Medicine and Health Sciences Commons^™

A Comparison Of Existing Risk Prediction Models In Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation, B. Worku, M. Gaudino, D. Avgerinos, K. Ramasubbu, I. Gambardella, I. Gulkarov, S. Khin

Journal Articles

© 2020 The Author(s) Background: Patients undergoing consideration for venoarterial extracorporeal membrane oxygenation (VA-ECMO) require an immediate risk profile assessment in the setting of incomplete information. A number of survival prediction models for critically ill patients and patients undergoing elective cardiac surgery or institution of VA-ECMO support have been designed. We assess the ability of these models to predict outcomes in a cohort of patients undergoing institution of VA-ECMO for cardiogenic shock or cardiac arrest. Methods: Fifty-one patients undergoing institution of VA-ECMO support were retrospectively analyzed. APACHE II, SOFA, SAPS II, Encourage, SAVE, and ACEF scores were calculated. Their ability …

Multifocal Extracranial Mycotic Aneurysms In A Patient With Endocarditis, A. M. Spring, M. A. Catalano, B. F. Farber, K. V. Krishnasastry, P. J. Yu

Journal Articles

© 2020 This report describes the case of a 44-year-old man with Streptococcus gallolyticus (formerly S. bovis) endocarditis requiring surgical mitral valve replacement who developed multifocal extracranial mycotic aneurysms after the resolution of infection.

Management Of Elective Aortic Valve Replacement Over The Long Term In The Era Of Covid-19, C. Basman, C. A. Kliger, L. Pirelli, S. J. Scheinerman

Journal Articles

No abstract provided.

Biomarkers Of Inflammation In Heart Failure Patients With Reduced And Preserved Ejection Fractions: Multi-Ethnic Study Of Atherosclerosis, Michelle Lynne Stone

UNF Graduate Theses and Dissertations

Purpose Examine the relationships between high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and soluble tumor necrosis factor-α receptor-1 (sTNF-R1) and the cumulative risk of heart failure with reduced (HFrEF) and preserved (HFpEF) ejection fractions in a diverse, population-based sample. Methods Study sample included 6,814 adult (45-84 years of age) men and women who participated in the Multi-Ethnic Study of Atherosclerosis and were free of cardiovascular disease at baseline. Cox regression was used to calculate the hazard ratios (HR) associated with elevated baseline hs-CRP (> 3-10 mg/L), IL-6 (> 75^th percentile) and sTNF-R1 (> 75^th percentile) and risk of overall …

Cardiovascular: Outcomes And Innovations Report, Maine Medical Center

Annual Reports

2020 Annual Report

Hypermetabolism In Critically Ill Patients With Covid-19 And The Effects Of Hypothermia: A Case Series, Pj Yu, H Cassiere, K Bocchieri, S Derosa, S Yar, A Hartman

Journal Articles

No abstract provided.

Quality Of Life Outcomes In Tracheobronchomalacia Surgery, J Mcginn, B Herbert, A Maloney, B Patton, R Lazzaro

Journal Articles

No abstract provided.

Heparin-Induced Thrombocytopenia In Patients Readmitted After Open Cardiac Surgical Procedures: A Case Series, M A. Catalano, V Prasad, A M. Spring, H Cassiere, T Y. Chang, A Hartman, Pj Yu

Journal Articles

No abstract provided.

The Impact Of Native Language Status On The Frequency Of Heart Failure Readmissions, Cooper Blazek, Dave Katzianer, Md

Phase 1

Introduction. Heart failure readmissions are costly and lead to poor health outcomes. The efficacy of discharge instructions or other outpatient interventions may be affected by patient’s primary language status. The aim of this study is to look at the impact of primary language status on the frequency of heart failure admissions.

Methods. This study was a retrospective chart review of EMRs, on Epic software, at Jefferson academic medical center and community affiliate in Philadelphia, PA between March 2017 and October 2018. Patients were included if they had a principal diagnosis of HF or a diagnosis associated with “acute” heart failure …

Evaluation Of Ventricular Repolarization In Patients Undergoing Cardiac Resynchronization Therapy (Crt) Using Two Modalities: Conventional Biventricular Pacing Vs. His-Bundle Pacing, Anshul Gupta, Behzad B. Pavri, Md, Fhrs

Phase 1

Introduction:

Permanent His-bundle pacing (HBP) is being used as an alternative to biventricular pacing (BiVP) for CRT. HBP preserves the physiologic pattern of ventricular activation and markedly reduces ventricular dyssynchrony. While ventricular depolarization with HBP vs. BiVP has been studied, the effects of the 2 modalities on repolarization have not been compared. The purpose of this study was to compare ventricular repolarization in patients with HBP and BiVP. We hypothesize that HBP provides more physiologic repolarization as compared to BiVP.

Methods: ECG repolarization parameters were analyzed in patients who underwent HBP and BiVP using the first available ECG post implant. …

A Randomized Control Trial To Compare Npo Status Against A Specialized Pre-Cardiac Cath Diet, Carri Woods Mba, Msn, Rn, Michelle Wood Msn, Rn-Bc

Nursing Active Studies

The purpose of this research study is to identify best practice for NPO status prior to a cardiac catheterization through a comparative evaluation. This prospective, randomized control study will evaluate current standard of care NPO guidelines and a specialized pre-cardiac catheterization diet in low-medium risk patients undergoing elective cardiac catheterization.

PI: Carri Woods MBA, MSN, RN; Michelle Wood MSN, RN-BC

Contact: carri.woods@parkview.com; michelle.wood@parkview.com

Effect Of Hiv Prevalence And Gender On Cardiovascular Disease Deaths, Tanjeev Ahmad

Scholarship in Medicine - All Papers

Cardiovascular disease is a widely diagnosed condition that can have many etiologies and factors that changes its prognosis. This project was aimed at investigating two potential factors that changes its prognosis: HIV status and gender. Data on HIV status was collected from NCHHSTP AtlasPlus for all US states and territories and data on cardiovascular disease deaths and corresponding gender was collected from Interactive Atlas of Heart Disease and Stroke for all US states and territories. Using a linear regression test, a correlation was tested for between HIV status and cardiovascular disease deaths for every US state/territory followed by a test …

The Role Of Mitochondrial Pyruvate Carrier 1 (Mpc1) In Heart Failure And Its Implications For Cardiac Recovery, Obadiah Issachar Kirk

Mahurin Honors College Capstone Experience/Thesis Projects

Heart failure (HF) is a complex syndrome with high mortality rates around the world. HF also has diverse etiology as many things contribute such as hypertension, obesity, coronary artery disease, inflammation, and cardiac arrhythmias. Studies have shown that unloading of a failing heart with a left ventricular assist device (LVAD) can lead to cardiac recovery in a subpopulation of individuals with advanced HF. RNA-sequencing and protein expression analysis of myocardial tissue from HF patients who underwent the LVAD implant and heart transplant indicated that subpopulation of HF patients who responded to LVAD unloading had significantly lower levels of mitochondrial pyruvate …

Quality Improvement: Patient Education For Management Of Hypertension In Pregnancy, Kriti Goel

Scholarship in Medicine - All Papers

Objective: We introduced maternal hypertension education tools that address illiteracy in underserved populations. Through these tools, we aim to improve patients’ knowledge of their conditions. We also aim to determine if healthcare providers perceive a benefit to the use of the tools. Ultimately, we hope these changes will lead to better short- and long-term health outcomes for mother and child.

Methods: Pregnant women with any form of hypertension at Five Rivers Center for Women’s Health (FRHC) were surveyed during OB visits. The Patient Questionnaire includes objective knowledge questions on their condition and self-reported comprehension questions. Forty-five women were surveyed during …

The Efficacy Of Thoratec Implantable Ventricular Assist Devices Compared To Syncardia Total Artificial Hearts As Bridge-To-Transplantation Therapy In Adults With Biventricular Heart Failure, Alexandria Davenport

Capstone Showcase

Abstract

Introduction: Systolic heart failure is a chronic condition in which there is a decrease in the heart’s ability to pump blood to the body. While there are several treatments for the symptoms of heart failure, the only curative treatment for most causes of chronic heart failure is a heart transplant. Due to the limited number of heart donors, 72.2% of patients in need of a heart transplant in 2017 spent up to 2 years waiting for a transplant. Mechanical circulatory support has been used to increase patient survival to transplantation. In the past, these machines were external devices that …

Fit Clinical Decision-Making Unusual Echocardiographic Findings Of Myocarditis Mimicking An Aortic Runoff Lesion, Sarah Studyvin, Christine Symes, Barbara A. Pahud, Nitin Madan

Posters

No abstract provided.

Process Factors Affecting Reperfusion Time In Patients Presenting With St-Segment Elevation Myocardial Infarction (Stemi), Richard R. Wall

Theses and Dissertations

Abstract PROCESS FACTORS AFFECTING REPERFUSION TIME IN PATIENTS

PRESENTING WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION (STEMI) By Richard R. Wall MSRS, RT(R)(CT)(CI), RCIS

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University.

Virginia Commonwealth University, 2020.

Dissertation Chair: Jeffrey S. Legg Ph.D. Associate Professor and Chair, Department of Radiation Sciences

An ST-segment myocardial infarction (STEMI) occurs when the blood flow to the myocardium is suddenly and completely blocked causing the myocardium to become ischemic. A STEMI is a life-threatening condition that necessitates emergent medical treatment. Research has shown that longer …

Contemporary Epidemiology Of Rising Atrial Septal Defect Trends Across Usa 1991–2016: A Combined Ecological Geospatiotemporal And Causal Inferential Study, Albert Stuart Reece, Gary Kenneth Hulse

Research outputs 2014 to 2021

© 2020, The Author(s). Background: Cardiovascular anomalies are the largest group of congenital anomalies and the major cause of death in young children, with various data linking rising atrial septal defect incidence (ASDI) with prenatal cannabis exposure. Objectives / Hypotheses. Is cannabis associated with ASDI in USA? Is this relationship causal? Methods: Geospatiotemporal cohort study, 1991–2016. Census populations of adults, babies, congenital anomalies, income and ethnicity. Drug exposure data on cigarettes, alcohol abuse, past month cannabis use, analgesia abuse and cocaine taken from National Survey of Drug Use and Health (78.9% response rate). Cannabinoid concentrations from Drug Enforcement Agency. Inverse …

Management Of Acute Myocardial Infarction During The Covid-19 Pandemic., E. Mahmud, H. L. Dauerman, F. G. Welt, J. C. Messenger, S. V. Rao, C. Grines, A. Mattu, R. Jauhar, P. Meraj, T. D. Henry, +3 Additional Authors

Journal Articles

The worldwide pandemic caused by the novel acute respiratory syndrome coronavirus 2 (SARS-CoV2) has resulted in a new and lethal disease termed coronavirus disease 2019 (COVID-19). Although there is an association between cardiovascular disease and COVID-19, the majority of patients who need cardiovascular care for the management of ischemic heart disease may not be infected with COVID-19. The objective of this document is to provide recommendations for a systematic approach for the care of patients with an acute myocardial infarction (AMI) during the COVID-19 pandemic. There is a recognition of two major challenges in providing recommendations for AMI care in …

Safety Of Magnetic Resonance Imaging Scanning In Patients With Cardiac Resynchronization Therapy–Defibrillators Incorporating Quadripolar Left Ventricular Leads, C. A. Rinaldi, P. J. Vitoff, D. G. Nair, R. Bernstein, S. E. Mountantonakis, A. Rapacciuolo, N. Carter, H. F. Tse, U. B. Green

Journal Articles

© 2020 The Authors Background: Magnetic resonance imaging (MRI) scanning of magnetic resonance (MR)-conditional cardiac implantable cardioverter-defibrillators (ICDs) can be performed safely following specific protocols. MRI safety with cardiac resynchronization therapy–defibrillators (CRT-Ds) incorporating quadripolar left ventricular (LV) leads is less clear. Objective: The purpose of this study was to evaluate the safety and effectiveness of ICDs and CRT-D systems with quadripolar LV leads after an MRI scan. Methods: The ENABLE MRI Study included 230 subjects implanted with a Boston Scientific ImageReady ICD (n = 39) or CRT-D (n = 191) incorporating quadripolar LV leads undergoing nondiagnostic 1.5-T MRI scans (lumbar …

Evaluating The Validity Of Risk Scoring In Predicting Pacemaker Rates Following Transcatheter Aortic Valve Replacement, A. M. Spring, M. A. Catalano, V. Prasad, B. Rutkin, E. Koss, A. Hartman, P. J. Yu

Journal Articles

Copyright © 2020 Alexander M. Spring et al. Introduction: Requirement of permanent pacemaker (PPM) implantation is a known and common postoperative consequence of transcatheter aortic valve replacement (TAVR). The Emory risk score has been recently developed to help risk stratify the need for PPM insertion in patients undergoing TAVR with SAPIEN 3 valves. Our aim was to assess the validity of this risk score in our patient population, as well as its applicability to patients receiving self-expanding valves. Methods: We conducted a retrospective review of 479 TAVR patients without preoperative pacemakers from November 2016 through December 2018. Preoperative risk factors …

Cardiac Structural Changes After Transcatheter Aortic Valve Replacement: Systematic Review And Meta-Analysis Of Cardiovascular Magnetic Resonance Studies, G. Mehdipoor, S. Chen, S. Chatterjee, P. Torkian, O. Ben-Yehuda, M. B. Leon, G. W. Stone, M. R. Prince

Journal Articles

© 2020 The Author(s). Background: Transcatheter aortic valve replacement (TAVR) is increasingly used to treat patients with severe aortic stenosis (AS). Cardiovascular magnetic resonance imaging (CMR) provides reliable and reproducible estimates for assessment of cardiac structure and function after TAVR. The goal of this study was to conduct a systematic review and meta-analysis of the literature to assess left ventricular (LV) volumes, mass and function by CMR after TAVR. Methods: Using Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines, we searched PubMed and Embase for studies reporting CMR findings before and at least 1 month after TAVR. Main factors of …

Increased Inpatient Mortality For Cardiovascular Patients During The First Covid-19 Epidemic In New York, S. Richardson, J. S. Hirsch, M. Narasimhan, J M. Crawford, T Mcginn, K W. Davidson, V. Singh

Journal Articles

No abstract provided.

The Paradox Of Stemi Regionalization: Widened Disparities Despite Some Benefits, R. O. Roswell, R. Brown, S. Richardson

Journal Articles

No abstract provided.

In Adult Patients 60+ Y.O. With Aaa, Would (F)Evar Lead To Least Amount Of Post-Operative Complications Than Traditional Osr?, Sandra Yoo

Capstone Showcase

INTRODUCTION: An abdominal aortic aneurysm (AAA) is a permanent ballooning of the abdominal aorta greater than 3cm in diameter. A small AAA is often asymptomatic. However, as time passes the risk of rupture increases as the diameter of the aneurysm widens. This can ultimately lead to massive internal bleeding and fatality. Surgery is the most common course of treatment for AAA. Most patients will undergo traditional open surgery, but this is often associated with prolonged in-hospital recovery and is contraindicated in an aging population that have a higher prevalence of comorbidities. With this in thought, some clinicians have been turning …

Fit Clinical Decision-Making: Isolated Polymorphic Ventricular Tachycardia In A Pediatric Patient: An Unusual Presentation Of Acute Mycocarditis, Natalie S. Shwaish, Bethany Runkel, Lindsey Malloy-Walton

Posters

No abstract provided.

Persistent Reduction In The Age Adjusted Mortality Rate From Aortic Valve Surgery In The United State With Elimination Of Gender Gap In Recent Years., Mohammad Reza Movahed, Sara Etemad, Mehrnoosh Hashemzadeh, Mehrtash Hashemzadeh

Articles, Abstracts, and Reports

BACKGROUND: Advancement in the surgical techniques should translate into better outcome. The goal of this study was to evaluate mortality trends from aortic valve surgery in the United State using large inpatient database.

METHOD: The Nationwide Inpatient Sample (NIS) database was used to calculate the age-adjusted mortality rate from aortic valve surgery from 1988 to 2011 in the United State using ICD-9 coding for aortic valve surgery.

RESULTS: We found that age adjusted mortality rate from aortic valve surgery gradually decreased from 1988 until end of study in 2011 to the lowest level with elimination of gender gap that was …

Investigating The Effects Of Brainstem Neuronal Adaptation On Cardiovascular Homeostasis., James H Park, Jonathan Gorky, Babatunde Ogunnaike, Rajanikanth Vadigepalli, James S Schwaber

Articles, Abstracts, and Reports

Central coordination of cardiovascular function is accomplished, in part, by the baroreceptor reflex, a multi-input multi-output physiological control system that regulates the activity of the parasympathetic and sympathetic nervous systems via interactions among multiple brainstem nuclei. Recent single-cell analyses within the brain revealed that individual neurons within and across brain nuclei exhibit distinct transcriptional states contributing to neuronal function. Such transcriptional heterogeneity complicates the task of understanding how neurons within and across brain nuclei organize and function to process multiple inputs and coordinate cardiovascular functions within the larger context of the baroreceptor reflex. However, prior analysis of brainstem neurons revealed …

Cardiometabolical Risk Factors Associated With Renal Function In Apparently Healthy Young Students: A Cross-Sectional Study, Lucia M. Perez-Navarro, Rafael Valdez-Ortiz, Araceli Alegria-Diaz, Miguel Murgia-Romero, Rafael Jimenez-Flores, Rafael Villalobos-Molina, Srinivas Mummidi, Ravindranath Duggirala, Juan C. Lopez-Alvarenga

School of Medicine Publications and Presentations

Background: Cardiometabolic risk factors (CMRFs) appear decades before developing chronic kidney disease (CKD) in adulthood.

Objective: The objective of the study was to identify the prevalence and association between CMRFs and kidney function in apparently healthy young adults (18-25 years old).

Methods: We included 5531 freshman year students. Data collected on CMRFs included central obesity, high body mass index (hBMI >25), blood pressure, glycemia, lipids, uric acid (UA >6.8 mg/dL), and insulin. Glomerular filtration rate (GFR) was estimated by CKD-Epidemiology Collaboration formula. We used logistic regression and a log linear for odds ratio (OR) (95% confidence level) and probabilities.

Results: …

Fit Clinical Decision-Making: Brain Abscess In A Nonfenestrated Fontan Patient, Bethany Runkel, Natalie Shwaish, Geetha Raghuveer, William Drake

Posters

No abstract provided.