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2. Protein Biomarkers of Adverse Clinical Features and Events in Sarcomeric Hypertrophic Cardiomyopathy

Author

Tahir, Usman A., Kolm, Paul, Kwong, Raymond Y., Desai, Milind Y., Dolman, Sarahfaye F., Deng, Shuliang, Appelbaum, Evan, Desvigne-Nickens, Patrice, DiMarco, John P., Tiwari, Gaurav, Friedrich, Matthias G., Zelaya-Portillo, Julissa H., Jerosch-Herold, Michael, Kim, Dong-Yun, Maron, Martin S., Piechnik, Stefan K., Schulz-Menger, Jeanette, Watkins, Hugh, Weintraub, William S., Neubauer, Stefan, Kramer, Christopher M., Jarolim, Petr, Gerszten, Robert E., and Ho, Carolyn Y.

Published
2024
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4. Effect of Aficamten on Cardiac Structure and Function in Obstructive Hypertrophic Cardiomyopathy: SEQUOIA-HCM CMR Substudy

Author

Masri, Ahmad, Cardoso, Rhanderson N., Abraham, Theodore P., Claggett, Brian L., Coats, Caroline J., Hegde, Sheila M., Kulac, Ian J., Lee, Matthew M.Y., Maron, Martin S., Merkely, Bela, Michels, Michelle, Olivotto, Iacopo, Oreziak, Artur, Jacoby, Daniel L., Heitner, Stephen B., Kupfer, Stuart, Malik, Fady I., Meng, Lisa, Solomon, Scott D., Wohltman, Amy, Kwong, Raymond Y., and Kramer, Christopher M.

Published
2024
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5. Impact of Aficamten on Echocardiographic Cardiac Structure and Function in Symptomatic Obstructive Hypertrophic Cardiomyopathy

Author

Hegde, Sheila M., Claggett, Brian L., Wang, Xiaowen, Jering, Karola, Prasad, Narayana, Roshanali, Farideh, Masri, Ahmad, Nassif, Michael E., Barriales-Villa, Roberto, Abraham, Theodore P., Cardim, Nuno, Coats, Caroline J., Kramer, Christopher M., Maron, Martin S., Michels, Michelle, Olivotto, Iacopo, Saberi, Sara, Jacoby, Daniel L., Heitner, Stephen B., Kupfer, Stuart, Meng, Lisa, Wohltman, Amy, Malik, Fady I., and Solomon, Scott D.

Published
2024
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6. Efficacy and Safety of Aficamten in Symptomatic Nonobstructive Hypertrophic Cardiomyopathy: Results From the REDWOOD-HCM Trial, Cohort 4

Author

MASRI, AHMAD, SHERRID, MARK V., ABRAHAM, THEODORE P., CHOUDHURY, LUBNA, GARCIA-PAVIA, PABLO, KRAMER, CHRISTOPHER M., BARRIALES-VILLA, ROBERTO, OWENS, ANJALI T., RADER, FLORIAN, NAGUEH, SHERIF F., OLIVOTTO, IACOPO, SABERI, SARA, TOWER-RADER, ALBREE, WONG, TIMOTHY C., COATS, CAROLINE J., WATKINS, HUGH, FIFER, MICHAEL A., SOLOMON, SCOTT D., HEITNER, STEPHEN B., JACOBY, DANIEL L., KUPFER, STUART, MALIK, FADY I., MENG, LISA, SOHN, REGINA L., WOHLTMAN, AMY, and MARON, MARTIN S.

Published
2024
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9. Machine learning for multidimensional response and survival after cardiac resynchronization therapy using features from cardiac magnetic resonance.

Author

Bivona, Derek, Tallavajhala, Srikar, Abdi, Mohamad, Oomen, Pim, Gao, Xu, Malhotra, Rohit, Darby, Andrew, Monfredi, Oliver, Mangrum, J, Mason, Pamela, Mazimba, Sula, Salerno, Michael, Kramer, Christopher, Epstein, Frederick, Holmes, Jeffrey, and Bilchick, Kenneth

Subjects
Cardiac resynchronization therapy, Heart failure, Implantable cardioverter-defibrillator, Machine learning, Magnetic resonance imaging
Abstract

BACKGROUND: Cardiac resynchronization therapy (CRT) response is complex, and better approaches are required to predict survival and need for advanced therapies. OBJECTIVE: The objective was to use machine learning to characterize multidimensional CRT response and its relationship with long-term survival. METHODS: Associations of 39 baseline features (including cardiac magnetic resonance [CMR] findings and clinical parameters such as glomerular filtration rate [GFR]) with a multidimensional CRT response vector (consisting of post-CRT left ventricular end-systolic volume index [LVESVI] fractional change, post-CRT B-type natriuretic peptide, and change in peak VO2) were evaluated. Machine learning generated response clusters, and cross-validation assessed associations of clusters with 4-year survival. RESULTS: Among 200 patients (median age 67.4 years, 27.0% women) with CRT and CMR, associations with more than 1 response parameter were noted for the CMR CURE-SVD dyssynchrony parameter (associated with post-CRT brain natriuretic peptide [BNP] and LVESVI fractional change) and GFR (associated with peak VO2 and post-CRT BNP). Machine learning defined 3 response clusters: cluster 1 (n = 123, 90.2% survival [best]), cluster 2 (n = 45, 60.0% survival [intermediate]), and cluster 3 (n = 32, 34.4% survival [worst]). Adding the 6-month response cluster to baseline features improved the area under the receiver operating characteristic curve for 4-year survival from 0.78 to 0.86 (P = .02). A web-based application was developed for cluster determination in future patients. CONCLUSION: Machine learning characterizes distinct CRT response clusters influenced by CMR features, kidney function, and other factors. These clusters have a strong and additive influence on long-term survival relative to baseline features.

Published
2022

11. Cardiac magnetic resonance defines mechanisms of sex-based differences in outcomes following cardiac resynchronization therapy.

Author

Bivona, Derek, Tallavajhala, Srikar, Abdi, Mohamad, Oomen, Pim, Gao, Xu, Malhotra, Rohit, Darby, Andrew, Monfredi, Oliver, Mangrum, J, Mason, Pamela, Mazimba, Sula, Salerno, Michael, Kramer, Christopher, Epstein, Frederick, Holmes, Jeffrey, and Bilchick, Kenneth

Subjects
cardiac resynchronization therapy, heart failure, implantable cardioverter defibrillator, magnetic resonance imaging, sex differences
Abstract

BACKGROUND: Mechanisms of sex-based differences in outcomes following cardiac resynchronization therapy (CRT) are poorly understood. OBJECTIVE: To use cardiac magnetic resonance (CMR) to define mechanisms of sex-based differences in outcomes after CRT and describe distinct CMR-based phenotypes of CRT candidates based on sex and non-ischemic/ischemic cardiomyopathy type. MATERIALS AND METHODS: In a prospective study, sex-based differences in three short-term CRT response measures [fractional change in left ventricular end-systolic volume index 6 months after CRT (LVESVI-FC), B-type natriuretic peptide (BNP) 6 months after CRT, change in peak VO2 6 months after CRT], and long-term survival were evaluated with respect to 39 baseline parameters from CMR, exercise testing, laboratory testing, electrocardiograms, comorbid conditions, and other sources. CMR was also used to quantify the degree of left-ventricular mechanical dyssynchrony by deriving the circumferential uniformity ratio estimate (CURE-SVD) parameter from displacement encoding with stimulated echoes (DENSE) strain imaging. Statistical methods included multivariable linear regression with evaluation of interaction effects associated with sex and cardiomyopathy type (ischemic and non-ischemic cardiomyopathy) and survival analysis. RESULTS: Among 200 patients, the 54 female patients (27%) pre-CRT had a smaller CMR-based LVEDVI (p = 0.04), more mechanical dyssynchrony based on the validated CMR CURE-SVD parameter (p = 0.04), a lower frequency of both late gadolinium enhancement (LGE) and ischemic cardiomyopathy (p < 0.0001), a greater RVEF (p = 0.02), and a greater frequency of LBBB (p = 0.01). After categorization of patients into four groups based on cardiomyopathy type (ischemic/non-ischemic cardiomyopathy) and sex, female patients with non-ischemic cardiomyopathy had the lowest CURE-SVD (p = 0.003), the lowest pre-CRT BNP levels (p = 0.01), the lowest post-CRT BNP levels (p = 0.05), and the most favorable LVESVI-FC (p = 0.001). Overall, female patients had better 3-year survival before adjustment for cardiomyopathy type (p = 0.007, HR = 0.45) and after adjustment for cardiomyopathy type (p = 0.009, HR = 0.67). CONCLUSION: CMR identifies distinct phenotypes of female CRT patients with non-ischemic and ischemic cardiomyopathy relative to male patients stratified by cardiomyopathy type. The more favorable short-term response and long-term survival outcomes in female heart failure patients with CRT were associated with lower indexed CMR-based LV volumes, decreased presence of scar associated with prior myocardial infarction and ICM, and greater CMR-based dyssynchrony with the CURE-SVD.

Published
2022

12. Cardiac Magnetic Resonance Assessment of Response to Cardiac Resynchronization Therapy and Programming Strategies.

Author

Gao, Xu, Abdi, Mohamad, Auger, Daniel, Sun, Changyu, Hanson, Christopher, Robinson, Austin, Schumann, Christopher, Oomen, Pim, Ratcliffe, Sarah, Malhotra, Rohit, Darby, Andrew, Monfredi, Oliver, Mangrum, J, Mason, Pamela, Mazimba, Sula, Holmes, Jeffrey, Kramer, Christopher, Epstein, Frederick, Salerno, Michael, and Bilchick, Kenneth

Subjects
cardiac magnetic resonance, cardiac resynchronization therapy, heart failure, implantable cardioverter-defibrillator, Aged, Cardiac Resynchronization Therapy, Female, Heart Failure, Humans, Magnetic Resonance Spectroscopy, Male, Predictive Value of Tests, Stroke Volume, Treatment Outcome, Ventricular Function, Left
Abstract

OBJECTIVES: The objective was to determine the feasibility and effectiveness of cardiac magnetic resonance (CMR) cine and strain imaging before and after cardiac resynchronization therapy (CRT) for assessment of response and the optimal resynchronization pacing strategy. BACKGROUND: CMR with cardiac implantable electronic devices can safely provide high-quality right ventricular/left ventricular (LV) ejection fraction (RVEF/LVEF) assessments and strain. METHODS: CMR with cine imaging, displacement encoding with stimulated echoes for the circumferential uniformity ratio estimate with singular value decomposition (CURE-SVD) dyssynchrony parameter, and scar assessment was performed before and after CRT. Whereas the pre-CRT scan constituted a single imaging set with complete volumetric, strain, and scar imaging, multiple imaging sets with complete strain and volumetric data were obtained during the post-CRT scan for biventricular pacing (BIVP), LV pacing (LVP), and asynchronous atrial pacing modes by reprogramming the device outside the scanner between imaging sets. RESULTS: 100 CMRs with a total of 162 imaging sets were performed in 50 patients (median age 70 years [IQR: 50-86 years]; 48% female). Reduction in LV end-diastolic volumes (P = 0.002) independent of CRT pacing were more prominent than corresponding reductions in right ventricular end-diastolic volumes (P = 0.16). A clear dependence of the optimal CRT pacing mode (BIVP vs LVP) on the PR interval (P = 0.0006) was demonstrated. The LVEF and RVEF improved more with BIVP than LVP with PR intervals ≥240 milliseconds (P = 0.025 and P = 0.002, respectively); the optimal mode (BIVP vs LVP) was variable with PR intervals

Published
2021

15. ACR Appropriateness Criteria® Sudden Onset of Cold, Painful Leg: 2023 Update

Author

Browne, William F., Sung, Jeffrey, Majdalany, Bill S., Khaja, Minhaj S., Calligaro, Keith, Contrella, Benjamin N., Ferencik, Maros, Gunn, Andrew J., Kapoor, Baljendra S., Keefe, Nicole A., Kokabi, Nima, Kramer, Christopher M., Kwun, Richard, Shamoun, Fadi, Sharma, Aditya M., Steenburg, Scott D., Trout, Andrew T., Vijay, Kanupriya, Wang, David S., and Steigner, Michael L.

Published
2023
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16. 2022 ACC/AHA guideline for the diagnosis and management of aortic disease: A report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines

Author

Isselbacher, Eric M., Preventza, Ourania, Hamilton Black, James, III, Augoustides, John G., Beck, Adam W., Bolen, Michael A., Braverman, Alan C., Bray, Bruce E., Brown-Zimmerman, Maya M., Chen, Edward P., Collins, Tyrone J., DeAnda, Abe, Jr., Fanola, Christina L., Girardi, Leonard N., Hicks, Caitlin W., Hui, Dawn S., Schuyler Jones, William, Kalahasti, Vidyasagar, Kim, Karen M., Milewicz, Dianna M., Oderich, Gustavo S., Ogbechie, Laura, Promes, Susan B., Ross, Elsie Gyang, Schermerhorn, Marc L., Singleton Times, Sabrina, Tseng, Elaine E., Wang, Grace J., Woo, Y. Joseph, Faxon, David P., Upchurch, Gilbert R., Jr, Aday, Aaron W., Azizzadeh, Ali, Boisen, Michael, Hawkins, Beau, Kramer, Christopher M., Luc, Jessica G.Y., MacGillivray, Thomas E., Malaisrie, S. Christopher, Osteen, Kathryn, Patel, Himanshu J., Patel, Parag J., Popescu, Wanda M., Rodriguez, Evelio, Sorber, Rebecca, Tsao, Philip S., Santos Volgman, Annabelle, Beckman, Joshua A., Otto, Catherine M., O'Gara, Patrick T., Armbruster, Anastasia, Birtcher, Kim K., de las Fuentes, Lisa, Deswal, Anita, Dixon, Dave L., Gorenek, Bulent, Haynes, Norrisa, Hernandez, Adrian F., Joglar, José A., Jones, W. Schuyler, Mark, Daniel, Mukherjee, Debabrata, Palaniappan, Latha, Piano, Mariann R., Rab, Tanveer, Spatz, Erica S., and Tamis-Holland, Jacqueline E.

Published
2023
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19. Cocoa to Improve Walking Performance in Older People With Peripheral Artery Disease: The Cocoa-Pad Pilot Randomized Clinical Trial

Author

McDermott, Mary M, Criqui, Michael H, Domanchuk, Kathryn, Ferrucci, Luigi, Guralnik, Jack M, Kibbe, Melina R, Kosmac, Kate, Kramer, Christopher M, Leeuwenburgh, Christiaan, Li, Lingyu, Lloyd-Jones, Donald, Peterson, Charlotte A, Polonsky, Tamar S, Stein, James H, Sufit, Robert, Van Horn, Linda, Villarreal, Francisco, Zhang, Dongxue, Zhao, Lihui, and Tian, Lu

Subjects
Clinical Trials and Supportive Activities, Complementary and Integrative Health, Prevention, Cardiovascular, Clinical Research, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, Aged, Aged, 80 and over, Beverages, Catechin, Chocolate, Double-Blind Method, Electron Transport Complex IV, Female, Humans, Male, Muscle, Skeletal, Peripheral Arterial Disease, Regional Blood Flow, Walking, clinical trial, intermittent claudication, mitochondria, muscles, peripheral artery disease, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Cardiovascular System & Hematology
Abstract

RationaleCocoa and its major flavanol component, epicatechin, have therapeutic properties that may improve limb perfusion and increase calf muscle mitochondrial activity in people with lower extremity peripheral artery disease (PAD).ObjectiveIn a phase II randomized clinical trial, to assess whether 6 months of cocoa improved walking performance in people with PAD, compared with placebo.Methods and resultsSix-month double-blind, randomized clinical trial in which participants with PAD were randomized to either cocoa beverage versus placebo beverage. The cocoa beverage contained 15 g of cocoa and 75 mg of epicatechin daily. The identical appearing placebo contained neither cocoa nor epicatechin. The 2 primary outcomes were 6-month change in 6-minute walk distance measured 2.5 hours after a study beverage at 6-month follow-up and 24 hours after a study beverage at 6-month follow-up, respectively. A 1-sided P

Published
2020

23. 3-Dimensional Strain Analysis of Hypertrophic Cardiomyopathy: Insights From the NHLBI International HCM Registry

Author

Heydari, Bobak, Satriano, Alessandro, Jerosch-Herold, Michael, Kolm, Paul, Kim, Dong-Yun, Cheng, Kathleen, Choi, Yuna L., Antiochos, Panagiotis, White, James A., Mahmod, Masliza, Chan, Kenneth, Raman, Betty, Desai, Milind Y., Ho, Carolyn Y., Dolman, Sarahfaye F., Desvigne-Nickens, Patrice, Maron, Martin S., Friedrich, Matthias G., Schulz-Menger, Jeanette, Piechnik, Stefan K., Appelbaum, Evan, Weintraub, William S., Neubauer, Stefan, Kramer, Christopher M., and Kwong, Raymond Y.

Published
2023
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25. Severe Relapse of Vaccine-Induced Guillain-Barré Syndrome After Treatment With Nivolumab.

Author

Yuen, Carlen, Kamson, David, Soliven, Betty, Kramer, Christopher, Goldenberg, Fernando, and Rezania, Kourosh

Subjects
Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Immunology, Brain Disorders, Orphan Drug, Biotechnology, Rare Diseases, Neurosciences, Immunization, Autoimmune Disease, Prevention, Neurodegenerative, Vaccine Related, Development of treatments and therapeutic interventions, 5.1 Pharmaceuticals, Good Health and Well Being, Aged, Guillain-Barre Syndrome, Humans, Influenza Vaccines, Male, Nivolumab, Recurrence, Clinical Sciences, Neurology & Neurosurgery, Clinical sciences
Abstract

Cancer immunotherapy with checkpoint inhibitors may result in neuromuscular immune-related adverse reactions, including Guillain-Barré syndrome (GBS)-like disease. On the other hand, checkpoint inhibitor therapy may result in exacerbation of underlying autoimmune diseases such as myasthenia gravis and multiple sclerosis. We present a patient who developed a severe and fatal relapse of postvaccination GBS after he was treated with nivolumab, a monoclonal antibody directed to programmed death-1 (PD-1), during a GBS treatment-related fluctuation. We recommend that caution be exercised in starting treatment with PD-1 inhibitors in the acute stage or early in the recovery period of GBS.

Published
2019

31. Cardiovascular Magnetic Resonance for Patients With COVID-19

Author

Petersen, Steffen E., Friedrich, Matthias G., Leiner, Tim, Elias, Matthew D., Ferreira, Vanessa M., Fenski, Maximilian, Flamm, Scott D., Fogel, Mark, Garg, Ria, Halushka, Marc K., Hays, Allison G., Kawel-Boehm, Nadine, Kramer, Christopher M., Nagel, Eike, Ntusi, Ntobeko A.B., Ostenfeld, Ellen, Pennell, Dudley J., Raisi-Estabragh, Zahra, Reeder, Scott B., Rochitte, Carlos E., Starekova, Jitka, Suchá, Dominika, Tao, Qian, Schulz-Menger, Jeanette, and Bluemke, David A.

Published
2022
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34. Society for Cardiovascular Magnetic Resonance (SCMR) guidelines for reporting cardiovascular magnetic resonance examinations

Author

Hundley, W. Gregory, Bluemke, David A., Bogaert, Jan, Flamm, Scott D., Fontana, Marianna, Friedrich, Matthias G., Grosse-Wortmann, Lars, Karamitsos, Theodoros D., Kramer, Christopher M., Kwong, Raymond Y., McConnell, Michael, Nagel, Eike, Neubauer, Stefan, Nijveldt, Robin, Pennell, Dudley J., Petersen, Steffen E., Raman, Subha V., and van Rossum, Albert

Published
2022
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35. Automatic Scar Segmentation from DE-MRI Using 2D Dilated UNet with Rotation-Based Augmentation

Author

Feng, Xue, Kramer, Christopher M., Salerno, Michael, Meyer, Craig H., Goos, Gerhard, Founding Editor, Hartmanis, Juris, Founding Editor, Bertino, Elisa, Editorial Board Member, Gao, Wen, Editorial Board Member, Steffen, Bernhard, Editorial Board Member, Woeginger, Gerhard, Editorial Board Member, Yung, Moti, Editorial Board Member, Puyol Anton, Esther, editor, Pop, Mihaela, editor, Sermesant, Maxime, editor, Campello, Victor, editor, Lalande, Alain, editor, Lekadir, Karim, editor, Suinesiaputra, Avan, editor, Camara, Oscar, editor, and Young, Alistair, editor

Published
2021
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36. Predictors of Major Atrial Fibrillation Endpoints in the National Heart, Lung, and Blood Institute HCMR

Author

Kramer, Christopher M., DiMarco, John P., Kolm, Paul, Ho, Carolyn Y., Desai, Milind Y., Kwong, Raymond Y., Dolman, Sarahfaye F., Desvigne-Nickens, Patrice, Geller, Nancy, Kim, Dong-Yun, Maron, Martin S., Appelbaum, Evan, Jerosch-Herold, Michael, Friedrich, Matthias G., Schulz-Menger, Jeanette, Piechnik, Stefan K., Mahmod, Masliza, Jacoby, Daniel, White, James, Chiribiri, Amedeo, Helms, Adam, Choudhury, Lubna, Michels, Michelle, Bradlow, William, Salerno, Michael, Dawson, Dana K., Weinsaft, Jonathan W., Berry, Colin, Nagueh, Sherif F., Buccarelli-Ducci, Chiara, Owens, Anjali, Casadei, Barbara, Watkins, Hugh, Weintraub, William S., and Neubauer, Stefan

Published
2021
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40. Quality assurance of quantitative cardiac T1-mapping in multicenter clinical trials – A T1 phantom program from the hypertrophic cardiomyopathy registry (HCMR) study

Author

Zhang, Qiang, Werys, Konrad, Popescu, Iulia A., Biasiolli, Luca, Ntusi, Ntobeko A.B., Desai, Milind, Zimmerman, Stefan L., Shah, Dipan J., Autry, Kyle, Kim, Bette, Kim, Han W., Jenista, Elizabeth R., Huber, Steffen, White, James A., McCann, Gerry P., Mohiddin, Saidi A., Boubertakh, Redha, Chiribiri, Amedeo, Newby, David, Prasad, Sanjay, Radjenovic, Aleksandra, Dawson, Dana, Schulz-Menger, Jeanette, Mahrholdt, Heiko, Carbone, Iacopo, Rimoldi, Ornella, Colagrande, Stefano, Calistri, Linda, Michels, Michelle, Hofman, Mark B.M., Anderson, Lisa, Broberg, Craig, Andrew, Flett, Sanz, Javier, Bucciarelli-Ducci, Chiara, Chow, Kelvin, Higgins, David, Broadbent, David A., Semple, Scott, Hafyane, Tarik, Wormleighton, Joanne, Salerno, Michael, He, Taigang, Plein, Sven, Kwong, Raymond Y., Jerosch-Herold, Michael, Kramer, Christopher M., Neubauer, Stefan, Ferreira, Vanessa M., and Piechnik, Stefan K.

Published
2021
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41. Femoral artery plaque characteristics, lower extremity collaterals, and mobility loss in peripheral artery disease

Author

McDermott, Mary M, Carroll, Timothy, Carr, James, Yuan, Chun, Ferrucci, Luigi, Guralnik, Jack M, Kibbe, Melina, Criqui, Michael H, Tian, Lu, Polonsky, Tamar, Zhao, Lihui, Gao, Ying, Hippe, Daniel S, Xu, Dongxiang, McCarthy, Walter, and Kramer, Christopher M

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Sciences, Cardiovascular, Biomedical Imaging, Clinical Research, Aged, Aged, 80 and over, Ankle Brachial Index, Chicago, Collateral Circulation, Dependent Ambulation, Female, Femoral Artery, Humans, Lipids, Longitudinal Studies, Magnetic Resonance Angiography, Male, Mobility Limitation, Necrosis, Peripheral Arterial Disease, Plaque, Atherosclerotic, Predictive Value of Tests, Regional Blood Flow, Risk Factors, Time Factors, Vascular Calcification, Walk Test, atherosclerotic plaque, intermittent claudication, lipid rich necrotic core, mobility, peripheral artery disease, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences
Abstract

Little is known about the prognostic significance of specific characteristics of magnetic resonance imaging (MRI) measured plaque in the superficial femoral artery (SFA). Associations of MRI-measured plaque quantity, lumen area, and plaque composition in the SFA with subsequent mobility loss were studied in people with lower extremity peripheral artery disease (PAD). Participants with an ankle-brachial index (ABI) < 1.00 were identified from Chicago medical centers and underwent direct visualization of atherosclerotic plaque in the SFA using MRI. Participants were followed annually for up to 4 years. Mobility loss was defined as becoming unable to walk up and down a flight of stairs or walk one-quarter of a mile without assistance among participants without mobility impairment at baseline. Analyses adjusted for age, sex, race, comorbidities, ABI, physical activity, and other confounders. Of 308 PAD participants without baseline mobility impairment, 100 (32.5%) developed mobility loss during follow-up. Compared to the lowest mean plaque area tertile at baseline, participants in the highest (worst) plaque area tertile had a higher rate of mobility loss (hazard ratio (HR) = 2.08, 95% confidence interval (CI) = 1.14-3.79, p = 0.018). Compared to the highest mean lumen area tertile, the smallest (worst) mean lumen area tertile was associated with greater mobility loss (HR = 2.18, 95% CI = 1.20-3.96, p = 0.011). Neither lipid rich necrotic core nor calcium in the SFA were associated with mobility loss. In conclusion, greater plaque quantity and smaller lumen area in the proximal SFA, but not lipid rich necrotic core or calcium, were associated with higher mobility loss in people with PAD.

Published
2017

42. Plaque Composition in the Proximal Superficial Femoral Artery and Peripheral Artery Disease Events

Author

McDermott, Mary M, Kramer, Christopher M, Tian, Lu, Carr, James, Guralnik, Jack M, Polonsky, Tamar, Carroll, Timothy, Kibbe, Melina, Criqui, Michael H, Ferrucci, Luigi, Zhao, Lihui, Hippe, Daniel S, Wilkins, John, Xu, Dongxiang, Liao, Yihua, McCarthy, Walter, and Yuan, Chun

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Sciences, Stroke, Atherosclerosis, Heart Disease, Cardiovascular, Clinical Research, Good Health and Well Being, Acute Coronary Syndrome, Aged, Amputation, Surgical, Ankle Brachial Index, Chicago, Comorbidity, Critical Illness, Female, Femoral Artery, Fibrosis, Humans, Ischemia, Kaplan-Meier Estimate, Lipids, Longitudinal Studies, Magnetic Resonance Angiography, Male, Middle Aged, Peripheral Arterial Disease, Plaque, Atherosclerotic, Predictive Value of Tests, Proportional Hazards Models, Risk Factors, Time Factors, Treatment Outcome, Vascular Calcification, Vascular Surgical Procedures, femoral artery, lipid rich, necrotic core, MRI, vascular medicine, lipid rich necrotic core, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences
Abstract

ObjectivesThe aim of this study was to describe associations of the presence of lipid-rich necrotic core (LRNC) in the proximal superficial femoral artery (SFA) with lower extremity peripheral artery disease (PAD) event rates and systemic cardiovascular event rates.BackgroundLRNC in the coronary and carotid arteries is associated with adverse outcomes but has not been studied previously in lower extremity arteries.MethodsParticipants with ankle-brachial index (ABI) values 0.15, and revascularization at 47-month follow-up (hazard ratio: 2.18; 95% confidence interval: 1.27 to 3.75; p = 0.005). The association of SFA LRNC with PAD events was maintained even when this combined outcome excluded lower extremity revascularization (hazard ratio: 2.58; 95% confidence interval: 1.25 to 5.33; p = 0.01). LRNC in the SFA was not associated with all-cause mortality, acute coronary events, or stroke.ConclusionsAmong patients with PAD, LRNC in the SFA was associated with higher rates of clinical PAD events, and this association was independent of ABI. Further study is needed to determine whether interventions that reduce SFA LRNC prevent PAD events.

Published
2017

47. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines

Author

Isselbacher, Eric M., Preventza, Ourania, Hamilton Black, James, III, Augoustides, John G., Beck, Adam W., Bolen, Michael A., Braverman, Alan C., Bray, Bruce E., Brown-Zimmerman, Maya M., Chen, Edward P., Collins, Tyrone J., DeAnda, Abe, Jr, Fanola, Christina L., Girardi, Leonard N., Hicks, Caitlin W., Hui, Dawn S., Schuyler Jones, William, Kalahasti, Vidyasagar, Kim, Karen M., Milewicz, Dianna M., Oderich, Gustavo S., Ogbechie, Laura, Promes, Susan B., Gyang Ross, Elsie, Schermerhorn, Marc L., Singleton Times, Sabrina, Tseng, Elaine E., Wang, Grace J., Woo, Y. Joseph, Faxon, David P., Upchurch, Gilbert R., Jr, Aday, Aaron W., Azizzadeh, Ali, Boisen, Michael, Hawkins, Beau, Kramer, Christopher M., Luc, Jessica G.Y., MacGillivray, Thomas E., Malaisrie, S. Christopher, Osteen, Kathryn, Patel, Himanshu J., Patel, Parag J., Popescu, Wanda M., Rodriguez, Evelio, Sorber, Rebecca, Tsao, Philip S., and Santos Volgman, Annabelle

Published
2022
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