Publications by authors named "Jaya Batra"
Thixotropic gels are the preferred choice in the collection of platelet-rich plasma as an easy solution to operator variability. One often unnoticed shortcoming is the entrapment of platelets in the gel layer's uppermost surface. We provide instructions to optimize platelet yield, ie, agitation to re-suspend platelets, setting the optimal G-force and time of centrifugation, and the essential use of a horizontal swing bucket centrifuge.
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- The study examined the effects of glucagon-like-peptide 1 receptor agonists (GLP1-RA) on heart transplant recipients dealing with diabetes and obesity, as there has been limited research in this area.
- A total of 74 patients were analyzed, with significant improvements in cardiometabolic parameters such as reduced BMI, lower blood sugar levels (HbA1C), and decreased LDL cholesterol after using GLP1-RA for around 383 days.
- Results indicated that GLP1-RA therapy was effective in managing diabetes and weight in these patients, with minimal impact on their immunosuppression medication adjustments.
Article Synopsis
- Antenatal cardiovascular disease significantly contributes to complications and deaths in pregnant women, with rheumatic mitral stenosis being particularly dangerous.
- A case of a young woman with severe pulmonary hypertension due to this condition during pregnancy illustrates the urgent need for specialized care.
- The management involved a coordinated effort from a multidisciplinary team and included advanced procedures like extracorporeal membrane oxygenation, a cesarean section, hysterectomy, and valve replacement surgery to ensure the safety of both mother and baby.
A Case of a Cardiac Hamartoma in Pregnancy: Preconception Through Delivery.
JACC Case Rep
December 2023
Article Synopsis
- A 32-year-old woman with a significant cardiac hamartoma sought preconception counseling from a specialized cardio-obstetrics group.
- Hemodynamic testing indicated that she had restrictive physiology, suggesting potential risks during pregnancy.
- The case emphasizes how advanced testing can help anticipate cardiovascular challenges during pregnancy for women with high-risk conditions.
Article Synopsis
- Among heart transplant recipients, a small number go on to receive multiple transplants, but the outcomes of these individuals are not well understood.
- A study of patients from the UNOS registry between 1990 and 2020 found that those receiving a third heart transplant had significantly higher rates of one-year and ten-year mortality compared to those who received their first or second transplant.
- The findings suggest that third heart transplants come with greater health risks, especially for older patients and those who experience acute graft failure, indicating a need for better management strategies for this unique group.
Case Report: Rare Presentation of Nodular Fasciitis over Dorsum of Wrist.
J Orthop Case Rep
November 2023
Article Synopsis
- - Nodular fasciitis is a non-cancerous tumor that typically appears as a fast-growing lump, sometimes affecting deep tissues like fascia and muscle, and the case discussed is unique as it occurs on the wrist.
- - A 33-year-old man experienced a painful lesion on his wrist that grew over five months, but imaging tests didn't provide clear answers, leading to an excisional biopsy for a definitive diagnosis.
- - This condition is often overlooked in cases of rapid soft-tissue growth, but it is self-limiting and can be diagnosed accurately through excisional biopsy.
Long-Term Outcomes of Permanent Pacemaker Implantation in Bicaval Heart Transplant Recipients.
JACC Clin Electrophysiol
September 2023
Article Synopsis
- Up to 10% of heart transplant patients may require permanent pacemakers (PPMs), with this study focusing on the long-term outcomes of those who did.
- Out of 1,082 heart transplant recipients studied, 41 (3.8%) needed PPMs mainly due to sinus node dysfunction and AV nodal disease, experiencing few complications.
- Notably, PPM implantations decreased after 2018, suggesting a shift towards more cautious management in the early postoperative period, with no significant differences in mortality or re-transplantation rates among patients with and without PPMs.
Article Synopsis
- - Non-US citizens/non-US residents (NCNR) make up a small but growing group in the heart donation and transplantation landscape, with 0.4% of heart donors and 0.7% of heart transplant recipients being NCNR from 2013 to 2020.
- - Most NCNR heart donors were Hispanic and mainly from the South and Southwest US, while NCNR recipients were predominantly non-Hispanic White, often arriving from countries with lower transplant rates.
- - After one year post-transplant, NCNR recipients showed no significant differences in mortality, infection, or rejection rates compared to US citizens and residents, indicating similar outcomes despite differing health backgrounds.
Article Synopsis
- A study was conducted to assess the risk factors and consequences of leukopenia (low white blood cell count) in patients following heart transplantation (HT), finding that 36% of recipients experienced this condition within the first 90 days post-transplant.
- The research included 506 adult HT recipients and identified that those who developed leukopenia had lower pre-transplant white blood cell counts, and the episode lasted for a median of 15.5 days.
- Importantly, early leukopenia was linked to an increased one-year mortality risk (6.6% for those with leukopenia vs. 2.1% for those without), indicating the need for further studies to optimize care for at-risk patients.
Article Synopsis
- Letermovir is a new medication for preventing cytomegalovirus (CMV) infections, especially in heart transplant recipients, that avoids the serious side effects linked to traditional treatments.
- In a study of 17 heart transplant patients, most were high-risk for CMV and received letermovir due to issues with another drug (valganciclovir); over half were still on letermovir after 5 months.
- Some patients experienced minor side effects or issues with CMV, highlighting the need for careful monitoring, and more research is needed to confirm letermovir's long-term safety and effectiveness.
Article Synopsis
- An increasing number of heart transplant (HT) recipients are presenting with pretransplant malignancies (PTM), rising from 3.2% in 2000 to 8.2% by 2020.
- PTM recipients experience higher 1-year mortality rates following HT, particularly those with hematologic cancers, but 5-year survival rates are similar for both PTM and non-PTM groups.
- The incidence of new malignancies at 5 years posttransplant is significantly greater in PTM patients, indicating a need for updated clinical guidelines that consider the complexities of this evolving patient population.
Article Synopsis
- The Val122Ile variant of transthyretin (TTR) amyloidosis primarily affects individuals of African descent in the U.S., but a cluster of cases has been found in white Italians.
- A study comparing Black and white individuals with Val122Ile TTR cardiac amyloidosis revealed that Black patients exhibited lower blood pressure and impaired renal function, alongside distinct differences in cardiac chamber performance.
- Despite similar ages at diagnosis, Black patients experienced worse cardiac dysfunction due to reduced ventricular capacitance, indicating a need for further research to determine if these differences stem from amyloidosis or other cardiovascular factors.
Article Synopsis
- * A study of 202 HCM patients revealed that women were older and had lower exercise capacity, alongside significant differences in heart function metrics like indexed pressure-volume area (PVA30) and ventricular capacity.
- * Results suggest that these disparities in heart function could indicate unique underlying mechanisms in women with HCM, leading to different therapeutic approaches compared to men.
CRP is an established inflammatory biomarker with prognostic value in patients with chronic heart failure, yet its role in continuous-flow left ventricular assist device (LVAD) patients is largely unknown. 5,183 patients from the INTERMACS registry who underwent durable LVAD between 2008 and 2017 and had preimplant CRP levels were included. The sample was stratified into two groups based on preimplant CRP levels: CRP of 0-10 mg/L (low) and >10 mg/L (high).
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- Transthyretin cardiac amyloidosis (ATTR-CA) is a lesser-known condition that can lead to heart failure, with the Val122Ile genetic variant being the most common in the U.S.
- A study involving 73 patients revealed that women were diagnosed at an older age than men (76 vs. 69 years), but both sexes showed similar heart function and mortality rates after 3 years.
- The results imply that while women may be older at diagnosis, they experience a less severe form of the disease compared to men, warranting further research for confirmation.
Article Synopsis
- - This study compared metabolomic profiles of 15 patients with hypertrophic cardiomyopathy (HCM) to 2 control groups without HCM during rest and peak exercise.
- - At rest, there were no significant differences in metabolic profiles between HCM cases and controls, but notable differences arose during exercise.
- - Specifically, four metabolic pathways showed significant changes in HCM patients when exercising, indicating how HCM affects cardiac metabolism under stress.
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- COVID-19 is caused by the SARS-CoV-2 virus, and there's growing concern about thrombotic events (blood clots) contributing to serious health issues in infected patients.
- The Global COVID-19 Thrombosis Collaborative Group discusses novel dosing strategies for common antithrombotic medications, particularly heparin, and explores the potential of other less common drugs for preventing COVID-19-related blood clots.
- The article emphasizes the need for further research, including clinical trials, to evaluate the safety and effectiveness of various treatments, and considers the role of immunomodulators with potential antithrombotic benefits.
Article Synopsis
- * Approximately 49.1% of the 3,978 patients studied received IT, with basiliximab and antithymocyte globulin being the most common agents, and the outcomes measured included graft survival, hospitalizations for rejection, infections, and transplant coronary artery disease (TCAD).
- * Results showed no significant difference in graft survival or hospitalization rates between those who received IT and those who did not; however, IT recipients had decreased TC
Article Synopsis
- The study investigates pregnancy outcomes and risks in women of child-bearing age who have either biologic or mechanical heart valves, revealing that the choice of valve can significantly impact maternal health.
- Among the 417 pregnancies studied, those with mechanical valves faced much higher rates of pregnancy loss and complications like hemorrhage and thromboembolism during delivery compared to those with biologic valves.
- The findings suggest that pregnancy increases the likelihood of needing reoperation for both types of prosthetics, but the risk is particularly elevated for women with mechanical valves shortly after delivery.
Article Synopsis
- Neurofibromatosis type 1 results from a mutation in the neurofibromin 1 gene, leading to excessive Ras signaling, increased cell growth, and the formation of tumors, including plexiform neurofibromas and malignant peripheral nerve sheath tumors.
- This mutation also appears in various cancers like glioblastoma, lung adenocarcinoma, and ovarian cancer, indicating a need for targeted therapies that can specifically treat NF1-deficient tumors.
- The study introduces Y100, a compound identified through a synthetic lethality screen, which disrupts metabolic and proteostasis balance and increases mitochondrial stress in NF1-deficient cancer cells, suggesting it could be a promising treatment strategy for these tumors.