
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - E Zhang
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - H G Zhang
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - X Zhao
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - L Zheng
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
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17
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Alkhatib I, Amaral DWP, Aralis T, Aramaki T, Arnquist IJ, Ataee Langroudy I, Azadbakht E, Banik S, Barker D, Bathurst C, Bauer DA, Bezerra LVS, Bhattacharyya R, Binder T, Bowles MA, Brink PL, Bunker R, Cabrera B, Calkins R, Cameron RA, Cartaro C, Cerdeño DG, Chang YY, Chaudhuri M, Chen R, Chott N, Cooley J, Coombes H, Corbett J, Cushman P, De Brienne F, di Vacri ML, Diamond MD, Fascione E, Figueroa-Feliciano E, Fink CW, Fouts K, Fritts M, Gerbier G, Germond R, Ghaith M, Golwala SR, Harris HR, Herbert N, Hines BA, Hollister MI, Hong Z, Hoppe EW, Hsu L, Huber ME, Iyer V, Jardin D, Jastram A, Kashyap VKS, Kelsey MH, Kubik A, Kurinsky NA, Lawrence RE, Li A, Loer B, Lopez Asamar E, Lukens P, MacDonell D, MacFarlane DB, Mahapatra R, Mandic V, Mast N, Mayer AJ, Meyer Zu Theenhausen H, Michaud ÉM, Michielin E, Mirabolfathi N, Mohanty B, Morales Mendoza JD, Nagorny S, Nelson J, Neog H, Novati V, Orrell JL, Oser SM, Page WA, Pakarha P, Partridge R, Podviianiuk R, Ponce F, Poudel S, Pyle M, Rau W, Reid E, Ren R, Reynolds T, Roberts A, Robinson AE, Saab T, Sadoulet B, Sander J, Sattari A, Schnee RW, Scorza S, Serfass B, Sincavage DJ, Stanford C, Street J, Toback D, Underwood R, Verma S, Villano AN, von Krosigk B, Watkins SL, Wills L, Wilson JS, Wilson MJ, Winchell J, Wright DH, Yellin S, Young BA, Yu TC, Zhang E, Zhang HG, Zhao X, Zheng L, Camilleri J, Kolomensky YG, Zuber S. Light Dark Matter Search with a High-Resolution Athermal Phonon Detector Operated above Ground. Phys Rev Lett 2021; 127:061801. [PMID: 34420312 DOI: 10.1103/physrevlett.127.061801] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 05/06/2021] [Accepted: 07/08/2021] [Indexed: 06/13/2023]
Abstract
We present limits on spin-independent dark matter-nucleon interactions using a 10.6 g Si athermal phonon detector with a baseline energy resolution of σ_{E}=3.86±0.04(stat)_{-0.00}^{+0.19}(syst) eV. This exclusion analysis sets the most stringent dark matter-nucleon scattering cross-section limits achieved by a cryogenic detector for dark matter particle masses from 93 to 140 MeV/c^{2}, with a raw exposure of 9.9 g d acquired at an above-ground facility. This work illustrates the scientific potential of detectors with athermal phonon sensors with eV-scale energy resolution for future dark matter searches.
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Affiliation(s)
- I Alkhatib
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - D W P Amaral
- Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
| | - T Aralis
- Division of Physics, Mathematics, & Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - T Aramaki
- SLAC National Accelerator Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - I J Arnquist
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - I Ataee Langroudy
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - E Azadbakht
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - S Banik
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni-752050, India
| | - D Barker
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - C Bathurst
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - D A Bauer
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - L V S Bezerra
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - R Bhattacharyya
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - T Binder
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - M A Bowles
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - P L Brink
- SLAC National Accelerator Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - R Bunker
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - B Cabrera
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - R Calkins
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - R A Cameron
- SLAC National Accelerator Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - C Cartaro
- SLAC National Accelerator Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - D G Cerdeño
- Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
- Instituto de Física Teórica UAM/CSIC, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Y-Y Chang
- Division of Physics, Mathematics, & Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - M Chaudhuri
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni-752050, India
| | - R Chen
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - N Chott
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - J Cooley
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - H Coombes
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - J Corbett
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - P Cushman
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - F De Brienne
- Département de Physique, Université de Montréal, Montréal, Quebec H3C 3J7, Canada
| | - M L di Vacri
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - M D Diamond
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - E Fascione
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - E Figueroa-Feliciano
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - C W Fink
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - K Fouts
- SLAC National Accelerator Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - M Fritts
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - G Gerbier
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - R Germond
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - M Ghaith
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - S R Golwala
- Division of Physics, Mathematics, & Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - H R Harris
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, Texas 77843, USA
| | - N Herbert
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - B A Hines
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
| | - M I Hollister
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - Z Hong
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - E W Hoppe
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - L Hsu
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M E Huber
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
- Department of Electrical Engineering, University of Colorado Denver, Denver, Colorado 80217, USA
| | - V Iyer
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni-752050, India
| | - D Jardin
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - A Jastram
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - V K S Kashyap
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni-752050, India
| | - M H Kelsey
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - A Kubik
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - N A Kurinsky
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - R E Lawrence
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - A Li
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - B Loer
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - E Lopez Asamar
- Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
| | - P Lukens
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D MacDonell
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - D B MacFarlane
- SLAC National Accelerator Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - R Mahapatra
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - V Mandic
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - N Mast
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - A J Mayer
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | | | - É M Michaud
- Département de Physique, Université de Montréal, Montréal, Quebec H3C 3J7, Canada
| | - E Michielin
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - N Mirabolfathi
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - B Mohanty
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni-752050, India
| | - J D Morales Mendoza
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - S Nagorny
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - J Nelson
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - H Neog
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - V Novati
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - J L Orrell
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - S M Oser
- Department of Physics & Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - W A Page
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - P Pakarha
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - R Partridge
- SLAC National Accelerator Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - R Podviianiuk
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - F Ponce
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - S Poudel
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - M Pyle
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - W Rau
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
| | - E Reid
- Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
| | - R Ren
- Department of Physics & Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - T Reynolds
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - A Roberts
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
| | - A E Robinson
- Département de Physique, Université de Montréal, Montréal, Quebec H3C 3J7, Canada
| | - T Saab
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - B Sadoulet
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J Sander
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - A Sattari
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - R W Schnee
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - S Scorza
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - B Serfass
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - D J Sincavage
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - C Stanford
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - J Street
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - D Toback
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - R Underwood
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - S Verma
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - A N Villano
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
| | - B von Krosigk
- Institut für Experimentalphysik, Universität Hamburg, 22761 Hamburg, Germany
| | - S L Watkins
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - L Wills
- Département de Physique, Université de Montréal, Montréal, Quebec H3C 3J7, Canada
| | - J S Wilson
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - M J Wilson
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
- Institut für Experimentalphysik, Universität Hamburg, 22761 Hamburg, Germany
| | - J Winchell
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - D H Wright
- SLAC National Accelerator Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - S Yellin
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - B A Young
- Department of Physics, Santa Clara University, Santa Clara, California 95053, USA
| | - T C Yu
- SLAC National Accelerator Laboratory, Kavli Institute for Particle Astrophysics and Cosmology, Menlo Park, California 94025, USA
| | - E Zhang
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - H G Zhang
- School of Physics & Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - X Zhao
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - L Zheng
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - J Camilleri
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - Yu G Kolomensky
- Department of Physics, University of California, Berkeley, California 94720, USA
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - S Zuber
- Department of Physics, University of California, Berkeley, California 94720, USA
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Singh TP, Moxon JV, Iyer V, Gasser TC, Jenkins J, Golledge J. Comparison of peak wall stress and peak wall rupture index in ruptured and asymptomatic intact abdominal aortic aneurysms. Br J Surg 2021; 108:652-658. [PMID: 34157087 DOI: 10.1002/bjs.11995] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 07/01/2020] [Accepted: 07/22/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Previous studies have suggested that finite element analysis (FEA) can estimate the rupture risk of an abdominal aortic aneurysm (AAA); however, the value of biomechanical estimates over measurement of AAA diameter alone remains unclear. This study aimed to compare peak wall stress (PWS) and peak wall rupture index (PWRI) in participants with ruptured and asymptomatic intact AAAs. METHODS The reproducibility of semiautomated methods for estimating aortic PWS and PWRI from CT images was assessed. PWS and PWRI were estimated in people with ruptured AAAs and those with asymptomatic intact AAAs matched by orthogonal diameter on a 1 : 2 basis. Spearman's correlation coefficient was used to assess the association between PWS or PWRI and AAA diameter. Independent associations between PWS or PWRI and AAA rupture were identified by means of logistic regression analyses. RESULTS Twenty individuals were included in the analysis of reproducibility. The main analysis included 50 patients with an intact AAA and 25 with a ruptured AAA. Median orthogonal diameter was similar in ruptured and intact AAAs (82·3 (i.q.r. 73·5-92·0) versus 81·0 (73·2-92·4) mm respectively; P = 0·906). Median PWS values were 286·8 (220·2-329·6) and 245·8 (215·2-302·3) kPa respectively (P = 0·192). There was no significant difference in PWRI between the two groups (P = 0·982). PWS and PWRI correlated positively with orthogonal diameter (both P < 0·001). Participants with high PWS, but not PWRI, were more likely to have a ruptured AAA after adjusting for potential confounders (odds ratio 5·84, 95 per cent c.i. 1·22 to 27·95; P = 0·027). This association was not maintained in all sensitivity analyses. CONCLUSION High aortic PWS had an inconsistent association with greater odds of aneurysm rupture in patients with a large AAA.
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Affiliation(s)
- T P Singh
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, Townsville, Australia
- Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Australia
| | - J V Moxon
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, Townsville, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Australia
| | - V Iyer
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, Townsville, Australia
- Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Australia
- Department of Vascular and Endovascular Surgery, Royal Brisbane and Women's Hospital Brisbane Queensland Australia
| | - T C Gasser
- KTH Solid Mechanics, Department of Engineering Mechanics, KTH Royal Institute of Technology, Stockholm, Sweden
| | - J Jenkins
- Department of Vascular and Endovascular Surgery, Royal Brisbane and Women's Hospital Brisbane Queensland Australia
| | - J Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, Townsville, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Australia
- Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Australia
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19
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Kumar A, Sammour Y, Reginauld S, Sato K, Agrawal N, Lee JM, Meenakshisundaram C, Ramanan T, Kamioka N, Sawant AC, Mohananey D, Gleason PT, Devireddy C, Krishnaswamy A, Mavromatis K, Grubb K, Svensson LG, Tuzcu EM, Block PC, Iyer V, Babaliaros V, Kapadia S, Samady H. Adverse clinical outcomes in patients undergoing both PCI and TAVR: Analysis from a pooled multi-center registry. Catheter Cardiovasc Interv 2020; 97:529-539. [PMID: 32845036 DOI: 10.1002/ccd.29233] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/02/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND There is a paucity of data regarding the optimum timing of PCI in relation to TAVR. OBJECTIVE We compared the major adverse cardiovascular and cerebrovascular events (MACCE) rates among patients who underwent percutaneous coronary intervention (PCI) before transcatheter aortic valve replacement (TAVR) with those who received PCI with/after TAVR. METHODS In this multicenter study, we pooled all consecutive patients who underwent TAVR at three high volume centers. RESULTS Among 3,982 patients who underwent TAVR, 327 (8%) patients underwent PCI within 1 year before TAVR, 38 (1%) had PCI the same day as TAVR and 15 (0.5%) had PCI within 2 months after TAVR. Overall, among patients who received both PCI and TAVR (n = 380), history of previous CABG (HR:0.501; p = .001), higher BMI at TAVR (HR:0.970; p = .038), and statin therapy after TAVR (HR:0.660, p = .037) were independently associated with lower MACCE while warfarin therapy after TAVR was associated with a higher risk of MACCE (HR:1.779, p = .017). Patients who received PCI within 1 year before TAVR had similar baseline demographics, STS scores, clinical risk factors when compared to patients receiving PCI with/after TAVR. Both groups were similar in PCI (Syntax Score, ACC/AHA lesion class) and TAVR (valve types, access) related variables. There were no significant differences in terms of MACCE (log rank p = .550), all-cause mortality (log rank p = .433), strokes (log rank p = .153), and repeat PCI (log rank p = .054) in patients who underwent PCI with/after TAVR when compared to patients who received PCI before TAVR. CONCLUSION Among patients who underwent both PCI and TAVR, history of CABG, higher BMI, and statin therapy had lower, while those discharged on warfarin, had higher adverse event rates. Adverse events rates were similar regardless of timing of PCI.
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Affiliation(s)
- Arnav Kumar
- Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Atlanta, Georgia
| | - Yasser Sammour
- Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Shawn Reginauld
- Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Atlanta, Georgia
| | - Kimi Sato
- Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Nikhil Agrawal
- Department of Medicine Division of Cardiology, State University of New York at Buffalo, Buffalo, New York
| | - Joo Myung Lee
- Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Atlanta, Georgia
| | | | - Thammi Ramanan
- Department of Medicine Division of Cardiology, State University of New York at Buffalo, Buffalo, New York
| | - Norihiko Kamioka
- Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Atlanta, Georgia
| | - Abhishek C Sawant
- Department of Medicine Division of Cardiology, State University of New York at Buffalo, Buffalo, New York
| | | | - Patrick T Gleason
- Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Atlanta, Georgia
| | - Chandan Devireddy
- Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Atlanta, Georgia
| | - Amar Krishnaswamy
- Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Kreton Mavromatis
- Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Atlanta, Georgia
| | - Kendra Grubb
- Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Atlanta, Georgia
| | - Lars G Svensson
- Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - E Murat Tuzcu
- Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Peter C Block
- Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Atlanta, Georgia
| | - Vijay Iyer
- Department of Medicine Division of Cardiology, State University of New York at Buffalo, Buffalo, New York
| | - Vasilis Babaliaros
- Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Atlanta, Georgia
| | - Samir Kapadia
- Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Habib Samady
- Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Atlanta, Georgia
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Sommer KN, Iyer V, Kumamaru KK, Rava RA, Ionita CN. Method to simulate distal flow resistance in coronary arteries in 3D printed patient specific coronary models. 3D Print Med 2020; 6:19. [PMID: 32761497 PMCID: PMC7410153 DOI: 10.1186/s41205-020-00072-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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] [Received: 02/10/2020] [Accepted: 07/24/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Three-dimensional printing (3DP) offers a unique opportunity to build flexible vascular patient-specific coronary models for device testing, treatment planning, and physiological simulations. By optimizing the 3DP design to replicate the geometrical and mechanical properties of healthy and diseased arteries, we may improve the relevance of using such models to simulate the hemodynamics of coronary disease. We developed a method to build 3DP patient specific coronary phantoms, which maintain a significant part of the coronary tree, while preserving geometrical accuracy of the atherosclerotic plaques and allows for an adjustable hydraulic resistance. METHODS Coronary computed tomography angiography (CCTA) data was used within Vitrea (Vital Images, Minnetonka, MN) cardiac analysis application for automatic segmentation of the aortic root, Left Anterior Descending (LAD), Left Circumflex (LCX), Right Coronary Artery (RCA), and calcifications. Stereolithographic (STL) files of the vasculature and calcium were imported into Autodesk Meshmixer for 3D model optimization. A base with three chambers was built and interfaced with the phantom to allow fluid collection and independent distal resistance adjustment of the RCA, LAD and LCX and branching arteries. For the 3DP we used Agilus for the arterial wall, VeroClear for the base and a Vero blend for the calcifications, respectively. Each chamber outlet allowed interface with catheters of varying lengths and diameters for simulation of hydraulic resistance of both normal and hyperemic coronary flow conditions. To demonstrate the manufacturing approach appropriateness, models were tested in flow experiments. RESULTS Models were used successfully in flow experiments to simulate normal and hyperemic flow conditions. The inherent mean resistance of the chamber for the LAD, LCX, and RCA, were 1671, 1820, and 591 (dynes ∙ sec/ cm5), respectively. This was negligible when compared with estimates in humans, with the chamber resistance equating to 0.65-5.86%, 1.23-6.86%, and 0.05-1.67% of the coronary resistance for the LAD, LCX, and RCA, respectively at varying flow rates and activity states. Therefore, the chamber served as a means to simulate the compliance of the distal coronary trees and to allow facile coupling with a set of known resistance catheters to simulate various physical activity levels. CONCLUSIONS We have developed a method to create complex 3D printed patient specific coronary models derived from CCTA, which allow adjustable distal capillary bed resistances. This manufacturing approach permits comprehensive coronary model development which may be used for physiologically relevant flow simulations.
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Affiliation(s)
- Kelsey N Sommer
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY, USA
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, USA
| | - Vijay Iyer
- University at Buffalo Cardiology, University at Buffalo Jacobs School of Medicine, Buffalo, NY, USA
| | | | - Ryan A Rava
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY, USA
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, USA
| | - Ciprian N Ionita
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY, USA.
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, USA.
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Podgorsak AR, Sommer KN, Reddy A, Iyer V, Wilson MF, Rybicki FJ, Mitsouras D, Sharma U, Fujimoto S, Kumamaru KK, Angel E, Ionita CN. Initial evaluation of a convolutional neural network used for noninvasive assessment of coronary artery disease severity from coronary computed tomography angiography data. Med Phys 2020; 47:3996-4004. [DOI: 10.1002/mp.14339] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 12/13/2022] Open
Affiliation(s)
- Alexander R. Podgorsak
- From the Canon Stroke and Vascular Research Center 875 Ellicott Street Buffalo NY 14222USA
| | - Kelsey N. Sommer
- From the Canon Stroke and Vascular Research Center 875 Ellicott Street Buffalo NY 14222USA
| | - Abhinay Reddy
- From the Canon Stroke and Vascular Research Center 875 Ellicott Street Buffalo NY 14222USA
| | - Vijay Iyer
- From the Canon Stroke and Vascular Research Center 875 Ellicott Street Buffalo NY 14222USA
| | - Michael F. Wilson
- From the Canon Stroke and Vascular Research Center 875 Ellicott Street Buffalo NY 14222USA
| | - Frank J. Rybicki
- Department of Radiology University of Cincinnati 234 Goodman Street Cincinnati OH USA
| | - Dimitrios Mitsouras
- San Francisco Department of Radiology and Biomedical Imaging University of California 505 Parnassus Avenue San Francisco CA 94143USA
| | - Umesh Sharma
- From the Canon Stroke and Vascular Research Center 875 Ellicott Street Buffalo NY 14222USA
| | - Shinchiro Fujimoto
- Department of Cardiovascular Medicine Juntendo University 3‐1‐3 Hongo, Bunkyo‐ku Tokyo Japan
| | - Kanako K. Kumamaru
- Department of Radiology Juntendo University 3‐1‐3 Hongo, Bunkyo‐ku Tokyo Japan
| | - Erin Angel
- Canon Medical Systems USA, Inc. 2441 Michelle Drive Tustin CA 92780USA
| | - Ciprian N. Ionita
- From the Canon Stroke and Vascular Research Center 875 Ellicott Street Buffalo NY 14222USA
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Joshi A, Iyer V. NOVEL TREATMENT APPROACH TO GLILD IN CVID PATIENTS USING SENOLYTIC THERAPY. Chest 2020. [DOI: 10.1016/j.chest.2020.05.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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23
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Sommer KN, Shepard LM, Mitsouras D, Iyer V, Angel E, Wilson MF, Rybicki FJ, Kumamaru KK, Sharma UC, Reddy A, Fujimoto S, Ionita CN. Patient-specific 3D-printed coronary models based on coronary computed tomography angiography volumes to investigate flow conditions in coronary artery disease. Biomed Phys Eng Express 2020; 6:045007. [PMID: 33444268 DOI: 10.1088/2057-1976/ab8f6e] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND 3D printed patient-specific coronary models have the ability to enable repeatable benchtop experiments under controlled blood flow conditions. This approach can be applied to CT-derived patient geometries to emulate coronary flow and related parameters such as Fractional Flow Reserve (FFR). METHODS This study uses 3D printing to compare such benchtop FFR results with a non-invasive CT-FFR research software algorithm and catheter based invasive FFR (I-FFR) measurements. Fifty-two patients with a clinical indication for I-FFR underwent a research Coronary CT Angiography (CCTA) prior to catheterization. CT images were used to measure CT-FFR and to generate patient-specific 3D printed models of the aortic root and three main coronary arteries. Each patient-specific model was connected to a programmable pulsatile pump and benchtop FFR (B-FFR) was derived from pressures measured proximal and distal to coronary stenosis using pressure transducers. B-FFR was measured for two coronary outflow rates ('normal', 250 ml min-1; and 'hyperemic', 500 ml min-1) by adjusting the model's distal coronary resistance. RESULTS Pearson correlations and ROC AUC were calculated using invasive I-FFR as reference. The Pearson correlation factor of CT-FFR and B-FFR-500 was 0.75 and 0.71, respectively. Areas under the ROCs for CT-FFR and B-FFR-500 were 0.80 (95%CI: 0.70-0.87) and 0.81 (95%CI: 0.64-0.91) respectively. CONCLUSION Benchtop flow simulations with 3D printed models provide the capability to measure pressure changes at any location in the model, for ultimately emulating the FFR at several simulated physiological blood flow conditions. CLINICAL TRIAL REGISTRATION https://clinicaltrials.gov/show/NCT03149042.
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Affiliation(s)
- Kelsey N Sommer
- Department of Biomedical Engineering, University at Buffalo, Buffalo, NY 14228, United States of America. Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, United States of America
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Iyer V, Landsmeer EA, Reijneveld SA. [Responsible use of screens: recommendations to limit myopia in children and young people]. Ned Tijdschr Geneeskd 2020; 164:D4106. [PMID: 32267641] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The excessive use of screens is a contemporary problem that can have a number of effects on health. It is of particular influence on the onset and exacerbation of myopia, and for these reasons a group of professionals decided to draw up recommendations on a more sensible use of screens. The group comprised an ophthalmologist-epidemiologist, an orthoptist, paediatric and adolescent physicians, a youth health care nurse, an orthopaedic surgeon, a movement therapist-epidemiologist, health scientists and psychologists. They recommend that on history-taking, standard questions concerning screen use and its associated problems should be asked. The parents can then be given targeted lifestyle advice for the child, i.e. after 20-30 minutes continuous screen use there should be a change of activity, and that the child should spend 2 hours a day outdoors. These recommendations will promote the health of children's eyes as well as their general development.
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Affiliation(s)
- V Iyer
- TNO, afd. Child Health/Onderwijs, Leiden
- Contact: V. Iyer
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25
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Kumar A, Sammour Y, Reginauld S, Sato K, Agrawal N, Meenakshisundaram C, Kamioka N, Sawant AC, Devireddy C, Krishnaswamy A, Greenbaum AB, Mavromatis K, Grubb K, Byku I, Svensson L, Tuzcu M, Block PC, Iyer V, Kapadia S, Babaliaros V. CRT-600.08 A Comparison of Clinical Outcomes According to the Timing of PCI and TAVR: A Pooled Analysis From a Multicenter Registry. JACC Cardiovasc Interv 2020. [DOI: 10.1016/j.jcin.2020.01.155] [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: 11/16/2022]
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26
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Mosleh W, Amer MR, Joshi S, Mather JF, Gandhi S, Iyer V, Curtis L, Kiernan FJ, McMahon S, Duvall L, McKay RG. Comparative Outcomes of Balloon-Expandable S3 Versus Self-Expanding Evolut Bioprostheses for Transcatheter Aortic Valve Implantation. Am J Cardiol 2019; 124:1621-1629. [PMID: 31547995 DOI: 10.1016/j.amjcard.2019.08.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/08/2019] [Accepted: 08/12/2019] [Indexed: 12/20/2022]
Abstract
To date, comparisons between the balloon-expandable Edwards Sapien S3 (S3) versus the self-expanding Evolut R or PRO (Evolut) valves have been limited with respect to procedural outcomes. We aim to compare the safety, efficacy, and procedural efficiency of the S3 versus the Medtronic Evolut bioprostheses in patients who underwent transcatheter aortic valve implantation for severe aortic stenosis. Retrospective analysis was performed of all consecutive transcatheter aortic valve implantation procedures performed through the transfemoral approach with either S3 or Evolut at our hospital between September 2015 and January 2019. A total of 581 patients were included. There were no significant differences between S3 (n = 452) and Evolut (n = 129) concerning in-hospital or 30-day safety outcomes. S3 was associated with significantly shorter fluoroscopy times, lower fluoroscopy Air Kerma, and higher contrast use. S3 had lower postprocedure aortic valve area (1.71 ± 0.45 vs 1.84 ± 0.50 cm2, p = 0.004), larger peak gradient at 30 days (10.7 ± 3.8 vs 7.0 ± 3.2 mm Hg, p <0.001), and lower aortic regurgitation (AR) rates postprocedure (47% vs 33%, p = 0.024) and at 30 days (50% vs 33%, p = 0.008), driven by mild AR. Device type was an independent predictor of AR postprocedure and at 30 days. Patients with ≥mild AR were more likely to have had Evolut valves (odds ratio = 2.94, p <0.001), especially in larger valves (>26 mm). Severe prosthesis-patient mismatch was higher in S3 (14.8% vs 7.9%, p <0.001). In conclusion, S3 is associated with less radiation exposure, higher contrast use, and lower incidence of AR at 30 days. Alternately, S3 has a higher transaortic gradient at 30 days, and higher levels of severe prosthesis-patient mismatch.
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Li Y, Halliwill K, Adams C, Iyer V, Riva L, Rosario RD, Fredlund E, Adams D, Balmain A. Genomic Mutational Signatures in Tumors Induced By High and Low Energy Radiation in Trp53-deficient Mouse Models. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kumamaru KK, Angel E, Sommer KN, Iyer V, Wilson MF, Agrawal N, Bhardwaj A, Kattel SB, Kondziela S, Malhotra S, Manion C, Pogorzelski K, Ramanan T, Sawant AC, Suplicki MM, Waheed S, Fujimoto S, Sharma UC, Rybicki FJ, Ionita CN. Inter- and Intraoperator Variability in Measurement of On-Site CT-derived Fractional Flow Reserve Based on Structural and Fluid Analysis: A Comprehensive Analysis. Radiol Cardiothorac Imaging 2019; 1:e180012. [PMID: 33778507 DOI: 10.1148/ryct.2019180012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 05/17/2019] [Accepted: 06/24/2019] [Indexed: 11/11/2022]
Abstract
Purpose To measure the inter- and intraobserver variability among operators of varying expertise in conducting CT-derived fractional flow reserve (CT FFR) measurements on-site by using structural and fluid analysis and to evaluate differences in reproducibility between two different training methods for end users. Materials and Methods This retrospective analysis of the prospectively enrolled cohort included 22 symptomatic patients who underwent both 320-detector row coronary CT angiography and catheter-derived fractional flow reserve (FFR) within 90 days. Thirteen operators of varying expertise were assigned to one of two training arms: arm 1, on-site training by a specialist in CT FFR technology; arm 2, self-training through use of written materials. After the training, all 13 operators reviewed the CT data and measured CT FFR in 24 vessels in 22 patients. Inter- and intraoperator variability and agreements between CT FFR and catheter-derived FFR measurements were evaluated. Results The overall intraclass correlation coefficient (ICC) among operators was 0.71 (95% confidence interval: 0.58, 0.83) with a mean absolute difference (± standard deviation) of 0.027 ± 0.022. The operators in arm 2 showed greater interoperator differences than those in arm 1 (0.031 ± 0.024 vs 0.023 ± 0.018; P = .024). Among operators who recalculated CT FFR, the mean CT FFR value did not significantly differ between the first and second calculations (ICC, 0.66; 95% confidence interval: 0.46, 0.87), with the medical specialists producing the lowest intraoperator variability (0.053 ± 0.060). The overall correlation coefficient between CT FFR and catheter FFR was r = 0.61, with a mean absolute difference of 0.096 ± 0.089. Conclusion Good reproducibility of CT FFR values calculated on-site on the basis of structural and fluid analysis was observed among operators of varying expertise. Face-to-face training sessions may cause less variability.© RSNA, 2019Supplemental material is available for this article.
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Affiliation(s)
- Kanako K Kumamaru
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Erin Angel
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Kelsey N Sommer
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Vijay Iyer
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Michael F Wilson
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Nikhil Agrawal
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Aishwarya Bhardwaj
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Sharma B Kattel
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Sandra Kondziela
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Saurabh Malhotra
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Christopher Manion
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Katherine Pogorzelski
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Tharmathai Ramanan
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Abhishek C Sawant
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Mary M Suplicki
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Sameer Waheed
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Shinichiro Fujimoto
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Umesh C Sharma
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Frank J Rybicki
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
| | - Ciprian N Ionita
- Department of Radiology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan (K.K.K.); Canon Medical Systems USA, Tustin, Calif (E.A.); Department of Biomedical Engineering (K.N.S., C.N.I.), Department of Medicine (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S.) and Department of Medicine (Cardiology) and Nuclear Medicine (S.M.), University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY; Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (K.N.S., C.N.I.); Clinical and Translational Research Center, University at Buffalo, Buffalo, NY (V.I., M.F.W., N.A., A.B., S.B.K., C.M., T.R., A.C.S., S.W., U.C.S., C.N.I.); Buffalo General Medical Center, Buffalo, NY (S.K., K.P., M.M.S.); Department of Cardiovascular Medicine, School of Medicine, Juntendo University, Tokyo, Japan (S.F.); and Department of Radiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada (F.J.R.)
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Weil BR, Suzuki G, Young RF, Iyer V, Canty JM. Troponin Release and Reversible Left Ventricular Dysfunction After Transient Pressure Overload. J Am Coll Cardiol 2019; 71:2906-2916. [PMID: 29929614 DOI: 10.1016/j.jacc.2018.04.029] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [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: 01/26/2018] [Revised: 03/28/2018] [Accepted: 04/03/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND The authors previously demonstrated that brief ischemia elicits cardiac troponin I (cTnI) release and myocyte apoptosis in the absence of necrosis. It remains uncertain whether other pathophysiological stresses can produce apoptosis and transient cTnI release without ischemia. OBJECTIVES This study sought to determine whether a transient increase in left ventricular (LV) preload elicits cTnI release in the absence of ischemia. METHODS Propofol-anesthetized swine (N = 13) received intravenous phenylephrine (PE) (300 μg/min) for 1 h to increase left ventricular end-diastolic pressure (LVEDP) to ∼30 mm Hg. Serial cTnI and echocardiographic function were assessed for 24 h, and myocardial tissue was analyzed for apoptosis and necrosis. RESULTS PE infusion increased systolic blood pressure from 137 ± 14 mm Hg to 192 ± 11 mm Hg (mean ± SD; p < 0.001) and increased LVEDP from 17 ± 2 mm Hg to 30 ± 5 mm Hg (p < 0.001). Myocardial flow measurements demonstrated no evidence of ischemia. Hemodynamics normalized rapidly after PE, but LV ejection fraction remained depressed (32 ± 21% vs. 58 ± 7%; p < 0.01) with normalization after 24 h (51 ± 16%; p = 0.31). Baseline transcoronary cTnI release was low (16 ± 20 ng/l) but increased to 856 ± 956 ng/l (p = 0.01) 1 h after LVEDP elevation. Circulating cTnI rose above the 99th percentile within 30 min and remained elevated at 24 h (1,462 ± 1,691 ng/l). Pathological analysis demonstrated myocyte apoptosis at 3 h (31.3 ± 11.9 myocytes/cm2 vs. 4.6 ± 3.7 myocytes/cm2; p < 0.01), that normalized after 24 h (6.2 ± 5.6 myocytes/cm2; p = 0.46) without histological necrosis. CONCLUSIONS Transient elevations of LVEDP lead to cTnI release, apoptosis, and reversible stretch-induced stunning in the absence of ischemia. Thus, preload-induced myocyte injury may explain many cTnI elevations seen in the absence of clinical signs or symptoms of myocardial ischemia.
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Affiliation(s)
- Brian R Weil
- Department of Physiology and Biophysics, University at Buffalo, Buffalo, New York; Clinical and Translational Research Center of the University at Buffalo, Buffalo, New York.
| | - Gen Suzuki
- Clinical and Translational Research Center of the University at Buffalo, Buffalo, New York; Department of Medicine, Division of Cardiovascular Medicine, University at Buffalo, Buffalo, New York
| | - Rebeccah F Young
- Clinical and Translational Research Center of the University at Buffalo, Buffalo, New York; Department of Medicine, Division of Cardiovascular Medicine, University at Buffalo, Buffalo, New York
| | - Vijay Iyer
- Clinical and Translational Research Center of the University at Buffalo, Buffalo, New York; Department of Medicine, Division of Cardiovascular Medicine, University at Buffalo, Buffalo, New York
| | - John M Canty
- Department of Physiology and Biophysics, University at Buffalo, Buffalo, New York; Clinical and Translational Research Center of the University at Buffalo, Buffalo, New York; Department of Medicine, Division of Cardiovascular Medicine, University at Buffalo, Buffalo, New York; Department of Biomedical Engineering, University at Buffalo, Buffalo, New York; VA WNY Health Care System, Buffalo, New York
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Agrawal N, Kattel S, Waheed S, Kapoor A, Singh V, Sharma A, Page BJ, Attwood KM, Iyer V, Pokharel S, Sharma UC. Clinical Outcomes after Transcatheter Aortic Valve Replacement in Cancer Survivors Treated with Ionizing Radiation. Cardiooncology 2019; 5:8. [PMID: 31815000 PMCID: PMC6897372 DOI: 10.1186/s40959-019-0044-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 04/22/2019] [Accepted: 06/26/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Improved cancer survival in patients treated with thoracic ionizing radiation (XRT) has resulted in unanticipated surge of aortic stenosis. Transcatheter aortic valve replacement (TAVR) has revolutionized the management of severe aortic stenosis. However, long-term clinical outcomes in radiation-exposed cohorts undergoing TAVR are unknown. We compared the all-cause mortality and major adverse cardiac events (MACE) in patients with prior chest XRT (C-XRT) undergoing TAVR. METHODS This is an observational cohort study in subjects who underwent TAVR for symptomatic severe aortic stenosis from 2012 to 2017 in a tertiary care referral center. We examined the all-cause mortality and MACE using cox proportional hazard analysis to identify the clinical predictors of survival in the cohort of patients who had a history of prior C-XRT for malignancy. RESULTS Of the 610 patients who underwent TAVR for symptomatic severe aortic stenosis, 75 had prior C-XRT. The majority of C-XRT patients had prior breast cancer (44%) followed by Hodgkin's lymphoma (31%), with the median time from XRT to TAVR of 19.0 years. During a mean follow up of 17.1 months after TAVR, all-cause mortality was 17%. Those with prior C-XRT had higher all-cause mortality (XRT: 29%; non-XRT:15%, p<0.01) and MACE (XRT: 57%; non-XRT: 27%, p<0.001) after TAVR. Patients with prior XRT had a higher incidence of atrial fibrillation (XRT: 48 %; non-XRT: 2.4%, p<0.01) and high-grade heart block (XRT: 20%; non-XRT: 9.1%, p=0.007) requiring pacemaker implant after TAVR. On multivariate cox proportional hazard analysis, prior XRT (HR: 2.07, p=0.003), poor renal function (HR: 1.29, p<0.001) and post-operative anemia requiring transfusion (HR: 1.16, p:0.001) were the strongest predictors of reduced survival. CONCLUSIONS Cancer survivors with prior C- XRT have higher incidence of all-cause mortality and MACE after TAVR. Careful patient selection and follow-up strategies are needed to improve outcomes.
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Affiliation(s)
- Nikhil Agrawal
- Department of Medicine, Division of Cardiology, Clinical & Translational Research Center (Suite 7030), Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
| | - Sharma Kattel
- Department of Medicine, Division of Cardiology, Clinical & Translational Research Center (Suite 7030), Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
| | - Sameer Waheed
- Department of Medicine, Division of Cardiology, Clinical & Translational Research Center (Suite 7030), Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
| | - Ankita Kapoor
- Department of Medicine, Division of Cardiology, Clinical & Translational Research Center (Suite 7030), Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
| | - Vasvi Singh
- Department of Medicine, Division of Cardiology, Clinical & Translational Research Center (Suite 7030), Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA USA
| | - Ashutosh Sharma
- Department of Medicine, Division of Cardiology, Clinical & Translational Research Center (Suite 7030), Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
| | - Brian J. Page
- Department of Medicine, Division of Cardiology, Clinical & Translational Research Center (Suite 7030), Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
| | - Kristopher M. Attwood
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY USA
| | - Vijay Iyer
- Department of Medicine, Division of Cardiology, Clinical & Translational Research Center (Suite 7030), Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
| | - Saraswati Pokharel
- Department of Pathology, Division of Thoracic Pathology and Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY USA
| | - Umesh C. Sharma
- Department of Medicine, Division of Cardiology, Clinical & Translational Research Center (Suite 7030), Jacob’s School of Medicine and Biomedical Sciences, Buffalo, NY USA
- Clinical & Translational Research Center (Suite 7030), 875 Ellicott Street, Buffalo, NY 14203 USA
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Potrony M, Puig‐Butille J, Ribera‐Sola M, Iyer V, Robles‐Espinoza C, Aguilera P, Carrera C, Malvehy J, Badenas C, Landi M, Adams D, Puig S. POT1 and TERT promoter molecular screening in Spanish melanoma families. Br J Dermatol 2019. [DOI: 10.1111/bjd.18055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Potrony M, Puig‐Butille J, Ribera‐Sola M, Iyer V, Robles‐Espinoza C, Aguilera P, Carrera C, Malvehy J, Badenas C, Landi M, Adams D, Puig S. 在一组西班牙黑色素瘤家族中,与黑色素瘤易感性有关的是 POT1
生殖系突变而非 TERT
启动子突变. Br J Dermatol 2019. [DOI: 10.1111/bjd.18074] [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: 11/30/2022]
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Potrony M, Puig-Butille J, Ribera-Sola M, Iyer V, Robles-Espinoza C, Aguilera P, Carrera C, Malvehy J, Badenas C, Landi M, Adams D, Puig S. POT1 germline mutations but not TERT promoter mutations are implicated in melanoma susceptibility in a large cohort of Spanish melanoma families. Br J Dermatol 2019; 181:105-113. [PMID: 30451293 PMCID: PMC6526091 DOI: 10.1111/bjd.17443] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Germline mutations in telomere-related genes such as POT1 and TERT predispose individuals to familial melanoma. OBJECTIVES To evaluate the prevalence of germline mutations in POT1 and TERT in a large cohort of Spanish melanoma-prone families (at least two affected first- or second-degree relatives). METHODS Overall, 228 CDKN2A wild-type melanoma-prone families were included in the study. Screening of POT1 was performed in one affected person from each family and TERT was sequenced in one affected patient from 202 families (26 families were excluded owing to DNA exhaustion/degradation). TERT promoter sequencing was extended to an additional 30 families with CDKN2A mutation and 70 patients with sporadic multiple primary melanoma (MPM) with a family history of other cancers. RESULTS We identified four families with potentially pathogenic POT1 germline mutations: a missense variant c.233T>C (p.Ile78Thr); a nonsense variant c.1030G>T (p.Glu344*); and two other variants, c.255G>A (r.125_255del) and c.1792G>A (r.1791_1792insAGTA, p.Asp598Serfs*22), which we confirmed disrupted POT1 mRNA splicing. A TERT promoter variant of unknown significance (c.-125C>A) was detected in a patient with MPM, but no germline mutations were detected in TERT promoter in cases of familial melanoma. CONCLUSIONS Overall, 1·7% of our CDKN2A/CDK4-wild type Spanish melanoma-prone families carry probably damaging mutations in POT1. The frequency of TERT promoter germline mutations in families with melanoma in our population is extremely rare.
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Affiliation(s)
- Miriam Potrony
- Dermatology Department, Melanoma Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Barcelona, Spain
| | - J.A. Puig-Butille
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Barcelona, Spain
- Biochemistry and Molecular Genetics Department, Melanoma Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - M. Ribera-Sola
- Dermatology Department, Melanoma Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - V. Iyer
- Biochemistry and Molecular Genetics Department, Melanoma Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - C.D. Robles-Espinoza
- Laboratorio Internacional de Investigación sobre el Genoma Humano, Universidad Nacional Autónoma de México, Campus Juriquilla, Santiago de Querétaro, Mexico
- Experimental Cancer Genetics Group, Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom
| | - P. Aguilera
- Dermatology Department, Melanoma Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Barcelona, Spain
| | - Cristina Carrera
- Dermatology Department, Melanoma Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Barcelona, Spain
| | - J. Malvehy
- Dermatology Department, Melanoma Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Barcelona, Spain
| | - C. Badenas
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Barcelona, Spain
- Biochemistry and Molecular Genetics Department, Melanoma Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - M.T. Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, United States of America
| | - D.J. Adams
- Experimental Cancer Genetics Group, Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom
| | - Susana Puig
- Dermatology Department, Melanoma Unit, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Barcelona, Spain
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Asleh R, Schettle S, Maltais S, Daly R, Iyer V, Stulak J, Rodeheffer R. Promising Novel Treatment with Intravenous Bevacizumab for Refractory Gastrointestinal Bleeding from Angiodysplastic Lesions in Patients Supported with a Continuous-Flow Left Ventricular Assist Device: A Pilot Study. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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Agnese R, Aralis T, Aramaki T, Arnquist I, Azadbakht E, Baker W, Banik S, Barker D, Bauer D, Binder T, Bowles M, Brink P, Bunker R, Cabrera B, Calkins R, Cameron R, Cartaro C, Cerdeño D, Chang YY, Cooley J, Cornell B, Cushman P, De Brienne F, Doughty T, Fascione E, Figueroa-Feliciano E, Fink C, Fritts M, Gerbier G, Germond R, Ghaith M, Golwala S, Harris H, Herbert N, Hong Z, Hoppe E, Hsu L, Huber M, Iyer V, Jardin D, Jastram A, Jena C, Kelsey M, Kennedy A, Kubik A, Kurinsky N, Lawrence R, Loer B, Lopez Asamar E, Lukens P, MacDonell D, Mahapatra R, Mandic V, Mast N, Miller E, Mirabolfathi N, Mohanty B, Morales Mendoza J, Nelson J, Neog H, Orrell J, Oser S, Page W, Partridge R, Pepin M, Ponce F, Poudel S, Pyle M, Qiu H, Rau W, Reisetter A, Ren R, Reynolds T, Roberts A, Robinson A, Rogers H, Saab T, Sadoulet B, Sander J, Scarff A, Schnee R, Scorza S, Senapati K, Serfass B, Speller D, Stanford C, Stein M, Street J, Tanaka H, Toback D, Underwood R, Villano A, von Krosigk B, Watkins S, Wilson J, Wilson M, Winchell J, Wright D, Yellin S, Young B, Zhang X, Zhao X. Search for low-mass dark matter with CDMSlite using a profile likelihood fit. Int J Clin Exp Med 2019. [DOI: 10.1103/physrevd.99.062001] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Shepard LM, Sommer KN, Angel E, Iyer V, Wilson MF, Rybicki FJ, Mitsouras D, Molloi S, Ionita CN. Initial evaluation of three-dimensionally printed patient-specific coronary phantoms for CT-FFR software validation. J Med Imaging (Bellingham) 2019; 6:021603. [PMID: 30891468 DOI: 10.1117/1.jmi.6.2.021603] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 02/19/2019] [Indexed: 12/17/2022] Open
Abstract
We developed three-dimensionally (3D) printed patient-specific coronary phantoms that are capable of sustaining physiological flow and pressure conditions. We assessed the accuracy of these phantoms from coronary CT acquisition, benchtop experimentation, and CT-FFR software. Five patients with coronary artery disease underwent 320-detector row coronary CT angiography (CCTA) (Aquilion ONE, Canon Medical Systems) and a catheter lab procedure to measure fractional flow reserve (FFR). The aortic root and three main coronary arteries were segmented (Vitrea, Vital Images) and 3D printed (Eden 260V, Stratasys). Phantoms were connected into a pulsatile flow loop, which replicated physiological flow and pressure gradients. Contrast was introduced and the phantoms were scanned using the same CT scanner model and CCTA protocol as used for the patients. Image data from the phantoms were input to a CT-FFR research software (Canon Medical Systems) and compared to those derived from the clinical data, along with comparisons between image measurements and benchtop FFR results. Phantom diameter measurements were within 1 mm on average compared to patient measurements. Patient and phantom CT-FFR results had an absolute mean difference of 4.34% and Pearson correlation of 0.95. We have demonstrated the capabilities of 3D printed patient-specific phantoms in a diagnostic software.
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Affiliation(s)
- Lauren M Shepard
- University at Buffalo, University Department of Biomedical Engineering, Buffalo, New York, United States.,Canon Stroke and Vascular Research Center, Buffalo, New York, United States
| | - Kelsey N Sommer
- University at Buffalo, University Department of Biomedical Engineering, Buffalo, New York, United States.,Canon Stroke and Vascular Research Center, Buffalo, New York, United States
| | - Erin Angel
- Canon Medical Systems USA, Tustin, California, United States
| | - Vijay Iyer
- University at Buffalo Medicine, Interventional Cardiology, UBMD, Buffalo, New York, United States
| | - Michael F Wilson
- University at Buffalo Medicine, Interventional Cardiology, UBMD, Buffalo, New York, United States
| | - Frank J Rybicki
- University of Ottawa, Ottawa Hospital Research Institute and the Department of Radiology, Ottawa, Canada
| | - Dimitrios Mitsouras
- University of Ottawa, Ottawa Hospital Research Institute and the Department of Radiology, Ottawa, Canada
| | - Sabee Molloi
- University of California Irvine, University Department of Radiological Sciences, Irvine, California, United States
| | - Ciprian N Ionita
- University at Buffalo, University Department of Biomedical Engineering, Buffalo, New York, United States.,Canon Stroke and Vascular Research Center, Buffalo, New York, United States.,University at Buffalo, University Department of Neurosurgery, Buffalo, New York, United States
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Agrawal N, Kattel S, Singh V, Kapoor A, Sharma A, Iyer V, Sharma U. PROGNOSTIC IMPACT OF PRIOR RADIATION EXPOSURE IN CANCER SURVIVORS WITH SEVERE AORTIC STENOSIS UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)31700-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Agnese R, Aralis T, Aramaki T, Arnquist IJ, Azadbakht E, Baker W, Banik S, Barker D, Bauer DA, Binder T, Bowles MA, Brink PL, Bunker R, Cabrera B, Calkins R, Cartaro C, Cerdeño DG, Chang YY, Cooley J, Cornell B, Cushman P, Di Stefano PCF, Doughty T, Fascione E, Figueroa-Feliciano E, Fink C, Fritts M, Gerbier G, Germond R, Ghaith M, Golwala SR, Harris HR, Hong Z, Hoppe EW, Hsu L, Huber ME, Iyer V, Jardin D, Jena C, Kelsey MH, Kennedy A, Kubik A, Kurinsky NA, Lawrence RE, Leyva JV, Loer B, Lopez Asamar E, Lukens P, MacDonell D, Mahapatra R, Mandic V, Mast N, Miller EH, Mirabolfathi N, Mohanty B, Morales Mendoza JD, Nelson J, Orrell JL, Oser SM, Page WA, Partridge R, Pepin M, Phipps A, Ponce F, Poudel S, Pyle M, Qiu H, Rau W, Reisetter A, Reynolds T, Roberts A, Robinson AE, Rogers HE, Romani RK, Saab T, Sadoulet B, Sander J, Scarff A, Schnee RW, Scorza S, Senapati K, Serfass B, So J, Speller D, Stanford C, Stein M, Street J, Tanaka HA, Toback D, Underwood R, Villano AN, von Krosigk B, Watkins SL, Wilson JS, Wilson MJ, Winchell J, Wright DH, Yellin S, Young BA, Zhang X, Zhao X. Erratum: First Dark Matter Constraints from a SuperCDMS Single-Charge Sensitive Detector [Phys. Rev. Lett. 121, 051301 (2018)]. Phys Rev Lett 2019; 122:069901. [PMID: 30822060 DOI: 10.1103/physrevlett.122.069901] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Indexed: 06/09/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.121.051301.
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Wilson MF, Sommer KN, Shepard LM, Iyer V, Sharma U, Rybicki FJ, Mitsouras D, Angel E, Ionita CN. FFR As A Gold Standard For CT-FFR Validation. Does The FFR Measurement Device Alter The Flow? J Cardiovasc Comput Tomogr 2019. [DOI: 10.1016/j.jcct.2018.12.031] [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: 10/27/2022]
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Khalil C, Pham M, Sawant AC, Sinibaldi E, Bhardwaj A, Ramanan T, Qureshi R, Khan S, Ibrahim A, Gowda SN, Pomakov A, Sadawarte P, Lahoti A, Hansen R, Baldo S, Colern G, Pershad A, Iyer V. Neutrophil-to-lymphocyte ratio predicts heart failure readmissions and outcomes in patients undergoing transcatheter aortic valve replacement. Indian Heart J 2019; 70 Suppl 3:S313-S318. [PMID: 30595282 PMCID: PMC6310731 DOI: 10.1016/j.ihj.2018.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/29/2018] [Accepted: 08/01/2018] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Neutrophil-to-lymphocyte ratio (NLR) has prognostic value in acute coronary syndromes. We investigated its utility for predicting heart failure (HF) admissions and major adverse cardiac outcomes in patients undergoing transcatheter aortic valve replacement (TAVR). METHODS Data on clinical, laboratory, procedural, HF admissions, and major adverse cardiac events (MACEs) (all-cause mortality, recurrence of myocardial infarction requiring intervention, stroke) for 298 consecutive patients who underwent TAVR between 2012 and 2016 in our tertiary center were collected. RESULTS Analysis included 298 patients. The mean age was 83 ± 8 years, 51% were males, and 95% were Caucasians. The median Society of Thoracic Surgeons risk score was 9 (interquartile range: 6.3-11.8). Receiver-operating curve analysis identified a cutoff value of NLR of 4.0 for MACE after TAVR and sensitivity of 68% and specificity of 68% {area under the curve [AUC] = 0.65 [95% confidence interval (CI): 0.51-0.79], p = 0.03}. An NLR of 4.0 for HF hospitalizations after TAVR and sensitivity of 60% and specificity of 57% [AUC = 0.61 (95% CI: 0.53-0.69), p = 0.01]. NLR ≥4.0 before TAVR significantly predicted MACE after TAVR (68.4% vs. 31.6%, p = 0.02) and HF hospitalizations (58.3% vs. 41.7%, p = 0.03). NLR with TAVR risk score increased the predictive value for MACE after TAVR from AUC = 0.61 (95% CI: 0.50-0.72, p = 0.06) to AUC = 0.69 (95% CI: 0.57-0.80, p = 0.007). CONCLUSION NLR predicts all-cause mortality, MACE, and HF hospitalization 1 year after TAVR. NLR with TAVR risk score improved predictability for MACE. Further studies for prognostication using NLR are warranted.
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Affiliation(s)
- Charl Khalil
- Division of Cardiology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Michael Pham
- Division of Cardiology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Abhishek C Sawant
- Division of Cardiology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Everett Sinibaldi
- Division of Cardiology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Aishwarya Bhardwaj
- Division of Cardiology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Tharmathai Ramanan
- Division of Cardiology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Reema Qureshi
- Dept of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Sahoor Khan
- Division of Cardiology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Amira Ibrahim
- Division of Cardiology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Smitha N Gowda
- Division of Cardiology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Alexander Pomakov
- Division of Cardiology, State University of New York at Buffalo, Buffalo, NY, USA
| | | | - Ankush Lahoti
- Division of Cardiology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Rosemary Hansen
- Division of Cardiology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Shannon Baldo
- Division of Cardiology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Gerald Colern
- Division of Cardiology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Ashish Pershad
- Division of Interventional Cardiology, Banner University Medical Center, Phoenix, AZ, USA
| | - Vijay Iyer
- Division of Cardiology, State University of New York at Buffalo, Buffalo, NY, USA.
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Lazkani M, Sawant AC, Taase A, Khan S, Fang K, Iyer V, Pershad A. Left atrial hemodynamics and left ventricular remodeling -predictors of outcomes after Transcatheter mitral valve repair with the MitraClip device. Catheter Cardiovasc Interv 2018; 93:128-133. [DOI: 10.1002/ccd.27804] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/01/2018] [Accepted: 07/12/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Mohamad Lazkani
- Division of Cardiology; University of Arizona; Phoenix Arizona
| | - Abhishek C. Sawant
- Division of Cardiology; State University of New York at Buffalo; Buffalo New York
| | - Alicia Taase
- Division of Cardiology; University of Arizona; Phoenix Arizona
| | - Sahoor Khan
- Division of Cardiology; State University of New York at Buffalo; Buffalo New York
| | - Kenith Fang
- Division of Cardiology; University of Arizona; Phoenix Arizona
| | - Vijay Iyer
- Division of Cardiology; State University of New York at Buffalo; Buffalo New York
| | - Ashish Pershad
- Division of Cardiology; University of Arizona; Phoenix Arizona
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Agnese R, Aralis T, Aramaki T, Arnquist IJ, Azadbakht E, Baker W, Banik S, Barker D, Bauer DA, Binder T, Bowles MA, Brink PL, Bunker R, Cabrera B, Calkins R, Cartaro C, Cerdeño DG, Chang YY, Cooley J, Cornell B, Cushman P, Di Stefano PCF, Doughty T, Fascione E, Figueroa-Feliciano E, Fink C, Fritts M, Gerbier G, Germond R, Ghaith M, Golwala SR, Harris HR, Hong Z, Hoppe EW, Hsu L, Huber ME, Iyer V, Jardin D, Jena C, Kelsey MH, Kennedy A, Kubik A, Kurinsky NA, Lawrence RE, Leyva JV, Loer B, Lopez Asamar E, Lukens P, MacDonell D, Mahapatra R, Mandic V, Mast N, Miller EH, Mirabolfathi N, Mohanty B, Morales Mendoza JD, Nelson J, Orrell JL, Oser SM, Page WA, Partridge R, Pepin M, Phipps A, Ponce F, Poudel S, Pyle M, Qiu H, Rau W, Reisetter A, Reynolds T, Roberts A, Robinson AE, Rogers HE, Romani RK, Saab T, Sadoulet B, Sander J, Scarff A, Schnee RW, Scorza S, Senapati K, Serfass B, So J, Speller D, Stanford C, Stein M, Street J, Tanaka HA, Toback D, Underwood R, Villano AN, von Krosigk B, Watkins SL, Wilson JS, Wilson MJ, Winchell J, Wright DH, Yellin S, Young BA, Zhang X, Zhao X. First Dark Matter Constraints from a SuperCDMS Single-Charge Sensitive Detector. Phys Rev Lett 2018; 121:051301. [PMID: 30118251 DOI: 10.1103/physrevlett.121.051301] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 06/20/2018] [Indexed: 06/08/2023]
Abstract
We present the first limits on inelastic electron-scattering dark matter and dark photon absorption using a prototype SuperCDMS detector having a charge resolution of 0.1 electron-hole pairs (CDMS HVeV, a 0.93 g CDMS high-voltage device). These electron-recoil limits significantly improve experimental constraints on dark matter particles with masses as low as 1 MeV/c^{2}. We demonstrate a sensitivity to dark photons competitive with other leading approaches but using substantially less exposure (0.49 g d). These results demonstrate the scientific potential of phonon-mediated semiconductor detectors that are sensitive to single electronic excitations.
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Affiliation(s)
- R Agnese
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - T Aralis
- Division of Physics, Mathematics, and Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - T Aramaki
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - I J Arnquist
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - E Azadbakht
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - W Baker
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - S Banik
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni-752050, India
| | - D Barker
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - D A Bauer
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - T Binder
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - M A Bowles
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - P L Brink
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - R Bunker
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - B Cabrera
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - R Calkins
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - C Cartaro
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - D G Cerdeño
- Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
- Instituto de Física Teórica UAM/CSIC, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Y-Y Chang
- Division of Physics, Mathematics, and Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - J Cooley
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - B Cornell
- Division of Physics, Mathematics, and Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - P Cushman
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - P C F Di Stefano
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - T Doughty
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - E Fascione
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - E Figueroa-Feliciano
- Department of Physics and Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - C Fink
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - M Fritts
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - G Gerbier
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - R Germond
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - M Ghaith
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - S R Golwala
- Division of Physics, Mathematics, and Astronomy, California Institute of Technology, Pasadena, California 91125, USA
| | - H R Harris
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - Z Hong
- Department of Physics and Astronomy, Northwestern University, Evanston, Illinois 60208-3112, USA
| | - E W Hoppe
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - L Hsu
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - M E Huber
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
- Department of Electrical Engineering, University of Colorado Denver, Denver, Colorado 80217, USA
| | - V Iyer
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni-752050, India
| | - D Jardin
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - C Jena
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni-752050, India
| | - M H Kelsey
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - A Kennedy
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - A Kubik
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - N A Kurinsky
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, 2575 Sand Hill Road, Menlo Park, California 94025, USA
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - R E Lawrence
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - J V Leyva
- Department of Physics, Santa Clara University, Santa Clara, California 95053, USA
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - B Loer
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - E Lopez Asamar
- Department of Physics, Durham University, Durham DH1 3LE, United Kingdom
| | - P Lukens
- Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - D MacDonell
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
| | - R Mahapatra
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - V Mandic
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - N Mast
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - E H Miller
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - N Mirabolfathi
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - B Mohanty
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni-752050, India
| | - J D Morales Mendoza
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - J Nelson
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - J L Orrell
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - S M Oser
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
| | - W A Page
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
| | - R Partridge
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - M Pepin
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - A Phipps
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - F Ponce
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - S Poudel
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - M Pyle
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - H Qiu
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - W Rau
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - A Reisetter
- Department of Physics, University of Evansville, Evansville, Indiana 47722, USA
| | - T Reynolds
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - A Roberts
- Department of Physics, University of Colorado Denver, Denver, Colorado 80217, USA
| | - A E Robinson
- Département de Physique, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - H E Rogers
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - R K Romani
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - T Saab
- Department of Physics, University of Florida, Gainesville, Florida 32611, USA
| | - B Sadoulet
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - J Sander
- Department of Physics, University of South Dakota, Vermillion, South Dakota 57069, USA
| | - A Scarff
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
| | - R W Schnee
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - S Scorza
- SNOLAB, Creighton Mine #9, 1039 Regional Road 24, Sudbury, Ontario P3Y 1N2, Canada
| | - K Senapati
- School of Physical Sciences, National Institute of Science Education and Research, HBNI, Jatni-752050, India
| | - B Serfass
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - J So
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - D Speller
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - C Stanford
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - M Stein
- Department of Physics, Southern Methodist University, Dallas, Texas 75275, USA
| | - J Street
- Department of Physics, South Dakota School of Mines and Technology, Rapid City, South Dakota 57701, USA
| | - H A Tanaka
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - D Toback
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - R Underwood
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - A N Villano
- School of Physics and Astronomy, University of Minnesota, Minneapolis, Minnesota 55455, USA
| | - B von Krosigk
- TRIUMF, Vancouver, British Columbia V6T 2A3, Canada
- Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z1, Canada
| | - S L Watkins
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - J S Wilson
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - M J Wilson
- Department of Physics, University of Toronto, Toronto, Ontario M5S 1A7, Canada
| | - J Winchell
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
| | - D H Wright
- SLAC National Accelerator Laboratory/Kavli Institute for Particle Astrophysics and Cosmology, 2575 Sand Hill Road, Menlo Park, California 94025, USA
| | - S Yellin
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - B A Young
- Department of Physics, Santa Clara University, Santa Clara, California 95053, USA
- Department of Physics, Stanford University, Stanford, California 94305, USA
| | - X Zhang
- Department of Physics, Queen's University, Kingston, Ontario K7L 3N6, Canada
| | - X Zhao
- Department of Physics and Astronomy, and the Mitchell Institute for Fundamental Physics and Astronomy, Texas A&M University, College Station, Texas 77843, USA
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Bhardwaj A, Ramanan T, Sawant AC, Sinibaldi E, Pham M, Khan S, Qureshi R, Agrawal N, Khalil C, Hansen R, Baldo S, Colern G, Corbelli J, Pershad A, Beck H, Iyer V. Quality of life outcomes in transcatheter aortic valve replacement patients requiring pacemaker implantation. J Arrhythm 2018; 34:441-449. [PMID: 30167016 PMCID: PMC6111478 DOI: 10.1002/joa3.12065] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 03/31/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Permanent pacemaker implantation is the most common complication after Transcatheter aortic valve replacement (TAVR) and is associated with worse outcomes and mortality. However, its impact on quality-of-life (QoL) outcomes remains unknown. METHODS We included 383 consecutive patients undergoing TAVR from January 2012 to 2016 who completed a baseline Kansas City Cardiomyopathy Questionnaire (KCCQ-12) health survey. The clinical, laboratory, angiographic, QoL, mortality, and occurrence of poor outcomes (KCCQ-12 score < 45 or KCCQ decrease of ≥10 points) were obtained. RESULTS The mean age was 83 ± 8 years, 51% were men, and majority were Caucasians (n = 364, 95%). Permanent pacemaker (PPM) was implanted in 11.5% of patients post-TAVR. PPM patients were more likely to have prior conduction disease including RBBB (25% vs 12%, P = .02) and PQ interval >250 ms (11% vs 5%, P = .07). One-month median KCCQ-12 scores were significantly lower among PPM patients (84.7 vs 68.8, P = .04), but did not differ significantly at 1-year (86.5 vs 90.6, P = .5) post-TAVR. Occurrence of poor outcomes did not differ significantly among those with or without PPM at 1 month (11% vs 7%, P = .39) and 1 year (13% vs 9%, P = .45), respectively. However, patients with poor QoL outcomes at 1 month post-TAVR also had significantly worse mortality during follow-up in unadjusted (31.3% vs 4.5%, P < .001) and adjusted (HR = 5.30, 95% [CI: 1.85-15.22, P = .002])analyses, respectively. CONCLUSION Permanent pacemaker implantation is associated with short-term reduction in QoL without long-term implications post-TAVR. Patients with poor QoL post-TAVR also have significantly higher mortality.
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Affiliation(s)
- Aishwarya Bhardwaj
- Department of MedicineDivision of CardiologyState University of New York at BuffaloBuffaloNYUSA
| | - Tharmathai Ramanan
- Department of MedicineDivision of CardiologyState University of New York at BuffaloBuffaloNYUSA
| | - Abhishek C. Sawant
- Department of MedicineDivision of CardiologyState University of New York at BuffaloBuffaloNYUSA
| | - Everett Sinibaldi
- Department of MedicineDivision of CardiologyState University of New York at BuffaloBuffaloNYUSA
| | - Michael Pham
- Department of MedicineDivision of CardiologyState University of New York at BuffaloBuffaloNYUSA
| | - Sahoor Khan
- Department of MedicineDivision of CardiologyState University of New York at BuffaloBuffaloNYUSA
| | - Reema Qureshi
- Department of MedicineDivision of CardiologyWarren Alpert Medical School of Brown UniversityProvidenceRIUSA
| | - Nikhil Agrawal
- Department of MedicineDivision of CardiologyState University of New York at BuffaloBuffaloNYUSA
| | - Charl Khalil
- Department of MedicineDivision of CardiologyState University of New York at BuffaloBuffaloNYUSA
| | - Rosemary Hansen
- Department of MedicineDivision of CardiologyState University of New York at BuffaloBuffaloNYUSA
| | - Shannon Baldo
- Department of MedicineDivision of CardiologyState University of New York at BuffaloBuffaloNYUSA
| | - Gerald Colern
- Department of MedicineDivision of CardiologyState University of New York at BuffaloBuffaloNYUSA
| | - John Corbelli
- Department of MedicineDivision of CardiologyState University of New York at BuffaloBuffaloNYUSA
| | - Ashish Pershad
- Department of MedicineDivision of Interventional CardiologyBanner University Medical CenterPhoenixAZUSA
| | - Hiroko Beck
- Department of MedicineDivision of CardiologyState University of New York at BuffaloBuffaloNYUSA
| | - Vijay Iyer
- Department of MedicineDivision of CardiologyState University of New York at BuffaloBuffaloNYUSA
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Sommer KN, Shepard L, Karkhanis NV, Iyer V, Angel E, Wilson MF, Rybicki FJ, Mitsouras D, Rudin S, Ionita CN. 3D Printed Cardiovascular Patient Specific Phantoms Used for Clinical Validation of a CT-derived FFR Diagnostic Software. Proc SPIE Int Soc Opt Eng 2018; 10578. [PMID: 29899591 DOI: 10.1117/12.2292736] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Purpose 3D printed patient specific vascular models provide the ability to perform precise and repeatable benchtop experiments with simulated physiological blood flow conditions. This approach can be applied to CT-derived patient geometries to determine coronary flow related parameters such as Fractional Flow Reserve (FFR). To demonstrate the utility of this approach we compared bench-top results with non-invasive CT-derived FFR software based on a computational fluid dynamics algorithm and catheter based FFR measurements. Materials and Methods Twelve patients for whom catheter angiography was clinically indicated signed written informed consent to CT Angiography (CTA) before their standard care that included coronary angiography (ICA) and conventional FFR (Angio-FFR). The research CTA was used first to determine CT-derived FFR (Vital Images) and second to generate patient specific 3D printed models of the aortic root and three main coronary arteries that were connected to a programmable pulsatile pump. Benchtop FFR was derived from pressures measured proximal and distal to coronary stenosis using pressure transducers. Results All 12 patients completed the clinical study without any complication, and the three FFR techniques (Angio-FFR, CT-FFR, and Benchtop FFR) are reported for one or two main coronary arteries. The Pearson correlation among Benchtop FFR/Angio-FFR, CT-FFR/ Benchtop FFR, and CT-FFR/ Angio-FFR are 0.871, 0.877, and 0.927 respectively. Conclusions 3D printed patient specific cardiovascular models successfully simulated hyperemic blood flow conditions, matching invasive Angio-FFR measurements. This benchtop flow system could be used to validate CT-derived FFR diagnostic software, alleviating both cost and risk during invasive procedures.
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Affiliation(s)
- Kelsey N Sommer
- Department of Biomedical Engineering, University at Buffalo, Buffalo NY 14228.,Toshiba-Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo NY 14208
| | - Lauren Shepard
- Department of Biomedical Engineering, University at Buffalo, Buffalo NY 14228.,Toshiba-Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo NY 14208
| | - Nitant Vivek Karkhanis
- Department of Biomedical Engineering, University at Buffalo, Buffalo NY 14228.,Toshiba-Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo NY 14208
| | - Vijay Iyer
- Toshiba-Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo NY 14208.,University at Buffalo Cardiology, University at Buffalo Jacobs School of Medicine, Buffalo NY 14208
| | - Erin Angel
- Canon Medical Systems USA, Irvine CA 92780
| | - Michael F Wilson
- Toshiba-Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo NY 14208.,University at Buffalo Cardiology, University at Buffalo Jacobs School of Medicine, Buffalo NY 14208
| | - Frank J Rybicki
- The Ottawa Hospital Research Institute and the Department of Radiology, University of Ottawa, Ottawa, ON, CA
| | | | - Stephen Rudin
- Department of Biomedical Engineering, University at Buffalo, Buffalo NY 14228.,Toshiba-Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo NY 14208
| | - Ciprian N Ionita
- Department of Biomedical Engineering, University at Buffalo, Buffalo NY 14228.,Toshiba-Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo NY 14208
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Bhardwaj A, Sawant A, Hansen R, Sadawarte P, Agrawal N, Ramanan T, Sinibaldi E, Lahoti A, Kumar A, Sato K, Fernandez S, Sharma U, Iyer V. SYSTOLIC IMPEDANCE AND DIASTOLIC WALL STRESS ARE NOVEL PREDICTORS OF HEART FAILURE HOSPITALIZATIONS IN PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)32098-9] [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: 10/17/2022]
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46
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Ramanan T, Sawant A, Bhardwaj A, Hansen R, Sinibaldi E, Pham M, Khalil C, Sharma A, Kumar A, Iyer V. THE AMERICAN COLLEGE OF CARDIOLOGY: TRANSCATHETER AORTIC VALVE REPLACEMENT RISK CALCULATOR ACCURATELY PREDICTS HEART FAILURE READMISSIONS AND QUALITY OF LIFE OUTCOMES. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31963-6] [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: 11/24/2022]
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47
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Agrawal N, Sawant A, Bhardwaj A, Ramanan T, Hansen R, Sinibaldi E, Sadawarte P, Lahoti A, Kumar A, Sato K, Elango K, Shah T, Fernandez S, Sharma U, Iyer V. CHANGE IN LEFT VENTRICULAR SYSTOLIC WALL STRESS PREDICTS HEART FAILURE READMISSIONS IN PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31950-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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48
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Singh V, Iyer V, Mursleen A, Hansen R, Fernandez S, Malhotra S. ACUTE CHANGE IN MYOCARDIAL DEFORMATION DOES NOT PREDICT HEART FAILURE READMISSION AFTER TAVR AMONG PATIENTS WITH A LOW FLOW LOW GRADIENT PHYSIOLOGY. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31953-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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49
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Singh V, Iyer V, Mursleen A, Hansen E, Fernandez S, Malhotra S. MYOCARDIAL CONTRACTILITY PREDICTS SYMPTOMATIC IMPROVEMENT ACROSS ALL FLOW-GRADIENT PATTERNS OF AORTIC STENOSIS AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31954-5] [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: 10/17/2022]
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50
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Kereiakes D, Meduri C, Makkar R, Linke A, Babaliaros V, Stoler R, Mishkel G, Rizik DG, Iyer V, Schindler J, Allocco D, Meredith I, Reardon M, Feldman T. PACEMAKER DEPENDENCY FOLLOWING TRANSCATHETER AORTIC VALVE IMPLANTATION: A SUBANALYSIS OF THE REPRISE III RANDOMIZED CONTROLLED CLINICAL TRIAL. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31537-7] [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: 11/26/2022]
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