Cardiovascular Diseases Commons^™

“So I Just Took Over”: African American Daughters Caregiving For Parents With Heart Failure, Nancy Thornton, Faith Pratt Hopp

Social Work Faculty Publications

This article examines the experiences of African American women who are caring for a parent with heart failure. Seven adult daughter caregivers completed in-depth, qualitative interviews, and a phenomenological approach was used for data analysis. Results suggest the presence of caregiving stressors, including heart failure symptoms and comorbidity, caregiving duties, social–emotional stressors, and distrust of the health system. Relevant coping strategies included valuing the caregiving role, coordinating care with siblings, taking charge, and spirituality. Social workers can play a critical role in supporting and advocating for caregivers of persons with heart failure, helping them to cope with stressors associated with …

Virtual Reality In Stroke Rehabilitation: A Meta-Analysis And Practical Implications For Clinicians, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.

Aneurysm Of Sinus Of Valsalva, Fateh Ali Tipoo Sultan, Nageeb Basir, Saulat H. Fatimi

Section of Cardiology

Aneurysm of sinus of Valsalva is a rare cardiac abnormality with congenital origin in most of the cases. If it is located in the right coronary sinus, it usually ruptures into a right heart chamber and frequently a ventricular septal defect (VSD) coexists with this condition. Early diagnosis and immediate surgical treatment can save the patient’s life in most cases. All the 3 cases reported in this series had aneurysm of right sinus of Valsalva with associated VSD and mild degree of aortic regurgitation (AR). Two of the cases ruptured aneurysm into the right ventricle. Trans-esophageal echocardiography was used to …

Iscore: A Risk Score To Predict Stroke Mortality, Gustavo Saposnik

Gustavo Saposnik

Stroke is a leading cause of death and adult disability. The ability to estimate prognosis in acute stroke patients directly affects treatment decisions for patients. It may also guide supportive care plans, facilitate patient and/or family counseling or discussions pertaining to end-of-life decisions. At the population level, prognostic estimations may assist policymakers in conducting fair comparisons when evaluating stroke fatality among different facilities for hospital outcomes and performance assessment. Clinicians usually rely on their own personal experience or average mortality reported in observational studies, which do not account for valuable information available at the time of the hospital presentation. Unfortunately, …

30-Year Trends In Heart Failure In Patients Hospitalized With Acute Myocardial Infarction, David Mcmanus, Marcello Chinali, Jane Saczynski, Joel Gore, Jorge Yarzebski, Frederick Spencer, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

Despite significant advances in its treatment, acute myocardial infarction (AMI) remains an important cause of heart failure (HF). Contemporary data remain lacking, however, describing long-term trends in incidence rates, demographic and clinical profiles, and outcomes of patients who develop HF as a complication of AMI. Our study sample consisted of 11,061 residents of the Worcester (Massachusetts) metropolitan area hospitalized with AMI at all greater Worcester hospitals in 15 annual study periods from 1975 to 2005. Overall, 32.4% of patients (n = 3,582) with AMI developed new-onset HF during their acute hospitalization. Patients who developed HF were generally older, more likely …

Recent Trends In The Incidence, Treatment, And Outcomes Of Patients With Stemi And Nstemi, David Mcmanus, Joel Gore, Jorge Yarzebski, Frederick Spencer, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: despite the widespread use of electrocardiographic changes to characterize patients presenting with acute myocardial infarction, little is known about recent trends in the incidence rates, treatment, and outcomes of patients admitted for acute myocardial infarction further classified according to the presence of ST-segment elevation. The objectives of this population-based study were to examine recent trends in the incidence and death rates associated with the 2 major types of acute myocardial infarction in residents of a large central Massachusetts metropolitan area. METHODS: We reviewed the medical records of 5383 residents of the Worcester (MA) metropolitan area hospitalized for either ST-segment …

Declining Length Of Stay For Patients Hospitalized With Ami: Impact On Mortality And Readmissions, Jane Saczynski, Darleen Lessard, Frederick Spencer, Jerry Gurwitz, Joel Gore, Jorge Yarzebski, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Length of hospital stay after acute myocardial infarction decreased significantly in the 1980s and 1990s. Whether length of stay has continued to decrease during the 2000s, and the impact of decreasing length of stay on rehospitalization and mortality, is unclear. We describe decade-long (1995-2005) trends in length of stay after acute myocardial infarction, and examine whether declining length of stay has impacted early rehospitalization and postdischarge mortality in a population-based sample of hospitalized patients.

METHODS: The study sample consisted of 4184 patients hospitalized with acute myocardial infarction in a central New England metropolitan area during 6 annual periods (1995, …

Management And Outcomes Of Renal Disease And Acute Myocardial Infarction, Paul Santolucito, Dennis Tighe, David Mcmanus, Jorge Yarzebski, Darleen Lessard, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Contemporary trends in the management and outcomes of chronic kidney disease patients who develop an acute myocardial infarction have not been adequately described, particularly from the more generalizable perspective of a population-based investigation. METHODS: The study population consisted of 6219 residents of the Worcester, Massachusetts, metropolitan area who were hospitalized with acute myocardial infarction in 6 annual periods between 1995 and 2005. Patients were categorized as having preserved kidney function (n=3154), mild to moderate chronic kidney disease (n=2313), or severe chronic kidney disease (n=752) at the time of hospital admission. RESULTS: Patients with chronic kidney disease were more likely …

Noncoronary Cardiac Abnormalities Are Associated With Coronary Artery Dilation And With Laboratory Inflammatory Markers In Acute Kawasaki Disease., Beth F. Printz, Lynn A. Sleeper, Jane W. Newburger, L Luann Minich, Timothy Bradley, Meryl S. Cohen, Deborah Frank, Jennifer S. Li, Renee Margossian, Girish S. Shirali, Masato Takahashi, Steven D. Colan, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: We explored the association of noncoronary cardiac abnormalities with coronary artery dilation and with laboratory inflammatory markers early after Kawasaki disease (KD) diagnosis.

BACKGROUND: Left ventricular (LV) dysfunction, mitral regurgitation (MR), and aortic root dilation occur early after diagnosis; their associations with coronary artery dilation and inflammatory markers have not been well-described.

METHODS: Centrally interpreted echocardiograms were obtained at KD diagnosis and 1 and 5 weeks after diagnosis on 198 subjects in the National Institutes of Health-sponsored Pediatric Heart Network KD pulsed steroid trial. Regression models were constructed to investigate the relationships among early LV dysfunction, MR, and aortic …

Alteplase: The Clot Buster, Mayer Goldberg

The Science Journal of the Lander College of Arts and Sciences

The following is an excerpt from the introduction of this article: The human body is defined by many complex and inconsistent characteristics. For example, the body forms blood clots in traumatic events, but blood clots are likewise associated with hazardous or fatal conditions. Platelets are small cells, derived from the precursor megakaryocytes, which are responsible for blood clotting to prevent bleeding from a ruptured blood vessel. Platelets fasten to each other and release a coagulation factor that solidifies around the ruptured area to prevent blood loss. A subordinate quantity of platelets can result in excessive bleeding. However, high platelet numbers …

Is Thrombolytic Therapy Safe When Used To Treat Elderly Patients?, Daniel Yaeger

The Science Journal of the Lander College of Arts and Sciences

Recently, research has been conducted to determine if thrombolytic therapy works to dissolve clots and if it is a safe treatment option. The specific purpose of this study is to determine if thrombolytic therapy is safe for use in the elderly. This study was conducted by reviewing the relevant literature that has been published from the time that research began to test the usefulness of thrombolytic therapy. Numerous journals were examined to ensure impartiality and emerge with an unbiased conclusion. The journals were discovered using PubMed article finder, using Google as a search engine, and by scrutinizing relevant references found …

Effects Of Calcium Supplementation On Cardiovascular Disease In Postmenopausal Women, Raizel Robinson

The Science Journal of the Lander College of Arts and Sciences

The following is an excerpt from the introduction of the article: In the United States, 53% of the population use dietary supplements. Of the people using supplements, 43% use calcium and 37% use vitamin D. However, 63% of women older than 60 years of age reported using dietary supplements (Park et al., 2009). Calcium supplementation, without co-administered vitamin D, increases the risk of myocardial infarction and cardiovascularrelated diseases among postmenopausal women. On the contrary, calcium supplementation with accompanied vitamin D may not produce similar effects.

Prevalence Of Thyroid Disorders Among Older People: Results From The São Paulo Ageing & Health Study, Paulo A. Lotufo

Paulo A Lotufo

This study aimed to estimate prevalence of thyroid disorders in the São Paulo Ageing & Health Study, an epidemiological study addressing several health-adverse outcomes among elderly people living in a poor area of São Paulo, Brazil. All participants answered a questionnaire and had a blood sample collected to assess levels of tireotropic hormone and free-thyroxine. Among 1,373 people (60.8% women), prevalence rates (95% confidence interval) for thyroid dysfunction (%) were: overt hyperthyroidism, 0.7% (0.2-1.1) [women: 0.8% (0.2-1.5); men: 0.4% (0.01-0.9)]; overt hypothyroidism, 5.7% (4.5-6.9) [women: 5.9% (4.3-7.5); men: 5.4% (3.5-7.3)]; subclinical hyperthyroidism, 2.4% (1.6-3.2) [women: 2.8% (1.6-3.9); men: 1.9% (0.7-3.0)]; …

Does Cardiac Resynchronization Therapy And Aerobic Exercise Improve Exercise Tolerance / Ability In Heart Failure Patiens Better Then Either Intervention Alone Or No Intervention At All?, Douglas Ader

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not cardiac resynchronization therapy with aerobic exercise improves exercise tolerance / ability better then either treatment alone or no intervention at all.

Is Vitamin E Supplementation Effective In Reducing Mortality Related To Cardiovascular Events In People With Type 2 Diabetes Mellitus?, Payal Amin

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not Vitamin E is effective in reducing the mortality related to cardiovascular event in patients with Type 2 Diabetes mellitus.

Can Ultrafiltration Be Used As Primary Treatment Of Congestive Heart Failure?, Jennifer Tallis

PCOM Physician Assistant Studies Student Scholarship

Objective: To determine whether ultrafiltration can be used as primary treatment of Congestive Heart Failure.

Comparison Of Predictive Protocols In Chest Pain Patients In A Tertiary Care Hospital In Karachi, Pakistan, Omer Moin, Uzma Khan, Nadeem Ullah Khan, Munawar Khursheed, Junaid Razzak

Department of Emergency Medicine

Background: The most challenging aspect in evaluation of a patient presenting with chest pain in the Emergency Department (ED) is diagnosis of acute cardiac ischemia (ACI). Various decisions aids have been developed to aid the ED physician in the diagnosis of chest pain. Three different predictive protocols – the Goldman protocol, ACI-TIPI, and the Troponin protocol are used in predicting the occurrence of ACI. None of these decision aids have been tested in the Pakistani population, where risk factors and prevalence of CAD are much different than what is seen in other regions of the world.Aims: The aim of …

Transitions Home For Patients With Heart Failure: A Pilot Program At A Critical Access Hospital, Rita M. Willey

Doctor of Nursing Practice (DNP) Projects

Background: Heart Failure (HF) disease management programs (DMP) have shown to improve outcomes. The aim of this heart failure pilot program is an evaluation program. Measurement of functional capacity utilized the Duke Activity Status Index (DASI) questionnaire. Since the DASI uses the patient’s ability to perform a set of common activities of daily living to gauge functional capacity based on the known metabolic cost of each activity in MET units, it is thought to be well suited for population studies in which assessment of functional capacity during follow-up is needed.

Setting: Rural Critical Access Hospital (CAH) with outpatient cardiology services. …

The Cardiac Atlas Project--An Imaging Database For Computational Modeling And Statistical Atlases Of The Heart, Carissa G. Fonseca, Michael Backhaus, David A. Bluemke, Randall D. Britten, Jae Do Chung, Brett R. Cowan, Alan H. Kadish

Office of the President Publications and Research

MOTIVATION: Integrative mathematical and statistical models of cardiac anatomy and physiology can play a vital role in understanding cardiac disease phenotype and planning therapeutic strategies. However, the accuracy and predictive power of such models is dependent upon the breadth and depth of noninvasive imaging datasets. The Cardiac Atlas Project (CAP) has established a large-scale database of cardiac imaging examinations and associated clinical data in order to develop a shareable, web-accessible, structural and functional atlas of the normal and pathological heart for clinical, research and educational purposes. A goal of CAP is to facilitate collaborative statistical analysis of regional heart shape …

Detection Of Cardiac Myosin Heavy Chain-Α-Specific Cd4 Cells By Using Mhc Class Ii/IaK Tetramers In A/J Mice, Chandirasegara Massilamany, Arunakumar Gangaplara, Nora M. Chapman, Noel Rose, Jay Reddy

Jay Reddy Publications

A/J mice bearing the H-2 allele IAk are highly susceptible to autoimmune myocarditis induced with cardiac myosin heavy chain (Myhc)-α 334–352, whereas B10.A mice carrying a similar allele IAk are relatively resistant, suggesting that the generation of Myhc-α-reactive T cell repertoires is influenced by genetic background. To enumerate the precursor frequencies of Myhc-α-specific CD4 T cells, we sought to create IAk tetramers for Myhc-α 334–352. Tetramers were created using approaches that involve covalent tethering of individual peptide sequences or exogenous loading of peptides into empty IAk molecules by peptide-exchange reaction. Using ribonuclease 43– 56 tetramers as controls, we demonstrated that …