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  1. Article ; Online: Successful transcatheter stent retrieval after stent dislodgement in the left main coronary artery.

    Rezkalla, Joshua / Kir, Devika / Gulati, Rajiv / Bell, Malcolm

    European heart journal. Case reports

    2023  Volume 7, Issue 8, Page(s) ytad349

    Language English
    Publishing date 2023-07-27
    Publishing country England
    Document type Case Reports
    ISSN 2514-2119
    ISSN (online) 2514-2119
    DOI 10.1093/ehjcr/ytad349
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  2. Article: Restructuring the Heart From Failure to Success: Role of Structural Interventions in the Realm of Heart Failure.

    Kir, Devika / Munagala, Mrudula

    Frontiers in cardiovascular medicine

    2022  Volume 9, Page(s) 839483

    Abstract: Heart failure through the spectrum of reduced (HFrEF), mid-range (or mildly reduced or HFmEF), and preserved ejection fraction (HFpEF), continues to plague patients' quality of life through recurrent admissions and high mortality rates. Despite ... ...

    Abstract Heart failure through the spectrum of reduced (HFrEF), mid-range (or mildly reduced or HFmEF), and preserved ejection fraction (HFpEF), continues to plague patients' quality of life through recurrent admissions and high mortality rates. Despite tremendous innovation in medical therapy, patients continue to experience refractory congestive symptoms due to adverse left ventricular remodeling, significant functional mitral regurgitation (FMR), and right-sided failure symptoms due to significant functional tricuspid regurgitation (FTR). As most of these patients are surgically challenging for open cardiac surgery, the past decade has seen the development and evolution of different percutaneous structural interventions targeted at improving FMR and FTR. There is renewed interest in the sphere of left ventricular restorative devices to effect reverse remodeling and thereby improve effective stroke volume and patient outcomes. For patients suffering from HFpEF, there is still a paucity of disease-modifying effective medical therapies, and these patients continue to have recurrent heart failure exacerbations due to impaired left ventricular relaxation and high filling pressures. Structural therapies involving the implantation of inter-atrial shunt devices to decrease left atrial pressure and the development of implantable devices in the pulmonary artery for real-time hemodynamic monitoring would help redefine treatment and outcomes for patients with HFpEF. Lastly, there is pre-clinical data supportive of soft robotic cardiac sleeves that serve to improve cardiac function, can assist contraction as well as relaxation of the heart, and have the potential to be customized for each patient. In this review, we focus on the role of structural interventions in heart failure as it stands in current clinical practice, evaluate the evidence amassed so far, and review promising structural therapies that may transform the future of heart failure management.
    Language English
    Publishing date 2022-04-20
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2781496-8
    ISSN 2297-055X
    ISSN 2297-055X
    DOI 10.3389/fcvm.2022.839483
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  3. Article ; Online: Takotsubo cardiomyopathy causing "transient heart failure" after cardiac surgery: A rare phenomenon.

    Kir, Devika / Demarchena, Eduardo J

    Journal of cardiac surgery

    2021  Volume 36, Issue 8, Page(s) 2774–2775

    MeSH term(s) Cardiac Surgical Procedures/adverse effects ; Heart Failure/etiology ; Humans ; Takotsubo Cardiomyopathy/etiology
    Language English
    Publishing date 2021-06-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639059-6
    ISSN 1540-8191 ; 0886-0440
    ISSN (online) 1540-8191
    ISSN 0886-0440
    DOI 10.1111/jocs.15677
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  4. Article ; Online: Old Dog, New Tricks: Use of CA 19-9 for Early Diagnosis of Pancreatic Cancer.

    Modi, Shrey / Kir, Devika / Saluja, Ashok Kumar

    Gastroenterology

    2021  Volume 160, Issue 4, Page(s) 1019–1021

    MeSH term(s) Early Detection of Cancer ; Humans ; Pancreatic Neoplasms/diagnosis
    Language English
    Publishing date 2021-01-05
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 80112-4
    ISSN 1528-0012 ; 0016-5085
    ISSN (online) 1528-0012
    ISSN 0016-5085
    DOI 10.1053/j.gastro.2021.01.001
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  5. Article ; Online: Response to Letter to the Editor: Triggers of Takotsubo Syndrome should be identified by exclusion.

    Kir, Devika / Beer, Nusen / de Marchena, Eduardo J

    Journal of cardiac surgery

    2021  Volume 36, Issue 6, Page(s) 2185–2186

    MeSH term(s) Humans ; Takotsubo Cardiomyopathy/diagnosis ; Takotsubo Cardiomyopathy/etiology
    Language English
    Publishing date 2021-04-06
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 639059-6
    ISSN 1540-8191 ; 0886-0440
    ISSN (online) 1540-8191
    ISSN 0886-0440
    DOI 10.1111/jocs.15559
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  6. Article ; Online: What Is the Status of Regenerative Therapy in Heart Failure?

    Kir, Devika / Patel, Mausam J / Munagala, Mrudula R

    Current cardiology reports

    2021  Volume 23, Issue 10, Page(s) 146

    Abstract: Purpose of review: Heart failure remains a major public health concern with high burden of morbidity and mortality despite advances in pharmacotherapy, device therapy, and surgical and percutaneous techniques. Cardiac regeneration may have a role to ... ...

    Abstract Purpose of review: Heart failure remains a major public health concern with high burden of morbidity and mortality despite advances in pharmacotherapy, device therapy, and surgical and percutaneous techniques. Cardiac regeneration may have a role to play in these patients with a huge unmet need for these therapies in patients with chronic ischemic heart disease, post-infarct heart failure, dilated cardiomyopathy, and heart failure with preserved ejection fraction.
    Recent findings: In this review, we focus on the pre-clinical and translational basis for different modes of cardiac regenerative medicine and then critically appraise the clinical evidence amassed from pivotal clinical trials focused on cardiac regeneration for ischemic and non-ischemic cardiomyopathies. Cardiac regenerative medicine is rapidly evolving with novel approaches involving cell-based, cell-free, tissue engineering, and hybrid therapies to achieve myocardial regeneration and repair. Further studies are warranted with a robust comparison arm with optimal contemporary medical therapy to translate regenerative therapies to a clinical reality.
    MeSH term(s) Heart ; Heart Failure/therapy ; Humans ; Myocardial Ischemia/therapy ; Regeneration ; Regenerative Medicine ; Stem Cell Transplantation
    Language English
    Publishing date 2021-08-19
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2055373-0
    ISSN 1534-3170 ; 1523-3782
    ISSN (online) 1534-3170
    ISSN 1523-3782
    DOI 10.1007/s11886-021-01575-3
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  7. Article ; Online: Cardiac sarcoidosis masquerading as ventricular tachycardia storm: a challenging diagnosis.

    Aitken, William / Tsang, Darren / Chaparro, Sandra / Kir, Devika

    BMJ case reports

    2021  Volume 14, Issue 2

    Abstract: A 67-year-old African-American woman with remote history of complete heart block (s/p pacemaker 3 years ago) and recent onset of ventricular tachycardia (VT) (s/p VT ablation and cardiac resynchronisation therapy defibrillator upgrade 3 months ago) ... ...

    Abstract A 67-year-old African-American woman with remote history of complete heart block (s/p pacemaker 3 years ago) and recent onset of ventricular tachycardia (VT) (s/p VT ablation and cardiac resynchronisation therapy defibrillator upgrade 3 months ago) presented to the hospital with VT storm. Workup showed newly reduced left ventricular ejection fraction with global hypokinesis (20%) and restrictive physiology. Positive technetium pyrophosphate scan was suspicious for TTR amyloid while serological workup revealed a monoclonal gammopathy. Cardiac MRI was contraindicated given remote brain aneurysm clip. Given clinical suspicion for cardiac sarcoidosis and divergent non-invasive workup, endomyocardial biopsy was performed which showed non-necrotising granulomas consistent with cardiac sarcoidosis. She was started on steroids with clinical improvement. Cardiac sarcoidosis is a challenging clinical diagnosis, particularly in patients without extracardiac manifestations. This case highlights the importance of a detailed and thorough workup of non-ischaemic cardiomyopathy and being cognizant of infiltrative disease as it can change patient management and outcomes.
    MeSH term(s) Aged ; Biopsy ; Cardiomyopathies/diagnosis ; Cardiomyopathies/drug therapy ; Cardiomyopathies/pathology ; Diagnosis, Differential ; Electrocardiography ; Female ; Humans ; Sarcoidosis/diagnosis ; Sarcoidosis/drug therapy ; Sarcoidosis/pathology ; Steroids/therapeutic use ; Tachycardia, Ventricular/diagnosis
    Chemical Substances Steroids
    Language English
    Publishing date 2021-02-09
    Publishing country England
    Document type Case Reports ; Journal Article ; Video-Audio Media
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2020-237530
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  8. Article ; Online: Heart Brake: An Unusual Cardiac Manifestation of COVID-19.

    Kir, Devika / Mohan, Chaitra / Sancassani, Rhea

    JACC. Case reports

    2020  Volume 2, Issue 9, Page(s) 1252–1255

    Abstract: A 49-year-old man presented with worsening high-grade fevers, dry cough, and shortness of breath. He tested positive for severe acute respiratory syndrome-coronavirus-2 and was noted to have bradycardia with intermittent high-degree atrioventricular ... ...

    Abstract A 49-year-old man presented with worsening high-grade fevers, dry cough, and shortness of breath. He tested positive for severe acute respiratory syndrome-coronavirus-2 and was noted to have bradycardia with intermittent high-degree atrioventricular block. However, cardiac biomarkers and echocardiographic findings were normal, thus making this an unusual and interesting manifestation of myocardial involvement of this novel coronavirus. (
    Keywords covid19
    Language English
    Publishing date 2020-05-03
    Publishing country Netherlands
    Document type Case Reports
    ISSN 2666-0849
    ISSN (online) 2666-0849
    DOI 10.1016/j.jaccas.2020.04.026
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  9. Article ; Online: Takotsubo cardiomyopathy caused by emotional stressors in the coronavirus disease 2019 (COVID-19) pandemic era.

    Kir, Devika / Beer, Nusen / De Marchena, Eduardo J

    Journal of cardiac surgery

    2020  Volume 36, Issue 2, Page(s) 764–769

    Abstract: The COVID-19 pandemic has had far-reaching consequences beyond the disease itself, including economic, social, political, religious, and psychological implications. This novel coronavirus has been shown to have cardiovascular manifestations in the form ... ...

    Abstract The COVID-19 pandemic has had far-reaching consequences beyond the disease itself, including economic, social, political, religious, and psychological implications. This novel coronavirus has been shown to have cardiovascular manifestations in the form of arrhythmias, conduction disturbances, myocarditis, stress cardiomyopathy, myocardial injury and myocardial ischemia or infarction from increased microvascular and/or macrovascular coagulopathy. However, in addition to these direct effects, we are now starting to recognize indirect cardiovascular effects of COVID-19 in the form of increased incidence of Takutsobo cardiomyopathy in patients without any evidence of coronavirus infection presumably due to the increased psychological stress of social isolation and societal turbulence. In this case series, we present two post-menopausal women, presenting with chest pain and acute coronary syndrome, who are finally diagnosed with stress cardiomyopathy, triggered by increased emotional stress-related to the pandemic. There is data from a retrospective cohort analysis showing a fourfold increase in the incidence of acute coronary syndrome resulting from stress cardiomyopathy during the pandemic period compared to similar times periods before the pandemic. Hence, health care providers need to be cognizant of the emotional ramifications of the ongoing pandemic in the form of increased risk of Takotsubo cardiomyopathy. Moreover, urgent measures need to be taken to help the at-risk population cope with the ongoing stressors to help decrease the incidence of this cardiomyopathy.
    MeSH term(s) Aged ; Aged, 80 and over ; COVID-19/complications ; COVID-19/epidemiology ; Electrocardiography ; Female ; Humans ; Pandemics ; Psychological Distress ; SARS-CoV-2 ; Stress, Psychological/complications ; Stress, Psychological/psychology ; Takotsubo Cardiomyopathy/diagnosis ; Takotsubo Cardiomyopathy/etiology ; Takotsubo Cardiomyopathy/psychology
    Language English
    Publishing date 2020-12-18
    Publishing country United States
    Document type Case Reports
    ZDB-ID 639059-6
    ISSN 1540-8191 ; 0886-0440
    ISSN (online) 1540-8191
    ISSN 0886-0440
    DOI 10.1111/jocs.15251
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    Zs.A 2221: Show issues Location:
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  10. Article ; Online: Patterns of care for first-detected atrial fibrillation: Insights from the Get With The Guidelines® - Atrial Fibrillation registry.

    Kir, Devika / Zhang, Shuaiqi / Kaltenbach, Lisa A / Fonarow, Gregg C / Matsouaka, Roland A / Piccini, Jonathan P / Desai, Nihar R

    Heart rhythm

    2022  Volume 19, Issue 7, Page(s) 1049–1057

    Abstract: Background: Despite multiple trials comparing rate with rhythm control, there is no consensus on the optimal management of first-detected atrial fibrillation (AF).: Objective: We analyzed current patterns of care for first-detected AF in the ... ...

    Abstract Background: Despite multiple trials comparing rate with rhythm control, there is no consensus on the optimal management of first-detected atrial fibrillation (AF).
    Objective: We analyzed current patterns of care for first-detected AF in the nationwide Get With The Guidelines® - Atrial Fibrillation registry.
    Methods: Patients hospitalized with first-detected AF from 2013 to 2019 were included, and a descriptive analysis was performed comparing planned rate with rhythm control. Multivariable logistic regression analysis was performed to identify predictors for choosing rhythm over rate control.
    Results: Of the 86,759 patients with AF, 17.8% (15,473) had first-detected AF; 11,685 patients were included from 126 sites. Overall, 51.3% (5999) of patients were treated with rate control and 48.7% (5686) with rhythm control at admission. Patients with planned rhythm control had a shorter length of stay and were more likely to be discharged home than a facility. A higher percentage of patients with planned rhythm control were discharged on anticoagulation than those with planned rate control (75.6% vs 70.9%) despite a higher underlying stroke risk in the rate control group (higher median CHA
    Conclusion: Less than half of the patients with first-detected AF receive rhythm control at admission. Given recent trial results, further studies should assess the long-term impact of rhythm control on patients' symptoms and quality of life, cardiovascular morbidity, and mortality.
    MeSH term(s) Aged ; Anticoagulants/therapeutic use ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/therapy ; Heart Failure/complications ; Humans ; Quality of Life ; Registries ; Risk Factors ; Stroke
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2022-03-02
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2229357-7
    ISSN 1556-3871 ; 1547-5271
    ISSN (online) 1556-3871
    ISSN 1547-5271
    DOI 10.1016/j.hrthm.2022.02.025
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