2024
Real-world evaluation of an algorithmic machine-learning-guided testing approach in stable chest pain: a multinational, multicohort study
Oikonomou E, Aminorroaya A, Dhingra L, Partridge C, Velazquez E, Desai N, Krumholz H, Miller E, Khera R. Real-world evaluation of an algorithmic machine-learning-guided testing approach in stable chest pain: a multinational, multicohort study. European Heart Journal - Digital Health 2024, 5: 303-313. PMID: 38774380, PMCID: PMC11104476, DOI: 10.1093/ehjdh/ztae023.Peer-Reviewed Original ResearchRisk of acute myocardial infarctionAssociated with lower oddsHospital health systemCoronary artery diseaseCardiac testingRisk of adverse outcomesUK BiobankHealth systemProvider-drivenLower oddsAssociated with better outcomesAcute myocardial infarctionBlack raceStable chest painFemale sexReal world evaluationDiabetes historyMulticohort studyFunction testsSuspected coronary artery diseaseYounger ageRisk profileAdverse outcomesMultinational cohortPost hoc analysis
2023
Current Landscape and Future Directions of Coronary Revascularization in Ischemic Systolic Heart Failure: A Review
Chuy K, Velazquez E, Lansky A, Jamil Y, Ahmad Y. Current Landscape and Future Directions of Coronary Revascularization in Ischemic Systolic Heart Failure: A Review. Journal Of The Society For Cardiovascular Angiography & Interventions 2023, 2: 101197. PMID: 39131064, PMCID: PMC11307589, DOI: 10.1016/j.jscai.2023.101197.Peer-Reviewed Original ResearchIschemic systolic heart failureSystolic heart failurePercutaneous coronary interventionHeart failureMedical therapyCoronary revascularizationBenefits of PCITrials of PCILeft ventricular systolic dysfunctionPrevalence of HFBenefit of CABGContemporary medical therapyIschemic ventricular dysfunctionCoronary artery bypassVentricular systolic dysfunctionCoronary artery diseaseIschemic heart diseaseAcute cardiac careComparative clinical effectivenessUnmet clinical needRecent revascularizationArtery bypassSystolic dysfunctionVentricular dysfunctionCoronary interventionThe Impact of Ejection Fraction on Major Adverse Limb Events after Lower Extremity Revascularization
Jamil Y, Huttler J, Alameddine D, Wu Z, Zhuo H, Mena-Hurtado C, Velazquez E, Guzman R, Ochoa Chaar C. The Impact of Ejection Fraction on Major Adverse Limb Events after Lower Extremity Revascularization. Annals Of Vascular Surgery 2023, 98: 210-219. PMID: 37802138, DOI: 10.1016/j.avsg.2023.08.009.Peer-Reviewed Original ResearchMajor adverse limb eventsReduced ejection fractionLower extremity revascularizationPeripheral arterial diseaseMALE-free survivalAdverse limb eventsCoronary artery diseaseEjection fractionExtremity revascularizationArtery diseaseLimb eventsChronic limb-threatening ischemiaLimb-threatening ischemiaTricuspid valve regurgitationKaplan-Meier curvesElectronic medical recordsMajor amputationSevere mitralDiastolic dysfunctionEchocardiographic findingsTransthoracic echocardiogramHeart failureValve regurgitationArterial diseaseSingle centerMECHANISTIC EVALUATION OF AN AI-DRIVEN CLINICAL DECISION SUPPORT TOOL TO PERSONALIZE THE USE OF ANATOMICAL TESTING IN SUSPECTED CORONARY ARTERY DISEASE
Oikonomou E, Suchard M, Miller E, Velazquez E, Khera R. MECHANISTIC EVALUATION OF AN AI-DRIVEN CLINICAL DECISION SUPPORT TOOL TO PERSONALIZE THE USE OF ANATOMICAL TESTING IN SUSPECTED CORONARY ARTERY DISEASE. Journal Of The American College Of Cardiology 2023, 81: 1360. DOI: 10.1016/s0735-1097(23)01804-1.Peer-Reviewed Original ResearchCoronary artery diseaseArtery diseaseAnatomical testingClinical decisionMechanistic evaluationDisease
2022
PCI in Patients With Heart Failure: Current Evidence, Impact of Complete Revascularization, and Contemporary Techniques to Improve Outcomes
Ahmad Y, Petrie M, Jolicoeur E, Madhavan M, Velazquez E, Moses J, Lansky A, Stone G. PCI in Patients With Heart Failure: Current Evidence, Impact of Complete Revascularization, and Contemporary Techniques to Improve Outcomes. Journal Of The Society For Cardiovascular Angiography & Interventions 2022, 1: 100020. PMID: 39132568, PMCID: PMC11307477, DOI: 10.1016/j.jscai.2022.100020.Peer-Reviewed Original ResearchPercutaneous coronary interventionLeft ventricular systolic dysfunctionCoronary artery diseaseHeart failureComplete revascularizationMedical therapyClinical outcomesClinical trialsCoronary artery bypassVentricular systolic dysfunctionClinical trial evidenceHigh operative riskHigh-risk patientsMajor cardiac surgeryExtent of revascularizationMinority of patientsFuture clinical trialsArtery bypassCause mortalityPeriprocedural complicationsSystolic dysfunctionCoronary interventionOperative riskArtery diseaseCardiac surgery
2021
Optimal medical therapy with or without surgical revascularization and long-term outcomes in ischemic cardiomyopathy
Farsky PS, White J, Al-Khalidi HR, Sueta CA, Rouleau J, Panza J, Velazquez E, O'Connor C, Investigators W, Dabrowski R, Djokovic L, Drazner M, Haddad H, Ali I, Keltai M, Naik A, Sopko G, Golba K, Andersson B, Carson P, Kukulski T. Optimal medical therapy with or without surgical revascularization and long-term outcomes in ischemic cardiomyopathy. Journal Of Thoracic And Cardiovascular Surgery 2021, 164: 1890-1899.e4. PMID: 33610365, PMCID: PMC8260609, DOI: 10.1016/j.jtcvs.2020.12.094.Peer-Reviewed Original ResearchConceptsOptimal medical therapyCoronary artery bypassMedical therapyArtery bypassIschemic cardiomyopathyCause mortalityIschemic Heart Failure (STICH) trialVentricular ejection fraction 35Improved long-term survivalEjection fraction 35Angiotensin receptor blockersHeart Failure TrialLower cardiovascular mortalityMultivariable Cox modelOutcomes of patientsVentricular ejection fractionCoronary artery diseaseLong-term outcomesLong-term survivalSurgical revascularizationReceptor blockersCardiovascular mortalityAntiplatelet drugsArtery diseaseEjection fraction
2020
Implications of Abnormal Exercise Electrocardiography With Normal Stress Echocardiography
Daubert MA, Sivak J, Dunning A, Douglas PS, Coyne B, Wang TY, Mark DB, Velazquez EJ. Implications of Abnormal Exercise Electrocardiography With Normal Stress Echocardiography. JAMA Internal Medicine 2020, 180: 494-502. PMID: 31985749, PMCID: PMC6990669, DOI: 10.1001/jamainternmed.2019.6958.Peer-Reviewed Original ResearchConceptsNormal stress echocardiographyComposite end pointStress echoExercise electrocardiographyStress echocardiographyMyocardial infarctionDownstream testingEnd pointDuke University Medical CenterExercise stress echoNegative exercise ECGStress ECG findingsAdverse cardiac eventsIncremental prognostic valueObservational cohort studyAdverse clinical eventsCoronary artery diseaseIndividual adverse eventsPopulation of patientsUniversity Medical CenterImaging resultsCoronary revascularizationAdverse eventsCardiac eventsCohort studyLIMITED TESTING FOR CORONARY ARTERY DISEASE IN PATIENTS WITH NEW-ONSET HEART FAILURE: FINDINGS FROM GET WITH THE GUIDELINES - HEART FAILURE
O'Connor K, Brophy T, Fonarow G, Blankstein R, Swaminathan R, Xu H, Matsouaka R, Albert N, Velazquez E, Yancy C, Heidenreich P, Hernandez A, DeVore A. LIMITED TESTING FOR CORONARY ARTERY DISEASE IN PATIENTS WITH NEW-ONSET HEART FAILURE: FINDINGS FROM GET WITH THE GUIDELINES - HEART FAILURE. Journal Of The American College Of Cardiology 2020, 75: 866. DOI: 10.1016/s0735-1097(20)31493-5.Peer-Reviewed Original Research
2019
Percutaneous coronary intervention outcomes in patients with stable coronary disease and left ventricular systolic dysfunction
DeVore AD, Yow E, Krucoff MW, Sherwood MW, Shaw LK, Chiswell K, O'Connor CM, Ohman EM, Velazquez EJ. Percutaneous coronary intervention outcomes in patients with stable coronary disease and left ventricular systolic dysfunction. ESC Heart Failure 2019, 6: 1233-1242. PMID: 31560171, PMCID: PMC6989282, DOI: 10.1002/ehf2.12510.Peer-Reviewed Original ResearchConceptsStable coronary artery diseasePercutaneous coronary interventionCoronary artery diseaseVentricular systolic dysfunctionSevere left ventricular systolic dysfunctionLeft ventricular systolic dysfunctionSystolic dysfunctionMedical therapyCardiovascular hospitalizationAddition of PCICanadian Cardiovascular Society class IIIImpact of PCIPercutaneous coronary intervention outcomesDuke University Medical CenterComposite of mortalityPropensity-matched cohortStable coronary diseaseAcute coronary syndromeHigh-risk patientsLong-term mortalityVentricular ejection fractionCox proportional hazardsUniversity Medical CenterCause mortalityCoronary syndromeMyocardial Viability and Long-Term Outcomes in Ischemic Cardiomyopathy
Panza JA, Ellis AM, Al-Khalidi HR, Holly TA, Berman DS, Oh JK, Pohost GM, Sopko G, Chrzanowski L, Mark DB, Kukulski T, Favaloro LE, Maurer G, Farsky PS, Tan RS, Asch FM, Velazquez EJ, Rouleau JL, Lee KL, Bonow RO. Myocardial Viability and Long-Term Outcomes in Ischemic Cardiomyopathy. New England Journal Of Medicine 2019, 381: 739-748. PMID: 31433921, PMCID: PMC6814246, DOI: 10.1056/nejmoa1807365.Peer-Reviewed Original ResearchMeSH KeywordsAgedCoronary Artery BypassEchocardiography, StressFemaleFollow-Up StudiesHeartHumansIncidenceKaplan-Meier EstimateMaleMiddle AgedMyocardial IschemiaProportional Hazards ModelsProspective StudiesStroke VolumeTomography, Emission-Computed, Single-PhotonTreatment OutcomeVentricular Function, LeftConceptsLeft ventricular ejection fractionVentricular ejection fractionMedical therapyEjection fractionMyocardial viabilityIschemic cardiomyopathyLeft ventricular systolic functionGoals of revascularizationCoronary artery bypassPrimary end pointVentricular systolic functionCoronary artery diseaseLeft ventricular functionLong-term outcomesLong-term survivalSurgical revascularizationDobutamine echocardiographyMedian durationSystolic functionArtery diseaseVentricular functionViable myocardiumLong-term benefitsLower incidenceCABGPCI and CABG for Treating Stable Coronary Artery Disease JACC Review Topic of the Week
Doenst T, Haverich A, Serruys P, Bonow RO, Kappetein P, Falk V, Velazquez E, Diegeler A, Sigusch H. PCI and CABG for Treating Stable Coronary Artery Disease JACC Review Topic of the Week. Journal Of The American College Of Cardiology 2019, 73: 964-976. PMID: 30819365, DOI: 10.1016/j.jacc.2018.11.053.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionMyocardial infarctionStable coronary artery diseaseMajority of infarctsCoronary artery bypassCoronary artery diseaseFlow-limiting lesionsNew infarctsArtery bypassCoronary interventionInfarct reductionArtery diseaseMedical therapyRevascularization proceduresVessel occlusionCABGSurvival effectReview TopicTreatment effectsInfarctionInfarctsIschemia detectionRevascularizationStenosisBypassBurden of medical co‐morbidities and benefit from surgical revascularization in patients with ischaemic cardiomyopathy
Ambrosy AP, Stevens SR, Al‐Khalidi H, Rouleau JL, Bouabdallaoui N, Carson PE, Adlbrecht C, Cleland JGF, Dabrowski R, Golba KS, Pina IL, Sueta CA, Roy A, Sopko G, Bonow RO, Velazquez EJ, Investigators O. Burden of medical co‐morbidities and benefit from surgical revascularization in patients with ischaemic cardiomyopathy. European Journal Of Heart Failure 2019, 21: 373-381. PMID: 30698316, PMCID: PMC6818499, DOI: 10.1002/ejhf.1404.Peer-Reviewed Original ResearchConceptsCharlson co-morbidity indexCCI scoreSurgical revascularizationEjection fractionMedical therapySTICH trialHeart failureIschemic cardiomyopathyKansas City Cardiomyopathy QuestionnaireCo-morbidity indexCoronary artery bypassCo-morbid conditionsHealth-related qualityCoronary artery diseaseRisk of deathProportional hazards modelYears of ageTreatment effectsGreater functional limitationsArtery bypassCause mortalityIschemic etiologyArtery diseaseWalk testBaseline confounders
2018
Childhood and adult exposure to secondhand tobacco smoke and cardiac structure and function: results from Echo-SOL
Peña M, Swett K, Kaplan RC, Perreira K, Daviglus M, Kansal MM, Cai J, Giachello AL, Gellman MD, Velazquez EJ, Rodriguez CJ. Childhood and adult exposure to secondhand tobacco smoke and cardiac structure and function: results from Echo-SOL. Open Heart 2018, 5: e000831. PMID: 30402256, PMCID: PMC6203071, DOI: 10.1136/openhrt-2018-000831.Peer-Reviewed Original ResearchLeft ventricular global longitudinal strainLeft ventricular ejection fractionIsovolumic relaxation timeSHS exposureCardiac structureTobacco smokersRight ventricular fractional area changeVentricular global longitudinal strainVentricular fractional area changeHousehold SHS exposureAtrial volume indexClinical heart failureSevere valvular diseaseVentricular ejection fractionCoronary artery diseaseGlobal longitudinal strainSecondhand smoke exposureFractional area changeHousehold secondhand smoke exposureAdolescents/adultsECHO-SOLArtery diseaseCardiac systolicDiastolic functionEchocardiographic measuresVariability in Ejection Fraction Measured By Echocardiography, Gated Single-Photon Emission Computed Tomography, and Cardiac Magnetic Resonance in Patients With Coronary Artery Disease and Left Ventricular Dysfunction
Pellikka PA, She L, Holly TA, Lin G, Varadarajan P, Pai RG, Bonow RO, Pohost GM, Panza JA, Berman DS, Prior DL, Asch FM, Borges-Neto S, Grayburn P, Al-Khalidi HR, Miszalski-Jamka K, Desvigne-Nickens P, Lee KL, Velazquez EJ, Oh JK. Variability in Ejection Fraction Measured By Echocardiography, Gated Single-Photon Emission Computed Tomography, and Cardiac Magnetic Resonance in Patients With Coronary Artery Disease and Left Ventricular Dysfunction. JAMA Network Open 2018, 1: e181456-e181456. PMID: 30646130, PMCID: PMC6324278, DOI: 10.1001/jamanetworkopen.2018.1456.Peer-Reviewed Original ResearchConceptsLeft ventricular ejection fractionCoronary artery diseaseCardiovascular magnetic resonanceVentricular ejection fractionArtery diseaseCore laboratorySingle photon emissionVentricular dysfunctionEjection fractionBland-Altman plotsLVEF measurementsAssociation of LVEFGated single-photon emissionIschemic heart failureLeft ventricular dysfunctionSubset of patientsOptimal treatment strategyImaging modalitiesMulticenter diagnostic studyCardiac magnetic resonanceInternational multicenter studyLVEF dataMost patientsHeart failureSurgical treatmentThe association between blood pressure and long-term outcomes of patients with ischaemic cardiomyopathy with and without surgical revascularization: an analysis of the STICH trial
Andersson B, She L, Tan RS, Jeemon P, Mokrzycki K, Siepe M, Romanov A, Favaloro LE, Djokovic LT, Raju PK, Betlejewski P, Racine N, Ostrzycki A, Nawarawong W, Das S, Rouleau JL, Sopko G, Lee KL, Velazquez EJ, Panza JA. The association between blood pressure and long-term outcomes of patients with ischaemic cardiomyopathy with and without surgical revascularization: an analysis of the STICH trial. European Heart Journal 2018, 39: 3464-3471. PMID: 30113633, PMCID: PMC6166135, DOI: 10.1093/eurheartj/ehy438.Peer-Reviewed Original ResearchConceptsBlood pressureCoronary artery diseaseHigh blood pressureMortality outcomesSTICH trialArtery diseaseHeart failureIschemic cardiomyopathyLandmark analysisInfluence of BPLong-term mortality outcomesBP-lowering medicationsIschemic HF patientsCoronary artery bypassOutcomes of patientsBaseline blood pressureDiastolic blood pressureLower blood pressureLong-term outcomesSystolic BP valuesCABG treatmentSurgical revascularizationArtery bypassHF patientsVentricular dysfunctionHFrEF other treatment: revascularization
Velazquez E, Petrie M. HFrEF other treatment: revascularization. 2018, 1881-1884. DOI: 10.1093/med/9780198784906.003.0431.Peer-Reviewed Original ResearchLong-term outcomes of mitral regurgitation by type and severity
Samad Z, Shaw LK, Phelan M, Glower DD, Ersboll M, Toptine JH, Alexander JH, Kisslo JA, Wang A, Mark DB, Velazquez EJ. Long-term outcomes of mitral regurgitation by type and severity. American Heart Journal 2018, 203: 39-48. PMID: 30015067, DOI: 10.1016/j.ahj.2018.05.001.Peer-Reviewed Original ResearchConceptsMR severityCause deathIschemic MRSurvival rateCause death riskCoronary artery diseaseLong-term outcomesAbsolute mortality ratesQualifying patientsArtery diseaseEchocardiography studyMitral regurgitationVentricular sizeIndeterminate causeBaseline severityDeath riskSevere MREchocardiography laboratoryHigh riskMortality rateClinical settingPatientsValve morphologySeverityMyxomatousSex Difference in Patients With Ischemic Heart Failure Undergoing Surgical Revascularization
Piña IL, Zheng Q, She L, Szwed H, Lang IM, Farsky PS, Castelvecchio S, Biernat J, Paraforos A, Kosevic D, Favaloro LE, Nicolau JC, Varadarajan P, Velazquez EJ, Pai RG, Cyrille N, Lee KL, Desvigne-Nickens P. Sex Difference in Patients With Ischemic Heart Failure Undergoing Surgical Revascularization. Circulation 2018, 137: 771-780. PMID: 29459462, PMCID: PMC5896331, DOI: 10.1161/circulationaha.117.030526.Peer-Reviewed Original ResearchConceptsIschemic left ventricular dysfunctionLeft ventricular dysfunctionCause mortalityCardiovascular mortalitySTICH trialSurgical deathsVentricular dysfunctionCardiovascular hospitalizationRisk factorsKansas City Cardiomyopathy Questionnaire overall summary scoreHigher New York Heart Association classCardiac Operative Risk Evaluation scoreCoronary artery disease risk factorsNew York Heart Association classHigher body mass indexComposite of deathCoronary artery bypassIschemic heart failureDisease risk factorsPoor prognostic factorVentricular ejection fractionCoronary artery diseaseBody mass indexLong-term outcomesOverall summary scoreSix-minute walk distance after coronary artery bypass grafting compared with medical therapy in ischaemic cardiomyopathy
Stewart RAH, Szalewska D, Stebbins A, Al-Khalidi HR, Cleland JGH, Rynkiewicz A, Drazner MH, White HD, Mark DB, Roy A, Kosevic D, Rajda M, Jasinski M, Leng CY, Tungsubutra W, Desvigne-Nickens P, Velazquez EJ, Petrie MC. Six-minute walk distance after coronary artery bypass grafting compared with medical therapy in ischaemic cardiomyopathy. Open Heart 2018, 5: e000752. PMID: 29531766, PMCID: PMC5845417, DOI: 10.1136/openhrt-2017-000752.Peer-Reviewed Original ResearchCoronary artery bypass surgeryIschemic left ventricular dysfunctionLeft ventricular dysfunctionWalk distanceVentricular dysfunctionMedical therapyMED groupFunctional capacityNew York Heart Association classSix-minute walk distanceMin walk distanceCoronary artery bypassArtery bypass surgeryVentricular ejection fractionCoronary artery diseaseArtery bypassBypass surgeryArtery diseaseAssociation classEjection fractionIschemic cardiomyopathySurgical treatmentTreatment allocationDisease trialsPatients
2017
Usefulness of Myocardial Annular Velocity Change During Mental Stress to Predict Cardiovascular Outcome in Patients With Coronary Artery Disease (From the Responses of Mental Stress-Induced Myocardial Ischemia to Escitalopram Treatment Trial)
Alenezi F, Brummett BH, Boyle SH, Samad Z, Babyak MA, Alzaeim N, Wilson J, Romano MMD, Sun JL, Ersboll M, O'Connor CM, Velazquez EJ, Jiang W. Usefulness of Myocardial Annular Velocity Change During Mental Stress to Predict Cardiovascular Outcome in Patients With Coronary Artery Disease (From the Responses of Mental Stress-Induced Myocardial Ischemia to Escitalopram Treatment Trial). The American Journal Of Cardiology 2017, 120: 1495-1500. PMID: 28917493, DOI: 10.1016/j.amjcard.2017.07.039.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseStable coronary artery diseaseAdverse cardiovascular outcomesCardiovascular outcomesArtery diseaseNew York Heart Association functional class IMental stress-induced myocardial ischemiaStress-induced myocardial ischemiaNonfatal cardiovascular eventsFunctional class IMental stress testingCox regression modelMS-induced changesCardiovascular eventsCause mortalityUnplanned hospitalizationPrognostic factorsMean ageMyocardial ischemiaSystolic velocityAnnular velocityPatientsMental stressClass IMACE