Diseases Commons^™

Detecting Cardio-Respiratory Instability In Neonates, Joshua Todd Carroll, Shahrokh Sani

Celebration of Student Scholarship Poster Sessions Archive

No abstract provided.

The Effect Of Sleep Quality And High Intensity Physical Activity On Inflammation And Cardiovascular Disease Risk Factors In College Students, Catherine Abraham

Honors Scholar Theses

Background: Inflammation is the common denominator in chronic conditions such as obesity, diabetes, and depression. While adequate physical activity and optimal sleep quality may help maintain normal inflammation levels, evidence is somewhat conflicting. Aim: This cross-sectional observational study aimed to assess how sleep quality and high intensity physical activity associated with cardiovascular disease (CVD) risk factors and inflammatory biomarkers in a sample of young adults (n=106, ages 18-25 years). Methods: Laboratory-based assessments included lifestyle behaviors (sleep quality, Pittsburgh Sleep Quality Index; self-reported frequency/intensity of physical activity; Healthy Behavior Index derived from reported preference for diet and physical activity), CVD risk …

Qualitative Exploration Of Spirituality In Heart Failure Patients, Abigail M. Reggio

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background.

Heart failure (HF) is a severe, progressive disease that afflicts large numbers of

individuals around the world. One significant factor affecting quality of life in persons

with HF is the extent to which spiritual needs are met. Developing an understanding of

spirituality in the HF patient is essential in order for the healthcare professional to

provide the highest quality care possible. This study focused on examining spirituality

in HF patients by means of conducting in-depth interviews with individuals diagnosed

with HF and completing a descriptive analysis of the responses. The goal of this study

was to gain insight into …

Association Of Self-Care Confidence And Hospital Readmission Following Student Nurse Led Congestive Heart Failure Transitional Care Project, Peyton A. Phelps

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract

Over 5 million Americans have been diagnosed with heart failure, and that number is growing. This disease is burdensome to the patient as it lessens their quality of life and to the healthcare system due to costliness and frequent readmissions. This study aims to evaluate if a student nurse led transitional care program can increase patient self-care confidence, in turn reducing 30 day hospital readmission rates. Twenty patients completed the Self Care of Heart Failure Index before and after a 14-week transitional care program. These reported data were compared using a paired samples t-test. There was not a …

The Effects Of Congestive Heart Failure On Quality Of Life: As Evaluated By The Minnesota Living With Heart Failure Questionnaire, Diana G. Gonzalez

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract

Congestive heart failure (CHF) is a chronic disease that impairs the quality of life (QoL) of patients and is associated with both high hospital readmission rates and healthcare resource utilization such as emergency services. This study proposed use a student led transitional care program in providing home care to NYHA functional class II and III CHF patients. It evaluated the impact of the program on their quality of life as measured by the Minnesota Living with Heart Failure Questionnaire© (MLWHFQ), the percentage of patients requiring readmission to the hospital within 30 days of initial hospitalization, and healthcare utilization. Thirty-six …

The Effects Of Smoking On The Calcification Of The Aortic Valve, Brittany Pendergraft

Biological Sciences Undergraduate Honors Theses

Calcific Aortic Valve Disease is responsible for approximately 28,000 deaths annually and the complete mechanism is not completely understood. The disease is known to be effected by an inflammatory response, osteogenic response and an oxidative stress response that leads to thickening and mineralization of the aortic valve. Originally, this disease was thought to be brought on by age and deterioration of the valve but these rapid stress responses when the valve is disrupted by biochemical and mechanical stress has led to its classification as an active disease. Smoking has been shown to have many of the same effects experienced by …

The Effects Of Pulmonary Hypertension In Diabetic Zucker Rats On Pulmonary Vascular Contraction And Right Ventricular Size, Michael Franzetti

Biological Sciences Undergraduate Honors Theses

Pulmonary hypertension is a life-threatening disease that is identified by a resting mean pulmonary arterial pressure over 25 mmHg and established by right heart catheterization (Saglam et al., 2015). The symptoms commonly associated with pulmonary hypertension include fatigue, dyspnea, syncope, and chest pain, which severely limit quality of life in diagnosed patients (Saglam et al., 2015). According to recent studies in patients with pulmonary hypertension, the one, three and five year mortality rates are 8%, 25%, and 34%, respectively (Burudpakdee, Shah, Joish, Divers, & Yaldo, 2014). Although some advances have been made in therapies for pulmonary hypertension, the prognosis is …

The Effects Of Patient Education And Knowledge Of Chf Patients As Evaluated By The Paksac Survey, Nabil Tovar

The Eleanor Mann School of Nursing Undergraduate Honors Theses

After diagnosis, management of congestive heart failure (CHF) can pose quite a struggle to many patients, since it requires that lifestyle changes be implemented into their daily life. Patients require the sufficient knowledge and education in order to best manage symptoms and improve their quality of life after being diagnosed. Use of Patient Knowledge of Self-care activities in Congestive Heart Failure^© (PaKSAC) survey in transitional care programs could identify patient gaps in knowledge, as well as decreasing acute care service use. The purpose of this research study was to investigate the knowledge level of CHF patients at the time …

Programming Heart Disease: Does Poor Maternal Nutrition Alter Expression Of Cardiac Markers Of Proliferation, Hypertrophy, And Fibrosis In Offspring?, Cathy Chun

Honors Scholar Theses

Maternal malnutrition can affect fetal organogenesis, metabolic processes, and factors involved in developmental regulation. Of the many physiological effects poor maternal nutrition can induce in offspring, one of the most important organs affected is the heart. Cardiovascular disease has been associated with poor maternal diet. It also been suggested that hypertension can originate during impaired intrauterine growth and development. Hypertension can trigger hypertensive heart disease and is associated with numerous heart complications. We hypothesized that poor maternal nutrition would alter critical growth factors associated with normal heart development, specifically, insulin-like growth factor (IGF)-1, IGF-2, transforming growth factor (TGF)β, and connective …

Effect Of Passive Heating On Males And Females With Elevated Arterial Stiffness, Forrest Blake Robinson

Graduate Theses and Dissertations

Context: Cardiovascular disease (CVD) is one of the leading causes of mortality in the United States, accounting for about 1 in every 4 deaths annually. Studies have shown that passive heating does have some degree of effect on arterial stiffness, but not much is known about populations with higher stiffness. Objective: To examine the independent effect of core temperature increase during passive heating on arterial stiffness. Methods: Participants visited the lab three times; one familiarization and two experimental trials. The experimental trials consisted of subjects being passively heated in an environment of 40°C / 40% relative humidity (HEAT) or normal …

Diffusion Modeling And Device Development For Peritoneal Membrane Oxygenation, Liana Hatoum

Department of Mechanical and Materials Engineering: Dissertations, Theses, and Student Research

Acute respiratory distress syndrome (ARDS) is a pulmonary disease that causes hypoxemia and respiratory failure. The mortality rate for ARDS ranges between 27% and 45%. Current treatments including mechanical ventilation and extracorporeal membrane oxygenation (ECMO) are often associated with high risk complications including barotrauma, infection, thrombosis, and hemorrhage. Alternative pulmonary support techniques are needed to improve the survival rate of patients suffering from ARDS. Previous studies introducing pure O₂ gas, perfluorocarbons and red blood cells into the intraperitoneal (IP) cavity have reported no effect or only a mild increase in oxygenation. Here we report peritoneal membrane oxygenation (PMO) using …

Time Of Year Affects Surgical Outcome Of Pediatric Congenital Heart Disease, Krystin Sinclair

Honors Projects in Science and Technology

Approximately 35,000 children are born in the US each year with Congenital Heart Disease (CHD). Surgical timing for many of these conditions is elective, and the distribution of surgical cases, therefore, varies with time of year. The hypothesis of this project is that time of the year for surgery is associated with mortality, length of hospital stay (LOS), and total hospital costs. A retrospective, cohort study was performed, using the Pediatric Health Information Systems (PHIS) Database to investigate these relationships.

Biventricular Myocardial Performance Is Impaired In Proportion To Severity Of Obstructive Sleep Apnea, Selahattin Akyol, Mustafa Cortuk, Ahmet Oytun Baykan, Kemal Kiraz, Abdurrezzak Borekci, Taner Seker, Mustafa Gur, Murat Cayli

The Texas Heart Institute Journal

Obstructive sleep apnea (OSA) is an independent risk factor for cardiovascular morbidity and death. Little information is available regarding the relationship between the severity of OSA and myocardial performance in OSA patients who have normal ejection fractions. We prospectively investigated this relationship, using the tissue-Doppler myocardial performance index (TD-MPI).

We conducted overnight, full-laboratory polysomnographic examinations of 116 patients, and calculated the left and right ventricular TD-MPIs. Patients were classified into 3 groups in accordance with their apnea-hypopnea index (AHI) levels: AHImild (≥5 to <15), AHImoderate (≥15 to <30), and AHIsevere (≥30).

Left and right ventricular TD-MPI values were higher in the AHIsevere group than in the AHImild and …

Cardiac Papillary Fibroelastoma: Single-Institution Experience With 14 Surgical Patients, Walid K Abu Saleh, Odeaa Al Jabbari, Basel Ramlawi, Michael J Reardon

The Texas Heart Institute Journal

In general, treatment for symptomatic and asymptomatic cardiac papillary fibroelastoma is surgical resection-particularly of left-sided lesions, because of the risk of systemic embolization. However, few institutions have enough experience with these tumors to validate this approach. We present our institutional experience with papillary fibroelastoma and discuss our current approach. We searched our institution's cardiac tumor database, identified all patients diagnosed with cardiac papillary fibroelastoma from 1992 through 2014, and recorded the clinical and pathologic characteristics of each case. We found 14 patients (mean age, 60.5 ± 12.3 yr) who had 18 lesions. Eleven patients (79%) were symptomatic; however, we could …

Bioprosthetic Aortic Valve Endocarditis In Association With Enterococcus Durans, Luca Fallavollita, Lorena Di Gioacchino, Fabrizio Balestrini

The Texas Heart Institute Journal

Enterococci are common organisms associated with endocarditis, but infection by Enterococcus durans is very rare. To our knowledge, only 3 cases have been reported in the medical literature, and all 3 have involved native valves. Here we publish the first reported case (to our knowledge) of E. durans endocarditis in association with a bioprosthetic aortic valve. After the organism and its antibiotic susceptibility were identified, the 74-year-old male patient was treated successfully with teicoplanin and gentamicin, over a course of 6 weeks.

Advancing A Guiding Catheter Across A Mechanical Aortic Valve, Wassim Shatila, Guilherme V Silva

The Texas Heart Institute Journal

No abstract provided.

Longitudinal Changes In Vascular Risk Markers And Mortality Rates Among A Latino Population With Hypertension, Matthew C Pflederer, Carlin S Long, Brenda Beaty, Edward P Havranek, Philip S Mehler, Angela Keniston, Mori J Krantz

The Texas Heart Institute Journal

Vascular markers such as pulse-wave velocity and carotid intima-media thickness (CIMT) might improve the prediction of incident cardiovascular disease beyond traditional risk factors. These vascular markers have not been well characterized in minority populations and might be more useful than inflammatory biomarkers. We conducted a prospective, longitudinal cohort study among hypertensive patients in an urban safety-net hospital. We evaluated inflammatory biomarkers, arterial pulse-wave velocity, and carotid intima-media thickness at baseline, 1 year, and 2 years. The primary outcome variable was CIMT. Generalized linear mixed-effects models were used to evaluate associations between CIMT and predictive variables accounting for the correlation of …

'Refractory Epilepsy': What Lies Beneath?, Syedah Saira Bokhari, Satwat Hashmi

Section of Internal Medicine

A 30-year-old woman presented to the emergency room with recurrent seizures for 5 days. She had been diagnosed with epilepsy 2 years previously but stopped treatment due to the side effects of her medications. She was now experiencing episodes every 15-30 min. While undergoing a brain MRI to investigate for structural central nervous system pathology, she experienced another episode, preceded by prodromal symptoms. Polymorphic ventricular tachycardia was noted during the event. Further investigation revealed a normal QT interval, normal electrolyte panel, normal coronaries and severe left ventricular systolic dysfunction. Cardiac MRI revealed non-ischaemic cardiomyopathy. The patient was managed with heart …

A Dataset To Assess Providers׳ Knowledge And Attitudes Towards The 2013 American College Of Cardiology/American Heart Association Cholesterol Management Guideline, Yashashwi Pokharel, Lynne Steinberg, Winston Chan, Julia M. Akeroyd, Peter H. Jones, Vijay Nambi, Khurram Nasir, Laura Petersen, Christie M. Ballantyne, Salim S. Virani

Office of the Provost

We previously examined provider׳s understanding of the 2013 American College of Cardiology/American Heart Association (ACC/AHA) cholesterol management guideline (DOI: http://dx.doi.org/10.1016/j.jacl.2015.11.002)(Virani et al., 2013) [1], and also assessed whether a case-based educational intervention could improve providers׳ knowledge gaps and attitudes towards the guideline (DOI: 10.1016/j.atherosclerosis.2015.12.044) (Pokharel, et al., 2016) [2]. Here we describe the dataset that we used to examine our objectives.

Relationship Of Optimism And Suicidal Ideation In Three Groups Of Patients At Varying Levels Of Suicide Risk, Jeff C. Huffman, Julia K. Boehm, Scott R. Beach, Eleanor E. Beale, Christina M. Dubois, Brian C. Healy

Psychology Faculty Articles and Research

Optimism has been associated with reduced suicidal ideation, but there have been few studies in patients at high suicide risk. We analyzed data from three study populations (total N=319) with elevated risk of suicide: (1) patients with a recent acute cardiovascular event, (2) patients hospitalized for heart disease who had depression or an anxiety disorder, and (3) patients psychiatrically hospitalized for suicidal ideation or following a suicide attempt. For each study we analyzed the association between optimism (measured by the Life-Orientation Test-Revised) and suicidal ideation, and then completed an exploratory random effects meta-analysis of the findings to synthesize this data. …

Higher Risk For Incident Heart Failure And Cardiovascular Mortality Among Community-Dwelling Octogenarians Without Pneumococcal Vaccination, Momanna Ahmed, Kanan Patel, Gregg C. Fonarow, Charity J. Morgan, Javed Butler, Vera Bittner, Andrzej Kulczycki, Raya Kheirbek, Wilbert S. Aronow, Ross D. Fletcher, Cynthia J. Brown, Ali Ahmed

NYMC Faculty Publications

AIMS: Octogenarians have the highest incidence of heart failure (HF) that is not fully explained by traditional risk factors. We explored whether lack of pneumococcal vaccination is associated with higher risk of incident HF among octogenarians.

METHODS AND RESULTS: In the Cardiovascular Health Study (CHS), 5290 community-dwelling adults, ≥65 years of age, were free of baseline HF and had data on pneumococcal vaccination. Of these, 851 were octogenarians, of whom, 593 did not receive pneumococcal vaccination. Multivariable-adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for associations of lack of pneumococcal vaccination with incident HF and other outcomes during 13 …

Optimizing Electrocardiogram Interpretation And Catheterization Laboratory Activation In St-Segment Elevation Myocardial Infarct, Alexander E. Sullivan, Mortada Shams, Marco A. Mercader, Jacob Varghese, Abudureyimu Shajidan, Bassel Hassouna, Vimala V. Jayanthi

GW Research Days 2016 - 2020

Background: To achieve the 90-minute reperfusion goal in ST-segment elevation myocardial infarction (STEMI) care, providers must diagnose STEMIs from electrocardiograms (ECGs) obtained upon emergency room arrival and appropriately activate the catheterization lab. To enhance early STEMI care, we sought to improve medical student STEMI recognition and diagnostic accuracy with a teaching module we designed and developed.

Methods: Through a literature review, we identified evidenced-based criteria for classic STEMI patterns, STEMI-equivalents with non-classic STEMI patterns including hyperacute T-waves, STEMI with existing left bundle branch block (LBBB) and Wellens’ syndrome and non-ischemic STEMI-mimics such as known LBBB, pericarditis, ventricular aneurysm, …

Role Of Serum Biomarkers In Early Detection Of Diabetic Cardiomyopathy In The West Virginian Population, Adam Shaver, Alexandra Nichols, Ellen A. Thompson, Amrita Mallick, Nandini Manne, Shanmuga Sundaram, Joseph I. Shapiro Md, Komal Sodhi

Biochemistry and Microbiology

Objectives: Diabetic cardiomyopathy (DCM) is an established complication of diabetes mellitus. In West Virginia, the especially high incidence of diabetes and heart failure validate the necessity of developing new strategies for earlier detection of DCM. Since most DCM patients remain asymptomatic until the later stages of the disease when the fibrotic complications become irreversible, we aimed to explore biomarkers that can identify early-stage DCM.

Methods: The patients were grouped into 4 categories based on clinical diabetic and cardiac parameters: Control, Diabetes (DM), Diastolic dysfunction (DD), and Diabetes with diastolic dysfunction (DM+DD), the last group being the preclinical DCM group.

Results: …

Effectiveness Of Pharmacist-Led Amiodarone Monitoring Services On Improving Adherence To Amiodarone Monitoring Recommendations: A Systematic Review, Dave L. Dixon, Steven P. Dunn, Michael S. Kelly, Timothy R. Mcllarky, Roy E. Brown

Pharmacy Faculty Articles and Research

Amiodarone remains the mostly frequently used antiarrhythmic in clinical practice and is most often used to maintain normal sinus rhythm in patients with atrial fibrillation who have failed a rate control strategy. Amiodarone has superior efficacy over other antiarrhythmics, a lower risk of torsade de pointes, and a better cardiovascular safety profile in patients with structural heart disease. However, amiodarone is associated with notable noncardiac toxicities affecting the thyroid, lungs, eyes, liver, and central nervous system. Since 2000, clinicians have been advised to follow amiodarone monitoring guidelines provided by the Heart Rhythm Society. Adherence to these recommendations in clinical practice, …

Stakeholder Perspectives On Changes In Hypertension Care Under The Patient-Centered Medical Home, Alison J. O'Donnell, Hillary R. Bogner, Peter F. Cronholm, Katherine Kellom, Michelle Miller-Day, Heather F. De Vries Mcclintock, Elise M. Kaye, Robert Gabbay

Communication Faculty Articles and Research

Introduction

Hypertension is a major modifiable risk factor for cardiovascular and kidney disease, yet the proportion of adults whose hypertension is controlled is low. The patient-centered medical home (PCMH) is a model for care delivery that emphasizes patientcentered and team-based care and focuses on quality and safety. Our goal was to investigate changes in hypertension care under PCMH implementation in a large multipayer PCMH demonstration project that may have led to improvements in hypertension control.

Methods

The PCMH transformation initiative conducted 118 semistructured interviews at 17 primary care practices in southeastern Pennsylvania between January 2011 and January 2012. Clinicians (n …

Alternative Surgical Approach To Repairing A Giant Sinus Of Valsalva Aneurysm, Vincenzo Giambruno, Cristina Cucchietti, Calogera Pisano, Jonathan Hyde

The Texas Heart Institute Journal

We report our method of surgically repairing an unruptured giant aneurysm of the right coronary sinus of Valsalva, a lesion that caused moderate aortic regurgitation but no symptoms in a 61-year-old woman. We excised the aneurysm, reconstructed the right sinus of Valsalva with use of a patch, performed mechanical aortic valve replacement directly through the excised aneurysm's cavity, and constructed a single bypass graft to the right coronary artery. The patient was discharged from the hospital after 5 days. Twelve months postoperatively, her clinical and echocardiographic results were normal, and she was doing well. To our knowledge, our surgical approach …

The Mosaic Mitral Valve Bioprosthesis: A Long-Term Clinical And Hemodynamic Follow-Up, Michele Celiento, Stefania Blasi, Andrea De Martino, Stefano Pratali, Aldo D Milano, Uberto Bortolotti

The Texas Heart Institute Journal

We reviewed the cases of 100 patients (mean age, 73 ± 10 yr; 64 men) who had mitral valve replacement with a Medtronic Mosaic porcine bioprosthesis from 1995 through 2011. The mean New York Heart Association (NYHA) class was 3 ± 0.7, and 52 patients were in atrial fibrillation. Prosthetic sizes were chiefly 27 mm (50 patients) and 29 mm (40 patients). Follow-up ended in December 2012 and is 97% complete, with a cumulative duration of 611 patient-years (mean duration, 6 ± 4.6 yr; maximum, 17.7 yr). The early mortality rate was 10% (6% in elective patients); late deaths occurred …

Durability Of The Starr-Edwards Heart Valve: Early Decisions Led To Successful Results, Albert Starr, Gary L Grunkemeier

The Texas Heart Institute Journal

No abstract provided.

Cutting The Cost Of Health Care: The Physician's Role, Herbert L Fred

The Texas Heart Institute Journal

No abstract provided.

Aortic Dissection Caused By Percutaneous Coronary Intervention: 2 New Case Reports And Detailed Analysis Of 86 Previous Cases, Priyank Shah, Sharad Bajaj, Fayez Shamoon

The Texas Heart Institute Journal

Aortic dissection, a rare sequela of percutaneous coronary intervention, can be fatal when it is not recognized and treated promptly. Treatment varies from conservative management to invasive aortic repair and revascularization. We report the cases of 2 patients whose aortic dissection was caused by percutaneous coronary intervention. In addition, we present detailed analyses of 86 previously reported cases. Aortic dissection was most often seen during intervention to the right coronary artery (in 76.7% of instances). The 2 most frequently reported causes were catheter trauma (in 54% of cases) and balloon inflation (in 23.8%). The overall mortality rate was 7.1%. We …