Kim A. Eagle

Bio: Kim A. Eagle is an academic researcher from University of Michigan. The author has contributed to research in topics: Aortic dissection & Myocardial infarction. The author has an hindex of 129, co-authored 823 publications receiving 75160 citations. Previous affiliations of Kim A. Eagle include University of Wisconsin Hospital and Clinics & Spaulding Rehabilitation Hospital.

Coronary Revascularization before Noncardiac Surgery

Abstract: The evaluation of cardiac risk before noncardiac surgical procedures and interventions aimed toward reducing that risk have become an integral part of the contemporary practice of medicine. In the ...

Pacemaker recycling: A notion whose time has come.

Abstract: The purpose of this paper is to summarize the need, feasibility, safety, legality, and ethical perspectives of pacemaker reutilization in low- and middle-income countries (LMICs). It will also describe, in-depth, Project My Heart Your Heart (PMHYH) as a model for pacemaker reuse in LMICs. The primary source of the discussion points in this paper is a collection of 14 publications produced by the research team at the University of Michigan and its collaborative partners. The need for pacemaker reutilization in LMICs is evident. Numerous studies show that the concept of pacemaker reutilization in LMICs is feasible. Infection and device malfunction are the main concerns in regard to pacemaker reutilization, yet many studies have shown that pacemaker reuse is not associated with increased infection risk or higher mortality compared with new device implantation. Under the right circumstances, the ethical and legal bases for pacemaker reutilization are supported. PMHYH is a proof of concept pacemaker donation initiative that has allowed funeral home and crematory directors to send explanted devices to an academic center for evaluation and re-sterilization before donation to underserved patients in LMICs. The time is now to pursue large-scale studies and trials of pacemaker reuse for the betterment of society. PMHYH is leading the way in the effort and is poised to conduct a prospective randomized, non-inferiority, multicenter study to confirm the clinical efficacy and safety of pacemaker reuse, for clinical and legal support.

Is the Optimal Management of Acute Type A Aortic Intramural Hematoma Evolving

Abstract: Aortic intramural hematoma (IMH) has been considered a variant or precursor of aortic dissection with no entry tear or false lumen flow; however, the pathophysiological mechanism, risk factors, and evolution are rather different from those of classic dissection. Hematoma forms within the aortic wall as a result of either hemorrhage of the vasa vasorum or, less commonly, an intimal fracture of an atherosclerotic plaque. The marked relationship between IMH and atherosclerotic disease explains the older age of these patients compared with those with aortic dissection, the higher incidence of arterial hypertension, and the tendency for descending aorta involvement (50% to 60%).1–5 Article see p 2046 Evolution of the IMH in the acute phase may be highly dynamic, with bleeding of the aorta wall increasing progressively, stabilizing or provoking disruption of the intima, which may lead to a classic or localized dissection. This intimal disruption may be seen in the early hours of presentation or some months after the intramural bleeding has occurred2,5–8 (Figure 1). For this reason, IMH has been considered a precursor of aortic dissection. However, 2 significant differences between IMH and aortic dissection appear to be well defined. First, IMH might regress spontaneously with time4,5,7,9 (Figure 2). Second, fewer severe cardiovascular complications, valvular aortic regurgitation, and visceral or peripheral ischemia are present.2,8 Therefore, IMH almost resembles an aortic dissection, but with a distinct, unique pathological nature. Figure 1. Acute type A IMH (white arrows) with ascending aorta diameter of 45 mm and intramural thickness of 8 mm (left). After 6 days, the ascending aorta dissection was visualized. Black arrows show the intimal flap (right). Figure 2. Acute type A IMH (white arrow) with extension to descending aorta. Aortic diameter was 54 mm, and IMH thickness was 12 mm (left). After 6 months of medical …

Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure

Abstract: The National High Blood Pressure Education Program presents the complete Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Like its predecessors, the purpose is to provide an evidence-based approach to the prevention and management of hypertension. The key messages of this report are these: in those older than age 50, systolic blood pressure (BP) of greater than 140 mm Hg is a more important cardiovascular disease (CVD) risk factor than diastolic BP; beginning at 115/75 mm Hg, CVD risk doubles for each increment of 20/10 mm Hg; those who are normotensive at 55 years of age will have a 90% lifetime risk of developing hypertension; prehypertensive individuals (systolic BP 120-139 mm Hg or diastolic BP 80-89 mm Hg) require health-promoting lifestyle modifications to prevent the progressive rise in blood pressure and CVD; for uncomplicated hypertension, thiazide diuretic should be used in drug treatment for most, either alone or combined with drugs from other classes; this report delineates specific high-risk conditions that are compelling indications for the use of other antihypertensive drug classes (angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, beta-blockers, calcium channel blockers); two or more antihypertensive medications will be required to achieve goal BP (<140/90 mm Hg, or <130/80 mm Hg) for patients with diabetes and chronic kidney disease; for patients whose BP is more than 20 mm Hg above the systolic BP goal or more than 10 mm Hg above the diastolic BP goal, initiation of therapy using two agents, one of which usually will be a thiazide diuretic, should be considered; regardless of therapy or care, hypertension will be controlled only if patients are motivated to stay on their treatment plan. Positive experiences, trust in the clinician, and empathy improve patient motivation and satisfaction. This report serves as a guide, and the committee continues to recognize that the responsible physician's judgment remains paramount.

Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.

Abstract: The rapid technological developments of the past decade and the changes in echocardiographic practice brought about by these developments have resulted in the need for updated recommendations to the previously published guidelines for cardiac chamber quantification, which was the goal of the joint writing group assembled by the American Society of Echocardiography and the European Association of Cardiovascular Imaging. This document provides updated normal values for all four cardiac chambers, including three-dimensional echocardiography and myocardial deformation, when possible, on the basis of considerably larger numbers of normal subjects, compiled from multiple databases. In addition, this document attempts to eliminate several minor discrepancies that existed between previously published guidelines.

ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease

Abstract: PREAMBLE......e4 APPENDIX 1......e121 APPENDIX 2......e122 APPENDIX 3......e124 REFERENCES......e124 It is important that the medical profession play a significant role in critically evaluating the use of diagnostic procedures and therapies as they are introduced in the detection, management,

ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction—Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction)

Abstract: Although considerable improvement has occurred in the process of care for patients with ST-elevation myocardial infarction (STEMI), room for improvement exists.[1–3][1][][2][][3] The purpose of the present guideline is to focus on the numerous advances in the diagnosis and management of patients