Publications by authors named "Kay D Everett"
Background: Current flow (Q) assessment in aortic stenosis (AS) uses stroke volume index (SVi), a volume (V)-based measure. However, V differs fundamentally from Q, which is defined as volume per unit time (mL/s).
Objectives: This study evaluates the prognostic significance of volume-flow (V-Q) discordance in patients with severe AS (aortic valve area <1 cm) undergoing transcatheter aortic valve replacement (TAVR).
Systemic Circulation in Advanced Heart Failure and Cardiogenic Shock: State-of-the-Art Review.
Circ Heart Fail
February 2025
The integrative physiology of the left ventricle and systemic circulation is fundamental to our understanding of advanced heart failure and cardiogenic shock. In simplest terms, any increase in aortic stiffness increases the vascular afterload presented to the failing left ventricle. The net effect is increased myocardial oxygen demand and reduced coronary perfusion pressure, thereby further deteriorating contractile function.
View Article and Find Full Text PDFArticle Synopsis
- Cardiolipin is crucial for mitochondrial function and is impacted by VA-ECMO, which is used in treating acute myocardial infarction, but its effects on heart damage are not well understood.
- The study found that both human patients requiring VA-ECMO and healthy swine subjected to this treatment showed significantly lower levels of cardiolipin and the enzyme tafazzin, indicating potential detrimental effects on the heart.
- Importantly, VA-ECMO increased heart damage during ischemia/reperfusion, evidenced by a larger infarct size in swine, suggesting that depleting cardiolipin during treatment may worsen myocardial injury.
Article Synopsis
- The study investigates whether combining ECMO with Impella (EC-Pella) can reduce heart damage in acute myocardial infarction, finding that EC-Pella lowers infarct size compared to ECMO alone when started before reperfusion.
- Results indicate that using EC-Pella before activating ECMO helps to decrease left ventricular pressure-volume area and activates protective signaling, but it doesn't fix mitochondrial dysfunction like ECMO alone.
- The research suggests that while EC-Pella may reduce heart damage, the processes that protect the heart and those that repair damage may not be directly linked when using ECMO in the context of acute myocardial infarction.
Epidemiology and management of right ventricular-predominant heart failure and shock in the cardiac intensive care unit.
Eur Heart J Acute Cardiovasc Care
July 2022
Article Synopsis
- Cardiogenic shock due to left ventricular failure is common in ICUs, while right ventricular (RV)-predominant heart failure causing shock is less understood.
- The article examines the frequency and causes of RV-predominant heart failure.
- It also explores treatment options, including medications and devices, for managing this complex clinical issue.
Background: Understanding the prognostic impact of right ventricular dysfunction (RVD) in cardiogenic shock (CS) is a key step toward rational diagnostic and treatment algorithms and improved outcomes. Using a large multicenter registry, we assessed (1) the association between hemodynamic markers of RVD and in-hospital mortality, (2) the predictive value of invasive hemodynamic assessment incorporating RV evaluation, and (3) the impact of RVD severity on survival in CS.
Methods And Results: Inpatients with CS owing to acute myocardial infarction (AMI) or heart failure (HF) between 2016 and 2019 were included.
Endovascular stents are the mainstay of interventional cardiovascular medicine. Technological advances have reduced biological and clinical complications but not mechanical failure. Stent strut fracture is increasingly recognized as of paramount clinical importance.
View Article and Find Full Text PDF