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Article ; Online: Aging in Heart Failure: Embracing Biology Over Chronology: JACC Family Series.

Goyal, Parag / Maurer, Mathew S / Roh, Jason

2024

Abstract: Age is among the most potent risk factors for developing heart failure and is strongly associated with adverse outcomes. As the global population continues to age and the prevalence of heart failure rises, understanding the role of aging in the ... ...

Abstract	Age is among the most potent risk factors for developing heart failure and is strongly associated with adverse outcomes. As the global population continues to age and the prevalence of heart failure rises, understanding the role of aging in the development and progression of this chronic disease is essential. Although chronologic age is on a fixed course, biological aging is more variable and potentially modifiable in patients with heart failure. This review describes the current knowledge on mechanisms of biological aging that contribute to the pathogenesis of heart failure. The discussion focuses on 3 hallmarks of aging-impaired proteostasis, mitochondrial dysfunction, and deregulated nutrient sensing-that are currently being targeted in therapeutic development for older adults with heart failure. In assessing existing and emerging therapeutic strategies, the review also enumerates the importance of incorporating geriatric conditions into the management of older adults with heart failure and in ongoing clinical trials.
Language	English
Publishing date	2024-03-21
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2705621-1
ISSN	2213-1787 ; 2213-1779
ISSN (online)	2213-1787
ISSN	2213-1779
DOI	10.1016/j.jchf.2024.02.021
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Article ; Online: Polypharmacy in Nursing Homes.

Roh, Elaine / Cota, Esteban / Lee, Jason P / Madievsky, Ruth / Eskildsen, Manuel A

Clinics in geriatric medicine

2022 Volume 38, Issue 4, Page(s) 653–666

Abstract: Older adults in the nursing home are at high risk for polypharmacy. This article provides a background of older adults in nursing homes and reviews key steps to address polypharmacy. ...

Abstract	Older adults in the nursing home are at high risk for polypharmacy. This article provides a background of older adults in nursing homes and reviews key steps to address polypharmacy.
MeSH term(s)	Aged ; Humans ; Inappropriate Prescribing ; Nursing Homes ; Polypharmacy
Language	English
Publishing date	2022-09-11
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1064151-8
ISSN	1879-8853 ; 0749-0690
ISSN (online)	1879-8853
ISSN	0749-0690
DOI	10.1016/j.cger.2022.05.007
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Article ; Online: Heart Failure With Preserved Ejection Fraction: Heterogeneous Syndrome, Diverse Preclinical Models.

Roh, Jason / Hill, Joseph A / Singh, Abhilasha / Valero-Muñoz, María / Sam, Flora

Circulation research

2022 Volume 130, Issue 12, Page(s) 1906–1925

Abstract: Heart failure with preserved ejection fraction (HFpEF) represents one of the greatest challenges facing cardiovascular medicine today. Despite being the most common form of heart failure worldwide, there has been limited success in developing ... ...

Abstract	Heart failure with preserved ejection fraction (HFpEF) represents one of the greatest challenges facing cardiovascular medicine today. Despite being the most common form of heart failure worldwide, there has been limited success in developing therapeutics for this syndrome. This is largely due to our incomplete understanding of the biology driving its systemic pathophysiology and the heterogeneity of clinical phenotypes, which are increasingly being recognized as distinct HFpEF phenogroups. Development of efficacious therapeutics fundamentally relies on robust preclinical models that not only faithfully recapitulate key features of the clinical syndrome but also enable rigorous investigation of putative mechanisms of disease in the context of clinically relevant phenotypes. In this review, we propose a preclinical research strategy that is conceptually grounded in model diversification and aims to better align with our evolving understanding of the heterogeneity of clinical HFpEF. Although heterogeneity is often viewed as a major obstacle in preclinical HFpEF research, we challenge this notion and argue that embracing it may be the key to demystifying its pathobiology. Here, we first provide an overarching guideline for developing HFpEF models through a stepwise approach of comprehensive cardiac and extra-cardiac phenotyping. We then present an overview of currently available models, focused on the 3 leading phenogroups, which are primarily based on aging, cardiometabolic stress, and chronic hypertension. We discuss how well these models reflect their clinically relevant phenogroup and highlight some of the more recent mechanistic insights they are providing into the complex pathophysiology underlying HFpEF.
MeSH term(s)	Cardiovascular Agents ; Heart Failure/genetics ; Heart Failure/therapy ; Humans ; Stroke Volume/physiology
Chemical Substances	Cardiovascular Agents
Language	English
Publishing date	2022-06-09
Publishing country	United States
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	80100-8
ISSN	1524-4571 ; 0009-7330 ; 0931-6876
ISSN (online)	1524-4571
ISSN	0009-7330 ; 0931-6876
DOI	10.1161/CIRCRESAHA.122.320257
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Article ; Online: Neurogenic Thoracic Outlet Syndrome in Division 1 Collegiate Athletes: Presentation, Diagnosis, and Treatment.

Olson, Emily Miller / Dyrek, Paige / Harris, Taylor / Fereydooni, Arash / Lee, Jason T / Kussman, Andrea / Roh, Eugene

Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine

2023 Volume 33, Issue 5, Page(s) 467–474

Abstract: Objective: Athletes who engage in repetitive upper-extremity exercise are susceptible to neurogenic thoracic outlet syndrome (nTOS). We sought to identify typical presenting symptoms and common findings on diagnostic workup, in addition to evaluating ... ...

Abstract	Objective: Athletes who engage in repetitive upper-extremity exercise are susceptible to neurogenic thoracic outlet syndrome (nTOS). We sought to identify typical presenting symptoms and common findings on diagnostic workup, in addition to evaluating rates of return to play following various treatment interventions. Design: Retrospective chart review. Setting: Single institution. Participants: Medical records of Division 1 athletes containing the diagnosis of nTOS between the years 2000 and 2020 were identified. Athletes with arterial or venous thoracic outlet syndrome were excluded. Independent variables: Demographics, sport, participation status, clinical presentation, physical examination findings, diagnostic workup, and treatments provided. Main outcome measures: Rate of return to play (RTP) to collegiate athletics. Results: Twenty-three female and 13 male athletes were diagnosed and treated for nTOS. Digit plethysmography showed diminished or obliterated waveforms with provocative maneuvers in 23 of 25 athletes. Forty-two percent were able to continue competing despite symptoms. Of the athletes who were initially unable to compete, 12% returned to full competition after physical therapy alone, 42% of those remaining were able to RTP after botulinum toxin injection, and an additional 42% of the remaining athletes RTP after thoracic outlet decompression surgery. Conclusions: Many athletes diagnosed with nTOS will be able to continue competing despite symptoms. Digit plethysmography is a sensitive diagnostic tool for nTOS to document anatomical compression at the thoracic inlet. Botulinum toxin injection had a significant positive effect on symptoms and a high rate of RTP (42%), allowing numerous athletes to avoid surgery and its prolonged recovery and associated risks. Clinical relevance: This study demonstrates that botulinum toxin injection had a high rate of return to full competition in elite athletes without the risks and recovery needed for surgical intervention, suggesting that this may be a good intervention especially among elite athletes who only experience symptoms with sport-related activities.
MeSH term(s)	Humans ; Male ; Female ; Treatment Outcome ; Retrospective Studies ; Decompression, Surgical ; Thoracic Outlet Syndrome/therapy ; Thoracic Outlet Syndrome/surgery ; Athletes ; Botulinum Toxins
Chemical Substances	Botulinum Toxins (EC 3.4.24.69)
Language	English
Publishing date	2023-05-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	1062530-6
ISSN	1536-3724 ; 1050-642X
ISSN (online)	1536-3724
ISSN	1050-642X
DOI	10.1097/JSM.0000000000001162
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Article ; Online: Cardioprotective and Anti-Inflammatory Effects of FAM3D in Myocardial Ischemia-Reperfusion Injury.

Rhee, James / Freeman, Rebecca / Roh, Kangsan / Lyons, Margaret / Xiao, Chunyang / Zlotoff, Daniel / Yeri, Ashish / Li, Haobo / Guerra, Justin / Guseh, J Sawalla / Kuznetsov, Alexandra / Houstis, Nicholas / Roh, Jason / Damilano, Federico / Liu, Xiaojun / Silverman, Michael / Kwong, Raymond / Das, Saumya / Rosenzweig, Anthony

Circulation research

2023 Volume 133, Issue 7, Page(s) 651–653

MeSH term(s)	Humans ; Myocardial Reperfusion Injury/prevention & control ; Anti-Inflammatory Agents/pharmacology ; Anti-Inflammatory Agents/therapeutic use ; Cytokines
Chemical Substances	Anti-Inflammatory Agents ; FAM3D protein, human ; Cytokines
Language	English
Publishing date	2023-08-28
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	80100-8
ISSN	1524-4571 ; 0009-7330 ; 0931-6876
ISSN (online)	1524-4571
ISSN	0009-7330 ; 0931-6876
DOI	10.1161/CIRCRESAHA.123.322640
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Article ; Online: Pulmonary Artery Mass in a Patient With Tuberculous Pericarditis.

Churchill, Jessica L / Ard, Kevin L / Roh, Jason D / Lu, Michael T

CASE (Philadelphia, Pa.)

2019 Volume 3, Issue 1, Page(s) 2–5

Language	English
Publishing date	2019-01-02
Publishing country	United States
Document type	Case Reports
ISSN	2468-6441
ISSN (online)	2468-6441
DOI	10.1016/j.case.2018.11.004
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Article ; Online: Intrinsic and Extrinsic Contributors to the Cardiac Benefits of Exercise.

Hastings, Margaret H / Castro, Claire / Freeman, Rebecca / Abdul Kadir, Azrul / Lerchenmüller, Carolin / Li, Haobo / Rhee, James / Roh, Jason D / Roh, Kangsan / Singh, Anand P / Wu, Chao / Xia, Peng / Zhou, Qiulian / Xiao, Junjie / Rosenzweig, Anthony

JACC. Basic to translational science

2023 Volume 9, Issue 4, Page(s) 535–552

Abstract: Among its many cardiovascular benefits, exercise training improves heart function and protects the heart against age-related decline, pathological stress, and injury. Here, we focus on cardiac benefits with an emphasis on more recent updates to our ... ...

Abstract	Among its many cardiovascular benefits, exercise training improves heart function and protects the heart against age-related decline, pathological stress, and injury. Here, we focus on cardiac benefits with an emphasis on more recent updates to our understanding. While the cardiomyocyte continues to play a central role as both a target and effector of exercise's benefits, there is a growing recognition of the important roles of other, noncardiomyocyte lineages and pathways, including some that lie outside the heart itself. We review what is known about mediators of exercise's benefits-both those intrinsic to the heart (at the level of cardiomyocytes, fibroblasts, or vascular cells) and those that are systemic (including metabolism, inflammation, the microbiome, and aging)-highlighting what is known about the molecular mechanisms responsible.
Language	English
Publishing date	2023-10-18
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2452-302X
ISSN (online)	2452-302X
DOI	10.1016/j.jacbts.2023.07.011
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Article ; Online: Why Don't We Have Proven Treatments for HFpEF?

Roh, Jason / Houstis, Nicholas / Rosenzweig, Anthony

Circulation research

2017 Volume 120, Issue 8, Page(s) 1243–1245

MeSH term(s)	Animals ; Heart Failure/diagnostic imaging ; Heart Failure/physiopathology ; Heart Failure/therapy ; Humans ; Stroke Volume/physiology ; Treatment Outcome
Language	English
Publishing date	2017-04-11
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	80100-8
ISSN	1524-4571 ; 0009-7330 ; 0931-6876
ISSN (online)	1524-4571
ISSN	0009-7330 ; 0931-6876
DOI	10.1161/CIRCRESAHA.116.310119
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Article ; Online: Impact of Scalene Muscle Botulinum Toxin Injection With and Without Surgery in Neurogenic Thoracic Outlet Syndrome.

Fereydooni, Arash / Ho, Vy T / Olson, Emily Miller / Dyrek, Paige / Harris, Taylor / Kussman, Andrea / Roh, Eugene / Lee, Jason T

Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine

2022 Volume 33, Issue 2, Page(s) 116–122

Abstract: Objective: Scalene blocks are part of both the diagnostic and treatment algorithm for patients presenting with symptoms of neurogenic thoracic outlet syndrome (nTOS). However, there is a paucity of data on the utility of scalene botulinum toxin ... ...

Abstract	Objective: Scalene blocks are part of both the diagnostic and treatment algorithm for patients presenting with symptoms of neurogenic thoracic outlet syndrome (nTOS). However, there is a paucity of data on the utility of scalene botulinum toxin injection (BTI) before surgical decompression. We sought to determine the impact of BTI with and without surgery at a multidisciplinary referral center. Design: Retrospective cohort study. Setting: Single institution tertiary academic center, 2011 to 2020. Patients: Seventy-seven consecutive patients. Interventions: Scalene muscle BTI for nTOS with or without surgical decompression. Main outcome measures: Pain relief and Quick Disability of the Arm, Shoulder and Hand (QDASH) score. Results: Seventy-seven patients, with a mean age of 31.4 years, had BTI for symptoms of nTOS. All patients underwent pretreatment physical therapy through the Edgelow protocol for a mean duration of 3.4 months. However, 72.7% had dynamic vascular compression on duplex ultrasound with provocative maneuvers and 85.7% had a positive physical examination finding. After BTI, 77.9% reported subjective relief, confirmed by an improved QDASH disability score. Thirty-one patients (40.3%) then went on to have further persistent symptoms and proceeded with first rib resection. After BTI + Surgery, 96.8% reported symptomatic relief and had a median QDASH score improvement of 21 (range: 10-40), with all reaching minimal clinically important differences in the QDASH score after combination therapy. Conclusions: In this reported series of chemodenervation in patients with nTOS, BTI is helpful in alleviating symptoms before definitive surgical decompression. BTI followed by first rib resection provides additional symptom improvement over BTI alone.
MeSH term(s)	Humans ; Adult ; Retrospective Studies ; Treatment Outcome ; Decompression, Surgical/methods ; Neck Muscles ; Thoracic Outlet Syndrome/drug therapy ; Thoracic Outlet Syndrome/surgery ; Thoracic Outlet Syndrome/diagnosis ; Botulinum Toxins/therapeutic use
Chemical Substances	Botulinum Toxins (EC 3.4.24.69)
Language	English
Publishing date	2022-11-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	1062530-6
ISSN	1536-3724 ; 1050-642X
ISSN (online)	1536-3724
ISSN	1050-642X
DOI	10.1097/JSM.0000000000001094
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Article ; Online: Association of activin A and postpartum blood pressure in peripartum cardiomyopathy.

Koczo, Agnes / Marino, Amy / Polsinelli, Vincenzo B / Alharethi, Rami / Damp, Julie / Ewald, Gregory / Givertz, Michael M / Boehmer, John / Hanley-Yanez, Karen / Rana, Sarosh / Roh, Jason / McNamara, Dennis M

Pregnancy hypertension

2023 Volume 34, Page(s) 60–66

Abstract: Background: Activin A has been implicated in the pathogenesis of patients with chronic hypertension and heart failure as well as patients with hypertensive disorders of pregnancy (HDP). Whether activin A correlates with blood pressure in patients with ... ...

Abstract	Background: Activin A has been implicated in the pathogenesis of patients with chronic hypertension and heart failure as well as patients with hypertensive disorders of pregnancy (HDP). Whether activin A correlates with blood pressure in patients with peripartum cardiomyopathy (PPCM) and HDP history has not previously been explored. Methods and results: 82 women with PPCM w/ and w/out HDP or hypertension history were selected for analysis from the Investigations in Pregnancy Associated Cardiomyopathy (IPAC) study. Serum biomarkers and blood pressure were assessed at the time of enrollment (median postpartum day 24). Levels of both sFlt-1 (SBP: r 0.47, p = 0.008; DBP: r 0.57, p < 0.001) and activin A (SBP: r 0.59, p < 0.001;DBP: r 0.68, p < 0.001) were noted to significantly correlate with blood pressure in patients with a history of HDP who went on to develop PPCM, but not in patients with chronic hypertension or no hypertensive history. The strongest correlation was between activin A levels and postpartum diastolic blood pressure for the subset with preeclampsia (DBP: r0.82, p < 0.001). This remained significant in multivariable linear regression analysis (DBP: β = 0.011, p = 0.015). Conclusion: In patients with PPCM, activin A and sFlt-1 levels had direct correlations with both systolic (SBP) and diastolic blood pressures (DBP), but only in participants with history of HDP. This correlation was more evident for activin A and strongest with a history of preeclampsia. Our findings suggest that activin A may play an important role in blood pressure modulation in women with HDP who subsequently develop PPCM.
MeSH term(s)	Pregnancy ; Humans ; Female ; Blood Pressure/physiology ; Pre-Eclampsia ; Peripartum Period ; Postpartum Period ; Cardiomyopathies ; Puerperal Disorders ; Hypertension/complications
Chemical Substances	activin A
Language	English
Publishing date	2023-10-16
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2584464-7
ISSN	2210-7797 ; 2210-7789
ISSN (online)	2210-7797
ISSN	2210-7789
DOI	10.1016/j.preghy.2023.10.002
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