Live Webcast Research Articles

Guest Editor Gavin Britz Oversees Special Issue on Neurovascular Disease for the <i>Methodist DeBakey Cardiovascular Journal</i>

The Methodist DeBakey Cardiovascular Journal provides timely updates on important topics in cardiovascular medicine with quarterly, thematic review-article issues. Each issue is curated by subject-matter-expert guest editors and includes invited reviews along with case reports, interesting multimodality images, and humanities submissions. Additional case reports, images, CME quizzes, and editorials are published on a continuous basis online. MDCVJ is geared towards cardiologists, cardiovascular surgeons, general practitioners, and CV residents and fellows and is indexed in PubMed and MEDLINE.MDCVJ is published by Houston Methodist DeBakey Heart & Vascular Center as part of DeBakey CV Education, an epicenter for cardiovascular academic and clinical education programs located in the heart of the Texas Medical Center. Along with the Journal, DeBakey CV Education offers online and hands-on training for cardiovascular healthcare professionals at all stages in their careers. DeBakey CV Education’s vast YouTube library features hundreds of training videos and live webcasts, including Journal features. Subscribe to the YouTube channel today and sign up for newsletter updates about training opportunities.

Between Art and Social Science: Scenic Composition as a Methodological Device

The scenic composition (SC) is a methodological device enabling the synthesis and articulation of researchers' own complex experiences of events witnessed during data collection. Positioned between art and social science, it makes use of literary conventions to synthesise "experience near" accounts of data for interpretation. This article explains how the SC is composed by drawing on associative thinking and illustrates its use within a specific case study. The conceptual basis of the SC is discussed with reference to the work of LORENZER, WINNICOTT and BION. This is the first study in which four compositions, each by a different researcher, have been used to provide a multi-faceted view of a complex event, a live webcast. The compositions are presented along with researchers' reflections. Common themes and significant differences relating to life situations, histories and dispositions of the researchers emerge. The differences were expressed through choice of literary genres, which are common cultural resources. We ask what was achieved through the use of SCs compared with a thematic analysis of the webcast, and find that apart from synthesising and presentational functions, they give access to a multi-sensory range of researchers' experiences, including unconscious elements which were then available for reflexive interpretation by an interpretation panel.

Important advances in technology and unique applications related to cardiac magnetic resonance imaging.

Cardiac magnetic resonance has become a well-established imaging modality and is considered the gold standard for myocardial tissue viability assessment and ventricular volumes quantification. Recent technological hardware and software advancements in magnetic resonance imaging technology have allowed the development of new methods that can improve clinical cardiovascular diagnosis and prognosis. The advent of a new generation of higher magnetic field scanners can be beneficial to various clinical applications. Also, the development of faster acquisition techniques have allowed mapping of the magnetic relaxation properties T1, T2, and T2* in the myocardium that can be used to quantify myocardial diffuse fibrosis, determine the presence of edema or inflammation, and measure iron within the myocardium, respectively. Another recent major advancement in CMR has been the introduction of three-dimension (3D) phase contrast imaging, also known as 4D flow. The following review discusses key advances in cardiac magnetic resonance technology and their potential to improve clinical cardiovascular diagnosis and outcomes.

Wading the River

The Methodist DeBakey Cardiovascular Journal provides timely updates on important topics in cardiovascular medicine with quarterly, thematic review-article issues. Each issue is curated by subject-matter-expert guest editors and includes invited reviews along with case reports, interesting multimodality images, and humanities submissions. Additional case reports, images, CME quizzes, and editorials are published on a continuous basis online. MDCVJ is geared towards cardiologists, cardiovascular surgeons, general practitioners, and CV residents and fellows and is indexed in PubMed and MEDLINE.MDCVJ is published by Houston Methodist DeBakey Heart & Vascular Center as part of DeBakey CV Education, an epicenter for cardiovascular academic and clinical education programs located in the heart of the Texas Medical Center. Along with the Journal, DeBakey CV Education offers online and hands-on training for cardiovascular healthcare professionals at all stages in their careers. DeBakey CV Education’s vast YouTube library features hundreds of training videos and live webcasts, including Journal features. Subscribe to the YouTube channel today and sign up for newsletter updates about training opportunities.

Overview of Quality in Cardiovascular Imaging and Procedures for Clinicians: Focus on Appropriate-Use-Criteria Guidelines

Cardiovascular imaging and procedures have experienced exponential growth over the past 20 years in terms of new modalities, procedure volume, technological sophistication, and cost. As a result, related quality improvement tools have become multifaceted works in progress. This article briefly summarizes the evolution of the time-honored American College of Cardiology Foundation/American Heart Association clinical practice guidelines versus the newer American College of Cardiology Foundation appropriate-use-criteria guidelines and how these may interact with emerging performance measures, clinical data registries, and cardiovascular laboratory accreditation initiatives.

Cardiac Amyloidosis

The Methodist DeBakey Cardiovascular Journal provides timely updates on important topics in cardiovascular medicine with quarterly, thematic review-article issues. Each issue is curated by subject-matter-expert guest editors and includes invited reviews along with case reports, interesting multimodality images, and humanities submissions. Additional case reports, images, CME quizzes, and editorials are published on a continuous basis online. MDCVJ is geared towards cardiologists, cardiovascular surgeons, general practitioners, and CV residents and fellows and is indexed in PubMed and MEDLINE.MDCVJ is published by Houston Methodist DeBakey Heart & Vascular Center as part of DeBakey CV Education, an epicenter for cardiovascular academic and clinical education programs located in the heart of the Texas Medical Center. Along with the Journal, DeBakey CV Education offers online and hands-on training for cardiovascular healthcare professionals at all stages in their careers. DeBakey CV Education’s vast YouTube library features hundreds of training videos and live webcasts, including Journal features. Subscribe to the YouTube channel today and sign up for newsletter updates about training opportunities.

Intracardiac Echocardiographic Atrial Septal Defect Closure

The Methodist DeBakey Cardiovascular Journal provides timely updates on important topics in cardiovascular medicine with quarterly, thematic review-article issues. Each issue is curated by subject-matter-expert guest editors and includes invited reviews along with case reports, interesting multimodality images, and humanities submissions. Additional case reports, images, CME quizzes, and editorials are published on a continuous basis online. MDCVJ is geared towards cardiologists, cardiovascular surgeons, general practitioners, and CV residents and fellows and is indexed in PubMed and MEDLINE.MDCVJ is published by Houston Methodist DeBakey Heart & Vascular Center as part of DeBakey CV Education, an epicenter for cardiovascular academic and clinical education programs located in the heart of the Texas Medical Center. Along with the Journal, DeBakey CV Education offers online and hands-on training for cardiovascular healthcare professionals at all stages in their careers. DeBakey CV Education’s vast YouTube library features hundreds of training videos and live webcasts, including Journal features. Subscribe to the YouTube channel today and sign up for newsletter updates about training opportunities.

Dr. Robert Roberts Oversees Special Issue on Genomic Medicine for the Methodist DeBakey Cardiovascular Journal

The Methodist DeBakey Cardiovascular Journal provides timely updates on important topics in cardiovascular medicine with quarterly, thematic review-article issues. Each issue is curated by subject-matter-expert guest editors and includes invited reviews along with case reports, interesting multimodality images, and humanities submissions. Additional case reports, images, CME quizzes, and editorials are published on a continuous basis online. MDCVJ is geared towards cardiologists, cardiovascular surgeons, general practitioners, and CV residents and fellows and is indexed in PubMed and MEDLINE.MDCVJ is published by Houston Methodist DeBakey Heart & Vascular Center as part of DeBakey CV Education, an epicenter for cardiovascular academic and clinical education programs located in the heart of the Texas Medical Center. Along with the Journal, DeBakey CV Education offers online and hands-on training for cardiovascular healthcare professionals at all stages in their careers. DeBakey CV Education’s vast YouTube library features hundreds of training videos and live webcasts, including Journal features. Subscribe to the YouTube channel today and sign up for newsletter updates about training opportunities.

Native Valve Pseudoaneurysm

The Methodist DeBakey Cardiovascular Journal provides timely updates on important topics in cardiovascular medicine with quarterly, thematic review-article issues. Each issue is curated by subject-matter-expert guest editors and includes invited reviews along with case reports, interesting multimodality images, and humanities submissions. Additional case reports, images, CME quizzes, and editorials are published on a continuous basis online. MDCVJ is geared towards cardiologists, cardiovascular surgeons, general practitioners, and CV residents and fellows and is indexed in PubMed and MEDLINE.MDCVJ is published by Houston Methodist DeBakey Heart & Vascular Center as part of DeBakey CV Education, an epicenter for cardiovascular academic and clinical education programs located in the heart of the Texas Medical Center. Along with the Journal, DeBakey CV Education offers online and hands-on training for cardiovascular healthcare professionals at all stages in their careers. DeBakey CV Education’s vast YouTube library features hundreds of training videos and live webcasts, including Journal features. Subscribe to the YouTube channel today and sign up for newsletter updates about training opportunities.

Integrating Users in an Interactive Video Education Project: Reframing the Patient-Centered Strategy of a Cystic Fibrosis Centre

This article reports on the formative evaluation of WebPEP (“Web-Based Patient Education Program”), an interactive video education project at ErasmusMC–Sophia Children’s Hospital (SCH) in Rotterdam, the Netherlands. Through monthly live webcasts, doctors, nurses, psychologists, and other healthcare professionals affiliated to SCH’s Cystic Fibrosis Team gave presentations on medical and psychosocial aspects related to cystic fibrosis (CF). These webcasts were first intended to educate and be educational to children between the ages of twelve and eighteen, but during the first year of the project they failed to attract this specific group. Instead, they generated unexpected enthusiasm among parents of young patients. The central question in this article is: How were patients “integrated” in the development of the WebPEP application? We show how the project’s initiator reacted to the lacking participation by prospective users: informed by the evaluation, he gradually shifted his attention from live interaction to the expansion of the video library, where the webcasts were stored for on demand viewing. Based on interviews and participant observations, we describe how the initiator reconfigured the WebPEP application and its users, and therewith reframed the CF Centre’s online patient education strategy. We discuss the importance of investigating the prospective and actual use of patient-centered e-health (PCEH) applications, and argue that a single technological artefact can be involved in different, coexisting practices of patient-centeredness. We conclude with a reflection on how formative research methods can contribute to the development of PCEH.

A tool to assess mobility status in critically ill patients: the Perme Intensive Care Unit Mobility Score.

The benefits of early mobilization for adult patients in the intensive care unit (ICU) are reduced length of ICU and hospital stays, fewer readmissions to the ICU, decreased duration of mechanical ventilation, fewer days of detrimental bedrest, minimal adverse or unsafe events, and improved walking distance. Because there are no available tools to specifically measure mobility status of patients in the ICU setting, there is an urgent need to create a reliable tool that measures and standardizes the assessment of mobility status for these patients. The purpose of this study was to describe the development of this novel ICU-specific tool to assess a patient's mobility status, examine the initial reliability of the tool, and address its clinical application. The Perme ICU Score was quickly and easily administered by physical therapists. Overall, the inter-rater agreement was 94%. A total of six items had kappa values of < .6, and these low scores may have been the result of the procedure to collect inter-rater scores, wherein one rater assisted with the activity while a second rater observed. In order to improve reliability, the authors developed directions to standardize the assessment. The Perme ICU Mobility Score is a tool developed to measure the patient's mobility status starting with the ability to follow commands and culminating in the distance walked in two minutes. Preliminary data suggest that the validity of this tool is supported by expert concurrence, its overall reliability is high, and its clinical use is acceptable.

Dr. Phil’s Art Corner: All Alone3G and ThudA10 Canyon

The Methodist DeBakey Cardiovascular Journal provides timely updates on important topics in cardiovascular medicine with quarterly, thematic review-article issues. Each issue is curated by subject-matter-expert guest editors and includes invited reviews along with case reports, interesting multimodality images, and humanities submissions. Additional case reports, images, CME quizzes, and editorials are published on a continuous basis online. MDCVJ is geared towards cardiologists, cardiovascular surgeons, general practitioners, and CV residents and fellows and is indexed in PubMed and MEDLINE.MDCVJ is published by Houston Methodist DeBakey Heart &amp; Vascular Center as part of DeBakey CV Education, an epicenter for cardiovascular academic and clinical education programs located in the heart of the Texas Medical Center. Along with the Journal, DeBakey CV Education offers online and hands-on training for cardiovascular healthcare professionals at all stages in their careers. DeBakey CV Education’s vast YouTube library features hundreds of training videos and live webcasts, including Journal features. Subscribe to the YouTube channel today and sign up for newsletter updates about training opportunities.

Sequencing your genome: what does it mean?

The human genome contains approximately 3.2 billion nucleotides and about 23,500 genes. Each gene has protein-coding regions that are referred to as exons. The human genome contains about 180,000 exons, which are collectively called an exome. An exome comprises about 1% of the human genome and hence is about 30 million nucleotides in size. Today's technologies afford the opportunity to sequence all nucleotides in the human exome and even in the human genome. Given that more than three-quarters of the known disease-causing variants are located in the exome, and considering the cost and technical challenges in analyzing the whole genome sequence data, the focus of present research is primarily on whole exome sequencing (WES). While WES at the medical sequencing level is still expensive, it is becoming more affordable. Cost will not likely be a major barrier in the near future, and the data analysis is becoming less tedious. The most difficult challenge at the heart of medical sequencing is interpreting the findings. Each exome contains about 13,500 single nucleotide variants (SNVs) that affect the amino acid sequence, and a large number are expected to be functional variants. The daunting task is to distinguish the variants that are pathogenic from those that have minimal or no discernible clinical effects. While various algorithms exist, none are sufficiently robust. Thus, in-depth knowledge in genetics and medicine is essential for the proper interpretation of the WES findings. This review will discuss the potential applications of the WES data in the practice of cardiovascular medicine.

Brugada syndrome.

Brugada syndrome is a rare cardiac arrhythmia characterized by electrocardiographic right bundle branch block and persistent ST-segment elevation in the right precordial leads. It is associated with ventricular fibrillation and a high risk for sudden cardiac death, predominantly in younger males with structurally normal hearts. Patients can remain asymptomatic, and electrocardiographic patterns can occur both spontaneously or after pharmacological induction. So far, several pathogenic genes have been identified as associated with the disease, but SCN5A is the most prevalent one. Two consensus reports to define the diagnostic criteria, risk stratification, and management of patients have been published in the last few years. This brief review focuses on the recent clinical diagnosis, genetic basis, and advances in pharmacological treatment of Brugada syndrome.

Cardiovascular Drugs and the Genetic Response

The emergence of personalized medicine mandates a complete understating of DNA sequence variation that modulates drug response. Initial forays have been made in the cardiac arena, yet much remains to be elucidated in the pharmacogenetics of cardiac drugs. Most progress has been made in describing DNA sequence variation related to the anticoagulant warfarin and the antiplatelet drug clopidogrel. This includes a description of DNA sequence variation that underlies pharmacokinetic and pharmacodynamic variability, the impact of such variation on predicting hard outcomes, and the ability of genotype-guided prescription to facilitate rapid titration to a therapeutic range while avoiding unnecessary high plasma levels. Nuanced prescription will require a complete inventory of DNA sequence variants that underlie drug-related side effects.

Genetics of coronary artery disease: an update.

In 2007, the first genetic risk variant, 9p21, was simultaneously discovered by two independent groups. 9p21 increases the risk of coronary artery disease in individuals with premature heart disease by twofold, and in the overall population the heterozygote is associated with a 25% increased risk and the homozygote with a 50% increased risk. It is of note that the risk mediated by 9p21 is independent of known risk factors. Since then, with the development of new technologies and the international consortium of CARDIoGRAM, there is now a total of 50 genetic risk variants confirmed and replicated for CAD. Of these 50, 35 mediate their risk by unknown mechanisms, indicating that the pathogenesis of atherosclerosis and myocardial infarction is due to additional factors as yet unknown. The role of genetic risk factors in the management of CAD is yet to be determined. Since many of them are independent of known risk factors, the genetic risk will in the future have to be incorporated into the guidelines, which recommend the target level of plasma LDL-C to be achieved based on the number of risk factors.

Cardiac Amyloidosis

The Methodist DeBakey Cardiovascular Journal provides timely updates on important topics in cardiovascular medicine with quarterly, thematic review-article issues. Each issue is curated by subject-matter-expert guest editors and includes invited reviews along with case reports, interesting multimodality images, and humanities submissions. Additional case reports, images, CME quizzes, and editorials are published on a continuous basis online. MDCVJ is geared towards cardiologists, cardiovascular surgeons, general practitioners, and CV residents and fellows and is indexed in PubMed and MEDLINE.MDCVJ is published by Houston Methodist DeBakey Heart &amp; Vascular Center as part of DeBakey CV Education, an epicenter for cardiovascular academic and clinical education programs located in the heart of the Texas Medical Center. Along with the Journal, DeBakey CV Education offers online and hands-on training for cardiovascular healthcare professionals at all stages in their careers. DeBakey CV Education’s vast YouTube library features hundreds of training videos and live webcasts, including Journal features. Subscribe to the YouTube channel today and sign up for newsletter updates about training opportunities.

Use of Stem Cells in Heart Failure Treatment: Where We Stand and Where We Are Going

End-stage heart failure is the final common pathway of an irreversible process associated with loss of myocardial cells. In this process, the capacity for renewal and repair of myocardial tissue is inadequate and ultimately leads to ventricular remodeling. Novel therapeutic strategies have been developed to prevent it, one being cell therapy, which has emerged as a potential approach to directly repopulate and repair the damaged heart. Here, we review the use of regenerative cell therapy for different cardiac diseases and discuss the positive effect of cell therapy mediated by paracrine factors instead of turning directly into cardiomyocytes.

O Sweet Spontaneous

The Methodist DeBakey Cardiovascular Journal provides timely updates on important topics in cardiovascular medicine with quarterly, thematic review-article issues. Each issue is curated by subject-matter-expert guest editors and includes invited reviews along with case reports, interesting multimodality images, and humanities submissions. Additional case reports, images, CME quizzes, and editorials are published on a continuous basis online. MDCVJ is geared towards cardiologists, cardiovascular surgeons, general practitioners, and CV residents and fellows and is indexed in PubMed and MEDLINE.MDCVJ is published by Houston Methodist DeBakey Heart &amp; Vascular Center as part of DeBakey CV Education, an epicenter for cardiovascular academic and clinical education programs located in the heart of the Texas Medical Center. Along with the Journal, DeBakey CV Education offers online and hands-on training for cardiovascular healthcare professionals at all stages in their careers. DeBakey CV Education’s vast YouTube library features hundreds of training videos and live webcasts, including Journal features. Subscribe to the YouTube channel today and sign up for newsletter updates about training opportunities.

Imaging Cardiac Stem Cell Transplantation Using Radionuclide Labeling Techniques: Clinical Applications and Future Directions

Stem cell therapy is emerging as a potential new therapy for patients with advanced heart failure. In recent years, advances in molecular imaging have allowed monitoring of stem cell homing and survival. In this review article, we will discuss the clinical application and future directions of stem cell imaging in advanced heart failure.