Publications by authors named "Ofer Havakuk"

Background: Information about left atrial (LA) 2-dimensional (2D) strain parameters in patients with the Omicron variant of COVID-19 is limited. The aim of this study is to evaluate LA strain (LAS) in COVID-19 patients with the Omicron variant and compare it to that of propensity-matched patients with the wild-type (WT) variant.

Methods: A total of 148 consecutive patients who were hospitalized with Omicron COVID-19 underwent an echocardiographic evaluation within the first day after hospital admission and were compared to propensity-matched patients (1:1) with the WT variant.

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  • The study investigates how stroke volume (SV) and stroke volume index (SVI) affect the prognosis of patients with severe primary mitral regurgitation (MR).
  • It analyzed data from 283 patients to find that a stroke volume of less than 55ml significantly correlates with higher mortality and heart failure hospitalizations, while SVs between 55-70ml showed no adverse effects.
  • The findings suggest that monitoring SV, particularly when it's below 55ml, can improve risk assessment for those with severe primary MR.
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Background: Cancer therapy is considered to cause accelerated ischemia. Ankle-Brachial Index (ABI) measurement is an inexpensive, simple, available test for the early diagnosis of peripheral artery disease (PAD); however, it is not performed routinely. We aimed to evaluate the role of routine ABI measurement for the diagnosis of PAD among patients diagnosed with cancer and whether it correlates with left ventricular (LV) dysfunction.

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  • A 39-year-old woman with a history of systemic lupus erythematosus (SLE) and antiphospholipid syndrome experienced ongoing symptoms including fever and joint pain.
  • She was admitted to the ER due to sudden difficulty breathing and discovered to have clubbed fingers, which started 5 months earlier; imaging showed severe mitral valve damage with a large mass.
  • Despite initial treatment for suspected infectious endocarditis and subsequent surgeries, the mass was ultimately diagnosed as high-grade sarcoma, underscoring the need for careful interdisciplinary management in unusual medical cases.
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Aim: Examine the performance of a simple echocardiographic "Killip score" (eKillip) in predicting heart failure (HF) hospitalizations and mortality after index event of decompensated HF hospitalization.

Methods: HF patients hospitalized at our facility between 03/2019-03/2021 who underwent an echocardiography during their index admission were included in this retrospective analysis. The cohort was divided into 4 classes of eKillip according to: stroke volume index (SVI) < 35ml/m > and E/E' ratio < 15 > .

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  • The study investigates factors that limit exercise in patients with hypertrophic cardiomyopathy (HCM) by using combined stress echocardiography and cardiopulmonary exercise testing.
  • It compares 36 HCM patients with 29 age and sex-matched controls, finding significant differences in cardiac function and pulmonary pressures during exercise.
  • Results show worsened diastolic function, increased pulmonary artery pressures, and reduced oxygen consumption in HCM patients compared to controls, indicating impaired exercise capacity in this population.
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Objectives: Though the concomitant occurrence of non-severe aortic stenosis (AS) and mitral regurgitation (MR) is highly prevalent, there are limited data to guide clinical decision-making in this condition. Here, we attempt to determine an aortic valve area (AVA) cut-off value associated with worse clinical outcomes in patients with combined non-severe AS and MR.

Methods: Single-centre, retrospective analysis of consecutive patients who underwent echocardiography examination between 2010 and 2021 with evidence of combined non-severe AS and MR.

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Background: Immune checkpoint inhibitors (ICIs) have revolutionized the prognosis of cancer. Diabetes mellitus (DM) has been shown to have a negative effect on patients treated with ICIs. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are effective antidiabetic therapies associated with reduced all-cause mortality and cardiovascular (CV) outcomes.

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Background: Immune checkpoint inhibitors (ICIs) such as pembrolizumab have revolutionized the treatment of metastatic non-small cell lung cancer (mNSCLC). Beta-adrenergic activation contributes to cancer initiation and progression. While non-selective beta-blocker were found to improve the efficacy of ICIs therapy, the role of beta-1 (β)-selective -blocker (βB) in lung cancer patients is unknown.

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  • * Diagnosing PCLs (Primary Cardiac Lymphomas) can be difficult due to challenges in obtaining tissue samples.
  • * The standard treatment for PCL involves the R-CHOP chemotherapy protocol.*
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  • The study aimed to investigate the causes of effort intolerance in patients with both peripheral arterial disease (PAD) and coronary artery disease (CAD) using combined stress echocardiography and cardiopulmonary exercise tests (CPET).
  • Twenty-three PAD + CAD patients were compared to age- and sex-matched CAD patients and normal controls through exercise testing that measured oxygen consumption and cardiac function.
  • Results showed that PAD + CAD patients experienced worse diastolic function, reduced oxygen consumption, and more instances of chronotropic incompetence (inability to increase heart rate) during exercise compared to CAD patients and controls, suggesting that their exercise limitations are linked to heart and peripheral health issues.
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Coronary sinus narrowing device (reducer) implantation has emerged as an effective treatment to improve the quality of life and functional capacity in patients suffering from disabling refractory angina. Left ventricle global longitudinal strain (LV-GLS) is a useful tool for early diagnosis of subclinical cardiac injury and an independent predictor for coronary artery disease. We aimed to investigate whether LV-GLS could help predict clinical improvement after coronary sinus reducer implantation.

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  • The study evaluates the risk of death or hospitalizations due to heart failure in patients with reduced ejection fraction (HFrEF) based on diastolic function metrics, highlighting the significance of diastolic dysfunction in heart failure prognosis.
  • It involved a retrospective analysis of 4717 patients treated at a tertiary hospital from 2010 to 2021, excluding those with significant left heart valvular dysfunction.
  • Findings show that specific diastolic indices like increased left atrial volume index (LAVI) and certain E-wave velocities correlate with higher mortality and hospitalization rates, indicating that even slightly abnormal diastolic function can lead to worse outcomes in these patients.
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Background: We aimed to test the differences in peak VO between males and females in patients diagnosed with heart failure (HF), using combined stress echocardiography (SE) and cardiopulmonary exercise testing (CPET).

Methods: Patients who underwent CPET and SE for evaluation of dyspnea or exertional intolerance at our institution, between January 2013 and December 2017, were included and retrospectively assessed. Patients were divided into three groups: HF with preserved ejection fraction (HFEF), HF with mildly reduced or reduced ejection fraction (HFEF/HFEF), and patients without HF (control).

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  • - The study analyzed cardiac issues in 162 patients hospitalized with the Omicron variant of COVID-19, comparing them to a matched group from the wild-type variant, focusing on detailed echocardiographic assessments.
  • - Results showed that while 53% of patients had normal echocardiograms, notable conditions included right ventricular (RV) dilation and dysfunction in 33% of patients, and elevated left ventricular (LV) filling pressure in 29%.
  • - Compared to the wild-type cohort, patients with Omicron exhibited smaller RV areas, improved RV function, and higher stroke volume, possibly due to lower pulmonary pressure, although LV function parameters remained mostly similar.
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Aims: Clinical trials comparing LVADs vs. conservative therapy were performed before the availability of novel medications or used suboptimal medical therapy. This study aimed to report that long-term stabilization of patients entering a left ventricular assist device (LVAD) programme is possible with the use of aggressive conservative therapy.

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  • A study compared lung ultrasound (LUS) results between Omicron-type and wild-type COVID-19 patients to assess the severity of lung disease and its prognostic implications.
  • Results showed that most hospitalized Omicron patients had abnormal LUS scores, with 37% experiencing mild and 15% severe scores, while wild-type patients had worse LUS characteristics.
  • Despite the milder nature of Omicron, the LUS score was linked to higher mortality and respiratory failure risks, indicating that even less severe cases still carry significant health concerns.
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Immune checkpoint inhibitor (ICI) and coronavirus disease 2019 (COVID-19) vaccine-induced myocarditis possibly share common mechanisms secondary to overactivation of the immune system. We aimed to compare the presenting characteristics of ICIs and COVID-19 vaccine-induced myocarditis. We performed a retrospective analysis of characteristics of patients diagnosed with either ICIs or COVID-19 vaccine-induced myocarditis and compared the results to a control group of patients diagnosed with acute viral myocarditis.

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The functional neural mechanisms underlying the cognitive benefits of aerobic exercise have been a subject of ongoing research in recent years. However, while most neuroimaging studies to date which examined functional neural correlates of aerobic exercise have used simple stimuli in highly controlled and artificial experimental conditions, our everyday life experiences require a much more complex and dynamic neurocognitive processing. Therefore, we have used a naturalistic complex information processing fMRI paradigm of story comprehension to investigate the role of an aerobically active lifestyle in the processing of real-life cognitive-demanding situations.

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Background: Advanced heart failure (HF) patients usually poorly tolerate guideline-directed HF medical therapy (GDMT) and suffer high rates of morbidity and mortality. The use of continuous inotropes in the outpatient settings is hampered by previous data showing excess morbidity. We aimed to assess the safety and efficacy of repetitive, intermittent, short-term intravenous milrinone therapy in advanced HF patients with an intention to introduce and up-titrate GDMT and improve functional class.

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Background: Continuous outpatient inotrope infusion therapy (COIIT) can be used as palliative or interim treatment in patients with advanced heart failure (AHF). Despite widespread use, there is a relative lack of data informing best practices. This study aimed to examine whether patterns of COIIT use differed by region and to explore whether observed differences influenced clinical outcomes.

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