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11. Dynamic assessment of left ventricular coupling and myocardial reserve in patients with cardiogenic shock.

Author

Kanelidis, Anthony J, Randazzo, Michael J, Kalantari, Sara, Smith, Bryan, Nguyen, Ann, Chung, Ben B, Swat, Stanley, Sarswat, Nitasha, Salerno, Christopher, Jeevanandam, Valluvan, Kim, Gene, Belkin, Mark N, and Grinstein, Jonathan

Subjects
PULMONARY artery catheters, CARDIOGENIC shock, CARDIAC output, HEART transplantation, COUPLINGS (Gearing)
Abstract

Aims Pulmonary artery catheter haemodynamics are associated with improved survival in cardiogenic shock (CS). We investigated the utility of aortic pulsatility index (API) and cardiac power output (CPO) as surrogates for left ventricular (LV) coupling and myocardial reserve, respectively, in patients with CS undergoing dynamic assessment after a milrinone bolus. Methods and results Patients with SCAI Stage C CS underwent a milrinone drug study (50 mcg/kg bolus infused over 10 min) to assess inotropic response. Haemodynamic measurements were obtained at baseline and following the bolus. Aortic pulsatility index and CPO were used to risk-stratify patients with the incidence of LV assist device (LVAD), orthotopic heart transplantation (OHT), or death at 1 year as the primary composite endpoint. Two hundred and twenty-four patients in SCAI Stage C CS underwent haemodynamics prior to milrinone bolus, and 117 patients had low baseline API < 1.45. Of the 117 patients, 88 had a final API < 2.2 after milrinone load, consistent with LV decoupling, in which 73% met the composite endpoint. The remaining 29 patients had a final API ≥ 2.2 consistent with LV recoupling, and only 55% met the composite endpoint (P = 0.046). Of the 117 patients, 40 patients had low myocardial reserve (final CPO < 0.77 W), in which 78% met the composite endpoint. Of the 77 patients who demonstrated myocardial reserve (final CPO ≥ 0.77 W), only 64% met the composite endpoint (P = 0.039). Conclusion The use of API and CPO in a dynamic assessment after provocative testing led to improved risk stratification in patients with SCAI Stage C CS for clinical outcomes including LVAD, OHT, or death at 1 year. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Transcatheter Aortic Valve Replacement in Left Ventricular Assist Device Patients with Aortic Regurgitation

Author

Belkin, Mark N., Imamura, Teruhiko, Fujino, Takeo, Kanelidis, Anthony J., Holzhauser, Luise, Ebong, Imo, Narang, Nikhil, Blair, John E., Nathan, Sandeep, Paul, Jonathan D., Shah, Atman P., Chung, Ben Bow, Nguyen, Ann, Smith, Bryan, Kalantari, Sara, Raikhelkar, Jayant, Ota, Takeyoshi, Jeevanandam, Valluvan, Kim, Gene, Burkhoff, Daniel, Sayer, Gabriel, and Uriel, Nir

Published
2020
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15. ATTR Gene Variants in HCM

Author

Kanelidis, Anthony J., primary, Slivnick, Jeremy A., additional, Campagna, Rachel, additional, Smith, Bryan, additional, Kalantari, Sara, additional, Sarswat, Nitasha, additional, and Kim, Gene, additional

Published
2024
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19. Hemodynamic Assessment Of Dynamic Left Ventricular Coupling And Myocardial Reserve Improves Risk Stratification In Patients With Decompensated Heart Failure And Cardiogenic Shock

Author

Kanelidis, Anthony, primary, Randazzo, Michael, additional, Kalantari, Sara, additional, Smith, Bryan, additional, Nguyen, Ann, additional, Chung, Ben Bow, additional, Sarswat, Nitasha, additional, Salerno, Christopher, additional, Jeevanandam, Valluvan, additional, Kim, Gene, additional, Belkin, Mark, additional, and Grinstein, Jonathan, additional

Published
2024
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20. Status One and Status Two Exception Use in the Updated Heart Allocation System

Author

PLANA, ALEJANDRO, primary, BELKIN, MARK N., additional, KANELIDIS, ANTHONY J., additional, PARKER, WILLIAM F., additional, JEEVANANDAM, VALLUVAN, additional, SALERNO, CHRISTOPHER, additional, NGUYEN, ANN B., additional, CHUNG, BOW B., additional, SMITH, BRYAN A., additional, KALANTARI, SARA, additional, SARSWAT, NITASHA, additional, KIM, GENE, additional, PINNEY, SEAN P., additional, and GRINSTEIN, JONATHAN, additional

Published
2023
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23. The prognostic role of advanced hemodynamic variables in patients with left ventricular assist devices

Author

Kanelidis, Anthony J., primary, Siddiqi, Umar, additional, Miller, Tamari, additional, Belkin, Mark, additional, Li, George, additional, Smith, Bryan, additional, Kalantari, Sara, additional, Nguyen, Ann, additional, Chung, Ben B., additional, Sarswat, Nitasha, additional, Kim, Gene, additional, Salerno, Christopher, additional, Jeevanandam, Valluvan, additional, Pinney, Sean, additional, and Grinstein, Jonathan, additional

Published
2022
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24. Postoperative tolvaptan use in left ventricular assist device patients: The TOLVAD randomized pilot study

Author

Belkin, Mark N., primary, Imamura, Teruhiko, additional, Rodgers, Daniel, additional, Kanelidis, Anthony J., additional, Henry, Michael P., additional, Fujino, Takeo, additional, Kagan, Viktoriya, additional, Meehan, Karen, additional, Okray, Justin, additional, Creighton, Shana, additional, LaBuhn, Colleen, additional, Song, Tae, additional, Ota, Takeyoshi, additional, Jeevanandam, Valluvan, additional, Nguyen, Ann B., additional, Chung, Ben B., additional, Smith, Bryan A., additional, Kalantari, Sara, additional, Grinstein, Jonathan, additional, Sarswat, Nitasha, additional, Pinney, Sean P., additional, Sayer, Gabriel, additional, Kim, Gene, additional, and Uriel, Nir, additional

Published
2022
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29. Calculation Of Cardiac Power Output With Right Atrial Pressure

Author

Belkin, Mark N., primary, Kalantari, Sara, additional, Kanelidis, Anthony J., additional, Miller, Tamari, additional, Besser, Stephanie, additional, Nguyen, Ann, additional, Chung, Bow, additional, Smith, Bryan, additional, Sarswat, Nitasha, additional, Kim, Gene, additional, Pinney, Sean, additional, and Grinstein, Jonathan, additional

Published
2022
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33. The prognostic role of advanced hemodynamic variables in patients with left ventricular assist devices.

Author

Kanelidis, Anthony J., Siddiqi, Umar, Miller, Tamari, Belkin, Mark, Li, George, Smith, Bryan, Kalantari, Sara, Nguyen, Ann, Chung, Ben B., Sarswat, Nitasha, Kim, Gene, Salerno, Christopher, Jeevanandam, Valluvan, Pinney, Sean, and Grinstein, Jonathan

Subjects
*HEART assist devices, *HEMODYNAMICS, *CARDIAC output, *PROGNOSIS, *HEART failure patients, *DEEP brain stimulation, *UNIVARIATE analysis, *TRANSCRANIAL magnetic stimulation
Abstract

Background: Invasive hemodynamic variables obtained from right heart catheterization have been used for risk‐stratifying patients with advanced heart failure (HF). However, there is a paucity of data on the prognostic value of invasive hemodynamic variables in patients with left ventricular assist devices (LVAD). We hypothesized that cardiac power output (CPO), cardiac power efficiency (CPE), and left ventricular stroke work index (LVSWI) can serve as prognostic markers in patients with LVADs. Methods: Baseline hemodynamic data from patients who had LVAD ramp studies at our institution from 4/2014 to 7/2018 were prospectively collected, from which advanced hemodynamic variables (CPO, CPE, and LVSWI) were retrospectively analyzed. Univariate and multivariable analyses were performed for hemocompatibility‐related adverse events (HRAE), HF admissions, and mortality. Results: Ninety‐one participants (age 61 ± 11 years, 34% women, 40% Black or African American, and 38% ischemic cardiomyopathy) were analyzed. Low CPE was significantly associated with mortality (HR 2.42, 95% CI 1.02–5.74, p = 0.045) in univariate analysis and Kaplan–Meier analysis (p = 0.04). Low LVSWI was significantly associated with mortality (HR 2.13, 95% CI 1.09–4.17, p = 0.03) in univariate analysis and Kaplan–Meier analysis (p = 0.02). CPO was not associated with mortality. CPO, CPE, and LVSWI were not associated with HRAE or HF admissions. Conclusions: Advanced hemodynamic variables can serve as prognostic indicators for patients with LVADs. Low CPE and LVSWI are prognostic for higher mortality, but no variables were associated with HF admissions or HRAEs. [ABSTRACT FROM AUTHOR]

Published
2023
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35. Supplemental Material, sj-pdf-2-ajh-10.1177_10499091211041079 - Clinician Ethical Perspectives on Extracorporeal Membrane Oxygenation in Practice

Author

Piscitello, Gina M., Bermea, Rene S., Stokes, John W., Gannon, Whitney D., Kanelidis, Anthony J., Konopka, Megan, Shappell, Claire, Frye, Laura K., Lyons, Patrick G., Siegler, Mark, and Parker, William F.

Subjects
111099 Nursing not elsewhere classified, 111702 Aged Health Care, FOS: Health sciences
Abstract

Supplemental Material, sj-pdf-2-ajh-10.1177_10499091211041079 for Clinician Ethical Perspectives on Extracorporeal Membrane Oxygenation in Practice by Gina M. Piscitello, Rene S. Bermea, John W. Stokes, Whitney D. Gannon, Anthony J. Kanelidis, Megan Konopka, Claire Shappell, Laura K. Frye, Patrick G. Lyons, Mark Siegler and William F. Parker in American Journal of Hospice and Palliative Medicine®

Published
2021
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36. Supplemental Material, sj-pdf-3-ajh-10.1177_10499091211041079 - Clinician Ethical Perspectives on Extracorporeal Membrane Oxygenation in Practice

Author

Piscitello, Gina M., Bermea, Rene S., Stokes, John W., Gannon, Whitney D., Kanelidis, Anthony J., Konopka, Megan, Shappell, Claire, Frye, Laura K., Lyons, Patrick G., Siegler, Mark, and Parker, William F.

Subjects
111099 Nursing not elsewhere classified, 111702 Aged Health Care, FOS: Health sciences
Abstract

Supplemental Material, sj-pdf-3-ajh-10.1177_10499091211041079 for Clinician Ethical Perspectives on Extracorporeal Membrane Oxygenation in Practice by Gina M. Piscitello, Rene S. Bermea, John W. Stokes, Whitney D. Gannon, Anthony J. Kanelidis, Megan Konopka, Claire Shappell, Laura K. Frye, Patrick G. Lyons, Mark Siegler and William F. Parker in American Journal of Hospice and Palliative Medicine®

Published
2021
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37. Supplemental Material, sj-pdf-1-ajh-10.1177_10499091211041079 - Clinician Ethical Perspectives on Extracorporeal Membrane Oxygenation in Practice

Author

Piscitello, Gina M., Bermea, Rene S., Stokes, John W., Gannon, Whitney D., Kanelidis, Anthony J., Konopka, Megan, Shappell, Claire, Frye, Laura K., Lyons, Patrick G., Siegler, Mark, and Parker, William F.

Subjects
111099 Nursing not elsewhere classified, 111702 Aged Health Care, FOS: Health sciences
Abstract

Supplemental Material, sj-pdf-1-ajh-10.1177_10499091211041079 for Clinician Ethical Perspectives on Extracorporeal Membrane Oxygenation in Practice by Gina M. Piscitello, Rene S. Bermea, John W. Stokes, Whitney D. Gannon, Anthony J. Kanelidis, Megan Konopka, Claire Shappell, Laura K. Frye, Patrick G. Lyons, Mark Siegler and William F. Parker in American Journal of Hospice and Palliative Medicine®

Published
2021
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40. Clinician Ethical Perspectives on Extracorporeal Membrane Oxygenation in Practice.

Author

Piscitello, Gina M., Bermea, Rene S., Stokes, John W., Gannon, Whitney D., Kanelidis, Anthony J., Konopka, Megan, Shappell, Claire, Frye, Laura K., Lyons, Patrick G., Siegler, Mark, and Parker, William F.

Abstract

Purpose: Extracorporeal membrane oxygenation (ECMO) is an expensive and scarce life sustaining treatment provided to certain critically ill patients. Little is known about the informed consent process for ECMO or clinician viewpoints on ethical complexities related to ECMO in practice. Methods: We sent a cross-sectional survey to all departments providing ECMO within 7 United States hospitals in January 2021. One clinician from each department completed the 42-item survey representing their department. Results: Fourteen departments within 7 hospitals responded (response rate 78%, N = 14/18). The mean time spent consenting patients or surrogate decision-makers for ECMO varied, from 7.5 minutes (95% CI 5-10) for unstable patients to 20 minutes (95% CI 15-30) for stable patients (p = 0.0001). Few clinician respondents (29%) report patients or surrogate decision-makers always possess informed consent for ECMO. Most departments (92%) have absolute exclusion criteria for ECMO such as older age (43%, cutoffs ranging from 60-75 years), active malignancy (36%), and elevated body mass index (29%). A significant minority of departments (29%) do not always offer the option to withdraw ECMO to patients or surrogate decision-makers. For patients who cannot be liberated from ECMO and are ineligible for heart or lung transplant, 36% of departments would recommend the patient be removed from ECMO and 64% would continue ECMO support. Conclusion: Adequate informed consent for ECMO is a major ethical challenge, and the content of these discussions varies. Use of categorical exclusion criteria and withdrawal of ECMO if a patient cannot be liberated from it differ among departments and institutions. [ABSTRACT FROM AUTHOR]

Published
2022
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45. VESSEL PREPARATION IMPROVES DRUG ELUTING STENT (DES) EXPANSION PARAMETERS VERSUS DIRECT CORONARY STENTING IN NON-COMPLEX LESIONS AS ASSESSED BY HIGH-RESOLUTION OPTICAL COHERENCE TOMOGRAPHY (OCT)

Author

Bharmal, Murtaza Ismail, primary, Marginean, Alexandru, additional, Lloyd, James, additional, Matsukage, Hitoshi, additional, Hashim, Farah, additional, Brummel, Kent, additional, Kanelidis, Anthony, additional, Blair, John, additional, Paul, Jonathan, additional, Shah, Atman, additional, and Nathan, Sandeep, additional

Published
2019
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46. The Reply

Author

Kanelidis, Anthony J., primary, Oehler, Drew, additional, and Paul, Jonathan D., additional

Published
2018
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47. A Combination of Allogeneic Stem Cells Promotes Cardiac Regeneration

Author

Natsumeda, Makoto, primary, Florea, Victoria, additional, Rieger, Angela C., additional, Tompkins, Bryon A., additional, Banerjee, Monisha N., additional, Golpanian, Samuel, additional, Fritsch, Julia, additional, Landin, Ana Marie, additional, Kashikar, Nilesh D., additional, Karantalis, Vasileios, additional, Loescher, Viky Y., additional, Hatzistergos, Kostas E., additional, Bagno, Luiza, additional, Sanina, Cristina, additional, Mushtaq, Muzammil, additional, Rodriguez, Jose, additional, Rosado, Marcos, additional, Wolf, Ariel, additional, Collon, Kevin, additional, Vincent, Louis, additional, Kanelidis, Anthony J., additional, Schulman, Ivonne H., additional, Mitrani, Raul, additional, Heldman, Alan W., additional, Balkan, Wayne, additional, and Hare, Joshua M., additional

Published
2017
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48. Synergistic Effects of Combined Cell Therapy for Chronic Ischemic Cardiomyopathy

Author

Karantalis, Vasileios, primary, Suncion-Loescher, Viky Y., additional, Bagno, Luiza, additional, Golpanian, Samuel, additional, Wolf, Ariel, additional, Sanina, Cristina, additional, Premer, Courtney, additional, Kanelidis, Anthony J., additional, McCall, Frederic, additional, Wang, Bo, additional, Balkan, Wayne, additional, Rodriguez, Jose, additional, Rosado, Marcos, additional, Morales, Azorides, additional, Hatzistergos, Konstantinos, additional, Natsumeda, Makoto, additional, Margitich, Irene, additional, Schulman, Ivonne Hernandez, additional, Gomes, Samirah A., additional, Mushtaq, Muzammil, additional, DiFede, Darcy L., additional, Fishman, Joel E., additional, Pattany, Pradip, additional, Zambrano, Juan Pablo, additional, Heldman, Alan W., additional, and Hare, Joshua M., additional

Published
2015
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50. Abstract 12127: Hyponatremia is Associated With Higher Readmission Rates in Patients With Left Ventricular Assist Devices

Author

Kanelidis, Anthony J, Imamura, Teruhiko, Yang, Ben, Miller, Tamari, Bharmal, Murtaza, Kim, Gene H, Sayer, Gabriel T, and Uriel, Nir

Abstract

Introduction:Hyponatremia is associated with increased morbidity and mortality in heart failure (HF) patients. The implication of hyponatremia post-left ventricular assist device (LVAD) remains unknown.Hypothesis:We hypothesized that LVAD patients with hyponatremia would have increased morbidity and mortality.Methods:A retrospective study of VAD patients between 4/2014-3/2018. Patients with LVAD exchange or right VAD implantation were excluded. Patients were stratified by the presence of hyponatremia (Na<135) at 30 days post-LVAD. Clinical variables included Na levels pre-LVAD and up through 1-year post-LVAD. HF readmissions and survival during 1-year follow-up were compared between the groups.Results:Of 204 patients identified, 170 with LVAD implantation were included in the study. Mean age was 55, 31% were male, and 29% had ischemic cardiomyopathy. Na levels improved from pre-LVAD to 1-year (135.9 ? 4.5 mEq/L to 138.9 ? 3.7 mEq/L, P<0.001). At 30 days, 35 patients were in the hyponatremia group and 135 patients were in the control group. No significant difference was observed for 1-year survival between the groups (81% vs. 77%, P=0.66; Figure 1A). The control group had significantly better 1-year freedom from HF readmission compared to the hyponatremia group (85% vs. 56%, P=0.001; Figure 1B). Among patients with normonatremia (N=110), those who developed de novo hyponatremia (N=17) had lower freedom from HF readmission than those who remained normonatremic (55% vs. 84%, P=0.022; Figure 1C). Among patients with hyponatremia (N=60), those who had persistent hyponatremia (N=18) had decreased freedom from HF readmission than those who improved to normonatremia (56% vs. 88%, P=0.008; Figure 1D).Conclusions:Hyponatremia in LVAD patients is associated with increased HF readmissions but not increased mortality. Further studies need to elucidate whether therapies directed at hyponatremia (tolvaptan) would improve outcomes in LVAD patients.

Published
2019
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