A5027929490- Heart Failure Treatment and Management
- Cardiovascular Function and Risk Factors
- Cardiovascular and exercise physiology
- Cardiac pacing and defibrillation studies
- Cardiac electrophysiology and arrhythmias
- Blood Pressure and Hypertension Studies
- Mechanical Circulatory Support Devices
- Cardiac Structural Anomalies and Repair
- Cardiac Imaging and Diagnostics
- Hemodynamic Monitoring and Therapy
- Heart Rate Variability and Autonomic Control
- Cardiac Valve Diseases and Treatments
- Cardiac Arrest and Resuscitation
- Acute Myocardial Infarction Research
- Nitric Oxide and Endothelin Effects
- Atrial Fibrillation Management and Outcomes
- Cardiac, Anesthesia and Surgical Outcomes
- Cardiac Arrhythmias and Treatments
- Cardiovascular Health and Disease Prevention
- Pulmonary Hypertension Research and Treatments
- Cardiovascular Effects of Exercise
- Renin-Angiotensin System Studies
- Pericarditis and Cardiac Tamponade
- Cardiomyopathy and Myosin Studies
- Cardiovascular Disease and Adiposity
Tulane University
2011-2023
Tulane Medical Center
2006-2011
Columbia University
1992-2008
Albert Einstein College of Medicine
1995-2005
Lille’s Cardiology Hospital
2005
Montefiore Medical Center
1986-2004
New York Hospital Queens
2004
NewYork–Presbyterian Hospital
1995-2004
Yeshiva University
1981-2004
Harvard University Press
2002
The leading cause of death in patients hospitalized for acute myocardial infarction is cardiogenic shock. We conducted a randomized trial to evaluate early revascularization with
Intravenous infusion of nesiritide, a brain (B-type) natriuretic peptide, has beneficial hemodynamic effects in patients with decompensated congestive heart failure. We investigated the clinical use nesiritide such patients.
Background Carvedilol has improved the symptomatic status of patients with moderate to severe heart failure in single-center studies, but its clinical effects have not been evaluated large, multicenter trials. Methods and Results We enrolled 278 (6-minute walk distance, 150 450 m) a left ventricular ejection fraction ≤0.35 at 31 centers. After an open-label, run-in period, each patient was randomly assigned (double-blind) either placebo (n=145) or carvedilol (n=133; target dose, 25 50 mg...
Background— Indirect evidence implicates endothelial dysfunction in the pathogenesis of vascular diseases associated with obstructive sleep apnea (OSA). We investigated directly whether and inflammation occur vivo endothelium patients OSA. The effects continuous positive airway pressure (CPAP) therapy on function repair capacity were assessed. Methods Results— Thirty-two newly diagnosed OSA 15 control subjects studied. Proteins that regulate basal nitric oxide (NO) production (endothelial NO...
We determined the short-term hemodynamic and clinical effects of levosimendan, a novel calcium-sensitizing agent, in patients with decompensated heart failure.One hundred forty-six New York Heart Association functional class III or IV failure (mean left ventricular ejection fraction 21+/-1%) who had pulmonary capillary wedge pressure >/=15 mm Hg cardiac index </=2.5 L x min(-1) m(-2) were enrolled multicenter, double-blind, placebo-controlled study randomized 2:1 to intravenous infusion...
Background Cardiogenic shock remains the leading cause of death patients hospitalized with acute myocardial infarction (MI). This study was conducted to examine (1) current spectrum cardiogenic shock, (2) proportion who are potential candidates for a trial early revascularization, and (3) apparent impact revascularization on mortality. Methods Results Nineteen participating centers in United States Belgium prospectively registered all diagnosed shock. Two hundred fifty-one were registered....
BACKGROUND Losartan is a new specific angiotensin II receptor antagonist with no agonist properties that provides the opportunity to study consequences of blockade. The objective present was evaluate hemodynamic and neurohormonal response losartan in patients congestive heart failure. METHODS AND RESULTS After baseline measurements using balloon-tipped pulmonary artery radial arterial catheters, were randomized receive single dose placebo or 5, 10, 25, 75, 150 mg double-blind, sequential...
The SHould we emergently revascularize Occluded Coronaries in cardiogenic shocK (SHOCK) Trial showed no benefit of early revascularization patients aged >/=75 years with acute myocardial infarction and shock. We examined the effect age on treatment outcomes shock SHOCK Registry.We compared clinical factors Registry due to pump failure <75 (n=588) (n=277), 30-day mortality treated <18 hours since onset those undergoing a later or procedure. After excluding deaths covariate-adjusted relative...
The renin-angiotensin system is thought to maintain elevated systemic vascular resistance in heart failure. hemodynamic effects of captopril (SQ 14225), an oral inhibitor angiotensin-converting enzyme, were measured 10 patients with stable congestive failure poorly controlled by digitalis and diuretics. At single daily doses 25 150 mg, the cardiac index rose from 1.75 +/- 0.18 2.27 0.39 (mean S.D.) liters per minute square meter (P less than 0.001), pulmonary-wedge pressure fell 26.5 7.5...
Lower limb blood flow, oxygen uptake, and femoral vein O2 content were measured at rest during maximal bicycle exercise, performed with two legs one leg, in four normal subjects five patients severe congestive heart failure. While flow lower vascular conductance significantly greater one-leg exercise than two-leg (6084 +/- 745 vs 5370 803 ml/min, p less .05, 52.3 8.0 45.1 8.2 U X 10(3), respectively), failure these values similar the forms of (1082 459 1053 479 ml/min 9.6 3.7 9.4 3.5...
The dynamics between mitral anulus motion, and, thus, motion of the base heart, and filling left atrium ventricle were studied by Doppler echocardiography in 12 normal subjects 28 patients with dilated cardiomyopathy. is associated two phases inflow from pulmonary veins. first phase (J) venous occurs during ventricular systole, concomitant descent toward apex, extent which 12.8 +/- 1.4 mm. end at cessation aortic ejection. About 100 msec later, a rapid recoil coincides onset transmitral...
BACKGROUND The vasodilatory response to intra-arterial administration of acetylcholine is reduced in patients with congestive heart failure compared that normal subjects. may be related decreased endothelial release nitric oxide, interaction peripheral alpha-adrenergic transmission, or production cyclooxygenase-dependent vasoconstricting substances. extent which each these mechanisms contributes the not known. METHODS AND RESULTS Thirty-one (New York Heart Association functional class...
BACKGROUND Tumor necrosis factor-alpha (TNF alpha), which we and others have shown to be elevated in patients with severe congestive heart failure (CHF), is involved the regulation of nitric oxide metabolism. Whether increased concentrations TNF alpha affect oxide-mediated vasodilation CHF has not been studied previously. METHODS AND RESULTS Serum alpha, interleukin-1 (IL-1), interleukin-2 (IL-2), interleukin-6 (IL-6) were determined venous blood (pg/mL) from 17 stable New York Heart...
Background: Many patients remain markedly symptomatic despite optimal current therapy for heart failure. Beta-blockers have often been viewed as contraindicated in this group because of their potential adverse short-term effects on cardiac function. Methods and Results: One hundred thirty-one with severe congestive failure were enrolled into a double-blind, placebo-controlled study the vasodilating beta-blocker carvedilol. All had symptomatic, advanced while standard triple therapy,...
Chronic congestive heart failure not controlled by conventional therapy was treated with intravenous amrinone, a new non-glycosidic, non-catecholamine cardiotonic agent. Eight patients New York Heart Association functional class III-IV symptoms were hemodynamically monitored. At peak effect, cardiac index (CI) increased from 1.84 +/- 0.32 to 2.74 0.44 l/min/m2 (mean SD) (p less than 0.001) and left ventricular filling pressure (LVFP) decreased 25.8 6.2 19.5 6.8 mm Hg 0.05), while rate mean...
The effects of amrinone, dobutamine, and a combination the two drugs on peak positive left ventricular dP/dt performance were evaluated in 11 patients with chronic congestive heart failure. When administered alone, both dobutamine (10.9 micrograms/kg/min) intravenous amrinone (1.9 mg/kg/min) significantly increased performance. compared addition resulted further increases cardiac index (to 1319 +/- 419 from 1202 376 mm Hg/sec, p less than .002, to 3.56 0.78 3.04 0.67 liters/min/m2, .01,...