Publications by authors named "Anita Kelsey"
Background: Percutaneous balloon mitral valvuloplasty (PBMV) is the ACC/AHA class I recommendation for treating symptomatic rheumatic mitral stenosis with suitable valve morphology, less than moderate MR and absence of left atrium clot. The mitral valve restenosis and significant mitral regurgitation (MR) are known adverse outcomes of PBMV. This study aimed to evaluate the outcomes of PBMV in patients with severe mitral stenosis and the effect of Commissural Calcification (CC) on the outcomes.
View Article and Find Full Text PDFAims: Clinical trials in heart failure with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF) commonly have detailed eligibility criteria. This may contribute to challenges with efficient enrolment and questions regarding the generalizability of trial findings.
Methods And Results: Patients with HFmrEF/HFpEF from a large US healthcare system were identified through a computable phenotype applied in linked imaging and electronic health record databases.
Article Synopsis
- There are pros and cons to both functional and anatomic testing for diagnosing obstructive coronary artery disease.
- Pre-test probability assessments help determine which testing method to use based on the patient's characteristics.
- Anatomic testing is often better for younger patients and women, while functional testing is useful for confirming ischemia and guiding treatment decisions.
Background: Heart failure (HF) guidelines recommend assessment of left ventricular ejection fraction (LVEF) to classify patients and guide therapy implementation. However, LVEF alone may be insufficient to adequately characterize patients with HF, especially those with mildly reduced or preserved LVEF. Recommendations on additional testing are lacking, and there are limited data on use of echocardiographic features beyond LVEF in patients with heart failure with mildly reduced or preserved LVEF.
View Article and Find Full Text PDFImaging Considerations and Clinical Implications of Mitral Annular Disjunction.
Circ Cardiovasc Imaging
September 2022
Article Synopsis
- - Mitral annular disjunction is a key structural feature linked to mitral valve disease, involving a separation at the insertion point of the valve.
- - This condition is associated with greater valve degeneration and a higher risk of sudden cardiac death, emphasizing its clinical significance.
- - The article calls for standardized reporting on this condition in cardiovascular imaging to improve patient risk assessment and care, while highlighting areas needing more research.
Background: Recent data suggest that patients with heart failure with reduced ejection fraction (HFrEF) and worsening heart failure (WHF) have potential for greater benefit from newer HF therapies. We investigated characteristics and outcomes of patients with HFrEF and WHF by severity of left ventricular dysfunction.
Methods: We identified patients with chronic symptomatic HFrEF (left ventricular ejection fraction [LVEF] ≤35%) and evidence of WHF (emergency department visit or hospitalization for acute HF within 12 months of index echocardiogram) treated at Duke University between 1/2009 and 12/2018.
Background: Heart failure with preserved ejection fraction (HFpEF) continues to increase in prevalence with a 50% mortality rate within 3 years of diagnosis, but lacking effective evidence-based therapies. Specific echocardiographic markers are not typically used to trigger alarm before acute HFpEF decompensation. The goal of this study was to retrospectively track changes in echocardiographic markers leading to the time of incident HFpEF hospitalization.
View Article and Find Full Text PDFArticle Synopsis
- Acute cardiovascular disease (CVD) hospitalizations decreased during the COVID-19 pandemic compared to pre-pandemic levels, particularly for heart failure patients.
- Despite the decline in hospitalizations, there was no significant change in in-hospital mortality rates, indicating that patients were not at a higher risk while hospitalized.
- Illness severity for heart failure patients showed mixed results, with some indicators suggesting increased risk, but overall, the impact of the pandemic on HF outcomes was limited.
Objective: This study evaluated whether vasomotor symptom (VMS) severity and number of moderate/severe menopausal symptoms (nMS) were associated with health outcomes, and whether calcium and vitamin D (CaD) modified the risks.
Methods: The Women's Health Initiative CaD study was a double blind, randomized, placebo-controlled trial, which tested 400 IU of 25-hydroxyvitamin-D and 1,000 mg of calcium per day in women aged 50 to 79 years. This study included 20,050 women (median follow-up of 7 y).
The infection caused by severe acute respiratory syndrome coronavirus-2, or COVID-19, can result in myocardial injury, heart failure, and arrhythmias. In addition to the viral infection itself, investigational therapies for the infection can interact with the cardiovascular system. As cardiologists and cardiovascular service lines will be heavily involved in the care of patients with COVID-19, our division organized an approach to manage these complications, attempting to balance resource utilization and risk to personnel with optimal cardiovascular care.
View Article and Find Full Text PDFObjective: Data in humans and nonhuman primates have suggested a possible synergistic effect of vitamin D and calcium (CaD) and estrogen on the cardiovascular disease (CVD) risk factors. Using randomized trial data we explored whether the effect of menopausal hormone therapy (HT) on CVD events is modified by CaD supplementation.
Methods: A prospective, randomized, double-blind, placebo-controlled trial was implemented among postmenopausal women in the Women's Health Initiative.
Objective: To determine whether men should be encouraged to enter the medical specialty of obstetrics and gynecology.
Methods: A self-administered survey was designed for and distributed to patients (N=264) in 13 obstetrics and gynecology waiting rooms in Connecticut. The survey was used to determine whether there were any patient preferences with regard to the gender of physicians providing obstetric and gynecologic care within this population.
Background: Percutaneous transcatheter closure of a patent foramen ovale (PFO) has been utilized over the last several years to prevent thromboembolic events in selected patients with a prior cryptogenic stroke. We describe our initial experience at Hartford Hospital with a transcatheter PFO closure system and our multidisciplinary approach.
Methods: From March to November 2002, we performed percutaneous transcatheter closure of a PFO in 16 patients with a prior history of cryptogenic stroke(s) and/or transient ischemic attack using the CardioSEAL Septal Occluder system.
Study Objective: To compare endogenous serum growth hormone concentrations over a 24-hour period in patients with chronic heart failure (CHF) and matched controls.
Design: Prospective, 24-hour, endogenous concentration comparison.
Setting: Hospital research center.