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  1. Article ; Online: Pathophysiology and Therapeutic Approaches to Acute Decompensated Heart Failure.

    Njoroge, Joyce N / Teerlink, John R

    Circulation research

    2021  Volume 128, Issue 10, Page(s) 1468–1486

    Abstract: Acute decompensated heart failure (ADHF) is one of the leading admission diagnoses worldwide, yet it is an entity with incompletely understood pathophysiology and limited therapeutic options. Patients admitted for ADHF have high in-hospital morbidity and ...

    Abstract Acute decompensated heart failure (ADHF) is one of the leading admission diagnoses worldwide, yet it is an entity with incompletely understood pathophysiology and limited therapeutic options. Patients admitted for ADHF have high in-hospital morbidity and mortality, as well as frequent rehospitalizations and subsequent cardiovascular death. This devastating clinical course is partly due to suboptimal medical management of ADHF with persistent congestion upon hospital discharge and inadequate predischarge initiation of life-saving guideline-directed therapies. While new drugs for the treatment of chronic HF continue to be approved, there has been no new therapy approved for ADHF in decades. This review will focus on the current limited understanding of ADHF pathophysiology, possible therapeutic targets, and current limitations in expanding available therapies in light of the unmet need among these high-risk patients.
    MeSH term(s) Acute Disease ; Body Fluids/physiology ; Cardio-Renal Syndrome/complications ; Cardiotoxins/therapeutic use ; Comorbidity ; Heart Failure/diagnosis ; Heart Failure/drug therapy ; Heart Failure/etiology ; Heart Failure/physiopathology ; Hospitalization ; Humans ; Inflammation Mediators/metabolism ; Myocardial Contraction/physiology ; Natriuretic Peptide, Brain/metabolism ; Patient Discharge ; Patient Readmission ; Renin-Angiotensin System/physiology ; Symptom Assessment ; Vascular Resistance ; Vasoconstriction/physiology ; Vasodilator Agents/therapeutic use
    Chemical Substances Cardiotoxins ; Inflammation Mediators ; Vasodilator Agents ; Natriuretic Peptide, Brain (114471-18-0)
    Language English
    Publishing date 2021-05-13
    Publishing country United States
    Document type Journal Article ; 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.121.318186
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  2. Article ; Online: Systolic time intervals in patients with heart failure: time to teach new dogs old tricks.

    Njoroge, Joyce N / Teerlink, John R

    European journal of heart failure

    2020  Volume 22, Issue 7, Page(s) 1183–1185

    MeSH term(s) Animals ; Dogs ; Heart Failure/epidemiology ; Humans ; Stroke Volume ; Systole
    Language English
    Publishing date 2020-02-13
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 1483672-5
    ISSN 1879-0844 ; 1388-9842
    ISSN (online) 1879-0844
    ISSN 1388-9842
    DOI 10.1002/ejhf.1725
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    Zs.A 5299: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
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  3. Article ; Online: Emerging Genotype-Phenotype Associations in Dilated Cardiomyopathy.

    Njoroge, Joyce N / Mangena, Jennifer C / Aribeana, Chiaka / Parikh, Victoria N

    Current cardiology reports

    2022  Volume 24, Issue 9, Page(s) 1077–1084

    Abstract: Purpose of review: The disease burden of inherited dilated cardiomyopathy (DCM) is large and likely underestimated. This population stands to benefit immensely from therapeutic approaches tailored to the underlying genetic causes. Here, we review recent ...

    Abstract Purpose of review: The disease burden of inherited dilated cardiomyopathy (DCM) is large and likely underestimated. This population stands to benefit immensely from therapeutic approaches tailored to the underlying genetic causes. Here, we review recent advances in understanding novel genotype-phenotype relationships and how these can improve the care of patients with inherited DCM.
    Recent findings: In the last several years, discovery of novel DCM-associated genes, gene-specific DCM outcomes, and nuanced information about variant-environment interactions have advanced our understanding of inherited DCM. Specifically, novel associations of genes with specific clinical phenotypes can help to assess sudden cardiac death risk and guide counseling around behavioral and environmental exposures that may worsen disease. Important expansions of the current genotype-phenotype profiling include the newly DCM-associated FLNC variant, prognostically significant LMNA, DSP inflammatory cardiomyopathy, and the highly penetrant features of RBM20 variants as well as the role of TTN variants in compounding the effects of environmental factors on toxin-mediated DCM. Future directions to improve diagnostic accuracy and prognostic improvement in DCM will center not just on identification of new genes, but also on understanding the interaction of known and novel variants in known DCM genes with patient genetic background and environment.
    MeSH term(s) Cardiomyopathy, Dilated/genetics ; Cardiomyopathy, Dilated/therapy ; Death, Sudden, Cardiac/etiology ; Genetic Association Studies ; Humans ; Mutation ; Phenotype ; Prognosis
    Language English
    Publishing date 2022-07-28
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, N.I.H., Extramural
    ZDB-ID 2055373-0
    ISSN 1534-3170 ; 1523-3782
    ISSN (online) 1534-3170
    ISSN 1523-3782
    DOI 10.1007/s11886-022-01727-z
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    Zs.A 5524: Show issues Location:
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  4. Article ; Online: How Cardiovascular Disease Fellows Can Promote Diversity and Inclusion in Cardiology: Doing Our Part.

    Njoroge, Joyce N / Youmans, Quentin R / Chuzi, Sarah

    Journal of the American College of Cardiology

    2021  Volume 78, Issue 11, Page(s) 1188–1192

    MeSH term(s) Cardiology/education ; Cultural Diversity ; Humans ; Mentoring ; Microaggression
    Language English
    Publishing date 2021-09-09
    Publishing country United States
    Document type Editorial
    ZDB-ID 605507-2
    ISSN 1558-3597 ; 0735-1097
    ISSN (online) 1558-3597
    ISSN 0735-1097
    DOI 10.1016/j.jacc.2021.07.012
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  5. Article: Cardiovascular Implications and Therapeutic Considerations in COVID-19 Infection.

    Judson, Gregory L / Kelemen, Benjamin W / Njoroge, Joyce N / Mahadevan, Vaikom S

    Cardiology and therapy

    2020  Volume 9, Issue 2, Page(s) 293–305

    Abstract: The ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has profoundly impacted all fields of medicine. Infection with SARS-CoV-2 and the resulting coronavirus of 2019 (COVID-19) syndrome has multiorgan effects. The pandemic has ...

    Abstract The ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has profoundly impacted all fields of medicine. Infection with SARS-CoV-2 and the resulting coronavirus of 2019 (COVID-19) syndrome has multiorgan effects. The pandemic has united researchers from bench to bedside in attempts to understand the pathophysiology of the disease and define optimal treatment strategies. Cardiovascular disease is highly prevalent and a leading cause of death across gender, race, and ethnic groups. As the pandemic spreads, there is increasing concern about the cardiovascular effects of the viral infection and the interaction of infection with existing cardiovascular disease. Additionally, there are concerns about the cardiac effects of the numerous treatment agents under study. It will be essential for cardiologists to understand the interplay between underlying cardiac comorbidities, acute cardiovascular effects of COVID-19 disease, and adverse effects of new treatments. Here we describe emerging evidence of the epidemiology of SARS-CoV-2 infection and underlying cardiovascular disease, the evidence for direct myocardial injury in SARS-CoV-2 infection, the specific presentations of cardiovascular involvement by SARS-CoV-2, and the cardiac effects of emerging treatments.
    Keywords covid19
    Language English
    Publishing date 2020-06-13
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2700626-8
    ISSN 2193-6544 ; 2193-8261
    ISSN (online) 2193-6544
    ISSN 2193-8261
    DOI 10.1007/s40119-020-00184-5
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  6. Article ; Online: The shock team: a multidisciplinary approach to early patient phenotyping and appropriate care escalation in cardiogenic shock.

    Brusca, Samuel B / Caughron, Hope / Njoroge, Joyce N / Cheng, Richard / O'Brien, Connor G / Barnett, Christopher F

    Current opinion in cardiology

    2022  Volume 37, Issue 3, Page(s) 241–249

    Abstract: Purpose of review: Cardiogenic shock (CS) is a highly morbid condition with mortality remaining greater than 30% despite improved pathophysiologic understanding and access to mechanical circulatory support (MCS). In response, shock teams modeled on ... ...

    Abstract Purpose of review: Cardiogenic shock (CS) is a highly morbid condition with mortality remaining greater than 30% despite improved pathophysiologic understanding and access to mechanical circulatory support (MCS). In response, shock teams modeled on successful multidisciplinary care structures for other diseases are being implemented nationwide.
    Recent findings: Primary data supporting a benefit of shock team implementation on patient outcomes are relatively limited and entirely observational. Four single-center before-and-after studies and one multicenter registry study have demonstrated improved outcomes in patients with CS, potentially driven by increased pulmonary artery catheter (PAC) utilization and earlier (and more appropriate) initiation of MCS. Shock teams are also supported by a growing body of literature recognizing the independent benefit of the interventions they seek to implement, including patient phenotyping with PAC use and an algorithmic approach to CS care. Though debated, MCS is also highly likely to improve CS outcomes when applied appropriately, which further supports a multidisciplinary shock team approach to patient and device selection.
    Summary: Shock teams likely improve patient outcomes by facilitating early patient phenotyping and appropriate intervention. Institutions should strongly consider adopting a multidisciplinary shock team approach to CS care, though additional data supporting these interventions are needed.
    MeSH term(s) Heart-Assist Devices ; Humans ; Multicenter Studies as Topic ; Registries ; Shock, Cardiogenic/therapy
    Language English
    Publishing date 2022-01-31
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 645186-x
    ISSN 1531-7080 ; 0268-4705
    ISSN (online) 1531-7080
    ISSN 0268-4705
    DOI 10.1097/HCO.0000000000000967
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    Zs.A 2556: Show issues Location:
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  7. Article ; Online: Nurturing Diverse Generations of the Medical Workforce for Success With Authenticity: An Association of Black Cardiologists' Roundtable.

    Haynes, Norrisa A / Johnson, Michelle / Lewsey, Sabra C / Alexander, Kevin M / Anstey, D Edmund / Dillenburg, Tierra / Njoroge, Joyce N / Gordon, Debra / Ofili, Elizabeth O / Yancy, Clyde W / Albert, Michelle A

    Circulation. Cardiovascular quality and outcomes

    2023  Volume 16, Issue 1, Page(s) e009032

    Abstract: The COVID-19 pandemic exposed the consequences of systemic racism in the United States with Black, Hispanic, and other racial and ethnic diverse populations dying at disproportionately higher rates than White Americans. Addressing the social and health ... ...

    Abstract The COVID-19 pandemic exposed the consequences of systemic racism in the United States with Black, Hispanic, and other racial and ethnic diverse populations dying at disproportionately higher rates than White Americans. Addressing the social and health disparities amplified by COVID-19 requires in part restructuring of the healthcare system, particularly the diversity of the healthcare workforce to better reflect that of the US population. In January 2021, the Association of Black Cardiologists hosted a virtual roundtable designed to discuss key issues pertaining to medical workforce diversity and to identify strategies aimed at improving racial and ethnic diversity in medical school, graduate medical education, faculty, and leadership positions. The Nurturing Diverse Generations of the Medical Workforce for Success with Authenticity roundtable brought together diverse stakeholders and champions of diversity and inclusion to discuss innovative ideas, solutions, and opportunities to address workforce diversification.
    MeSH term(s) Humans ; United States/epidemiology ; Cardiologists ; Pandemics ; COVID-19 ; Ethnicity ; Workforce
    Language English
    Publishing date 2023-01-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2483197-9
    ISSN 1941-7705 ; 1941-7713
    ISSN (online) 1941-7705
    ISSN 1941-7713
    DOI 10.1161/CIRCOUTCOMES.122.009032
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    Zs.A 6744: Show issues Location:
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  8. Article: Racial and Ethnic Disparities in Transthyretin Cardiac Amyloidosis.

    Spencer-Bonilla, Gabriela / Njoroge, Joyce N / Pearson, Keon / Witteles, Ronald M / Aras, Mandar A / Alexander, Kevin M

    Current cardiovascular risk reports

    2021  Volume 15, Issue 6

    Abstract: Purpose of review: Transthyretin amyloid cardiomyopathy (ATTR-CM) is a life-threatening disease that disproportionately affects older adults and people of African descent. This review discusses current knowledge regarding racial and ethnic disparities ... ...

    Abstract Purpose of review: Transthyretin amyloid cardiomyopathy (ATTR-CM) is a life-threatening disease that disproportionately affects older adults and people of African descent. This review discusses current knowledge regarding racial and ethnic disparities in the diagnosis and management of ATTR-CM.
    Recent findings: Historically, ATTR-CM was thought to be a rare cause of heart failure. Recent evidence has shown that ATTR-CM is more common among older adults, men, and people of African descent. In addition, significant geographic variation exists in the identification of amyloid cardiomyopathy. Despite the high burden of ATTR-CM among Black individuals, most clinical data for ATTR-CM are from North America and Europe. Moreover, only a minority of clinical trial participants thus far have been Black patients. In addition to racial differences, socioeconomic disparities may be further compounded by the potentially prohibitive cost and limited accessibility of disease-modifying ATTR therapies.
    Summary: ATTR-CM is an important cause of heart failure that disproportionately affects people of African descent. Efforts to promote earlier identification of ATTR-CM in general practice will likely improve clinical outcomes for all groups. Future trials should strive to enroll a higher proportion of Black patients. Furthermore, enhanced efforts are warranted to improve treatment accessibility among racial and ethnic minority groups that may be more likely to be affected by ATTR-CM.
    Language English
    Publishing date 2021-04-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2489103-4
    ISSN 1932-9563 ; 1932-9520
    ISSN (online) 1932-9563
    ISSN 1932-9520
    DOI 10.1007/s12170-021-00670-y
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  9. Article: Cardiovascular Implications and Therapeutic Considerations in COVID-19 Infection

    Judson, Gregory L / Kelemen, Benjamin W / Njoroge, Joyce N / Mahadevan, Vaikom S

    Cardiol Ther

    Abstract: The ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has profoundly impacted all fields of medicine. Infection with SARS-CoV-2 and the resulting coronavirus of 2019 (COVID-19) syndrome has multiorgan effects. The pandemic has ...

    Abstract The ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has profoundly impacted all fields of medicine. Infection with SARS-CoV-2 and the resulting coronavirus of 2019 (COVID-19) syndrome has multiorgan effects. The pandemic has united researchers from bench to bedside in attempts to understand the pathophysiology of the disease and define optimal treatment strategies. Cardiovascular disease is highly prevalent and a leading cause of death across gender, race, and ethnic groups. As the pandemic spreads, there is increasing concern about the cardiovascular effects of the viral infection and the interaction of infection with existing cardiovascular disease. Additionally, there are concerns about the cardiac effects of the numerous treatment agents under study. It will be essential for cardiologists to understand the interplay between underlying cardiac comorbidities, acute cardiovascular effects of COVID-19 disease, and adverse effects of new treatments. Here we describe emerging evidence of the epidemiology of SARS-CoV-2 infection and underlying cardiovascular disease, the evidence for direct myocardial injury in SARS-CoV-2 infection, the specific presentations of cardiovascular involvement by SARS-CoV-2, and the cardiac effects of emerging treatments.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #597878
    Database COVID19

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  10. Article ; Online: Cardiovascular Implications and Therapeutic Considerations in COVID-19 Infection

    Judson, Gregory L. / Kelemen, Benjamin W. / Njoroge, Joyce N. / Mahadevan, Vaikom S.

    Cardiology and Therapy ; ISSN 2193-8261 2193-6544

    2020  

    Keywords Cardiology and Cardiovascular Medicine ; covid19
    Language English
    Publisher Springer Science and Business Media LLC
    Publishing country us
    Document type Article ; Online
    DOI 10.1007/s40119-020-00184-5
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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