Sonika Patel

Kaiser Permanente

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Safanah Siddiqui

Medical University of South Carolina

Van‐Khue Ton

Massachusetts General Hospital

Keneil Shah

Rutgers New Jersey Medical School

James F. Childress

University of Virginia

Kiran Motwani

University of Maryland, Baltimore

Xinyuan Ning

University of Maryland, Baltimore

Paul K. J. Han

National Cancer Institute

Gautam Ramani

University of Maryland, Baltimore

Charles Resor

Tufts Medical Center

Mariem A. Sawan

Emory University

Cooperative Institutions

Inserm

University of Maryland, Baltimore

Assistance Publique – Hôpitaux de Paris

University of Milan

University of Maryland Medical Center

University of Toronto

Icahn School of Medicine at Mount Sinai

Harvard University

Universitat de Barcelona

Istituti di Ricovero e Cura a Carattere Scientifico

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A Case of Bartonella Quintana Culture-Negative Endocarditis

American Journal of Case Reports (2019)

Sonika Patel Mary Richert Rachel White Tyler Lambing Paul Saleeb

BACKGROUND:Culture-negative Bartonella quintana endocarditis is challenging to diagnose and is associated with high mortality rates. Diagnostic confirmation of Bartonella quintana infection requires specialized assays, as identifying Bartonella henselae endocarditis by serology can be difficult due to the high rate of serological cross-reactivity. This is a case report of culture-negative Bartonella quintana endocarditis that was diagnosed with epidemiologic data, histology, and nucleic acid amplification testing. CASE REPORT:A 28-year-old man with a history of homelessness was admitted to hospital with worsening productive cough, weight loss, and abdominal pain. A transthoracic echocardiogram (TTE) showed pulmonary valve vegetation and several aortic valve vegetations. His hospital course was complicated by cardiogenic shock and septic shock requiring transfer to a tertiary care medical intensive care unit. Although blood cultures remained negative for bacterial infection, serology testing was positive for Bartonella henselae and Bartonella quintana IgM and IgG. Nucleic acid amplification testing for 16S ribosomal RNA (rRNA) using valve tissue was diagnostic for Bartonella quintana. CONCLUSIONS:This case of culture-negative Bartonella quintana endocarditis demonstrates the use of diagnostic nucleic acid amplification methods to confirm the diagnosis.

Bartonella

10.12659/ajcr.915215

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Citations (9)

Financial Overview of an LVAD Program under Global Bundled Payment Model

Journal of Cardiac Failure (2019)

Sonika Patel Mariem A. Sawan Lynn Dees Gautam Ramani Van‐Khue Ton

10.1016/j.cardfail.2019.07.471

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Citations (1)

LEADLESS PACEMAKER INSERTION COMPLICATED BY RIGHT VENTRICULAR PSEUDOANEURYSM

Journal of the American College of Cardiology (2020)

Sonika Patel Safanah Siddiqui

Pseudoaneurysm

Right heart

10.1016/s0735-1097(20)33886-9

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A TEMPORAL EVALUATION AND COMPARISON OF HOSPITALIZATION COSTS OF TRANSCATHETER AORTIC VALVE REPLACEMENT AND SURGICAL AORTIC VALVE REPLACEMENT FROM 2016 TO 2020

Journal of the American College of Cardiology (2022)

Jonathan Na James F. Childress Michael Sokolow Paul K. J. Han Gregory Norcross

Valve replacement

10.1016/s0735-1097(22)01690-4

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Using Fluorodeoxyglucose (18F-FDG) PET/CT to monitor treatment response in cardiac sarcoidosis

Journal of Cardiology Case Reports (2021)

Sonika Patel Mariem A. Sawan Vahab Nemati Wengen Chen Paul K. J. Han

Rationale: Isolated cardiac sarcoidosis (CS) is a life-threatening condition that can be difficult to diagnose.This case report provides an example in which 18F-FDGand 82Rb-PET/CT studies were used to not only diagnose, but also to monitor and alter treatment for a patient with CS. Patient concerns:A 51-year-old male presented after witnessed cardiac arrest.Diagnosis: EKG was notable for frequent, polymorphic premature ventricular contractions and new right bundle branch block with left anterior fascicular block.TTE revealed EF of 45%.Coronary angiography was unremarkable.MRI one month later revealed EF of 20% with patchy delayed enhancement at the anterior wall and inferior septum at the mid-level, patchy right ventricular wall enhancement, and extensive transmural enhancement of the apex suggestive of CS. 18F-FDG-PET/CT showed foci of increased metabolic activity throughout the left ventricle (mainly in the inferior and anteroseptal walls).Myocardial perfusion imaging using 82Rb-PET/CT showed resting hypoperfusion in the entire inferior and mid-to-basal anteroseptal regions with a metabolism (18F-FDG) and perfusion (82Rb) mismatched pattern.CS was diagnosed based on new conduction disease, unexplained ventricular arrhythmias and heart failure, typical cardiac MRI findings, as well as 18F-FDG uptake in the anteroinferior walls with perfusion defect.While the gold standard test is the presence of non-caseating granulomas in cardiac tissues, EMB is low yield and was not performed in our patient. Interventions:The patient received an ICD and was treated with prednisone and mycophenolate.Repeat PET/CT one month later showed resolution of heterogeneous activity with persistent perfusion defect and the regimen was tapered.Six months later, he suffered a second cardiac arrest with an interval worsening of the inflammatory phase of CS and persistent mismatched perfusion pattern.Prednisone and mycophenolate doses were increased.Outcomes: Most recent PET/CT was notable for resolution of inflammation with persistent perfusion defect.Therefore, the patient continued his immunosuppressive regimen and remains arrhythmia free.Lessons: This case illustrates successful use of sequential 18F-FDG-PET/CT studies for diagnosis and monitoring of CS.Future studies are needed to determine the role of combined perfusion and metabolic PET/CT findings for guiding alterations in immunosuppressive therapy.

Cardiac sarcoidosis

Fluorodeoxyglucose

PET-CT

10.15761/jccr.1000167

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Comorbidity Burden and Adverse Outcomes After Transcatheter Aortic Valve Replacement

Journal of the American Heart Association (2021)

Daniel R. Feldman Mikhail Romashko Benjamin Koethe Sonika Patel Hassan Rastegar

Background Transcatheter aortic valve replacement (TAVR) has become the preferred treatment for symptomatic patients with aortic stenosis and elevated procedural risk. Many deaths following TAVR are because of noncardiac causes and comorbid disease burden may be a major determinant of postprocedure outcomes. The prevalence of comorbid conditions and associations with outcomes after TAVR has not been studied. Methods and Results This was a retrospective single-center study of patients treated with TAVR from January 2015 to October 2018. The association between 21 chronic conditions and short- and medium-term outcomes was assessed. A total of 341 patients underwent TAVR and had 1-year follow-up. The mean age was 81.4 (SD 8.0) years with a mean Society of Thoracic Surgeons predicted risk of mortality score of 6.7% (SD 4.8). Two hundred twenty (65%) patients had ≥4 chronic conditions present at the time of TAVR. There was modest correlation between Society of Thoracic Surgeons predicted risk of mortality and comorbid disease burden (r=0.32, P<0.001). After adjusting for Society of Thoracic Surgeons predicted risk of mortality, age, and vascular access, each additional comorbid condition was associated with increased rates of 30-day rehospitalizations (odds ratio, 1.21; 95% CI, 1.02-1.44), a composite of 30-day rehospitalization and 30-day mortality (odds ratio, 1.20; 95% CI, 1.02-1.42), and 1-year mortality (odds ratio, 1.29; 95% CI, 1.05-1.59). Conclusions Comorbid disease burden is associated with worse clinical outcomes in high-risk patients treated with TAVR. The risks associated with comorbid disease burden are not adequately captured by standard risk assessment. A systematic assessment of comorbid conditions may improve risk stratification efforts.

Valve replacement

10.1161/jaha.120.018978

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Citations (9)

Carpal Tunnel Syndrome and Future Amyloidosis

Journal of the American College of Cardiology (2019)

Van‐Khue Ton Sonika Patel Stephen S. Gottlieb

10.1016/j.jacc.2019.04.055

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Citations (4)

Piperacillin-induced Thrombocytopenia in a Dual Heart and Kidney Transplant Patient: A Case Report

Transplantation Proceedings (2017)