Nikoloz Koshkelashvili

Distinctive Electrocardiographic Features in African Americans Diagnosed with Takotsubo Cardiomyopathy.

Takotsubo cardiomyopathy (TC) can resemble acute anterior ST‐elevation myocardial infarction. Most studies have examined TC in Asians and Caucasians (non‐African Americans [AA]), while very few cases have been reported in AA. We aimed to assess the electrocardiographic features of TC in AA patients and compare them to non‐AA TC patients.

Transient ischemic dilation ratio in regadenoson, single isotope gated single-photon emission computed tomography myocardial perfusion imaging

Single isotope 99mTc single-photon emission computed tomography-myocardial perfusion imaging (SPECT-MPI) is the most commonly used protocol for nuclear stress testing. Transient ischemic dilation of the left ventricle (TID) has been considered a specific marker of severe coronary artery disease (CAD). Recent publications have questioned the clinical utility of TID, specifically with regadenoson as a stressor and 4DM-SPECT software for TID analysis. These findings have not been demonstrated using other imaging packages. The goal of our study was to establish the TID threshold in the identification of Multi-vessel CAD using Quantitative Perfusion SPECT (QPS) software. Included in this study are 190 patients that had undergone regadenoson-stress, same day, single-isotope 99mTc MPI and had a coronary angiography within a designated 3-month period. QPS (Cedars-Sinai, LA, CA) automated image analysis software was used to calculate TID ratios which were compared across different CAD categories. Coronary angiograms were reviewed to identify both obstructive and nonobstructive CAD. The mean TID for patients with nonobstructive CAD (n = 91) was 1.02 ± 0.11, and the threshold for TID was 1.24. A receiver operating characteristic curve showed that TID had a poor discriminatory capacity to identify MVD (area under the curve 0.58) with a sensitivity of 3% and a specificity of 97%. In our study with regadenoson MPI in a predominantly African-American population, TID was found to be a poor predictor of MVD using QPS software. The reason is unclear but possibly related to the significant decline in the prevalence of severe CAD in the area where our study took place.

Electrocardiographic and echocardiographic changes in patients undergoing liver transplant stratified by outcomes

Background: Association between electrocardiographic (EKG) and echocardiographic (Echo) parameters and outcomes in cirrhotic cardiomyopathy are not clear. Methods: We studied 73 adult patients with liver cirrhosis referred for liver transplantation between January 2007 and December 2013 at a tertiary liver transplant center. A complete 12-lead EKG and Echo was done prior to and after liver transplant. Patients with history of coronary artery disease, pre-existing heart failure and valvular heart disease were excluded. Standard 2D echo and diastolic function parameters were studied. We excluded 10 patients with incomplete data. Results: Mean age was 55± 8yrs, 65% (41 of 63) were men and the mean EF (ejection fraction) was 61±8%. Prevalence of diastolic dysfunction (DD) was 57% (36 of 63), of which 25%(9 of 36) were Stage 1, 67%(24 of 36) were Stage 2 and 8%(3 of 36) were Stage 3, respectively. There were 22(30%) deaths in the follow up period (1132 ± 795 days). Among the survivors, the PR-interval, QRS duration, QTC interval and Left atrial volume index showed statistically significant improvement compared to the deceased subjects. There was a trend towards improvement in DD post-transplant. Mortality was 15% in subjects with improved diastolic function versus 34% with worsening diastolic function (p=0.1). Death was predominantly due to non-cardiac complications (table). Conclusions: Prevalence of DD in cirrhotic cardiomyopathy was 57% in our study. There was a significant improvement in EKG and Echo parameters post-transplant. However, it did not significantly improve outcomes as most of the deaths were due to non-cardiac complications. Incidence of post-transplant major complications ![][1] [1]: /embed/graphic-1.gif

Electrocardiographic changes in patients ≥ 100 years of age

Article history: Received 28 January 2016 Accepted 20 February 2016 Available online 24 February 2016 tests were used to compare baseline characteristics. All analyses were performed using IBM SPSS Statistics 22.0. A 2-tailed p-value b0.05 was considered significant. The study included 217 subjects; 53 patients were male and 137 were Caucasian. Sixty-eight percent of the patients had normal sinus rhythm but only 17 patients (8%) had a normal ECG. Themost common

Polymicrobial infective endocarditis caused by Neisseria sicca and Haemophilus parainfluenzae.

Infective endocarditis is a common clinical problem in industrialized countries. Risk factors include abnormal cardiac valves, a history of endocarditis, intracardiac devices, prosthetic valves and intravenous drug use. We report a case of polymicrobial infective endocarditis in a 33 year-old female with a history chronic heroin use caused by Neisseria sicca and Haemophilus parainfluenzae. We believe the patient was exposed to these microbes by cleansing her skin with saliva prior to injection. Pairing a detailed history with the consideration of atypical agents is crucial in the proper diagnosis and management of endocarditis in patients with high-risk injection behaviors.