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Article ; Online: Sleep Duration and Cardiovascular Disease Prevalence - The Debate Continues.

Aggarwal, Saurabh / Aggarwal, Gaurav / Loomba, Rohit Seth

2020 Volume 128, Page(s) 159

MeSH term(s)	Cardiovascular Diseases ; Cross-Sectional Studies ; Humans ; Nutrition Surveys ; Prevalence ; Risk Factors
Language	English
Publishing date	2020-05-19
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2020.05.023
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Article ; Online: Persistent Right Venous Valve: Insights From Multimodality Imaging.

Kadiyala, Madhavi / Hui, Kevin / Banga, Sandeep / Loomba, Rohit Seth / Pandian, Natesa G / Kutty, Shelby

Circulation. Cardiovascular imaging

2021 Volume 14, Issue 5, Page(s) e010977

Abstract: Anatomic variants in the right atrium are under-recognized and under-reported phenomena in cardiac imaging. In the fetus, right atrium serves as a conduit for oxygenated blood to be delivered to the left heart bypassing the right ventricle and the ... ...

Abstract	Anatomic variants in the right atrium are under-recognized and under-reported phenomena in cardiac imaging. In the fetus, right atrium serves as a conduit for oxygenated blood to be delivered to the left heart bypassing the right ventricle and the nonfunctional lungs. The anatomy in the fetal right atrium is designed for such purposeful circulation. The right and left venous valves are prominent structures in the fetal heart that direct inferior vena caval flow towards the foramen ovale. These anatomic structures typically regress and the foramen ovale closes after birth. However, the venous valves can persist leading to a range of anatomic, physiological, and pathological consequences in the adult. We describe various presentations of persistent venous valves, focusing on the right venous valve in this illustrated multimodality imaging article.
Language	English
Publishing date	2021-05-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2435045-X
ISSN	1942-0080 ; 1941-9651
ISSN (online)	1942-0080
ISSN	1941-9651
DOI	10.1161/CIRCIMAGING.120.010977
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Zs.A 6743: Show issues

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Article ; Online: Hemodynamic effects of ketamine in children with congenital heart disease and/or pulmonary hypertension.

Loomba, Rohit S / Gray, Seth B / Flores, Saul

Congenital heart disease

2018 Volume 13, Issue 5, Page(s) 646–654

Abstract: Introduction: Ketamine is a drug often used for procedural sedation or as adjunct agent for general sedation in children with congenital heart disease. In the clinical realm, there is often confusion regarding the effects of ketamine on hemodynamics, ... ...

Abstract	Introduction: Ketamine is a drug often used for procedural sedation or as adjunct agent for general sedation in children with congenital heart disease. In the clinical realm, there is often confusion regarding the effects of ketamine on hemodynamics, particularly pulmonary vascular resistance and systemic vascular resistance. We performed a meta-analysis of studies investigating the effects of ketamine on hemodynamics. Methods: A systematic review was conducted to identify studies characterizing the hemodynamic effects of ketamine in children with congenital heart disease. Studies were assessed for quality and those of satisfactory quality with pre- and postketamine hemodynamics for each patient were included in the final analyses. Those not limited to pediatric patients and those not limited to patients with congenital heart disease were excluded from the final analyses. Results: A total of 7 studies with 139 patients were included in the final analyses. Pulmonary vascular resistance, systemic vascular resistance, mean pulmonary artery pressure, mean systemic pressure, heart rate, pH, and arterial oxygen concentration did not significantly change with administration of ketamine. Carbon dioxide concentration did increase significantly by a mean of 1.38 mm Hg with the administration of ketamine. Conclusion: Ketamine has minimal impact on hemodynamics in children with congenital heart disease when used at usual clinical doses. Systemic vascular resistance and pulmonary vascular resistance are not significantly altered. Blood gas values are also only minimally affected by ketamine.
MeSH term(s)	Anesthesia/methods ; Anesthetics, Dissociative/administration & dosage ; Cardiac Surgical Procedures ; Child ; Heart Defects, Congenital/physiopathology ; Heart Defects, Congenital/surgery ; Hemodynamics/drug effects ; Humans ; Hypertension, Pulmonary/physiopathology ; Hypertension, Pulmonary/surgery ; Ketamine/administration & dosage
Chemical Substances	Anesthetics, Dissociative ; Ketamine (690G0D6V8H)
Language	English
Publishing date	2018-09-27
Publishing country	United States
Document type	Journal Article ; Systematic Review
ZDB-ID	2274321-2
ISSN	1747-0803 ; 1747-079X
ISSN (online)	1747-0803
ISSN	1747-079X
DOI	10.1111/chd.12662
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Article ; Online: Role of angiotensin receptor blockers for management of aortic root dilation associated with Marfan syndrome.

Loomba, Rohit Seth / Arora, Rohit R

Expert review of cardiovascular therapy

2011 Volume 9, Issue 10, Page(s) 1257–1259

MeSH term(s)	Angiotensin Receptor Antagonists/therapeutic use ; Aortic Diseases/drug therapy ; Aortic Diseases/etiology ; Dilatation, Pathologic/drug therapy ; Dilatation, Pathologic/etiology ; Humans ; Marfan Syndrome/complications
Chemical Substances	Angiotensin Receptor Antagonists
Language	English
Publishing date	2011-10
Publishing country	England
Document type	Editorial ; Review
ZDB-ID	2192343-7
ISSN	1744-8344 ; 1477-9072
ISSN (online)	1744-8344
ISSN	1477-9072
DOI	10.1586/erc.11.130
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Zs.A 6107: Show issues

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Article ; Online: Obstructive sleep apnea and atrial fibrillation: a call for increased awareness and effective management.

Loomba, Rohit Seth / Arora, Rohit

American journal of therapeutics

2012 Volume 19, Issue 1, Page(s) e21–4

Abstract: Many studies have noted a correlation between obstructive sleep apnea (OSA) and atrial fibrillation (AF). Although there is a need for large randomized control trials, the present data are quite convincing and can be used to improve current treatment ... ...

Abstract	Many studies have noted a correlation between obstructive sleep apnea (OSA) and atrial fibrillation (AF). Although there is a need for large randomized control trials, the present data are quite convincing and can be used to improve current treatment procedures. Reviews, randomized control trials, and meta-analyses were obtained using electronic search strategies such as Medline and Cochrane Library. References of electronically obtained studies were then used to conduct hand searches for additional relevant studies. Sources were deemed relevant if they discussed the relationship between AF and OSA in respect to incidence, mechanism, recurrence, or treatment. Selected sources were then stratified on the basis of quality. Correlations between OSA and AF are present, and OSA seems to lend itself to the development, progression, and post-ablation recurrence of AF. Treatment of OSA before ablation can help reduce AF recurrence, allowing for more efficient treatment of AF. It is thus important for physicians to monitor AF patients for OSA and monitor those with OSA for AF.
MeSH term(s)	Atrial Fibrillation/epidemiology ; Atrial Fibrillation/etiology ; Atrial Fibrillation/therapy ; Catheter Ablation/methods ; Disease Progression ; Humans ; Incidence ; Recurrence ; Risk Factors ; Sleep Apnea, Obstructive/complications ; Sleep Apnea, Obstructive/epidemiology ; Sleep Apnea, Obstructive/physiopathology
Language	English
Publishing date	2012-01
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1280786-2
ISSN	1536-3686 ; 1075-2765
ISSN (online)	1536-3686
ISSN	1075-2765
DOI	10.1097/MJT.0b013e3181e70c49
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Zs.A 4351: Show issues

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Article: Fibrates: where are we now?

Seth Loomba, Rohit / Arora, Rohit

Therapeutic advances in cardiovascular disease

2009 Volume 3, Issue 1, Page(s) 91–96

Abstract: Unlabelled: Cardiovascular disease remains a leading cause of mortality worldwide. As dyslipidemia increases cardiovascular disease risk, proper management of dyslipidemia is one means by which to decrease cardiovascular disease risk. This review ... ...

Abstract	Unlabelled: Cardiovascular disease remains a leading cause of mortality worldwide. As dyslipidemia increases cardiovascular disease risk, proper management of dyslipidemia is one means by which to decrease cardiovascular disease risk. This review focuses on dyslipidemia treatment utilizing fibrate therapy, which targets high trigylcerides, low HDL, and high small, dense LDL, while contrasting fibrate therapy with statin therapy and combined therapy. Studies were obtained using electronic search strategies, such as Medline and Cochrane Library. Sources selected were limited to those that discussed fibrates, statins, and combined therapy, with specific emphasis placed on sources that focused on fibrates. Selected studies were then assessed for quality via analysis of the study's methodology, results, and data. Results: of selected studies were then stratified using a rating system devised to determine the quality of results using the scientific evidence provided for them. Combination fibrate and statin therapy can be more effective in achieving optimal lipid levels than just fibrate or statin therapy alone without significant side effects as long as gemfibrozil is not used in therapy.
MeSH term(s)	C-Reactive Protein/metabolism ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/metabolism ; Cardiovascular Diseases/prevention & control ; Clofibric Acid/adverse effects ; Clofibric Acid/therapeutic use ; Drug Therapy, Combination ; Dyslipidemias/complications ; Dyslipidemias/drug therapy ; Dyslipidemias/metabolism ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Hypolipidemic Agents/adverse effects ; Hypolipidemic Agents/therapeutic use ; Lipoproteins, HDL/blood ; Lipoproteins, LDL/blood ; Risk Assessment ; Treatment Outcome ; Triglycerides/blood
Chemical Substances	Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypolipidemic Agents ; Lipoproteins, HDL ; Lipoproteins, LDL ; Triglycerides ; Clofibric Acid (53PF01Q249) ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2009-02
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2485062-7
ISSN	1753-9455 ; 1753-9447
ISSN (online)	1753-9455
ISSN	1753-9447
DOI	10.1177/1753944708096281
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Zs.A 6798: Show issues

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Article ; Online: Hyperglycemia and acute coronary syndrome: a systematic review of hyperglycemia's impact on ACS.

Loomba, Rohit Seth / Arora, Rohit

American journal of therapeutics

2010 Volume 17, Issue 2, Page(s) e48–51

Abstract: The association between hyperglycemia and increased mortality associated with acute coronary syndrome (ACS) has been studied and affirmed. Although more studies are needed to explore how managing this hyperglycemia can affect ACS mortality, the need to ... ...

Abstract	The association between hyperglycemia and increased mortality associated with acute coronary syndrome (ACS) has been studied and affirmed. Although more studies are needed to explore how managing this hyperglycemia can affect ACS mortality, the need to educate regarding current data is urgent so that it can be clinically applied. Reviews, randomized controlled trials, and other studies were obtained by means of electronic search strategies, such as Medline and Cochrane Library, as well as hand selection. Sources selected were limited to those that discussed ACS and hyperglycemia, and specific emphasis was placed on sources that focused on ACS and hyperglycemia in conjunction with one another. Selected studies were then assessed for quality and relevance. Clear correlations between mean and persistent glucose levels and ACS mortality are found. Persistent glucose levels offer a better model to predict ACS mortality than on-admission glucose levels. However, findings concerning the effect on ACS-related mortality of controlling glucose levels have been conflicting.
MeSH term(s)	Acute Coronary Syndrome/complications ; Acute Coronary Syndrome/mortality ; Blood Glucose ; Hospitalization ; Humans ; Hyperglycemia/complications ; Hyperglycemia/physiopathology ; Time Factors
Chemical Substances	Blood Glucose
Language	English
Publishing date	2010-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1280786-2
ISSN	1536-3686 ; 1075-2765
ISSN (online)	1536-3686
ISSN	1075-2765
DOI	10.1097/01.mjt.0000369908.44628.89
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Zs.A 4351: Show issues

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Article ; Online: Prevention of cardiovascular disease utilizing fibrates--a pooled meta-analysis.

Loomba, Rohit Seth / Arora, Rohit

American journal of therapeutics

2010 Volume 17, Issue 6, Page(s) e182–8

Abstract: Dyslipidemia increases the risk of cardiovascular disease (CVD) risk which is a leading cause of mortality. This creates the need for therapies to effectively manage dyslipidemia to decrease the CVD risk associated with it. This meta-analysis evaluates ... ...

Abstract	Dyslipidemia increases the risk of cardiovascular disease (CVD) risk which is a leading cause of mortality. This creates the need for therapies to effectively manage dyslipidemia to decrease the CVD risk associated with it. This meta-analysis evaluates fibrate therapy in respect to dealing with dyslipidemia and CVD risk. Fibrates significantly reduced plasma total cholesterol by 8% and significantly reduced triglyceride levels by 30%. High density lipoprotein cholesterol levels were raised by 9% with fibrates. All-cause mortality and noncardiovascular mortality were both significantly increased with fibrates but these significant changes no longer appeared after trials using clofibrate were removed from the analysis. There was no significant reduction in fatal myocardial infarction but there was a significant 22% reduction of nonfatal myocardial infarction. Fibrates can effectively reduce low density lipoprotein C (LDL-C) while also optimizing high-density lipoprotein and triglyceride levels as well, which statins do not. Negative effects of fibrates were not significant after clofibrate trials were removed from consideration in the study. It should be noted that gemfibrozil should not be used as well due to its adverse effects.
MeSH term(s)	Cardiovascular Diseases/prevention & control ; Fibric Acids/therapeutic use ; Humans ; Hypolipidemic Agents/therapeutic use ; Randomized Controlled Trials as Topic ; Treatment Outcome
Chemical Substances	Fibric Acids ; Hypolipidemic Agents
Language	English
Publishing date	2010-11
Publishing country	United States
Document type	Journal Article ; Meta-Analysis
ZDB-ID	1280786-2
ISSN	1536-3686 ; 1075-2765
ISSN (online)	1536-3686
ISSN	1075-2765
DOI	10.1097/MJT.0b013e3181dcf72b
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Zs.A 4351: Show issues

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Article ; Online: Statin therapy and aortic stenosis: a systematic review of the effects of statin therapy on aortic stenosis.

Loomba, Rohit Seth / Arora, Rohit

American journal of therapeutics

2010 Volume 17, Issue 4, Page(s) e110–4

Abstract: Aortic stenosis is a condition that is inflicting an increasing number of the elderly in North America and Europe. Current treatment for aortic stenosis is aortic valve replacement. An expanding pool of knowledge regarding the mechanism of aortic ... ...

Abstract	Aortic stenosis is a condition that is inflicting an increasing number of the elderly in North America and Europe. Current treatment for aortic stenosis is aortic valve replacement. An expanding pool of knowledge regarding the mechanism of aortic stenosis has led to the testing of statins to reduce the progression of aortic stenosis. Reviews, randomized, controlled trials and other studies pertaining to the topic were searched for using Medline, Cochrane Library, and ScienceDirect. Search terms used were "HMG-CoA reductase inhibitors" and "aortic stenosis." Studies found were then searched for relevant data and ranked using a rating system to determine the validity and quality of the study's results by evaluating the methodology used to include patients, clinical end points examined, and the methodology used to analyze data. Hand searches for referenced studies were also carried out. Studies with relevant results of acceptable quality were then incorporated. Statins have been found to be generally ineffective in delaying the progression of aortic stenosis, although some cohort studies found improvements in valve hemodynamics. Aortic stenosis lesions are characterized by calcific and lipoproteinacous deposits and end-stage aortic stenosis results in valve ossification. Although retrospective and prospective cohort studies show that statins do delay progression of aortic stenosis and improve hemodynamics of the affected valve, randomized, controlled study data do not reinforce these findings. Simvastatin and Ezetimibe in Aortic Stenosis (SEAS), a large randomized, controlled trial, not only found that statins have no significant effect on progression of aortic stenosis, but that statin therapy in those with aortic stenosis may lead to a higher incidence of cancer.
MeSH term(s)	Anticholesteremic Agents/adverse effects ; Anticholesteremic Agents/therapeutic use ; Aortic Valve Stenosis/drug therapy ; Aortic Valve Stenosis/physiopathology ; Calcinosis/drug therapy ; Disease Progression ; Hemodynamics/drug effects ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Neoplasms/etiology ; Ossification, Heterotopic/drug therapy
Chemical Substances	Anticholesteremic Agents ; Hydroxymethylglutaryl-CoA Reductase Inhibitors
Language	English
Publishing date	2010-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1280786-2
ISSN	1536-3686 ; 1075-2765
ISSN (online)	1536-3686
ISSN	1075-2765
DOI	10.1097/MJT.0b013e3181a2b1a6
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Article ; Online: Increased return of spontaneous circulation at the expense of neurologic outcomes: Is prehospital epinephrine for out-of-hospital cardiac arrest really worth it?

Loomba, Rohit Seth / Nijhawan, Karan / Aggarwal, Saurabh / Arora, Rohit Romesh

Journal of critical care

2015 Volume 30, Issue 6, Page(s) 1376–1381

Abstract: Introduction: Current guidelines for the management of out-of-hospital cardiac arrest (OHCA) recommend the use of prehospital epinephrine by initial responders. This recommendation was initially based on data from animal models of cardiac arrest and ... ...

Abstract	Introduction: Current guidelines for the management of out-of-hospital cardiac arrest (OHCA) recommend the use of prehospital epinephrine by initial responders. This recommendation was initially based on data from animal models of cardiac arrest and minimal human data, but since its inception, more human data regarding prehospital epinephrine in this setting are now available. Although out-of-hospital return of spontaneous circulation (ROSC) may be higher with the use of epinephrine, worse neurologic outcomes may be associated with its use. Methods: A systematic review of the literature was conducted by search of databases including PubMed, Embase, and OVID to identify studies comparing patients with OHCA who had received epinephrine before arrival to the hospital with those who had not. Studies were assessed for quality and bias, and data were abstracted from studies deemed appropriate for inclusion. A meta-analysis was conducted using a Mantel-Haenszel model for dichotomous outcomes. Outcomes studied were prehospital ROSC, survival at 1 month, survival to discharge, and positive neurologic outcome. Results: A total of 14 studies with 655853 patients were included for the meta-analysis. The use of epinephrine for OHCA before arrival to the hospital was associated with a significant increase in ROSC (odds ratio, 2.86; P<.001) and a significant increase in the risk of poor neurologic outcome at the time of discharge (odds ratio 0.51, P=.008). There was no significant difference in survival at 1 month or survival to discharge. Conclusion: Use of epinephrine before arrival to the hospital for OHCA does not increase survival to discharge but does make it more likely for those who are discharged to have poor neurologic outcome. There is a need for additional randomized controlled trials.
MeSH term(s)	Adrenergic beta-Agonists/therapeutic use ; Blood Circulation/drug effects ; Blood Circulation/physiology ; Cardiopulmonary Resuscitation/methods ; Emergency Medical Services/methods ; Emergency Medical Services/statistics & numerical data ; Epinephrine/therapeutic use ; Humans ; Nervous System Diseases/etiology ; Odds Ratio ; Out-of-Hospital Cardiac Arrest/drug therapy ; Out-of-Hospital Cardiac Arrest/mortality ; Survival Analysis
Chemical Substances	Adrenergic beta-Agonists ; Epinephrine (YKH834O4BH)
Language	English
Publishing date	2015-12
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Review
ZDB-ID	632818-0
ISSN	1557-8615 ; 0883-9441
ISSN (online)	1557-8615
ISSN	0883-9441
DOI	10.1016/j.jcrc.2015.08.016
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