Noelle N. Mann
· MDStony Brook University · Cardiology
Active 1993–2025
About
Dr. Noelle N Mann is a Clinical Professor of Medicine at Stony Brook University. Her expertise lies in cardiology, with a focus on nuclear cardiology and noninvasive cardiac imaging. She has contributed to the evaluation of myocardial ischemia and viability through various imaging techniques and has been involved in academic activities related to women's heart health. Her educational background includes a fellowship in IM-Cardiology at Stony Brook University Medical Center completed in 2001, a residency in Internal Medicine at Icahn School of Medicine - Mount Sinai Medical Center completed in 1998, and medical school at Mount Sinai School of Medicine CUNY, graduating in 1995. Dr. Mann holds board certifications in Adult Comprehensive Echocardiography, Nuclear Cardiology, Cardiovascular Disease, and Internal Medicine. Her professional work encompasses both clinical practice and academic research, contributing to the field of cardiology through her expertise and publications.
Research topics
- Cardiology
- Medicine
- Internal medicine
- Radiology
- Intensive care medicine
Selected publications
Utility of perioperative beta blocker therapy in patients undergoing cardiac surgery
European Heart Journal · 2025-11-01
articleAbstract Background Although there is abundant literature supporting the clinical utility of beta blocker initiation before non-cardiac surgery in high-risk patient populations, data supporting the routine initiation or continuation of beta blockers before and after cardiac surgery remains unclear. Purpose To perform a systematic review and meta-analysis evaluating the use of peri-operative beta-blockers in patients undergoing cardiac surgery and evaluate clinical outcomes such as rates of postoperative arrhythmias, cerebrovascular accidents (CVA), and in-hospital and all-cause mortality. Methods A literature search was performed using the databases PubMed, Embase, and Web of Science, identifying studies that evaluated the association of pre-operative initiation and continuation of beta-blocker with clinical endpoints in patients undergoing cardiac surgery. The endpoints of interest included development of post-operative atrial fibrillation (AFib), supraventricular tachycardia (SVT), in-hospital mortality, all-cause mortality, and CVA. Results 19 studies with 3749 patients (2018 treated with beta blockers, 1731 not treated with beta blockers) met inclusion criteria. The average follow-up duration was 12 days (ranging from 1 day to 90 days), the mean age was 63.4 years, 70% were men. Cardiac surgeries including coronary artery bypass grafting, aortic valve replacement, and mitral valve replacement. In patients undergoing cardiac surgery, perioperative use of beta blockers was associated with a significantly lower risk of post-op AFib (OR 0.49, 95% CI 0.31-0.78; P<0.01). Subgroup analysis shows this association was primarily with use of IV Landiolol and with a non-statistically significant trend toward lower risk of AFib in patients initiated or maintained on oral beta blockers (OR 0.29, 95% CI 0.20-0.41; p<0.01; OR 0.62, 95% CI 0.33-1.16; P=0.06). There was a statistically significantly lower risk of developing SVT after cardiac surgery in patients treated with beta-blockers (OR 0.45, 95% CI 0.24-0.86, P=0.02). The association between beta blocker use and other clinical endpoints including the risk of CVA, in-hospital mortality, and all-cause mortality were not statistically significant, however there was a trend toward lower risk of both in-hospital and all-cause mortality in patients who were treated with beta-blockers compared to those who were not (OR 0.46, 95% CI 0.16-1.36; P=0.16; OR 0.50, 95% CI 0.17-1.47; P=0.21). Discussion: This meta-analysis demonstrates that in patients who are undergoing cardiac surgery, preoperative initiation of beta-blockers, particularly IV Landilol, or continuation of chronic beta-blockers is associated with a lower risk of adverse cardiovascular outcomes, particularly post-operative AFib and SVT. The use of beta-blockers may also be associated with a mortality benefit, however additional high-quality studies with extended follow-up time and monitoring are needed to fully elucidate this association.Figure 1 Figure 2
Abstract 4351680: Madly Dangerous: Unmasking the Arrhythmogenic Nature of Valvular Heart Disease
Circulation · 2025-11-03
articleA 36-year-old woman (G2P1) at 8 weeks gestation, with a few days of nonbilious vomiting, presented following an out-of-hospital ventricular fibrillation (VF) cardiac arrest. Return of spontaneous circulation was achieved after multiple defibrillation attempts. Given ongoing sustained ventricular tachycardia (VT), she was intubated and cannulated for extracorporeal membrane oxygenation (ECMO). Initial transthoracic echocardiography revealed reduced left ventricular ejection fraction (LVEF) and mitral annular disjunction (MAD), with a peak lateral mid-systolic velocity of 20 cm/s (Figure 1). Left heart catheterization showed normal coronary arteries and a right heart catheterization raised concerns for intravascular volume depletion. Her hospital course was complicated by abdominal distension and a drop in hemoglobin, raising suspicion for peritoneal bleeding. A CT aortogram confirmed hemoperitoneum, and a transvaginal ultrasound showed no intrauterine pregnancy. She underwent emergent surgical evacuation of a ruptured ectopic pregnancy with right salpingectomy. Postoperatively, she experienced persistent polymorphic VT and prolonged QTc. Amiodarone was discontinued and she was initiated on lidocaine for VT management. Notably, a Holter monitor four years prior had shown non-sustained monomorphic and polymorphic VT. A cardiac MRI (CMR) at that time demonstrated normal LVEF with evidence of myocardial fibrosis, but the patient deferred treatment and was lost to follow-up. Following stabilization, the patient’s LVEF recovered, and she was successfully decannulated from ECMO. Repeat CMR prior to discharge confirmed bileaflet mitral valve prolapse with MAD measuring 8.5 mm in length (Figure 2). She was transitioned to oral antiarrhythmic therapy and underwent subcutaneous implantable cardioverter-defibrillator (ICD) placement. Outpatient genetic testing was negative. MAD is a recognized substrate for out-of-hospital cardiac arrest. In this patient, the presence of MAD, along with a catecholamine surge from a ruptured ectopic pregnancy and acute hypokalemia from vomiting, likely created a highly proarrhythmic state. High-risk features in MAD associated with arrhythmic events include bileaflet mitral valve prolapse, myocardial fibrosis on CMR, MAD length equal to or >8.5 mm, and peak lateral mid-systolic velocity >16 cm/s. ICD implantation should be considered in patients with these characteristics, particularly those with sustained ventricular arrhythmias.
European Heart Journal · 2024-10-01
reviewOpen accessSenior authorAbstract Introduction Aortic stenosis (AS) and cardiac amyloidosis (CA) frequently coexist and is commonly observed in older individuals referred for aortic valve replacement (AVR). However, the association of CA with adverse outcomes after AVR has not been well established. Purpose This meta-analysis aimed to evaluate the association of CA with adverse cardiovascular outcomes in patients with severe AS after undergoing AVR. Methods A literature search was performed for studies evaluating patients with severe AS undergoing AVR, comparing clinical endpoints on follow-up for patients with and without CA. The clinical endpoints included all-cause mortality and heart failure (HF) hospitalization. Databases searched included Ovid MEDLINE, Embase, and Web of Science. Subgroup analysis was performed for short term (<30 days) and long term (>30 days) mortality. The search was not restricted to time or publication status. Results Five studies including 1,105 patients with severe AS (111 with concurrent CA, 904 without CA) met inclusion criteria. The mean follow-up duration was 24.6 months, mean age was 81.2 years and 55.4% were men. Mean echocardiographic aortic valve parameters included valve area of 0.715cm2, mean gradient of 41.8 mmHg, and peak velocity of 4.2m/s. The mean left ventricular ejection fraction was 58%. All except 1 study included only patients with ATTR CA while excluding other causes of CA. There was no statistically significant difference in all-cause mortality between patients with and without CA following AVR, both in short-term (OR 0.94; 95% CI 0.17-5.31; p=0.95) and long-term (OR 1.72; 95% CI 0.75-3.91; p=0.20) follow-up. However, patients without CA demonstrated a significantly lower risk of heart failure hospitalization post-AVR compared to those with CA (OR 2.49; 95% CI 1.18–5.23; p = 0.02). Conclusion In the context of patients with severe AS undergoing AVR, the presence of CA does not appear to significantly impact short-term or long-term all-cause mortality. Notably, patients without CA exhibited a lower risk of heart failure hospitalization following AVR. These findings underscore the importance of considering cardiac amyloidosis in the clinical management of severe AS and highlight potential differences in outcomes based on its presence or absence. Additional studies are needed to elucidate outcome differences for CA patients who undergo surgical versus transcatheter AVR.Figure 1
Cardiovascular revascularization medicine · 2024 · 4 citations
- Medicine
- Internal medicine
- Cardiology
IJC Heart & Vasculature · 2024 · 8 citations
- Medicine
- Internal medicine
- Cardiology
Background: -analysis aims to characterize the utility of native T1 mapping and ECV in patients with non-ischemic cardiomyopathy (NICM) and to clarify the prognostic significance of elevated values. Methods: A literature search was conducted for studies reporting on use of CMR-based native T1 mapping and ECV measurement in NICM patients and their association with major adverse cardiac events (MACE), ventricular arrhythmias (VAs), and left ventricular reverse remodeling (LVRR). Databases searched included: Ovid MEDLINE, EMBASE, Web of Science, and Google Scholar. The search was not restricted to time or publication status. Results: Native T1 and ECV were significantly higher in NICM patients compared to controls (MD 78.80, 95 % CI 50.00, 107.59; p < 0.01; MD 5.86, 95 % CI 4.55, 7.16; p < 0.01). NICM patients who experienced MACE had higher native T1 and ECV (MD 52.87, 95 % CI 26.59, 79.15; p < 0.01; MD 6.03, 95 % CI 3.79, 8.26; p < 0.01). There was a non-statistically significant trend toward higher native T1 time in NICM patients who experienced VAs. NICM patients who were poor treatment responders had higher baseline native T1 and ECV (MD 40.58, 95 % CI 12.90, 68.25; p < 0.01; MD 3.29, 95 % CI 2.25, 4.33; p < 0.01). Conclusions: CMR-based native T1 and ECV quantification may be useful tools for risk stratification of patients with NICM. They may provide additional diagnostic utility in combination with LGE, which poorly characterizes fibrosis in patients with diffuse myocardial involvement.
European Heart Journal · 2024
- Medicine
- Cardiology
- Internal medicine
Abstract Background Acute myocardial infarction complicated by cardiogenic shock (AMI-CS) continues to portend poor clinical prognosis and remains a major cause of morbidity and mortality. Although venoarterial (VA) extracorporeal membrane oxygenation (ECMO) is frequently used in the treatment of AMI-CS, studies evaluating its benefit compared to percutaneous ventricular assist devices (pVAD) or standard medical therapy in this patient population have yielded conflicting results. Purpose The goal of this meta-analysis is to evaluate the use of ECMO compared to either pVAD or medical therapy with or without intra-aortic balloon counterpulsation (IABP) in patients presenting with AMI-CS. Methods A database search was performed for studies reporting on the association of ECMO compared to pVAD or medical therapy with or without IABP with clinical outcomes in patients with AMI-CS. The endpoints of interest were 30-day all-cause mortality and long term all-cause mortality. The databases searched included Pubmed, Web of Science, and Embase. The search was not restricted by time or publication status. Registry studies were excluded from this analysis. Results A total of 8 studies with 937 participants (447 treated with ECMO, 243 treated with pVAD, 247 treated with medical therapy with or without IABP) met inclusion criteria. Mean age was 63 years old, 80.5% were men, mean left ventricular ejection fraction was 26%, mean follow-up was 6.3 months (ranging 1-12 months). Treatment of AMI-CS patients with ECMO was not associated with lower risk of 30-day all-cause mortality compared to pVAD or standard medical therapy with or without IABP placement (OR 1.29, 95% CI 0.87-1.90; p=0.21; OR 0.58, 95% CI 0.25-1.35; p=0.13). Heterogenetic was low to moderate for each subgroup. Test for subgroup differences did not demonstrate statistically significant differences in the results for pVAD and for standard medical therapy with or without IABP (p=0.10, I2=64.1%). Compared to pVAD, ECMO was not associated lower risk of long-term mortality (OR 1.27, 95% CI 0.85-1.90; p=0.24). The heterogeneity for this analysis was low (I2=0%). Conclusion In patients presenting with AMI-CS, use of VA-ECMO is not associated with lower risk of mortality compared to pVAD or standard medical therapy with or without IABP placement. The risks and benefits of ECMO should be carefully considered compared to other forms of temporary mechanical circulatory support.Figure 1
Journal of the American College of Cardiology · 2024-10-01
articleAssociation of PCI with outcomes in stable coronary artery disease
European Heart Journal · 2024-10-01
articleSenior authorAbstract Background The utility of percutaneous coronary intervention (PCI) in patients with stable symptomatic coronary artery disease (CAD) remains unclear. Although there has been recent literature to suggest that PCI may improve anginal symptoms, studies evaluating the association of PCI with clinical outcomes compared to optimal medical therapy (OMT) has yielded conflicting results. Purpose We performed a systematic review and meta-analysis evaluating the association of PCI compared to OMT with adverse cardiovascular outcomes in patients with stable CAD. Methods A literature search was performed using the databases Ovid MEDLINE, Embase, and Web of Science, identifying studies that evaluated the association of PCI with clinical endpoints in patients with symptomatic stable CAD. The primary endpoint was all-cause mortality. Secondary endpoints were recurrent acute myocardial infarction (AMI), cerebrovascular accident (CVA), and unplanned coronary revascularization. The search was not restricted to time or publication status. Results A total of 17 studies with 20,389 patients (11,294 PCI, 9095 OMT) met inclusion criteria. Mean follow-up duration was 3.98 years (ranging from 1 year to 6.5 years), mean age was 63.8, mean ejection fraction was 59%. All patients had symptomatic CAD with lesion severity &gt;50%. Compared to OMT, PCI was associated with lower risk of mortality on short-term (≤1 year) but not long-term (&gt;1 year) follow-up (OR 0.5, 95% CI 0.29-0.86; p=0.01; OR 0.68; 95% CI 0.42-1.12; p=0.88). PCI was not associated with lower risk of AMI or need for unplanned coronary revascularization (OR 1.02; 95% CI 0.73-1.44; p=0.90; OR 0.87; 95% CI 0.51-1.49; p=0.61). There was a trend toward lower risk of CVA in patients treated with OMT compared to PCI, however this was not statistically significant (OR 1.46; 95% CI 0.96-2.22; p=0.07). Conclusions The use of PCI in patients with stable CAD is associated with lower risk of all-cause mortality on short-term follow-up, however this association was not seen on long-term follow-up &gt;1 year. PCI was not associated with lower risk of AMI or unplanned revascularization and may be associated with increased risk of CVA compared to OMT. Additional high-quality studies are needed to further associate the utility of PCI in this patient population.Figure 1Figure 2
Research Square · 2024-03-12
reviewOpen accessAbstract Introduction Right Heart Failure (RHF) is an important consequence of implant of left ventricular assist devices (LVAD). Right ventricular (RV) analysis with speckle tracking echo (STE) can assist in the assessment of the RV. This meta-analysis examines preoperative RV strain on STE as a predictor of postoperative RHF. Methods Literature was reviewed in Pubmed, EMBASE, and Web of Science for studies reporting on the association of preoperative RV free wall (FWS), global longitudinal (GLS), and septal longitudinal (SLS) strain with postoperative RV failure following LVAD placement. Strain parameters were compared between the two groups. Results A total of 13 studies with 933 patients undergoing LVAD implantation met inclusion criteria. 254 patients subsequently developed RHF and 679 did not develop RHF. Mean follow up was 15 months. The mean age of participants was 55.9 years and 85% were male. Baseline RVFWS, RVGLS, and RVSLS were significantly reduced in patients who developed post-implantation RHF compared to patients who did not develop post-implantation RHF (MD 3.77, 95% CI 2.39, 5.15; p<0.01; MD 2.67, 95% CI 1.16, 4.17; p<0.01; MD 3.59, 95% CI 0.83, 6.35; p=0.01). The heterogeneity was considerable for all three analyses (RVFWS I2=88%, RVGLS I2=92%, RVSLS I2=83%), likely due to vendor-specific differences in strain measurements and differences in echocardiography lab protocols. To address this, a random-effects model was used. Conclusions Preoperative RV FWS, GLS, and SLS were all associated with postoperative RHF. STE may be helpful in risk stratification of RHF following LVAD implant.
Research Square · 2024-03-12
reviewOpen accessAbstract Background: Myocardial strain imaging by speckle tracking echocardiography (STE) has demonstrated prognostic utility in several disease states. However, the association of strain measurements with acute cellular rejection (ACR) after cardiac transplantation is not well established. This meta-analysis aims to evaluate the association of myocardial strain measurements with acute cellular rejection in cardiac transplant patients. Methods: A literature search was conducted using Ovid MEDLINE, EMBASE, and Web of Science for studies reporting on the association of left ventricular (LV) global longitudinal (GLS), radial (GRS), and circumferential (GCS) strain in cardiac transplant patients with and without acute cellular rejection. Subgroup analysis was performed by ISHLT standardized ACR grading to compare grade 1R versus Grade 2R and higher. Results: A total of 21 studies with 2502 transplant patients (1465 without ACR versus 1037 with ACR) were included. Patients with ACR had significantly lower GLS compared to patients without ACR on biopsy (MD 2.84, 95% CI 1.5-4.18; p<0.01). Patients with ACR grade ≥2R had significantly lower GLS compared to patients with ACR grade 1R (MD 2.36, 95% CI 1.49-3.23; p<0.01). Patients with ACR had a significantly lower GCS compared to patients without ACR and GCS was significantly lower in patients with ACR grade ≥2R compared to patients with ACR grade 1R (MD 2.29, 95% CI 1.08, 3.51; MD 2.83, 95% CI 0.08-5.59; p=0.04). Conclusions: Left ventricular GLS and GCS may represent useful markers to identify cardiac transplant patients with ACR.
Frequent coauthors
- 22 shared
Michael Tao
Stony Brook University Hospital
- 15 shared
Navneet Sharma
- 13 shared
Tahmid Rahman
Stony Brook University Hospital
- 12 shared
Smadar Kort
Stony Brook University Hospital
- 12 shared
Deepu Alexander
Saint Francis Hospital
- 11 shared
Paul M. Kim
Johns Hopkins Medicine
- 10 shared
Mohammed Al‐Sadawi
Memorial Sloan Kettering Cancer Center
- 10 shared
Chad Gier
Stony Brook University Hospital
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