Publications by authors named "Peter M Belford"

Article Synopsis
  • The study examines the use of mechanical circulatory support (MCS) in patients with acute myocardial infarction-cardiogenic shock (AMI-CS) over a 13-year period using national hospital data.
  • It found that 40.2% of admissions utilized an MCS device, primarily the intra-aortic balloon pump (IABP), and most patients remained on their initial device with limited escalation to more advanced devices.
  • Additionally, escalation of MCS devices was linked to higher in-hospital mortality, indicating that sicker patients may require advanced support, while the use of durable left ventricular assist devices (LVAD) and heart transplants has increased, suggesting MCS serves as an effective bridge to these treatments.
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The Society of Cardiovascular Angiography and Intervention (SCAI) classified cardiogenic shock (CS) into five stages ranging from A-E. There remains significant ambiguity regarding the assessment and management of SCAI Stage B. Given its nebulous nature that can rapidly escalate, prompt interventions are needed.

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Background: There has been conflicting reports on the effect of new trainees on clinical outcomes at teaching hospitals in the first training month (July in the United States of America). We sought to assess this "July effect" in a contemporary acute myocardial infarction (AMI) population.

Methods: Adult (>18 years) AMI hospitalizations in May and July in urban teaching and urban nonteaching hospitals in the United States were identified from the HCUP-NIS database (2000-2017).

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Background and objectives: Primary percutaneous coronary intervention (PCI)-related outcomes in acute myocardial infarction (AMI) have improved over time, but there are limited data on the length of stay (LOS) in relation to in-hospital mortality. Materials and Methods: A retrospective cohort of adult AMI admissions was identified from the National Inpatient Sample (2000−2017) and stratified into short (≤3 days) and long (>3 days) LOS. Outcomes of interest included temporal trends in LOS and associated in-hospital mortality, further sub-stratified based on demographics and comorbidities.

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Pulmonary embolism (PE) can have a wide range of hemodynamic effects, from asymptomatic to a life-threatening medical emergency. Pulmonary embolism (PE) is associated with high mortality and requires careful risk stratification for individualized management. PE is divided into three risk categories: low risk, intermediate-risk, and high risk.

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Fulminant myocarditis is characterized by life threatening heart failure presenting as cardiogenic shock requiring inotropic or mechanical circulatory support to maintain tissue perfusion. There are limited data on the role of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in the management of fulminant myocarditis. This review seeks to evaluate the management of fulminant myocarditis with a special emphasis on the role and outcomes with VA-ECMO use.

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Prosthesis-patient mismatch occurs when the effective prosthetic valve area is smaller than that of a normal human valve. Its importance in pregnancy is unknown. We describe an asymptomatic patient with higher than normal transvalvular gradients due to prosthesis-patient mismatch who developed congestive heart failure in late pregnancy.

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