Publications by authors named "Leor Perl"
Background: The use of transcatheter aortic valve implantation (TAVI) for severe aortic stenosis is expanding to patients across the entire spectrum of surgical risk. We aimed to perform a meta-analysis comparing TAVI and surgical aortic valve replacement (SAVR) in trials enrolling lower risk patients.
Methods: We conducted a meta-analysis of randomized controlled trials (RCTs) comparing safety and efficacy outcomes between TAVI and SAVR among lower risk patients (mean/median STS score <4).
Aims: To evaluate the association between transcatheter edge-to-edge repair (TEER) and outcomes in patients with significant mitral regurgitation (MR) following acute myocardial infarction (MI), focusing on the aetiology of acute post-MI MR in high-risk surgical patients.
Methods And Results: The International Registry of MitraClip in Acute Mitral Regurgitation following Acute Myocardial Infarction (IREMMI) includes 187 patients with severe MR post-MI managed with TEER. Of these, 176 were included in the analysis, 23 (13%) patients had acute papillary muscle rupture (PMR) and 153 (87%) acute secondary MR.
Intra-Aortic Balloon Pump: Overall and Temporal Trends of Comparative Effectiveness in a National Registry.
Catheter Cardiovasc Interv
February 2025
Background: Although the latest studies failed to prove the benefit of routine intra-aortic balloon pump (IABP) use in patients with acute myocardial infarction (MI) presenting with cardiogenic shock, the benefit of IABP utilization in selected cases in "real world" practice is unknown.
Aims: We sought to follow temporal trends in IABP use in a real-world cohort of acute coronary syndrome (ACS).
Methods: We evaluated IABP utilization and patient outcomes from the Acute Coronary Syndrome in Israel Survey (ACSIS) between the years 2000 and 2021.
Gender-Related Outcomes in Saphenous Vein Graft Interventions.
Catheter Cardiovasc Interv
February 2025
Background: Saphenous vein graft percutaneous coronary intervention (SVG-PCI) is a relatively common procedure in patients after coronary artery bypass grafting (CABG). Although internal mammary artery is considered optimal, SVG is still used in the majority of patients.
Aims: Investigating the potential role of gender differences in the incidence and outcomes of SVG-PCI.
Impact of intravascular ultrasound for coronary bifurcations treated with last generations stents: insights from the BIFURCAT-ULTRA registry.
Eur Heart J Qual Care Clin Outcomes
November 2024
Background: Bifurcation lesions are associated with higher rates of major adverse cardiovascular events (MACE).
Aim: To investigate the impact of imaging-guided PCI in a real-world population with coronary bifurcation lesions.
Methods: From the ULTRA-BIFURCAT registry, we compared IVUS vs.
Background And Aim: Endoscopic ultrasound (EUS) is the most sensitive method for evaluation of pancreatic lesions but is limited by significant operator dependency. Artificial intelligence (AI), in the form of computer-aided detection (CADe) systems, has shown potential in increasing accuracy and bridging operator dependency in several endoscopic domains. However, the complexity of integrating AI into EUS is far more challenging.
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- The study evaluates the performance of ultrathin drug-eluting stents (DES) versus thin-strut DES and drug-eluting balloons (DEB) in treating in-stent restenosis (ISR) in patients.
- Results show that ultrathin DES significantly lowers the risk of adverse events, including cardiac death and need for revascularization, when compared to both thin-strut DES and DEBs after three years of follow-up.
- Additionally, in patients with diffuse ISR, ultrathin DES outperformed thin-strut DES in reducing risks of target lesion revascularization (TLR) and target vessel revascularization (TVR).
Background: Coronary artery disease (CAD) is a leading cause of death in the elderly population. Data regarding percutaneous coronary interventions (PCIs) in nonagenarians are scarce, and differences in long term outcomes between generations remain unclear. We aimed to study the pattern and temporal trends of nonagenarians treated with PCI.
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- The objective was to create a web-based AI tool that predicts drug sustainability (DS) for infliximab and vedolizumab in patients with moderate-to-severe Ulcerative Colitis (UC), addressing a gap in reliable prediction methods.!
- The study included data from three Israeli medical centers, analyzing patients treated for over 54 weeks without corticosteroids, hospitalizations, or surgeries, using machine learning for accurate predictions based on baseline clinical data.!
- The developed model showed strong predictive performance with an area under the ROC curve of 0.86 and accuracy ranging from 65.5% to 76.9%, promising improvements in clinical decision-making for managing UC while enhancing precision medicine practices.!
Article Synopsis
- Haemodynamic monitoring with implantable pressure sensors lowers heart failure hospitalizations and empowers patients to manage their treatment, potentially enhancing adherence and reducing healthcare provider workloads.
- The VECTOR-HF I and IIa studies evaluate a patient self-management approach for heart failure, showing no serious complications and high adherence (91.4%) over a year, with significant reductions in hospitalizations and improvements in physical function and quality of life.
- Interim results indicate that patient self-management using left atrial pressure monitoring is safe, feasible, and may lead to better outcomes for heart failure patients.
Rationale & Objective: Kidney function can be adversely affected by significant tricuspid regurgitation (TR) owing to effects on cardiac output and systemic venous congestion. However, the impact of significant TR on short- and long-term kidney function following a kidney transplant remains uncertain.
Study Design: Retrospective observational cohort.
Article Synopsis
- End-stage renal disease significantly increases cardiovascular risks, but kidney transplantation can help reduce these risks, even in patients with systolic heart failure.
- A study of 604 kidney transplant patients revealed that 28% experienced a notable improvement in heart function post-transplant, with female patients showing greater recovery.
- The findings suggest that kidney transplantation can improve left ventricular systolic function in certain patients, highlighting its potential benefits even for those with heart issues.
Aims: A majority of acute coronary syndromes (ACS) present without typical ST elevation. One-third of non-ST-elevation myocardial infarction (NSTEMI) patients have an acutely occluded culprit coronary artery [occlusion myocardial infarction (OMI)], leading to poor outcomes due to delayed identification and invasive management. In this study, we sought to develop a versatile artificial intelligence (AI) model detecting acute OMI on single-standard 12-lead electrocardiograms (ECGs) and compare its performance with existing state-of-the-art diagnostic criteria.
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- Acute ischemic stroke is a significant risk following transcatheter aortic valve replacement (TAVR), prompting the development of cerebral embolic protection devices (CEPD) to reduce this risk.
- A study compared patients who underwent TAVR without CEPD (CEPD-) to those with CEPD (CEPD+) to assess characteristics and outcomes related to stroke.
- Findings indicated no significant differences in stroke rates, severity, or disability outcomes between the two groups, although the CEPD+ group had notably different types of strokes, suggesting that the efficacy of CEPD in preventing acute ischemic stroke is still questionable.
Background: The field of artificial intelligence (AI) is poised to significantly influence the future of medicine. With the accumulation of vast databases and recent advancements in computer science methods, AI's capabilities have been demonstrated in numerous areas, from diagnosis and morbidity prediction to patient treatment. Establishing an AI research and development unit within a medical center offers multiple advantages, particularly in fostering research and tapping into the immediate potential of AI at the patient's bedside.
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- Acute mitral regurgitation (MR) following myocardial infarction (MI) can result from papillary muscle rupture (PMR), leading to high risks for patients; this study explores using transcatheter edge-to-edge mitral valve repair (TEER) as a treatment option.
- Data from 30 centers across Europe, North America, and the Middle East revealed that TEER was performed on 23 high-risk patients within a week of their MI, achieving procedural success in 87% and a significant reduction in MR severity.
- The outcomes indicated that 70% of patients could be discharged after treatment, showcasing TEER's potential as a viable emergency intervention or a bridge to further surgical options for critically ill patients with PM
Industry-academia Collaboration is an academic activity within academia(educational institutions such as universities, research institutes, etc.)formed to research and develop new technologies, create new businesses and knowledge, and recruit outsourcing human resources. There is a collaboration between an industry(a private company, a group that engages in broad commercial activities and links research and development directly to economic activity)and academia.
View Article and Find Full Text PDFBackground: The use of drug-eluting balloons (DEBs) remains clinically relevant in the contemporary era of drug-eluting stent percutaneous coronary interventions (DES-PCI), especially in the setting of in-stent restenosis (ISR). Our goal was to assess the outcomes of ISR patients in a large prospective registry.
Methods: A total of 2329 consecutive patients with ISR-PCI (675 using DEB and 1654 with DES) were treated in our medical centre from 2010 to 2021.
Background: The electrocardiogram (ECG) is one of the most accessible and comprehensive diagnostic tools used to assess cardiac patients at the first point of contact. Despite advances in computerized interpretation of the electrocardiogram (CIE), its accuracy remains inferior to physicians. This study evaluated the diagnostic performance of an artificial intelligence (AI)-powered ECG system and compared its performance to current state-of-the-art CIE.
View Article and Find Full Text PDFBackground: Cardiogenic shock (CS) remains the leading cause of ST elevation myocardial infarction (STEMI)-related mortality. Contemporary studies have shown no sex-related differences in mortality.
Methods: STEMI-CS patients undergoing primary percutaneous coronary intervention (PPCI) were included based on a dedicated prospective STEMI database.
Background Little is known about the impact of transcatheter mitral valve edge-to-edge repair on changes in left ventricular ejection fraction (LVEF) and the effect of an acute reduction in LVEF on prognosis. We aimed to assess changes in LVEF after transcatheter mitral valve edge-to-edge repair for both primary and secondary mitral regurgitation (PMR and SMR, respectively), identify rates and predictors of LVEF reduction, and estimate its impact on prognosis. Methods and Results In this international multicenter registry, patients with both PMR and SMR undergoing transcatheter mitral valve edge-to-edge repair were included.
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