Publications by authors named "Omar Abou Ezzeddine"
Background: The prognosis in patients with advanced cardiac amyloidosis (CA) remains poor.
Objectives: We sought to describe survival post heart transplantation (HT) in amyloid compared with non-amyloid recipients, highlight waitlist times within the new allocation system across three Organ Procurement and Transplantation Network (OPTN) regions, and describe multiorgan transplantation (MOT) in hereditary amyloidosis.
Methods: This is a retrospective review of end-stage CA patients who underwent HT at Mayo Clinic from January 2007 to December 2020.
Background: A multidisciplinary approach improves guideline-directed medical therapy in systolic heart failure (HF), but its efficacy in patients with HF due to cardiac sarcoidosis is unreported.
Methods And Results: In a retrospective cohort study, we reviewed 848 patients from our institutional cardiac sarcoidosis clinics, identifying those with a cardiac sarcoidosis diagnosis, HF (left ventricular ejection fraction <50%) at index evaluation, and echocardiograms within 90 days and 11 to 36 months. Patients were stratified by participation in a pharmacist-led medication therapy management (MTM) program for guideline-directed medical therapy optimization (MTM versus non-MTM [NMTM]) without randomization.
Article Synopsis
- A study investigated the prevalence of non-sustained ventricular tachycardia (NSVT) in patients with wild-type transthyretin cardiac amyloidosis (ATTRwt-CA) and its link to sustained ventricular arrhythmias and mortality.
- Out of 217 patients, 53% exhibited NSVT during Holter monitoring, and 5.1% experienced sustained ventricular arrhythmias during an average follow-up of 27 months.
- The presence of NSVT was associated with a higher risk of sustained ventricular arrhythmias, while all-cause mortality was similar between NSVT and non-NSVT groups, although prominent ventricular ectopy was linked to increased risks of both outcomes.
Article Synopsis
- AL amyloidosis can lead to heart issues (AL-CM), and existing imaging techniques struggle to identify heart dysfunction accurately.* -
- A study involving cardiac MRIs compared patients with AL-CM to healthy individuals, revealing lower myocardial function index (MFI) in AL-CM patients and indicating MFI as a potential marker for risk assessment.* -
- The findings showed that a lower MFI correlates with worse survival rates, making it a valuable tool for evaluating heart health in AL-CM patients.*
Article Synopsis
- Cardiac sarcoidosis (CS) can lead to heart failure with reduced ejection fraction (HFrEF), and the effectiveness of guideline-directed medical therapy (GDMT) in these patients was studied.
- In a study of 881 CS patients, 79 met the criteria, showing significant improvements in left ventricular ejection fraction (LVEF) after GDMT was optimized over a median follow-up of 16 months.
- The results indicated that better GDMT scores led to improved heart function and outcomes, while the type of immunosuppressive treatment did not significantly affect these results.
Article Synopsis
- The study evaluates an AI model (A2E) that analyzes ECGs to predict survival in patients with cardiac amyloidosis (CA), focusing on three patient groups: light chain amyloidosis (AL), wild-type transthyretin amyloidosis (ATTRwt), and hereditary transthyretin amyloidosis (ATTRv).
- Data from 2533 CA patients were analyzed, and results showed that those with higher A2E scores had a significantly increased risk of death.
- The findings suggest that the A2E model provides useful prognostic information, helping to better assess the risk of death in patients with both AL and ATTR amyloidosis.
Article Synopsis
- Current guidelines for using implantable cardioverter-defibrillators (ICDs) in patients with cardiac sarcoidosis and low left ventricular ejection fraction (LVEF) are inconsistent and vary in recommendations.
- This study aimed to assess the risk of ventricular arrhythmias in these patients and compared outcomes based on differing LVEF levels.
- Results showed that patients with LVEF between 36%-49% and those with LVEF ≤35% had similar arrhythmic risks, but those with secondary prevention ICDs demonstrated a significantly higher risk of sustained ventricular tachycardia and fibrillation.
Background: It is unknown whether cardiac resynchronization therapy (CRT) would improve or halt the progression of heart failure (HF) in patients with mild to moderately reduced ejection fraction (HFmmrEF) and left bundle branch block (LBBB).
Objective: This study aimed to investigate the outcomes of CRT in patients with HFmmrEF and left ventricular conduction delay.
Methods: A prospective, randomized clinical trial sponsored by the National Heart, Lung, and Blood Institute included 76 patients who met the study inclusion criteria (left ventricular ejection fraction [LVEF] of 36%-50% and LBBB).
Background: The 2014 Heart Rhythm Society consensus statement defines histological (definite) and clinical (probable) diagnostic categories of cardiac sarcoidosis (CS), but few studies have compared their arrhythmic phenotypes and outcomes.
Objective: The purpose of this study was to evaluate the electrophysiological/arrhythmic phenotype and outcomes of patients with definite and probable CS.
Methods: We analyzed the arrhythmic/electrophysiological phenotype in a single-center North American cohort of 388 patients (median age 56 years; 39% female, n = 151) diagnosed with definite (n = 58) or probable (n = 330) CS (2000-2022).
Article Synopsis
- Sarcoidosis patients with heart failure (SwHF) have poorer outcomes compared to those without heart failure (SwoHF), including higher rates of arrhythmias and readmissions.* -
- A study using the US Nationwide Readmission Database analyzed data from 97,961 hospitalized sarcoidosis patients, revealing that SwHF had longer hospital stays and increased healthcare costs.* -
- Key factors influencing mortality in sarcoidosis patients include heart failure, older age, male sex, and existing liver disease, with SwHF patients showing a higher mortality rate upon readmission.*
Respirophasic MR in HFrEF with severe pulmonary vascular disease and low output heart failure– Is there a role for treating the MR? @yreddyhf @BrendenIngraham @mayoclinicCV
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- A study evaluated the effect of amyloidosis on clinical outcomes for elderly patients with aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) over a four-year period.
- The analysis included over 304,000 patients, and it was found that those with amyloidosis were typically older and had other health issues, but showed similar outcomes in terms of in-hospital mortality and complications compared to those without amyloidosis.
- Overall, the findings suggest that having amyloidosis does not significantly increase risks during TAVR procedures for patients with aortic stenosis.
Background: Myocardial inflammation contributes to the pathogenesis of arrhythmogenic cardiomyopathy (ACM), a clinically and genetically heterogenous disorder. Due to phenotypic overlap, some patients with genetic ACM may be evaluated for an underlying inflammatory cardiomyopathy. However, the cardiac fludeoxyglucose (FDG) positron emission tomography (PET) findings in ACM patients have not been elucidated.
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- Sarcoidosis, amyloidosis, hemochromatosis, and scleroderma are significant contributors to nonischemic cardiomyopathy (NICM), which can lead to sudden cardiac death, especially in patients experiencing in-hospital cardiac arrest.
- A study analyzing data from over 19 million hospitalizations between 2010 and 2019 found that only 0.77% had NICM, with a notable increase in its prevalence over the years.
- The study revealed higher in-hospital mortality rates among females and older adults with NICM, identifying risk factors such as age, gender, Hispanic race, COPD, and malignancy that could predict mortality in these patients.
Routine Laboratory Biomarkers As Prognostic Indicators of Cardiac Sarcoidosis Outcomes.
Sarcoidosis Vasc Diffuse Lung Dis
September 2022
Background: Biomarkers to monitor disease activity and predict major adverse cardiac events (MACE) in CS have not been described previously. We aimed to identify biomarkers to predict MACE in cardiac sarcoidosis (CS).
Methods: Patients (N=232) diagnosed with CS were retrospectively enrolled.
Background: Transthyretin amyloid cardiomyopathy (ATTR-CM) is increasingly recognized as a treatable cause of heart failure (HF). Advances in diagnosis and therapy have increased the number of patients diagnosed at early stages, but prognostic data on patients without HF symptoms are lacking. Moreover, it is unknown whether asymptomatic patients benefit from early initiation of transthyretin (TTR) stabilizers.
View Article and Find Full Text PDFImportance: Transthyretin amyloid cardiomyopathy (ATTR-CM) is a form of heart failure (HF) with preserved ejection fraction (HFpEF). Technetium Tc 99m pyrophosphate scintigraphy (PYP) enables ATTR-CM diagnosis. It is unclear which patients with HFpEF have sufficient risk of ATTR-CM to warrant PYP.
View Article and Find Full Text PDFCardiac resynchronization therapy response in cardiac sarcoidosis.
J Cardiovasc Electrophysiol
September 2022
Introduction: Cardiac sarcoidosis (CS) is a nonischemic cardiomyopathy (NICM) characterized by infiltration of noncaseating granulomas involving the heart with highly variable clinical manifestations that can include conduction abnormalities and systolic heart failure. Cardiac resynchronization therapy (CRT) has shown significant promise in NICM, though little is known about its efficacy in patients with CS.
Objective: To determine if CRT improved cardiac remodeling in patients with CS.
Importance: Heart failure (HF) with preserved ejection fraction (HFpEF) is common, is frequently associated with ventricular wall thickening, and has no effective therapy. Transthyretin amyloid cardiomyopathy (ATTR-CM) can cause the HFpEF clinical phenotype, has highly effective therapy, and is believed to be underrecognized.
Objective: To examine the prevalence of ATTR-CM without and with systematic screening in patients with HFpEF and ventricular wall thickening.