Publications by authors named "Freimark D"

Article Synopsis
  • This study aimed to assess the relationship between flow measurements from left ventricular assist devices (LVADs) and invasive cardiac output measurements using different methods.
  • Researchers analyzed data from 102 LVAD patients, identifying significant discordance between methods, where 45% had differences when using indirect Fick and 48% with thermodilution compared to pump flow.
  • The findings suggested that while LVAD flow estimates correlate strongly with traditional cardiac output measures, particularly thermodilution, the correlation improves when low indirect Fick values are excluded.
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Despite progress in therapy, heart failure (HF) inflicts a heavy burden of hospital admissions. In this study, we identified among 1360 community-dwelling HF patients (mean age 70.7 ± 11.

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Background: Heart failure with improved ejection fraction (HFimpEF) is a recently recognized entity presenting a diagnostic and therapeutic challenge. Our aim was to characterize the profile of HFimpEF patients and evaluate predictors for EF lack of improvement among heart failure with reduced ejection fraction (HFrEF) patients.

Methods: We included ambulatory HFrEF patients (EF≤40%) between January 1, 2015, and September 1, 2022, with two consecutive echocardiography exams at least 6 months apart.

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Article Synopsis
  • Recurrent pericarditis (RP) affects about 30% of patients who initially experience acute pericarditis (AP), with a study examining 765 patients revealing that 17.5% had recurrence within an average of 101 days.
  • Patients experiencing recurrence often show less severe clinical signs compared to their first event, with notable differences in ECG changes, pericardial effusion, and inflammatory markers.
  • There is a need for further research on advanced biomarkers and imaging techniques to better identify and understand true RP events.
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Aims: This is a sub-analysis of a randomized controlled trial on heart failure (HF) disease management (DM) in which patients with HF ( = 1,360; 27.5% women) were assigned randomly to DM ( = 682) or usual care (UC) ( = 678). Study intervention did not significantly affect the rate of hospital admissions or mortality.

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Aims: To describe the effect of subsequent pregnancies (SSP) on left ventricular (LV) function and outcomes in patients with peripartum cardiomyopathy (PPCM).

Methods: Among146 women with PPCM who were prospectively followed at two medical centres in Israel (2007-2019), 75 SSPs (in 50 women) were identified: 8 miscarriages, 8 terminations, and 59 life birth.

Results: Forty-five patients with 59 full-term SSPs [mean age was 32.

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Aims: Data about the prognostic interplay between mitral regurgitation MR and left ventricular (LV) function in the outcome of patients admitted with acute heart failure (AHF) are scarce. We evaluated the prognostic impact of MR severity and LV function on mortality and on recurrent heart failure hospitalization (re-HFH) in patients admitted with AHF. Methods and Results: In total, 6843 patients admitted with AHF were evaluated: 2521 patients with LV ejection fraction (LVEF) ≤ 40% (reduced LVEF), 1238 of them (51%) having ≥moderate MR; and 4322 with LVEF > 40% (preserved LVEF), 1175 of them (27%) having ≥moderate MR.

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Background: Vaccines against SARS-COV2 have been crucial in efforts against COVID19, yet there have been reports of pericarditis following vaccination with mRNA-based vaccines.

Methods: We questioned consecutive patients with a history of acute pericarditis (AP) evaluated in the pericardial disease clinic during 3-11/2020 in a single tertiary center. Patients with significant myocardial involvement or pericarditis secondary to another systemic disease were excluded.

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Article Synopsis
  • The study aimed to assess the safety and effectiveness of preoperative levosimendan in patients receiving left ventricular assist devices (LVADs), focusing on outcomes like right ventricular failure (RVF) and in-hospital mortality.
  • The analysis included 62 patients, dividing them into two groups: those treated with levosimendan and those who were not, finding similar rates and times for RVF, inotropic support, and length of hospital stays between both groups.
  • The research concluded that while levosimendan was safe to use before LVAD implantation, it did not significantly improve post-operative outcomes compared to the control group.
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  • The study focuses on hypertrophic cardiomyopathy with reduced ventricular function (HCMr), which is distinct from typical heart failure associated with preserved ejection fraction.
  • A registry of 1,328 HCM patients was analyzed, revealing that 2.8% had HCMr at the start, and 3.5% developed it during a 9-year follow-up, with various factors like younger age and arrhythmia linked to its onset.
  • Genetic testing showed that 72% of 53 patients with HCMr had pathogenic variants, especially in myosin binding protein C, and those with HCMr faced higher risks of advanced heart failure treatments like VAD or transplantation.
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Aims: To assess the effect of angiotensin receptor blockers/neprilysin inhibitors (ARNI) on left ventricular (LV) ejection fraction (LVEF) and LV dimensions in a real-life cohort of heart failure and reduced ejection fraction (HFrEF) patients, while analysing patient characteristics that may predict reverse LV remodelling.

Methods And Results: The ARNI-treated HFrEF patients followed at a single tertiary medical centre HF-outpatient clinic were included in the study. Clinical and echocardiographic parameters were evaluated prior to ARNI initiation, and while on ARNI therapy, assessing patient characteristics associated with reverse LV remodelling.

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Aims: Dilated cardiomyopathy (DCM) associated with dystrophin gene (DMD) mutations in individuals with mild or absent skeletal myopathy is often indistinguishable from other DCM forms. We sought to describe the phenotype and prognosis of DMD associated DCM in DMD mutation carriers without severe skeletal myopathy.

Methods And Results: At 26 European centres, we retrospectively collected clinical characteristics and outcomes of 223 DMD mutation carriers (83% male, 33 ± 15 years).

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Background: While single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) is a well-established noninvasive procedure for the evaluation of patients with coronary artery disease (CAD), it is unable to detect the presence of, or underestimates the extent of CAD in certain patients. We aimed to show that a bio-impedance device can detect early post-stress changes in several hemodynamic parameters, thereby serving as a potential marker for the presence of significant ischemia.

Methods: Prospectively enrolled patients, referred to our Medical Center for clinically-indicated MPI, underwent testing using a Non-Invasive Cardiac System (NICaS) before and immediately after exercise.

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Background: The impact of sex on mortality in patients with acute heart failure (AHF) is unresolved. We aimed to investigate the impact of sex on both short- and long-term mortality outcomes after hospitalization for AHF.

Methods: We analyzed data of 2,328 patients with AHF who were enrolled in the multicenter national survey in Israel between March and April 2003 and followed up until December 2014.

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Background: Filamin C is a cytoskeletal protein expressed in cardiac cells. Nonsense variations in the filamin C gene (FLNC) were associated with dilated and arrhythmogenic cardiomyopathies.

Methods And Results: We identified an intronic variation in FLNC gene (c.

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Hypomagnesemia is commonly observed in heart transplant (HT) recipients receiving calcineurin inhibitors. Since low serum magnesium (s-Mg) has been implicated in the progression of atherosclerosis, potentially leading to worsening coronary heart disease, arrhythmias and sudden death, we investigated the association between s-Mg and HT outcomes. Between 2002 and 2017, 150 HT patients assessed for s-Mg were divided into high (≥1.

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Background: Diabetes mellitus type 2 (DM2) is a risk factor for developing heart failure but there is no specific therapy for diabetic heart disease. Sodium glucose transporter 2 inhibitors (SGLT2I) are recently developed diabetic drugs that primarily work on the kidney. Clinical data describing the cardiovascular benefits of SGLT2Is highlight the potential therapeutic benefit of these drugs in the prevention of cardiovascular events and heart failure.

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Background: Diabetes mellitus (DM) is a major cause of morbidity and mortality following heart transplantation (HT), with 21% and 35% of survivors being affected within 1 and 5 years following HT, respectively. Magnesium deficiency is common among HT patients treated with calcineurin inhibitors and is a known risk factor for DM in non-HT patients. We therefore investigated the association between serum Mg (s-Mg) levels and new-onset diabetes after transplantation (NODAT).

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Article Synopsis
  • The study assessed heart transplantation outcomes based on the mechanism of the donor's brain death, comparing traumatic brain death (TBD) and non-traumatic brain death (NTBD).
  • Recipients of hearts from TBD donors showed significantly higher 10-year survival rates (58.1%) compared to those from NTBD donors (37.6%), with a notable reduction in mortality and rejection rates in the TBD group.
  • The findings suggest that the mode of brain death is crucial for predicting heart transplant success, indicating that hearts from TBD donors lead to better long-term outcomes, including lower rates of cardiac allograft vasculopathy.
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Background: While physical rehabilitation has been shown to be beneficial and safe for patients suffering from heart failure, data on rehabilitation for hypertrophic cardiomyopathy (HCM) patients are limited.

Methods: Forty-five HCM patients participated in an exercise rehabilitation program. Exercise capacity was measured in metabolic equivalent of task (METs) units and functional status was defined according to the New York Heart Association (NYHA).

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Minimal attention has been paid to understanding the implications of the chronicity of heart failure (HF) diagnosis on prognosis of hospitalized patients with acute HF (AHF). We aimed to assess the differences in outcomes between hospitalized patients with AHF that are new-onset (de-novo) AHF and acutely decompensated chronic HF (ADCHF). We analyzed data of 2,328 patients with AHF, who were enrolled in the HF survey in Israel.

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Article Synopsis
  • - The study aimed to investigate how the age difference between heart donors and recipients influences the outcomes of heart transplantation.
  • - Researchers analyzed 234 patients from 1995 to 2017, categorizing them into groups based on donor-recipient age differences, and found higher baseline health risks in the group with much younger donors.
  • - Ultimately, the findings indicated that the age difference between donors and recipients does not significantly affect long-term survival or other key outcomes after heart transplantation.
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Article Synopsis
  • The study examined the impact of early recurrent grade 1R rejections on long-term results after heart transplants, focusing on grades 1A versus 1B/2.
  • It involved analyzing data from heart transplant patients between 1992 and 2017, specifically looking at those with multiple early rejections within three months.
  • Findings showed that early recurrent 1R rejections are linked to a higher risk of later rejections, worse survival rates, and increased cardiovascular mortality, with severity differing between patients classified as 1B/2 and those as 1A.
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Background: Ethnicity may affect graft longevity and recipient mortality after heart transplantation (HTx). We hypothesized that differences in ethnic origin between Arabs and Jews undergoing HTx in Israel may contribute to differences in long-term outcomes.

Methods: The study population comprised all 254 patients who underwent HTx between 1991 and 2017 in a tertiary medical center located in the center of Israel.

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Article Synopsis
  • * Researchers created induced pluripotent stem cells (iPSCs) from two DMD patients to study heart cell dysfunction, analyzing dystrophin expression and using various electrophysiological techniques to understand heart function.
  • * The study found that both male and female iPSC-derived heart cells exhibited significant electrical activity issues and irregular heartbeats, with specific differences in how they responded based on their genetic background, helping to explain cardiac problems associated with DMD.
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