Recent ucd_ome_posters_cardio items

Lower Mortality In Tricuspid Valve EndocarditisPatients Who Inject Drugs

Wed, 25 Jun 2025 00:00:00 +0000

Lower Mortality In Tricuspid Valve EndocarditisPatients Who Inject Drugs

Comparing Intra-Operative Left Ventricular Contractility Measurements: Echocardiogram vs. Novel Software

Thu, 5 Dec 2024 00:00:00 +0000

The contractility of the left ventricle (LV) is an important characterization of cardiac function and is oftenmeasured through dP/dtmax, defined as the maximum rate of left ventricular pressure change during isovolumetriccontraction. It can also be summarized globally by measurement of the left ventricular ejection fraction. Directmeasurement of left ventricular pressure is difficult as it involves invasive catheter placement, but other methodsof measuring dP/dtmax have been developed, such as echocardiographic analysis of the mitral regurgitation jet.While more convenient and less invasive, this method still has many limitations given inherent variability. Morerecently, several studies have used arterial pressure waveform analysis as a new method of determining dP/dtmax.Though more invasive, this modality is highly applicable in an operating room setting because many patientsalready have arterial catheters placed. Current evidence in literature is conflicted in regards to the...

Precision Medicine: Improving Identification and Treatment of Heart Failure Patients

Mon, 18 Nov 2024 00:00:00 +0000

Despite advances in clinical and diagnostic medicine, heart failure (HF) is commonly misdiagnosed. This can lead to sub-optimal care and a decline in quality of life and in patient outcomes. Studies show that even patients diagnosed with HF don’t always receive optimal care. Guideline directed medical therapy (GDMT) is a wellestablished pharmaceutical framework to treat HFrEF that has shown clear mortality benefits. GDMT consists of initiating therapy with the following therapeutics before titrating to optimal dose:- β-Blockers (BB) - ACEi, ARB or ARNI - Mineralocorticoid receptor antagonist (MRA). However, studies show that significant gaps in both usage and dosages of GDMT still exist. As such, we propose creating a cohort of UCD HF patients using discrete variables (i.e. BNP, LVEF) to improve HF detection and treatment.

Reliability of 2D-Speckle-Tracking for Myocardial Strain Measurements

Mon, 18 Nov 2024 00:00:00 +0000

Myocardial strain imaging using 2D-speckle-tracking echocardiography (STE) is a relatively new method for analyzing myocardial function. Myocardial strain measures the shortening of myocytes in three directions: longitudinally, circumferentially, and radially. While ejection fraction (EF) is a common measure of heart health, strain measurements are more sensitive to changes in ventricular function and thus can be used to detect subclinical cardiac abnormalities that may not be seen by EF measurements. Strain values for various chambers have implications for identifying and treating many different cardiomyopathies. Speckle-tracking echocardiography and tissue Doppler imaging (TDI) are the two primary methods for measuring strain using echocardiography. STE is more clinically relevant than TDI due to its ability to distinguish passive tethering from active contractility and its independence of ultrasound beam angle. Reliability of strain measurements from STE is not universally...

Non-Adherence to the American College of Cardiology/American Heart Association(ACC/AHA) Guidelines for Exercise Treadmill Testing

Mon, 4 Nov 2024 00:00:00 +0000

• ACC/AHA guidelines (GLs) recommend Ex treadmill test (ETT) without imaging as the initial test to evaluate patients with chest pain who have normal baseline ECG andadequate exercise capability.

• Stress imaging (ESE or ex-MPI) preferred by clinicians because of superior sensitivity and specificity to standard treadmill.

• Studies show ETT performs adequately vs. stress imaging for Dx and progmosis.

• ETT preferred because: relatively low cost, less labor and technician demand.

Effect of Sleep Apnea on Atrial Fibrillation and Atrial Flutter Recurrence Rates followingPosterior Wall Isolation vs Conventional Ablation

Tue, 29 Oct 2024 00:00:00 +0000

Obstructive Sleep Apnea (OSA) is a risk factor for both atrial fibrillation (AF) and atrial flutter (AFL). Non-pulmonary triggershave been described in patients with OSA.

Patients suffering with Paroxysmal Atrial Fibrillation refractory to antiarrythmic medications are commonly treated with catheter radiofrequency-ablation. The most common location for ablation for AF would be the pulmonary veins as it approaches the left atrium. This has been the conventional ablation site. Another catheter based technique known has Posterior Wall Isolation (PWI), is also routinely used. Here, the posterior wall of the left atrium is ablated. PWI has shown mild efficacy in reducing recurrence rates of AF in patients without OSA. There has been work looking at the efficacy of radiofrequency ablation in patients with OSA. Following a review of the literature, we found that radiofrequency ablation was less effective in reducing recurrence of AF in OSA patients compared to control. There...

Evaluation of the agreement of minimally-invasive cardiac output monitors before and after cardiopulmonary bypass

Tue, 29 Oct 2024 00:00:00 +0000

Cardiac output (CO) monitoring is an important tool for hemodynamic optimization.[1] Bolus thermodilution (BTD) with a pulmonary artery catheter (PAC) remains the gold standard for CO measurement, but is invasive and has been associated with complications. [2] This study evaluates the level of agreement of CO values measured from multiple minimally-invasive CO monitor systems before and after cardiopulmonary bypass (CPB).

Procainamide vs Ibutilide in the Cardioversion of Recent-Onset Atrial Fibrillation and Flutter in the Emergency Department: A Retrospective Cohort Study

Mon, 28 Oct 2024 00:00:00 +0000

Intravenous (IV) procainamide and ibutilide are two commonly used medications for the cardioversion of emergency department (ED) patients with recent onset (<48 hours) atrial fibrillation (AF) and atrial flutter (AFL;either = AF/AFL) across North America. It is unclear which medication is preferable. No trials have compared these agents for this indication and North American societyguidelines offer contradictory recommendations: procainamide is the drug of choice in the Canadian guideline, where ibutilide is not recommended; the converse is true in U.S. guidelines. Issues of effectiveness, safety, and ease of use may contribute to drug selection. Ibutilide carries a black-box warning for the risk for torsadede pointes (polymorphic ventricular tachycardia [VT]) and requires at least 4h of monitoring, making it riskier and more cumbersome to administer than procainamide.

Associations among Shared Care, Adherence to Guideline-Directed Medical Therapy, and Hospital Readmissions

Wed, 16 Oct 2024 00:00:00 +0000

Heart failure (HF) is of special interest to healthcare professionals and policymakers alike, due to both cost and efficiency burdens – and there is lack of ownership and accountability with these issues. Projected to cost the US healthcare system $57 billion annually by 2030[1]. 20% of HF patients are also readmitted within 30 days of discharge. These persistent issues demand novel evaluations to improve heart failure management – specifically, evaluation of physician behavior at the population level.

Patients with Acute Myocardial Infarction Type 2 were Less Likely to get Referred to Cardiac Rehabilitation than Patients with Acute Myocardial Infarction Type 1

Wed, 16 Oct 2024 00:00:00 +0000

Cardiovascular disease remains the leading cause of death in the United States. Amongst a myriad of treatments, cardiac rehabilitation (CR) is one of the non-invasive interventions implemented to reduce re-hospitalizations and mortality related to cardiovascular disease. CR is largely underutilized, however, with only 20-30% participation1 Current ACC guidelines recommend patients who have experienced an Acute myocardial infarction ( AMI) to participate in CR within the year of the cardiovascular event. However, further specification for AMI type 2 participation compared to type 1 is not as clear.

Medical Practice Variations Among Out-of-Hospital Cardiac Arrest (OHCA) Patients: Race/Ethnicity and Insurance Factors

Fri, 11 Oct 2024 00:00:00 +0000

Healthcare disparities have been identified among out-of–hospital cardiac arrest (OHCA) patients, the most common cause of cardiac death.1 Decreased odds of cardiac catheterization has been found to be associated with non-White race and non-private insurance at the patient level among California 24/7 Percutaneous Coronary Intervention (PCI) centers.2 Our current work expands on this research by identifying specific clinical practices, such as cardiac catheterization regardless of rhythm, use of advanced therapeutics and targeted temperature management, associated with race and insurance status of patients within California. With this research we wish to aid the process of eliminating healthcare disparities among California OHCA patients by identifying these correlations.

Volumetric intracardiac echocardiography (vICE) is feasible for procedural guidance of transcatheter mitral edge-to-edge repair (mTEER)

Fri, 11 Oct 2024 00:00:00 +0000

Transcatheter mitral edge-to edge repair(mTEER) is a minimally invasive, catheter-based therapy used to treat mitralregurgitation. The gold standard for intraprocedural guidance of mTEER is transesophageal echocardiography (TEE).4-dimensional volumetric intracardiacechocardiography (vICE) is an alternativeimaging modality that provides volumetricimages with multiplanar reconstruction forguidance during structural heart procedures.

Do the Social Determinants of Health affect Myocardial Infarction Prognosis?

Thu, 29 Aug 2024 00:00:00 +0000

Myocardial infarctions (MIs) largely contribute to the US Cardiovascular disease burden with over 800,00 MIs per year. Previous work has shown that the prognosis for sub-groups patients post MI is variable. Investigations of extrinsic factors such as the social determinants of health (SoDH), that possibly impact prognosis, are limited. The aim of this study is to determine what social factors may relate and/or contribute to MI prognosis after medical therapies.

A Zip Code Tabulation Area-Level Analysis of Food Insecurity and Social Determinants of Coronary Heart Disease in California

Thu, 29 Aug 2024 00:00:00 +0000

Coronary heart disease (CHD) is the most common type of cardiovascular disease (CVD), affecting 7.2% of adults ≥ 20 years of age in the United States (U.S.). CHD prevalence is disproportionately high amongCalifornia’s (CA) racial and ethnic minority populations. Social determinants of health (SDOH) play a significant role in CHD and CVD risk factors, which have a higher prevalence among Hispanics and Blacks. Among the key SDOH that drive disparities in CHD is access to nutritious food. There are barriers to the availability of foods that support healthy eating patterns, such as living in a “food desert,” or low-income areas where nutritious food sources are limited. Other SDOH associated with CHD outcomes include socioeconomic (SES) factors, such as education andhealth insurance status.

Deriving a Rule for Termination of Resuscitation in Pediatric Out-of-Hospital Cardiac Arrest

Thu, 29 Aug 2024 00:00:00 +0000

Pediatric out-of-hospital cardiac arrest (OHCA) is an uncommon and stressful situation for providers. Despite advanced life support interventions and optimal resuscitationtechniques, pediatric OHCA carries a low survival rate of 11.3%. Accepted criteria exist for adult patients, but not children. There is a need to develop criteria to guide termination ofresuscitation in cases when continued care would be futile.

Temporal Trends and Patterns in Heart Failure with Improved Left Ventricular Ejection Fraction: A Retrospective Cohort Study

Thu, 29 Aug 2024 00:00:00 +0000

Heart failure (HF) with reduced ejection fraction (HFrEF) remains a leading cause of morbidity and mortality. Heart failure withimproved ejection fraction (HFimpEF) has better prognosis and outcomes. However, improvement only occurs in a subpopulationof HFrEF.

Onset of Atrial Fibrillation Recurrences in Patients Post Ablation

Wed, 28 Aug 2024 00:00:00 +0000

There are still gaps in our knowledge regardingthe pathogenesis, prevention as well asapproaches to improve success in themanagement of atrial fibrillation (AF). Catheter ablation remains one of the preferredtreatment options for paroxysmal, persistent, and long- standing AF.

The goal of this prospective cohort study was to determine which type of AF is more likely to have recurrences post catheter ablation and when the recurrence is most likely to occur.

Low Voltage Areas in Left Atrium are Related to Delayed Invasive Care for Atrial Fibrillation

Wed, 28 Aug 2024 00:00:00 +0000

Areas of low voltage electrograms (<0.5 mV) (LVA) are known to correlate with areas of atrial fibrosis and are related to clinical outcomes after ablation. We hypothesized that delay in seeking invasive treatment is linked to larger LVA.

Assessing Racial Bias in Pulse Oximetry Using Graded Skin Tone Scale

Wed, 28 Aug 2024 00:00:00 +0000

Race and ethnicity correlate poorly with skin color. Despite a statistical significance difference in SaO2 – SpO2 across all MMSTS, it is unclear if there is a clinical significance to these findings as there is no trend between SaO2 – SpO2 and MMSTS.

Intensive blood pressure lowering in individuals with low diastolic blood pressure and elevated troponin levels in SPRINT

Wed, 28 Aug 2024 00:00:00 +0000

Hypertension (HTN) affects ~1.4 billion people worldwide and is a leading cause of cardiovascular disease (CVD) and earlydeath. Recent guidelines recommend lower blood pressure (BP) targets, but the optimal BP target for individuals with low diastolic BP (DBP) remains controversial because of the Jcurve phenomenon: Low DBP is associated with increased CVD risk and death, thought to be due to reduced coronary perfusion indiastole. High sensitivity cardiac troponin T (hs-cTnT), a biomarker of subclinical myocardial injury, may be able to identify individualswith low DBP at-risk of harm from additional BP lowering. However, there are no data from randomized trials on whether lower BP targets have similar CVD and mortality benefits inindividuals with low DBP and elevated hs-cTnT.

An Observational Study Comparing Intrathoracic Pressure Changes and Stroke Volume Variation with Abdominal Insufflation: SVV vs Pes

Tue, 27 Aug 2024 00:00:00 +0000

Compare and correlate predictive agreementbetween Pes and Edwards ClearSite hemodynamic measurement changesfollowing abdominal insufflation.