Publications by authors named "Waksmonski C"

Background: Cardio-obstetrics refers to a team-based approach to maternal care that includes multidisciplinary collaboration among maternal fetal medicine, cardiology, and others.

Objectives: This study sought to describe clinical characteristics, maternal and fetal outcomes, and cardiovascular readmissions in a cohort of pregnant women with underlying cardiovascular disease (CVD) followed by a cardio-obstetrics team.

Methods: We identified patients evaluated by our cardio-obstetrics team from January 1, 2010, through December 31, 2019, at a quaternary care hospital in New York City.

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There are multiple imaging modalities available for the assessment of pregnant women with known or suspected cardiac disease. Because of its safety and general availability, echocardiography is the preferred study of choice for the evaluation of ventricular function, valvular heart disease, congenital heart disease, evaluation of the aorta, and the estimation of cardiac hemodynamics in a pregnant patient. Cardiac MRI can be performed, especially for diseases of the aorta and complex congenital heart disease.

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Background: Outcomes data in patients with aortic regurgitation or mitral regurgitation have been limited to small series with generally <10 years of follow-up. The quantitative impact of pulmonary artery hypertension has not been well described. The purpose of this study was to describe the 15-year mortality of aortic regurgitation and mitral regurgitation.

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The impact of left ventricular ejection fraction (LVEF) on outcome in patients with heart failure (HF) undergoing noncardiac surgery has not been extensively evaluated. In this study, 174 patients (mean age, 75+/-12 years, 47% male, mean LVEF (47%+/-18%) underwent intermediate- or high-risk noncardiac surgery. Patients were stratified by LVEF, and adverse perioperative complications were identified and compared.

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Objective: To evaluate contemporary perinatal and cardiac outcomes of pregnancies in women with major structural congenital heart disease.

Methods: Obstetric, neonatal, and cardiac outcomes were abstracted retrospectively from medical records of all women with congenital cardiac disease delivering at our institution from 2000-2007 and compared by type of structural defect. Predictors of adverse cardiac or obstetric events were identified.

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Objectives: To correlate estimated pulmonary artery pressures (PAP) by echocardiography with right heart catheterization (RHC) measurements and to correlate estimated left ventricular ejection fraction (EF) by echocardiography with cardiac output (CO) measurements by RHC.

Study Design: All women who had echocardiography at a single institution during a 6-year period and underwent RHC during pregnancy were included. Echocardiography estimates of right ventricular systolic pressure (RVSP) and EF were correlated with measured RHC PAP and CO, respectively.

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Previous studies have reported that left ventricular (LV) thrombus is a complication in 10-56% of ST-segment elevation acute anterior wall myocardial infarctions (AWMI). Data suggest that changes in acute myocardial infarction management such as early anticoagulation, thrombolysis, and most recently, primary percutaneous coronary intervention (PCI), may decrease thrombus occurrence. Early time to reperfusion has been shown to decrease mortality and improve LV function recovery.

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Pregnancy in patients with severe hypercholesterolemia and coronary artery disease results in multiple problems both for mother and fetus; the most potent agents for low-density lipoprotein (LDL) cholesterol reduction, the HMG-CoA reductase inhibitors (statins) cannot be used during pregnancy. We present a case in which LDL apheresis via heparin-induced extracorporeal LDL precipitation was employed safely and efficaciously during pregnancy in a woman with heterozygous familial hypercholesterolemia and stable coronary artery disease.

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Background: Orthostatic hypotension is a dangerous problem in elderly patients, often exacerbated by vasodilator medications. Age- and disease-related impairments in cardioacceleration and diastolic ventricular function may make older patients particularly vulnerable to the hypotensive effects of these drugs. Therefore we aimed to determine mechanisms of postural blood pressure regulation in elderly patients with coronary artery disease and to compare the effects of isosorbide dinitrate and nicardipine hydrochloride on postural blood pressure homeostasis in these patients.

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Objectives: In certain younger patients with congestive heart failure (CHF), Doppler/echocardiography has identified a "restrictive" pattern of early diastolic ventricular filling characterized by very rapid early filling and a steep deceleration slope. We asked whether a similar restrictive pattern can be identified in very old patients with CHF, and if so, what are its clinical correlates and prognostic implications.

Design: Retrospective cohort with prospective follow-up.

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Objective: To determine the ability of transesophageal echocardiography to accurately identify or exclude left atrial thrombi.

Design: Prospective cohort study.

Setting: University hospital.

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Background: Thromboembolism related to atrial fibrillation (AF) is a major cause of morbidity and mortality. Patients with acute thromboembolism and AF are at high risk for early recurrent events.

Objective: To determine the prevalence of left atrial thrombi in patients who had acute thromboembolism and newly diagnosed AF.

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Objectives: The purpose of this study was to determine the value of contemporary echocardiography for patient diagnosis and management in clinical practice.

Background: Although the use of echocardiography is growing rapidly, there is little information about its clinical utility.

Methods: A prospective observational study was performed at a community-based, tertiary care teaching hospital.

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Faulty incorporation of the common pulmonary vein leaves it as a distinct structure posteriorly, into which the pulmonary veins empty. This "chamber" is separated from the anterior "fetal" left atrium (containing the left atrial appendage and communicating with the mitral valve) by a diaphragm, and is known as cor triatriatum, one of the rarest of cardiac malformations. Less pronounced but still incomplete regression of this vein would result in the persistence of a portion of the common pulmonary vein appearing as a mass along the lateral wall of the left atrium at the junction of the left atrial appendage and left upper pulmonary vein.

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A 38-yr-old woman presented with an anterolateral myocardial infarction following blunt chest trauma sustained in a motor vehicle accident. Subsequent cardiac catheterization revealed a large left ventricular aneurysm and angiographic evidence of dissection of the proximal left anterior descending artery. Review of the literature and management are discussed.

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A radioimmunoassay for human cardiac myosin light chains (CM-LC) was developed and evaluated as a selective diagnostic test for acute myocardial infarction (AMI). The assay had a sensitivity of 1.0 ng/ml (+/- 2 standard deviations) in serum.

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