Publications by authors named "Salpy Pamboukian"
Objective: Despite advancements in heart failure (HF) diagnostics and treatment, many palliative care patients with HF often seek complementary and alternative medicine (CAM) to improve quality of life and address unmet physical and emotional needs. This study aimed to explore the prevalence and patterns of CAM use among HF patients in a large academic medical ambulatory HF clinic in Alabama.
Methods: This cross-sectional, descriptive study included HF patients from the University of Alabama at Birmingham HF clinic.
Strategies and outcomes of extracorporeal membrane oxygenation use in peripartum patients: a single institution experience.
J Matern Fetal Neonatal Med
December 2024
Background: Extracorporeal membrane oxygenation (ECMO) use in peripartum patients is rare, and there is a gap in the literature on the outcomes and guidance on using ECMO in peripartum patients. This study describes ECMO strategies our institution uses for peripartum patients and reports outcomes of ECMO use in peripartum patients with respiratory and/or cardiac failure.
Methods: A case series of all peripartum patients, defined as pregnant or up to 6 weeks after delivery of an infant >20 weeks gestation, from 2018 to 2023 from a single center requiring ECMO support.
A comparison of quality-adjusted life years in older adults after heart transplantation versus long-term mechanical support: Findings from the SUSTAIN-IT study.
J Heart Lung Transplant
September 2024
Article Synopsis
- - The study evaluated the quality-adjusted life years (QALYs) in older heart failure patients (ages 60-80) who received either heart transplants (with or without pre-transplant mechanical support) or long-term mechanical circulatory support.
- - Data from 393 patients showed that those who underwent heart transplantation without pre-surgery support had significantly higher QALYs at 24 months compared to those who had pre-surgery support or long-term mechanical support.
- - Findings suggest that QALY assessments can guide healthcare policy and clinical decisions regarding the most beneficial treatment options for elderly patients with heart failure.
Article Synopsis
- The study investigates the genetic factors associated with advanced dilated cardiomyopathy (DCM), particularly focusing on rare genetic variants related to patients requiring devices like left ventricular assist devices (LVAD) or heart transplants (HT).
- Researchers analyzed data from a diverse group of 1,198 patients enrolled in a precision medicine study, classifying the severity of DCM based on treatment type and assessing genetic variants in 36 related genes.
- Findings revealed that 26.2% of patients with advanced DCM (LVAD/HT) had pathogenic genetic variants, significantly more than those with only an implantable cardioverter defibrillator (15.9%) or neither treatment (15.0%), indicating a strong genetic link to
Article Synopsis
- - The study investigates the genetic differences in dilated cardiomyopathy (DCM) among Black, Hispanic, and White patients, noting that Black patients face higher familial risk and worse health outcomes compared to White patients, despite most existing genetic data coming from the latter group.
- - Researchers conducted a cross-sectional study involving over 1,000 patients across various US heart failure centers, focusing on genetic variants in 36 DCM-related genes, classified based on their significance and clinical impact.
- - Findings revealed that Black patients displayed a lower percentage of clinically actionable genetic variants compared to White patients (8.2% vs 25.5%), particularly in the TTN gene, highlighting potential disparities in genetic influences on DCM severity among different ances
Background: Gastrointestinal bleeding (GIB) affects up to 40% of continuous-flow left ventricular assist device (CF-LVAD) recipients. A higher risk of GIB is seen in CF-LVAD recipients with lower device pulsatility without a known mechanism. One hypothesis is that the novel hemodynamics in CF-LVAD recipients affect angiogenesis signaling.
View Article and Find Full Text PDFBackground: Information about health-related quality of life (HRQOL) among caregivers of older patients with heart failure who receive heart transplantation (HT) and mechanical circulatory support (MCS) is sparse. We describe differences and factors associated with change in HRQOL before and early post-surgery among caregivers of older heart failure patients who underwent 3 surgical therapies: HT with pretransplant MCS (HT MCS), HT without pretransplant MCS (HT non-MCS), and long-term MCS.
Methods: Caregivers of older patients (60-80 years) from 13 US sites completed the EQ-5D-3 L visual analog scale (0 [worst]-100 [best] imaginable health state) and dimensions before and 3 and 6 months post-surgery.
Article Synopsis
- Cardiovascular screening for first-degree relatives (FDRs) of patients with dilated cardiomyopathy (DCM) was studied to determine its effectiveness among those without known familial DCM and across different demographics.
- The study involved 1,365 adult FDRs who underwent echocardiograms and ECGs, revealing that 14.1% were newly diagnosed with DCM, left ventricular systolic dysfunction (LVSD), or left ventricular enlargement (LVE).
- The results showed higher diagnosis rates in older FDRs and those with hypertension or obesity, indicating that screening is beneficial for all FDRs, regardless of race or ethnicity.
Caregiver burden before heart transplantation and long-term mechanical circulatory support: Findings from the sustaining quality of life of the aged: Transplant or mechanical support (SUSTAIN-IT) study.
J Heart Lung Transplant
September 2023
Background: Caregiving for heart failure (HF) patients is burdensome. We examined differences in caregiver burden for 3 groups of older advanced HF patients: (1) supported with mechanical circulatory support (MCS) before heart transplantation (HT MCS), (2) awaiting transplant without MCS (HT non-MCS), and (3) prior to long-term MCS and factors associated with burden.
Method: From October 1, 2015 to December 31, 2018, we enrolled 276 caregivers for HF patients from 13 U.
Article Synopsis
- The DCM Precision Medicine Study aimed to improve the communication of genetic disease risk among first-degree relatives of individuals diagnosed with dilated cardiomyopathy (DCM), focusing on enhancing participation in clinical screenings.
- A booklet was created to assist probands in conveying the importance of cardiovascular screening to their at-risk family members, and its effectiveness was evaluated in a large controlled trial.
- Results showed that first-degree relatives of probands who received the booklet had a higher screening completion rate (19.5%) compared to those who did not receive it (16.0%), indicating the booklet's success in motivating screenings.
Background: Extracorporeal membrane oxygenation (ECMO) has revolutionized the treatment of refractory cardiac and respiratory failure, and its use continues to increase, particularly in adults. However, ECMO-related morbidity and mortality remain high.
Main Text: In this review, we investigate and expand upon the current state of the art in thoracic transplant and extracorporeal life support (ELS).
Background: Restoring health-related quality of life (HRQOL) is a therapeutic goal for older patients with advanced heart failure. We aimed to describe change in HRQOL in older patients (60-80 years) awaiting heart transplantation (HT) with or without pretransplant mechanical circulatory support (MCS) or scheduled for long-term MCS, if ineligible for HT, from before to 6 months after these surgeries and identify factors associated with change.
Methods: Patients from 13 US sites completed the EuroQol 5-dimension 3L questionnaire and Kansas City Cardiomyopathy Questionnaire-12 at baseline and 3 and 6 months after HT or long-term MCS.
Ventriculo-arterial (VA) coupling has been shown to have physiologic importance in heart failure (HF). We hypothesized that the systemic arterial pulsatility index (SAPi), a measure that integrates pulse pressure and a proxy for left ventricular end-diastolic pressure, would be associated with adverse outcomes in advanced HF. We evaluated the SAPi ([systemic systolic blood pressure-systemic diastolic blood pressure]/pulmonary artery wedge pressure) obtained from the final hemodynamic measurement in patients randomized to therapy guided by a pulmonary arterial catheter (PAC) and with complete data in the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial.
View Article and Find Full Text PDFBackground There is a paucity of research describing health-related quality of life (HRQOL) in older adults considered for advanced heart failure surgical therapies. Using data from our SUSTAIN-IT (Sustaining Quality of Life of the Aged: Heart Transplant or Mechanical Support) study, we aimed to compare HRQOL among 3 groups of older (60-80 years) patients with heart failure before heart transplantation (HT) or long-term mechanical circulatory support (MCS) and identify factors associated with HRQOL: (1) HT candidates with MCS, (2) HT candidates without MCS, or (3) candidates ineligible for HT and scheduled for long-term MCS. Methods and Results Patients from 13 US sites completed assessments, including self-reported measures of HRQOL (EuroQol-5 Dimension Questionnaire, Kansas City Cardiomyopathy Questionnaire-12), depressive symptoms (Personal Health Questionnaire-8), anxiety (State-Trait Anxiety Inventory-state form), cognitive status (Montreal Cognitive Assessment), and performance-based measures (6-minute walk test and 5-m gait speed).
View Article and Find Full Text PDFArticle Synopsis
- Early detection of idiopathic dilated cardiomyopathy (DCM) in at-risk family members can allow for earlier treatment, but most research has focused on White patients, ignoring the higher risks faced by Black patients.* -
- This study aimed to assess how common familial DCM is among patients with the condition and to determine the risk for first-degree relatives across different racial and ethnic groups.* -
- The research involved 1,220 DCM patients and their family members, finding a 11.6% prevalence of familial DCM in those studied, which could rise to 29.7% if all relatives were screened.*
Background Despite advances in resuscitation medicine, the burden of in-hospital cardiac arrest (IHCA) remains substantial. The impact of these advances and changes in resuscitation guidelines on IHCA survival remains poorly defined. To better characterize evolving patient characteristics and temporal trends in the nature and outcomes of IHCA, we undertook a 20-year analysis of a national database.
View Article and Find Full Text PDFBackground Heart failure (HF) imposes significant burden on patients and caregivers. Longitudinal data on caregiver health-related quality of life (HRQOL) and burden in ambulatory advanced HF are limited. Methods and Results Ambulatory patients with advanced HF (n=400) and their participating caregivers (n=95) enrolled in REVIVAL (Registry Evaluation of Vital Information for VADs [Ventricular Assist Devices] in Ambulatory Life) were followed up for 24 months, or until patient death, left ventricular assist device implantation, heart transplantation, or loss to follow-up.
View Article and Find Full Text PDFBackground Factors related to health-related quality of life (HRQOL) 2 years after left ventricular assist device (LVAD) implantation are unknown. We sought to determine whether preimplant intended goal of LVAD therapy (heart transplant candidate [short-term group], uncertain heart transplant candidate [uncertain group], and heart transplant ineligible [long-term group]) and other variables were related to HRQOL 2 years after LVAD implantation. Methods and Results Our LVAD sample (n=1620) was from INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support).
View Article and Find Full Text PDFLeft ventricular assist devices (LVADs) improve quality of life (QoL) and functional capacity (FC) for patients with advanced heart failure. The association between adverse events (AEs) and changes in QoL and FC are unknown. Patients treated with the HeartWare ventricular assist device (HVAD) with paired 6-minute walk distance (6MWD, n = 263) and Kansas City Cardiomyopathy Questionnaires (KCCQ, n = 272) at baseline and 24 months in the ENDURANCE and ENDURANCE Supplemental Trial databases were included.
View Article and Find Full Text PDFArticle Synopsis
- PAPP has prognostic value in heart failure, particularly in HFrEF patients with pulmonary hypertension, indicating potential adverse outcomes.
- In a study of 550 patients with the CardioMEMS device, those with lower PAPP values (≤0.583) showed a significantly increased risk of heart failure hospitalization but a notable reduction in annualized mortality (46%) compared to those with higher PAPP values.
- The findings suggest that lower PAPP correlates with higher mortality risk in HFrEF patients, highlighting the need for further research on PAPP's clinical applications in monitoring systems.
Heart failure (HF) is one of the major causes of morbidity and mortality in the world. According to a 2019 American Heart Association report, about 6.2 million American adults had HF between 2013 and 2016, being responsible for almost 1 million admissions.
View Article and Find Full Text PDFRacial and socioeconomic disparity associates with differences in cardiac DNA methylation among men with end-stage heart failure.
Am J Physiol Heart Circ Physiol
May 2021
Article Synopsis
- Heart failure (HF) is a complex condition affecting many individuals worldwide, and only about 50% of patients benefit from standard treatments, highlighting the need to explore its molecular differences.
- A study investigated epigenetic factors in end-stage HF patients, analyzing DNA methylation patterns in cardiac biopsies from men receiving left ventricular assist devices (LVAD), revealing distinct methylation signatures based largely on race.
- The findings suggest that African American patients have a higher mortality rate post-LVAD compared to Caucasian patients, possibly linked to socioeconomic disparities, indicating a need for further research into how these factors impact heart failure outcomes.