Voluntary Faculty
Voluntary faculty are typically clinicians or others who are employed outside of the School but make significant contributions to department programs at the medical center or at affiliate institutions.
Voluntary rank detailsRobert Aaron Levine, MD
Clinical ProfessorAbout
Research
Publications
2026
Aortic Stenosis Progression: Lessons from Multimodality Imaging
Jain R, Padang R, Postalian A, Dal-Bianco J, Zweig B, Ito S, Hodara R, Levine R, Oh J. Aortic Stenosis Progression: Lessons from Multimodality Imaging. Mayo Clinic Proceedings 2026 PMID: 42285495, DOI: 10.1016/j.mayocp.2026.06.008.Peer-Reviewed Original ResearchProgression of aortic stenosisAortic stenosisAssociated with significant morbidityClinical utilityCardiac magnetic resonance imagingCardiac computed tomographyMultimodal imagingUtilization of echocardiographySevere aortic stenosisAortic valve calcificationAssessment of aortic stenosisCalcific aortic stenosisQuantify severitySeverity of diseaseMagnetic resonance imagingSignificant morbidityClinical research trialsValve calcificationStenosisMultiple signaling pathwaysNuclear imagingResonance imagingSignaling pathwayActive metabolic processesMetabolic activityImprovement in left atrial strain after percutaneous mitral valvuloplasty is an independent prognostic marker in patients with rheumatic mitral stenosis
Pantaleao A, Figueiredo F, Mutarelli A, Guarçoni B, Carvalho H, Fonseca I, Dahan S, Kang J, Sindre R, Oliveira J, Aikawa E, Levine R, Nunes M, Network O. Improvement in left atrial strain after percutaneous mitral valvuloplasty is an independent prognostic marker in patients with rheumatic mitral stenosis. Frontiers In Cardiovascular Medicine 2026, 13: 1719283. PMID: 42222110, PMCID: PMC13219354, DOI: 10.3389/fcvm.2026.1719283.Peer-Reviewed Original ResearchLA reservoir strainPercutaneous mitral valvuloplastyMitral valve replacementRheumatic mitral stenosisMitral stenosisPrognostic valueRheumatic MSMitral valvuloplastyComposite outcomeCardiac deathDetection of LA dysfunctionLA pressure overloadLeft Atrial StrainPost-procedure improvementProgressive atrial remodelingRisk reduction of deathComposite of cardiac deathMedian Follow-UpSpeckle-tracking echocardiographyCox proportional hazards modelsEarly detectionProportional hazards modelTransthoracic echocardiogramAtrial strainPrognostic factorsRecommendations for the Identification and Mitigation of Cardiac Ultrasound Artifacts: A Guideline from the American Society of Echocardiography
Saric M, Sadeghpour A, Alizade L, Alizadehasl A, Bertrand P, Billick K, Chebrolu B, Faletra F, Kelsey A, Lang R, Levine R, Pourafkari L, Walling S. Recommendations for the Identification and Mitigation of Cardiac Ultrasound Artifacts: A Guideline from the American Society of Echocardiography. Journal Of The American Society Of Echocardiography 2026, 39: 435-475. PMID: 42070896, DOI: 10.1016/j.echo.2026.01.007.Peer-Reviewed Original ResearchConceptsAmerican Society of EchocardiographyUltrasound artifactsThree-dimensional echocardiographyAmerican SocietyArtifact generationClinical impactCardiac ultrasoundClinical consequencesColor DopplerExternal equipmentUltrasound imaging technologyEchocardiographic modesUltrasoundArtifactsEchocardiographyUltrasound imagingReal case
2025
Left Atrial Plication for Left Ventricular Posterior Wall Bending With Atrial Functional Mitral Regurgitation
Iwataki M, Oishi Y, Miki H, Onoue T, Nagata Y, Levine R, Otsuji Y, Nishimura Y, Kataoka M. Left Atrial Plication for Left Ventricular Posterior Wall Bending With Atrial Functional Mitral Regurgitation. JACC Case Reports 2025, 31: 106394. PMID: 41342815, PMCID: PMC12905679, DOI: 10.1016/j.jaccas.2025.106394.Peer-Reviewed Original ResearchAtrial functional mitral regurgitationFunctional mitral regurgitationGiant LAMitral regurgitationMV repairMitral valve (MV) surgeryLeft atriumLeft atrial plicationRheumatic mitral regurgitationLow cardiac outputGiant left atriumMV replacementChordal preservationPatient 2Patient 1Basal posterior wallPosterior wallCardiac outputPatientsPlicationRegurgitationRepairSurgeryThe value of a novel three-dimensional mitral valve index in the assessment of the haemodynamic severity of rheumatic mitral stenosis
Giffoni R, Hung J, Neto J, de Sousa Pinto A, Gomes N, Pantaleão A, de Magalhães Esteves W, Dal-Bianco J, Tan T, Levine R, Nunes M. The value of a novel three-dimensional mitral valve index in the assessment of the haemodynamic severity of rheumatic mitral stenosis. Echo Research & Practice 2025, 12: 33. PMID: 41219791, PMCID: PMC12606853, DOI: 10.1186/s44156-025-00094-z.Peer-Reviewed Original ResearchMitral stenosisHaemodynamic severityRheumatic MSHaemodynamic burdenClinical presentationSeverity of rheumatic mitral stenosisPulmonary artery systolic pressureNet atrioventricular complianceArtery systolic pressureLeft atrial volumeRheumatic mitral stenosisClinical presentation of MSPresentation of MSTransmitral pressure gradientMitral valve geometryMean pressure gradientTenting heightTenting volumeAtrial volumeEchocardiographic assessmentValve anatomyAtrioventricular complianceMitral annulusMitral valveHaemodynamic consequencesGlobal prevalence and sex differences in rheumatic heart disease: a systematic review and updated meta-analysis
Mutarelli A, Pantaleao A, Melo P, Nogueira W, Nogueira A, Felix N, Generoso G, Cardoso R, Lupieri A, Aikawa E, Levine R, Nunes M. Global prevalence and sex differences in rheumatic heart disease: a systematic review and updated meta-analysis. Frontiers In Cardiovascular Medicine 2025, 12: 1615158. PMID: 41282342, PMCID: PMC12631635, DOI: 10.3389/fcvm.2025.1615158.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsRheumatic heart diseaseRheumatic heart disease prevalenceAcute rheumatic feverGlobal prevalenceMeta-analysisPrevalence of rheumatic heart diseaseSequelae of acute rheumatic feverHeart diseaseLow-to-middle-income countriesAcquired cardiac diseaseCross-sectional studyWHF criteriaValve lesionsWHO criteriaFemale predominanceIndividuals aged 5Health systemSubgroup analysisRheumatic feverLow-income familiesCardiac diseaseRisk factorsSex disparitiesSystematic reviewEndemic regionsAtrial Functional Mitral Regurgitation Small Volumes, Big Consequences
Levine R, Dal-Bianco J, Otsuji Y. Atrial Functional Mitral Regurgitation Small Volumes, Big Consequences. JACC Cardiovascular Imaging 2025, 18: 1297-1299. PMID: 41026077, DOI: 10.1016/j.jcmg.2025.08.018.Commentaries, Editorials and LettersCollagen Fiber Maturity and Architecture in MVP-Associated Fibrosis Quantified by Digital Pathology
Phookan R, Morningstar J, Loizzi B, Van Kampen A, Gensemer C, Dieterlen M, Spampinato R, Petitjean L, Petitjean M, Petrucci T, Fenner R, Griner J, Byerly K, Levine R, Borger M, Norris R. Collagen Fiber Maturity and Architecture in MVP-Associated Fibrosis Quantified by Digital Pathology. Cells 2025, 14: 1536. PMID: 41090764, PMCID: PMC12523760, DOI: 10.3390/cells14191536.Peer-Reviewed Original ResearchConceptsMitral valve prolapseRegional myocardial fibrosisMyocardial fibrosisArrhythmogenic mitral valve prolapseHistopathological analysisAnalysis of endomyocardial biopsiesLife-threatening ventricular arrhythmiasPersistent fibrotic phenotypeMitral valve repairTime of surgeryRisk of arrhythmiaQuantitative image analysisLeaflet involvementEndomyocardial biopsyValve repairValve prolapseVentricular functionSurgical guidelinesVentricular arrhythmiasSubvalvular apparatusSurgical interventionMyocardial scarCollagen fiber maturationFibrotic phenotypeFibrosisShort- and Long-Term Effects of Pulsed Ultrasound Cavitation Therapy of Calcified Valvular Interstitial Cells in Culture
Clift C, Goudot G, Bogut G, Kasai T, van Kampen A, Negrao Pantaleao A, Messas E, Aikawa M, Singh S, Levine R, Pernot M, Aikawa E. Short- and Long-Term Effects of Pulsed Ultrasound Cavitation Therapy of Calcified Valvular Interstitial Cells in Culture. Ultrasound In Medicine & Biology 2025, 51: 1936-1944. PMID: 40796501, DOI: 10.1016/j.ultrasmedbio.2025.06.026.Peer-Reviewed Original ResearchConceptsHuman valvular interstitial cellsAortic stenosisUltrasound therapyInterstitial cellsFirst-in-human studyAcute effectsTranscatheter aortic valve replacementLong-term effectsAortic valve replacementSevere aortic stenosisLeft ventricular hypertrophyValvular interstitial cellsCalcified aortic stenosisAortic valve diseaseEffects of ultrasound therapyProteomic profilingCalcific aortic valve diseaseOutflow tractSurgical repairValve replacementCardiac failureCalcification in vitroInvasive alternativeVentricular hypertrophySurgical interventionIs mitral annular disjunction the cause of arrhythmogenic mitral valve prolapse?
van Kampen A, Levine R, Borger M. Is mitral annular disjunction the cause of arrhythmogenic mitral valve prolapse? European Heart Journal 2025, 46: 2806-2808. PMID: 40272106, PMCID: PMC12277878, DOI: 10.1093/eurheartj/ehaf264.Commentaries, Editorials and Letters
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