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Navin Kapur

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https://www.readbyqxmd.com/read/29674141/trends-in-utilization-of-mechanical-circulatory-support-in-patients-hospitalized-after-out-of-hospital-cardiac-arrest
#1
Nileshkumar J Patel, Nish Patel, Bhaskar Bhardwaj, Harsh Golwala, Varun Kumar, Varunsiri Atti, Shilpkumar Arora, Smit Patel, Nilay Patel, Gabriel A Hernandez, Apurva Badheka, Carlos E Alfonso, Mauricio G Cohen, Deepak L Bhatt, Navin K Kapur
OBJECTIVE: This study sought to examine the trends and predictors of mechanical circulatory support (MCS) use in patients hospitalized after out-of-hospital cardiac arrest (OHCA). BACKGROUND: There is a paucity of data regarding MCS use in patients hospitalized after OHCA. METHODS: We conducted an observational analysis of MCS use in 960,428 patients hospitalized after OHCA between January 2008 and December 2014 in the Nationwide Inpatient Sample database...
April 16, 2018: Resuscitation
https://www.readbyqxmd.com/read/29666074/when-the-vest-does-not-fit-representations-of-trial-results-deviating-from-rigorous-data-interpretation
#2
Larry A Allen, Eric D Adler, Antoni Bayés-Genis, Meredith A Brisco-Bacik, Julio A Chirinos, Brian Claggett, Jennifer L Cook, James C Fang, Finn Gustafsson, Carolyn Y Ho, Navin K Kapur, Scott E Klewer, Robb D Kociol, David E Lanfear, Orly Vardeny, Nancy K Sweitzer
No abstract text is available yet for this article.
April 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29650544/evaluation-and-management-of-right-sided-heart-failure-a-scientific-statement-from-the-american-heart-association
#3
REVIEW
Marvin A Konstam, Michael S Kiernan, Daniel Bernstein, Biykem Bozkurt, Miriam Jacob, Navin K Kapur, Robb D Kociol, Eldrin F Lewis, Mandeep R Mehra, Francis D Pagani, Amish N Raval, Carey Ward
BACKGROUND AND PURPOSE: The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality...
May 15, 2018: Circulation
https://www.readbyqxmd.com/read/29618581/causes-and-predictors-of-30-day-readmission-in-patients-with-acute-myocardial-infarction-and-cardiogenic-shock
#4
Mahek Shah, Shantanu Patil, Brijesh Patel, Manyoo Agarwal, Carlos D Davila, Lohit Garg, Sahil Agrawal, Navin K Kapur, Ulrich P Jorde
BACKGROUND: Acute myocardial infarction (AMI) occurs as a result of irreversible damage to cardiac myocytes secondary to lack of blood supply. Cardiogenic shock complicating AMI has significant associated morbidity and mortality, and data on postdischarge outcomes are limited. METHODS AND RESULTS: We derived the study cohort of patients with AMI and cardiogenic shock from the 2013 to 2014 Healthcare Cost and Utilization Project National Readmission Database. Incidence, predictors, and causes of 30-day readmissions were analyzed...
April 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29604289/effect-of-spironolactone-on-myocardial-fibrosis-and-other-clinical-variables-in-patients-with-hypertrophic-cardiomyopathy-a-prospective-randomized-trial
#5
Martin S Maron, Raymond H Chan, Navin Kapur, Iris J Jaffe, Adam P McGraw, Raj Kerur, Barry J Maron, James E Udelson
BACKGROUND: Myocardial fibrosis has proved to be an important marker and determinant in the pathogenesis of hypertrophic cardiomyopathy . In particular, scar formation, if substantial, can promote ventricular tachyarrhythmias or progressive heart failure in the absence ofleft ventricular outflow obstruction. Therefore, an intervention to mitigate myocardial fibrosis would be potentially advantageous to hypertrophic cardiomyopathy patients. METHODS: Eligible hypertrophic cardiomyopathy patients were randomized 1:1 in a prospective double-blind fashion to spironolactone 50 mg or placebo to be taken over a 12-month period...
March 28, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29540471/outcomes-after-continuous-flow-left-ventricular-assist-device-implantation-as-destination-therapy-at-transplant-versus-nontransplant-centers
#6
D Marshall Brinkley, David DeNofrio, Robin Ruthazer, Amanda R Vest, Navin K Kapur, Gregory S Couper, Michael S Kiernan
BACKGROUND: Since Food and Drug Administration's approval of the HeartMate II left ventricular assist device (LVAD) as destination therapy, the number of hospitals offering LVAD therapy has grown rapidly. A rising number are performed at centers without internal transplant programs. We sought to determine whether outcomes after destination therapy LVAD implantation are similar at transplant and nontransplant centers. METHODS AND RESULTS: Adult recipients of a primary, continuous-flow LVAD as destination therapy between January 2012 and March 2014 from the Interagency Registry for Mechanically Assisted Circulatory Support were included...
March 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29519902/thirty-day-readmissions-after-left-ventricular-assist-device-implantation-in-the-united-states-insights-from-the-nationwide-readmissions-database
#7
Sahil Agrawal, Lohit Garg, Mahek Shah, Manyoo Agarwal, Brijesh Patel, Amitoj Singh, Aakash Garg, Ulrich P Jorde, Navin K Kapur
BACKGROUND: Early readmissions contribute significantly to heart failure-related morbidity and negatively affect quality of life. Data on left ventricular assist device (LVAD)-related 30-day readmissions are scarce and limited to small studies. METHODS AND RESULTS: Patients undergoing LVAD implantation between January 2013 and November 2014 who survived the index hospitalization were identified in the Nationwide Readmissions Database. We analyzed the incidence, predictors, causes, and costs of 30-day readmissions...
March 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29514806/left-ventricular-unloading-using-an-impella-cp-improves-coronary-flow-and-infarct-zone-perfusion-in-ischemic-heart-failure
#8
Shin Watanabe, Kenneth Fish, Jason C Kovacic, Olympia Bikou, Lauren Leonardson, Koichi Nomoto, Jaume Aguero, Navin K Kapur, Roger J Hajjar, Kiyotake Ishikawa
BACKGROUND: Delivering therapeutic materials, like stem cells or gene vectors, to the myocardium is difficult in the setting of ischemic heart failure because of decreased coronary flow and impaired microvascular perfusion (MP). The aim of this study was to determine if mechanical left ventricular (LV) unloading with the Impella increases coronary flow and MP in a subacute myocardial infarction. METHODS AND RESULTS: Anterior transmural myocardial infarction (infarct size, 26...
March 7, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29487140/bone-morphogenetic-protein-9-reduces-cardiac-fibrosis-and-improves-cardiac-function-in-heart-failure
#9
Kevin J Morine, Xiaoying Qiao, Sam York, Peter S Natov, Vikram Paruchuri, Yali Zhang, Mark J Aronovitz, Richard H Karas, Navin K Kapur
Background -Heart failure is a growing cause of morbidity and mortality worldwide. Transforming growth factor beta (TGF-β1) promotes cardiac fibrosis, but also activates counter-regulatory pathways that serve to regulate TGF-β1 activity in heart failure. Bone morphogenetic protein 9 (BMP9) is a member of the TGFβ family of cytokines and signals via the downstream effector protein Smad1. Endoglin is a TGFβ co-receptor that promotes TGF-β1 signaling via Smad3 and binds BMP9 with high affinity. We hypothesized that BMP9 limits cardiac fibrosis by activating Smad1 and attenuating Smad3 and further that neutralizing endoglin activity promotes BMP9 activity...
February 27, 2018: Circulation
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
#10
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...
January 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29054842/acute-biventricular-mechanical-circulatory-support-for-cardiogenic-shock
#11
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
#12
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
#13
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) have 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...
March 2018: 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
#14
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
#15
Navin K Kapur, Carlos D Davila
No abstract text is available yet for this article.
December 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28923988/contemporary-management-of-cardiogenic-shock-a-scientific-statement-from-the-american-heart-association
#16
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
#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, 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...
November 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
#18
Krishna C Penumatsa, Deniz Toksoz, Rod R Warburton, Mousa Kharnaf, Ioana R Preston, Navin K 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 cross-linking 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 cross-linking, extracellular matrix collagen accumulation, and fibroblast-to-myofibroblast transformation...
November 1, 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
#19
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
#20
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
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