Publications by authors named "Stephanie Besser"
Background: The benefit of pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) is well established; its efficacy in patients with heart failure preserved ejection fraction (HFpEF) is less clear.
Objective: The objective of the study was to compare AF and heart failure (HF) rehospitalizations after PVI in patients with HFpEF vs HFrEF.
Methods: The IBM MarketScan Database was used to identify patients undergoing PVI for AF.
Article Synopsis
- Diabetes mellitus (DM) and elevated lipoprotein(a) [Lp(a)] are both significant predictors of coronary artery disease (CAD) outcomes, but their combined effects are not well understood.
- A study analyzing data from over 6,200 patients found that those with either condition had higher rates of cardiovascular death or myocardial infarction (MI), especially those with elevated Lp(a).
- Elevated Lp(a) was shown to be an independent risk factor for CAD outcomes, increasing risk for patients with or without DM.
Background: Lipoprotein (a) [Lp(a)] is a robust predictor of coronary heart disease outcomes, with targeted therapies currently under investigation. We aimed to evaluate the association of high Lp(a) with standard modifiable risk factors (SMuRFs) for incident first acute myocardial infarction (AMI).
Methods And Results: This retrospective study used the Mass General Brigham Lp(a) Registry, which included patients aged ≥18 years with an Lp(a) measurement between 2000 and 2019.
Natural language processing to phenotype coronary computed tomography angiography: Development, validation, and initial results of a large multi-institution cohort.
J Cardiovasc Comput Tomogr
July 2024
Background: Cardiogenic shock (CS) is complicated by high mortality rates. Targeted temperature control (TTC) has been proposed as an adjunct therapy in CS. This study aims to examine the safety of TTC in patients presenting with CS.
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- Lipoprotein(a) [Lp(a)] is linked to a higher risk of atherosclerotic cardiovascular disease (ASCVD), but it's unclear if risk thresholds differ based on existing ASCVD status.
- A study analyzed over 16,000 patients' Lp(a) levels and their association with major adverse cardiovascular events (MACE) over nearly 12 years.
- Results showed that elevated Lp(a) levels significantly increase the risk of MACE for both groups (those with and without baseline ASCVD), indicating that Lp(a) risk assessment might need different strategies for primary vs. secondary prevention.
Background: Non-obstructing small coronary plaques may not be well recognized by expert readers during coronary computed tomography angiography (CCTA) evaluation. Recent developments in atherosclerosis imaging quantitative computed tomography (AI-QCT) enabled by machine learning allow for whole-heart coronary phenotyping of atherosclerosis, but its diagnostic role for detection of small plaques on CCTA is unknown.
Methods: We performed AI-QCT in patients who underwent serial CCTA in the multinational PARADIGM study.
Article Synopsis
- The OCEAN(a)-Outcomes trial is investigating if lowering Lp(a) levels can reduce cardiovascular events in patients who have had a myocardial infarction or PCI and have high Lp(a) levels (≥200 nmol/L).
- This study analyzed data from 3,142 patients aged 18-85 with previous MI or PCI, measuring Lp(a) between 2000 and 2019, finding that 12.3% had elevated Lp(a).
- Results showed a significantly higher rate of major cardiovascular events in patients with elevated Lp(a) compared to those without, suggesting that high Lp(a) is linked to increased cardiovascular risk.
Background: Whether racial disparities in outcomes are present after catheter ablation for scar-related ventricular tachycardia (VT) is not known.
Objective: The purpose of this study was to examine whether racial differences exist in outcomes for patients undergoing VT ablation.
Methods: From March 2016 through April 2021, consecutive patients undergoing catheter ablation for scar-related VT at the University of Chicago were prospectively enrolled.
Aims: Although myocardial scar assessment using late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) imaging is frequently indicated for patients with implantable cardioverter defibrillators (ICDs), metal artefact can degrade image quality. With the new wideband technique designed to mitigate device related artefact, CMR is increasingly used in this population. However, the common clinical indications for CMR referral and impact on clinical decision-making and prognosis are not well defined.
View Article and Find Full Text PDFObjectives: This study sought to analyze the impact of the American College of Cardiology, American Heart Association, and Heart Rhythm Society (ACC/AHA/HRS) guidelines for cardiac resynchronization therapy with defibrillator (CRT-D) update on utilization and efficacy of CRT-D.
Background: In September 2012, the ACC/AHA/HRS guidelines for CRT-D were modified to include left bundle branch block (LBBB) as a Class I indication.
Methods: The IBM Watson MarketScan Database was queried between January 1, 2003, and December 31, 2018, for CRT-D implants or upgrades.
Article Synopsis
- - The study investigates whether catheter ablation as a first-line treatment for ventricular tachycardia (VT) during implantable cardioverter defibrillator (ICD) implantation is more effective than standard medical therapy plus ICD in patients with cardiomyopathy.
- - The trial involved 180 patients and found that those in the ablation group showed lower recurrence rates of VT and required fewer ICD shocks compared to the control group over an average follow-up period of 31 months.
- - Results suggest that early ablation may offer significant benefits in reducing VT recurrence and hospitalizations for patients with nonischemic cardiomyopathy, potentially filling a current gap in clinical guidelines.
Background: Patients with concomitant anemia and congestive heart failure have poor outcomes. The prevalence and clinical risk of anemia in patients receiving durable left ventricular assist devices (LVAD) remain unknown.
Methods: We retrospectively analyzed patients who underwent LVAD implantation between 2014 and 2018.
The prognostic impact of mitral inflow wave overlap during ivabradine therapy in patients with heart failure with reduced ejection fraction (HFrEF) remains to be unknown. Thus, in this study, we have retrospectively examined consecutive inpatients with HFrEF admitted with decompensated heart failure who continued ivabradine following the index discharge. Ideal heart rate (HR), at which echocardiographic mitral inflow wave overlap is theoretically 0, was retrospectively calculated as follows: 96 - 0.
View Article and Find Full Text PDFBackground: Artificial intelligence is increasingly utilized to aid in the interpretation of cardiac magnetic resonance (CMR) studies. One of the first steps is the identification of the imaging plane depicted, which can be achieved by both deep learning (DL) and classical machine learning (ML) techniques without user input. We aimed to compare the accuracy of ML and DL for CMR view classification and to identify potential pitfalls during training and testing of the algorithms.
View Article and Find Full Text PDFBackground: The initial derivation of cardiac power output (CPO) included the difference between mean arterial pressure (MAP) and right atrial pressure (RAP) in the numerator, before multiplying by cardiac output (CO). We hypothesized that the inclusion of RAP (CPO-RAP) would enhance the prognostic performance of this parameter in those with an elevated RAP.
Methods And Results: We obtained patient-level data from the ESCAPE trial via the Biolincc database.
Background: Catheter ablation strategies for ventricular fibrillation (VF) and polymorphic ventricular tachycardia (PMVT) are not established when spontaneous triggers are rare or absent.
Objective: The purpose of this study was to report the feasibility and efficacy of a novel empiric ablation strategy of pacemapping to stored implantable cardioverter-defibrillator (ICD) template electrograms (SITE) of the clinical premature ventricular contraction (PVC) trigger.
Methods: Fifteen patients with drug-refractory VF/PMVT receiving defibrillator shocks without identifiable and mappable PVC triggers were prospectively analyzed.
Background: Although His bundle pacing (HBP) has been shown to improve left ventricular ejection fraction (LVEF), its impact on mitral regurgitation (MR) remains uncertain.
Objectives: The aim of this study was to evaluate change in functional MR after HBP in patients with left ventricular (LV) systolic dysfunction.
Methods: Paired echocardiograms were retrospectively assessed in patients with reduced LVEF (<50%) undergoing HBP for pacing or resynchronization.
Objectives: The aim of this study was to determine whether left ventricular ejection fraction (LVEF) and right ventricular ejection fraction (RVEF) and left ventricular mass (LVM) measurements made using 3 fully automated deep learning (DL) algorithms are accurate and interchangeable and can be used to classify ventricular function and risk-stratify patients as accurately as an expert.
Background: Artificial intelligence is increasingly used to assess cardiac function and LVM from cardiac magnetic resonance images.
Methods: Two hundred patients were identified from a registry of individuals who underwent vasodilator stress cardiac magnetic resonance.
Introduction: Hypertension is associated with adverse cardiovascular outcomes and is geographically concentrated in urban underserved neighborhoods. This study examines the temporal-spatial association between individual exposure to violent crime and blood pressure.
Methods: A retrospective observational cohort study analyzed 39,211 patients with 227,595 blood pressure measurements from 2014 to 2016 at 3 outpatient clinics at an academic medical center in Chicago.
Article Synopsis
- The study compared echocardiographic features and clinical characteristics of 234 patients admitted during the first and second waves of the pandemic to identify factors associated with mortality.
- Findings revealed a significant reduction in all-cause mortality from 35.2% in the first wave to 14.7% in the second, while certain echocardiographic measures were worse in the first wave, though demographic factors remained constant across the two waves.
Management of constrictive pericarditis is often clinically challenging. Heart rate (HR) modulation using ivabradine is associated with improved clinical outcomes in patients with systolic heart failure, although it remains uninvestigated for other clinical purposes. We aimed to assess the impact of HR control in patients with constrictive pericarditis.
View Article and Find Full Text PDFBackground: Atrial arrhythmias following hematopoietic stem cell transplantation (HSCT) have been associated with increased length of stay, need for intensive care, and increased mortality within one-year post-transplant. We sought to identify echocardiographic parameters that may predict the development of new atrial arrhythmias post-HSCT.
Methods: We performed a retrospective chart review of 753 consecutive patients who underwent HSCT at the University of Chicago from January 2015 through December 2019.
Introduction: Current evidence suggests that high sensitivity cardiac troponin-T (hs-cTnT) values differ based on sex, race, age, and kidney function. However, most studies examining the relationship of hs-cTnT and these individual factors are in healthy participants, leading to difficulty in interpreting hs-cTnT values in the Emergency Department (ED) setting. We seek to examine the relationship between hs-cTnT values and sex, race, age, and kidney function in a contemporary, urban academic setting.
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