Gerard Aurigemma - Academia.edu (original) (raw)

Papers by Gerard Aurigemma

Research paper thumbnail of Abstract 2543: Left Ventricular Diastolic Function in a Broad Range of Patients with Hypertension: The Valsartan in Diastolic Dysfunction (VALIDD) Trial

Circulation, Oct 31, 2006

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Research paper thumbnail of Table Of Contents ACC/AHA Guidelines for the Clinical Application of Echocardiography A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Clinical Application of Echocardiography) Developed in Collaboration With the American So...

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Research paper thumbnail of Response to letters regarding article, "systolic and diastolic mechanics in stress cardiomyopathy

Circulation, Jan 10, 2015

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Research paper thumbnail of The utility of newly derived Doppler echocardiographic variables in the diagnosis and management of patients with heart failure

Current Cardiology Reports, 2004

Doppler echocardiography, because of its noninvasive nature, is an ideal tool to evaluate patient... more Doppler echocardiography, because of its noninvasive nature, is an ideal tool to evaluate patients with heart failure (HF), offering the potential to improve early identification and management of these patients. Although traditional Doppler indices have allowed characterization of diastolic filling abnormalities associated with various HF states, important limitations are recognized. More refined Doppler techniques such as analysis of color M-mode flow propagation velocity, tissue Doppler imaging, and strain parameters can add to the ability of the noninvasive laboratory to improve the identification and management of this group of patients. These newer techniques as well as the traditional Doppler assessment of transmitral left ventricular inflow and pulmonary venous inflow velocities are reviewed as methods to improve the diagnosis and management of patients with HF.

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Research paper thumbnail of of chronic mitral regurgitation Left ventricular length-force-shortening relations before and after surgical correction

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Research paper thumbnail of Prevalence of Pulmonary Hypertension in Elderly Patients with Diastolic Heart Failure

Journal of Cardiac Failure - J CARD FAIL, 2007

... Interestingly, age-related increases in arterial stiffening are worse in women than in men (L... more ... Interestingly, age-related increases in arterial stiffening are worse in women than in men (Levy D, Redfeild MM et al, Smulyan H et al, Hayward CS and Kelly RP, Gatzka CD, et al). Thus elderly ... 8. Gottdiener JS, Kitzman DW, Aurigemma GP, Arnold AM, Manolio TA. ...

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Research paper thumbnail of Prognosis in Diastolic Heart Failure

Progress in Cardiovascular Diseases, 2005

Diastolic dysfunction and the clinical syndrome of diastolic heart failure have become well recog... more Diastolic dysfunction and the clinical syndrome of diastolic heart failure have become well recognized as contributors to the overall burden of congestive heart failure. This increasing awareness has led to several recent investigations into the impact of diastolic abnormalities on morbidity and mortality. This article reviews the current state of knowledge regarding the prognosis of patient populations with diastolic dysfunction and diastolic heart failure.

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Research paper thumbnail of Paradoxical changes in brain natriuretic peptide levels and loading conditions after intravenous conscious sedation

Journal of the American Society of Echocardiography, 2004

Elevated filling pressure and wall stress have been proposed as stimuli for elevated brain natriu... more Elevated filling pressure and wall stress have been proposed as stimuli for elevated brain natriuretic peptide (BNP) levels. Narcotic and benzodiazepine sedation, such as is used for transesophageal echocardiography (TEE), is known to decrease filling pressures. We hypothesized that lower filling pressure and wall stress associated with intravenous conscious sedation (IVCS) would lead to lower BNP levels. We studied BNP levels, blood pressure, and echocardiographic indices of filling pressure and wall stress before and after IVCS and TEE. When data before and after IVCS and TEE were compared, mean blood pressure decreased (149 +/- 24/83 +/- 14 mm Hg vs 126 +/- 29/69 +/- 14; P < .01), as did mitral Doppler E wave velocity (82 +/- 23 cm/s vs 76 +/- 22; P < .05), right ventricular/atrial gradient (31 +/- 10 mm Hg vs 29 +/- 13; P < .05), and wall stress. However, BNP levels increased (195 +/- 407 pg/mL vs 238 +/- 458; P < .01). In a series of patients undergoing clinically indicated TEE, BNP levels increase above baseline after IVCS. The increase in BNP occurs despite lower blood pressure, lower mitral Doppler E velocity, lower right ventricular/atrial gradient, and lower wall stress compared with baseline. The mechanism of the paradoxical increase in BNP is not entirely clear, but it may conceivably be a result of counterregulatory hormone release caused by acute decrease in blood pressure.

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Research paper thumbnail of Which indexes of filling behavior should be used to characterize left ventricular diastolic function when changes in heart rate and atrioventricular delay occur?

Journal of the American Society of Echocardiography, 1997

The routine use of the peak early-to-peak atrial velocity, early velocity integral-to-atrial velo... more The routine use of the peak early-to-peak atrial velocity, early velocity integral-to-atrial velocity integral, and early velocity integral-to-the total filling velocity integral ratios are limited because they are influenced by heart rate and atrioventricular delay. Hence, we sought to establish whether these ratios could be normalized to account for the differences in cycle length (RR interval) and diastolic filling period when heart rate and atrioventricular delay were altered in 18 patients with programmable dual-chamber pacemakers. We further explored whether these and other parameters of the mitral velocity profile could be used to characterize the mitral filling pattern during isoproterenol and methoxamine infusions-interventions that are likely to change both heart rate and left ventricular filling. The early velocity integral-to-atrial velocity integral and early velocity integral-to-the total filling velocity integral ratios were more sensitive to minor variations in heart rate and atrioventricular delay than the peak early-to-peak atrial velocity ratio. The early velocity integral-to-atrial velocity integral and early velocity integral-to-total filling velocity integral ratios could not be normalized to account for differences in RR interval or diastolic filling period, whereas the peak early-to-peak atrial velocity ratio became less sensitive to changes in heart rate when it was divided by the RR interval, or diastolic filling period, or square root of diastolic filling period. Because the diastolic filling period is affected by atrioventricular delay independent of changes in the RR interval, these ratios were also corrected for the functional cycle length, defined as the interval from R-wave of the electrocardiogram to the end of the diastolic filling period. When corrected for either the functional cycle length or diastolic filling period or square root of diastolic filling period, only the peak early-to-peak atrial velocity ratio became less sensitive to variations in the atrioventricular delay. The ratio of diastolic filling period expressed as a proportion of RR interval or functional cycle length changed significantly when heart rate and atrioventricular delay were altered and did not improve when diastolic filling period was divided by the square root of RR or square root of functional cycle length. However, when the square root of diastolic filling period was divided by the RR interval or functional cycle length, the effects of heart rate and atrioventricular delay were not apparent. Of all the ratios, the ratio of square root of diastolic filling period expressed as a proportion of RR interval or functional cycle length was the most useful to differentiate the confounding effects of heart rate (+/-atrioventricular delay) from the effects of isoproterenol and methoxamine on left ventricular filling. Hence, this ratio appeared to be a heart rate- and atrioventricular delay-independent index of left ventricular diastolic function.

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Research paper thumbnail of Age related changes in left atrial size and geometry

Journal of the American College of Cardiology, 2003

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Research paper thumbnail of The tako-tsubo syndrome (transient apical ballooning): A United States perspective

Journal of the American College of Cardiology, 2003

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Research paper thumbnail of Left Ventricular Length-Force-Shortening Relations Before and After Surgical Correction of Chronic Mitral Regurgitation

Journal of the American College of Cardiology, 1998

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Research paper thumbnail of Left ventricular hypertrophy and mortality after aortic valve replacement for aortic stenosis

Journal of the American College of Cardiology, 1993

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Research paper thumbnail of Serum levels of carbohydrate antigen 125 in patients with chronic heart failure

Journal of the American College of Cardiology, 2003

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Research paper thumbnail of Low flow–low gradient aortic stenosis

Journal of the American College of Cardiology, 2004

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Research paper thumbnail of Heart failure in pressure overload hypertrophy

Journal of the American College of Cardiology, 2002

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Research paper thumbnail of Task force 4: Training in echocardiography

Journal of the American College of Cardiology, 1995

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Research paper thumbnail of Effects of diabetes with or without hypertension in the genesis of left ventricular hypertrophy in the rat

Journal of the American College of Cardiology, 1996

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Research paper thumbnail of Does myocardial function decline with age?

Journal of the American College of Cardiology, 2003

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Research paper thumbnail of 1129-211 Cardioversion of chronic atrial fibrillation is associated with an immediate drop in brain natriuretic peptide

Journal of the American College of Cardiology, 2004

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Research paper thumbnail of Abstract 2543: Left Ventricular Diastolic Function in a Broad Range of Patients with Hypertension: The Valsartan in Diastolic Dysfunction (VALIDD) Trial

Circulation, Oct 31, 2006

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Research paper thumbnail of Table Of Contents ACC/AHA Guidelines for the Clinical Application of Echocardiography A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Clinical Application of Echocardiography) Developed in Collaboration With the American So...

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Response to letters regarding article, "systolic and diastolic mechanics in stress cardiomyopathy

Circulation, Jan 10, 2015

Bookmarks Related papers MentionsView impact

Research paper thumbnail of The utility of newly derived Doppler echocardiographic variables in the diagnosis and management of patients with heart failure

Current Cardiology Reports, 2004

Doppler echocardiography, because of its noninvasive nature, is an ideal tool to evaluate patient... more Doppler echocardiography, because of its noninvasive nature, is an ideal tool to evaluate patients with heart failure (HF), offering the potential to improve early identification and management of these patients. Although traditional Doppler indices have allowed characterization of diastolic filling abnormalities associated with various HF states, important limitations are recognized. More refined Doppler techniques such as analysis of color M-mode flow propagation velocity, tissue Doppler imaging, and strain parameters can add to the ability of the noninvasive laboratory to improve the identification and management of this group of patients. These newer techniques as well as the traditional Doppler assessment of transmitral left ventricular inflow and pulmonary venous inflow velocities are reviewed as methods to improve the diagnosis and management of patients with HF.

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Research paper thumbnail of of chronic mitral regurgitation Left ventricular length-force-shortening relations before and after surgical correction

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Prevalence of Pulmonary Hypertension in Elderly Patients with Diastolic Heart Failure

Journal of Cardiac Failure - J CARD FAIL, 2007

... Interestingly, age-related increases in arterial stiffening are worse in women than in men (L... more ... Interestingly, age-related increases in arterial stiffening are worse in women than in men (Levy D, Redfeild MM et al, Smulyan H et al, Hayward CS and Kelly RP, Gatzka CD, et al). Thus elderly ... 8. Gottdiener JS, Kitzman DW, Aurigemma GP, Arnold AM, Manolio TA. ...

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Research paper thumbnail of Prognosis in Diastolic Heart Failure

Progress in Cardiovascular Diseases, 2005

Diastolic dysfunction and the clinical syndrome of diastolic heart failure have become well recog... more Diastolic dysfunction and the clinical syndrome of diastolic heart failure have become well recognized as contributors to the overall burden of congestive heart failure. This increasing awareness has led to several recent investigations into the impact of diastolic abnormalities on morbidity and mortality. This article reviews the current state of knowledge regarding the prognosis of patient populations with diastolic dysfunction and diastolic heart failure.

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Paradoxical changes in brain natriuretic peptide levels and loading conditions after intravenous conscious sedation

Journal of the American Society of Echocardiography, 2004

Elevated filling pressure and wall stress have been proposed as stimuli for elevated brain natriu... more Elevated filling pressure and wall stress have been proposed as stimuli for elevated brain natriuretic peptide (BNP) levels. Narcotic and benzodiazepine sedation, such as is used for transesophageal echocardiography (TEE), is known to decrease filling pressures. We hypothesized that lower filling pressure and wall stress associated with intravenous conscious sedation (IVCS) would lead to lower BNP levels. We studied BNP levels, blood pressure, and echocardiographic indices of filling pressure and wall stress before and after IVCS and TEE. When data before and after IVCS and TEE were compared, mean blood pressure decreased (149 +/- 24/83 +/- 14 mm Hg vs 126 +/- 29/69 +/- 14; P < .01), as did mitral Doppler E wave velocity (82 +/- 23 cm/s vs 76 +/- 22; P < .05), right ventricular/atrial gradient (31 +/- 10 mm Hg vs 29 +/- 13; P < .05), and wall stress. However, BNP levels increased (195 +/- 407 pg/mL vs 238 +/- 458; P < .01). In a series of patients undergoing clinically indicated TEE, BNP levels increase above baseline after IVCS. The increase in BNP occurs despite lower blood pressure, lower mitral Doppler E velocity, lower right ventricular/atrial gradient, and lower wall stress compared with baseline. The mechanism of the paradoxical increase in BNP is not entirely clear, but it may conceivably be a result of counterregulatory hormone release caused by acute decrease in blood pressure.

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Which indexes of filling behavior should be used to characterize left ventricular diastolic function when changes in heart rate and atrioventricular delay occur?

Journal of the American Society of Echocardiography, 1997

The routine use of the peak early-to-peak atrial velocity, early velocity integral-to-atrial velo... more The routine use of the peak early-to-peak atrial velocity, early velocity integral-to-atrial velocity integral, and early velocity integral-to-the total filling velocity integral ratios are limited because they are influenced by heart rate and atrioventricular delay. Hence, we sought to establish whether these ratios could be normalized to account for the differences in cycle length (RR interval) and diastolic filling period when heart rate and atrioventricular delay were altered in 18 patients with programmable dual-chamber pacemakers. We further explored whether these and other parameters of the mitral velocity profile could be used to characterize the mitral filling pattern during isoproterenol and methoxamine infusions-interventions that are likely to change both heart rate and left ventricular filling. The early velocity integral-to-atrial velocity integral and early velocity integral-to-the total filling velocity integral ratios were more sensitive to minor variations in heart rate and atrioventricular delay than the peak early-to-peak atrial velocity ratio. The early velocity integral-to-atrial velocity integral and early velocity integral-to-total filling velocity integral ratios could not be normalized to account for differences in RR interval or diastolic filling period, whereas the peak early-to-peak atrial velocity ratio became less sensitive to changes in heart rate when it was divided by the RR interval, or diastolic filling period, or square root of diastolic filling period. Because the diastolic filling period is affected by atrioventricular delay independent of changes in the RR interval, these ratios were also corrected for the functional cycle length, defined as the interval from R-wave of the electrocardiogram to the end of the diastolic filling period. When corrected for either the functional cycle length or diastolic filling period or square root of diastolic filling period, only the peak early-to-peak atrial velocity ratio became less sensitive to variations in the atrioventricular delay. The ratio of diastolic filling period expressed as a proportion of RR interval or functional cycle length changed significantly when heart rate and atrioventricular delay were altered and did not improve when diastolic filling period was divided by the square root of RR or square root of functional cycle length. However, when the square root of diastolic filling period was divided by the RR interval or functional cycle length, the effects of heart rate and atrioventricular delay were not apparent. Of all the ratios, the ratio of square root of diastolic filling period expressed as a proportion of RR interval or functional cycle length was the most useful to differentiate the confounding effects of heart rate (+/-atrioventricular delay) from the effects of isoproterenol and methoxamine on left ventricular filling. Hence, this ratio appeared to be a heart rate- and atrioventricular delay-independent index of left ventricular diastolic function.

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Research paper thumbnail of Age related changes in left atrial size and geometry

Journal of the American College of Cardiology, 2003

Bookmarks Related papers MentionsView impact

Research paper thumbnail of The tako-tsubo syndrome (transient apical ballooning): A United States perspective

Journal of the American College of Cardiology, 2003

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Left Ventricular Length-Force-Shortening Relations Before and After Surgical Correction of Chronic Mitral Regurgitation

Journal of the American College of Cardiology, 1998

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Left ventricular hypertrophy and mortality after aortic valve replacement for aortic stenosis

Journal of the American College of Cardiology, 1993

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Serum levels of carbohydrate antigen 125 in patients with chronic heart failure

Journal of the American College of Cardiology, 2003

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Low flow–low gradient aortic stenosis

Journal of the American College of Cardiology, 2004

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Heart failure in pressure overload hypertrophy

Journal of the American College of Cardiology, 2002

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Task force 4: Training in echocardiography

Journal of the American College of Cardiology, 1995

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Effects of diabetes with or without hypertension in the genesis of left ventricular hypertrophy in the rat

Journal of the American College of Cardiology, 1996

Bookmarks Related papers MentionsView impact

Research paper thumbnail of Does myocardial function decline with age?

Journal of the American College of Cardiology, 2003

Bookmarks Related papers MentionsView impact

Research paper thumbnail of 1129-211 Cardioversion of chronic atrial fibrillation is associated with an immediate drop in brain natriuretic peptide

Journal of the American College of Cardiology, 2004

Bookmarks Related papers MentionsView impact