Publications by authors named "Sivaram Neppala"

Background: Pulmonary hypertension (pHTN) has been associated with increased morbidity and mortality after mitral Transcatheter Edge-to-Edge Repair (TEER), but the association remains uncertain. This study aims to evaluate the impact of pHTN on cardiovascular outcomes following TEER.

Methods: We searched PubMed, Scopus, and Medline to identify studies reporting outcomes after TEER in individuals with pHTN.

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Background: Stroke associated with atrial fibrillation (AF) is a significant cause of mortality. This study analyzed demographic trends and disparities in mortality rates due to stroke in AF patients aged ≥25 years.

Methods: A retrospective analysis was conducted to acquire death data using the Centers for Disease Control and Prevention database from 1999 to 2020.

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Article Synopsis
  • Coronary artery disease (CAD) significantly affects mortality rates in adults with diabetes mellitus (DM) in the U.S., with over 1.4 million deaths recorded between 1999 and 2020.
  • The study found a decrease in age-adjusted mortality rates for CAD in DM, with men having higher rates than women, and the most significant declines noted in Hispanic populations.
  • Geographic and racial disparities in mortality rates were evident, with the highest rates occurring in American Indians/Alaska Natives and nonmetropolitan areas, calling for focused public health interventions.
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We examined the effect of increased levels of plasma ketones on left ventricular (LV) function, myocardial glucose uptake (MGU), and myocardial blood flow (MBF) in patients with type 2 diabetes (T2DM) with heart failure. Three groups of patients with T2DM (n = 12 per group) with an LV ejection fraction (EF) ≤50% received incremental infusions of β-hydroxybutyrate (β-OH-B) for 3-6 h to increase the plasma β-OH-B concentration throughout the physiologic (groups I and II) and pharmacologic (group III) range. Cardiac MRI was performed at baseline and after each β-OH-B infusion to provide measures of cardiac function.

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Introduction: Low carbohydrate ketogenic diets have received renewed interest for the treatment of obesity and type 2 diabetes. These diets promote weight loss, improve glycemic control, and reduce insulin resistance. However, whether the improvements in glycemic control and insulin sensitivity are secondary to the weight loss or result from a direct effect of hyperketonemia is controversial.

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Background: Type 2 myocardial infarction (T2MI) is an ischemic myocardial injury in the context of oxygen supply/demand mismatch in the absence of a primary coronary event. However, though there is a rising prevalence of depression and its potential association with type 1 myocardial infarction (T1MI), data remains non-existent to evaluate the association with T2MI.

Aim: To identify the prevalence and risk of T2MI in adults with depression and its impact on the in-hospital outcomes.

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Cardiovascular disease (CVD) remains a significant global health challenge despite advancements in prevention and treatment. Elevated Lipoprotein(a) [Lp(a)] levels have emerged as a crucial risk factor for CVD and aortic stenosis, affecting approximately 20 of the global population. Research over the last decade has established Lp(a) as an independent genetic contributor to CVD and aortic stenosis, beginning with Kare Berg's discovery in 1963.

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Purpose Of Review: What is new? Cardiovascular disease (CVD) is the leading cause of mortality in type 2 diabetes (T2D) individuals. Of the major risk factors for CVD, less than 10% of T2D people meet the American Diabetes Association/American Heart Association recommended goals of therapy. The present review examines how much of the absolute cardiovascular (CV) risk in type 2 diabetes patients can be explained by major CV intervention trials.

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Background: Body Mass Index (BMI) has a significant impact on Coronavirus disease (COVID-19) patient outcomes; however, major adverse cardiac and cerebrovascular outcomes in patients with severe sepsis have been poorly understood. Our study aims to explore and provide insight into its association.

Methods: This is an observational study looking at the impact of BMI on COVID-19-severe sepsis hospitalizations.

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Background: Several neurological complications are being reported in hospitalized patients with severe COVID-19 infection. This is presumed due to direct spread of infection or due to immunological response. Acute disseminated encephalomyelitis (ADEM) is a rare inflammatory and demyelinating disorder of the central nervous system that is often preceded by infection or vaccination.

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Background: Spine surgery rates have increased and the high postoperative morbidity in these patients result in increased costs. Consequently, it is essential to identify patients at risk of adverse outcomes.

Objective: To assess whether preoperative Timed Up and Go (TUG) test performance can predict high-grade postoperative complications.

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Background: Ileocecal valve (ICV) lesions are difficult to resect endoscopically and patients are often referred for laparoscopic colectomy. ICV involvement has been shown to be related to technical failure and tumor recurrence after endoscopic mucosal resection (EMR) and represents a challenge for endoscopic submucosal dissection (ESD). Few publications have focused specifically on endoscopic management of ICV lesions.

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Article Synopsis
  • Endoscopic submucosal dissection (ESD) is a technique used to remove early-stage gastrointestinal tumors, primarily in Asia, but its adoption in Western countries is limited, prompting this study on its learning curve in the U.S.
  • A retrospective analysis of 540 ESD cases performed by a single operator revealed that proficiency benchmarks for successful resections were reached after approximately 250 procedures, with en bloc resection rates increasing significantly before plateauing.
  • The study concludes that training for ESD takes longer in the West due to the complexity of lesions tackled early in training, differing from the experiences in Asia.
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