The Experts below are selected from a list of 1245 Experts worldwide ranked by ideXlab platform
Lingjun Wang - One of the best experts on this subject based on the ideXlab platform.
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transplantation of isl1 cardiac progenitor cells in small intestinal submucosa improves infarcted heart function
Stem Cell Research & Therapy, 2017Co-Authors: Lingjun Wang, Elizabeth M Meier, Shuo Tian, Shaoxiang Xian, Zhong WangAbstract:Application of cardiac stem cells combined with biomaterial scaffold is a promising therapeutic strategy for heart repair after Myocardial infarction. However, the optimal cell types and biomaterials remain elusive. In this study, we seeded Isl1+ embryonic cardiac progenitor cells (CPCs) into decellularized porcine small intestinal submucosa extracellular matrix (SIS-ECM) to assess the therapeutic potential of Isl1+ CPCs and the biocompatibility of SIS-ECM with these cells. We observed that SIS-ECM supported the viability and attachment of Isl1+ CPCs. Importantly, Isl1+ CPCs differentiated into cardiomyocytes and endothelial cells 7 days after seeding into SIS-ECM. In addition, SIS-ECM with CPC-derived cardiomyocytes showed spontaneous contraction and responded to β-adrenergic stimulation. Next, patches of SIS-ECM seeded with CPCs for 7 days were transplanted onto the outer surface of infarcted myocardium in mice. Four weeks after transplantation, the patches were tightly attached to the surface of the host myocardium and remained viable. Transplantation of patches improved cardiac function, decreased the left ventricular Myocardial Scarring area, and reduced fibrosis and heart failure. Transplantation of Isl1+ CPCs seeded in SIS-ECM represents an effective approach for cell-based heart therapy.
Michele Parker - One of the best experts on this subject based on the ideXlab platform.
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prevalence of regional Myocardial thinning and relationship with Myocardial Scarring in patients with coronary artery disease
JAMA, 2013Co-Authors: Dipan J Shah, Michele Parker, Han W Kim, Olga James, Robert O Bonow, Robert M Judd, Raymond J KimAbstract:Results Of 1055 consecutive patients with CAD screened, 201 (19% (95% CI, 17% to 21%)) had regional wall thinning. Wall thinning spanned a mean of 34% (95% CI, 32% to 37% (SD, 15%)) of LV surface area. Within these regions, the extent of scar- ring was 72% (95% CI, 69% to 76% (SD, 25%)); however, 18% (95% CI, 13% to 24%) of thinned regions had limited scar burden (50% of total extent). Among pa- tients with thinning undergoing revascularization and follow-up cine-CMR (n=42), scarextentwithinthethinnedregionwasinverselyrelatedtoregional(r=0.72,P.001)
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assessment of Myocardial Scarring improves risk stratification in patients evaluated for cardiac defibrillator implantation
Journal of the American College of Cardiology, 2012Co-Authors: Igor Klem, Jonathan W Weinsaft, Michele Parker, Han W Kim, Robert M Judd, Tristram D Bahnson, Donald D Hegland, Brenda Hayes, Raymond J KimAbstract:Objectives We tested whether an assessment of Myocardial Scarring by cardiac magnetic resonance imaging (MRI) would improve risk stratification in patients evaluated for implantable cardioverter-defibrillator (ICD) implantation. Background Current sudden cardiac death risk stratification emphasizes left ventricular ejection fraction (LVEF); however, most patients suffering sudden cardiac death have a preserved LVEF, and many with poor LVEF do not benefit from ICD prophylaxis. Methods One hundred thirty-seven patients undergoing evaluation for possible ICD placement were prospectively enrolled and underwent cardiac MRI assessment of LVEF and scar. The pre-specified primary endpoint was death or appropriate ICD discharge for sustained ventricular tachyarrhythmia. Results During a median follow-up of 24 months the primary endpoint occurred in 39 patients. Whereas the rate of adverse events steadily increased with decreasing LVEF, a sharp step-up was observed for scar size >5% of left ventricular mass (hazard ratio [HR]: 5.2; 95% confidence interval [CI]: 2.0 to 13.3). On multivariable Cox proportional hazards analysis, including LVEF and electrophysiological-study results, scar size (as a continuous variable or dichotomized at 5%) was an independent predictor of adverse outcome. Among patients with LVEF >30%, those with significant Scarring (>5%) had higher risk than those with minimal or no (≤5%) Scarring (HR: 6.3; 95% CI: 1.4 to 28.0). Those with LVEF >30% and significant Scarring had risk similar to patients with LVEF ≤30% (p = 0.56). Among patients with LVEF ≤30%, those with significant Scarring again had higher risk than those with minimal or no Scarring (HR: 3.9; 95% CI: 1.2 to 13.1). Those with LVEF ≤30% and minimal Scarring had risk similar to patients with LVEF >30% (p = 0.71). Conclusions Myocardial Scarring detected by cardiac MRI is an independent predictor of adverse outcome in patients being considered for ICD placement. In patients with LVEF >30%, significant Scarring (>5% LV) identifies a high-risk cohort similar in risk to those with LVEF ≤30%. Conversely, in patients with LVEF ≤30%, minimal or no Scarring identifies a low-risk cohort similar to those with LVEF >30%.
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detection of left ventricular thrombus by delayed enhancement cardiovascular magnetic resonance prevalence and markers in patients with systolic dysfunction
Journal of the American College of Cardiology, 2008Co-Authors: Jonathan W Weinsaft, Han W Kim, Dipan J Shah, Igor Klem, Anna Lisa Crowley, Rhoda Brosnan, Olga James, Manesh R Patel, John F Heitner, Michele ParkerAbstract:Objectives This study sought to assess the prevalence and markers of left ventricular (LV) thrombus among patients with systolic dysfunction. Background Prior studies have yielded discordant findings regarding prevalence and markers of LV thrombus. Delayed-enhancement cardiovascular magnetic resonance (DE-CMR) identifies thrombus on the basis of tissue characteristics rather than just anatomical appearance and is potentially highly accurate. Methods Prevalence of thrombus by DE-CMR was determined in 784 consecutive patients with systolic dysfunction (left ventricular ejection fraction [LVEF] Results Among this at-risk population (age 60 ± 14 years; LVEF 32 ± 11%), DE-CMR detected thrombus in 7% (55 patients) and cine-CMR in 4.7% (37 patients, p Conclusions In a broad cross section of patients with systolic dysfunction, thrombus prevalence was 7% by DE-CMR and included small intracavitary and small or large mural thrombus missed by cine-CMR. Prevalence increased with worse LVEF, ischemic etiology, and increased Myocardial Scarring.
Jonathan W Weinsaft - One of the best experts on this subject based on the ideXlab platform.
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assessment of Myocardial Scarring improves risk stratification in patients evaluated for cardiac defibrillator implantation
Journal of the American College of Cardiology, 2012Co-Authors: Igor Klem, Jonathan W Weinsaft, Michele Parker, Han W Kim, Robert M Judd, Tristram D Bahnson, Donald D Hegland, Brenda Hayes, Raymond J KimAbstract:Objectives We tested whether an assessment of Myocardial Scarring by cardiac magnetic resonance imaging (MRI) would improve risk stratification in patients evaluated for implantable cardioverter-defibrillator (ICD) implantation. Background Current sudden cardiac death risk stratification emphasizes left ventricular ejection fraction (LVEF); however, most patients suffering sudden cardiac death have a preserved LVEF, and many with poor LVEF do not benefit from ICD prophylaxis. Methods One hundred thirty-seven patients undergoing evaluation for possible ICD placement were prospectively enrolled and underwent cardiac MRI assessment of LVEF and scar. The pre-specified primary endpoint was death or appropriate ICD discharge for sustained ventricular tachyarrhythmia. Results During a median follow-up of 24 months the primary endpoint occurred in 39 patients. Whereas the rate of adverse events steadily increased with decreasing LVEF, a sharp step-up was observed for scar size >5% of left ventricular mass (hazard ratio [HR]: 5.2; 95% confidence interval [CI]: 2.0 to 13.3). On multivariable Cox proportional hazards analysis, including LVEF and electrophysiological-study results, scar size (as a continuous variable or dichotomized at 5%) was an independent predictor of adverse outcome. Among patients with LVEF >30%, those with significant Scarring (>5%) had higher risk than those with minimal or no (≤5%) Scarring (HR: 6.3; 95% CI: 1.4 to 28.0). Those with LVEF >30% and significant Scarring had risk similar to patients with LVEF ≤30% (p = 0.56). Among patients with LVEF ≤30%, those with significant Scarring again had higher risk than those with minimal or no Scarring (HR: 3.9; 95% CI: 1.2 to 13.1). Those with LVEF ≤30% and minimal Scarring had risk similar to patients with LVEF >30% (p = 0.71). Conclusions Myocardial Scarring detected by cardiac MRI is an independent predictor of adverse outcome in patients being considered for ICD placement. In patients with LVEF >30%, significant Scarring (>5% LV) identifies a high-risk cohort similar in risk to those with LVEF ≤30%. Conversely, in patients with LVEF ≤30%, minimal or no Scarring identifies a low-risk cohort similar to those with LVEF >30%.
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detection of left ventricular thrombus by delayed enhancement cardiovascular magnetic resonance prevalence and markers in patients with systolic dysfunction
Journal of the American College of Cardiology, 2008Co-Authors: Jonathan W Weinsaft, Han W Kim, Dipan J Shah, Igor Klem, Anna Lisa Crowley, Rhoda Brosnan, Olga James, Manesh R Patel, John F Heitner, Michele ParkerAbstract:Objectives This study sought to assess the prevalence and markers of left ventricular (LV) thrombus among patients with systolic dysfunction. Background Prior studies have yielded discordant findings regarding prevalence and markers of LV thrombus. Delayed-enhancement cardiovascular magnetic resonance (DE-CMR) identifies thrombus on the basis of tissue characteristics rather than just anatomical appearance and is potentially highly accurate. Methods Prevalence of thrombus by DE-CMR was determined in 784 consecutive patients with systolic dysfunction (left ventricular ejection fraction [LVEF] Results Among this at-risk population (age 60 ± 14 years; LVEF 32 ± 11%), DE-CMR detected thrombus in 7% (55 patients) and cine-CMR in 4.7% (37 patients, p Conclusions In a broad cross section of patients with systolic dysfunction, thrombus prevalence was 7% by DE-CMR and included small intracavitary and small or large mural thrombus missed by cine-CMR. Prevalence increased with worse LVEF, ischemic etiology, and increased Myocardial Scarring.
Han W Kim - One of the best experts on this subject based on the ideXlab platform.
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prevalence of regional Myocardial thinning and relationship with Myocardial Scarring in patients with coronary artery disease
JAMA, 2013Co-Authors: Dipan J Shah, Michele Parker, Han W Kim, Olga James, Robert O Bonow, Robert M Judd, Raymond J KimAbstract:Results Of 1055 consecutive patients with CAD screened, 201 (19% (95% CI, 17% to 21%)) had regional wall thinning. Wall thinning spanned a mean of 34% (95% CI, 32% to 37% (SD, 15%)) of LV surface area. Within these regions, the extent of scar- ring was 72% (95% CI, 69% to 76% (SD, 25%)); however, 18% (95% CI, 13% to 24%) of thinned regions had limited scar burden (50% of total extent). Among pa- tients with thinning undergoing revascularization and follow-up cine-CMR (n=42), scarextentwithinthethinnedregionwasinverselyrelatedtoregional(r=0.72,P.001)
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assessment of Myocardial Scarring improves risk stratification in patients evaluated for cardiac defibrillator implantation
Journal of the American College of Cardiology, 2012Co-Authors: Igor Klem, Jonathan W Weinsaft, Michele Parker, Han W Kim, Robert M Judd, Tristram D Bahnson, Donald D Hegland, Brenda Hayes, Raymond J KimAbstract:Objectives We tested whether an assessment of Myocardial Scarring by cardiac magnetic resonance imaging (MRI) would improve risk stratification in patients evaluated for implantable cardioverter-defibrillator (ICD) implantation. Background Current sudden cardiac death risk stratification emphasizes left ventricular ejection fraction (LVEF); however, most patients suffering sudden cardiac death have a preserved LVEF, and many with poor LVEF do not benefit from ICD prophylaxis. Methods One hundred thirty-seven patients undergoing evaluation for possible ICD placement were prospectively enrolled and underwent cardiac MRI assessment of LVEF and scar. The pre-specified primary endpoint was death or appropriate ICD discharge for sustained ventricular tachyarrhythmia. Results During a median follow-up of 24 months the primary endpoint occurred in 39 patients. Whereas the rate of adverse events steadily increased with decreasing LVEF, a sharp step-up was observed for scar size >5% of left ventricular mass (hazard ratio [HR]: 5.2; 95% confidence interval [CI]: 2.0 to 13.3). On multivariable Cox proportional hazards analysis, including LVEF and electrophysiological-study results, scar size (as a continuous variable or dichotomized at 5%) was an independent predictor of adverse outcome. Among patients with LVEF >30%, those with significant Scarring (>5%) had higher risk than those with minimal or no (≤5%) Scarring (HR: 6.3; 95% CI: 1.4 to 28.0). Those with LVEF >30% and significant Scarring had risk similar to patients with LVEF ≤30% (p = 0.56). Among patients with LVEF ≤30%, those with significant Scarring again had higher risk than those with minimal or no Scarring (HR: 3.9; 95% CI: 1.2 to 13.1). Those with LVEF ≤30% and minimal Scarring had risk similar to patients with LVEF >30% (p = 0.71). Conclusions Myocardial Scarring detected by cardiac MRI is an independent predictor of adverse outcome in patients being considered for ICD placement. In patients with LVEF >30%, significant Scarring (>5% LV) identifies a high-risk cohort similar in risk to those with LVEF ≤30%. Conversely, in patients with LVEF ≤30%, minimal or no Scarring identifies a low-risk cohort similar to those with LVEF >30%.
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detection of left ventricular thrombus by delayed enhancement cardiovascular magnetic resonance prevalence and markers in patients with systolic dysfunction
Journal of the American College of Cardiology, 2008Co-Authors: Jonathan W Weinsaft, Han W Kim, Dipan J Shah, Igor Klem, Anna Lisa Crowley, Rhoda Brosnan, Olga James, Manesh R Patel, John F Heitner, Michele ParkerAbstract:Objectives This study sought to assess the prevalence and markers of left ventricular (LV) thrombus among patients with systolic dysfunction. Background Prior studies have yielded discordant findings regarding prevalence and markers of LV thrombus. Delayed-enhancement cardiovascular magnetic resonance (DE-CMR) identifies thrombus on the basis of tissue characteristics rather than just anatomical appearance and is potentially highly accurate. Methods Prevalence of thrombus by DE-CMR was determined in 784 consecutive patients with systolic dysfunction (left ventricular ejection fraction [LVEF] Results Among this at-risk population (age 60 ± 14 years; LVEF 32 ± 11%), DE-CMR detected thrombus in 7% (55 patients) and cine-CMR in 4.7% (37 patients, p Conclusions In a broad cross section of patients with systolic dysfunction, thrombus prevalence was 7% by DE-CMR and included small intracavitary and small or large mural thrombus missed by cine-CMR. Prevalence increased with worse LVEF, ischemic etiology, and increased Myocardial Scarring.
Raymond J Kim - One of the best experts on this subject based on the ideXlab platform.
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prevalence of regional Myocardial thinning and relationship with Myocardial Scarring in patients with coronary artery disease
JAMA, 2013Co-Authors: Dipan J Shah, Michele Parker, Han W Kim, Olga James, Robert O Bonow, Robert M Judd, Raymond J KimAbstract:Results Of 1055 consecutive patients with CAD screened, 201 (19% (95% CI, 17% to 21%)) had regional wall thinning. Wall thinning spanned a mean of 34% (95% CI, 32% to 37% (SD, 15%)) of LV surface area. Within these regions, the extent of scar- ring was 72% (95% CI, 69% to 76% (SD, 25%)); however, 18% (95% CI, 13% to 24%) of thinned regions had limited scar burden (50% of total extent). Among pa- tients with thinning undergoing revascularization and follow-up cine-CMR (n=42), scarextentwithinthethinnedregionwasinverselyrelatedtoregional(r=0.72,P.001)
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assessment of Myocardial Scarring improves risk stratification in patients evaluated for cardiac defibrillator implantation
Journal of the American College of Cardiology, 2012Co-Authors: Igor Klem, Jonathan W Weinsaft, Michele Parker, Han W Kim, Robert M Judd, Tristram D Bahnson, Donald D Hegland, Brenda Hayes, Raymond J KimAbstract:Objectives We tested whether an assessment of Myocardial Scarring by cardiac magnetic resonance imaging (MRI) would improve risk stratification in patients evaluated for implantable cardioverter-defibrillator (ICD) implantation. Background Current sudden cardiac death risk stratification emphasizes left ventricular ejection fraction (LVEF); however, most patients suffering sudden cardiac death have a preserved LVEF, and many with poor LVEF do not benefit from ICD prophylaxis. Methods One hundred thirty-seven patients undergoing evaluation for possible ICD placement were prospectively enrolled and underwent cardiac MRI assessment of LVEF and scar. The pre-specified primary endpoint was death or appropriate ICD discharge for sustained ventricular tachyarrhythmia. Results During a median follow-up of 24 months the primary endpoint occurred in 39 patients. Whereas the rate of adverse events steadily increased with decreasing LVEF, a sharp step-up was observed for scar size >5% of left ventricular mass (hazard ratio [HR]: 5.2; 95% confidence interval [CI]: 2.0 to 13.3). On multivariable Cox proportional hazards analysis, including LVEF and electrophysiological-study results, scar size (as a continuous variable or dichotomized at 5%) was an independent predictor of adverse outcome. Among patients with LVEF >30%, those with significant Scarring (>5%) had higher risk than those with minimal or no (≤5%) Scarring (HR: 6.3; 95% CI: 1.4 to 28.0). Those with LVEF >30% and significant Scarring had risk similar to patients with LVEF ≤30% (p = 0.56). Among patients with LVEF ≤30%, those with significant Scarring again had higher risk than those with minimal or no Scarring (HR: 3.9; 95% CI: 1.2 to 13.1). Those with LVEF ≤30% and minimal Scarring had risk similar to patients with LVEF >30% (p = 0.71). Conclusions Myocardial Scarring detected by cardiac MRI is an independent predictor of adverse outcome in patients being considered for ICD placement. In patients with LVEF >30%, significant Scarring (>5% LV) identifies a high-risk cohort similar in risk to those with LVEF ≤30%. Conversely, in patients with LVEF ≤30%, minimal or no Scarring identifies a low-risk cohort similar to those with LVEF >30%.
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Myocardial Scarring in asymptomatic or mildly symptomatic patients with hypertrophic cardiomyopathy
Journal of the American College of Cardiology, 2002Co-Authors: Lubna Choudhury, Heiko Mahrholdt, Anja Wagner, Kelly M Choi, Michael D Elliott, Francis J Klocke, Robert O Bonow, Robert M Judd, Raymond J KimAbstract:Abstract Objectives We sought to ascertain whether Myocardial Scarring occurs in living unselected patients with hypertrophic cardiomyopathy (HCM). Background Myocardial Scarring is known to occur in select HCM patients, who were highly symptomatic prior to death or who died suddenly. The majority of HCM patients, however, are minimally symptomatic and have not suffered sudden death. Methods Cine and gadolinium-enhanced magnetic resonance imaging was performed in 21 HCM patients who were predominantly asymptomatic. Gadolinium hyperenhancement was assumed to represent Myocardial scar, and the extent of scar was compared to left ventricular (LV) morphology and function. Results Scarring was present in 17 patients (81%). Scarring occurred only in hypertrophied regions (≥10 mm), was patchy with multiple foci, and predominantly involved the middle third of the ventricular wall. All 17 patients had Scarring at the junction of the interventricular septum and the right ventricular (RV) free wall. On a regional basis, the extent of Scarring correlated positively with wall thickness (r = 0.36, p Conclusions Myocardial Scarring is common in asymptomatic or mildly symptomatic HCM patients who have not suffered sudden death. When present, Scarring occurs in hypertrophied regions, is consistently localized to the junctions of the septum and RV free wall, and correlates positively with regional hypertrophy and inversely with regional contraction.
