Overview of Adult Cardiovascular Disease Social Security Administration Compassionate Allowances Outreach Hearing on Cardiovascular Disease and Multiple Organ Transplants November 9th 2010 University of Maryland Baltimore County - PowerPoint PPT Presentation

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Overview of Adult Cardiovascular Disease Social Security Administration Compassionate Allowances Outreach Hearing on Cardiovascular Disease and Multiple Organ Transplants November 9th 2010 University of Maryland Baltimore County

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Title: Overview of Adult Cardiovascular Disease Social Security Administration Compassionate Allowances Outreach Hearing on Cardiovascular Disease and Multiple Organ Transplants November 9th 2010 University of Maryland Baltimore County


1
Overview of Adult Cardiovascular DiseaseSocial
Security Administration Compassionate Allowances
Outreach Hearing on Cardiovascular Disease and
Multiple Organ TransplantsNovember 9th
2010University of Maryland Baltimore County
  • Gaby Weissman MD
  • Washington Hospital Center
  • Georgetown University Hospital
  • Assistant Professor Clinical Medicine

2
Burden of CVD - Mortality
World Health Organization - https//apps.who.int/i
nfobase/Mortality.aspx
3
Burden of CVD - Mortality
World Health Organization - https//apps.who.int/i
nfobase/Mortality.aspx
4
Burden of CVD Risk Factors - Hypertension
American Heart Association - http//www.americanhe
art.org/downloadable/heart/1261003279882FS14HBP10.
pdf
5
Burden of CVD Risk Factors - Diabetes Mellitus
American Heart Association - http//www.americanhe
art.org/downloadable/heart/1236357007811FS12DIAB08
.pdf
6
Burden of CVD Risk Factors - Obesity
American Heart Association - http//www.americanhe
art.org/downloadable/heart/1236358025411OVRWGHT.pd
f
7
ACC/AHA/ASNC Guidelines for the clinical use of
cardiac radionuclide imaging 2003.Schinkel A,
et al. Noninvasive evaluation of ischemic heart
disease Eur Heart J 200324789-800.Uchechukwu
K. et al. Diagnostic accuracy of Rb-82
myocardial perfusion. JACC491052-58Nandalur
KR. et al. Diagnostic performance of stress
cardiac MRI- a meta analysis. JACC501343-53.Acc
uracy Trial Budoff MJ. et al. JACC
2008.CORE-64 Trial Miller JM. et al.
Circulation. 20071162627-2633.
Evaluating IHD
8
Burden of CVD Heart Failure
Lloyd-Jones D. et al Circulation. Published
online Dec 15, 2008.
9
Burden of CVD Heart Failure
Lloyd-Jones D. et al Circulation. Published
online Dec 15, 2008.
10
Heart Failure Common Causes
Dickstein K. et al . Eur Heart J 2008. 29,
2388-2442.
11
Heart Failure Classification
12
Heart Failure Prognosis Based on Stage
Ammar KA et al . Circulation 2007 115, 1563-1570.
13
Heart Failure BNP
Change in NT-Pro BNP predicts re-hospitalization
14
Evaluating Heart Function
  • Anatomy
  • Heart Structure
  • Coronary Anatomy/stenosis
  • Function
  • LVEF
  • RVEF
  • Coronary Flow
  • Stress testing
  • Exercise Capacity
  • Stress testing
  • Cardiopulmonary testing

15
Evaluating Heart Function
  • Tests of Anatomy
  • Echo
  • MRI
  • CT
  • Tests of coronary perfusion
  • Stress nuclear
  • Stress echo
  • Stress MRI
  • Tests of exercise capacity
  • ETT
  • CPET
  • 6 minute walk

16
Prognosis - LVEF
Curtis JP et al J Am Coll Cardiol. 2003 736-42.
17
Cardiopulmonary stress testing
Lavie CJ. et al Am J Cardiol. 2004 93588-593.
18
Prognosis - Exercise stress testing
Hsich E. et al Am J Cardiol. 2004 93588-593.
19
Heart Failure Prognosis Models
Levy WC. et al. The Seattle heart failure model
prediction of survival in heart failure.
Circulation. 20061131424.
20
Heart Failure Prognosis Models
Lee DS et al. Predicting mortality among patients
hospitalized for heart failure. J Am Medical
Association. 20032902581-87.
21
Future of Testing in HF
  • mIBG - Evaluation of the sympathetic nervous
    system
  • cMR - fibrosis imaging
  • Myocardial strain measurements

1. Karamitos TD. Et al. The role of
cardiovascular magnetic resonance imaging in
heart failure. J Am Coll Cardiol.
2009541407-1424. 2. Jacobson AF. et al.
Myocardial Iodine-123 Meta-Iodobenzylguanidine
Imaging and cardiac events in heart failure. J Am
Coll Cardiol. 2010552212-21. 3. Cho GY. et al.
Global 2-Dimensional strain as a new
prognosticator in patients with heart failure. J
Am Coll Cardiol. 200954618-24.
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