Publications by authors named "Chirag Rajyaguru"

3 Publications

  • Page 1 of 1

Increased E/A Ratio is a Risk Factor for the Formation of Pleural Effusion in Heart Failure.

Lung 2020 02 18;198(1):229-233. Epub 2019 Dec 18.

VA Medical Center, UCSF Fresno, 2615 E. Clinton Ave, Fresno, CA, 9370-2223, USA.

Purpose: Pleural effusion is a common finding in patients with congestive heart failure (CHF). The pathogenesis of pleural effusion in heart failure is multifactorial. However, the role of right and left ventricular function assessed by ECHO cardiogram has not been studied. Therefore, we explored the association between right and left ventricular parameters on echocardiogram in patients with heart failure with and without pleural effusion diagnosed using CT scan of chest.

Methods: A case-control study was utilized to explore the objectives. Using strict exclusion criteria, patients admitted with a single diagnosis of acute CHF were stratified into those with and without pleural effusion using CT scan of chest done at admission. Multiple logistic regression analysis was used to identify significant factors associated with pleural effusion.

Results: Among the 70 patients, 36 (51%) had pleural effusions. The mean E/A ratio in patients with effusion (2.53 ± 1.1) was significantly higher than in patients without effusion (1.15 ± 0.9), p < 0.01. Multiple logistic regression analysis showed that elevated E/A ratio was significantly associated with pleural effusion, OR 3.26 (95% CI 1.57-6.77, p < 0.009). Left ventricular ejection fraction (LVEF), septal E', lateral E', and medial E/E' ratio were not significantly different in patients with and without pleural effusion.

Conclusion: Elevated E/A ratio is a risk factor for the formation of pleural effusion in patients with heart failure.
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February 2020

The wearable cardioverter-defibrillator vest: Indications and ongoing questions.

Prog Cardiovasc Dis 2019 May - Jun;62(3):256-264. Epub 2019 May 9.

Division of Cardiology, Electrophysiology and Arrhythmia Service, University of California, San Francisco. Electronic address:

Multiple clinical trials have demonstrated the efficacy of implantable cardioverter-defibrillators (ICDs) for the prevention of sudden cardiac death (SCD) among specific high-risk populations. However, it remains unclear how to optimally treat those patients who are at elevated risk of cardiac arrest but are not among the presently identified groups proven to benefit from an ICD, are unable to tolerate surgical device implantation, or refuse invasive therapies. The wearable cardioverter-defibrillator (WCD) is an alternative antiarrhythmic device that provides continuous cardiac monitoring and defibrillation capabilities through a noninvasive, electrode-based system. The WCD has been shown to be highly effective at restoration of sinus rhythm in patients with a ventricular tachyarrhythmia, and one randomized trial using the WCD in patients with recent myocardial infarction at elevated risk for arrhythmic death reported a decrease in overall mortality despite no SCD mortality benefit. The current clinical indications for WCD use are varied and continue to evolve as experience with this technology increases.
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October 2019