Scholars@Duke
Mihai V. Podgoreanu

Mihai V. Podgoreanu

Associate Professor of Anesthesiology
Anesthesiology, Cardiothoracic
mihai.podgoreanu@duke.edu
Box 3094 DUMC, Durham, NC 27710
DUMC, Anesthesiology Box 3094, Box 3094, Durham, NC 27710

Selected Publications

Right Ventricle-Pulmonary Artery Coupling in Patients Undergoing Cardiac Interventions.

Journal Article Curr Cardiol Rep · June 2024 PURPOSE OF REVIEW: This review aims to summarize the fundamentals of RV-PA coupling, its non-invasive means of measurement, and contemporary understanding of RV-PA coupling in cardiac surgery, cardiac interventions, and congenital heart disease. RECENT FIN ... Full text Link to item Cite

Reduce intraoperative albumin utilisation in cardiac surgical patients: a quality improvement initiative.

Journal Article BMJ Open Qual · April 24, 2024 BACKGROUND: Albumin continues to be used routinely by cardiac anaesthesiologists perioperatively despite lack of evidence for improved outcomes. The Multicenter Perioperative Outcomes Group (MPOG) data ranked our institution as one of the highest intraoper ... Full text Link to item Cite

The Role of Recipient Thyroid Hormone Supplementation in Primary Graft Dysfunction After Heart Transplantation: A Propensity-Adjusted Analysis.

Journal Article J Cardiothorac Vasc Anesth · November 2023 OBJECTIVES: To investigate whether recipient administration of thyroid hormone (liothyronine [T3]) is associated with reduced rates of primary graft dysfunction (PGD) after orthotopic heart transplantation. DESIGN: Retrospective cohort study. SETTING: Sing ... Full text Link to item Cite

Splanchnic Nerve Modulation Effects on Surrogate Measures of Venous Capacitance.

Journal Article J Am Heart Assoc · July 18, 2023 Background Splanchnic nerve modulation (SNM) is an emerging procedure to reduce cardiac filling pressures in heart failure. Although the main contributor to reduction in cardiac preload is thought to be increased venous capacitance in the splanchnic circul ... Full text Link to item Cite

Predictive capabilities of the European registry for patients with mechanical circulatory support right-sided heart failure risk score after left ventricular assist device implantation.

Journal Article J Cardiothorac Vasc Anesth · October 2022 OBJECTIVES: The prediction of right heart failure (RHF) after left ventricular assist device (LVAD) implantation remains a challenge. Recently, risk scores were derived from analysis of the European Registry for Patients with Mechanical Circulatory Support ... Full text Link to item Cite

Conventional Ultrafiltration During Elective Cardiac Surgery and Postoperative Acute Kidney Injury.

Journal Article J Cardiothorac Vasc Anesth · May 2021 OBJECTIVE: Conventional ultrafiltration (CUF) during cardiopulmonary bypass (CPB) serves to hemoconcentrate blood volume to avoid allogeneic blood transfusions. Previous studies have determined CUF volumes as a continuous variable are associated with posto ... Full text Open Access Link to item Cite

Bedside Allogeneic Erythrocyte Washing with a Cell Saver to Remove Cytokines, Chemokines, and Cell-derived Microvesicles.

Journal Article Anesthesiology · March 1, 2021 BACKGROUND: Removal of cytokines, chemokines, and microvesicles from the supernatant of allogeneic erythrocytes may help mitigate adverse transfusion reactions. Blood bank-based washing procedures present logistical difficulties; therefore, we tested the h ... Full text Link to item Cite

Apolipoprotein L1 (APOL1) Coding Variants Are Associated With Creatinine Rise After Cardiac Surgery.

Journal Article J Cardiothorac Vasc Anesth · December 2020 OBJECTIVE: Acute kidney injury (AKI) is a complication of cardiac surgery that is considerably more common in African Americans (1.5-fold). Although homozygous status for apolipoprotein L1 (APOL1) risk alleles is associated with chronic kidney disease in i ... Full text Link to item Cite

Association between primary graft dysfunction and acute kidney injury after orthotopic heart transplantation - a retrospective, observational cohort study.

Journal Article Transpl Int · August 2020 Acute kidney injury (AKI) and primary graft dysfunction (PGD) are serious complications after heart transplantation (HT). The relationship between AKI and PGD is poorly understood. We sought to examine the incidence of AKI and identify risk factors associa ... Full text Link to item Cite

Stellate Ganglion Blockade for the Treatment of Refractory Ventricular Arrhythmias.

Journal Article JACC Clin Electrophysiol · May 2020 OBJECTIVES: This study sought to describe our institutional experience with establishing a neurocardiology service in an attempt to provide autonomic modulation as a treatment for ventricular arrhythmias (VAs). BACKGROUND: Treatment-refractory VAs are comm ... Full text Link to item Cite

EUROMACS-RHF Risk Score and 3D Echocardiography as Predictors of Right Heart Failure after Left Ventricular Assist Device Implantation

Conference The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · April 1, 2020 PURPOSE: Right heart failure (RHF) after LVAD implantation is associated with significant morbidity and mortality. Recently, the EUROMACS-RHF risk score was developed to predict postoperative RHF in this setting. In a single-center analysis, we assessed th ... Full text Cite

Intravenous Lidocaine Does Not Improve Neurologic Outcomes after Cardiac Surgery: A Randomized Controlled Trial.

Journal Article Anesthesiology · June 2019 BACKGROUND: Cognitive decline after cardiac surgery occurs frequently and persists in a significant proportion of patients. Preclinical studies and human trials suggest that intravenous lidocaine may confer protection in the setting of neurologic injury. I ... Full text Open Access Link to item Cite

Contribution of Baroreceptor Function to Pain Perception and Perioperative Outcomes.

Journal Article Anesthesiology · April 2019 Baroreceptors are mechanosensitive elements of the peripheral nervous system that maintain homeostasis by coordinating physiologic responses to external and internal stimuli. While it is recognized that carotid and cardiopulmonary baroreceptor reflexes mod ... Full text Link to item Cite

Temporary autonomic modulation with botulinum toxin type A to reduce atrial fibrillation after cardiac surgery.

Journal Article Heart Rhythm · February 2019 BACKGROUND: Postoperative atrial fibrillation (POAF) frequently complicates cardiac surgery and is associated with worse outcomes. The cardiac autonomic nervous system is implicated in the pathogenesis of POAF. OBJECTIVE: The purpose of this study was to d ... Full text Link to item Cite

Transplanting a heart with a persistent left superior vena cava.

Journal Article J Thorac Cardiovasc Surg · February 2019 Full text Link to item Cite

Annexin A1 Bioactive Peptide Promotes Resolution of Neuroinflammation in a Rat Model of Exsanguinating Cardiac Arrest Treated by Emergency Preservation and Resuscitation.

Journal Article Front Neurosci · 2019 Neuroinflammation initiated by damage-associated molecular patterns, including high mobility group box 1 protein (HMGB1), has been implicated in adverse neurological outcomes following lethal hemorrhagic shock and polytrauma. Emergency preservation and res ... Full text Link to item Cite

Genome-Wide Association Study Links Receptor Tyrosine Kinase Inhibitor Sprouty 2 to Thrombocytopenia after Coronary Artery Bypass Surgery.

Conference Thromb Haemost · September 2018 INTRODUCTION:  Thrombocytopenia after cardiac surgery independently predicts stroke, acute kidney injury and death. To understand the underlying risks and mechanisms, we analysed genetic variations associated with thrombocytopenia in patients undergoing co ... Full text Link to item Cite

Predictive ability of perioperative atrial fibrillation risk indices in cardiac surgery patients: a retrospective cohort study.

Journal Article Can J Anaesth · July 2018 PURPOSE: The Multicenter Study of Perioperative Ischemia (McSPI) AFRisk index predicts postoperative atrial fibrillation (POAF) after cardiac surgery, but requires pre-, intra-, and postoperative data. Other more abbreviated risk indices exist, but there i ... Full text Link to item Cite

Primary graft dysfunction after heart transplantation: Incidence, trends, and associated risk factors.

Journal Article Am J Transplant · June 2018 Changes in heart transplantation (HT) donor and recipient demographics may influence the incidence of primary graft dysfunction (PGD). We conducted a retrospective study to evaluate PGD incidence, trends, and associated risk factors by analyzing consecutiv ... Full text Link to item Cite

Pre- and postoperative anemia, acute kidney injury, and mortality after coronary artery bypass grafting surgery: a retrospective observational study.

Journal Article Can J Anaesth · January 2018 BACKGROUND: Preoperative and postoperative anemia have been identified individually as potential risk factors for postoperative complications after coronary artery bypass grafting (CABG) surgery. Their interrelationship with acute kidney injury (AKI) and l ... Full text Link to item Cite

Perioperative Genomics

Chapter · January 1, 2018 Preliminary candidate gene and genome-wide association studies (GWAS) suggest that susceptibility to adverse perioperative events, including cardiac (myocardial infarction, ventricular dysfunction, atrial fibrillation), neurologic, and renal (among others) ... Full text Cite

Platelet Counts and Postoperative Stroke After Coronary Artery Bypass Grafting Surgery.

Journal Article Anesth Analg · October 2017 BACKGROUND: Declining platelet counts may reveal platelet activation and aggregation in a postoperative prothrombotic state. Therefore, we hypothesized that nadir platelet counts after on-pump coronary artery bypass grafting (CABG) surgery are associated w ... Full text Open Access Link to item Cite

Angiotensin Receptor Blockade Improves Cardiac Surgical Outcomes in Patients With Metabolic Syndrome.

Journal Article Ann Thorac Surg · July 2017 BACKGROUND: Perioperative use of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEis) in patients undergoing cardiac operations remains controversial. The current practice of discontinuing renin-angiotensin-system inhib ... Full text Link to item Cite

Association between CK-MB Area Under the Curve and Tranexamic Acid Utilization in Patients Undergoing Coronary Artery Bypass Surgery.

Journal Article J Thromb Thrombolysis · May 2017 Myonecrosis after coronary artery bypass graft (CABG) surgery is associated with excess mortality. Tranexamic acid (TA), an anti-fibrinolytic agent, has been shown to reduce peri-operative blood loss without increasing the risk of myocardial infarction (MI ... Full text Open Access Link to item Cite

Neuroprotective Effects of Annexin A1 Tripeptide after Deep Hypothermic Circulatory Arrest in Rats.

Journal Article Front Immunol · 2017 Resolution agonists, including lipid mediators and peptides such as annexin A1 (ANXA1), are providing novel approaches to treat inflammatory conditions. Surgical trauma exerts a significant burden on the immune system that can affect and impair multiple or ... Full text Link to item Cite

Effect of intravenous lidocaine on the transcerebral inflammatory response during cardiac surgery: a randomized-controlled trial.

Journal Article Can J Anaesth · November 2016 PURPOSE: Postoperative cognitive dysfunction (POCD) occurs frequently after cardiac surgery. The pathophysiology of POCD remains elusive, but previous work showed that intravenous lidocaine may be protective against POCD, possibly by modulating cerebral in ... Full text Link to item Cite

In Reply.

Journal Article Anesthesiology · August 2016 Full text Link to item Cite

Proteomic Profiling Reveals Adaptive Responses to Surgical Myocardial Ischemia-Reperfusion in Hibernating Arctic Ground Squirrels Compared to Rats.

Journal Article Anesthesiology · June 2016 BACKGROUND: Hibernation is an adaptation to extreme environments known to provide organ protection against ischemia-reperfusion (I/R) injury. An unbiased systems approach was utilized to investigate hibernation-induced changes that are characteristic of th ... Full text Link to item Cite

Interleukin-1β gene variants are associated with QTc interval prolongation following cardiac surgery: a prospective observational study.

Journal Article Can J Anaesth · April 2016 BACKGROUND: We characterized cardiac surgery-induced dynamic changes of the corrected QT (QTc) interval and tested the hypothesis that genetic factors are associated with perioperative QTc prolongation independent of clinical and procedural factors. METHOD ... Full text Open Access Link to item Cite

Gene signatures of postoperative atrial fibrillation in atrial tissue after coronary artery bypass grafting surgery in patients receiving β-blockers.

Journal Article J Mol Cell Cardiol · March 2016 Atrial tissue gene expression profiling may help to determine how differentially expressed genes in the human atrium before cardiopulmonary bypass (CPB) are related to subsequent biologic pathway activation patterns, and whether specific expression profile ... Full text Link to item Cite

Platelet Counts, Acute Kidney Injury, and Mortality after Coronary Artery Bypass Grafting Surgery.

Journal Article Anesthesiology · February 2016 BACKGROUND: Cardiac surgery requiring cardiopulmonary bypass is associated with platelet activation. Because platelets are increasingly recognized as important effectors of ischemia and end-organ inflammatory injury, the authors explored whether postoperat ... Full text Open Access Link to item Cite

Genome-wide association study of acute kidney injury after coronary bypass graft surgery identifies susceptibility loci.

Journal Article Kidney Int · October 2015 Acute kidney injury (AKI) is a common, serious complication of cardiac surgery. Since prior studies have supported a genetic basis for postoperative AKI, we conducted a genome-wide association study (GWAS) for AKI following coronary bypass graft (CABG) sur ... Full text Open Access Link to item Cite

Intraoperative Magnesium Administration Does Not Reduce Postoperative Atrial Fibrillation After Cardiac Surgery.

Journal Article Anesth Analg · October 2015 BACKGROUND: Hypomagnesemia has been associated with an increased risk of postoperative atrial fibrillation (POAF). Although previous studies have suggested a beneficial effect of magnesium (Mg) therapy, almost all of these are limited by small sample size ... Full text Link to item Cite

Genome-wide association study of new-onset atrial fibrillation after coronary artery bypass grafting surgery.

Journal Article Am Heart J · September 2015 BACKGROUND: Postoperative atrial fibrillation (AF) is a potentially life-threatening complication after coronary artery bypass graft (CABG) surgery. Genetic predisposition may predict risk for developing postoperative AF. METHODS: Study subjects underwent ... Full text Link to item Cite

Apolipoprotein epsilon 4 genotype is associated with less improvement in cognitive function five years after cardiac surgery: a retrospective cohort study.

Journal Article Can J Anaesth · June 2015 PURPOSE: Cognitive performance after cardiac surgery can be impaired, and genetic risk factors have previously been suggested. When compared with other isoforms of the gene, the apolipoprotein epsilon 4 (APOE4) allele is associated with worse outcomes in m ... Full text Link to item Cite

Genome-wide association study of perioperative myocardial infarction after coronary artery bypass surgery.

Journal Article BMJ Open · May 6, 2015 OBJECTIVES: Identification of patient subpopulations susceptible to develop myocardial infarction (MI) or, conversely, those displaying either intrinsic cardioprotective phenotypes or highly responsive to protective interventions remain high-priority knowl ... Full text Open Access Link to item Cite

Effects of deep hypothermic circulatory arrest on the blood brain barrier in a cardiopulmonary bypass model--a pilot study.

Journal Article Heart Lung Circ · October 2014 BACKGROUND: Neurologic injury is common after cardiac surgery and disruption of the blood brain barrier (BBB) has been proposed as a contributing factor. We sought to study BBB characteristics in a rodent model of cardiopulmonary bypass (CPB) and deep hypo ... Full text Link to item Cite

G protein-coupled receptor kinase 5 gene polymorphisms are associated with postoperative atrial fibrillation after coronary artery bypass grafting in patients receiving β-blockers.

Other Circ Cardiovasc Genet · October 2014 BACKGROUND: We hypothesized that genetic variations in the adrenergic signaling pathway and cytochrome P450 2D6 enzyme are associated with new-onset atrial fibrillation (AF) in patients who underwent coronary artery bypass grafting and were treated with pe ... Full text Link to item Cite

Organ protective mechanisms common to extremes of physiology: a window through hibernation biology.

Journal Article Integr Comp Biol · September 2014 Supply and demand relationships govern survival of animals in the wild and are also key determinants of clinical outcomes in critically ill patients. Most animals' survival strategies focus on the supply side of the equation by pursuing territory and resou ... Full text Link to item Cite

Effect of pregabalin on cerebral outcome after cardiopulmonary bypass with deep hypothermic circulatory arrest in rats.

Journal Article J Thorac Cardiovasc Surg · July 2014 OBJECTIVE: Activation of presynaptic voltage-gated calcium channels and release of glutamate play a central role in neuronal necrosis after cardiopulmonary bypass with deep hypothermic circulatory arrest. Pregabalin binds to the α2-δ subunit of voltage-gat ... Full text Link to item Cite

Arterial hyperoxia during cardiopulmonary bypass and postoperative cognitive dysfunction.

Journal Article J Cardiothorac Vasc Anesth · June 2014 OBJECTIVE: To determine the effect of arterial normobaric hyperoxia during cardiopulmonary bypass (CPB) on postoperative neurocognitive function. The authors hypothesized that arterial hyperoxia during CPB is associated with neurocognitive decline at 6 wee ... Full text Link to item Cite

Preoperative CYP2D6 metabolism-dependent β-blocker use and mortality after coronary artery bypass grafting surgery.

Journal Article J Thorac Cardiovasc Surg · April 2014 OBJECTIVE: Recently, the role of β-blockers (BBs) in reducing perioperative mortality has been challenged. The conflicting results might have resulted from the extent of BB metabolism by the cytochrome P-450 (CYP2D6) isoenzyme. The purpose of the present s ... Full text Open Access Link to item Cite

A genome-wide association study of variants associated with acquisition of Staphylococcus aureus bacteremia in a healthcare setting.

Journal Article BMC Infect Dis · February 13, 2014 BACKGROUND: Humans vary in their susceptibility to acquiring Staphylococcus aureus infection, and research suggests that there is a genetic basis for this variability. Several recent genome-wide association studies (GWAS) have identified variants that may ... Full text Open Access Link to item Cite

Intraoperative magnesium administration does not improve neurocognitive function after cardiac surgery.

Journal Article Stroke · December 2013 BACKGROUND AND PURPOSE: Neurocognitive decline occurs frequently after cardiac surgery and persists in a significant number of patients. Magnesium is thought to provide neuroprotection by preservation of cellular energy metabolism, blockade of the N-methyl ... Full text Link to item Cite

Perioperative Genomics

Journal Article · August 29, 2013 Full text Cite

Genomic Basis of Perioperative Medicine

Chapter · April 15, 2013 "The Handbook of Clinical Anesthesia, Seventh Edition, is a companion to the parent textbook, Clinical Anesthesia, Seventh Edition. ... Cite

Predictors of cognitive recovery after cardiac surgery.

Journal Article Anesth Analg · February 2013 BACKGROUND: Postoperative neurocognitive decline occurs frequently. Although predictors of cognitive injury have been well examined, factors that modulate recovery have not. We sought to determine the predictors of cognitive recovery after initial injury f ... Full text Link to item Cite

Perioperative Genomics

Chapter · November 15, 2012 Full text Cite

A comparative evaluation of transesophageal and transthoracic echocardiography for measurement of left ventricular systolic strain using speckle tracking.

Journal Article J Cardiothorac Vasc Anesth · February 2012 OBJECTIVE: The authors hypothesized that the measurement of strain by speckle tracking with transesophageal echocardiography (TEE) is feasible and comparable to transthoracic echocardiography (TTE). DESIGN: A prospective observational comparative study. SE ... Full text Link to item Cite

Cardiac receptors

Chapter · January 1, 2012 Homeostatic regulation of the cardiovascular system relies on the ability of the heart to recognize and respond to many extracellular signaling molecules, including peptides, biogenic amines, steroid hormones, fatty acid derivatives and a variety of other ... Full text Cite

A randomized, double blind, placebo controlled clinical trial of the preoperative use of ketamine for reducing inflammation and pain after thoracic surgery.

Journal Article J Anesth · October 2011 PURPOSE: We hypothesized that patients who received ketamine during thoracic surgery would benefit from suppression of the inflammatory cascade, represented by lower interleukin (IL)-6 and C-reactive protein (CRP) plasma levels. METHODS: This study was a r ... Full text Link to item Cite

Thrombomodulin gene variants are associated with increased mortality after coronary artery bypass surgery in replicated analyses.

Journal Article Circulation · September 13, 2011 BACKGROUND: We tested the hypothesis that genetic variation in thrombotic and inflammatory pathways is independently associated with long-term mortality after coronary artery bypass graft (CABG) surgery. METHODS AND RESULTS: Two separate cohorts of patient ... Full text Link to item Cite

Case 4-2011: malignant hyperthermia in cardiac surgery.

Journal Article J Cardiothorac Vasc Anesth · August 2011 Full text Link to item Cite

Utility of a simple algorithm to grade diastolic dysfunction and predict outcome after coronary artery bypass graft surgery.

Journal Article Ann Thorac Surg · June 2011 BACKGROUND: Inclusion of a measure of left ventricular diastolic dysfunction (LVDD) may improve risk prediction after cardiac surgery. Current LVDD grading guidelines rely on echocardiographic variables that are not always available or aligned to allow gra ... Full text Link to item Cite

Energetics and metabolism in the failing heart: important but poorly understood.

Journal Article Curr Opin Clin Nutr Metab Care · July 2010 PURPOSE OF REVIEW: Profound abnormalities in myocardial energy metabolism occur in heart failure and correlate with clinical symptoms and survival. Available comprehensive human metabolic data come from small studies, enrolling patients across heart failur ... Full text Link to item Cite

Association of the 98T ELAM-1 polymorphism with increased bleeding after cardiac surgery.

Journal Article J Cardiothorac Vasc Anesth · June 2010 OBJECTIVE: Hemorrhage continues to be a major problem after cardiac surgery despite the routine use of antifibrinolytic drugs, with striking inter-patient variability poorly explained by already known risk factors. The authors tested the hypothesis that ge ... Full text Link to item Cite

Rare deletions at 16p13.11 predispose to a diverse spectrum of sporadic epilepsy syndromes.

Journal Article Am J Hum Genet · May 14, 2010 Deletions at 16p13.11 are associated with schizophrenia, mental retardation, and most recently idiopathic generalized epilepsy. To evaluate the role of 16p13.11 deletions, as well as other structural variation, in epilepsy disorders, we used genome-wide sc ... Full text Link to item Cite

Cognitive function after major noncardiac surgery, apolipoprotein E4 genotype, and biomarkers of brain injury.

Other Anesthesiology · April 2010 BACKGROUND: Postoperative cognitive dysfunction (POCD) is a significant cause of morbidity after noncardiac surgery. Identified risk factors are largely limited to demographic characteristics. We hypothesized that POCD was associated with apolipoprotein E4 ... Full text Link to item Cite

Pulse pressure and long-term survival after coronary artery bypass graft surgery.

Journal Article Anesth Analg · February 1, 2010 BACKGROUND: Data from longitudinal studies reveal that widened pulse pressure (PP) is a major predictor of coronary heart disease and mortality, but it is unknown whether PP similarly decreases survival after coronary artery bypass graft (CABG) surgery for ... Full text Link to item Cite

Metabolomic profiling reveals distinct patterns of myocardial substrate use in humans with coronary artery disease or left ventricular dysfunction during surgical ischemia/reperfusion.

Journal Article Circulation · April 7, 2009 Featured Publication BACKGROUND: Human myocardial metabolism has been incompletely characterized in the setting of surgical cardioplegic arrest and ischemia/reperfusion. Furthermore, the effect of preexisting ventricular state on ischemia-induced metabolic derangements has not ... Full text Link to item Cite

Effect of lidocaine on endothelin-1-mediated airway smooth muscle contraction in the rat trachea.

Journal Article Minerva Anestesiol · November 2008 BACKGROUND: Endothelin-1 (ET-1) is a 21-amino acid peptide that induces airway smooth muscle (ASM) constriction by activating G-protein-coupled endothelin receptors A (ETA) and B (ETB), thereby increasing intracellular calcium ([Ca(2+)]i). Lidocaine can ca ... Link to item Cite

Relationship of genetic variability and depressive symptoms to adverse events after coronary artery bypass graft surgery.

Journal Article Psychosom Med · November 2008 Featured Publication OBJECTIVE: To assess genetic variability in two serotonin-related gene polymorphisms (MAOA-uVNTR and 5HTTLPR) and their relationships to depression and adverse cardiac events in a sample of patients undergoing coronary artery bypass surgery. METHODS: A tot ... Full text Link to item Cite

A novel survival model of cardioplegic arrest and cardiopulmonary bypass in rats: a methodology paper.

Journal Article J Cardiothorac Surg · August 19, 2008 Featured Publication BACKGROUND: Given the growing population of cardiac surgery patients with impaired preoperative cardiac function and rapidly expanding surgical techniques, continued efforts to improve myocardial protection strategies are warranted. Prior research is mostl ... Full text Link to item Cite

Pharmacogenomics and end-organ susceptibility to injury in the perioperative period.

Journal Article Best Pract Res Clin Anaesthesiol · March 2008 Featured Publication Genomic medicine has provided new mechanistic understanding for many complex diseases over the last 5-10 years. More recently genomic approaches have been applied to the perioperative paradigm, facilitating identification of patients at high risk for adver ... Full text Link to item Cite

Deterioration of regional wall motion immediately after coronary artery bypass graft surgery is associated with long-term major adverse cardiac events.

Journal Article Anesthesiology · November 2007 Featured Publication BACKGROUND: Patients undergoing coronary artery bypass graft (CABG) surgery frequently develop wall motion abnormalities diagnosed by intraoperative transesophageal echocardiography. However, the relation between deterioration in wall motion and postoperat ... Full text Link to item Cite

Effects of extreme hemodilution during cardiac surgery on cognitive function in the elderly.

Journal Article Anesthesiology · October 2007 BACKGROUND: Strategies for neuroprotection including hypothermia and hemodilution have been routinely practiced since the inception of cardiopulmonary bypass. Yet postoperative neurocognitive deficits that diminish the quality of life of cardiac surgery pa ... Full text Link to item Cite

Genetic variants in P-selectin and C-reactive protein influence susceptibility to cognitive decline after cardiac surgery.

Journal Article J Am Coll Cardiol · May 15, 2007 Featured Publication OBJECTIVES: We hypothesized that candidate gene polymorphisms in biologic pathways regulating inflammation, cell matrix adhesion/interaction, coagulation-thrombosis, lipid metabolism, and vascular reactivity are associated with postoperative cognitive defi ... Full text Link to item Cite

Inflammatory gene polymorphisms and risk of postoperative myocardial infarction after cardiac surgery.

Journal Article Circulation · July 4, 2006 Featured Publication BACKGROUND: The inflammatory response triggered by cardiac surgery with cardiopulmonary bypass (CPB) is a primary mechanism in the pathogenesis of postoperative myocardial infarction (PMI), a multifactorial disorder with significant inter-patient variabili ... Full text Link to item Cite

Case report: optimizing intraoperative detection of pulmonary embolism using contrast-enhanced echocardiography.

Journal Article Can J Anaesth · July 2006 PURPOSE: Perioperative pulmonary embolism (PE) is associated with significant morbidity and mortality. Intraoperatively, the clinical management of patients with PE can be enhanced by the use of transesophageal echocardiography (TEE) to visualize emboli, a ... Full text Link to item Cite

New paradigms in cardiovascular medicine: emerging technologies and practices: perioperative genomics.

Journal Article J Am Coll Cardiol · December 6, 2005 Featured Publication Considerable progress has been made in understanding the pathophysiology of perioperative stress responses and their impact on the cardiovascular system; however, researchers are just beginning to unravel genetic and molecular determinants that predispose ... Full text Link to item Cite

APOE polymorphism is associated with risk of severe sepsis in surgical patients.

Journal Article Crit Care Med · November 2005 Featured Publication OBJECTIVE: To test for an association between apolipoprotein E (APOE) genotypes and the occurrence of severe sepsis in an elective surgical cohort. DESIGN: Prospective, observational, single cohort study. SETTING: Sixteen-bed surgical intensive care unit ( ... Full text Link to item Cite

Genetic polymorphisms and the risk of stroke after cardiac surgery.

Journal Article Stroke · September 2005 Featured Publication BACKGROUND AND PURPOSE: Stroke represents a significant cause of morbidity and mortality after cardiac surgery. Although the risk of stroke varies according to both patient and procedural factors, the impact of genetic variants on stroke risk is not well u ... Full text Link to item Cite

Differential cardiac gene expression during cardiopulmonary bypass: ischemia-independent upregulation of proinflammatory genes.

Journal Article J Thorac Cardiovasc Surg · August 2005 Featured Publication OBJECTIVE: Cardiac surgery with cardiopulmonary bypass induces both systemic and local inflammatory responses implicated in the pathogenesis of myocardial dysfunction. Multifactorial perioperative sources of myocardial injury complicate understanding of th ... Full text Link to item Cite

The new age of medical genomics.

Journal Article Br J Anaesth · August 2005 Featured Publication Full text Link to item Cite

Genetic factors contribute to bleeding after cardiac surgery.

Journal Article J Thromb Haemost · June 2005 Featured Publication BACKGROUND: Postoperative bleeding remains a common, serious problem for cardiac surgery patients, with striking inter-patient variability poorly explained by clinical, procedural, and biological markers. OBJECTIVE: We tested the hypothesis that genetic po ... Full text Link to item Cite

Preoperative statin therapy does not reduce cognitive dysfunction after cardiopulmonary bypass.

Journal Article J Cardiothorac Vasc Anesth · June 2005 OBJECTIVE: The purpose of this study was to determine if patients receiving statin therapy before coronary artery bypass grafting surgery would have less cognitive dysfunction after cardiopulmonary bypass as a consequence of a diminished inflammatory respo ... Full text Link to item Cite

Association of genetic polymorphisms with risk of renal injury after coronary bypass graft surgery.

Journal Article Am J Kidney Dis · March 2005 Featured Publication BACKGROUND: Post-cardiac surgery renal dysfunction is a common, serious, multifactorial disorder, with interpatient variability predicted poorly by preoperative clinical, procedural, and biological markers. Therefore, we tested the hypothesis that selected ... Full text Link to item Cite

Predictors of inotrope use during separation from cardiopulmonary bypass.

Journal Article J Cardiothorac Vasc Anesth · August 2004 OBJECTIVE: To identify the demographic, clinical, and echocardiographic features that predict the use of inotropic support at separation from cardiopulmonary bypass (CPB). DESIGN: Retrospective study of consecutive patients undergoing coronary artery bypas ... Full text Link to item Cite

Genomics and the circulation.

Journal Article Br J Anaesth · July 2004 Featured Publication Full text Link to item Cite

The association of patent foramen ovale and atrial fibrillation after coronary artery bypass graft surgery.

Journal Article Anesth Analg · March 2004 UNLABELLED: Atrial fibrillation (AF) is associated with considerable morbidity and increased resource utilization after coronary artery bypass graft surgery. In this study, we sought to determine whether patent foramen ovale (PFO) and atrial septal aneurys ... Full text Link to item Cite

The genetics of bleeding after cardiac surgery

Conference AMERICAN JOURNAL OF HUMAN GENETICS · November 1, 2003 Link to item Cite

Low serum magnesium level predicts major adverse cardiac events after coronary artery bypass graft surgery.

Journal Article Am Heart J · June 2003 BACKGROUND: Despite improved myocardial protection strategies and enhanced surgical techniques, mortality after coronary artery bypass graft surgery (CABG) remains essentially unchanged. This may be because of the increasing age of patients who undergo pri ... Full text Link to item Cite

Quantitative echocardiographic assessment of regional wall motion and left ventricular asynchrony with color kinesis in cardiac surgery patients.

Journal Article Anesth Analg · May 2003 UNLABELLED: Conventional echocardiographic interpretation of regional wall motion abnormalities is subjective and experience dependent. Delayed contraction in the ejection phase (tardokinesis) and regional systolic asynchrony, sensitive markers of myocardi ... Full text Link to item Cite

Lower endotoxin immunity predicts increased cognitive dysfunction in elderly patients after cardiac surgery.

Journal Article Stroke · February 2003 BACKGROUND AND PURPOSE: Although coronary artery bypass graft surgery (CABG) improves the quality of life and functional capacity for numerous patients, many also exhibit impairment in cognitive function immediately after surgery. Although the etiology of ... Full text Link to item Cite

Synchronous rhythmical vasomotion in the human cutaneous microvasculature during nonpulsatile cardiopulmonary bypass.

Journal Article Anesthesiology · November 2002 Featured Publication BACKGROUND: The origin, control mechanisms, and functional significance of oscillations in microvascular flow are incompletely understood. Although the traditional belief has been that only low-frequency oscillations (0.04-0.10 Hz) can originate at the mic ... Full text Link to item Cite

Mitral flow propagation velocity identifies patients with abnormal diastolic function during coronary artery bypass graft surgery.

Journal Article Anesth Analg · September 2002 UNLABELLED: Flow propagation velocity (Vp) is a new method of assessing left ventricular (LV) diastolic (D) function that seems to be insensitive to heart rate and preload changes. We hypothesized that Vp <50 cm/s identifies patients with D dysfunction and ... Full text Link to item Cite

Arterial-venous CO2 tension difference reflects oxygen debt after cardiopulmonary bypass

Journal Article Critical Care Medicine · January 1, 1999 Introduction: The gradient between venous and arterial carbon dioxide tension (Pv-aCO2) increases with resuscitation from states of intravascular depletion such as hemorragic shock. We hypothesized that Pv-aCO2 might increase following hypothermic cardiopu ... Full text Cite

Carbon dioxide production (VCO2) predicts after heart surgery better than end tidal CO2

Journal Article Critical Care Medicine · January 1, 1999 Introduction: Measures of metabolic recovery as VCO2, oxygen consumption (VO2) and cardiac output (CO) may predict outcome after CPB1. The purpose of this study was to compare the effiacy of monitoring post-CPB VCO2 with that of end-tidal CO2 (etCO2) in me ... Full text Cite

Arterial-venous CO2 tension gradient (Pa-vCO2) reflects oxygen debt after cardiopulmonary bypass

Journal Article Critical Care Medicine · January 1, 1999 INTRODUCTION: Pv-aCO2 increases with resuscitation from states of shock. We hypothesized that Pv-aCO2 increases following hypothermic cardiopulmonary bypass (CPB) due to the oxygen debt incurred. The recovery pattern of Pv-aCO2 was compared to those of O2 ... Full text Cite