Cardiovascular Science Research Articles

May Literature Synopsis

May Literature Synopsis

Microvascular anatomy and physiology laboratory class using the Australian cane toad

The microvasculature is a key part of the cardiovascular system and teaching microvascular structure and function is a key part of any cardiovascular science course. The Australian cane toad Bufo marinus / Rhinella marina is an economical and widely available species within Australia which can be used to demonstrate basic principles of blood flow and microvascular anatomy and physiology in an in vivo setting.In the laboratory class, cane toads of either gender (approx. 120 g) are anesthetized by immersion in 0.3 % ethyl 3‐aminobenzoate methanesulfonate (MS‐222) for 15 min and for the duration of the class (about 2 hr) swabs soaked in MS‐222 are placed on the skin. Level of anaesthesia is regularly assessed by the corneal reflex. At the end of the class toads are euthanized by cardiac removal (UNSW ACEC approval #19/67B). The surgical procedure involves a small incision in the upper abdomen, through which a lung, the bladder and the mesentery may be exteriorized and the microvasculature examined under a microscope equipped with a camera for video streaming to high definition monitors.The class is designed to demonstrate principles delivered in lectures and allow students to integrate knowledge of these principles into microvascular homeostasis and adaptation to interventions. Microvascular features which can be clearly demonstrated include microvascular anatomy and structural adaptations in different tissues, including the lung (pulmonary microcirculation), urinary bladder and mesentery. Observable physiological phenomena include blood flow velocity and its’ effect blood cell behaviour, axial streaming, plasma skimming, leukocyte rolling and adhesion, vasoconstriction and the response of the mesenteric microvasculature to haemorrhage.Student learning is assessed through pre‐ and post‐class exercises completed on‐line. The pre‐class exercise includes demonstrative videos and a brief quiz. This is intended to ensure students have read and understood the laboratory class notes, along with some basic vascular science, prior to the class, avoiding time‐wasting. The post‐class exercise includes video material recorded during the class accompanied by a quiz aimed at testing the students’ understanding of the observations made; for example, the physiological advantage of unique microvascular anatomy in certain tissues, or the mechanism underlying capillary swelling and hemodilution during haemorrhage. The videos can be edited into a package and used to deliver the class in an on‐line format if required. Thus, the cane toad preparation allows key aspects of microvascular anatomy, physiology, pharmacology and rheology to be demonstrated and taught in a clear and compelling fashion.

Meeting abstracts from the 15th international conference on neonatal and childhood pulmonary vascular disease

Meeting abstracts from the 15th international conference on neonatal and childhood pulmonary vascular disease

Study of immunogenicity, safety and efficacy of covishield vaccine among health care workers in a tertiary cardiac care centre

PurposeThe pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might be curtailed by vaccination. We assessed the safety, and immunogenicity of Covishield vaccine among Health care workers (HCWs) in a tertiary cardiac care centre. MethodsIt's a prospective analytical study, conducted at Sri Jayadeva Institute of cardiovascular science and research centre, Mysore, between January 2021 to May 2021. Pre and Post vaccination SARS CoV2 IgG antibodies were assessed among 122 HCWs. Interval between two doses in this study were 4 and 6 weeks. Adverse events following immunisation b(AEFI) and efficacy were assessed and followed up for two month post vaccination. ResultsPost vaccination seropositivity was 69.67% in overall study participants. Seropositivity and P/N ratio median value in uninfected and infected group were 60.43% (n ​= ​55),3.47 (IQR: 2.56–5.22) and 96.77% (n ​= ​30),9.49 (IQR: 7.57–12.30) respectively (P ​< ​0.001). Seropositivity and P/N ratio after 4 and 6 weeks were 48.3% (n ​= ​60), 2.95 (IQR: 1.91–4.24), and 83.8% (n ​= ​31), 4.88, (IQR: 3.39–6.43) respectively (P ​< ​0.001). AEFI after first and second dose was 72.9% and 27.8% (p ​< ​0.05) respectively. The most common symptoms after both doses of vaccination were local pain (73% & 88.2%), followed by fever (38.2% & 26.5%). The average duration of symptoms in both doses was 1.75 days. Of 122 participants only 10 (8.19%) had breakthrough infection after two doses of vaccination with mild severity. ConclusionCovishield vaccine has showed seropositivity of 69.67%.It has acceptable level of safety profile. Seropositivity and P/N ratio has increased with increase in interval between two doses. Though it has not prevented breakthrough infection it has certainly reduced the severity of infection.

Developing a Sustainable Cardiovascular Disease Research Strategy in Tanzania Through Training: Leveraging From the East African Centre of Excellence in Cardiovascular Sciences Project.

IntroductionCardiovascular disease (CVD) contribute the largest mortality burden globally, with most of the deaths (80% of all deaths) occurring in low and middle-income countries (LMICs), including Tanzania. Despite the increasing burden, to date, CVD research output is still limited in Tanzania, as it is for many sub-Saharan Africa (SSA) countries. This trend hinders the establishment of locally informed CVD management and policy changes. Here, we aim to review the existing gaps while highlighting the available opportunities for a sustainable CVD research strategy in Tanzania.MethodsA rapid review of available literature on CVD research in SSA was conducted, with emphasis on the contribution of Tanzania in the world literature of CVD. Through available literature, we identify strategic CVD research priorities in Tanzania and highlight challenges and opportunities for sustainable CVD research output.FindingsShortage of skilled researchers, inadequate research infrastructure, limited funding, and lack of organized research strategies at different levels (regional, country, and institutional) are among the existing key bottlenecks contributing to the low output of CVD research in Tanzania. There is generally strong global, regional and local political will to address the CVD epidemic. The establishment of the East African Centre of Excellence in Cardiovascular Sciences (EACoECVS) offers a unique opportunity for setting strategies and coordinating CVD research and training for Tanzania and the East African region.ConclusionThere is a light of hope for long-term sustainable CVD research output from Tanzania, taking advantage of the ongoing activities and plans for the evolving EACoECVS. The Tanzanian experience can be taken as a lesson for other SSA countries.

Is Asymptomatic Severe Aortic Stenosis Still a Waiting Game?

Is Asymptomatic Severe Aortic Stenosis Still a Waiting Game?

A Rare Disease Leading to Hypertension

HomeHypertensionVol. 79, No. 6A Rare Disease Leading to Hypertension No AccessCase ReportRequest AccessFull TextAboutView Full TextView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toNo AccessCase ReportRequest AccessFull TextA Rare Disease Leading to Hypertension Jing Chen, Xin Chen, Anna F. Dominiczak, Robert M. Carey, Cheryl L. Laffer, Fernando Elijovich, Sandra J. Taler, Tanja Dudenbostel, Rhian M. Touyz and Ji-Guang Wang Jing ChenJing Chen Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (J.C., X.C.). Search for more papers by this author , Xin ChenXin Chen https://orcid.org/0000-0002-7970-6991 Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (J.C., X.C.). Search for more papers by this author , Anna F. DominiczakAnna F. Dominiczak https://orcid.org/0000-0003-4913-3608 BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, United Kingdom (A.F.D.). Search for more papers by this author , Robert M. CareyRobert M. Carey https://orcid.org/0000-0001-7238-7396 Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health System, Charlottesville (R.M.C.). Search for more papers by this author , Cheryl L. LafferCheryl L. Laffer https://orcid.org/0000-0002-6453-6010 Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN (C.L.L., F.E.). Search for more papers by this author , Fernando ElijovichFernando Elijovich https://orcid.org/0000-0002-2511-056X Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN (C.L.L., F.E.). Search for more papers by this author , Sandra J. TalerSandra J. Taler Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN (S.J.T.). Search for more papers by this author , Tanja DudenbostelTanja Dudenbostel https://orcid.org/0000-0003-3260-8363 Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, Department of Medicine, University of Alabama, Birmingham (T.D.). Search for more papers by this author , Rhian M. TouyzRhian M. Touyz https://orcid.org/0000-0003-0670-0887 Research Institute of the McGill University Health Centre, McGill University, Montreal, Canada (R.M.T.). Search for more papers by this author and Ji-Guang WangJi-Guang Wang Correspondence to: Ji-Guang Wang, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin 2nd Rd, Shanghai 200025, China. Email E-mail Address: [email protected] https://orcid.org/0000-0001-8511-1524 Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (J.-G.W.). Search for more papers by this author Originally published18 Mar 2022https://doi.org/10.1161/HYPERTENSIONAHA.122.18678Hypertension. 2022;79:1147–1152FootnotesThe opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.Presented in part at the Clinical-Pathological Conference chaired by Anna F. Dominiczak and Rhian Touyz at the virtual Hypertension Scientific Sessions 2021, September 28, 2021. Jing Chen, Xin Chen, and Ji-Guang Wang presented the case and led the discussion.For Sources of Funding and Disclosures, see page 1151.Correspondence to: Ji-Guang Wang, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Ruijin 2nd Rd, Shanghai 200025, China. Email [email protected]com.cn

The Pathway to a High Impact Journal and Scopus Indexation–New Achievement of the International Journal of Cardiovascular Sciences

“If everyone is moving forward together, then success takes care of itself.” Henry Ford […] The Pathway to a High Impact Journal and Scopus Indexation – New Achievement of the International Journal of Cardiovascular Sciences

Association of Anxiety and Depression in Patients Undergoing Cardiac Catheterization With Number of Major Coronary Artery Stenosis: A Cross-Sectional Study.

IntroductionThe relationship between the level of anxiety and depression among coronary artery disease (CAD) patients and coronary angiographic findings is ambiguously mentioned in studies. Past evidence shows that the relationship between anxiety and depression with coronary artery disease can be bidirectional. There is a paucity of literature on the association of levels of anxiety and depression with the number of coronary arteries involved in coronary artery disease.MethodsThis study was conducted in a tertiary care hospital to find the level of anxiety and depression in patients undergoing cardiac catheterization and their association with the numbers of the major coronary artery involved. Patients undergoing cardiac catheterization in the Department of Cardiovascular Science of a tertiary care hospital in India from May 2020 to December 2020 were considered for inclusion in the study. Coronary artery disease was diagnosed based on the combination of clinical, ECG, echocardiography, or biomarker parameters in various combinations. These patients were further subjected to coronary angiogram to know the extent of stenosis and the number of coronary vessels involved in the disease. The level of anxiety and depression was measured by using the Hospital Anxiety and Depression Scale (HADS) during the period of admission and at least 24 hours after diagnosis and at least 12 hours before cardiac catheterization. The data was entered into SPSS software version 22.0 (Armonk, NY: IBM Corp.) for statistical analysis. Chi-square test, Kolmogorov-Smirnov test, and Kruskal-Wallis test were used for the interpretation of data and find an association between severity of anxiety and depression with the number of major coronary vessels involved.ResultsAnxiety was seen in 83.3% of the patients with 31.5% having severe anxiety. Depression was found in 77.8% with 38.9% suffering from severe depression. The anxiety and depression scores of HADS were significantly higher in those with triple-vessel disease compared to the double-vessel or single-vessel disease.ConclusionScreening and management of anxiety and depression is an essential part of the care of patients with coronary artery disease. People with triple-vessel disease need the most attention and appropriate management of anxiety and depression.

From the Heart to the Brain: Building Bridges to a Better Future.

This Presidential Address was delivered at the International Stroke Conference in March 2021, during the coronavirus pandemic. Dr Elkind, the President of the American Heart Association (AHA) at the time, is a vascular neurologist with a research focus on stroke epidemiology. This address interweaves personal reflections on a career in clinical neurology, stroke research, and public health with a discussion of the role of the AHA in improving cardiovascular health at multiple levels. Throughout its history, the AHA has had leaders representing many different areas of cardiovascular science and medicine, including stroke. More recently, its focus has expanded from a traditional emphasis on cardiovascular events illness and events, like heart disease and stroke, to an appreciation of the role of the vascular system in brain health, healthy aging, cognitive decline, and dementia. During the pandemic, as the bidirectional effects of the coronavirus on cardiovascular disease has been elucidated, the benefits of a broad and multidisciplinary approach to cardiovascular disease and public health have become more apparent than ever. In addition, with growing awareness of the disproportionate effects of the pandemic on communities of color in the United States and globally, the AHA has redoubled its focus on addressing the social determinants of health, including structural racism. Central to these efforts is the construction of bridges between the generation of scientific knowledge and action for the public good. Our success will depend on the combination of basic, translational, clinical and population research with programs of public and professional education, advocacy, and social action.

Anthropometrics and Myocardial Infarction Risk: A Misleading Evidence Was Accepted by Cardiovascular Sciences When Errors of Bias Were Overlooked Worldwide. When Should We End Discussion about the Optimal Metric?

Despite the impact of the COVID‑19 pandemic, myocardial infarction remains the leading cause of cardiovascular deaths in Europe. Body mass index (BMI)-defined obesity is a major risk factor for myocardial infarction. However, in the association of anthropometrics and myocardial infarction, the lack of balance between the simple body measurements when comparing healthy and unhealthy cases has demonstrated that affects the outcome. Thus, regardless of association strength of anthropometrics, other criteria to judge the biological causality must be investigated. We aim to assess different studies worldwide to understand the key concepts to demonstrate association biases for anthropometrics when predicting myocardial infarction risk. In this approach, natural mathematical inequalities between simple measurements in healthy subjects were investigated. Weight, height, height/2, waist circumference and hip circumference mathematically represent absolute values that do not express mathematically equality for the true risk. That way, the mathematical concept of fraction or ratio in anthropometrics such as BMI, waist-to-hip ratio (WHR) or waist-to-height ratio (WHtR) plays an important role. Thus, some anthropometrics may be seen as confounding variables when measuring high-risk body composition. Weight is a confounding factor without indicating a high-risk body composition, meaning that BMI is not fully predictive. WHR is a confounding variable concerning waist and WHtR due to imbalances between the mean hip–waist and hip–height, respectively, which indicates a protective overestimation for hip concerning waist and height. Waist measure may be a confounding variable concerning WHtR due to an imbalance in the mean waist–height. This occurs if, and only if, WHtR risk cut-off is &gt;0.5 and if height is ignored as volume factor, therefore creating an overestimation of risk for waist circumference in the tallest people and underestimation in the shortest. Mathematically/anthropometrically, only WHtR-associated risk above BMI, waist and WHR holds true while considering it as a relative risk volume linked to a causal pathway of higher cardiometabolic risk. In conclusion, WHtR is the only metric that is directly associated to a risk volume and having more biological plausibility. It should be used to assess the anthropometrically-measured myocardial infarction risk, once the imbalances between measurements and association biases are recognised.

Association of Chest CT Severity Scores and Vaccination Status in COVID-19 Disease: A Cross-sectional Study

Introduction: Coronavirus Disease 2019 (COVID-19) has emerged as a pandemic with substantial morbidity and mortality. While global efforts towards mitigating the infection are focused on the vaccination of population, studies are warranted to prove the efficacy of vaccine in prevention of infection or reducing the severity of infection in affected patients. The 25-point High Resolution Computed Tomography (HRCT) severity score has proved to be an effective tool in estimating the severity of lung infection and correlates with laboratory parameters and disease outcome. The HRCT scores hence provide an objective evidence to prove the efficacy of vaccines in vaccinated individuals by assessing the extent of lung involvement. Aim: To compare the chest CT severity score in vaccinated and unvaccinated COVID-19 infected patients. Materials and Methods: This cross-sectional study was conducted in the Department of Radiology, at Sri Jayadeva Institute of Cardiovascular Sciences and Research, Mysuru, Karnataka, India. The data of HRCT scores and vaccination status was collected during the month of April 2021 from patients who were suspected to have COVID-19 infection and underwent a chest HRCT scan. The severity of lung infection in vaccinated and unvaccinated individuals was compared based on the HRCT scores and the association between these variables were analysed. The association between the respective variables were studied using Fischer’s-exact and Kruskal-Wallis tests. Results: The study involved a total of 178 subjects (males were 98), where 127 (71.3%) were unvaccinated and 51 (28.6%) were vaccinated with one or both doses {Covaxin (Bharat Biotech) vaccine or Covishield (Oxford-AstraZeneca) vaccine approved by Emergency Use Authorisation (EUA)}. The frequency of disease was least in 14 (7.9%) among fully vaccinated subjects. Severe COVID-19 associated pneumonia with severity score of 18 or more was seen in 7% of unvaccinated individuals, while none of the partial/fully vaccinated individuals had severe disease. The median CT severity score was significantly higher among unvaccinated patients compared to partially and fully vaccinated patients (p-value=0.001). Fully vaccinated patients had almost low CT severity score indicating mild form of disease. Conclusion: To the best of authors knowledge, this study is the first to describe the chest CT severity scores of vaccinated individuals in comparison with the unvaccinated COVID-19 infected patients. The disease severity was significantly higher among unvaccinated patients compared to partially and fully vaccinated patients. The present study has provided substantial evidence of vaccine efficacy in reducing the disease severity in COVID-19 infected patients.

Neutralising Antibodies in Healthcare Workers after Two Doses of Covishield Vaccine at Three Months and Six Months: A Single-centre Observational Study

Introduction: The emergence of Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) as a pandemic has put the global population at risk for its infection. It has also led to an accelerated effort to develop vaccines that can mitigate progression to severe infections at a minimum. The ambiguity about existence of antibodies in the human serum poses problem in formulating public health policies like suitable interval between doses of vaccines, appropriate time for vaccinating population, post natural infection, necessity of booster doses along with single dose. Aim: To estimate neutralising antibody level following vaccination of Healthcare Workers (HCWs) after three months and six months respectively. Materials and Methods: This was a prospective observational study performed in Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru, Karnataka, India after Institutional Ethics Committee (IEC) approval from January 2021 to February 2022. The study was conducted in 304 HCWs in the institute who had received two doses of Recombinant ChAdOx1 nCoV- 19 Corona Virus Vaccine (Covishield). 41 HCWs who were naturally infected with SARS-CoV-2 either before or after vaccination were also included. These participants were then subjected to IgG neutralising antibody titer estimation at three months and six months, postvaccination. Results: The study included 304 eligible HCWs. Majority of the participants belonged to the age group of 31-40 years (35.9%). Majority of the study participants were females (51%). Of the 304 participants, 263 were uninfected and 41 participants had been infected before and after vaccination. At the six month follow-up, it was observed that all but one HCW had seroconverted with majority of the participants showing more than 60% antibody level. Participants in the age group of 31-40 years showed the highest level and this observation was found to be statistically significant. Conclusion: Neutralising antibody response in HCWs is a key indicator of the efficacy of the vaccination program for Coronavirus Disease-2019 (COVID-19) in India.

Abstracts Presented at the 2nd Annual Advancing Healthcare Innovation Summit: Nov 11, 2022, Cincinnati, OH

Abstracts Presented at the 2nd Annual Advancing Healthcare Innovation Summit: Nov 11, 2022, Cincinnati, OH

A comparison of over-the-counter available smartwatches and devices for electrocardiogram based detection of atrial fibrillation

Abstract Background There is an increasing number of smartwatches and devices commercially available that can generate and automatically interpret an electrocardiogram (ECG). Such devices have an enormous potential to improve population screening and telemonitoring of atrial fibrillation (AF). Purpose There is limited data on the sensitivity, specificity and interpretability of these devices and comparative studies are lacking. Our purpose was to compare three frequently used devices for AF detection. Methods We performed a single-center, prospective study in consecutive patients with AF presenting for electrical cardioversion (ECV). We collected a standard 12-lead ECG recording immediately followed by four times 30 seconds of ECG recordings from different devices for every patient prior to the ECV. These paired measurements were considered simultaneous. If the ECV was performed, the same measurements were repeated afterwards. The standard 12L-ECGs were interpreted by a cardiologist and used as golden standard for heart rhythm. The different devices used for the 30 second ECGs were: Withings Move ECG (lead I), Apple Watch series 5 (lead I), Kardia Mobile 6L (six leads) and Withings/Apple (1:1 ratio) on left knee (lead II). Sensitivity and specificity were determined for each AF detection algorithm excluding patients with atrial flutter (AFL) or uninterpretable ECGs. In addition, proportions of uninterpretable ECGs were determined including all patients and including only patients with sinus rhythm (SR) and compared between devices using McNemar's test. Results A total of 220 patients were included (age 70±10 years, female 35%, first ECV 44%) and in total 415 12-lead ECGs were performed (45% SR, 45% AF, 10% AFL). The sensitivity/specificity were overall similar for all devices (Withings 98%/95%, Apple 94%/98%, Kardia 99%/91%. P&amp;gt;0.05 for all). In detail, Kardia was the most sensitive test with highest proportion of suspected AF (57%) whereas Apple was the most specific, as shown by the highest proportion of normal heart rate results by the device (55%, P=0.003 compared to Kardia (43%)). Overall, Withings, Apple and Kardia had a comparable proportion of uninterpretable ECGs (20%, 20%, 24%, respectively. P&amp;gt;0.05 for all). Lead II had higher proportion of uninterpretable ECGs (32%, p&amp;lt;0.01 compared to all). More specifically, Kardia had a higher rate of uninterpretable ECGs in those with SR (P&amp;lt;0.05 compared to Withings (lead I) and Apple (lead I)). Conclusion In all devices, we found sensitivity/specificity for AF detection between 91%-99%, better than previous studies reported, and 20–24% of uninterpretable ECGs. Kardia was the most sensitive device, but less useful to rule out atrial fibrillation whereas Apple had numerically highest specificity. We aim to further evaluate both cardiologist interpretation and accuracy of atrial flutter detection using different leads to inform clinical use. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Tergooi Cardiology department, J.P. Bokma was supported with a research grant by Amsterdam Cardiovascular Sciences Overview and comparison

791 Virtual visits in HF outpatient management during COVID-19-related lockdown

AimsFollowing the COVID‐19 pandemic‐related lockdown period in Italy, people have experienced psycho-physical distress. Many hospitals were converted in COVID-19 healthcare places and many specialist outpatient’s services were drastically reduced. Virtual visits may represent a strategy to overcome the lack of HF outpatient’s services, during this period. Our own experience underlines the importance of virtual visits to face the clinical and health status deterioration, associated with COVID-19, in HF outpatients.Methods and resultsWe conducted an observational study, enrolling consecutive HF outpatients, previously hospitalized at the Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences of Sapienza University of Rome, who were discharged within 31 March 2019, and 30 April 2019. Two follow-up periods were scheduled: (i) within 20–30 days after the beginning of lockdown (ii) at 3 months after lockdown’s end. Virtual visits were conducted through telephone, assessing changes in clinical and health status; the latter was assessed through the short version of the Kansas City Cardiomyopathy Questionnaire (KCCQ-12). According to the presence of at least one sign of HF deterioration, patients were divided into two groups: Group 1: patients who experienced a modification in at least one clinical parameter suggestive of HF deterioration. Group 2: patients who do not experienced any modification of HF deterioration clinical parameter. KCCQ-12 mean scores were compared between the two groups, at both scheduled virtual visits, in order to evaluate any change in HF outpatients’ health status, during and after the COVID-19-related-lockdown. 160 HF outpatients have been included in the study: 63 in the group 1, 97 in the group 2. At the first virtual visit, group 1 reported significantly lower mean KCCQ-12 score, compared to group 2 [46.2 (±14.6) vs. 53.8 (±11); CI: 95% 11.6 to − 3.6; P = 0.0003]. At the second virtual visit, group 1 patients reported a slightly, but not statistically significant, lower mean KCCQ-12 score, compared to group 2 [52.2 (± 13.3) vs. 53.1(±14.4); 95% CI: −5.4 to 3.6; P = 0.69]. Comparing the KCCQ-12 mean scores of each group between the two scheduled virtual visits, group 1 reported a statistically significant increase at the second visit, compared to the first [52.2 (±13.3) vs. 46.2 (±14.6); CI: 95% 1.1–11; P = 0.017]. Group 2 showed no statistically significant variation of mean KCCQ-12 score between the two follow-up periods [53.1 (±14.4) vs. 53.8 (±11); CI: 95% −4.3 to 3; P = 0.704].Conclusionswe observed a significant worsening of health status in HF outpatients who have experienced clinical deterioration. Therefore, patients were either hospitalized or received the optimization of diuretic and anti-hypertensive therapies. A significant health status improvement was observed at three months after the end of the lockdown, suggesting the importance of virtual visit as an adequate method to follow-up HF outpatients, reporting particular benefits in those with worsening of HF clinical signs and health status.

2021 RSNA Outstanding Researcher

HomeRadiologyVol. 302, No. 1 PreviousNext CommunicationsFree AccessSpecial Communications2021 RSNA Outstanding ResearcherMary C. MahoneyMary C. MahoneyMary C. MahoneyPublished Online:Nov 30 2021https://doi.org/10.1148/radiol.219024MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Pamela K. Woodard, MDDownload as PowerPointOpen in Image Viewer A leading researcher in cardiothoracic imaging and a generous mentor, Pamela K. Woodard, MD, specializes in cardiac CT and MRI techniques and in translating novel cardiovascular PET radiotracers into human subjects.“Dr Woodard is truly an outstanding researcher,” said RSNA President Mary C. Mahoney, MD. “She is respected not only for her enormous success in funded research, but her generous mentoring of so many of our future leaders in imaging research.”Dr Woodard is the Hugh Monroe Wilson professor of radiology and professor of biomedical engineering at the Mallinckrodt Institute of Radiology, Washington University in St Louis, Mo, where she is also the senior vice chair and division director of Radiology Research Facilities. In this role, she provides administrative oversight to the directors of the department’s 10 National Institutes of Health (NIH) research facilities, including the preclinical and clinical imaging PET and MRI research facilities and the Cyclotron Facility. She is also director of the Center for Clinical Imaging Research, head of Cardiac MR/CT, director of the Radiology Research Resident Track, and the program director of the NIH-funded T32 TOP-TIER (Training Opportunities in Translational Imaging Education and Research) clinician-scientist training program in translational imaging research.Dr Woodard received her undergraduate degree from Duke University in Durham, NC, and her medical degree from the Duke University School of Medicine. She completed her internship in internal medicine at the University of North Carolina at Chapel Hill, a residency in diagnostic radiology at Duke University, and a fellowship in cardiothoracic imaging at the Mallinckrodt Institute of Radiology.Following early success in securing grant funding, including a 1996 Siemens Medical Solutions/RSNA Research Fellow Grant and a 1999 Carestream Health/RSNA Research Scholar Grant, Dr Woodard secured multiple NIH grants. Early in her career, she was a principal investigator (PI) on the landmark NIH-funded PIOPED II project, published in the New England Journal of Medicine, which established multi-detector CT as the principal method for pulmonary embolism diagnosis. She also led a key project on the Washington University NIH contract, Programs of Excellence in Nanotechnology, which developed a receptor-targeted radiotracer for atherosclerotic plaque imaging.Dr Woodard currently leads her own research program and is a PI or MPI on three NIH R01 grants for the translation of cardiovascular radiotracers into humans. She has nearly 200 peer-reviewed manuscripts, several patents, and has served as a charter member on NIH study sections, including Clinical and Integrative Cardiovascular Sciences (CICS) and Medical Imaging (MEDI), and chair of the NIH study section, Imaging Guided Interventions and Surgery. She has received numerous awards for her work, including being named an Academy of Radiology and Biomedical Imaging Research (ARBIR) Distinguished Investigator.A revered leader in organized radiology, Dr Woodard serves on the board of directors of ARBIR and the Missouri Radiological Society. She also serves on the American College of Radiology (ACR) Board of Chancellors as the ACR chair of the Commission on Research. She is a past president of the North American Society for Cardiovascular Imaging. Her expertise has informed the R&E Foundation Research Grant Study Section and the Quantitative Imaging Biomarkers Alliance.Article HistoryPublished online: Nov 30 2021Published in print: Jan 2022 FiguresReferencesRelatedDetailsRecommended Articles Linda Moy, MD, Named New Editor of RadiologyRadioGraphics2022Volume: 42Issue: 2pp. E37-E38Linda Moy, MD, Named New Editor of RadiologyRadiology2022Volume: 303Issue: 1pp. 3-4David A. Bluemke, MD, PhD, Named Editor of RadiologyRadiology2016Volume: 282Issue: 1pp. 10-11David A. Bluemke, MD, PhD, Named Editor of RadiologyRadioGraphics2017Volume: 37Issue: 1pp. 5-62020 RSNA Outstanding ResearcherRadiology2020Volume: 298Issue: 1pp. 1See More RSNA Education Exhibits Imaging of Suspected Pulmonary Embolism and Deep Venous Thrombosis in Obese PatientsDigital Posters2020Clinical Aspects Relating to Acute Pulmonary Embolism ImagingDigital Posters2018Acute Pulmonary Embolism: The Role of the Radiologist from Diagnosis to TreatmentDigital Posters2018 RSNA Case Collection Acute pulmonary embolismRSNA Case Collection2022Carotid WebRSNA Case Collection2020Pulmonary Embolism with Right Heart StrainRSNA Case Collection2020 Vol. 302, No. 1 Metrics Altmetric Score PDF download

Abstract 14093: Open Thoracic Surgical Implantation of Cardiac Pacemakers in Rodents

Introduction: Cardiovascular science has greatly benefited from bioelectronics and genetic engineering. However, combinations of these approaches have been hampered by challenges in genetic engineering of large animals and implantation of cardiac devices in rodents. New surgical approaches to reliably interface bioelectronics to the heart with minimal disruption to the native physiology are necessary for validation of novel bioelectronics therapies and bioelectronics-enabled in vivo studies of physiology. Objective: To develop an effective and reproducible surgical approach to implant epicardial devices in rodents. Methods: All rat surgeries (n = 138) were performed according to protocols approved by The George Washington University Institutional Animal Care and Use Committee. Inhaled isoflurane vapors provided general anesthesia. After orotracheal intubation, an intercostal incision was made and retracted in order to view the target cardiac implantation area (a). The electrode pad of a novel leadless battery-free pacemaker (b) was sutured or attached by bioadhesive to the epicardium with the device body placed subcutaneously. The ribs, muscle, and skin were subsequently closed. Post-operative care included injectable analgesics. Daily pacing trials confirmed device functionality. Results: Rats survive and quickly recover from the operation without complications. Electrocardiograms reveal that implanted miniature battery-free cardiac pacemakers pace the heart for up to 32 days after surgery (c). Echocardiography and assessment of biomarkers demonstrate no disruption to mechanical function (d) and no evidence of myocardial ischemia (e) or heart failure (f), respectively. Conclusions: This surgical technique reliably implants epicardial devices in rodents. It has broad applications to verify the long-term functionality and biocompatibility of innovative bioelectronics and to conduct in vivo studies of cardiovascular physiology.

SPONTANEOUS CORONARY ARTERY DISSECTION: AN EPIDEMIOLOGICAL AND ANGIOGRAPHICAL STUDY FROM A HIGH VOLUME TERTIARY CARE CARDIAC CENTRE

CONTEXT: Spontaneous coronary artery dissection (SCAD) is a non-atherosclerotic cause for acute coronary syndrome (ACS). Although a rare disease, due to increased awareness and early use of coronary angiography more cases are being picked up of late. Patient characteristics and management differ from those of typical ACS cases, hence recognition of SCAD is very important. AIM: To identify epidemiologic and clinical characteristics of patients with SCAD and determine outcomes. DESIGN: Data of 10002 patients who underwent coronary angiography (CAG) between 1st June 2018 and 31st May 2019 were retrospectively analysed to determine the cases of SCAD at Sri Jayadeva Institute of Cardiovascular Sciences &amp; Research. Epidemiologic and clinical characteristics of 51 such patients with SCAD were then analysed. OUTCOME MEASURES: Clinical characteristics, predisposing factors, angiographic ndings RESULT: In 51 patients (08 women and 43 men) who were hospitalized for ACS, spontaneous dissection of coronaries was detected. The mean age for women was 49.75 years &amp; 48.27 for men. Precipitating factors were hypertension in 14 patients (27.45%), dyslipidemia in 3 patients (5%) and smoking in 10 patients (19.60%). Diabetes was noted in 6 patients (11%). In 16 patients, the coronary angiography showed multivessel disease, while in 08 patients there were no signicant lesions in the coronary vessels. The left anterior descending (LAD) artery was the most commonly affected coronary artery (56.9%, 29 of 51 cases) followed by right coronary artery (35.3%,18 of 51 cases. Mid &amp; distal segments were the common sites for dissection (85%, 44 of 51). CONCLUSION: SCAD was noted with similar incidence in our sample population as seen in previous studies. The incidence is more in men as opposed to other studies wherein females had a higher incidence. Risk factors like hypertension, dyslipidemia &amp; diabetes were seen in a small percentage. LAD was the most common artery to be affected. Most patients were managed conservatively without the need for revascularization

Sex and Gender Equity in Research and Publishing: International Journal of Cardiovascular Sciences endorses SAGER Guidelines

According to the recently published “Cardiovascular Statistics – Brazil 2020”, mortality from cardiovascular diseases (CVD) is proportionally higher in women compared to men. The INTERHEART study demonstrated that the population attributable risk for myocardial infarction associated with modifiable risk factors of smoking, alcohol use, high-risk diet, and physical inactivity, was significantly higher among women than men. Evidence from the VIRGO study (Variation in Recovery: Role of Gender on Outcomes of Young Acute Myocardial Infarction [AMI] Patients) indicates that both health [...]