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Article ; Online: Operative Teaching of Coronary Bypass and Need for Repeat Catheterization: Does it Matter Who is Sewing?

Tolis, George / Piechura, Laura M / Mohan, Navyatha / Pomerantsev, Eugene V / Hirji, Sameer A / Bloom, Jordan P

2023 Volume 80, Issue 6, Page(s) 826–832

Abstract: Objective: There are no studies to date comparing the patency of coronary bypass grafts constructed by attending surgeons versus trainees and the potential consequences of any such disparities. We explored this issue by comparing the patency of ... ...

Abstract	Objective: There are no studies to date comparing the patency of coronary bypass grafts constructed by attending surgeons versus trainees and the potential consequences of any such disparities. We explored this issue by comparing the patency of individual anastomoses performed by residents versus the attending surgeon. Design: We reviewed 765 continuous cases performed by a single surgeon which involved at least 1 coronary bypass anastomosis, totaling 2,173 distal anastomoses. At a median follow-up time of 36 months (interquartile range 20.5-47.3), 83 (10.9%) patients had undergone 110 cardiac catheterization procedures after their original operation for various indications. This angiographic information provided the data for our comparison cohorts. Setting: Cardiac surgery practice within an academic setting PARTICIPANTS: Adult patient undergoing coronary bypass grafting RESULTS: Of the 83 patients that underwent repeat catheterization, 23 (27.7%) were resident cases, 25 (30.1%) were attending cases and 35 (42.2%) were mixed. There were 4/83 (4.8%) patients with angiographic evidence of internal mammary artery graft compromise of which 3/4 (75%) had been constructed by the attending surgeon. Angiographic evidence of saphenous vein graft compromise was appreciated in 16/83 (19.3%) patients of which 9/16 (56.3%) of the grafts were constructed by the attending surgeon. Conclusions: Liberal involvement of surgical trainees as primary operators in coronary revascularization cases led to equivalent rates of postoperative ischemic complications between the attending and resident groups. The outcome equivalence was also maintained when evaluated at the individual anastomosis patency level between the 2 groups. We conclude that academic programs should continue providing trainees significant experience as primary operating surgeons without fear of clinical outcome compromise.
MeSH term(s)	Adult ; Humans ; Coronary Angiography ; Vascular Patency ; Coronary Artery Bypass/methods ; Postoperative Complications ; Catheterization ; Treatment Outcome ; Saphenous Vein/transplantation
Language	English
Publishing date	2023-04-18
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	2277538-9
ISSN	1878-7452 ; 1931-7204
ISSN (online)	1878-7452
ISSN	1931-7204
DOI	10.1016/j.jsurg.2023.04.001
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Article ; Online: ECG-guided non-invasive estimation of pulmonary congestion in patients with heart failure.

Raghu, Aniruddh / Schlesinger, Daphne / Pomerantsev, Eugene / Devireddy, Srikanth / Shah, Pinak / Garasic, Joseph / Guttag, John / Stultz, Collin M

Scientific reports

2023 Volume 13, Issue 1, Page(s) 3923

Abstract: Quantifying hemodynamic severity in patients with heart failure (HF) is an integral part of clinical care. A key indicator of hemodynamic severity is the mean Pulmonary Capillary Wedge Pressure (mPCWP), which is ideally measured invasively. Accurate non- ... ...

Abstract	Quantifying hemodynamic severity in patients with heart failure (HF) is an integral part of clinical care. A key indicator of hemodynamic severity is the mean Pulmonary Capillary Wedge Pressure (mPCWP), which is ideally measured invasively. Accurate non-invasive estimates of the mPCWP in patients with heart failure would help identify individuals at the greatest risk of a HF exacerbation. We developed a deep learning model, HFNet, that uses the 12-lead electrocardiogram (ECG) together with age and sex to identify when the mPCWP > 18 mmHg in patients who have a prior diagnosis of HF. The model was developed using retrospective data from the Massachusetts General Hospital and evaluated on both an internal test set and an independent external validation set, from another institution. We developed an uncertainty score that identifies when model performance is likely to be poor, thereby helping clinicians gauge when to trust a given model prediction. HFNet AUROC for the task of estimating mPCWP > 18 mmHg was 0.8 [Formula: see text] 0.01 and 0.[Formula: see text] 0.01 on the internal and external datasets, respectively. The AUROC on predictions with the highest uncertainty are 0.50 [Formula: see text] 0.02 (internal) and 0.[Formula: see text] 0.04 (external), while the AUROC on predictions with the lowest uncertainty were 0.86 ± 0.01 (internal) and 0.82 ± 0.01 (external). Using estimates of the prevalence of mPCWP > 18 mmHg in patients with reduced ventricular function, and a decision threshold corresponding to an 80% sensitivity, the calculated positive predictive value (PPV) is 0.[Formula: see text] 0.01when the corresponding chest x-ray (CXR) is consistent with interstitial edema HF. When the CXR is not consistent with interstitial edema, the estimated PPV is 0.[Formula: see text] 0.02, again at an 80% sensitivity threshold. HFNet can accurately predict elevated mPCWP in patients with HF using the 12-lead ECG and age/sex. The method also identifies cohorts in which the model is more/less likely to produce accurate outputs.
MeSH term(s)	Humans ; Retrospective Studies ; Heart Failure/complications ; Heart Failure/diagnosis ; Lung ; Electrocardiography ; Hemodynamics
Language	English
Publishing date	2023-03-09
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-30900-9
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Article: Obesity Modifies Clinical Outcomes of Right Ventricular Dysfunction.

Ma, Janet I / Zern, Emily / Jiang, Nona / Wang, Dongyu / Rambarat, Paula / Pomerantsev, Eugene / Picard, Michael H / Ho, Jennifer E

medRxiv : the preprint server for health sciences

2023

Abstract: Introduction: Right ventricular (RV) dysfunction is associated with increased mortality across a spectrum of cardiovascular diseases. The role of obesity in RV dysfunction and adverse outcomes is unclear.: Methods: We examined patients undergoing ... ...

Abstract	Introduction: Right ventricular (RV) dysfunction is associated with increased mortality across a spectrum of cardiovascular diseases. The role of obesity in RV dysfunction and adverse outcomes is unclear. Methods: We examined patients undergoing right heart catheterization between 2005-2016 in a hospital-based cohort. Linear regression was used to examine the association of obesity with hemodynamic indices of RV dysfunction [pulmonary artery pulsatility index (PAPi), right atrial pressure: pulmonary capillary wedge pressure ratio (RAP:PCWP), RV stroke work index (RVSWI)]. Cox models were used to examine the association of RV function measures with clinical outcomes. Results: Among 8285 patients (mean age 63 years, 40% women), higher BMI was associated with worse indices of RV dysfunction, including lower PAPi (β -0.26, SE 0.01, p <0.001), higher RA:PCWP ratio (β 0.25, SE 0.01, p-value <0.001), and lower RVSWI (β -0.05, SE 0.01, p-value <0.001). Over 7.3 years of follow-up, we observed 3006 mortality and 2004 heart failure (HF) hospitalization events. RV dysfunction was associated with greater risk of mortality (eg PAPi: HR 1.11 per 1-SD increase, 95% CI 1.04-1.18), with similar associations with risk of HF hospitalization. BMI modified the effect of RV dysfunction on outcomes (P-interaction <=0.005 for both), such that the effect of RV dysfunction was more pronounced at higher BMI. Conclusions: Patients with obesity had worse hemodynamic measured indices of RV function across a broad hospital-based sample. While RV dysfunction was associated with worse clinical outcomes including mortality and HF hospitalization, this association was especially pronounced among individuals with higher BMI.
Language	English
Publishing date	2023-01-18
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.01.18.23284734
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Article: Sex Differences in Pulmonary Hypertension and Associated Right Ventricular Dysfunction.

Ma, Janet I / Owunna, Ndidi / Jiang, Nona M / Huo, Xiaodan / Zern, Emily / McNeill, Jenna N / Lau, Emily S / Pomerantsev, Eugene / Picard, Michael H / Wang, Dongyu / Ho, Jennifer E

medRxiv : the preprint server for health sciences

2024

Abstract: Background: Prior studies have established the impact of sex differences on pulmonary arterial hypertension (PAH). However, it remains unclear whether these sex differences extend to other hemodynamic subtypes of pulmonary hypertension (PH).: Methods!# ...

Abstract	Background: Prior studies have established the impact of sex differences on pulmonary arterial hypertension (PAH). However, it remains unclear whether these sex differences extend to other hemodynamic subtypes of pulmonary hypertension (PH). Methods: We examined sex differences in PH and hemodynamic PH subtypes in a hospital-based cohort of individuals who underwent right heart catheterization between 2005-2016. We utilized multivariable linear regression to assess the association of sex with hemodynamic indices of RV function [PA pulsatility index (PAPi), RV stroke work index (RVSWI), and right atrial: pulmonary capillary wedge pressure ratio (RA:PCWP)]. We then used Cox regression models to examine the association between sex and clinical outcomes among those with PH. Results: Among 5208 individuals with PH (mean age 64 years, 39% women), there was no significant sex difference in prevalence of PH overall. However, when stratified by PH subtype, 31% of women vs 22% of men had pre-capillary (P<0.001), 39% vs 51% had post-capillary (P=0.03), and 30% vs 27% had mixed PH (P=0.08). Female sex was associated with better RV function by hemodynamic indices, including higher PAPi and RVSWI, and lower RA:PCWP ratio (P<0.001 for all). Over 7.3 years of follow-up, female sex was associated with a lower risk of heart failure hospitalization (HR 0.83, CI 95% CI 0.74- 0.91, p value <0.001). Conclusions: Across a broad hospital-based sample, more women had pre-capillary and more men had post-capillary PH. Compared with men, women with PH had better hemodynamic indices of RV function and a lower risk of HF hospitalization. Clinical perspective: What Is New? Although sex differences have been explored in pulmonary arterial hypertension, sex differences across pulmonary hypertension (PH) in broader samples inclusive of all hemodynamic subtypes remain less well definedWe delineate sex differences in hemodynamic subtypes of PH and associated right ventricular function in a large, heterogenous, hospital-based sample of individuals who underwent right heart catheterizationSex has a significant impact on prevalence of PH across hemodynamic subtypes as well as associated RV function What Are the Clinical Implications? Understanding sex differences across different PH hemodynamic subtypes is paramount to refining risk stratification between men and womenFurther elucidating sex differences in associated RV function and clinical outcomes may aid in developing sex-specific therapies or management strategies to improve clinical outcomes.
Language	English
Publishing date	2024-04-27
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.04.25.24306398
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Book ; Online: Data Augmentation for Electrocardiograms

Raghu, Aniruddh / Shanmugam, Divya / Pomerantsev, Eugene / Guttag, John / Stultz, Collin M.

2022

Abstract: Neural network models have demonstrated impressive performance in predicting pathologies and outcomes from the 12-lead electrocardiogram (ECG). However, these models often need to be trained with large, labelled datasets, which are not available for many ...

Abstract	Neural network models have demonstrated impressive performance in predicting pathologies and outcomes from the 12-lead electrocardiogram (ECG). However, these models often need to be trained with large, labelled datasets, which are not available for many predictive tasks of interest. In this work, we perform an empirical study examining whether training time data augmentation methods can be used to improve performance on such data-scarce ECG prediction problems. We investigate how data augmentation strategies impact model performance when detecting cardiac abnormalities from the ECG. Motivated by our finding that the effectiveness of existing augmentation strategies is highly task-dependent, we introduce a new method, TaskAug, which defines a flexible augmentation policy that is optimized on a per-task basis. We outline an efficient learning algorithm to do so that leverages recent work in nested optimization and implicit differentiation. In experiments, considering three datasets and eight predictive tasks, we find that TaskAug is competitive with or improves on prior work, and the learned policies shed light on what transformations are most effective for different tasks. We distill key insights from our experimental evaluation, generating a set of best practices for applying data augmentation to ECG prediction problems. Comment: Conference on Health, Inference, and Learning (CHIL) 2022
Keywords	Computer Science - Machine Learning
Subject code	006
Publishing date	2022-04-08
Publishing country	us
Document type	Book ; Online
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Article ; Online: Obesity Modifies Clinical Outcomes of Right Ventricular Dysfunction.

Ma, Janet I / Zern, Emily K / Parekh, Juhi K / Owunna, Ndidi / Jiang, Nona / Wang, Dongyu / Rambarat, Paula K / Pomerantsev, Eugene / Picard, Michael H / Ho, Jennifer E

Circulation. Heart failure

2023 Volume 16, Issue 11, Page(s) e010524

Abstract: Background: Right ventricular (RV) dysfunction is associated with increased mortality across a spectrum of cardiovascular diseases. The role of obesity in RV dysfunction and adverse outcomes is unclear.: Methods: We examined patients undergoing right ...

Abstract	Background: Right ventricular (RV) dysfunction is associated with increased mortality across a spectrum of cardiovascular diseases. The role of obesity in RV dysfunction and adverse outcomes is unclear. Methods: We examined patients undergoing right heart catheterization between 2005 and 2016 in a hospital-based cohort. Linear regression was used to examine the association of obesity with hemodynamic indices of RV dysfunction (pulmonary artery pulsatility index, right atrial pressure:pulmonary capillary wedge pressure ratio, RV stroke work index). Cox models were used to examine the association of RV function measures with clinical outcomes. Results: Among 8285 patients (mean age, 63 years; 40% women), higher body mass index was associated with worse indices of RV dysfunction, including lower pulmonary artery pulsatility index (β, -0.23; SE, 0.01; Conclusions: Patients with obesity had worse hemodynamic measured indices of RV function across a broad hospital-based sample. While RV dysfunction was associated with worse clinical outcomes including mortality and heart failure hospitalization, this association was especially pronounced among individuals with higher body mass index.
MeSH term(s)	Humans ; Female ; Middle Aged ; Male ; Ventricular Dysfunction, Right ; Heart Failure ; Retrospective Studies ; Pulmonary Artery ; Obesity/complications ; Stroke ; Ventricular Function, Right
Language	English
Publishing date	2023-10-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	2429459-7
ISSN	1941-3297 ; 1941-3289
ISSN (online)	1941-3297
ISSN	1941-3289
DOI	10.1161/CIRCHEARTFAILURE.123.010524
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Book ; Online: Learning to Predict with Supporting Evidence

Raghu, Aniruddh / Guttag, John / Young, Katherine / Pomerantsev, Eugene / Dalca, Adrian V. / Stultz, Collin M.

Applications to Clinical Risk Prediction

2021

Abstract: The impact of machine learning models on healthcare will depend on the degree of trust that healthcare professionals place in the predictions made by these models. In this paper, we present a method to provide people with clinical expertise with domain- ... ...

Abstract	The impact of machine learning models on healthcare will depend on the degree of trust that healthcare professionals place in the predictions made by these models. In this paper, we present a method to provide people with clinical expertise with domain-relevant evidence about why a prediction should be trusted. We first design a probabilistic model that relates meaningful latent concepts to prediction targets and observed data. Inference of latent variables in this model corresponds to both making a prediction and providing supporting evidence for that prediction. We present a two-step process to efficiently approximate inference: (i) estimating model parameters using variational learning, and (ii) approximating maximum a posteriori estimation of latent variables in the model using a neural network, trained with an objective derived from the probabilistic model. We demonstrate the method on the task of predicting mortality risk for patients with cardiovascular disease. Specifically, using electrocardiogram and tabular data as input, we show that our approach provides appropriate domain-relevant supporting evidence for accurate predictions. Comment: ACM Conference on Health, Learning, and Inference 2021
Keywords	Computer Science - Machine Learning
Subject code	006
Publishing date	2021-03-03
Publishing country	us
Document type	Book ; Online
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Article ; Online: Identifying high risk clinical phenogroups of pulmonary hypertension through a clustering analysis.

Rambarat, Paula / Zern, Emily K / Wang, Dongyu / Roshandelpoor, Athar / Zarbafian, Shahrooz / Liu, Elizabeth E / Wang, Jessica K / McNeill, Jenna N / Andrews, Carl T / Pomerantsev, Eugene V / Diamant, Nathaniel / Batra, Puneet / Lubitz, Steven A / Picard, Michael H / Ho, Jennifer E

PloS one

2023 Volume 18, Issue 8, Page(s) e0290553

Abstract: Introduction: The classification and management of pulmonary hypertension (PH) is challenging due to clinical heterogeneity of patients. We sought to identify distinct multimorbid phenogroups of patients with PH that are at particularly high-risk for ... ...

Abstract	Introduction: The classification and management of pulmonary hypertension (PH) is challenging due to clinical heterogeneity of patients. We sought to identify distinct multimorbid phenogroups of patients with PH that are at particularly high-risk for adverse events. Methods: A hospital-based cohort of patients referred for right heart catheterization between 2005-2016 with PH were included. Key exclusion criteria were shock, cardiac arrest, cardiac transplant, or valvular surgery. K-prototypes was used to cluster patients into phenogroups based on 12 clinical covariates. Results: Among 5208 patients with mean age 64±12 years, 39% women, we identified 5 distinct multimorbid PH phenogroups with similar hemodynamic measures yet differing clinical outcomes: (1) "young men with obesity", (2) "women with hypertension", (3) "men with overweight", (4) "men with cardiometabolic and cardiovascular disease", and (5) "men with structural heart disease and atrial fibrillation." Over a median follow-up of 6.3 years, we observed 2182 deaths and 2002 major cardiovascular events (MACE). In age- and sex-adjusted analyses, phenogroups 4 and 5 had higher risk of MACE (HR 1.68, 95% CI 1.41-2.00 and HR 1.52, 95% CI 1.24-1.87, respectively, compared to the lowest risk phenogroup 1). Phenogroup 4 had the highest risk of mortality (HR 1.26, 95% CI 1.04-1.52, relative to phenogroup 1). Conclusions: Cluster-based analyses identify patients with PH and specific comorbid cardiometabolic and cardiovascular disease burden that are at highest risk for adverse clinical outcomes. Interestingly, cardiopulmonary hemodynamics were similar across phenogroups, highlighting the importance of multimorbidity on clinical trajectory. Further studies are needed to better understand comorbid heterogeneity among patients with PH.
MeSH term(s)	Male ; Humans ; Female ; Middle Aged ; Aged ; Hypertension, Pulmonary/genetics ; Hypertension ; Heart Diseases ; Atrial Fibrillation ; Cluster Analysis
Language	English
Publishing date	2023-08-25
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0290553
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Article ; Online: In-hospital outcomes in invasively managed acute myocardial infarction patients who receive morphine.

McCarthy, Cian P / Bhambhani, Vijeta / Pomerantsev, Eugene / Wasfy, Jason H

Journal of interventional cardiology

2017 Volume 31, Issue 2, Page(s) 150–158

Abstract: Objective: We aimed to analyze the association between morphine and in-hospital outcomes in invasively managed ST elevation myocardial infarction (STEMI) and non-ST elevation acute coronary syndrome (NSTE-ACS) patients.: Background: Morphine is ... ...

Abstract	Objective: We aimed to analyze the association between morphine and in-hospital outcomes in invasively managed ST elevation myocardial infarction (STEMI) and non-ST elevation acute coronary syndrome (NSTE-ACS) patients. Background: Morphine is commonly used for analgesia in the setting of acute coronary syndromes (ACS); however, recently its utility in ACS has come under closer scrutiny. Methods: We identified all STEMI and NSTE-ACS patients undergoing coronary angiogram +/- percutaneous intervention between January 2009 and July 2016 in our center and recorded patient characteristics and inpatient outcomes. Results: Overall, 3027 patients were examined. Overall, STEMI patients who received morphine had no difference in in-hospital mortality [4.18% vs. 7.54%, odds ratio (OR): 0.36, P = 0.19], infarct size (mean troponin level 0.75 ng/mL vs. 1.29 ng/mL, P = 0.32) or length of hospital stay (P = 0.61). The NSTE-ACS patients who received morphine had a longer hospital stay (mean 6.58 days vs. 4.78 days, P < 0.0001) and larger infarct size (mean troponin 1.16 ng/mL vs. 0.90 ng/mL, P = 0.02). Comparing matched patients, the use of morphine was associated with larger infarct size (mean troponin 1.14 ± 1.92 ng/mL vs. 0.83 ± 1.49 ng/mL, P = 0.01), longer hospital stay (6.5 ± 6.82 days vs. 4.89 ± 5.36 days, P = 0.004) and a trend towards increased mortality (5% vs. 2%, OR: 2.55, P = 0.06) in NSTE-ACS patients but morphine did not affect outcomes in the propensity matched STEMI patients. Conclusion: In a large retrospective study, morphine was associated with larger infarct size, a longer hospital stay and a trend towards increased mortality in invasively managed NSTE-ACS patients even after adjustment for clinical characteristics.
MeSH term(s)	Acute Coronary Syndrome/diagnosis ; Acute Coronary Syndrome/drug therapy ; Acute Coronary Syndrome/mortality ; Acute Coronary Syndrome/surgery ; Aged ; Analgesics, Opioid/administration & dosage ; Analgesics, Opioid/adverse effects ; Female ; Hospital Mortality ; Humans ; Length of Stay ; Male ; Middle Aged ; Morphine/administration & dosage ; Morphine/adverse effects ; Odds Ratio ; Outcome and Process Assessment, Health Care ; Percutaneous Coronary Intervention/adverse effects ; Percutaneous Coronary Intervention/methods ; Retrospective Studies ; ST Elevation Myocardial Infarction/diagnosis ; ST Elevation Myocardial Infarction/drug therapy ; ST Elevation Myocardial Infarction/mortality ; ST Elevation Myocardial Infarction/surgery ; United States/epidemiology
Chemical Substances	Analgesics, Opioid ; Morphine (76I7G6D29C)
Language	English
Publishing date	2017-11-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	1036325-7
ISSN	1540-8183 ; 0896-4327
ISSN (online)	1540-8183
ISSN	0896-4327
DOI	10.1111/joic.12464
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Article ; Online: Association of Pulmonary Artery Pulsatility Index With Adverse Cardiovascular Events Across a Hospital-Based Sample.

Zern, Emily K / Wang, Dongyu / Rambarat, Paula / Bernard, Samuel / Paniagua, Samantha M / Liu, Elizabeth E / McNeill, Jenna / Wang, Jessica K / Andrews, Carl T / Pomerantsev, Eugene V / Picard, Michael H / Ho, Jennifer E

Circulation. Heart failure

2022 Volume 15, Issue 2, Page(s) e009085

Abstract: Background: The pulmonary artery pulsatility index (PAPi), calculated from the ratio of the pulmonary artery pulse pressure to right atrial pressure, is a predictor of right ventricular failure after inferior myocardial infarction and left ventricular ... ...

Abstract	Background: The pulmonary artery pulsatility index (PAPi), calculated from the ratio of the pulmonary artery pulse pressure to right atrial pressure, is a predictor of right ventricular failure after inferior myocardial infarction and left ventricular assist device implantation. Whether PAPi is associated with adverse outcomes across a heterogeneous population is unknown. Methods: We examined consecutive patients undergoing right heart catheterization between 2005 and 2016 in a hospital-based cohort. Multivariable Cox models were utilized to examine the association between PAPi and all-cause mortality, major adverse cardiac events, and heart failure hospitalizations. Results: We studied 8285 individuals (mean age 63 years, 39% women) with median PAPi across quartiles 1.7, 2.8, 4.2, and 8.7, who were followed over a mean follow-up of 6.7±3.3 years. Patients in the lowest PAPi quartile had a 60% greater risk of death compared with the highest quartile (multivariable-adjusted hazard ratio, 1.60 [95% CI, 1.36-1.88], Conclusions: Compared with the highest PAPi quartile, patients in PAPi quartiles 1 to 3 had a greater risk of all-cause mortality, major adverse cardiac events, and heart failure hospitalizations, with greatest risk observed in the lowest quartile. A low PAPi, even at values higher than previously reported, may serve an important role in identifying high-risk individuals across a broad spectrum of cardiovascular disease.
MeSH term(s)	Adult ; Aged ; Cardiac Catheterization/adverse effects ; Female ; Heart/physiopathology ; Heart Failure/physiopathology ; Heart-Assist Devices/adverse effects ; Hospitals ; Humans ; Male ; Middle Aged ; Pulmonary Artery/physiopathology ; Pulmonary Wedge Pressure/physiology ; Risk Factors ; Ventricular Dysfunction, Right/physiopathology ; Ventricular Function, Right/physiology
Language	English
Publishing date	2022-02-09
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2429459-7
ISSN	1941-3297 ; 1941-3289
ISSN (online)	1941-3297
ISSN	1941-3289
DOI	10.1161/CIRCHEARTFAILURE.121.009085
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