Rohit seth loomba

BACKGROUND: Nonalcoholic steatohepatitis (NASH) is a progressive liver disease with no approved treatment. Resmetirom is an oral, liver-directed, thyroid hormone receptor beta-selective agonist in development for the treatment of NASH with liver fibrosis. METHODS: We are conducting an ongoing phase 3 trial involving adults with biopsy-confirmed NASH and a fibrosis stage of F1B, F2, or F3 (stages range from F0 [no fibrosis] to F4 [cirrhosis]). Patients were randomly assigned in a 1:1:1 ratio to receive once-daily resmetirom at a dose of 80 mg or 100 mg or placebo...

Anatomic variants in the right atrium are under-recognized and under-reported phenomena in cardiac imaging. In the fetus, right atrium serves as a conduit for oxygenated blood to be delivered to the left heart bypassing the right ventricle and the nonfunctional lungs. The anatomy in the fetal right atrium is designed for such purposeful circulation. The right and left venous valves are prominent structures in the fetal heart that direct inferior vena caval flow towards the foramen ovale. These anatomic structures typically regress and the foramen ovale closes after birth...

BACKGROUND: Discussions continue as to whether ventricular septal defects are best categorized according to their right ventricular geography or their borders. This is especially true when considering the perimembranous defect. Our aim, therefore, was to establish the phenotypic feature of the perimembranous defect, and to establish the ease of distinguishing its geographical variants. METHODS AND RESULTS: We assessed unrepaired isolated perimembranous ventricular defects from six historic archives, subcategorizing them using the ICD-11 coding system...

INTRODUCTION: Ketamine is a drug often used for procedural sedation or as adjunct agent for general sedation in children with congenital heart disease. In the clinical realm, there is often confusion regarding the effects of ketamine on hemodynamics, particularly pulmonary vascular resistance and systemic vascular resistance. We performed a meta-analysis of studies investigating the effects of ketamine on hemodynamics. METHODS: A systematic review was conducted to identify studies characterizing the hemodynamic effects of ketamine in children with congenital heart disease...

INTRODUCTION: Current guidelines for the management of out-of-hospital cardiac arrest (OHCA) recommend the use of prehospital epinephrine by initial responders. This recommendation was initially based on data from animal models of cardiac arrest and minimal human data, but since its inception, more human data regarding prehospital epinephrine in this setting are now available. Although out-of-hospital return of spontaneous circulation (ROSC) may be higher with the use of epinephrine, worse neurologic outcomes may be associated with its use...

BACKGROUND: Data regarding the associations between sleep duration and clinical cardiovascular (CV) events are limited. We aimed to analyze any associations between self-reported sleep duration and CV events. HYPOTHESIS METHODS: This is a cross-sectional analysis of nationally representative population of noninstitutionalized US civilians recruited in the 2007 to 2008 National Health and Nutrition Examination Survey. This is a questionnaire-based study including only those subjects who answered questions on sleep duration and CV events...

The prevalence of peripheral artery disease is steadily increasing and is associated with significant morbidity, including a significant percentage of amputations. Peripheral artery disease often goes undiagnosed, making its prevention increasingly important. Patients with peripheral arterial disease are at increased risk of adverse cardiovascular outcomes which makes prevention even more important. Several risk factors have been identified in the pathophysiology of peripheral artery disease which should be modified to decrease risk...

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A small number of nonrandomized and retrospective studies have compared outcomes of classical Norwood procedures for hypoplasticleft-heart syndrome and single ventricle lesions involving a Blalock-Taussig (BT) shunt to the modified procedure using a right ventricle to pulmonary artery conduit. Some of these studies reported data for the same outcomes and a meta-analysis was done to analyze pooled outcomes comparing in-hospital mortality, interstage mortality, cardiopulmonary bypass time, systolic and diastolic blood pressures 24 h postoperatively, length of intensive care and hospital stay, and need for postoperative extracorporeal membrane oxygenation...

Many studies have noted a correlation between obstructive sleep apnea (OSA) and atrial fibrillation (AF). Although there is a need for large randomized control trials, the present data are quite convincing and can be used to improve current treatment procedures. Reviews, randomized control trials, and meta-analyses were obtained using electronic search strategies such as Medline and Cochrane Library. References of electronically obtained studies were then used to conduct hand searches for additional relevant studies...

Dyslipidemia increases the risk of cardiovascular disease (CVD) risk which is a leading cause of mortality. This creates the need for therapies to effectively manage dyslipidemia to decrease the CVD risk associated with it. This meta-analysis evaluates fibrate therapy in respect to dealing with dyslipidemia and CVD risk. Fibrates significantly reduced plasma total cholesterol by 8% and significantly reduced triglyceride levels by 30%. High density lipoprotein cholesterol levels were raised by 9% with fibrates...

The association between hyperglycemia and increased mortality associated with acute coronary syndrome (ACS) has been studied and affirmed. Although more studies are needed to explore how managing this hyperglycemia can affect ACS mortality, the need to educate regarding current data is urgent so that it can be clinically applied. Reviews, randomized controlled trials, and other studies were obtained by means of electronic search strategies, such as Medline and Cochrane Library, as well as hand selection. Sources selected were limited to those that discussed ACS and hyperglycemia, and specific emphasis was placed on sources that focused on ACS and hyperglycemia in conjunction with one another...

With new study findings becoming available, the American College of Cardiology (ACC) and the American Heart Association (AHA) have made additions and revisions to their guidelines for treating patients with ST elevation myocardial infarctions (STEMI). It is important for clinicians to be familiar with these changes so that they may be applied and assist in the treatment of patients. Electronic searches on databases such as PubMed, Cochrane Library, and Medline were conducted using specific keywords pertaining to the ACC/AHA guidelines and the specific topics discussed in these guidelines to find randomized controlled trials, meta-analyses, and systematic reviews...

Aortic stenosis is a condition that is inflicting an increasing number of the elderly in North America and Europe. Current treatment for aortic stenosis is aortic valve replacement. An expanding pool of knowledge regarding the mechanism of aortic stenosis has led to the testing of statins to reduce the progression of aortic stenosis. Reviews, randomized, controlled trials and other studies pertaining to the topic were searched for using Medline, Cochrane Library, and ScienceDirect. Search terms used were "HMG-CoA reductase inhibitors" and "aortic stenosis...

UNLABELLED: Cardiovascular disease remains a leading cause of mortality worldwide. As dyslipidemia increases cardiovascular disease risk, proper management of dyslipidemia is one means by which to decrease cardiovascular disease risk. This review focuses on dyslipidemia treatment utilizing fibrate therapy, which targets high trigylcerides, low HDL, and high small, dense LDL, while contrasting fibrate therapy with statin therapy and combined therapy. Studies were obtained using electronic search strategies, such as Medline and Cochrane Library...

OBJECTIVE: Coronary heart disease (CHD) mortality is higher in women than in men and misdiagnosis of CHD in women is one of the reasons for this, with differences in the presentation of CHD between men and women being a cause for the misdiagnosis. This review discusses the need for evidence-based guidelines to diagnose and treat CHD in women. METHODS: Reviews, randomized controlled trials, and other studies pertinent to the topic were obtained using electronic search strategies, such as MEDLINE and Cochran Library, as well as manual selection...