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  1. Article ; Online: Utility of Fractional Flow Reserve Computed Tomography Angiography in Patients With Stable Coronary Artery Disease.

    Tao, Michael / Gier, Chad / Al-Sadawi, Mohammed / Dhaliwal, Simrat / Masson, Ravi / Rahman, Tahmid / Gavalas, Michael / Tam, Edlira / Mann, Noelle

    The American journal of cardiology

    2023  Volume 208, Page(s) 31–36

    Abstract: Coronary computed tomography angiography is a modality with high negative predictive value for evaluation of coronary artery disease (CAD). However, its diagnostic accuracy for obstructive CAD is limited by multiple factors. Fractional flow reserve (FFR) ...

    Abstract Coronary computed tomography angiography is a modality with high negative predictive value for evaluation of coronary artery disease (CAD). However, its diagnostic accuracy for obstructive CAD is limited by multiple factors. Fractional flow reserve (FFR) computed tomography (FFR
    MeSH term(s) Humans ; Coronary Artery Disease/diagnostic imaging ; Fractional Flow Reserve, Myocardial ; Computed Tomography Angiography/methods ; Coronary Angiography/methods ; Tomography, X-Ray Computed ; Myocardial Infarction ; Coronary Vessels ; Predictive Value of Tests ; Coronary Stenosis
    Language English
    Publishing date 2023-10-07
    Publishing country United States
    Document type Meta-Analysis ; Journal Article
    ZDB-ID 80014-4
    ISSN 1879-1913 ; 0002-9149
    ISSN (online) 1879-1913
    ISSN 0002-9149
    DOI 10.1016/j.amjcard.2023.07.080
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The Effect of TAVR on Left Ventricular and Left Atrial Mechanics in Patients with Aortic Stenosis.

    Anastasius, Malcolm / Ro, Richard / Gavalas, Michael / Patel, Neil / Prandi, Francesca Romana / Tang, Gilbert H L / Krishnamoorthy, Parasuram / Sharma, Samin K / Kini, Annapoorna / Lerakis, Stamatios

    Journal of cardiovascular development and disease

    2022  Volume 9, Issue 2

    Abstract: Background. ...

    Abstract Background.
    Language English
    Publishing date 2022-01-21
    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/jcdd9020035
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Discriminatory performance of positive urine hemoglobin for detection of significant hemolysis in patients with continuous-flow left ventricular assist devices.

    Gavalas, Michael V / Breskin, Alexander / Yuzefpolskaya, Melana / Eisenberger, Andrew / Castagna, Francesco / Demmer, Ryan T / Flannery, Margaret / Garan, A Reshad / Takeda, Koji / Takayama, Hiroo / Naka, Yoshifumi / Topkara, Veli K / Colombo, Paolo C

    The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation

    2017  Volume 36, Issue 1, Page(s) 59–63

    Abstract: Background: Serum lactate dehydrogenase (LDH) is the standard measure for detection of hemolysis and thus surveillance for device thrombosis in patients on continuous-flow left ventricular assist device (CF-LVAD) support. Significant hemolysis has been ... ...

    Abstract Background: Serum lactate dehydrogenase (LDH) is the standard measure for detection of hemolysis and thus surveillance for device thrombosis in patients on continuous-flow left ventricular assist device (CF-LVAD) support. Significant hemolysis has been defined as LDH ≥600 IU/L. However, LDH testing requires phlebotomy, precluding frequent home monitoring. Simple dipstick urinalysis (UA) for urine hemoglobin (U-Hb) overcomes this limitation. This study correlated U-Hb and LDH levels and evaluated the performance of UA for detection of significant hemolysis in patients with CF-LVADs.
    Methods: U-Hb and LDH were measured concurrently 956 times in 221 patients with CF-LVADs. Statistics were computed to determine accuracy of UA in detecting LDH ≥600 IU/L, with a positive result being any detected U-Hb. All analyses were performed with and without excluding for 1) conditions associated with tissue damage, which are known to increase LDH, and 2) suspected or confirmed urinary tract infections or hematuria, which are known to cause hemoglobinuria for reasons other than hemolysis.
    Results: Mean LDH for absent/mild/severe U-Hb was 360 IU/L/467 IU/L IU/L/777 IU/L without exclusions, 354 IU/L/444 IU/L IU/L/651 IU/L after excluding non-hemolytic LDH elevations, 370 IU/L/513 IU/L IU/L/1,357 IU/L after excluding urinary tract infections and hematuria, and 367 IU/L/470 IU/L IU/L/1,217 IU/L when both exclusions applied (all p < 0.001). Absent U-Hb had a negative predictive value for LDH ≥600 IU/L of >90% for all analyses.
    Conclusions: Serum LDH is significantly associated with U-Hb levels. Absence of U-Hb appears to efficiently exclude significant hemolysis in patients with CF-LVADs. Because it can be performed by patients at home, hemoglobinuria monitoring may enable more intense surveillance and earlier diagnosis of device thrombosis.
    Language English
    Publishing date 2017-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1062522-7
    ISSN 1557-3117 ; 1053-2498
    ISSN (online) 1557-3117
    ISSN 1053-2498
    DOI 10.1016/j.healun.2016.08.026
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Outcomes after stroke complicating left ventricular assist device.

    Willey, Joshua Z / Gavalas, Michael V / Trinh, Pauline N / Yuzefpolskaya, Melana / Reshad Garan, A / Levin, Allison P / Takeda, Koji / Takayama, Hiroo / Fried, Justin / Naka, Yoshifumi / Topkara, Veli K / Colombo, Paolo C

    The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation

    2016  Volume 35, Issue 8, Page(s) 1003–1009

    Abstract: Background: Stroke is one of the leading complications during continuous flow-left ventricular assist device (CF-LVAD) support. Risk factors have been well described, although less is known regarding treatment and outcomes. We present a large single- ... ...

    Abstract Background: Stroke is one of the leading complications during continuous flow-left ventricular assist device (CF-LVAD) support. Risk factors have been well described, although less is known regarding treatment and outcomes. We present a large single-center experience on stroke outcome and transplant eligibility by stroke sub-type and severity in CF-LVAD patients.
    Methods: Between January 1, 2008, and April 1, 2015, 301 patients underwent CF-LVAD (266 HeartMate II [HM I], Thoratec Corp, Pleasanton, CA; 35 HeartWare [HVAD], HeartWare International Inc, Framingham, MA). Stroke was defined as a focal neurologic deficit with abnormal neuroimaging. Intracerebral hemorrhage (ICH) definition excluded sub-dural hematoma and hemorrhagic conversion of an ischemic stroke (IS). Treatment in IS included intra-arterial embolectomy when appropriate; treatment in ICH included reversal of coagulopathy. Stroke severity was measured using the National Institutes of Health Stroke Scale (NIHSS). Outcomes were in-hospital mortality and transplant status.
    Results: Stroke occurred in 40 patients: 8 ICH (4 HM II, 4 HVAD) and 32 IS (26 HM II, 6 HVAD). Among 8 ICH patients, there were 4 deaths (50%), with NIHSS of 18.8 ± 13.7 vs 1.8 ± 1.7 in survivors (p = 0.049). Among 32 IS patients, 12 had hemorrhagic conversion and 5 were treated with intra-arterial embolectomy. There were 9 deaths (28%), with NIHSS of 16.2 ± 10.8 vs 7.0 ± 7.6 in survivors (p = 0.011). Among the 32 IS patients, 12 underwent transplant, and 1 is awaiting transplant. No ICH patients received a transplant.
    Conclusions: In-hospital mortality after stroke is significantly affected by the initial neurologic impairment. Patients with IS appear to benefit the most from in-hospital treatment and often make sufficient recovery to be able to progress to transplant.
    MeSH term(s) Brain Ischemia ; Heart Failure ; Heart-Assist Devices ; Hospital Mortality ; Humans ; Retrospective Studies ; Stroke ; Treatment Outcome
    Language English
    Publishing date 2016-03-30
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1062522-7
    ISSN 1557-3117 ; 1053-2498
    ISSN (online) 1557-3117
    ISSN 1053-2498
    DOI 10.1016/j.healun.2016.03.014
    Database MEDical Literature Analysis and Retrieval System OnLINE

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