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Gaby Weissman MD Washington Hospital Center Georgetown University Hospital

Overview of Adult Cardiovascular Disease Social Security Administration Compassionate Allowances Outreach Hearing on Cardiovascular Disease and Multiple Organ Transplants November 9 th 2010 University of Maryland Baltimore County. Gaby Weissman MD Washington Hospital Center

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Gaby Weissman MD Washington Hospital Center Georgetown University Hospital

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  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/infobase/Mortality.aspx

  3. Burden of CVD - Mortality World Health Organization - https://apps.who.int/infobase/Mortality.aspx

  4. Burden of CVD Risk Factors - Hypertension American Heart Association - http://www.americanheart.org/downloadable/heart/1261003279882FS14HBP10.pdf

  5. Burden of CVD Risk Factors - Diabetes Mellitus American Heart Association - http://www.americanheart.org/downloadable/heart/1236357007811FS12DIAB08.pdf

  6. Burden of CVD Risk Factors - Obesity American Heart Association - http://www.americanheart.org/downloadable/heart/1236358025411OVRWGHT.pdf

  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 2003;24:789-800.Uchechukwu K. et al. Diagnostic accuracy of Rb-82 myocardial perfusion. JACC;49:1052-58Nandalur KR. et al. Diagnostic performance of stress cardiac MRI- a meta analysis. JACC;50:1343-53.Accuracy Trial: Budoff MJ. et al. JACC 2008.CORE-64 Trial: Miller JM. et al. Circulation. 2007;116:2627-2633. 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. Anatomy Heart Structure Coronary Anatomy/stenosis Function LVEF RVEF Coronary Flow Stress testing Exercise Capacity Stress testing Cardiopulmonary testing Evaluating Heart Function

  15. 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 Evaluating Heart Function

  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; 93:588-593.

  18. Prognosis - Exercise stress testing Hsich E. et al Am J Cardiol. 2004; 93:588-593.

  19. Heart Failure : Prognosis Models Levy WC. et al. The Seattle heart failure model: prediction of survival in heart failure. Circulation. 2006;113:1424.

  20. Heart Failure : Prognosis Models Lee DS et al. Predicting mortality among patients hospitalized for heart failure. J Am Medical Association. 2003;290:2581-87.

  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. 2009;54;1407-1424. 2. Jacobson AF. et al. Myocardial Iodine-123 Meta-Iodobenzylguanidine Imaging and cardiac events in heart failure. J Am Coll Cardiol. 2010;55:2212-21. 3. Cho GY. et al. Global 2-Dimensional strain as a new prognosticator in patients with heart failure. J Am Coll Cardiol. 2009;54;618-24.

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