Browsing by Author "Jarori, Upasana"

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    Mitral Annular Plane Systolic Excursion: An Early Marker of Mortality in Severe COVID-19 Infection
    (Elsevier, 2020-08-18) Jarori, Upasana; Maatman, Thomas K.; Maatman, Benjamin; Mastouri, Ronald; Sawada, Stephen G.; Khemka, Abhishek; Medicine, School of Medicine
    Respiratory failure is a major cause of mortality among hospitalized patients with COVID-19. Previous studies have shown that right ventricular (RV) dilation and reduced RV longitudinal strain are markers of poor outcome in this disease. COVID-19 can cause direct myocardial injury resulting in left ventricular (LV) systolic dysfunction and heart failure suggesting that assessment of LV function might also have prognostic value. Reduction of longitudinal systolic function assessed by mitral annular plane systolic excursion (MAPSE) is an early indicator of myocardial disease in various cardiac disorders. In this retrospective study, we investigated the prognostic value of MAPSE in patients admitted with respiratory failure related to COVID-19 infection.
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    Prognostic utility of blood pressure-adjusted global and basal systolic longitudinal strain
    (Bioscientifica, 2016-03) Rhea, Isaac B.; Rehman, Shuja; Jarori, Upasana; Choudhry, Muhammad W.; Feigenbaum, Harvey; Sawada, Stephen G.; Department of Medicine, IU School of Medicine
    Assessment of global longitudinal systolic strain (GLS) and longitudinal systolic strain of the basal segments (BLS) has shown prognostic value in cardiac disorders. However, strain is reduced with increased afterload. We assessed the prognostic value of GLS and BLS adjusted for afterload. GLS and BLS were determined in 272 subjects with normal ejection fraction and no known coronary disease, or significant valve disease. Systolic blood pressure (SP) and diastolic blood pressure (DP) obtained at the time of echocardiography were used to adjust GLS and BLS as follows: strain×SP (mmHg)/120 mmHg and strain×DP (mmHg)/80 mmHg. Patients were followed for cardiac events and mortality. The mean age was 53±15 years and 53% had hypertension. There were 19 cardiac events and 70 deaths over a mean follow-up of 26±14 months. Cox analysis showed that left ventricular mass index (P=0.001), BLS (P<0.001), and DP-adjusted BLS (P<0.001) were independent predictors of cardiac events. DP-adjusted BLS added incremental value (P<0.001) to the other two predictors and had an area under the curve of 0.838 for events. DP (P=0.001), age (P=0.001), ACE inhibitor use (P=0.017), and SP-adjusted BLS (P=0.012) were independent predictors of mortality. SP-adjusted BLS added incremental value (P=0.014) to the other independent predictors. In conclusion, DP-adjusted BLS and SP-adjusted BLS were independent predictors of cardiac events and mortality, respectively. Blood pressure-adjusted strain added incremental prognostic value to other predictors of outcome.
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    Recurrent Parotid Adenocarcinoma Presenting as Diffuse Myocardial Metastatic Disease
    (Allen Press, 2022) El-Am, Edward A.; Jarori, Upasana; Grethlein, Sara J.; Mastouri, Ronald; Khemka, Abhishek; Medicine, School of Medicine
    A 64-year-old man who had undergone treatment for left parotid adenocarcinoma presented with progressive exertional shortness of breath. Evaluation revealed metastatic invasion of the myocardium as a rare presentation of recurrent parotid adenocarcinoma. This case highlights the importance of using multimodal imaging methods in diagnostic evaluation and a collaborative multidisciplinary approach in managing patient care.