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Gaby Weissman MD Washington Hospital Center Georgetown University Hospital

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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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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

slide7

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 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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