Sounok Sen, MD
Biography
Sounok Sen, MD, is a cardiologist specializing in advanced heart failure, heart transplantation, and mechanical circulatory support. He cares for adult patients both in the clinic and in the hospital. In addition to caring for patients with new diagnoses of heart failure and those with chronic heart failure, he sees patients who have received or are being considered for heart transplantation and left ventricular assist devices (LVADs).
Dr. Sen was inspired to care for patients with heart failure by mentors he worked with during his cardiology fellowship at Duke University School of Medicine. “Before then, I didn’t truly appreciate the full potential of these advanced therapies. But being part of that multidisciplinary care team and experiencing firsthand how these therapies change people’s lives, I was inspired, ” he says.
Each heart patient is unique, Dr. Sen says, and that’s something he takes very seriously. “In cardiology, we have the benefit of looking at large clinical trials to help guide patient care, but we also know that everyone is different. I believe in taking an individualized approach to each patient and their journey.” That requires understanding each patient’s expectations and educating and counseling them as they prepare to undergo treatments that could help them reach their goals.
While he considers himself a clinician first, Dr. Sen is motivated to investigate approaches that better enable patients to access lifesaving therapies such as LVADs and heart transplants, including strategies that would make more donor hearts available to those who are waiting for them.
Titles
- Assistant Professor
- Medical Director Cardiac Transplantation and Mechanical Circulatory Support, Heart Failure Program
- Co Director Hypertrophic Cardiomyopathy Program, Cardiomyopathy & Inherited Cardiovascular Disease Program
Education & Training
- Cardiovascular Disease FellowshipDuke University (2020)
- Advanced Heart Failure and Cardiac Transplant FellowshipDuke University (2019)
- Internal Medicine ResidencyMassachusetts General Hospital (2016)
- MDYale School of Medicine (2013)
- BEngSciUniversity of Pennsylvania, Bioengineering (2007)
Additional Information
- Dhingra L, Sangha V, Aminorroaya A, Bryde R, Gaballa A, Ali A, Mehra N, Krumholz H, Sen S, Kramer C, Martinez M, Desai M, Oikonomou E, Khera R. A Multicenter Evaluation of the Impact of Therapies on Deep Learning-based Electrocardiographic Hypertrophic Cardiomyopathy Markers. The American Journal Of Cardiology 2024 PMID: 39581517, DOI: 10.1016/j.amjcard.2024.11.028.
- Nargesi A, Adejumo P, Dhingra L, Rosand B, Hengartner A, Coppi A, Benigeri S, Sen S, Ahmad T, Nadkarni G, Lin Z, Ahmad F, Krumholz H, Khera R. Automated Identification of Heart Failure With Reduced Ejection Fraction Using Deep Learning-Based Natural Language Processing. JACC Heart Failure 2024 PMID: 39453355, DOI: 10.1016/j.jchf.2024.08.012.
- Tarras E, Sen S, Wang H, Singh I. Dyspnea in a Patient With Metastatic Breast Cancer. CHEST Pulmonary 2024, 2: 100074. DOI: 10.1016/j.chpulm.2024.100074.
- Tarras E, Sen S, Wang H, Singh I. Tumoral Pulmonary Hypertension in a Patient With Metastatic Breast Cancer: Diagnostic Opportunity of the Right Heart Catheterization. 2024, a2208-a2208. DOI: 10.1164/ajrccm-conference.2024.209.1_meetingabstracts.a2208.
- Williams S, Kalakoutas A, Olusanya S, Schrage B, Tavazzi G, Carnicelli A, Montero S, Vandenbriele C, Luk A, Lim H, Bhagra S, Ott S, Farrero M, Samsky M, Kennedy J, Sen S, Agrawal R, Rampersad P, Coniglio A, Pappalardo F, Barnett C, Proudfoot A. The management of heart failure cardiogenic shock: an international RAND appropriateness panel. Critical Care 2024, 28: 105. PMID: 38566212, PMCID: PMC10988801, DOI: 10.1186/s13054-024-04884-5.
- Park D, Jamil Y, Babapour G, Kim J, Campbell G, Akman Z, Kochar A, Sen S, Samsky M, Sikand N, Frampton J, Damluji A, Nanna M. Association of cardiovascular diseases with cognitive performance in older adults. American Heart Journal 2024, 273: 10-20. PMID: 38575050, PMCID: PMC11162917, DOI: 10.1016/j.ahj.2024.03.016.
- Sikand N, Sen S. Are Cardiac Myosin Inhibitors Useful in Patients With Hypertrophic Obstructive Cardiomyopathy and Comorbid Hypertension? ∗. JACC Heart Failure 2024, 12: 580-582. PMID: 38448152, DOI: 10.1016/j.jchf.2023.12.021.
- Fuery M, Leifer E, Samsky M, Sen S, O'Connor C, Fiuzat M, Ezekowitz J, Piña I, Whellan D, Mark D, Felker G, Desai N, Januzzi J, Ahmad T. Prognostic Impact of Repeated NT-proBNP Measurements in Patients With Heart Failure With Reduced Ejection Fraction. JACC Heart Failure 2023, 12: 479-487. PMID: 38127049, DOI: 10.1016/j.jchf.2023.11.007.
- Korutla L, Hoffman J, Rostami S, Hu R, Korutla V, Markmann C, Mullan C, Sotolongo A, Habertheuer A, Romano C, Acker M, Sen S, Agarwal D, Jayaraman A, Li B, Davis M, Naji A, Vallabhajosyula P. Circulating T cell specific extracellular vesicle profiles in cardiac allograft acute cellular rejection. American Journal Of Transplantation 2023, 24: 419-435. PMID: 38295008, DOI: 10.1016/j.ajt.2023.10.021.
- Sen S. Heart failure with reduced ejection fraction: clinical and economic burden and insights into current and emerging treatments. The American Journal Of Managed Care 2023, 29: s180-s186. PMID: 37677742, DOI: 10.37765/ajmc.2023.89415.
- Ghazi L, Yamamoto Y, Fuery M, O'Connor K, Sen S, Samsky M, Riello R, Dhar R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Electronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial. European Heart Journal 2023, 44: 4233-4242. PMID: 37650264, DOI: 10.1093/eurheartj/ehad512.
- Lerman J, Green C, Molina M, Maharaj V, Ortega‐Legaspi J, Sen S, Flattery M, Maziarz E, Shah K, Martin C, Alexy T, Shah P, Morris A, DeVore A, Cole R. Multicenter study of universal prophylaxis versus pre‐emptive therapy for patients at intermediate risk (R+) for CMV following heart transplantation. Clinical Transplantation 2023, 37: e15065. PMID: 37392192, PMCID: PMC10592402, DOI: 10.1111/ctr.15065.
- O’Connor K, Yamamoto Y, Sen S, Samsky M, Wilson F, Desai N, Ahmad T, Fuery M. Risk Prediction for Heart Failure Patients Admitted to the Intensive Care Unit Insights From REVeAL-HF. JACC Heart Failure 2023, 11: 727-728. PMID: 37052546, DOI: 10.1016/j.jchf.2023.01.021.
- Cavalier J, Bhattacharya P, Patolia H, Chandramouli S, Sen S, Karra R, Maurer M, Khouri M. Multicenter Transthyretin Cardiac Amyloidosis Study Demonstrates Differences In Phenotype And Outcomes By Race. Journal Of Cardiac Failure 2023, 29: 699-700. DOI: 10.1016/j.cardfail.2022.10.381.
- Patolia H, Chandramouli S, Cavalier J, Sen S, Arps K, Pokorney S, Karra R, Khouri M. Atrial Fibrillation And Conduction Disease Are Associated With Cardiac Amyloidosis Subtypes. Journal Of Cardiac Failure 2023, 29: 550-551. DOI: 10.1016/j.cardfail.2022.10.014.
- Ragnarsson S, Morrison A, Higaki A, Mullan C, Sen S, Ahmad T, Anwer M, Geirsson A, Maulion C, Davis R. Utilization of an Independent Procurement Team for Direct Procurement and Machine Perfusion of Cardiac Allografts Following Donation after Cardiac Death. The Journal Of Heart And Lung Transplantation 2023, 42: s279-s280. DOI: 10.1016/j.healun.2023.02.638.
- Chouairi F, Miller P, Loriaux D, Katz J, Sen S, Ahmad T, Fudim M. Trends and Outcomes in Cardiac Arrest Among Heart Failure Admissions. The American Journal Of Cardiology 2023, 194: 93-101. PMID: 36889986, DOI: 10.1016/j.amjcard.2023.01.012.
- Fuery M, Leifer E, Samsky M, Sen S, O'Connor C, Fiuzat M, Ezekowitz J, Pina I, Whellan D, Mark D, Felker G, Desai N, Januzzi J, Ahmad T. WHAT IS THE VALUE OF REPEATED NT-PROBNP MEASUREMENTS IN CHRONIC HEART FAILURE WITH REDUCED EJECTION FRACTION? Journal Of The American College Of Cardiology 2023, 81: 624. DOI: 10.1016/s0735-1097(23)01068-9.
- Chouairi F, Mullan C, Ahmed A, Bhinder J, Guha A, Miller P, Jastreboff A, Fuery M, Chiravuri M, Geirsson A, Desai N, Maulion C, Sen S, Ahmad T, Anwer M. Clinical implications of Type 2 diabetes on outcomes after cardiac transplantation. PLOS ONE 2022, 17: e0273111. PMID: 36516178, PMCID: PMC9750001, DOI: 10.1371/journal.pone.0273111.
- Ghazi L, O'Connor K, Yamamoto Y, Fuery M, Sen S, Samsky M, Riello R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial. American Heart Journal 2022, 257: 111-119. PMID: 36493842, DOI: 10.1016/j.ahj.2022.12.002.
- Park D, An S, Attanasio S, Jolly N, Malhotra S, Doukky R, Samsky M, Sen S, Ahmad T, Nanna M, Vij A. Network Meta-Analysis Comparing Angiotensin Receptor-Neprilysin Inhibitors, Angiotensin Receptor Blockers, and Angiotensin-Converting Enzyme Inhibitors in Heart Failure With Reduced Ejection Fraction. The American Journal Of Cardiology 2022, 187: 84-92. PMID: 36459752, PMCID: PMC10958453, DOI: 10.1016/j.amjcard.2022.10.026.
- Mullan CW, Komlo C, Clark KAA, Sen S, Anwer M, Geirsson A, Ahmad T, Davis RP. Survival After Heart Transplantation From SARS-CoV-2–Positive Donors. JACC Heart Failure 2022, 10: 874-876. PMID: 36328657, PMCID: PMC9555312, DOI: 10.1016/j.jchf.2022.08.006.
- Samsky MD, Sen S. Sacubitril/Valsartan in Advanced Heart Failure Shattering the Paradigm to Focus on Real LIFE ∗. JACC Heart Failure 2022, 10: 457-458. PMID: 35772854, DOI: 10.1016/j.jchf.2022.05.011.
- Chouairi F, Milner A, Sen S, Guha A, Stewart J, Jastreboff AM, Mori M, Clark KA, Miller PE, Fuery MA, Rogers JG, Notarianni A, Jacoby D, Maulion C, Anwer M, Geirsson A, Desai NR, Ahmad T, Mullan CW. Impact of Obesity on Heart Transplantation Outcomes. Journal Of The American Heart Association 2021, 10: e021346. PMID: 34854316, PMCID: PMC9075353, DOI: 10.1161/jaha.121.021346.
- Fuery MA, Chouairi F, Natov P, Bhinder J, Rose Chiravuri M, Wilson L, Clark KA, Reinhardt SW, Mullan C, Miller PE, Davis RP, Rogers JG, Patel CB, Sen S, Geirsson A, Anwer M, Desai N, Ahmad T. Trends and Outcomes of Cardiac Transplantation in the Lowest Urgency Candidates. Journal Of The American Heart Association 2021, 10: e023662. PMID: 34743559, PMCID: PMC9075266, DOI: 10.1161/jaha.121.023662.
- Chouairi F, Fuery M, Clark KA, Mullan CW, Stewart J, Caraballo C, Clarke J, Sen S, Guha A, Ibrahim NE, Cole RT, Holaday L, Anwer M, Geirsson A, Rogers JG, Velazquez EJ, Desai NR, Ahmad T, Miller PE. Evaluation of Racial and Ethnic Disparities in Cardiac Transplantation. Journal Of The American Heart Association 2021, 10: e021067. PMID: 34431324, PMCID: PMC8649228, DOI: 10.1161/jaha.120.021067.
- Miller PE, Mullan CW, Chouairi F, Sen S, Clark KA, Reinhardt S, Fuery M, Anwer M, Geirsson A, Formica R, Rogers JG, Desai NR, Ahmad T. Mechanical ventilation at the time of heart transplantation and associations with clinical outcomes. European Heart Journal Acute Cardiovascular Care 2021, 10: 843-851. PMID: 34389855, PMCID: PMC8557439, DOI: 10.1093/ehjacc/zuab063.
- Chouairi F, Fuery MA, Mullan CW, Caraballo C, Sen S, Maulion C, Wilkinson ST, Surti T, McCullough M, Miller PE, Pacor J, Leifer ES, Felker GM, Velazquez EJ, Fiuzat M, O'Connor CM, Januzzi JL, Desai NR, Ahmad T. The Impact of Depression on Outcomes in Patients With Heart Failure and Reduced Ejection Fraction Treated in the GUIDE-IT Trial. Journal Of Cardiac Failure 2021, 27: 1359-1366. PMID: 34166799, DOI: 10.1016/j.cardfail.2021.06.008.
- Chouairi F, Pacor J, Miller PE, Fuery MA, Caraballo C, Sen S, Leifer ES, Felker GM, Fiuzat M, O’Connor C, Januzzi JL, Friedman DJ, Desai NR, Ahmad T, Freeman JV. Effects of Atrial Fibrillation on Heart Failure Outcomes and NT-proBNP Levels in the GUIDE-IT Trial. Mayo Clinic Proceedings Innovations Quality & Outcomes 2021, 5: 447-455. PMID: 33997640, PMCID: PMC8105522, DOI: 10.1016/j.mayocpiqo.2021.02.005.
- Rehorn MR, Black-Maier E, Loungani R, Sen S, Sun AY, Friedman DJ, Koontz JI, Schroder JN, Milano CA, Khouri MG, Katz JN, Patel CB, Pokorney SD, Daubert JP, Piccini JP. Electrical storm in patients with left ventricular assist devices: Risk factors, incidence, and impact on survival. Heart Rhythm 2021, 18: 1263-1271. PMID: 33839327, DOI: 10.1016/j.hrthm.2021.03.047.
- Mullan CW, Sen S, Ahmad T. Left Ventricular Assist Devices Versus Heart Transplantation for End Stage Heart Failure is a Misleading Equivalency∗. JACC Heart Failure 2021, 9: 290-292. PMID: 33795115, DOI: 10.1016/j.jchf.2021.02.004.
- Mullan CW, Chouairi F, Sen S, Mori M, Clark KAA, Reinhardt SW, Miller PE, Fuery MA, Jacoby D, Maulion C, Anwer M, Geirsson A, Mulligan D, Formica R, Rogers JG, Desai NR, Ahmad T. Changes in Use of Left Ventricular Assist Devices as Bridge to Transplantation With New Heart Allocation Policy. JACC Heart Failure 2021, 9: 420-429. PMID: 33714748, DOI: 10.1016/j.jchf.2021.01.010.
- Chouairi F, Mullan CW, Sen S, Mori M, Fuery M, Elder RW, Lesse J, Norton K, Clark KA, Miller PE, Mulligan D, Formica R, Rogers JG, Jacoby D, Maulion C, Anwer M, Geirsson A, Desai NR, Ahmad T. Impact of the new heart allocation policy on patients with restrictive, hypertrophic, or congenital cardiomyopathies. PLOS ONE 2021, 16: e0247789. PMID: 33651802, PMCID: PMC7924739, DOI: 10.1371/journal.pone.0247789.
- Loring Z, Sen S, Black-Maier E, Atwater BD, Russell SD, DeVore AD, Piccini JP. Reducing ECG Artifact From Left Ventricular Assist Device Electromagnetic Interference. Journal Of The American Heart Association 2020, 9: e017563. PMID: 32787630, PMCID: PMC7660795, DOI: 10.1161/jaha.120.017563.
- Sen S, Newby LK. In HF with LVEF ≤ 42.5%, sacubitril-valsartan vs RAS inhibitors reduced a composite of CV death or HF hospitalization. Annals Of Internal Medicine 2020, 172: jc65. PMID: 32539517, DOI: 10.7326/acpj202006160-065.
- Salik JR, Sen S, Picard MH, Weiner RB, Dudzinski DM. The application of appropriate use criteria for transthoracic echocardiography in a cardiac intensive care unit. Echocardiography 2019, 36: 631-638. PMID: 30969477, DOI: 10.1111/echo.14314.
- Sen S, Rogers JG. Different Strokes for Different Folks. ASAIO Journal 2019, 65: 205-206. PMID: 30807380, DOI: 10.1097/mat.0000000000000977.
- The risk of bleeding with the use of antiplatelet agents for the treatment of cardiovascular diseaseNathan AS, Sen S, Yeh RW. The risk of bleeding with the use of antiplatelet agents for the treatment of cardiovascular disease. Expert Opinion On Drug Safety 2017, 16: 561-572. PMID: 28387542, DOI: 10.1080/14740338.2017.1315101.
- Gautam S, Kim T, Shoda T, Sen S, Deep D, Luthra R, Ferreira MT, Pinho MG, Spiegel DA. An Activity‐Based Probe for Studying Crosslinking in Live Bacteria. Angewandte Chemie International Edition 2015, 54: 10492-10496. PMID: 26204841, DOI: 10.1002/anie.201503869.
- Gautam S, Kim T, Shoda T, Sen S, Deep D, Luthra R, Ferreira M, Pinho M, Spiegel D. An Activity‐Based Probe for Studying Crosslinking in Live Bacteria. Angewandte Chemie 2015, 127: 10638-10642. DOI: 10.1002/ange.201503869.
- Makarov DV, Soulos PR, Gold HT, Yu JB, Sen S, Ross JS, Gross CP. Regional-Level Correlations in Inappropriate Imaging Rates for Prostate and Breast Cancers: Potential Implications for the Choosing Wisely Campaign. JAMA Oncology 2015, 1: 185-194. PMID: 26181021, PMCID: PMC4707944, DOI: 10.1001/jamaoncol.2015.37.
- Sen S, Wang SY, Soulos PR, Frick KD, Long JB, Roberts KB, Yu JB, Evans SB, Chagpar AB, Gross CP. Response. Journal Of The National Cancer Institute 2014, 106: dju198. PMID: 25114276, PMCID: PMC4200056, DOI: 10.1093/jnci/dju198.
- Sen S, Wang SY, Soulos PR, Frick KD, Long JB, Roberts KB, Yu JB, Evans SB, Chagpar AB, Gross CP. Examining the Cost-Effectiveness of Radiation Therapy Among Older Women With Favorable-Risk Breast Cancer. Journal Of The National Cancer Institute 2014, 106: dju008. PMID: 24598714, PMCID: PMC3982782, DOI: 10.1093/jnci/dju008.
- Sen S, Soulos PR, Herrin J, Roberts KB, Yu JB, Lesnikoski BA, Ross JS, Krumholz HM, Gross CP. For-profit hospital ownership status and use of brachytherapy after breast-conserving surgery. Surgery 2013, 155: 776-788. PMID: 24787104, PMCID: PMC4008843, DOI: 10.1016/j.surg.2013.12.009.
- Sen S, Soulos P, Frick K, Long J, Roberts K, Yu J, Evans S, Chagpar A, Gross C. Understanding Costs and Value of Newer Radiation Modalities Among Older Women With Breast Cancer. International Journal Of Radiation Oncology • Biology • Physics 2012, 84: s35. DOI: 10.1016/j.ijrobp.2012.07.096.
- Sen S, Jacobs NT, Boxberger JI, Elliott DM. Human annulus fibrosus dynamic tensile modulus increases with degeneration. Mechanics Of Materials 2012, 44: 93-98. PMID: 22247579, PMCID: PMC3254102, DOI: 10.1016/j.mechmat.2011.07.016.
- O’Connell G, Sen S, Elliott DM. Human annulus fibrosus material properties from biaxial testing and constitutive modeling are altered with degeneration. Biomechanics And Modeling In Mechanobiology 2011, 11: 493-503. PMID: 21748426, PMCID: PMC3500512, DOI: 10.1007/s10237-011-0328-9.
- O’Connell G, Jacobs NT, Sen S, Vresilovic EJ, Elliott DM. Axial creep loading and unloaded recovery of the human intervertebral disc and the effect of degeneration. Journal Of The Mechanical Behavior Of Biomedical Materials 2011, 4: 933-942. PMID: 21783103, PMCID: PMC3143379, DOI: 10.1016/j.jmbbm.2011.02.002.
- Nerurkar NL, Sen S, Baker BM, Elliott DM, Mauck RL. Dynamic culture enhances stem cell infiltration and modulates extracellular matrix production on aligned electrospun nanofibrous scaffolds. Acta Biomaterialia 2010, 7: 485-491. PMID: 20728589, PMCID: PMC2994961, DOI: 10.1016/j.actbio.2010.08.011.
- Nerurkar NL, Sen S, Huang AH, Elliott DM, Mauck RL. Engineered Disc-Like Angle-Ply Structures for Intervertebral Disc Replacement. Spine 2010, 35: 867-873. PMID: 20354467, PMCID: PMC3421837, DOI: 10.1097/brs.0b013e3181d74414.
- Nerurkar NL, Baker BM, Sen S, Wible EE, Elliott DM, Mauck RL. Nanofibrous biologic laminates replicate the form and function of the annulus fibrosus. Nature Materials 2009, 8: 986-992. PMID: 19855383, PMCID: PMC3415301, DOI: 10.1038/nmat2558.
- Boxberger JI, Orlansky AS, Sen S, Elliott DM. Reduced nucleus pulposus glycosaminoglycan content alters intervertebral disc dynamic viscoelastic mechanics. Journal Of Biomechanics 2009, 42: 1941-1946. PMID: 19539936, PMCID: PMC2756063, DOI: 10.1016/j.jbiomech.2009.05.008.
- Nerurkar N, Sen S, Wible E, Stambough J, Elliott D, Mauck R. Mesenchymal Stem Cell Seeded Nanofibrous Laminates Mimic the Multi-Scale Form and Function of the Annulus Fibrosus. 2009, 417-418. DOI: 10.1115/sbc2009-206812.
- Sen S, Boxberger J, Schroeder Y, Orias A, Elliott D. Effect of Degeneration on the Dynamic Viscoelastic Properties of Human Annulus Fibrosus in Tension. 2008, 609-610. DOI: 10.1115/sbc2008-193057.
- Boxberger J, Auerbach J, Sen S, Dodge G, Elliott D. Intervertebral Disc Function Is Restored in an In Vivo Model of Chronic Nucleus Pulposus Glycosaminoglycan Reduction. 2008, 127-128. DOI: 10.1115/sbc2008-192937.
- Beckstein JC, Sen S, Schaer TP, Vresilovic EJ, Elliott DM. Comparison of Animal Discs Used in Disc Research to Human Lumbar Disc. Spine 2008, 33: e166-e173. PMID: 18344845, DOI: 10.1097/brs.0b013e318166e001.
- Boxberger JI, Auerbach JD, Sen S, Elliott DM. An In Vivo Model of Reduced Nucleus Pulposus Glycosaminoglycan Content in the Rat Lumbar Intervertebral Disc. Spine 2008, 33: 146-154. PMID: 18197098, PMCID: PMC2696404, DOI: 10.1097/brs.0b013e31816054f8.
- Baker B, O’Connell G, Sen S, Nathan A, Elliott D, Mauck R. Multi-Lamellar and Multi-Axial Maturation of Cell-Seeded Fiber-Reinforced Tissue Engineered Constructs. 2007, 1013-1014. DOI: 10.1115/sbc2007-176434.
- O’Connell G, Sen S, Baker B, Mauck R, Elliott D. Biaxial Mechanics of Musculoskeletal Tissue and Fiber-Reinforced Scaffolds. 2007, 935-936. DOI: 10.1115/sbc2007-176540.
- Boxberger JI, Sen S, Yerramalli CS, Elliott DM. Nucleus pulposus glycosaminoglycan content is correlated with axial mechanics in rat lumbar motion segments. Journal Of Orthopaedic Research® 2006, 24: 1906-1915. PMID: 16865712, DOI: 10.1002/jor.20221.
Biography
Sounok Sen, MD, is a cardiologist specializing in advanced heart failure, heart transplantation, and mechanical circulatory support. He cares for adult patients both in the clinic and in the hospital. In addition to caring for patients with new diagnoses of heart failure and those with chronic heart failure, he sees patients who have received or are being considered for heart transplantation and left ventricular assist devices (LVADs).
Dr. Sen was inspired to care for patients with heart failure by mentors he worked with during his cardiology fellowship at Duke University School of Medicine. “Before then, I didn’t truly appreciate the full potential of these advanced therapies. But being part of that multidisciplinary care team and experiencing firsthand how these therapies change people’s lives, I was inspired, ” he says.
Each heart patient is unique, Dr. Sen says, and that’s something he takes very seriously. “In cardiology, we have the benefit of looking at large clinical trials to help guide patient care, but we also know that everyone is different. I believe in taking an individualized approach to each patient and their journey.” That requires understanding each patient’s expectations and educating and counseling them as they prepare to undergo treatments that could help them reach their goals.
While he considers himself a clinician first, Dr. Sen is motivated to investigate approaches that better enable patients to access lifesaving therapies such as LVADs and heart transplants, including strategies that would make more donor hearts available to those who are waiting for them.
Titles
- Assistant Professor
- Medical Director Cardiac Transplantation and Mechanical Circulatory Support, Heart Failure Program
- Co Director Hypertrophic Cardiomyopathy Program, Cardiomyopathy & Inherited Cardiovascular Disease Program
Education & Training
- Cardiovascular Disease FellowshipDuke University (2020)
- Advanced Heart Failure and Cardiac Transplant FellowshipDuke University (2019)
- Internal Medicine ResidencyMassachusetts General Hospital (2016)
- MDYale School of Medicine (2013)
- BEngSciUniversity of Pennsylvania, Bioengineering (2007)
Additional Information
- Dhingra L, Sangha V, Aminorroaya A, Bryde R, Gaballa A, Ali A, Mehra N, Krumholz H, Sen S, Kramer C, Martinez M, Desai M, Oikonomou E, Khera R. A Multicenter Evaluation of the Impact of Therapies on Deep Learning-based Electrocardiographic Hypertrophic Cardiomyopathy Markers. The American Journal Of Cardiology 2024 PMID: 39581517, DOI: 10.1016/j.amjcard.2024.11.028.
- Nargesi A, Adejumo P, Dhingra L, Rosand B, Hengartner A, Coppi A, Benigeri S, Sen S, Ahmad T, Nadkarni G, Lin Z, Ahmad F, Krumholz H, Khera R. Automated Identification of Heart Failure With Reduced Ejection Fraction Using Deep Learning-Based Natural Language Processing. JACC Heart Failure 2024 PMID: 39453355, DOI: 10.1016/j.jchf.2024.08.012.
- Tarras E, Sen S, Wang H, Singh I. Dyspnea in a Patient With Metastatic Breast Cancer. CHEST Pulmonary 2024, 2: 100074. DOI: 10.1016/j.chpulm.2024.100074.
- Tarras E, Sen S, Wang H, Singh I. Tumoral Pulmonary Hypertension in a Patient With Metastatic Breast Cancer: Diagnostic Opportunity of the Right Heart Catheterization. 2024, a2208-a2208. DOI: 10.1164/ajrccm-conference.2024.209.1_meetingabstracts.a2208.
- Williams S, Kalakoutas A, Olusanya S, Schrage B, Tavazzi G, Carnicelli A, Montero S, Vandenbriele C, Luk A, Lim H, Bhagra S, Ott S, Farrero M, Samsky M, Kennedy J, Sen S, Agrawal R, Rampersad P, Coniglio A, Pappalardo F, Barnett C, Proudfoot A. The management of heart failure cardiogenic shock: an international RAND appropriateness panel. Critical Care 2024, 28: 105. PMID: 38566212, PMCID: PMC10988801, DOI: 10.1186/s13054-024-04884-5.
- Park D, Jamil Y, Babapour G, Kim J, Campbell G, Akman Z, Kochar A, Sen S, Samsky M, Sikand N, Frampton J, Damluji A, Nanna M. Association of cardiovascular diseases with cognitive performance in older adults. American Heart Journal 2024, 273: 10-20. PMID: 38575050, PMCID: PMC11162917, DOI: 10.1016/j.ahj.2024.03.016.
- Sikand N, Sen S. Are Cardiac Myosin Inhibitors Useful in Patients With Hypertrophic Obstructive Cardiomyopathy and Comorbid Hypertension? ∗. JACC Heart Failure 2024, 12: 580-582. PMID: 38448152, DOI: 10.1016/j.jchf.2023.12.021.
- Fuery M, Leifer E, Samsky M, Sen S, O'Connor C, Fiuzat M, Ezekowitz J, Piña I, Whellan D, Mark D, Felker G, Desai N, Januzzi J, Ahmad T. Prognostic Impact of Repeated NT-proBNP Measurements in Patients With Heart Failure With Reduced Ejection Fraction. JACC Heart Failure 2023, 12: 479-487. PMID: 38127049, DOI: 10.1016/j.jchf.2023.11.007.
- Korutla L, Hoffman J, Rostami S, Hu R, Korutla V, Markmann C, Mullan C, Sotolongo A, Habertheuer A, Romano C, Acker M, Sen S, Agarwal D, Jayaraman A, Li B, Davis M, Naji A, Vallabhajosyula P. Circulating T cell specific extracellular vesicle profiles in cardiac allograft acute cellular rejection. American Journal Of Transplantation 2023, 24: 419-435. PMID: 38295008, DOI: 10.1016/j.ajt.2023.10.021.
- Sen S. Heart failure with reduced ejection fraction: clinical and economic burden and insights into current and emerging treatments. The American Journal Of Managed Care 2023, 29: s180-s186. PMID: 37677742, DOI: 10.37765/ajmc.2023.89415.
- Ghazi L, Yamamoto Y, Fuery M, O'Connor K, Sen S, Samsky M, Riello R, Dhar R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Electronic health record alerts for management of heart failure with reduced ejection fraction in hospitalized patients: the PROMPT-AHF trial. European Heart Journal 2023, 44: 4233-4242. PMID: 37650264, DOI: 10.1093/eurheartj/ehad512.
- Lerman J, Green C, Molina M, Maharaj V, Ortega‐Legaspi J, Sen S, Flattery M, Maziarz E, Shah K, Martin C, Alexy T, Shah P, Morris A, DeVore A, Cole R. Multicenter study of universal prophylaxis versus pre‐emptive therapy for patients at intermediate risk (R+) for CMV following heart transplantation. Clinical Transplantation 2023, 37: e15065. PMID: 37392192, PMCID: PMC10592402, DOI: 10.1111/ctr.15065.
- O’Connor K, Yamamoto Y, Sen S, Samsky M, Wilson F, Desai N, Ahmad T, Fuery M. Risk Prediction for Heart Failure Patients Admitted to the Intensive Care Unit Insights From REVeAL-HF. JACC Heart Failure 2023, 11: 727-728. PMID: 37052546, DOI: 10.1016/j.jchf.2023.01.021.
- Cavalier J, Bhattacharya P, Patolia H, Chandramouli S, Sen S, Karra R, Maurer M, Khouri M. Multicenter Transthyretin Cardiac Amyloidosis Study Demonstrates Differences In Phenotype And Outcomes By Race. Journal Of Cardiac Failure 2023, 29: 699-700. DOI: 10.1016/j.cardfail.2022.10.381.
- Patolia H, Chandramouli S, Cavalier J, Sen S, Arps K, Pokorney S, Karra R, Khouri M. Atrial Fibrillation And Conduction Disease Are Associated With Cardiac Amyloidosis Subtypes. Journal Of Cardiac Failure 2023, 29: 550-551. DOI: 10.1016/j.cardfail.2022.10.014.
- Ragnarsson S, Morrison A, Higaki A, Mullan C, Sen S, Ahmad T, Anwer M, Geirsson A, Maulion C, Davis R. Utilization of an Independent Procurement Team for Direct Procurement and Machine Perfusion of Cardiac Allografts Following Donation after Cardiac Death. The Journal Of Heart And Lung Transplantation 2023, 42: s279-s280. DOI: 10.1016/j.healun.2023.02.638.
- Chouairi F, Miller P, Loriaux D, Katz J, Sen S, Ahmad T, Fudim M. Trends and Outcomes in Cardiac Arrest Among Heart Failure Admissions. The American Journal Of Cardiology 2023, 194: 93-101. PMID: 36889986, DOI: 10.1016/j.amjcard.2023.01.012.
- Fuery M, Leifer E, Samsky M, Sen S, O'Connor C, Fiuzat M, Ezekowitz J, Pina I, Whellan D, Mark D, Felker G, Desai N, Januzzi J, Ahmad T. WHAT IS THE VALUE OF REPEATED NT-PROBNP MEASUREMENTS IN CHRONIC HEART FAILURE WITH REDUCED EJECTION FRACTION? Journal Of The American College Of Cardiology 2023, 81: 624. DOI: 10.1016/s0735-1097(23)01068-9.
- Chouairi F, Mullan C, Ahmed A, Bhinder J, Guha A, Miller P, Jastreboff A, Fuery M, Chiravuri M, Geirsson A, Desai N, Maulion C, Sen S, Ahmad T, Anwer M. Clinical implications of Type 2 diabetes on outcomes after cardiac transplantation. PLOS ONE 2022, 17: e0273111. PMID: 36516178, PMCID: PMC9750001, DOI: 10.1371/journal.pone.0273111.
- Ghazi L, O'Connor K, Yamamoto Y, Fuery M, Sen S, Samsky M, Riello R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial. American Heart Journal 2022, 257: 111-119. PMID: 36493842, DOI: 10.1016/j.ahj.2022.12.002.
- Park D, An S, Attanasio S, Jolly N, Malhotra S, Doukky R, Samsky M, Sen S, Ahmad T, Nanna M, Vij A. Network Meta-Analysis Comparing Angiotensin Receptor-Neprilysin Inhibitors, Angiotensin Receptor Blockers, and Angiotensin-Converting Enzyme Inhibitors in Heart Failure With Reduced Ejection Fraction. The American Journal Of Cardiology 2022, 187: 84-92. PMID: 36459752, PMCID: PMC10958453, DOI: 10.1016/j.amjcard.2022.10.026.
- Mullan CW, Komlo C, Clark KAA, Sen S, Anwer M, Geirsson A, Ahmad T, Davis RP. Survival After Heart Transplantation From SARS-CoV-2–Positive Donors. JACC Heart Failure 2022, 10: 874-876. PMID: 36328657, PMCID: PMC9555312, DOI: 10.1016/j.jchf.2022.08.006.
- Samsky MD, Sen S. Sacubitril/Valsartan in Advanced Heart Failure Shattering the Paradigm to Focus on Real LIFE ∗. JACC Heart Failure 2022, 10: 457-458. PMID: 35772854, DOI: 10.1016/j.jchf.2022.05.011.
- Chouairi F, Milner A, Sen S, Guha A, Stewart J, Jastreboff AM, Mori M, Clark KA, Miller PE, Fuery MA, Rogers JG, Notarianni A, Jacoby D, Maulion C, Anwer M, Geirsson A, Desai NR, Ahmad T, Mullan CW. Impact of Obesity on Heart Transplantation Outcomes. Journal Of The American Heart Association 2021, 10: e021346. PMID: 34854316, PMCID: PMC9075353, DOI: 10.1161/jaha.121.021346.
- Fuery MA, Chouairi F, Natov P, Bhinder J, Rose Chiravuri M, Wilson L, Clark KA, Reinhardt SW, Mullan C, Miller PE, Davis RP, Rogers JG, Patel CB, Sen S, Geirsson A, Anwer M, Desai N, Ahmad T. Trends and Outcomes of Cardiac Transplantation in the Lowest Urgency Candidates. Journal Of The American Heart Association 2021, 10: e023662. PMID: 34743559, PMCID: PMC9075266, DOI: 10.1161/jaha.121.023662.
- Chouairi F, Fuery M, Clark KA, Mullan CW, Stewart J, Caraballo C, Clarke J, Sen S, Guha A, Ibrahim NE, Cole RT, Holaday L, Anwer M, Geirsson A, Rogers JG, Velazquez EJ, Desai NR, Ahmad T, Miller PE. Evaluation of Racial and Ethnic Disparities in Cardiac Transplantation. Journal Of The American Heart Association 2021, 10: e021067. PMID: 34431324, PMCID: PMC8649228, DOI: 10.1161/jaha.120.021067.
- Miller PE, Mullan CW, Chouairi F, Sen S, Clark KA, Reinhardt S, Fuery M, Anwer M, Geirsson A, Formica R, Rogers JG, Desai NR, Ahmad T. Mechanical ventilation at the time of heart transplantation and associations with clinical outcomes. European Heart Journal Acute Cardiovascular Care 2021, 10: 843-851. PMID: 34389855, PMCID: PMC8557439, DOI: 10.1093/ehjacc/zuab063.
- Chouairi F, Fuery MA, Mullan CW, Caraballo C, Sen S, Maulion C, Wilkinson ST, Surti T, McCullough M, Miller PE, Pacor J, Leifer ES, Felker GM, Velazquez EJ, Fiuzat M, O'Connor CM, Januzzi JL, Desai NR, Ahmad T. The Impact of Depression on Outcomes in Patients With Heart Failure and Reduced Ejection Fraction Treated in the GUIDE-IT Trial. Journal Of Cardiac Failure 2021, 27: 1359-1366. PMID: 34166799, DOI: 10.1016/j.cardfail.2021.06.008.
- Chouairi F, Pacor J, Miller PE, Fuery MA, Caraballo C, Sen S, Leifer ES, Felker GM, Fiuzat M, O’Connor C, Januzzi JL, Friedman DJ, Desai NR, Ahmad T, Freeman JV. Effects of Atrial Fibrillation on Heart Failure Outcomes and NT-proBNP Levels in the GUIDE-IT Trial. Mayo Clinic Proceedings Innovations Quality & Outcomes 2021, 5: 447-455. PMID: 33997640, PMCID: PMC8105522, DOI: 10.1016/j.mayocpiqo.2021.02.005.
- Rehorn MR, Black-Maier E, Loungani R, Sen S, Sun AY, Friedman DJ, Koontz JI, Schroder JN, Milano CA, Khouri MG, Katz JN, Patel CB, Pokorney SD, Daubert JP, Piccini JP. Electrical storm in patients with left ventricular assist devices: Risk factors, incidence, and impact on survival. Heart Rhythm 2021, 18: 1263-1271. PMID: 33839327, DOI: 10.1016/j.hrthm.2021.03.047.
- Mullan CW, Sen S, Ahmad T. Left Ventricular Assist Devices Versus Heart Transplantation for End Stage Heart Failure is a Misleading Equivalency∗. JACC Heart Failure 2021, 9: 290-292. PMID: 33795115, DOI: 10.1016/j.jchf.2021.02.004.
- Mullan CW, Chouairi F, Sen S, Mori M, Clark KAA, Reinhardt SW, Miller PE, Fuery MA, Jacoby D, Maulion C, Anwer M, Geirsson A, Mulligan D, Formica R, Rogers JG, Desai NR, Ahmad T. Changes in Use of Left Ventricular Assist Devices as Bridge to Transplantation With New Heart Allocation Policy. JACC Heart Failure 2021, 9: 420-429. PMID: 33714748, DOI: 10.1016/j.jchf.2021.01.010.
- Chouairi F, Mullan CW, Sen S, Mori M, Fuery M, Elder RW, Lesse J, Norton K, Clark KA, Miller PE, Mulligan D, Formica R, Rogers JG, Jacoby D, Maulion C, Anwer M, Geirsson A, Desai NR, Ahmad T. Impact of the new heart allocation policy on patients with restrictive, hypertrophic, or congenital cardiomyopathies. PLOS ONE 2021, 16: e0247789. PMID: 33651802, PMCID: PMC7924739, DOI: 10.1371/journal.pone.0247789.
- Loring Z, Sen S, Black-Maier E, Atwater BD, Russell SD, DeVore AD, Piccini JP. Reducing ECG Artifact From Left Ventricular Assist Device Electromagnetic Interference. Journal Of The American Heart Association 2020, 9: e017563. PMID: 32787630, PMCID: PMC7660795, DOI: 10.1161/jaha.120.017563.
- Sen S, Newby LK. In HF with LVEF ≤ 42.5%, sacubitril-valsartan vs RAS inhibitors reduced a composite of CV death or HF hospitalization. Annals Of Internal Medicine 2020, 172: jc65. PMID: 32539517, DOI: 10.7326/acpj202006160-065.
- Salik JR, Sen S, Picard MH, Weiner RB, Dudzinski DM. The application of appropriate use criteria for transthoracic echocardiography in a cardiac intensive care unit. Echocardiography 2019, 36: 631-638. PMID: 30969477, DOI: 10.1111/echo.14314.
- Sen S, Rogers JG. Different Strokes for Different Folks. ASAIO Journal 2019, 65: 205-206. PMID: 30807380, DOI: 10.1097/mat.0000000000000977.
- The risk of bleeding with the use of antiplatelet agents for the treatment of cardiovascular diseaseNathan AS, Sen S, Yeh RW. The risk of bleeding with the use of antiplatelet agents for the treatment of cardiovascular disease. Expert Opinion On Drug Safety 2017, 16: 561-572. PMID: 28387542, DOI: 10.1080/14740338.2017.1315101.
- Gautam S, Kim T, Shoda T, Sen S, Deep D, Luthra R, Ferreira MT, Pinho MG, Spiegel DA. An Activity‐Based Probe for Studying Crosslinking in Live Bacteria. Angewandte Chemie International Edition 2015, 54: 10492-10496. PMID: 26204841, DOI: 10.1002/anie.201503869.
- Gautam S, Kim T, Shoda T, Sen S, Deep D, Luthra R, Ferreira M, Pinho M, Spiegel D. An Activity‐Based Probe for Studying Crosslinking in Live Bacteria. Angewandte Chemie 2015, 127: 10638-10642. DOI: 10.1002/ange.201503869.
- Makarov DV, Soulos PR, Gold HT, Yu JB, Sen S, Ross JS, Gross CP. Regional-Level Correlations in Inappropriate Imaging Rates for Prostate and Breast Cancers: Potential Implications for the Choosing Wisely Campaign. JAMA Oncology 2015, 1: 185-194. PMID: 26181021, PMCID: PMC4707944, DOI: 10.1001/jamaoncol.2015.37.
- Sen S, Wang SY, Soulos PR, Frick KD, Long JB, Roberts KB, Yu JB, Evans SB, Chagpar AB, Gross CP. Response. Journal Of The National Cancer Institute 2014, 106: dju198. PMID: 25114276, PMCID: PMC4200056, DOI: 10.1093/jnci/dju198.
- Sen S, Wang SY, Soulos PR, Frick KD, Long JB, Roberts KB, Yu JB, Evans SB, Chagpar AB, Gross CP. Examining the Cost-Effectiveness of Radiation Therapy Among Older Women With Favorable-Risk Breast Cancer. Journal Of The National Cancer Institute 2014, 106: dju008. PMID: 24598714, PMCID: PMC3982782, DOI: 10.1093/jnci/dju008.
- Sen S, Soulos PR, Herrin J, Roberts KB, Yu JB, Lesnikoski BA, Ross JS, Krumholz HM, Gross CP. For-profit hospital ownership status and use of brachytherapy after breast-conserving surgery. Surgery 2013, 155: 776-788. PMID: 24787104, PMCID: PMC4008843, DOI: 10.1016/j.surg.2013.12.009.
- Sen S, Soulos P, Frick K, Long J, Roberts K, Yu J, Evans S, Chagpar A, Gross C. Understanding Costs and Value of Newer Radiation Modalities Among Older Women With Breast Cancer. International Journal Of Radiation Oncology • Biology • Physics 2012, 84: s35. DOI: 10.1016/j.ijrobp.2012.07.096.
- Sen S, Jacobs NT, Boxberger JI, Elliott DM. Human annulus fibrosus dynamic tensile modulus increases with degeneration. Mechanics Of Materials 2012, 44: 93-98. PMID: 22247579, PMCID: PMC3254102, DOI: 10.1016/j.mechmat.2011.07.016.
- O’Connell G, Sen S, Elliott DM. Human annulus fibrosus material properties from biaxial testing and constitutive modeling are altered with degeneration. Biomechanics And Modeling In Mechanobiology 2011, 11: 493-503. PMID: 21748426, PMCID: PMC3500512, DOI: 10.1007/s10237-011-0328-9.
- O’Connell G, Jacobs NT, Sen S, Vresilovic EJ, Elliott DM. Axial creep loading and unloaded recovery of the human intervertebral disc and the effect of degeneration. Journal Of The Mechanical Behavior Of Biomedical Materials 2011, 4: 933-942. PMID: 21783103, PMCID: PMC3143379, DOI: 10.1016/j.jmbbm.2011.02.002.
- Nerurkar NL, Sen S, Baker BM, Elliott DM, Mauck RL. Dynamic culture enhances stem cell infiltration and modulates extracellular matrix production on aligned electrospun nanofibrous scaffolds. Acta Biomaterialia 2010, 7: 485-491. PMID: 20728589, PMCID: PMC2994961, DOI: 10.1016/j.actbio.2010.08.011.
- Nerurkar NL, Sen S, Huang AH, Elliott DM, Mauck RL. Engineered Disc-Like Angle-Ply Structures for Intervertebral Disc Replacement. Spine 2010, 35: 867-873. PMID: 20354467, PMCID: PMC3421837, DOI: 10.1097/brs.0b013e3181d74414.
- Nerurkar NL, Baker BM, Sen S, Wible EE, Elliott DM, Mauck RL. Nanofibrous biologic laminates replicate the form and function of the annulus fibrosus. Nature Materials 2009, 8: 986-992. PMID: 19855383, PMCID: PMC3415301, DOI: 10.1038/nmat2558.
- Boxberger JI, Orlansky AS, Sen S, Elliott DM. Reduced nucleus pulposus glycosaminoglycan content alters intervertebral disc dynamic viscoelastic mechanics. Journal Of Biomechanics 2009, 42: 1941-1946. PMID: 19539936, PMCID: PMC2756063, DOI: 10.1016/j.jbiomech.2009.05.008.
- Nerurkar N, Sen S, Wible E, Stambough J, Elliott D, Mauck R. Mesenchymal Stem Cell Seeded Nanofibrous Laminates Mimic the Multi-Scale Form and Function of the Annulus Fibrosus. 2009, 417-418. DOI: 10.1115/sbc2009-206812.
- Sen S, Boxberger J, Schroeder Y, Orias A, Elliott D. Effect of Degeneration on the Dynamic Viscoelastic Properties of Human Annulus Fibrosus in Tension. 2008, 609-610. DOI: 10.1115/sbc2008-193057.
- Boxberger J, Auerbach J, Sen S, Dodge G, Elliott D. Intervertebral Disc Function Is Restored in an In Vivo Model of Chronic Nucleus Pulposus Glycosaminoglycan Reduction. 2008, 127-128. DOI: 10.1115/sbc2008-192937.
- Beckstein JC, Sen S, Schaer TP, Vresilovic EJ, Elliott DM. Comparison of Animal Discs Used in Disc Research to Human Lumbar Disc. Spine 2008, 33: e166-e173. PMID: 18344845, DOI: 10.1097/brs.0b013e318166e001.
- Boxberger JI, Auerbach JD, Sen S, Elliott DM. An In Vivo Model of Reduced Nucleus Pulposus Glycosaminoglycan Content in the Rat Lumbar Intervertebral Disc. Spine 2008, 33: 146-154. PMID: 18197098, PMCID: PMC2696404, DOI: 10.1097/brs.0b013e31816054f8.
- Baker B, O’Connell G, Sen S, Nathan A, Elliott D, Mauck R. Multi-Lamellar and Multi-Axial Maturation of Cell-Seeded Fiber-Reinforced Tissue Engineered Constructs. 2007, 1013-1014. DOI: 10.1115/sbc2007-176434.
- O’Connell G, Sen S, Baker B, Mauck R, Elliott D. Biaxial Mechanics of Musculoskeletal Tissue and Fiber-Reinforced Scaffolds. 2007, 935-936. DOI: 10.1115/sbc2007-176540.
- Boxberger JI, Sen S, Yerramalli CS, Elliott DM. Nucleus pulposus glycosaminoglycan content is correlated with axial mechanics in rat lumbar motion segments. Journal Of Orthopaedic Research® 2006, 24: 1906-1915. PMID: 16865712, DOI: 10.1002/jor.20221.