Medicine and Health Sciences Commons^™

Evidence For Minimal Cardiogenic Potential Of Stem Cell Antigen 1-Positive Cells In The Adult Mouse Heart., Lauren E Neidig, Florian Weinberger, Nathan J Palpant, John Mignone, Amy M Martinson, Daniel W Sorensen, Ingrid Bender, Natsumi Nemoto, Hans Reinecke, Lil Pabon, Jeffery D Molkentin, Charles E Murry, Jop H Van Berlo

Articles, Abstracts, and Reports

No abstract provided.

Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson

Master's Projects and Capstones

Abstract

Problem: Heart failure (HF), also known as congestive heart failure (CHF), is the number one diagnosis-related group (DRG) for people 65 years of age and older in the United States. This disease group is complicated and debilitating, requiring frequent hospitalizations with high mortality rates. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified CHF as an area for improvement in hospitals.

Context: This was a quality improvement project for an integrated medical center in the Central Valley, California with over 19,000 HF patients. In 2018, for patients 65 years and older, HF is the third-most admitted DRG …

The Association Between Doppler Measures Of Cardiac Function And Outcomes In Patients With Left Ventricular Ejection Fraction ≤ 40% Undergoing Noncardiovascular Surgeries, Yang Shi, Rachel Pedersen, Matthew Rappelt, Robyn Shearer, Nasir Z. Sulemanjee, Dianne L. Zwicke, T. Edward Hastings, Omar M. Cheema, Vinay Thohan

Aurora Heart Failure / Transplant Faculty

Background: Preoperative risk assessments of individuals who undergo major noncardiac surgery have focused on ischemic heart disease. Information on how to assess the noncardiac surgical risks for patients with depressed cardiac function, as seen in heart failure, is sparse. Echocardiography is routinely performed in patients with depressed cardiac function and is an accepted standard cardiac assessment. Transthoracic echocardiography (TTE) provides strong independent prognostic implications in a wide range of cardiovascular conditions.

Purpose: To identify the echocardiographic parameters associated with outcomes among patients undergoing major noncardiac surgery.

Methods: A retrospective single-institution investigation identified 1,770 patients who underwent one or more major …

Mechanisms Of Left Ventricular Thrombus Formation In Heart Failure With Reduced Ejection Fraction: Novel Insights From Two-Dimensional Speckle Tracking Echocardiography, Dhruv Chawla, Tracy Hammonds, Tadele Mengesha, Matt Umland, Khawaja Afzal Ammar, Vinay Thohan

Aurora Heart Failure / Transplant Faculty

Background: Patients suffering from heart failure with reduced ejection fraction (HFrEF) are at increased risk for left ventricular (LV) thrombus and subsequent thromboembolism, yet anticoagulation is not routinely recommended for left ventricular ejection fraction (LVEF) alone. We sought to determine the role of two-dimensional speckle tracking echocardiography (2D-STE) to quantify regional changes in cardiac function associated with LV thrombus, which may prospectively guide anticoagulation.

Purpose: Help enable cardiovascular clinicians to use 2D-STE to evaluate regional strain patterns among patients with HFrEF with and without LV thrombus. Our results suggest that statistically lower regional longitudinal strain patterns in a well-matched cohort …

Restoration Of Left Ventricular Function Following Lvad Implantation – Remission Or Recovery? A Case Series., Shiksha Joshi, Mariah Barlow, Maya Guglin

The VAD Journal

Background

A wide range of left ventricular (LV) recovery rates on left ventricular assist device (LVAD) support have been reported. In this case series, we summarize our experience with LVAD explantation for presumed LV recovery.

Case series

Out of 240 patients who received an LVAD implant in our program since its inception, we explanted/inactivated the pump for presumed LV recovery in only three patients. All three of these patients had relapse of cardiomyopathy within 6 months of explantation.

Conclusion

Our experience does not support the existence of LV recovery following LVAD implantation as a common phenomenon. Improvement in LV function …

Problems Experienced In The Second And Third Months After Discharge From A Heart Failure-Related Hospitalization, Joan S. Grant, Lucinda J. Graven

Journal of Patient-Centered Research and Reviews

The purpose of this study was to identify high-priority problems experienced by individuals during the second and third month after discharge from an acute care facility for heart failure. This descriptive, exploratory study, an extension of a previous analysis that examined high-priority problems in the first month, comprised 19 participants who were assigned to an intervention group that received a randomized, 12-week-pilot coping partnership (COPE-HF) intervention. A trained research nurse provided the intervention, and participants used a standard list to identify high-priority heart failure-related problems. Quantitative and content data analysis was conducted. While the highest-priority problem continued to be managing …

Trajectory Of Thirst Intensity And Distress From Admission To 4-Week Follow Up At Home In Patients With Heart Failure, Nana Waldréus, Misook L. Chung, Martje H. L. Van Der Wal, Tiny Jaarsma

Nursing Faculty Publications

Background: Patients with heart failure (HF) can suffer from increased thirst intensity and distress. Trajectories of thirst intensity and distress from hospital to home are unclear. The aim of this study was to describe thirst intensity and distress trajectories in patients from the time of hospital admission to 4 weeks after discharge, and describe trajectories of thirst intensity and distress by patients’ characteristics (gender, age, body mass index [BMI], plasma urea, anxiety, and depression).

Patients and methods: In this observational study, data were collected from patients with HF (n=30) at hospital admission, discharge, and at 2 and 4 weeks after …

Myocyte [Na+]I Dysregulation In Heart Failure And Diabetic Cardiomyopathy, Sanda Despa

Pharmacology and Nutritional Sciences Faculty Publications

By controlling the function of various sarcolemmal and mitochondrial ion transporters, intracellular Na⁺ concentration ([Na⁺]_i) regulates Ca²⁺ cycling, electrical activity, the matching of energy supply and demand, and oxidative stress in cardiac myocytes. Thus, maintenance of myocyte Na⁺ homeostasis is vital for preserving the electrical and contractile activity of the heart. [Na⁺]_i is set by the balance between the passive Na⁺ entry through numerous pathways and the pumping of Na⁺ out of the cell by the Na⁺/K⁺-ATPase. This equilibrium is perturbed in heart failure, …

Micronutrient Deficiency Independently Predicts Time To Event In Patients With Heart Failure, Terry A. Lennie, Christina Andreae, Mary Kay Rayens, Eun Kyeung Song, Sandra B. Dunbar, Susan J. Pressler, Seongkum Heo, Jinshil Kim, Debra K. Moser

Nursing Faculty Publications

Background—Dietary micronutrient deficiencies have been shown to predict event‐free survival in other countries but have not been examined in patients with heart failure living in the United States. The purpose of this study was to determine whether number of dietary micronutrient deficiencies in patients with heart failure was associated with shorter event‐free survival, defined as a combined end point of all‐cause hospitalization and death.

Methods and Results—Four‐day food diaries were collected from 246 patients with heart failure (age: 61.5±12 years; 67% male; 73% white; 45% New York Heart Association [NYHA] class III/IV) and analyzed using Nutrition Data Systems …

Rapamycin Attenuates Cardiac Fibrosis In Experimental Uremic Cardiomyopathy By Reducing Marinobufagenin Levels And Inhibiting Downstream Pro-Fibrotic Signaling, Steven T. Haller Phd, Yanling Yan Phd, Christopher A. Drummond Phd, Joe Xie Md, Jiang Tian Phd, David J. Kennedy Phd, Victoria Y. Shilova Phd, Zijian Xie Phd, Jiang Liu Phd, Christopher J. Cooper Md, Deepak Malhotra Md, Phd, Joseph I. Shapiro Md, Olga V. Fedorova Phd, Alexei Y. Bagrov Md, Phd

Jiang Liu

Background: Experimental uremic cardiomyopathy causes cardiac fibrosis and is causally related to the increased circulating levels of the cardiotonic steroid, marinobufagenin (MBG), which signals through Na/K‐ATPase. Rapamycin is an inhibitor of the serine/threonine kinase mammalian target of rapamycin (mTOR) implicated in the progression of many different forms of renal disease. Given that Na/K‐ATPase signaling is known to stimulate the mTOR system, we speculated that the ameliorative effects of rapamycin might influence this pathway.

Methods and Results: Biosynthesis of MBG by cultured human JEG‐3 cells is initiated by CYP27A1, which is also a target for rapamycin. It was demonstrated that 1 …

Rapamycin Attenuates Cardiac Fibrosis In Experimental Uremic Cardiomyopathy By Reducing Marinobufagenin Levels And Inhibiting Downstream Pro-Fibrotic Signaling, Steven T. Haller Phd, Yanling Yan Phd, Christopher A. Drummond Phd, Joe Xie Md, Jiang Tian Phd, David J. Kennedy Phd, Victoria Y. Shilova Phd, Zijian Xie Phd, Jiang Liu Phd, Christopher J. Cooper Md, Deepak Malhotra Md, Phd, Joseph I. Shapiro Md, Olga V. Fedorova Phd, Alexei Y. Bagrov Md, Phd

Zijian Xie

Background: Experimental uremic cardiomyopathy causes cardiac fibrosis and is causally related to the increased circulating levels of the cardiotonic steroid, marinobufagenin (MBG), which signals through Na/K‐ATPase. Rapamycin is an inhibitor of the serine/threonine kinase mammalian target of rapamycin (mTOR) implicated in the progression of many different forms of renal disease. Given that Na/K‐ATPase signaling is known to stimulate the mTOR system, we speculated that the ameliorative effects of rapamycin might influence this pathway.

Methods and Results: Biosynthesis of MBG by cultured human JEG‐3 cells is initiated by CYP27A1, which is also a target for rapamycin. It was demonstrated that 1 …

Rapamycin Attenuates Cardiac Fibrosis In Experimental Uremic Cardiomyopathy By Reducing Marinobufagenin Levels And Inhibiting Downstream Pro-Fibrotic Signaling, Steven T. Haller Phd, Yanling Yan Phd, Christopher A. Drummond Phd, Joe Xie Md, Jiang Tian Phd, David J. Kennedy Phd, Victoria Y. Shilova Phd, Zijian Xie Phd, Jiang Liu Phd, Christopher J. Cooper Md, Deepak Malhotra Md, Phd, Joseph I. Shapiro Md, Olga V. Fedorova Phd, Alexei Y. Bagrov Md, Phd

Yanling Yan

Background: Experimental uremic cardiomyopathy causes cardiac fibrosis and is causally related to the increased circulating levels of the cardiotonic steroid, marinobufagenin (MBG), which signals through Na/K‐ATPase. Rapamycin is an inhibitor of the serine/threonine kinase mammalian target of rapamycin (mTOR) implicated in the progression of many different forms of renal disease. Given that Na/K‐ATPase signaling is known to stimulate the mTOR system, we speculated that the ameliorative effects of rapamycin might influence this pathway.

Methods and Results: Biosynthesis of MBG by cultured human JEG‐3 cells is initiated by CYP27A1, which is also a target for rapamycin. It was demonstrated that 1 …

Rapamycin Attenuates Cardiac Fibrosis In Experimental Uremic Cardiomyopathy By Reducing Marinobufagenin Levels And Inhibiting Downstream Pro-Fibrotic Signaling, Steven T. Haller Phd, Yanling Yan Phd, Christopher A. Drummond Phd, Joe Xie Md, Jiang Tian Phd, David J. Kennedy Phd, Victoria Y. Shilova Phd, Zijian Xie Phd, Jiang Liu Phd, Christopher J. Cooper Md, Deepak Malhotra Md, Phd, Joseph I. Shapiro Md, Olga V. Fedorova Phd, Alexei Y. Bagrov Md, Phd

Joseph I Shapiro MD

Background: Experimental uremic cardiomyopathy causes cardiac fibrosis and is causally related to the increased circulating levels of the cardiotonic steroid, marinobufagenin (MBG), which signals through Na/K‐ATPase. Rapamycin is an inhibitor of the serine/threonine kinase mammalian target of rapamycin (mTOR) implicated in the progression of many different forms of renal disease. Given that Na/K‐ATPase signaling is known to stimulate the mTOR system, we speculated that the ameliorative effects of rapamycin might influence this pathway.

Methods and Results: Biosynthesis of MBG by cultured human JEG‐3 cells is initiated by CYP27A1, which is also a target for rapamycin. It was demonstrated that 1 …

Standardizing The Palliative Care Referral Process, Ronaviv M. Garcia

Master's Projects and Capstones

Standardizing the Palliative Care Referral Process

Problem: Heart failure (HF) is one of the most common causes of hospital admissions and emergency department visits in the United States. HF patients are at high risk for hospital readmission: 25% of HF patients discharged from the hospital are readmitted within 30 days of discharge, and 50% are readmitted within 6 months (Vedel & Khanossov, 2015).

Context: Palliative Care (PC) has been shown to be an effective way of managing distressing HF symptoms and thus of reducing hospital readmissions, yet patients are infrequently referred to PC services during their transition from hospital to …

Assessment Of Nursing Knowledge Before And After Implementation Of Educational Intervention On Heart Failure, Sarah Scott

Dissertations

Purpose: The purpose of this study was to assess the knowledge of nursing staff on a cardiology unit before and after the implementation of heart failure specific education. Methods: Forty staff nurses on a cardiology unit at a single institution were given The Nurses Knowledge of Heart Failure Education Principles Survey (NKHFEP), a validated tool to assess nursing knowledge of heart failure. A series of four educational sessions were given to the same forty nurses. They were then given the NKHFEP survey a second time to assess change in knowledge post educational intervention. Results: The mean of Pre-education (M = …

An "Exercise" In Cardiac Metabolism, Stephen C. Kolwicz Jr.

Health and Exercise Physiology Faculty Publications

Research has demonstrated that the high capacity requirements of the heart are satisfied by a preference for oxidation of fatty acids. However, it is well known that a stressed heart, as in pathological hypertrophy, deviates from its inherent profile and relies heavily on glucose metabolism, primarily achieved by an acceleration in glycolysis. Moreover, it has been suggested that the chronically lipid overloaded heart augments fatty acid oxidation and triglyceride synthesis to an even greater degree and, thus, develops a lipotoxic phenotype. In comparison, classic studies in exercise physiology have provided a basis for the acute metabolic changes that occur during …

Power To The Patients: A Heart Failure Transitions Of Care Program In A Heart Resource Center, Katherine Nicole Oxina Padiernos Bsn, Rn, Dnp Student, Scot Nolan Dnp, Rn, Cns, Ccrn, Teri Armour -Burton Phd, Cnml, Ne-Bc, Colleen Austel Nadeau Bsn, Rn, Chfn

Doctor of Nursing Practice Final Manuscripts

Background: In the United States an estimated 5.7 million adults have heart failure (HF), costing $30.7 billion annually. National HF readmission rates have remained high at 21.3%. After an extensive literature review, the purpose of this project was to incorporate teach back methods, self care education, resource accessibility, and increased post-discharge contact through an outpatient heart failure transitions of care program.

Methods and Results: Prior to discharge, HF patients were recruited and given a pre-test Self Care of Heart Failure Index (SCHFI). A DNP student and progressive care unit registered nurses provided discharge education utilizing a Healthy Heart Tracker booklet …

Examining The Relationships Between Ethnicity, Palliative Care And Readmissions In The Heart Failure Population, Deanna Johnston

Dissertations

Specific Aim: The aim of this dissertation is to analyze the relationships between ethnicity, palliative care consultation and readmissions in the heart failure population at a community hospital that serves a large diverse population.

Background: Hospitals struggle with preventing readmissions. There are many interventions that can be implemented to help prevent readmissions, and Palliative Care (PC) is one of those interventions. PC has many benefits including symptom management, improved communication through the healthcare continuum, understanding of illness and treatment options, and can be provided in conjunction with curative treatments. Heart failure is one of the most common readmission diagnoses. …

The Efficacy Of The Teach-Back Method Of Education On Readmission Rates In Heart Failure Patients Within 30 Days Of Discharge, Catherine Lynch

Senior Honors Projects, 2010-2019

Background: The teach-back method is a method of education that is being used with heart failure patients in order to improve their quality of education and lower readmission rates. This literature review is aimed at synthesizing studies conducted to determine the efficacy of the teach-back method with this specific patient population.

Methods: Electronic searches of CINAHL and PubMed were performed through James Madison University libraries. Articles selected for inclusion were evaluated for study design, relevance, and sample size.

Results: Three studies met eligibility criteria, these studies showed statistically significant evidence that the teach-back method did reduce readmission rates in heart …

The Effect Of Home Health Interventions On Hospital Readmission Rates In Patients With Congestive Heart Failure, Lindsay Reavis

Doctor of Nursing Practice Projects

Heart failure is a common diagnosis that affects millions of people worldwide. Unfortunately, heart failure is associated with a high risk of 30-day hospital readmission rates. Home health nurses have the potential to bridge the gap between discharge and hospital readmission by providing up-to-date patient education on a one-to-one basis. Research indicates home health nurses lack knowledge of the disease process, nurse management of the disease, and treatment. This project focused on an educational session about the pathophysiology of heart failure, fluid/weight monitoring, diet, medications, and exercise with a pre- and post-tests evaluating home health nurses understanding of heart failure. …

The Effect Of Nurse- Led Group Discussions By Race On Depressive Symptoms In Patients With Heart Failure, Ubolrat Piamjariyakul, Noreen C. Thompson, Christy Russell, Carol E. Smith

Clinical and Translational Science Institute

Background—African Americans with heart failure (HF) have the highest rates of depression among all ethnicities in the United States. Objectives—To compare the effects by race on depressive symptoms and topics discussed in the first clinic appointment after HF hospitalization. Methods—This study is a secondary analysis of data obtained from a randomized clinical trial that tested a patient group discussion of HF self-management intervention with 93 Caucasians and 77 African Americans. Results—The reduction in depressive symptoms was significantly greater among African American patients within the intervention group (F = 3.99, p = .047) than controls. There were significant differences by race …

Problems Experienced In The First Month After Discharge From A Heart Failure-Related Hospitalization, Joan S. Grant, Lucinda J. Graven, Kelly Fuller

Journal of Patient-Centered Research and Reviews

Purpose: Heart failure is a global health concern with high morbidity and mortality rates. Individuals with heart failure commonly experience problems that impact daily life. However, little is known regarding which problems are most significant during the immediate posthospitalization period. Thus, the purpose of this study was to identify high-priority problems experienced by individuals the first month after discharge from an acute care facility with a diagnosis of heart failure.

Methods: This descriptive, exploratory study was part of a 12-week randomized controlled pilot study that examined the efficacy of a coping partnership intervention (COPE-HF Partnership) between a trained research nurse …

The Effectiveness Of The Cardiac Resynchronization In A Patient With Ischemic Cardiomyopathy, Diana R. Tudorașcu, Constantin Bătăiosu, Alina Paraschiv, Elena-Anca Târtea, Ionuț Donoiu, Cristina Florescu

Journal of Mind and Medical Sciences

Cardiac resynchronization therapy (CRT) in multiple and large trials has been demonstrated to improve symptoms and decrease hospitalization and mortality of patients when used in addition to optimal medical therapy. The global mechanical performance of the heart is affected in subjects with heart failure by atrio-ventricular, interventricular, or intraventricular conduction disorders, which lead to the desynchronization of electrical activity. Cardiac resynchronization therapy can effectively improve the clinical and haemodynamic status of these patients. According to literature data, CRT is performed only on well-selected patients (who qualify for CRT based on current indications), and approximately 70% of those patients respond favorably. …

What Did We Learn About Vads In 2017?, Maya Guglin

The VAD Journal

No abstract provided.

A Mixed Methods Study Of Symptom Perception In Patients With Chronic Heart Failure, Elliane Irani

Faculty Scholarship

Background: Early heart failure (HF) symptoms are frequently unrecognized for reasons that are unclear. We explored symptom perception in patients with chronic HF. Methods: We enrolled 36 HF out-patients into a longitudinal sequential explanatory mixed methods study. We used objectively measured thoracic fluid accumulation and daily reports of signs and symptoms to evaluate accuracy of detected changes in fluid retention. Patterns of symptom interpretation and response were explored in telephone interviews conducted every 2 weeks for 3-months. Results: In this sample, 44% had a mismatch between objective and subjective fluid retention; younger persons were more likely to have mismatch. In …

Evaluating Impedance Monitoring To Reduce Hospital Readmissions For Patients With Heart Failure With Reduced Ejection Fraction: An Integrative Review, Abigail Newton

Doctoral Dissertations and Scholarly Projects

Congestive Heart Failure (HF) is a chronic progressive cardiac disorder with high mortality rates and is the number one reason for hospital readmission in the United States. More than 5 million Americans live with HF with more than 900,000 new diagnoses annually. The likelihood of developing HF increases with age making it the most common primary diagnosis for patients over age 65. HF has a significant impact on quality of life, with depression being a common comorbid condition. Thoracic impedance monitoring has shown to reduce exacerbations and hospitalizations in patients with HF. This project evaluated the literature related to impedance …

Heart Failure Follow Up Phone Calls, Melissa Lampert, Anne Major

Nursing Posters

Increase the number of 72-hour post-discharge follow-up phone calls for patients hospitalized with a primary diagnosis of heart failure.

This is a quality measure required for Joint Commission Heart Failure Certification and also to maintain American Heart Association Gold Plus Status.

The Association Of Hyponatremia With Race, Ethnicity, And Gender In Patients Admitted For Acute Decompensated Heart Failure Diagnoses, Vikas Sunder, Md, Rene Alvarez, Md, Evan Carabelli, Md

Division of Internal Medicine Faculty Papers & Presentations

Background: Hyponatremia, defined by a serum sodium concentration less than 135 mEq/L, is seen in approximately 25% of patients admitted with congestive heart failure (CHF). Hyponatremia on admission has been shown to increase in-hospital mortality and to be an independent predictor of 6month mortality. Prior work has shown that CHF patients with hyponatremia on admission are more likely to be Caucasian. Given its prognostic significance, hyponatremia and its association with patient characteristics warrants further study.

Methods: We queried for unique admissions to Temple University Hospital between 2011 and 2015 with a DRG code of "291-293" to represent a …

Effects Of The Na-Cl Co-Transporter (Ncc) In Western Diet Induced Metabolic And Cardiac Dysfunction, Zachary S. Cutter

Theses and Dissertations

Interleukin-18 (IL-18) is a pro-inflammatory cytokine known to be involved in maintaining metabolic homeostasis; however, also capable of inducing cardiac dysfunction. Additionally, IL-18, has been shown to bind to a novel receptor, the Na-Cl Co-transporter (NCC). We hypothesized that NCC mediates IL-18 metabolic and cardiac signaling in mice. Using male C57BL/6J mice, we compared the metabolic and cardiac function changes after at least 8 weeks of high-saturated fat high sugar diet (Western Diet) in NCC knockout (NCCKO), IL-18 knockout (IL-18KO), and wild-type mice. We show that NCCKO mice have significantly increased body weight gain from baseline, no difference in fasting …

Management Of Amiodarone-Induced Thyrotoxicosis At A Cardiac Transplantation Centre, Michelle Isaacs, Monique Costin, Ron Bova, Helen L. Barrett, Drew Heffernan, Katherine Samaras, Jerry R. Greenfield

Medical Papers and Journal Articles

Background: Amiodarone-induced thyrotoxicosis (AIT) is associated with significant morbidity and mortality, particularly in patients with cardiac failure. The aim of the study was to evaluate the management of AIT at a tertiary hospital specialising in cardiac failure and transplantation.

Methods: Retrospective audit of 66 patients treated for AIT by Endocrinology (2007–2016), classified as type 1 (T1) or type 2 (T2) based on radiological criteria. Main outcome measurements were response rate to initial treatment, time to euthyroidism, and frequency/safety of thyroidectomy.

Results: Mean age was 60 ± 2 years; 80% were male. Sixty-four patients commenced medical treatment: thionamides (THIO) in 23, …