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        Does a Gradient-Adjusted Cardiac Power Index Improve Prediction of Post-Transcatheter Aortic Valve Replacement Survival Over Cardiac Power Index?

        Pradyumna Agasthi,Sai Harika Pujari,Farouk Mookadam,Andrew Tseng,Nithin R. Venepally,Panwen Wang,Mohamed Allam,John Sweeney,Mackram Eleid,Floyd David Fortuin,David R. Holmes Jr,Nirat Beohar,Reza Arsan 연세대학교의과대학 2020 Yonsei medical journal Vol.61 No.6

        Purpose: Cardiac power (CP) index is a product of mean arterial pressure (MAP) and cardiac output (CO). In aortic stenosis, however, MAP is not reflective of true left ventricular (LV) afterload. We evaluated the utility of a gradient-adjusted CP (GCP) index in predicting survival after transcatheter aortic valve replacement (TAVR), compared to CP alone. Materials and Methods: We included 975 patients who underwent TAVR with 1 year of follow-up. CP was calculated as (CO×MAP)/[451×body surface area (BSA)] (W/m2). GCP was calculated using augmented MAP by adding aortic valve mean gradient (AVMG) to systolic blood pressure (CP1), adding aortic valve maximal instantaneous gradient to systolic blood pressure (CP2), and adding AVMG to MAP (CP3). A multivariate Cox regression analysis was performed adjusting for baseline covariates. Receiver operator curves (ROC) for CP and GCP were calculated to predict survival after TAVR. Results: The mortality rate at 1 year was 16%. The mean age and AVMG of the survivors were 81±9 years and 43±4 mm Hg versus 80±9 years and 42±13 mm Hg in the deceased group. The proportions of female patients were similar in both groups (p=0.7). Both CP and GCP were independently associated with survival at 1 year. The area under ROCs for CP, CP1, CP2, and CP3 were 0.67 [95% confidence interval (CI), 0.62–0.72], 0.65 (95% CI, 0.60–0.70), 0.66 (95% CI, 0.61–0.71), and 0.63 (95% CI 0.58–0.68), respectively. Conclusion: GCP did not improve the accuracy of predicting survival post TAVR at 1 year, compared to CP alone.

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        ABO blood group and rhesus factor association with inpatient COVID-19 mortality and severity: a two-year retrospective review

        Alexander T. Phan,Ari A. Ucar,Aldin Malkoc,Janie Hu,Luke Buxton,Alan W. Tseng,Fanglong Dong,Julie P.T. Nguyễn,Arnav P. Modi,Ojas Deshpande,Johnson Lay,Andrew Ku,Dotun Ogunyemi,Sarkis Arabian 대한혈액학회 2023 Blood Research Vol.58 No.3

        Background Early reports have indicated a relationship between ABO and rhesus blood group types and infection with SARS-CoV-2. We aim to examine blood group type associations with COVID-19 mortality and disease severity. Methods This is a retrospective chart review of patients ages 18 years or older admitted to the hospital with COVID-19 between January 2020 and December 2021. The primary outcome was COVID-19 mortality with respect to ABO blood group type. The secondary outcomes were 1. Severity of COVID-19 with respect to ABO blood group type, and 2. Rhesus factor association with COVID-19 mortality and disease severity. Disease severity was defined by degree of supplemental oxygen requirements (ambient air, low-flow, high-flow, non-invasive mechanical ventilation, and invasive mechanical ventilation). Results The blood type was collected on 596 patients with more than half (54%, N=322) being O+. The ABO blood type alone was not statistically associated with mortality (P=0.405), while the RH blood type was statistically associated with mortality (P <0.001). There was statistically significant association between combined ABO and RH blood type and mortality (P =0.014). Out of the mortality group, the O+ group had the highest mortality (52.3%), followed by A+ (22.8%). The combined ABO and RH blood type was statistically significantly associated with degree of supplemental oxygen requirements (P =0.005). The Kaplan-Meier curve demonstrated that Rh- patients had increased mortality. Conclusion ABO blood type is not associated with COVID-19 severity and mortality. Rhesus factor status is associated with COVID-19 severity and mortality. Rhesus negative patients were associated with increased mortality risk.

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