Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

An Analytical Model Of Motion Artifacts In A Measured Arterial Pulse Signal—Part Ii: Tactile Sensors, Md Mahfuzur Rahman, Subodh Toraskar, Mamun Hasan, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

This paper, the second of two parts, presents an analytical model of motion artifacts (MA) in measured pulse signals by a tactile sensor, which contains a deformable microstructure sitting on a substrate. While the tissue-contact-sensor (TCS) stack and the sensor are both treated as a 1DOF (degree-of-freedom) system, tissue–sensor contact joins their mass together to form a 1DOF system with springs and dampers on both sides. MA on the sensor substrate causes baseline drift and time-varying system parameters (TVSP) of the TCS stack simultaneously. An analytical model is developed to mathematically relate baseline drift and TVSP to a measured pulse …

Body Composition In Patients With Obesity-Related Heart Failure With Preserved Ejection Fraction: A Comparison Study, Hannah Salmons, Syed Imran Ahmed, Hayley E. Billingsley, Alex Reavey-Cantwell, Roshanak Markley, Michele Golino, Marco Giuseppe Del Buono, Juan Ignacio Damonte, Sebastian Pinel, R. Lee Franco, Antonio Abbate, Carrie P. Earthman, Salvatore Carbone

EVMS School of Health Professions Faculty Publications

Background

Appendicular lean mass index is a major determinant of cardiorespiratory fitness in patients with obesity-related heart failure with preserved ejection fraction (HFpEF). Moreover, appendicular lean mass index can be used to diagnose sarcopenia and sarcopenic obesity in this population. We aimed to validate the ability of segmental single-frequency bioelectrical impedance analysis (SF-BIA) to assess body composition compared with dual-energy x-ray absorptiometry (DXA) in patients with HFpEF and obesity, with a focus on appendicular lean mass index for its critical role in diagnosing sarcopenia and sarcopenic obesity.

Methods

We analyzed 62 euvolemic patients from a heart failure outpatient clinic with …

Why Ai Monitoring Faces Resistance And What Healthcare Organizations Can Do About It: An Emotion-Based Perspective, Karl Werder, Lan Cao, Eun Hee Park, Balasubramaniam Ramesh

Information Technology & Decision Sciences Faculty Publications

Continuous monitoring of patients' health facilitated by artificial intelligence (AI) has enhanced the quality of health care, that is, the ability to access effective care. However, AI monitoring often encounters resistance to adoption by decision makers. Healthcare organizations frequently assume that the resistance stems from patients' rational evaluation of the technology's costs and benefits. Recent research challenges this assumption and suggests that the resistance to AI monitoring is influenced by the emotional experiences of patients and their surrogate decision makers. We develop a framework from an emotional perspective, provide important implications for healthcare organizations, and offer recommendations to help reduce …

Formulation Development Of Dual-Compartment Topical Inserts Combining Tenofovir Alafenamide And Elvitegravir For Flexible On-Demand Hiv Prevention, Vivek Agrahari, M. Melissa Peet, Neelima Chandra, Prakash Ramalingam, Pardeep K. Gupta, Sriramakamal Jonnalagadda, Onkar N. Singh, Timothy J. Mccormick, Gustavo F. Doncel, Meredith R. Clark

Department of Obstetrics & Gynecology Faculty Publications

Pre-exposure prophylaxis (PrEP) has emerged as a prominent approach for the prevention of HIV infections. While the latest advances have resulted in effective oral and injectable product options, there are still gaps in on-demand, event-driven, topical products for HIV prevention that are safe and effective. Here we describe the formulation development of a dual-compartment topical insert containing tenofovir alafenamide fumarate (TAF) and elvitegravir (EVG) that may be administered when needed, vaginally or rectally, pre- or post-coitus, for flexible HIV prophylaxis. Specifically, we describe the lab-scale formulation development, preclinical mucosal safety and pharmacokinetics (PK) testing in rabbits, long-term stability, and scale-up …

Electrochemical And Nanomaterial Based Strategies For Nonenzymatic Glucose Detection: A Review, Reagan Aviha, Gymama Slaughter

Center for Bioelectronics Publications

Electrochemical glucose sensing technologies have undergone significant evolution, with continual advancements aimed at improving sensitivity, selectivity, and user convenience. This review systematically explores the development of emerging nonenzymatic glucose sensor designs. Nonenzymatic sensors are critically evaluated for their ability to overcome enzymatic limitations, leveraging novel materials and catalytic mechanisms. Additionally, the emergence of smartphone-integrated glucose monitoring systems is highlighted as the fifth generation, representing a paradigm shift toward personalized, real-time healthcare management. Emphasis is placed on the strategies employed to reduce the working electrode potential and enhance analytical performance. Key analytical metrics and real-sample applicability are evaluated, and persistent challenges …

Motion Artifacts (Ma) At-Rest In Measured Arterial Pulse Signals: Time-Varying Amplitude In Each Harmonic And Non-Flat Harmonic-Ma Coupled Baseline, Md Mahfuzur Rahman, Mamun Hasan, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

Motion artifacts (MA) cause great variability in a measured arterial pulse signal, and treatment of MA solely as a baseline drift (BD) fails to eliminate its effect on the measured signal. This paper presents a study on the effect of MA at rest (< 0.7 Hz) on measured arterial pulse signals using a microfluidic-based tactile sensor. By taking full account of the dynamic behavior of the transmission path from the true pulse signal in an artery to a measured pulse signal at the sensor, the tissue-contact-sensor (TCS) stack, an analytical model of MA in a measured pulse signal is developed. In this model, the TCS stack is treated as a 1DOF system for its dynamic behavior; MA is quantified as the displacement (i.e., BD) and time-varying system parameters (TVSP) of the TCS stack. The mathematical expression of MA in a measured pulse signal reveals that while BD remains as low-frequency additive noise, TVSP causes time-varying harmonics in a measured pulse signal. Further time-frequency analysis (TFA) of measured pulse signals validates the existence of TVSP and, for the first time, reveals its effect on a measured pulse signal: time-varying amplitude in each harmonic and non-flat harmonic-MA-coupled baseline.

Electrochemical Detection Of Prostate Cancer—Associated Mirna-141 Using A Low-Cost Disposable Biosensor, Alexander Hunt, Gymama Slaughter

Center for Bioelectronics Publications

Prostate cancer is the second leading cause of cancer-related deaths among men in the United States. The early detection of aggressive forms is critical. Current diagnostic methods, including PSA testing and biopsies, are invasive and often yield false results. MicroRNA-141 (miRNA-141) has emerged as a promising non-invasive biomarker due to its elevated levels in the urine of patients with metastatic prostate cancer. Here, a low-cost, paper-based electrochemical biosensor for the sensitive detection of miRNA-141 in synthetic urine is reported. The device employs inkjet-printed gold electrodes on photopaper, functionalized with thiolated single-stranded DNA-141 capture probes for specific target recognition. The biosensor …

American Heart Association Blood Pressure Classification And Subsequent Risk Of Preeclampsia, Rebecca Horgan, Erkan Kalafat, Elena Sinkovskaya, Alfred Abuhamad, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Background: In 2017, the American Heart Association (AHA) and American College of Cardiology updated their hypertension guidelines for the nonpregnant population, lowering the diagnostic thresholds to systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg. This reclassification has raised important questions regarding whether blood pressure (BP) values previously considered within the normal range in pregnancy may, in fact, confer an increased risk for hypertensive disorders of pregnancy (HDPs).

Objective: To evaluate the association between first-trimester BP classified by AHA thresholds and the subsequent development of HDPs.

Study design: This was a secondary analysis of a prospective, multicenter cohort …

A Rare Complication Of Dilation And Evacuation: Unrecognized Extrauterine Retained Products Of Conception, Aviana Terschueren, Lauren Siewertsz Van Reesema, Joseph Hudgens

Department of Obstetrics & Gynecology Faculty Publications

Introduction: Surgical abortions, including dilation and evacuation, are among the safest gynecological procedures, with complication rates ranging from 0.5–4.0%. Uterine perforation, though rare (0.2–0.8%), can result in serious sequela, including translocation of retained products of conception into the abdominal cavity. We present a rare case of abdominal retained products of conception following a second-trimester dilation and evacuation.

Case Report: A 29-year-old G3P1112 underwent an elective surgical abortion at 17 weeks’ gestation, complicated by hemorrhage necessitating transfer to an outside hospital. She was treated with uterotonics and a blood transfusion and was discharged after a 6-day hospitalization. Initial transvaginal ultrasound showed …

Training Set Augmentation And Harmonization Enables Radiomic Models To Detect Early Onset Of Lung Cancer, Claire Huchthausen, Menglin Shi, Gabriel L.A. Sousa, James Larner, Einsley Janowski, Jonathan Colen, Krishni Wijesooriya

Data Science Faculty Publications

Radiomics-based machine learning models have the potential to detect lung cancer at inception from CT scans and transform patient outcomes. Low malignancy rates in early-development pulmonary nodules (PNs) and variable image acquisition hinder development of clinically applicable radiomics-based early detection models. To address these challenges, we augmented training using later-development PNs and harmonized for acquisition effects. We first trained machine learning models to predict PN malignancy using radiomic features from scans of early-development benign and malignant PNs (n = 187) harmonized using ComBat. Observing near-chance performance, we augmented training with later-development benign and malignant PNs (n = 225). We evaluated …

Clinician Perspectives On Virtual Reality Use In Physical Therapy Practice In The United States, Danielle T. Felsberg, Jared T. Mcguirt, Scott E. Ross, Louisa D. Raisbeck, Charlend K. Howard, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

The primary goal of physical rehabilitation is to assess movement impairments and restore function to improve overall quality of life. Virtual reality (VR) may provide the optimal environment to promote these goals due to its motivating and modifiable nature which can be difficult to accomplish through traditional real-world therapeutic methods. Current research of VR for rehabilitation has demonstrated that VR interventions can produce clinically meaningful change in motor outcomes. Despite this, adoption and usage of VR by physical therapy professionals is unclear due to the limited research in this area. Thus, the purpose of this study was to identify the …

An Analytical Model Of Motion Artifacts In A Measured Arterial Pulse Signal—Part I: Accelerometers And Ppg Sensors, Md Mahfuzur Rahman, Subodh Toraskar, Mamun Hasan, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

This paper, the first of two parts, presents an analytical model of motion artifacts (MAs) in measured pulse signals by accelerometers and photoplethysmography (PPG) sensors. As the transmission path from the true pulse signal in an artery to the sensor output (measured pulse signal), the tissue-contact-sensor (TCS) stack is modeled as a 1DOF (degree-of-freedom) system. MAs cause baseline drift of the mass and simultaneously time-varying system parameters (TVSPs) of the TCS stack. With arterial wall displacement and pulsatile pressure serving separately as the true pulse signal, an analytical model is developed to mathematically relate baseline drift and TVSP to a …

Motion Artifacts Removal From Measured Arterial Pulse Signals At Rest: A Generalized Sdof-Model-Based Time-Frequency Method, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

Motion artifacts (MA) are a key factor affecting the accuracy of a measured arterial pulse signal at rest. This paper presents a generalized time–frequency method for MA removal that is built upon a single-degree-of-freedom (SDOF) model of MA, where MA is manifested as time-varying system parameters (TVSPs) of the SDOF system for the tissue–contact-sensor (TCS) stack between an artery and a sensor. This model distinguishes the effects of MA and respiration on the instant parameters of harmonics in a measured pulse signal. Accordingly, a generalized SDOF-model-based time–frequency (SDOF-TF) method is developed to obtain the instant parameters of each harmonic in …

Upper Airway Soot And Facial Burns Do Not Necessitate Intubation, Jessica Burgess, John Dubensky

Department Surgery Faculty Publications

Introduction

Identifying which patients are at risk for respiratory decompensation, whether from airway compromise or inhalation injury, is an important component of initial burn resuscitation. Findings that traditionally suggest the need for intubation include cutaneous burns to the face and neck, soot seen in the upper airway, and carbonaceous sputum. However, evidence suggests that a significant number of pre-burn center intubations are ultimately unnecessary. The purpose of this investigation was to determine if head and neck burns or sputum seen in the upper airways were correlated with the need for intubation.

Methods

This was a retrospective review of adults admitted …

Is It Getting Better? An Evaluation Of Two Successive Generations Of Chatgpt In Answering Specialized Vascular Surgery Questions, Dongjin Suh, Quang Le, Leana Dogbe, Kedar Lavingia, Michael Amendola

Department Surgery Faculty Publications

Purpose: Large language models (LLMs) can generate clinically relevant text; however, their performance in highly specialized medical domains remains uncertain. This study evaluated ChatGPT-3.5 and ChatGPT-4 (OpenAI) using vascular surgery board–style questions from the Vascular Education and Self-Assessment Program, version 4 (VESAP4) and compared the two public model versions (June and November 2023).

Materials and Methods: All non-image VESAP4 questions (n=384) were presented independently three times to each model version (ChatGPT-3.5 June/November; ChatGPT-4, June/November). Outcomes included accuracy (proportion correct), consistency (same option letter across all three attempts and “consistently correct”), explanation length (word count), and modes of failure classified for …

Surgical Management Of Gastroenteropancreatic Neuroendocrine Tumors, Lisa M. Kenney, Marybeth Hughes

Department Surgery Faculty Publications

Background/Objectives: Neuroendocrine tumors (NETs) are heterogeneous malignancies arising from enterochromaffin cells that can arise from the gastrointestinal (GI) tract and pancreas. Surgical management is the cornerstone of treatment, with the optimal approach tailored by tumor grade, size, location, and presence of metastasis. This review discusses the current strategies for the surgical management of NETs of the gastroenteropancreatic tract. Methods: A review of the available literature was conducted to evaluate surgical approaches to NETs. Consensus guidelines were incorporated to synthesize evidence-based recommendations. Results: For gastric NETs, surgical approach depends on Rindi Classification, WHO grade, and tumor size, with endoscopic approaches favored …

Copula-Based Bayesian Model For Detecting Differential Gene Expression, Prasansha Liyanaarachchi, N. Rao Chaganty

Mathematics & Statistics Faculty Publications

Deoxyribonucleic acid, more commonly known as DNA, is a fundamental genetic material in all living organisms, containing thousands of genes, but only a subset exhibit differential expression and play a crucial role in diseases. Microarray technology has revolutionized the study of gene expression, with two primary types available for expression analysis: spotted cDNA arrays and oligonucleotide arrays. This research focuses on the statistical analysis of data from spotted cDNA microarrays. Numerous models have been developed to identify differentially expressed genes based on the red and green fluorescence intensities measured using these arrays. We propose a novel approach using a Gaussian …

Ambulatory Arterial Stiffness Index: Regression Method Comparison And Its Association With Pulse Pressure And Circadian Patterns, José R. Ayala-Hernández, Cristina López-Sánchez, Orlando M. Ayala, Camilo E. Palencia-Tejedor

Engineering Technology Faculty Publications

The Arterial Stiffness Index (AASI) is a calculation obtained through Ambulatory Blood Pressure Monitoring (ABPM), and is an indirect measure of the elastic properties of the arterial wall; but there is heterogeneity in its scope as a predictor of vascular wall health. A comparison is made between linear regression and exponential regression of the AASI, as well as an analysis of variance, according to circadian patterns and pulse pressure (PP) values. This work is an analytical observational study in 106 individuals, most of them women (63%) with a mean age of 53 ± 17.32 years. The coefficient of determination (r2) …

Gold Nanoparticle-Enhanced Molecularly Imprinted Polymer Electrode For Non-Enzymatic Lactate Sensing, Christopher Animashaun, Abdellatif Ait Lahcen, Gymama Slaughter

Center for Bioelectronics Publications

We are reporting the development of a high-performance, non-enzymatic electrochemical biosensor for selective lactate detection, integrating laser-induced graphene (LIG), gold nanoparticles (AuNPs), and a molecularly imprinted polymer (MIP) synthesized from poly(3,4-ethylenedioxythiophene) (PEDOT). The LIG electrode offers a highly porous, conductive scaffold, while electrodeposited AuNPs enhance catalytic activity and signal amplification. The PEDOT-based MIP layer, electropolymerized via cyclic voltammetry, imparts molecular specificity by creating lactate-specific binding sites. Cyclic voltammetry confirmed successful molecular imprinting and enhanced interfacial electron transfer. The resulting LIG/AuNPs/MIP biosensor demonstrated a wide linear detection range from 0.1 µM to 2500 µM, with a sensitivity of 22.42 µA/log(µM) and …

Molecular Imprinting And Nanomaterial Synergy For Lactate Detection, Christopher Animashaun, Gymama Slaughter

Center for Bioelectronics Publications

Molecularly imprinted polymer (MIP)-based electrochemical sensors have emerged as promising non-enzymatic platforms for the selective and stable detection of clinically and environmentally relevant biomarkers. This review provides a critical, comprehensive analysis of recent advances in MIP-based lactate sensing, with particular emphasis on hybrid systems that integrate conductive nanomaterials including gold and silver nanoparticles, laser-induced graphene, and reduced graphene oxide. These synergistic combinations leverage enhanced surface area, electrical conductivity, and molecular recognition to improve sensor sensitivity, selectivity, and long-term operational stability. Key fabrication strategies, such as electropolymerization, green nanomaterial synthesis, and surface imprinting, are critically examined for their roles in optimizing …

Implementing A Chatbot To Promote Hereditary Breast & Ovarian Cancer Genetic Screening In Women's Health: Identifying Barriers And Facilitators To Screening Adoption, Easton N. Wollney, Shireen Madani Sims, Luisel J. Ricks-Santi, Elizabeth Eddy, Daniel Wiesman, Carla L. Fisher

Department of Biomedical and Translational Sciences Faculty Publications

Background

To promote genetic screening among women at risk for hereditary breast and ovarian cancer (HBOC), the American College of Obstetricians and Gynecologists recommends that risk assessment be integrated into practice. Chatbots like the Genetic Information Assistant (Gia®) are increasingly implemented to expand access to hereditary genetic screening. Factors that impact chatbot implementation for HBOC risk screening and women's uptake are not fully realized. To refine implementation strategies prior to full scale implementation, we sought to identify women's perceived facilitators/barriers to adopting Gia screening in a rural population within a large healthcare system in the southern United States.

Methods

We …

Pediatric Cancer Incidence, Temporal Trends, And Mortality In The United States By Health Disparities Indicators, Seer (1973-2014), Prachi P. Chavan, Laurens Holmes Jr.

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background: Pediatric cancer incidence has been increasing in the United States, despite improvement in pediatric cancer survival. This steady increase in incidence trends is not completely understood but maybe associated with social and environmental factors. In this study we aimed to assess the cumulative incidence, temporal trends, and mortality rates in pediatric cancer. Additionally, we examined sub-group variability in both incidence and mortality rates. Methods: Data from Surveillance, Epidemiology, and End Results (SEER) −18 from 1973–2014 were used for the purpose of analysis in this study. Age-adjusted incidence rates were used to assess temporal trends in cancer among children aged < 1–19 years. Univariable and multivariable binomial regression models were used to examine the association between race and cancer mortality while adjusting for potential confounders. Results: There were 92,594 cancer diagnoses during this period. White children comprised 74,758, (80.7%), black children 10,030, (10.8%), and other races 6648, (7.2%). Overall the age-adjusted cumulative incidence was slightly higher among white children (16.4%) than black children (12.4%) and other (13.0%). Children aged 15–19 years and those in metropolitan regions were more likely to be diagnosed with pediatric cancer. Relative to females, males were 16% more likely to die from the disease [adjusted Risk Ratio (aRR): 1.16, 95% Confidence Interval (CI): 1.09–1.22]. Additionally, compared to white children, black children had higher mortality rates [(aRR): 1.37, 99% CI: 1.23–1.52]. Conclusions: There is an increasing trend in pediatric cancer incidence; while white children have the highest incidence, black children and males indicated a survival disadvantage, indicative of racial and sex variability in overall pediatric cancer in the United States.

Anaplastic Large Cell Lymphoma In Children And Adolescents, Eric J. Lowe, Wilhelm Woessmann

Department of Pediatrics Faculty Publications

Anaplastic lymphoma kinase (ALK)-positive anaplastic large-cell lymphoma (ALCL) accounts for >95% of ALCL cases in children and adolescents. The first description of ALCL as a CD30-positive lymphoma in 1985 was followed by the detection of chromosomal translocations involving the ALK gene at chromosome 2p23. The pathogenesis of ALK-positive ALCL is based on signalling from the constitutive active ALK kinase. The clinical characteristics, therapy regimens and outcome data were reported in the 1990s and 2000s. Different chemotherapy regimens led to astonishingly similar long-term event-free survival rates of 70%, independent of the drugs, doses and duration of therapy. Additionally, patients with relapsed …

Fabrication Of Palladium Decorated Zinc Oxide Nanostructures For Non-Enzymatic Glucose Sensing, Reagan Aviha, Anju Joshi, Gymama Slaughter

Center for Bioelectronics Publications

The growing global burden of diabetes necessitates the development of glucose sensors that are not only reliable and sensitive but also cost-effective and amenable to point-of-care use. In this work, we report a non-enzymatic electrochemical glucose sensor based on laser-induced graphene (LIG), functionalized with zinc oxide (ZnO) and palladium (Pd) nanostructures. The ZnO nanostructures were systematically optimized on the LIG surface by varying electrochemical deposition parameters, including applied potential, temperature, and deposition time, to enhance the electrocatalytic oxidation of glucose in alkaline medium. Subsequent modification with Pd nanostructures further improved the electrocatalytic activity and sensitivity of the sensor. The performance …

Advanced Nanocomposite-Based Electrochemical Sensor For Ultra-Sensitive Dopamine Detection In Physiological Fluids, Megha Shinde, Gymama Slaughter

Center for Bioelectronics Publications

This study presents a novel point-of-care electrochemical sensor for dopamine (DA) detection, featuring a flexible laser-induced graphene (LIG) modified with a unique nanocomposite comprising Nb₄C₃T_x MXene, polypyrrole (PPy), and iron nanoparticles (FeNPs). The LIG-Nb₄C₃T_x MXene-PPy-FeNPs is characterized by scanning electron microscopy to confirm the successful surface modification. The electrochemical performance of the fabricated sensor via cyclic voltammetry showed significant electrochemical activity upon Nb₄C₃T_x MXene-PPy-FeNPs nanocomposite modification of the LIG surface with an increased peak anodic current (Ipa) from 43 μA to 104 μA. The sensor …

Electrochemical Strategies For Microrna Quantification Leveraging Amplification And Nanomaterials: A Review, Alexander Hunt, Gymama Slaughter

Center for Bioelectronics Publications

MicroRNAs (miRNAs) are small, non-coding RNAs that regulate gene expression and have emerged as critical biomarkers in various diseases, including cancer. Their stability in bodily fluids and role as oncogenes or tumor suppressors make them attractive targets for non-invasive diagnostics. However, conventional detection methods, such as Northern blotting, RT-PCR, and microarrays, are limited by low sensitivity, lengthy protocols, and limited specificity. Electrochemical biosensors offer a promising alternative, providing high sensitivity, rapid response times, portability, and cost-effectiveness. These biosensors translate miRNA hybridization events into quantifiable electrochemical signals, often leveraging redox-active labels, mediators, or intercalators. Recent advancements in nanomaterials and signal amplification …

Emergent Transcatheter Tricuspid Edge-To-Edge Repair For Right Ventricular Shock From Tricuspid Regurgitation In Hypertrophic Cardiomyopathy, Nicholas J. Valle, Amin Yehya, Animesh Rathore, Erich L. Kiehl, Matthew R. Summers

Department of Medicine Faculty Publications

Background

Transcatheter tricuspid edge-to-edge repair (T-TEER) is an emerging technology used to treat severe tricuspid regurgitation (TR). The pivotal trials demonstrating the safety and efficacy of T-TEER exclude patients with severely reduced left ventricular function (≤20%).

Case Summary

We demonstrate the use of T-TEER in a patient with end-stage hypertrophic cardiomyopathy who suffered acute, torrential TR and subsequently developed cardiogenic shock as a complication of high-risk transvenous lead extraction. Why Beyond the Guidelines Currently, there are no guidelines addressing the nonsurgical emergent management of acute TR.

Discussion

The TriClip system (Abbott) may have certain advantages when used in managing acute …

The Timing For Primary Prevention For Icd In The Current Era Of Pharmacotherapy, Anastasia Shchendrygina, Amin Yehya, Hadi Skouri

Department of Medicine Faculty Publications

Recent advances in the pharmacological therapy of heart failure with reduced ejection fraction (HFrEF) have significantly impacted the overall survival, heart failure hospitalisations and rates of sudden cardiac death (SCD). In this context, the relevant timing of placing ICDs as primary prevention is a matter of on-going debate. This manuscript provides evidence for an updated view regarding the timing of implanting ICD in eligible patients with HFrEF receiving optimal guideline-directed medical therapy, accounting for the timing to reverse cardiac remodelling (RCR) occurrence and residual SCD risks over time. Clinically significant RCR occurs beyond 3 months of optimal guideline-directed medical therapy, …

Delayed Hypertension Diagnosis And Its Association With Cardiovascular Treatment And Outcomes, Yuan Lu, John E. Brush Jr, Chungsoo Kim, Yuntian Liu, Xin Xin, Chenxi Huang, Mitsuaki Sawano, Patrick Young, Jacob Mcpadden, Mark Anderson, John S. Burrows, Jordan R. Asher, Harlan M. Krumholz

Department of Medicine Faculty Publications

Importance Hypertension is a major risk factor for cardiovascular disease, yet delays in diagnosis may limit timely treatment initiation and increase cardiovascular risk.

Objectives To examine the timing of clinical hypertension diagnosis, its association with antihypertensive medication prescribing, and its association with long-term cardiovascular outcomes.

Design, Setting, and Participants This retrospective cohort study analyzed electronic health record (EHR) data from an integrated health care system. Adults aged 18 to 85 years with at least 2 outpatient blood pressure (BP) readings of 140/90 mm Hg or more recorded at least 30 days apart from January 1, 2010, to December 31, 2021, …

Left Ventricular Assist Device Destination Therapy: A Journey To Home And Beyond, Mian Z. Munir, Marissa C. Galicia-Castillo, Mia Achitoov, Amin Yehya

Department of Medicine Faculty Publications

[Case] Mr H is a 74-year-old man with history of end-stage heart failure (ESHF) secondary to hereditary transthyretin cardiac amyloidosis. Our patient underwent placement of a HeartMate II (Abbott) left ventricular assist device (LVAD) as destination therapy (DT) at an outside hospital and later came to us (Sentara Heart Hospital) for continued management because he resided in the area. Over a 2-year period, the patient experienced multiple hospital admissions for acute heart failure (HF) exacerbations, delirium, and recurrent low-flow alarms. During his last hospitalization, the palliative medicine team was consulted to facilitate goals-of-care discussions with the patient and his family, …