Publications by authors named "Nicholas S Amoroso"
Background: This study aimed to determine whether artificial intelligence (AI)-based automated assessment of left atrioventricular coupling index (LACI) can provide incremental value above other traditional risk factors for predicting mortality among patients with severe aortic stenosis (AS) undergoing coronary CT angiography (CCTA) before transcatheter aortic valve replacement (TAVR).
Methods: This retrospective study evaluated patients with severe AS who underwent CCTA examination before TAVR between September 2014 and December 2020. An AI-prototype software fully automatically calculated left atrial and left ventricular end-diastolic volumes and LACI was defined by the ratio between them.
Article Synopsis
- Coronary CT angiography (CCTA) is crucial before transcatheter aortic valve replacement (TAVR), and this study aimed to assess how well AI software can predict major adverse cardiovascular events (MACE) in TAVR patients by analyzing cardiac parameters.
- The study included 648 patients, revealing that 17.9% experienced MACE within an average follow-up of 24 months, with left ventricle long axis shortening (LV-LAS) identified as a key predictor of MACE after considering other clinical factors.
- The results showed that the AI-derived LV-LAS significantly improved prediction models for MACE, demonstrating that automated cardiac assessments can effectively aid in risk stratification prior to TAVR procedures
Article Synopsis
- Aortic valve replacement (AVR) is crucial for patients with severe aortic regurgitation (AR), but some with moderate AR may also face high mortality if untreated.
- A study analyzed over 81,000 patients with AR to understand how various clinical factors, like left ventricular function and heart dilation, influence mortality risk.
- The findings indicate that both moderate and severe AR, along with specific cardiac damage markers, significantly increase mortality risk, suggesting a need for further investigation on AVR for those with less severe AR but concerning clinical features.
Article Synopsis
- The study analyzed real-world data on aortic regurgitation (AR) severity to assess patient evaluations by the Heart Valve Team, rates of aortic valve replacement (AVR), and mortality among untreated patients.
- Data were collected from over a million patients from various US institutions, focusing specifically on those with documented AR severity from echocardiograms.
- Findings revealed that patients with moderate-to-severe AR had low rates of Heart Valve Team evaluations and AVR and experienced increased mortality rates, highlighting the need for earlier referrals for better outcomes.
Article Synopsis
- - The study focused on evaluating the safety and effectiveness of the APTURE transcatheter shunt system in patients with heart failure and left ventricular ejection fraction (LVEF) greater than 40%.
- - Results showed that the APTURE shunt had a low incidence of serious complications (2.6%) and helped improve heart function, as indicated by reduced pulmonary capillary wedge pressure and improved quality of life scores over a year.
- - Overall, the findings suggest that the APTURE shunt is a promising option for managing heart failure in patients with mildly reduced or preserved ejection fraction.
Minimally invasive strategies to treat valvular heart disease have emerged over the past 2 decades. The use of transcatheter aortic valve replacement in the treatment of severe aortic stenosis, for example, has recently expanded from high- to low-risk patients and became an alternative treatment for those with prohibitive surgical risk. With the increase in transcatheter strategies, multimodality imaging, including echocardiography, CT, fluoroscopy, and cardiac MRI, are used.
View Article and Find Full Text PDFBackground: Renal disease is associated with poor prognosis despite guideline-directed cardiovascular therapy, and outcomes by sex in this population remain uncertain.
Methods And Results: Patients (n=5213) who underwent a MitraClip procedure in the National Cardiovascular Data Registry Transcatheter Valve Therapy registry were evaluated for the primary composite outcome of all-cause mortality, stroke, and new requirement for dialysis by creatinine clearance (CrCl). Centers for Medicare and Medicaid Services-linked data were available in 63% of patients (n=3300).
Background: Atherosclerotic disease of the superficial femoral artery (SFA) is frequently seen and can be treated with percutaneous interventions, traditionally via femoral artery access. There are limited reports of transpedal artery access for peripheral artery interventions, but none to date describing routine primary transpedal artery approach for SFA stenting.
Methods: In this preliminary study, we report 4 patients who underwent successful endovascular SFA stenting using a single transpedal artery access via a new ultra-low profile 6 Fr sheath (Glidesheath Slender; Terumo Corporation).
Periprocedural hyperglycemia is an independent predictor of mortality in patients who underwent percutaneous coronary intervention (PCI). However, periprocedural management of blood glucose is not standardized. The effects of routinely continuing long-acting glucose-lowering medications before coronary angiography with possible PCI on periprocedural glycemic control have not been investigated.
View Article and Find Full Text PDFDrug-eluting stents have dramatically reduced the risk of restenosis, but concerns of an increased risk of stent thrombosis have provided uncertainty about their use. Recent studies have continued to show improved procedural and clinical outcomes with drug-eluting stents both in the setting of acute coronary syndromes and stable coronary artery disease. Newer generation drug-eluting stents (especially everolimus-eluting stents) have been shown to be not only efficacious but also safe with reduced risk of stent thrombosis when compared with bare-metal stents, potentially changing the benchmark for stent safety from bare-metal stents to everolimus-eluting stents.
View Article and Find Full Text PDFIncreased platelet activity is associated with adverse cardiovascular events. The mean platelet volume (MPV) correlates with platelet activity; however, the relation between the MPV and long-term mortality in patients undergoing percutaneous coronary intervention (PCI) is not well established. Furthermore, the role of change in the MPV over time has not been previously evaluated.
View Article and Find Full Text PDFHyperglycemia is common in nondiabetic patients with acute myocardial infarction (AMI). Elevated blood glucose level may reflect a response to stress, an underlying abnormal glucometabolic state or both. Regardless of mechanism, hyperglycemia complicating AMI is associated with an inflammatory and prothrombotic state, depressed myocardial contractility and increased short- and long-term mortality.
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