30 results match your criteria: "Duke University Medical Center Durham NC USA.[Affiliation]"

In the last three decades, ablation of atrial fibrillation (AF) has become an evidence-based safe and efficacious treatment for managing the most common cardiac arrhythmia. In 2007, the first joint expert consensus document was issued, guiding healthcare professionals involved in catheter or surgical AF ablation. Mounting research evidence and technological advances have resulted in a rapidly changing landscape in the field of catheter and surgical AF ablation, thus stressing the need for regularly updated versions of this partnership which were issued in 2012 and 2017.

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Racial and Ethnic Disparities in the Use and Outcomes With WATCHMAN FLX: A SURPASS Analysis of the NCDR Left Atrial Appendage Occlusion Registry.

J Am Heart Assoc

December 2024

Section of Cardiovascular Medicine Yale University School of Medicine, New Haven, Connecticut and Center for Outcomes Research and Evaluation, Yale-New Haven Hospital New Haven CT USA.

Background: Left atrial appendage occlusion (LAAO) is increasingly used as an alternative to oral anticoagulation for stroke prevention in select patients with atrial fibrillation. Data on outcomes in racial and ethnic minority individuals are limited. This analysis assessed differences in the use and outcomes of LAAO by race and ethnicity in a large national registry.

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  • Diagnostic variables from insertable cardiac monitors can help identify heart failure (HF) patients at risk, but high-risk alerts must be paired with interventions to improve patient outcomes.
  • The ALLEVIATE-HF study involved patients with recent HF events, using a risk score based on various monitor diagnostics to guide intervention protocols, including diuretic uptitration.
  • Results showed that the intervention was generally safe, with positive symptom resolution in most cases, indicating the feasibility of tailored medication management based on high-risk alerts.
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  • Septic shock leads to increased end-diastolic volume (EDV) and decreased ejection fraction in survivors, unlike nonsurvivors, whose EDV does not increase due to more severe diastolic dysfunction early in the condition.* -
  • In a study with beagles, findings indicate that septic animals experienced significant heart issues, including wall edema and thinning, resulting in decreased heart performance, particularly in nonsurvivors during the initial phase of sepsis.* -
  • The research suggests that cardiac dysfunction during sepsis is connected to microvascular injury and edema, with important implications for understanding heart changes and recovery in septic patients.*
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  • * Beagles were given either saline or epinephrine infusions, with results indicating that while epinephrine significantly increased plasma levels, it did not worsen heart function compared to saline.
  • * The findings suggest that heart dysfunction in sepsis is not mainly caused by high levels of catecholamines, but also highlight changes in microcirculatory perfusion and heart function variability between treated and untreated groups.
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Objective Ischemia, Subjective Angina, and Psychological Distress in Angina With No Obstructive Coronary Disease.

J Am Heart Assoc

August 2024

Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology) Shenzhen Guangdong China.

Background: Angina with no obstructive coronary disease (ANOCA) and ischemia with no obstructive coronary disease, prevalent yet underrecognized conditions, mostly affect women. Previous studies rarely distinguished between them. We aimed to compare the prevalence of objective ischemia through various examinations in women with ANOCA and assess the impact of objective and subjective ischemia on their mental health.

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Background: Black patients meeting indications for implantable cardioverter-defibrillators (ICDs) have lower rates of implantation compared with White patients. There is little understanding of how mental health impacts the decision-making process among Black patients considering ICDs. Our objective was to assess the association between depressive symptoms and ICD implantation among Black patients with heart failure.

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  • Transcatheter edge-to-edge repair (TEER) is a less invasive option for treating mitral regurgitation but carries higher long-term mortality and reintervention risks compared to surgery.
  • A survey of 201 patients showed a clear preference for TEER over surgery, even if it meant accepting greater risks of reintervention and hospitalizations.
  • For patients to prefer surgery over TEER, they would require significant functional improvement, equivalent to moving from class III to class I of the New York Heart Association classification over 5 years.
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  • Sodium glucose cotransporter-2 (SGLT2) inhibitors, like dapagliflozin, are recommended for heart failure treatment, but their economic impact when added to standard care hasn't been thoroughly evaluated.
  • A cost-effectiveness analysis was conducted using data from key trials showing that adding dapagliflozin can improve patient quality of life by 0.53 QALYs, with varying cost-effectiveness ratios depending on the price of the drug.
  • The results suggest that dapagliflozin can be valuable in treating heart failure, with its cost-effectiveness sensitive to its price and impact on cardiovascular mortality, indicating it remains a beneficial option for patients under certain cost conditions.
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The sympathetic nervous system is involved in the physiological pathogenesis of many different types of chronic pain. Sympathetic blocks can interrupt the reflex control system by intercepting the noxious afferent fibers accompanying autonomic nerves, resulting in changes in peripheral or central sensory processing. A lumbar sympathetic ganglion block (LSGB), as a treatment method, refers to the injection of nerve blockers into the corresponding lumbar sympathetic nerve segments, usually requiring imaging assistance (CT, X-ray, ultrasound) to guide.

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  • There is ongoing uncertainty regarding the use of primary prevention implantable cardioverter-defibrillators (ICDs) in older patients with hypertrophic cardiomyopathy, emphasizing the need for clarity in treatment options.
  • A study analyzed data from patients who received ICDs between 2010 and 2016, noting an overall increase in ICD utilization across age groups, including those aged 65 and older.
  • Key risk factors for postdischarge mortality and hospitalization after ICD implantation in older patients included older age, severe heart failure symptoms, and low left ventricular ejection fraction, while a history of nonsustained ventricular tachycardia was particularly associated with hospitalizations for cardiac issues.*
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Recent advances in wearable technology through convenient and cuffless systems will enable continuous, noninvasive monitoring of blood pressure (BP), heart rate, and heart rhythm on both longitudinal 24-hour measurement scales and high-frequency beat-to-beat BP variability and synchronous heart rate variability and changes in underlying heart rhythm. Clinically, BP variability is classified into 4 main types on the basis of the duration of monitoring time: very-short-term (beat to beat), short-term (within 24 hours), medium-term (within days), and long-term (over months and years). BP variability is a strong risk factor for cardiovascular diseases, chronic kidney disease, cognitive decline, and mental illness.

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Background Women remain underrepresented in cardiology. We aimed to assess gender trends in research authorship, authorship in leading roles, mentorship, and research team diversity. Methods and Results We identified "cardiac and cardiovascular systems" journals from 2002 to 2020 using Journal Citation Reports 2019 (Web of Science, Clarivate Analytics).

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Background Women with atrial fibrillation (AF) demonstrate more AF-related symptoms and worse quality of life (QOL). Whether increased use of ablation in women reduces sex-related QOL differences is unknown. Sex-related outcomes for ablation versus drug therapy was a prespecified analysis in the CABANA (Catheter Ablation Versus Antiarrhythmic Drug Therapy for Atrial Fibrillation) trial.

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Risk factors for nonadherence to osteoporosis medication have been well described for cohorts of women with osteoporosis, but little is known about predictors or mediators of nonadherence in men. We conducted a secondary analysis of a national cohort of male veterans to explore factors associated with nonadherence to osteoporosis medications. We included veterans with a prescription for an oral bisphosphonate or calcitonin between 2000 and 2010.

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Unlabelled: Insulin resistance in adolescents with obesity associates with a sex-dependent metabolic 'signature' comprising branched-chain amino acids (BCAAs), glutamate and C3/C5 acylcarnitines (C3/C5), implicating altered flux through BCAA catabolic pathways. Here, we investigated the effects of lifestyle intervention on BCAA catabolism and insulin sensitivity. We hypothesized (1) weight reduction and improved insulin sensitivity associate with enhanced BCAA catabolism; (2) baseline BCAAs and their metabolic by-products predict changes in weight and insulin sensitivity during lifestyle intervention.

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Abaloparatide Real-World Patient Experience Study.

JBMR Plus

March 2021

Health Economics and Outcomes Research Radius Health, Inc. Waltham, MA USA.

Despite the availability of various osteoporosis treatments, adherence remains suboptimal. One contributing factor may be patient experience with therapy. This US, multicenter, combined retrospective chart review and patient questionnaire study included postmenopausal women at high risk for fracture and is the first study to describe real-world patient experience with abaloparatide (ABL) injection.

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Homing endonucleases (HE) are enzymes capable of cutting DNA at highly specific target sequences, the repair of the generated double-strand break resulting in the insertion of the HE-encoding gene ("homing" mechanism). HEs are present in all three domains of life and viruses; in eukaryotes, they are mostly found in the genomes of mitochondria and chloroplasts, as well as nuclear ribosomal RNAs. We here report the case of a HE that accidentally integrated into a telomeric region of the nuclear genome of the fungal maize pathogen .

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Background: Focal impulse and rotor modulation (FIRM) can cause slowing, organization, and occasionally termination of atrial fibrillation (AF), although results have been mixed. To further characterize changes in AF during rotor ablation, we quantified morphologic and temporal activation changes following FIRM.

Methods: In patients undergoing FIRM ablation for AF, we retrospectively analyzed coronary sinus bipolar EGMs before and after rotor ablation, including EGM activation frequency and regularity, dominant frequency (DF), and organizational index (OI).

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  • Catheter ablation is an effective treatment for atrial fibrillation (AF) in patients with heart failure (HF), and this study compares its efficacy between those with ischemic and nonischemic heart failure.
  • The research involved 242 patients, showing that nonischemic patients were generally younger and had better heart function, but overall outcomes in symptom relief and functional status were similar across both groups after the procedure.
  • Both groups experienced significant improvements in their symptoms and functional abilities post-ablation, and there was no notable difference in the recurrence of atrial arrhythmias at 12 months between ischemic (74%) and nonischemic patients (78%).
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Ventricular arrhythmias are an important cause of morbidity and mortality and come in a variety of forms, from single premature ventricular complexes to sustained ventricular tachycardia and fibrillation. Rapid developments have taken place over the past decade in our understanding of these arrhythmias and in our ability to diagnose and treat them. The field of catheter ablation has progressed with the development of new methods and tools, and with the publication of large clinical trials.

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Sound pressure waves surround individuals in everyday life and are perceived by animals and humans primarily through sound or vibration. When sound pressure waves traverse through a solid medium, vibration will result. Vibration has long been considered an unwanted variable in animal research and may confound scientific endeavors using animals.

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Background: The optimal way of pacing in patients with an indication for pacing and concomitant first-degree atrioventricular (AV)-block is not known, and consequently, firm guidelines on this topic are lacking. This study explored the current pacemaker programming pattern in patients with first-degree AV-block who have a dual chamber pacemaker without cardiac resynchronization.

Methods: The study was a retrospective chart review conducted at Duke University Hospital.

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Objective: Identify the number of allowable missing values still permitting valid surrogate score calculation for the Unified Dyskinesia Rating Scale (UDysRS).

Background: Missing data frequently occur in Parkinson's disease rating scales, and they compromise data validity, risking data exclusion from final analyses.

Methods: Accessing the International Parkinson and Movement Disorder Society-sponsored UDysRS translation databases (3313 complete scores).

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