Publications by authors named "Odayme Quesada"

21 Publications

  • Page 1 of 1

Angiogenic CD34 Stem Cell Therapy in Coronary Microvascular Repair-A Systematic Review.

Cells 2021 May 8;10(5). Epub 2021 May 8.

Lindner Center for Research, The Christ Hospital, Cincinnati, OH 45219, USA.

Ischemia with non-obstructive coronary arteries (INOCA) is an increasingly recognized disease, with a prevalence of 3 to 4 million individuals, and is associated with a higher risk of morbidity, mortality, and a worse quality of life. Persistent angina in many patients with INOCA is due to coronary microvascular dysfunction (CMD), which can be difficult to diagnose and treat. A coronary flow reserve <2.5 is used to diagnose endothelial-independent CMD. Antianginal treatments are often ineffective in endothelial-independent CMD and thus novel treatment modalities are currently being studied for safety and efficacy. CD34 cell therapy is a promising treatment option for these patients, as it has been shown to promote vascular repair and enhance angiogenesis in the microvasculature. The resulting restoration of the microcirculation improves myocardial tissue perfusion, resulting in the recovery of coronary microvascular function, as evidenced by an improvement in coronary flow reserve. A pilot study in INOCA patients with endothelial-independent CMD and persistent angina, treated with autologous intracoronary CD34 stem cells, demonstrated a significant improvement in coronary flow reserve, angina frequency, Canadian Cardiovascular Society class, and quality of life (ESCaPE-CMD, NCT03508609). This work is being further evaluated in the ongoing FREEDOM (NCT04614467) placebo-controlled trial.
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http://dx.doi.org/10.3390/cells10051137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8151216PMC
May 2021

Use of Ballistocardiography to Monitor Cardiovascular Hemodynamics in Preeclampsia.

Womens Health Rep (New Rochelle) 2021 20;2(1):97-105. Epub 2021 Apr 20.

Division of Cardiology, Department of Internal Medicine, University of California San Francisco, San Francisco, California, USA.

Pregnancy requires a complex physiological adaptation of the maternal cardiovascular system, which is disrupted in women with pregnancies complicated by preeclampsia, putting them at higher risk of future cardiovascular events. The measurement of body movements in response to cardiac ejection ballistocardiogram (BCG) can be used to assess cardiovascular hemodynamics noninvasively in women with preeclampsia. Using a previously validated, modified weighing scale for assessment of cardiovascular hemodynamics through measurement of BCG and electrocardiogram (ECG) signals, we collected serial measurements throughout pregnancy and postpartum and analyzed data in 30 women with preeclampsia and 23 normotensive controls. Using BCG and ECG signals, we extracted measures of cardiac output, J-wave amplitude × heart rate (J-amp × HR). Mixed-effect models with repeated measures were used to compare J-amp × HRs between groups at different time points in pregnancy and postpartum. In normotensive controls, the J-amp × HR was significantly lower early postpartum (E-PP) compared with the second trimester (T2;  = 0.016) and third trimester (T3;  = 0.001). Women with preeclampsia had a significantly lower J-amp × HR compared with normotensive controls during the first trimester (T1;  = 0.026). In the preeclampsia group, there was a trend toward an increase in J-amp × HR from T1 to T2 and then a drop in J-amp × HR at T3 and further drop at E-PP. We observe cardiac hemodynamic changes consistent with those reported using well-validated tools. In pregnancies complicated by preeclampsia, the maximal force of contraction is lower, suggesting lower cardiac output and a trend in hemodynamics consistent with the hyperdynamic disease model of preeclampsia.
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http://dx.doi.org/10.1089/whr.2020.0127DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8080913PMC
April 2021

New generation drug eluting stents: Closing the gap in sex disparity in cardiovascular outcomes in women.

Catheter Cardiovasc Interv 2021 Apr;97(5):805-806

The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, Ohio.

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http://dx.doi.org/10.1002/ccd.29665DOI Listing
April 2021

Diagnostic Cardiovascular Imaging and Therapeutic Strategies in Pregnancy: JACC Focus Seminar 4/5.

J Am Coll Cardiol 2021 Apr;77(14):1813-1822

Cardiovascular Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.

The prevalence of cardiovascular disease (CVD) in pregnancy, both diagnosed and previously unknown, is rising, and CVD is a leading cause of maternal morbidity and mortality. Historically, women of child-bearing potential have been underrepresented in research, leading to lasting knowledge gaps in the cardiovascular care of pregnant and lactating women. Despite these limitations, clinicians should be familiar with the safety of frequently used diagnostic and therapeutic interventions to adequately care for this at-risk population. This review, the fourth of a 5-part series, provides evidence-based recommendations regarding the use of common cardiovascular diagnostic tests and medications in pregnant and lactating women.
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http://dx.doi.org/10.1016/j.jacc.2021.01.056DOI Listing
April 2021

Angina relates to coronary flow in women with ischemia and no obstructive coronary artery disease.

Int J Cardiol 2021 06 1;333:35-39. Epub 2021 Mar 1.

Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address:

Background: Women with suspected ischemia and no obstructive coronary artery disease (INOCA) often have coronary microvascular dysfunction (CMD) as measured by impaired coronary flow reserve (CFR), which is associated with angina and adverse cardiovascular events. CFR is a ratio of hyperemic to baseline average peak velocity (bAPV), and the relation of baseline flow to angina is not understood.

Methods: We evaluated 259 women enrolled in the WISE-Coronary Vascular Dysfunction (WISE-CVD) project with suspected CMD who underwent invasive coronary functional testing. We analyzed variables stratified by high (e.g. ≥22 cm/s) vs low (<22 cm/s) bAPV, using t-test or Wilcoxon rank; linear and multivariable regression was used with bAPV as a continuous variable.

Results: Women with high bAPV had worse Seattle Angina Questionnaire (SAQ) angina frequency (58 ± 26 vs 67 ± 25, p = 0.005) and SAQ-7 scores (57 ± 22 vs 62 ± 21, p = 0.03), with higher nitrate (p = 0.02) and ranolazine use (p = 0.03). The high bAPV subgroup also had lower CFR (p < 0.001)). Linear regression related higher bAPV with lower SAQ-7 (p = 0.01) and lower angina frequency scores (p = 0.001). These results remained significant in multivariable modelling adjusting for baseline differences (p < 0.04). SAQ-7 was significantly predicted by bAPV.

Conclusions: Among women with suspected INOCA, angina relates to high bAPV, a result supported by the concomitant greater use of anti-anginal drugs. These results suggest that high bAPV contributes to impaired CFR and may represent a specific pathophysiologic contributor to CMD and may be a treatment target in INOCA subjects.
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http://dx.doi.org/10.1016/j.ijcard.2021.02.064DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107128PMC
June 2021

Women and atrial fibrillation.

J Cardiovasc Electrophysiol 2020 Dec 17. Epub 2020 Dec 17.

Cooper Medical School of Rowan University, Camden, New Jersey, USA.

Atrial fibrillation (AF) remains a growing problem in the United States and worldwide, imposing a high individual and health system burden, including increased resource consumption due to repeated hospitalizations, stroke, dementia, heart failure, and death. This comprehensive review summarizes the most recent data on sex-related differences in risks associated with AF. Women with AF have increased risk of stroke and death compared to men, and possible reasons for this disparity are explored. Women also continue to have worse symptoms and quality of life, and poorer outcomes with stroke prevention, as well as with rate and rhythm control management strategies. Many current rhythm control treatment strategies for AF, including cardioversion and ablation, are used less frequently in women as compared to men, whereas women are more likely to be treated with rate control strategies or antiarrhythmic drugs. Sex differences should be considered in treating women with AF to improve outcomes and women and men should be offered the same interventions for AF. We need to improve the evidence base to understand if variation in utilization of rate and rhythm control management between men and women represents health inequities or appropriate clinical judgement.
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http://dx.doi.org/10.1111/jce.14838DOI Listing
December 2020

STEMI in young women: Don't miss spontaneous coronary artery dissection!

Catheter Cardiovasc Interv 2020 11;96(6):1231-1232

The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, Ohio.

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http://dx.doi.org/10.1002/ccd.29357DOI Listing
November 2020

Coronary Vascular Function and Cardiomyocyte Injury: A Report From the WISE-CVD.

Arterioscler Thromb Vasc Biol 2020 12 8;40(12):3015-3021. Epub 2020 Oct 8.

Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA (J.W., O.Q., B.A., B.S., T.D.H., J.V.E., C.N.B.M.).

Objective: Women with symptoms or signs of myocardial ischemia but no obstructive coronary artery disease (INOCA) often have coronary vascular dysfunction and elevated risk for adverse cardiovascular events. We hypothesized that u-hscTnI (ultra-high-sensitivity cardiac troponin I), a sensitive indicator of ischemic cardiomyocyte injury, is associated with coronary vascular dysfunction in women with INOCA. Approach and Results: Women (N=263) with INOCA enrolled in the WISE-CVD study (Women's Ischemic Syndrome Evaluation-Coronary Vascular Dysfunction) underwent invasive coronary vascular function testing and u-hscTnI measurements (Simoa HD-1 Analyzer; Quanterix Corporation, Lexington, MA). Logistic regression models, adjusted for traditional cardiovascular risk factors were used to evaluate associations between u-hscTnI and coronary vascular function. Women with coronary vascular dysfunction (microvascular constriction and limited coronary epicardial dilation) had higher plasma u-hscTnI levels (both =0.001). u-hscTnI levels were associated with microvascular constriction (odds ratio, 1.38 per doubling of u-hscTnI [95% CI, 1.03-1.84]; =0.033) and limited coronary epicardial dilation (odds ratio, 1.37 per doubling of u-hscTnI [95% CI, 1.04-1.81]; =0.026). u-hscTnI levels were not associated with microvascular dilation or coronary epicardial constriction.

Conclusions: Our findings indicate that higher u-hscTnI is associated with coronary vascular dysfunction in women with INOCA. This suggests that ischemic cardiomyocyte injury in the setting of coronary vascular dysfunction has the potential to contribute to adverse cardiovascular outcomes observed in these women. Additional studies are needed to confirm and investigate mechanisms underlying these findings in INOCA. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT00832702.
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http://dx.doi.org/10.1161/ATVBAHA.120.314260DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8079158PMC
December 2020

Can We Improve Cardiovascular Disease for Women Using Data Under Our Noses?: A Need for Changes in Policy and Focus.

JAMA Cardiol 2020 Dec;5(12):1398-1400

Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, California.

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http://dx.doi.org/10.1001/jamacardio.2020.4117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8074640PMC
December 2020

Left ventricular mass and myocardial scarring in women with hypertensive disorders of pregnancy.

Open Heart 2020 08;7(2)

Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA

Aims: Hypertensive disorders of pregnancy (HDP) predict future cardiovascular events. We aim to investigate relations between HDP history and subsequent hypertension (HTN), myocardial structure and function, and late gadolinium enhancement (LGE) scar.

Methods And Results: We evaluated a prospective cohort of women with suspected ischaemia with no obstructive coronary artery disease (INOCA) who underwent stress/rest cardiac magnetic resonance imaging (cMRI) with LGE in the Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction study. Self-reported history of pregnancy and HDP (gestational HTN, pre-eclampsia, toxaemia and eclampsia) were collected at enrollment. In our cohort of 346, 20% of women report a history of HDP. HDP history was associated with 3.2-fold increased odds of HTN. Women with a history of HDP and HTN had higher cMRI measured left ventricular (LV) mass compared with women with HDP only (99.4±2.6 g vs 87.7±3.2 g, p=0.02). While we found a similar frequency of LGE scar, we observed a trend towards increased LGE scar size (5.1±3.4 g vs 8.0±3.4 g, p=0.09) among the women with HDP history compared to women without.

Conclusion: In a high-risk cohort of women with suspected INOCA, 20% had a history of HDP. Women with HDP history were more likely to develop HTN. Our study demonstrates higher LV mass in women with HDP and concomitant HTN. Although the presence of LGE scar was not different in women with and without HDP history, we observed a trend towards larger scar size in women with HDP. Future studies are needed to better assess the relationship of HDP and cardiac morphology and LGE scarring in a larger cohort of women.
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http://dx.doi.org/10.1136/openhrt-2020-001273DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7412584PMC
August 2020

Temporal Trends in Angina, Myocardial Perfusion, and Left Ventricular Remodeling in Women With No Obstructive Coronary Artery Disease Over 1-Year Follow-Up: Results From WISE-CVD.

J Am Heart Assoc 2020 07 24;9(13):e016305. Epub 2020 Jun 24.

Barbra Streisand Women's Heart Center Cedars Sinai Smidt Heart Institute Los Angeles CA.

Background Women with ischemia and no obstructive coronary artery disease are increasingly recognized and found to be at risk for major adverse cardiovascular events. Methods and Results In 214 women with suspected ischemia and no obstructive coronary artery disease who completed baseline and 1-year follow-up vasodilatory stress cardiac magnetic resonance imaging, we investigated temporal trends in angina (Seattle Angina Questionnaire [SAQ]), myocardial perfusion reserve index, blood pressure, and left ventricular (LV) remodeling and function from baseline to 1-year follow-up and explored associations between these different parameters. We observed concordant positive trends in 4/5 SAQ domains, SAQ-7, myocardial perfusion reserve index, blood pressure, LV mass, and LV mass-to-volume ratio. There was no association between SAQ-7 improvement and myocardial perfusion reserve index improvement over 1-year follow-up (=0.1). Higher indexed LV end-diastolic volume and time to peak filling rate at baseline were associated with increased odds of clinically relevant SAQ-7 improvement (odds ratio [OR], 1.05; 95% CI, 1.0-1.1; and OR, 2.40; 95% CI, 1.1-5.0, respectively). Hypertension was associated with decreased odds of SAQ-7 improvement (OR, 0.41; 95% CI, 0.19-0.91). Conclusions In women with ischemia and no obstructive coronary artery disease clinically treated with cardiac medications over 1 year, we observed concurrent temporal trends toward improvement in SAQ, myocardial perfusion reserve index, blood pressure, LV mass, and LV mass-to volume ratio. We showed that abnormalities in LV morphology and diastolic function at baseline were predictive of clinically significant improvement in angina at follow-up, whereas history of hypertension was associated with lower odds. Future studies are needed to assess the mechanisms and treatments responsible for the improvements we observed. Registration URL: https://www.clini​caltr​ials.gov; Unique identifier: NCT02582021.
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http://dx.doi.org/10.1161/JAHA.119.016305DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670509PMC
July 2020

Angina Hospitalization Rates in Women With Signs and Symptoms of Ischemia But no Obstructive Coronary Artery Disease: A Report from the WISE (Women's Ischemia Syndrome Evaluation) Study.

J Am Heart Assoc 2020 02 17;9(4):e013168. Epub 2020 Feb 17.

Barbra Streisand Women's Heart Center Cedars-Sinai Heart Smidt Institute Los Angeles CA.

Background Recurrent hospitalization is prevalent in women with signs and symptoms of ischemia and no obstructive coronary artery disease. We hypothesized that rates of angina hospitalization might have changed over time, given advances in diagnostic and therapeutic approaches. Methods and Results We evaluated 551 women enrolled in the WISE (Women's Ischemia Syndrome Evaluation) study with no obstructive coronary artery disease (CAD) for a follow-up period of 9.1 years. We analyzed angina hospitalization rates using the Kaplan-Meier method. Univariate analysis and multivariable Cox proportional hazard models were developed for prediction of angina hospitalization in women with signs and symptoms of angina and no CAD. A total of 223 women had nonobstructive CAD (>20-50%
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http://dx.doi.org/10.1161/JAHA.119.013168DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7070186PMC
February 2020

Heart failure with preserved ejection fraction: Similarities and differences between women and men.

Int J Cardiol 2020 04 9;304:101-108. Epub 2020 Jan 9.

National Heart Lung and Blood Institute, Bethesda, MD, United States of America.

The syndrome of heart failure (HF) with preserved ejection fraction (HFpEF) is now recognized to account for up to half of HF cases and is the dominant form of HF in older adults, especially women. Multiple factors conspire in this predilection of HFpEF for older women. This review will discuss the epidemiology, pathophysiology, prognosis, and treatment of HFpEF with emphasis on the similarities and differences in cardiovascular aging changes, and the differential impact of comorbidities in women versus men. Responses to pharmacologic and lifestyle interventions are also reviewed. We conclude by suggesting future directions for both prevention and treatment of this common and highly morbid cardiovascular disorder.
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http://dx.doi.org/10.1016/j.ijcard.2020.01.003DOI Listing
April 2020

Design, methodology and baseline characteristics of the Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD).

Am Heart J 2020 02 5;220:224-236. Epub 2019 Dec 5.

Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA. Electronic address:

A significant number of women with signs and symptoms of ischemia with no obstructive coronary artery disease (INOCA) have coronary vascular dysfunction detected by invasive coronary reactivity testing (CRT). However, the noninvasive assessment of coronary vascular dysfunction has been limited.

Methods: The Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) was a prospective study of women with suspected INOCA aimed to investigate whether (1) cardiac magnetic resonance imaging (CMRI) abnormalities in left ventricular morphology and function and myocardial perfusion predict CRT measured coronary microvascular dysfunction, (2) these persistent CMRI abnormalities at 1-year follow-up predict persistent symptoms of ischemia, and (3) these CMRI abnormalities predict cardiovascular outcomes. By design, a sample size of 375 women undergoing clinically indicated invasive coronary angiography for suspected INOCA was projected to complete baseline CMRI, a priori subgroup of 200 clinically indicated CRTs, and a priori subgroup of 200 repeat 1-year follow-up CMRIs.

Results: A total of 437 women enrolled between 2008 and 2015, 374 completed baseline CMRI, 279 completed CRT, and 214 completed 1-year follow-up CMRI. Mean age was 55± 11 years, 93% had 20%-50% coronary stenosis, and 7% had <20% stenosis by angiography.

Conclusions: The WISE-CVD study investigates the utility of noninvasive CMRI to predict coronary vascular dysfunction in comparison to invasive CRT, and the prognostic value of CMRI abnormalities for persistent symptoms of ischemia and cardiovascular outcomes in women with INOCA. WISE-CVD will provide new understanding of a noninvasive imaging modality for future clinical trials.
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http://dx.doi.org/10.1016/j.ahj.2019.11.017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7147836PMC
February 2020

Adverse Pregnancy Outcomes Are Associated with Reduced Coronary Flow Reserve in Women With Signs and Symptoms of Ischemia Without Obstructive Coronary Artery Disease: A Report from the Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction Study.

J Womens Health (Larchmt) 2020 04 20;29(4):487-492. Epub 2019 Dec 20.

Division of Cardiology, Department of Medicine, University of Florida, Gainesville, Florida.

We assessed history of adverse pregnancy outcomes (APOs) and coronary microvascular dysfunction (CMD) in the Women's Ischemia Syndrome Evaluation-Coronary Vascular Dysfunction (WISE-CVD) cohort of women with signs and symptoms of ischemia without obstructive coronary artery disease (CAD). We hypothesized that women with CMD with symptoms and signs of ischemia, without obstructive CAD, are more likely to have a history of APO. WISE-CVD recruited women with suspected ischemia found to have no obstructive CAD ( = 324). A subset of these women underwent coronary reactivity testing, including coronary flow reserve (CFR) ( = 185). Relationship between history of any APO and CMD was assessed by multivariable linear regression analyses. APOs included any of the following: hypertension during pregnancy, preeclampsia, eclampsia, gestational diabetes, or intrauterine growth restriction (low-birth-weight child). Overall, 79/324 (24%) women reported at least one APO. Women with APOs were younger (52 vs. 56 years,  = 0.001), were more likely obese (body mass index 32 vs. 29 kg/m,  = 0.004), and had a history of hypertension (56% vs 36%,  = 0.002), but otherwise had no additional differences in cardiac risk variables versus women without APOs. Among the subgroup who underwent invasive CFR testing ( = 185), those with an APO had lower CFR (2.53 vs. 2.76,  = 0.016) versus those without APO. History of APOs in women with signs and symptoms of ischemia without obstructive CAD is associated with lower CFR indicative of CMD. Whether common pathways involving diffuse microvascular dysfunction may account for this suggested association remains unclear. Further investigation is needed to expand on these exploratory findings.
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http://dx.doi.org/10.1089/jwh.2019.7925DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194309PMC
April 2020

Cardiovascular and pregnancy outcomes in women with coronary microvascular dysfunction: a case series.

Eur Heart J Case Rep 2019 Jun;3(2)

Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Boulevard, Suite A3600, Los Angeles, CA, USA.

Background: Coronary microvascular dysfunction (CMD) is associated with adverse cardiovascular outcomes. Coronary microvascular dysfunction is observed in women of childbearing age, however, the frequency of adverse pregnancy outcomes (APO) is unknown.

Case Summary: Women previously enrolled in a single centre prospective CMD registry diagnosed using invasive coronary reactivity testing were included. Among 279 women enrolled, 5 of 47 (10.6%) of childbearing age (18-44 years) subsequently became pregnant, representing a fertility rate of 36.8 births per 1000 women-years. None had history of hypertension, diabetes, or smoking. Four (80%) had a history of prior spontaneous miscarriage. Median age at CMD diagnosis was 32 years (IQR: 32-35). During pregnancy, most reported stable or improved angina, while one reported increased angina frequency, an emergency room visit and accelerated anti-anginal therapy. None experienced gestational hypertension, diabetes, pre-eclampsia, myocardial infarction, or death. Two (40%) experienced APO of preterm delivery and small neonate for gestational age. Following pregnancy, angina severity scores, and/or functional capacity decreased in three women (60%).

Discussion: In this first case-series of five women with CMD who became pregnant, increased angina and accelerated care during pregnancy and post-partum was not commonly observed. Fertility rates were lower than the national average, while prior spontaneous miscarriage and subsequent APO were higher. Further studies are warranted to understand and manage pregnancy in women with CMD, as well as the impact of pregnancy on longer term angina, functional capacity, and outcomes.
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http://dx.doi.org/10.1093/ehjcr/ytz071DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6601184PMC
June 2019

Why names matter for women: MINOCA/INOCA (myocardial infarction/ischemia and no obstructive coronary artery disease).

Clin Cardiol 2018 Feb 2;41(2):185-193. Epub 2018 Mar 2.

Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, California.

The syndromes of myocardial infarction/myocardial ischemia with No Obstructive Coronary Artery Disease (MINOCA/INOCA) are increasingly evident. A majority of these patients have coronary microvascular dysfunction. These patients have elevated risk for a cardiovascular event (including acute coronary syndrome, myocardial infarction, stroke, and repeated cardiovascular procedures) and appear to be at higher risk for development of heart failure with preserved ejection fraction. Terminology such as coronary artery disease or coronary heart disease is often synonymous with obstructive atherosclerosis in the clinician's mind, leaving one at a loss to recognize or explain the phenomenon of MINOCA and INOCA with elevated risk. We review the available literature regarding stable and unstable ischemic heart disease that suggests that use of the ischemic heart disease (IHD) terminology matters for women, and should facilitate recognition of risk to provide potential treatment targets and optimized health.
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http://dx.doi.org/10.1002/clc.22894DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489859PMC
February 2018

Stent in false versus true lumen of left anterior descending artery identified on cardiac computed tomography.

J Cardiovasc Comput Tomogr 2018 Jul - Aug;12(4):e9-e10. Epub 2017 Oct 7.

Mark S. Taper Imaging Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

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http://dx.doi.org/10.1016/j.jcct.2017.10.001DOI Listing
January 2019

Prenatal hazardous substance use and adverse birth outcomes.

J Matern Fetal Neonatal Med 2012 Aug 11;25(8):1222-7. Epub 2012 May 11.

Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06510, USA.

Objective: Assess the relative effects of a variety of illicit and licit drugs on risk for adverse birth outcomes.

Methods: We used data from two large prospective investigations, and a novel analytic method, recursive partitioning class analysis to identify risk factors associated with preterm birth and delivering a small for gestational age infant.

Results: Compared to cocaine and opiate non-users, cocaine users were 3.53 times as likely (95% CI: 1.65-7.56; p = 0.001) and opiate users 2.86 times as likely (95% CI: 1.11-7.36; p = 0.03) to deliver preterm. The odds of delivering a small for gestational age infant for women who smoked more than two cigarettes daily was 3.74, (95% CI: 2.47-5.65; p<0.0001) compared to women who smoked two or less cigarettes daily and had one previous child. Similarly, less educated, nulliparous women who smoked two or fewer cigarettes daily were 4.12 times as likely (95% CI: 2.04-8.34; p < 0.0001) to have a small for gestational age infant.

Conclusions: Among our covariates, prenatal cocaine and opiate use are the predominant risk factors for preterm birth; while tobacco use was the primary risk factor predicting small for gestational age at delivery. Multi-substance use did not substantially increase risk of adverse birth outcomes over these risk factors.
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http://dx.doi.org/10.3109/14767058.2011.602143DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3398231PMC
August 2012

Production, purification and preliminary X-ray crystallographic studies of adeno-associated virus serotype 7.

Acta Crystallogr Sect F Struct Biol Cryst Commun 2007 Dec 30;63(Pt 12):1073-6. Epub 2007 Nov 30.

Department of Biochemistry and Molecular Biology, McKnight Brain Institute, Center for Structural Biology, University of Florida, Gainesville, FL 32610, USA.

Crystals of baculovirus-expressed adeno-associated virus serotype 7 capsids diffract X-rays to approximately 3.0 A resolution. The crystals belong to the rhombohedral space group R3, with unit-cell parameters a = 252.4, c = 591.2 A in the hexagonal setting. The diffraction data were processed and reduced to an overall completeness of 79.0% and an R(merge) of 12.0%. There are three viral capsids in the unit cell. The icosahedral threefold axis is coincident with the crystallographic threefold axis, resulting in one third of a capsid (20 monomers) per crystallographic asymmetric unit. The orientation of the viral capsid has been determined by rotation-function searches and is positioned at (0, 0, 0) by packing considerations.
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http://dx.doi.org/10.1107/S1744309107060289DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2344100PMC
December 2007