A5034130923- Cardiac Imaging and Diagnostics
- Cardiac pacing and defibrillation studies
- Cardiac electrophysiology and arrhythmias
- Cardiac Arrhythmias and Treatments
- Acute Myocardial Infarction Research
- Cardiovascular Function and Risk Factors
- Atrial Fibrillation Management and Outcomes
- Heart Failure Treatment and Management
- Coronary Interventions and Diagnostics
- Health Systems, Economic Evaluations, Quality of Life
- Cardiac Structural Anomalies and Repair
- Cardiac Valve Diseases and Treatments
- Statistical Methods in Clinical Trials
- Cardiovascular Effects of Exercise
- Advanced MRI Techniques and Applications
- Statistical Methods and Inference
- Mechanical Circulatory Support Devices
- Vitamin C and Antioxidants Research
- Cardiovascular Disease and Adiposity
- Cardiovascular Syncope and Autonomic Disorders
- Antiplatelet Therapy and Cardiovascular Diseases
- Venous Thromboembolism Diagnosis and Management
- Blood Pressure and Hypertension Studies
- Cardiovascular and exercise physiology
- Cardiac Arrest and Resuscitation
Clinical Research Institute
2015-2024
Duke University
2015-2024
Duke Medical Center
2007-2020
Duke University Hospital
1996-2017
Cornell University
2002-2017
NewYork–Presbyterian Hospital
2002-2017
Tufts Medical Center
2017
Tufts University
2017
Boston University
2017
Oregon Health & Science University
2017
Sudden death from cardiac causes remains a leading cause of among patients with congestive heart failure (CHF). Treatment amiodarone or an implantable cardioverter-defibrillator (ICD) has been proposed to improve the prognosis in such patients.We randomly assigned 2521 New York Heart Association (NYHA) class II III CHF and left ventricular ejection fraction (LVEF) 35 percent less conventional therapy for plus placebo (847 patients), (845 conservatively programmed, shock-only, single-lead ICD...
Empirical antiarrhythmic therapy has not reduced mortality among patients with coronary artery disease and asymptomatic ventricular arrhythmias. Previous studies have suggested that guided by electrophysiologic testing might reduce the risk of sudden death.
Abstract Regression models such as the Cox proportional hazards model have had increasing use in modelling and estimating prognosis of patients with a variety diseases. Many applications involve large number variables to be modelled using relatively small patient sample. Problems overfitting identifying important covariates are exacerbated analysing because accuracy is more function events than sample size. We used general index predictive discrimination measure ability developed on training...
Background— Dual-chamber (DDDR) pacing preserves AV synchrony and may reduce heart failure (HF) atrial fibrillation (AF) compared with ventricular (VVIR) in sinus node dysfunction (SND). However, DDDR often results prolonged QRS durations (QRSd) as the result of right stimulation, desynchronization result. The effect pacing-induced patients normal baseline QRSd is unknown. Methods Results— Baseline was obtained from 12-lead ECGs before pacemaker implantation MOST, a 2010-patient, 6-year,...
Patients with heart failure who receive an implantable cardioverter-defibrillator (ICD) for primary prevention (i.e., of a first life-threatening arrhythmic event) may later therapeutic shocks from the ICD. Information about long-term prognosis after ICD therapy in such patients is limited.Of 829 were randomly assigned to therapy, we implanted 811. that followed onset ventricular tachycardia or fibrillation considered be appropriate. All other inappropriate.Over median follow-up period 45.5...
Many patients have symptoms suggestive of coronary artery disease (CAD) and are often evaluated with the use diagnostic testing, although there limited data from randomized trials to guide care.
The prognosis of patients hospitalized with acute myocardial ischemia is quite variable. We examined the value serum levels cardiac troponin T, creatine kinase MB (CK-MB) levels, and electrocardiographic abnormalities for risk stratification in ischemia.
Background Despite remarkable advances in the treatment of acute myocardial infarction, substantial early patient mortality remains. Appropriate choices among alternative therapies and use clinical resources depend on an estimate patient’s risk. Individual patients reflect a combination features that influence prognosis, these factors must be appropriately weighted to produce accurate assessment Prior studies define prognosis either were performed before widespread thrombolysis or limited...
<h3>Importance</h3>Studies in experimental and human heart failure suggest that phosphodiesterase-5 inhibitors may enhance cardiovascular function thus exercise capacity with preserved ejection fraction (HFPEF).<h3>Objective</h3>To determine the effect of inhibitor sildenafil compared placebo on clinical status HFPEF.<h3>Design</h3>Multicenter, double-blind, placebo-controlled, parallel-group, randomized trial 216 stable outpatients HF, ≥50%, elevated N-terminal brain-type natriuretic...
We compared the efficacy of immediate coronary angioplasty after acute myocardial infarction with that elective at 7 to 10 days in patients treated initially intravenous tissue plasminogen activator. The activator (150 mg) was administered 2.95±1.1 hours onset symptoms, 386 infarction. Ninety minutes later, patency artery serving area infarct demonstrated by angiography 288 (75 percent). Bleeding problems were frequently encountered, as evidenced an average drop hematocrit 11.7±6.5 points...
Background —Appropriate treatment policies should include an accurate estimate of a patient’s baseline risk. Risk modeling to date has been underutilized in patients with acute coronary syndromes without persistent ST-segment elevation. Methods and Results —We analyzed the relation between characteristics 30-day incidence death composite or myocardial (re)infarction 9461 elevation enrolled PURSUIT trial [Platelet glycoprotein IIb/IIIa Unstable angina: Receptor Suppression Using Integrilin...
The survival benefit of a strategy coronary-artery bypass grafting (CABG) added to guideline-directed medical therapy, as compared with therapy alone, in patients coronary artery disease, heart failure, and severe left ventricular systolic dysfunction remains unclear.
Ultrafiltration is an alternative strategy to diuretic therapy for the treatment of patients with acute decompensated heart failure. Little known about efficacy and safety ultrafiltration in failure complicated by persistent congestion worsened renal function.We randomly assigned a total 188 failure, function, stepped pharmacologic (94 patients) or patients). The primary end point was bivariate change from baseline serum creatinine level body weight, as assessed 96 hours after random...
The treadmill exercise test identifies patients with different degrees of risk death from cardiovascular events. We devised a prognostic score, based on the results testing, that accurately predicts outcome among inpatients referred for cardiac catheterization. This study was designed to determine whether this score could also predict prognosis in unselected outpatients.
Directional coronary atherectomy is a new technique of revascularization by which atherosclerotic plaque excised and retrieved from target lesions. With respect to the rate restenosis clinical outcomes, it not known how this procedure compares with balloon angioplasty, relies on dilation vessel wall. We compared after angioplasty that atherectomy.
Surgical ventricular reconstruction is a specific procedure designed to reduce left volume in patients with heart failure caused by coronary artery disease. We conducted trial address the question of whether surgical added coronary-artery bypass grafting (CABG) would decrease rate death or hospitalization for cardiac causes, as compared CABG alone.Between September 2002 and January 2006, total 1000 an ejection fraction 35% less, disease that was amenable CABG, dominant anterior dysfunction...
Type A behavior pattern was assessed using the structured interview and hostility level a subscale of Minnesota Multiphase Personality Inventory in 424 patients who underwent diagnostic coronary arteriography for suspected heart disease. In contrast to non-Type patients, significantly greater proportion had at least one artery with clinically significant occlusion 75% or greater. addition, only 48% those very low scores (less than equal 10) on Hostility scale exhibited occlusion; contrast,...
<h3>Importance</h3> Catheter ablation is more effective than drug therapy in restoring sinus rhythm patients with atrial fibrillation (AF), but its incremental effect on long-term quality of life (QOL) uncertain. <h3>Objective</h3> To determine whether catheter beneficial conventional for improving QOL AF. <h3>Design, Setting, and Participants</h3> An open-label randomized clinical trial vs 2204 symptomatic AF older 65 years or younger at least 1 risk factor stroke. Patients were enrolled...
<h3>Importance</h3> Small studies suggest that low-dose dopamine or nesiritide may enhance decongestion and preserve renal function in patients with acute heart failure dysfunction; however, neither strategy has been rigorously tested. <h3>Objective</h3> To test the 2 independent hypotheses that, compared placebo, addition of (2 μg/kg/min) (0.005 μg/kg/min without bolus) to diuretic therapy will dysfunction. <h3>Design, Setting, Participants</h3> Multicenter, double-blind, placebo-controlled...
Optimal management of patients with stable chest pain relies on the prognostic information provided by noninvasive cardiovascular testing, but there are limited data from randomized trials comparing anatomic functional testing.