Publications by authors named "Damian Kurian"
Article Synopsis
- The study focuses on evaluating the occurrence of transthyretin cardiac amyloidosis (ATTR-CA) in older Black and Caribbean Hispanic individuals with heart issues and increased wall thickness.
- *It analyzes recruitment data from various medical institutions, discovering that Harlem Hospital had the highest enrollment rates, linked to factors like direct recruitment by care teams, education level, and English proficiency.
- *The findings suggest that recruitment strategies and participant demographics significantly influence enrollment success, while other factors like chronic diseases or perceived discrimination did not impact enrollment rates.
Article Synopsis
- ATTR-CM is a type of heart failure that often goes undiagnosed, particularly in individuals aged 60 and older, with a notable variant (V122I) found in 3.4% of self-identified Black individuals in the U.S.
- The SCAN-MP study aims to explore the prevalence of ATTR-CM in older Black and Hispanic individuals with heart failure using specialized imaging techniques, focusing on the V122I variant's effects.
- Results show a 6.8% prevalence of ATTR-CM and a 39% phenotypic penetrance for V122I carriers; clinical markers like prealbumin levels might help in identifying which carriers have the condition.
Article Synopsis
- Deficits in physical function are linked to lower quality of life and worse health outcomes in Black and Hispanic patients with heart failure (HF).
- The SCAN-MP study involved 320 participants who were assessed for physical performance and completion of a health questionnaire, revealing that 70.9% had physical deficits.
- Severe physical deficits correlated with lower quality of life scores and a significantly higher risk of HF hospitalization compared to those with no deficits.
Article Synopsis
- Transthyretin amyloid cardiomyopathy (ATTR-CM) is a significant cause of heart failure in older adults, often linked to a specific genetic variant (pV142I) primarily found in individuals of West African descent.
- The SCAN-MP study aims to determine how prevalent ATTR-CM is in older Black and Caribbean Hispanic patients with heart failure, using noninvasive imaging techniques.
- This study is the largest of its kind focusing on cardiac amyloidosis in these populations and could lead to better treatment strategies using the approved drug tafamidis.
Article Synopsis
- The study investigates the best heart-to-contralateral chest (H/CL) ratio threshold for diagnosing transthyretin cardiac amyloidosis (ATTR-CA) using Tc pyrophosphate (PYP) imaging in older adults with heart failure.
- Among 229 patients, only 14 confirmed cases of ATTR-CA were identified, and most scans showed no PYP uptake, highlighting the challenge of accurate diagnosis.
- An H/CL threshold of ≥ 1.4 provided high specificity and positive predictive value, but a lower threshold of ≥ 1.3 had higher sensitivity, indicating that using these thresholds in low pretest probability populations could lead to misclassifications.
Article Synopsis
- * A study analyzed the link between body mass index (BMI) and the presence of ATTR-CA or the Val122Ile variant in patients, finding that those with ATTR-CA+Val122Ile had lower median BMI compared to others.
- * The association remains strong, particularly in Black and Hispanic patients, indicating that a BMI under 30 kg/m is a significant marker for ATTR-CA+Val122Ile, which is further compounded by increased left ventricle wall thickness.
Article Synopsis
- Lyme carditis (LC) is a heart condition linked to early disseminated Lyme disease, typically causing transient but potentially serious cardiac issues, as outlined in a case study of a 42-year-old man who experienced severe symptoms after a tick bite.
- The patient suffered from generalized weakness, presyncope, and dyspnea, and was diagnosed with a severe cardiac conduction issue leading to a brief cardiac arrest, treated with IV ceftriaxone and a temporary pacemaker.
- This case is notable because it occurred in an urban hospital where such cases are rare, and the diagnosis was unexpected given the patient's circumstances related to the COVID-19 pandemic.
Article Synopsis
- Obesity hypoventilation syndrome (OHS) is defined by severe obesity (BMI ≥30 kg/m²), high daytime carbon dioxide levels, and obstructive sleep apnea, potentially leading to serious complications like pulmonary hypertension and heart issues.
- A case study of a 53-year-old man with a BMI of 75 kg/m² revealed right ventricular dysfunction and failure linked to OHS, despite no other lung diseases being present.
- The patient's treatment included the use of continuous positive airway pressure (CPAP) and supplemental oxygen to manage his condition and improve his breathing during sleep.
Article Synopsis
- - A 25-year-old obese man experienced acute shortness of breath, chest pain, and palpitations and was found to have serious complications linked to a saddle pulmonary embolism.
- - Laboratory tests showed elevated D-dimer and troponin levels, and an echocardiogram indicated the presence of a thrombus and McConnell's sign in his heart.
- - He underwent a surgical embolectomy, which is suggested to provide better outcomes than other treatments in similar cases, though formal treatment guidelines are lacking due to the rarity of such cases in young patients.
Article Synopsis
- - The study analyzed the effects of short-term (≤ 6 months) versus long-term (≥ 12 months) dual antiplatelet therapy (DAPT) in 15,378 patients who underwent drug-eluting stent (DES) implantation to see which duration had better health outcomes.
- - Results showed no significant differences in major adverse events (like death, heart attack, or strokes) between the two groups, indicating that both durations are similarly effective.
- - However, patients on long-term DAPT experienced a higher risk of major bleeding compared to those on short-term therapy, suggesting that a shorter duration might be safer.
Article Synopsis
- Coronary vasospasm can cause serious issues like myocardial injury and sudden cardiac death, yet is often overlooked as a diagnosis compared to more common causes like atherosclerosis.
- A middle-aged man with a smoking and cocaine history experienced chest pain and sweating, with an ECG showing abnormal changes that resolved after nitroglycerin, indicating a spasm rather than blockage.
- An angiogram revealed a significant narrowing in his coronary artery, and after a procedure to fix it, he remained symptom-free, highlighting the importance of recognizing vasospasm in patients with risk factors.
Article Synopsis
- Recent findings highlight the link between post-procedure bleeding and increased mortality, leading to a focus on transradial coronary interventions in the U.S.
- Despite its advantages, such as reduced access site bleeding, transradial access is still only used in 1% of coronary interventions in the U.S., compared to 50% in countries like India and Japan.
- The authors share their experiences using transradial methods for lower extremity, renal, and subclavian interventions, noting that it often simplifies the procedure and allows for same-day patient discharge.
Article Synopsis
- This study compares the transradial approach (TRA) and transfemoral approach (TFA) for aortoiliac angioplasty/stenting using data from interventions performed between 2007 and 2009.
- In the study, both groups had similar demographic and clinical characteristics, but the TRA group had a higher percentage of total occlusions and shorter discharge times.
- The results show that TRA is as safe and effective as TFA, offering fewer access-site complications and less time in the hospital.
Transradial intervention of iliac and superficial femoral artery disease is feasible.
J Interv Cardiol
October 2008
Article Synopsis
- Percutaneous intervention for iliac artery (IA) and superficial femoral artery (SFA) disease is typically done through femoral access but can be challenging for certain patients.
- In a study of 159 patients, 15 had interventions attempted via the radial artery due to factors like obesity or severe artery disease.
- The transradial intervention (TRI) was successful in 93% of cases, improving the ankle-brachial index and showing no complications, suggesting it is a safe alternative for some patients.
Article Synopsis
- The case report discusses a procedure where both common iliac arteries are stented using a radial access approach.
- This method reduces the risk of bleeding complications and eliminates the need for a crossover technique.
- Patients can benefit from same-day discharge after the procedure, making it more convenient.
Article Synopsis
- A patient suffering from severe pulmonary hypertension caused by rheumatic mitral valve disease was not responding to standard treatments, including prostacyclin.
- Continuous infusion of nesiritide led to significant and lasting reductions in pulmonary vascular resistance.
- The treatment also improved kidney function and helped maintain a normal fluid balance in the patient.
Article Synopsis
- * A high percentage (98%) of these patients had traditional coronary risk factors, like high cholesterol and smoking.
- * Revascularization procedures (like stents or bypass surgery) were conducted safely, with low rates of in-hospital mortality.