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BACKGROUND The diagnosis of cardiac amyloidosis (CA) is challenging owing to vague symptomatology and non-specific echocardiographic findings. OBJECTIVE To describe regional patterns in longitudinal strain (LS) using two-dimensional speckle-tracking echocardiography in CA and to test the hypothesis that regional differences would help differentiate CA(More)
BACKGROUND Treatment-related cardiac death is the primary, noncancer cause of mortality in adult survivors of childhood malignancies. Early detection of cardiac dysfunction may identify a high-risk subset of survivors for early intervention. OBJECTIVES This study sought to determine the prevalence of cardiac dysfunction in adult survivors of childhood(More)
Ischemia caused by coronary artery disease and myocardial infarction leads to aberrant ventricular remodeling and cardiac fibrosis. This occurs partly through accumulation of gene expression changes in resident fibroblasts, resulting in an overactive fibrotic phenotype. Long-term adaptation to a hypoxic insult is likely to require significant modification(More)
CONTEXT Current guidelines recommend the use of aldosterone antagonists (AA) in patients with moderately severe to severe symptoms [New York Heart Association (NYHA) class III to IV] and systolic heart failure. OBJECTIVE To determine the efficacy of AA in improving ejection fraction (EF) and functional capacity and to assess whether this effect was(More)
AIMS Hypertension is one of the main drivers of the heart failure (HF) epidemic. The aims of this study were to profile fibro-inflammatory biomarkers across stages of the hypertensive heart disease (HHD) spectrum and to examine whether particular biochemical profiles in asymptomatic patients identify a higher risk of evolution to HF. METHODS AND RESULTS(More)
BACKGROUND The optimal timing of postmastectomy radiation for women undergoing delayed permanent implant exchange continues to remain controversial. The objective of our study is to compare complication rates when tissue expanders are exchanged for permanent implants pre- vs postradiation. METHODS A retrospective review of 54 consecutive patients who(More)
PURPOSE Preferred hemodialysis (HD) access is an autologous fistula. Vascular grafts are used in patients with vessels unsuitable to accomplish an arteriovenous fistula (AVF). It is recommended that most current grafts mature in situ for 2-3 weeks before being accessed. Graft complications occur because the structure was not designed for the trauma of(More)
The accepted approach to patients with intermittent calf claudication is nonoperative unless the symptoms are truly incapacitating, in which case arteriography and either percutaneous angioplasty or operation is indicated. Arteriography is considered a preoperative procedure. However, with improvements in percutaneous angioplasty, we have altered our(More)
Decisions regarding surgery for mitral regurgitation (MR) are predicated on the accurate quantification of MR severity. Quantitative parameters, including vena contracta width, regurgitant volume and fraction, and effective regurgitant orifice area have prognostic significance and are recommended to be obtained from patients with more than mild MR. New(More)
Of 724 bypasses with polytetrafluoroethylene grafts performed for critical ischemia during a 6-year period, 165 (23%) failed and necessitated reoperation for continued limb salvage. Forty-three failures occurred in 199 femoral-above-knee-popliteal bypasses (F-AKP), 33 failures in 177 femoral-below-knee-popliteal bypasses (F-BKP), 52 failures in 182(More)