Publications by authors named "Klempfner Robert"
Background: Age and sex can be estimated using artificial intelligence on the basis of various sources. The aims of this study were to test whether convolutional neural networks could be trained to estimate age and predict sex using standard transthoracic echocardiography and to evaluate the prognostic implications.
Methods: The algorithm was trained on 76,342 patients, validated in 22,825 patients, and tested in 20,960 patients.
(1) Cardiac rehabilitation often emphasizes aerobic capacity while overlooking the importance of muscle strength. This study evaluated the impact of an enhanced remote strength training program (RCR-ST) on cardiac rehabilitation. (2) In this randomized prospective study (RCT registration number SMC-9080-22), 50 patients starting cardiac rehabilitation were assessed for muscle strength, aerobic capacity, and self-reported outcomes at baseline and after 16 weeks.
View Article and Find Full Text PDFBackground: We aimed to assess in a prospective multicenter study the quality of echocardiographic exams performed by inexperienced users guided by a new artificial intelligence software and evaluate their suitability for diagnostic interpretation of basic cardiac pathology and quantitative analysis of cardiac chamber and function.
Methods: The software (UltraSight, Ltd) was embedded into a handheld imaging device (Lumify; Philips). Six nurses and 3 medical residents, who underwent minimal training, scanned 240 patients (61±16 years; 63% with cardiac pathology) in 10 standard views.
Article Synopsis
- Current guidelines recommend implantable cardioverter-defibrillators (ICDs) for all patients with symptomatic heart failure and low left ventricular ejection fraction, but many may not benefit from them.
- The study evaluated the feasibility of using the MADIT-II-based Risk Stratification Score (MRSS) to differentiate patients and gauge their likely survival benefits from ICDs.
- Results indicated that among 2,177 patients, different MRSS risk groups had varying survival benefits from ICDs, suggesting that this score can help identify who might actually benefit from prophylactic ICD implantation.
Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. Acute exacerbations of COPD (AECOPD) drastically affect the clinical course of the disease. We aimed to evaluate the treatment of AECOPD in the internal medicine departments in Israel, nationwide.
View Article and Find Full Text PDFPatient-centered health care (PCC) is a framework of clinical care focused on the patient's individual health care needs. In particular, it emphasizes the development of a partnership between the patient, physician, and healthcare workers to actively involve and empower the patient in their health care decisions. Additionally, PCC goals include ensuring access to care, emotional support, engaging patient support systems, physical comfort, and continuity of care.
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- - The study investigates the impact of sodium glucose cotransporter 2 inhibitors (SGLT2i) on atrial tachyarrhythmias (ATA) in patients with cardiac implantable electronic devices (CIEDs), revealing a notable reduction in ATA hospitalizations linked to SGLT2i use.
- - Analyzing data from 13,888 patients over 24,442 years of follow-up, results show a 22% decrease in ATA risk and all-cause mortality among SGLT2i users, particularly in heart failure patients, but no significant effect on ventricular tachyarrhythmias (VTA).
- - The findings suggest that SGLT2i can significantly lower ATA and mortality
Aims: Cardiac rehabilitation is an essential component of secondary prevention consistently unexploited by most eligible patients. Accordingly, the remote cardiac rehabilitation program (RCRP) was developed to create optimal conditions for remote instruction and supervision for patients to enable successful completion of the program.
Methods: This study comprised 306 patients with established coronary heart disease who underwent a 6-month RCRP.
Purpose: Asynchronous home-based cardiac rehabilitation (HBCR) is a viable alternative to center-based cardiac rehabilitation (CBCR). However, to achieve significant functional improvement, a high level of adherence and activity must be achieved. The effectiveness of HBCR among patients who actively avoid CBCR has not been effectively investigated.
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- * Patients with baseline AF (2% of the total) tended to be older, predominantly male, and had more comorbidities, while male sex, age, obesity, and heart-related issues were identified as strong predictors of AF.
- * Among those without baseline AF, 85 new cases were identified during follow-up, with age, heart failure, and congenital heart disease being significant risk factors; the CHARGE-AF risk score proved to be a better predictor of AF than the CHADS-VAS
Understanding patients' survival probability as well as the factors affecting it constitute a significant concern for researchers and practitioners, in particular for patients with severe chronic illnesses such as congestive heart failure (CHF). CHF is a clinical syndrome characterized by comorbidities and adverse medical events. Risk stratification to identify patients most likely to die shortly after hospital discharge can improve the quality of care by better allocating organizational resources and personalized interventions.
View Article and Find Full Text PDFBackground: Low-density lipoprotein cholesterol (LDL-C) lowering is key to reduce atherosclerotic disease progression and recurrent events for patients after acute coronary syndrome (ACS). However, LDL-C management for post-ACS patients remains challenging in clinical practice.
Hypothesis: The ACS EuroPath III project was designed to optimize LDL-C management in post-ACS patients by promoting guideline implementation and translating existing evidence into effective actions.
Article Synopsis
- * It involved 92 patients, with 84 undergoing DT; all successfully terminated induced ventricular fibrillation without complications, and follow-ups showed no inappropriate shocks or lead malfunctions.
- * The results indicated that while DT posed no complications, it did not yield any clinically significant findings for patient management.
Background: Remote cardiac rehabilitation (RCR) after myocardial infarction is an innovative Israeli national program in the field of telecardiology. RCR is included in the Israeli health coverage for all citizens. It is generally accepted that telemedicine programs better apply to younger patients because it is thought that they are more technologically literate than are older patients.
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- A nationwide study in Israel investigated the impact of the COVID-19 pandemic on admissions and outcomes for patients with non-ST-segment myocardial infarction (NSTEMI) over an 8-week period.
- Results showed that 56% of NSTEMI patients were admitted during the pandemic compared to 44% in the same period two years prior, with no significant differences in demographics between the two groups.
- Despite a longer time from symptom onset to hospital admission during the pandemic, in-hospital mortality rates and 30-day mortality rates were similar across both time periods, indicating that care quality for NSTEMI may not have been adversely affected.
Background: A significant number of coronary artery disease patients do not attain guideline recommended LDL levels. Participating in a cardiac rehabilitation (CR) program has been shown to improve adherence to medical therapy.
Objectives: Evaluate the specific lipid lowering therapy (LLT) prescribed and percent of subjects achieving LDL levels of <70 mg/dL before and after 3 months following CR program initiation.
Objectives: Despite documented benefits and physicians' recommendations to participate in cardiac rehabilitation (CR) programs, the average dropout rate remains between 12-56%. This study's goal was to demonstrate that using personalized interventions can significantly increase patient adherence.
Method: Ninety-five patients (ages 18-90) eligible for the CR program were randomly recruited and received personalized interventions using the Well-Beat system.
Episodes of acute ileitis or colitis have been associated with future development of inflammatory bowel diseases (IBD). Nevertheless, the rate of future IBD among patients diagnosed with signs or symptoms of acute bowel inflammation is unknown. We aimed to assess the risk of IBD development among patients presenting with signs or symptoms of ileitis or colitis.
View Article and Find Full Text PDFBackground: Contemporary data on the independent association of severe tricuspid regurgitation (TR) with excess mortality are needed. The aims of this study were to describe contemporary outcomes of patients with severe TR and to identify outcome modifiers.
Methods: Consecutive echocardiographic reports linked to clinical data from the largest medical center in Israel (2007-2019) were reviewed.
Background: The CHA2DS2-VASC score is used to assess the risk of cerebrovascular accident (CVA) in patients with atrial fibrillation (AF) or atrial flutter (AFL).
Objectives: We aimed to determine whether this score can determine the risk of CVA during the first year after hospitalization, in patients without known AF/AFL.
Design: Single-center retrospective cohort.
Background: The Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery (SYNTAX) trial showed that the SYNTAX score (SS) is a useful tool for customizing revascularization treatment for patients with multivessel coronary disease. In the past decade, the Clinical SS (CSS) has emerged as a comprehensive tool. This novel tool considers the SS as well as patient clinical parameters such as age, creatinine clearance, and ejection fraction, which were shown to be relevant for patient prognosis.
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- * Among the 2,202 patients with moderate AS studied, the five-year death rate was significantly higher (46%) compared to those without moderate AS (18%).
- * The risk of death from moderate AS is influenced by factors like age and ejection fraction, particularly affecting patients under 80 years and those with lower heart function.
Congestive Heart Failure (CHF) is among the most prevalent chronic diseases worldwide, and is commonly associated with comorbidities and complex health conditions. Consequently, CHF patients are typically hospitalized frequently, and are at a high risk of premature death. Early detection of an envisaged patient disease trajectory is crucial for precision medicine.
View Article and Find Full Text PDFIntroduction: We aimed to compare the outcomes of acute coronary syndrome (ACS) patients undergoing in-hospital percutaneous coronary intervention treated with prasugrel versus ticagrelor.
Methods: Among 7,233 patients enrolled to the Acute Coronary Syndrome Israeli Survey (ACSIS) between 2010 and 2018, we identified 1,126 eligible patients treated with prasugrel and 817 with ticagrelor. Comparison between the groups was performed separately in ST-elevation myocardial infarction (STEMI) patients, propensity score matched (PSM) STEMI patients, and non-ST-elevation ACS (NSTE-ACS) patients.
Introduction: Up to 20% of patients presenting with acute coronary syndrome (ACS) have no traditional cardiovascular risk-factors (RFs). Data regarding the determinants, management, and outcomes of these patients are scarce.
Objectives: To evaluate the management, outcomes, and time-dependent changes of ACS patients without RFs.