Publications by authors named "David E Steidley"

Background: The prognosis in patients with advanced cardiac amyloidosis (CA) remains poor.

Objectives: We sought to describe survival post heart transplantation (HT) in amyloid compared with non-amyloid recipients, highlight waitlist times within the new allocation system across three Organ Procurement and Transplantation Network (OPTN) regions, and describe multiorgan transplantation (MOT) in hereditary amyloidosis.

Methods: This is a retrospective review of end-stage CA patients who underwent HT at Mayo Clinic from January 2007 to December 2020.

View Article and Find Full Text PDF

Athlete's heart (AH) represents the heart's remarkable ability to adapt structurally and functionally to prolonged and intensive athletic training. Characterized by increased left ventricular (LV) wall thickness, enlarged cardiac chambers, and augmented cardiac mass, AH typically maintains or enhances systolic and diastolic functions. Despite the positive health implications, these adaptations can obscure the difference between benign physiological changes and early manifestations of cardiac pathologies such as dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), and arrhythmogenic cardiomyopathy (ACM).

View Article and Find Full Text PDF
Article Synopsis
  • The study focuses on cardiac amyloidosis (CA) in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR), highlighting that CA commonly leads to poor outcomes for these patients.
  • The researchers analyzed data from 1,426 TAVR patients using an ECG AI model to predict CA risk, discovering that 24.4% had a high probability of CA, yet only 1.2% were clinically diagnosed.
  • Results showed that a high CA probability significantly correlated with increased all-cause mortality and rates of major adverse cardiovascular events, particularly heart failure hospitalizations, suggesting that these patients should undergo further diagnostic assessment for CA.
View Article and Find Full Text PDF

Cardiac allograft vasculopathy (CAV) is a distinct form of coronary artery disease that represents a major cause of death beyond the first year after heart transplantation. The pathophysiology of CAV is still not completely elucidated; it involves progressive circumferential wall thickening of both the epicardial and intramyocardial coronary arteries. Coronary angiography is still considered the gold-standard test for the diagnosis of CAV, and intravascular ultrasound (IVUS) can detect early intimal thickening with improved sensitivity.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates graft dysfunction (GD) after heart transplantation in patients who test negative for rejection through biopsy, using cardiac magnetic resonance imaging (CMR) to identify potential rejection or inflammation.
  • Among 34 heart transplant recipients with biopsy-negative GD, 16 showed left ventricular late gadolinium enhancement (LGE) patterns, indicating possible underlying heart issues, with those exhibiting LGE experiencing GD symptoms and greater hemodynamic changes.
  • Despite differences in symptom presence and timing of GD onset between those with and without LGE, both groups showed similar improvement in left ventricular ejection fraction (LVEF) over time, suggesting that GD may improve regardless of LGE status.
View Article and Find Full Text PDF

Objectives: To report long-term outcomes of nonmelanoma skin cancer (NMSC) in immunosuppressed cardiac and liver transplant recipients (CLTR).

Materials And Methods: The authors reviewed CLTR at the Mayo Clinic in Arizona from 1986 to 2013. Patient and tumor characteristics were recorded.

View Article and Find Full Text PDF

Cardiac resynchronization therapy (CRT) reduces ventricular arrhythmia (VA) burden in some patients with heart failure, but its effect after left ventricular assist device (LVAD) implantation is unknown. We compared VA burden in patients with CRT devices in situ who underwent LVAD implantation and continued CRT (n = 39) to those who had CRT turned off before discharge (n = 26). Implantable cardioverter-defibrillator (ICD) shocks were significantly reduced in patients with continued CRT (1.

View Article and Find Full Text PDF

Emergent mechanical support with transfer of patients in acute cardiopulmonary shock to specialty centers for definitive management is often required at non-transplant centers. An alternative approach to the traditional "hub and spoke" model is presented. A team of health care specialists from our hospital is deployed to the community hospital for stabilization, possible implantation, and transfer of patients to our tertiary care facility.

View Article and Find Full Text PDF