Medicine and Health Sciences Commons^™

Association Of Glucagon-Like Peptide-1 Receptor Agonist Use With Cardiovascular Risk Reduction In Patients With Obstructive Sleep Apnea And Obesity: A Real-World Analysis, Jaeun Ahn, Jummin Song, Kyle Admire, Yu Chang, Kuan-Yu Chi, Joshua M. Sill

Cardiovascular Research Symposium

Introduction: Obstructive sleep apnea (OSA) is a well-established risk factor for cardiovascular disease. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated promising potential in reducing cardiovascular risk and alleviating the severity of OSA. However, a significant knowledge gap remains regarding the impact of GLP-1RAs on cardiovascular events in OSA patients. This study utilizes large-scale global electronic healthcare record data to evaluate the associations of GLP-1RAs with improved cardiovascular outcomes.

Methods: We conducted a propensity score-matched retrospective cohort study using aggregate data from the TriNetX Global Network, which includes over 160 million patients from more than 120 healthcare organizations worldwide. The study …

Successful Transcatheter Edge-To-Edge Repair Of Mitral And Tricuspid Valves In A 77-Year-Old Patient With Structural Heart Disease, Omar Khan, Matthew Summers

Cardiovascular Research Symposium

This patient is a 77-year-old male with non-ischemic cardiomyopathy, severe tricuspid regurgitation, and moderate mitral regurgitation who underwent successful transcatheter edge-to-edge repair (TEER) of both valves. Post-procedure, the patient exhibited significant symptomatic improvement and reduced regurgitation severity, highlighting the feasibility of dual-valve TEER in high-risk patients.

Using Atrial Pacing Trials After Tavr To Assess Conduction Abnormalities And Predict Need For Pacemaker Implantation, Hemish M. Philip, Matthew R. Summers, Shirish R. Yasa, Hasani Amir, Daiwik P. Munjwani, Thomas A. Cook, Matthew G. Jackson

Cardiovascular Research Symposium

Abstract:

Background: Transcatheter Aortic Valve Replacement (TAVR) is the standard of care for many patients with severe aortic stenosis who cannot undergo surgical intervention. However, conduction disturbances remain a frequent complication, particularly with self-expanding valves. This often leads to permanent pacemaker implantation (PPI). At Sentara Heart Hospital, atrial pacing at 140 bpm is standard practice during TAVR to assess AV conduction.

Objective: This study aims to evaluate whether preserved 1:1 atrioventricular (AV) conduction during routine atrial pacing at 140 bpm after self-expanding TAVR predicts a low likelihood of requiring PPI, thus yielding a high negative predictive value (NPV).

Methods: We …

Mitochondria Targeted Dicarbonyl Scavenging With Mito2hoba Reduces Atherosclerosis By Enhancing Plaque Stability And Suppressing Inflammation In Hyperlipidemic Ldlr⁻/⁻ Mice, Michael T. Dileonardo, Macrae F. Linton

Cardiovascular Research Symposium

Mitochondria Targeted Dicarbonyl Scavenging with Mito2HOBA Reduces Atherosclerosis by Enhancing Plaque Stability and Suppressing Inflammation in Hyperlipidemic Ldlr⁻/⁻ Mice

Michael DiLeonardo¹, Huan Tao PhD², Lei Ding BS², Youmin Zhang BS², Sergey Dikalov PhD³, Patricia G. Yancey PhD², and MacRae F. Linton MD²

¹Eastern Virginia Medical School, Department of Medicine ²Cardiovascular Medicine and ³Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN

Introduction: Atherosclerosis is a chronic inflammatory disease driven by lipid accumulation, immune cell activation, and oxidative stress. Recent evidence indicates that macrophage mitochondrial dysfunction …

Comparing Immediate And Short-Term Outcomes And Success In Conservative Versus Surgical Treatment Of Pulmonary Embolism (Pe), Madison Baldauf, Animesh Rathore Md

Cardiovascular Research Symposium

BACKGROUND:

Pulmonary embolism (PE) is a dangerous and life-threatening medical condition which significantly increases risk of cardiovascular fatality. Although each PE treatment strategy has shown to be effective to some degree, there is limited data on they compare. The objective of this study is to evaluate the outcomes of PE treatment with anticoagulation versus interventional treatments.

METHODS:

A Retrospective chart review was performed of all patients identified as having a PE at Sentara Norfolk General Hospital from January 1, 2021 to December 31, 2022. Using Redcap, patient information was recorded, including age, sex, race, body mass index, and pertinent history. …

Mortality And Heart Failure Exacerbations With Incretin-Mimetic Drugs For Weight Loss In Patients With Obesity-Related Heart Failure With Preserved Ejection Fraction, Leila Humphreys, Salvatore Carbone, Syed Imran Ahmed

Cardiovascular Research Symposium

Research has shown that incretin-mimetic agents approved and used for weight loss may help treat heart failure by improving their quality of life and functional capacity. Whether differences exist between these agents in the HFpEF population has not been tested before. Our study set out to see if these agents affected risk of all-cause mortality and further heart failure related hospitalizations in patients with obesity-related HFpEF and whether differences exist among them.

Nadph Oxidase Isoforms (Nox-2 And Nox-4) In Myocardial Ischemia/Reperfusion Injury: Platelet Rich Plasma (Prp) As A Therapeutic Agent, Barbara Y. Hargrave, Frank Lattanzio

Cardiovascular Research Symposium

Introduction: Blood flow restoration to ischemic cardiac tissue is a critical and necessary intervention that has an associated downside: reperfusion injury. Reperfusion injury is a complicated process mediated in part by a pathological increase in reactive oxygen species (ROS). Although extremely elevated levels of ROS can cause cell damage, a minimum level of ROS is necessary for activation of Hydroxylated-HIF-1a (HIF-1a) and inhibition of Peroxisome Proliferator-Activated Receptor-alpha (PPARa) during myocardial ischemic reperfusion injury (MIRI). MIRI clinical manifestations include arrhythmias, myocardial stunning, decreased ventricular contractility and no-reflow. Platelet rich plasma (PRP) has improved left ventricular (LV) function after MIRI in …

Staged Cervical Laminoplasty And Pulmonary Endarterectomy In A Patient With Concomitant Cervical Stenosis And Severe Pulmonary Hypertension, Jacob C. Chen, Gustavo A. Heresi, Nakul S. Kumar, Andrej Alfirevic, Anand Mehta, Haytham Elgharably

Cardiovascular Research Symposium

No abstract provided.

Predicting Cardiovascular Mortality In Hampton Roads Using Social Determinants Of Health, Mohan D. Pant, Aditya Chakraborty, Prachi P. Chavan, George Mcleod, Brett J. Sierra, Glenn A. Yap, Brian C. Martin, Ebbie Kalan, Gregory T. Scott

Cardiovascular Research Symposium

Background: In Virginia’s Hampton Roads (HR) region, minority populations experience notably higher mortality rates than white populations. Despite abundant research on the association between social determinants of health (SDOH) and cardiovascular mortality rates at the state and national levels, there is a lack of research examining this association in the HR region.

Objective: The main objective of this study is to train and validate a geospatial-temporal predictive model to examine the association between SDOH and cardiovascular mortality, in the HR region.

Methods: Utilizing a longitudinal dataset (2010–2021) from the Virginia Department of Health and the U.S. Census Bureau, we trained …

A Modern Analytical Method To Forecast Cerebrovascular Diseases (Cd), And Heart Diseases (Hd) Using Multivariate Time Series Model Utilizing The Cdc Provisional Mortality Data, Aditya Chakraborty, Mohan Pant

Cardiovascular Research Symposium

Background: In this study, a new analytical approach was introduced to answer specific questions related to mortalities due to cerebrovascular diseases, heart diseases, and the association of these mortalities with twelve other causes of death (COD).

Methods: A multivariate time series forecasting model was developed utilizing each of the CODs by taking the weekly and yearly seasonality into account, and the mortality counts were forecasted using the most recent CDC weekly mortality count data. A new COD data matrix was structured for all CODs as a function of weeks by combining the observed and predicted values of the mortality counts. …

Role Of Cd45 Dependent Signaling In B-Cell Subsets In Atherosclerosis, Shelby Ma, Elena Galkina, Aravindan Balaguru

Cardiovascular Research Symposium

No abstract provided.

A 16-Year Experience Of Popliteal Artery Aneurysm Repair: Endovascular Stent Grafting Matches Surgical Bypass At A Cost Of Much Higher Reintervention Rates, Thomas A. Cook, David J. Dexter, Hosam F. El Sayed, Nicholas L. Bandy, Benjamin B. Samberg, Emily D. Burnett, Jacob A. Hoffman, Jean M. Panneton

Cardiovascular Research Symposium

Objective: To compare long-term outcomes of popliteal artery aneurysm (PAA) repair via open surgical bypass and endovascular stenting, focusing on patency, freedom from major amputation, and reintervention rate.

Methods: A retrospective review of all limbs treated for PAA from 2008–2024 across a single healthcare system was conducted. Baseline demographics, clinical presentation, operative details, and postoperative outcomes were collected. Long-term outcomes (≥ 5 years) included primary, primary assisted, and secondary patency, reintervention rate, major adverse cardiac events (MACE), major adverse limb events (MALE), freedom from major amputation, and all-cause mortality. Statistical analyses were done as appropriate utilizing SPSS.

Results: We identified …

Clonal Hematopoiesis And Thromboembolic Diseases: A Review, Jaekeun Jung, Jee Hyuk Byun, Janghee Woo

Cardiovascular Research Symposium

Clonal hematopoiesis of indeterminate potential (CHIP) has been identified as a novel risk factor for cardiovascular diseases, primarily mediated by CHIP-induced systemic inflammation. Emerging evidence suggests that CHIP may also contribute to the risk of thromboembolic diseases. This review highlights recent findings on the impact of CHIP on various thromboembolic conditions, such as deep vein thrombosis, pulmonary embolism, chronic thromboembolic pulmonary hypertension, and ischemic stroke. Studies have demonstrated an association between CHIP and an increased risk of deep vein thrombosis, pulmonary embolism, chronic thromboembolic pulmonary hypertension and ischemic stroke. CHIP-induced systemic inflammation may amplify vascular endothelial damage and complement cascade …

Student Nurse-Led Hypertension Management In A Rural Free Clinic, Leslie Okhirkhian

Cardiovascular Research Symposium

This pilot project seeks to evaluate the effect of nurse-led assessments and education on blood pressure control among adult patients with prehypertension and hypertension who attend a free health clinic located inside of a rural community in Southeastern Virginia. A leading, modifiable risk factor for cardiovascular disease is hypertension, yet disparities in consistent healthcare access and education disproportionately affect rural populations. Nurse-led interventions are a promising strategy for improving hypertension control through personalized education, blood pressure monitoring, and follow-up.

Methods: Participants with a diagnosis of prehypertension or hypertension were recruited from a free rural health clinic (n=20). Over a 7-week …

Iatrogenic Aortic Coarctation Physiology After Elephant Trunk Procedure For Type A Aortic Dissection, Khushie Matharoo, Emidio Germano Md, Animesh Rathore Md

Cardiovascular Research Symposium

Introduction: Surgical management of type A aortic dissections has evolved, with growing adoption of extended aortic repairs into the descending aorta. Despite accumulating experience in complex aortic repairs, morbidity and mortality remain high. We present a case of iatrogenic aortic coarctation post-elephant trunk procedure that was ultimately repaired via a thoracic endovascular aortic repair (TEVAR).

Methods: The patient is a 40-year-old male with a medical history of hypertension and cigarette smoking who presented with acute onset of dizziness, hypotension, acute kidney injury (AKI) (Cr 1.4, baseline 0.9) and type 2 myocardial infarction. Echocardiogram showed severe aortic insufficiency, and CTA evidenced …

Development Of Overt Hypo-Attenuated Leaflet Thickening Following Transcatheter Aortic Valve Replacement, Stephonda Lewis, Hemish M. Philip, Matthew Summers

Cardiovascular Research Symposium

Background: Transcatheter aortic valve replacement (TAVR) is a cornerstone therapy for severe aortic stenosis. Up to one-third of patients develop hypoattenuated leaflet thickening (HALT) within the first year post-TAVR. HALT, a form of leaflet thrombosis, can progress to leaflet immobility and structural deterioration. Despite its significance, no unified approach exists for screening or management of HALT after TAVR.

Case Presentation: A 64-year-old woman presented with shortness of breath on exertion. Exam revealed a 3/6 systolic murmur, and echocardiogram confirmed severe aortic stenosis. She underwent TAVR with resolution of symptoms and was discharged on clopidogrel (Plavix) as single antiplatelet therapy. Two …

Novel Guidewire Technique For Paravalvular Leak Repair Following Tavr: A Case Report, Daiwik Munjwani, Bharadwaj Chintalapati, Casey Barry, Matthew R. Summers

Cardiovascular Research Symposium

Background:

Paravalvular leak (PVL) is a recognized complication following transcatheter aortic valve replacement (TAVR), associated with increased mortality, heart failure symptoms, and hemolytic anemia. Standard percutaneous PVL closure relies on crossing the defect with a 0.035-inch hydrophilic guidewire, followed by exchange for a stiffer wire to enable device delivery. However, traversing the defect can be technically challenging due to decreased maneuverability of the guidewire. We report a case of PVL repair using a modified 0.014-inch polymer-jacketed coronary guidewire and aspiration guidewire strategy that facilitated stable device deployment and complete leak closure.

Case Presentation and Management:

An 86-year-old woman with prior …

Vcd-Induced Model Of Menopause To Study Effects Of Sleep Fragmentation On Atherogenesis, Sarah Shackelford B.S, Alina Moriarty M.S., Basudha Habisyasi M.S., Kathleen Coleman B.S., Pavla Brachova Phd, Diane Duffy Phd, Elena Galkina Phd

Cardiovascular Research Symposium

Introduction: Atherosclerosis is a chronic disease characterized by plaque buildup within arteries, leading to cardiovascular diseases. Sleep fragmentation (SF), defined as less than seven hours of uninterrupted sleep, is a recognized risk factor and is commonly observed in menopausal women. Menopause causes a decline in estrogen and ovarian follicles, resulting in the loss of estrogen’s protective anti-atherogenic effects. SF exacerbates atherosclerosis by promoting oxidative stress and inflammation. Since SF contributes to atherosclerosis, and menopausal women are particularly affected by disturbed sleep, we aim to examine how menopause affects atherogenesis in the conditions of disturbed sleep.

Methods: We used the 4-vinylcyclohexene …

Ai-Guided Simulation And Single-Cusp Cleve To Enable High-Risk Valve-In-Valve Tavr, Joshua Dolsen Md, Omar Sale Bs, Nicholas Valle Do, Matthew Summers Md

Cardiovascular Research Symposium

Title

AI-Guided Simulation and Single-Cusp CLEVE to Enable High-Risk Valve-in-Valve TAVR

Authors

Joshua Dolsen MD, Omar Saleh BSc, Nicholas Valle DO, Matthew Summers MD,

Introduction

Acute coronary obstruction is a rare but potentially fatal complication of transcatheter aortic valve replacement (TAVR), with a markedly increased risk in valve-in-valve (ViV) procedures due to anatomical constraints. The risk is further heightened in patients with complex anatomy, such as low coronary ostia or narrow sinuses of Valsalva. Despite advances in imaging and procedural techniques, pre-procedural risk stratification has remained largely static, relying primarily on pre-procedural imaging with Computed Tomography (CT). Recently, artificial intelligence …

Socioeconomic, Behavioral, And Health Profiles Of Women With Eclampsia: Findings From The 2020–2022 National Pregnancy Risk Assessment Monitoring System Data, Jessi Bates, Gurgen Grigoryants, Hongyun Fu

Cardiovascular Research Symposium

Background: Eclampsia is a severe obstetric complication with significant maternal health implications, disproportionately affects women with certain sociodemographic and health risk factors. This study investigates the characteristics and outcomes of women who experienced eclampsia using data from the national Pregnancy Risk Assessment Monitoring System (PRAMS).

Methods: This analysis included a sample of 729 women with eclampsia from the 2020–2022 PRAMS (N = 238,575). Descriptive statistics, chi-square tests, and multivariate logistic regression were conducted to examine patterns and factors associated with preterm-birth, low birth weight (LBW), and cesarean delivery.

Results: Over half of the women were aged ≥35 years (50.6%), unmarried …

Understanding Hispanic Cultural Strengths Through Parents’ Voices: Insights For Interdisciplinary School Personnel, David Moran, Johana Rocha, Kristy Carlisle

Journal of Human Services Scholarship and Interprofessional Collaboration

Examining the strengths of Hispanic cultural values among K-12 school students is a generally understudied concept, and from their parents’ perspective specifically. This study sought to take a qualitative approach toward the exploration of Hispanic parents’ perspectives on how their cultural values promote strengths within their school-aged children. Hispanic parents (N = 8) participated in bilingual (i.e., Spanish and English) focus groups, with the results providing content that can inform culturally responsive prevention and intervention strategies to support the roles of interdisciplinary school personnel who regularly interact with the children. Findings pointed to (a) interaction with peers and school …

'Managed Hearts’ In Helper-Education: Gender Non-Binary Helper-Educators’ Experiences Of Emotional Labor, Jordan Pearce

Counseling & Human Services Theses & Dissertations

The unique experiences of people who identify with a gender beyond the binary paradigm dominant in the Global West are not well understood. The literature provides little insight into the experiences and perspectives of these individuals in a variety of contexts, including in their workplaces. As various social movements collide, they bring amplified attention to the mental health of marginalized communities and to workers, as well as the dynamics of modern work environments, and the specific needs of certain individuals doing certain types of work. The current study explored the experiences of gender non-binary individuals (GNI) working as helper-educators engaged …

A Focused Ethnography: Mental Health Therapists In Pediatric Integrated Care, Melanie Agustin

Counseling & Human Services Theses & Dissertations

The scope of practice for Licensed Professional Counselors (LPCs) and counseling residents (LPC-R) in integrated behavioral health (IBH) settings is grounded in accredited, theory-informed education and training. The benefits of IBH models are well-documented, however there is limited research that addresses how counselors develop professionally and clinically function, while navigating within pediatric inpatient environments. This qualitative dissertation used a focused ethnographic design to explore the lived experiences of ten purposively sampled counselors (n = 10) through demographic surveys, field observation, and semi-structured interviews. Reflexive journaling bracketed researcher bias, and thematic analysis, supported by NVivo and new member checking, guided interpretation. …

Adolescent E-Cigarette Expectancies: Measure Development And Preliminary Validity Of The Electronic Nicotine Vaping Outcomes Measure For Youth, Paul T. Harrell, Kelli J. England, Tracey E. Barnett, Vani N. Simmons, Richard W. Handel, Amy C. Paulson

Department of Pediatrics Faculty Publications

BACKGROUND: Electronic nicotine delivery systems (“e-cigarettes”) are the nicotine product most commonly used by adolescents. Research, treatment, and policy could benefit from measures of adolescent e-cigarette beliefs about outcomes of use (ie, expectancies). In the current study, we developed and tested an adolescent electronic nicotine vaping expectancy measure.

METHODS: A focus group with adolescents evaluated potential e-cigarette expectancy items. A panel of national experts assisted in revision of these items. Finally, items were administered to a sample of adolescents 14-17 years old (N = 267, Mean age 15.6, SD = 1.1, 50.9% Female, 50.2% Non-Hispanic White, 22.5% Non-Hispanic Black, 14.2% …

The Inside Scoop: Elucidating The Three-Way Relationship Between Schistosoma Mansoni, The Gut, And Vaccines, Mariam A. Mhanna

Biomedical Sciences Theses & Dissertations

Schistosomiasis is a neglected tropical disease that affects over 250 million people worldwide. This blood fluke infection burdens communities and areas with limited to no access to clean fresh water. When a host is exposed to cercariae, the infectious agent, in a body of water, it matures in the host’s circulation into adult female and male worms. Copulated adult worms migrate to the mesentery, in the case of Schistosoma mansoni, and produce eggs that can cross the intestinal barrier and get excreted in the feces to continue the lifecycle. The effects of S. mansoni infection on the host …

Student Impressions Of Undergraduate Art Therapy Education: A Survey, Shana Baird

EVMS School of Health Professions Theses & Dissertations

In addressing art therapy education, Taylor (1991) suggested that undergraduate art therapy education is controversial in that professional entry into the field is at the masters' level. Undergraduate programs offering degrees in art therapy range from providing a combination of psychology and studio art courses, offering art therapy courses and fieldwork experience, in addition to psychology and studio art, with variances in program curricula and requirements between the two extremes.

Therefore, graduates of undergraduate art therapy programs who further study art therapy at the graduate level enter with diverse levels of introduction to the field, preparation, and experience. Because differences …

Exploring The Relationship Between Cannabis Use Motives And Readiness To Change Among Young Adult College Students, Emma Kathryn Rawls

Psychology Theses & Dissertations

Cannabis use among young adult college students has risen steadily over the past decade, raising concerns about the associated health, academic, and psychological consequences. While cannabis use motives and readiness to change have each been linked to use patterns and outcomes, limited research has examined how these factors interact. The current study investigated whether readiness to change, based on the Transtheoretical Model (TTM), moderates the relationship between cannabis use motives and cannabis-related consequences as well as past-30-day use frequency. A sample of 100 college students 18-25 years old (M_age = 20.08, SD = 2.12; 67% female; 55.0% Black or …

Predictors Of Healthcare Providers' Readiness For Health System Transformation In Saudi Arabia, Ahmed Ali Alasiri

Health Services Research Dissertations

The healthcare system in Saudi Arabia is undergoing significant health reform to warrant sustainable welfare provision. Privatization or public-private partnerships (PPPs) were introduced in 2021 and outlined the vision for the health system for 2023. The planned initiatives aim to be comprehensive and effectively reach individuals and society, including citizens, noncitizens, and visitors. This dissertation seeks to study and explore privatization, the role of healthcare providers, and their capacity to adapt to the transformation of the healthcare system. To achieve this ambitious goal, several interrelated projects have been undertaken. The first project was a systematic review aimed at studying the …

Mental Health Counselors’ Perceptions Of Professional Identity As Correctional Counselors In An Integrated Behavioral Healthcare Setting, Jeanel L. Franklin, Kevin C. Snow, Edward S. Neukrug

Journal of Human Services Scholarship and Interprofessional Collaboration

This interpretive phenomenological study of four individuals examined clinical mental health counselors (MHCs) in a correctional integrated behavioral healthcare (IBH) setting to the purpose of examining how the unique experiences and roles of MHCs employed as correctional counselors in an IBH setting impacted the perceptions of their professional identity/development as counselors. Findings indicated how environment, work relationships, and multiple foci of mental health roles contributed to professional growth and identity development. Participants experienced an adaptive transitional process when applying counseling styles to the setting and population as well as integrating experiences as correctional counselors into pre-existing professional identities. Practical implications …

The Effects Of A Triaging Educational Training Program On Triaging Knowledge, Self-Efficacy And Accuracy In Emergency Department Nurses In A Private Hospital In Saudi Arabia, Sawsan Falatah, Janice Hawkins, Craig Cunningham

Graduate Student Government Association Research Conference

Inaccurate triage decisions can lead to increased length of patient stays in the emergency department, increased rehospitalizations, and increased risk of mortality, all of which are quality of care indicators (Srinivas et al., 2021). The triaging decisions in the emergency department at our facility are conducted by relatively new and inexperienced nurses. Anecdotal evidence from the emergency department leadership suggests that inaccurate triaging decisions are being made. In addition, 60 percent of a limited sample of 30 charts that were recently reviewed contained inaccurate triaging decisions. The accuracy of these triaging decisions has not been systematically evaluated at our facility. …