Linda Pape's research while affiliated with University of Worcester and other places
What is this page?
This page lists the scientific contributions of an author, who either does not have a ResearchGate profile, or has not yet added these contributions to their profile.
It was automatically created by ResearchGate to create a record of this author's body of work. We create such pages to advance our goal of creating and maintaining the most comprehensive scientific repository possible. In doing so, we process publicly available (personal) data relating to the author as a member of the scientific community.
If you're a ResearchGate member, you can follow this page to keep up with this author's work.
If you are this author, and you don't want us to display this page anymore, please let us know.
It was automatically created by ResearchGate to create a record of this author's body of work. We create such pages to advance our goal of creating and maintaining the most comprehensive scientific repository possible. In doing so, we process publicly available (personal) data relating to the author as a member of the scientific community.
If you're a ResearchGate member, you can follow this page to keep up with this author's work.
If you are this author, and you don't want us to display this page anymore, please let us know.
Publications (94)
Objective:
The International Registry of Acute Aortic Dissection (IRAD) celebrated its 25th anniversary January 2021. This study evaluated IRAD's role in promoting the understanding and management of acute aortic dissection (AD) over these years.
Methods:
IRAD studies were identified, analyzed, and ranked according to their citations per year (c...
Background and aims:
Complications of bicuspid aortic valve commonly include aortic stenosis, aortic regurgitation, and ascending aortic dilation. The progression of these lesions is not well described.
Materials and methods:
We reviewed 249 bicuspid aortic valve patients with at least two echocardiograms from 2006 to 2016. Valve morphology (rig...
Objectives:
We performed a meta-analysis to evaluate the efficacy and safety of transcatheter aortic valve replacement (TAVR) in comparison to surgical aortic valve replacement (SAVR) in intermediate-risk patients.
Background:
TAVR is an established treatment option in high-risk patients with severe aortic valve stenosis (AS). There are fewer da...
Introduction: Bicuspid aortic valves (BAV) are associated with aortic regurgitation (AR), aortic stenosis (AS), and aortic dilation.
Hypothesis: Does the type of cusp fusion impact the development of valvular dysfunction and aortic disease in patients with BAV?
Methods: In a large retrospective cohort study with long term follow up, 259 patients...
Background: Prior research has elucidated differences in patient history, presentation, and outcomes between women and men with acute aortic dissection (AAD). However, little is known about the impact of gender on long-term outcomes. The aim of the current study was to utilize data on Type A AAD (TAAAD) patients enrolled in the International Regist...
Background: This study assessed the incidence of lower limb ischemia as well as trends in management and outcomes while examining acute aortic dissection patients over a period of 15 years. Additionally, differences in clinical presentation, interventions performed, and mortality between patients with and without lower limb ischemia were investigat...
Background: While prior research has documented the rate of progression of BAV to severe AS, myocardial function factors have received less attention. We hypothesized that reduced GLS might conceivably identify a high risk subset of BAV patients, as it has in other instances of severe valvular heart disease, such as chronic severe aortic regurgitat...
Introduction: Patients with Marfan Syndrome have an increased risk of sudden death due to aortic dissection, mostly preceded by aortic dilatation.There has been considerable interest in evaluating the role of angiotensin blockade with Angiotensin Converting Enzyme (ACE) inhibitors or Angiotensin Receptor Blockers (ARB) on reducing the progression o...
Diagnosis, treatment, and outcomes of acute aortic dissection (AAS) are changing.
This study examined 17-year trends in the presentation, diagnosis, and hospital outcomes of AAD from the International Registry of Acute Aortic Dissection (IRAD).
Data from 4,428 patients enrolled at 28 IRAD centers between December 26, 1995, and February 6, 2013, wer...
Background:
The outcome of patients with acute type B aortic dissection (ABAD) is strongly related to their clinical presentation. The purpose of this study was to investigate predictors for mortality among patients presenting with ABAD and to create a predictive model to estimate individual risk of in-hospital mortality using the International Re...
Background: Aortic size is the determining factor for prophylactic intervention on diseased aortas. However, recent studies have shown that dissecting aortas are often sized well below the diameters defined by surgical guidelines. Whether or not adjusting aortic diameters for body size will better categorize patients at risk for aortic dissection r...
Introduction: The outcome of acute type B aortic dissection (ABAD) patients is strongly related to the clinical presentation. The purpose of this study was to investigate predictors for mortality among patients presenting ABAD and to create a predictive model to estimate individual risk of in-hospital mortality using the International Registry of A...
Few data exist on race-related differences in acute aortic dissection patients.
We evaluated black (n = 189, 14%) or white (n = 1165, 86%) patients (mean age 62.8 ± 15.3 years; 36.4% women) enrolled in 13 US centers participating in the International Registry of Acute Aortic Dissection. We excluded patients of other racial descent.
Type B acute aor...
Introduction:
The classical presentation of a patient with Type B acute aortic dissection (TBAAD) is characterized by severe chest, back, or abdominal pain, ripping or tearing in nature. However, some patients present with painless acute aortic dissection, which can lead to a delay in diagnosis and treatment. We utilized the International Registry...
Background: Young patients (pts) with acute aortic dissection (AAD) have distinct risk factors and presenting symptoms compared to older pts, but whether these differences extend past discharge is relatively unknown.
Methods: Among pts presenting with AAD enrolled in the International Registry of Acute Aortic Dissection, pts <40 (N=280) were compar...
Bicuspid aortic valves are associated with aortic dilation and dissection. There is a paucity of prospective studies evaluating changes in aortic size over time in adult subjects with bicuspid aortic valves.
A total of 115 subjects with asymptomatic bicuspid aortic valves were enrolled from 2003-2008 and followed prospectively over 5 years. Clinica...
Introduction: Current guidelines report that arch involvement in aortic dissection requires open surgical repair. However, arch dissections are frequently managed with less invasive treatment when ascending aorta involvement is absent. The aim of this project is to clarify the importance of aortic arch involvement in such conditions,
Methods: Patie...
Introduction/Purpose: To examine trends in patient presentation, diagnosis and outcomes of acute aortic dissection over 15 years since the original report from the International Registry of Acute Aortic Dissection (IRAD).
Methods: Patient data were collected at 28 international referral centers from 1996 up to the present. Trends were analyzed amon...
The effects of medications on the outcome of aortic dissection remain poorly understood. We sought to address this by analyzing the International Registry of Acute Aortic Dissection (IRAD) global registry database. A total of 1,301 patients with acute aortic dissection (722 with type A and 579 with type B) with information on their medications at d...
The risk of acute type B aortic dissection is thought to increase with descending thoracic aortic diameter. Currently, elective repair of the descending thoracic aorta is indicated for an aortic diameter of 5.5 cm or greater. We sought to investigate the relationship between aortic diameter and acute type B aortic dissection, and the utility of aor...
Performing preoperative coronary angiography (CA) before surgical repair of a type A acute aortic dissection (TA-AAD) remains controversial. Although the information provided by CA may be useful in planning the surgical approach, the potential delay to surgery and complications of CA may confer added risk of death before definitive repair of the ao...
Serial echocardiographic follow-up of patients with a bicuspid aortic valve (BAV), in addition to providing assessment of valve dysfunction, can help identify those at risk of aortic complications. However, currently there is no standardized echocardiographic method for measuring the ascending aorta. We examined the echocardiograms of 45 patients w...
The Assessment of Cardioversion Using Transesophageal Echocardiography (ACUTE) II study compared enoxaparin with unfractionated heparin (UFH) as bridging therapy in patients with atrial fibrillation >2 days in duration who underwent transesophageal echocardiography-guided cardioversion. In the present study, the anticoagulant and anti-inflammatory...
Stanford Type B acute aortic dissection (TB-AAD) spares the ascending aorta and is optimally managed with medical therapy in the absence of complications. However, the treatment of TB-AAD with aortic arch involvement (AAI) remains an unresolved issue.
We examined 498 patients with TB-AAD enrolled in the International Registry of Acute Aortic Dissec...
Studies of aortic aneurysm patients have shown that the risk of rupture increases with aortic size. However, few studies of acute aortic dissection patients and aortic size exist. We used data from our registry of acute aortic dissection patients to better understand the relationship between aortic diameter and type A dissection.
We examined 591 ty...
Aortic dissection is a catastrophic medical emergency if not recognized early and treated promptly. There is no survival study
of untreated dissection to assess the natural history. Nevertheless, the prognosis has been shown to be poor
Figure 4.1.
This bar graph demonstrates the Stanford surgical mortality for aortic dissection from 1963 to 1992....
Follow-up survival studies in patients with acute type B aortic dissection have been restricted to a small number of patients in single centers. We used data from a contemporary registry of acute type B aortic dissection to better understand factors associated with adverse long-term survival.
We examined 242 consecutive patients discharged alive wi...
Earlier studies evaluating long-term survival in type A acute aortic dissection (TA-AAD) have been restricted to a small number of patients in single center experiences. We used data from a contemporary, multi-center international registry of TA-AAD patients to better understand factors associated with long-term survival.
We examined 303 consecutiv...
The clinical profiles, presentation, and outcomes of patients with acute aortic dissections and associated periaortic hematomas on aortic imaging have not been described in a large cohort. This study sought to assess the prognostic implications of periaortic hematomas in patients with aortic dissections and to identify factors associated with in-ho...
The definition, prevalence, outcomes, and appropriate treatment strategies for acute intramural hematoma (IMH) continue to be debated.
We studied 1010 patients with acute aortic syndromes who were enrolled in the International Registry of Aortic Dissection (IRAD) to delineate the prevalence, presentation, management, and outcomes of acute IMH by co...
The ACUTE Trial studied a transesophageal echocardiography (TEE)-guided strategy compared with a conventional strategy for management of patients with atrial fibrillation undergoing direct current cardioversion. The primary aim was to determine if patient functional capacity, measured by the Duke Activity Status Index (DASI), would differ between t...
The risk of acute aortic dissection (AAD) exhibits chronobiological variations with peak onset in the morning and in winter. However, it is not known whether the time of day or season of the year of the AAD affects clinical outcomes. We studied 1,032 patients enrolled in the International Registry of Acute Aortic Dissection from January 1997 to Dec...
Morbidity and mortality from aortic dissection remain high despite advances in diagnosis and treatment. Simple markers to identify patients at high risk for non-aortic complications of dissection are lacking. We investigated the effect of renal insufficiency on the presentation, complications, and outcome of patients with acute aortic dissection. W...
To evaluate the clinical characteristics and outcomes of patients with painless acute aortic dissection (AAD).
For this study conducted from 1997 to 2001, we searched the International Registry of Acute Aortic Dissection to identify patients with painless AAD (group 1). Their clinical features and in-hospital events were compared with patients who...
There are less data on the clinical and diagnostic imaging characteristics, management, and outcomes of patients with previous cardiac surgery (PCS) presenting with acute type A aortic dissection (AAD).
In 617 patients with AAD, we evaluated the differences in the clinical characteristics, management, and in-hospital outcomes of the cohorts with an...
Few data exist on gender-related differences in clinical presentation, diagnostic findings, management, and outcomes in acute aortic dissection (AAD).
Accordingly, we evaluated 1078 patients enrolled in the International Registry of Acute Aortic Dissection (IRAD) to assess differences in clinical features, management, and in-hospital outcomes betwe...
The clinical features and outcomes of elderly patients with acute type B aortic dissection (ABAD) are less well known. Accordingly, we sought to evaluate the clinical features and outcomes and derive a simple risk stratification rule for elderly with ABAD.
We categorized 383 patients with ABAD enrolled in the International Registry of Acute Aortic...
The goal of this study was to better characterize the young patient with aortic dissection (AoD).
Aortic dissection is unusual in young patients, and frequently associated with unusual presentations.
Data were collected on 951 patients diagnosed with AoD between January 1996 and November 2001. Two categories of patients, <40 years and >or=40 years,...
Bicuspid aortic valve (BAV) is associated with premature valve dysfunction and abnormalities of the ascending aorta. Limited data exist regarding serial changes of aortic dilation in patients with BAV. We studied paired transthoracic echocardiograms of 68 patients with BAV (mean age 44 years) and with at least 2 examinations >12 months apart (mean...
We sought to evaluate the clinical characteristics, management, and outcomes of elderly patients with acute type A aortic dissection.
Few data exist on the clinical manifestations and outcomes of acute type A aortic dissection in an elderly patient cohort.
We categorized 550 patients with type A aortic dissection enrolled in the International Regis...
As the prevalence of vascular disease increases, the use of invasive diagnostic and therapeutic vascular techniques such as percutaneous revascularization and coronary artery bypass grafting (CABG) will continue to grow. Although relatively rare, aortic dissection (AD) is a major complication of these procedures, and may be life threatening. Despit...
Acute aortic dissection is a life-threatening medical emergency associated with high rates of morbidity and mortality. Data are limited regarding the effect of recent imaging and therapeutic advances on patient care and outcomes in this setting.
To assess the presentation, management, and outcomes of acute aortic dissection.
Case series with patien...
This study demonstrated that, compared with normal controls, coronary artery dimensions are not increased appropriately for the increase in left ventricular mass in patients with nonischemic cardiomyopathy. The extent of coronary artery dimension to left ventricular mass mismatch did not correlate with the severity of heart failure.
Although both mitral leaflets contribute equally to the preservation of left ventricular function after mitral valve replacement, most surgeons routinely excise the anterior mitral leaflet. Possible disadvantages of leaflet retention are left ventricular outflow tract obstruction and interference with prosthetic valve motion. In 31 patients undergo...
To determine the relative value of two-dimensional (2D) echocardiography vs carotid duplex scanning and to devise an optimal, cost-effective diagnostic approach for older patients with cerebral ischemia, 68 consecutive patients in sinus rhythm who suffered focal cerebral ischemia were studied. All patients underwent 2D echocardiography and carotid...
We examined the clinical and echocardiographic characteristics of patients undergoing aortic valve replacement for aortic stenosis whose continuous wave Doppler studies showed abnormal intracavitary flow acceleration.
The clinical and Doppler echocardiographic records of 53 consecutive patients undergoing aortic valve replacement for aortic stenosi...
The diagnosis of myocardial contusion is often difficult, as traditional methods such as serial electrocardiograms, cardiac enzyme (creatine kinase [CK-MB]) analysis, and echocardiography lack sensitivity and specificity. Recent reports have shown that 111In labelled antimyosin scanning has high sensitivity for detecting cardiac injury. However, no...
To determine how frequently new wall-motion abnormalities that are indicative of ischemia accompany thallium redistribution, 47 consecutive patients underwent two-dimensional echocardiography during routine dipyridamole-thallium stress testing. A secondary aim of the study was to determine whether the addition of isometric handgrip exercises to the...
4,071 consecutive cardiac catheterizations were reviewed retrospectively to obtain 56 cases of pure mitral regurgitation among whom chest X-ray, electrocardiography and echocardiography had been performed within 10 days of catheterization. Mitral regurgitation was mild to moderate (1-2+) in 7 of the 56 cases while 49 had more severe regurgitation (...
Nonpenetrating chest trauma can result in a variety of cardiac injuries including acute valvular insufficiency. In this report, we describe a case of traumatic aortic insufficiency detected by transesophageal echocardiography (TEE). The capability of TEE to diagnose aortic dissection, demonstrate myocardial wall motion abnormalities, and assess val...
To determine the characteristics of infective endocarditis in our hospital, we reviewed all patients with that diagnosis at the University of Massachusetts Medical Center, Worcester, between 1981 and 1988. Of 113 patients with infective endocarditis, 56 (50%) had staphylococcal endocarditis. Despite aggressive medical and surgical therapy, in-hospi...
A previously healthy 20-year-old man underwent emergency surgery for repair of a right ventricular free wall laceration that was the result of a knife wound. A systolic murmur was first heard 1 month later, and two-dimensional echocardiography and color flow mapping demonstrated a communication between the left and right ventricle in the region of...
In brief: Regular exercise training results in a variety of cardiovascular adaptations including increases in left ventricular chamber size and wall thickness, and in resting vagal tone. These anatomic and physiologic changes may produce abnormalities in the ECG and echocardiogram. In the past, physicians often interpreted these changes as patholog...
Left ventricular (LV) mural thrombi have long been recognized as a complication of acute myocardial infarction (AMI). Recent echocardiographic studies suggest an incidence of 2 to 18% in patients with AMI. Anterior infarctions are found to have a much higher incidence of mural thrombus than inferior infarctions.1 Previous reports have noted conflic...
Remarkable diagnostic and therapeutic advances have occurred during the last twenty years in the management of critically ill patients. Many of these advances involve technological devices that improve diagnostic or therapeutic capabilities in the Intensive Care Unit (ICU). One area in which great strides have been made is the field of non-invasive...
Trained racing greyhounds are known to have cardiomegaly, higher mean arterial pressure and cardiac indices and lower systemic arterial resistances at rest than mongrel dogs. In order to distinguish between those hemodynamic and left ventricular functional characteristics that are inborn in the greyhound as opposed to those which are acquired throu...
We report a case of extensive myocardial calcification in a 50-year-old woman. It is rare when such cases are not associated with either metastatic deposition or infarction. However, this patient had a childhood illness of either rheumatic fever or some type of myocarditis, which most likely caused her extensive myocardial calcification.
The myocardial uptake of 15-(p-iodophenyl)-6- tellurapentadecanoic acid ( TPDA ) was studied in dogs during coronary occlusion and after reperfusion. In eight dogs with a 3 hour occlusion (Group A) with (n = 5) and without (n = 3) 30 minutes of reperfusion, iodine-125 TPDA uptake correlated well with microsphere myocardial blood flow over a wide ra...
Exercise-induced cardiac hypertrophy has been associated with normal resting left ventricula function and, after cessation of training, variable degrees of regression. The racing greyhound is as animal with cardiac hypertrophy said to be part congenital and part exercise-induced. Racing grcy hounds underwent serial cardiac catheterization three tim...
Forty-five normal subjects (36 control subjects, four wrestlers and five cross country runners) and 21 patients with symptoms of cardiovascular disease (11 without and 10 with significant arteriographic evidence for coronary artery disease (CAD) underwent maximal exercise treadmill tests. Twelve lead ECGs were recorded and the voltage amplitude of...
Despite much interest in the effects of exercise on the myocardium, and the need to develop animal models which mimic conditions leading to cardiac hypertrophy, little attention has been focused on the trained racing greyhound. The current study compared two groups of anesthetized trained racing greyhounds (a total of 20 animals, 12 of whom were ma...
Oxygen consumption was measured in 500 patients (151 F, 349 M, ages 12-84 yr.) undergoing routine cardiac catheterization. Sex, age, and heart rate were found to be the strongest predictors of oxygen consumption index (OCI). Males had higher OCI values than females at any age. Older patients of both sexes had lower OCI values than younger patients....
The flow-directed balloon-tipped catheter is extensively used in intensive care units, catheterization laboratories, operating rooms, and emergency wards. Major complications associated with its use have not been frequently reported. In a recent 2-year period in four hospitals, we identified five cases of fatal pulmonary hemorrhage resulting from b...
Citations
... The first necropsy report of George II (1760) raised suspicion towards this devastating disease [1]. More recent international registries such as the International Registry of Acute Aortic Dissection (IRAD) (1996-now), have put major effort in analysing the clinical presentation, treatment strategies, and outcomes of specific AD subtypes [2,3]. Together with the ongoing interest of international research collaborations in this disease entity and the ongoing development of newer ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/1006941581111298-1617084989314_Q64/Daniele-Bissacco.jpg)
... Conflicting results were reported on the relationship between baseline diameter and growth rate in BAV, with studies showing positive (25,26), negative (27,30) or absence (26,28,29,35,36) of association. These conflicting results might be due to differences in patients' characteristics (especially regarding the prevalence of aortic valve dysfunction), analyzed regions, imaging technique, and the frequent and heterogeneous use of thresholds to dichotomize both diameter and growth rate. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/272561669931025-1441995174429_Q64/Matthew-Parker-28.jpg)
![[object Object]](https://i1.rgstatic.net/ii/profile.image/1055766341509120-1628725719171_Q64/Amartya-Kundu.jpg)
... Regarding the time of symptom onset, they are usually classified as acute (up to 14 days), subacute (15-90 days), and chronic (> 90 days) [3] . Regarding the site of involvement, they are classified as Stanford [4][5][6][7][8][9] type A (with involvement of the ascending aorta) and type B (without involvement of the ascending aorta) [3][4][5] . ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/391675110281221-1470394031817_Q64/Dan-Gilon.jpg)
... growth, rupture, or death). 63 No longitudinal study has assessed the role of antithrombotic therapy after intramural haematoma, while case series suggest that anticoagulation does not impact intramural haematoma progression. Close monitoring with imaging techniques should be performed in all patients following acute aortic syndromes. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/11431281180957018-1691772231618_Q64/M-Zubair-5.jpg)
![[object Object]](https://i1.rgstatic.net/ii/profile.image/1154372151062528-1652235176656_Q64/Kevin-Harris-10.jpg)
... 5 Subsequent studies have also demonstrated its utility in patients with intermediate risk and low risk. 6,7 TCAR is a hybrid procedure that allows direct transcarotid stent delivery through surgical exposure of the common carotid artery with neuroprotection using dynamic flow reversal. The principal benefits of this procedure compared with traditional transfemoral carotid artery stenting (TF-CAS) derive from the avoidance of navigating the aortic arch and elimination of the need for unprotected deployment of a distal embolic protection device. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/282308264382471-1444318943523_Q64/Partha-Sardar.jpg)
![[object Object]](https://i1.rgstatic.net/ii/profile.image/272280982913044-1441928253613_Q64/Saurav-Chatterjee-2.jpg)
![[object Object]](https://i1.rgstatic.net/ii/profile.image/278461001289737-1443401684975_Q64/Dmitriy-Feldman-2.jpg)
![[object Object]](https://i1.rgstatic.net/ii/profile.image/272326767935554-1441939169820_Q64/Sammy-Elmariah.jpg)
... Although we first believed we could identify patients whose ascending aorta procedure was prophylactic on the basis of aortic diameter measurements, aortic imaging was not always reliable, although dilatation was largely confined to the proximal aorta. Further, although aortic diameter is the strongest driver of intervention, it is not the only factor considered. 25 For example, younger patients of short stature or with a bicuspid aortic valve, 26 connective tissue disorder, 27 or family history of aortic disease may be considered at higher risk than an older individual with a different risk of aortic rupture or dissection. 28 Likewise, porcelain aorta may be considered for repair at a smaller diameter (Table E4). ...
... Longterm endurance training increases venous return and BV, which explains the increase in preload. The eccentric growth of the left ventricle is stimulated, which typically increases new sarcomers, leading to myofibril elongation and chamber enlargement (Alpert et al. 1989, Effron 1989, Fleck 1988, Morganroth et al. 1975, Richey & Brown 1998. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/278996576161797-1443529375381_Q64/Ann-Ward-2.jpg)
... Although immediate surgical intervention significantly improves survival, surgical mortality of T(A)AD patients remains high [6]. The in-hospital mortality of T(A)AD was reported as high as 22% over the last decade [7]. Due to the complex etiology and high mortality, the treatment and perioperative management of T(A)AD remain a great challenge. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/272477351837712-1441975071472_Q64/Elise-Woznicki.jpg)
... As the performance of BAAD is various, the diagnosis of this disease and the identification of high-risk patients are difficult, and prognosis of each patient is unpredictable [Tolenaar 2013;Wilkinson 2013]. Old age, abnormal kidney function, female sex, and low albumin have been considered as risk prognostic markers [Tolenaar 2014;Ko 2015;Zeng 2016]. ...
... The surgical treatment of aortic dissection type A (AD) has sufficiently evolved during the last decade and the outcomes have improved significantly. The mortality rate decreased from 25% in 1995 to 18% in 2013 according to IRAD (International Registry of Acute Aortic Dissection) data [1]. Although surgery was effective in reducing mortality, aorta-related long-term complications continue to be a major cause of concern for patients surgically treated for AD. ...
