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Article ; Online: Cardiac Tamponade and Pericardiocentesis: Recognition, Standard Techniques, and Modern Advancements.

Il'Giovine, Zachary J / Gage, Ann / Higgins, Andrew

2024 Volume 42, Issue 2, Page(s) 159–164

Abstract: Pericardiocentesis is an important diagnostic and therapeutic procedure. In the setting of cardiac tamponade, pericardiocentesis can rapidly improve hemodynamics, and in cases of diagnostic uncertainty, pericardiocentesis allows for fluid analysis to aid ...

Abstract	Pericardiocentesis is an important diagnostic and therapeutic procedure. In the setting of cardiac tamponade, pericardiocentesis can rapidly improve hemodynamics, and in cases of diagnostic uncertainty, pericardiocentesis allows for fluid analysis to aid in diagnosis. In contemporary practice, the widespread availability of ultrasonography has made echocardiographic guidance the standard of care. Additional tools such as micropuncture technique, live ultrasonographic guidance, and adjunctive tools including fluoroscopy continue to advance and enhance procedural efficiency and safety. When performed by experienced operators, pericardiocentesis is a safe, effective, and potentially life-saving procedure.
MeSH term(s)	Humans ; Pericardiocentesis/methods ; Cardiac Tamponade/surgery ; Pericardial Effusion/diagnosis ; Echocardiography/methods
Language	English
Publishing date	2024-03-27
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	1196385-2
ISSN	1558-2264 ; 0733-8651
ISSN (online)	1558-2264
ISSN	0733-8651
DOI	10.1016/j.ccl.2024.02.004
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Article ; Online: Cardiac Critical Care: The Evolution of a Novel Subspecialty.

Gage, Ann / Higgins, Andrew / Lee, Ran

Methodist DeBakey cardiovascular journal

2022 Volume 18, Issue 3, Page(s) 24–29

Abstract: Driven by evolving patient demographics and disease burdens over the past several decades, the demands placed on the cardiac intensive care unit have steadily increased. Originally born out of the need for post-infarction arrhythmia monitoring, the ... ...

Abstract	Driven by evolving patient demographics and disease burdens over the past several decades, the demands placed on the cardiac intensive care unit have steadily increased. Originally born out of the need for post-infarction arrhythmia monitoring, the modern cardiac intensive care space is now encountering progressively more complex patients with multisystem organ failure and, increasingly, complex mechanical circulatory support. This complexity has fueled a demand for specifically trained cardiac intensivists, and many different training pathways have emerged nationwide. In this article, we provide an overview of the evolution, landscape, training, and future of the subspecialty of cardiac critical care.
MeSH term(s)	Arrhythmias, Cardiac ; Coronary Care Units ; Critical Care ; Humans ; Intensive Care Units ; Shock, Cardiogenic
Language	English
Publishing date	2022-06-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2544079-2
ISSN	1947-6108 ; 1947-6108
ISSN (online)	1947-6108
ISSN	1947-6108
DOI	10.14797/mdcvj.1092
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Article: New-onset atrial fibrillation among COVID-19 patients: A narrative review.

Talaei, Fahimeh / Banga, Akshat / Pursell, Amanda / Gage, Ann / Pallipamu, Namratha / Seri, Amith Reddy / Adhikari, Ramesh / Kashyap, Rahul / Surani, Salim

World journal of critical care medicine

2023 Volume 12, Issue 5, Page(s) 236–247

Abstract: Over the last three years, research has focused on examining cardiac issues arising from coronavirus disease 2019 (COVID-19) infection, including the emergence of new-onset atrial fibrillation (NOAF). Still, no clinical study was conducted on the ... ...

Abstract	Over the last three years, research has focused on examining cardiac issues arising from coronavirus disease 2019 (COVID-19) infection, including the emergence of new-onset atrial fibrillation (NOAF). Still, no clinical study was conducted on the persistence of this arrhythmia after COVID-19 recovery. Our objective was to compose a narrative review that investigates COVID-19-associated NOAF, emphasizing the evolving pathophysiological mechanisms akin to those suggested for sustaining AF. Given the distinct strategies involved in the persistence of atrial AF and the crucial burden of persistent AF, we aim to underscore the importance of extended follow-up for COVID-19-associated NOAF. A comprehensive search was conducted for articles published between December 2019 and February 11, 2023, focusing on similarities in the pathophysiology of NOAF after COVID-19 and those persisting AF. Also, the latest data on incidence, morbidity-mortality, and management of NOAF in COVID-19 were investigated. Considerable overlaps between the mechanisms of emerging NOAF after COVID-19 infection and persistent AF were observed, mostly involving reactive oxygen pathways. With potential atrial remodeling associated with NOAF in COVID-19 patients, this group of patients might benefit from long-term follow-up and different management. Future cohort studies could help determine long-term outcomes of NOAF after COVID-19.
Language	English
Publishing date	2023-12-09
Publishing country	United States
Document type	Journal Article ; Review
ISSN	2220-3141
ISSN	2220-3141
DOI	10.5492/wjccm.v12.i5.236
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Article ; Online: Socioeconomic status, alcohol use and the role of social support and neighbourhood environment among individuals meeting criteria for a mental health problem: a cross-sectional study.

Puddephatt, Jo-Anne / Jones, Andrew / Gage, Suzanne H / Goodwin, Laura

Social psychiatry and psychiatric epidemiology

2024

Abstract: Purpose: Indicators of socioeconomic status (SES), such as education and occupational grade, are known to be associated with alcohol use but this has not been examined among individuals with a mental health problem. This study developed latent classes ... ...

Abstract	Purpose: Indicators of socioeconomic status (SES), such as education and occupational grade, are known to be associated with alcohol use but this has not been examined among individuals with a mental health problem. This study developed latent classes of SES, their associations with alcohol use, and examined the indirect effect via social support and neighbourhood environment. Methods: A secondary analysis of the 2014 Adult Psychiatric Morbidity Survey was conducted among participants with a mental health problem (N = 1,436). SES classes were determined using a range of indicators. Alcohol use was measured using the Alcohol Use Disorder Identification Test. Social support and neighbourhood neighbourhood environment were measured using validated questionnaires. A latent class analysis was conducted to develop SES classes. Multinomial logistic regression examined associations of SES and alcohol use. Structural equation models tested indirect effects via social support and neighbourhood environment. Results: A four-class model of SES was best-fitting; "economically inactive,GCSE-level and lower educated,social renters", "intermediate/routine occupation,GCSE-level educated,mixed owner/renters", "retired, no formal education,homeowners", and "professional occupation,degree-level educated,homeowners". Compared to "professional occupation,degree-level educated, homeowners", SES classes were more likely to be non-drinkers; odds were highest for "economically inactive,GCSE-level and lower educated,social renters" (OR = 4.96,95%CI 3.10-7.93). "Retired, no formal education,homeowners" were less likely to be hazardous drinkers (OR = 0.35,95%CI 0.20-0.59). Associations between "economically inactive,GCSE-level and lower educated,social renters" and "retired, no formal education,homeowners" and non- and harmful drinking via social support and neighbourhood environment were significant. Conclusions: In contrast to the alcohol harms paradox, among individuals with a mental health problem, lower SES groups were more likely to be non-drinkers while no associations with harmful drinking were found. There is also a need to examine the alcohol harms paradox in the context of the area in which they live.
Language	English
Publishing date	2024-04-26
Publishing country	Germany
Document type	Journal Article
ZDB-ID	623071-4
ISSN	1433-9285 ; 0037-7813 ; 0933-7954
ISSN (online)	1433-9285
ISSN	0037-7813 ; 0933-7954
DOI	10.1007/s00127-024-02670-w
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Article ; Online: Lupus and Left Ventricular Assist Devices: High-Risk for Bleeding?

Gage, Ann / Blumer, Vanessa / Joyce, Emer

ASAIO journal (American Society for Artificial Internal Organs : 1992)

2019 Volume 65, Issue 8, Page(s) e95–e96

Abstract: Continuous-flow left ventricular assist devices (LVAD) have become an increasingly utilized treatment strategy for patients with end-stage heart failure. Despite the improved outcomes evident with current generation pumps, proper patient selection ... ...

Abstract	Continuous-flow left ventricular assist devices (LVAD) have become an increasingly utilized treatment strategy for patients with end-stage heart failure. Despite the improved outcomes evident with current generation pumps, proper patient selection remains crucial to minimize the risk of potential adverse events. The evolving use of these devices as destination therapy (DT) has led to growing numbers of patients with higher risk comorbid conditions being evaluated as potential LVAD candidates. Understanding which patient and disease-specific characteristics increase postoperative morbidity and mortality is paramount as this technology continues to expand and the experience with select populations remains limited. Presented here is a case of a patient with systemic lupus erythematosus receiving a HeartWare LVAD as DT complicated by recurrent, diffuse spontaneous bleeding. The case presented here highlights a potential unique bleeding complication in a high-risk patient cohort and underscores the need to enhance our understanding of factors influencing outcomes in high-risk populations after LVAD therapy.
MeSH term(s)	Cohort Studies ; Female ; Heart Failure/therapy ; Heart Ventricles/physiopathology ; Heart-Assist Devices/adverse effects ; Hemorrhage/etiology ; Humans ; Lupus Erythematosus, Systemic/complications ; Lupus Erythematosus, Systemic/therapy ; Middle Aged ; Patient Selection ; Risk Factors
Language	English
Publishing date	2019-01-11
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	759982-1
ISSN	1538-943X ; 0162-1432 ; 1058-2916
ISSN (online)	1538-943X
ISSN	0162-1432 ; 1058-2916
DOI	10.1097/MAT.0000000000000946
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Article ; Online: Reacquainting Cardiology With Mechanical Ventilation in Response to the COVID-19 Pandemic.

Gage, Ann / Higgins, Andrew / Lee, Ran / Panhwar, Muhammad Siyab / Kalra, Ankur

JACC. Case reports

2020 Volume 2, Issue 9, Page(s) 1402–1406

Keywords	covid19
Language	English
Publishing date	2020-03-27
Publishing country	Netherlands
Document type	Editorial
ISSN	2666-0849
ISSN (online)	2666-0849
DOI	10.1016/j.jaccas.2020.03.007
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Article ; Online: Training Paradigms in Critical Care Cardiology: A Scoping Review of Current Literature.

Vallabhajosyula, Saraschandra / Mehta, Aryan / Bansal, Mridul / Jentzer, Jacob C / Applefeld, Willard N / Sinha, Shashank S / Geller, Bram J / Gage, Ann E / Rose, Scott W / Barnett, Christopher F / Katz, Jason N / Morrow, David A / Roswell, Robert O / Solomon, Michael A

JACC. Advances

2024 Volume 3, Issue 3

Abstract: Background: Over the past decade there has been increasing interest in critical care medicine (CCM) training for cardiovascular medicine (CV) physicians either in isolation (separate programs in either order [CV/CCM], integrated critical care cardiology ...

Abstract	Background: Over the past decade there has been increasing interest in critical care medicine (CCM) training for cardiovascular medicine (CV) physicians either in isolation (separate programs in either order [CV/CCM], integrated critical care cardiology [CCC] training) or hybrid training with interventional cardiology (IC)/heart failure/transplant (HF) with targeted CCC training. Objective: To review the contemporary landscape of CV/CCM, CCC, and hybrid training. Methods: We reviewed the literature from 2000-2022 for publications discussing training in any combination of internal medicine CV/CCM, CCC, and hybrid training. Information regarding training paradigms, scope of practice and training, duration, sequence, and milestones was collected. Results: Of the 2,236 unique citations, 20 articles were included. A majority were opinion/editorial articles whereas two were surveys. The training pathways were classified into - (i) specialty training in both CV (3 years) and CCM (1-2 years) leading to dual American Board of Internal Medicine (ABIM) board certification, or (ii) base specialty training in CV with competencies in IC, HF or CCC leading to a non-ABIM certificate. Total fellowship duration varied between 4-7 years after a three-year internal medicine residency. While multiple articles commented on the ability to integrate the fellowship training pathways into a holistic and seamless training curriculum, few have highlighted how this may be achieved to meet competencies and standards. Conclusions: In 20 articles describing CV/CCM, CCC, and hybrid training, there remains significant heterogeneity on the standardized training paradigms to meet training competencies and board certifications, highlighting an unmet need to define CCC competencies.
Language	English
Publishing date	2024-02-09
Publishing country	United States
Document type	Journal Article
ISSN	2772-963X
ISSN (online)	2772-963X
DOI	10.1016/j.jacadv.2024.100850
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Article ; Online: Need for a Cardiogenic Shock Team Collaborative-Promoting a Team-Based Model of Care to Improve Outcomes and Identify Best Practices.

Senman, Balimkiz / Jentzer, Jacob C / Barnett, Christopher F / Bartos, Jason A / Berg, David D / Chih, Sharon / Drakos, Stavros G / Dudzinski, David M / Elliott, Andrea / Gage, Ann / Horowitz, James M / Miller, P Elliott / Sinha, Shashank S / Tehrani, Behnam N / Yuriditsky, Eugene / Vallabhajosyula, Saraschandra / Katz, Jason N

Journal of the American Heart Association

2024 Volume 13, Issue 6, Page(s) e031979

Abstract: Cardiogenic shock continues to carry a high mortality rate despite contemporary care, with no breakthrough therapies shown to improve survival over the past few decades. It is a time-sensitive condition that commonly results in cardiovascular ... ...

Abstract	Cardiogenic shock continues to carry a high mortality rate despite contemporary care, with no breakthrough therapies shown to improve survival over the past few decades. It is a time-sensitive condition that commonly results in cardiovascular complications and multisystem organ failure, necessitating multidisciplinary expertise. Managing patients with cardiogenic shock remains challenging even in well-resourced settings, and an important subgroup of patients may require cardiac replacement therapy. As a result, the idea of leveraging the collective cognitive and procedural proficiencies of multiple providers in a collaborative, team-based approach to care (the "shock team") has been advocated by professional societies and implemented at select high-volume clinical centers. A slowly maturing evidence base has suggested that cardiogenic shock teams may improve patient outcomes. Although several registries exist that are beginning to inform care, particularly around therapeutic strategies of pharmacologic and mechanical circulatory support, none of these are currently focused on the shock team approach, multispecialty partnership, education, or process improvement. We propose the creation of a Cardiogenic Shock Team Collaborative-akin to the successful Pulmonary Embolism Response Team Consortium-with a goal to promote sharing of care protocols, education of stakeholders, and discovery of how process and performance may influence patient outcomes, quality, resource consumption, and costs of care.
MeSH term(s)	Humans ; Shock, Cardiogenic/diagnosis ; Shock, Cardiogenic/therapy ; Shock, Cardiogenic/etiology
Language	English
Publishing date	2024-03-08
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2653953-6
ISSN	2047-9980 ; 2047-9980
ISSN (online)	2047-9980
ISSN	2047-9980
DOI	10.1161/JAHA.123.031979
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Article ; Online: Comparative effectiveness of exercise electrocardiography versus exercise echocardiography in women presenting with suspected coronary artery disease: a randomized study.

Gurunathan, Sothinathan / Shanmuganathan, Mayooran / Chopra, Ankur / Pradhan, Jiwan / Aboud, Lily / Hampson, Reinette / Yakupoglu, Haci Yakup / Bioh, Gabriel / Banfield, Ann / Gage, Heather / Khattar, Raj / Senior, Roxy

European heart journal open

2023 Volume 3, Issue 3, Page(s) oead053

Abstract: Aims: There is a paucity of randomized diagnostic studies in women with suspected coronary artery disease (CAD). This study sought to assess the relative value of exercise stress echocardiography (ESE) compared with exercise electrocardiography (Ex-ECG) ...

Abstract	Aims: There is a paucity of randomized diagnostic studies in women with suspected coronary artery disease (CAD). This study sought to assess the relative value of exercise stress echocardiography (ESE) compared with exercise electrocardiography (Ex-ECG) in women with CAD. Methods and results: Accordingly, 416 women with no prior CAD and intermediate probability of CAD (mean pre-test probability 41%), were randomized to undergo either Ex-ECG or ESE. The primary endpoints were the positive predictive value (PPV) for the detection of significant CAD and downstream resource utilization. The PPV of ESE and Ex-ECG were 33% and 30% ( Conclusion: In intermediate-risk women who are able to exercise, Ex-ECG had similar efficacy to an ESE strategy, with higher resource utilization whilst providing cost savings.
Language	English
Publishing date	2023-05-22
Publishing country	England
Document type	Journal Article
ISSN	2752-4191
ISSN (online)	2752-4191
DOI	10.1093/ehjopen/oead053
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Article ; Online: Identifying beliefs driving COVID-19 vaccination: Lessons for effective messaging.

MacEwan, Sarah R / Kenah, Eben / Dixon, Graham N / Stevens, Jack / Eiterman, Leanna Perez / Powell, Jonathan R / Gage, Christopher B / Rush, Laura J / Panchal, Ashish R / McAlearney, Ann Scheck

Human vaccines & immunotherapeutics

2023 Volume 19, Issue 3, Page(s) 2266929

Abstract: Increasing vaccination acceptance has been essential during the COVID-19 pandemic and in preparation for future public health emergencies. This study aimed to identify messaging strategies to encourage vaccine uptake by measuring the drivers of COVID-19 ... ...

Abstract	Increasing vaccination acceptance has been essential during the COVID-19 pandemic and in preparation for future public health emergencies. This study aimed to identify messaging strategies to encourage vaccine uptake by measuring the drivers of COVID-19 vaccination among the general public. A survey to assess COVID-19 vaccination acceptance and hesitancy was advertised on Facebook in February-April 2022. The survey included items asking about COVID-19 vaccination status and participant demographics, and three scales assessing medical mistrust, perceived COVID-19 risk, and COVID-19 vaccine confidence (adapted from the Oxford COVID-19 vaccine confidence and complacency scale). The main outcome was vaccination, predicted by patient demographics and survey scale scores. Of 1,915 survey responses, 1,450 (75.7%) were included, with 1,048 (72.3%) respondents reporting they had been vaccinated. In a multivariable regression model, the COVID-19 vaccine confidence scale was the strongest predictor of vaccination, along with education level and perceived COVID-19 risk. Among the items on this scale, not all were equally important in predicting COVID-19 vaccination. The items that best predicted vaccination, at a given score on the COVID-19 vaccine confidence scale, included confidence that vaccine side effects are minimal, that the vaccine will work, that the vaccine will help the community, and that the vaccine provides freedom to move on with life. This study improved our understanding of perceptions most strongly associated with vaccine acceptance, allowing us to consider how to develop messages that may be particularly effective in encouraging vaccination among the general public for both the COVID-19 pandemic and future public health emergencies.
MeSH term(s)	Humans ; COVID-19 Vaccines ; Emergencies ; Pandemics ; Trust ; COVID-19/prevention & control ; Vaccination
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2023-11-10
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2664176-8
ISSN	2164-554X ; 2164-5515
ISSN (online)	2164-554X
ISSN	2164-5515
DOI	10.1080/21645515.2023.2266929
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