Publications by authors named "Deepa Gopal"
Background: Systemic sclerosis-related pulmonary hypertension (SSc-PH) is a heterogeneous disease, often complicated by concomitant left ventricular (LV) dysfunction. However, the contribution of heterogeneity in LV dysfunction is unclear. The objective in this study was to identify regional clusters of LV longitudinal strain via echocardiography to determine how subgroups of LV dysfunction contribute to mortality in SSc-PH.
View Article and Find Full Text PDFDiversity in academic medicine and research enhances the quality of the science produced and the efficacy of patient care. Diversity, equity, inclusion, and accessibility (DEIA) statements have recently been suggested or required by academic job postings as a way to measure candidate's commitments to fostering DEIA in their role. In this perspective, we discuss steps to craft effective DEIA statements that convey your actions in, and commitment to, DEIA.
View Article and Find Full Text PDFBackground: Clinical significance of an integrated evaluation of epicardial adipose tissue (EAT) and the right ventricle (RV) in heart failure with preserved ejection fraction (HFpEF) is unknown.
Objectives: The authors investigated the potential of EAT and RV quantification for obesity-related pathophysiology and risk stratification in obese HFpEF patients using cardiovascular magnetic resonance (CMR).
Methods: A total of 150 patients (obese, body mass index ≥30 kg/m; n = 73, nonobese, body mass index <30 kg/m; n = 77) with a clinical diagnosis of HFpEF undergoing CMR were retrospectively identified.
Article Synopsis
- Mitochondrial DNA (mtDNA) variants can lead to various diseases, and a specific variant allele frequency (VAF) level must be reached to trigger biochemical defects, known as the biochemical threshold.
- The study reviewed 76 publications on how VAF impacts oxidative phosphorylation (OXPHOS) activities across different human tissues, revealing inconsistencies and suggesting the threshold could be less than the commonly cited >60% VAF.
- Analysis revealed that while some cases with similar VAF levels showed varying biochemical activity, more research is needed to clarify the biochemical thresholds for specific mtDNA variants in related cell types.
Background: Limited data exist regarding cardiac manifestations of Chagas disease in migrants living in non-endemic regions.
Methods: A retrospective cohort analysis of 109 patients with Chagas disease seen at Boston Medical Center (BMC) between January 2016 and January 2023 was performed. Patients were identified by screening and testing migrants from endemic regions at a community health center and BMC.
Article Synopsis
- The study investigates the levels of high sensitivity troponin T (hs-cTnT), hs-cTnI, and NT-proBNP in adults with chronic kidney disease (CKD) to better understand their performance and associations with cardiovascular disease (CVD) mortality.
- In a cohort of 1,068 CKD patients, significant percentages showed elevated levels of NT-proBNP (78.8%) and hs-cTnT (42.6%), with results indicating stronger increases in hs-cTnT and NT-proBNP with drops in kidney function compared to hs-cTnI.
- The findings suggest that adults with CKD have higher cardiac biomarker levels than previously recognized
Article Synopsis
- In systemic sclerosis (SSc), pulmonary hypertension (SSc-PH) is a major health concern, but the role of left ventricular (LV) dysfunction in this context is not well understood.
- A study of 165 SSc patients found that 74.2% with SSc-PH had LV dysfunction, significantly impacting their survival rates compared to those without pulmonary hypertension.
- The findings suggest that assessing LV dysfunction using global longitudinal strain could be crucial for evaluating risk and improving management strategies for patients with SSc-PH.
Background: Despite the importance of early cardiovascular disease (CVD) intervention, little data exists for evaluating cardiovascular risk in adults without traditional CVD risk factors (e.g., diabetes, hypertension).
View Article and Find Full Text PDFArticle Synopsis
- Researchers created a scoring system to identify systemic sclerosis (SSc) patients at risk for pulmonary hypertension (PH) and predict their overall mortality using data from pulmonary function tests, echocardiograms, and chest CT scans.* -
- In a study with 117 SSc patients, 51.3% were found to have PH, and the scoring tool demonstrated high sensitivity (0.87), specificity (0.74), and accuracy (0.80) for predicting PH.* -
- Each one-point increase in the score was linked to a higher risk of all-cause mortality, indicating that with further validation, this tool could improve early detection of PH in SSc patients.*
Article Synopsis
- - CARS (Cardiac Amyloidosis Registry Study) is a multicenter project launched in 2019 to study the natural history and treatment of cardiac amyloidosis, involving patients across the U.S. from 1997 to 2025.
- - As of February 2023, 1415 patients have been enrolled, with 82% diagnosed with transthyretin (ATTR) and 18% with light chain (AL) amyloidosis, highlighting a diverse cohort that includes a significant portion of Black participants.
- - The study aims to address important clinical questions about cardiac amyloidosis and improve comparisons of treatment options, with plans for future international collaboration to enhance its findings.
Article Synopsis
- This study explores the relationship between exercise impairments and biomarkers in heart failure with preserved ejection fraction (HFpEF), focusing on exercise rather than just resting states.
- A detailed analysis of 277 proteins was conducted on 151 individuals, identifying specific protein signatures linked to different exercise responses, which helps reveal underlying mechanisms of HFpEF.
- The findings suggest that these protein signatures not only highlight potential new therapeutic targets but also offer methods for early risk assessment and prevention of HFpEF.
Article Synopsis
- * Key factors linked to shorter survival include a delay of over 6 months from symptom onset to diagnosis, high bone marrow plasmacytosis, elevated troponin levels, and advanced heart failure classifications.
- * Early responses to treatment—both hematologic and cardiac—are crucial for improving survival rates, with significant boosts in overall survival observed for patients achieving these responses within specific timeframes.
Article Synopsis
- The American Heart Association's "ideal cardiovascular health" (CVH) framework identifies modifiable risk factors to lower the risk of cardiovascular disease (CVD), and metabolomics can reveal connections between these factors and CVD development.
- A study involving 3,056 adults showed that CVH scores were linked to various metabolites that were also associated with the risk of atrial fibrillation (AF) and heart failure (HF), emphasizing that certain metabolites mediate this connection.
- Specifically, three metabolites significantly mediated the link between CVH scores and AF, while seven metabolites partially mediated the association with HF, highlighting important metabolic pathways involved in cardiovascular health.
Article Synopsis
- - Collecting accurate demographic information, especially on sexual orientation and gender identity (SOGI), is essential for addressing the healthcare needs of marginalized groups, particularly the LGBTQIA2S+ community.
- - Inclusive demographics can reduce psychological harm caused by erasure, improve health outcomes by revealing connections between identity and diseases, and enhance overall data precision across all populations.
- - Advocacy and proper representation in medical research can help combat the political and social threats faced by the LGBTQIA2S+ community, fostering a sense of belonging and addressing health inequities.
Article Synopsis
- Mitochondrial dysfunction is a key factor in cardiomyopathies and heart failure, but the specific mechanisms behind these issues are not well understood, especially how they affect energy production and overall metabolism.
- Heart failure is characterized by inadequate energy (ATP) production due to oxidative phosphorylation problems, but it's crucial to look beyond just ATP levels to understand broader metabolic disruptions.
- The concept of a "mitochondrial ecosystem" illustrates how interconnected mitochondrial pathways and functions affect heart health, emphasizing the need for a comprehensive approach to study and develop treatments for heart failure.
Article Synopsis
- Patients with systemic sclerosis-related pulmonary hypertension (SSc-PH) show a poorer response to PAH treatment and higher mortality rates compared to those with idiopathic PAH.
- This study analyzed data from 39 SSc-PH patients to identify factors that predict their hemodynamic response to therapy, measured by a significant reduction in pulmonary vascular resistance.
- Findings revealed that patients with lower pulmonary arterial wedge pressure (PAWP) had a significantly higher chance of achieving a positive hemodynamic response, highlighting the role of underlying cardiac issues in treatment efficacy.
Article Synopsis
- The study aimed to create a systematic protocol for dissecting and preserving human hearts to improve biobanking for cardiovascular research, expanding on previous transcriptomics work.
- Current cardiac biobanks are limited, mostly housing biopsy tissues, which makes it hard to link full organ conditions with clinical data.
- Findings showed that RNA and metabolite stability were maintained for up to 12 hours after death, indicating the potential for high-quality multiomics data essential for understanding human cardiovascular disease (CVD).
Article Synopsis
- A study analyzed 378 patients suspected of having transthyretin amyloid cardiomyopathy (ATTR-CM) who were referred for noninvasive technetium-99m pyrophosphate (PYP) imaging, focusing on the prevalence of light chain abnormalities.
- Out of these, 26% showed abnormal plasma cell dyscrasia (PCD) markers, and after excluding other conditions, 82 patients were assessed, with 76% having positive PYP scans.
- The findings indicated that 69% of confirmed ATTR-CM cases exhibited a free light chain (FLC) ratio between 1.65 and 3.1, suggesting that ATTR-CM may be diagnosed without needing a cardiac biopsy when
Article Synopsis
- High-dose melphalan and stem cell transplantation (HDM/SCT) shows long-term effectiveness in treating AL amyloidosis, with 39% of patients achieving complete hematologic response (CR).
- The median CR duration is 12.3 years, while overall survival (OS) for patients with CR is impressive, reaching up to 15 years for some.
- Factors such as elevated dFLC levels and plasma cell percentages are linked to shorter event-free survival (EFS), allowing the development of a risk score to better predict outcomes.
A Multimodal Prediction Model for Diagnosing Pulmonary Hypertension in Systemic Sclerosis.
Arthritis Care Res (Hoboken)
July 2023
Article Synopsis
- The study focuses on improving the diagnosis of pulmonary hypertension (PH) in patients with systemic sclerosis (SSc) by using better prediction models to potentially reduce unnecessary invasive procedures like right heart catheterization (RHC).
- Researchers analyzed data from 130 SSc patients, comparing three predictive models (random forest, classification and regression tree, logistic regression) to see which was most effective in identifying PH accurately.
- The random forest model was found to be the most effective, achieving high sensitivity and specificity, with key predictors being pulmonary artery diameter and carbon monoxide diffusing capacity, which could help select patients who truly need RHC.
Article Synopsis
- Diflunisal is an anti-inflammatory drug that helps stabilize transthyretin and may slow down neurological decline in patients with hereditary transthyretin amyloidosis.
- A study at the Boston University Amyloidosis Centre analyzed 104 patients with wild-type transthyretin cardiac amyloidosis, focusing on the effects of diflunisal over one year, with a total of 35 receiving the treatment.
- Results indicated that diflunisal was linked to improved survival rates compared to those not on the drug, even after adjusting for other health factors, though it had no significant impact on cardiac biomarkers during the observation period.
Article Synopsis
- - Mitochondria are key organelles in energy production, containing their own genome (mtDNA) that is passed down maternally and interacts with nuclear genes to function properly.
- - Heteroplasmy, or the coexistence of different mtDNA variants within a single mitochondrion, can lead to varied presentations of mitochondrial disease and affects how these genetic traits are inherited and expressed in tissues.
- - The development of induced pluripotent stem cells (iPSCs) and gene editing technologies has opened new avenues for studying how variations in mitochondrial genetics influence cellular functions and disease characteristics.