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The presence of diastolic and systolic dysfunction in patients with impaired relaxation filling pattern

Pratap, Balaji; Kallur, Kamala Ramya; Argulian, Edgar
BACKGROUND:Impaired relaxation filling pattern in the presence of preserved left ventricular ejection fraction is a common finding which is ascribed to early diastolic dysfunction. We thought to determine the distribution of various markers of systolic and diastolic dysfunction in these patients. METHODS:A total of 106 patients were included in this retrospective observational study. Diastolic dysfunction was defined using the American Society of Echocardiography recommendations ("50% rule"). The systolic dysfunction was evaluated by global longitudinal strain and circumferential strain. For further analysis, the patients were divided into the lower strain (lower tertile) and higher strain (upper tertiles) groups based on longitudinal strain. RESULTS:There were marked differences between the groups in essential echocardiographic parameters. Patients in the lower strain group were more likely to have definite diastolic dysfunction (23% vs 7%, P<.01) and less likely to have normal diastolic function (54% vs 80%, P<.01). They also showed lower circumferential strain (-21.2% vs -25.7%, P<.01). In multivariate analysis, left atrial enlargement (odds ratio (OR) 4.6, 95% confidence interval (CI) 1.2-17.1), left ventricular mass index (OR 1.03, 95% CI 1.0-1.1), left ventricular end-diastolic volume (OR 1.1, 95% CI 1.0-1.1), and E-wave deceleration time (OR 0.99, 95% CI 0.98-1.0) were independently associated with lower global longitudinal strain. CONCLUSIONS:Patients with impaired relaxation filling pattern in the presence of preserved left ventricular ejection fraction have a wide spectrum of left ventricular systolic and diastolic performance abnormalities. Isolated assessment of diastolic dysfunction may not fully characterize this group of patients.
PMID: 28370233
ISSN: 1540-8175
CID: 5344412

Health-related quality of life after transcatheter or surgical aortic valve replacement in high-risk patients with severe aortic stenosis: an updated review of literature

Chatterjee, Saurav; Kumbhani, Dharam Jaydeep; Sardar, Partha; Chakraborty, Anasua; Biondi-Zoccai, Giuseppe; Sabharwal, Manpreet Singh; Ro, Richard; Pratap, Balaji; Bavishi, Chirag P; Bangalore, Sripal
Recent trials have highlighted the comparable mortality benefits and durability of the results for patients with severe aortic stenosis (AS) and high surgical risk managed with either transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (AVR). Various national guidelines and international regulatory bodies have approved TAVR, thereby leading to potential wide usage and dissemination of this technique worldwide. Quality-of-life outcomes, in spite of being an important measure of success and acceptability of the procedure, have not been publicized as extensively. For high risk patients with severe AS, implementation of TAVR has resulted in comparable survival, but different and novel adverse events compared with AVR. We present an updated review focusing on the quality-of-life outcomes and issues with this new and important procedural approach.
PMID: 24585114
ISSN: 1523-3782
CID: 967402

FEMALE GENDER, LASER SHEATH USE AND OPERATOR SKILL DRIVE THE SUCCESS AND COMPLICATION RATES OF CARDIAC DEVICE LEAD EXTRACTION: AN ACAP REGISTRY ANALYSIS [Meeting Abstract]

Pierce, Matthew; Pratap, Balaji; Pamidimukala, Chaithanya; Bastawrose, Joseph; Lingannan, Archana; Panneerselvam, Narmadha; Gurram, Adilaxmi; Patel, Dipen; Kalamkar, Prachi; Usmani, Rishad; Umali, Tad; Herzog, Eyal; Aziz, Emad
ISI:000359579101039
ISSN: 0735-1097
CID: 5344502

EFFECT OF RACE ON LONGTERM OUTCOMES IN PATIENTS ADMITTED WITH ACUTE CORONARY SYNDROME: AN ACAP-PAIN REGISTRY ANALYSIS [Meeting Abstract]

Aziz, Emad F.; Pamidimukala, Chaithanya; Pratap, Balaji; Pai, Urvi; Bastawrose, Joseph; Mohamed, Shuaib; Patel, Neel; Smolarski, Alyosha; Usmani, Rishad; Bharathi, Ramya; John, Eun S.; Benjo, Alexandre; Herzog, Eyal
ISI:000316555200205
ISSN: 0735-1097
CID: 5344482

THE CALM BEFORE THE STORM: FIVE-YEAR FOLLOW-UP OF ACS PATIENTS DEMONSTRATE A LATE STEEP INCREASE IN CARDIOVASCULAR EVENTS - AN ACAP-ACS DATABASE ANALYSIS [Meeting Abstract]

Aziz, Emad F.; Pamidimukala, Chaithanya; Pratap, Balaji; Bastawrose, Joseph; Pai, Urvi; Mohamed, Shuaib; Bharathi, Ramya; Abbas, Taskheer; Aziz, Joshua; Alburo, Ammy; Javed, Fahad; Benjo, Alexandre; Herzog, Eyal
ISI:000316555200210
ISSN: 0735-1097
CID: 5344492

Implementing a pathway for the management of acute coronary syndrome leads to improved compliance with guidelines and a decrease in angina symptoms

Aziz, Emad F; Javed, Fahad; Pulimi, Sandeep; Pratap, Balaji; De Benedetti Zunino, Maria E; Tormey, Deborah; Hong, Mun K; Herzog, Eyal
We describe our experience with the Advanced Cardiac Admission Program (ACAP) at our institution. The ACAP program is a hospital-wide implementation of critical pathways-based management of all cardiac patients. Data review of patients admitted for acute coronary syndromes from the ACAP-PAIN database and a comparative study of outcomes before and after implementation of the pathways-based assessment and treatment protocols. In the pre-ACAP and post-ACAP patient groups, antiplatelet use at admission improved from 50% to 75% (p<.01), ACE-I use improved from 32% to 54% (p<.0001), statins use increased from 35% to 62% (p<.0001), and smoking cessation awareness increased from 15% to 86% (p<.0001). At 1-year follow-up, 84% of patients with CAD were treated with statins, and 47% had LDL cholesterol <100 mg/dL, compared with 20% and 9%, respectively, with conventional treatment before ACAP implementation (p<.0001). Recurrent angina symptoms and nonfatal myocardial infarction rates decreased from 28.5% to 13% (p = .02), and 15% to 5% (p = 0.03), respectively. Pathway-based programs like ACAP significantly enhance administration of guidelines-based cardioprotective medications both during hospital stay and at 1-year follow-up.
PMID: 22059781
ISSN: 1945-1474
CID: 5344382

Toxic effects of marijuana on the cardiovascular system [Case Report]

Pratap, Balaji; Korniyenko, Aleksandr
We present a case of marijuana-induced ST segment elevation mimicking Brugada syndrome in a young man. Cannabis can have a multitude of effects on the different organ systems of the body; we take a closer look at its effects on the cardiovascular system, including acute coronary syndrome, arrhythmias and congestive heart failure.
PMID: 22194141
ISSN: 1559-0259
CID: 5344402

A novel SELF-pathway for management of patients presenting with unexplained-syncope appropriately identify high risk patients as validated by the OESIL score [Meeting Abstract]

Aziz, EF; Parnidimukala, CK; Park, T; Bastawrose, J; Pokal, M; Siripuram, C; Wei, H; Reddy, R; Alwood, D; Rittenhouse, C; Pratap, Balaji; Herzog, E
ORIGINAL:0016159
ISSN: 1941-7705
CID: 5347752

Short and long term outcomes of patients admitted with unexplained syncope using a simple novel SELF-pathway [Meeting Abstract]

Aziz, EF; Pamidimukala, CK; Bastawrose, J; Park, T; Pratap, Balaji; Pokal, M; Siripurum, C; Tangwongchai, K; Alwood, D; Rittenhouse, C; Herzog, E
ORIGINAL:0016160
ISSN: 1941-7705
CID: 5347762

Major Gap Exists Between Races in Applying Published Guidelines for Primary Prevention of Sudden Cardiac Death; An ESCAPE Database Analysis [Meeting Abstract]

Aziz, Emad F.; Pamidimukala, Chaithanya K.; Bastawrose, Joseph; Pratap, Balaji; Pai, Urvi; Kahn, Jonathan; Muafa, Haitem; Cho, Eun Sik; Lizardo, Ian; Jadeja, Neville; Awad, Anthony; Benjo, Alexandre M.; Javed, Fahad; Herzog, Eyal
ISI:000208885008397
ISSN: 0009-7322
CID: 5344422