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2. Demographic-Based Personalized Left Ventricular Hypertrophy Thresholds for Hypertrophic Cardiomyopathy Diagnosis

Author

Shiwani, Hunain, Davies, Rhodri H., Topriceanu, Constantin-Cristian, Ditaranto, Raffaello, Owens, Anjali, Raman, Betty, Augusto, João, Hughes, Rebecca K., Torlasco, Camilla, Dowsing, Ben, Artico, Jessica, Joy, George, Miranda, Inês, Witschey, Walter, Rodriguez-Palomares, Jose F., Badia, Clara, Crotti, Lia, Cortina-Borja, Mario, Chuang, Michael L., Kwong, Raymond Y., Kramer, Christopher M., Manning, Warren, Ho, Carolyn Y., Kellman, Peter, Hughes, Alun D., Biagini, Elena, Mohiddin, Saidi, Lopes, Luis, Litt, Harold, Ferrari, Victor, Captur, Gabriella, Moon, James C., Bachiller, Rocio, Zaha, Vlad, Peshock, Ronald M., Hobbs, Helen H., Shah, Anil, Rosmini, Stefania, Castelletti, Silvia, Pierce, Iain, Moschonas, Konstantinos, Webber, Matt, Sivalokanathan, Sanjay, Malcolmson, James, Thompson, Elizabeth, Lovato, Luigi, Ponziani, Alberto, Badia-Molins, Clara, and Ferrari, Victor A.

Published
2025
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42. Prevalence of pectus excavatum in an adult population-based cohort estimated from radiographic indices of chest wall shape.

Author

Biavati, Mikaela, Kozlitina, Julia, Alder, Adam C., Foglia, Robert, McColl, Roderick W., Peshock, Ronald M., Kelly, Robert E., and Kim Garcia, Christine

Subjects
PECTUS excavatum, TEENAGE boys, COMPUTED tomography, STERNUM, DIAGNOSTIC imaging
Abstract

Background: Pectus excavatum is the most common chest wall skeletal deformity. Although commonly evaluated in adolescence, its prevalence in adults is unknown. Methods and findings: Radiographic indices of chest wall shape were analyzed for participants of the first (n = 2687) and second (n = 1780) phases of the population-based Dallas Heart Study and compared to clinical cases of pectus (n = 297). Thoracic computed tomography imaging studies were examined to calculate the Haller index, a measure of thoracic axial shape, and the Correction index, which quantitates the posterior displacement of the sternum relative to the ribs. At the level of the superior xiphoid, 0.5%, 5% and 0.4% of adult Dallas Heart Study subjects have evidence of pectus excavatum using thresholds of Haller index >3.25, Correction index >10%, or both, respectively. Radiographic measures of pectus are more common in females than males and there is a greater prevalence of pectus in women than men. In the general population, the Haller and Correction indices are associated with height and weight, independent of age, gender, and ethnicity. Repeat imaging of a subset of subjects (n = 992) demonstrated decreases in the mean Haller and Correction indices over seven years, suggesting change to a more circular axial thorax, with less sternal depression, over time. Conclusions: To our knowledge, this is the first study estimating the prevalence of pectus in an unselected adult population. Despite the higher reported prevalence of pectus cases in adolescent boys, this study demonstrates a higher prevalence of radiographic indices of pectus in adult females. [ABSTRACT FROM AUTHOR]

Published
2020
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43. Creating a Research and Clinical Care Partnership through EMR and Clinical Research System Integration

Author

Ranganathan, Dipti, Bell, Melody, Willett, DuWayne, and Peshock, Ronald M.

Subjects
Articles
Abstract

EMRs are essential in modern healthcare. At the same time there has been the rapid development of clinical research systems (CRS) which offer specific tools to facilitate research protocol development, execution and management. However, examples of integrating a commercial EMR and CRS are rare. We describe our experience in the analysis, resolution of issues, design, and implementation of EMR/CR integration in a large academic medical center with affiliated hospitals. Our initial results suggest that (1) neither the EMR nor CRS system alone will suffice to facilitate clinical research, (2) there are important benefits to integration of the EMR and CRS systems and (3) this integration can be leveraged across multiple institutions.

Published
2013

44. Contributors

Author

Akçakaya, Mehmet, Alpendurada, Francisco, Appelbaum, Evan, Arai, Andrew, Auger, Dominique, Balaban, Robert S., Bax, Jeroen J., Bellenger, Nicholas G., Bluemke, David A., Botnar, René M., Butler, Craig Ronald, Caravan, Peter, Celeng, Csilla, Chuang, Michael L., de Roos, Albert, Delgado, Victoria, Dharmakumar, Rohan, Dweck, Marc R., Farzaneh-Far, Afshin, Fayad, Zahi A., Firmin, David, Fogel, Mark A., Frank, Herbert, Friedrich, Matthias G., Gale, Eric M., Geva, Tal, Grizzard, John D., Halliday, Brian P., Hansen, Michael, Hauser, Thomas H., Hong, Susie N., Huelnhagen, Till, Hundley, W. Gregory, Ibrahim, El-Sayed H., Ipek, Esra Gucuk, Jerosch-Herold, Michael, Judd, Robert M., Keegan, Jennifer, Kellman, Peter, Khan, Muhammad Shahzeb, Khosa, Faisal, Khurshid, Kiran, Kilner, Philip J., Kim, Daniel H., Kim, Raymond J., Kim, W. Yong, Kramer, Christopher M., Krieger, Eric V., Kwong, Raymond Y., Leb, Jay S., Lederman, Robert, Leiner, Tim, Li, Debiao, Lopez, David, Maceira, Alicia M., Mahrholdt, Heiko, Makowski, Marcus R., Manning, Warren J., Marcu, Constantin B., Maron, Martin S., Mohiaddin, Raad H., Moon, James C., Motwani, Manish, Nakamori, Shiro, Nazarian, Saman, Nensa, Felix, Neubauer, Stefan, Nezafat, Reza, Nienaber, Christoph A., Niendorf, Thoralf, Partington, Sara L., Paterson, Ian, Paul, Katharina, Pennell, Dudley J., Peshock, Ronald M., Peters, Dana C., Planken, R. Nils, Plein, Sven, Powell, Andrew J., Prasad, Sanjay, Prieto, Claudia, Pushparajah, Kuberan, Rashid, Imran, Razavi, Reza S., Rehwald, Wolfgang G., Robson, Philip M., Rodgers, Christopher T., Rogers, Toby, Rowin, Ethan J., Rudd, James H.F., Sakuma, Hajime, Salerno, Michael, Schlosser, Thomas, Schwitter, Juerg, Sechtem, Udo P., Stacey, R. Brandon, Stuber, Matthias, Sykora, Teresa, Tayal, Upasana, te Riele, Anneline S.J.M., Treibel, Thomas A., Tsaftaris, Sotirios A., Valente, Anne Marie, van den Bosch, Harrie, van der Bijl, Pieter, van Rossum, Albert C., Wendell, David C., Westenberg, Jos J.M., Westwood, Mark A., Wilke, Norbert, Winter, Lukas, and Yang, Hsin-Jung

Published
2019
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46. Association of Concentric Left Ventricular Hypertrophy With Subsequent Change in Left Ventricular End-Diastolic Volume.

Author

Garg, Sonia, de Lemos, James A., Matulevicius, Susan A., Ayers, Colby, Pandey, Ambarish, Neeland, Ian J., Berry, Jarett D., McColl, Roderick, Maroules, Christopher, Peshock, Ronald M., and Drazner, Mark H.

Abstract

BACKGROUND: In the conventional paradigm of the progression of left ventricular hypertrophy, a thick-walled left ventricle (LV) ultimately transitions to a dilated cardiomyopathy. There are scant data in humans demonstrating whether this transition occurs commonly without an interval myocardial infarction. METHODS AND RESULTS: Participants (n=1282) from the Dallas Heart Study underwent serial cardiac magnetic resonance ≈7 years apart. Those with interval cardiovascular events and a dilated LV (increased LV end-diastolic volume [EDV] indexed to body surface area) at baseline were excluded. Multivariable linear regression models tested the association of concentric hypertrophy (increased LV mass and LV mass/volume0.67) with change in LVEDV. The study cohort had a median age of 44 years, 57% women, 43% black, and 11% (n=142) baseline concentric hypertrophy. The change in LVEDV in those with versus without concentric hypertrophy was 1 mL (-9 to 12) versus -2 mL (-11 to 7), respectively, P<0.01. In multivariable linear regression models, concentric hypertrophy was associated with larger follow-up LVEDV (P≤0.01). The progression to a dilated LV was uncommon (2%, n=25). CONCLUSIONS: In the absence of interval myocardial infarction, concentric hypertrophy was associated with a small, but signifcantly greater, increase in LVEDV after 7-year follow-up. However, the degree of LV enlargement was minimal, and few participants developed a dilated LV. These data suggest that if concentric hypertrophy does progress to a dilated cardiomyopathy, such a transition would occur over a much longer timeframe (eg, decades) and may be less common than previously thought. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifer: NCT00344903. [ABSTRACT FROM AUTHOR]

Published
2017
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47. Developing a Cross-institutional Information Security Program

Author

Marshall, Andrea, Adrian, Pam, Marcee, Alice K., Kirksey, Kirk, and Peshock, Ronald M.

Subjects
Posters
Abstract

Healthcare organizations across the country are searching for methods to address escalating healthcare costs. One strategy is to leverage resources across affiliated but independent organizations. This approach is common in other industries; yet, protecting confidential patient information is unique to the healthcare industry. Guaranteed protection of patient confidentiality is a critical step in any inter-organizational strategy. Because of the need to leverage resources, the University of Texas Southwestern Medical Center (UT Southwestern) and its affiliates initiated a cross-institutional effort to address information security and confidentiality issues.

Published
2001

49. Females have a blunted cardiovascular response to one year of intensive supervised endurance training.

Author

Howden, Erin J., Perhonen, Merja, Peshock, Ronald M., Rong Zhang, Arbab-Zadeh, Armin, Adams-Huet, Beverley, and Levine, Benjamin D.

Subjects
PHYSIOLOGICAL aspects of physical fitness, ATHLETE physiology, CARDIOVASCULAR system physiology, PHYSICAL training & conditioning, AEROBIC capacity, PHYSIOLOGY
Abstract

Cross-sectional studies in athletes suggest that endurance training augments cardiovascular structure and function with apparently different phenotypes in athletic males and females. It is unclear whether the longitudinal response to endurance training leads to similar cardiovascular adaptations between sexes. We sought to determine whether males and females demonstrate similar cardiovascular adaptations to 1 yr of endurance training, matched for training volume and intensity. Twelve previously sedentary males (26 ± 7, n = 7) and females (31 ± 6, n = 5) completed 1 yr of progressive endurance training. All participants underwent a battery of tests every 3 mo to determine maximal oxygen uptake (...O2max) and left ventricle (LV) function and morphology (cardiac magnetic resonance imaging). Pulmonary artery catheterization was performed before and after 1 yr of training, and pressure- volume and Starling curves were constructed during decreases (lower-body negative pressure) and increases (saline infusion) in cardiac volume. Males progressively increased ...O2max, LV mass, and mean wall thickness, before reaching a plateau from month 9 to 12 of training. In contrast, despite exactly the same training, the response in females was markedly blunted, with ...O2max, LV mass, and mean wall thickness plateauing after only 3 mo of training. The response of LV end-diastolic volume was not influenced by sex (males +20% and females +18%). After training Starling curves were shifted upward and left, but the effect was greatest in males (interaction P = 0.06). We demonstrate for the first time clear sex differences in response to 1 yr of matched endurance training, such that the development of ventricular hypertrophy and increase in ...O2max in females is markedly blunted compared with males. [ABSTRACT FROM AUTHOR]

Published
2015
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