Scholars@Duke
Vinay Thohan

Vinay Thohan

Adjunct Associate in the Department of Medicine
Medicine, Cardiology

Selected Publications

Atrial Mechanics, Atrial Cardiomyopathy and Impact of Atrial Interventions.

Journal Article J Card Fail · October 2024 Our comprehension of atrial mechanics, atrial cardiomyopathy and their clinical implications across various cardiovascular conditions has advanced significantly. Atrial interventions can have differing effects on atrial mechanics. With the rapid increase i ... Full text Link to item Cite

Interatrial Shunt Treatment for Heart Failure: The Randomized RELIEVE-HF Trial.

Journal Article Circulation · September 23, 2024 BACKGROUND: An interatrial shunt may provide an autoregulatory mechanism to decrease left atrial pressure and improve heart failure (HF) symptoms and prognosis. METHODS: Patients with symptomatic HF with any left ventricular ejection fraction (LVEF) were r ... Full text Link to item Cite

Serum Proteomic Analysis of Peripartum Cardiomyopathy Reveals Distinctive Dysregulation of Inflammatory and Cholesterol Metabolism Pathways.

Journal Article JACC Heart Fail · September 2023 BACKGROUND: The pathophysiology of peripartum cardiomyopathy (PPCM) and its distinctive biological features remain incompletely understood. High-throughput serum proteomic profiling, a powerful tool to gain insights into the pathophysiology of diseases at ... Full text Link to item Cite

Use of a Pulmonary Artery Pressure Sensor to Manage Patients With Left Ventricular Assist Devices.

Journal Article Circ Heart Fail · June 2023 BACKGROUND: Hemodynamic-guided management with a pulmonary artery pressure sensor (CardioMEMS) is effective in reducing heart failure hospitalization in patients with chronic heart failure. This study aims to determine the feasibility and clinical utility ... Full text Link to item Cite

Echocardiographic assessment of radial right ventricular function in heart transplant recipients.

Journal Article ESC Heart Fail · December 2021 AIMS: Right ventricular (RV) allograft dysfunction is present in half of all heart transplant (HT) recipients. Non-invasive assessment of RV function in the setting of rejection is not well described. We outline an echocardiographic technique, short-axis f ... Full text Link to item Cite

A principal components analysis of factors associated with successful implementation of an LVAD decision support tool.

Journal Article BMC Med Inform Decis Mak · March 20, 2021 BACKGROUND: A central goal among researchers and policy makers seeking to implement clinical interventions is to identify key facilitators and barriers that contribute to implementation success. Despite calls from a number of scholars, empirical insights i ... Full text Link to item Cite

The effect of pre-transplant and post-transplant anti-AT1R antibodies in heart transplant recipients

Journal Article Transplantation Reports · December 1, 2020 Background: The presence of autoantibodies to angiotensin 2 type 1 receptor (anti-AT1R) have been implicated in allograft pathobiology following organ transplantation. While the significance of these antibodies has been described in renal transplantation, ... Full text Cite

Left ventricular assist systems and infection-related outcomes: A comprehensive analysis of the MOMENTUM 3 trial.

Journal Article J Heart Lung Transplant · August 2020 BACKGROUND: In a randomized controlled trial (MOMENTUM 3), the HeartMate 3 (HM3) fully magnetically levitated centrifugal-flow left ventricular assist device (LVAD) demonstrated superiority over the HeartMate II (HMII) axial-flow LVAD. These findings were ... Full text Link to item Cite

Infection-Related Morbidity with Continuous-Flow Left Ventricular Assist Systems: A Comprehensive Analysis of the Randomized MOMENTUM 3 Trial

Conference The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · April 1, 2020 PURPOSE: The MOMENTUM 3 trial established superiority of a fully magnetically-levitated HeartMate 3 (HM3) centrifugal pump over the axial flow HeartMate II (HMII) pump on hemocompatibility-related outcomes. Infection-related outcomes were no different betw ... Full text Cite

Benefits of Neurohormonal Therapy in Patients With Continuous-Flow Left Ventricular Assist Devices.

Journal Article ASAIO J · April 2020 Left ventricular assist devices (LVADs) have dramatically improved short-term outcomes among patients with advanced heart failure. While neurohormonal blockade (NHB) is the cornerstone of treatment for patients with heart failure with reduced ejection frac ... Full text Link to item Cite

Jamestown Canyon virus encephalitis in a heart transplant patient.

Journal Article Transpl Infect Dis · February 2020 Jamestown Canyon virus (JtCV) is an arbovirus and a member of the California serogroup. To our knowledge, all the cases of JtCV have been reported in immunocompetent patients since it was first detected in 1997. We report a case of JtCV encephalitis in a s ... Full text Link to item Cite

Strong muscles, weak heart: testosterone-induced cardiomyopathy.

Journal Article ESC Heart Fail · October 2019 Exogenous anabolic androgen steroid use is associated with adverse cardiovascular outcomes. A 53-year-old bodybuilder presented with 3 months of exertional dyspnoea. Physical examination showed tachycardia and pan-systolic murmur; an echocardiogram showed ... Full text Link to item Cite

Pulmonary arterial hypertension and pregnancy

Chapter · September 21, 2019 The historic mortality among women with pulmonary arterial hypertension (PAH) who choose to endure pregnancy and delivery has been consistently reported between 30% and 60%. The normal physiologic changes during pregnancy and the postpartum period can caus ... Full text Cite

Breastfeeding, Cellular Immune Activation, and Myocardial Recovery in Peripartum Cardiomyopathy.

Journal Article JACC Basic Transl Sci · June 2019 The etiology of peripartum cardiomyopathy remains unknown. One hypothesis is that an increase in the 16-kDa form of prolactin is pathogenic and suggests that breastfeeding may worsen peripartum cardiomyopathy by increasing prolactin, while bromocriptine, w ... Full text Link to item Cite

The association between novel clinical factors and gastrointestinal bleeding among patients supported with continuous-flow left ventricular assist device therapy.

Journal Article J Card Surg · June 2019 BACKGROUND: This study explores novel preimplantation risk factors associated with gastrointestinal bleeding (GIB) after continuous-flow left ventricular assist device (CF-LVAD) implantation. CF-LVAD therapy implantation for patients with advanced heart fa ... Full text Link to item Cite

Xenoreactive antibodies and latent fibrin formation in VAD and cardiac transplant recipients can confound the detection and measurement of anti-AT1R antibodies.

Journal Article Am J Transplant · November 2018 Autoantibodies to the angiotensin II type 1 receptor (AT1R) are thought to be important in antibody-mediated rejection (AMR), especially in the absence of anti-HLA antibodies. We used a variety of methods to examine the specificity of a commercially availa ... Full text Link to item Cite

Healthcare Resource Use and Cost Implications in the MOMENTUM 3 Long-Term Outcome Study.

Journal Article Circulation · October 30, 2018 BACKGROUND: The MOMENTUM 3 trial compares the centrifugal HeartMate 3 (HM3) with the axial HeartMate II (HMII) continuous-flow left ventricular assist system in patients with advanced heart failure, irrespective of the intended goal of therapy. The trial's ... Full text Link to item Cite

A Multisite Randomized Controlled Trial of a Patient-Centered Ventricular Assist Device Decision Aid (VADDA Trial).

Journal Article J Card Fail · October 2018 BACKGROUND: Studies indicate that decision making and informed consent among patients considering left ventricular assist device (LVAD) support for advanced heart failure could be improved. In the VADDA (Ventricular Assist Device Decision Aid) trial, we te ... Full text Link to item Cite

Circulating T-Cell Subsets, Monocytes, and Natural Killer Cells in Peripartum Cardiomyopathy: Results From the Multicenter IPAC Study.

Journal Article J Card Fail · January 2018 OBJECTIVE: The aim of this work was to evaluate the hypothesis that the distribution of circulating immune cell subsets, or their activation state, is significantly different between peripartum cardiomyopathy (PPCM) and healthy postpartum (HP) women. BACKG ... Full text Link to item Cite

Myocardial Recovery in Patients With Systolic Heart Failure and Autoantibodies Against β1-Adrenergic Receptors.

Journal Article J Am Coll Cardiol · February 28, 2017 BACKGROUND: Among various cardiac autoantibodies (AAbs), those recognizing the β1-adrenergic receptor (β1AR) demonstrate agonist-like effects and induce myocardial damage that can be reversed by β-blockers and immunoglobulin G3 (IgG3) immunoadsorption. OBJ ... Full text Link to item Cite

Role of Echocardiography in the Evaluation of Left Ventricular Assist Devices: the Importance of Emerging Technologies.

Journal Article Curr Cardiol Rep · July 2016 The role of left ventricular assist devices (LVAD) in patients with end-stage heart failure is well known, both as a temporary treatment before transplantation and as destination therapy, in a scenario of a relative shortage of donors to satisfy the increa ... Full text Link to item Cite

Many de novo donor-specific antibodies recognize β2 -microglobulin-free, but not intact HLA heterodimers.

Journal Article HLA · May 2016 Solid-phase single antigen bead (SAB) assays are standard of care for detection and identification of donor-specific antibody (DSA) in patients who receive solid organ transplantation (SOT). While several studies have documented the reproducibility and sen ... Full text Link to item Cite

Right Ventricular Function in Peripartum Cardiomyopathy at Presentation Is Associated With Subsequent Left Ventricular Recovery and Clinical Outcomes.

Journal Article Circ Heart Fail · May 2016 BACKGROUND: Peripartum cardiomyopathy has variable disease progression and left ventricular (LV) recovery. We hypothesized that baseline right ventricular (RV) size and function are associated with LV recovery and outcome. METHODS AND RESULTS: Investigatio ... Full text Link to item Cite

Shared Genetic Predisposition in Peripartum and Dilated Cardiomyopathies.

Journal Article N Engl J Med · January 21, 2016 Background Peripartum cardiomyopathy shares some clinical features with idiopathic dilated cardiomyopathy, a disorder caused by mutations in more than 40 genes, including TTN, which encodes the sarcomere protein titin. Methods In 172 women with peripartum ... Full text Link to item Cite

Expecting the unexpected: right atrial mass in a transplant patient

Journal Article ESC Heart Failure · December 1, 2015 We present a 71-year-old male, who had had a heart transplantation 24 years prior, who came to our clinic with a low-grade fever and a new II/VI holosystolic murmur. Echocardiography showed a large mass in the right atrium with attachment near the junction ... Full text Cite

Role of Diastolic Function in Preserved Exercise Capacity in Patients with Reduced Ejection Fractions.

Journal Article J Am Soc Echocardiogr · October 2015 BACKGROUND: Some patients with markedly reduced ejection fractions (EFs) (<35%) have preserved exercise performance greater than predicted for age and gender. Because diastolic function may be a determinant of exercise performance, this study was conducted ... Full text Link to item Cite

Clinical significance of intermediate left ventricular trabeculations in cardiac magnetic resonance.

Journal Article Acta Cardiol · October 2015 OBJECTIVE: Although the clinical importance of left ventricular noncompaction cardiomyopathy (LVNC) is known, few data exist that describe the prognosis associated with intermediate levels of LV trabeculations that do not meet criteria for LVNC. METHODS: T ... Full text Link to item Cite

Comparison of Brachial Vein Versus Internal Jugular Vein Approach for Access to the Right Side of the Heart With or Without Myocardial Biopsy.

Journal Article Am J Cardiol · September 1, 2015 Right heart catheterization (RHC) and endomyocardial biopsy are mainstay procedures for patients with heart failure and heart transplantation. Approaches are predominantly neck (internal jugular) or leg (femoral vein). We describe a novel arm (brachial/bas ... Full text Link to item Cite

Mechanism of decreased sensitivity of dobutamine associated left ventricular wall motion analyses for appreciating inducible ischemia in older adults.

Journal Article J Cardiovasc Magn Reson · April 8, 2015 BACKGROUND: Dobutamine associated left ventricular (LV) wall motion analyses exhibit reduced sensitivity for detecting inducible ischemia in individuals with increased LV wall thickness. This study was performed to better understand the mechanism of this r ... Full text Link to item Cite

Abnormal stress-related measures of arterial stiffness in middle-aged and elderly men and women with impaired fasting glucose at risk for a first episode of symptomatic heart failure.

Journal Article J Am Heart Assoc · January 14, 2015 BACKGROUND: Abnormal resting arterial stiffness is present in middle-aged and elderly persons with abnormalities of fasting glucose (diabetes or impaired fasting glucose) and is associated with exercise intolerance. We sought to determine whether these sam ... Full text Link to item Cite

Longitudinal assessment of concurrent changes in left ventricular ejection fraction and left ventricular myocardial tissue characteristics after administration of cardiotoxic chemotherapies using T1-weighted and T2-weighted cardiovascular magnetic resonance.

Journal Article Circ Cardiovasc Imaging · November 2014 BACKGROUND: In a murine anthracycline-related cardiotoxicity model, increases in cardiovascular magnetic resonance myocardial contrast-enhanced T1-weighted signal intensity are associated with myocellular injury and decreases with left ventricular ejection ... Full text Link to item Cite

Reply to the editor.

Journal Article J Thorac Cardiovasc Surg · November 2014 Full text Link to item Cite

Mitral regurgitation in left ventricular noncompaction cardiomyopathy assessed by cardiac MRI.

Journal Article J Heart Valve Dis · September 2014 BACKGROUND AND AIM OF THE STUDY: Previous case reports have described patients with left ventricular noncompaction cardiomyopathy (LVNC) with significant mitral regurgitation (MR). The study aim was to determine if LVNC is associated with MR, as assessed b ... Link to item Cite

Practical value of identifying antibodies to cryptic HLA epitopes in cardiac transplantation.

Journal Article J Heart Lung Transplant · July 2014 BACKGROUND: Identification of antibodies to human leukocyte antigens (HLA) by single antigen bead arrays has led to the common practice of virtual crossmatching. However, inappropriate assignment of anti-HLA specificities can lead to false-positive virtual ... Full text Link to item Cite

The practical role of echocardiography in selection, implantation, and management of patients requiring LVAD therapy.

Journal Article Curr Cardiol Rep · April 2014 Viable treatment options for advanced heart failure have not emerged as the number of people afflicted with this condition has grown. Although heart transplantation is the only curative strategy for patients with end-stage heart failure, the relative short ... Full text Link to item Cite

Right ventricular morphology and systolic function in left ventricular noncompaction cardiomyopathy.

Journal Article Am J Cardiol · March 15, 2014 The distinction between normal right ventricular (RV) trabeculations from abnormal has been difficult. We evaluated whether RV volume and function are related to left ventricular (LV) noncompaction (NC) cardiomyopathy and clinical events. Trabeculations or ... Full text Link to item Cite

Small, short-duration, dobutamine-induced perfusion defects are not associated with adverse prognosis in intermediate-risk individuals receiving cardiovascular magnetic resonance stress imaging.

Journal Article J Comput Assist Tomogr · 2014 OBJECTIVE: The objective of this study was to assess the frequency and prognostic utility of small, short-duration left ventricular myocardial perfusion defects during dobutamine cardiovascular magnetic resonance (DCMR) stress imaging. METHODS: We performe ... Full text Link to item Cite

Anemia and associated clinical outcomes in patients with heart failure due to reduced left ventricular systolic function.

Journal Article Clin Cardiol · October 2013 BACKGROUND: Anemia is associated with decreased functional capacity, reduced quality of life, and worsened outcomes among patients with heart failure (HF) due to reduced left ventricular ejection fraction (HFREF). We sought to evaluate the independent effe ... Full text Link to item Cite

Comparison of systolic and diastolic criteria for isolated LV noncompaction in CMR.

Journal Article JACC Cardiovasc Imaging · September 2013 OBJECTIVES: This study used cardiac magnetic resonance (CMR) to compare standard criteria for left ventricular noncompaction (LVNC). BACKGROUND: LVNC as a distinct cardiomyopathy is supported by a growing number of publications. Echocardiographic and CMR c ... Full text Link to item Cite

Low to moderate dose anthracycline-based chemotherapy is associated with early noninvasive imaging evidence of subclinical cardiovascular disease.

Journal Article JACC Cardiovasc Imaging · August 2013 OBJECTIVES: The goal of this study was to determine if low to moderate doses of anthracycline-based chemotherapy (Anth-bC) are associated with subclinical cardiovascular (CV) injury. BACKGROUND: Cancer survivors who receive Anth-bC experience premature CV ... Full text Link to item Cite

Robot-assisted laparoscopic radical prostatectomy after heart transplantation

Journal Article Urology Annals · January 1, 2013 Prostate cancer (CaP) is the leading visceral malignancy in males. Patients who undergo cardiac transplantation are immune compromised, thus presenting a therapeutic challenge. Immunosuppresion could accelerate tumor growth, while medical intervention may ... Full text Cite

Implantable cardiac defibrillators and sudden death in recent onset nonischemic cardiomyopathy: results from IMAC2.

Journal Article J Card Fail · September 2012 BACKGROUND: Given the potential for recovery in recent onset nonischemic cardiomyopathy (ROCM), the timing and need for implantable cardioverter-defibrillator (ICDs) remains controversial. We examined the utilization of ICDs and the impact on survival for ... Full text Link to item Cite

Left ventricular mechanical dyssynchrony in acute onset cardiomyopathy: association of its resolution with improvements in ventricular function.

Journal Article JACC Cardiovasc Imaging · May 2011 OBJECTIVES: The purpose of this study was to evaluate mechanical dyssynchrony in patients with acute onset cardiomyopathy with narrow QRS interval, and its association with improvements in left ventricular (LV) function. BACKGROUND: LV dyssynchrony has bee ... Full text Link to item Cite

Incessant ventricular tachycardia and cardiogenic shock: A common presentation of an uncommon diagnosis

Journal Article American Journal of the Medical Sciences · January 1, 2011 Giant cell myocarditis is a rare and highly lethal disease that is characterized by a rapidly progressive course of biventricular dysfunction. The authors present a case of giant cell myocarditis that presented with incessant ventricular tachycardia and ca ... Full text Cite

The rationale for an acute heart failure syndromes clinical trials network.

Journal Article J Card Fail · August 2009 BACKGROUND: Clinical trials involving novel therapies treating acute heart failure syndromes (AHFS) have shown limited success with regard to both efficacy and safety. As a direct result, outcomes have changed little over time and AHFS remains a disease pr ... Full text Link to item Cite

The challenges associated with current clinical trials for diastolic heart failure.

Journal Article Curr Opin Cardiol · May 2009 PURPOSE OF REVIEW: Diastolic heart failure (DHF) is the culmination of various cardiovascular insults, producing a proportionally greater alteration of diastolic performance, subtle reductions of systolic function and the clinical syndrome of heart failure ... Full text Link to item Cite

Perioperative risk assessment among patients with congestive heart failure: a call for guidelines.

Journal Article Methodist Debakey Cardiovasc J · 2009 Each year, more than 10 million major noncardiac surgical procedures are performed in the United States. Current perioperative risk assessment focusing on ischemic heart disease and adherence to practice guidelines reduces morbidity and mortality. An estim ... Full text Link to item Cite

Constrictive pericarditis after cardiac transplantation: a case report and literature review.

Journal Article J Heart Lung Transplant · October 2008 We present a patient who was found to have constrictive pericarditis 6 months after cardiac allograft transplantation. The many invasive and non-invasive diagnostic procedures that were undertaken are reviewed, as is the gross pathology seen during surgery ... Full text Link to item Cite

The effect of etanercept on cardiac transplant recipients: a study of TNFalpha antagonism and cardiac allograft hypertrophy.

Journal Article Transplantation · August 27, 2007 Cardiac allograft hypertrophy is associated with persistent expression of cardiac tumor necrosis factor (TNF)-alpha. We investigated whether TNFalpha antagonism would impact allograft hypertrophy. EFECT (EFfect of Etanercept on Cardiac Transplantation) was ... Full text Link to item Cite

Global diastolic strain rate for the assessment of left ventricular relaxation and filling pressures.

Journal Article Circulation · March 20, 2007 BACKGROUND: Diastolic strain rate (SR) measurements that comprise all left ventricular (LV) segments are advantageous over myocardial velocity for assessment of diastolic function. Mitral early diastolic velocity (E)/SR ratio during the isovolumetric relax ... Full text Link to item Cite

Dynamic expression of the membrane attack complex (MAC) of the complement system in failing human myocardium.

Journal Article Am J Cardiol · June 1, 2006 Inflammatory cytokine-mediated pathways are activated in heart failure and participate in the pathogenesis and progression of the disease. Another major response to inflammation is mediated through the complement system with the production of the membrane ... Full text Link to item Cite

Cardiac allograft vasculopathy: the Achilles' heel of long-term survival after cardiac transplantation.

Journal Article Curr Atheroscler Rep · March 2006 Over the past 40 years, cardiac transplantation has evolved as the single best long-term option for eligible candidates with end-stage heart failure. Approximately 2000 transplants are performed annually in the United States, and with the institution of ca ... Full text Link to item Cite

Cellular and hemodynamics responses of failing myocardium to continuous flow mechanical circulatory support using the DeBakey-Noon left ventricular assist device: a comparative analysis with pulsatile-type devices.

Journal Article J Heart Lung Transplant · May 2005 BACKGROUND: An increasing number of continuous flow pumps are currently under clinical studies, however very little data exist on the hemodynamic and cellular responses of the failing heart to continuous flow support. The purpose of this investigation was ... Full text Link to item Cite

Plasma neurohormone levels correlate with left ventricular functional and morphological improvement in LVAD patients.

Journal Article J Surg Res · January 2005 OBJECTIVE: Brain natriuretic peptide (BNP) and endothelin-1 (ET-1) have been shown to be markers of left ventricular (LV) function. To determine the feasibility of using serial assays of these neurohormones in the assessment of cardiac status in the left v ... Full text Link to item Cite

Aldosterone antagonism and congestive heart failure: a new look at an old therapy.

Journal Article Curr Opin Cardiol · July 2004 PURPOSE OF REVIEW: More than 5 million people in the United States alone have congestive heart failure, and an estimated 40 million have established risks and warrant therapy. Mineralocorticoid antagonists have emerged as a new paradigm for the treatment o ... Full text Link to item Cite

The response of the failing heart to chronic mechanical unloading.

Journal Article Curr Opin Cardiol · May 2004 PURPOSE OF REVIEW: The authors present a comprehensive analysis of the evidence in support of improvements at the cellular, structural, and hemodynamic levels after left ventricular assist device support. RECENT FINDINGS: The use of left ventricular assist ... Full text Link to item Cite

Prognostic implications of echocardiography in advanced heart failure.

Journal Article Curr Opin Cardiol · May 2004 PURPOSE OF REVIEW: The growing epidemic of systolic congestive heart failure mandates strategies to identify accurately people with high morbidity and mortality. Echocardiography remains the most widely available noninvasive tool for the assessment of card ... Full text Link to item Cite

New surgical therapies for heart failure.

Journal Article Curr Opin Cardiol · May 2003 A growing number of patients present with heart failure. Some of them may qualify for surgical correction of their cardiac condition. Since heart transplantation will always be available to only a small number of patients, several new surgical techniques h ... Full text Link to item Cite

Endothelin-1: a new target of therapeutic intervention for the treatment of heart failure.

Journal Article Curr Opin Cardiol · May 2000 Endothelin-1 has been appreciated in animals and humans as a potential target for inhibition in patients with acutely decompensated congestive heart failure (CHF), as well as patients with a chronic low-output state. There has been intense interest in dete ... Full text Link to item Cite