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11. TWO HEARTS OF A KIND

Author

Nowariak, Meagan, primary, Casey, Susan, additional, Berg, Allison, additional, Hauser, Robert G., additional, Witt, Dawn R., additional, Cavalcante, Joao L., additional, and Sengupta, Jay, additional

Published
2023
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17. Variation in Advanced Diagnostic Imaging Practice Patterns and Associated Risks Prior to Superior Cavopulmonary Connection: A Multicenter Analysis

Author

Gartenberg, Ari J., primary, Glatz, Andrew C., additional, Nunes, Mariana, additional, Griffin, Lindsay, additional, Rigsby, Cynthia K., additional, Armstrong, Aimee K., additional, Casey, Susan A., additional, Witt, Dawn R., additional, Schmidt, Christian W., additional, Lesser, John, additional, and Han, B. Kelly, additional

Published
2021
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21. Segurança, Eficácia e Protocolo de Dose de Metoprolol para Redução de Frequência Cardíaca em Pacientes Pediátricos Externos que Passaram por Angiografia Cardíaca por TC

Author

Nunes, Mariana de Oliveira, primary, Witt, Dawn R., additional, Casey, Susan A., additional, Stanberry, Larissa I., additional, Caye, David J., additional, J.Chu, Bradford, additional, Lindberg, B. Jana, additional, Lesser, John R., additional, and Han, B. Kelly, additional

Published
2021
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24. The problem of diabetes and cardiovascular disease: include women in the solution

Author

Witt, Dawn R., Boucher, Jackie L., and Hayes, Sharonne N.

Subjects
Women -- Health aspects, Mortality -- Social aspects -- Forecasts and trends -- United States, Diabetes -- Care and treatment -- Demographic aspects, Cardiovascular diseases -- Demographic aspects -- Care and treatment, Market trend/market analysis, Health
Abstract

Do men and women with diabetes fare equally in cardiovascular disease (CVD) prevention and mortality? It appears that they do not. Although mortality from CVD is on the decline, (1) [...]

Published
2013

29. Abstract 16354: Evolving Clinical Profile of Takotsubo Cardiomyopathy: 2001-2006 vs. 2011-2016.

Author

Witt, Dawn R, Kunz, Miranda S, Storey, Katelyn M, Garberich, Ross F, Maron, Barry J, and Sharkey, Scott W

Subjects
*TAKOTSUBO cardiomyopathy, *CARDIOMYOPATHIES, *ACUTE diseases
Abstract

Background: During the past two decades, recognition of takotsubo cardiomyopathy (TTC) has expanded, bringing the realization that this entity is more common and diverse than initially regarded. In the early TTC experience, clinical profile was characterized by predominance of women, presence of emotional triggers, and low mortality. Our recent observations suggest considerable change has occurred in TTC patient characteristics. To document this evolution, we compared patients from our early and more recent experience. Methods: We identified 381 consecutive TTC patients presenting between 2001 and 2016. From this population, we identified an early cohort of 80 consecutive patients (2001-2006) and a recent cohort of 202 consecutive patients (2011-2016). We compared demographic information, clinical characteristics, and hospital outcomes between the early and recent cohorts. Results: The accompanying table compares the early and recent cohorts. Conclusions: During this 15-year single center experience, the prevalence of TTC has increased nearly 3-fold. With broader experience, new and uncommon ballooning patterns have emerged including focal and basal phenotypes. The frequency of ST-segment elevation has decreased, indicating initial ECG findings are broader than previously appreciated. The occurrence of TTC with physical triggers has increased substantially, likely representing increased recognition of TTC complicating acute illness during hospitalization. The proportion of males has also increased, perhaps because a physical stress (i.e. acute illness) is necessary to trigger TTC events in men. In the recent experience, nearly one-fourth of patients received inotropic drugs. Therefore, either TTC patients are more hemodynamically unstable, or these agents, frequently used to treat hypotension in acutely ill patients, might act as TTC triggers. Despite these changes in TTC characteristics, mortality remains stable. [ABSTRACT FROM AUTHOR]

Published
2018

31. Safety, Efficacy, and Dose Protocol of Metoprolol for Heart Rate Reduction in Pediatric Outpatients Undergoing Cardiac CT Angiography.

Author

Nunes MO, Witt DR, Casey SA, Stanberry LI, Caye DJ, J Chu B, Lindberg BJ, Lesser JR, and Han BK

Subjects
Adolescent, Child, Computed Tomography Angiography, Coronary Angiography, Heart Rate, Humans, Male, Outpatients, Radiation Dosage, Retrospective Studies, Coronary Artery Disease, Metoprolol adverse effects
Abstract

Background: Image quality and radiation dose are optimized with a slow, steady heart rate (HR) when imaging the coronary arteries during cardiac computed tomography angiography (CCTA). The safety, efficacy, and protocol for HR reduction with beta blocker medication is not well described in a pediatric patient population., Objective: Provide a safe and efficient metoprolol dose protocol to be used in pediatric outpatients undergoing CCTA., Methods: We conducted a retrospective review of all pediatric outpatients who received metoprolol during CCTA. Demographic and clinical characteristics were summarized and the average reduction in HR was estimated using a multivariate linear regression model. Images were evaluated on a 1-4 scale (1= optimal)., Results: Seventy-eight pediatric outpatients underwent a CCTA scan with the use of metoprolol. The median age was 13 years, median weight of 46 kg, and 36 (46%) were male. The median doses of metoprolol were 1.5 (IQR 1.1, 1.8) mg/kg and 0.4 (IQR 0.2, 0.7) mg/kg for oral and intravenous administrations, respectively. Procedural dose-length product was 57 (IQR 30, 119) mGy*cm. The average reduction in HR was 19 (IQR 12, 26) beats per minute, or 23%. No complications or adverse events were reported., Conclusion: Use of metoprolol in a pediatric outpatient setting for HR reduction prior to CCTA is safe and effective. A metoprolol dose protocol can be reproduced when a slower HR is needed, ensuring faster acquisition times, clear images, and associated reduction in radiation exposure in this population. (Arq Bras Cardiol. 2021; 116(1):100-105).

Published
2021
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