Overview of Adult Cardiovascular Disease
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Overview of Adult Cardiovascular Disease Social Security Administration Compassionate Allowances Outreach Hearing on Cardiovascular Disease and Multiple Organ Transplants November 9 th 2010 University of Maryland Baltimore County. Gaby Weissman MD Washington Hospital Center

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Gaby weissman md washington hospital center georgetown university hospital

Overview of Adult Cardiovascular DiseaseSocial Security Administration Compassionate Allowances Outreach Hearing on Cardiovascular Disease and Multiple Organ TransplantsNovember 9th 2010University of Maryland Baltimore County

  • Gaby Weissman MD

  • Washington Hospital Center

  • Georgetown University Hospital

  • Assistant Professor Clinical Medicine


Burden of cvd mortality

Burden of CVD - Mortality

World Health Organization - https://apps.who.int/infobase/Mortality.aspx


Burden of cvd mortality1

Burden of CVD - Mortality

World Health Organization - https://apps.who.int/infobase/Mortality.aspx


Burden of cvd risk factors hypertension

Burden of CVD Risk Factors - Hypertension

American Heart Association - http://www.americanheart.org/downloadable/heart/1261003279882FS14HBP10.pdf


Burden of cvd risk factors diabetes mellitus

Burden of CVD Risk Factors - Diabetes Mellitus

American Heart Association - http://www.americanheart.org/downloadable/heart/1236357007811FS12DIAB08.pdf


Burden of cvd risk factors obesity

Burden of CVD Risk Factors - Obesity

American Heart Association - http://www.americanheart.org/downloadable/heart/1236358025411OVRWGHT.pdf


Gaby weissman md washington hospital center georgetown university hospital

ACC/AHA/ASNC Guidelines for the clinical use of cardiac radionuclide imaging 2003.Schinkel A, et al. Noninvasive evaluation of ischemic heart disease: Eur Heart J 2003;24:789-800.Uchechukwu K. et al. Diagnostic accuracy of Rb-82 myocardial perfusion. JACC;49:1052-58Nandalur KR. et al. Diagnostic performance of stress cardiac MRI- a meta analysis. JACC;50:1343-53.Accuracy Trial: Budoff MJ. et al. JACC 2008.CORE-64 Trial: Miller JM. et al. Circulation. 2007;116:2627-2633.

Evaluating IHD


Burden of cvd heart failure

Burden of CVD: Heart Failure

Lloyd-Jones D. et al Circulation. Published online Dec 15, 2008.


Burden of cvd heart failure1

Burden of CVD: Heart Failure

Lloyd-Jones D. et al Circulation. Published online Dec 15, 2008.


Heart failure common causes

Heart Failure : Common Causes

Dickstein K. et al . Eur Heart J 2008. 29, 2388-2442.


Heart failure classification

Heart Failure Classification


Heart failure prognosis based on stage

Heart Failure : Prognosis Based on Stage

Ammar KA et al . Circulation 2007 115, 1563-1570.


Heart failure bnp

Heart Failure : BNP

Change in NT-Pro BNP predicts re-hospitalization


Evaluating heart function

Anatomy

Heart Structure

Coronary Anatomy/stenosis

Function

LVEF

RVEF

Coronary Flow

Stress testing

Exercise Capacity

Stress testing

Cardiopulmonary testing

Evaluating Heart Function


Evaluating heart function1

Tests of Anatomy

Echo

MRI

CT

Tests of coronary perfusion

Stress nuclear

Stress echo

Stress MRI

Tests of exercise capacity

ETT

CPET

6 minute walk

Evaluating Heart Function


Prognosis lvef

Prognosis - LVEF

Curtis JP et al J Am Coll Cardiol. 2003; 736-42.


Cardiopulmonary stress testing

Cardiopulmonary stress testing

Lavie CJ. et al Am J Cardiol. 2004; 93:588-593.


Prognosis exercise stress testing

Prognosis - Exercise stress testing

Hsich E. et al Am J Cardiol. 2004; 93:588-593.


Heart failure prognosis models

Heart Failure : Prognosis Models

Levy WC. et al. The Seattle heart failure model: prediction of survival in heart failure. Circulation. 2006;113:1424.


Heart failure prognosis models1

Heart Failure : Prognosis Models

Lee DS et al. Predicting mortality among patients hospitalized for heart failure. J Am Medical Association. 2003;290:2581-87.


Future of testing in hf

Future of Testing in HF

  • mIBG - Evaluation of the sympathetic nervous system

  • cMR - fibrosis imaging

  • Myocardial strain measurements

1.Karamitos TD. Et al. The role of cardiovascular magnetic resonance imaging in heart failure. J Am Coll Cardiol. 2009;54;1407-1424.

2.Jacobson AF. et al. Myocardial Iodine-123 Meta-Iodobenzylguanidine Imaging and cardiac events in heart failure. J Am Coll Cardiol. 2010;55:2212-21.

3.Cho GY. et al. Global 2-Dimensional strain as a new prognosticator in patients with heart failure. J Am Coll Cardiol. 2009;54;618-24.


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