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Association Of Lipid-Related Genetic Variants With The Incidence Of Atrial Fibrillation: The Afgen Consortium, Faye L. Norby, David D. McManus 2016 University of Minnesota, Minneapolis

Association Of Lipid-Related Genetic Variants With The Incidence Of Atrial Fibrillation: The Afgen Consortium, Faye L. Norby, David D. Mcmanus

David D. McManus

BACKGROUND: Several studies have shown associations between blood lipid levels and the risk of atrial fibrillation (AF). To test the potential effect of blood lipids with AF risk, we assessed whether previously developed lipid gene scores, used as instrumental variables, are associated with the incidence of AF in 7 large cohorts.

METHODS: We analyzed 64,901 individuals of European ancestry without previous AF at baseline and with lipid gene scores. Lipid-specific gene scores, based on loci significantly associated with lipid levels, were calculated. Additionally, non-pleiotropic gene scores for high-density lipoprotein cholesterol (HDLc) and low-density lipoprotein cholesterol (LDLc) were calculated using ...


Atrial Fibrillation Without Comorbidities: Prevalence, Incidence And Prognosis (From The Framingham Heart Study), Eun-Jeong Kim, Xiaoyan Yin, Joao D. Fontes, Jared W. Magnani, Steven A. Lubitz, David D. McManus, Sudha Seshadri, Ramachandran S. Vasan, Patrick T. Ellinor, Martin G. Larson, Emelia J. Benjamin, Michael Rienstra 2016 Massachusetts General Hospital

Atrial Fibrillation Without Comorbidities: Prevalence, Incidence And Prognosis (From The Framingham Heart Study), Eun-Jeong Kim, Xiaoyan Yin, Joao D. Fontes, Jared W. Magnani, Steven A. Lubitz, David D. Mcmanus, Sudha Seshadri, Ramachandran S. Vasan, Patrick T. Ellinor, Martin G. Larson, Emelia J. Benjamin, Michael Rienstra

David D. McManus

BACKGROUND: The epidemiology of atrial fibrillation (AF) without comorbidities, known as 'lone AF', is uncertain. Although it has been considered a benign condition, we hypothesized that it confers a worse prognosis compared with a matched sample without AF.

METHODS: We described the proportion of AF without comorbidities (clinical, subclinical cardiovascular disease and triggers) among the entire AF sample in Framingham Heart Study (FHS). We compared AF without comorbidities with typical AF, and age-, sex- and cohort-matched individuals without AF, using Cox proportional hazards analysis in relation to combined cardiovascular events (stroke, heart failure, myocardial infarction), and mortality.

RESULTS: Of 10 ...


Training New Mothers In Infant Cardiopulmonary Resuscitation (Cpr), Gavin C. Barr Jr. MD, Marna R. Greenberg DO, MPH, FACEP, Valerie Rupp RN, BSN, Charles C. Worrilow MD, Katie Fredericks, Anne Marie Crown, John Reed RRT 2016 Lehigh Valley Health Network

Training New Mothers In Infant Cardiopulmonary Resuscitation (Cpr), Gavin C. Barr Jr. Md, Marna R. Greenberg Do, Mph, Facep, Valerie Rupp Rn, Bsn, Charles C. Worrilow Md, Katie Fredericks, Anne Marie Crown, John Reed Rrt

Charles Worrilow, MD.

No abstract provided.


Cardiomems™ In Lvad Patients: A Case Series, Maya Guglin, Bennet George, Sarah Branam, Amanda Hart 2016 Gill Heart Institute, University of Kentucky

Cardiomems™ In Lvad Patients: A Case Series, Maya Guglin, Bennet George, Sarah Branam, Amanda Hart

The VAD Journal

Patients with a left ventricular assist device (LVAD) commonly encounter issues with volume status post-implant. Volume overload can result from incomplete compensation of left ventricular failure or from right ventricular failure. The CardioMEMS™ intracardiac hemodynamic monitoring device is an area of growing interest regarding the management of chronic congestive heart failure, however, its utility has not been serially investigated in patients with an LVAD. We present a case series of patients with ventricular assist devices care for at our institution in which the CardioMEMS™ device aided in the management of volume status and pump performance.


Cardiopulmonary Resuscitation: Is The Emergency Department Visit An Opportunity To Recommend Education? (Poster), Marna R. Greenberg DO, MPH, FACEP, Gavin C. Barr Jr. MD, Jon D. Willardson DO, Nicholas M. Dowling DO, Jennifer L. Sears DO, Valerie Rupp RN, BSN, Kimberly Hamilton BA, Kevin Weaver DO 2016 Lehigh Valley Health Network

Cardiopulmonary Resuscitation: Is The Emergency Department Visit An Opportunity To Recommend Education? (Poster), Marna R. Greenberg Do, Mph, Facep, Gavin C. Barr Jr. Md, Jon D. Willardson Do, Nicholas M. Dowling Do, Jennifer L. Sears Do, Valerie Rupp Rn, Bsn, Kimberly Hamilton Ba, Kevin Weaver Do

Kevin Weaver, D.O., FACOEP

No abstract provided.


Cardiopulmonary Resuscitation Prescription Program: A Prospective Randomized Pilot Study, Marna R. Greenberg DO, MPH, FACEP, Gavin Barr MD, Valerie Rupp RN, BSN, Nainesh C. Patel MD, Kevin R. Weaver DO, Kimberly Hamilton BA, James F. Reed III, PhD 2016 Lehigh Valley Health Network

Cardiopulmonary Resuscitation Prescription Program: A Prospective Randomized Pilot Study, Marna R. Greenberg Do, Mph, Facep, Gavin Barr Md, Valerie Rupp Rn, Bsn, Nainesh C. Patel Md, Kevin R. Weaver Do, Kimberly Hamilton Ba, James F. Reed Iii, Phd

Kevin Weaver, D.O., FACOEP

No abstract provided.


Ligation Of The Outflow Graft Of The Left Ventricular Assist Device For Management Of Hemolysis Due To Pump Thrombosis, Jean Touchan, Alexis Shafii, Maya Guglin 2016 University of Kentucky

Ligation Of The Outflow Graft Of The Left Ventricular Assist Device For Management Of Hemolysis Due To Pump Thrombosis, Jean Touchan, Alexis Shafii, Maya Guglin

The VAD Journal

Pump thrombosis is a serious complication of continuous-flow left ventricular assist devices (LVAD). Treatment options include medical thrombolysis, surgical pump exchange or urgent heart transplantation. We are reporting a case of pump thrombosis with active hemolysis and acute renal failure managed surgically by isolating the LVAD while awaiting renal recovery and donor heart availability.


Caregiver Burden Is Low Nine To Twelve Months After Ventricular Assist Device Implantation, Roxana Ghashghaei, Hao Tran, Jorge Silva, Barry H. Greenberg, Denise Barnard, Eric Adler 2016 University of California, San Diego

Caregiver Burden Is Low Nine To Twelve Months After Ventricular Assist Device Implantation, Roxana Ghashghaei, Hao Tran, Jorge Silva, Barry H. Greenberg, Denise Barnard, Eric Adler

The VAD Journal

Background:

Prior studies have found that caregivers of chronically ill patients, including those with heart failure, have significant stress and burden. Ventricular Assist Devices (VADs) are a promising therapeutic modality for end stage heart failure. However, caregiver burden has not previously been studied in the caregivers of VAD patients.

Methods:

We studied 31 caregivers of VAD patients receiving care at University of California, San Diego. Validated instruments tools, such as the Bakas Caregiving Outcomes scale and Oberst Caregiving Demand and Difficulty sub-scales, were used to measure the caregivers’ psychological burden.

Results:

Nearly half of the caregivers were the patient’s ...


Can A Point-Of-Care Troponin I Assay Be As Good As A Central Laboratory Assay? A Midas Investigation., W. Frank Peacock, Deborah Diercks, Robert Birkhahn, Adam J. Singer, Judd Hollander, Richard Nowak, Basmah Safdar, Chadwick D. Miller, Mary Peberdy, Francis Counselman, Abhinav Chandra, Joshua Kosowsky, James Neuenschwander, Jon Schrock, Elizabeth Lee-Lewandrowski, William Arnold, John Nagurney 2016 Baylor College of Medicine

Can A Point-Of-Care Troponin I Assay Be As Good As A Central Laboratory Assay? A Midas Investigation., W. Frank Peacock, Deborah Diercks, Robert Birkhahn, Adam J. Singer, Judd Hollander, Richard Nowak, Basmah Safdar, Chadwick D. Miller, Mary Peberdy, Francis Counselman, Abhinav Chandra, Joshua Kosowsky, James Neuenschwander, Jon Schrock, Elizabeth Lee-Lewandrowski, William Arnold, John Nagurney

Department of Emergency Medicine Faculty Papers

BACKGROUND: We aimed to compare the diagnostic accuracy of the Alere Triage Cardio3 Tropinin I (TnI) assay (Alere, Inc., USA) and the PathFast cTnI-II (Mitsubishi Chemical Medience Corporation, Japan) against the central laboratory assay Singulex Erenna TnI assay (Singulex, USA).

METHODS: Using the Markers in the Diagnosis of Acute Coronary Syndromes (MIDAS) study population, we evaluated the ability of three different assays to identify patients with acute myocardial infarction (AMI). The MIDAS dataset, described elsewhere, is a prospective multicenter dataset of emergency department (ED) patients with suspected acute coronary syndrome (ACS) and a planned objective myocardial perfusion evaluation. Myocardial infarction ...


Pharmacologic Diuresis Is Safer Than Ultrafiltration For Cardiorenal Syndrome, Grace Choong 2016 Wayne State University

Pharmacologic Diuresis Is Safer Than Ultrafiltration For Cardiorenal Syndrome, Grace Choong

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Bart BA, Goldsmith SR, Lee KL et al. Ultrafiltration in decompensated heart failure with cardiorenal syndrome. N Engl J Med. 2012;367:2296-2304. doi: 10.1056/NEJMoa1210357


Acute Appendicitis: A Potential Complication Of Continuous-Flow Left Ventricular Assist Device Support, Joshua S. Roark, Akinniran A. Abisogun, Jason N. Katz 2016 University of North Carolina

Acute Appendicitis: A Potential Complication Of Continuous-Flow Left Ventricular Assist Device Support, Joshua S. Roark, Akinniran A. Abisogun, Jason N. Katz

The VAD Journal

Acute appendicitis, while common in younger patients, is an unusual cause for hospitalization among older adults. We report a case series of 3 individuals who had been previously implanted with a continuous-flow left ventricular assist device (CF-LVAD) for end-stage heart failure, and who subsequently developed acute appendicitis. Both axial-flow technology and nonpulsatile systemic blood flow have been implicated as potential causes for bleeding and thrombosis in contemporary LVAD populations(1-3). This case series represents the first report of acute appendicitis as an adverse event following LVAD implantation and represents a patient demographic that would historically be at very low-risk for ...


Total Artificial Heart Imaging And Complications: A Pictorial Review, Carrie K. Gomez, Susan K. Hobbs 2016 University of Rochester

Total Artificial Heart Imaging And Complications: A Pictorial Review, Carrie K. Gomez, Susan K. Hobbs

The VAD Journal

Heart failure is a serious cause of morbidity and mortality with many patients ultimately requiring heart transplantation. As the rate of heart failure continues to increase and surpass the number of available donor hearts, the need for cardiac assist devices is rapidly rising. The total artificial heart has emerged as an effective therapeutic option in patients with end-stage biventricular heart failure who are awaiting orthotopic heart transplantation. The TAH replaces the patient’s native ventricle and valves and has one of the highest bridge to transplant rates. Many complications have been associated with the TAH including infections, bleeding, thrombosis, device ...


Characterization Of Left-Ventricular Thrombus Formation Using High Frequency Ultrasound, Kelsey A. Bullens, Arvin H. Soepriatna, Pavlos P. Vlachos, Craig J. Goergen 2016 Purdue University

Characterization Of Left-Ventricular Thrombus Formation Using High Frequency Ultrasound, Kelsey A. Bullens, Arvin H. Soepriatna, Pavlos P. Vlachos, Craig J. Goergen

The Summer Undergraduate Research Fellowship (SURF) Symposium

Heart failure is a leading cause of death in the United States, and cardiac thrombus, a common morbidity associated with heart failure, significantly increases a patient’s risk of embolic events. The objective of this project is to characterize left-ventricular (LV) thrombus development using high frequency ultrasound imaging in a murine model. C57BL/6J wild-type mice (n=6) were injected intraperitoneally with iron dextran five times a week for six weeks to increase oxidative stress in the heart. Granulocyte-colony stimulating factor (G-CSF) was subcutaneously injected daily during the second week to initiate stem cell migration and stimulate endothelial cell activation ...


Herpes Zoster And Cardiovascular Events In Adults: A Systematic Review, Nathaniel A. Erskine, Hoang Tran, Len L. Levin, Christine M. Ulbricht, Joyce D. Fingeroth, Catarina I. Kiefe, Robert J. Goldberg 2016 University of Massachusetts Medical School

Herpes Zoster And Cardiovascular Events In Adults: A Systematic Review, Nathaniel A. Erskine, Hoang Tran, Len L. Levin, Christine M. Ulbricht, Joyce D. Fingeroth, Catarina I. Kiefe, Robert J. Goldberg

Robert J. Goldberg

Background: Stroke and myocardial infarction have been reported to occur after the development of herpes zoster (shingles), a common and preventable disease.

Purpose: To evaluate literature describing the association between herpes zoster and its subtypes with the occurrence of cardiovascular events.

Data Sources: PubMed, SCOPUS (Embase), OAIster, Google Scholar (searched in January 2016)

Study Selection: Studies published up to January 2016 examining the association between herpes zoster or subtype of herpes zoster with the occurrence of cardiovascular events, including stroke, transient ischemic attack, or an acute coronary event, were selected. Case reports, case studies, and studies of non-general adult populations ...


Accumulation Of Metabolic Cardiovascular Risk Factors In Black And White Young Adults Over 20 Years, Nina P. Paynter, Catarina I. Kiefe, Cora E. Lewis, Catherine M. Loria, David C. Goff, Donald Lloyd-Jones 2016 Harvard Medical School

Accumulation Of Metabolic Cardiovascular Risk Factors In Black And White Young Adults Over 20 Years, Nina P. Paynter, Catarina I. Kiefe, Cora E. Lewis, Catherine M. Loria, David C. Goff, Donald Lloyd-Jones

Catarina I. Kiefe

BACKGROUND: Cross-sectional clustering of metabolic risk factors for cardiovascular disease in middle-aged adults is well described, but less is known regarding the order in which risk factors develop through young adulthood and their relation to subclinical atherosclerosis.

METHOD AND RESULTS: A total of 3178 black and white women and men in the Coronary Artery Risk Development in Young Adults study were assessed to identify the order in which cardiovascular disease risk factors including diabetes, hypertension, dyslipidemia (low high-density lipoprotein cholesterol or high triglyceride levels), hypercholesterolemia (high total or low-density lipoprotein cholesterol), and obesity develop. Observed patterns of risk factor development ...


Age And Sex Differences In Long-Term Outcomes Following Implantable Cardioverter-Defibrillator Placement In Contemporary Clinical Practice: Findings From The Cardiovascular Research Network, Frederick A. Masoudi, Jerry H. Gurwitz, Robert J. Goldberg 2016 University of Colorado

Age And Sex Differences In Long-Term Outcomes Following Implantable Cardioverter-Defibrillator Placement In Contemporary Clinical Practice: Findings From The Cardiovascular Research Network, Frederick A. Masoudi, Jerry H. Gurwitz, Robert J. Goldberg

Robert J. Goldberg

BACKGROUND: Patient sex and age may influence rates of death after receiving an implantable cardioverter-defibrillator for primary prevention. Differences in outcomes other than mortality and whether these differences vary by heart failure symptoms, etiology, and left ventricular ejection fraction are not well characterized.

METHODS AND RESULTS: We studied 2954 patients with left ventricular ejection fraction < /=0.35 undergoing first-time implantable cardioverter-defibrillator for primary prevention within the Cardiovascular Research Network; 769 patients (26%) were women, and 2827 (62%) were aged > 65 years. In a median follow-up of 2.4 years, outcome rates per 1000 patient-years were 109 for death, 438 for hospitalization, and 111 for heart failure hospitalizations. Procedure-related complications occurred in 8.36%. In multivariable models, women had significantly lower risks of death (hazard ...


Cardiovascular Health Awareness And The Effect Of An Educational Intervention On School-Aged Children In A Rural District Of India, Madhab Ray, Santanu Guha, Meghna Ray, Anita Kundu, Bipasha Ray, Kaushik Kundu, Santanu Goswami, Deepak Bhatt, Harry P. Selker, Robert J. Goldberg 2016 Tufts University

Cardiovascular Health Awareness And The Effect Of An Educational Intervention On School-Aged Children In A Rural District Of India, Madhab Ray, Santanu Guha, Meghna Ray, Anita Kundu, Bipasha Ray, Kaushik Kundu, Santanu Goswami, Deepak Bhatt, Harry P. Selker, Robert J. Goldberg

Robert J. Goldberg

BACKGROUND AND OBJECTIVES: India is the second most populous country in the world and two-thirds of its population is less than 35 years old. This survey was conducted to assess the level of health awareness of cardiovascular disease in adolescent school-aged children 14-16 years old, with the goal of establishing school-based health education and development of heart-healthy lifestyle practices.

METHODS: A school-based survey was conducted in the rural district of West Midnapore, India between June and July of 2014. This involved a pre-evaluation of cardiovascular disease (CVD) health awareness, a short presentation on CVD, and a post-evaluation of CVD health ...


Comparing Direct Factor Xa Inhibitors And Warfarin In The Prevention Of Stroke In Patients With Atrial Fibrillation, Alessandra Lof, Stephanie Pillai 2016 James Madison University

Comparing Direct Factor Xa Inhibitors And Warfarin In The Prevention Of Stroke In Patients With Atrial Fibrillation, Alessandra Lof, Stephanie Pillai

Physician Assistant Capstones

Objective: To evaluate the overall efficacy, advantages, and disadvantages of treatment with direct factor Xa inhibitors as compared to warfarin in the prevention of stroke in patients with atrial fibrillation. Methods: A quantitative meta-analysis was performed on three separate studies, each of which evaluated the efficacy and safety outcomes of a direct factor Xa inhibitor versus warfarin in preventing stroke in patients with atrial fibrillation. The direct factor Xa inhibitors that were evaluated included apixaban, edoxaban, and rivaroxaban. Results: The direct factor Xa inhibitors were found to be as effective, and in some cases more effective, than warfarin in preventing ...


Routine Screening For Abdominal Aortic Aneurysm: Is It For Everyone?, Catherine E. Nowak 2016 James Madison University

Routine Screening For Abdominal Aortic Aneurysm: Is It For Everyone?, Catherine E. Nowak

Physician Assistant Capstones

Objective: Determine whether routine abdominal ultrasound screening in all men ages 65 and over, not just those who are symptomatic or at risk, would be beneficial in reducing the mortality rate from abdominal aortic aneurysms (AAA). Design: Systematic literature review. Methods: The clinical question investigated is whether routine ultrasound screening of AAA for men over age 65 reduces AAA-related mortality as compared to not routinely screening. Searches were done through PubMed using the keywords: screening, abdominal aortic aneurysm, reduce, and mortality. Citations used by the USPSTF AAA screening guidelines were also added to the literature search. In PubMed, further limitations ...


Left Ventricular Noncompaction Syndrome: A Rare Congenital Cardiomyopathy, Ashwini V. Mallad, MBBS, Waseem Ahmed, MD, Madhulika Urella, MD, Dr. Mehiar El-Hamdani, MD, FACC, FSCAI 2016 Marshall University School of Medicine

Left Ventricular Noncompaction Syndrome: A Rare Congenital Cardiomyopathy, Ashwini V. Mallad, Mbbs, Waseem Ahmed, Md, Madhulika Urella, Md, Dr. Mehiar El-Hamdani, Md, Facc, Fscai

Marshall Journal of Medicine

Isolated left ventricular noncompaction cardiomyopathy (LVNC) is a rare congenital condition occurring due to arrest of myocardial compaction in the first trimester, resulting in a thin layer of compacted epicardium and thick hypertrabeculated myocardium containing deep recesses. This article presents a 44-year-old female with progressive dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and pleuritic chest pain. Examination revealed elevated jugular venous distention, lower extremity edema, and bibasilar crackles on lung auscultation, while the electrocardiogram (EKG) exhibited left bundle branch block. Two-dimensional echocardiography (2D-Echo) showed a dilated left ventricle (LV) with ejection fraction (EF) of 25% and severe diffuse hypokinesia. Cardiac magnetic resonance ...


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