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  1. Article ; Online: Raising the Bar: Setting a New Standard for Invasive Hemodynamics in Heart Failure.

    Vorovich, Esther / Schilling, Joel D

    Journal of cardiac failure

    2023  Volume 29, Issue 11, Page(s) 1519–1521

    MeSH term(s) Humans ; Heart Failure/diagnosis ; Hemodynamics ; Blood Pressure
    Language English
    Publishing date 2023-09-02
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 1281194-4
    ISSN 1532-8414 ; 1071-9164
    ISSN (online) 1532-8414
    ISSN 1071-9164
    DOI 10.1016/j.cardfail.2023.08.015
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  2. Article ; Online: The Mechanical Revolution.

    Vorovich, Esther

    Journal of cardiac failure

    2018  Volume 24, Issue 5, Page(s) 335–336

    MeSH term(s) Equipment Design ; Heart Failure/therapy ; Heart-Assist Devices ; Humans
    Language English
    Publishing date 2018-04-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1281194-4
    ISSN 1532-8414 ; 1071-9164
    ISSN (online) 1532-8414
    ISSN 1071-9164
    DOI 10.1016/j.cardfail.2018.04.001
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  3. Article ; Online: Myocarditis: a primer for intensivists.

    Ammirati, Enrico / Vorovich, Esther / Combes, Alain

    Intensive care medicine

    2023  Volume 49, Issue 9, Page(s) 1123–1126

    MeSH term(s) Humans ; Myocarditis ; Critical Care ; Intensive Care Units
    Language English
    Publishing date 2023-07-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-023-07143-3
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  4. Article ; Online: Continuous Monitoring of Blood Pressure Using a Wrist-Worn Cuffless Device.

    Sayer, Gabriel / Piper, Greta / Vorovich, Esther / Raikhelkar, Jayant / Kim, Gene H / Rodgers, Daniel / Shimbo, Daichi / Uriel, Nir

    American journal of hypertension

    2022  Volume 35, Issue 5, Page(s) 407–413

    Abstract: Background: Measuring an accurate blood pressure (BP) in ambulatory patients is critical for therapeutic decisions. An accurate noninvasive device that measures BP continuously could provide a more comprehensive assessment of BP. The aim of this study ... ...

    Abstract Background: Measuring an accurate blood pressure (BP) in ambulatory patients is critical for therapeutic decisions. An accurate noninvasive device that measures BP continuously could provide a more comprehensive assessment of BP. The aim of this study was to determine whether the LiveOne device, a cuffless wristband that provides continuous BP measurements, is accurate in comparison to an invasive arterial line (A-line).
    Methods: We enrolled hospitalized patients and healthy volunteers in this multicenter study. All patients had an invasive A-line. Waveforms were simultaneously downloaded from the A-line and LiveOne device. The primary outcome was the correlation between the LiveOne device and the A-line for systolic BP (SBP) and diastolic BP (DBP).
    Results: Thirty-four patients with 233 measurement periods were included. Mean age was 60.7 ± 15.2 years, and 15 (44%) were female. The correlation for SBP was 0.91 and for DBP was 0.85. The mean band error was 0.0 ± 6.9 mm Hg for SBP and 1.2 ± 5.7 mm Hg for DBP. The mean absolute error was 8.2 ± 5.8 mm Hg for SBP and 6.4 ± 3.9 mm Hg for DBP. For SBP, 98% of LiveOne measurements were within 15 mm Hg and for DBP, 92% of LiveOne measurements were within 10 mm Hg.
    Conclusions: The LiveOne device provides continuous, noninvasive BP measurements that are accurate in comparison to A-line measurements. The portability and unobtrusive nature of this device and the ability to provide continuous BP measurements may offer advantages over currently available BP monitors.
    Clinical trials registration: Trial Number NCT03919136.
    MeSH term(s) Aged ; Blood Pressure/physiology ; Blood Pressure Determination ; Female ; Humans ; Hypertension ; Male ; Middle Aged ; Sphygmomanometers ; Wrist
    Language English
    Publishing date 2022-06-23
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 639383-4
    ISSN 1941-7225 ; 1879-1905 ; 0895-7061
    ISSN (online) 1941-7225 ; 1879-1905
    ISSN 0895-7061
    DOI 10.1093/ajh/hpac020
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  5. Article ; Online: HFSA Expert Consensus Statement on the Medical Management of Patients on Durable Mechanical Circulatory Support.

    Trachtenberg, Barry / Cowger, Jennifer / Jennings, Douglas L / Grafton, Gillian / Loyaga-Rendon, Renzo / Cogswell, Rebecca / Klein, Liviu / Shah, Palak / Kiernan, Michael / Vorovich, Esther

    Journal of cardiac failure

    2023  Volume 29, Issue 4, Page(s) 479–502

    Abstract: The medical management of patients supported with durable continuous flow left ventricular assist device (LVAD) support encompasses pharmacological therapies administered in the preoperative, intraoperative, postoperative, and chronic LVAD support stages. ...

    Abstract The medical management of patients supported with durable continuous flow left ventricular assist device (LVAD) support encompasses pharmacological therapies administered in the preoperative, intraoperative, postoperative, and chronic LVAD support stages. As patients live longer on LVAD support, the risks of LVAD-related complications and progression of cardiovascular and other diseases increase. Using existing data from cohort studies, registries, randomized trials, and expert opinion, this Heart Failure Society of America Consensus Document on the Medical Management of Patients on Durable Mechanical Circulatory Support offers best practices on the management of patients on durable mechanical circulatory support, focusing on pharmacological therapies administered to patients on continuous flow LVADs. Although quality data in the LVAD population are few, the use of guideline-directed heart failure medical therapies and the importance of blood pressure management, right ventricular preload and afterload optimization, and antiplatelet and anticoagulation regimens are discussed. Recommended pharmacological regimens used to mitigate or treat common complications encountered during LVAD support, including arrhythmias, vasoplegia, mucocutaneous bleeding, and infectious complications, are addressed. Finally, this document touches on important potential pharmacological interactions from antidepressants and herbal and nutritional supplements of relevance to providers of patients on LVAD support.
    MeSH term(s) Humans ; Heart Failure ; Heart-Assist Devices/adverse effects ; Lung ; Cohort Studies ; Arrhythmias, Cardiac
    Language English
    Publishing date 2023-02-22
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, N.I.H., Extramural
    ZDB-ID 1281194-4
    ISSN 1532-8414 ; 1071-9164
    ISSN (online) 1532-8414
    ISSN 1071-9164
    DOI 10.1016/j.cardfail.2023.01.009
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  6. Article ; Online: Corrigendum to "HFSA Expert Consensus Statement on the Medical Management of Patients on Durable Mechanical Circulatory Support": Journal of Cardiac Failure Vol. 29 No. 4, pp. 479-502.

    Trachtenberg, Barry / Jennings, Douglas / Grafton, Gillian / Loyaga-Rendon, Renzo / Cogswell, Rebecca / Klein, Liviu / Shah, Palak / Kiernan, Mike / Vorovich, Esther / Cowger, Jennifer

    Journal of cardiac failure

    2023  Volume 29, Issue 9, Page(s) 1342

    Language English
    Publishing date 2023-07-04
    Publishing country United States
    Document type Published Erratum
    ZDB-ID 1281194-4
    ISSN 1532-8414 ; 1071-9164
    ISSN (online) 1532-8414
    ISSN 1071-9164
    DOI 10.1016/j.cardfail.2023.06.004
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  7. Article ; Online: Multiparametric Cardiac Magnetic Resonance Imaging Detects Altered Myocardial Tissue and Function in Heart Transplantation Recipients Monitored for Cardiac Allograft Vasculopathy.

    Abbasi, Muhannad A / Blake, Allison M / Sarnari, Roberto / Lee, Daniel / Anderson, Allen S / Ghafourian, Kambiz / Khan, Sadiya S / Vorovich, Esther E / Rich, Jonathan D / Wilcox, Jane E / Yancy, Clyde W / Carr, James C / Markl, Michael

    Journal of cardiovascular imaging

    2022  Volume 30, Issue 4, Page(s) 263–275

    Abstract: Background: Cardiac allograft vasculopathy (CAV) is a complication beyond the first-year post-heart transplantation (HTx). We aimed to test the utility of cardiac magnetic resonance (CMR) to detect functional/structural changes in HTx recipients with ... ...

    Abstract Background: Cardiac allograft vasculopathy (CAV) is a complication beyond the first-year post-heart transplantation (HTx). We aimed to test the utility of cardiac magnetic resonance (CMR) to detect functional/structural changes in HTx recipients with CAV.
    Methods: Seventy-seven prospectively recruited HTx recipients beyond the first-year post-HTx and 18 healthy controls underwent CMR, including cine imaging of ventricular function and T1- and T2-mapping to assess myocardial tissue changes. Data analysis included quantification of global cardiac function and regional T2, T1 and extracellular volume based on the 16-segment model. International Society for Heart and Lung Transplantation criteria was used to adjudicate CAV grade (0-3) based on coronary angiography.
    Results: The majority of HTx recipients (73%) presented with CAV (1: n = 42, 2/3: n = 14, 0: n = 21). Global and segmental T2 (49.5 ± 3.4 ms vs 50.6 ± 3.4 ms, p < 0.001;16/16 segments) were significantly elevated in CAV-0 compared to controls. When comparing CAV-2/3 to CAV-1, global and segmental T2 were significantly increased (53.6 ± 3.2 ms vs. 50.6 ± 2.9 ms, p < 0.001; 16/16 segments) and left ventricular ejection fraction was significantly decreased (54 ± 9% vs. 59 ± 9%, p < 0.05). No global, structural, or functional differences were seen between CAV-0 and CAV-1.
    Conclusions: Transplanted hearts display functional and structural alteration compared to native hearts, even in those without evidence of macrovasculopathy (CAV-0). In addition, CMR tissue parameters were sensitive to changes in CAV-1 vs. 2/3 (mild vs. moderate/severe). Further studies are warranted to evaluate the diagnostic value of CMR for the detection and classification of CAV.
    Language English
    Publishing date 2022-10-21
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 3020035-0
    ISSN 2586-7296 ; 2586-7210
    ISSN (online) 2586-7296
    ISSN 2586-7210
    DOI 10.4250/jcvi.2022.0003
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  8. Article ; Online: Hyponatremia Is a Powerful Predictor of Poor Prognosis in Left Ventricular Assist Device Patients.

    Tibrewala, Anjan / Wehbe, Ramsey M / Wu, Tingqing / Harap, Rebecca / Ghafourian, Kambiz / Wilcox, Jane E / Okwuosa, Ike S / Vorovich, Esther E / Ahmad, Faraz S / Yancy, Clyde / Pawale, Amit / Anderson, Allen S / Pham, Duc T / Rich, Jonathan D

    ASAIO journal (American Society for Artificial Internal Organs : 1992)

    2022  Volume 68, Issue 12, Page(s) 1475–1482

    Abstract: Serum sodium is an established prognostic marker in heart failure (HF) patients and is associated with an increased risk of morbidity and mortality. We sought to study the prognostic value of serum sodium in left ventricular assist device (LVAD) patients ...

    Abstract Serum sodium is an established prognostic marker in heart failure (HF) patients and is associated with an increased risk of morbidity and mortality. We sought to study the prognostic value of serum sodium in left ventricular assist device (LVAD) patients and whether hyponatremia reflects worsening HF or an alternative mechanism. We identified HF patients that underwent LVAD implantation between 2008 and 2019. Hyponatremia was defined as Na ≤134 mEq/L at 3 months after implantation. We assessed for differences in hyponatremia before and after LVAD implantation. We also evaluated the association of hyponatremia with all-cause mortality and recurrent HF hospitalizations. There were 342 eligible LVAD patients with a sodium value at 3 months. Among them, there was a significant improvement in serum sodium after LVAD implantation compared to preoperatively (137.2 vs. 134.7 mEq/L, P < 0.0001). Patients with and without hyponatremia had no significant differences in echocardiographic and hemodynamic measurements. In a multivariate analysis, hyponatremia was associated with a markedly increased risk of all-cause mortality (HR 3.69, 95% CI, 1.93-7.05, P < 0.001) when accounting for age, gender, co-morbidities, use of loop diuretics, and B-type natriuretic peptide levels. Hyponatremia was also significantly associated with recurrent HF hospitalizations (HR 2.11, 95% CI, 1.02-4.37, P = 0.04). Hyponatremia in LVAD patients is associated with significantly higher risk of all-cause mortality and recurrent HF hospitalizations. Hyponatremia may be a marker of ongoing neurohormonal activation that is more sensitive than other lab values, echocardiography parameters, and hemodynamic measurements.
    MeSH term(s) Humans ; Heart-Assist Devices/adverse effects ; Hyponatremia/etiology ; Heart Failure/complications ; Heart Failure/surgery ; Prognosis ; Sodium ; Retrospective Studies ; Treatment Outcome
    Chemical Substances Sodium (9NEZ333N27)
    Language English
    Publishing date 2022-11-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 759982-1
    ISSN 1538-943X ; 0162-1432 ; 1058-2916
    ISSN (online) 1538-943X
    ISSN 0162-1432 ; 1058-2916
    DOI 10.1097/MAT.0000000000001691
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  9. Article ; Online: Propensity Score-Matched Comparison of Right Ventricular Strain in Women and Men Before and After Left Ventricular Assist Device Implantation.

    Kislitsina, Olga N / D Rich, Jonathan / Wilcox, Jane E / E Vorovich, Esther / Wu, Tingqing / Churyla, Andrei / S Harap, Rebecca / Andrei, Adin-Christian / McCarthy, Patrick M / Yancy, Clyde W / Pham, Duc Thin

    Innovations (Philadelphia, Pa.)

    2022  Volume 17, Issue 2, Page(s) 102–110

    Abstract: Objective: ...

    Abstract Objective:
    MeSH term(s) Female ; Heart Failure/surgery ; Heart Ventricles/surgery ; Heart-Assist Devices/adverse effects ; Humans ; Male ; Propensity Score ; Retrospective Studies ; Tricuspid Valve Insufficiency/complications ; Ventricular Dysfunction, Right/epidemiology
    Language English
    Publishing date 2022-03-11
    Publishing country United States
    Document type Journal Article
    ISSN 1559-0879
    ISSN (online) 1559-0879
    DOI 10.1177/15569845221081937
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  10. Article ; Online: Clinical Course of Patients in Cardiogenic Shock Stratified by Phenotype.

    Zweck, Elric / Kanwar, Manreet / Li, Song / Sinha, Shashank S / Garan, A Reshad / Hernandez-Montfort, Jaime / Zhang, Yijing / Li, Borui / Baca, Paulina / Dieng, Fatou / Harwani, Neil M / Abraham, Jacob / Hickey, Gavin / Nathan, Sandeep / Wencker, Detlef / Hall, Shelley / Schwartzman, Andrew / Khalife, Wissam / Mahr, Claudius /
    Kim, Ju H / Vorovich, Esther / Whitehead, Evan H / Blumer, Vanessa / Westenfeld, Ralf / Burkhoff, Daniel / Kapur, Navin K

    JACC. Heart failure

    2023  Volume 11, Issue 10, Page(s) 1304–1315

    Abstract: Background: Cardiogenic shock (CS) patients remain at 30% to 60% in-hospital mortality despite therapeutic innovations. Heterogeneity of CS has complicated clinical trial design. Recently, 3 distinct CS phenotypes were identified in the CSWG ( ... ...

    Abstract Background: Cardiogenic shock (CS) patients remain at 30% to 60% in-hospital mortality despite therapeutic innovations. Heterogeneity of CS has complicated clinical trial design. Recently, 3 distinct CS phenotypes were identified in the CSWG (Cardiogenic Shock Working Group) registry version 1 (V1) and external cohorts: I, "noncongested;" II, "cardiorenal;" and III, "cardiometabolic" shock.
    Objectives: The aim was to confirm the external reproducibility of machine learning-based CS phenotypes and to define their clinical course.
    Methods: The authors included 1,890 all-cause CS patients from the CSWG registry version 2. CS phenotypes were identified using the nearest centroids of the initially reported clusters.
    Results: Phenotypes were retrospectively identified in 796 patients in version 2. In-hospital mortality rates in phenotypes I, II, III were 23%, 41%, 52%, respectively, comparable to the initially reported 21%, 45%, and 55% in V1. Phenotype-related demographic, hemodynamic, and metabolic features resembled those in V1. In addition, 58.8%, 45.7%, and 51.9% of patients in phenotypes I, II, and III received mechanical circulatory support, respectively (P = 0.013). Receiving mechanical circulatory support was associated with increased mortality in cardiorenal (OR: 1.82 [95% CI: 1.16-2.84]; P = 0.008) but not in noncongested or cardiometabolic CS (OR: 1.26 [95% CI: 0.64-2.47]; P = 0.51 and OR: 1.39 [95% CI: 0.86-2.25]; P = 0.18, respectively). Admission phenotypes II and III and admission Society for Cardiovascular Angiography and Interventions stage E were independently associated with increased mortality in multivariable logistic regression compared to noncongested "stage C" CS (P < 0.001).
    Conclusions: The findings support the universal applicability of these phenotypes using supervised machine learning. CS phenotypes may inform the design of future clinical trials and enable management algorithms tailored to a specific CS phenotype.
    MeSH term(s) Humans ; Shock, Cardiogenic ; Heart Failure/complications ; Retrospective Studies ; Reproducibility of Results ; Disease Progression ; Hospital Mortality
    Language English
    Publishing date 2023-06-21
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2705621-1
    ISSN 2213-1787 ; 2213-1779
    ISSN (online) 2213-1787
    ISSN 2213-1779
    DOI 10.1016/j.jchf.2023.05.007
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