Venkat Lakshmi Kishan Vuddanda

Midterm outcomes of transmyocardial laser revascularization with intramyocardial injection of adipose derived stromal cells for severe refractory angina

Introduction Refractory angina has limited effective therapeutic options and often contributes to frequent hospitalizations, morbidity and impaired quality of life. Aim We sought to examine midterm results of a bio-interventional therapy combining transmyocardial laser revascularization (TMLR) and intramyocardial injection of adipose derived stem cells (ADSC) in patients with refractory angina not amenable to percutaneous or surgical revascularization. Material and methods We included 15 patients with severe refractory angina and anterior wall ischemia who were ineligible for revascularization strategies. Adipose tissue was harvested and purified, giving the stem cell concentrate. All patients underwent left anterior thoracotomy and TMLR using a low-powered holmium : yttrium–aluminum–garnet laser and intramyocardial injection of ADSC using a combined delivery system. Results No deaths or major adverse cardiovascular or cerebrovascular events were observed in the 6-month follow-up. Mean ejection fraction increased from 35% to 38%, and mean Canadian Cardiovascular Society Angina Score decreased from 3.2 to 1.4, with decreased necessity of nitrate usage. Seventy-three percent of patients reported health improvement particularly regarding general health and bodily pain. Improvement in endocardial movement, myocardial thickening and stroke volume index (35.26 to 46.23 ml/m2) on cardiac magnetic resonance imaging (MRI) was observed in 3 patients who had repeat CMR imaging after 6 months. Conclusions Our study suggested that interventional therapy combining TMLR with intramyocardial implantation of ADSC may reduce symptoms and improve quality of life in patients with refractory angina. These early findings need further validation in large scale randomized controlled trials.

Prevalence and In-Hospital Outcomes of Uremic and Dialysis Pericarditis: A United States National Study

Background: In the modern dialysis era, uremic and dialysis pericarditis (UDP) are less frequently encountered in clinical practice. We sought to determine the secular variation and in-hospital outcomes of UDP. Methods: Using the U.S. Nationwide Inpatient Sample databases 2003 through 2012, we

IN-HOSPITAL OUTCOMES AND HOSPITALIZATIONS FOR ACUTE RHEUMATIC HEART DISEASE: A UNITED STATES NATIONAL STUDY

Background: Acute rheumatic heart disease (ARHD) is a serious manifestation of acute rheumatic fever (ARF) and can result in long-term cardiac complications. Literature suggests that the incidence of ARF is declining in the United States (US). However, the secular variation of ARHD has not been

ARRHYTHMIAS IN HOSPITALIZED HEART TRANSPLANTED PATIENTS: A UNITED STATES NATIONAL STUDY

Background: Abnormal anatomy, sympathetic denervation, rejection, and infection may increase the risk for arrhythmias in heart transplant (HT) recipients. Data are limited regarding arrhythmias in hospitalized HT patients. Methods: Using the U. S. Nationwide Inpatient Sample databases 2003 through

LOW PLATELET COUNT AND FATAL MYOCARDIAL INFARCTION: A POPULATION BASED ANALYSIS

High platelet count has been causally linked to increased risk of fatal myocardial infarction (MI). However, the data on the possible association of low platelet count with fatal MI are limited. This cohort study used data from the Third National Health and Nutrition Examination survey, 1988-94 (