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Navin Kapur

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https://www.readbyqxmd.com/read/29056460/use-of-a-percutaneous-temporary-circulatory-support-device-as-a-bridge-to-decision-during-acute-decompensation-of-advanced-heart-failure
#1
Shelley A Hall, Nir Uriel, Sandra A Carey, Michelle Edens, Geoffrey Gong, Michele Esposito, Ryan O'Kelly, Shiva Annamalai, Nima Aghili, S Adatya, Navin K Kapur
BACKGROUND: Prognosis is poor for patients with decompensated advanced heart failure (HF) refractory to medical therapy. Evaluating candidacy for durable mechanical circulatory support (MCS), cardiac transplantation, or palliative care is complex, and time is often needed to stabilize the patient hemodynamically. The Impella 5.0 (Abiomed, Danvers, MA) is a minimally invasive axial-flow catheter capable of providing full temporary hemodynamic support. We report a multicenter series on the use of this device for bridge to decision (BTD) in decompensated advanced HF patients...
September 30, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29054842/acute-biventricular-mechanical-circulatory-support-for-cardiogenic-shock
#2
Sudeep Kuchibhotla, Michele L Esposito, Catalina Breton, Robert Pedicini, Andrew Mullin, Ryan O'Kelly, Mark Anderson, Dennis L Morris, George Batsides, Danny Ramzy, Mark Grise, Duc Thinh Pham, Navin K Kapur
BACKGROUND: Biventricular failure is associated with high in-hospital mortality. Limited data regarding the efficacy of biventricular Impella axial flow catheters (BiPella) support for biventricular failure exist. The aim of this study was to explore the clinical utility of percutaneously delivered BiPella as a novel acute mechanical support strategy for patients with cardiogenic shock complicated by biventricular failure. METHODS AND RESULTS: We retrospectively analyzed data from 20 patients receiving BiPella for biventricular failure from 5 tertiary-care hospitals in the United States...
October 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29054200/the-role-of-acute-circulatory-support-in-st-segment-elevation-myocardial-infarction-complicated-by-cardiogenic-shock
#3
REVIEW
Michele Esposito, Yousef Bader, Robert Pedicini, Catalina Breton, Andrew Mullin, Navin K Kapur
In the setting of ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock, three primary treatment objectives include providing circulatory support, ventricular unloading, and restoring myocardial perfusion. In addition to primary percutaneous coronary intervention, each of these three objectives can be achieved with appropriate use of an acute mechanical circulatory support (AMCS) pump. Over the past decade, utilization of percutaneously-delivered AMCS devices including the Impella axial-flow catheter, TandemHeart left atrial-to-femoral artery bypass system, and veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has grown exponentially...
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29032225/right-ventricular-dysfunction-in-acute-myocardial-infarction-complicated-by-cardiogenic-shock-a-hemodynamic-analysis-of-the-should-we-emergently-revascularize-occluded-coronaries-for-cardiogenic-shock-shock-trial-and-registry
#4
Anuradha Lala, Yu Guo, Jinfeng Xu, Michele Esposito, Kevin Morine, Richard Karas, Stuart D Katz, Judith S Hochman, Daniel Burkhoff, Navin K Kapur
BACKGROUND: The prevalence and significance of right ventricular dysfunction (RVD) in patients with cardiogenic shock due to acute myocardial infarction (AMI-CS) has not been well characterized. We hypothesized that RVD is common in AMI-CS and associated with worse clinical outcomes. METHODS AND RESULTS: We retrospectively analyzed patients with available hemodynamics enrolled in the SHould we emergently revascularize Occluded coronaries for Cardiogenic shocK (SHOCK) Trial (n=139) and Registry (n=258) to identify RVD in AMI-CS...
October 11, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29021348/early-right-ventricular-assist-device-use-in-patients-undergoing-continuous-flow-left-ventricular-assist-device-implantation-incidence-and-risk-factors-from-the-interagency-registry-for-mechanically-assisted-circulatory-support
#5
Michael S Kiernan, E Wilson Grandin, Marshall Brinkley, Navin K Kapur, Duc Thinh Pham, Robin Ruthazer, J Eduardo Rame, Pavan Atluri, Edo Y Birati, Guilherme H Oliveira, Francis D Pagani, James K Kirklin, David Naftel, Robert L Kormos, Jeffrey J Teuteberg, David DeNofrio
BACKGROUND: To investigate preimplant risk factors associated with early right ventricular assist device (RVAD) use in patients undergoing continuous-flow left ventricular assist device (LVAD) surgery. METHODS AND RESULTS: Patients in the Interagency Registry for Mechanically Assisted Circulatory Support who underwent primary continuous-flow-LVAD surgery were examined for concurrent or subsequent RVAD implantation within 14 days of LVAD. Risk factors for RVAD implantation and the combined end point of RVAD or death within 14 days of LVAD were assessed with stepwise logistic regression...
October 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29020366/timing-timing-timing-the-emerging-concept-of-the-door-to-support-time-for-cardiogenic-shock
#6
Navin K Kapur, Carlos D Davila
No abstract text is available yet for this article.
July 25, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28923988/contemporary-management-of-cardiogenic-shock-a-scientific-statement-from-the-american-heart-association
#7
REVIEW
Sean van Diepen, Jason N Katz, Nancy M Albert, Timothy D Henry, Alice K Jacobs, Navin K Kapur, Ahmet Kilic, Venu Menon, E Magnus Ohman, Nancy K Sweitzer, Holger Thiele, Jeffrey B Washam, Mauricio G Cohen
Cardiogenic shock is a high-acuity, potentially complex, and hemodynamically diverse state of end-organ hypoperfusion that is frequently associated with multisystem organ failure. Despite improving survival in recent years, patient morbidity and mortality remain high, and there are few evidence-based therapeutic interventions known to clearly improve patient outcomes. This scientific statement on cardiogenic shock summarizes the epidemiology, pathophysiology, causes, and outcomes of cardiogenic shock; reviews contemporary best medical, surgical, mechanical circulatory support, and palliative care practices; advocates for the development of regionalized systems of care; and outlines future research priorities...
October 17, 2017: Circulation
https://www.readbyqxmd.com/read/28820968/reduced-activin-receptor-like-kinase-1-activity-promotes-cardiac-fibrosis-in-heart-failure
#8
Kevin J Morine, Xiaoying Qiao, Vikram Paruchuri, Mark J Aronovitz, Emily E Mackey, Lyanne Buiten, Jonathan Levine, Keshan Ughreja, Prerna Nepali, Robert M Blanton, S Paul Oh, Richard H Karas, Navin K Kapur
INTRODUCTION: Activin receptor-like kinase 1 (ALK1) mediates signaling via the transforming growth factor beta-1 (TGFβ1), a pro-fibrogenic cytokine. No studies have defined a role for ALK1 in heart failure. HYPOTHESIS: We tested the hypothesis that reduced ALK1 expression promotes maladaptive cardiac remodeling in heart failure. METHODS AND RESULTS: In patients with advanced heart failure referred for left ventricular (LV) assist device implantation, LV Alk1 mRNA and protein levels were lower than control LV obtained from patients without heart failure...
July 18, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28775095/transglutaminase-2-in-pulmonary-and-cardiac-tissue-remodeling-in-experimental-pulmonary-hypertension
#9
Krishna C Penumatsa, Deniz Toksoz, Rod R Warburton, Mousa Kharnaf, Ioana R Preston, Navin Kumar Kapur, Chaitan Khosla, Nicholas S Hill, Barry L Fanburg
Tissue matrix remodeling and fibrosis leading to loss of pulmonary arterial and right ventricular compliance are important features of both experimental and clinical pulmonary hypertension (PH). We have previously reported that transglutaminase 2 (TG2) is involved in PH development while others have shown it to be a crosslinking enzyme that participates in remodeling of extracellular matrix in fibrotic diseases in general. In the present studies, we used a mouse model of experimental PH (Sugen 5416 and hypoxia; SuHypoxia) and cultured primary human cardiac and pulmonary artery adventitial fibroblasts to evaluate the relationship of TG2 to the processes of fibrosis, protein crosslinking, extracellular matrix collagen accumulation and fibroblast to myofibroblast transformation...
August 3, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28716832/mechanical-circulatory-support-devices-for-acute-right-ventricular-failure
#10
REVIEW
Navin K Kapur, Michele L Esposito, Yousef Bader, Kevin J Morine, Michael S Kiernan, Duc Thinh Pham, Daniel Burkhoff
Right ventricular (RV) failure remains a major cause of global morbidity and mortality for patients with advanced heart failure, pulmonary hypertension, or acute myocardial infarction and after major cardiac surgery. Over the past 2 decades, percutaneously delivered acute mechanical circulatory support pumps specifically designed to support RV failure have been introduced into clinical practice. RV acute mechanical circulatory support now represents an important step in the management of RV failure and provides an opportunity to rapidly stabilize patients with cardiogenic shock involving the RV...
July 18, 2017: Circulation
https://www.readbyqxmd.com/read/28600099/integrating-interventional-cardiology-and-heart-failure-management-for-cardiogenic-shock
#11
REVIEW
Navin K Kapur, Carlos D Davila, Marwan F Jumean
Cardiogenic shock remains one of the most common causes of in-hospital death. Recent data have identified an overall increase in patient complexity, with cardiogenic shock in the setting of acute myocardial infarction. The use of percutaneous acute mechanical circulatory support (AMCS) has steadily grown in the past decade. Guidelines and consensus statements addressing proper patient selection, timing of AMCS implantation, device choice, and postimplantation protocol are appearing. The emerging role of interventional heart failure specialists within the heart team includes integration and understanding of advanced hemodynamic and cathether-based therapies, with the goal of improving outcomes...
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28580136/acute-mechanical-circulatory-support-for-cardiogenic-shock-the-door-to-support-time
#12
REVIEW
Michele L Esposito, Navin K Kapur
Cardiogenic shock (CS) remains a major cause of in-hospital mortality in the setting of acute myocardial infarction. CS begins as a hemodynamic problem with impaired cardiac output leading to reduced systemic perfusion, increased residual volume within the left and right ventricles, and increased cardiac filling pressures. A critical step towards the development of future algorithms is a clear understanding of the treatment objectives for CS. In this review, we introduce the "door to support" time as an emerging target of therapy to improve outcomes associated with CS, define four key treatment objectives in the management of CS, discuss the importance of early hemodynamic assessment and appropriate selection of acute mechanical circulatory support (AMCS) devices for CS, and introduce a classification scheme that identifies subtypes of CS based on cardiac filling pressures...
2017: F1000Research
https://www.readbyqxmd.com/read/28554716/acute-hemodynamic-effects-of-intra-aortic-balloon-counterpulsation-pumps-in-advanced-heart-failure
#13
Shiva K Annamalai, Lyanne Buiten, Michele L Esposito, Vikram Paruchuri, Andrew Mullin, Catalina Breton, Robert Pedicini, Ryan O'Kelly, Kevin Morine, Benjamin Wessler, Ayan R Patel, Michael S Kiernan, Richard H Karas, Navin K Kapur
BACKGROUND: The utility of intra-aortic balloon counterpulsation pumps (IABPs) in low cardiac output states is unknown and no studies have explored the impact of IABP therapy on ventricular workload in patients with advanced heart failure (HF). For these reasons, we explored the acute hemodynamic effects of IABP therapy in patients with advanced HF. METHODS: We prospectively studied 10 consecutive patients with stage D HF referred for IABP placement before left ventricular assist device (LVAD) surgery and compared with 5 control patients with preserved left ventricular (LV) ejection fraction (EF) who did not receive IABP therapy...
August 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28489331/scai-hfsa-clinical-expert-consensus-document-on-the-use-of-invasive-hemodynamics-for-the-diagnosis-and-management-of-cardiovascular-disease
#14
EDITORIAL
Paul Sorajja, Barry A Borlaug, Vasiliki V Dimas, James C Fang, Paul R Forfia, Michael M Givertz, Navin K Kapur, Morton J Kern, Srihari S Naidu
No abstract text is available yet for this article.
June 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28489324/executive-summary-of-the-scai-hfsa-clinical-expert-consensus-document-on-the-use-of-invasive-hemodynamics-for-the-diagnosis-and-management-of-cardiovascular-disease
#15
Paul Sorajja, Barry A Borlaug, Vivian Dimas, James C Fang, Paul R Forfia, Michael M Givertz, Navin K Kapur, Morton J Kern, Srihari S Naidu
No abstract text is available yet for this article.
June 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28454731/executive-summary-of-the-scai-hfsa-clinical-expert-consensus-document-on-the-use-of-invasive-hemodynamics-for-the-diagnosis-and-management-of-cardiovascular-disease
#16
Michael M Givertz, James C Fang, Paul Sorajja, Vivian Dimas, Paul R Forfia, Navin K Kapur, Morton J Kern, Srihari S Naidu, Barry A Borlaug
No abstract text is available yet for this article.
June 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28213819/conditional-knockout-of-activin-like-kinase-1-alk-1-leads-to-heart-failure-without-maladaptive-remodeling
#17
Kevin J Morine, Xiaoying Qiao, Vikram Paruchuri, Mark J Aronovitz, Emily E Mackey, Lyanne Buiten, Jonathan Levine, Keshan Ughreja, Prerna Nepali, Robert M Blanton, Richard H Karas, S Paul Oh, Navin K Kapur
Activin like kinase-1 (AlK-1) mediates signaling via the transforming growth factor beta (TGFβ) family of ligands. AlK-1 activity promotes endothelial proliferation and migration. Reduced AlK-1 activity is associated with arteriovenous malformations. No studies have examined the effect of global AlK-1 deletion on indices of cardiac remodeling. We hypothesized that reduced levels of AlK-1 promote maladaptive cardiac remodeling. To test this hypothesis, we employed AlK-1 conditional knockout mice (cKO) harboring the ROSA26-CreER knock-in allele, whereby a single dose of intraperitoneal tamoxifen triggered ubiquitous Cre recombinase-mediated excision of floxed AlK-1 alleles...
May 2017: Heart and Vessels
https://www.readbyqxmd.com/read/27970368/tct-196-from-door-to-balloon-to-door-to-unload-a-transcriptomic-analysis-identifies-that-primary-unloading-globally-shifts-gene-expression-and-preserves-mitochondrial-integrity-within-the-infarct-zone-during-the-acute-phase-of-ami
#18
Michele Esposito, Yali Zhang, Gavin Schnitzler, Vikram Paruchuri, Xiaoying Qiao, Shiva Annamalai, Emily Mackey, Kevin Morine, Andrew Mullin, Tobias Rheude, Catalina Breton, Richard Karas, Noam Josephy, Navin Kapur
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970301/tct-135-increased-circulating-plasma-free-hemoglobin-levels-not-lactate-dehydrogenase-levels-identify-hemolysis-among-patients-with-cardiogenic-shock-treated-with-an-impella-micro-axial-flow-catheter
#19
Michele Esposito, Ryan O'Kelly, Nima Aghili, Shiva Annamalai, Anas Hamadeh, Michael Kiernan, Amanda Vest, David DeNofrio, Navin Kapur
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970296/tct-132-utility-of-the-save-score-as-a-predictor-of-survival-in-cardiogenic-shock-requiring-va-ecmo-or-impella-for-acute-mechanical-circulatory-support
#20
Sudeep Kuchibhotla, Michele Esposito, David Zisa, Ryan O'Kelly, Shiva Annamalai, Adel Ghuloom, Leslie Lussier, Catalina Breton, Tobias Rheude, Andrew Mullin, Carey Kimmelstiel, Michael Kiernan, Amanda Vest, Navin Kapur
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
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