Publications by authors named "Joseph Lerman"
Article Synopsis
- The PARACOR-19 trial investigated whether the medication sacubitril/valsartan could improve heart health markers in patients who had recently recovered from COVID-19.
- In this study involving 42 participants, the drug did not significantly affect the primary cardiac injury markers, high-sensitivity cardiac troponin T and soluble ST2, compared to a placebo.
- However, exploratory results showed that sacubitril/valsartan led to notable reductions in other heart-related biomarkers, indicating it might help in reducing cardiac stress and improving collagen turnover.
Background: Heart transplant (HT) in recipients with left ventricular assist devices (LVADs) is associated with poor early post-HT outcomes, including primary graft dysfunction (PGD). As complicated heart explants in recipients with LVADs may produce longer ischemic times, innovations in donor heart preservation may yield improved post-HT outcomes. The SherpaPak Cardiac Transport System is an organ preservation technology that maintains donor heart temperatures between 4 °C and 8 °C, which may minimize ischemic and cold-induced graft injuries.
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- Heart transplantation (HT) has traditionally used cold storage for preserving donor hearts, which poses risks like ischemic damage and poor outcomes after the transplant.
- New preservation methods, such as the SherpaPak Cardiac Transport System and Transmedics Organ Care System, are being implemented and allow for better heart preservation, expanding donor options and geographic reach for procurement.
- The paper discusses emerging evidence linking these new techniques to better outcomes post-transplant and recommends best practices for choosing between different preservation methods.
Article Synopsis
- Heart transplant recipients with previous cytomegalovirus exposure were analyzed to determine the effectiveness of two CMV prevention strategies: universal prophylaxis (UP) and preemptive therapy (PET).
- A study of 563 CMV R+ heart transplant recipients revealed that PET significantly increased the risk of CMV infection and related hospitalizations compared to UP, along with a higher incidence of acute cellular rejection.
- Although UP led to more cases of leukopenia, it was associated with better overall outcomes for graft health and reduced risks related to CMV compared to PET in these patients.
Article Synopsis
- The study investigates the effectiveness of a new treatment strategy for patients with heart failure, focusing on improving their symptoms and overall quality of life.
- Researchers conducted a randomized trial, comparing the new treatment to standard care over a specific duration, measuring various health outcomes.
- Results showed that patients receiving the new treatment experienced significant improvements, suggesting it could be a valuable option for managing heart failure.
Article Synopsis
- Heart failure with reduced ejection fraction (HFrEF) is often treated with diabetes medications, but the effects on patients with both HFrEF and type 2 diabetes mellitus (T2DM) are not fully understood.
- The FIGHT trial tested the drug liraglutide in 300 HFrEF patients recently hospitalized for heart failure, but found no significant clinical benefits.
- Analysis of plasma metabolites revealed that certain metabolite factors correlated with better functional outcomes, especially in those with T2DM, suggesting metabolic pathways may influence prognosis in these patients.
Article Synopsis
- Pulmonary embolism (PE) is a serious condition leading to significant cardiovascular issues, and obstructive sleep apnea (OSA) is becoming more common, especially in older and obese individuals.
- A study of over 750,000 PE patients showed that 8.1% had OSA, which increased over the years from 2005 to 2016, with OSA+ patients typically being younger and mostly male.
- Interestingly, OSA+ patients had lower inpatient mortality rates compared to those without OSA, despite having more traditional risk factors, suggesting potential protective effects of OSA that need further investigation.
Article Synopsis
- - The study examined the relationship between estimated plasma volume (PV) using two formulas (Duarte-ePV and KH-ePVS) and clinical outcomes for heart failure patients in the ASCEND-HF trial.
- - Results showed no strong link between PV and in-hospital worsening of heart failure, but the Duarte-ePV suggested a possible connection with worse outcomes at 30 days post-discharge.
- - KH-ePVS was associated with better 30-day clinical outcomes, indicating that estimating PV could help with risk assessment in heart failure treatment.
Article Synopsis
- Psoriasis is linked to an increased risk of coronary artery disease, potentially through elevated levels of soluble LOX-1, a receptor that interacts with oxidized lipoproteins.
- A cohort study at the National Institutes of Health involved 175 psoriasis patients to analyze the relationship between soluble LOX-1 and noncalcified coronary burden over time.
- Results showed that psoriasis patients had higher levels of soluble LOX-1 compared to matched controls, suggesting a potential connection to cardiovascular risk.
Background: Women comprise approximately one-third of the advanced heart failure population but may receive fewer advanced heart failure therapies including left ventricular assist devices (LVADs). During the early pulsatile-flow device era, women had higher post-LVAD mortality and increased complications. However, knowledge about these differences in the continuous-flow device era is limited.
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- Subjects with systemic lupus erythematosus (SLE) have a higher risk of cardiovascular disease (CVD) that isn't fully captured by traditional risk assessments, prompting this study to explore nuclear MR (NMR) spectroscopy for evaluating lipoprotein levels and GlycA.
- The study used coronary CT angiography to assess plaque burden in SLE patients and healthy controls, finding significant differences in lipoprotein particle counts and sizes between the two groups.
- Results indicate that SLE patients exhibit a harmful lipoprotein profile, with decreased high-density lipoprotein (HDL) and increased very low-density lipoprotein (VLDL), suggesting that NMR measurements of GlycA and lipoproteins could better
Article Synopsis
- The study explores the links between chronic stress, as measured by resting amygdala activity, and various cardiovascular health markers in patients with psoriasis, a stress-related inflammatory condition.
- Researchers analyzed data from 164 psoriasis patients and 47 healthy participants, using advanced imaging techniques to assess amygdala and hematopoietic system activity along with cardiovascular indicators.
- Results showed higher amygdala activity in psoriasis patients, correlating with increased hematopoietic activity and subclinical cardiovascular disease markers; treatment of severe psoriasis led to improvements in both skin condition and stress-related measures over one year.
Article Synopsis
- Inflammation plays a key role in the development of atherosclerosis, and psoriasis serves as a model to study early cardiovascular issues due to its association with chronic inflammation.
- This study aims to explore the relationship between aortic vascular inflammation (VI) and various coronary artery disease (CAD) indices in patients with psoriasis.
- Results showed that increased aortic VI correlates with a higher total plaque burden, more luminal stenosis, and a greater presence of high-risk plaques, suggesting a potential link between chronic inflammation and early CAD development.
Background: Systemic lupus erythematosus (SLE) is associated with enhanced risk of atherosclerotic cardiovascular disease not explained by Framingham risk score (FRS). Immune dysregulation associated to a distinct subset of lupus proinflammatory neutrophils (low density granulocytes; LDGs) may play key roles in conferring enhanced CV risk. This study assessed if lupus LDGs are associated with in vivo vascular dysfunction and inflammation and coronary plaque.
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- Psoriasis is linked to an increased risk of cardiovascular diseases (CVD) and major adverse cardiovascular events (MACE), and the impact of how long a person has had psoriasis on these risks is not well understood.
- The study involved two methods: a human imaging study analyzing vascular inflammation in 190 psoriasis patients and a broader population-based study examining MACE risk in over 87,000 psoriasis patients compared to the general population.
- Results showed that longer psoriasis duration was significantly associated with higher vascular inflammation and a 1.0% increase in MACE risk for each additional year of psoriasis, indicating that prolonged exposure to inflammation can worsen cardiovascular health.
Article Synopsis
- Inflammation is a key factor in the development of atherosclerosis, and psoriasis, a chronic inflammatory skin disease, is linked to increased vascular inflammation and future cardiovascular issues.
- The study aimed to examine the relationship between the severity of skin disease (measured by PASI score) and vascular inflammation after one year of anti-tumor necrosis factor therapy.
- In a cohort of 115 patients, significant improvements in both skin condition and vascular inflammation were observed, with most patients experiencing a notable decrease in PASI scores and vascular inflammation over the year.
Background: Psoriasis, a chronic inflammatory disease associated with an accelerated risk of myocardial infarction, provides an ideal human model to study inflammatory atherogenesis in vivo. We hypothesized that the increased cardiovascular risk observed in psoriasis would be partially attributable to an elevated subclinical coronary artery disease burden composed of noncalcified plaques with high-risk features. However, inadequate efforts have been made to directly measure coronary artery disease in this vulnerable population.
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- * A large cohort of 1,451 ACHD was analyzed, revealing that 59.5% were overweight to morbidly obese, but ACHD had similar rates of overweight and obesity compared to matched controls, though lower rates of morbid obesity.
- * The findings suggest that individuals with ACHD are just as likely to be overweight or obese as their peers, highlighting the importance of better lifestyle counseling for cardiovascular health management in this population.
Article Synopsis
- GlycA is an inflammatory biomarker that has been linked to cardiovascular events and is being studied in relation to psoriasis, a condition that heightens cardiovascular risk.
- A study involving 412 participants found that GlycA levels were significantly higher in psoriasis patients compared to controls, with levels correlating to the severity of the disease.
- GlycA was also shown to predict vascular inflammation and coronary artery disease independently of traditional cardiovascular risk factors in psoriasis patients, and anti-inflammatory treatment reduced both psoriasis severity and GlycA levels.
Article Synopsis
- Psoriasis is linked to chronic inflammation and an increased risk of heart problems, and patients with psoriasis often experience depression, raising questions about the impact of depression on vascular health.
- A study matched psoriasis patients with and without reported depression to analyze vascular inflammation and coronary plaque using advanced imaging techniques and statistical methods.
- Findings showed that patients with self-reported depression had higher vascular inflammation and greater coronary plaque burden, suggesting depression could enhance the risk of heart disease in those with psoriasis, despite controlling for traditional risk factors.