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Article ; Online: Cell therapy for heart failure: lessons learned from SCIENCE.

Sanz-Ruiz, Ricardo / Perin, Emerson C / Fernández-Avilés, Francisco

2023 Volume 25, Issue 4, Page(s) 588–590

MeSH term(s)	Humans ; Heart Failure/therapy ; Cell- and Tissue-Based Therapy
Language	English
Publishing date	2023-03-15
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.2807
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Article ; Online: Using the Apple Watch to Record Multiple-Lead Electrocardiograms in Detecting Myocardial Infarction: Where Are We Now?

Li, Ke / Elgalad, Abdelmotagaly / Cardoso, Cristiano / Perin, Emerson C

Texas Heart Institute journal

2022 Volume 49, Issue 4

Abstract: Although the outcome after myocardial infarction depends on the time to treatment, a delay between symptom onset and treatment is common. Apple Watch, a popular wearable device, provides the ability to perform an electrocardiogram. We review the progress ...

Abstract	Although the outcome after myocardial infarction depends on the time to treatment, a delay between symptom onset and treatment is common. Apple Watch, a popular wearable device, provides the ability to perform an electrocardiogram. We review the progress made in using the Apple Watch to record multiple electrocardiogram leads for diagnosing myocardial infarction. Although the data are encouraging, many limitations remain, and more research is needed. Nevertheless, the Apple Watch could eventually serve as a self-check tool for patients who have chest pains or other symptoms of myocardial infarction, thus substantially decreasing the time to treatment and improving the outcome after myocardial infarction.
MeSH term(s)	Chest Pain ; Electrocardiography ; Humans ; Myocardial Infarction/diagnosis ; Wearable Electronic Devices
Language	English
Publishing date	2022-08-05
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	604761-0
ISSN	1526-6702 ; 0730-2347
ISSN (online)	1526-6702
ISSN	0730-2347
DOI	10.14503/THIJ-22-7845
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Article ; Online: Texas Heart Institute International Symposium on Cardiovascular Regenerative Medicine.

Perin, Emerson C / Taylor, Doris A

Circulation research

2018 Volume 122, Issue 2, Page(s) 205–206

MeSH term(s)	Academies and Institutes/trends ; Cardiovascular Diseases/therapy ; Congresses as Topic/trends ; Heart/physiology ; Humans ; Regenerative Medicine/methods ; Regenerative Medicine/trends ; Texas
Language	English
Publishing date	2018-01-18
Publishing country	United States
Document type	News
ZDB-ID	80100-8
ISSN	1524-4571 ; 0009-7330 ; 0931-6876
ISSN (online)	1524-4571
ISSN	0009-7330 ; 0931-6876
DOI	10.1161/CIRCRESAHA.117.312100
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Article: Device-based therapy for decompensated heart failure: An updated review of devices in development based on the DRI

de Oliveira Cardoso, Cristiano / Elgalad, Abdelmotagaly / Li, Ke / Perin, Emerson C

Frontiers in cardiovascular medicine

2022 Volume 9, Page(s) 962839

Abstract: Congestive heart failure (HF) is a devastating disease leading to prolonged hospitalization, high morbidity and mortality rates, and increased costs. Well-established treatments for decompensated or unstable patients include medications and mechanical ... ...

Abstract	Congestive heart failure (HF) is a devastating disease leading to prolonged hospitalization, high morbidity and mortality rates, and increased costs. Well-established treatments for decompensated or unstable patients include medications and mechanical cardiac support devices. For acute HF decompensation, new devices are being developed to help relieve symptoms and recover heart and renal function in these patients. A recent device-based classification scheme, collectively classified as DRI
Language	English
Publishing date	2022-09-21
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2022.962839
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Article ; Online: Gene Therapy Knockdown of Hippo Signaling Resolves Arrhythmic Events in Pigs After Myocardial Infarction.

Zhang, Sui / Liu, Shijie / Leach, John P / Li, Ke / Perin, Emerson C / Martin, James F

Circulation

2022 Volume 146, Issue 20, Page(s) 1558–1560

MeSH term(s)	Animals ; Swine ; Hippo Signaling Pathway ; Myocardial Infarction/genetics ; Myocardial Infarction/therapy ; Arrhythmias, Cardiac ; Genetic Therapy
Language	English
Publishing date	2022-11-14
Publishing country	United States
Document type	Letter ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
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.122.059972
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Article ; Online: Role of Physicians in Guiding Patients Away From Unproven Stem Cell Interventions.

Matthews, Kirstin R W / Kawam, Omar / Sprung, Keri / Perin, Emerson C / Master, Zubin

Texas Heart Institute journal

2022 Volume 49, Issue 2

MeSH term(s)	Humans ; Physicians ; Stem Cells
Language	English
Publishing date	2022-03-08
Publishing country	United States
Document type	Editorial
ZDB-ID	604761-0
ISSN	1526-6702 ; 0730-2347
ISSN (online)	1526-6702
ISSN	0730-2347
DOI	10.14503/THIJ-21-7768
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Article ; Online: Rare delayed cardiac tamponade in a pig after cardiac surgery.

Li, Ke / Segura, Ana Maria / Sun, Junping / Chen, Qi / Cheng, Jie / Perin, Emerson C / Elgalad, Abdelmotagaly

Veterinary medicine and science

2022 Volume 8, Issue 5, Page(s) 1965–1968

Abstract: Objective: Delayed cardiac tamponade, a life-threatening complication of pericardial effusion in humans, has rarely been described in large animal models. We report here a pig with cardiac tamponade that developed 29 days after cardiac surgery.: Study ...

Abstract	Objective: Delayed cardiac tamponade, a life-threatening complication of pericardial effusion in humans, has rarely been described in large animal models. We report here a pig with cardiac tamponade that developed 29 days after cardiac surgery. Study design: Case report. Animals: One 45-kg domestic pig. Methods: Open-chest surgery was performed on a pig to induce chronic heart failure. At 15 days after surgery, the pig's breathing appeared laboured; induced heart failure was considered the cause. Routine heart failure medications were administered. Results: On day 28, the pig's status deteriorated. On day 29, echocardiography performed just before the pig's death showed a large pericardial effusion, mainly in the lateral and anterior walls of the right heart, with several fibre exudation bands. The right heart was severely compressed with an extremely small right ventricle. An emergency sternotomy was unsuccessful. Pathologic examination showed a severely thickened, fibrous pericardium. The pericardial sac was distended (up to 4.5 cm) and was full of dark brown, soft, friable material. Epicardial haemorrhage with a fresh, organised thrombus was noted in the pericardium. Conclusion: Delayed tamponade occurring at least 15 days after open-chest surgery is easy to misdiagnose or overlook in large animal models where attention is often focused on primary pathological model changes. To decrease mortality in animal models, researchers should be aware of potential complications and use the same level of follow-up monitoring of large animals as in clinical care.
MeSH term(s)	Animals ; Cardiac Surgical Procedures/adverse effects ; Cardiac Surgical Procedures/veterinary ; Cardiac Tamponade/diagnosis ; Cardiac Tamponade/etiology ; Cardiac Tamponade/veterinary ; Heart Failure/complications ; Heart Failure/pathology ; Heart Failure/veterinary ; Humans ; Pericardial Effusion/diagnosis ; Pericardial Effusion/etiology ; Pericardial Effusion/surgery ; Pericardial Effusion/veterinary ; Pericardium/pathology ; Swine ; Swine Diseases
Language	English
Publishing date	2022-08-03
Publishing country	England
Document type	Case Reports
ZDB-ID	2819409-3
ISSN	2053-1095 ; 2053-1095
ISSN (online)	2053-1095
ISSN	2053-1095
DOI	10.1002/vms3.892
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Phase 3 DREAM-HF Trial of Mesenchymal Precursor Cells in Chronic Heart Failure.

Borow, Kenneth M / Yaroshinsky, Alex / Greenberg, Barry / Perin, Emerson C

Circulation research

2019 Volume 125, Issue 3, Page(s) 265–281

Abstract: Advanced heart failure (HF) is a progressive disease characterized by recurrent hospitalizations and high risk of mortality. Indeed, outcomes in late stages of HF approximate those seen in patients with various aggressive malignancies. Clinical trials ... ...

Abstract	Advanced heart failure (HF) is a progressive disease characterized by recurrent hospitalizations and high risk of mortality. Indeed, outcomes in late stages of HF approximate those seen in patients with various aggressive malignancies. Clinical trials assessing beneficial outcomes of new treatments in patients with cancer have used innovative approaches to measure impact on total disease burden or surrogates to assess treatment efficacy. Although most cardiovascular outcomes trials continue to use time-to-first event analyses to assess the primary efficacy end point, such analyses do not adequately reflect the impact of new treatments on the totality of the chronic disease burden. Consequently, patient enrichment and other strategies for ongoing clinical trial design, as well as new statistical methodologies, are important considerations, particularly when studying a population with advanced chronic HF. The DREAM-HF trial (Double-Blind Randomized Assessment of Clinical Events With Allogeneic Mesenchymal Precursor Cells in Advanced Heart Failure) is an ongoing, randomized, sham-controlled phase 3 study of the efficacy and safety of mesenchymal precursor cells as immunotherapy in patients with advanced chronic HF with reduced ejection fraction. Mesenchymal precursor cells have a unique multimodal mechanism of action that is believed to result in polarization of proinflammatory type 1 macrophages in the heart to an anti-inflammatory type 2 macrophage state, inhibition of maladaptive adverse left ventricular remodeling, reversal of cardiac and peripheral endothelial dysfunction, and recovery of deranged vasculature. The objective of DREAM-HF is to confirm earlier phase 2 results and evaluate whether mesenchymal precursor cells will reduce the rate of nonfatal recurrent HF-related major adverse cardiac events while delaying or preventing progression of HF to terminal cardiac events. DREAM-HF is an example of an ongoing contemporary events-driven cardiovascular cell-based immunotherapy study that has utilized the concepts of baseline disease enrichment, prognostic enrichment, and predictive enrichment to improve its efficiency by using accumulating data from within as well as external to the trial. Adaptive enrichment designs and strategies are important components of a rational approach to achieve clinical research objectives in shorter clinical trial timelines and with increased cost-effectiveness without compromising ethical standards or the overall statistical integrity of the study. The DREAM-HF trial also presents an alternative approach to traditional composite time-to-first event primary efficacy end points. Statistical methodologies such as the joint frailty model provide opportunities to expand the scope of events-driven HF with reduced ejection fraction clinical trials to utilize time to recurrent nonfatal HF-related major adverse cardiac events as the primary efficacy end point without compromising the integrity of the statistical analyses for terminal cardiac events. In advanced chronic HF with reduced ejection fraction studies, the joint frailty model is utilized to reflect characteristics of the high-risk patient population with important unmet therapeutic needs. In some cases, use of the joint frailty model may substantially reduce sample size requirements. In addition, using an end point that is acceptable to the Food and Drug Administration and the European Medicines Agency, such as recurrent nonfatal HF-related major adverse cardiac events, enables generation of clinically relevant pharmacoeconomic data while providing comprehensive views of the patient's overall cardiovascular disease burden. The major goal of this review is to provide lessons learned from the ongoing DREAM-HF trial that relate to biologic plausibility and flexible clinical trial design and are potentially applicable to other development programs of innovative therapies for patients with advanced cardiovascular disease. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02032004.
MeSH term(s)	Cell Differentiation ; Clinical Trials, Phase III as Topic/methods ; Double-Blind Method ; Endothelium, Vascular/physiopathology ; Endpoint Determination ; Health Services Needs and Demand ; Heart Failure/economics ; Heart Failure/immunology ; Heart Failure/physiopathology ; Heart Failure/therapy ; Humans ; Immunotherapy/methods ; Inflammation ; Macrophages/classification ; Macrophages/immunology ; Mesenchymal Stem Cell Transplantation ; Multicenter Studies as Topic/methods ; Neovascularization, Pathologic/etiology ; Randomized Controlled Trials as Topic/methods ; Research Design ; Stroke Volume ; Treatment Outcome ; Ventricular Remodeling
Language	English
Publishing date	2019-07-18
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.119.314951
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Article ; Online: Radiation exposure during distal and traditional radial coronary angiography and percutaneous coronary intervention: a meta-analysis of randomized controlled trials.

Cardoso, Cristiano de Oliveira / Li, Ke / Moctezuma-Ramirez, Angel / Hanna, Franklin / Ribeiro, Marcelo Harada / Megaly, Michael S / Azzalini, Lorenzo / Elgalad, Abdelmotagaly / Perin, Emerson C

The Journal of invasive cardiology

2023 Volume 35, Issue 11

Abstract: Objectives: Previous studies show that the distal transradial approach (dTRA) is safe and effective for coronary angiography and percutaneous coronary intervention. However, the effect of dTRA on radiation exposure in the catheterization laboratory has ... ...

Abstract	Objectives: Previous studies show that the distal transradial approach (dTRA) is safe and effective for coronary angiography and percutaneous coronary intervention. However, the effect of dTRA on radiation exposure in the catheterization laboratory has not been characterized. The authors analyzed the available literature to compare the radiation exposure associated with dTRA vs the traditional radial approach (TRA). Methods: A systematic review and meta-analysis of the scientific literature was conducted by using relevant terms to search the PubMed, Embase, and Cochrane Library databases from their inception until October 13, 2022, to identify randomized controlled trials (RCTs) comparing dTRA with TRA. The primary outcome was radiation exposure reported as fluoroscopy time, air kerma, or kerma-dose product. The standard mean difference (SMD) and its 95% confidence interval were used to summarize continuous variables. Random effect and meta-regression also were used for analyses. Results: Among 484 studies identified, 7 were RCTs, with a total of 3427 patients (1712 dTRA, 1715 TRA). No difference was found between dTRA and TRA in radiation exposure quantified as fluoroscopy time (SMD -0.10 [-0.36, 0.15], P=.43) or air kerma (SMD -0.31 [-0.74, 0.13], P=.17). The overall estimate favored lower kerma-area product in the TRA (SMD 0.19 [0.08, 0.30], P=.0006). Meta-regression showed no correlation between fluoroscopy time and year of publication. Conclusions: Compared with TRA, dTRA was associated with significantly greater radiation exposure per the kerma-area product during interventional cardiology procedures, with no differences in fluoroscopy time and air kerma.
MeSH term(s)	Humans ; Coronary Angiography/adverse effects ; Coronary Angiography/methods ; Cardiac Catheterization/adverse effects ; Cardiac Catheterization/methods ; Randomized Controlled Trials as Topic ; Percutaneous Coronary Intervention/adverse effects ; Percutaneous Coronary Intervention/methods ; Radiation Exposure/adverse effects ; Radiation Exposure/prevention & control ; Radial Artery
Language	English
Publishing date	2023-09-12
Publishing country	United States
Document type	Meta-Analysis ; Systematic Review ; Journal Article
ZDB-ID	1154372-3
ISSN	1557-2501 ; 1042-3931
ISSN (online)	1557-2501
ISSN	1042-3931
DOI	10.25270/jic/23.00206
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Zs.MO 272: Show issues
Zs.MG 31: Show issues

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Article ; Online: Direct Stimulation of Cardiogenesis: A New Paradigm for Treating Heart Disease.

Martin, James F / Perin, Emerson C / Willerson, James T

Circulation research

2017 Volume 121, Issue 1, Page(s) 13–15

MeSH term(s)	Animals ; Heart/physiology ; Heart Diseases/metabolism ; Heart Diseases/pathology ; Heart Diseases/therapy ; Heart Failure/metabolism ; Heart Failure/pathology ; Heart Failure/therapy ; Humans ; Organogenesis/physiology ; Protein-Serine-Threonine Kinases/metabolism ; Treatment Outcome
Chemical Substances	Hippo protein, human (EC 2.7.11.1) ; Protein-Serine-Threonine Kinases (EC 2.7.11.1)
Language	English
Publishing date	2017-06-22
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; 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.117.311062
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