Methodist DeBakey Heart Center Research Articles

Editorial introductions

Editorial introductions

Editorial introductions

Editorial introductions

Editorial introductions

Current Opinion in Cardiology was launched in 1985. It is part of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of cardiology is divided into 14 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editors for this issue. SECTION EDITORS Sherif F. NaguehSherif F. NaguehAfter graduating from the Cairo University Faculty of Medicine, Egypt, in 1986, Dr Nagueh emigrated to Houston, Texas, USA. He completed his medicine residency and cardiology fellowship at Baylor College of Medicine, USA. He is currently Professor of Medicine at Weill Medical College of Cornell University, USA; and Medical Director of the Echocardiography Laboratory at the Methodist DeBakey Heart Center in Houston, Texas, USA. Dr Nagueh has received several awards, including the Second Annual Feigenbaum Lecture at the American Society of Echocardiography meeting in 2001. He sits on the Editorial Boards of the Journal of the American College of Cardiology, Circulation, Journal of the American Society of Echocardiography, and Clinical Science; and has served as the Imaging and echocardiography Section Editor for Current Opinion in Cardiology since 2001. Andrew PipeAndrew PipeDr Andrew Pipe graduated from Queen's University, Canada in 1974. He is currently Chief of the Division of Prevention and Rehabilitation at the University of Ottawa Heart Institute, Canada, and is also a Professor in the Faculty of Medicine at the University of Ottawa, Canada. He is currently involved in clinical research assessing new approaches to smoking cessation, strategies designed to facilitate exercise adoption, and novel initiatives to prevent cardiovascular disease. Dr Pipe has addressed audiences in over 30 nations and is frequently consulted on issues related to tobacco use and smoking cessation, physical activity and health, and drug use in sport. Dr Pipe is the recipient of the International Olympic Committee's Award for “Sport, Health and Wellbeing” and honourary degrees from Queen's University (LLD), Brock University (DSc), Canada and the University of Guelph (DSc), Canada. He was the recipient of the Canadian Cardiovascular Society's Dr Harold N. Segall Award for distinguished contributions to the prevention of cardiovascular disease, and was named to the Order of Canada in 2002.

Letter by Nagueh et al Regarding Article, “Tissue Doppler Imaging in the Estimation of Intracardiac Filling Pressure in Decompensated Patients With Advanced Systolic Heart Failure”

To the Editor: We read with interest the article by Mullens et al,1 which reported that, in patients with decompensated systolic heart failure, the early transmitral velocity to tissue Doppler mitral annular early diastolic velocity (E/Ea) ratio may not be reliable in predicting filling pressures, especially in patients with larger left ventricular volumes, lower cardiac indices, and cardiac resynchronization therapy pacing. We want to express caution in interpreting these results because they contradict abundant data previously published and validated.2 Our concern is that the conclusions proffered may convey the wrong message about the use of E/Ea as a noninvasive estimate of filling pressures in patients with heart failure and left ventricular systolic dysfunction, in whom the ratio generally works well. The first major issue is the composition of …

Inflammation and Cardiovascular Risk

Vijay Nambi is an Assistant Professor in the Section of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, Center for Cardiovascular Prevention, the Methodist DeBakey Heart Center, Staff Cardiologist at the Ben Taub General Hospital and Staff at the Michael E DeBakey Veterans Affairs Hospital in Houston, TX, USA. He also serves as the program director of the Atherosclerosis and Vascular Medicine fellowship at the Baylor College of Medicine. His research interests are biomarkers, risk stratification and imaging as related to coronary and peripheral arterial disease.

Octogenarians Tolerate Heart Surgery Well

Octogenarians Tolerate Heart Surgery Well

An Unusual Cause of Aortic Regurgitation

HomeCirculation: Cardiovascular ImagingVol. 1, No. 2An Unusual Cause of Aortic Regurgitation Free AccessResearch ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyRedditDiggEmail Jump toSupplementary MaterialsFree AccessResearch ArticlePDF/EPUBAn Unusual Cause of Aortic Regurgitation Sherif F. Nagueh, MD Sherif F. NaguehSherif F. Nagueh From the Department of Cardiology, Methodist DeBakey Heart and Vascular Center, The Methodist Hospital, Houston, Tex. Search for more papers by this author Originally published1 Sep 2008https://doi.org/10.1161/CIRCIMAGING.108.790931Circulation: Cardiovascular Imaging. 2008;1:e13–e14A 42-year-old man presented with acute onset of severe dyspnea, fever, and positive blood cultures for Staphylococcus aureus. His medical history was relevant for aortic root surgery, including replacement of the aortic root and aortic valve with a homograft 3 years ago. His physical examination revealed sinus tachycardia, a heart rate of 120 bpm, and a blood pressure of 84/45 mm Hg. Bibasilar rales were present, and the jugular veins were distended to the angle of the mandible. Transesophageal echocardiography was performed to examine the underlying reasons for his acute deterioration.Transesophageal echocardiography revealed the presence of a dehiscence of the homograft, with flow occurring between the left ventricular outflow tract and a pseudoaneurysm in the plane of the intervalvular fibrosa, without vegetations on the aortic valve. Hemodynamically significant aortic regurgitation (AR) was present through the site of the dehiscence, but not the aortic valve itself (Data Supplement Movies I-IV), and pulsed wave Doppler of the descending aorta revealed holodiastolic flow reversal (Figure 1). Continuous wave Doppler signal of the AR jet was consistent with significant AR, showing a short pressure half-time (Figure 2). In addition, echolucent areas with septations were seen surrounding the homograft (Data Supplement Movie I), consistent with multiple abscess cavities. Doppler interrogation showed early closure of the mitral valve and diastolic mitral regurgitation (Figure 3, left). Pulmonary venous flow (Figure 3, right) revealed a reduced systolic velocity to diastolic velocity ratio and a prominent atrial reversal signal. Collectively, these Doppler findings are consistent with a highly elevated left ventricular end-diastolic pressure (atrial reversal >50 cm/s, premature closure of the mitral valve, and diastolic mitral regurgitation), as well as an increased mean left atrial pressure (systolic/diastolic, <1) due to AR. Download figureDownload PowerPointFigure 1. Pulsed wave Doppler recording from the descending thoracic aorta shows forward flow in systole (above the baseline), with holodiastolic flow reversal (below the baseline and delineated by the arrows). This finding is consistent with hemodynamically significant AR.Download figureDownload PowerPointFigure 2. Continuous wave Doppler of the AR jet. Notice the rather dense signal when compared with forward flow across the aortic valve and the steep deceleration, leading to a very short pressure half-time (95 ms, arrow).Download figureDownload PowerPointFigure 3. Left side shows mitral inflow by pulsed wave Doppler. Diastolic flow is abbreviated with premature closure of the mitral valve (arrow above baseline) and diastolic mitral regurgitation (arrow below baseline). Both observations are diagnostic of highly elevated left ventricular end-diastolic pressure. On the right, is a recording from the left pulmonary vein. Forward flow in systole (S) is reduced, whereas forward flow in diastole (D) is increased. This finding indicates increased mean left atrial pressure. In addition, the increased atrial reversal velocity with left atrial contraction confirms the increased left ventricular end-diastolic pressure.Aortic graft dehiscence is a rare complication after aortic root surgery, whether with composite grafts or homografts. The hemodynamic consequences depend on the extent of dehiscence and can lead to severe perivalvular regurgitation and acute heart failure, as in this case. Aortography may not visualize a single site dehiscence, nor the mechanism of regurgitation. On the other hand, transesophageal echocardiography has a high accuracy in identifying the location and extent of the dehiscence, the presence of aortic root and aortic valve pathology, and the severity of regurgitation, as seen in this case.The online-only Data Supplement is available at http://circimaging.ahajournals.org/cgi/content/full/1/2/e13/DC1DisclosuresNone.FootnotesCorrespondence to Sherif F. Nagueh, MD, Methodist DeBakey Heart Center, 6550 Fannin, SM-677, Houston, TX 77030. E-mail [email protected] Previous Back to top Next FiguresReferencesRelatedDetails September 2008Vol 1, Issue 2Article InformationMetrics Download: 285 https://doi.org/10.1161/CIRCIMAGING.108.790931PMID: 19808521 Originally publishedSeptember 1, 2008 PDF download Advertisement SubjectsCongenital Heart DiseaseEchocardiographyHeart FailureValvular Heart Disease

384: Stem cell factor mRNA expression during mechanical circulatory support with left ventricular assist devices correlates with cardiac mast cell populations in the failing human heart

STEM CELL FACTOR MRNA EXPRESSION DURING MECHANICAL CIRCULATORY SUPPORT WITH LEFT VENTRICULAR ASSIST DEVICES CORRELATES WITH CARDIAC MAST CELL POPULATIONS IN THE FAILING HUMAN HEART J. Jahanyar, K.A. Youker, M. Loebe, H. Chai, C. Assad-Kottner, G. Torre-Amione, G.P. Noon, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX; Methodist DeBakey Heart Center, The Methodist Hospital, Houston, TX

Combined Open and Stent Graft Repair of an Arch and Descending Thoracic Aortic Aneurysm: The Hybrid Procedure

Surgeons at The Methodist Hospital and the Methodist DeBakey Heart Center have a long history of contributions to the treatment of thoracic aortic aneurysms. In the 1950s, Dr. Michael E. DeBakey pioneered the use of artificial grafts for aortic replacement and Drs. DeBakey and Denton Cooley introduced the use of cardiopulmonary bypass to repair aneurysms of the ascending aorta and aortic arch. Dr. Stanley Crawford then introduced surgical repair of the descending and thoracoabdominal aneurysm. Half a century later, the Methodist DeBakey Heart Center has now performed more descending and thoracoabdominal aortic aneurysm repairs than any other institution in the world. Despite these advances, treatment of aneurysms involving both the ascending aorta/aortic arch segment and the descending thoracic aorta have continued to pose a formidable surgical challenge: aortic arch repair traditionally requires circulatory arrest and profound hypothermia via median sternotomy followed by a later descending thoracic aorta repair through a left thoracotomy. Recently, a patient who had undergone previous ascending thoracic aortic aneurysm repair for dissection presented with a large arch and descending thoracic aortic aneurysm and a high risk of standard surgical repair. A unique, minimally-invasive hybrid approach of open and stent graft repair with aortic arch debranching was successfully employed, again advancing the field of thoracic aortic surgery at the Methodist DeBakey Heart Center.

The Hybrid Procedure For Surgical Repair Of Thoracoabdominal Aneurysms

INTRODUCTION Cardiovascular surgeons at the Methodist DeBakey Heart Center have a long history of leadership in the treatment of aortic pathology, and nowhere is this leadership more apparent than with thoracoabdominal aneurysms (TAAs). The Methodist DeBakey Heart Center has more experience in treating TAAs than any other institution in the world. Yet despite our expertise and concentration of surgical experts, TAA repair remains complex and carries significant morbidity and mortality. The center's success with endograft repair of infrarenal abdominal aortic aneurysm has led our team to extend these techniques to thoracoabdominal aneurysm repair in an effort to decrease the magnitude of this surgery.

The Hybrid Procedure for Surgical Repair of Thoracoabdominal Aneurysms

Cardiovascular surgeons at the Methodist DeBakey Heart Center have a long history of leadership in the treatment of aortic pathology, and nowhere is this leadership more apparent than with thoracoabdominal aneurysms (TAAs). The Methodist DeBakey Heart Center has more experience in treating TAAs than any other institution in the world. Yet despite our expertise and concentration of surgical experts, TAA repair remains complex and carries significant morbidity and mortality. The center’s success with endograft repair of infrarenal abdominal aortic aneurysm has led our team to extend these techniques to thoracoabdominal aneurysm repair in an effort to decrease the magnitude of this surgery.

Intracardiac Ultrasound-Guided Approaches for Managing Heart Rhythm Disorders

Heart rhythm disorders (atrial and ventricular arrhythmias) result in significant morbidity and mortality. Atrial fibrillation is the most common cardiac arrhythmia, affecting more than two million Americans, responsible for one-third of all strokes in patients over 65 years of age, and costing $9 billion annually to manage.1 Another 300,000 Americans die of sudden cardiac death each year, mainly due to ventricular tachyarrhythmias that cause intractable, extremely rapid heartbeats.2 Since current pharmacological therapy for managing cardiac arrhythmias is often ineffective and can even be proarrhythmic, treatment has emphasized non-pharmacological therapies such as ablation, pacing and defibrillation. Effectively managing complex cardiac arrhythmias during electrophysiology studies hinges on several factors including: 1) developing catheter mapping techniques to identify causes and details of arrhythmias; 2) integrating anatomical imaging methods to connect the arrhythmias with underlying cardiac structure; 3) targeting non-pharmacological therapies to abolish arrhythmias; and 4} advancing diagnostic methods to elucidate the effects of therapy. This report is a brief review of recent translational research conducted in collaboration with scientists at Methodist DeBakey Heart Center and Baylor College of Medicine to address some of these issues.

Center For Cardiovascular Disease Prevention: Risk Assessment And Reduction

INTRODUCTION Cardiovascular disease is the number one cause of death in the United States, accounting for more than 1.4 million deaths each year (American Heart Association. Heart and Stroke Statistics—2004 Update. Dallas, Texas: American Heart Association, 2003). The Center for Cardiovascular Disease Prevention (CCDP) was created in 2000, as a partnership between the Methodist DeBakey Heart Center and Baylor College of Medicine, to identify and implement new preventive and therapeutic strategies to reduce pain, suffering and death from cardiovascular disease. In clinical and translational research, investigators at the CCDP use a comprehensive approach directed at improving both risk assessment and risk reduction.

Long-Term Survival after Cardiac Autotransplantation for Sarcoma with Successful Late Redo Cardiac Autotransplantation and Right Pneumonectomy for Recurrent Left Atrial Sarcoma

Primary cardiac malignancy is rare and represents a therapeutic challenge. At the Methodist DeBakey Heart Center we have developed the cardiac autotransplantation procedure - consisting of cardiac explantation, ex vivo tumor resection with cardiac reconstruction, and cardiac reimplantation - for left atrial and intracavitary left ventricular tumors. Here we report a case of successful cardiac autotransplantation for left atrial sarcoma, and successful redo autotransplantation and right pneumonectomy when the malignancy recurred five years after the initial procedure.

INVITED COMMENTARY

INVITED COMMENTARY

Center for Cardiovascular Disease Prevention: Risk Assessment and Reduction

Cardiovascular disease is the number one cause of death in the United States, accounting for more than 1.4 million deaths each year (American Heart Association. Heart and Stroke Statistics-2004 Update. Dallas, Texas: American Heart Association, 2003). The Center for Cardiovascular Disease Prevention (CCDP) was created in 2000, as a partnership between the Methodist DeBakey Heart Center and Baylor College of Medicine, to identify and implement new preventive and therapeutic strategies to reduce pain, suffering and death from cardiovascular disease. In clinical and translational research, investigators at the CCDP use a comprehensive approach directed at improving both risk assessment and risk reduction.