Cardiology Commons^™

Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia

Journal of Nonprofit Innovation

Urban farming can enhance the lives of communities and help reduce food scarcity. This paper presents a conceptual prototype of an efficient urban farming community that can be scaled for a single apartment building or an entire community across all global geoeconomics regions, including densely populated cities and rural, developing towns and communities. When deployed in coordination with smart crop choices, local farm support, and efficient transportation then the result isn’t just sustainability, but also increasing fresh produce accessibility, optimizing nutritional value, eliminating the use of ‘forever chemicals’, reducing transportation costs, and fostering global environmental benefits.

Imagine Doris, who is …

Lazarus Syndrome After Aortic Aneurysm Repair, Kevyn Niu, Jamie Lee Aldakkour, Charles Huyghues-Despointes, Yizhi Lin

HCA Healthcare Journal of Medicine

Introduction

Lazarus syndrome is defined as the spontaneous return of circulation after cessation of cardiopulmonary resuscitation (CPR). Though there have been multiple cases of Lazarus syndrome documented in the literature, it is a significantly underreported phenomenon with less than 100 cases reported in the literature since the first case in 1982.

Case Presentation

After elective aortic aneurysm repair, an 88-year-old with a do-not-resuscitate directive had cardiac arrest, briefly showing post-mortem respiration and pulse. Despite resuscitation efforts including pharmacological intervention and CPR, he passed away within an hour. This case highlights complexities in end-of-life care and warrants exploration of post-mortem physiological …

Maternal Western Diet Programs Cardiometabolic Dysfunction And Hypothalamic Inflammation Via Epigenetic Mechanisms Predominantly In The Male Offspring, Mona Elgazzaz, Clara Berdasco, Jone Garai, Melody Baddoo, Shiping Lu, Hisham Daoud, Jovanny Zabaleta, Franck Mauvais-Jarvis, Eric Lazartigues

School of Medicine Faculty Publications

Objective; Maternal exposure during pregnancy is a strong determinant of offspring health outcomes. Such exposure induces changes in the offspring epigenome resulting in gene expression and functional changes. In this study, we investigated the effect of maternal Western hypercaloric diet (HCD) programming during the perinatal period on neuronal plasticity and cardiometabolic health in adult offspring. Methods; C57BL/6J dams were fed HCD for 1 month prior to mating with regular diet (RD) sires and kept on the same diet throughout pregnancy and lactation. At weaning, offspring were maintained on either HCD or RD for 3 months resulting in 4 treatment groups …

Social Determinants Of Health And Disparities In Hypertension And Cardiovascular Diseases, Abhishek Chaturvedi, Anqi Zhu, Naga Vaishnav Gadela, Dorairaj Prabhakaran, Tazeen Jafar

Department of Medicine

High blood pressure causes over 10 million preventable deaths annually globally. Populations in low- and middle-income countries suffer the most, experiencing increased uncontrolled blood pressure and cardiovascular disease (CVD) deaths. Despite improvements in high-income countries, disparities persist, notably in the United States, where Black individuals face up to 4× higher CVD mortality than White individuals. Social determinants of health encompass complex, multidimensional factors linked to an individual's birthplace, upbringing, activities, residence, workplaces, socioeconomic and environmental structures, and significantly affect health outcomes, including hypertension and CVD. This review explored how social determinants of health drive disparities in hypertension and related CVD …

Effect Of Flecainide And Ibutilide Alone And In Combination To Terminate And Prevent Recurrence Of Atrial Fibrillation, Alexander Burashnikov, José M. Di Diego, Bence Patocskai, Debra S. Echt, Luiz Belardinelli, Charles Antzelevitch

Division of Cardiology Faculty Papers

BACKGROUND: There is a need for improved approaches to rhythm control therapy of atrial fibrillation (AF).

METHODS: The effectiveness of flecainide (1.5 µmol/L) and ibutilide (20 nmol/L), alone and in combination, to cardiovert and prevent AF recurrence was studied in canine-isolated coronary-perfused right atrioventricular preparations. We also examined the safety of the combination of flecainide (1.5 µmol/L) and ibutilide (50 nmol/L) using canine left ventricular wedge preparations.

RESULTS: Sustained AF (>1 hour) was inducible in 100%, 60%, 20%, and 0% of atria in the presence of acetylcholine alone, acetylcholine+ibutilide, acetylcholine+flecainide, and acetylcholine+ibutilide+flecainide, respectively. When used alone, flecainide and ibutilide …

Point-Of-Care Ultrasound For The Diagnosis Of Frequent Cardiovascular Diseases: A Review, Ernesto Calderon Martinez, Edna Diarte, Diana Othon, Leonardo Rodriguez Reyes, Daniel A. Aguirre Cano, Carolina Cantu Navarro, Maria G. Ycaza, David Arriaga Escamilla, Jinal Choudhari, George Michel

School of Medicine Publications and Presentations

Point-of-care ultrasound (POCUS) has emerged as an indispensable diagnostic tool in cardiology, particularly within the emergency department. This narrative synthesis provides a comprehensive exploration of POCUS applications in cardiovascular diseases, elucidating its multifaceted roles and addressing challenges. The review delves into the technical attributes of POCUS, emphasizing its noninvasive nature, radiation-free qualities, and suitability for non-radiologists. It navigates through educational strategies, stressing the importance of structured programs for the seamless integration of POCUS into clinical practice. Highlighting its efficacy, the synthesis discusses POCUS applications in various scenarios such as dyspnea, chest pain, cardiac arrest, aortic dissection, pericardial effusion, and pulmonary …

Rare Presentation Of Postpericardiotomy Syndrome After Left Atrial Myxoma Removal, Jessy Feng, Shyama Appareddy, Yaman Gibran, Aryana Garza, Jacqueline Luevano, Gustavo Garcia

School of Medicine Publications and Presentations

Postpericardiotomy syndrome (PPS) is a known complication of cardiac valve surgery, but it has not been commonly reported as a postoperative complication of cardiac myxoma removal. A 78-year-old female with hypertension and atrial fibrillation presenting with angina was found to have a large left atrial myxoma (7.5 cm × 4.4 cm). The myxoma was resected; however, 1-week postoperation hemoglobin and blood pressure decreased with elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Limited transthoracic echocardiogram (TTE) showed moderate pericardial effusion, confirming the diagnosis of PPS. This case highlights the importance of monitoring patients postremoval of myxoma for symptoms of …

Shorter Duration Of Dual Antiplatelet Therapy Following Second Generation Drug Eluting Stent Placement, Alexandra Coy, Caitlyn M. Murtha

Physician Assistant Capstones, 2020-current

Heart disease is the leading cause of death in both men and women in The United States. Because advanced heart disease is often treated with percutaneous coronary intervention (PCI) for stent implantation, many patients will be put on dual antiplatelet therapy to prevent adverse effects such as stent thrombosis or restenosis. The purpose of this literature review is to determine if the development of second-generation drug eluting stents allows for a shorter, 6-month, duration of dual antiplatelet therapy (DAPT) versus the currently recommended 12 months. The articles discussed in this review were obtained on PubMed and narrowed using search terms …

In Memoriam: Prof. Dr. Rer. Nat. Jeanette Erdmann, Pashmina Wiqar Shah, Satwat Hashmi, Tobias Reinberger, Nadine Odenthal, Luis Eichelmann, Daria Kosenko, Ilyas Ahmad, Jaafar Al-Hasani, Till Joscha Demal, Zouhair Aherrahrou

Department of Biological & Biomedical Sciences

No abstract provided.

Closing The Gaps In Care Of Dyslipidemia: Revolutionizing Management With Digital Health And Innovative Care Models, Samuel J. Apple, Rachel Clark, Jonathan Daich, Macarena Lopez Gonzalez, Robert J. Ostfeld, Peter P. Toth, Vera Bittner, Seth S. Martin, Jamal S. Rana, Salim S. Virani

Office of the Provost

Although great progress has been made in the diagnostic and treatment options for dyslipidemias, unawareness, underdiagnosis and undertreatment of these disorders remain a significant global health concern. Growth in digital applications and newer models of care provide novel tools to improve the management of chronic conditions such as dyslipidemia. In this review, we discuss the evolving landscape of lipid management in the 21st century, current treatment gaps and possible solutions through digital health and new models of care. Our discussion begins with the history and development of value-based care and the national establishment of quality metrics for various chronic conditions. …

Beyond The Basics: Unraveling The Complexity Of Coronary Artery Calcification, Satwat Hashmi, Pashmina Wiqar Shah, Zouhair Aherrahrou, Elena Aikawa, Rédouane Aherrahrou

Department of Biological & Biomedical Sciences

Coronary artery calcification (CAC) is mainly associated with coronary atherosclerosis, which is an indicator of coronary artery disease (CAD). CAC refers to the accumulation of calcium phosphate deposits, classified as micro- or macrocalcifications, that lead to the hardening and narrowing of the coronary arteries. CAC is a strong predictor of future cardiovascular events, such as myocardial infarction and sudden death. Our narrative review focuses on the pathophysiology of CAC, exploring its link to plaque vulnerability, genetic factors, and how race and sex can affect the condition. We also examined the connection between the gut microbiome and CAC, and the impact …

Myocardial Protection In High-Risk Cardiopulmonary Bypass Support, Subhasis Chatterjee, Marc R. Moon

Journal of Shock and Hemodynamics

The development of cardioplegia has facilitated complex cardiac surgery and allowed high-risk patients to safely tolerate life-saving procedures. By following the principles of electromechanical arrest, inducing hypothermia, and using adjunctive agents to help mitigate the effects of hypothermia and ischemia reperfusion injury, cardioplegia can be safely induced with various commercially available compositions, which can be delivered by several different surgical techniques. Although many studies have compared these methods, there is little consensus on whether any one method is superior to another. Just as a surgeon may need to modify technique according to individual patient factors, so too must a surgeon …

Ablation Of Accessory Pathway From Right Atrial Appendage To Anatomic Left Ventricle In L-Transposition Of The Great Arteries, Shree Lata Radhakrishnan, Robert O. Drutel, Cody M. Williams, Raman Danrad, Kelly K. Gajewski, Paul A. Lelorier

School of Medicine Faculty Publications

No abstract provided.

Association Between Remote Monitoring And Interstage Morbidity And Death In Patients With Single-Ventricle Heart Disease Across Socioeconomic Groups., Bianca Cherestal, Lori A. Erickson, Janelle R. Noel-Macdonnell Phd, Girish S. Shirali, Hayley S. Hancock, Doaa Aly, Matthew Files, Sarah Clauss, Natalie Jayaram

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Despite improvements in survival over time, the mortality rate for infants with single-ventricle heart disease remains high. Infants of low socioeconomic status (SES) are particularly vulnerable. We sought to determine whether use of a novel remote monitoring program, the Cardiac High Acuity Monitoring Program, mitigates differences in outcomes by SES.

METHODS AND RESULTS: Within the Cardiac High Acuity Monitoring Program, we identified 610 infants across 11 centers from 2014 to 2021. All enrolled families had access to a mobile application allowing for near-instantaneous transfer of patient information to the care team. Patients were divided into SES tertiles on the …

Ischemic Stroke Revealing Libman-Sacks Endocarditis: A Case Report, Malak Alaoui Yazidi, Fatima Zahra Merzouk, Hajar Rabii, Hicham Benyoussef, Ilham Bensahi, Rachida Habbal

Journal of the Saudi Heart Association

Libman-Sacks endocarditis (LSE) is a characteristic but rare feature of systemic lupus erythematosus (SLE), which can be found in association with antiphospholipid syndrome (APS), exposing the patient to an increased embolism risk, particularly the occurrence of ischemic stroke. We present a case involving a 64-year-old man who was admitted for ischemic stroke accompanied by a fever. Cardiac investigation revealed mitral vegetations along with severe mitral regurgitation. The diagnosis of Libman-Sacks endocarditis associated with SLE and APS was made after a laboratory work-up showing negative blood cultures and positive antibodies. This case underlines the importance of early diagnosis for better management …

Role Of Midodrine On Vasopressor Duration In Patients With Sepsis, Kamah J. Ellena, Jenna L. Combs, Heather M. Draper, Julie J. Belfer

Journal of Shock and Hemodynamics

Existing literature evaluating the off-label use of midodrine has focused primarily on postoperative hypotensive patients requiring a single vasopressor. This study aimed to evaluate the impact of midodrine on vasopressor duration and length of stay in patients receiving vasopressors for sepsis-related hypotension. This is an institutional review board-approved, single-center, retrospective analysis of critically ill patients with hypotension secondary to sepsis who received midodrine and intravenous vasopressors compared to those who received intravenous vasopressors alone. Patients were matched by Acute Physiology and Chronic Health Evaluation II score, suspected source of infection, and presence of bacteremia. One hundred patients were included in …

Impact Of Comorbid Heart Failure Among Hospitalized Patients With Sarcoidosis: A United States Population-Based Cohort Study, Bruce Adrian Casipit, Kevin Bryan Lo, Carlo Gabriel Casipit, Abdiodun Idowu, Aman Amanullah

Einstein Health Papers

BACKGROUND: There is paucity of data regarding the impact of concomitant heart failure (HF) on the in-hospital outcomes among hospitalized sarcoidosis patients. We aim to investigate the factors associated with concomitant HF and its impact on in-hospital outcomes among hospitalized sarcoidosis patients.

METHODS: We utilized the 2018-2020 National Inpatient Sample (NIS) Database in conducting this study. Multivariable logistic and linear regression models were used to examine the factors associated with HF and hospital-associated outcomes among patients with sarcoidosis.

RESULTS: A total of 36,864 hospitalized patients with sarcoidosis were identified, of which 24.78 % (n = 9135/36,864) had concomitant HF. Factors …

Atrial Appendage Accessory Pathway Ablation: Tips For Recognition And Approach To Ablation, Nikola Dragisic, Emily R. Backes, Lindsey Malloy-Walton, Philip M. Chang

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Temporal Artery Pseudoaneurysm In A Pediatric Patient, Gowri Gowda, Donald Mendoza, Amanda Tullos, Jessica Zagory, Malachi Sheahan

School of Medicine Faculty Publications

Superficial temporal artery pseudoaneurysms are an uncommon vascular pathology that can present after head or facial trauma. Furthermore, they are rarely reported in the pediatric population. Ultrasound can be a useful tool in the diagnosis because it is easily accessible and can be rapidly acquired. We report a case that demonstrates the utility of ultrasound in the diagnosis of a superficial temporal artery pseudoaneurysm.

Pakistan Study Of Premature Coronary Atherosclerosis In Young Adults (Pak-Sehat): A Prospective Longitudinal Study Protocol Investigating The Prevalence, Severity And Determinants Of Atherosclerotic Cardiovascular Disease In The Young Adult Pakistani Population, Bashir Hanif, Sana Sheikh, Ghazal Peerwani, Miguel Cainzos Achirica, Wajiha Javed, Jaffer Bin Baqar, Zainab Samad, Faiza Bashir, Salim S. Virani, Khurram Nasir, Saba Aijaz

Department of Medicine

Introduction Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity, mortality and health expenditures worldwide. Despite having higher ASCVD in the Pakistani population, data on subclinical coronary atherosclerosis in young Pakistanis remain scarce. The Pakistan Study of prematurely coronary atherosclerosis in young Adults (PAK-SEHAT) aims to assess the prevalence, severity and determinants of subclinical coronary atherosclerosis among Pakistani men (35–60 years) and women (35–65 years) free of clinically symptomatic ASCVD and will assess 5-year rates of ASCVD event
Methods and analysis PAK-SEHAT is an ongoing prospective cohort study with 2000 participants from all provinces of Pakistan who will be …

Clinical Trials In Cardiogenic Shock: Challenges And Solutions For The Future, Anju Bhardwaj, Sahoor Khan, Shashank Sinha, Preethi Pirlamarla, Rajiv Sankaranarayanan, Alexander Hajduczok, Holger Thiele, Navin Kapur

Division of Cardiology Faculty Papers

No abstract provided.

Pseudocystic Myxoid Liposarcoma Of The Posterior Chest Wall - A Rare Case Report, Saad Shakil, Sareema Eman Akhtar, Mahum Zaidi, Rizwan Ajmal, Abdulla K. Alsubai, Rahul Ramtohul, Absam Akbar, Aysa Tabassi, Aylin Tabassi, Talal Almas

Medical College Documents

Introduction and importance: Liposarcoma (LPS) is a common soft-tissue sarcoma predominantly diagnosed in adults, arising from malignant adipose cells. Among its various subtypes, myxoid LPS (MLPS) stands out as the second most frequent, accounting for ~30% of all LPS cases. This particular subtype typically manifests in males between the ages of 40 and 50 and is commonly found in the lower extremities. Although rare, MLPS may also occur in the head, neck, and infrequently in the back. Chest wall LPS cases are also sparsely reported.
Case presentation: In this report, we present a case of MLPS in a 69-year-old male …

Association Between E-Cigarette Use And Myocardial Infarction: A Systematic Review And Meta-Analysis, Muhammad Talal Ashraf, Asim Shaikh, Muhammad Shakeel Khuzzaim Khan, Naseer Uddin, Muhammad Arham Bin Kashif, Syed Hassan Ahmed Rizvi, Hammad Khalid, Stafford Jude Sam, Affan Sohail

Department of Medicine

Background: The popularity of e-cigarettes has risen dramatically over the last few years, particularly among the younger population. Although the use of combustible cigarettes has established evidence to be associated with the development of several adverse cardiopulmonary diseases, the investigations regarding the prospective long-term effects of e-cigarette use on the cardiovascular system have just begun. We set to investigate if there is an association between the history of MI and e-cigarette use among smokers and non-smokers?
Methods: The current review aims to assess the association of myocardial infarction with e-cigarette consumption. PubMed, Google Scholar, and Cochrane Central Register of Controlled …

A Systematic Review And Meta-Analysis Of The Prevalence And Risk Factors In Cardiac Implantable Electronic Device Malfunction, Abdullah Saeed, Abdullah Alshafea, Monerah Alqthami, Abdulrahman Bin Saeed, Foton A. Alahmri, Norah S. Alqahtani, Fatimah A. Al-Muslat, Atheer Alqahtani

Journal of the Saudi Heart Association

Introduction: Cardiac implantable electronic devices (CIED) include permanent pacemakers (PPMs), implantable cardioverter defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. They treat several cardiac issues and are dependent on batteries; however, similar to any medical equipment, they can fail. The prevalence and risk factors for CIED malfunction must be understood for earlier detection and better patient outcomes. Material and methods: A comprehensive search was conducted through electronic bibliographic sources (PubMed and Cochrane) until January 2023 in order to identify reviews, cohort studies and case reports pertaining to CIED. The primary outcome is the probability of CIED malfunction. The secondary outcome …

Heartburn's Hidden Impact: A Narrative Review Exploring Gastroesophageal Reflux Disease (Gerd) As A Cardiovascular Disease Risk Factor, Jacob J. Gries, Bing Chen, Salim S. Virani, Hafeez Ul Hassan Virk, Hani Jneid, Chayakrit Krittanawong

Office of the Provost

Gastroesophageal reflux disease (GERD) is a very common disease with an estimated 442 million cases worldwide. It is a well-documented independent risk factor for many gastrointestinal pathologies, however, its role in cardiovascular disease (CVD) is unclear, despite its high prevalence in patients with CVD. Although traditionally considered a causative agent of noncardiac chest pain, a common imitator of cardiac chest pain, or an incidentally shared comorbidity in patients with CVD, a number of studies have implicated GERD and its therapies as risk factors for CVD. This narrative review will explore the relationship between GERD and CVD, including medical and mechanical …

Prevalence Of Central Venous Stenosis Among Black And White Eskd Patients With Dysfunctional Dialysis Access, Vipul Chitalia Md, Jonathan Ravid, Arinze Nkiruka, Kristina Yamkovoy, Matthew Diamond, Rohit Pillai, Tyler J. Ryan, Saran Lotfollahzadeh, Janice Weinberg, Alik Farber, Rajendran Vivendhan, Jean Francis, Nathanael Fillmore, Najia Idrees

Journal of Health Disparities Research and Practice

In the United States, significant racial and ethnic disparities exist in chronic kidney disease (CKD) and its management. Hemodialysis constitutes the main stay of renal replacement therapy for end-stage kidney disease (ESKD), which is initiated using central venous catheters (CVC) in most CKD patients in the United States. Black ESKD patients have higher usage and greater time on CVC for hemodialysis compared to White patients. This trend places Black patients at a potentially higher risk for CVC-related complications such as central venous stenosis (CVS). We posited that Black patients would have a higher prevalence and a greater risk of CVS. …

Treatment Of Refractory Ventricular Tachycardia With Radiofrequency Ablation And Temporary Mechanical Circulatory Support, Som P. Singh, Alejandro Vidal Margenat, David L. Boone, Ellen Condoure, Ramesh Hariharan

The VAD Journal

Catheter-based radiofrequency ablation has long been recognized as an effective treatment for refractory ventricular tachycardia (VT). A 57-year-old male with severe coronary artery disease underwent percutaneous mechanical circulatory support because of worsening cardiogenic shock after failed revascularization attempts. Despite aggressive medical management, the patient experienced refractory VT episodes, leading to the decision to proceed with radiofrequency catheter ablation. Notably, the Impella 5.5 device (Abiomed) provided critical left ventricular support during the ablation procedure. This case underscores the potential benefits of Impella support during radiofrequency ablation of complex ventricular arrhythmias.

Defying The Vicious Cycle: An Intriguing Case Of Brash Syndrome, Ahmed Shehadah, Himal Kharel, Pulkit Gandhi

Advances in Clinical Medical Research and Healthcare Delivery

BRASH Syndrome is a rare and life-threatening condition marked by the combination of bradycardia, renal failure, atrioventricular (AV) nodal blockade, shock, and hyperkalemia. This case report presents a 79-year-old female with acute kidney injury, hyperkalemia, and severe bradycardia without typical EKG changes associated with hyperkalemia. The aim of this article is to provide a comprehensive overview of BRASH syndrome, including its clinical manifestations, underlying pathophysiology, diagnostic approaches, and management strategies. The patient's presentation, laboratory findings, and response to treatment support the diagnosis of BRASH syndrome. The syndrome's pathogenesis involves a vicious cycle of bradycardia, renal failure, AV nodal blockade, and …

The Prevalence And Impact Of Obesity On The Outcomes Of Patients Undergoing Transcatheter Mitral Valve Repair Using Mitraclip - A National Inpatient Sample Analysis 2016 To 2020., Garba Rimamskep Shamaki, Favour Markson, Osarenren Idemudia, Andrew Murphy, Tamunoinemi Bob-Manuel, Akanimo Antia, David Corteville

Advances in Clinical Medical Research and Healthcare Delivery

Background: Low Body Mass Index (BMI) is associated with poor outcomes in patients who undergo various cardiac interventions. Studies on patients with elevated BMI have produced mixed results. Our study aims to evaluate the impact of obesity on the in-hospital outcomes of patients undergoing transcatheter mitral valve repair using MitraClip in the United States.

Methods: The National Inpatient Sample (NIS) database (2016-2020) was analyzed to identify patients who underwent transcatheter mitral valve repair using MitraClip. Patients less than 18 years, with protein-energy malnutrition and rapid weight loss, were excluded. Our final study population was classified into Obese (BMI ≥ 30 …

Kounis Syndrome – Anaphylaxis-Induced Acute Coronary Syndrome, Austin T. Thacker Do, Brachman Herzig Oms, Brendan Robinson Do, Ahad Anjum Do

Advances in Clinical Medical Research and Healthcare Delivery

Kounis syndrome is an underdiagnosed condition in which anaphylaxis triggers vasospastic acute coronary syndrome, either with or without underlying coronary artery disease. The prevalence of this syndrome among hospitalized patients for allergic/hypersensitivity/anaphylactic reactions in the United States is 1.1%, with a 7% rate of all-cause inpatient mortality. This article presents an anaphylaxis-induced acute coronary syndrome case in a patient with underlying coronary artery disease. The pathophysiological mechanism of anaphylactic-induced acute coronary syndrome involves the inflammatory mediators of type I hypersensitivity reactions.