Publications by authors named "Pabon M"
Electrocardiographic Changes in Pregnant Patients With Congenital Heart Disease.
Ann Noninvasive Electrocardiol
January 2025
Background: Electrocardiograms (EKGs) are routinely performed in pregnant patients with pre-existing cardiovascular disease. However, in pregnant patients with congenital heart disease (CHD), EKG changes during gestation have not been explored.
Methods: We performed a retrospective study of pregnant patients with CHD enrolled in the STORCC initiative.
Background: Preeclampsia is a hypertensive disorder of pregnancy characterized by systemic endothelial dysfunction. The pathophysiology of preeclampsia remains incompletely understood. This study used human venous endothelial cell (EC) transcriptional profiling to investigate potential novel mechanisms underlying EC dysfunction in preeclampsia.
View Article and Find Full Text PDFBackground: IMPLEMENT-HF demonstrated a virtual team-based care strategy was safe and improved prescription of guideline directed medical therapy (GDMT) in hospitalized patients with heart failure and reduced ejection fraction (HFrEF). We evaluated differences in efficacy and safety outcomes by ethnicity in IMPLEMENT-HF.
Methods: IMPLEMENT-HF evaluated a provider-facing virtual team-based care strategy vs.
Aims: The temporal changes in clinical profiles and outcomes of high-risk myocardial infarction survivors enrolled in clinical trials are poorly described. This study compares mortality rates, baseline characteristics, and the prognostic impact of therapies among participants of the VALIANT and PARADISE-MI trials.
Methods And Results: Exclusively VALIANT participants who matched the inclusion criteria of the PARADISE-MI trial were included in the analysis.
Aims: To evaluate clinical outcomes, echocardiographic features, and the efficacy and safety of sacubitril/valsartan compared to valsartan across age groups in the PARAGON-HF trial.
Methods And Results: A total of 4796 participants ≥50 years of age with chronic heart failure (HF) and left ventricular ejection fraction (LVEF) ≥45% were divided into three age groups: <65 years (n = 825), 65-74 years (n = 1772), and ≥75 years (n = 2199). Echocardiograms of 1097 patients were analysed in a standardized fashion at a core imaging laboratory.
Article Synopsis
- - The study investigated how race influences the effects of the heart failure treatment sacubitril/valsartan, comparing its safety and efficacy among White, Asian, and Black patients based on data from two large clinical trials (PARADIGM-HF and PARAGON-HF).
- - Results showed that Black and Asian patients had a higher risk of heart failure hospitalization or cardiovascular death compared to White patients, even though the treatment was effective for all racial groups, with no significant difference in efficacy observed across races.
- - Severe angioedema (swelling) was more common in Black patients receiving sacubitril/valsartan compared to those on alternative treatments, highlighting potential racial disparities in treatment response and safety.
Article Synopsis
- Arterial trauma to the axillary subclavian segment poses significant health risks, and endovascular therapy is emerging as a preferable treatment option over traditional surgical methods due to the complexity of accessing these vessels.
- A study conducted over 15 years at a university hospital in Cali, Colombia, analyzed outcomes for 32 patients with traumatic injuries to these arteries who received endovascular treatment, with most patients being young and male.
- The findings revealed that the majority of injuries were penetrating (mostly from gunshot wounds), with a low incidence of intraoperative complications, but notable occurrences of pseudoaneurysms and thrombosis among the patients treated.
Article Synopsis
- The study investigates differences between men and women in heart function after a heart attack (MI) to understand why women have higher rates of hospitalization for heart failure.
- It analyzes echocardiographic data from 544 patients in the PARADISE-MI trial to assess heart function pre and post-MI, focusing on parameters like left ventricular ejection fraction (LVEF) and chamber sizes.
- Although women showed better heart function indicators at the start, the study found that the changes over 8 months and the relationship between heart function metrics and clinical outcomes were similar for both sexes.
Article Synopsis
- Patients with heart failure and improved ejection fraction (HFimpEF) face significant health risks during hospitalizations, showing higher rates of complicated hospital admissions compared to patients with consistently higher ejection fractions (LVEF >40%).
- In a study involving 6263 patients, those with HFimpEF accounted for 18% and experienced more severe hospital events despite similar lengths of stay and in-hospital mortality rates as patients with stable LVEF.
- The outcomes indicated that 66% of HFimpEF patients experienced a decrease in their LVEF to ≤40%, pointing to potential ongoing heart function decline despite previous improvements.
Article Synopsis
- Tolerance to a substance requires increasing amounts of it over time to achieve the same effects, but the mechanisms behind this process are not fully understood.
- Researchers are using Drosophila melanogaster (fruit flies) to study tolerance, as they share genetic similarities with humans that are relevant to alcohol responses and disorders.
- The study reveals an inverse relationship between initial resistance to ethanol and tolerance development, suggesting that some mutants may display 'secondary' tolerance due to their initial sensitivity, and it proposes a new method for evaluating tolerance that takes this relationship into account.
Article Synopsis
- Preeclampsia is a pregnancy-related condition characterized by high blood pressure and a disruption in the balance of certain proteins, potentially leading to cardiovascular risks due to microvascular dysfunction.
- Researchers compared cardiac function in women with severe preeclampsia to those with normal pregnancies and nonpostpartum controls using advanced imaging techniques to assess myocardial flow and resistance.
- Results indicated that women who had preeclampsia showed significantly decreased blood flow and increased vascular resistance, highlighting reduced coronary microvascular function soon after delivery, which could have long-term health implications.
Article Synopsis
- Hypotension, a common side effect of sacubitril/valsartan, was analyzed in heart failure patients with mildly reduced or preserved ejection fraction in the PARAGON-HF trial.
- The study found that 13% of participants and a higher proportion in the sacubitril/valsartan group experienced hypotension, which led to increased risks of cardiovascular events and hospitalizations.
- Results indicated that patients with a left ventricular ejection fraction (LVEF) ≥60% were particularly at higher risk of hypotension when treated with sacubitril/valsartan compared to valsartan.
Article Synopsis
- The brain has a vast diversity of cell types, and existing transgenic models often target multiple cell types rather than specific neurons.
- An iterative ATAC approach was developed to enhance the specificity of transgene expression by identifying open chromatin regions in neurons, leading to more refined targeting of neuronal subsets.
- This method not only helps in studying neurons linked to specific behaviors, like sleep, but is also versatile for use in other cell types and organisms.
Article Synopsis
- Preeclampsia is a pregnancy-related condition characterized by high blood pressure and microvascular dysfunction, potentially increasing cardiovascular risks post-pregnancy.
- A study compared women with severe preeclampsia to those with normal pregnancies and non-postpartum controls using cardiac imaging to assess heart function and blood flow.
- Results showed that women who experienced preeclampsia had significantly reduced heart function and increased vascular resistance, indicating potential long-term cardiovascular issues, warranting further investigation for preventive measures.
Article Synopsis
- Hypertensive disorders of pregnancy (HDP) are linked to long-term cardiovascular risks for women, though the reasons are not fully understood.
- A study involving 5,168 Hispanic/Latina women revealed that 14% had a history of de novo HDP, which was associated with lower left ventricle ejection fraction and higher risks of abnormal cardiac geometry.
- Findings indicate that previous HDP can lead to measurable cardiac issues in women, with current hypertension only partially explaining these effects.
Article Synopsis
- Tolerance requires increased substance amounts after initial exposure to achieve the same effects.
- Researchers have studied model organisms, like fruit flies, to understand tolerance due to their relevance to human alcohol responses and overlapping genetic factors.
- This study reveals an inverse relationship between initial resistance to alcohol and tolerance, suggesting that measuring tolerance should focus on relative change in sedation time, and offers a method to evaluate potential tolerance mutants using linear regression analysis.
Background: Women with heart failure with reduced ejection fraction (HFrEF) receive less guideline-recommended therapy and experience worse quality of life than men.
Objectives: The authors sought to assess differences in baseline characteristics, outcomes, efficacy, and safety of omecamtiv mecarbil between men and women enrolled in the GALACTIC-HF (Registrational Study With Omecamtiv Mecarbil [AMG 423] to Treat Chronic Heart Failure With Reduced Ejection Fraction) study.
Methods: In GALACTIC-HF, patients with symptomatic heart failure with EF of 35% or less, recent heart failure event, and elevated natriuretic peptides were randomized to omecamtiv mecarbil or placebo.
This review summarizes the evaluation for underlying rheumatic conditions in patients presenting with acute pericarditis, treatment considerations for specific rheumatic conditions, and the role of imaging in diagnosis and monitoring. Pericarditis may be one of the initial presentations of a rheumatic disease or identified in a patient with known rheumatic disease. There is also growing evidence for using anti-inflammatory and immunosuppressive agents for treating recurrent pericarditis, which can overlap with the treatment of rheumatic diseases.
View Article and Find Full Text PDFAims: The Dapagliflozin Evaluation to Improve the Lives of Patients with Preserved Ejection Fraction Heart Failure (DELIVER) trial demonstrated the sodium-glucose cotransporter 2 inhibitor dapagliflozin to be beneficial in patients with symptomatic heart failure (HF) with improved ejection fraction (HFimpEF; those with prior left ventricular ejection fraction ≤40% that had improved to >40% by enrolment). Whether this benefit differs by background medical therapy is unclear. The current study aims to determine the efficacy and safety of dapagliflozin among patients with HFimpEF by background medical therapy.
View Article and Find Full Text PDFPurpose Of Review: Cardiovascular disease (CVD) is the leading cause of death in women. Women with history of adverse pregnancy outcomes (APOs) have approximately two-fold risk of future CVD, but until recently the association with future heart failure (HF) was unclear. Here, we summarize evidence for associations of APOs with HF, potential underlying mechanisms, and future directions for clinical translation.
View Article and Find Full Text PDFBackground: Scalable and safe approaches for heart failure guideline-directed medical therapy (GDMT) optimization are needed.
Objectives: The authors assessed the safety and effectiveness of a virtual care team guided strategy on GDMT optimization in hospitalized patients with heart failure with reduced ejection fraction (HFrEF).
Methods: In a multicenter implementation trial, we allocated 252 hospital encounters in patients with left ventricular ejection fraction ≤40% to a virtual care team guided strategy (107 encounters among 83 patients) or usual care (145 encounters among 115 patients) across 3 centers in an integrated health system.