Browsing by Author "Krasuski, RA"
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Item Open Access Impact of diabetes in patients with pulmonary hypertension.(Pulm Circ, 2015-03) Hart, SA; Krasuski, RA; Smith, B; Wang, A; Harrison, JK; Bashore, TMDiabetes complicates management in a number of disease states and adversely impacts survival; how diabetes affects patients with pulmonary hypertension (PH) has not been well characterized. With insulin resistance having recently been demonstrated in PH, we sought to examine the impact of diabetes in these patients. Demographic characteristics, echo data, and invasive hemodynamic data were prospectively collected for 261 patients with PH referred for initial hemodynamic assessment. Diabetes was defined as documented insulin resistance or treatment with antidiabetic medications. Fifty-five patients (21%) had diabetes, and compared with nondiabetic patients, they were older (mean years ± SD, 61 ± 13 vs. 56 ± 16; [Formula: see text]), more likely to be black (29% vs. 14%; [Formula: see text]) and hypertensive (71% vs. 30%; [Formula: see text]), and had higher mean (±SD) serum creatinine levels (1.1 ± 0.5 vs. 1.0 ± 0.4; [Formula: see text]). Diabetic patients had similar World Health Organization functional class at presentation but were more likely to have pulmonary venous etiology of PH (24% vs. 10%; [Formula: see text]). Echo findings, including biventricular function, tricuspid regurgitation, and pressure estimates were similar. Invasive pulmonary pressures and cardiac output were similar, but right atrial pressure was appreciably higher (14 ± 8 mmHg vs. 10 ± 5 mmHg; [Formula: see text]). Despite similar management, survival was markedly worse and remained so after statistical adjustment. In summary, diabetic patients referred for assessment of PH were more likely to have pulmonary venous disease than nondiabetic patients with PH, with hemodynamics suggesting greater right-sided diastolic dysfunction. The markedly worse survival in these patients merits further study.Item Open Access Incremental Value of Cardiac Magnetic Resonance Imaging for Assessing Pulmonic Valve Regurgitation(Journal of Heart Valve Disease, 2015-07-01) Krasuski, RA; Zdradzinski, MJ; Hart, SA; Elkin, RL; Flamm, SItem Open Access Inhaled treprostinil sodium for pulmonary hypertension(Expert Opinion on Orphan Drugs, 2014-01-01) Gupta, V; Krasuski, RAIntroduction: Pulmonary arterial hypertension is an increasingly recognized heterogeneous disease with significant morbidity and mortality, requiring a multimodal approach to treatment. Inhalation administration of treprostinil sodium (Tyvaso®) permits higher local drug concentration without some of the side effects of parenteral prostanoids. Areas covered: After a broad discussion centering on available prostacyclins, a thorough literature review of treprostinil is undertaken, focusing on the timeline of clinical studies, specifically highlighting the major trials that shape current indications and usage. The literature search was undertaken via multiple search engines and strategies with review of cited and associated articles to provide a comprehensive discussion on the topic. Expert opinion: While safe and well tolerated, inhaled treprostinil sodium should be limited, based on available data, to use as add-on therapy for patients with Group I pulmonary hypertension not effectively controlled on oral therapy. Despite documented safety for the conversion from inhaled iloprost to inhaled treprostinil, the transition of patients stable on parenteral agents to inhaled treprostinil should be cautioned due to the potential for clinical decompensation. © 2014 Informa UK, Ltd.Item Open Access Motorized Scooters: Boon or Bane? Reply(AMERICAN JOURNAL OF CARDIOLOGY, 2010-08-15) Zagol, BW; Krasuski, RAItem Open Access Response to Letter Regarding Article, "Long-Term Outcome and Impact of Surgery on Adults With Coronary Arteries Originating From the Opposite Coronary Cusp"(CIRCULATION, 2011-10-04) Krasuski, RA; Kalahasti, V; Hobbs, R; Hart, S; Magyar, D; Lorber, R; Pettersson, G; Blackstone, E