Tara Dourian

Bio: Tara Dourian is an academic researcher from McGill University. The author has contributed to research in topics: Predictive value of tests & Cohort study. The author has an hindex of 3, co-authored 3 publications receiving 220 citations. Previous affiliations of Tara Dourian include Jewish General Hospital.

Meta-analysis of usefulness of d-dimer to diagnose acute aortic dissection.

Abstract: Numerous studies have examined whether plasma D-dimer (DD) can be used to identify patients with acute aortic dissection (AAD). These studies have been inconclusive because of their limited sample sizes and the different cut-off values employed. We aimed to conduct a systematic review and meta-analysis to examine the utility of plasma DD as a screening tool for AAD. We systematically searched EMBASE and MEDLINE and hand-searched relevant articles to identify studies investigating plasma DD as a screening tool for AAD. A value of 500 ng/ml was defined as the threshold for a positive plasma DD finding because it is widely used for ruling out pulmonary emboli. Using DerSimonian-Laird random-effects models we pooled data across studies to estimate sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios (LRs). We identified 7 studies involving 298 subjects with AAD and 436 without. When data were pooled across studies, sensitivity (0.97, 95% confidence interval [CI] 0.94 to 0.99) and negative predictive value (0.96, 95% CI 0.93 to 0.98) were high. Specificity (0.56, 95% CI 0.51 to 0.60) and positive predictive value (0.60, 95% CI 0.55 to 0.66) were low. Negative LR showed an excellent discriminative ability (0.06, 95% CI 0.03 to 0.12), whereas positive LR did not (2.43, 95% CI 1.89 to 3.12). In conclusion, our meta-analysis suggests that plasma DD <500 ng/ml is a useful screening tool to identify patients who do not have AAD. Plasma DD may thus be used to identify subjects who are unlikely to benefit from further aortic imaging.

2014 ESC Guidelines on the Diagnosis and Treatment of Aortic Diseases

Abstract: Autores/Miembros del Grupo de Trabajo: Raimund Erbel (Coordinador) (Alemania), Victor Aboyans (Coordinador) (Francia), Catherine Boileau (Francia), Eduardo Bossone (Italia), Roberto Di Bartolomeo (Italia), Holger Eggebrecht (Alemania), Arturo Evangelista (Espana), Volkmar Falk (Suiza), Herbert Frank (Austria), Oliver Gaemperli (Suiza), Martin Grabenwoger (Austria), Axel Haverich (Alemania), Bernard Iung (Francia), Athanasios John Manolis (Grecia), Folkert Meijboom (Paises Bajos), Christoph A. Nienaber (Alemania), Marco Roffi (Suiza), Herve Rousseau (Francia), Udo Sechtem (Alemania), Per Anton Sirnes (Noruega), Regula S. von Allmen (Suiza) y Christiaan J.M. Vrints (Belgica)

2014 ESC Guidelines on the diagnosis and treatment of aortic diseases

Abstract: 3D : three-dimensional AAA : abdominal aortic aneurysm AAS : acute aortic syndrome ACC : American College of Cardiology ACE : angiotensin-converting enzyme AD : Aortic dissection ADAM : Aneurysm Detection and Management AHA : American Heart Association AJAX : Amsterdam Acute Aneurysm AO : aorta AOS : aneurysms-osteoarthritis syndrome ARCH : Aortic Arch Related Cerebral Hazard ATS : arterial tortuosity syndrome BAV : bicuspid aortic valve BSA : body surface area CI : confidence interval CoA : coarctation of the aorta CPG : Committee for Practice Guidelines CSF : cerebrospinal fluid CT : computed tomography DREAM : Dutch Randomized Aneurysm Management DUS : Doppler ultrasound EBCT : electron beam computed tomography ECG : electrocardiogram EDS : Ehlers-Danlos syndrome EDSIV : Ehlers-Danlos syndrome type IV ESC : European Society of Cardiology ESH : European Society of Hypertension EVAR : endovascular aortic repair FDG : 18F-fluorodeoxyglucose FL : false lumen GCA : giant cell arteritis GERAADA : German Registry for Acute Aortic Dissection Type A IAD : iatrogenic aortic dissection IMH : intramural haematoma INSTEAD : Investigation of Stent Grafts in Patients with type B Aortic Dissection IRAD : International Registry of Aortic Dissection IVUS : intravascular ultrasound LCC : left coronary cusp LDS : Loeys-Dietz syndrome MASS : Multicentre Aneurysm Screening Study MESA : Multi-Ethnic Study of Atherosclerosis MPR : multiplanar reconstruction MRA : magnetic resonance angiography MRI : magnetic resonance imaging MSCT : multislice computed tomography NA : not applicable NCC : non-coronary cusp ns-TAAD : non-syndromic thoracic aortic aneurysms and dissection OR : odds ratio OVER : Open Versus Endovascular Repair OxVasc : Oxford Vascular study PARTNER : Placement of AoRtic TraNscathetER Valves PAU : penetrating aortic ulcer PICSS : Patent Foramen Ovale in Cryptogenic Stroke study PET : positron emission tomography RCCA : right common carotid artery RCC : right coronary cusp RCT : randomized, clinical trial RR : relative risk SIRS : systemic inflammatory response SMC : smooth muscle cell TAA : thoracic aortic aneurysm TAAD : thoracic aortic aneurysms and dissection TAI : traumatic aortic injury TEVAR : thoracic endovascular aortic repair TGF : transforming growth factor TI : separate thyroid artery (A. thyroidea) TL : true lumen TOE : transoesophageal echocardiography TS : Turner Syndrome TTE : transthoracic echocardiography UKSAT : UK Small Aneurysm Trial ULP : ulcer-like projection WARSS : Warfarin-Aspirin Recurrent Stroke Study Guidelines summarize and evaluate all available evidence at the time of the writing process, on a particular issue with the aim of assisting health professionals in selecting the best management strategies for an individual patient, with a given condition, taking into account the impact on outcome, as well as the risk-benefit-ratio of particular diagnostic or therapeutic means. Guidelines and recommendations should help the health professionals to make decisions in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate. A great number of Guidelines have been issued in recent years by the European Society of Cardiology (ESC) as well as by other societies and organisations. Because of the impact on clinical practice, quality criteria for the development of guidelines have been established in order to make all decisions …

Cardiovascular Disease in Ageing: An Overview on Thoracic Aortic Aneurysm as an Emerging Inflammatory Disease.

Abstract: Medial degeneration associated with thoracic aortic aneurysm and acute aortic dissection was originally described by Erdheim as a noninflammatory lesion related to the loss of smooth muscle cells and elastic fibre fragmentation in the media. Recent evidences propose the strong role of a chronic immune/inflammatory process in aneurysm evocation and progression. The coexistence of inflammatory cells with markers of apoptotic vascular cell death in the media of ascending aorta with aneurysms and type A dissections raises the possibility that activated T cells and macrophages may contribute to the elimination of smooth muscle cells and degradation of the matrix. On the other hand, several inflammatory pathways (including TGF-β, TLR-4 interferon-γ, chemokines, and interferon-γ) seem to be involved in the medial degeneration related to aged and dilated aorta. This is an overview on thoracic aortic aneurysm as an emerging inflammatory disease.

Out of Balance—Systemic Iron Homeostasis in Iron-Related Disorders

Abstract: Iron is an essential element in our daily diet. Most iron is required for the de novo synthesis of red blood cells, where it plays a critical role in oxygen binding to hemoglobin. Thus, iron deficiency causes anemia, a major public health burden worldwide. On the other extreme, iron accumulation in critical organs such as liver, heart, and pancreas causes organ dysfunction due to the generation of oxidative stress. Therefore, systemic iron levels must be tightly balanced. Here we focus on the regulatory role of the hepcidin/ferroportin circuitry as the major regulator of systemic iron homeostasis. We discuss how regulatory cues (e.g., iron, inflammation, or hypoxia) affect the hepcidin response and how impairment of the hepcidin/ferroportin regulatory system causes disorders of iron metabolism.