Publications by authors named "Jordan Strom"
Article Synopsis
- * Current guidelines for treating asymptomatic patients focus on heart size and function, but even after surgery, there's still a risk of heart failure and death.
- * New methods, including machine learning and advanced imaging techniques, are being developed to identify high-risk patients who might benefit from earlier interventions, with valve repair being the preferred treatment.
Background: Identifying individuals with severe aortic stenosis (AS) at high risk of mortality remains challenging using current clinical imaging methods.
Objectives: The purpose of this study was to evaluate an artificial intelligence decision support algorithm (AI-DSA) to augment the detection of severe AS within a well-resourced health care setting.
Methods: Agnostic to clinical information, an AI-DSA trained to identify echocardiographic phenotype associated with an aortic valve area (AVA)<1 cm using minimal input data (excluding left ventricular outflow tract measures) was applied to routine transthoracic echocardiograms (TTE) reports from 31,141 U.
Background: The optimal hemoglobin threshold to guide red blood cell (RBC) transfusion for patients with acute myocardial infarction (MI) and anemia is uncertain.
Objective: To estimate the efficacy of 4 individual hemoglobin thresholds (<10 g/dL [<100 g/L], <9 g/dL [<90 g/L], <8 g/dL [<80 g/L], and <7 g/dL [<70 g/L]) to guide transfusion in patients with acute MI and anemia.
Design: Prespecified secondary analysis of the MINT (Myocardial Ischemia and Transfusion) trial using target trial emulation methods.
Article Synopsis
- * In a study involving nearly 9 million Medicare patients, 60% experienced frailty progression over a median follow-up of 2.4 years, with rapid progression correlating to worse health outcomes.
- * Patients with faster frailty progression had fewer days alive at home, indicating a decline in quality of life, further emphasizing the negative impact of worsening frailty on overall health.
Background: Transcatheter aortic valve implantation (TAVI) rates are lower among Black compared with White individuals. However, it is unclear whether racial residential segregation, which remains common in the United States, contributes to observed disparities in TAVI rates.
Objectives: The purpose of this study was to evaluate the association between county-level racial segregation, and aortic stenosis (AS) diagnosis, management, and outcomes.
Article Synopsis
- The study aimed to establish normal echocardiographic values for heart chamber size and function in healthy adults aged 65 and older, addressing the lack of clear definitions for age-related cardiac health.
- Analysis of 3,032 participants, with 608 fitting healthy aging criteria, revealed that sex and race/ethnicity significantly affected cardiac structure and function, including noted differences in chamber size and function.
- Current guidelines erroneously classified 81.6% of healthy older adults as having cardiac abnormalities, highlighting the need for updated standards that reflect the diversity within this population.
Background: The mortality risk attributable to moderate aortic stenosis (AS) remains incompletely characterized and has historically been underestimated. We aim to evaluate the association between moderate AS and all-cause death, comparing it with no/mild AS (in a general referral population and in patients with heart failure with reduced ejection fraction).
Methods And Results: A systematic review and pooled meta-analysis of Kaplan-Meier-derived reconstructed time-to-event data of studies published by June 2023 was conducted to evaluate survival outcomes among patients with moderate AS in comparison with individuals with no/mild AS.
Right ventricular (RV) to pulmonary arterial (PA) coupling describes the ability of the RV to augment contractility in response to increased afterload. Several echocardiographic indexes of RV-PA coupling have been defined; however, the optimal numerator in the coupling ratio is unclear. We sought to establish which of these ratios is best for assessing RV-PA coupling based on their relations with 6-minute walk distance (6MWD), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and the Kansas City Cardiomyopathy Questionnaire (KCCQ) in aging adults.
View Article and Find Full Text PDFArticle Synopsis
- Normalization of echocardiographic measurements based on body surface area can misclassify patients with obesity or sarcopenia, highlighting the need for better alternative normalization methods.
- A study involving 3032 individuals assessed echocardiographic parameters, focusing on a subgroup of 608 without cardiopulmonary diseases to derive normative values based on various body size indexation methods.
- The findings indicate that body surface area and height provided more consistent results across different racial and ethnic groups, with height showing the least variability between sexes.
F-FDG PET/CT and radiolabeled leukocyte SPECT/CT imaging for the evaluation of cardiovascular infection in the multimodality context: ASNC Imaging Indications (ASNC I) Series Expert Consensus Recommendations from ASNC, AATS, ACC, AHA, ASE, EANM, HRS, IDSA, SCCT, SNMMI, and STS.
J Nucl Cardiol
April 2024
Article Synopsis
- This document is the first in the ASNC I series focusing on the role of radionuclide imaging for diagnosing cardiovascular infections, notably infective endocarditis, using a detailed consensus-based approach.
- It highlights the rising incidence of cardiovascular infections, which present high risks and complications, and discusses the limitations of current diagnostic methods like echocardiography.
- Advanced imaging techniques such as FDG PET/CT and SPECT/CT can improve diagnostic accuracy by revealing infection in cardiac devices and surrounding areas, emphasizing the need for better imaging strategies in complex cases.
F-FDG PET/CT and Radiolabeled Leukocyte SPECT/CT Imaging for the Evaluation of Cardiovascular Infection in the Multimodality Context: ASNC Imaging Indications (ASNC I) Series Expert Consensus Recommendations From ASNC, AATS, ACC, AHA, ASE, EANM, HRS, IDSA, SCCT, SNMMI, and STS.
JACC Cardiovasc Imaging
June 2024
Article Synopsis
- * A thorough consensus was reached using a modified Delphi method to outline clinical indications, diagnostic criteria, and a structured algorithm for diagnosis due to the rising incidence and high risks associated with these infections.
- * Advanced imaging techniques, such as F-FDG PET/CT, can improve the evaluation and management of cardiovascular infections, particularly in complicated cases involving prosthetic valves and cardiac devices, while also highlighting the need for further research to optimize these applications.
F-FDG PET/CT and radiolabeled leukocyte SPECT/CT imaging for the evaluation of cardiovascular infection in the multimodality context: ASNC Imaging Indications (ASNC I) Series Expert Consensus Recommendations from ASNC, AATS, ACC, AHA, ASE, EANM, HRS, IDSA, SCCT, SNMMI, and STS.
Heart Rhythm
May 2024
This document on cardiovascular infection, including infective endocarditis, is the first in the American Society of Nuclear Cardiology Imaging Indications (ASNC I) series to assess the role of radionuclide imaging in the multimodality context for the evaluation of complex systemic diseases with multi-societal involvement including pertinent disciplines. A rigorous modified Delphi approach was used to determine consensus clinical indications, diagnostic criteria, and an algorithmic approach to diagnosis of cardiovascular infection including infective endocarditis. Cardiovascular infection incidence is increasing and is associated with high morbidity and mortality.
View Article and Find Full Text PDF18F-FDG PET/CT and radiolabeled leukocyte SPECT/CT imaging for the evaluation of cardiovascular infection in the multimodality context: ASNC Imaging Indications (ASNC I2) Series Expert Consensus Recommendations from ASNC, AATS, ACC, AHA, ASE, EANM, HRS, IDSA, SCCT, SNMMI, and STS.
Clin Infect Dis
March 2024
Article Synopsis
- This document is the first in a series by the American Society of Nuclear Cardiology focusing on the use of radionuclide imaging for diagnosing cardiovascular infections, particularly infective endocarditis, in a comprehensive healthcare context.
- A modified Delphi method was used to establish clinical indications, diagnostic criteria, and a structured approach for diagnosing these infections, which are increasingly common and associated with significant health risks.
- Advanced imaging techniques, such as 18F-FDG PET/CT and SPECT/CT leukocyte scintigraphy, can significantly boost diagnostic accuracy and guide treatment decisions, especially for patients with complex cardiovascular issues or unclear initial imaging results.
Article Synopsis
- Frailty, which increases the risk of heart and brain-related health issues, was examined in older adults (65+) in a study involving over 26 million Medicare beneficiaries from 2003 to 2015.
- The study found that 20% of participants experienced worsening frailty over time, leading to significantly higher risks for major adverse cardiovascular events, overall mortality, and specific conditions like heart failure and strokes compared to those with stable frailty levels.
- Faster frailty progression correlated with more severe health outcomes and fewer days living independently at home, highlighting the importance of monitoring frailty in elderly patients.
Background: Ultrasound enhancing agents (UEAs) are an invaluable adjunct to stress and transthoracic echocardiography (STE) to improve left ventricular visualization. Despite multiple single center studies evaluating UEA use, investigation into the rates, sources of variation, and outcomes of UEA use on a national level in the United States (US) has been limited by lack of validation of UEA codes for claims analyses.
Methods: We conducted a retrospective cross-sectional study, 2019-2022, using linked multicenter electronic medical record (EMR) data from > 30 health systems linked to all-payor claims data representing > 90% of the US population.
Article Synopsis
- The study aimed to establish standard echocardiographic values for heart chamber size and function in older adults (≥ 65 years) who are healthy and free of major health conditions.
- Analyzed data from 608 participants revealed significant differences in heart structure and function based on sex and race; women had smaller chambers and better heart function, while White participants exhibited larger heart dimensions compared to other groups.
- The findings suggest that current guidelines may misclassify a significant number of healthy older adults as having cardiac abnormalities, emphasizing the need for revised standards that account for differences in heart health associated with aging.
Article Synopsis
- A study compared two blood transfusion strategies for patients with myocardial infarction and low hemoglobin: a restrictive strategy (transfusion if hemoglobin <7 or 8 g/dL) and a liberal strategy (transfusion if hemoglobin <10 g/dL).
- Involving 3,504 patients, results showed that the liberal group received significantly more transfusions but did not experience a reduced risk of death or recurrent myocardial infarction at 30 days compared to the restrictive group.
- The findings suggest that while the liberal strategy may not improve outcomes, the potential risks of the restrictive strategy remain uncertain, indicating the need for further research.
Background: Female sex is frequently cited as a risk factor for anthracycline cardiotoxicity based on pediatric data, but the role of sex in the development of cardiotoxicity has not been clearly established in adults.
Objectives: To assess the effect of female sex on the development of incident heart failure (HF) in adult patients treated with anthracyclines.
Methods: This was a retrospective cohort study of 1525 adult patients with no prior history of HF or cardiomyopathy who were treated with anthracyclines between 1992 and 2019.
Background: Peak tricuspid regurgitant velocity (TRV) on transthoracic echocardiography (TTE) is a commonly obtained parameter and robust predictor of subsequent adverse clinical outcomes.
Objectives: The purpose of this study was to determine the predictors and clinical significance of TRV progression.
Methods: We retrospectively linked consecutive outpatient TTE reports from our institution to 2005 to 2017 Medicare claims.