Browsing by Author "Hamza, Taye H."

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    Cardiac Imaging and Biomarkers for Assessing Myocardial Fibrosis in Children with Hypertrophic Cardiomyopathy
    (Elsevier, 2023) Kirmani, Sonya; Woodard, Pamela K.; Shi, Ling; Hamza, Taye H.; Canter, Charles E.; Colan, Steven D.; Pahl, Elfriede; Towbin, Jeffrey A.; Webber, Steven A.; Rossano, Joseph W.; Everitt, Melanie D.; Molina, Kimberly M.; Kantor, Paul F.; Jefferies, John L.; Feingold, Brian; Addonizio, Linda J.; Ware, Stephanie M.; Chung, Wendy K.; Ballweg, Jean A.; Lee, Teresa M.; Bansal, Neha; Razoky, Hiedy; Czachor, Jason; Lunze, Fatima I.; Marcus, Edward; Commean, Paul; Wilkinson, James D.; Lipshultz, Steven E.; Pediatrics, School of Medicine
    Background: Myocardial fibrosis, as diagnosed on cardiac magnetic resonance imaging (cMRI) by late gadolinium enhancement (LGE), is associated with adverse outcomes in adults with hypertrophic cardiomyopathy (HCM), but its prevalence and magnitude in children with HCM have not been established. We investigated: (1) the prevalence and extent of myocardial fibrosis as detected by LGE cMRI; (2) the agreement between echocardiographic and cMRI measurements of cardiac structure; and (3) whether serum concentrations of N-terminal pro hormone B-type natriuretic peptide (NT-proBNP) and cardiac troponin-T are associated with cMRI measurements. Methods: A cross-section of children with HCM from 9 tertiary-care pediatric heart centers in the U.S. and Canada were enrolled in this prospective NHLBI study of cardiac biomarkers in pediatric cardiomyopathy (ClinicalTrials.gov Identifier: NCT01873976). The median age of the 67 participants was 13.8 years (range 1-18 years). Core laboratories analyzed echocardiographic and cMRI measurements, and serum biomarker concentrations. Results: In 52 children with non-obstructive HCM undergoing cMRI, overall low levels of myocardial fibrosis with LGE >2% of left ventricular (LV) mass were detected in 37 (71%) (median %LGE, 9.0%; IQR: 6.0%, 13.0%; range, 0% to 57%). Echocardiographic and cMRI measurements of LV dimensions, LV mass, and interventricular septal thickness showed good agreement using the Bland-Altman method. NT-proBNP concentrations were strongly and positively associated with LV mass and interventricular septal thickness (P < .001), but not LGE. Conclusions: Low levels of myocardial fibrosis are common in pediatric patients with HCM seen at referral centers. Longitudinal studies of myocardial fibrosis and serum biomarkers are warranted to determine their predictive value for adverse outcomes in pediatric patients with HCM.
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    Progressive Left Ventricular Remodeling for Predicting Mortality in Children With Dilated Cardiomyopathy: The Pediatric Cardiomyopathy Registry
    (American Heart Association, 2024) Kantor, Paul F.; Shi, Ling; Colan, Steven D.; Orav, E. John; Wilkinson, James D.; Hamza, Taye H.; Webber, Steven A.; Canter, Charles E.; Towbin, Jeffrey A.; Everitt, Melanie D.; Pahl, Elfriede; Ware, Stephanie M.; Rusconi, Paolo G.; Lamour, Jacqueline M.; Jefferies, John L.; Addonizio, Linda J.; Lipshultz, Steven E.; Pediatric Cardiomyopathy Registry Investigators; Medical and Molecular Genetics, School of Medicine
    Background: Pediatric dilated cardiomyopathy often leads to death or cardiac transplantation. We sought to determine whether changes in left ventricular (LV) end-diastolic dimension (LVEDD), LV end-diastolic posterior wall thickness, and LV fractional shortening (LVFS) over time may help predict adverse outcomes. Methods and results: We studied children up to 18 years old with dilated cardiomyopathy, enrolled between 1990 and 2009 in the Pediatric Cardiomyopathy Registry. Changes in LVFS, LVEDD, LV end-diastolic posterior wall thickness, and the LV end-diastolic posterior wall thickness:LVEDD ratio between baseline and follow-up echocardiograms acquired ≈1 year after diagnosis were determined for children who, at the 1-year follow-up had died, received a heart transplant, or were alive and transplant-free. Within 1 year after diagnosis, 40 (5.0%) of the 794 eligible children had died, 117 (14.7%) had undergone cardiac transplantation, and 585 (73.7%) had survived without transplantation. At diagnosis, survivors had higher median LVFS and lower median LVEDD Z scores. Median LVFS and LVEDD Z scores improved among survivors (Z score changes of +2.6 and -1.1, respectively) but remained stable or worsened in the other 2 groups. The LV end-diastolic posterior wall thickness:LVEDD ratio increased in survivors only, suggesting beneficial reverse LV remodeling. The risk for death or cardiac transplantation up to 7 years later was lower when LVFS was improved at 1 year (hazard ratio [HR], 0.83; P=0.004) but was higher in those with progressive LV dilation (HR, 1.45; P<0.001). Conclusions: Progressive deterioration in LV contractile function and increasing LV dilation are associated with both early and continuing mortality in children with dilated cardiomyopathy. Serial echocardiographic monitoring of these children is therefore indicated.
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    Surgery or Endovascular Therapy for Chronic Limb-Threatening Ischemia
    (Massachusetts Medical Society, 2022-11-07) Farber, Alik; Menard, Matthew T.; Conte, Michael S.; Kaufman, John A.; Powell, Richard J.; Choudhry, Niteesh K.; Hamza, Taye H.; Assmann, Susan F.; Creager, Mark A.; Cziraky, Mark J.; Dake, Michael D.; Jaff, Michael R.; Reid, Diane; Siami, Flora S.; Sopko, George; White, Christopher J.; van Over, Max; Strong, Michael B.; Villarreal , Maria F.; McKean, Michelle; Azene, Ezana; Azarbal, Amir; Barleben, Andrew; Chew, David K.; Clavijo, Leonardo C.; Douville, Yvan; Findeiss, Laura; Garg, Nitin; Gasper, Warren; Giles, Kristina A.; Goodney, Philip P.; Hawkins, Beau M.; Herman, Christine R.; Kalish, Jeffrey A.; Koopmann, Matthew C.; Laskowski, Igor A.; Mena-Hurtado, Carlos; Motaganahalli, Raghu; Rowe, Vincent L.; Schanzer, Andres; Schneider, Peter A.; Siracuse, Jeffrey J.; Venermo, Maarit; Rosenfield, Kenneth; BEST-CLI Investigators; Surgery, School of Medicine
    BACKGROUND Patients with chronic limb-threatening ischemia (CLTI) require revascularization to improve limb perfusion and thereby limit the risk of amputation. It is uncertain whether an initial strategy of endovascular therapy or surgical revascularization for CLTI is superior for improving limb outcomes. METHODS In this international, randomized trial, we enrolled 1830 patients with CLTI and infrainguinal peripheral artery disease in two parallel-cohort trials. Patients who had a single segment of great saphenous vein that could be used for surgery were assigned to cohort 1. Patients who needed an alternative bypass conduit were assigned to cohort 2. The primary outcome was a composite of a major adverse limb event — which was defined as amputation above the ankle or a major limb reintervention (a new bypass graft or graft revision, thrombectomy, or thrombolysis) — or death from any cause. RESULTS In cohort 1, after a median follow-up of 2.7 years, a primary-outcome event occurred in 302 of 709 patients (42.6%) in the surgical group and in 408 of 711 patients (57.4%) in the endovascular group (hazard ratio, 0.68; 95% confidence interval [CI], 0.59 to 0.79; P<0.001). In cohort 2, a primary-outcome event occurred in 83 of 194 patients (42.8%) in the surgical group and in 95 of 199 patients (47.7%) in the endovascular group (hazard ratio, 0.79; 95% CI, 0.58 to 1.06; P=0.12) after a median follow-up of 1.6 years. The incidence of adverse events was similar in the two groups in the two cohorts. CONCLUSIONS Among patients with CLTI who had an adequate great saphenous vein for surgical revascularization (cohort 1), the incidence of a major adverse limb event or death was significantly lower in the surgical group than in the endovascular group. Among the patients who lacked an adequate saphenous vein conduit (cohort 2), the outcomes in the two groups were similar. (Funded by the National Heart, Lung, and Blood Institute; BEST-CLI ClinicalTrials.gov number, NCT02060630.)