Cardiovascular Diseases Commons^™

Successful Extracorporeal Membrane Oxygenation In The Management Of Acute Respiratory Distress Syndrome And Cardiopulmonary Collapse Secondary To Amniotic Fluid Embolism, Sumon Roy, Nishit A. Biniwale, Venkata S. Pendela, Patricia Oates, Katrina Wojciechowski, Scott C. Feitell

The VAD Journal

Amniotic fluid embolism (AFE) is one of the most devastating complications of pregnancy that typically manifests as acute cardiopulmonary collapse during delivery or in the postpartum period. The potential role of extracorporeal membrane oxygenation (ECMO) as a management technique in severe cases of AFE remains largely unknown given the limited literature available. In this report, we present the first case, to our knowledge, of successful implementation of ECMO as a life-saving measure in a case of hemorrhagic shock due to postpartum bleeding complicated by severe AFE leading to acute respiratory distress syndrome (ARDS) ultimately requiring tracheostomy. Hemodynamic decompensation is often …

Dennd5b Regulates Intestinal Triglyceride Absorption And Body Mass, Scott M. Gordon, Edward B. Neufeld, Zhihong Yang, Milton Pryor, Lita A. Freeman, Xiao Fan, Iftikhar J. Kullo, Leslie G. Biesecker, Alan T. Remaley

Saha Cardiovascular Research Center Faculty Publications

Regulation of lipid absorption by enterocytes can influence metabolic status in humans and contribute to obesity and related complications. The intracellular steps of chylomicron biogenesis and transport from the Endoplasmic Reticulum (ER) to the Golgi complex have been described, but the mechanisms for post-Golgi transport and secretion of chylomicrons have not been identified. Using a newly generated Dennd5b^−/− mouse, we demonstrate an essential role for this gene in Golgi to plasma membrane transport of chylomicron secretory vesicles. In mice, loss of Dennd5b results in resistance to western diet induced obesity, changes in plasma lipids, and reduced aortic atherosclerosis. In …

Gait Alterations In Peripheral Arterial Disease Are Not Worsened By The Presence Of Diabetes, Hafizur Rahman

UNO Student Research and Creative Activity Fair

Peripheral arterial disease (PAD) is a vascular disease where atherosclerotic blockages restrict blood flow to muscles in the lower extremities. Diabetes is a common co-morbid condition in PAD and has been shown to increase the risk of lower extremity amputation compared to PAD without diabetes. Although there is a clear pathological relationship between diabetes and PAD, the gait mechanics involved remain indistinct. Therefore, the purpose of this study was to determine whether the presence of diabetes in addition to PAD results in greater functional impairment during ambulation. Twenty-three subjects with PAD and twelve controls consented to participate in the research. …

The Effects Of A 12-Week Jump Rope Exercise Program On Abdominal Adiposity, Vasoactive Substances, Inflammation & Vascular Function In Prehypertensive Adolescent Girls, Ronald Headid

UNO Student Research and Creative Activity Fair

Childhood obesity is strongly associated with cardiovascular disease (CVD) development. It is necessary to combat unfavorable outcomes of obesity at a young age by utilizing effective interventions, such as exercise. Purpose: We sought to examine the effects of a jump rope exercise program on CVD risk factors, including body composition, vasoactive substances, inflammation, and vascular function in prehypertensive adolescent girls. Methods: Forty girls (age 14-16) were recruited and randomly assigned to a jump rope exercise group (EX, n=20) or control group (CON, n=20). Body composition, nitrate and nitrite levels, endothelin-1 (ET-1), c-reactive protein (CRP), systolic blood pressure and diastolic blood …

The Effects Of Swimming Training On Arterial Stiffness, Muscular Strength And Cardiorespiratory Endurance In Postmenopausal Women With Stage 2 Hypertension, Steven Scott

UNO Student Research and Creative Activity Fair

Objective:

Aging is associated with progressive decreases in arterial health and function as well as overall fitness. It is crucial to prevent or reduce the negative effects of aging on vasculature and fitness components by implementing appropriate lifestyle interventions, such as exercise training. We examined the effects of a swimming (SWM) regimen on arterial stiffness (pulse wave velocity, PWV), blood pressure (BP), wave reflection (AIx), muscle strength and aerobic capacity in postmenopausal women with stage 2 hypertension.

Methods:

Using a parallel experimental design, participants were randomly assigned to either a SWM (n=52) or non-exercising control group (n=48) for 20 weeks. …

Impacts Of Dietary Nitrate On Endothelial Function, Arterial Stiffness, And Systemic Vascular Pressure In Peripheral Arterial Disease, Elizabeth J. Pekas, Steven D. Scott, Ronald J. Headid Iii, Michael D. Shukis, Jeonghwa Shin, Jiwon Song, Song-Young Park

UNO Student Research and Creative Activity Fair

Peripheral arterial disease (PAD) is the manifestation of atherosclerotic plaque in the larger arteries of the legs, which results in impaired blood flow to the lower extremities. Markers of vascular health, including endothelial function and arterial stiffness, have been shown to be attenuated in PAD.

Purpose: We sought to examine the effects of a nitrate supplement (body mass-normalized dosage of beetroot juice) on vascular function measurements such as endothelial function, arterial stiffness, and central and peripheral blood pressure in patients with PAD. We hypothesized that acute intake of a nitrate supplement would improve vascular function.

Methods: PAD patients (stage II-III, …

Femoral Vein Transposition Arteriovenous Fistula Is A Feasible Option In "Selected" Patients As Hemodialysis Access, Zia Ur Rehman, Asfia Arham, Ziad Sophie

Section of Cardiothoracic Surgery

Introduction: Lower extremity hemodialysis access is offered to the patients who have severe central venous stenosis. Femoral vein transposition arteriovenous fistula (FV tAVF) is an alternative to lower leg arteriovenous prosthetic grafts. Its safety and patency is under observation.
Materials and Methods: This is a retrospective review of patients who had FV tAVF between January 2011 and March 2016. Preoperative clinical findings, intraoperative findings, postoperative complications, and patency of the AVF were noted and analyzed.
Results: There were 7 patients who underwent FV tAVF during this study period. Most patients were female (6 : 1), with mean …

The Business Cycle And Health: An Analysis Of How Macroeconomic Conditions Impact Health Outcomes In The U.S., Talitha Kumaresan

Honors Theses

The U.S. spends about twice as much per person on healthcare, yet the disease burden remains higher in the U.S. than in comparable countries (Sawyer and Cox 2018; Sawyer and Gonzales 2017). Although health status is perceived to be an outcome of individual decision making, the business cycle also affects health. While the effect of macroeconomic shocks on health outcomes has been studied extensively, results remain inconclusive. This analysis uses longitudinal data over 30 years and panel data models to examine the effect of macroeconomic conditions on obesity, diabetes, hypertension, depression, congestive heart failure, and heart attack or myocardial infarction. …

Joint Association Of Urinary Sodium And Potassium Excretion With Cardiovascular Events And Mortality: Prospective Cohort Study, Martin O'Donnell, Andrew Mente, Sumathy Rangarajan, Matthew J. Mcqueen, Neil O'Leary, Lu Yin, Xiaoyun Liu, Sumathi Swaminathan, Rasha Khatib, Romaina Iqbal

Community Health Sciences

Objective: To evaluate the joint association of sodium and potassium urinary excretion (as surrogate measures of intake) with cardiovascular events and mortality, in the context of current World Health Organization recommendations for daily intake (<2.0 g sodium, >3.5 g potassium) in adults.
Design: International prospective cohort study.
Setting: 18 high, middle, and low income countries, sampled from urban and rural communities.
Participants: 103 570 people who provided morning fasting urine samples.
Main outcome measures: Association of estimated 24 hour urinary sodium and potassium excretion (surrogates for intake) with all cause mortality and major cardiovascular events, using multivariable Cox regression. A six category …

The Purification Of Human Adult Progenitor Cell Types To Promote Angiogenesis, Stephen E. Sherman

Electronic Thesis and Dissertation Repository

Cellular transplantation strategies have aimed to combat critical limb ischemia (CLI) by inducing endogenous blood vessel regeneration. Transplantation of mesenchymal stromal cells (MSC) for CLI has proven safe and well-tolerated but demonstrated only modestly improved clinical outcomes explained in part by a lack of MSC survival and/or potency in ischemic tissues. This thesis focuses on the development of improved transplantation strategies for patients with CLI utilizing purified pro-angiogenic subsets of MSC and endothelial colony forming cells (ECFC) seeded within decellularized adipose tissue (DAT) bioscaffolds. First, I investigated whether purification of bone marrow-derived MSC based on a conserved stem cell function, …

Health Literacy And Type 2 Diabetes In Barbados, Coralene Quimby-Worrell

The Qualitative Report

In this qualitative instrumental single case study, I explored how patients living with Type 2 diabetes (T2D) in Barbados manage the disease and what role health literacy might play. Purposeful sampling aided in selecting the sample for the study. The sample was 23 participants who were 40 years and older, diagnosed with T2D, living in Barbados, and attending the Endocrine Center for treatment. Participants responded to 13 open ended questions used to answer the research questions. Information was coded using NVivo 10 software and the software provided the themes based on the participants’ responses to the interview questions. The themes …

Innovation And Competition In Advanced Therapy Medicinal Products, Enrique Seoane-Vazquez, Vaishali Shukla, Rosa Rodriguez-Monguio

Pharmacy Faculty Articles and Research

"Advanced therapy medicinal products (ATMPs), including gene therapy, cell therapy, and tissue engineering products, represent a paradigm shift in health care as they have great potential for preventing and treating many diseases (Food and Drug Administration (FDA), 2013). By way of example, only 367 (8.0%) of the 4,603 rare diseases and conditions listed by the NIH Genetic and Rare Diseases Information Center had at least one FDA-approved drug therapy in early 2018. An estimated 3,038 (66.0%) of those rare diseases and conditions are congenital and genetic diseases that could potentially be treated by gene therapy. There are already ATMPs under …

Improving The Genetic Diagnosis Of Familial Hypercholesterolemia, Michael Iacocca

Electronic Thesis and Dissertation Repository

Familial hypercholesterolemia (FH) is a genetic disorder of severely elevated low-density lipoprotein (LDL) cholesterol that is widely underdiagnosed and undertreated. To improve the identification of FH and initiate timely and appropriate treatment strategies, genetic testing is becoming increasingly offered worldwide as a central part of diagnosis. I describe three main ways providing a genetic diagnosis in FH can be improved. First, next-generation sequencing (NGS)-based approaches can be used to reliably identify large-scale variant types known as copy number variations (CNVs) in the LDL receptor gene (LDLR); second, NGS methodology can be further applied to extend CNV screening to …

Analyzing Myocardial R2* Mapping Pre- And Post-Myocardial Infarction In A Canine Model, Khalid Abdalla

Electronic Thesis and Dissertation Repository

Myocardial hemorrhage (MH) may occur following myocardial infarction (MI). Myocardial hemorrhage can be assessed by image-based measurements of R2* (1/T2*) which are sensitive to iron-based byproducts of hemorrhage. However, automated detection of MH throughout the entire left ventricle (LV) is challenging due to R2* contributions from magnetic field distortions (susceptibility artifact). To provide insight for improved MH detection, we analyzed canine cardiac magnetic resonance images that had previously been acquired at baseline and several time points (3 to 41 days) following experimentally induced MI. The images were processed to generate R2* maps and cardiac polar plots. A baseline composite polar …

Association Between Plasma Neutrophil Gelatinase-Associated Lipocalin And Cardiac Disease Hospitalizations And Deaths In Older Women, James J.H. Chong, Richard L. Prince, Peter L. Thompson, Sujitha Thavapalachandran, Esther Ooi, Amanda Devine, E E.M. Lim, Elizabeth Byrnes, Germaine Wong, Wai H. Lim, Joshua R. Lewis

Research outputs 2014 to 2021

Background Neutrophil gelatinase-associated lipocalin ( NGAL ) or lipocalin 2 may promote atherosclerosis and plaque instability leading to increased risk of cardiac events. We investigated the relationships between plasma NGAL , cardiovascular disease biomarkers, and long-term cardiac events. Methods and Results The study population consisted of 1131 ambulant older white women (mean age 75 years) without clinical coronary heart disease ( CHD ) and measures of plasma NGAL in the Perth Longitudinal Study of Ageing Women with 14.5-year CHD and heart failure hospitalizations or death (events) captured using linked records. Over 14.5 years, 256 women had CHD events, while 118 …

Lipids, Reactive Oxygen Species, And Health, Heather Bowen

DNP Research Projects

Cardiovascular disease (CVD) is the leading cause of death in the United States. Coronary artery disease (CAD), where plaque builds up to create atherosclerosis, puts patients at risk for heart attack or stroke. Mitochondrial Reactive Oxygen Species (ROS) have been implicated as a source of oxidative stress that can lead to the development of CAD, and diets high in fat potentiate this occurrence. As certain fats are heated and experience chemical and physical degradation, they cause an increased risk of obesity, diabetes, various forms of cancer, and CVD. This research study, based on CREATION Health ideals, aimed to evaluate the …

Environmental Regulation Of The Heart: The Role Of Non-Coding Rna And Epigenetics In Influencing Mitochondrial And Cellular Health, Quincy Alexander Hathaway

Graduate Theses, Dissertations, and Problem Reports

The mitochondrion, a small but ubiquitously distributed organelle in the cell, continues to be the focus of many disease pathogeneses, tissue and organ dysfunctions, and other morbidities that occur throughout the body. The purpose of this work was to understand how cardiac mitochondrion are altered in disease and pathological states, specifically in their adaptation to environmentally stimulated regulatory networks, such as epigenetic modifications and promotion/inhibition of non-coding RNAs. Acute stress to mitochondrial regulation (inhalation toxicology) as well as chronic (type 2 diabetes mellitus) was examined. Using a FVB transgenic microRNA-378a mouse knockout model, the cardiovascular impact derived from altering the …

Neurochemical Factors Associated With The Initial Pathophysiological Reaction To Large Vessel Occlusion Stroke, Sarah R. Martha

Theses and Dissertations--Nursing

Ischemic stroke is the leading cause of disability world-wide and affects over 800,000 people per year in the United States. The majority of these strokes are ischemic due to a blockage of blood flow to the brain. Damage to the brain occurs at the onset of stroke, neuronal cell death is irreversible and therefore, quick treatment to remove blockage is critical factor in the recovery from stroke. Mechanical thrombectomy as a treatment for ischemic stroke provides an ideal opportunity to collect blood distal and proximal to the cerebral thrombus to examine neurochemical changes occurring during stroke.

The purpose of this …

End-Of-Life Decision-Making In Patients With A Cardiac Device, Jessica Harman Thompson

Theses and Dissertations--Nursing

Heart failure (HF) is one of the top causes of mortality in the United States and globally. In order to combat the high mortality rates of this disease, medical technology, including internal cardioverter defibrillators (ICD) and left ventricular assist devices (LVAD), have become one of the most common treatments. Over the past 10 years the utilization of these cardiac devices has increased exponentially, which has created a new phenomenon of how we discuss death with patients who have one of these devices. The purpose of this dissertation is to increase understanding of the end-of-life decision making processes and current experiences …

Implementing A Discharge Navigator Reducing 30-Day Readmissions For Heart Failure And Sepsis Populations, Karen Weeks

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

A national focus for healthcare reform is preventing hospital readmissions. Thirty-day unplanned hospital readmissions impact patient outcomes and are costly to the healthcare system. This project explored the impact between the discharge navigator and 30-day unplanned readmissions for heart failure and sepsis populations in a 238-bed community hospital located in central Virginia. The primary aim of this discharge navigator project was to reduce 30-day readmissions for the heart failure and sepsis populations to meet the goals of the top quartile for like hospitals and the evaluation of cost avoidance for these readmissions. Heart failure and sepsis populations are high risks …