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1. Cost-Effectiveness of a Shock Team Approach in Refractory Cardiogenic Shock

Author

Taleb, Iosif, Giannouchos, Theodoros V., Kyriakopoulos, Christos P., Clawson, Antoine, Davis, Erin S., Sideris, Konstantinos, Tseliou, Eleni, Shah, Kevin S., Tonna, Joseph E., Dranow, Elizabeth, Jones, Tara L., Carter, Spencer J., Fang, James C., Stehlik, Josef, Ohsfeldt, Robert L., Selzman, Craig H., Hanff, Thomas C., and Drakos, Stavros G.

Published
2024
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2. Cardiac Reverse Remodeling Mediated by HeartMate 3 Left Ventricular Assist Device: Comparison to Older Generation Devices

Author

Yin, Michael Yaoyao, Maneta, Eleni, Kyriakopoulos, Christos P., Michaels, Alexander T., Genovese, Leonard D., Indaram, Mahathi B., Wever-Pinzon, Omar, Singh, Ramesh, Tseliou, Eleni, Taleb, Iosif, Nemeh, Hassan W., Alharethi, Rami, Tang, Daniel G., Goldstein, Jake, Hanff, Thomas C., Selzman, Craig H., Cowger, Jennifer, Kanwar, Manreet, Shah, Palak, and Drakos, Stavros G.

Published
2024
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3. Integration of Patient Reported Quality-of-life Data into Risk Assessment in Heart Failure

Author

SIDERIS, KONSTANTINOS, ZHANG, MINGYUAN, WOHLFAHRT, PETER, SIU, ALFONSO F., SHEN, JINCHENG, CARTER, SPENCER, KYRIAKOPOULOS, CHRISTOS P., TALEB, IOSIF, WEVER-PINZON, OMAR, SHAH, KEVIN, SELZMAN, CRAIG H., RODRIGUEZ-CORREA, CARLOS, KAPELIOS, CHRIS, BRINKER, LINA, ALHARETHI, RAMI, HESS, RACHEL, DRAKOS, STAVROS G., STEINBERG, BENJAMIN A., FANG, JAMES C., KFOURY, ABDALLAH G., MELENOVSKY, VOJTECH, GREENE, TOM, SPERTUS, JOHN A., and STEHLIK, JOSEF

Published
2024
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5. Abstract 15177: Unloading Reveals a Latent Cardiomyocyte Regeneration Potential in the Human Heart

Author

Derks, Wouter, Rode, Julian, Collin, Sofia, Rost, Fabian, Heinke, Paula, Hariharan, Anjana, Pickel, Lauren, Simonova, Irina, Lázár, Eniko, Graham, Evan, Jashari, Ramadan, Andrä, Michaela, Jeppsson, Anders, Salehpour, Mehran, Alkass, Kanar, Druid, Henrik, Kyriakopoulos, Christos, Taleb, Iosif, Shankar, Thirupura S S, Selzman, Craig, Sadek, Hesham A, Jovinge, Stefan, Brusch, Lutz, Frisen, Jonas, Drakos, Stavros G, and Bergmann, Olaf

Published
2023
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6. Pathophysiologic Vasodilation in Cardiogenic Shock and Its Impact on Mortality.

Author

Chavez, Miguel A., Anderson, McHale, Kyriakopoulos, Christos P., Scott, Monte, Dranow, Elizabeth, Maneta, Eleni, Hamouche, Rana, Taleb, Iosif, Leon, Jacy, Kogelschatz, Benjamin, Goldstein, Jake, Billia, Filio, Baran, David A., Tehran, Behnam, Goodwin, Matt, Selzman, Craig H., Tonna, Joseph E., Fang, James C., Drakos, Stavros G., and Hanff, Thomas C.

Abstract

BACKGROUND: Cardiogenic shock (CS) mortality remains near 40%. In addition to inadequate cardiac output, patients with severe CS may exhibit vasodilation. We aimed to examine the prevalence and consequences of vasodilation in CS. METHODS: We analyzed all patients hospitalized at a CS referral center who were diagnosed with CS stages B to E and did not have concurrent sepsis or recent cardiac surgery. Vasodilation was defined by lower systemic vascular resistance (SVR), higher norepinephrine equivalent dose, or a blunted SVR response to pressors. Threshold SVR values were determined by their relation to 14-day mortality in spline models. The primary outcome was death within 14 days of CS onset in multivariable-adjusted Cox models. RESULTS: This study included 713 patients with a mean age of 60 years and 27% females; 14-day mortality was 28%, and 38% were vasodilated. The median SVR was 1308 dynes•s•cm−5 (interquartile range, 870–1652), median norepinephrine equivalent was 0.11 µg/kg per minute (interquartile range, 0–0.2), and 28% had a blunted pressor response. Each 100-dynes•s•cm−5 decrease in SVR below 800 was associated with 20% higher mortality (adjusted hazard ratio, 1.23; P=0.004). Each 0.1-µg/kg per minute increase in norepinephrine equivalent dose was associated with 15% higher mortality (adjusted hazard ratio, 1.12; P<0.001). A blunted pressor response was associated with a nearly 2-fold mortality increase (adjusted hazard ratio, 1.74; P=0.003). CONCLUSIONS: Pathophysiologic vasodilation is prevalent in CS and independently associated with an increased risk of death. CS vasodilation can be identified by SVR <800 dynes•s•cm−5, high doses of pressors, or a blunted SVR response to pressors. Additional studies exploring mechanisms and treatments for CS vasodilation are needed. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Clinical Characteristics and Outcomes of Patients Suffering Acute Decompensated Heart Failure Complicated by Cardiogenic Shock.

Author

Kyriakopoulos, Christos P., Sideris, Konstantinos, Taleb, Iosif, Maneta, Eleni, Hamouche, Rana, Tseliou, Eleni, Chong Zhang, Presson, Angela P., Dranow, Elizabeth, Shah, Kevin S., Jones, Tara L., Fang, James C., Stehlik, Josef, Selzman, Craig H., Goodwin, Matthew L., Tonna, Joseph E., Hanff, Thomas C., and Drakos, Stavros G.

Abstract

BACKGROUND: Cardiogenic shock (CS) can stem from multiple causes and portends poor prognosis. Prior studies have focused on acute myocardial infarction-CS; however, acute decompensated heart failure (ADHF)-CS accounts for most cases. We studied patients suffering ADHF-CS to identify clinical factors, early in their trajectory, associated with a higher probability of successful outcomes. METHODS: Consecutive patients with CS were evaluated (N=1162). We studied patients who developed ADHF-CS at our hospital (N=562). Primary end point was native heart survival (NHS), defined as survival to discharge without receiving advanced HF therapies. Secondary end points were adverse events, survival, major cardiac interventions, and hospital readmissions within 1 year following index hospitalization discharge. Association of clinical data with NHS was analyzed using logistic regression. RESULTS: Overall, 357 (63.5%) patients achieved NHS, 165 (29.2%) died, and 41 (7.3%) were discharged post advanced HF therapies. Of 398 discharged patients (70.8%), 303 (53.9%) were alive at 1 year. Patients with NHS less commonly suffered cardiac arrest, underwent intubation or pulmonary artery catheter placement, or received temporary mechanical circulatory support, had better hemodynamic and echocardiographic profiles, and had a lower vasoactive-inotropic score at shock onset. Bleeding, hemorrhagic stroke, hemolysis in patients with mechanical circulatory support, and acute kidney injury requiring renal replacement therapy were less common compared with patients who died or received advanced HF therapies. After multivariable adjustments, clinical variables associated with NHS likelihood included younger age, history of systemic hypertension, absence of cardiac arrest or acute kidney injury requiring renal replacement therapy, lower pulmonary capillary wedge pressure and vasoactive-inotropic score, and higher tricuspid annular plane systolic excursion at shock onset (all P<0.05). CONCLUSIONS: By studying contemporary patients with ADHF-CS, we identified clinical factors that can inform clinical management and provide future research targets. Right ventricular function, renal function, pulmonary artery catheter placement, and type and timing of temporary mechanical circulatory support warrant further investigation to improve outcomes of this devastating condition. [ABSTRACT FROM AUTHOR]

Published
2024
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8. Distinct Transcriptomic and Proteomic Profile Specifies Patients Who Have Heart Failure With Potential of Myocardial Recovery on Mechanical Unloading and Circulatory Support

Author

Drakos, Stavros G., Badolia, Rachit, Makaju, Aman, Kyriakopoulos, Christos P., Wever-Pinzon, Omar, Tracy, Christopher M., Bakhtina, Anna, Bia, Ryan, Parnell, Timothy, Taleb, Iosif, Ramadurai, Dinesh K.A., Navankasattusas, Sutip, Dranow, Elizabeth, Hanff, Thomas C., Tseliou, Eleni, Shankar, Thirupura S., Visker, Joseph, Hamouche, Rana, Stauder, Elizabeth L., Caine, William T., Alharethi, Rami, Selzman, Craig H., and Franklin, Sarah

Published
2023
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9. The pyruvate-lactate axis modulates cardiac hypertrophy and heart failure

Author

Cluntun, Ahmad A., Badolia, Rachit, Lettlova, Sandra, Parnell, K. Mark, Shankar, Thirupura S., Diakos, Nikolaos A., Olson, Kristofor A., Taleb, Iosif, Tatum, Sean M., Berg, Jordan A., Cunningham, Corey N., Van Ry, Tyler, Bott, Alex J., Krokidi, Aspasia Thodou, Fogarty, Sarah, Skedros, Sophia, Swiatek, Wojciech I., Yu, Xuejing, Luo, Bai, Merx, Shannon, Navankasattusas, Sutip, Cox, James E., Ducker, Gregory S., Holland, William L., McKellar, Stephen H., Rutter, Jared, and Drakos, Stavros G.

Published
2021
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10. Abstract 11629: Multicenter Development and Validation of a Machine Learning Risk Model to Predict Right Ventricular Failure Following Mechanical Circulatory Support: The STOP-RVF Score

Author

Kyriakopoulos, Christos P, Taleb, Iosif, Ijaz, Naila, Demertzis, Zachary, Peruri, Adithya, Wever-Pinzon, Omar, Koliopoulou, Antigone G, Bonios, Michael J, Hanff, Thomas C, Dranow, Elizabeth, Giannouchos, Theodoros V, Sideris, Konstantinos, Nelson, Marisca, Elmer, Ashley, Tang, Daniel, Nemeh, Hassan, Stehlik, Josef, Fang, James C, Selzman, Craig H, Alharethi, Rami, Caine, William, Cowger, Jennifer, Shah, Palak, and Drakos, Stavros G

Published
2022
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11. Abstract 11588: Multicenter Development and Validation of a Machine Learning Model to Predict Myocardial Recovery During LVAD Support: The UCAR Score

Author

Kyriakopoulos, Christos P, Taleb, Iosif, Wever-Pinzon, Omar, Selzman, Craig H, Kfoury, Abdallah, Bonios, Michael J, Wever-Pinzon, James, Yin, Michael Y, Tseliou, Eleni, Stehlik, Josef, Alharethi, Rami, Caine, William, Fang, James C, Koliopoulou, Antigone G, Sideris, Konstantinos, Nelson, Marisca, Elmer, Ashley, Dranow, Elizabeth, Singh, Ramesh, Psotka, Mitchell, Birks, Emma J, Slaughter, Mark S, Koenig, Steven, Kyvernitakis, Andreas, Hoffman, Karlee, Guglin, Maya, Kotter, John, Campbell, Kenneth S, Silvestry, Scott C, Vidic, Andrija, Raval, Nirav, Cowger, Jennifer, Kanwar, Manreet, Shah, Palak, and Drakos, Stavros G

Published
2022
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12. Impact of Diabetes and Glycemia on Cardiac Improvement and Adverse Events Following Mechanical Circulatory Support.

Author

Kyriakopoulos, Christos P., Taleb, Iosif, Tseliou, Eleni, Sideris, Konstantinos, Hamouche, Rana, Maneta, Eleni, Nelson, Marisca, Krauspe, Ethan, Selko, Sean, Visker, Joseph R., Dranow, Elizabeth, Goodwin, Matthew L., Alharethi, Rami, Wever Pinzon, Omar, Fang, James C., Stehlik, Josef, Selzman, Craig H., Hanff, Thomas C., and Drakos, Stavros G.

Published
2024
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13. FGF21 (Fibroblast Growth Factor 21) Defines a Potential Cardiohepatic Signaling Circuit in End-Stage Heart Failure

Author

Sommakia, Salah, Almaw, Naredos H., Lee, Sandra H., Ramadurai, Dinesh K.A., Taleb, Iosif, Kyriakopoulos, Christos P., Stubben, Chris J., Ling, Jing, Campbell, Robert A., Alharethi, Rami A., Caine, William T., Navankasattusas, Sutip, Hoareau, Guillaume L., Abraham, Anu E., Fang, James C., Selzman, Craig H., Drakos, Stavros G., and Chaudhuri, Dipayan

Published
2021
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15. FGF21 (Fibroblast Growth Factor 21) Defines a Potential Cardiohepatic Signaling Circuit in End-Stage Heart Failure

Author

Sommakia, Salah, Almaw, Naredos H., Lee, Sandra H., Ramadurai, Dinesh K.A., Taleb, Iosif, Kyriakopoulos, Christos P., Stubben, Chris J., Ling, Jing, Campbell, Robert A., Alharethi, Rami A., Caine, William T., Navankasattusas, Sutip, Hoareau, Guillaume L., Abraham, Anu E., Fang, James C., Selzman, Craig H., Drakos, Stavros G., and Chaudhuri, Dipayan

Published
2022
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17. Bridge‐to‐transplant temporary mechanical circulatory support and risk of allosensitization.

Author

Sideris, Konstantinos, Lázár‐Molnár, Eszter, Kyriakopoulos, Christos P., Taleb, Iosif, Hurst, Denise, Ugolini, Sharon, Selzman, Craig H., Brinker, Lina, Drakos, Stavros G., Tonna, Joseph E., Geer, Laura, Goodwin, Matthew L., Wever‐Pinzon, Omar, Hanff, Thomas C., Fang, James C., Carter, Spencer, and Stehlik, Josef

Subjects
ARTIFICIAL blood circulation, INTRA-aortic balloon counterpulsation, HEART assist devices, RED blood cell transfusion, EXTRACORPOREAL membrane oxygenation
Abstract

Introduction: Since the 2018 change in the US adult heart allocation policy, more patients are bridged‐to‐transplant on temporary mechanical circulatory support (tMCS). Previous studies indicate that durable left ventricular assist devices (LVAD) may lead to allosensitization. The goal of this study was to assess whether tMCS implantation is associated with changes in sensitization. Methods: We included patients evaluated for heart transplants between 2015 and 2022 who had alloantibody measured before and after MCS implantation. Allosensitization was defined as development of new alloantibodies after tMCS implant. Results: A total of 41 patients received tMCS before transplant. Nine (22.0%) patients developed alloantibodies following tMCS implantation: 3 (12.0%) in the intra‐aortic balloon pump group (n = 25), 2 (28.6%) in the microaxial percutaneous LVAD group (n = 7), and 4 (44.4%) in the veno‐arterial extra‐corporeal membrane oxygenation group (n = 9)—p =.039. Sensitized patients were younger (44.7 ± 11.6 years vs. 54.3 ± 12.5 years, p =.044), were more likely to be sensitized at baseline ‐ 4 of 9 (44.4%) compared to 1 out of 32 (3.1%) (p =.001) and received more transfusions with red blood cells (6 (66.7%) vs. 8 (25%), p =.02) and platelets (6 (66.7%) vs. 5 (15.6%), p =.002). There was no significant difference in tMCS median duration of support (4 [3,15] days vs. 8.5 [5,14.5] days, p =.57). Importantly, out of the 11 patients who received a durable LVAD after tMCS, 5 (45.5%) became sensitized, compared to 4 out of 30 patients (13.3%) who only had tMCS—p =.028. Conclusions: Our findings suggest that patients bridged‐to‐transplant with tMCS, without significant blood product transfusions and a subsequent durable LVAD implant, have a low risk of allosensitization. Further studies are needed to confirm our findings and determine whether risk of sensitization varies by type of tMCS and duration of support. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Artificial intelligence predictive analytics in heart failure: results of the pilot phase of a pragmatic randomized clinical trial.

Author

Sideris, Konstantinos, Weir, Charlene R, Schmalfuss, Carsten, Hanson, Heather, Pipke, Matt, Tseng, Po-He, Lewis, Neil, Sallam, Karim, Bozkurt, Biykem, Hanff, Thomas, Schofield, Richard, Larimer, Karen, Kyriakopoulos, Christos P, Taleb, Iosif, Brinker, Lina, Curry, Tempa, Knecht, Cheri, Butler, Jorie M, and Stehlik, Josef

Abstract

Objectives We conducted an implementation planning process during the pilot phase of a pragmatic trial, which tests an intervention guided by artificial intelligence (AI) analytics sourced from noninvasive monitoring data in heart failure patients (LINK-HF2). Materials and methods A mixed-method analysis was conducted at 2 pilot sites. Interviews were conducted with 12 of 27 enrolled patients and with 13 participating clinicians. iPARIHS constructs were used for interview construction to identify workflow, communication patterns, and clinician's beliefs. Interviews were transcribed and analyzed using inductive coding protocols to identify key themes. Behavioral response data from the AI-generated notifications were collected. Results Clinicians responded to notifications within 24 hours in 95% of instances, with 26.7% resulting in clinical action. Four implementation themes emerged: (1) High anticipatory expectations for reliable patient communications, reduced patient burden, and less proactive provider monitoring. (2) The AI notifications required a differential and tailored balance of trust and action advice related to role. (3) Clinic experience with other home-based programs influenced utilization. (4) Responding to notifications involved significant effort, including electronic health record (EHR) review, patient contact, and consultation with other clinicians. Discussion Clinician's use of AI data is a function of beliefs regarding the trustworthiness and usefulness of the data, the degree of autonomy in professional roles, and the cognitive effort involved. Conclusion The implementation planning analysis guided development of strategies that addressed communication technology, patient education, and EHR integration to reduce clinician and patient burden in the subsequent main randomized phase of the trial. Our results provide important insights into the unique implications of implementing AI analytics into clinical workflow. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Machine Learning Multicenter Risk Model to Predict Right Ventricular Failure After Mechanical Circulatory Support: The STOP-RVF Score.

Author

Taleb, Iosif, Kyriakopoulos, Christos P., Fong, Robyn, Ijaz, Naila, Demertzis, Zachary, Sideris, Konstantinos, Wever-Pinzon, Omar, Koliopoulou, Antigone G., Bonios, Michael J., Shad, Rohan, Peruri, Adithya, Hanff, Thomas C., Dranow, Elizabeth, Giannouchos, Theodoros V., Krauspe, Ethan, Zakka, Cyril, Tang, Daniel G., Nemeh, Hassan W., Stehlik, Josef, and Fang, James C.

Published
2024
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22. The Role of Nonglycolytic Glucose Metabolism in Myocardial Recovery Upon Mechanical Unloading and Circulatory Support in Chronic Heart Failure

Author

Badolia, Rachit, Ramadurai, Dinesh K.A., Abel, E. Dale, Ferrin, Peter, Taleb, Iosif, Shankar, Thirupura S., Krokidi, Aspasia Thodou, Navankasattusas, Sutip, McKellar, Stephen H., Yin, Michael, Kfoury, Abdallah G., Wever-Pinzon, Omar, Fang, James C., Selzman, Craig H., Chaudhuri, Dipayan, Rutter, Jared, and Drakos, Stavros G.

Published
2020
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27. Clinical and histopathological effects of heart failure drug therapy in advanced heart failure patients on chronic mechanical circulatory support

Author

Catino, Anna B., Ferrin, Peter, Wever‐Pinzon, James, Horne, Benjamin D., Wever‐Pinzon, Omar, Kfoury, Abdallah G., McCreath, Lauren, Diakos, Nikolaos A., McKellar, Stephen, Koliopoulou, Antigone, Bonios, Michael J., Al‐Sarie, Mohammad, Taleb, Iosif, Dranow, Elizabeth, Fang, James C., and Drakos, Stavros G.

Published
2018
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31. Effect of Portable, In-Hospital Extracorporeal Membrane Oxygenation on Clinical Outcomes.

Author

Ciullo, Anna L., Wall, Natalie, Taleb, Iosif, Koliopoulou, Antigone, Stoddard, Kathleen, Drakos, Stavros G., Welt, Fred G., Goodwin, Matthew, Van Dyk, Nate, Kagawa, Hiroshi, McKellar, Stephen H., Selzman, Craig H., and Tonna, Joseph E.

Subjects
EXTRACORPOREAL membrane oxygenation, CARDIOGENIC shock, ARTIFICIAL blood circulation, TREATMENT effectiveness, OVERALL survival
Abstract

The time between onset of cardiogenic shock and initiation of mechanical circulatory support is inversely related to patient survival as delays in transporting patients to the operating room (OR) for venoarterial extracorporeal membrane oxygenation (VA ECMO) could prove fatal. A primed and portable VA ECMO system may allow faster initiation of ECMO in various hospital locations and subsequently improve outcomes for patients in cardiogenic shock. We reviewed our institutional experience with VA ECMO based on two time periods: beginning of our VA ECMO program and from initiation of our primed and portable in-hospital ECMO system. The primary endpoint was patient survival to discharge. A total of 137 patients were placed on VA ECMO during the study period; n = 66 (48%) before and n = 71 (52%) after program initiation. In the second era, the proportion of OR ECMO initiation decreased significantly (from 92% to 49%, p < 0.01) as more patients received ECMO in other hospital units, including the emergency department (p < 0.01) and during cardiac arrest (12% vs. 38%, p < 0.01). Survival to hospital discharge was equivalent between the two groups (30% vs. 42%, p = 0.1) despite more patients being placed on ECMO during ongoing cardiac arrest. Finally, we observed increased clinical volume since initiation of the in-hospital, portable ECMO system. Developing an in-hospital, primed and portable VA ECMO program resulted in increased clinical volume with equivalent patient survival despite a sicker cohort of patients. We conclude that more rapid deployment of VA ECMO may extend the treatment eligibility to more patients and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Published
2022
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32. LVAD as a Bridge to Remission from Advanced Heart Failure: Current Data and Opportunities for Improvement.

Author

Kyriakopoulos, Christos P., Kapelios, Chris J., Stauder, Elizabeth L., Taleb, Iosif, Hamouche, Rana, Sideris, Konstantinos, Koliopoulou, Antigone G., Bonios, Michael J., and Drakos, Stavros G.

Subjects
HEART assist devices, HEART failure, ARTIFICIAL blood circulation
Abstract

Left ventricular assist devices (LVADs) are an established treatment modality for advanced heart failure (HF). It has been shown that through volume and pressure unloading they can lead to significant functional and structural cardiac improvement, allowing LVAD support withdrawal in a subset of patients. In the first part of this review, we discuss the historical background, current evidence on the incidence and assessment of LVAD-mediated cardiac recovery, and out-comes including quality of life after LVAD support withdrawal. In the second part, we discuss current and future opportunities to promote LVAD-mediated reverse remodeling and improve our pathophysiological understanding of HF and recovery for the benefit of the greater HF population. [ABSTRACT FROM AUTHOR]

Published
2022
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33. Machine Learning Identification Of Transcriptomics And Clinical Characteristics Associated With Myocardial Recovery In Heart Failure Patients Undergoing Mechanical Circulatory Support

Author

Kyriakopoulos, Christos P, Visker, Joseph R, Brintz, Ben J, Taleb, Iosif, Badolia, Rachit, Haaland, Benjamin, Shankar, Thirupura S, Ling, Jing, Hamouche, Rana, Tseliou, Eleni, Sideris, Konstantinos, Scott, Monte, Krauspe, Ethan, Navankasattusas, Sutip, Wever-Pinzon, Omar, Hanff, Thomas C, Bailey, Stephen, Koenig, Steven, Alharethi, Rami, Greene, Tom H, Selzman, Craig H, Slaughter, Mark S, Kanwar, Manreet, Shah, Palak, and Drakos, Stavros G

Published
2023
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34. HEALTH RELATED QUALITY OF LIFE AS PREDICTOR OF OUTCOMES IN HEART FAILURE WITH PRESERVED EJECTION FRACTION

Author

Sideris, Konstantinos, Zhang, Mingyuan, Siu, Alfonso F., Wohlfahrt, Peter, Shen, Jincheng, Kyriakopoulos, Christos P., Taleb, Iosif, Wever-Pinzon, Omar, Shah, Kevin, Selzman, Craig H., Correa, Carlos Rodriguez, Kapelios, Christos, Brinker, Lina M., Alharethi, Rami, Hess, Rachel, Drakos, Stavros George, Steinberg, Benjamin Adam, Kfoury, Abdallah G., Spertus, John A., Fang, James C., and Stehlik, Josef

Published
2023
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36. Predicting mortality in cardiogenic shock secondary to ACS requiring short‐term mechanical circulatory support: The ACS‐MCS score.

Author

Marashly, Qussay, Taleb, Iosif, Kyriakopoulos, Christos P., Dranow, Elizabeth, Jones, Tara L., Tandar, Anwar, Overton, Sean D., Tonna, Joseph E., Stoddard, Kathleen, Wever‐Pinzon, Omar, Kemeyou, Line, Koliopoulou, Antigone G., Shah, Kevin S., Nourian, Kimiya, Richins, Tyler J., Burnham, Tyson S., Welt, Frederick G., McKellar, Stephen H., Nativi‐Nicolau, Jose, and Drakos, Stavros G.

Published
2021
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38. Predicting Cardiac Structural And Functional Improvement On Left Ventricular Assist Device Support: The Externally Validated UCAR Score

Author

Kyriakopoulos, Christos P., Taleb, Iosif, Wever-Pinzon, Omar, Selzman, Craig, Kfoury, Abdallah, Catino, Anna, Tseliou, Eleni, Stehlik, Josef, Alharethi, Rami, Fang, James C., Koliopoulou, Antigone, Goodwin, Matthew, Kagawa, Hiroshi, Dranow, Elizabeth, Singh, Ramesh, Psotka, Mitchell, Birks, Emma, Slaughter, Mark S., Koenig, Steven, Kyvernitakis, Andreas, Hoffman, Karlee, Guglin, Maya, Kotter, John, Vidic, Andrija, Raval, Nirav, Kanwar, Manreet, Shah, Palak, and Drakos, Stavros G.

Published
2022
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42. Outcomes of Asian-Americans Implanted With Left Ventricular Assist Devices: An Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Analysis.

Author

Taleb, Iosif, Wever-Pinzon, James, Wang, Wenyan, Koliopoulou, Antigone, Dranow, Elizabeth, Yu, Tao, Yin, Lixue, McKellar, Stephen H., Stehlik, Josef, Fang, James C., Wever-Pinzon, Omar, Selzman, Craig H., and Drakos, Stavros G.

Subjects
*HEART assist devices, *ASIAN Americans, *BODY mass index, *CARDIAC surgery, *CORONARY disease, *HEART failure treatment, *ACQUISITION of data, *RETROSPECTIVE studies, *HEART ventricles, *TREATMENT effectiveness, *STROKE volume (Cardiac output), *LONGITUDINAL method, *HEART failure
Abstract

Background: Studies have indicated differences between Asians and Whites in their propensity for stroke, coronary artery disease, heart failure, bleeding and thrombosis. We investigated whether Asian-Americans on durable left ventricular assist devices (LVADs) exhibit differential morbidity and mortality when compared to Whites.Methods: We analysed prospectively collected data from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database to compare the outcomes after LVAD implantation of Asians versus Whites.Results: In total, 7,018 patients were included, 130 were identified as Asian-Americans. Asian-Americans were younger, had lower body mass index, higher serum bilirubin and lower albumin levels. In a multivariable regression model, there was no difference in survival between the two groups. Asian-Americans had lower incidence of device malfunction and after adjusting for multiple factors this remained lower. The adjusted risk of a major safety composite outcome, including major bleeding, major infection, stroke and device malfunction, revealed no difference between the two groups.Conclusions: Although prior studies have reported worse cardiac surgery outcomes in Asians, in this INTERMACS analysis Asian-Americans appear to have similar survival and risk of adverse events as their White counterparts. The incidence of device malfunction was lower in the Asian-Americans, both in a univariate model and after adjusting for multiple clinical factors. Future, larger studies of Asian-Americans with end-stage heart failure and LVAD support are warranted to confirm these results. [ABSTRACT FROM AUTHOR]

Published
2020
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43. Perm1 regulates cardiac energetics as a downstream target of the histone methyltransferase Smyd1.

Author

Oka, Shin-ichi, Sabry, Amira D., Horiuchi, Amanda K., Cawley, Keiko M., O'Very, Sean A., Zaitsev, Maria A., Shankar, Thirupura S., Byun, Jaemin, Mukai, Risa, Xu, Xiaoyong, Torres, Natalia S., Kumar, Anil, Yazawa, Masayuki, Ling, Jing, Taleb, Iosif, Saijoh, Yukio, Drakos, Stavros G., Sadoshima, Junichi, and Warren, Junco S.

Subjects
HEART failure patients, REPORTER genes, GENE targeting, BIOENERGETICS, ESTROGEN
Abstract

The transcriptional regulatory machinery in mitochondrial bioenergetics is complex and is still not completely understood. We previously demonstrated that the histone methyltransferase Smyd1 regulates mitochondrial energetics. Here, we identified Perm1 (PPARGC-1 and ESRR-induced regulator, muscle specific 1) as a downstream target of Smyd1 through RNA-seq. Chromatin immunoprecipitation assay showed that Smyd1 directly interacts with the promoter of Perm1 in the mouse heart, and this interaction was significantly reduced in mouse hearts failing due to pressure overload for 4 weeks, where Perm1 was downregulated (24.4 ± 5.9% of sham, p<0.05). Similarly, the Perm1 protein level was significantly decreased in patients with advanced heart failure (55.2 ± 13.1% of donors, p<0.05). Phenylephrine (PE)-induced hypertrophic stress in cardiomyocytes also led to downregulation of Perm1 (55.7 ± 5.7% of control, p<0.05), and adenovirus-mediated overexpression of Perm1 rescued PE-induced downregulation of estrogen-related receptor alpha (ERRα), a key transcriptional regulator of mitochondrial energetics, and its target gene, Ndufv1 (Complex I). Pathway enrichment analysis of cardiomyocytes in which Perm1 was knocked-down by siRNA (siPerm1), revealed that the most downregulated pathway was metabolism. Cell stress tests using the Seahorse XF analyzer showed that basal respiration and ATP production were significantly reduced in siPerm1 cardiomyocytes (40.7% and 23.6% of scrambled-siRNA, respectively, both p<0.05). Luciferase reporter gene assay further revealed that Perm1 dose-dependently increased the promoter activity of the ERRα gene and known target of ERRα, Ndufv1 (Complex I). Overall, our study demonstrates that Perm1 is an essential regulator of cardiac energetics through ERRα, as part of the Smyd1 regulatory network. [ABSTRACT FROM AUTHOR]

Published
2020
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