Publications by authors named "Prem Soman"
Background: In the phase 3 randomized controlled study, ATTRibute-CM, acoramidis, a transthyretin (TTR) stabilizer, demonstrated significant efficacy on the primary endpoint. Participants with transthyretin amyloid cardiomyopathy (ATTR-CM) who completed ATTRibute-CM were invited to enroll in an open-label extension study (OLE). We report efficacy and safety data of acoramidis in participants who completed ATTRibute-CM and enrolled in the ongoing OLE.
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- Right ventricular free-wall strain is a potential key diagnostic indicator in patients with transthyretin cardiac amyloidosis (ATTR-CA), which affects all parts of the heart.
- In a study involving 108 ATTR-CA patients and 106 controls, this strain measurement was shown to be independently linked to the diagnosis of ATTR-CA when combined with other echocardiographic parameters.
- Furthermore, a right ventricular free-wall strain of -16% or less was associated with a threefold increased risk of major cardiovascular and cerebrovascular events, highlighting its importance for risk assessment in these patients.
Article Synopsis
- Hereditary transthyretin amyloidosis (ATTRv) and wild-type ATTR amyloidosis (ATTRwt) are rare and progressive disorders characterized by the accumulation of amyloid fibrils in various organs, leading to significant health complications and unmet medical needs for patients.
- The Amyloidosis Forum, a partnership between the FDA and the Amyloidosis Research Consortium, recently discussed strategies for advancing drug development and clinical trial designs for ATTR amyloidosis, considering perspectives from various stakeholders.
- With the changing landscape of ATTR amyloidosis, reliance on historical control data is diminishing, highlighting the importance of using contemporary real-world data to inform clinical trial designs and address relevant clinical questions effectively.
Article Synopsis
- - Cardiac SPECT imaging technology is evolving with new applications, moving beyond traditional methods to incorporate advanced techniques like digital SPECT and low-dose imaging strategies.
- - Innovations include the use of deep learning algorithms, sourceless emission attenuation correction, and novel detection methods for conditions like amyloid cardiomyopathy and cardiac allograft vasculopathy.
- - The review highlights the importance of SPECT in assessing myocardial blood flow, cardiac function, and treatment responses, ultimately showcasing its real-world effectiveness and value in clinical settings.
Neuromuscular manifestations of wild type transthyretin amyloidosis: a review and single center's experience.
Front Cardiovasc Med
February 2024
Article Synopsis
- Transthyretin amyloidosis (ATTR) is characterized by the buildup of harmful transthyretin protein in various organs, mainly affecting the heart and peripheral nerves.
- There are two types: variant ATTR (caused by mutations) and wild type ATTR (ATTRwt), commonly seen in elderly men and previously called "senile amyloidosis," leading to heart problems and possibly heart failure.
- The article discusses the unclear prevalence of ATTRwt-related neuropathy, particularly in older patients, highlighting the diagnostic challenges and the need for better understanding of its neurological and musculoskeletal symptoms.
Article Synopsis
- The study aims to evaluate the effectiveness of O-water PET myocardial perfusion imaging in diagnosing coronary artery disease (CAD) by comparing it to established methods like invasive coronary angiography (ICA) and coronary computed tomography angiogram (CCTA).
- O-water is noted for its high accuracy in measuring blood flow in the heart, but its clinical use has been limited due to complex production and analysis requirements.
- The RAPID WATER FLOW study will involve around 215 participants from multiple sites and will focus on O-water PET’s sensitivity and specificity in detecting significant blockages, also considering specific populations like women, obese, and diabetic individuals.
Article Synopsis
- - Transthyretin amyloid cardiomyopathy involves the buildup of misfolded proteins in the heart, and acoramidis is a medication designed to stabilize these proteins, showing over 90% effectiveness in laboratory tests.
- - In a phase 3 trial, 632 patients were randomly assigned to receive either acoramidis or a placebo for 30 months, evaluating outcomes like death rates, hospitalizations, and specific health indicators.
- - The results demonstrated that acoramidis significantly outperformed the placebo in multiple health measures, with a high win ratio favoring acoramidis, while the frequency of side effects was similar in both groups.
Article Synopsis
- The study aimed to assess how diagnostic cardiovascular procedure volumes rebounded in the U.S. and abroad during the year after COVID-19 hit, relying on data from 669 facilities worldwide.
- In the early pandemic (April 2020), procedure volumes dropped significantly but showed a better recovery in U.S. facilities by April 2021 compared to non-U.S. facilities, although high-income non-U.S. countries showed similar recovery rates as the U.S.
- Regional variations within the U.S. were noted, with the Midwest having the highest recovery rate, but no specific factors were found to predict recovery levels from the initial drop in procedure volumes.
Article Synopsis
- The study investigates the safety of catheter ablation therapy for atrial fibrillation in patients with cardiac amyloidosis (CA) compared to those with dilated cardiomyopathy (DCM).
- Data were analyzed from hospitalizations between 2015 and 2019, revealing that patients with CA were older and had more prior health issues than those with DCM, but both groups showed similar short-term outcomes after the procedure.
- Ultimately, the findings indicate that the short-term safety outcomes and complication rates of atrial fibrillation ablation are comparable between CA and DCM patients, suggesting further research is necessary to assess long-term safety.
Left Bundle Branch Block and Cardiac Resynchronization Therapy: Effector or Bystander?
Circ Cardiovasc Imaging
November 2022
Article Synopsis
- CZT-based detectors are more sensitive than conventional Anger-MPI in diagnosing coronary artery disease (CAD) during myocardial perfusion imaging (MPI), but they show lower specificity and accuracy.
- The study involved 83 patients who underwent stress/rest tests with both CZT and conventional SPECT cameras, with 15 international readers evaluating the images for comparison.
- Results indicated that while CZT-MPI had better image quality and higher sensitivity (87.5% vs. 62.5%), it also had significantly lower specificity (40% vs. 100%), highlighting the need for additional training for less experienced readers.
Accuracy and Reproducibility of Myocardial Blood Flow Quantification by Single Photon Emission Computed Tomography Imaging in Patients With Known or Suspected Coronary Artery Disease.
Ana Carolina do A H de Souza Hendrik J Harms Laurel Martell Courtney Bibbo Meagan Harrington Prem Soman
Circ Cardiovasc Imaging
June 2022
Article Synopsis
- SPECT imaging, specifically with cadmium zinc telluride detectors, can accurately measure myocardial blood flow (MBF) and myocardial flow reserve (MFR), but its reliability is still being evaluated, particularly for multivessel and microvascular coronary artery disease.
- A study compared Tc-sestamibi SPECT with N-ammonia positron emission tomography in 34 patients to validate the accuracy of MBF and MFR measurements, and assessed the reproducibility of the SPECT technique in another group of 14 patients.
- Results showed that SPECT MBF measurements reconstructed with spline fitting had a strong correlation with PET results, indicating better accuracy and reproducibility, while standard reconstruction
Article Synopsis
- Pyrophosphate imaging (PYP) is effective for diagnosing transthyretin cardiac amyloidosis (ATTR-CA), but some results remain unclear due to persistent blood pool activity linked to low heart function.
- In a study of 189 patients, 43 were diagnosed with ATTR-CA, revealing that those with the condition showed lower left ventricular ejection fraction (LVEF) and other signs of impaired cardiac function compared to those without.
- The research concludes that about 8% of patients with negative PYP SPECT scans still show significant blood pool activity, suggesting that routine PYP SPECT imaging is essential to avoid misinterpretations.
Article Synopsis
- - The study aims to establish normal left ventricular (LV) measurements using a solid-state DSPECT camera, noting that existing normative values from traditional SPECT cameras might not be applicable.
- - It involved 92 healthy organ donors (mean age 54.4 years) who underwent myocardial perfusion imaging, ensuring they had no known cardiac disease or medications.
- - Results showed specific LV measurements (ejection fraction, volume) for both women and men, suggesting organ donors are a valuable group for developing DSPECT-specific normal values for clinical application.
Article Synopsis
- In stable coronary artery disease, revascularization is beneficial primarily for patients with high-risk coronary anatomy (HRCA).
- A study created and validated a model that uses clinical data and exercise stress test results to predict HRCA, analyzing data from patients at Cleveland Clinic and later validating it at the University of Pittsburgh Medical Center.
- The research identified 10 key predictors of HRCA, establishing a reliable prediction model with a c-statistic of 0.79, showing it effectively identifies patients at risk for HRCA who may benefit from revascularization.