Cardiovascular System Commons^™

The Effects Of Timing And Long-Term Estrogen Deficiency On Cardiac Fibrosis Following Chronic Sympathetic Stimulation, Samuel Wisecarver

Undergraduate Honors Theses

Evidence in animal studies show that estrogen in women is cardioprotective, but discrepancies remain between clinical and animal studies regarding progression of cardiovascular disease after menopause. Cardiac fibrosis, the build-up of type I and III collagen fibers, is a staple of cardiac remodeling. The goal of this study was to examine the effects of long-term estrogen loss in the heart; this study includes two time points (1-month and 5-month) post-ovariectomy. Mice were randomly selected for 4 treatment groups: SHAM, Ovariectomy (OVX), Isoproterenol (ISO) (a β-adrenergic agonist used to mimic chronic sympathetic stimulation) and OVX+ISO. Mice were infused with either Saline …

Role Of Kvβ2 Subunits In Regulation Of Resistance Arterial Tone., Sean M Raph

Electronic Theses and Dissertations

Voltage-gated potassium (Kv) channels control vascular resistance and facilitate the augmentation of myocardial blood flow in response to increases in cardiac workload (i.e., metabolic hyperemia). Native sarcolemmal Kv1 channels in arterial myocytes associate with a heteromeric auxiliary complex consisting of intracellular Kvβ1 and Kvβ2 proteins. The Kvβ proteins differentially regulate the function of heterologously expressed Kv channels, as well as native Kv1 channels in excitable cells of the cardiovascular and nervous systems. The physiological importance of vascular Kvβ proteins in mediating vasodilation remains unknown. In this study, I tested the hypothesis that Kvβ proteins functionally regulate vascular tone in response …

Design And Control Of A Peristaltic Pump To Simulate Left Atrial Pressure In A Conductive Silicone Model, Jeremy Collins

Mechanical Engineering Undergraduate Honors Theses

According to the CDC, atrial fibrillation is responsible for more than 454,000 hospitalizations and approximately 158,000 deaths per year. A common treatment for atrial fibrillation is catheter ablation, a process in which a long flexible tube is guided through the femoral artery and to the source of arrhythmia in the heart, where it measures the electrical potential at various locations and converts problematic heart tissue to scar tissue via ablation. This paper details the design and control of a low-cost ($400) peristaltic pump system using repetitive control to replicate blood pressure in the left atrium in a conductive silicone model …

Supply, Demand, And Quality: A Three-Pronged Approach To Blood Product Management In Developing Countries, Kyle L. Gress, Karina Charipova, Ivan Urits, Omar Viswanath, Alan D. Kaye

Journal of Patient-Centered Research and Reviews

While transfusion of blood and blood products is instinctively linked to the provision of emergent care, blood and blood products are also routinely used for the treatment of subacute and chronic conditions. Despite the efforts of the World Health Organization and others, developing countries are faced with a three-part problem when it comes to access to and delivery of transfusions: insufficient supply, excessive demand, and inadequate quality of available supply. Developing countries rely heavily on replacement and remunerated donors rather than voluntary nonremunerated donors due to concerns regarding donation- and transfusion-transmitted infection as well as local and cultural beliefs. While …

What Did We Learn About Vads In 2020?, Maya Guglin

The VAD Journal

This is our 7th annual literature review on mechanical circulatory support (MCS) devices.

Our previous reports were well received by the readers. The full text of the reviews for 2014, 2015, 2016, 2017, 2018, and 2019 are available online.

In this review, we summarized the most interesting and important, from our standpoint, publications covering MCS from 2020. There may be some slight overlap with the end of 2019 because some papers were published online first, and the year of the publication changed when they became available in print.

For the fourth time this year, we …

C25: The “Spot Sign”: A Predictor Of Hematoma Expansion, Mckenzie Merritt

Annual Research Symposium

No abstract provided.

Chromosome Xq23 Is Associated With Lower Atherogenic Lipid Concentrations And Favorable Cardiometabolic Indices, Pradeep Natarajan, Akhil Pampana, Sarah E. Graham, Sanni E. Ruotsalainen, James A. Perry, Paul S. De Vries, Jai G. Broome, James P. Pirruccello, Michael C. Honigberg, Krishna Aragam, Brooke Wolford, Jennifer A. Brody, Lucinda Antonacci-Fulton, Moscati Arden, Stella Aslibekyan, Themistocles L. Assimes, Christie M. Ballantyne, Lawrence F. Bielak, Joshua C. Bis, Brian E. Cade, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Autosomal genetic analyses of blood lipids have yielded key insights for coronary heart disease (CHD). However, X chromosome genetic variation is understudied for blood lipids in large sample sizes. We now analyze genetic and blood lipid data in a high-coverage whole X chromosome sequencing study of 65,322 multi-ancestry participants and perform replication among 456,893 European participants. Common alleles on chromosome Xq23 are strongly associated with reduced total cholesterol, LDL cholesterol, and triglycerides (min P = 8.5 × 10⁻⁷²), with similar effects for males and females. Chromosome Xq23 lipid-lowering alleles are associated with reduced odds for CHD among 42,545 …

Sculpting Organs: An Arts-Based Educational Activity For Anatomy Learning, Annika Gupta

Senior Theses

As an integral component of healthcare, a comprehensive understanding of anatomy is necessary for accurate clinical diagnoses and medical procedures. Beginning in undergraduate classrooms (premedical), there is a need to explore new ways of teaching and learning anatomy to train healthcare professionals. Traditional methods of attending a lecture and reading a textbook may not be the most effective method to learn about anatomical structures—or to engage learners. However, recent studies have reported promising results in the use of arts-based approaches to enhance anatomy learning. Of these, clay sculpting can provide an opportunity for students to participate in an active and …

Guideline-Directed Heart Failure Therapy In Patients After Left Ventricular Assist Device Implantation, Bailey M. Colvin, James C. Coons, Craig J. Beavers

The VAD Journal

Background: Left ventricular assist devices (LVADs) are used as an advanced therapy option for patients with stage D heart failure. These devices provide mechanical unloading of the heart as either a bridge to transplant or recovery, or as destination therapy. In patients with LVADs, there are emerging data on the use of heart failure guideline-directed medical therapy (GDMT) to improve outcomes. This review describes the current evidence available for the use of neurohormonal blocking agents in patients with LVADs.

Methods: Articles were found using PubMed and web searches for heart failure therapies/neurohormonal blockade and LVADs. Studies were included if they …

Successful Pregnancy With Centrifugal Flow Left Ventricular Assist Device: A Case Report And Review Of The Literature, Seyed Hamed Hosseini Dehkordi, Matthew R. Lippmann, Travis Abicht, Andrew J. Sauer, Nicholas A. Haglund, Marc R. Parrish, Jared Staab, Bhanu Gupta

The VAD Journal

Successful deliveries from patients supported by axial flow left ventricular devices have been previously reported. We present the first case of a successful pregnancy and birth in a patient with a centrifugal-flow left ventricular assist device. A 24-year-old female with methamphetamine-induced cardiomyopathy and end-stage congestive heart failure supported by a HeartWare™ ventricular assist device (Medtronic) presented two years after device implantation with an unplanned pregnancy at 11-weeks of gestation. Following a multidisciplinary evaluation by experts in advanced heart failure, maternal fetal medicine, cardiothoracic surgery, anesthesia, ethics, psychiatry, and palliative care, an advanced plan of care was established. An elective induction …

Resident Heart Rate Variability During Cataract Surgery, Ahmad Baiyasi, Shibandri Das, Ferris Bayasi, Faisal Ridha Al-Timimi

Medical Student Research Symposium

Purpose: To evaluate ophthalmology resident anxiousness and cardiovascular response by tracking resident heart rate (HR) when performing cataract surgery during their last year of residency.

Methods: A prospective analysis of 31 cataract cases, completed by three residents (two females and one male), at the Kresge Eye Institute in August and September 2020 was performed. Inclusion criteria for cases included all cataract cases performed by PGY-4 residents at the Kresge Eye Institute who downloaded the Heart Graph app supported by iOS. Residents with android mobile devices were excluded from the study. Informed consent was obtained from all residents who utilized the …

Summary Of 2019 Brano Heart Failure Forum Presentations, Rajko Radovancevic, Bojan Vrtovec, Igor D. Gregoric

The VAD Journal

The Branislav “Brano” Radovancevic Heart Failure Forum (BHFF) was established in 2008. Each year, experts in the field of heart failure gather to learn, discuss and debate the recent advances and theories related to diagnostics and therapeutics. The 12th Annual BHFF was held September 18-21, 2019, in Belgrade, Serbia, and was attended by over 350 participants from 15 countries. Over four days, seventeen separate sessions focused on challenges and solutions related to mechanical circulatory support and heart transplantation. For the first time, a summary of selected presentations was organized and presented herein.

Decreased Inr On Lvad Support: To Bridge Or Not To Bridge?, Maya Guglin

The VAD Journal

In volume 6, issue 2 of The VAD Journal, we published a paper by Rainess et al. who reported their experience with managing subtherapeutic INRs, mostly in patients with HeartMate II (Thoratec, Pleasanton, CA). Although, the cohort did include some HeartMate 3-supported patients. In their program (Wake Forest University), pharmacists manage anticoagulation according to the institutional protocol, which allows bridging with low molecular weight heparin when INR decreases to less than 1.8. The study is unique because the patients did NOT require interruption of anticoagulation for any purpose. In all instances, the INR decreased because of dietary variations, recent …

Comprehensive Echocardiographic Findings In Critically Ill Covid-19 Patients With Or Without Prior Cardiac Disease, Renuka Jain, Pedro D. Salinas, Stacie Kroboth, Abigail Kaminski, Sarah Roemer, Ana Cristina Perez Moreno, Bijoy K Khandheria

Journal of Patient-Centered Research and Reviews

Purpose: Coronavirus disease 2019 (COVID-19) presents with a spectrum of disease severity, the most serious cases requiring intensive care. Echocardiography is a front-line tool in evaluating cardiovascular complications of COVID-19 in the intensive care unit (ICU); we analyzed transthoracic echocardiograms obtained from this patient population with state-of-the-art ultrasound technology.

Methods: All patients with COVID-19 requiring ICU admission on whom a transthoracic echocardiogram was obtained were included in the study. Focused transthoracic protocols were performed by experienced sonographers. Echocardiographic variables, including speckle-tracking echocardiography, were collected and analyzed. Clinical information was obtained from the electronic medical record. Patients were followed until discharge. …

Advantages Of Bridging To Durable Left Ventricular Assist Device With The Impella 5.0, Manish K. Patel

The VAD Journal

The mainstay therapy for patients in critical cardiogenic shock (CS) is temporary mechanical circulatory support. Although there is a trend toward use of durable left ventricular assist devices (LVAD) in patients that are less ill, we present our experience with using the Impella 5.0 (Abiomed) to illustrate the potential benefits of supporting patients with critical CS before durable LVAD implantation. Since 2012, our use of the Impella has increased from 5 to 38 per year. Mortality is highest early after LVAD implantation, but our long-term survival is better than data reported to the INTERMACS registry. Use of an Impella 5.0 …

A "Blinking" Left Ventricular Assist Device, Maya Guglin, Roopa Rao

The VAD Journal

A 61-year-old male with history of coronary artery disease and end stage ischemic cardiomyopathy underwent a successful implantation of a HeartMate 3 device with an uneventful recovery. However, after 6 months, he complained of increased fatigue, intermittent dizziness, and weakness after minor exertion. The pulsatility index was increased to 8, but the left ventricular assist device (LVAD) was otherwise functioning properly. No major changes in either medications or laboratory results were noted. The patient started getting low flow alarms seven months after the procedure and the dizziness increased. On the controller, a continuously changing (“blinking”) speed was noted (Supplemental Video …

Transcatheter Aortic Valve Replacement (Tavr), Emily Wentzel

Student Research Poster Presentations 2021

Transcatheter Aortic Valve Replacement (TAVR)

Emily Wentzel

Lynn Blazaskie

Abstract

Transcatheter Aortic Valve Replacement, or TAVR, is a procedure that is performed when a patient is in need of a new aortic valve. This is a procedure done to relieve symptoms of aortic stenosis. TAVR first began in France in 2002 and came to the United States in 2005. Cardiac Catheterization is the modality that is utilized in order to perform this procedure along with a cardiac catheterization team. The team includes cardiac catheterization technologists, doctors, nurses, cardiovascular surgeons, and ultrasound technologists. Cardiac Catheterization is a minor surgical procedure that …

Cardiac Arrest And Global Ischemia Reperfusion Injury: Role Of Mitochondria And Cannabinoid Receptor 2 Signaling., Jennifer L. Bradley

Theses and Dissertations

We explored the effects of cardiac arrest on mitochondria populations and heart whole tissue lysate proteomics utilizing the Weil Institute’s in vivo rat model of cardiac arrest and cardiopulmonary resuscitation. We have discovered that brain mitochondria are more sensitive to global ischemia compared to heart mitochondria. Additionally, complex I is the most sensitive electron transport chain complex to ischemic injury and is a major control point of the rate of oxidative phosphorylation following cardiac arrest and cardiopulmonary resuscitation. Preservation of brain mitochondrial activity and function during cardiac arrest may enhance outcomes and recovery.

A recent article focusing on acute myocardial …

Short-Term Fasting And Autonomic Control, Joshua Gonzalez

Dissertations, Master's Theses and Master's Reports

Obesity is a chronic metabolic disorder associated with increased risk of cardiovascular disease. Evidence suggests that chronic intermittent fasting improves cardiometabolic health and reduces arterial blood pressure. However, the mechanisms underlying the reductions in blood pressure and improved cardiovascular health observed from chronic fasting studies remain unclear. The autonomic nervous system has a central role in the regulation of blood pressure and is essential for cardiovascular homeostasis. We conducted a study to investigate how acute fasting influences autonomic control of blood pressure at rest and during stress. Twenty-five young, healthy, normal weight, normotensive participants were tested twice, once in the …

Cardioporation Enhances Myocardial Gene Expression In Rat Heart, Carly Boye, Sezgi Arpag, Nina Burcus, Cathryn Lundberg, Scott Declemente, Richard Heller, Michael Francis, Anna Bulysheva

Bioelectrics Publications

Damage from myocardial infarction (MI) and subsequent heart failure are serious public health concerns. Current clinical treatments and therapies to treat MI damage largely do not address the regeneration of cardiomyocytes. In a previous study, we established that it is possible to promote regeneration of cardiac muscle with vascular endothelial growth factor B gene delivery directly to the ischemic myocardium. In the current study we aim to optimize cardioporation parameters to increase expression efficiency by varying electrode configuration, applied voltage, pulse length, and plasmid vector size. By using a surface monopolar electrode, optimized pulsing conditions and reducing vector size, we …