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  1. Article ; Online: Crossing the chasm of donor organ recovery in heart transplantation.

    Boulet, Jacinthe / Mehra, Mandeep R

    European heart journal

    2023  Volume 44, Issue 44, Page(s) 4675–4677

    MeSH term(s) Humans ; Tissue Donors ; Heart Transplantation ; Europe
    Language English
    Publishing date 2023-11-22
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 603098-1
    ISSN 1522-9645 ; 0195-668X
    ISSN (online) 1522-9645
    ISSN 0195-668X
    DOI 10.1093/eurheartj/ehac707
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  2. Article ; Online: Contemporary Left Ventricular Assist Device Therapy as a Bridge or Alternative to Transplantation.

    Boulet, Jacinthe / Wanderley, Mauro R B / Mehra, Mandeep R

    Transplantation

    2023  

    Abstract: Left ventricular assist devices (LVADs), which were introduced as a bridge to heart transplantation, are now an established alternative to heart transplantation (HT) for patients with advanced heart failure. These devices have undergone significant ... ...

    Abstract Left ventricular assist devices (LVADs), which were introduced as a bridge to heart transplantation, are now an established alternative to heart transplantation (HT) for patients with advanced heart failure. These devices have undergone significant technological advancements over the years, and contemporary LVADs prolong life substantially in patients dependent on inotropic therapy or in those with severe ambulatory advanced heart failure with a median survival that exceeds 5 y, and most patients benefit from a doubling in functional capacity, even among those intended as destination therapy because of ineligibility for transplantation. Other intended goals for LVAD implantation consist of (1) bridge to remission or recovery and (2) bridge to transplant or candidacy for transplant. In the former situation, few selected patients underwent LVAD implantation, facilitating myocardial remission to recovery that allowed explantation. Among those bridged to transplantation, survival in the intended goal was excellent, with 80% success at 5 y (with a 50% rate of transplantation). In this review, we provide a brief historical background on the evolution of LVADs and discuss outcomes with contemporary pumps, immunological and infection-related impact of such devices, impact of bridging in HT, and use of devices for facilitating myocardial recovery and remission. Furthermore, we discuss implications of HT allocation policies, with a specific focus within the United States, and outline future perspectives and novel device in development.
    Language English
    Publishing date 2023-10-24
    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.0000000000004834
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  3. Article ; Online: Confluence of the Physical Brain and Perceptual Mind With Ventricular Assist Devices.

    Mehra, Mandeep R / Boulet, Jacinthe

    JACC. Heart failure

    2021  Volume 9, Issue 11, Page(s) 852–854

    MeSH term(s) Brain ; Heart Failure/therapy ; Heart Transplantation ; Heart-Assist Devices ; Humans
    Language English
    Publishing date 2021-09-08
    Publishing country United States
    Document type Editorial
    ZDB-ID 2705621-1
    ISSN 2213-1787 ; 2213-1779
    ISSN (online) 2213-1787
    ISSN 2213-1779
    DOI 10.1016/j.jchf.2021.06.009
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  4. Article ; Online: Inflammation in heart failure: pathophysiology and therapeutic strategies.

    Boulet, Jacinthe / Sridhar, Vikas S / Bouabdallaoui, Nadia / Tardif, Jean-Claude / White, Michel

    Inflammation research : official journal of the European Histamine Research Society ... [et al.

    2024  Volume 73, Issue 5, Page(s) 709–723

    Abstract: A role for inflammation in the development and progression of heart failure (HF) has been proposed for decades. Multiple studies have demonstrated the potential involvement of several groups of cytokines and chemokines in acute and chronic HF, though ... ...

    Abstract A role for inflammation in the development and progression of heart failure (HF) has been proposed for decades. Multiple studies have demonstrated the potential involvement of several groups of cytokines and chemokines in acute and chronic HF, though targeting these pathways in early therapeutic trials have produced mixed results. These studies served to highlight the complexity and nuances of how pro-inflammatory pathways contribute to the pathogenesis of HF. More recent investigations have highlighted how inflammation may play distinct roles based on HF syndrome phenotypes, findings that may guide the development of novel therapies. In this review, we propose a contemporary update on the role of inflammation mediated by the innate and adaptive immune systems with HF, highlighting differences that exist across the ejection fraction spectrum. This will specifically be looked at through the lens of established and novel biomarkers of inflammation. Subsequently, we review how improvements in inflammatory pathways may mediate clinical benefits of existing guideline-directed medical therapies for HF, as well as future therapies in the pipeline targeting HF and inflammation.
    MeSH term(s) Humans ; Heart Failure/physiopathology ; Heart Failure/immunology ; Heart Failure/drug therapy ; Inflammation/immunology ; Inflammation/physiopathology ; Animals ; Cytokines/immunology ; Cytokines/metabolism
    Chemical Substances Cytokines
    Language English
    Publishing date 2024-03-28
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 1221794-3
    ISSN 1420-908X ; 1023-3830
    ISSN (online) 1420-908X
    ISSN 1023-3830
    DOI 10.1007/s00011-023-01845-6
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  5. Article ; Online: The Panvascular Interplay in Pathophysiology and Prognosis of Cardiac Allograft Vasculopathy.

    Mehra, Mandeep R / Boulet, Jacinthe / Pelletier-Galarneau, Matthieu

    Journal of the American College of Cardiology

    2022  Volume 80, Issue 17, Page(s) 1629–1632

    MeSH term(s) Humans ; Heart Transplantation/adverse effects ; Heart Diseases ; Prognosis ; Allografts
    Language English
    Publishing date 2022-10-06
    Publishing country United States
    Document type Editorial ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 605507-2
    ISSN 1558-3597 ; 0735-1097
    ISSN (online) 1558-3597
    ISSN 0735-1097
    DOI 10.1016/j.jacc.2022.08.753
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    Zs.MO 196: Show issues

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  6. Article ; Online: Cardiac Xenotransplantation: Challenges, Evolution, and Advances.

    Boulet, Jacinthe / Cunningham, Jonathan W / Mehra, Mandeep R

    JACC. Basic to translational science

    2022  Volume 7, Issue 7, Page(s) 716–729

    Abstract: The increased need for heart transplantation in patients with advanced heart failure has introduced demand for a greater supply of donor hearts. Progress in cross-species experimental models has led to promise for ushering in the clinical use of ... ...

    Abstract The increased need for heart transplantation in patients with advanced heart failure has introduced demand for a greater supply of donor hearts. Progress in cross-species experimental models has led to promise for ushering in the clinical use of xenotransplantation (XTx) as a potential solution to the organ shortage worldwide. In this review, the authors first highlight the historical advances that led to the first pig-to-human heart transplantation, a landmark moment in the field of advanced heart failure. The authors discuss immunologic, infectious, and physiological challenges for implementation of XTx, as well as innovations in the science of genetic manipulation that allowed clinical translation of this therapy. The authors consider ongoing barriers that affect ongoing translation of this technology into clinical care in the current era. Finally, the authors propose a framework for advancing clinical application of XTx.
    Language English
    Publishing date 2022-06-15
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2452-302X
    ISSN (online) 2452-302X
    DOI 10.1016/j.jacbts.2022.05.003
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  7. Article ; Online: Hemodynamic Aberrancies in Left Ventricular Assist Device-Associated Heart Failure Syndromes.

    Boulet, Jacinthe / Nayak, Aditi / Mehra, Mandeep R

    Journal of cardiac failure

    2022  Volume 28, Issue 12, Page(s) 1738–1740

    MeSH term(s) Humans ; Heart-Assist Devices/adverse effects ; Heart Failure/diagnosis ; Heart Failure/therapy ; Syndrome ; Hemodynamics ; Ventricular Function, Left
    Language English
    Publishing date 2022-09-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1281194-4
    ISSN 1532-8414 ; 1071-9164
    ISSN (online) 1532-8414
    ISSN 1071-9164
    DOI 10.1016/j.cardfail.2022.09.007
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  8. Article ; Online: A Silent Arrhythmia: How Would You Manage This Patient?

    Boulet, Jacinthe / Massie, Emmanuelle / Liszkowski, Mark

    Circulation

    2021  Volume 143, Issue 22, Page(s) 2205–2207

    MeSH term(s) Arrhythmias, Cardiac/diagnosis ; Electrocardiography/methods ; Humans ; Male ; Middle Aged
    Language English
    Publishing date 2021-06-01
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 80099-5
    ISSN 1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
    ISSN (online) 1524-4539
    ISSN 0009-7322 ; 0069-4193 ; 0065-8499
    DOI 10.1161/CIRCULATIONAHA.121.054894
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  9. Article ; Online: Heart Failure With Midrange Ejection Fraction-What Is It, If Anything?

    Boulet, Jacinthe / Massie, Emmanuelle / Rouleau, Jean-Lucien

    The Canadian journal of cardiology

    2020  Volume 37, Issue 4, Page(s) 585–594

    Abstract: The patient cohort with left ventricular ejection fractions (LVEFs) of 41%-49%, which has been defined as heart failure with midrange ejection fraction (HFmrEF), represent a significant proportion of the heart failure (HF) population. Despite the clear ... ...

    Abstract The patient cohort with left ventricular ejection fractions (LVEFs) of 41%-49%, which has been defined as heart failure with midrange ejection fraction (HFmrEF), represent a significant proportion of the heart failure (HF) population. Despite the clear cutoffs established by different society guidelines, confusion remains regarding the exact significance of midrange LVEF within the HF syndrome. Patients with LVEF 41%-49% represent a heterogeneous group of patients sharing pathophysiologic mechanisms, biomarker profiles, comorbidities, and clinical characteristics with patients with preserved and reduced LVEF. In this clinical review, we discuss the underlying pathophysiologic mechanisms that culminate in the clinical syndrome of HF and contribute to the disparities observed between HFpEF, HFrEF, and HFmrEF. We highlight differences and similarities in clinical characteristics and imaging features between HFpEF and HFrEF in an effort to disentangle the heterogeneous group of patients with midrange LVEF, but ultimately we conclude that LVEF should be seen as simply one important element of a continuum throughout the HF syndrome, and that although is useful, it is an oversimplification, because HF syndrome is more of a continuum. The underlying pathophysiology, etiology, and comorbidities of patients presenting with HF is becoming ever more important as the limitations of a classification solely based on LVEF are being better recognised, and as patient-specific personalisation of care is becoming ever more important.
    Language English
    Publishing date 2020-12-02
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 632813-1
    ISSN 1916-7075 ; 0828-282X
    ISSN (online) 1916-7075
    ISSN 0828-282X
    DOI 10.1016/j.cjca.2020.11.013
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  10. Article ; Online: Cancer Screening in Solid Organ Transplant Recipients: A Focus on Screening Liver, Lung, and Kidney Recipients for Cancers Related to the Transplanted Organ.

    Dharia, Atit / Boulet, Jacinthe / Sridhar, Vikas S / Kitchlu, Abhijat

    Transplantation

    2021  Volume 106, Issue 1, Page(s) e64–e65

    Abstract: Over the last few decades, the life expectancy of solid organ transplant recipients (SOTRs) has improved significantly. With SOTRs living longer, more recipients are dying from cancer. There is a reported 2- to 3-fold increased risk of cancer-specific ... ...

    Abstract Over the last few decades, the life expectancy of solid organ transplant recipients (SOTRs) has improved significantly. With SOTRs living longer, more recipients are dying from cancer. There is a reported 2- to 3-fold increased risk of cancer-specific mortality in SOTRs compared with the general population. Cancer in an SOTR can be de novo, recurrent, or donor-derived. Cancer screening in this population is crucial, as early detection and treatment may improve outcomes. In the absence of randomized controlled trials dedicated to SOTRs, clinicians rely on clinical practice guidelines from regional and national transplant societies; however, these may vary considerably across jurisdictions and transplanted organ. At present, no widely accepted consensus exists for cancer screening protocols in SOTRs, particularly with regard to screening for malignancy related to transplanted organ. Some SOTRs may be at higher risk of malignancies within the allograft. This is particularly the case in lung and liver recipients, though less common in kidney recipients who are at increased risk of developing renal cell cancer in their native kidneys. This increased risk has not been uniformly incorporated into screening recommendations for SOTRs. In this review, we summarize the cancer screening recommendations for SOTRs from various transplant organizations based on transplanted organ. This review also discusses the complexity and controversies surrounding screening of cancer in the allograft and future avenues to improve cancer detection in this context. More studies specific to SOTRs are required to form generalizable and evidence-based cancer screening guidelines, particularly with respect to cancer screening in the allograft.
    MeSH term(s) Early Detection of Cancer ; Humans ; Kidney ; Liver ; Lung ; Neoplasms/diagnosis ; Neoplasms/epidemiology ; Neoplasms/etiology ; Organ Transplantation/adverse effects ; Transplant Recipients
    Language English
    Publishing date 2021-04-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 208424-7
    ISSN 1534-6080 ; 0041-1337
    ISSN (online) 1534-6080
    ISSN 0041-1337
    DOI 10.1097/TP.0000000000003773
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