Medicine and Health Sciences Commons^™

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 …

Blood Culture Contamination Rates, Jackqueline R. Easley

Walden Dissertations and Doctoral Studies

The timely and accurate collection of blood culture specimens is essential for improving patient outcomes and minimizing complications. Contaminated specimens can lead to unnecessary antibiotic use, prolonged hospital stays, and delays in appropriate treatment. At one eastern healthcare facility, monthly blood culture contamination rates reached an average of 4.5%, prompting the need for a targeted intervention. The objective of this project was to determine whether a structured process and trained team could reduce contamination rates to below 1%. De-identified data were reviewed using descriptive statistics to observe contamination trends over time, by department, and by month. Using the t-test, contamination …

Staff Education On Perinatal Opioid Use Disorder, Mukisha Livingston Gunter

Walden Dissertations and Doctoral Studies

Perinatal Opioid Use Disorder (POUD) constitutes a significant public health issue with important ramifications for both mothers and their newborns. The gap in practice identified for this Doctor of Nursing Practice staff education project was the perinatal nurses’ lack of knowledge regarding POUD. The problem was the need for POUD education for the nurses. The practice focus questions were: Will there be a change in knowledge by perinatal nurses following the delivery of the education as shown by a pretest/posttest? Will the participants evaluate the education as having met the program objectives related to the curriculum presented? Guided by the …

It’S Yappy Hour! Standardized Rounding That Keeps Patient Families In The Loop, Brittany Culp, Audrey Hinchey, Bronwen Seidel, Michelle Aboagye, Dileen Bilbas, Cheyanne Dias

2024

No abstract provided.

Time Ticks Slowly For Kidney Transplant Reform: Eskd Patient Challenges And Opportunities, Gregory P. Hess

College of Population Health Faculty Papers

No abstract provided.

Dna Double-Stranded Breaks, A Hallmark Of Aging, Defined At The Nucleotide Resolution, Are Increased And Associated With Transcription In The Cardiac Myocytes In Lmna-Cardiomyopathy, Benjamin Cathcart, Sirisha M Cheedipudi, Leila Rouhi, Zhongming Zhao, Priyatansh Gurha, Ali J Marian

Faculty, Staff and Student Publications

Aims: An intrinsic feature of gene transcription is the formation of DNA superhelices near the transcription bubble, which are resolved upon induction of transient double-stranded breaks (DSBs) by topoisomerases. Unrepaired DSBs are pathogenic as they lead to cell cycle arrest, senescence, inflammation, and organ dysfunction. We posit that DSBs would be more prevalent at the genomic sites that are associated with gene expression. The objectives were to identify and characterize genome-wide DSBs at the nucleotide resolution and determine the association of DSBs with transcription in cardiac myocytes.

Methods and results: We identified the genome-wide DSBs in ∼1 million cardiac myocytes …

Timely Resection Of Juvenile Nasopharyngeal Angiofibroma Following Embolization For Uncontrolled Acute Epistaxis Case Report., Koffi L. Lakpa, Timothy Mcculloch, Michael D. Puricelli

Manuscripts, Articles, Book Chapters and Other Papers

Uncontrolled epistaxis in patients with juvenile nasopharyngeal angiofibroma requires prompt intervention. When embolization is required, neovascularization can occur, making expedited surgical resection essential. We conducted a single-institution, retrospective review of one patient. This case study details the patient's clinical presentation and his preoperative, intraoperative, and postoperative course. We present the management of a 14-year-old male with a juvenile nasopharyngeal angiofibroma, who 3 days after initial evaluation at our institution, developed uncontrolled epistaxis requiring embolization at an outside hospital before transfer back to our institution for further management. He initially presented to an outside emergency department with acute epistaxis refractory to …

Hiv-1 Controllers Possess A Unique Cd8+ T Cell Activation Phenotype And Loss Of Control Is Associated With Increased Expression Of Exhaustion Markers, Amber D. Jones, Zachary Capriotti, Erin Santos, Angel Lin, Rachel Van Duyne, Stephen Smith, Zachary Klase

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

BACKGROUND: HIV-1 controllers are a rare population of individuals that exhibit spontaneous control of HIV-1 infection without antiretroviral therapy. Understanding the mechanisms by which HIV-1 controllers maintain and eventually lose this ability would be highly valuable in HIV-1 cure or vaccine research. Previous work revealed the ability of CD8+ T cells isolated from HIV-1 controllers to suppress HIV-1 replication in matched CD4+ T cells and PBMCs ex vivo and suggested the loss of control may be tied to CD8+ T cell exhaustion.

RESULTS: We explored whether CD8+ T cell exhaustion plays a role in the maintenance and loss of control …

Peptide-Based Inorganic Nanoparticles As Efficient Intracellular Delivery Systems, Amir Nasrolahi Shirazi, Rajesh Vadlapatla, Ajoy Koomer, Anthony Nguyen, Vian Khoury, Keykavous Parang

Pharmacy Faculty Articles and Research

Background/Objectives: Peptide-based inorganic nanoparticles (PINPs) have emerged as promising candidates for intracellular delivery due to their unique structural and functional attributes. These hybrid nanostructures combine the high surface area and tunable optical/magnetic properties of metal cores (e.g., Au, Ag, Fe3O4) with the biocompatibility, targeting specificity, and responsive behavior of peptides. In particular, peptides with amphipathic or cell-penetrating features could facilitate efficient transport of molecular cargos across cellular membranes while enabling stimulus-responsive drug release in target tissues. Methods: We review key synthesis methods (especially green, peptide-mediated one-pot approaches), functionalization strategies (e.g., thiol-gold bonds, click chemistries), and characterization techniques (TEM, …

Exploration Of Counselors’ Epistemology: Epistemic Style Perspectives In Helping Relationships, Muty Rachmadiny Utami, Nissa Aulia Belistiana Utami, Nandang Budiman

Jurnal Kajian Bimbingan dan Konseling

Epistemological studies provide important insights into how counselors build their knowledge related to the helping relationship through epistemic styles. This study aims to describe the epistemology of the helping relationship in counseling. A qualitative approach with a case study design was used to explore the experiences of guidance and counseling teachers and students as research participants. Data were collected through the analysis of counseling documents and semi-structured interviews with guidance and counseling teachers as well as five counselee participants. The study results discuss the epistemology of the helping relationship of counselors in seven themes: sources of counselor knowledge, the process …

Rampes: Unveiling The Ideal Counselor Traits In The Sanghyang Siksakandang Karesian Manuscript, Ade Hidayat, Mamat Supriatna

Jurnal Kajian Bimbingan dan Konseling

This study aims to describe the ideal characteristics of a counselor based on the values contained in the Sanghyang Siksakandang Karesian (SSK) manuscript. A hermeneutic approach was employed to interpret the meaning of the text from the perspective of guidance and counseling grounded in local wisdom. The findings indicate that the concept of Rampes, mentioned 24 times in the manuscript, serves as the foundation for shaping a counselor’s professional, moral, and integrative character. This concept comprises three dimensions: (1) Bakti, which reflects religious awareness as a creature of God as well as a commitment to ethical behavior; (2) Wastu Siwong, …

Mycoplasma Pneumoniae-Induced Mucositis Sine Rash: Case Report In An Adult Patient, Mónica Gómez-Manzanares, Víctor Haro Gónzalez-Vico, Marina Montero-García, Omar Al-Wattar Ceballos

Sultan Qaboos University Medical Journal

No abstract provided.

Staff Education On Discharge Planning For A County Crisis Stabilization Unit, Eric Rowshaun Luster

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project was a staff education initiative developed to address insufficient staff knowledge related to discharge planning for homeless individuals experiencing mental health crises. The purpose of the project was to examine whether enhanced staff training could improve knowledge of transitional care planning, thereby supporting equitable, safe, and inclusive discharge processes. By improving staff proficiency, the project sought to reduce gaps in care coordination and promote continuity of treatment for a highly vulnerable patient population. The project was implemented at a Crisis Stabilization Unit (CSU) in the southern United States that serves individuals experiencing homelessness, …