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Ciccarone Articles

Ciccarone Center Research

Topic

Vascular Imaging

Landmark Article

Combined cardiac magnetic resonance imaging and C-reactive protein levels identify a cohort at low risk for defibrillator firings and death.
By: Wu KC, Gerstenblith G, Guallar E, Marine JE, Dalal D, Cheng A, Marbán E, Lima JA, Tomaselli GF, Weiss RG.
Annually, ~80,000 Americans receive guideline-based primary prevention implantable cardioverter-defibrillators (ICDs), but appropriate firing rates are low. In a cohort of primary prevention ICD candidates, combining a myocardial heterogeneity index with an inflammatory biomarker identified a subgroup with a very low risk for adverse cardiac events, including ventricular arrhythmias. This novel approach warrants further investigation to confirm its value as a clinical risk stratification tool.
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Allopurinol acutely increases adenosine triphosphate energy delivery in failing human hearts.
By: Hirsch GA, Bottomley PA, Gerstenblith G, Weiss RG.
Intravenous administration of the XO inhibitor allopurinol acutely improves the relative and absolute concentrations of myocardial high-energy phosphates and ATP flux through creatine kinase (CK) in the failing human heart, offering direct evidence that myofibrillar CK energy delivery can be pharmaceutically augmented in the failing human heart.
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Creatine kinase-mediated improvement of function in failing mouse hearts provides causal evidence the failing heart is energy starved.
By: Gupta A, Akki A, Wang Y, Leppo MK, Chacko VP, Foster DB, Caceres V, Shi S, Kirk JA, Su J, Lai S, Paolocci N, Steenbergen C, Gerstenblith G, Weiss RG.
It has long been hypothesized that reduced energy delivery contributes to the contractile dysfunction of heart failure (HF). These observations provide direct evidence that the failing heart is “energy starved” as it relates to cardiac CK. In addition, these data identify CK as a promising therapeutic target for preventing and treating HF and possibly diseases involving energy-dependent dysfunction in other organs with temporally varying energy demands.
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Longitudinal predictors of progression of carotid atherosclerosis in rheumatoid arthritis.
By: Giles JT, Post WS, Blumenthal RS, Polak J, Petri M, Gelber AC, Szklo M, Bathon JM.
These prospective data provide evidence that inflammation is a contributor to the progression of subclinical atherosclerosis in rheumatoid arthritis and that it is potentially modified favorably by tumor necrosis factor inhibitors and detrimentally by glucocorticoids.
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Vascular imaging.
By: Ratchford EV.

Vascular imaging has now become routine in many echocardiography laboratories. With increasing recognition of the systemic nature of atherosclerosis, cardiologists are becoming more involved in imaging outside the heart both for clinical and research purposes.

The relationship of insulin resistance and extracoronary calcification in the multi-ethnic study of atherosclerosis.
By: Tison GH, Blaha MJ, Budoff MJ, Katz R, Rivera JJ, Bertoni AG, Wong ND, Blumenthal RS, Szklo M, Eng J, Tracy R, Nasir K.
The homeostasis model assessment of insulin resistance has a positive and graded association with extra-coronary calcification, but not independently of cardiovascular risk factors, particularly metabolic syndrome components.
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The relationship of insulin resistance and extracoronary calcification in the multi-ethnic study of atherosclerosis.
By: Tison GH, Blaha MJ, Budoff MJ, Katz R, Rivera JJ, Bertoni AG, Wong ND, Blumenthal RS, Szklo M, Eng J, Tracy R, Nasir K.
We hypothesized that insulin resistance, measured by the homeostasis model assessment of insulin resistance (HOMA-IR), is independently associated with prevalent and incident extra-coronary calcification (ECC). We concluded that HOMA has a positive and graded association with ECC, but not independently of cardiovascular risk factors, particularly metabolic syndrome components.
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Localized calcific constrictive pericarditis masquerading as a basal aneurysm.
By: Blaha MJ, Panjrath G, Chacko M, Schulman SP.
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Relation of mitral annular calcium and coronary calcium (from the Multi-Ethnic Study of Atherosclerosis [MESA]).
By: Hamirani YS, Nasir K, Blumenthal RS, Takasu J, Shavelle D, Kronmal R, Budoff M.
Atherosclerosis is a complex diffuse disorder. The close correlation between CAC score on computed tomography and extent and severity of coronary atherosclerosis is well established. It has been suggested that mitral annular calcification (MAC) may be a manifestation of generalized atherosclerosis. We observed a strong association between MAC and increasing burden of CAC. This association weakened but persisted after adjustment for age, gender, and other traditional risk factors. These findings suggest that presence of MAC is an indicator of atherosclerotic burden rather than just a degenerative change of the mitral valve.
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Association of left ventricular hypertrophy with incident hypertension: the multi-ethnic study of atherosclerosis.
By: Shimbo D, Muntner P, Mann D, Barr RG, Tang W, Post W, Lima J, Burke G, Bluemke D, Shea S.
Increased LV mass and changes in LV geometry may precede hypertension onset. The authors examined the associations of LV mass and geometry, assessed by cardiac magnetic resonance imaging, with hypertension incidence in 2,567 normotensive participants enrolled in 2000-2002 in MESA. Higher levels of LV concentric geometry, defined by higher LV mass to end-diastolic volume quartiles, were associated with higher risk of incident hypertension in a fully adjusted model. In a final model containing both quartiles of LV mass and LV mass/volume, along with all covariates including baseline blood pressure, higher LV mass quartiles were associated with incident hypertension, whereas higher LV mass/volume quartiles were not. In this multiethnic cohort, alterations in LV mass preceded hypertension onset among normotensive individuals.
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