A5079471118- Hormonal Regulation and Hypertension
- Cardiac Imaging and Diagnostics
- Adrenal and Paraganglionic Tumors
- Blood Pressure and Hypertension Studies
- Systemic Lupus Erythematosus Research
- Adrenal Hormones and Disorders
- Cardiovascular Disease and Adiposity
- Atherosclerosis and Cardiovascular Diseases
- Atrial Fibrillation Management and Outcomes
- Vitamin D Research Studies
- Sodium Intake and Health
- Acute Myocardial Infarction Research
- Electrolyte and hormonal disorders
- Cardiovascular Function and Risk Factors
- Cardiac Arrhythmias and Treatments
- Birth, Development, and Health
- Diabetes Management and Research
- Health Systems, Economic Evaluations, Quality of Life
- Cardiovascular, Neuropeptides, and Oxidative Stress Research
- Pregnancy and preeclampsia studies
- Apelin-related biomedical research
- Diabetes Treatment and Management
- Parathyroid Disorders and Treatments
- Renin-Angiotensin System Studies
- Cardiac electrophysiology and arrhythmias
Brigham and Women's Hospital
2016-2025
Harvard University
2014-2025
Cardiovascular Research Associates
2024
University of Belgrade
2021-2023
Cedars-Sinai Medical Center
2023
Beth Israel Deaconess Medical Center
2011-2023
Mass General Brigham
2023
Pontificia Universidad Católica de Chile
2017
London School of Hygiene & Tropical Medicine
2017
University of Washington
2017
This Quick Reference Guide for Clinicians contains recommendations on the care of patients with unstable angina based a combination evidence obtained through extensive literature reviews and consensus among members private-sector, expert panel. Principal conclusions include: Many suspected having can be discharged home after adequate initial evaluation. Further outpatient evaluation may scheduled up to 72 hours presentation clinical symptoms judged at low risk complications. Patients acute...
Primary aldosteronism is a nonsuppressible renin-independent aldosterone production that causes hypertension and cardiovascular disease.To characterize the prevalence of production, as well biochemically overt primary aldosteronism, in relation to blood pressure.Cross-sectional study.4 U.S. academic medical centers.Participants with normotension (n = 289), stage 1 115), 2 203), resistant 408).Participants completed an oral sodium suppression test, regardless or renin levels, confirmatory...
Primary aldosteronism is a severe form of autonomous aldosteronism. Milder forms and renin-independent may be common, even in normotension. We characterized aldosterone secretion 210 normotensives who had suppressed plasma renin activity (<1.0 ng/mL per hour), completed an oral sodium suppression test, received infusion angiotensin II, measurements blood pressure renal flow. Continuous associations between urinary excretion rate, renin, potassium handling were investigated. Severe that...
Background: Primary aldosteronism is recognized as a severe form of renin-independent that results in excessive mineralocorticoid receptor (MR) activation. Objective: To investigate whether spectrum subclinical increases risk for hypertension exists among normotensive persons. Design: Cohort study. Setting: National community-based Participants: 850 untreated participants MESA (Multi-Ethnic Study Atherosclerosis) with measurements serum aldosterone and plasma renin activity (PRA)....
We are witnessing a revolution in our understanding of primary aldosteronism (PA). In the past 2 decades, we have learned that PA is highly prevalent syndrome largely attributable to pathogenic somatic mutations, contributes cardiovascular, metabolic, and kidney disease, when recognized, can be adequately treated with widely available mineralocorticoid receptor antagonists and/or surgical adrenalectomy. Unfortunately, rarely diagnosed, or treated, mainly because lack awareness education....
Primary aldosteronism (PA) is an endocrinopathy characterized by dysregulated aldosterone production that occurs despite suppression of renin and angiotensin II, non-suppressible volume sodium loading. The effectiveness surgical adrenalectomy for patients with lateralizing PA the attenuation excess leading to blood pressure reduction, correction hypokalemia, increases in renin-biomarkers collectively indicate a reversal pathophysiology restoration normal physiology. Even though vast majority...
Abstract Context Primary aldosteronism is a form of low-renin hypertension characterized by dysregulated aldosterone production. Objective To investigate the contributions renin-independent and ACTH-mediated in individuals with phenotype representing entire continuum blood pressure. Design/Participants Human physiology study 348 participants severe and/or resistant hypertension, hypokalemia, elevated pressure stage I/II normal Setting 4 international centers. Interventions/Main Outcome...
BACKGROUND: Preeclampsia is a pregnancy-specific hypertensive disorder associated with an imbalance in circulating proangiogenic and antiangiogenic proteins. Preclinical evidence implicates microvascular dysfunction as potential mediator of preeclampsia-associated cardiovascular risk. METHODS: Women singleton pregnancies complicated by severe antepartum-onset preeclampsia comparator group normotensive deliveries underwent cardiac positron emission tomography within 4 weeks delivery. A...
Observational studies in primary hyperaldosteronism suggest a positive relationship between aldosterone and parathyroid hormone (PTH); however, interventions to better characterize the physiological renin-angiotensin-aldosterone system (RAAS) PTH are needed. We evaluated effect of individual RAAS components on using 4 humans without hyperaldosteronism. was measured before after study (1) low-dose angiotensin II (Ang II) infusion (1 ng/kg per minute) captopril administration (25 mg×1); (2)...
Aldosterone and PTH are implicated in the pathogenesis of cardiovascular skeletal diseases. An expanding body evidence supports a bidirectional positive physiologic relationship between aldosterone PTH. Large population-based studies confirming this relationship, whether it may be targeted as potential method to mitigate clinical consequences associated with excess PTH, needed.
Abstract Aims Hypertension is a well-established heart failure (HF) risk factor, especially in the context of adverse left ventricular (LV) remodelling. We aimed to use myocardial flow reserve (MFR) and global longitudinal strain (GLS), markers subclinical microvascular dysfunction, refine hypertensive HF assessment. Methods results Consecutive patients undergoing symptom-prompted stress cardiac positron emission tomography (PET)-computed transthoracic echocardiogram within 90 days without...
Primary aldosteronism, characterized by overt renin-independent aldosterone production, is a common but underrecognized form of hypertension and cardiovascular disease. Growing evidence suggests that milder subclinical forms primary aldosteronism are highly prevalent, yet their contribution to disease not well characterized.
Abstract Context: Mild cases of autonomous aldosterone secretion may go unrecognized using current diagnostic criteria for primary aldosteronism (PA). Objective: To investigate whether the inability to stimulate renin serves as a biomarker and mineralocorticoid receptor (MR) activation. Participants: Six hundred sixty-three normotensive mildly hypertensive participants, who were confirmed not have PA guideline on no antihypertensive medications. Design: Participants had their maximally...
Aldosterone production and mineralocorticoid receptor activation are implicated in myocardial fibrosis cardiovascular events. Cardiac structure function were assessed 4547 participants without prevalent heart failure (HF) the ARIC study (Atherosclerosis Risk Communities), with echocardiography, aldosterone, plasma renin activity measurement (2011-2013). Subjects characterized by as suppressed (≤0.5 ng/mL per hour) or unsuppressed (>0.5 hour). Cross-sectional relationships cardiac function,...
Clinicians frequently rely on aldosterone thresholds derived from older immunoassays to diagnose primary aldosteronism. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is increasingly widespread and reported yield lower concentrations.
BACKGROUND: Advanced chronic kidney disease is associated with high cardiovascular risk, even after transplant. Pretransplant cardiac testing may identify patients who require additional assessment before transplant or would benefit from risk optimization. The objective of the current study was to determine relative prognostic utility pretransplant positron emission tomography (PET) and single-photon computed (SPECT) myocardial perfusion imaging (MPI) for posttransplant major adverse events...
BACKGROUND: Primary aldosteronism, an endocrinopathy present in ≥10% to 25% of patients with hypertension, confers excess cardiovascular risk that can be mitigated aldosterone-directed therapy. However, only 2% eligible undergo guideline-recommended screening. This study aimed bypass clinical inertia and identify people primary aldosteronism using pragmatic, direct-to-patient testing. METHODS: Hypertensive adults were recruited via online platforms underwent virtual consent local phlebotomy....
A continuum of non-suppressible aldosterone production has been demonstrated in normotensive individuals, termed subclinical primary aldosteronism (PA), and is consistently associated with increased risk for developing hypertension cardiovascular disease. The hormonal mechanisms accounting PA are not well understood. To quantify the magnitude PA, prospectively recruited participants (n=75) had their maximally suppressed plasma assessed after maintaining supine posture following an oral...