Mazen Albaghdadi

• Graduate Assistant, Interventional Cardiology; Fellow, Vascular Medicine and Intervention at Massachusetts General Hospital

Percutaneous balloon mitral valvuloplasty (PBMV) is a safe alternative to management of a pregnant woman with mitral stenosis. We report the first successful PBMV in a 27-year-old pregnant patient in Tanzania at 32 weeks gestation with NYHA functional class III symptoms. PBMV yielded excellent results.

Background Despite cardiovascular disease being the leading cause of death in India, limited data exist regarding the factors associated with outcomes in patients with diabetes who suffer acute myocardial infarction (AMI). Methods We examined 21,374 patients with AMI enrolled in the ACS QUIK trial. We compared in-hospital and 30-day major adverse...

Introduction: The 2022 USPSTF guidelines issued a grade C recommendation for aspirin in patients aged 40-59 and recommended against its use in patients ≥ 60 years. We sought to assess if coronary artery calcium (CAC) would allow for personalized allocation of aspirin. Methods: Using MESA, aspirin naïve participants without high-risk bleeding featur...

Background: There is a paucity of real-world data on the in-hospital (IH) and post-discharge outcomes in patients undergoing lower extremity peripheral vascular intervention (PVI) with adjunctive atherectomy. Aims: In this retrospective, registry-based study, we evaluated IH and post-discharge outcomes among patients undergoing PVI, treated with...

Background: Icosapent ethyl (IPE), a high purity ethyl ester of eicosapentaenoic acid (EPA), is FDA-approved to reduce cardiovascular events among patients with or at risk for cardiovascular disease with elevated triglyceride levels. However, in vivo mechanisms underlying these findings remain unclear. Here we investigated whether IPE reduces plaqu...

Transcatheter aortic valve replacement has emerged as the preferred treatment modality in most patients with severe aortic stenosis. With its global adoption and broader application in younger and healthier patients, the issue of transcatheter bioprosthetic valve degeneration and its impact on valve durability continues to earn clinical relevance....

Background: For rheumatic mitral stenosis (MS), a multidisciplinary evaluation is mandatory to determine the optimal treatment: medical, percutaneous balloon mitral valvuloplasty (PBMV) or valve surgery. Clinical and imaging evaluations are essential for procedural risk assessment and outcomes. PBMV interventions are increasingly available in Afri...

Background: Transcatheter aortic valve replacement (TAVR) has become the standard of care for most patients with severe aortic stenosis (AS), but the impact of medical therapy prescribing patterns on post-TAVR patients has not been thoroughly investigated. Methods: We analyzed Optum® claims data from 9,012 adults who received TAVR for AS (Januar...

Background: Liraglutide, a GLP-1- receptor agonists approved for the treatment of type 2 diabetes and obesity confers a lower CVD mortality. However, mechanisms underlying this finding remain unknown, particularly in normoglycemic subjects. We investigated the effects of liraglutide on the progression and pathobiology of atherosclerosis using multi...

Background Limited data exist on the risk profile and outcomes among young patients with acute myocardial infarction(AMI) in low-and middle-income countries(LMICs). This study explored differences in the clinical characteristics, medical care, and outcomes of AMI in young adults in India with a subanalysis focusing on sex disparities amongst the yo...

Climate change is the greatest existential challenge to planetary and human health and is dictated by a shift in the Earth’s weather and air conditions owing to anthropogenic activity. Climate change has resulted not only in extreme temperatures, but also in an increase in the frequency of droughts, wildfires, dust storms, coastal flooding, storm s...

Abstract Background Public acceptance of governmental measures are key to controlling the spread of infectious diseases. The COVID-19 pandemic has placed a significant burden on healthcare systems for high-income countries as well as low- and middle-income countries (LMICs). The ability of LMICs to respond to the challenge of the COVID-19 pandemic...

Optical molecular imaging using near-infrared fluorescence (NIRF) light is an emerging high-resolution imaging approach to image a wide range of molecular and cellular species in vivo. Imaging using NIR wavelengths (650–900 nm) enables deeper photon penetration into tissue and reduced tissue autofluorescence, resulting in higher sensitivity to dete...

The outcome of coronary and endovascular revascularization depends on the interaction between biologic tissues and structures with a tailored technology. While the development and application of devices and revascularization techniques for percutaneous coronary and vascular interventions have advanced rapidly in recent years, several challenges rem...

Background: Rheumatic heart disease (RHD) is the most common acquired heart disease occurring in children and adolescents. RHD is associated with significant morbidity and mortality particularly in low and middle- income countries (LMICs) where the burden is estimated to be higher compared to high income countries. Subclinical RHD is the presence...

Introduction: Patients with diabetes are more likely to experience an acute myocardial infarction (AMI), heart failure, or death from cardiovascular (CV) causes than patients without diabetes. Despite cardiovascular disease being the leading cause of death in India, limited data exists on the outcome of patients with diabetes who suffer acute cardi...

Emerging evidence suggests that males are more susceptible to severe infection by the SARS-CoV-2 virus than females. A variety of mechanisms may underlie the observed gender-related disparities including differences in sex hormones. However, the precise mechanisms by which female sex hormones may provide protection against SARS-CoV-2 infectivity re...

Coronary artery disease (CAD) remains a leading cause of mortality and warrants new imaging approaches to better guide clinical care. We report on a miniaturized, hybrid intravascular catheter and imaging system for comprehensive coronary artery imaging in vivo. Our catheter exhibits a total diameter of 1.0 mm (3.0 French), equivalent to standalone...

Objective Near-infrared autofluorescence (NIRAF) of atherosclerosis associates with intraplaque hemorrhage and is detectable in living patients with coronary artery disease. However, further mechanisms underlying NIRAF generation have not been fully characterized. Here, we investigated the role of lipids and oxidative stress in NIRAF generation in...

Transcatheter procedures offer an alternative to cardiac surgery in select patients with structural heart disease (SHD). Unfortunately, inadvertent disruption of electrical pathways and subsequent development of new onset conduction disturbances can occur in up to 5–70% of percutaneous interventions, result in pacemaker implantation, and confer a w...

Ascertainment bias is a well-recognized source of bias in research, but few studies have systematically analyzed sources of ascertainment bias in randomized trials in which blinding is not possible and endpoint assessment is not protocolized. In the current study, we sought to evaluate differences in the clinical practice patterns of trial investig...

Background: Rheumatic heart disease (RHD) is the most common acquired heart disease occurring in children and adolescents. RHD is associated with significant morbidity and mortality particularly in low and middle- income countries (LMICs) where the burden is estimated to be higher compared to high income countries. Subclinical RHD is the presence o...

Aims Our aim was to explore sex differences and inequalities in terms of medical management and cardiovascular disease (CVD) outcomes in a low/middle-income country (LMIC), where reports are scarce. Methods We examined sex differences in presentation, management and clinical outcomes in 21 374 patients presenting with acute coronary syndrome (ACS)...

Purpose To examine nationwide variations in inpatient use of drug-coated balloons (DCBs) for treating femoropopliteal segment occlusive disease and whether DCBs are associated with reduced early out-of-hospital health care utilization. Materials and Methods The study included 24,022 patients who survived hospitalization for femoropopliteal revascu...

Atherosclerosis, a chronic inflammatory disease of the arteries, remains a leading cause of death worldwide despite significant advances in treatment over the past several decades. Detailed studies reveal inextricable links between atherosclerosis progression and its underlying pathobiology, ultimately leading to clinical complications of acute myo...

Introduction: Despite the increasing interest in sex differences in acute coronary syndrome (ACS) presentation, management, and outcomes in high-income countries, reports on such differences from low- and middle-income countries (LMICs) are limited. Limited resources in LMICs may worsen health disparities experienced by women and vulnerable populat...

Introduction: Substantial heterogeneity exists in reperfusion strategies for patients with ST-segment myocardial infarction (STEMI) in low- and middle-income countries (LMICs). We sought to compare outcomes associated with primary percutaneous coronary intervention (PPCI) and non-primary percutaneous coronary intervention (nPPCI) reperfusion strat...

Background: Paclitaxel coated balloons (PCBs) control iliofemoral atherosclerotic lesions yet restenosis rates remain high without class effect. We leveraged novel imaging and computational modeling to add insight into the micromorphology dependence of coating transfer and optimize device efficacy. Methods: We compared PCBs coated with amorphous/f...

Background: Peri-device leak (PDL) following left atrial appendage occlusion (LAAO) may lead to an increased risk of thrombosis. However, current modalities for PDL detection, such as trans-esophageal echo (TEE) and cardiac CT do not provide quantitative measures of PDL. Objective: to use dielectric imaging (DI) to measure PDL from a Watchman (W...

Oral anticoagulation reduces the ischemic stroke risk in patients with nonvalvular atrial fibrillation (NVAF) but inherently increases the bleeding risk. Percutaneous left atrial appendage occlusion (LAAO) offers an alternative to long-term anticoagulation in patients at risk for cardioembolic events due to underlying atrial fibrillation. Although...

Objective To evaluate the impact of COVID‐19 pandemic migitation measures on of ST‐elevation myocardial infarction (STEMI) care. Background We previously reported a 38% decline in cardiac catheterization activations during the early phase of the COVID‐19 pandemic mitigation measures. This study extends our early observations using a larger sample...

Paclitaxel coated balloon catheters (PCB) were developed as a polymer-free non-implantable alternative to drug eluting stents, delivering similar drug payloads in a matter of minutes. While PCB have shown efficacy in treating peripheral arterial disease in certain patient groups, restenosis rates remain high and there is no class effect. To help fu...

Emerging evidence suggests that males are more susceptible to severe infection by the SARS-CoV-2 virus than females. A variety of mechanisms may underlie the observed gender-related disparities including differences in sex hormones. However, the precise mechanisms by which female sex hormones may provide protection against SARS-CoV-2 infectivity re...

Paclitaxel drug-coated balloons (DCBs) reduce restenosis, but their overall safety has recently raised concerns. This study hypothesized that DCBs could lessen inflammation and reduce plaque progression. Using 25 rabbits with cholesterol feeding− and balloon injury− induced lesions, DCB-percutaneous transluminal angioplasty (PTA), plain PTA, or sha...

The COVID-19 Pandemic has significantly impacted the US healthcare system. To preserve resources, including personal protective equipment (PPE) and hospital beds to care for COVID-19 patients, the Centers for Disease Control and Prevention (CDC) recommended deferral of elective cardiac procedures (1), including coronary angiography and percutaneous...

Background Paclitaxel (PTX) drug-coated balloons (DCBs) are effective at reducing restenosis following endovascular arterial revascularization; however, their efficacy is limited in highly calcified/impermeable arteries. However, no in vivo tool exists to guide arterial lesion preparation prior to DCB to optimize permeability but minimize vessel tr...

This study sought to evaluate perisplenic artery nerve distribution and the feasibility of splenic artery denervation (SDN). The NEXION radiofrequency catheter was used to perform SDN in healthy and inflammatory arthritis pigs. Splenic artery anatomy, nerve distribution, and splenic norepinephrine (NEPI) levels were evaluated before and after SDN....

Objectives: This study determined whether in vivo positron emission tomography (PET) of arterial inflammation (18F-fluorodeoxyglucose [18F-FDG]) or microcalcification (18F-sodium fluoride [18F-NaF]) could predict restenosis following PTA. Background: Restenosis following lower limb percutaneous transluminal angioplasty (PTA) is common, unpredict...

Front Cover: Plaque‐targeting peptides and liver X receptor agonists self assemble to form amphipathic nanofibers. Upon intravenous injection, the nanofibers target atherosclerotic lesions and reduced plaque burden. These findings demonstrate the potential of supramolecular system applications in cardiovascular nanomedicine. This is reported by Nee...

The rising prevalence of cardiovascular disease worldwide necessitates novel therapeutic approaches to manage atherosclerosis. Intravenously administered nanostructures are a promising noninvasive approach to deliver therapeutics that reduce plaque burden. The drug Liver X Receptor agonist GW3965 (LXR) can reduce atherosclerosis by promoting choles...

Inferior vena cava filters (IVCF) are associated with complications which may be due to delayed retrieval. Initiation of an automated reminder system may improve retrieval rates and reduce complications. A computerized reminder system, which provides interactive email reminders after implantation while collecting IVCF use data, was implemented. IVC...

Background Extracorporeal membrane oxygenation (ECMO) has been used to stabilize patients with massive pulmonary embolism though few reports describe this approach. We describe the presentation, management and outcomes of patients who received ECMO for massive pulmonary embolism (PE) in our pulmonary embolism response team (PERT) registry. Methods...

Objective: Atherosclerosis is the leading cause of death and disability in the United States. We hypothesize that systemic administration of a novel nanofiber will target areas of atherosclerosis and regress atherosclerotic lesions. Methods: Self assembling peptide amphiphile (PA) nanofibers were synthesized. An 18 amino acid sequence which retains...

Table S1. Comparison of Baseline Characteristics Between Included and Excluded Patients Table S2. First Cardiopulmonary Exercise Testing Characteristics in Patients Who Had Both CPET and in Those Who Had Only the First Figure S1. Summary of individual subject baseline and key echocardiographic, cardiopulmonary exercise test findings, and symptoms...

Background: Little data exist regarding the functional capacity of patients following acute pulmonary embolism. We sought to characterize the natural history of symptom burden, right ventricular (RV) structure and function, and exercise capacity among survivors of massive and submassive pulmonary embolism. Methods and results: Survivors of subma...

Coassembled peptide amphiphile nanofibers designed to target atherosclerotic plaque and enhance cholesterol efflux are shown to encapsulate and deliver a liver X receptor agonist to increase efflux from murine macrophages in vitro. Fluorescence microscopy reveals that the nanofibers, which display an apolipoprotein-mimetic peptide, localize at plaq...

Mortality associated with high-risk pulmonary embolism (PE) remains high. Extra-corporeal membrane oxygenation (ECMO) allows for acute hemodynamic stabilization and potentially for administration of other disease process altering therapies. We sought to compare two eras: pre-ECMO and post-ECMO in relation to high-risk PE treatment and mortality. A...

Cardiovascular disease (CVD) represents a major public health problem in low- and middle-income countries. Global health partnerships emphasizing training and sustainability have begun to emerge in an effort to stem the tide of CVD [(1)][1]. As has been described by other fellows-in-training (FITs

Dual antiplatelet therapy is considered mandatory after new-generation drug-eluting coronary stent implantation to reduce ischemic complications such as stent thrombosis, but the need for dual antiplatelet therapy makes the timing of elective surgery difficult. Interrupting dual antiplatelet therapy places patients at risk for stent thrombosis, and...

Objective To quantify the association between high-density lipoprotein (HDL) subfractions, efflux capacity, and inflammatory markers at baseline and the effect of supervised exercise on these HDL parameters in patients with peripheral artery disease (PAD). Methods The study to improve leg circulation (SILC) was a randomized trial of supervised tre...

Biodegradable vascular scaffolds (BVS) are novel treatments for obstructive atherosclerotic cardiovascular disease developed to overcome the limitations of traditional metallic drug-eluting stents. The mechanical properties of bioabsorbable polymers used for the production of novel BVS are a key consideration for the clinical translation of this em...

Large volumes of data are continuously generated from clinical notes and diagnostic studies catalogued in electronic health records (EHRs). Echocardiography is one of the most commonly ordered diagnostic tests in cardiology. This study sought to explore the feasibility and reliability of using natural language processing (NLP) for large-scale and t...

List of eighty data elements with synonymous terminologies. This table lists the eighty data elements that EchoInfer extracts from Echo reports along with their synonyms. (DOC)

Accuracy of eighty data elements extracted during this study. This table lists the accuracy (precision, recall, specificity, negative predictive value and F-1 score) of the eighty data elements extracted by EchoInfer. (DOC)

Breakdown of percentage of echocardiographic reports lacking any mention of various data elements as determined by EchoInfer. This figure shows the relative proportion of Echo reports that miss ten of eighty data elements. (DOC)

To present a theoretical basis for noninvasively characterizing in vivo fluid-mechanical energy losses and to apply it in a pilot study of patients known to express abnormal aortic flow patterns. Four-dimensional flow MRI was used to characterize laminar viscous energy losses in the aorta of normal controls (n = 12, age = 37 ± 10 yr), patients with...

A 44-year-old patient with back pain and dyspnea was noted to have calcifications overlying the lower mediastinum on a thoracic spine radiograph (A). Noncontrast chest computed tomography revealed a calcified mass projecting over the cardiac silhouette (B). Transthoracic echocardiogram showed a right ventricular (RV) mass occupying mid chamber to a...

Acute heart failure syndromes (AHFS) are a heterogeneous group of commonly encountered and difficult to manage clinical syndromes associated with high morbidity and mortality. Dyspnoea, pulmonary, and systemic congestion often characterize AHFS due to acutely elevated intracardiac filling pressures and fluid overload. Diuresis, respiratory support,...

Hospitalizations for acute heart failure syndromes (AHFS) are associated with high post-discharge mortality and readmission rates in spite of available therapies. Renin-angiotensin-aldosterone system (RAAS) antagonists improve outcomes in outpatients with heart failure (HF) and reduced ejection fraction, however these therapies have not been tested...

The sympathetic nervous system and the kidneys exert considerable influence on the long-term control of blood pressure. The ability of the baroreflex to influence both these systems of arterial pressure regulation via the central ner-vous system suggests that the baroreflex may contribute to the chronic regulation of mean arterial pressure. The abi...

Bone-implant interface is characterized by a complex array of cells and macromolecules in a mineralizing matrix forming a micromechanical environment that transmits biomechanical stresses. The biomechanical properties of the bone-implant interface are unknown. Here we examined the bone-implant interface in a submicron length scale with atomic force...