nutch_noindex
CANCELAR
/nutch_noindex

Cecilio (Leo) Lopez, MD

Especialidades médicas y/o especialidades quirúrgicas

Cardiology

Trabajo y educación

Educación

Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, 5/18/1987

Últimos años de residencia

Boston Childrens Hospital Pediatric Residency, Boston, MA, 6/30/1990

Subespecialidad

Boston Childrens Hospital Pediatric Cardiology Fellowship, Boston, MA, 6/30/1994

Certificado(s) de especialidad

Pediatric Cardiology, American Board of Pediatrics

Todo Publicaciones

How Well Does the Neonatal Heart Measure Up? Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography Lopez, L., Colan, S. D. 2019; 32 (7): 9068

View details for DOI 10.1016/j.echo.2019.04.423

View details for PubMedID 31272594

2019 ACC/AHA/ASE Key Data Elements and Definitions for Transthoracic Echocardiography: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Transthoracic Echocardiography) and the American Society of Echocardiography CIRCULATION-CARDIOVASCULAR IMAGING Douglas, P. S., Carabello, B. A., Lang, R. M., Lopez, L., Pellikka, P. A., Picard, M. H., Thomas, J. D., Varghese, P., Wang, T. Y., Weissman, N. J., Wilgus, R. 2019; 12 (7): e000027

View details for DOI 10.1161/HCI.0000000000000027

View details for Web of Science ID 000475945900002

View details for PubMedID 31233331

Challenges With Left Ventricular Functional Parameters: The Pediatric Heart Network Normal Echocardiogram Database. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography Frommelt, P. C., Minich, L. L., Trachtenberg, F. L., Altmann, K., Camarda, J., Cohen, M. S., Colan, S. D., Dragulescu, A., Frommelt, M. A., Johnson, T. R., Kovalchin, J. P., Lin, L., Mahgerefteh, J., Nutting, A., Parra, D. A., Pearson, G. D., Pignatelli, R., Sachdeva, R., Soriano, B. D., Spurney, C., Srivastava, S., Statile, C. J., Stelter, J., Stylianou, M., Thankavel, P. P., Tierney, E. S., van der Velde, M. E., Lopez, L. 2019

Abstract

The reliability of left ventricular (LV) systolic functional indices calculated from blinded echocardiographic measurements of LV size has not been tested in a large cohort of healthy children. The objective of this study was to estimate interobserver variability in standard measurements of LV size and systolic function in children with normal cardiac anatomy and qualitatively normal function.The Pediatric Heart Network Normal Echocardiogram Database collected normal echocardiograms from healthy children 18years old distributed equally by age, gender, and race. A core lab used two-dimensional echocardiograms to measure LV dimensions from which a separate data coordinating center calculated LV volumes and systolic functional indices. To evaluate interobserver variability, two independent expert pediatric echocardiographic observers remeasured LV dimensions on a subset of studies, while blinded to calculated volumes and functional indices.Of 3,215 subjects with measurable images, 552 (17%) had a calculated LV shortening fraction (SF)<25% and/or LV ejection fraction (EF)<50%; the subjects were significantly younger and smaller than those with normal values. When the core lab and independent observer measurements were compared, individual LV size parameter intraclass correlation coefficients were high (0.81-0.99), indicating high reproducibility. The intraclass correlation coefficients were lower for SF (0.24) and EF (0.56). Comparing reviewers, 40/56 (71%) of those with an abnormal SF and 36/104 (35%) of those with a normal SF based on core lab measurements were calculated as abnormal from at least one independent observer. In contrast, an abnormal EF was less commonly calculated from the independent observers' repeat measures; only 9/47 (19%) of those with an abnormal EF and 8/113 (7%) of those with a normal EF based on core lab measurements were calculated as abnormal by at least one independent observer.Although blinded measurements of LV size show good reproducibility in healthy children, subsequently calculated LV functional indices reveal significant variability despite qualitatively normal systolic function. This suggests that, in clinical practice, abnormal SF/EF values may result in repeat measures of LV size to match the subjective assessment of function. Abnormal LV functional indices were more prevalent in younger, smaller children.

View details for DOI 10.1016/j.echo.2019.05.025

View details for PubMedID 31351792

Cardiovascular imaging in Turner syndrome: state-of-the-art practice across the lifespan. Heart (British Cardiac Society) Mortensen, K. H., Young, L., De Backer, J., Silberbach, M., Collins, R. T., Duijnhouwer, A. L., Pandya, B., Gravholt, C. H., Lopez, L., Roos-Hesselink, J. W. 2018; 104 (22): 182331

Abstract

Cardiovascular imaging is essential to providing excellent clinical care for girls and women with Turner syndrome (TS). Congenital and acquired cardiovascular diseases are leading causes of the lifelong increased risk of premature death in TS. Non-invasive cardiovascular imaging is crucial for timely diagnosis and treatment planning, and a systematic and targeted imaging approach should combine echocardiography, cardiovascular magnetic resonance and, in select cases, cardiac CT. In recent decades, evidence has mounted for the need to perform cardiovascular imaging in all females with TS irrespective of karyotype and phenotype. This is due to the high incidence of outcome-determining lesions that often remain subclinical and occur in patterns specific to TS. This review provides an overview of state-of-the-art cardiovascular imaging practice in TS, by means of a review of the most recent literature, in the context of a recent consensus statement that has highlighted the role of cardiovascular diseases in these females.

View details for PubMedID 30228249

Cardiovascular Health in Turner Syndrome: A Scientific Statement From the American Heart Association. Circulation. Genomic and precision medicine Silberbach, M., Roos-Hesselink, J. W., Andersen, N. H., Braverman, A. C., Brown, N., Collins, R. T., De Backer, J., Eagle, K. A., Hiratzka, L. F., Johnson, W. H., Kadian-Dodov, D., Lopez, L., Mortensen, K. H., Prakash, S. K., Ratchford, E. V., Saidi, A., van Hagen, I., Young, L. T. 2018; 11 (10): e000048

Abstract

Girls and women with Turner syndrome face a lifelong struggle with both congenital heart disease and acquired cardiovascular conditions. Bicuspid aortic valve is common, and many have left-sided heart obstructive disease of varying severity, from hypoplastic left-sided heart syndrome to minimal aortic stenosis or coarctation of the aorta. Significant enlargement of the thoracic aorta may progress to catastrophic aortic dissection and rupture. It is becoming increasingly apparent that a variety of other cardiovascular conditions, including early-onset hypertension, ischemic heart disease, and stroke, are the major factors reducing the life span of those with Turner syndrome. The presentations and management of cardiovascular conditions in Turner syndrome differ significantly from the general population. Therefore, an international working group reviewed the available evidence regarding the diagnosis and treatment of cardiovascular diseases in Turner syndrome. It is recognized that the suggestions for clinical practice stated here are only the beginning of a process that must also involve the establishment of quality indicators, structures and processes for implementation, and outcome studies.

View details for DOI 10.1161/HCG.0000000000000048

View details for PubMedID 30354301