Scholars@Duke
Zainab Samad

Zainab Samad

Adjunct Associate Professor in the Department of Medicine
Medicine, Cardiology

Selected Publications

Longitudinal trends in stroke risk factors and mortality over 20 years from a central stroke referral center in Pakistan using clinically digitized data.

Journal Article eNeurologicalSci · December 2025 BACKGROUND: Limited data exists on long-term stroke trends in low- and middle-income countries, including Pakistan, despite its growing burden. Understanding these trends is crucial for informing healthcare strategies and public health interventions. This ... Full text Link to item Cite

PROTOCOL: Effectiveness of Interventions for the Prevention and Treatment of Obesity in Children and Adolescents From Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

Journal Article Campbell Systematic Reviews · December 1, 2025 Childhood obesity represents a major and growing public health challenge, with a disproportionate burden in low- and middle-income countries (LMICs). This systematic review will address a critical evidence gap by synthesising existing research on the effec ... Full text Cite

School eHealth education program Pakistan (eSHEPP): an exploratory qualitative study of stakeholder perspectives on design, barriers, and facilitators.

Journal Article J Health Popul Nutr · November 26, 2025 BACKGROUND: Noncommunicable diseases (NCDs) are a growing health challenge in low- and middle-income countries (LMICs), including Pakistan. Adolescence is a critical period for shaping lifelong behaviors, yet school-based health education remains limited, ... Full text Link to item Cite

School eHealth Education Program Pakistan (eSHEPP) to improve NCDs awareness in adolescents from urban Pakistan: a mixed method design protocol.

Journal Article J Health Popul Nutr · October 14, 2025 BACKGROUND: Non-communicable diseases (NCDs) pose a significant health threat, particularly among adolescents in low- and middle-income countries (LMICs) such as Pakistan. Unhealthy habits, including poor diet, physical inactivity, and substance use, often ... Full text Link to item Cite

Non-communicable diseases prevention and control in Pakistan: recommendations from policy and public health experts.

Journal Article BMC Proc · October 14, 2025 BACKGROUND: Non-communicable diseases (NCD) represent a significant and growing global health challenge, disproportionately affecting low- and middle-income countries (LMICs) like Pakistan. Despite their profound public health and economic implications, ef ... Full text Link to item Cite

Changes in electrical vectors correlated with coronary insufficiency with recent symptoms.

Journal Article Sci Rep · October 6, 2025 Vectorcardiography (VCG) enables measurement of voltages and directions of resultant spatial vectors in the heart that are altered by myocardial ischemia. To validate the ability of VCG to detect electrophysiological effects of regional myocardial ischemia ... Full text Link to item Cite

Does Time Matter? Impact of Residency Start Month on EGS Outcome in Pakistan.

Journal Article World J Surg · October 2025 BACKGROUND: Trainee turnover in hospitals with induction of new, less experienced residents and changeover in the clinical teams has been considered an essential factor for increased morbidity and mortality. In high-income countries (HICs), this is known a ... Full text Link to item Cite

A systems-change approach to addressing the mortality surveillance gap in Pakistan.

Journal Article J Glob Health · August 4, 2025 With a lack of cause of death estimation and an inadequate and fragmented Civil Registration and Vital Statistics system, Pakistan faces a significant gap in data on mortality. This poses significant challenges for health policy planning and monitoring. In ... Full text Link to item Cite

Identifying mobile health interventions for post-discharge stroke and myocardial infarction patients: a scoping review.

Journal Article BMJ Open · July 30, 2025 OBJECTIVES: Data on postdischarge care for stroke and myocardial infarction (MI) patients remain limited. Logistical barriers, including fragmented communication and poor coordination between patients and physicians, contribute to suboptimal outcomes and h ... Full text Link to item Cite

Assessing the Efficacy and Impact of Using a Simulation-Based Approach for Rapid Critical Care Capacity Development at Scale.

Journal Article Simul Healthc · July 7, 2025 In response to the increased COVID-19 cases and staff limitations, the need to enhance critical care capacity was identified by the Aga Khan University Hospital (AKUH). We designed and delivered a series of in-person simulation-based workshops to rapidly u ... Full text Link to item Cite

Stroke in Heart Failure With Reduced Ejection Fraction: Systematic Review and Meta-Analysis of Randomized Trials.

Journal Article JACC Heart Fail · July 2025 BACKGROUND: Patients with heart failure with reduced ejection fraction (HFrEF) have a heightened stroke risk. However, stroke as an endpoint in heart failure trials remains under-reported. OBJECTIVES: The authors sought to define the incidence, characteris ... Full text Link to item Cite

Multicomponent intervention for controlling hypertension in the adult rural population of Pakistan: a protocol for a hybrid type III implementation-effectiveness cluster randomised controlled trial.

Journal Article BMJ Open · June 27, 2025 INTRODUCTION: Though prior trials have shown the effectiveness of community-based hypertension detection and care delivery models, their adoption and translation to practice has been slow. In this study, we will develop and test strategies for the implemen ... Full text Link to item Cite

Addressing the challenge of rheumatic heart disease in Pakistan: A call to action.

Journal Article Dialogues Health · June 2025 Despite its high prevalence, Acute rheumatic fever (ARF) and Rheumatic heart disease (RHD) is underrepresented in Pakistan's national and federal health plans. To address this gap, we gathered multi-geographic and specialty perspectives from frontline clin ... Full text Link to item Cite

Weekends at risk: Uncovering the impact of the weekend effect on emergency general surgery.

Journal Article Surgery · May 2025 BACKGROUND: Weekend admissions have been proposed to be associated with the worst outcomes across varied patient populations and health care systems. However, there is a dearth of literature on weekend effects in low- and middle-income countries like Pakis ... Full text Link to item Cite

A Matched Comparison of Patient Outcomes in Emergency General Surgery Conditions: Understanding Variability in Operative and Nonoperative Cases.

Journal Article World J Surg · April 2025 BACKGROUND: Emergency general surgery (EGS) is a subset of acute care surgery that can be managed surgically and conservatively. Various factors influence decisions regarding operative or nonoperative management. Our study aimed to identify EGS patients wh ... Full text Link to item Cite

A Step Beyond Mortality: Identifying Factors of Prolonged Hospital Stay for Emergency General Surgery Conditions in a Low- and Middle-Income Country.

Journal Article J Surg Res · February 2025 INTRODUCTION: While various factors leading to prolonged length of stay (LOS) have been identified for emergency general surgery (EGS), there is limited literature on specific factors for individual emergent specialties. This study aimed to identify patien ... Full text Link to item Cite

Peer-to-peer tele-consultative services for critical care, Afghanistan, Kenya, Pakistan, United Republic of Tanzania.

Journal Article Bull World Health Organ · February 1, 2025 OBJECTIVE: To develop a tele-intensive care service providing peer-to-peer teleconsultation for physicians in remote and resource-constrained health-care settings for treatment of critically ill patients, and to evaluate the outcomes of the service. METHOD ... Full text Link to item Cite

Identifying those at risk: predicting patient factors associated with worse EGS outcomes.

Journal Article Trauma Surg Acute Care Open · 2025 BACKGROUND: Comorbidity has a detrimental impact on Emergency General Surgery (EGS) outcomes. In lesser-developed countries with inconsistent documentation of comorbid conditions, undiagnosed and progressively worsening comorbidities can worsen EGS outcome ... Full text Link to item Cite

Infections do not play fair: the Charlson-Age Comorbidity Index reveals sex-specific risk in laparotomy patients in an LMIC.

Journal Article Trauma Surg Acute Care Open · 2025 BACKGROUND: Surgical site infections (SSIs) are a major cause of increased morbidity, hospital stay, care costs, and mortality in surgical patients; these can be prognosticated by the Charlson Comorbidity Index (CCI) and accounting for age-the Charlson-Age ... Full text Link to item Cite

Quality of life after myocardial infarction in the pakistani population - insights from a single-center cohort study.

Journal Article BMC Cardiovasc Disord · December 23, 2024 BACKGROUND: Health-related Quality of life (HRQoL) assessment is essential for optimizing patient care, treatment adjustments, and medical decision-making, particularly in post-Myocardial Infarction (MI) patients, but limited data exists on HRQOL post-MI f ... Full text Link to item Cite

Identification of Gender Differences in Acute Myocardial Infarction Presentation and Management at Aga Khan University Hospital-Pakistan: Natural Language Processing Application in a Dataset of Patients With Cardiovascular Disease.

Journal Article JMIR Form Res · December 20, 2024 BACKGROUND: Ischemic heart disease is a leading cause of death globally with a disproportionate burden in low- and middle-income countries (LMICs). Natural language processing (NLP) allows for data enrichment in large datasets to facilitate key clinical re ... Full text Link to item Cite

Taxing tobacco as a strategy to reduce consumption and increase public health benefits in Pakistan.

Journal Article East Mediterr Health J · December 3, 2024 BACKGROUND: Tobacco consumption poses a significant challenge to global health and contributes to the increase in noncommunicable diseases and premature deaths. AIM: To investigate the potential impact of a 70% tobacco tax on consumption and government rev ... Full text Link to item Cite

Health Data Sciences and Cardiovascular Disease in Africa: Needs and the Way Forward.

Journal Article Curr Atheroscler Rep · November 2024 PURPOSE OF REVIEW: The rising burden of cardiovascular disease (CVD) in Africa is of great concern. Health data sciences is a rapidly developing field which has the potential to improve health outcomes, especially in low-middle income countries with burden ... Full text Link to item Cite

Risk factors for mortality in hospitalized COVID-19 patients across five waves in Pakistan.

Journal Article Sci Rep · August 30, 2024 This retrospective cohort study aims to describe the clinical characteristics and outcomes and assess risk factors for mortality across the epidemic waves in hospitalized COVID-19 patients in a major tertiary-care center in Pakistan. A total of 5368 patien ... Full text Link to item Cite

Mass online training of health care workers during COVID-19: approach, impact, and outcomes for over 10,000 health care providers.

Journal Article Public Health · August 2024 OBJECTIVES: COVID-19 revealed major shortfalls in healthcare workers (HCWs) trained in acute and critical care worldwide, especially in low-resource settings. We aimed to assess mass online courses' efficacy in preparing HCWs to manage COVID-19 patients an ... Full text Link to item Cite

Obesity and risk of hypertension in preadolescent urban school children: insights from Pakistan.

Journal Article J Health Popul Nutr · June 20, 2024 BACKGROUND: Childhood obesity and hypertension are growing concerns globally, especially in developing countries. This study investigated the association between overall and central obesity at baseline, and prehypertension or hypertension at follow-up amon ... Full text Link to item Cite

Frameworks for procurement, integration, monitoring, and evaluation of artificial intelligence tools in clinical settings: A systematic review.

Journal Article PLOS Digit Health · May 2024 Research on the applications of artificial intelligence (AI) tools in medicine has increased exponentially over the last few years but its implementation in clinical practice has not seen a commensurate increase with a lack of consensus on implementing and ... Full text Link to item Cite

The algorithm journey map: a tangible approach to implementing AI solutions in healthcare.

Journal Article NPJ Digit Med · April 9, 2024 When integrating AI tools in healthcare settings, complex interactions between technologies and primary users are not always fully understood or visible. This deficient and ambiguous understanding hampers attempts by healthcare organizations to adopt AI/ML ... Full text Link to item Cite

Ambulatory blood pressure levels in individuals with uncontrolled clinic hypertension across Bangladesh, Pakistan, and Sri Lanka.

Journal Article J Clin Hypertens (Greenwich) · April 2024 Hypertension is a leading risk factor for cardiovascular disease in South Asia. The authors aimed to assess the cross-country differences in 24-h ambulatory, daytime, and nighttime systolic blood pressure (SBP) among rural population with uncontrolled clin ... Full text Link to item Cite

Implications of Atrial Fibrillation for Guideline-Directed Therapy in Patients With Heart Failure: JACC State-of-the-Art Review.

Journal Article J Am Coll Cardiol · March 5, 2024 Atrial fibrillation (AF) and heart failure (HF) are common cardiovascular conditions that frequently coexist. Among patients with HF, more than one-half also have AF. Both are associated with significant morbidity and mortality. Moreover, the prevalence of ... Full text Link to item Cite

A review of top cardiology and cardiovascular medicine journal guidelines regarding the use of generative artificial intelligence tools in scientific writing.

Journal Article Curr Probl Cardiol · March 2024 BACKGROUND: Generative Artificial Intelligence (AI) tools have experienced rapid development over the last decade and are gaining increasing popularity as assistive models in academic writing. However, the ability of AI to generate reliable and accurate re ... Full text Link to item Cite

Telemedicine During a Pandemic: Challenges, Opportunities & Way Forward at a Tertiary Care Hospital.

Journal Article Hosp Top · 2024 Telemedicine is utilized to deliver health care services remotely. TM gained popularity as a result of pandemics, it can help the patients to get required medical care while sitting in the comfortable environment of their homes. In the future, it will cont ... Full text Link to item Cite

No healthcare coverage, big problem: lack of insurance for older population associated with worse emergency general surgery outcomes.

Journal Article Trauma Surg Acute Care Open · 2024 INTRODUCTION: Older populations, being a unique subset of patients, have poor outcomes for emergency general surgery (EGS). In regions lacking specialized medical coverage for older patients, disparities in healthcare provision lead to poor clinical outcom ... Full text Link to item Cite

Building block for success: A case study of capacity-strengthening in grant administration for Pakistani universities.

Journal Article PLoS One · 2024 BACKGROUND: Grant administration plays a pivotal role in the success of research and academic endeavors. However, in Pakistan, academic institutions often face challenges in this domain, primarily due to a lack of specialized training and infrastructure. A ... Full text Link to item Cite

The Association Between Race, Ethnicity and Sleep Quality and Duration: A National Health Interview Survey Study.

Journal Article Curr Probl Cardiol · December 2023 BACKGROUND: Inadequate sleep duration and poor sleep quality are associated with adverse cardiovascular outcomes. METHODS: Using data from the National Health Interview Survey, we compared self-reported sleep duration and quality among different groups: Wh ... Full text Link to item Cite

Global Cardiovascular Research: Gaps and Opportunities.

Journal Article Curr Cardiol Rep · December 2023 PURPOSE OF REVIEW: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. CVDs contribute to a large health and economic burden on a global scale. We aim to describe the current landscape of global cardiovascular research, ... Full text Link to item Cite

PAKistan Study of prEmature coronary atHerosclerosis in young AdulTs (PAK-SEHAT): a prospective longitudinal study protocol investigating the prevalence, severity and determinants of atherosclerotic cardiovascular disease in the young adult Pakistani population.

Journal Article BMJ Open · November 19, 2023 INTRODUCTION: Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity, mortality and health expenditures worldwide. Despite having higher ASCVD in the Pakistani population, data on subclinical coronary atherosclerosis in young Pakistan ... Full text Link to item Cite

Trends in ischemic heart disease among females in low-and middle-income countries from 1990 to 2019.

Journal Article Int J Cardiol · October 1, 2023 BACKGROUND: Ischemic heart disease (IHD) is a major contributor to mortality in low-and middle-income-countries (LMICs). However, trends in IHD in females in LMICs are not well described. METHODS: We analyzed the Global Burden of Disease (GBD) Study from 1 ... Full text Link to item Cite

Health data ecosystem in Pakistan: a multisectoral qualitative assessment of needs and opportunities.

Journal Article BMJ Open · September 21, 2023 OBJECTIVE: Data are essential for tracking and monitoring of progress on health-related sustainable development goals (SDGs). But the capacity to analyse subnational and granular data is limited in low and middle-income countries. Although Pakistan lags be ... Full text Link to item Cite

The COVID-19 Pandemic and Coronary Heart Disease: the Next Surge.

Journal Article Curr Atheroscler Rep · September 2023 PURPOSE OF REVIEW: In this narrative review, we highlight different ways in which the COVID-19 pandemic has impacted coronary heart disease (CHD) burden and how a surge in morbidity and mortality may be expected in the near future. We also discuss potentia ... Full text Link to item Cite

School Health Education Program in Pakistan (SHEPP): findings from a feasibility trial in pre-adolescent school children from a lower middle-income country.

Journal Article Pilot Feasibility Stud · July 17, 2023 BACKGROUND: The school environment plays an essential role in promoting health education and physical activity for children and adolescents. We aim to assess the feasibility of threefold health education program in children and its potential efficacy on ph ... Full text Link to item Cite

Prevalence and Predictors of Premature Coronary Heart Disease Among Asians in the United States: A National Health Interview Survey Study.

Journal Article Curr Probl Cardiol · July 2023 Identifying Asian subgroups with higher risk of premature coronary heart disease (CHD) can help implement targeted strategies to prevent future CHD events. We conducted this National Health Interview Survey study from 2006 to 2015 among participants with h ... Full text Link to item Cite

Challenges of managing hypertension in Pakistan - a review.

Journal Article Clin Hypertens · June 15, 2023 BACKGROUND: This review aims to describe existing evidence on the state of hypertension in Pakistan, including the prevalence, associated risk factors, preventive strategies, and challenges in the management of hypertension. METHODS: A comprehensive litera ... Full text Link to item Cite

Variation in resource utilization and mortality among patients with varying MR type and severity.

Journal Article Am Heart J · June 2023 BACKGROUND: Limited data exists regarding the relationships between resource use and outcomes in patients with mitral regurgitation (MR). We examined resource utilization and outcomes across MR type and severity. METHODS: Using the Duke Echocardiography La ... Full text Link to item Cite

Highlights of Cardiovascular Disease Prevention Studies Presented at the 2023 American College of Cardiology Conference.

Journal Article Curr Atheroscler Rep · June 2023 PURPOSE OF REVIEW: To summarize selected late-breaking science on cardiovascular (CV) disease prevention presented at the 2023 American College of Cardiology (ACC) conference. RECENT FINDINGS: The CLEAR outcomes randomized control trial (RCT) compared bemp ... Full text Link to item Cite

National cervical cancer burden estimation through systematic review and analysis of publicly available data in Pakistan.

Journal Article BMC Public Health · May 5, 2023 BACKGROUND: Cervical cancer is a major cause of cancer-related deaths among women worldwide. Paucity of data on cervical cancer burden in countries like Pakistan hamper requisite resource allocation. OBJECTIVE: To estimate the burden of cervical cancer in ... Full text Link to item Cite

Sex disparity in left ventricular hypertrophy in South Asians with hypertension: influence of central obesity and high blood pressure.

Journal Article J Hum Hypertens · April 2023 Women have been reported to be at greater risk of left ventricular hypertrophy (LVH) than men in South Asia, but whether the sex disparity is affected by central obesity and blood pressure has not been well studied. We examined prospectively the interactio ... Full text Link to item Cite

Gender Differences in Clinical Outcomes After Percutaneous Coronary Intervention-Analysis of 15,106 Patients from the Cardiac Registry of Pakistan Database.

Journal Article Am J Cardiol · February 1, 2023 There is a scarcity of data on gender differences in outcomes during and after percutaneous coronary intervention (PCI) in the South Asian population. We assessed the gender differences in in-hospital mortality and complications in patients who underwent P ... Full text Link to item Cite

The state of health in Pakistan and its provinces and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019.

Journal Article Lancet Glob Health · February 2023 BACKGROUND: Understanding health trends and estimating the burden of disease at the national and subnational levels helps policy makers track progress and identify disparities in overall health performance. The Global Burden of Diseases, Injuries, and Risk ... Full text Link to item Cite

Cardiovascular risk reduction in polycystic ovary syndrome

Chapter · January 1, 2023 PCOS patients have a higher prevalence of traditional risk factors for cardiovascular disease (CVD), and insulin resistance significantly contributes to the pathogenesis of these risk factors. Although central obesity has been reported to potentiate athero ... Full text Cite

Prevalence of familial hypercholesterolemia in a country-wide laboratory network in Pakistan: 10-year data from 988, 306 patients.

Journal Article Prog Cardiovasc Dis · 2023 INTRODUCTION: Familial hypercholesterolemia (FH) is a modifiable risk factor for premature coronary heart disease but is poorly diagnosed and treated. We leveraged a large laboratory network in Pakistan to study the prevalence, gender and geographic distri ... Full text Link to item Cite

Implementation evaluation of a medical student-led intervention to enhance students' engagement with research: Findings and lessons learned.

Journal Article PLoS One · 2023 INTRODUCTION: Medical colleges globally have student organizations that serve to enable students' involvement in research. However, details of their approach and activities are seldom published to serve as learning for student organizations in other settin ... Full text Link to item Cite

Opportunities and challenges to non-communicable disease (NCD) research and training in Pakistan: a qualitative study from Pakistan.

Journal Article BMJ Open · December 19, 2022 INTRODUCTION: Most of the global non-communicable disease (NCD)-related death burden is borne by low and middle-income countries (LMICs). In LMICs like Pakistan, however, a major gap in responding to NCDs is a lack of high-quality research leading to polic ... Full text Link to item Cite

Racial Disparity in Flu Vaccine Uptake Among Asian American Individuals: A National Health Interview Survey Study.

Journal Article Curr Probl Cardiol · December 2022 Vaccination coverage rates across Asian American subpopulations with atherosclerotic cardiovascular disease (ASCVD) and diabetes mellitus is not well-studied. We used data from the National Health Interview Survey (NHIS) from 2006 to 2018 and included part ... Full text Link to item Cite

Association of U.S. birth, duration of residence in the U.S., and atherosclerotic cardiovascular disease risk factors among Asian adults.

Journal Article Prev Med Rep · October 2022 INTRODUCTION: Prior studies have shown a direct association between U.S. birth and duration of residence with atherosclerotic cardiovascular disease (ASCVD) though, few have specifically focused on Asian Americans. METHODS: We utilized cross-sectional data ... Full text Link to item Cite

Left Atrial Appendage Occlusion Versus Oral Anticoagulation in Atrial Fibrillation : A Decision Analysis.

Journal Article Ann Intern Med · September 2022 BACKGROUND: Left atrial appendage occlusion (LAAO) is a potential alternative to oral anticoagulants in selected patients with atrial fibrillation (AF). Compared with anticoagulants, LAAO decreases major bleeding risk, but there is uncertainty regarding th ... Full text Open Access Link to item Cite

Heterogeneity in the prevalence of premature hypertension among Asian American populations compared with white individuals: A National Health Interview Survey study.

Journal Article Int J Cardiol Cardiovasc Risk Prev · September 2022 BACKGROUND: Differences in prevalence of risk factors such as hypertension may explain heterogeneity in cardiovascular risk across Asian American populations. METHODS: We used National Health Interview Survey (NHIS) data from 2006 to 2018 among White, Chin ... Full text Link to item Cite

Association Between Social Vulnerability Index and Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Study.

Journal Article J Am Heart Assoc · August 2, 2022 Background Social and environmental factors play an important role in the rising health care burden of cardiovascular disease. The Centers for Disease Control and Prevention developed the Social Vulnerability Index (SVI) from US census data as a tool for p ... Full text Link to item Cite

Disparities in adult critical care resources across Pakistan: findings from a national survey and assessment using a novel scoring system.

Journal Article Crit Care · July 11, 2022 BACKGROUND: In response to the COVID-19 pandemic, concerted efforts were made by provincial and federal governments to invest in critical care infrastructure and medical equipment to bridge the gap of resource-limitation in intensive care units (ICUs) acro ... Full text Link to item Cite

Genome-wide association study reveals novel genetic loci: a new polygenic risk score for mitral valve prolapse.

Journal Article European heart journal · May 2022 AimsMitral valve prolapse (MVP) is a common valvular heart disease with a prevalence of >2% in the general adult population. Despite this high incidence, there is a limited understanding of the molecular mechanism of this disease, and no medical t ... Full text Cite

Evaluation of Factors Underlying Sex-Based Disparities in Cardiovascular Care in Adults With Self-reported Premature Atherosclerotic Cardiovascular Disease.

Journal Article JAMA Cardiol · March 1, 2022 IMPORTANCE: There are limited data regarding sex-based differences in physical and mental health domains and health care access in adults with premature atherosclerotic cardiovascular disease (ASCVD). OBJECTIVE: To study the association of sex with physica ... Full text Link to item Cite

Factors and outcomes associated with improved left ventricular systolic function in patients with cardiomyopathy.

Journal Article Cardiol J · 2022 BACKGROUND: Many patients in the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) had a significant improvement (> 10%) in the left ventricular ejection fraction (LVEF) during the course of the study, but the factors and outcomes associated with such ... Full text Link to item Cite

Leveraging Clinical Digitized Data to Understand Temporal Characteristics and Outcomes of Acute Myocardial Infarctions at a Tertiary Care Medical Centre in Pakistan from 1988-2018 - Methods and Results.

Journal Article Glob Heart · 2022 BACKGROUND AND OBJECTIVE: Few data exist on trends in acute myocardial infarction (AMI) patterns spanning recent epidemiological shifts in low middle-income countries (LMICs). To understand temporal disease patterns of AMI characteristics and outcomes betw ... Full text Link to item Cite

Hypertension in Women: A South-Asian Perspective.

Journal Article Front Cardiovasc Med · 2022 INTRODUCTION: Hypertension is an important contributor to cardiovascular disease related morbidity and mortality. Despite the magnitude of its negative impact on cardiovascular outcomes, treatment and control of hypertension remain suboptimal in both men a ... Full text Link to item Cite

South Asian ethnicity: What can we do to make this risk enhancer a risk equivalent?

Journal Article Prog Cardiovasc Dis · 2022 South Asians account for around 25% of the global population and are the fastest-growing ethnicity in the US. This population has an increasing burden of atherosclerotic cardiovascular disease (ASCVD) which is also seen in the diaspora. Current risk predic ... Full text Link to item Cite

Can Sound Public Health Policies Stem the Tide of Burgeoning Epidemic of Cardiovascular Disease in South Asians?

Journal Article Curr Cardiol Rep · October 23, 2021 PURPOSE OF REVIEW: To revisit the importance of prevention strategies and policies in reducing the burden of ischemic heart disease in South Asian countries. RECENT FINDINGS: South Asia has seen rapid growth in its population with variable improvement in h ... Full text Link to item Cite

Sex-Related Disparities in Cardiovascular Health Care Among Patients With Premature Atherosclerotic Cardiovascular Disease.

Journal Article JAMA Cardiol · July 1, 2021 IMPORTANCE: There is a paucity of data regarding secondary prevention care disparities in women with premature and extremely premature atherosclerotic cardiovascular disease (ASCVD), defined as an ASCVD event at 55 years or younger and 40 years or younger, ... Full text Link to item Cite

African American-Caucasian American differences in aortic valve replacement in patients with severe aortic stenosis.

Journal Article Am Heart J · April 2021 BACKGROUND: Among patients with severe aortic stenosis (AS), there are limited data on aortic valve replacement (AVR), reasons for nonreceipt and mortality by race. METHODS: Utilizing the Duke Echocardiography Laboratory Database, we analyzed data from 110 ... Full text Link to item Cite

Recreational substance use among patients with premature atherosclerotic cardiovascular disease.

Journal Article Heart · April 2021 OBJECTIVE: Despite an upsurge in the incidence of atherosclerotic cardiovascular diseases (ASCVD) among young adults, the attributable risk of recreational substance use among young patients has been incompletely evaluated. We evaluated the association of ... Full text Link to item Cite

Performance and Determinants of Serum Creatinine and Cystatin C-Based GFR Estimating Equations in South Asians.

Journal Article Kidney Int Rep · April 2021 INTRODUCTION: The creatinine-based Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimated glomerular filtration rate (eGFR) equation was calibrated for the general Pakistan population (eGFRcr-PK) to eliminate bias and improve accuracy. Cysta ... Full text Link to item Cite

Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association.

Journal Article Circulation · February 23, 2021 BACKGROUND: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, ... Full text Open Access Link to item Cite

Disparities in Cardiovascular Research Output and Disease Outcomes among High-, Middle- and Low-Income Countries - An Analysis of Global Cardiovascular Publications over the Last Decade (2008-2017).

Journal Article Glob Heart · January 18, 2021 BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. Health research is crucial to managing disease burden. Previous work has highlighted marked discrepancies in research output and disease burden between high-in ... Full text Link to item Cite

Prescribing Patterns of Antihypertensive Medications in Low- and Middle-Income Countries: A Systematic Review.

Journal Article Asia Pac J Public Health · January 2021 Hypertension is highly prevalent, but its pharmacological management has not been well evaluated in low- and middle-income countries (LMICs). This review examined the prescribing patterns of antihypertensives in LMICs. Data were extracted from a total of 2 ... Full text Link to item Cite

Impact of COVID-19 on Cardiovascular Disease Presentation, Emergency Department Triage and Inpatient Cardiology Services in a Low- to Middle-Income Country - Perspective from a Tertiary Care Hospital of Pakistan.

Journal Article Glob Heart · 2021 AIMS: To identify the changes in cardiovascular disease presentation, emergency room triage and inpatient diagnostic and therapeutic pathways. METHODS: We conducted a retrospective cohort study at the Aga Khan University Hospital, Karachi. We collected dat ... Full text Link to item Cite

Predicting the Development of Reduced Left Ventricular Ejection Fraction in Patients With Left Bundle Branch Block.

Journal Article Am J Cardiol · December 15, 2020 Left bundle branch block (LBBB) increases the likelihood of developing reduced left ventricular (LV) ejection fraction (EF) but predicting which patients with LBBB and normal LVEF will develop decreased LVEF remains challenging. Fifty patients with LBBB an ... Full text Link to item Cite

Autoimmune Rheumatic Diseases and Premature Atherosclerotic Cardiovascular Disease: An Analysis From the VITAL Registry.

Journal Article Am J Med · December 2020 BACKGROUND: Although the association between autoimmune rheumatic diseases and atherosclerotic cardiovascular disease is well-known, there is a lack of data regarding the role of such disorders in patients with premature and extremely premature atheroscler ... Full text Link to item Cite

Air pollution and Non Communicable Diseases.

Journal Article J Pak Med Assoc · November 2020 Link to item Cite

Analysis of COVID-19 burden, epidemiology and mitigation strategies in Muslim majority countries.

Journal Article East Mediterr Health J · October 13, 2020 BACKGROUND: Muslim majority countries have experienced a considerable burden of COVID-19 infection. However, there has been a relative lack of research comparing COVID-19 outbreaks and responses between Muslim-majority countries. AIMS: This study aimed to ... Full text Link to item Cite

The prognostic value of diastolic and systolic mechanical left ventricular dyssynchrony among patients with coronary artery disease and heart failure.

Journal Article J Nucl Cardiol · October 2020 BACKGROUND: Prevalence and prognostic value of diastolic and systolic dyssynchrony in patients with coronary artery disease (CAD) + heart failure (HF) or CAD alone are not well understood. METHODS: We included patients with gated single-photon emission com ... Full text Link to item Cite

Evaluation of Aspirin and Statin Therapy Use and Adherence in Patients With Premature Atherosclerotic Cardiovascular Disease.

Journal Article JAMA Netw Open · August 3, 2020 IMPORTANCE: Studies on the use of and adherence to secondary prevention therapies in patients with premature and extremely premature atherosclerotic cardiovascular disease (ASCVD) are lacking. OBJECTIVE: To evaluate and compare aspirin use, any statin use, ... Full text Link to item Cite

Premature Atherosclerotic Cardiovascular Disease: What Have We Learned Recently?

Journal Article Curr Atheroscler Rep · July 16, 2020 PURPOSE OF REVIEW: In contrast to patients with non-premature atherosclerotic cardiovascular disease (ASCVD), patients with premature ASCVD have not observed a similar decline in cardiovascular mortality and recurrent adverse events. We sought to review th ... Full text Link to item Cite

Prevalence and Associations of Metabolic Syndrome in an Urban High Diabetes Risk Population in a Low/Middle-Income Country.

Journal Article Metab Syndr Relat Disord · June 2020 Background: We aimed to assess the burden of metabolic syndrome (MetS), and evaluate the phenotypic variation of MetS in a population at high risk for diabetes in urban Karachi, Pakistan. Methods: This study was embedded in a lifestyle intervention trial f ... Full text Link to item Cite

Estimation of the burden of out-of-hospital traumatic cardiac arrest in Karachi, Pakistan, using a cross-sectional capture-recapture analysis.

Journal Article Int J Emerg Med · May 14, 2020 BACKGROUND: The burden of trauma-related-out-of-hospital cardiac arrest (OHCA) in developing countries like Pakistan remains largely unexplored due to a lack of organized pre-hospital systems. In order to estimate the burden, we used a two-sample capture-r ... Full text Link to item Cite

Association between frequency of primary care provider visits and evidence-based statin prescribing and statin adherence: Findings from the Veterans Affairs system.

Journal Article Am Heart J · March 2020 BACKGROUND: Statin use remains suboptimal in patients with atherosclerotic cardiovascular disease (ASCVD). We assessed if the frequency of visits with primary care providers (PCPs) is associated with higher use of evidence-based statin prescriptions and ad ... Full text Link to item Cite

The Use of Sex-Specific Factors in the Assessment of Women's Cardiovascular Risk.

Journal Article Circulation · February 18, 2020 Cardiovascular disease (CVD) is the leading cause of death among women in the United States. As compared with men, women are less likely to be diagnosed appropriately, receive preventive care, or be treated aggressively for CVD. Sex differences between men ... Full text Link to item Cite

Secondary prevention of cardiovascular diseases in India: Findings from registries and large cohorts.

Journal Article Indian Heart J · 2020 Several registries and quality improvement initiatives have focused on assessing and improving secondary prevention of CVD in India. While the Treatment and Outcomes of Acute Coronary Syndromes in India (CREATE), Indian Heart Rhythm Society-Atrial Fibrilla ... Full text Link to item Cite

Clinical research in Africa And Middle East: roadmap for reform and harmonisation of the regulatory framework and sustainable capacity development

Journal Article Journal of Global Health Reports · November 1, 2019 The Middle East, Mediterranean, Africa (MEMA) region, is composed of 68 countries, totalling a population of over 1.6 billion ie, 20% of the world. It contributes little to the international effort of health knowledge production, hosting only 6% of the wor ... Full text Cite

Echocardiographic Assessment of Right Ventricular Function and Response to Therapy in Pulmonary Arterial Hypertension.

Journal Article Am J Cardiol · October 15, 2019 Echocardiography is a key tool in the management of patients with pulmonary arterial hypertension (PAH), but many potential parameters could be used to assess response to therapy. In this retrospective study of 48 patients with severe PAH at baseline, we e ... Full text Link to item Cite

The Prognostic Value of Diastolic and Systolic Mechanical Left Ventricular Dyssynchrony Among Patients With Coronary Heart Disease.

Conference JACC Cardiovasc Imaging · July 2019 OBJECTIVES: The goal of this study was to examine whether diastolic dyssynchrony, measured by using gated single-photon emission computed tomography (GSPECT) myocardial perfusion imaging (MPI) in patients with coronary artery disease (CAD), is independentl ... Full text Link to item Cite

Predictors and Changes in Cardiac Hemodynamics and Geometry With Transcatheter Aortic Valve Implantation.

Journal Article Am J Cardiol · March 1, 2019 The introduction of transcatheter aortic valve implantation (TAVI) has revolutionized the treatment of patients with severe aortic stenosis (AS). However, despite the great clinical success of TAVI, less is known about the cardiac hemodynamics and structur ... Full text Link to item Cite

Crowdsourcing consensus: proposal of a novel method for assessing accuracy in echocardiography interpretation.

Journal Article Int J Cardiovasc Imaging · November 2018 Quality in stress echocardiography interpretation is often gauged against coronary angiography (CA) data but anatomic obstructive coronary disease on CA is an imperfect gold standard for a stress induced wall motion abnormality. We examined the utility of ... Full text Link to item Cite

Clinical Utility and Prognostic Value of Right Atrial Function in Pulmonary Hypertension.

Journal Article Circ Cardiovasc Imaging · November 2018 Background Although right atrial (RA) enlargement is an established marker for adverse outcomes, the prognostic importance of RA dysfunction independent of RA size in pulmonary arterial hypertension is not known. Methods and Results Study subjects with pul ... Full text Link to item Cite

Long-term outcomes of mitral regurgitation by type and severity.

Journal Article Am Heart J · September 2018 BACKGROUND: We aimed to determine the association of MR severity and type with all-cause death in a large, real-world, clinical setting. METHODS: We reviewed full echocardiography studies at Duke Echocardiography Laboratory (01/01/1995-12/31/2010), classif ... Full text Link to item Cite

Clinical and Echocardiographic Predictors of Outcomes in Patients With Pulmonary Hypertension.

Journal Article Am J Cardiol · September 1, 2018 In pulmonary hypertension (PH), measurement of various echocardiographic parameters that assess right heart function is recommended by current clinical guidelines. Limited data exists on the combined value of clinical and echocardiographic parameters in pr ... Full text Link to item Cite

Right Ventricular Longitudinal Strain Reproducibility Using Vendor-Dependent and Vendor-Independent Software.

Journal Article J Am Soc Echocardiogr · June 2018 BACKGROUND: Right ventricular peak systolic longitudinal strain (RVLS) has emerged as an approach for quantifying right ventricular function in diseases such as pulmonary hypertension and congenital heart disease. A major limitation in applying RVLS is tha ... Full text Link to item Cite

Impaired Recovery of Left Ventricular Function in Patients With Cardiomyopathy and Left Bundle Branch Block.

Journal Article J Am Coll Cardiol · January 23, 2018 BACKGROUND: Patients with left bundle branch block (LBBB) often respond to cardiac resynchronization therapy (CRT) with left ventricular ejection fraction (LVEF) improvement. Guideline-directed medical therapy (GDMT), not CRT, is first-line therapy for pat ... Full text Link to item Cite

Epidemiologic studies targeting primary cardiovascular disease prevention in South Asia.

Journal Article Indian Heart J · 2018 South Asia has experienced a 73% increase in healthy life years lost due to ischemic heart disease between 1990 and 2010. There is a lack of quality data relating to cardiovascular risk factors and disease from this region. Several observational and prospe ... Full text Link to item Cite

Strain Basics and Global Longitudinal Strain

Chapter · January 1, 2018 Measurement of myocardial global longitudinal strain (GLS) is no longer a research tool. Rather, GLS is now used for risk assessment and management of patients with a wide variety of clinical disorders. GLS is clearly a useful supplement to routine quantit ... Full text Cite

The Role of Echocardiography in Mitral Valve Repair

Chapter · January 1, 2018 Echocardiography is a versatile diagnostic technology integral to the assessment and treatment of mitral regurgitation (MR). MR is broadly classified as primary—resulting from abnormalities of the MV leaflets or apparatus, or secondary—arising from left ve ... Full text Cite

Comparison of Incidence of Left Ventricular Systolic Dysfunction Among Patients With Left Bundle Branch Block Versus Those With Normal QRS Duration.

Journal Article Am J Cardiol · December 1, 2017 We compared the incidence of left ventricular systolic dysfunction (LVSD) among patients with left bundle branch block (LBBB) to a matched cohort of patients with a narrow QRS duration <120 ms (NQRS). We hypothesized patients with preserved ejection fracti ... Full text Link to item Cite

Usefulness of Myocardial Annular Velocity Change During Mental Stress to Predict Cardiovascular Outcome in Patients With Coronary Artery Disease (From the Responses of Mental Stress-Induced Myocardial Ischemia to Escitalopram Treatment Trial).

Journal Article Am J Cardiol · November 1, 2017 Mental stress-induced myocardial ischemia is common and a prognostic factor of adverse cardiovascular outcomes in patients with coronary artery disease (CAD). The present study aimed at examining associations between mental stress-induced myocardial annula ... Full text Link to item Cite

Prevalence and Outcomes of Left-Sided Valvular Heart Disease Associated With Chronic Kidney Disease.

Journal Article J Am Heart Assoc · October 11, 2017 BACKGROUND: Chronic kidney disease (CKD) is an adverse prognostic marker for valve intervention patients; however, the prevalence and related outcomes of valvular heart disease in CKD patients is unknown. METHODS AND RESULTS: Included patients underwent ec ... Full text Open Access Link to item Cite

Improving on the diagnostic characteristics of echocardiography for pulmonary hypertension.

Journal Article Int J Cardiovasc Imaging · September 2017 This retrospective study evaluated the diagnostic characteristics of a combination of echocardiographic parameters for pulmonary hypertension (PH). Right ventricular systolic pressure (RVSP) estimation by echocardiography (echo) is used to screen for PH. H ... Full text Link to item Cite

Assessment of Paravalvular Leak After Transcatheter Aortic Valve Replacement: Transesophageal Echocardiography Compared With Transthoracic Echocardiography.

Journal Article J Cardiothorac Vasc Anesth · August 2017 OBJECTIVES: Determine whether moderate or greater paravalvular leak (PVL) after transcatheter aortic valve replacement quantified using intraoperative transesophageal echocardiography (TEE) is associated with mortality and investigate the correlation betwe ... Full text Link to item Cite

Mitral Regurgitation After Orthotopic Lung Transplantation: Natural History and Impact on Outcomes.

Journal Article J Cardiothorac Vasc Anesth · June 2017 OBJECTIVE: Progression of mitral regurgitation (MR) after orthotopic lung transplantation (OLT) may be an underrecognized phenomenon due to the overlapping symptomatology of pulmonary and valvular disease. Literature evaluating the progression of MR after ... Full text Open Access Link to item Cite

Mental stress-induced left ventricular dysfunction and adverse outcome in ischemic heart disease patients.

Journal Article Eur J Prev Cardiol · April 2017 Aims Mental stress-induced myocardial ischemia (MSIMI) occurs in up to 70% of patients with clinically stable ischemic heart disease and is associated with increased risk of adverse prognosis. We aimed to examine the prognostic value of indices of MSIMI an ... Full text Link to item Cite

Incidence and Predictors of Left Atrial Appendage Thrombus in Patients Treated With Nonvitamin K Oral Anticoagulants Versus Warfarin Before Catheter Ablation for Atrial Fibrillation.

Journal Article Am J Cardiol · April 1, 2017 The utility of routine transesophageal echocardiography (TEE) to exclude left atrial appendage (LAA) thrombus before atrial fibrillation (AF) ablation in patients treated with nonvitamin K oral anticoagulant (NOAC) therapy is unclear. This single-center re ... Full text Link to item Cite

Associations between positive emotional well-being and stress-induced myocardial ischemia: Well-being scores predict exercise-induced ischemia.

Journal Article J Psychosom Res · February 2017 OBJECTIVE: Depressive symptoms have been associated with myocardial ischemia induced by mental (MSIMI) and exercise (ESIMI) stress in clinically stable ischemic heart disease (IHD) patients, but the association between positive emotions and inducible ische ... Full text Link to item Cite

Echocardiography in the Risk Assessment of Acute Pulmonary Embolism.

Journal Article Semin Respir Crit Care Med · February 2017 Acute pulmonary embolism (PE) is a major cause of morbidity and mortality and is classified as massive (high risk), submassive (intermediate risk), or nonmassive (low risk) based on the hemodynamic status and clinical characteristics of the patient. At thi ... Full text Link to item Cite

Stable ischemic heart disease in women: current perspectives.

Journal Article Int J Womens Health · 2017 Cardiovascular disease is the leading cause of death in women accounting for 1 in every 4 female deaths. Pathophysiology of ischemic heart disease in women includes epicardial coronary artery, endothelial dysfunction, coronary vasospasm, plaque erosion and ... Full text Link to item Cite

Functional Mitral Regurgitation: Appraising the Evidence Behind Recommended Treatment Strategies.

Journal Article Curr Cardiol Rep · December 2016 Functional mitral regurgitation (MR) is the most common type of MR encountered in clinical practice. Because the disease arises from the ventricular aspect of the mitral valve apparatus, treatment therapies are less defined and outcomes are poor. In this r ... Full text Link to item Cite

Frequent Activation Delay-Induced Mechanical Dyssynchrony and Dysfunction in the Systemic Right Ventricle.

Journal Article J Am Soc Echocardiogr · November 2016 BACKGROUND: Patients with systemic right ventricles frequently experience progressive heart failure and conduction abnormalities leading to abnormal ventricular activation. Activation delay-induced mechanical dyssynchrony can contribute to ventricular fail ... Full text Link to item Cite

Clinical and echocardiographic predictors of mortality in acute pulmonary embolism.

Journal Article Cardiovasc Ultrasound · October 28, 2016 PURPOSE: The aim of this study was to evaluate the utility of adding quantitative assessments of cardiac function from echocardiography to clinical factors in predicting the outcome of patients with acute pulmonary embolism (PE). METHODS: Patients with a d ... Full text Open Access Link to item Cite

Clinical and echocardiographic predictors of mortality in acute pulmonary embolism

Journal Article Cardiovascular ultrasound · October 28, 2016 PURPOSE: The aim of this study was to evaluate the utility of adding quantitative assessments of cardiac function from echocardiography to clinical factors in predicting the outcome of patients with acute pulmonary embolism (PE). METHODS: Patients with a d ... Cite

Grading Aortic Stenosis With Mean Gradient and Aortic Valve Area: A Comparison Between Preoperative Transthoracic and Precardiopulmonary Bypass Transesophageal Echocardiography.

Journal Article J Cardiothorac Vasc Anesth · October 2016 OBJECTIVE: The authors hypothesized that average precardiopulmonary bypass (pre-CPB) transesophageal echocardiographic (TEE) mean gradient (PGm) and aortic valve area (AVA) values would be significantly different from preoperative transthoracic (TTE) value ... Full text Open Access Link to item Cite

Aortic valve surgery and survival in patients with moderate or severe aortic stenosis and left ventricular dysfunction.

Journal Article Eur Heart J · July 21, 2016 AIMS: We aimed to determine the frequency of aortic valve surgery (AVR) with or without coronary artery bypass grafting (CABG), among patients with moderate/severe aortic stenosis (AS) and left ventricular systolic dysfunction (LVSD), and its relationship ... Full text Link to item Cite

Echocardiographic agreement in the diagnostic evaluation for infective endocarditis.

Journal Article Int J Cardiovasc Imaging · July 2016 Echocardiography is essential for the diagnosis and management of infective endocarditis (IE). However, the reproducibility for the echocardiographic assessment of variables relevant to IE is unknown. Objectives of this study were: (1) To define the reprod ... Full text Link to item Cite

An Approach to Improve the Negative Predictive Value and Clinical Utility of Transthoracic Echocardiography in Suspected Native Valve Infective Endocarditis.

Journal Article J Am Soc Echocardiogr · April 2016 BACKGROUND: In patients with suspected native valve infective endocarditis, current guidelines recommend initial transthoracic echocardiography (TTE) followed by transesophageal echocardiography (TEE) if clinical suspicion remains. The guidelines do not ac ... Full text Link to item Cite

Implementing a Continuous Quality Improvement Program in a High-Volume Clinical Echocardiography Laboratory: Improving Care for Patients With Aortic Stenosis.

Journal Article Circ Cardiovasc Imaging · March 2016 BACKGROUND: The management of aortic stenosis rests on accurate echocardiographic diagnosis. Hence, it was chosen as a test case to examine the utility of continuous quality improvement (CQI) approaches to increase echocardiographic data accuracy and relia ... Full text Open Access Link to item Cite

The MitraClip and survival in patients with mitral regurgitation at high risk for surgery: A propensity-matched comparison.

Journal Article Am Heart J · November 2015 BACKGROUND: We compared 30-day and 1-year survival among high-risk mitral regurgitation (MR) patients treated with the MitraClip (Abbott Vascular, Abbott Park, IL) with matched non-surgically treated patients from the Duke Echocardiography Laboratory Datab ... Full text Link to item Cite

Management and outcomes in patients with moderate or severe functional mitral regurgitation and severe left ventricular dysfunction.

Journal Article Eur Heart J · October 21, 2015 AIMS: The management and outcomes of patients with functional moderate/severe mitral regurgitation and severe left ventricular (LV) systolic dysfunction are not well defined. We sought to determine the characteristics, management strategies, and outcomes o ... Full text Link to item Cite

Temporal Trends in Disease Severity and Predicted Surgical Risk at the Time of Referral for Echocardiography in Patients Diagnosed with Aortic Stenosis.

Journal Article Crit Pathw Cardiol · September 2015 BACKGROUND: Calcific aortic stenosis (AS) is the most common underlying pathology in patients undergoing heart valve surgery, with an expected increasing prevalence among the aging population. METHODS AND RESULTS: We identified the temporal trends in refer ... Full text Link to item Cite

Use of outcome measures in pulmonary hypertension clinical trials.

Journal Article Am Heart J · September 2015 OBJECTIVES: To evaluate the use of surrogate measures in pulmonary hypertension (PH) clinical trials and how it relates to clinical practice. BACKGROUND: Studies of pulmonary arterial hypertension (PAH) employ a variety of surrogate measures in addition to ... Full text Link to item Cite

Echocardiographic Findings Predict In-Hospital and 1-Year Mortality in Left-Sided Native Valve Staphylococcus aureus Endocarditis: Analysis From the International Collaboration on Endocarditis-Prospective Echo Cohort Study.

Journal Article Circ Cardiovasc Imaging · July 2015 BACKGROUND: Staphylococcus aureus left-sided native valve infective endocarditis (LNVIE) has higher complication and mortality rates compared with endocarditis from other pathogens. Whether echocardiographic variables can predict prognosis in S aureus LNVI ... Full text Link to item Cite

Metabolomics analysis reveals insights into biochemical mechanisms of mental stress-induced left ventricular dysfunction.

Journal Article Metabolomics · June 1, 2015 Mental stress induced left ventricular dysfunction (LVD) has been associated with a greater risk of adverse events in coronary heart disease (CHD) patients independent of conventional risk indicators. The underlying biochemical mechanisms of this cardiovas ... Full text Link to item Cite

Candida infective endocarditis: an observational cohort study with a focus on therapy.

Journal Article Antimicrob Agents Chemother · April 2015 Candida infective endocarditis is a rare disease with a high mortality rate. Our understanding of this infection is derived from case series, case reports, and small prospective cohorts. The purpose of this study was to evaluate the clinical features and u ... Full text Link to item Cite

Platelet aggregation and mental stress induced myocardial ischemia: Results from the Responses of Myocardial Ischemia to Escitalopram Treatment (REMIT) study.

Journal Article Am Heart J · April 2015 BACKGROUND: Mental stress-induced myocardial ischemia (MSIMI) is common in patients with ischemic heart disease (IHD) and associated with a poorer cardiovascular prognosis. Platelet hyperactivity is an important factor in acute coronary syndrome. This stud ... Full text Open Access Link to item Cite

Platelet aggregation and mental stress induced myocardial ischemia: Results from the Responses of Myocardial Ischemia to Escitalopram Treatment (REMIT) study

Journal Article American Heart Journal · April 1, 2015 Background Mental stress-induced myocardial ischemia (MSIMI) is common in patients with ischemic heart disease (IHD) and associated with a poorer cardiovascular prognosis. Platelet hyperactivity is an important factor in acute coronary syndrome. This study ... Full text Cite

Impact of early valve surgery on outcome of Staphylococcus aureus prosthetic valve infective endocarditis: analysis in the International Collaboration of Endocarditis-Prospective Cohort Study.

Journal Article Clin Infect Dis · March 1, 2015 BACKGROUND: The impact of early valve surgery (EVS) on the outcome of Staphylococcus aureus (SA) prosthetic valve infective endocarditis (PVIE) is unresolved. The objective of this study was to evaluate the association between EVS, performed within the fir ... Full text Link to item Cite

One-year outcome following biological or mechanical valve replacement for infective endocarditis.

Journal Article Int J Cardiol · January 15, 2015 BACKGROUND: Nearly half of patients require cardiac surgery during the acute phase of infective endocarditis (IE). We describe the characteristics of patients according to the type of valve replacement (mechanical or biological), and examine whether the ty ... Full text Link to item Cite

Predictors and progression of aortic stenosis in patients with preserved left ventricular ejection fraction.

Journal Article Am J Cardiol · January 1, 2015 We aimed to characterize the hemodynamic progression of aortic stenosis (AS) in a contemporary unselected cohort of patients with preserved left ventricular ejection fraction. Current guidelines recommend echocardiographic surveillance of hemodynamic progr ... Full text Link to item Cite

Predictors Of 30-Day Survival In Acute Pulmonary Embolism

Conference AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE · January 1, 2015 Link to item Cite

Notice

Journal Article Journal of the American College of Cardiology · December 2014 Full text Cite

Sex differences in platelet reactivity and cardiovascular and psychological response to mental stress in patients with stable ischemic heart disease: insights from the REMIT study.

Journal Article J Am Coll Cardiol · October 21, 2014 BACKGROUND: Although emotional stress is associated with ischemic heart disease (IHD) and related clinical events, sex-specific differences in the psychobiological response to mental stress have not been clearly identified. OBJECTIVES: We aimed to study th ... Full text Link to item Cite

Blood flow visualization with real time high speed ultrasound

Conference IEEE International Ultrasonics Symposium Ius · October 20, 2014 A new method of acquiring and displaying high speed ultrasound images has been developed. To extract flow information from the low intensity reflections of moving blood in these high frame rate images, difference imaging was found to be a particularly appl ... Full text Cite

A critical review of hemodynamic changes and left ventricular remodeling after surgical aortic valve replacement and percutaneous aortic valve replacement.

Journal Article Am Heart J · August 2014 UNLABELLED: The introduction of transcatheter aortic valve replacement (TAVR) in clinical practice has widened options for symptomatic patients at high surgical risk; however, it is not known whether TAVR has equivalent or prolonged benefits in terms of le ... Full text Link to item Cite

Surgical revascularization is associated with maximal survival in patients with ischemic mitral regurgitation: a 20-year experience.

Journal Article Circulation · June 17, 2014 BACKGROUND: The optimal treatment for ischemic mitral regurgitation remains actively debated. Our objective was to evaluate the relationship between ischemic mitral regurgitation treatment strategy and survival. METHODS AND RESULTS: We retrospectively revi ... Full text Link to item Cite

Comprehensive assessment of right ventricular function in patients with pulmonary hypertension with global longitudinal peak systolic strain derived from multiple right ventricular views.

Journal Article J Am Soc Echocardiogr · June 2014 BACKGROUND: Right ventricular (RV) function is a strong predictor of mortality in pulmonary hypertension (PH), but two-dimensional (2D) echocardiography-derived assessments of RV function that could aid in risk assessment and management of patients with PH ... Full text Link to item Cite

The impact of pulmonary hypertension on morbidity and mortality following major lung resection.

Journal Article Eur J Cardiothorac Surg · June 2014 OBJECTIVES: Pulmonary hypertension is considered a poor prognostic factor for or even a contraindication to major lung resection, but evidence for this claim is lacking. This study evaluates the impact of pulmonary hypertension on morbidity and mortality f ... Full text Link to item Cite

Right ventricular mechanics using a novel comprehensive three-view echocardiographic strain analysis in a normal population.

Journal Article J Am Soc Echocardiogr · April 2014 BACKGROUND: Although quantitative right ventricular (RV) strain analysis may be useful in congenital and acquired heart disease populations with RV failure, a comprehensive, standardized approach is lacking. An 18-segment RV strain analysis obtained from t ... Full text Link to item Cite

Impaired resting myocardial annular velocities are independently associated with mental stress-induced ischemia in coronary heart disease.

Journal Article JACC Cardiovasc Imaging · April 2014 OBJECTIVES: The aim of this study was to investigate the association between resting myocardial function as assessed by tissue Doppler myocardial velocities and the propensity to develop mental stress-induced ischemia (MSIMI). BACKGROUND: Tissue Doppler my ... Full text Link to item Cite

IMPORTANCE OF AORTIC STENOSIS IN PATIENTS PRESENTING WITH ACUTE MYOCARDIAL INFARCTION

Journal Article Journal of the American College of Cardiology · April 2014 Full text Cite

SERIAL CHANGES IN MYOCARDIAL STRAIN IN MEDICALLY MANAGED SEVERE AORTIC STENOSIS AND LONG TERM OUTCOMES

Journal Article Journal of the American College of Cardiology · April 2014 Full text Cite

PROGRESSION OF SIGNIFICANT FUNCTIONAL MR IN MEDICALLY MANAGED PATIENTS

Journal Article Journal of the American College of Cardiology · April 2014 Full text Cite

Aortic annular geometry and sizing: Echocardiography

Chapter · November 1, 2013 A complete and accurate assessment of the aortic annulus and the surrounding structures is accomplished non-invasively by on organized echocardiographic approch employing a variety of techniques. An approch with transthoracic and transesophageal imaging mo ... Full text Cite

Effect of escitalopram on mental stress-induced myocardial ischemia: results of the REMIT trial.

Journal Article JAMA · May 22, 2013 IMPORTANCE: Mental stress can induce myocardial ischemia and also has been implicated in triggering cardiac events. However, pharmacological interventions aimed at reducing mental stress-induced myocardial ischemia (MSIMI) have not been well studied. OBJEC ... Full text Link to item Cite

Prevalence and clinical characteristics of mental stress-induced myocardial ischemia in patients with coronary heart disease.

Journal Article J Am Coll Cardiol · February 19, 2013 OBJECTIVES: The goal of this study was to evaluate the prevalence and clinical characteristics of mental stress-induced myocardial ischemia. BACKGROUND: Mental stress-induced myocardial ischemia is prevalent and a risk factor for poor prognosis in patients ... Full text Link to item Cite

Influence of the timing of cardiac surgery on the outcome of patients with infective endocarditis and stroke.

Journal Article Clin Infect Dis · January 2013 BACKGROUND: The timing of cardiac surgery after stroke in infective endocarditis (IE) remains controversial. We examined the relationship between the timing of surgery after stroke and the incidence of in-hospital and 1-year mortalities. METHODS: Data were ... Full text Link to item Cite

Relationships between cardiac magnetic resonance imaging abnormalities in the inter-ventricular septum and Selvester QRS scoring criteria for anterior-septal myocardial infarction in patients with right ventricular volume overload.

Journal Article J Electrocardiol · 2013 BACKGROUND: Patients with ostium secundum atrial septal defects (ASDs) were studied to determine the prevalence of Selvester anteroseptal myocardial infarction QRS points, and to test the hypothesis that there is a relationship between these criteria and t ... Full text Link to item Cite

HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort.

Journal Article PLoS One · 2013 The HACEK organisms (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) are rare causes of infective endocarditis (IE). The objective of this study is to describe the clinical characteristics a ... Full text Link to item Cite

Depressive symptoms and mental stress-induced myocardial ischemia in patients with coronary heart disease.

Journal Article Psychosom Med · 2013 OBJECTIVES: The aim of this study was to examine the associations between depressive symptoms and mental stress-induced myocardial ischemia (MSIMI) in patients with coronary heart disease (CHD). METHODS: Adult patients with documented CHD were recruited fo ... Full text Link to item Cite

Comparison of need for operative therapy in patients with mitral valve prolapse involving both leaflets versus posterior leaflet only.

Journal Article Am J Cardiol · November 1, 2012 Mitral valve prolapse may involve 1 leaflet or 2 leaflets, yet management guidelines do not differentiate posterior leaflet (PML) from bileaflet (BML) prolapse. We hypothesized that patients with BML have a prolonged natural history with more severe atrial ... Full text Link to item Cite

Variability of global left ventricular deformation analysis using vendor dependent and independent two-dimensional speckle-tracking software in adults.

Journal Article J Am Soc Echocardiogr · November 2012 BACKGROUND: Evaluation of myocardial deformation by two-dimensional speckle-tracking is useful for clinical and research purposes. However, differences may exist among different ultrasound machines, software packages, frame rates, and observers. METHODS: T ... Full text Link to item Cite

A meta-analysis and systematic review of computed tomography angiography as a diagnostic triage tool for patients with chest pain presenting to the emergency department.

Journal Article J Nucl Cardiol · April 2012 BACKGROUND: To assess clinical utility of computed tomography angiography (CTA) in the diagnosis of chest pain patients presenting to emergency departments (EDs), we conducted a meta-analysis of CTA in patients with suspected acute coronary syndromes (ACSs ... Full text Link to item 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

Responses of mental stress-induced myocardial ischemia to escitalopram treatment: background, design, and method for the Responses of Mental Stress Induced Myocardial Ischemia to Escitalopram Treatment trial.

Journal Article Am Heart J · January 2012 BACKGROUND: Mental stress-induced myocardial ischemia (MSIMI) is common in patients with clinically stable coronary heart disease (CHD) and is associated with poor outcomes. Depression is a risk factor of MSIMI. The REMIT trial investigates whether selecti ... Full text Link to item Cite

Prevalence and predictors of mechanical dyssynchrony as defined by phase analysis in patients with left ventricular dysfunction undergoing gated SPECT myocardial perfusion imaging.

Journal Article J Nucl Cardiol · February 2011 BACKGROUND: A novel method to quantify dyssynchrony using phase analysis of single-photon emission computed tomography (SPECT) myocardial perfusion imaging has been developed. We sought to determine the prevalence of SPECT-derived mechanical dyssynchrony, ... Full text Link to item Cite

Impact of early surgery on survival of patients with severe mitral regurgitation.

Journal Article Heart · February 2011 BACKGROUND: Optimal timing of surgery in degenerative mitral regurgitation (MR) remains a controversial topic. The impact of current ACC/AHA guideline recommendations about optimal timing of surgery on outcomes is untested and contemporary data are lacking ... Full text Link to item Cite

Anatomic and clinical correlates of septal morphology in hypertrophic cardiomyopathy.

Journal Article Eur J Echocardiogr · February 2011 UNLABELLED: Aim The presence of septal hypertrophy in hypertrophic cardiomyopathy (HCM) is common. To date, there has been no accepted classification of septal morphology in HCM. Furthermore, the possible relationship between septal morphology and clinical ... Full text Link to item Cite

Renal function and risk stratification of diabetic and nondiabetic patients undergoing evaluation for coronary artery disease.

Journal Article JACC Cardiovasc Imaging · July 2010 OBJECTIVES: The aim of this study was to evaluate the impact of renal function by estimated glomerular filtration rate (eGFR) on risk stratification of diabetic and nondiabetic patients undergoing myocardial perfusion imaging (MPI) by single-photon emissio ... Full text Link to item Cite

Infective Endocarditis

Journal Article · May 21, 2010 Full text Cite

The utility of modified Butler-Leggett criteria for right ventricular hypertrophy in detection of clinically significant shunt ratio in ostium secundum-type atrial septal defect in adults.

Journal Article J Electrocardiol · 2010 BACKGROUND: This study was performed to test the hypothesis that there exists a correlation between the Butler-Leggett (BL) criterion for right ventricular hypertrophy on the electrocardiogram and the Qp/Qs shunt ratio in adults with ostium secundum atrial ... Full text Link to item Cite

Provisional vs. complex stenting strategy for coronary bifurcation lesions: meta-analysis of randomized trials.

Journal Article J Invasive Cardiol · November 2009 BACKGROUND: To assess the optimal percutaneous coronary intervention (PCI) approach for coronary artery bifurcation lesions (CBL), we conducted a meta-analysis of randomized trials comparing provisional stenting (PS) to complex stenting strategy (CS). DATA ... Link to item Cite

Reporting and representation of race/ethnicity in published randomized trials.

Journal Article Am Heart J · November 2009 BACKGROUND: Although adequate representation of specific subgroups (eg, women and the elderly) in randomized controlled trials (RCTs) has been under intense scrutiny, there are few data on representation by race. METHODS: Using all RCTs cited by the 2007 A ... Full text Link to item Cite

Use of phase analysis of gated SPECT perfusion imaging to quantify dyssynchrony in patients with mild-to-moderate left ventricular dysfunction.

Journal Article J Nucl Cardiol · 2009 BACKGROUND: CRT has been shown to be beneficial in the majority of patients with NYHA class III-IV symptoms, prolonged QRS duration, and an EF < or =35%. The use of imaging modalities to quantify dyssynchrony may help identify patients who may benefit from ... Full text Link to item Cite

Predictive value of myocardial perfusion single-photon emission computed tomography and the impact of renal function on cardiac death.

Journal Article Circulation · December 9, 2008 BACKGROUND: Patients with chronic kidney disease (CKD) have worse cardiovascular outcomes than those without CKD. The prognostic utility of myocardial perfusion single-photon emission CT (MPS) in patients with varying degrees of renal dysfunction and the i ... Full text Link to item Cite

Echocardiographic risk stratification for early surgery with endocarditis: a cost-effectiveness analysis.

Journal Article Heart · May 2008 BACKGROUND: Despite widespread acceptance of echocardiography for diagnosis of infective endocarditis, few investigators have evaluated its utility as a risk-stratification tool to aid therapeutic decision-making. METHODS: A decision tree and Markov analys ... Full text Link to item Cite

Closing the gap: treating hypertension in women.

Journal Article Cardiol Rev · 2008 Hypertension is a common and readily modifiable risk factor for cardiovascular and cerebrovascular disease. Despite extensive clinical trial results and efforts to increase public awareness, it remains inadequately controlled in the general population. Wom ... Full text Link to item Cite

Acute myocardial infarction: profile and management at a tertiary care hospital in Karachi.

Journal Article J Pak Med Assoc · January 2002 OBJECTIVE: Acute Myocardial Infarction (AMI) is a rising epidemic in developing countries. While studies in the West have established the characteristics and management of AMI patients, comprehensive data reflecting these issues in the Pakistani subjects i ... Link to item Cite

Hormone replacement therapy menopause with a better future--a survey of views on hormone replacement therapy (HRT).

Journal Article J Pak Med Assoc · December 2001 OBJECTIVE: To assess the views and prescribing practices of doctors regarding hormone replacement therapy (HRT). METHODS: In April 1999, 103 doctors from a teaching hospital participated in a survey. Using a self-administered questionnaire, subjects were c ... Link to item Cite