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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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


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Burden of CVD - Mortality

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


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Burden of CVD - Mortality

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


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Burden of CVD Risk Factors - Hypertension

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


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Burden of CVD Risk Factors - Diabetes Mellitus

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


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Burden of CVD Risk Factors - Obesity

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


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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


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Burden of CVD: Heart Failure radionuclide imaging 2003.

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


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Burden of CVD: Heart Failure radionuclide imaging 2003.

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


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Heart Failure : Common Causes radionuclide imaging 2003.

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


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Heart Failure Classification radionuclide imaging 2003.


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Heart Failure : Prognosis Based on Stage radionuclide imaging 2003.

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


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Heart Failure : BNP radionuclide imaging 2003.

Change in NT-Pro BNP predicts re-hospitalization


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Anatomy radionuclide imaging 2003.

Heart Structure

Coronary Anatomy/stenosis

Function

LVEF

RVEF

Coronary Flow

Stress testing

Exercise Capacity

Stress testing

Cardiopulmonary testing

Evaluating Heart Function


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Tests of Anatomy radionuclide imaging 2003.

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


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Prognosis - LVEF radionuclide imaging 2003.

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


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Cardiopulmonary stress testing radionuclide imaging 2003.

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


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Prognosis - Exercise stress testing radionuclide imaging 2003.

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


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Heart Failure : Prognosis Models radionuclide imaging 2003.

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


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Heart Failure : Prognosis Models radionuclide imaging 2003.

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


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Future of Testing in HF radionuclide imaging 2003.

  • 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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