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Cardiovascular Diseases Commons

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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 2017 Sheikh Khalifa bin Hamad Al Thani Center for Integrative Research on Cardiovascular Aging, Aurora Research Institute

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

Dianne Zwicke, MD, FACC, FACP, FCCP

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 ...


Echocardiographic Predictors Of Admission Among Patients With Heart Failure With Reduced Ejection Fraction, Chi C. Cho, Yang Shi, Robyn Shearer, Nasir Z. Sulemanjee, Dianne L. Zwicke, T. Edward Hastings, Omar M. Cheema, Vinay Thohan 2017 Aurora Research Institute, Aurora Health Care

Echocardiographic Predictors Of Admission Among Patients With Heart Failure With Reduced Ejection Fraction, Chi C. Cho, Yang Shi, Robyn Shearer, Nasir Z. Sulemanjee, Dianne L. Zwicke, T. Edward Hastings, Omar M. Cheema, Vinay Thohan

Dianne Zwicke, MD, FACC, FACP, FCCP

Background: Congestive heart failure afflicts 5.7 million people in the United States with annual incidence of 600,000 and mortality of 280,000. Heart failure accounts for greater than 1 million hospitalizations annually and the single largest inpatient Medicare expense. As the U.S. population ages and greater emphasis is placed on population health as a means to bend projected health care expenditures, large health care organizations will need to develop algorithms to identify patients at high risk with heart failure and possibly preempt hospitalizations. Doppler echocardiography is routinely performed in clinical assessment of severe heart failure.

Purpose: We ...


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 2017 Sheikh Khalifa bin Hamad Al Thani Center for Integrative Research on Cardiovascular Aging, Aurora Research Institute

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

Dianne Zwicke, MD, FACC, FACP, FCCP

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 ...


Echocardiographic Predictors Of Admission Among Patients With Heart Failure With Reduced Ejection Fraction, Chi C. Cho, Yang Shi, Robyn Shearer, Nasir Z. Sulemanjee, Dianne L. Zwicke, T. Edward Hastings, Omar M. Cheema, Vinay Thohan 2017 Aurora Research Institute, Aurora Health Care

Echocardiographic Predictors Of Admission Among Patients With Heart Failure With Reduced Ejection Fraction, Chi C. Cho, Yang Shi, Robyn Shearer, Nasir Z. Sulemanjee, Dianne L. Zwicke, T. Edward Hastings, Omar M. Cheema, Vinay Thohan

Dianne Zwicke, MD, FACC, FACP, FCCP

Background: Congestive heart failure afflicts 5.7 million people in the United States with annual incidence of 600,000 and mortality of 280,000. Heart failure accounts for greater than 1 million hospitalizations annually and the single largest inpatient Medicare expense. As the U.S. population ages and greater emphasis is placed on population health as a means to bend projected health care expenditures, large health care organizations will need to develop algorithms to identify patients at high risk with heart failure and possibly preempt hospitalizations. Doppler echocardiography is routinely performed in clinical assessment of severe heart failure.

Purpose: We ...


Patient Preferences For Cardiovascular Preventive Medication: A Systematic Review, Loai Albarqouni, Jenny Doust, Paul Glasziou 2017 Bond University

Patient Preferences For Cardiovascular Preventive Medication: A Systematic Review, Loai Albarqouni, Jenny Doust, Paul Glasziou

Jenny Doust

OBJECTIVE:

To systematically review current evidence regarding the minimum acceptable risk reduction of a cardiovascular event that patients feel would justify daily intake of a preventive medication.

METHODS:

We used the Web of Science to track the forward and backward citations of a set of five key articles until 15 November 2016. Studies were eligible if they quantitatively assessed the minimum acceptable benefit-in absolute values-of a cardiovascular disease preventive medication among a sample of the general population and required participants to choose if they would consider taking the medication.

RESULTS:

Of 341 studies screened, we included 22, involving a total ...


The Contribution Of Individual Exercise Training Components To Clinical Outcomes In Randomised Controlled Trials Of Cardiac Rehabilitation: A Systematic Review And Meta-Regression, Bridget Abell, Paul Glasziou, Tammy Hoffmann 2017 Bond University

The Contribution Of Individual Exercise Training Components To Clinical Outcomes In Randomised Controlled Trials Of Cardiac Rehabilitation: A Systematic Review And Meta-Regression, Bridget Abell, Paul Glasziou, Tammy Hoffmann

Paul Glasziou

Background While the clinical benefits of exercise-based cardiac rehabilitation are well established, there is extensive variation in the interventions used within these trials. It is unknown whether variations in individual components of these exercise interventions provide different relative contributions to overall clinical outcomes. This study aims to systematically examine the relationship between individual components of the exercise intervention in cardiac rehabilitation (such as intensity and frequency) and clinical outcomes for people with coronary heart disease. Methods In this systematic review, eligible trials were identified via searches of databases (PubMed, Allied and Complementary Medicine, EMBASE, PEDro, Science Citation Index Expanded, CINAHL ...


Patient Preferences For Cardiovascular Preventive Medication: A Systematic Review, Loai Albarqouni, Jenny Doust, Paul Glasziou 2017 Bond University

Patient Preferences For Cardiovascular Preventive Medication: A Systematic Review, Loai Albarqouni, Jenny Doust, Paul Glasziou

Paul Glasziou

OBJECTIVE: To systematically review current evidence regarding the minimum acceptable risk reduction of a cardiovascular event that patients feel would justify daily intake of a preventive medication. METHODS: We used the Web of Science to track the forward and backward citations of a set of five key articles until 15 November 2016. Studies were eligible if they quantitatively assessed the minimum acceptable benefit-in absolute values-of a cardiovascular disease preventive medication among a sample of the general population and required participants to choose if they would consider taking the medication. RESULTS: Of 341 studies screened, we included 22, involving a total ...


Culturally Adaptive Storytelling Intervention Versus Didactic Intervention To Improve Hypertension Control In Vietnam: A Cluster-Randomized Controlled Feasibility Trial, Hoa L. Nguyen, Jeroan J. Allison, Duc A. Ha, German Chiriboga, Ha N. Ly, Hanh T. Tran, Cuong K. Nguyen, Diem M. Dang, Ngoc T. Phan, Nguyen C. Vu, Quang P. Nguyen, Robert J. Goldberg 2017 University of Massachusetts Medical School

Culturally Adaptive Storytelling Intervention Versus Didactic Intervention To Improve Hypertension Control In Vietnam: A Cluster-Randomized Controlled Feasibility Trial, Hoa L. Nguyen, Jeroan J. Allison, Duc A. Ha, German Chiriboga, Ha N. Ly, Hanh T. Tran, Cuong K. Nguyen, Diem M. Dang, Ngoc T. Phan, Nguyen C. Vu, Quang P. Nguyen, Robert J. Goldberg

Robert J. Goldberg

BACKGROUND: Vietnam is experiencing an epidemiologic transition with an increased prevalence of non-communicable diseases. Novel, large-scale, effective, and sustainable interventions to control hypertension in Vietnam are needed. We report the results of a cluster-randomized feasibility trial at 3 months follow-up conducted in Hung Yen province, Vietnam, designed to evaluate the feasibility and acceptability of two community-based interventions to improve hypertension control: a "storytelling" intervention, "We Talk about Our Hypertension," and a didactic intervention. METHODS: The storytelling intervention included stories about strategies for coping with hypertension, with patients speaking in their own words, and didactic content about the importance of healthy ...


Culturally Adaptive Storytelling Intervention Versus Didactic Intervention To Improve Hypertension Control In Vietnam: A Cluster-Randomized Controlled Feasibility Trial, Hoa L. Nguyen, Jeroan J. Allison, Duc A. Ha, German Chiriboga, Ha N. Ly, Hanh T. Tran, Cuong K. Nguyen, Diem M. Dang, Ngoc T. Phan, Nguyen C. Vu, Quang P. Nguyen, Robert J. Goldberg 2017 University of Massachusetts Medical School

Culturally Adaptive Storytelling Intervention Versus Didactic Intervention To Improve Hypertension Control In Vietnam: A Cluster-Randomized Controlled Feasibility Trial, Hoa L. Nguyen, Jeroan J. Allison, Duc A. Ha, German Chiriboga, Ha N. Ly, Hanh T. Tran, Cuong K. Nguyen, Diem M. Dang, Ngoc T. Phan, Nguyen C. Vu, Quang P. Nguyen, Robert J. Goldberg

Jeroan J. Allison

BACKGROUND: Vietnam is experiencing an epidemiologic transition with an increased prevalence of non-communicable diseases. Novel, large-scale, effective, and sustainable interventions to control hypertension in Vietnam are needed. We report the results of a cluster-randomized feasibility trial at 3 months follow-up conducted in Hung Yen province, Vietnam, designed to evaluate the feasibility and acceptability of two community-based interventions to improve hypertension control: a "storytelling" intervention, "We Talk about Our Hypertension," and a didactic intervention. METHODS: The storytelling intervention included stories about strategies for coping with hypertension, with patients speaking in their own words, and didactic content about the importance of healthy ...


Ten-Year (2001-2011) Trends In The Incidence Rates And Short-Term Outcomes Of Early Versus Late Onset Cardiogenic Shock After Hospitalization For Acute Myocardial Infarction, Hoa L. Nguyen, Jorge L. Yarzebski, Darleen M. Lessard, Joel M. Gore, David D. McManus, Robert J. Goldberg 2017 University of Massachusetts Medical School

Ten-Year (2001-2011) Trends In The Incidence Rates And Short-Term Outcomes Of Early Versus Late Onset Cardiogenic Shock After Hospitalization For Acute Myocardial Infarction, Hoa L. Nguyen, Jorge L. Yarzebski, Darleen M. Lessard, Joel M. Gore, David D. Mcmanus, Robert J. Goldberg

University of Massachusetts Medical School Faculty Publications

BACKGROUND: Cardiogenic shock (CS) is a serious complication of acute myocardial infarction, and the time of onset of CS has a potential role in influencing its prognosis. Limited contemporary data exist on this complication, however, especially from a population-based perspective. Our study objectives were to describe decade-long trends in the incidence, in-hospital mortality, and factors associated with the development of CS in 3 temporal contexts: (1) before hospital arrival for acute myocardial infarction (prehospital CS); (2) within 24 hours of hospitalization (early CS); and (3) > /=24 hours after hospitalization (late CS).

METHODS AND RESULTS: The study population consisted of 5782 ...


Ten-Year (2001-2011) Trends In The Incidence Rates And Short-Term Outcomes Of Early Versus Late Onset Cardiogenic Shock After Hospitalization For Acute Myocardial Infarction, Hoa L. Nguyen, Jorge L. Yarzebski, Darleen M. Lessard, Joel M. Gore, David D. McManus, Robert J. Goldberg 2017 University of Massachusetts Medical School

Ten-Year (2001-2011) Trends In The Incidence Rates And Short-Term Outcomes Of Early Versus Late Onset Cardiogenic Shock After Hospitalization For Acute Myocardial Infarction, Hoa L. Nguyen, Jorge L. Yarzebski, Darleen M. Lessard, Joel M. Gore, David D. Mcmanus, Robert J. Goldberg

Open Access Articles

BACKGROUND: Cardiogenic shock (CS) is a serious complication of acute myocardial infarction, and the time of onset of CS has a potential role in influencing its prognosis. Limited contemporary data exist on this complication, however, especially from a population-based perspective. Our study objectives were to describe decade-long trends in the incidence, in-hospital mortality, and factors associated with the development of CS in 3 temporal contexts: (1) before hospital arrival for acute myocardial infarction (prehospital CS); (2) within 24 hours of hospitalization (early CS); and (3) > /=24 hours after hospitalization (late CS).

METHODS AND RESULTS: The study population consisted of 5782 ...


Pharmacological Approaches For The Management Of Patients With Moderately Elevated Triglycerides (150-499 Mg/Dl), Michael S. Kelly, Craig Beavers, John D. Bucheit, Evan M. Sisson, Dave L. Dixon 2017 Chapman University

Pharmacological Approaches For The Management Of Patients With Moderately Elevated Triglycerides (150-499 Mg/Dl), Michael S. Kelly, Craig Beavers, John D. Bucheit, Evan M. Sisson, Dave L. Dixon

Pharmacy Faculty Articles and Research

Hypertriglyceridemia, defined as serum triglyceride (TG) levels > 150 mg/dL, now affects over one-quarter of the U.S. adult population and is associated with an increased risk of atherosclerotic cardiovascular disease. Available guidelines for managing hypertriglyceridemia vary with respect to triglyceride thresholds and severity of disease. Lifestyle modifications and management of secondary causes (e.g., diabetes) remain the first step in managing hypertriglyceridemia, with pharmacotherapy reserved to reduce the risk of pancreatitis and/or further reduce TG levels. Several classes of lipid-lowering agents are available with variable TG-lowering efficacy. While there is no consensus regarding the choice of initial TG-lowering ...


Complete Congenital Heart Block: A Case Of Multilevel Block., Ian W Hovis, David N Schidlow, Jeffrey P Moak 2017 George Washington University

Complete Congenital Heart Block: A Case Of Multilevel Block., Ian W Hovis, David N Schidlow, Jeffrey P Moak

Pediatrics Faculty Publications

No abstract provided.


Burden Of Psychosocial And Cognitive Impairment In Patients With Atrial Fibrillation, John A. Bostrom, Jane S. Saczynski, Alexandra M. Hajduk, Kevin Donahue, Lawrence S. Rosenthal, Clifford Browning, Cynthia Ennis, Kevin C. Floyd, Heather Richardson, Nada Esa, Jessica Ogarek, David D. McManus 2017 University of Massachusetts Medical School

Burden Of Psychosocial And Cognitive Impairment In Patients With Atrial Fibrillation, John A. Bostrom, Jane S. Saczynski, Alexandra M. Hajduk, Kevin Donahue, Lawrence S. Rosenthal, Clifford Browning, Cynthia Ennis, Kevin C. Floyd, Heather Richardson, Nada Esa, Jessica Ogarek, David D. Mcmanus

UMass Center for Clinical and Translational Science Supported Publications

BACKGROUND: Impairments in psychosocial status and cognition relate to poor clinical outcomes in patients with atrial fibrillation (AF). However, how often these conditions co-occur and associations between burden of psychosocial and cognitive impairment and quality of life (QoL) have not been systematically examined in patients with AF.

METHODS: A total of 218 patients with symptomatic AF were enrolled in a prospective study of AF and psychosocial factors between May 2013 and October 2014 at the University of Massachusetts Medical Center. Cognitive function, depression, and anxiety were assessed at baseline and AF-specific QoL was assessed 6 months after enrollment using validated ...


Arteriovenous Fistula Patency In The 3 Years Following Vonapanitase And Placebo Treatment, Eric K. Peden, Timothy P. O'Connor, Barry J. Browne, Bradley S. Dixon, Andres Schanzer, Stephen C. Jensik, Albert D. Sam 2nd, Steven K. Burke 2017 Houston Methodist Hospital

Arteriovenous Fistula Patency In The 3 Years Following Vonapanitase And Placebo Treatment, Eric K. Peden, Timothy P. O'Connor, Barry J. Browne, Bradley S. Dixon, Andres Schanzer, Stephen C. Jensik, Albert D. Sam 2nd, Steven K. Burke

Andres Schanzer

OBJECTIVE: This study explored the long-term outcomes of arteriovenous fistulas treated with vonapanitase (recombinant human elastase) at the time of surgical creation.

METHODS: This was a randomized, double-blind, placebo-controlled trial of 151 patients undergoing radiocephalic or brachiocephalic arteriovenous fistula creation who were randomized equally to placebo, vonapanitase 10 mug, or vonapanitase 30 mug. The results after 1 year of follow-up were previously reported. The current analysis occurred when the last patient treated was observed for 3 years. For the current analysis, the primary end point was primary patency; the secondary end points included secondary patency, use of the fistula for ...


Mitochondrial Dna Heteroplasmy In Cardiac Tissue From Individuals With And Without Coronary Artery Disease, Erik Hefti, Javier G. Blanco 2017 Harrisburg University of Science and Technology

Mitochondrial Dna Heteroplasmy In Cardiac Tissue From Individuals With And Without Coronary Artery Disease, Erik Hefti, Javier G. Blanco

Harrisburg University Faculty Works

The cellular environment associated with coronary artery disease (CAD) can lead to mitochondrial DNA (mtDNA) damage. Mitochondrial variants in some copies of mtDNA (heteroplasmy) and mtDNA content are potential genetic biomarkers for CAD-associated disease states. Massively parallel sequencing and qRT-PCR techniques were used to measure heteroplasmic variants and mtDNA content in heart samples from donors with (n = 8) and without (n = 7) documented CAD. Both groups showed increased numbers of heteroplasmic mtDNA variants in the control region (CR) (p < .0010, ANOVA). The donors with CAD displayed a 41.07% increase in heteroplasmic mtDNA variant number in the CR (p = .043), an 87.50% increase in the number of heteroplasmic mtDNA deletions (p = .12), and a 48.76% increase in ...


Uncertainty Of 1-D Fluid Models In Patients With Pulmonary Hypertension, Mitchel J. Colebank 2017 North Carolina State University

Uncertainty Of 1-D Fluid Models In Patients With Pulmonary Hypertension, Mitchel J. Colebank

Biology and Medicine Through Mathematics Conference

No abstract provided.


Risk Factors For Heart Failure In Patients With Chronic Kidney Disease: The Cric (Chronic Renal Insufficiency Cohort) Study., Jiang He, Michael Shlipak, Amanda Anderson, Jason A Roy, Harold I Feldman, Radhakrishna Reddy Kallem, Radhika Kanthety, John W Kusek, Akinlolu Ojo, Mahboob Rahman, Ana C Ricardo, Elsayed Z Soliman, Myles Wolf, Xiaoming Zhang, Dominic Raj, Lee Hamm 2017 George Washington University

Risk Factors For Heart Failure In Patients With Chronic Kidney Disease: The Cric (Chronic Renal Insufficiency Cohort) Study., Jiang He, Michael Shlipak, Amanda Anderson, Jason A Roy, Harold I Feldman, Radhakrishna Reddy Kallem, Radhika Kanthety, John W Kusek, Akinlolu Ojo, Mahboob Rahman, Ana C Ricardo, Elsayed Z Soliman, Myles Wolf, Xiaoming Zhang, Dominic Raj, Lee Hamm

Medicine Faculty Publications

Background Heart failure is common in patients with chronic kidney disease. We studied risk factors for incident heart failure among 3557 participants in the CRIC (Chronic Renal Insufficiency Cohort) Study.

Methods and Results Kidney function was assessed by estimated glomerular filtration rate (eGFR) using serum creatinine, cystatin C, or both, and 24‐hour urine albumin excretion. During an average of 6.3 years of follow‐up, 452 participants developed incident heart failure. After adjustment for age, sex, race, and clinical site, hazard ratio (95% CI) for heart failure associated with 1 SD lower creatinine‐based eGFR was 1.67 (1 ...


Effect Of Exercise Training On Microvascular Function In African American And Caucasian Women, Huimin Yan, Keyshla M. Melendex-Rosado, Robert C. Hickner 2017 University of Massachusetts Boston

Effect Of Exercise Training On Microvascular Function In African American And Caucasian Women, Huimin Yan, Keyshla M. Melendex-Rosado, Robert C. Hickner

UMass Center for Clinical and Translational Science Research Retreat

African Americans (AA), especially women, exhibit long-standing disparities in cardiovascular disease (CVD) and obesity. The prevalence of endothelial dysfunction, directly linked to hypertension, is considerably greater in AA than Caucasians (C). Vascular smooth muscle function (mediating endothelium-independent vasodilation) is also related to CVD risk factors but is underappreciated because most literature in C suggest endothelium-independent vasodilatory response is resistance to change with disease (hypertension) or exercise training. Furthermore, the regulation of local skeletal muscle blood flow (an important site of peripheral resistance) has not been sufficiently assessed. Microdialysis is the only method that allows monitoring of microvascular blood flow while ...


Accuracy And Coverage Of Using The Assigned International Classification Of Diseases, 9th And 10th Revision, Clinical Modification Codes For Detecting Bleeding Events In Electronic Health Record, Victoria J. Wang, David D. McManus, Hong Yu 2017 University of Massachusetts Medical School

Accuracy And Coverage Of Using The Assigned International Classification Of Diseases, 9th And 10th Revision, Clinical Modification Codes For Detecting Bleeding Events In Electronic Health Record, Victoria J. Wang, David D. Mcmanus, Hong Yu

UMass Center for Clinical and Translational Science Research Retreat

Background: Hemorrhages are common events that confer significant risk for in-hospital and post-discharge morbidity and mortality among cardiovascular disease (CVD) patients treated with anticoagulation. International Classification of Diseases, 9th and 10th Revision, Clinical Modification (ICD-9-CM, ICD-10-CM) codes have been widely used in CVD research and managements.

Objective: To determine the accuracy and coverage of assigned ICD-CM codes for reporting bleeding events.

Methods: From the University of Massachusetts Medical School electronic health record (EHR) database we identified 21k patients on anticoagulation with high bleeding risks based on their ICD-9-CM or ICD-10-CM codes. Through manual chart review, we selected one unstructured note ...


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