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  1. Article ; Online: Reorienting Ourselves to Delirium: Caring for Older Patients Hospitalized With Heart Failure.

    Fraser, Meg T / Mcilvennan, Colleen K

    Journal of cardiac failure

    2021  Volume 27, Issue 4, Page(s) 460–463

    Language English
    Publishing date 2021-01-07
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 1281194-4
    ISSN 1532-8414 ; 1071-9164
    ISSN (online) 1532-8414
    ISSN 1071-9164
    DOI 10.1016/j.cardfail.2021.02.001
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  2. Article ; Online: Pharmacotherapy in the heart transplant recipient: A primer for nurse clinicians and pharmacists.

    Fraser, Meg / Page, Robert L / Chow, Sheryl / Alexy, Tamas / Peters, Laura

    Clinical transplantation

    2024  Volume 38, Issue 2, Page(s) e15252

    Abstract: Heart transplantation (HT) is the definitive treatment for eligible patients with end-stage heart disease. A major complication of HT is allograft rejection which can lead to graft dysfunction and death. The guiding principle of chronic immunosuppression ...

    Abstract Heart transplantation (HT) is the definitive treatment for eligible patients with end-stage heart disease. A major complication of HT is allograft rejection which can lead to graft dysfunction and death. The guiding principle of chronic immunosuppression therapy is to prevent rejection of the transplanted organ while avoiding oversuppression of the immune system, which can cause opportunistic infections and malignancy. The purpose of this review is to describe immunosuppressive management of the HT recipient-including agent-specific pharmacology and pharmacokinetics, outcomes data, adverse effects, clinical considerations, and recent guideline updates. We will also provide recommendations for medical prophylaxis of immunosuppressed patients based on the most recent clinical guidelines. Additionally, we highlight the importance of medical therapy adherence and the effect of social determinants of health on the long-term management of HT. HT recipients are a complex and high-risk population. The objective of this review is to describe basic pharmacotherapy in HT and implications for nurses and pharmacists.
    MeSH term(s) Humans ; Pharmacists ; Nurse Clinicians ; Immunosuppressive Agents ; Heart Transplantation/adverse effects ; Immunosuppression Therapy ; Graft Rejection/drug therapy ; Graft Rejection/etiology ; Graft Rejection/prevention & control
    Chemical Substances Immunosuppressive Agents
    Language English
    Publishing date 2024-02-03
    Publishing country Denmark
    Document type Journal Article ; Review
    ZDB-ID 639001-8
    ISSN 1399-0012 ; 0902-0063
    ISSN (online) 1399-0012
    ISSN 0902-0063
    DOI 10.1111/ctr.15252
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  3. Article ; Online: From the Other Side of the Exam Room: Using the New Universal Definition and Classification of Heart Failure to Engage Patients and Caregivers.

    Fraser, Meg / McIlvennan, Colleen K / Joseph, Namita / Alexy, Tamas

    Journal of cardiac failure

    2022  Volume 29, Issue 9, Page(s) 1338–1339

    MeSH term(s) Humans ; Caregivers ; Heart Failure/diagnosis
    Language English
    Publishing date 2022-02-11
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1281194-4
    ISSN 1532-8414 ; 1071-9164
    ISSN (online) 1532-8414
    ISSN 1071-9164
    DOI 10.1016/j.cardfail.2022.01.017
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  4. Article ; Online: Nursing care of the patient hospitalized with heart failure: A scientific statement from the American Association of Heart Failure Nurses.

    Fraser, Meg / Barnes, Stephanie G / Barsness, Carol / Beavers, Craig / Bither, Cynthia J / Boettger, Samantha / Hallman, Christine / Keleman, Anne / Leckliter, Lauren / McIlvennan, Colleen K / Ozemek, Cemal / Patel, Amit / Pierson, Natalie W / Shakowski, Courtney / Thomas, S Craig / Whitmire, Tara / Anderson, Kelley M

    Heart & lung : the journal of critical care

    2024  Volume 64, Page(s) e1–e16

    MeSH term(s) Humans ; United States/epidemiology ; Heart Failure ; Patient Care Team ; American Heart Association
    Language English
    Publishing date 2024-02-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 193129-5
    ISSN 1527-3288 ; 0147-9563
    ISSN (online) 1527-3288
    ISSN 0147-9563
    DOI 10.1016/j.hrtlng.2024.01.007
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  5. Article ; Online: Nursing care of the patient hospitalized with heart failure: Executive summary: A Scientific statement from the American association of heart failure nurses.

    Fraser, Meg / Barnes, Stephanie G / Barsness, Carol / Beavers, Craig / Bither, Cynthia J / Boettger, Samantha / Hallman, Christine / Keleman, Anne / Leckliter, Lauren / McIlvennan, Colleen K / Ozemek, Cemal / Patel, Amit / Pierson, Natalie W / Shakowski, Courtney / Thomas, S Craig / Whitmire, Tara / Anderson, Kelley M

    Heart & lung : the journal of critical care

    2024  Volume 64, Page(s) A1–A5

    MeSH term(s) Humans ; United States ; Heart Failure ; Patient Care Team ; American Heart Association
    Language English
    Publishing date 2024-02-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 193129-5
    ISSN 1527-3288 ; 0147-9563
    ISSN (online) 1527-3288
    ISSN 0147-9563
    DOI 10.1016/j.hrtlng.2024.01.008
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  6. Article ; Online: Corrigendum to: "Nursing Care of the Patient Hospitalized with Heart Failure: Executive Summary: A Scientific Statement from the American Association of Heart Failure Nurses" [Heart Lung. 64(2024).A1-A5/doi:10.1016/j.hrtlng.2024.01.008. Epub 2024 Feb 7].

    Fraser, Meg / Barnes, Stephanie G / Barsness, Carol / Beavers, Craig / Bither, Cynthia J / Boettger, Samantha / Hallman, Christine / Keleman, Anne / Leckliter, Lauren / McIlvennan, Colleen K / Ozemek, Cemal / Patel, Amit / Pierson, Natalie W / Shakowski, Courtney / Thomas, S Craig / Whitmire, Tara / Anderson, Kelley M

    Heart & lung : the journal of critical care

    2024  Volume 66, Page(s) 46

    Language English
    Publishing date 2024-04-04
    Publishing country United States
    Document type Published Erratum
    ZDB-ID 193129-5
    ISSN 1527-3288 ; 0147-9563
    ISSN (online) 1527-3288
    ISSN 0147-9563
    DOI 10.1016/j.hrtlng.2024.03.009
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  7. Article ; Online: Substance Use-Associated Mortality among Heart Donors after the COVID-19 National Emergency Increased but Did Not Affect Peri-Transplant Outcomes.

    Fraser, Meg / Nzemenoh, Bellony / Jackson, Scott / Chaikijurajai, Thanat / Halmosi, Robert / Toth, Kalman / Khan, Wahab J / Alexy, Tamas

    Journal of cardiovascular development and disease

    2023  Volume 10, Issue 5

    Abstract: Introduction: The COVID-19 pandemic and consequent social isolation prompted a surge in mental health disorders and substance use in the general population and, therefore, in potential organ donors. We aimed to evaluate if this led to a change in donor ... ...

    Abstract Introduction: The COVID-19 pandemic and consequent social isolation prompted a surge in mental health disorders and substance use in the general population and, therefore, in potential organ donors. We aimed to evaluate if this led to a change in donor characteristics, including the mechanism and circumstance of death, and how this may have affected clinical outcomes following heart transplantation.
    Methods: We identified all heart donors from the SRTR database between 18 October 2018 and 31 December 2021, excluding those who donated immediately after the US national emergency declaration. Donors were stratified into pre-COVID-19 (Pre-Cov; through 12 March 2020) and post-COVID-19 national emergency declaration cohorts (Post-Cov; 1 August 2020 through 31 December 2021) based on the heart procurement date. Relevant demographics, cause of death, and substance use history were collected in addition to graft cold ischemic time, the incidence of primary graft dysfunction (PGD), and recipient survival at 30 days post-transplant.
    Results: A total of 10,314 heart donors were identified; 4941 were stratified into the Pre-Cov and 5373 into the Post-Cov cohorts. There was no difference in demographics, but illicit drug use was significantly higher in the Post-Cov group, leading to an increased incidence of death from drug intoxication. Fatal gunshot wounds were also more common. Despite these changes, the incidence of PGD remained similar (
    Conclusion: Our findings confirm that COVID-19 had a major impact on mental health and psychosocial life with an associated increase in illicit substance use and fatal intoxication rates in heart transplant donors. These changes did not alter peri-operative mortality following heart transplantation. Future studies are needed to ensure that long-term outcomes remain unaffected.
    Language English
    Publishing date 2023-05-20
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2777082-5
    ISSN 2308-3425 ; 2308-3425
    ISSN (online) 2308-3425
    ISSN 2308-3425
    DOI 10.3390/jcdd10050222
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  8. Article ; Online: Temporary Mechanical Circulatory Support Use and Clinical Outcomes of Simultaneous Heart/Kidney Transplant Recipients in the Pre- and Post-heart Allocation Policy Change Eras.

    Agdamag, Arianne C / Riad, Samy / Maharaj, Valmiki / Jackson, Scott / Fraser, Meg / Charpentier, Victoria / Nzemenoh, Bellony / Martin, Cindy M / Alexy, Tamas

    Transplantation

    2023  Volume 107, Issue 7, Page(s) 1605–1614

    Abstract: Background: The use of temporary mechanical circulatory support (tMCS) devices (intra-aortic balloon pump; Impella 2.5, CP, 5.0; venoarterial extracorporeal membrane oxygenation) increased significantly across the United States for heart transplant ... ...

    Abstract Background: The use of temporary mechanical circulatory support (tMCS) devices (intra-aortic balloon pump; Impella 2.5, CP, 5.0; venoarterial extracorporeal membrane oxygenation) increased significantly across the United States for heart transplant candidates after the allocation policy change. Whether this practice change also affected simultaneous heart-kidney (SHK) candidates and recipient survival is understudied.
    Methods: We used the Scientific Registry of Transplant Recipients database to identify adult SHK recipients between January 2010 and March 2022. The population was stratified into pre- and post-heart allocation change cohorts. Kaplan-Meier curves were generated to compare 1-y survival rates. A Cox proportional hazards model was used to investigate the effect of allocation period on patient survival. Recipient outcomes bridged with eligible tMCS devices were compared in the post-heart allocation era. In a separate analysis, SHK waitlist mortality was evaluated between the allocation eras.
    Results: A total of 1548 SHK recipients were identified, and 1102 were included in the final cohort (534 pre-allocation and 568 post-allocation change). tMCS utilization increased from 17.9% to 51.6% after the allocation change, with venoarterial extracorporeal membrane oxygenation use rising most significantly. However, 1-y post-SHK survival remained unchanged in the full cohort (log-rank P  = 0.154) and those supported with any of the eligible tMCS devices. In a separate analysis (using a larger cohort of all SHK listings), SHK waitlist mortality at 1 y was significantly lower in the current allocation era ( P  = 0.002).
    Conclusions: Despite the remarkable increase in tMCS use in SHK candidates after the heart allocation change, 1 y posttransplant survival remained unchanged. Further studies with larger cohorts and longer follow-ups are needed to confirm these findings.
    MeSH term(s) Adult ; Humans ; United States ; Kidney Transplantation/adverse effects ; Heart Transplantation/adverse effects ; Proportional Hazards Models ; Heart-Assist Devices ; Kidney ; Policy ; Retrospective Studies ; Heart Failure/diagnosis ; Heart Failure/surgery ; Waiting Lists
    Language English
    Publishing date 2023-06-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 208424-7
    ISSN 1534-6080 ; 0041-1337
    ISSN (online) 1534-6080
    ISSN 0041-1337
    DOI 10.1097/TP.0000000000004518
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  9. Article ; Online: Survival After Simultaneous Heart-kidney Transplant in Recipients With a Durable LVAD and Chronic Kidney Disease: Effect of the 2018 Heart Allocation Policy Change.

    Fraser, Meg / Agdamag, Arianne C / Riad, Samy / Nzemenoh, Bellony N / Jackson, Scott / Money, Joel / Knoper, Ryan / Martin, Cindy M / Alexy, Tamas

    Transplantation

    2023  Volume 108, Issue 2, Page(s) 524–529

    Abstract: Background: Heart transplantation remains the most definitive therapy for qualified candidates with end-stage heart failure. Concomitant kidney disease is common in this population prompting an increase in simultaneous heart-kidney (SHK) transplantation ...

    Abstract Background: Heart transplantation remains the most definitive therapy for qualified candidates with end-stage heart failure. Concomitant kidney disease is common in this population prompting an increase in simultaneous heart-kidney (SHK) transplantation in recent years. The goal of our study was to explore the effects of the 2018 heart allocation policy (HAP) change on candidate listing characteristics and compare survival rates at 1 y in patients that were supported with a left ventricular assist device (LVAD) pretransplant and underwent SHK or heart alone transplant (HAT).
    Methods: We used data from the Scientific Registry of Transplant Recipients and identified all adults who underwent primary SHK or HAT between January 2010 and March 2022. Recipients supported with a durable LVAD and estimated glomerular filtration rate <60 mL/min/1.73 m 2 were selected (n = 309 SHK; 217 pre- and 92 post-HAP and n = 3,324 HAT; 2738 pre- and 586 post-HAP).
    Results: Difference in survival at 1 y did not reach statistical significance. Comparing the 1-y survival of SHK and HAT recipients who were bridged with LVAD pre-HAP, we found no significant difference ( P = 0.694). Adjusting for the same covariates in a multivariable model did not affect the results (SHK versus HAT hazard ratio 0.84 [0.51, 1.37]; P = 0.48). In contrast, SHK recipients supported with an LVAD who were listed and transplanted post-HAP change had significantly lower 1-y survival, when compared with HAT ( P = 0.037).
    Conclusions: Our findings suggest that the HAP change had a potentially negative impact on the survival of select patients undergoing SHK transplant. Further research is warranted in this area.
    MeSH term(s) Adult ; Humans ; Kidney Transplantation/methods ; Heart-Assist Devices ; Treatment Outcome ; Retrospective Studies ; Heart Transplantation ; Kidney ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/surgery ; Heart Failure/diagnosis ; Heart Failure/surgery
    Language English
    Publishing date 2023-09-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 208424-7
    ISSN 1534-6080 ; 0041-1337
    ISSN (online) 1534-6080
    ISSN 0041-1337
    DOI 10.1097/TP.0000000000004781
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  10. Article: COVID cardiomyopathy: Is it time to involve the cardiologists?

    Chowdhury, Mohammed / Maharaj, Valmiki R / Francis, Gary S / Alexy, Tamas / Fraser, Meg

    The Indian journal of medical research

    2020  Volume 152, Issue 3, Page(s) 169–171

    MeSH term(s) COVID-19 ; Cardiologists ; Cardiomyopathies/diagnosis ; Cardiomyopathies/epidemiology ; Cardiovascular Diseases ; Humans ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-10-27
    Publishing country India
    Document type Editorial
    ZDB-ID 390883-5
    ISSN 0971-5916 ; 0019-5340
    ISSN 0971-5916 ; 0019-5340
    DOI 10.4103/ijmr.IJMR_3760_20
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