Publications by authors named "Nasrien E Ibrahim"

Background: Heart failure (HF) is increasing in the United States, and awareness is needed for prevention. Hypertension is the leading cause of HF, and adherence to antihypertensive medication is critical for reducing HF risk. Self-efficacy positively influences health-promoting behaviors.

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  • Cardiomyopathy (CDM) during pregnancy significantly impacts maternal health, with serious risks leading to morbidity and mortality.
  • Analysis of delivery hospitalizations from 2005-2020 showed that peripartum cardiomyopathy (PPCM) represented the majority of cases, followed closely by dilated cardiomyopathy (DCM), while hypertrophic (HCM) and restrictive cardiomyopathy (RCM) were less common.
  • PPCM was linked to the highest in-hospital mortality and adverse events, though its prevalence has decreased over time, while DCM and HCM rates have increased, highlighting a need for more research in this area.
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Introduction: Persons with diabetes are at risk for developing a cardiomyopathy through several pathophysiological mechanisms independent of traditional risk factors for heart failure. Among those with diabetic cardiomyopathy (DbCM), the relationship between natriuretic peptides, cardiac structural abnormalities and functional capacity is largely unknown.

Methods: In this prespecified subgroup analysis of the Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure (ARISE-HF) trial, 685 participants with asymptomatic DbCM underwent baseline echocardiography data, laboratory investigations, and functional assessments.

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Online education materials are widely used by patients and caregivers to understand the management of complex chronic diseases such as heart failure (HF). Organizations such as the American Medical Association and National Institutes of Health recommend that materials be written at a 6th-grade reading level. The current study examined the readability and accessibility of online education materials for patients with HF.

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Background: Diabetic cardiomyopathy (DbCM) increases risk of overt heart failure in individuals with diabetes mellitus. Racial and ethnic differences in DbCM remain unexplored.

Objectives: The authors sought to identify racial and ethnic differences among individuals with type 2 diabetes mellitus, structural heart disease, and impaired exercise capacity.

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Background: Progression to symptomatic heart failure is a complication of type 2 diabetes; heart failure onset in this setting is commonly preceded by deterioration in exercise capacity.

Objectives: This study sought to determine whether AT-001, a highly selective aldose reductase inhibitor, can stabilize exercise capacity among individuals with diabetic cardiomyopathy (DbCM) and reduced peak oxygen uptake (Vo).

Methods: A total of 691 individuals with DbCM meeting inclusion and exclusion criteria were randomized to receive placebo or ascending doses of AT-001 twice daily.

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  • Financial barriers significantly affect access to heart transplantation, with patients incurring costs for hospitalization, medications, and travel.
  • A study analyzed 1,000 GoFundMe campaigns for heart transplants, ultimately including 634 campaigns, mostly for white males and adults, with about 15% raising no funds.
  • The research underscores the financial hardships faced by patients and calls for advocacy to enhance equitable access and coverage for heart transplantation across society.
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Guideline-directed medical therapies and guideline-directed nonpharmacological therapies improve quality of life and survival in patients with heart failure (HF), but eligible patients, particularly women and individuals from underrepresented racial and ethnic groups, are often not treated with these therapies. Implementation science uses evidence-based theories and frameworks to identify strategies that facilitate uptake of evidence to improve health. In this scientific statement, we provide an overview of implementation trials in HF, assess their use of conceptual frameworks and health equity principles, and provide pragmatic guidance for equity in HF.

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Background: Diabetic cardiomyopathy (DbCM) is a form of Stage B heart failure (HF) at high risk for progression to overt disease. Using baseline characteristics of study participants from the Aldose Reductase Inhibition for Stabilization of Exercise Capacity in Heart Failure (ARISE-HF) Trial we sought to characterize clinical characteristics of individuals with findings consistent with DbCM.

Methods: Among study participants meeting inclusion criteria, clinical characteristics, laboratory testing, imaging, Kansas City Cardiomyopathy Questionnaire (KCCQ), Physical Activity Scale of the Elderly (PASE) and cardiopulmonary exercise testing (CPET) results were tabulated.

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  • - Heart failure (HF) is usually classified based on left ventricular ejection fraction (LVEF), but this method relies on arbitrary cutpoints that might not reflect the physiological complexities of the condition.
  • - A recent review by the Heart Failure Collaboratory analyzed various clinical trials and found that many HF treatments work effectively across a wide range of LVEF values, although their specific effects can differ depending on the LVEF level.
  • - Moving forward, it is proposed that HF classification focuses on whether LVEF is reduced or not, while promoting further research to test new treatments across the entire LVEF spectrum.
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Purpose Of Review: To discuss the prevailing racial and ethnic disparities in heart failure (HF) care by identifying barriers to equitable care and proposing solutions for achieving equitable outcomes.

Recent Findings: Throughout the entire spectrum of HF care, from prevention to implementation of guideline-directed medical therapy and advanced interventions, racial and ethnic disparities exist. Factors such as differential distribution of risk factors, poor access to care, inadequate representation in clinical trials, and discrimination from healthcare clinicians, among others, contribute to these disparities.

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Racial and ethnic disparities in the access to left atrial appendage occlusion (LAAO) have been previously described. However, it remains unclear if there have been any changes in these disparities over the years and if the disparities include other racial and ethnic groups not previously studied. We aimed to determine the temporal evolution of the racial and ethnic disparities in the utilization of LAAO from 2016 to 2019.

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  • - 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.
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Background: Diabetic cardiomyopathy (DbCM) is a specific form of heart muscle disease that may result in substantial morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM). Hyperactivation of the polyol pathway is one of the primary mechanisms in the pathogenesis of diabetic complications, including development of DbCM. There is an unmet need for therapies targeting the underlying metabolic abnormalities that drive this form of Stage B heart failure (HF).

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Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) (canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin), although initially developed as glucose-lowering drugs, provide significant beneficial effects on cardiorenal outcomes, including heart failure, regardless of type 2 diabetes status. Integration of SGLT-2is into clinical practice requires practical guidance for physicians about their use. To overcome physicians' clinical inertia for SGLT-2i use, including addressing safety, potentially a barrier to their use, a roundtable discussion with physicians from three specialties (cardiology, endocrinology, and nephrology) was conducted.

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