Publications by authors named "Syed W Yusuf"

Non-bacterial thrombotic endocarditis (NBTE), formerly recognized as marantic endocarditis, represents a rare cardiovascular pathology intricately linked with hypercoagulable states, notably malignancy and autoimmune disorders. Characterized by the development of sterile vegetations comprised of fibrin and platelets on cardiac valves, NBTE poses a diagnostic challenge due to its resemblance to infective endocarditis. Therapeutic endeavours primarily revolve around addressing the underlying aetiology and instituting anticoagulant regimens to forestall embolic events, with surgical intervention seldom warranted.

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Introduction: The Coronavirus Disease - 2019 (COVID-19) pandemic significantly impacted healthcare service provision and put diabetic patients at increased risk of adverse health outcomes. We aimed to assess the impact of the COVID-19 pandemic on the incidence and demographic shift of major lower-limb amputation in diabetic patients.

Methods: We performed a retrospective analysis of diabetic patient records undergoing major lower-limb amputation between 01/03/2019 and 01/03/2021 at the Royal Sussex County Hospital, the regional arterial hub for Sussex.

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Article Synopsis
  • The study investigated how levels of peripheral cytokines, particularly IL-6 and TNF-α, can predict outcomes and guide treatment for patients with immune checkpoint inhibitor (ICI) myocarditis, a condition that affects the heart due to cancer treatment.
  • Conducted on 65 mostly male patients averaging 67.8 years old, the study found high levels of IL-6 in 74% and TNF-α in 68% of participants, but these cytokine levels did not correlate with differences in mortality or major adverse cardiovascular events (MACEs) over 90 days.
  • The research concluded that while IL-6 and TNF-α are common in ICI myocard
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Article Synopsis
  • * CVD risk may increase for cancer survivors due to long-term complications from cancer and its treatments, with cellular senescence playing a significant role in this relationship.
  • * The article seeks to explore the mechanisms connecting premature cellular aging to CVD in cancer survivors and suggests future research directions for a deeper understanding of this complex issue.
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Background: Carcinoid heart disease is increasingly recognized and challenging to manage due to limited outcomes data. This is the largest known cohort study of valvular pathology, treatment (including pulmonary and tricuspid valve replacements [PVR and TVR]), dispairties, mortality, and cost in patients with malignant carcinoid tumor (MCT).

Methods: Machine learning-augmented propensity score-adjusted multivariable regression was conducted for clincal outcomes in the 2016-2018 U.

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Introduction: This study examined the role of echocardiographic and cardiac histomorphology parameters in predicting mortality in patients with cardiac AL amyloidosis.

Methods: Patients with endomyocardial biopsy-proven cardiac AL amyloidosis treated at MD Anderson Cancer Center between 6/2011 and 6/2020 were identified. Stored echocardiographic images and endomyocardial biopsy samples were processed for myocardial strain analysis and a detailed histomorphology characterization.

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Radiation therapy (RT) to the chest increases the patients' risk of cardiovascular disease (CVD). A complete understanding of the mechanisms by which RT induces CVD could lead to specific preventive, therapeutic approaches. It is becoming evident that both genotoxic chemotherapy agents and radiation induce mitochondrial dysfunction and cellular senescence.

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Article Synopsis
  • - Numerous studies show that cancer treatments can cause premature cell aging, leading to age-related diseases, primarily through a process called senescence-associated secretory phenotype (SASP) triggered by telomere damage.
  • - Telomere dysfunction from cancer therapies can lead to lasting cellular issues such as mitochondrial dysfunction and increased reactive oxygen species, contributing to the side effects experienced by cancer survivors.
  • - The interaction between cellular mechanisms involving p90 ribosomal S6 kinase and ERK5 signaling is crucial in connecting telomere damage, mitochondrial problems, persistent SASP, and the risk of developing cardiovascular diseases in individuals who have survived cancer.
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Myocardial dysfunction in patients with cancer is a major cause of morbidity and mortality. Cancer therapy-related cardiotoxicities are an important contributor to the development of cardiomyopathy in this patient population. Furthermore, cardiac AL amyloidosis, cardiac malignancies/metastases, accelerated atherosclerosis, stress cardiomyopathy, systemic and pulmonary hypertension are also linked to the development of myocardial dysfunction.

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Aim: This study investigated the factors predicting survival and the recurrence of pericardial effusion (PE) requiring pericardiocentesis (PCC) in patients with cancer.

Materials And Methods: We analyzed the data of patients who underwent PCC for large PEs from 2010 to 2020 at The University of Texas MD Anderson Cancer Center. The time to the first recurrent PE requiring PCC was the interval from the index PCC with pericardial drain placement to first recurrent PE requiring drainage (either repeated PCC or a pericardial window).

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This case illustrates the unusual clinical presentation and natural progression of type A aortic dissection, found incidentally on echocardiogram in a patient with breast cancer. Possible association of tyrosine kinase inhibitor with aortic dissection is reviewed in the light of this case.

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Article Synopsis
  • Cancer survival rates have improved, leading to heightened attention on cardiovascular disease as a key factor in overall survivorship for cancer patients.
  • The article reviews existing research on acute coronary syndrome (ACS) in cancer patients, covering its causes, risk factors, symptoms, treatments, and outcomes.
  • There's increasing evidence that targeted medical and invasive treatments for ACS can enhance health outcomes for cancer patients, highlighting the importance of selecting the right patients and personalizing therapies.
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Background: There is a paucity of data regarding the association between radiation exposure of heart substructures and the incidence of major coronary events (MCEs) in patients with esophageal cancer (ESOC) undergoing chemoradiation therapy. We studied radiation dosimetric determinants of MCE risk and measured their impact on patient prognosis using a cohort of ESOC patients treated at a single institution. Methods: Between March 2005 and October 2015, 355 ESOC patients treated with concurrent chemoradiotherapy were identified from a prospectively maintained and institutional-regulatory-board-approved clinical database.

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Purpose Of Review: Despite the advancements of modern radiotherapy, radiation-induced cardiovascular disease (RICVD) remains a common cause of morbidity and mortality among cancer survivors.

Recent Findings: Proposed pathogenetic mechanisms of RICVD include endothelial cell damage with accelerated atherosclerosis, pro-thrombotic alterations in the coagulation pathway as well as inflammation and fibrosis of the myocardial, pericardial, valvular, and conduction tissues. Prevention of RICVD can be achieved by minimizing the exposure of the cardiovascular system to radiation, by treatment of underlying cardiovascular risk factors and cardiovascular disease, and possibly by prophylactic pharmacotherapy post exposure.

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The incidence of cardiovascular disease (CVD) is higher in cancer survivors than in the general population. Several cancer treatments are recognized as risk factors for CVD, but specific therapies are unavailable. Many cancer treatments activate shared signaling events, which reprogram myeloid cells (MCs) towards persistent senescence-associated secretory phenotype (SASP) and consequently CVD, but the exact mechanisms remain unclear.

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Background: Infective endocarditis (IE) is more common in patients with cancer as compared with the general population. Due to an immunocompromised state, the need for invasive procedures, hypercoagulability and the presence of indwelling catheters, patients with cancer are particularly predisposed to the development of IE.

Objectives: Limited information exists about IE in patients with cancer.

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Contralateral gate cannulation is one of the key steps of endovascular aortic aneurysm repair (EVAR), and multiple different techniques and tips have been described to ensure accurate and swift performance of this step. In some cases, a crossover approach, entailing an up-and-over wire access from the ipsilateral limb into the contralateral gate followed by snaring the wire to the contralateral groin and proceeding with contralateral limb deployment is needed. The risks with this technique include the necessity of completely deploying the stent-graft main body, ipsilateral limb, and release of its trigger wires which essentially render the graft untethered, and cause concerns about the graft migrating upwards or "buckling" during advancement of the contralateral limb in challenging anatomy.

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Patients with cancer and aortic stenosis (AS) are exposed to several factors that could accelerate the progression of AS. This study aimed to determine the cumulative incidence of AS progression and associated factors in these patients. This retrospective cohort study included patients with cancer, mild or moderate AS and at least two echocardiograms 6 months apart between 1996 and 2016 at MD Anderson Cancer Center.

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The recent surge in cancer drug approval has provided us in cardio-oncology with a new and unique era, which modern medicine has not experienced before: the diminishing availability of "conventional" evidence-based medicine. The drastic and quick changes in oncology has made it difficult, and at times even impossible, to establish a meaningful evidence-based cardio-oncology practice by simply following the oncologists' practice. For the modern cardio-oncologist, it seems that a more proactive approach and methodology is needed.

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Previously, we reported that post-translational modifications (PTMs) of MAGI1, including S741 phosphorylation and K931 de-SUMOylation, both of which are regulated by p90RSK activation, lead to endothelial cell (EC) activation. However, roles for p90RSK and MAGI1-PTMs in regulating EC permeability remain unclear despite MAGI1 being a junctional molecule. Here, we show that thrombin (Thb)-induced EC permeability, detected by the electric cell-substrate impedance sensing (ECIS) based system, was decreased by overexpression of dominant negative p90RSK or a MAGI1-S741A phosphorylation mutant, but was accelerated by overexpression of p90RSK, siRNA-mediated knockdown of , or the MAGI1-K931R SUMOylation mutant.

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Despite the advancements of modern radiotherapy, radiation-induced heart disease remains a common cause of morbidity and mortality amongst cancer survivors. This review outlines the basic mechanism, clinical presentation, risk stratification, early detection, possible mitigation, and treatment of this condition.

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Speckle-tracking echocardiography has enabled clinicians to detect changes in myocardial function with more sensitivity than that afforded by traditional diastolic and systolic functional measurements, including left ventricular ejection fraction. Speckle-tracking echocardiography enables evaluation of myocardial strain in terms of strain (percent change in length of a myocardial segment relative to its length at baseline) and strain rate (strain per unit of time). Both measurements have potential for use in diagnosing and monitoring the cardiovascular side effects of cancer therapy.

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