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Start Over Author "Kapur, Navin K." Publisher wiley-blackwell
48 results on '"Kapur, Navin K."'

1. Treatment of Acute Myocardial Infarction and Cardiogenic Shock: Outcomes of the RECOVER III Postapproval Study by Society of Cardiovascular Angiography and Interventions Shock Stage.

Author

Hanson, Ivan D., Rusia, Akash, Palomo, Andres, Tawney, Adam, Pow, Timothy, Dixon, Simon R., Meraj, Perwaiz, Sievers, Eric, Johnson, Michael, Wohns, David, Ali, Omar, Kapur, Navin K., Grines, Cindy, Burkhoff, Daniel, Anderson, Mark, Lansky, Alexandra, Naidu, Srihari S., Basir, Mir B., and O'Neill, William

Published
2024
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12. Considerations for cardiac catheterization laboratory procedures during the COVID‐19 pandemic perspectives from the Society for Cardiovascular Angiography and Interventions Emerging Leader Mentorship (SCAI ELM) Members and Graduates.

Author

Szerlip, Molly, Anwaruddin, Saif, Aronow, Herbert D., Cohen, Mauricio G., Daniels, Matthew J., Dehghani, Payam, Drachman, Douglas E., Elmariah, Sammy, Feldman, Dmitriy N., Garcia, Santiago, Giri, Jay, Kaul, Prashant, Kapur, Navin K., Kumbhani, Dharam J., Meraj, Perwaiz M., Morray, Brian, Nayak, Keshav R., Parikh, Sahil A., Sakhuja, Rahul, and Schussler, Jeffrey M.

Published
2020
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15. SCAI clinical expert consensus statement on the classification of cardiogenic shock: This document was endorsed by the American College of Cardiology (ACC), the American Heart Association (AHA), the Society of Critical Care Medicine (SCCM), and the Society of Thoracic Surgeons (STS) in April 2019

Author

Baran, David A., Grines, Cindy L., Bailey, Steven, Burkhoff, Daniel, Hall, Shelley A., Henry, Timothy D., Hollenberg, Steven M., Kapur, Navin K., O'Neill, William, Ornato, Joseph P., Stelling, Kelly, Thiele, Holger, Diepen, Sean, and Naidu, Srihari S.

Published
2019
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18. Increased Plasma‐Free Hemoglobin Levels Identify Hemolysis in Patients With Cardiogenic Shock and a Trans valvular Micro‐Axial Flow Pump.

Author

Esposito, Michele L., Morine, Kevin J., Annamalai, Shiva K., O'Kelly, Ryan, Pedicini, Robert, Breton, Catalina, Mullin, Andrew, Kapur, Navin K., Hamadeh, Anas, Kiernan, Michael S., DeNofrio, David, and Aghili, Nima

Subjects
HEMOLYSIS & hemolysins, CARDIOGENIC shock, HEART assist devices, BIOLOGICAL tags, HEMOGLOBINS
Abstract

Hemolysis is a potential limitation of percutaneously delivered left‐sided mechanical circulatory support pumps, including trans valvular micro‐axial flow pumps (TVP). Hemolytic biomarkers among durable left ventricular assist devices include lactate dehydrogenase (LDH) >2.5 times the upper limit of normal (ULN) and plasma‐free hemoglobin (pf‐Hb) >20 mg/dL. We examined the predictive value of these markers among patients with cardiogenic shock (CS) receiving a TVP. We retrospectively studied records of 116 consecutive patients receiving an Impella TVP at our institution between 2012 and 2017 for CS. Twenty‐three met inclusion/exclusion criteria, and had sufficient pf‐Hb data for analysis. Area under receiver‐operator characteristic (ROC) curve for diagnosing hemolysis were calculated. Mean age was 62 ± 14 years and ejection fraction was 15 ± 5%. Mean duration of support was 5.4 ± 3.5 days. Pre‐device LDH levels were >2.5x ULN in 71% (n = 5/7) of 5.0 and 29% of CP patients, while pre‐device pf‐Hb levels were >20 mg/dL in 14% (n = 1/7) of 5.0 and 25% (n = 4/16) of CP patients. Given elevated baseline LDH and pf‐Hb levels, we defined hemolysis as a pf‐Hb level >40 mg/dL within 72 h post‐implant plus clinical evidence of device‐related hemolysis. We identified that 30% (n = 7/23) had device‐related hemolysis. Using ROC curve‐derived cut‐points, an increase in delta pf‐Hb by >27mg/dL, not delta LDH, within 24 h after TVP implant (delta pf‐Hb: C‐statistic = 0.79, sensitivity: 57%, specificity: 93%, p <0.05) was highly predictive of hemolysis. In conclusion, we identified a change in pf‐Hb, not LDH, levels is highly sensitive and specific for hemolysis in patients treated with a TVP for CS. [ABSTRACT FROM AUTHOR]

Published
2019
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20. A quality framework for the role of invasive, non‐interventional cardiologists in the present‐day cardiac catheterization laboratory: A multidisciplinary SCAI/HFSA expert consensus statement.

Author

Mulukutla, Suresh R., Babb, Joseph D., Baran, David A., Boudoulas, Konstantinos Dean, Feldman, Dmitriy N., Hall, Shelley A., Jennings, Henry S., Kapur, Navin K., Rao, Sunil V., Reginelli, Joel, Schussler, Jeffrey M., Yang, Eric H., and Cigarroa, Joaquin E.

Published
2018
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28. 2015 SCAI/ACC/HFSA/STS clinical expert consensus statement on the use of percutaneous mechanical circulatory support devices in cardiovascular care (Endorsed by the American heart assocation, the cardiological society of India, and sociedad latino Americana de cardiologia intervencion; Affirmation of value by the canadian association of interventional cardiology-association canadienne de cardiologie d'intervention)

Author

Rihal, Charanjit S., Naidu, Srihari S., Givertz, Michael M., Szeto, Wilson Y., Burke, James A., Kapur, Navin K., Kern, Morton, Garratt, Kirk N., Goldstein, James A., Dimas, Vivian, and Tu, Thomas

Published
2015
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33. 2015 SCAI/ ACC/ HFSA/ STS clinical expert consensus statement on the use of percutaneous mechanical circulatory support devices in Cardiovascular Care (Endorsed by the American heart association, the Cardiological society of India, and Sociedad Latino Americana de Cardiología Intervencionista; Affirmation of value by the Canadian association of interventional Cardiology-association Canadienne de Cardiologie d'intervention)

Author

Rihal, Charanjit S., Naidu, Srihari S., Givertz, Michael M., Szeto, Wilson Y., Burke, James A., Kapur, Navin K., Kern, Morton, Garratt, Kirk N., Goldstein, James A., Dimas, Vivian, and Tu, Thomas

Published
2015
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36. Transaxillary Impella support: Bridging the gap of powerful left ventricular support.

Author

Jung, Christian, Westenfeld, Ralf, and Kapur, Navin K.

Subjects
LEFT heart ventricle, HYPERHIDROSIS, INTRA-aortic balloon counterpulsation, HEART assist devices, VENTRICULAR septal defects, CARDIOPULMONARY bypass, CARDIOGENIC shock, HEMODILUTION
Abstract

Currently, these devices are frequently used in cardiogenic shock patients as a bridge to recovery or to durable treatment options like left ventricular assist device or highly urgent heart transplantation. After insertion of an Impella 5.0, hemodynamic values improved, which is known to be associated with improved survival.[13] The patient underwent subsequent double patch repair of the ventricular septal defect including coronary artery bypass grafting on cardiopulmonary bypass with Impella removal during the procedure. Percutaneous left-ventricular support with the Impella-2.5-assist device in acute cardiogenic shock: results of the Impella-EUROSHOCK-registry. [Extracted from the article]

Published
2019
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45. Early Utilization of Mechanical Circulatory Support in Acute Myocardial Infarction Complicated by Cardiogenic Shock: The National Cardiogenic Shock Initiative.

Author

Basir MB, Lemor A, Gorgis S, Patel KC, Kolski BC, Bharadwaj AS, Todd JW, Tehrani BN, Truesdell AG, Lasorda DM, Lalonde TA, Kaki A, Schrieber TL, Patel NC, Senter SR, Gelormini JL, Marso SP, Rahman AM, Federici RE, Wilkins CE, Thomas McRae A 3rd, Nsair A, Caputo CP, Khuddus MA, Chahin JJ, Dupont AG, Goldsweig AM, Lim MJ, Kapur NK, Wohns DHW, Zhou Y, Hacala MJ, and O'Neill WW

Subjects
Aged, Female, Humans, Male, Middle Aged, Lactic Acid, Shock, Cardiogenic diagnosis, Shock, Cardiogenic etiology, Shock, Cardiogenic therapy, Treatment Outcome, Heart-Assist Devices, Myocardial Infarction complications, Myocardial Infarction therapy
Abstract

Background: Acute myocardial infarction complicated by cardiogenic shock (AMI-CS) is associated with significant morbidity and mortality. Mechanical circulatory support (MCS) devices increase systemic blood pressure and end organ perfusion while reducing cardiac filling pressures., Methods and Results: The National Cardiogenic Shock Initiative (NCT03677180) is a single-arm, multicenter study. The purpose of this study was to assess the feasibility and effectiveness of utilizing early MCS with Impella in patients presenting with AMI-CS. The primary end point was in-hospital mortality. A total of 406 patients were enrolled at 80 sites between 2016 and 2020. Average age was 64±12 years, 24% were female, 17% had a witnessed out-of-hospital cardiac arrest, 27% had in-hospital cardiac arrest, and 9% were under active cardiopulmonary resuscitation during MCS implantation. Patients presented with a mean systolic blood pressure of 77.2±19.2 mm Hg, 85% of patients were on vasopressors or inotropes, mean lactate was 4.8±3.9 mmol/L and cardiac power output was 0.67±0.29 watts. At 24 hours, mean systolic blood pressure improved to 103.9±17.8 mm Hg, lactate to 2.7±2.8 mmol/L, and cardiac power output to 1.0±1.3 watts. Procedural survival, survival to discharge, survival to 30 days, and survival to 1 year were 99%, 71%, 68%, and 53%, respectively., Conclusions: Early use of MCS in AMI-CS is feasible across varying health care settings and resulted in improvements to early hemodynamics and perfusion. Survival rates to hospital discharge were high. Given the encouraging results from our analysis, randomized clinical trials are warranted to assess the role of utilizing early MCS, using a standardized, multidisciplinary approach.

Published
2023
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46. Successful use of Impella 5.5 to manage cardiogenic shock complicated by COVID-19.

Author

Mahrokhian SH, Nordan T, Ortoleva JP, Cobey FC, Chen FY, Kapur NK, and Kawabori M

Subjects
Humans, Retrospective Studies, SARS-CoV-2, Shock, Cardiogenic etiology, Shock, Cardiogenic therapy, Stroke Volume, Treatment Outcome, Ventricular Function, Left, COVID-19, Heart-Assist Devices
Abstract

Background: Acute decompensated heart failure in patients with coronavirus disease 2019 (COVID-19) is becoming increasingly common., Aims: In this case report, we describe the successful use of an Impella 5.5 (Abiomed) to treat cardiogenic shock refractory to inotropic therapy., Materials & Methods: Transthoracic and transesophageal echocardiography confirmed severely diminished left ventricular ejection fraction and a reverse-transcription polymerase chain reaction test revealed that the patient was COVID-19 positive during his hospital admission., Results: Following initiation of inotropic therapy, we placed an Impella 5.5 for further cardiac support. The patient's LVEF and cardiac index improved after 21 days on the Impella 5.5 and was maintained following explant., Discussion & Conclusion: The findings reported here demonstrate successful use of an Impella 5.5 to improve native heart function in refractory cardiogenic shock and further indicate its use as an option for those in acute decompensated heart failure who have tested positive for COVID-19 infection., (© 2021 Wiley Periodicals LLC.)

Published
2021
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47. Phenotyping Cardiogenic Shock.

Author

Zweck E, Thayer KL, Helgestad OKL, Kanwar M, Ayouty M, Garan AR, Hernandez-Montfort J, Mahr C, Wencker D, Sinha SS, Vorovich E, Abraham J, O'Neill W, Li S, Hickey GW, Josiassen J, Hassager C, Jensen LO, Holmvang L, Schmidt H, Ravn HB, Møller JE, Burkhoff D, and Kapur NK

Subjects
Adult, Aged, Denmark, Female, Humans, Male, Middle Aged, Registries, Risk Assessment, Risk Factors, Shock, Cardiogenic physiopathology, United States, Hemodynamics, Hospital Mortality, Shock, Cardiogenic classification, Shock, Cardiogenic mortality
Abstract

Background Cardiogenic shock (CS) is a heterogeneous syndrome with varied presentations and outcomes. We used a machine learning approach to test the hypothesis that patients with CS have distinct phenotypes at presentation, which are associated with unique clinical profiles and in-hospital mortality. Methods and Results We analyzed data from 1959 patients with CS from 2 international cohorts: CSWG (Cardiogenic Shock Working Group Registry) (myocardial infarction [CSWG-MI; n=410] and acute-on-chronic heart failure [CSWG-HF; n=480]) and the DRR (Danish Retroshock MI Registry) (n=1069). Clusters of patients with CS were identified in CSWG-MI using the consensus k means algorithm and subsequently validated in CSWG-HF and DRR. Patients in each phenotype were further categorized by their Society of Cardiovascular Angiography and Interventions staging. The machine learning algorithms revealed 3 distinct clusters in CS: "non-congested (I)", "cardiorenal (II)," and "cardiometabolic (III)" shock. Among the 3 cohorts (CSWG-MI versus DDR versus CSWG-HF), in-hospital mortality was 21% versus 28% versus 10%, 45% versus 40% versus 32%, and 55% versus 56% versus 52% for clusters I, II, and III, respectively. The "cardiometabolic shock" cluster had the highest risk of developing stage D or E shock as well as in-hospital mortality among the phenotypes, regardless of cause. Despite baseline differences, each cluster showed reproducible demographic, metabolic, and hemodynamic profiles across the 3 cohorts. Conclusions Using machine learning, we identified and validated 3 distinct CS phenotypes, with specific and reproducible associations with mortality. These phenotypes may allow for targeted patient enrollment in clinical trials and foster development of tailored treatment strategies in subsets of patients with CS.

Published
2021
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48. Left Ventricular Unloading Using an Impella CP Improves Coronary Flow and Infarct Zone Perfusion in Ischemic Heart Failure.

Author

Watanabe S, Fish K, Kovacic JC, Bikou O, Leonardson L, Nomoto K, Aguero J, Kapur NK, Hajjar RJ, and Ishikawa K

Subjects
Animals, Coronary Angiography, Disease Models, Animal, Echocardiography, Doppler, Female, Heart Failure diagnostic imaging, Heart Failure etiology, Heart Failure physiopathology, Male, Myocardial Infarction diagnostic imaging, Myocardial Infarction physiopathology, Nitroprusside pharmacology, Prosthesis Design, Recovery of Function, Sus scrofa, Time Factors, Vasodilator Agents pharmacology, Coronary Circulation drug effects, Heart Failure therapy, Heart-Assist Devices, Myocardial Infarction complications, Prosthesis Implantation instrumentation, Ventricular Function, Left drug effects
Abstract

Background: Delivering therapeutic materials, like stem cells or gene vectors, to the myocardium is difficult in the setting of ischemic heart failure because of decreased coronary flow and impaired microvascular perfusion (MP). The aim of this study was to determine if mechanical left ventricular (LV) unloading with the Impella increases coronary flow and MP in a subacute myocardial infarction., Methods and Results: Anterior transmural myocardial infarction (infarct size, 26.0±3.4%) was induced in Yorkshire pigs. At 2 weeks after myocardial infarction, 6 animals underwent mechanical LV unloading by Impella, whereas 4 animals underwent pharmacological LV unloading using sodium nitroprusside for 2 hours. LV unloading with Impella significantly reduced end-diastolic volume (-16±11mL, P =0.02) and end-diastolic pressure (EDP; -32±23 mm Hg, P =0.03), resulting in a significant decrease in LV end-diastolic wall stress (EDWS) (infarct: 71.6±14.7 to 43.3±10.8 kdynes/cm 2 [ P =0.02]; remote: 66.6±20.9 to 40.6±13.3 kdynes/cm 2 [ P =0.02]). Coronary flow increased immediately and remained elevated after 2 hours in Impella-treated pigs. Compared with the baseline, MP measured by fluorescent microspheres significantly increased within the infarct zone (109±81%, P =0.003), but not in the remote zone. Although sodium nitroprusside effectively reduced LV-EDWS, 2 (50%) of sodium nitroprusside-treated pigs developed profound systemic hypotension. A significant correlation was observed between the infarct MP and EDWS ( r 2 =0.43, P =0.03), suggesting an important role of EDWS in regulating MP during LV unloading in the infarcted myocardium., Conclusions: LV unloading using an Impella decreased EDWS and increased infarct MP without hemodynamic decompensation. Mechanical LV unloading is a novel and efficient approach to increase infarct MP in patients with subacute myocardial infarction., (© 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.)

Published
2018
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