57 results match your criteria: "Cardiovascular Institute at Allegheny Health Network[Affiliation]"
Cardiac Recovery: Webcast September 24 2024.
Methodist Debakey Cardiovasc J
December 2024
Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah Health and School of Medicine, Salt Lake City, Utah, US.
This 61-minute webcast features a conversation about "Cardiac Recovery"-the focus of Issue 20.4. Led by the issue's editors, the discussion engages the authors on emerging themes and lessons learned while researching and writing the articles.
View Article and Find Full Text PDFCurrent Approaches to Optimize Donor Heart for Transplantation.
J Heart Lung Transplant
December 2024
Department of Cardiothoracic Surgery, NYU Langone Health, New York, NY, USA.
Heart transplantation remains a critical therapy for patients with end-stage heart failure, offering incremental survival and improved quality of life. One of the key components behind the success of heart transplantation is the condition and preservation of the donor heart. In this review, we provide a comprehensive overview of ischemic reperfusion injury, risk factors associated with primary graft dysfunction, current use of various preservation solutions for organ procurement and recent advancements in donor heart procurement technologies.
View Article and Find Full Text PDFPractice Variation in Temporary Mechanical Circulatory Support for Cardiogenic Shock.
J Card Fail
December 2024
The CardioVascular Center, Tufts Medical Center, Boston, MA. Electronic address:
Pitfalls in the World of Evidence-Based Medicine: Should IABP Be en-DANGER-ed by the DanGer Shock Trial?
Circ Heart Fail
December 2024
Department of Cardiology, Cardiovascular Institute at Allegheny Health Network, Pittsburgh, PA (M.K.K.).
Association of Hemometabolic Trajectory and Mortality: Insights From the Cardiogenic Shock Working Group Registry.
J Card Fail
October 2024
The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts. Electronic address:
Article Synopsis
- Cardiogenic shock (CS) is a serious condition that can lead to severe complications, and this study looked at how changes in hemodynamic (blood flow-related) measurements correlate with patient outcomes in those suffering from heart failure or heart attack.
- Researchers analyzed data from over 2,200 patients to compare the hemodynamic profiles at the start and end of hospitalization, finding that mortality rates were higher in patients with acute myocardial infarction compared to those with heart failure.
- The study revealed that improvements in various hemodynamic and metabolic factors during hospitalization, such as lower blood pressure and better cardiac output, were linked to increased survival rates in both groups of patients.
Early stroke following durable left ventricular assist device (LVAD) implantation: An analysis of the Society of Thoracic Surgeons Intermacs National Database.
J Heart Lung Transplant
October 2024
Division of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, South Carolina. Electronic address:
Article Synopsis
- - This study examined the incidence and risk factors for early stroke within the first week after the implantation of a left ventricular assist device (LVAD), revealing that 5.9% of patients experienced a stroke, with about half occurring in the initial 7 days post-surgery.
- - Key findings indicated that older age, having a temporary mechanical circulatory support (MCS) device, being of white race, and the presence of a left atrial clot before surgery were all associated with a higher risk of early stroke.
- - The study highlights the need for ongoing risk assessment and improvement strategies in the management of patients undergoing LVAD implantation to reduce early stroke occurrences.
Authors' response to comment and opinion.
J Heart Lung Transplant
January 2025
Cardiovascular Institute at Allegheny Health Network, Pittsburgh, Pennsylvania.
Serial Shock Severity Assessment Within 72 Hours After Diagnosis: A Cardiogenic Shock Working Group Report.
J Am Coll Cardiol
August 2024
The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts, USA. Electronic address:
Article Synopsis
- The CSWG-SCAI staging system helps assess the severity of cardiogenic shock (CS) in patients, but there’s limited data on how these stages change over time and affect outcomes.
- This study analyzed data from 3,268 patients with acute myocardial infarction-related CS and heart failure-related CS to see how their SCAI stages changed over 72 hours.
- Findings showed that most patients’ stages changed within the first 24 hours, particularly those in stage B who had a high risk of worsening, indicating that early detection and ongoing evaluation are crucial for improving patient outcomes.
Myocardial Recovery in Cardiogenic Shock.
Methodist Debakey Cardiovasc J
August 2024
Cardiovascular Institute at Allegheny Health Network, Pittsburgh, Pennsylvania, US.
Article Synopsis
- * Heart replacement therapies can be effective but are limited to a small group of patients; thus, understanding the underlying causes and optimizing recovery factors is crucial.
- * This review discusses the pathophysiology of CS, what helps predict heart recovery, and emphasizes the need for more research to bridge the knowledge gaps in treating CS effectively.
Medical Management and Device-Based Therapies in Chronic Heart Failure.
J Soc Cardiovasc Angiogr Interv
December 2023
Inova Schar Heart and Vascular Institute, Inova Fairfax Medical Campus, Falls Church, Virginia.
Article Synopsis
- * Many patients continue to experience severe symptoms and face risks such as rehospitalization and increased mortality despite advancements in medication.
- * Recent years have seen growth in innovative device-based therapies for HF, addressing these gaps and showing effectiveness in managing the condition across various patient profiles.
Dynamic Risk Estimation of Adverse Events in Ambulatory LVAD Patients: A MOMENTUM 3 Analysis.
JACC Heart Fail
November 2024
Columbia University Irving Medical Center and New York-Presbyterian Hospital, New York, New York, USA.
Article Synopsis
- Hemocompatibility issues post-left ventricular assist device (LVAD) implantation lead to complications like gastrointestinal bleeding, stroke, or death, but predicting these risks is challenging.* -
- A secondary analysis of the MOMENTUM 3 trial utilized a multistate model to evaluate 2,056 LVAD patients, revealing a 2-year incidence rate of 25.6% for gastrointestinal bleeding, 6.0% for stroke, and 12.3% for death.* -
- The multistate model, which includes 39 variables, provides a tool for stratifying risk and predicting adverse events in ambulatory LVAD patients, potentially improving clinical decision-making.*
Pragmatic approach to temporary mechanical circulatory support in acute right ventricular failure.
J Heart Lung Transplant
November 2024
Cardiovascular Institute at Allegheny Health Network, Pittsburgh, Pennsylvania.
Article Synopsis
- Acute right ventricular failure (RVF) often occurs in various diseases and can lead to serious health issues, particularly when accompanied by cardiogenic shock (CS).
- Right-sided temporary mechanical circulatory support (tMCS) devices are utilized to relieve heart stress and improve blood circulation in affected patients, although there is no agreed-upon protocol for their use.
- This review aims to outline the current treatments for acute RVF, the decision-making process for using tMCS devices, key management elements like fluid levels and anticoagulation, and guidelines for gradually discontinuing tMCS support.
Extrinsic outflow graft obstruction of the HeartMate 3 LVAD: A state-of-the-art review.
J Heart Lung Transplant
November 2024
Division of Cardiovascular Medicine, University of Utah School of Medicine, Salt Lake City, Utah.
While notable improvements in survival, the incidence of hemocompatibility-related adverse events, hospitalizations, and cost have been demonstrated with the only commercially available durable left ventricular assist device, a category of pump malfunctions characterized by outflow graft obstruction has been noted with broader use and clinical follow-up of recipients of this technology. Of particular concern is the accumulation of acellular biodebris between the outflow graft and bend relief covering the outflow graft at its origin with the pump (which we term extrinsic outflow graft obstruction at the bend relief). This process tends to be insidious, occurs late in the postoperative course, can be challenging to diagnose, and can result in significant morbidity and mortality.
View Article and Find Full Text PDFPrognostic Implications of Quantifying Vasoactive Medications in Cardiogenic Shock.
J Card Fail
November 2024
Tufts University School of Medicine, Boston, MA. Electronic address:
Clinical outcomes among cardiogenic shock patients supported with high-capacity Impella axial flow pumps: A report from the Cardiogenic Shock Working Group.
J Heart Lung Transplant
September 2024
The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts. Electronic address:
Article Synopsis
- The Impella 5.0 and 5.5 pumps are mechanical assist devices used in patients with severe cardiogenic shock (CS), but there is limited real-world data on their usage and outcomes.* -
- A study analyzed data from 6,205 patients across 34 hospitals, focusing on 754 who received Impella pumps between 2020-2023, with findings indicating that 32% used the Impella as the only device while 68% combined it with others.* -
- The overall survival rate for patients using Impella was 67%, with 20.4% achieving native heart recovery and 45.5% requiring heart replacement therapy; those with acute myocardial infarction had different outcomes compared
Mechanical Preload Reduction: Harnessing a Cornerstone of Heart Failure Management to Improve Clinical Outcomes.
ASAIO J
October 2024
Department of Cardiology, The Cardiovascular Research Foundation, New York, New York.
Article Synopsis
- Decongestion is a key treatment goal for patients with decompensated heart failure, focusing on reducing excess fluid in the body.
- Current methods for achieving decongestion primarily include diuretics and hemofiltration, though new mechanical technologies are being developed.
- The review covers the underlying causes of decompensated heart failure, the importance of managing cardiac preload, new technologies aimed at preload reduction, and their potential use in clinical settings.
Body Mass Index and Mortality in Cardiogenic Shock.
ASAIO J
October 2024
Department of Cardiology, The CardioVascular Center, Tufts Medical Center, Boston, Massachusetts.
Article Synopsis
- - The study examined how body mass index (BMI) affects mortality rates in patients experiencing cardiogenic shock (CS), using a large cohort from the Cardiogenic Shock Working Group registry.
- - Results showed that a higher BMI correlated with increased mortality, particularly in those with heart failure-related mechanisms, while patients with normal weight had the lowest mortality rates.
- - In the cohort, normal weight patients had a mortality rate of 29.0%, compared to 35.1% for obese and 36.7% for severely obese patients, though no significant differences were observed among BMI categories in cases related to acute myocardial infarction.
Rethinking the Nomenclature of Heart Failure Cardiogenic Shock: Do We Need to Start De Novo?
Circ Heart Fail
March 2024
Inova Schar Heart and Vascular, Falls Church, VA (V.B., M.A.P.).
Heart failure related cardiogenic shock: An ISHLT consensus conference content summary.
J Heart Lung Transplant
February 2024
Heart, Vascular Thoracic Institute, Cleveland Clinic Florida, Weston, Florida. Electronic address:
Article Synopsis
- * A lack of high-quality evidence makes it challenging to establish standardized practices for managing heart failure-related cardiogenic shock (HF-CS), which constitutes over half of CS cases.
- * An international conference aimed to create a consensus on defining and managing HF-CS, involving 54 experts from various fields to review literature and discuss clinical practices for better outcomes.
A multicenter evaluation of the HeartMate 3 risk score.
J Heart Lung Transplant
April 2024
Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina. Electronic address:
Background: The Heartmate 3 (HM3) risk score (HM3RS) was derived and validated internally from within the Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy with HeartMate 3 (MOMENTUM 3) trial population and provides 1- and 2-year mortality risk prediction for patients in those before HM3 left ventricular assist device (LVAD) implantation. We aimed to evaluate the HM3RS in nontrial unselected patients, including those not meeting inclusion criteria for MOMENTUM 3 trial enrollment.
Methods: Patients who underwent HM3 LVAD implant at 1 of 7 US centers between 2017 and 2021, with at least 1-year follow-up, were included in this analysis.
Reply: miRNAs and Mitral Interventions in Heart Failure.
JACC Heart Fail
December 2023
Cardiovascular Institute at Allegheny Health Network, Pittsburgh, Pennsylvania, USA. Electronic address:
Impact of Female Sex on Cardiogenic Shock Outcomes: A Cardiogenic Shock Working Group Report.
JACC Heart Fail
December 2023
The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts, USA. Electronic address:
Article Synopsis
- The study focused on comparing survival rates at discharge between women and men who experienced cardiogenic shock (CS) related to acute myocardial infarction (AMI) and heart failure (HF).
- Out of 5,083 CS patients, 1,522 were women, who showed worse survival rates and higher rates of vascular complications compared to men, particularly in the HF-CS group.
- The findings suggest that women are less likely to receive certain advanced treatments and may face unique challenges leading to poor outcomes, emphasizing the need for further research to improve their care.
Equitable Access to Advanced Heart Failure Therapies in the United States: A Call to Action.
J Card Fail
January 2024
Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI; Cardiovascular Institute at Allegheny Health Network, Pittsburgh, PA. Electronic address:
Outcomes of Patients Transferred to Tertiary Care Centers for Treatment of Cardiogenic Shock: A Cardiogenic Shock Working Group Analysis.
J Card Fail
April 2024
The CardioVascular Center, Tufts Medical Center, Boston, MA. Electronic address:
Article Synopsis
- Consensus recommendations suggest transferring patients with cardiogenic shock (CS) from less equipped "spoke" centers to more advanced "hub" centers, but the outcomes of such transfers are not well understood outside specific health systems.
- The analysis, using data from a national registry including 15 U.S. sites, compared characteristics and outcomes of transferred patients versus those admitted directly to hub centers, focusing on acute myocardial infarction (AMI-CS) and heart failure-related cardiogenic shock (HF-CS).
- Results showed that 54.4% of enrolled patients were transferred, with transfer patients having higher mortality rates than nontransfer patients, primarily due to HF-CS; factors such as age and the need for advanced treatments were linked to increased mortality among
Mitral Interventions in Heart Failure.
JACC Heart Fail
August 2023
Cardiovascular Institute at Allegheny Health Network, Pittsburgh, Pennsylvania, USA. Electronic address:
Article Synopsis
- Patients with heart failure and secondary mitral regurgitation (SMR) experience worse health outcomes and quality of life compared to those without SMR.
- Guideline-directed medical therapy remains the primary treatment for SMR, and recent trials on mitral transcatheter edge-to-edge repair have improved insights on which patients might benefit from these procedures with a focus on multidisciplinary care.
- The success of these repairs has led to investigations into their use in populations like end-stage heart failure and cardiogenic shock, alongside ongoing development of new transcatheter devices to enhance treatment options for patients with symptomatic SMR.