Publications by authors named "Isabel C Alvarez"
Background: Disopyramide is used to treat heart failure symptoms in patients with obstructive hypertrophic cardiomyopathy (HCM) with known medium-term efficacy and safety, while long-term outcomes are unknown.
Methods And Results: A total of 92 consecutive patients with symptomatic obstructive HCM with peak left ventricular outflow tract gradients of ≥30 mm Hg at rest or with provocation who were maintained on disopyramide for ≥5 years at 2 dedicated HCM centers were included: 92 patients; mean age, 62.5 years; 54% women; treated with disopyramide for median 7.
Article Synopsis
- In patients with hypertrophic cardiomyopathy (HCM), the study aimed to evaluate the relationship between apical aneurysm size and common risk factors with the occurrence of deadly arrhythmias and unexplained strokes.
- Among 108 patients studied, 19.4% experienced events like sudden cardiac death or serious arrhythmias, with a significant risk linked to larger aneurysm sizes and the presence of major HCM risk factors.
- Atrial fibrillation was common, and while stroke incidence was low without known causes, overall findings suggest that smaller aneurysms (less than 2 cm) pose a lower risk for severe events over five years.
Article Synopsis
- Latent left ventricular outflow tract obstruction (LVOTO) is a significant issue for patients with hypertrophic cardiomyopathy (HCM), making it essential to find effective ways to diagnose it.
- A study involving 252 HCM patients showed that postprandial echocardiography (after eating) revealed significantly higher LVOT gradients compared to routine assessments, indicating that eating can provoke these obstructions.
- The findings suggest that using echocardiography after meals can help identify LVOTO in many patients and lead to effective treatment options, with symptom relief observed in a large percentage of those treated.
Advancing patient-centered research practices in a pragmatic patient-level randomized clinical trial: A thematic analysis of stakeholder engagement in Emergency Medicine Palliative Care Access (EMPallA).
Res Involv Engagem
January 2024
Background: Involving patient and community stakeholders in clinical trials adds value by ensuring research prioritizes patient goals both in conduct of the study and application of the research. The use of stakeholder committees and their impact on the conduct of a multicenter clinical trial have been underreported clinically and academically. The aim of this study is to describe how Study Advisory Committee (SAC) recommendations were implemented throughout the Emergency Medicine Palliative Care Access (EMPallA) trial.
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- Mitral valve (MV) elongation is linked to obstructive hypertrophic cardiomyopathy (HCM) and this study aimed to analyze the histopathological characteristics of MV residual leaflets in patients with this condition.
- Researchers examined 22 MV residual leaflets from patients undergoing surgery and compared their structure and composition to 11 control leaflets from healthy individuals.
- Findings showed that MV residual leaflets in HCM had disorganized structures with abnormal features such as expanded spongiosa and fragmented elastic fibers, indicating significant alterations compared to normal valves.
Article Synopsis
- Apical left ventricular (LV) aneurysms in patients with hypertrophic cardiomyopathy (HCM) are common and significantly linked to mid-LV obstruction, with a striking 95% of patients showing this condition in the study.
- The study compared echocardiograms and cardiac MRIs of 108 patients with HCM-related aneurysms against 110 controls (63 normal and 47 with mid-HCM without aneurysms) to assess the frequency and characteristics of mid-LV obstruction.
- Key findings included smaller systolic areas and larger papillary muscle areas in aneurysm patients, indicating altered heart function, with more than 80% showing an absence of blood flow during mid-systole; the results