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Brian P. Shapiro, M.D., M.A.

  1. Cardiologist
  2. Echocardiographer
  3. Internist

Publicaciones

  1. Kashou AH, Noseworthy PA, Beckman TJ, Anavekar NS, Cullen MW, Angstman KB, Sandefur BJ, Shapiro BP, Wiley BW, Kates AM, Sadhu J, Thakker P, Huneycutt D, Braisted A, Smith SW, Baranchuk A, Grauer K, O'Brien K, Kaul V, Gambhir HS, Knohl SJ, Restrepo D, May AM. EDUCATE: An international, randomized controlled trial for teaching electrocardiography. Curr Probl Cardiol. 2024 Mar; 49 (3):102409 Epub 2024 Jan 15
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  2. Cortes P, Elsayed AA, Stancampiano FF, Barusco FM, Shapiro BP, Bi Y, Heckman MG, Peng Z, Kempaiah P, Palmer WC. Clinical and genetic predictors of cardiac dysfunction assessed by echocardiography in patients with hereditary hemochromatosis. Int J Cardiovasc Imaging. 2024 Jan; 40 (1):45-53 Epub 2023 Oct 11
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  3. Kashou AH, Noseworthy PA, Beckman TJ, Anavekar NS, Cullen MW, Boswell CL, Angstman KB, Sandefur BJ, Shapiro BP, Wiley BW, Kates AM, Huneycutt D, Braisted A, Kerwin S, Young B, Rowlandson I, Beard JW, Baranchuk A, O'Brien K, Knohl SJ, May AM. Predictors of ECG Interpretation Proficiency in Healthcare Professionals. Curr Probl Cardiol. 2023 Dec; 48 (12):102011 Epub 2023 Aug 04
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  4. Kashou AH, Noseworthy PA, Beckman TJ, Anavekar NS, Cullen MW, Angstman KB, Sandefur BJ, Shapiro BP, Wiley BW, Kates AM, Huneycutt D, Braisted A, Manoukian SV, Kerwin S, Young B, Rowlandson I, Beard JW, Baranchuk A, O'Brien K, Knohl SJ, May AM. Impact of Computer-Interpreted ECGs on the Accuracy of Healthcare Professionals. Curr Probl Cardiol. 2023 Nov; 48 (11):101989 Epub 2023 July 22
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  5. Kashou AH, Noseworthy PA, Beckman TJ, Anavekar NS, Angstman KB, Cullen MW, Sandefur BJ, Friedman PA, Shapiro BP, Wiley BW, Kates AM, Braisted A, Huneycutt D, Baranchuk A, Beard JW, Kerwin S, Young B, Rowlandson I, Knohl SJ, O'Brien K, May AM. Exploring Factors Influencing ECG Interpretation Proficiency of Medical Professionals. Curr Probl Cardiol. 2023 Oct; 48 (10):101865 Epub 2023 June 13
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  6. Kashou AH, Noseworthy PA, Beckman TJ, Anavekar NS, Cullen MW, Angstman KB, Sandefur BJ, Shapiro BP, Wiley BW, Kates AM, Huneycutt D, Braisted A, Smith SW, Baranchuk A, Grauer K, O'Brien K, Kaul V, Gambhir HS, Knohl SJ, Albert D, Kligfield PD, Macfarlane PW, Drew BJ, May AM. ECG Interpretation Proficiency of Healthcare Professionals. Curr Probl Cardiol. 2023 Oct; 48 (10):101924 Epub 2023 July 01
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  7. Kashou AH, Noseworthy PA, Beckman TJ, Anavekar NS, Cullen MW, Angstman KB, Sandefur BJ, Thompson CA, Halvorsen AJ, Shapiro BP, Wiley BW, Kates AM, Cosco D, Sadhu JS, Thakker PD, Huneycutt D, Braisted A, Smith SW, Baranchuk A, Grauer K, O'Brien K, Kaul V, Gambhir HS, Knohl SJ, Restrepo D, Kligfield PD, Macfarlane PW, Drew BJ, May AM. Education curriculum assessment for teaching electrocardiography: Rationale and design for the prospective, international, randomized controlled EDUCATE trial. J Electrocardiol. 2023 Sep-Oct; 80:166-173 Epub 2023 July 13
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  8. Morales-Lara AC, Elkhatib W, Oluleye O, Alhusain R, Saad A, Salwa N, Siddiqui H, Wieczorek MA, Ray J, Parikh P, Burger C, Shapiro B, Kusumoto F, Pillai D, Adedinsewo D. Impact of Pulmonary Hypertension Hemodynamic Phenotype on Incident Atrial Fibrillation. Cardiology. 2023; 148(4):353-362. Epub 2023 Jun 05.
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  9. Lugo-Fagundo NS, Sennhauser S, Shapiro BP. 53-Year-Old Man With Progressive Dyspnea. Mayo Clin Proc. 2023 Jun; 98 (6):933-938 Epub 2023 Apr 29
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  10. Lara-Breitinger KM, Scott CG, Nkomo VT, Pellikka PA, Kane GC, Chaliki HP, Shapiro BP, Eleid MF, Alkhouli M, Greason KL, Pislaru SV, Rihal CS. Tricuspid Regurgitation Impact on Outcomes (TRIO): A Simple Clinical Risk Score. Mayo Clin Proc. 2022 Aug; 97 (8):1449-1461 Epub 2022 Aug 01
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  11. Umadat G, Moktan V, Shapiro B. 61-Year-Old Man With Nausea and Vomiting. Mayo Clin Proc. 2022 Jan; 97 (1):170-175 Epub 2021 Dec 01
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  12. Bryde R, Applewhite AI, Abu Dabrh AM, Taylor BJ, Heckman MG, Filmalter SE, Pujalte G, Rojas C, Heckman AJ, Brigham TJ, Prokop LJ, Shapiro BP. Cardiac structure and function in elite female athletes: A systematic review and meta-analysis. Physiol Rep. 2021 Dec; 9 (23):e15141
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  13. Burger CD, DuBrock HM, Cartin-Ceba R, Moss JE, Shapiro BP, Frantz RP. Topic-Based, Recent Literature Review on Pulmonary Hypertension. Mayo Clin Proc. 2021 Dec; 96 (12):3109-3121 Epub 2021 Aug 31
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  14. Taylor BJ, Shapiro BP, Johnson BD. Exercise intolerance in heart failure: The important role of pulmonary hypertension. Exp Physiol. 2020 Dec; 105 (12):1997-2003 Epub 2020 Mar 16
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  15. Rojas CA, Livingston D, Padilla G, Feldhaus J, Rajan C, Bowman AW, Shapiro BP, Mergo PJ. Signs of Increased Intrapericardial Pressure on Chest Computed Tomography: Pictorial Review With Echocardiography, Cardiac Computed Tomography, and Cardiac Magnetic Resonance Imaging Correlation. J Thorac Imaging. 2020 May; 35 (3):143-152
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  16. Bryde RE, Ray JC, Sacco KA, Shapiro B, Cooper L. Eosinophillic Myocarditis Secondary to Metastatic Melanoma. Radiol Cardiothorac Imaging. 2019 Oct 31; 1 (4):e190076
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  17. Bryde RE, Ray JC, Sacco KA, Shapiro B, Cooper L. Eosinophillic Myocarditis Secondary to Metastatic Melanoma. Radiol Cardiothorac Imaging. 2019 Oct 31; 1 (4):e190076
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  18. Ray JC, Burger C, Mergo P, Safford R, Blackshear J, Austin C, Fairweather D, Heckman MG, Zeiger T, Dubin M, Shapiro B. Pulmonary arterial stiffness assessed by cardiovascular magnetic resonance imaging is a predictor of mild pulmonary arterial hypertension. Int J Cardiovasc Imaging. 2019 Oct; 35 (10):1881-1892 Epub 2018 June 22
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  19. Alsaad AA, Shapiro BP. Appropriately testing patients with intermediate risk for coronary artery disease: how well are we doing? BMJ Evid Based Med. 2018 Aug; 23 (4):142-149 Epub 2018 May 05
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  20. Shapiro BP, Ambrosius WT, Blackshear JL, Cushman WC, Whelton PK, Oparil S, Beddhu S, Dwyer JP, Gren LH, Kostis WJ, Lioudis M, Pisoni R, Rosendorff C, Haley WE, SPRINT Research Group*. Impact of Intensive Versus Standard Blood Pressure Management by Tertiles of Blood Pressure in SPRINT (Systolic Blood Pressure Intervention Trial). Hypertension. 2018 Jun; 71 (6):1064-1074 Epub 2018 Apr 30
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  21. Stross WC, Alsaad AA, Shapiro BP. 42-Year-Old Woman With Bilateral Arm Tightness. Mayo Clin Proc. 2018 May; 93 (5):e45-e51 Epub 2018 Feb 01
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  22. Batton KA, Austin CO, Bruno KA, Burger CD, Shapiro BP, Fairweather D. Sex differences in pulmonary arterial hypertension: role of infection and autoimmunity in the pathogenesis of disease. Biol Sex Differ. 2018 Apr 18; 9 (1):15
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  23. Blackshear JL, Safford RE, Thomas CS, Bos JM, Ackerman MJ, Geske JB, Ommen SR, Shapiro BP, Johns GS. Platelet Function Analyzer 100 and Brain Natriuretic Peptide as Biomarkers in Obstructive Hypertrophic Cardiomyopathy. Am J Cardiol. 2018 Mar 15; 121 (6):768-774 Epub 2017 Dec 25
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  24. Halawa A, Burton MC, Maniaci MJ, Shapiro BP, Yip DS, Hodge DO, Vargas ER, Dawson N. Association of Anemia with Outcomes of Acute Heart Failure. South Med J. 2018 Feb; 111 (2):103-108
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  25. Austin CO, Chen D, Thomas CS, Safford RE, Shapiro BP, Bryan JA, Ray JC, Blackshear JL. Von Willebrand factor multimer quantitation for assessment of cardiac lesion severity and bleeding risk. Res Pract Thromb Haemost. 2018 Jan; 2 (1):155-161 Epub 2017 Dec 21
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  26. Austin Chistopher, Chen Dong, Thomas Colleen, Safford Robert, Shapiro Brian, Bryan Justin, Ray Jordan, Blackshear Joseph. Von Willebrand factor multimer quantitation for assessment of cardiac lesion severity and bleeding risk Research and Practice in Thrombosis and Haemostasis.12/21/2017;2017:(00):1-7.
  27. Chang TI, Reboussin DM, Chertow GM, Cheung AK, Cushman WC, Kostis WJ, Parati G, Raj D, Riessen E, Shapiro B, Stergiou GS, Townsend RR, Tsioufis K, Whelton PK, Whittle J, Wright JT, Papademetriou V, SPRINT Research Group*. Visit-to-Visit Office Blood Pressure Variability and Cardiovascular Outcomes in SPRINT (Systolic Blood Pressure Intervention Trial). Hypertension. 2017 Oct; 70 (4):751-758 Epub 2017 July 31
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  28. Soliman EZ, Ambrosius WT, Cushman WC, Zhang ZM, Bates JT, Neyra JA, Carson TY, Tamariz L, Ghazi L, Cho ME, Shapiro BP, He J, Fine LJ, Lewis CE, SPRINT Research Study Group. Effect of Intensive Blood Pressure Lowering on Left Ventricular Hypertrophy in Patients With Hypertension: SPRINT (Systolic Blood Pressure Intervention Trial). Circulation. 2017 Aug 1; 136 (5):440-450 Epub 2017 May 16
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  29. Austin C, Burger C, Kane G, Safford R, Blackshear J, Ung R, Ray J, Alsaad A, Alassas K, Shapiro B. High-risk echocardiographic features predict mortality in pulmonary arterial hypertension. Am Heart J. 2017 Jul; 189:167-176.
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  30. Snipelisky D, Ray J, Vallabhajosyula S, Matcha G, Squier S, Lewis J, Holliday R, Aggarwal N, Askew JW 3rd, Shapiro B, Anavekar N. Usefulness for Predicting Cardiac Events After Orthotopic Liver Transplantation of Myocardial Perfusion Imaging and Dobutamine Stress Echocardiography Preoperatively. Am J Cardiol. 2017 Apr 01; 119: (7)1008-1011.
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  31. Shillcutt SK, Tavazzi G, Shapiro BP, Diaz-Gomez J. Pulmonic Regurgitation in the Adult Cardiac Surgery Patient. J Cardiothorac Vasc Anesth. 2017 Feb; 31 (1):215-228 Epub 2016 July 14
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  32. Diaz-Gomez JL, Alvarez AB, Danaraj JJ, Freeman ML, Lee AS, Mookadam F, Shapiro BP, Ramakrishna H. A novel semiquantitative assessment of right ventricular systolic function with a modified subcostal echocardiographic view. Echocardiography. 2017 Jan; 34 (1):44-52 Epub 2016 Oct 14
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  33. Koop AH, Melendez-Rosado JM, Farres H, Mergo PJ, Shapiro BP. Penetrating aortic ulcer manifesting as atypical chest pain Journal of Radiology and Imaging.2016;1:(3):18-19.
  34. Ung RL, McRee CW, Shapiro BP. 64-Year-Old-Woman With Chest Pressure and Shortness of Breath. Mayo Clin Proc. 2016 May; 91 (5):e61-5 Epub 2016 Mar 25
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  35. Ray JC, Snipelisky DF, Shapiro BP. 40-Year-Old Woman With Breathlessness and Fatigue. Mayo Clin Proc. 2016 Apr; 91: (4)e49-53.
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  36. Blackshear JL, Kusumoto H, Safford RE, Wysokinska E, Thomas CS, Waldo OA, Stark ME, Shapiro BP, Ung S, Moussa I, Agnew RC, Landolfo K, Chen D. Usefulness of Von Willebrand Factor Activity Indexes to Predict Therapeutic Response in Hypertrophic Cardiomyopathy. Am J Cardiol. 2016 Feb 1; 117 (3):436-42 Epub 2015 Nov 19
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  37. Kim EK, Chang SA, Choi JO, Glockner J, Shapiro B, Choe YH, Fine N, Jang SY, Kim SM, Miller W, Lee SC, Oh JK. Concordant and Discordant Cardiac Magnetic Resonance Imaging Delayed Hyperenhancement Patterns in Patients with Ischemic and Non-Ischemic Cardiomyopathy. Korean Circ J. 2016 Jan; 46 (1):41-7 Epub 2016 Jan 14
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  38. Safford RE, Ray JC, Burger CD, Blackshear JL, Mergo PJ, Shapiro BP. Is cardiac magnetic resonance imaging underutilized in the diagnosis of pulmonary hypertension? Advances in Pulmonary Hypertension.2015;14:(2)102-4.
  39. Shapiro BP. Pulmonary Hypertenstion Due to Left Heart Disease Advances in Pulmonary Hypertension .2015;14:(2)
  40. Snipelisky DF, McRee C, Seeger K, Levy M, Shapiro BP. Coronary interventions before liver transplantation might not avert postoperative cardiovascular events. Tex Heart Inst J. 2015 Oct; 42(5):438-42.
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  41. De Marco T, Shapiro B. Pulmonary Hypertension Due to Left Heart Disease - Pulmonary Hypertension Roundtable Advances in Pulmonary Hypertension. 2015; 14.
  42. Blackshear JL, Stark ME, Agnew RC, Moussa ID, Safford RE, Shapiro BP, Waldo OA, Chen D. Remission of recurrent gastrointestinal bleeding after septal reduction therapy in patients with hypertrophic obstructive cardiomyopathy-associated acquired von Willebrand syndrome. J Thromb Haemost. 2015 Feb; 13 (2):191-6 Epub 2014 Dec 12
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  43. Pagan RJ, Parikh PP, Mergo PJ, Gerber TC, Mankad R, Freeman WD, Shapiro BP. Emerging role of cardiovascular CT and MRI in the evaluation of stroke. AJR Am J Roentgenol. 2015 Feb; 204(2):269-80.
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  44. Austin C, Alassas K, Burger C, Safford R, Pagan R, Duello K, Kumar P, Zeiger T, Shapiro B. Echocardiographic assessment of estimated right atrial pressure and size predicts mortality in pulmonary arterial hypertension. Chest. 2015 Jan; 147 (1):198-208
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  45. Blackshear JL, Wysokinska EM, Safford RE, Thomas CS, Shapiro BP, Ung S, Stark ME, Parikh P, Johns GS, Chen D. Shear stress-associated acquired von Willebrand syndrome in patients with mitral regurgitation. J Thromb Haemost. 2014 Dec; 12 (12):1966-74 Epub 2014 Oct 17
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  46. McRee CW, Ray JC, Shapiro BP. 78-year-old-woman with dyspnea on exertion. Mayo Clin Proc. 2014 Nov; 89(11):e109-13. Epub 2014 Nov 03.
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  47. McRee CW, Mergo P, Parikh P, Pollak A, Shapiro BP. Modern advances in cardiovascular imaging: cardiac computed tomography and cardiovascular MRI in pericardial disease. Future Cardiol. 2014 Nov; 10(6):769-79.
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  48. Filsoof DM, Snipelisky DF, Shapiro BP. Use of a melody pulmonary valve in transcatheter valve-in-valve replacement for tricuspid valve bioprosthesis degeneration. Tex Heart Inst J. 2014 Sep; 41(5):511-3.
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  49. Snipelisky D, Levy M, Shapiro B. Utility of dobutamine stress echocardiography as part of the pre-liver transplant evaluation: an evaluation of its efficacy. Clin Cardiol. 2014 Aug; 37 (8):468-72 Epub 2014 Apr 09
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  50. Hassanein AS, Khalifa AM, Al-Atabany W, El-Wakad MT, Shapiro B, Ibrahim ESH. Automatic synthesis of cine viability MRI images for evaluation of coronary heart disease. 2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2014. 2014; 5117-20.
  51. Austin C, Alassas K, Burger C, Safford R, Pagan R, Duello K, Kumar P, Zeiger T, Shapiro B. Echocardiographic Assessment of Estimated Right Atrial Pressure and Size Predicts Mortality in Pulmonary Arterial Hypertension. Chest. 2014; In press. Epub 2014 Sep 11
  52. Alassas K, Mergo P, Ibrahim el-S, Burger C, Safford R, Parikh P, Shapiro B. Cardiac MRI as a diagnostic tool in pulmonary hypertension. Future Cardiol. 2014 Jan; 10(1):117-30.
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  53. Snipelisky D, Burger C, Shapiro B, Kusumoto F. Electrocardiographic changes in patients responding to treatment with group I pulmonary arterial hypertension. South Med J. 2013 Nov; 106 (11):618-23
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  54. Kumar P, Blackshear JL, Ibrahim el-SH, Mergo P, Parikh P, Batton K, Shapiro B. Advances of cardiovascular MRI in hypertrophic cardiomyopathy. Future Cardiol. 2013 Sep; 9(5):697-709.
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  55. Snipelisky D, Stancampiano F, Shapiro B. Antiphospholipid syndrome as a cause for recurrent myocardial infarction. Acute Card Care. 2013 Sep; 15(3):80-2. Epub 2013 Aug 08.
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  56. Batton K, Moussa I, Blackshear J, Mergo P, Austin C, Shapiro B. Use of cardiac magnetic resonance imaging for alcohol septal ablation in hypertrophic obstructive cardiomyopathy. Acute Card Care. 2013 Jun; 15: (2)44-6.
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  57. Giesbrandt KJ, Bolan CW, Shapiro BP, Edwards WD, Mergo PJ. Diffuse diseases of the myocardium: MRI-pathologic review of nondilated cardiomyopathies. AJR Am J Roentgenol. 2013 Mar; 200(3):W266-73.
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  58. Giesbrandt KJ, Bolan CW, Shapiro BP, Edwards WD, Mergo PJ. Diffuse diseases of the myocardium: MRI-pathologic review of cardiomyopathies with dilatation. AJR Am J Roentgenol. 2013 Mar; 200(3):W274-82.
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  59. Shapiro BP, Mergo PJ, Snipelisky DF, Kantor B, Gerber TC. Radiation dose in cardiac imaging: how should it affect clinical decisions? AJR Am J Roentgenol. 2013 Mar; 200(3):508-14.
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  60. Blackshear JL, Wysokinska EM, Safford RE, Thomas CS, Stark ME, Shapiro BP, Ung S, Johns GS, Chen D. Indexes of von Willebrand factor as biomarkers of aortic stenosis severity (from the Biomarkers of Aortic Stenosis Severity [BASS] study). Am J Cardiol. 2013 Feb 1; 111 (3):374-81 Epub 2012 Nov 17
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  61. Austin C, Shapiro B, Mergo P, Aschi M, Kusumoto F. Congenital Cardiomyopathy Presenting as Palpitations and Heart Failure Northeast Florida Medicine. 2013.
  62. Snipelisky D, Donovan S, Levy M, Satyanarayana R, Shapiro B. Cardiac troponin elevation predicts mortality in patients undergoing orthotopic liver transplantation. J Transplant. 2013; 2013:252838 Epub 2013 July 14
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  63. Austin CO, Kramer D, Canabal J, Krishna M, Mergo P, Shapiro BP. A heart of stone: a case of acute development of cardiac calcification and hemodynamic collapse. J Cardiovasc Comput Tomogr. 2013 Jan-Feb; 7 (1):66-8 Epub 2012 Dec 05
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  64. Shapiro BP, Mergo PJ, Austin CO, Kantor B, Gerber TC. Assessing the available techniques for testing myocardial viability: what does the future hold? Future Cardiol. 2012 Nov; 8(6):819-36.
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  65. Austin C, Shapiro B, Mergo P, Aschi M, Kusumoto F. Congenital Cardiomyopathy Presenting as Palpitations and Heart Failure in an Otherwise Healthy Adult. Clinical Images in Medicine.2012;
  66. Boilson BA, Larsen K, Harbuzariu A, Delacroix S, Korinek J, Froehlich H, Bailey KR, Scott CG, Shapiro BP, Boerrigter G, Chen HH, Redfield MM, Burnett JC Jr, Simari RD. Regulation of circulating progenitor cells in left ventricular dysfunction. Circ Heart Fail. 2010 Sep; 3 (5):635-42 Epub 2010 June 23
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  67. Shapiro BP, Young PM, Kantor B, Choe YH, McCollough CH, Gerber TC. Radiation dose reduction in CT coronary angiography. Curr Cardiol Rep. 2010 Jan; 12 (1):59-67
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  68. Salisbury AC, Shapiro BP, Martinez MW. Extensive myocardial and mitral annular calcification leading to mitral regurgitation and restrictive cardiomyopathy: An unusual case of caseous calcification of the mitral annulus. J Cardiovasc Comput Tomogr. 2009 Sep-Oct; 3(5):351-3. Epub 2009 Jun 21.
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  69. Shapiro BP, Owan TE, Mohammed SF, Meyer DM, Mills LD, Schalkwijk CG, Redfield MM. Advanced glycation end products accumulate in vascular smooth muscle and modify vascular but not ventricular properties in elderly hypertensive canines. Circulation. 2008 Sep 2; 118 (10):1002-10 Epub 2008 Aug 18
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  70. Jaber WA, Maniu C, Krysiak J, Shapiro BP, Meyer DM, Linke WA, Redfield MM. Titin isoforms, extracellular matrix, and global chamber remodeling in experimental dilated cardiomyopathy: functional implications and mechanistic insight. Circ Heart Fail. 2008 Sep; 1 (3):192-9 Epub 2008 June 25
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  71. Shapiro BP, Owan TE, Mohammed S, Kruger M, Linke WA, Burnett JC Jr, Redfield MM. Mineralocorticoid signaling in transition to heart failure with normal ejection fraction. Hypertension. 2008 Feb; 51 (2):289-95 Epub 2007 Dec 17
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  72. Shapiro BP, Lam CS, Patel JB, Mohammed SF, Kruger M, Meyer DM, Linke WA, Redfield MM. Acute and chronic ventricular-arterial coupling in systole and diastole: insights from an elderly hypertensive model. Hypertension. 2007 Sep; 50: (3)503-11.
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  73. Shapiro BP, McGoon MD, Redfield MM. Unexplained pulmonary hypertension in elderly patients. Chest. 2007 Jan; 131 (1):94-100
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  74. Shapiro BP, Nishimura RA, McGoon MD, Redfield MM. Diastolic Diagnostic Dilemmas: Diastolic Heart Failure Causing Pulmonary Hypertension, Pulmonary Hypertension Causing Diastolic Dysfunction. Advances in Pulmonary Hypertension. 2006; 5:13-20.
  75. Shapiro BP, Sprung J, Scott K, Arendt K, Krowka MJ, Afessa B. Cardiovascular collapse induced by position-dependent pulmonary vein occlusion in a patient with fibrosing mediastinitis. Anesthesiology. 2005 Sep; 103 (3):661-3
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  76. Shapiro BP, Chen HH, Burnett JC Jr, Redfield MM. Use of plasma brain natriuretic peptide concentration to aid in the diagnosis of heart failure. Mayo Clin Proc. 2003 Apr; 78 (4):481-6
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PST-20225978