Bassam Omar - Academia.edu (original) (raw)
Papers by Bassam Omar
Circulation: Cardiovascular Quality and Outcomes, 2017
Background: Gated stress studies with Thallium previously suggested that SPECT overestimated the ... more Background: Gated stress studies with Thallium previously suggested that SPECT overestimated the ejection fraction obtained with other modalities, limiting its use. Objective: To compare ejection fractions (EF) obtained from post pharmacologic stress gated SPECT using Technicium99m with EFs estimated by transthoracic echocardiography (TTE) or cardiac catheterization (angio). Methods: From a university-based outpatient stress lab, 502 stress tests performed over 14 months were reviewed; 126 gated pharmacologic stress tests were analyzed. Contemporaneous TTEs were available in 114, and angios in 26 of the studies. The stress nuclear protocols included a slow walk and the stress agent was regadenoson in the majority of the studies. Mean EF reported from the post-stress gated SPECT, TTEs, and angios were tested with ANOVA. The absolute variance in EF between each two contemporaneous groups was averaged and compared using a 2-tailed student t-test to the other groups. Results: The mean E...
Circulation, 2018
Background: Obtaining a fasting lipid profile prior to a scheduled clinic visit can facilitate de... more Background: Obtaining a fasting lipid profile prior to a scheduled clinic visit can facilitate decision making at the time of the visit. However, this places extra burden on patients and can decrease compliance. Purpose: To assess the frequency of lipid measurement in patients asked to have blood draw a week before clinic visit versus on the same day of clinic visit, and assess how this will affect achieving lipid targets. Methods: A University-based cardiology clinic notes were examined. Patients were scheduled for a fasting lipid profile a week prior to the clinic visit in year 1. Poor compliance was noted and prompted a same day as clinic visit measurement of lipids if a patient could not comply with laboratory appointment (fasting or non-fasting) in year 2, with further lipid management conducted by phone. Patients with documented coronary artery disease were included. A total of 200 encounters (100 in each year) were analyzed. Results: Only 64 (64%) of patients in year 1 had li...
License, which permits unrestricted use, distribution, and reproduction in any medium, provided t... more License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Tension pneumothorax can infrequently cause ventricular arrhythmias and increase the threshold of defibrillation. It should be suspected whenever there is difficulty in defibrillation for a ventricular arrhythmia. Purpose. To report a case of traumatic tension pneumothorax leading to ventricular tachycardia and causing defibrillator failure. Case. A 65-year-old African-American female was brought in to our emergency department complaining of dyspnea after being forced down by cops. She had history of mitral valve replacement for severe mitral regurgitation and biventricular implantable cardioverter defibrillator inserted for nonischemic cardiomyopathy. Shortly after arrival, she developed sustained ventricular tachycardia, causing repetitive unsuccessful ICD shocks. She was intubated and ventricular tachycardia resolved with amiodarone. Che...
Journal of Endocrinology and Metabolism, 2015
Diabetes mellitus (DM) is an epidemic which affects close to 100 million patients worldwide; the ... more Diabetes mellitus (DM) is an epidemic which affects close to 100 million patients worldwide; the majority being type 2 diabetes mellitus. The rising incidence has resulted in a proportional increase in the frequency of cardiovascular disease attributable to DM, as revealed by various population-based studies. Over the past 50 years, DM has been shown to be an important and independent risk factor in the development of a variety of cardiac conditions, especially vascular disease, primarily through accelerated atherosclerosis. Diabetic neuropathy is a serious complication of DM, which leads to the impairment of cardiovascular autonomic control. Diabetic cardiac autonomic neuropathy results in heart rate abnormalities, exercise intolerance, orthostatic blood pressure abnormalities, QT interval prolongation, silent ischemia and diabetic cardiomyopathy, all of which lead to increased morbidity and mortality related to diabetes. This conditions remains difficult to diagnose and treat, requiring a multifaceted approach. Inflammation appears to play a central role in accelerating many of the injurious effects of DM on the cardiovascular system. Expression of specific inflammatory markers has been directly linked to some of the known harmful effects of DM on the cardiovascular system, in addition to indirectly potentiating the deleterious effects of other major cardiovascular disease risk factors. Hyperglycemia results in increased intracellular glucose which triggers several pro-inflammatory reactions leading to the production of harmful free radicals and the formation of advanced glycation end products. These have been linked to the development of diabetic atherogenic dyslipidemia, in addition to glycation and loss of the protective effect of high density lipoproteins in diabetic subjects, thereby worsening the atherosclerotic burden in DM. Addressing hyperglycemia, therefore, is only one of many vital components in the treatment of diabetes. Traditional risk factors for heart disease and stroke tend to be further potentiated by the presence of DM, however, even after adequate control of hyperglycemia. Clinical evidence and major clinical guidelines address this conundrum by pointing out unmet needs of adequate cardiovascular protection, and call for aggressive control of risk factors in the diabetic population.
Reviews in cardiovascular medicine, 2014
Postextrasystolic T-wave changes have been described as early as 1915. The significance and mecha... more Postextrasystolic T-wave changes have been described as early as 1915. The significance and mechanism of such changes remain controversial. Because postextrasystolic ST changes are rare, much of the ensuing discussion concentrates on the closely related and more commonly reported phenomenon of postextrasystolic T-wave inversion. This report documents the case of a 67-year-old man with a history of coronary artery disease who was admitted to the hospital with chest pain.
Background: Racial and gender differences influence control of coronary disease risk factors, and... more Background: Racial and gender differences influence control of coronary disease risk factors, and have often been related to socioeconomic issues. Methods: Encounters from a university-based primar...
Background: Availability of lipid profile during a patient’s clinic encounter can improve decisio... more Background: Availability of lipid profile during a patient’s clinic encounter can improve decision-making in regards to therapy, and help achieve therapeutic goals. Methods: Encounters from 2 clinics run by one cardiologist; a University-based clinic and a Veterans Administration (VA) clinic were compared for availability of cholesterol profiles and level of cholesterol control in patients with coronary disease. Results: There were 93 out of 300 encounters (31%) with documented coronary disease (CAD) in the University clinic and 77 out of 134 encounters (57%) in the VA clinic. University patients with CAD had 61% (57/93) lipid documentation during their encounters, while VA patients had 99% (76/77) documentation. The average total cholesterol and LDL for University patients was 179 ± 42 mg/dL and 111 ± 35 mg/dL respectively, compared with 154 ± 38 mg/dL and 93 ± 35 mg/dL for the VA patients respectively (P Conclusion: Better control of cholesterol levels is seen in the VA-based clin...
Circulation: Cardiovascular Quality and Outcomes, 2017
Background: Gated stress studies with Thallium previously suggested that SPECT overestimated the ... more Background: Gated stress studies with Thallium previously suggested that SPECT overestimated the ejection fraction obtained with other modalities, limiting its use. Objective: To compare ejection fractions (EF) obtained from post pharmacologic stress gated SPECT using Technicium99m with EFs estimated by transthoracic echocardiography (TTE) or cardiac catheterization (angio). Methods: From a university-based outpatient stress lab, 502 stress tests performed over 14 months were reviewed; 126 gated pharmacologic stress tests were analyzed. Contemporaneous TTEs were available in 114, and angios in 26 of the studies. The stress nuclear protocols included a slow walk and the stress agent was regadenoson in the majority of the studies. Mean EF reported from the post-stress gated SPECT, TTEs, and angios were tested with ANOVA. The absolute variance in EF between each two contemporaneous groups was averaged and compared using a 2-tailed student t-test to the other groups. Results: The mean E...
Circulation, 2018
Background: Obtaining a fasting lipid profile prior to a scheduled clinic visit can facilitate de... more Background: Obtaining a fasting lipid profile prior to a scheduled clinic visit can facilitate decision making at the time of the visit. However, this places extra burden on patients and can decrease compliance. Purpose: To assess the frequency of lipid measurement in patients asked to have blood draw a week before clinic visit versus on the same day of clinic visit, and assess how this will affect achieving lipid targets. Methods: A University-based cardiology clinic notes were examined. Patients were scheduled for a fasting lipid profile a week prior to the clinic visit in year 1. Poor compliance was noted and prompted a same day as clinic visit measurement of lipids if a patient could not comply with laboratory appointment (fasting or non-fasting) in year 2, with further lipid management conducted by phone. Patients with documented coronary artery disease were included. A total of 200 encounters (100 in each year) were analyzed. Results: Only 64 (64%) of patients in year 1 had li...
License, which permits unrestricted use, distribution, and reproduction in any medium, provided t... more License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Tension pneumothorax can infrequently cause ventricular arrhythmias and increase the threshold of defibrillation. It should be suspected whenever there is difficulty in defibrillation for a ventricular arrhythmia. Purpose. To report a case of traumatic tension pneumothorax leading to ventricular tachycardia and causing defibrillator failure. Case. A 65-year-old African-American female was brought in to our emergency department complaining of dyspnea after being forced down by cops. She had history of mitral valve replacement for severe mitral regurgitation and biventricular implantable cardioverter defibrillator inserted for nonischemic cardiomyopathy. Shortly after arrival, she developed sustained ventricular tachycardia, causing repetitive unsuccessful ICD shocks. She was intubated and ventricular tachycardia resolved with amiodarone. Che...
Journal of Endocrinology and Metabolism, 2015
Diabetes mellitus (DM) is an epidemic which affects close to 100 million patients worldwide; the ... more Diabetes mellitus (DM) is an epidemic which affects close to 100 million patients worldwide; the majority being type 2 diabetes mellitus. The rising incidence has resulted in a proportional increase in the frequency of cardiovascular disease attributable to DM, as revealed by various population-based studies. Over the past 50 years, DM has been shown to be an important and independent risk factor in the development of a variety of cardiac conditions, especially vascular disease, primarily through accelerated atherosclerosis. Diabetic neuropathy is a serious complication of DM, which leads to the impairment of cardiovascular autonomic control. Diabetic cardiac autonomic neuropathy results in heart rate abnormalities, exercise intolerance, orthostatic blood pressure abnormalities, QT interval prolongation, silent ischemia and diabetic cardiomyopathy, all of which lead to increased morbidity and mortality related to diabetes. This conditions remains difficult to diagnose and treat, requiring a multifaceted approach. Inflammation appears to play a central role in accelerating many of the injurious effects of DM on the cardiovascular system. Expression of specific inflammatory markers has been directly linked to some of the known harmful effects of DM on the cardiovascular system, in addition to indirectly potentiating the deleterious effects of other major cardiovascular disease risk factors. Hyperglycemia results in increased intracellular glucose which triggers several pro-inflammatory reactions leading to the production of harmful free radicals and the formation of advanced glycation end products. These have been linked to the development of diabetic atherogenic dyslipidemia, in addition to glycation and loss of the protective effect of high density lipoproteins in diabetic subjects, thereby worsening the atherosclerotic burden in DM. Addressing hyperglycemia, therefore, is only one of many vital components in the treatment of diabetes. Traditional risk factors for heart disease and stroke tend to be further potentiated by the presence of DM, however, even after adequate control of hyperglycemia. Clinical evidence and major clinical guidelines address this conundrum by pointing out unmet needs of adequate cardiovascular protection, and call for aggressive control of risk factors in the diabetic population.
Reviews in cardiovascular medicine, 2014
Postextrasystolic T-wave changes have been described as early as 1915. The significance and mecha... more Postextrasystolic T-wave changes have been described as early as 1915. The significance and mechanism of such changes remain controversial. Because postextrasystolic ST changes are rare, much of the ensuing discussion concentrates on the closely related and more commonly reported phenomenon of postextrasystolic T-wave inversion. This report documents the case of a 67-year-old man with a history of coronary artery disease who was admitted to the hospital with chest pain.
Background: Racial and gender differences influence control of coronary disease risk factors, and... more Background: Racial and gender differences influence control of coronary disease risk factors, and have often been related to socioeconomic issues. Methods: Encounters from a university-based primar...
Background: Availability of lipid profile during a patient’s clinic encounter can improve decisio... more Background: Availability of lipid profile during a patient’s clinic encounter can improve decision-making in regards to therapy, and help achieve therapeutic goals. Methods: Encounters from 2 clinics run by one cardiologist; a University-based clinic and a Veterans Administration (VA) clinic were compared for availability of cholesterol profiles and level of cholesterol control in patients with coronary disease. Results: There were 93 out of 300 encounters (31%) with documented coronary disease (CAD) in the University clinic and 77 out of 134 encounters (57%) in the VA clinic. University patients with CAD had 61% (57/93) lipid documentation during their encounters, while VA patients had 99% (76/77) documentation. The average total cholesterol and LDL for University patients was 179 ± 42 mg/dL and 111 ± 35 mg/dL respectively, compared with 154 ± 38 mg/dL and 93 ± 35 mg/dL for the VA patients respectively (P Conclusion: Better control of cholesterol levels is seen in the VA-based clin...