Clinical Assistant Professor, Medicine - Gastroenterology & Hepatology
Medical Education:Ross University School of Medicine (2011) West Indies
Board Certification: Gastroenterology, American Board of Internal Medicine (2017)
Fellowship:SUNY Downstate Medical Center (2017) NY
Board Certification: Internal Medicine, American Board of Internal Medicine (2014)
Residency:UCSF Fresno Internal Medicine Residency (2014) CA
Internship:UCSF Fresno Internal Medicine Residency (2012) CA
Increased E/A Ratio is a Risk Factor for the Formation of Pleural Effusion in Heart Failure.
PURPOSE: Pleural effusion is a common finding in patients with congestive heart failure (CHF). The pathogenesis of pleural effusion in heart failure is multifactorial. However, the role of right and left ventricular function assessed by ECHO cardiogram has not been studied. Therefore, we explored the association between right and left ventricular parameters on echocardiogram in patients with heart failure with and without pleural effusion diagnosed using CT scan of chest.METHODS: A case-control study was utilized to explore the objectives. Using strict exclusion criteria, patients admitted with a single diagnosis of acute CHF were stratified into those with and without pleural effusion using CT scan of chest done at admission. Multiple logistic regression analysis was used to identify significant factors associated with pleural effusion.RESULTS: Among the 70 patients, 36 (51%) had pleural effusions. The mean E/A ratio in patients with effusion (2.53±1.1) was significantly higher than in patients without effusion (1.15±0.9), p<0.01. Multiple logistic regression analysis showed that elevated E/A ratio was significantly associated with pleural effusion, OR 3.26 (95% CI 1.57-6.77, p<0.009). Left ventricular ejection fraction (LVEF), septal E', lateral E', and medial E/E' ratio were not significantly different in patients with and without pleural effusion.CONCLUSION: Elevated E/A ratio is a risk factor for the formation of pleural effusion in patients with heart failure.
View details for DOI 10.1007/s00408-019-00308-2
View details for PubMedID 31853638
The Impact of Hepatitis C Anti Viral Therapy Initiative on Overall Health Maintenance
NATURE PUBLISHING GROUP. 2018: S559–S560
View details for Web of Science ID 000464611002126