Diseases Commons^™

Your Heart And Diabetes, Rodney Richmond

Faculty Research ​and Publications

No abstract provided.

Human Igg1 Antibodies Suppress Angiogenesis In A Target-Independent Manner, Sasha Bogdanovich, Younghee Kim, Takeshi Mizutani, Reo Yasuma, Laura Tudisco, Valeria Cicatiello, Ana Bastos-Carvalho, Nagaraj Kerur, Yoshio Hirano, Judit Z. Baffi, Valeria Tarallo, Shengjian Li, Tetsuhiro Yasuma, Parthasarathy Arpitha, Benjamin James Fowler, Charles B. Wright, Ivana Apicella, Adelaide Greco, Arturo Brunetti, Menotti Ruvo, Annamaria Sandomenico, Miho Nozaki, Ryo Ijima, Hiroki Kaneko, Yuichiro Ogura, Hiroko Terasaki, Balamurali K. Ambati, Jeanette H. W. Leusen, Wallace Y. Langdon, Michael R. Clark, Bradley D. Gelfand, Jayakrishna Ambati

Ophthalmology and Visual Science Faculty Publications

Aberrant angiogenesis is implicated in diseases affecting nearly 10% of the world’s population. The most widely used anti-angiogenic drug is bevacizumab, a humanized IgG1 monoclonal antibody that targets human VEGFA. Although bevacizumab does not recognize mouse Vegfa, it inhibits angiogenesis in mice. Here we show bevacizumab suppressed angiogenesis in three mouse models not via Vegfa blockade but rather Fc-mediated signaling through FcγRI (CD64) and c-Cbl, impairing macrophage migration. Other approved humanized or human IgG1 antibodies without mouse targets (adalimumab, alemtuzumab, ofatumumab, omalizumab, palivizumab and tocilizumab), mouse IgG2a, and overexpression of human IgG1-Fc or mouse IgG2a-Fc, also inhibited angiogenesis in wild-type …

The Value Of Contrast Echocardiography, Shannon C. Treiber, Bijoy K. Khandheria

Journal of Patient-Centered Research and Reviews

Purpose

There is much evidence-based research proving the effectiveness of contrast echocardiography, but there are still questions and concerns about its specific uses. This study tested the effectiveness of contrast echocardiography in defining the left ventricular endocardial border.

Methods

From 30 patients, a total of 60 echocardiograms –– 30 with and 30 without use of contrast –– were retrospectively reviewed by four blinded cardiologists with advanced training in echocardiography. No single cardiologist reviewed contrast and noncontrast images of the same patient. Each set of 30 echocardiograms was then studied for wall-motion scoring. Visualization of left ventricular wall segments and a …

Development And Validation Of A Preprocedural Risk Score To Predict Access Site Complications After Peripheral Vascular Interventions Based On The Vascular Quality Initiative Database, Daniel Ortiz, Maharaj Singh, Arshad Jahangir, Suhail Allaqaband, Anjan Gupta, Tanvir Bajwa, Mark W. Mewissen

Journal of Patient-Centered Research and Reviews

Purpose

Access site complications following peripheral vascular intervention (PVI) are associated with prolonged hospitalization and increased mortality. Prediction of access site complication risk may optimize PVI care; however, there is no tool designed for this. We aimed to create a clinical scoring tool to stratify patients according to their risk of developing access site complications after PVI.

Methods

The Society for Vascular Surgery’s Vascular Quality Initiative database yielded 27,997 patients who had undergone PVI at 131 North American centers. Clinically and statistically significant preprocedural risk factors associated with in-hospital, post-PVI access site complications were included in a multivariate logistic regression …

Non-Hdl-C Or Apolipoprotein-B Versus Ldl-C Screening For Evaluation And Treatment Of Atherosclerotic Cardiovascular Disease, Grant Coauette

Physician Assistant Scholarly Project Posters

• Lowering low-density lipoprotein cholesterol (LDL-C) concentration in the population has been a goal of researchers and clinicians to prevent atherosclerotic cardiovascular disease (ASCVD).

• Controversy surrounds using [LDL-C] as the primary lipid biomarker to evaluate the risk of cardiovascular events. An article search dating back to 2005 of PubMed and The Cochran Library was conducted.

• The purpose of this investigation was to determine if LDL-C should be the primary lipid biomarker used to determine ASCVD treatment and prevention. This investigation researched other lipid biomarkers and targets to determine clinical relevance and if the level of those markers more …

Screening For Cardiovascular Disease In Children, Jesse Fladmark

Physician Assistant Scholarly Project Posters

Introduction: Cardiovascular disease is one of the leading causes of death in the world with significant burden on the health care system.

Review of Literature: The focus of this paper is to look at previous studies, mostly systematic reviews and metaanalysis, in search of various clinical screening methods in the pediatric population for determining cardiovascular disease risk. Waist to height ratio can be used to screen children for cardiovascular disease with a specificity of 96% when using 0.55 as the cut-off point. An increase in waist circumference along with increased BMI places a child at a much higher risk of …

Serum Biomarkers Compared To Neural Imaging In The Differentiation Of Stroke Etiologies, Kevin Conboy

Physician Assistant Scholarly Project Posters

• Stroke is a leading cause of disability and morbidity and the fourth leading cause of death in the United States, and the second leading cause of death worldwide.

• Early restoration of blood flow is the most effective treatment of ischemic stroke by intravenous thrombolytic therapy within 3-4.5hrs of symptom onset.

• Patient outcomes have been shown to improve with earlier thrombolytics, each 15 minute increment increases survival by 3.0-4.0%.

• Non-contrast CT is the current standard for differentiation of stroke. It is beneficial due to speed of acquisition and its high sensitivity in ruling out hemorrhagic stroke.

• …

Patient Self-Management: Impact Of Racism-Related Vigilance In The Management Of Hypertension In African-Americans, Rackelle N. Wilkinson-Alston

Writing Across the Curriculum

It is important to understand the role that discrimination plays in health disparities. This paper will discuss racism-related vigilance, and its role in health outcomes in hypertensive African-Americans (AAs). This paper will also attempt to provide insight on how the absence of a culturally competent health care system may predispose AAs to developing stress-induced hypertension due to racism-related vigilance. This paper will explore how community partnership programs may be beneficial interventions for building resilience and promoting positive health behaviors among hypertensive AAs in the face of discrimination-related vigilance.

Trimethylamine N-Oxide: The Good, The Bad And The Unknown, Manuel T. Velasquez, Ali Ramezani, Alotaibi Manal, Dominic S. Raj

Medicine Faculty Publications

Trimethylamine N-oxide (TMAO) is a small colorless amine oxide generated from choline, betaine, and carnitine by gut microbial metabolism. It accumulates in the tissue of marine animals in high concentrations and protects against the protein-destabilizing effects of urea. Plasma level of TMAO is determined by a number of factors including diet, gut microbial flora and liver flavin monooxygenase activity. In humans, a positive correlation between elevated plasma levels of TMAO and an increased risk for major adverse cardiovascular events and death is reported. The atherogenic effect of TMAO is attributed to alterations in cholesterol and bile acid metabolism, activation …

Quality Of Life And Athletic Participation Assessment In Children And Adolescents With Congenital Heart Disease, Kayla Stuckey

Honors Program Theses

Just under 1% of infants are born with a heart defect [congenital heart disease (CHD)], and as a result of treatment and early diagnosis, 85% of these children survive into adulthood. Few studies have investigated the quality of life, global happiness, and athletic participation in pediatric populations, especially with respect to those who have CHD. In 2010, the number of people aged 0-18 years who had CHD was estimated to be between 1,905,000 and 2,102,000, and there are varying qualities of life that these children experience based on disease severity. In addition to patients who are born with CHD, children …

Coronary Flow Reserve In Adults With Systemic Right Or Single Ventricles, Laura J. Olivieri, Li-Yueh Hsu, Anitha S. John, Karen S. Kuehl, Andrew Arai

Pediatrics Posters and Presentations

No abstract provided.

Why Is Postoperative Atrial Fibrillation Difficult To Prevent And Treat: Potential Roles Of Unrecognized Magnesium Deficiency And Release Of Ceramide And Platelet-Activating Factor, Burton M. Altura, Nilank C. Shah, Gatha J. Shah, Jose Luis Perez-Albela, Bella T. Altura

Touro College of Osteopathic Medicine (Middletown) Publications and Research

Heart failure is a major cause of morbidity and mortality whose costs impose staggering health-care costs and often lengthy hospitalizations. Post-operative atrial fibrillation (POAF) represents a leading cause for heart failure, particularly after cardiac and lung surgeries. Although PAOF is a common cardiac arrhythmia, it is impossible to predict. As the worldwide population is aging, the incidence and prevalence of PAOF is growing. Identifying mechanisms for PAOF is attracting a considerable amount of research with no agreement on the mechanism(s). Our research on the heart and cardiovascular system, over the past 50-plus years, leads us to believe that major causes …

Insights Into The Possible Mechanisms By Which Platelet-Activating Factor And Paf-Receptors Function In Vascular Smooth Muscle In Magnesium Deficiency And Vascular Remodeling: Possible Links To Atherogenesis, Hypertension And Cardiac Failure, Burton M. Altura, Nilank C. Shah, Gatha J. Shah, Jose Luis Perez-Albela, Bella T. Altura

The School of Health Sciences Publications and Research

The authors discuss different studies concerning the relationship between platelet-activating factor (PAF) and PAF-receptors with atherosclerosis and hypertension.

Molecular Basis Of Sex Differences In Cardiac Hypertrophy And Heart Failure, Maya James

Online Theses and Dissertations

Transforming growth factor beta ligands and receptors are known to be pro-hypertrophic and pro-fibrotic factors in the heart, and are known to contribute to the development of cardiac hypertrophy and heart failure. It is well established that premenopausal females possess a lower incidence of these pathologies. We and others have observed a greater level of fibrosis in male hearts compared to female hearts in rodent models of cardiac hypertrophy. It is well established that estrogen is cardioprotective in that it can prevent the development of cardiac hypertrophy, as well as abrogate the development of heart failure following sustained cardiac hypertrophy. …

Development And Evaluation Of A Firefighter Physical Performance Program For Undergraduate Fire And Safety Students, Jessica Ann Moody

Online Theses and Dissertations

The number one on-duty cause of death in the fire service is heart attacks. The International Association of Firefighters and the International Association of Fire Chiefs teamed up to create the Candidate Physical Ability Test (CPAT). Fire departments across the nation will have consistent physical performance tests to hire more physically capable candidates as part of the Wellness-Fitness Initiative (International Association of Fire Fighters, 2014).

Eastern Kentucky University is a nationally recognized school for its fire science program; however students are not required to take educational classes to better prepare them for physical performance tests. Students starting in a training …

Genotoxic Effects Of Magnesium Deficiency In The Cardiovascular System And Their Relationships To Cardiovascular Diseases And Atherogenesis, Burton M. Altura, Nilank C. Shah, Gatha J. Shah, Bella T. Altura

The School of Health Sciences Publications and Research

The authors present evidence for a novel, new hypothesis whereby magnesium deficiency (MgD) acts as a genotoxic agent which probably causes numerous, hertofore, unrecognized consequences, even over a short-term, on the physiological, molecular and biochemical machinery of cardiovascular tissues and cells. The end result of these genotoxic effects of MgD probably plays important roles in the etiology and generation of diverse cardiovascular diseases, atherosclerosis, inflammation, and strokes via alterations in the epigenome of cardiovascular tissues and cells. The importance of adequate water-borne and dietary levels of Mg is emphasized.

The Expression Of Platelet-Activating Factor Is Induced By Low Extracellular Mg2+ In Aortic, Cerebral And Neonatal Coronary Vascular Smooth Muscle; Cross Talk With Ceramide Production, Nf–Kb And Proto-Oncogenes: Possible Links To Atherogenesis And Sudden Cardiac Death In Children And Infants, And Aging: Hypothesis, Review And Viewpoint, Burton M. Altura, Wenyan Li, Aimin Zhang, Tao Zheng, Nilank C. Shah, Gatha J. Shah, Bella T. Altura

The School of Health Sciences Publications and Research

An attempt is made, herein, to reconcile, and integrate, various phenomena associated with magnesium deficiency (MgD) in cardiovascular health, disease, and aging as well as reasons for the high incidence of sudden cardiac death in infants and young adults. With new experiments, we demonstrate, for the first time, that very low concentrations of platelet-activating factor (PAF), when added to primary cultured cerebral, neonatal coronary, and aortic vascular smooth muscle (VSM) cells (from three different mammals) promote rapid rises in free intracellular Ca2+ ions and a significant, concomitant reduction in free intracellular Mg2+ ions; these actions of PAF being curtailed with …

Magnesium Deficiency Results In Oxidation And Fragmentation Of Dna, Down Regulation Of Telomerase Activity, And Ceramide Release In Cardiovascular Tissues And Cells: Potential Relationship To Atherogenesis, Cardiovascular Diseases And Aging, Burton M. Altura, Nilank C. Shah, Gatha J. Shah, Jose Luis Perez-Albela, Bella T. Altura

The School of Health Sciences Publications and Research

The authors discuss the potential relationship between magnesium, cardiovascular diseases, and aging.

Potential Roles Of Magnesium Deficiency In Inflammation And Atherogenesis: Importance And Cross-Talk Of Platelet-Activating Factor And Ceramide, Burton M. Altura, Asefa Gebrewold, Nilank C. Shah, Gatha J. Shah, Bella T. Altura

The School of Health Sciences Publications and Research

Epidemiologic studies in North America and Europe have shown that people consuming Western-type diets are low in magnesium (Mg) content (i.e., < 30 - 65% of the RDA for Mg); most such diets in the USA show that 60 - 80% of Americans are consuming only 185 - 235 mg/day of Mg. Low Mg content in areas of soft-water, and Mg-poor soil, is associated with high incidences of ischemic heart disease (IHD), coronary artery disease, hypertension, and sudden cardiac death (SCD). It is clear that the leading underlying cause of death worldwide is atherosclerosis. Importantly, both animal and human studies have shown an inverse relationship between dietary intake of Mg and atherosclerosis. The myocardial level of Mg has consistently been observed to be lower in subjects dying from IHD and SCD in soft-water areas than those in hard-water areas. Over the past 20 years, our laboratories, using several types of primary cultured vascular smooth muscle (VSM) cells, and myocardial cells, demonstrated that declining levels of extracellular Mg ([Mg2+]0) activated several enzymatic pathways to produce increases in cellular sphingolipids, particularly ceramides which are known to exert numerous types of cardiovascular manifestations including inflammatory effects; the latter play important roles in atherogenesis and cardiovascular diseases. Approximately 20 years ago, we reported that low [Mg2+]0 caused formation of platelet-activating factor (PAF) as well as other types of PAF-like molecules and suggested that these molecules might be causative agents in low Mg2+- induced IHD and SCD. Herein, we review results and data from our labs which strongly support roles for ceramides, PAF and PAF-like lipids in low [Mg2+]0-induced IHD and SCD.

Sudden Cardiac Death In Infants, Children And Young Adults: Possible Roles Of Dietary Magnesium Intake And Generation Of Platelet-Activating Factor In Coronary Arteries, Burton M. Altura, Wenyan Li, Aimin Zhang, Tao Zheng, Nilank C. Shah, Gatha J. Shah, Bella T. Altura

The School of Health Sciences Publications and Research

Magnesium (Mg) is a co-factor for more than 500 enzymes, and is the second most abundant intracellular cation after potassium. It is vital in numerous physiological, cellular and biochemical functions and systems necessary for life. Approximately 35 years ago, our laboratory suggested that a progressive, dietary deficiency and/or metabolic induced loss of Mg from the body, beginning early in life, particularly during development of the coronary arteries, could lead to coronary arterial vasospasm, ischemic heart disease, and sudden-cardiac death (SCD). Herein, we review evidence for a brand-new, novel hypothesis which combines knowledge suggesting a combined role for hypomagnesemia and platelet-activating …

Coronary Artery Calcium Scoring Vs. Exercise Tolerance Testing: Diagnoses And Risk Stratification Of Ascvd, Brittany Anundson

Physician Assistant Scholarly Project Posters

• Atherosclerotic cardiovascular disease (ASCVD) is highly prevalent in today’s society and contributes to high rates of mortality involved with heart disease.

• The initial assessment of ASCVD and risk stratification concerning the development of an acute coronary event can be performed in a number of ways.

• Current American Heart Association (AHA) guidelines recommend exercise stress testing (ETT) as the initial, noninvasive evaluation of choice.

• However, the accuracy of this test is highly dependent on the patient’s endurance, body mass index, and artifact, making analyzation difficult.

• Non-contrast cardiac computed tomography (CT) with coronary artery calcium (CAC) scoring …

Direct Factor Xa Inhibitors Versus Warfarin In Non-Valvular Atrial Fibrillation: Efficacy, Safety, Cost, And Reversibility, Cory D. Jacobs

Physician Assistant Scholarly Project Posters

Atrial fibrillation is a common cause for stroke. Vitamin K antagonists such as warfarin are an effective prophylactic medication to prevent stroke in patients with atrial fibrillation. Warfarin, however, has a narrow therapeutic index, reacts with certain foods, increases bleeding risks, and requires frequent monitoring. New medications have been developed to prevent clot formation while avoiding the negative effects of warfarin. The purpose of this study was to compare direct factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban) versus warfarin in stroke prevention, safety, and cost.

The review of literature analyzed studies comparing warfarin and direct factor Xa inhibitors in patients …

Pcsk9 Inhibitors: A Review Of The Efficacy, Safety And Current Literature Recommendations, Lacey L. Jandrin

Physician Assistant Scholarly Project Posters

Atherosclerotic cardiovascular disease is the leading cause of morbidity and mortality in developed counties. It is estimated that 60 million Americans have LDL-C levels > 160 mg/dl. Only about 1/3 of these patients meet treated LDL cholesterol goals of < 70 mg/dl indicating a need for greater control. High dose statins have been the mainstay in treatment of dyslipidemia, however, up to 20% of patients are statin intolerant indicating a need for secondary treatment strategies. This lead to the development of monoclonal antibodies to proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. PCSK9 inhibitors result in decreased destruction of the low-density lipoprotein receptor (LDL-R) which leads to an increase in the transport of LDL-C to its destruction effectively reducing LDL-C levels in the blood. The purpose of this study is to analyze the literature available on the efficacy and safety of new PCSK9 inhibitors. The results of this literature review indicated that PCSK9 inhibitors effectively lowered LDL-C by an average of approximately 50%. The evidence reviewed by this analysis indicate that 70% of patients treated with PCSK9 inhibitors met LDL-C goals. The findings also indicate that the side effects associated with this new class of medications are comparable to current side effects seen with traditional cholesterol lowering agents. The largest side effect seen in up to 10% of patients were injection site reactions and did not require discontinuation of the medication. The results of this analysis indicate that PCSK9 inhibitors may be of benefit in patients who are statin intolerant, do not meet LDL-C goals on traditional statin therapy or have familial hypercholesterolemia. Education in use of injectables, cost and insurance coverage and dosing schedule are likely to be areas of continued research and may affect use of this new class of cholesterol lowering agents.

Does Adherence To A Plant-Based Diet Cause A Statistically Significant Decrease In The Risk Of Cardiovascular Events?, Amber H. Johnson

Physician Assistant Scholarly Project Posters

• One of the current problems in many affluent societies is the straightforward access to convenience and fast foods. Although these selections have suitability for today’s fast-paced world, overall nutritional value becomes the martyr of such practices. It is a logical thought that there could be a correlation between this nutritional pattern and the ever-increasing presence of obesity, cardiovascular disease, type 2 diabetes mellitus, hypertension, dyslipidemia, cancer, and other conditions carrying a proverbial death sentence.

• The intent of this review of the literature was to determine the effect a plant-based diet versus an omnivorous diet would have on adults, …

Impact Of Increasing Glp-1 On Markers Of Inflammation, Glucose Control And Cardiovascular Risk Factors In Patients With Type 2 Diabetes, Kristina Sandstedt

Physician Assistant Scholarly Project Posters

There is a strong established relationship between diabetes and cardiovascular disease. Much of the latest research studies have identified a link between the inflammatory processes and the pathogenesis of both cardiovascular disease and diabetes. Specific inflammatory markers include: Interleukins 1,6,18; C-reactive protein, Fibrinogen, Tumor Necrosis Factor-α, PAI-I and cell adhesion molecules. As a result, there has been an emphasis on identifying therapeutic approaches that would improve both markers of inflammation and glucose control. The endocrine hormones known as incretins, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropicpolypeptide (GIP), are produced in the gastrointestinal tract following ingestion of a meal. In individuals with …

Is The High Frequency Of Postoperative Atrial Fibrillation After Cardiac And Lung Surgeries Related To Hypomagnesemia And Releases Of Ceramides And Platelet-Activating Factor?, Burton M. Altura, Nilank C. Shah, Gatha J. Shah, Aimin Zhang, Wenyan Li, Bella T. Altura

Touro College of Osteopathic Medicine (Middletown) Publications and Research

The authors discuss the possible role of hypomagnesemia, ceramides and platelet-activating factor in the incidence of postoperative atrial fibrillation after cardiac and lung surgeries.

Effects Of Moderate Intake Of Alcohol On Coronary Heart Disease, Eli Derdik

The Science Journal of the Lander College of Arts and Sciences

The french paradox is caused by an inconsistency with scientific experimentation: The French have a very high intake of saturated fat and cholesterol, which is associated with coronary heart disease, yet they have un-commensurately low levels of deaths due to this disease. It has been proposed that alcohol, as a part of the French diet, is the factor that helps decrease the risk of heart disease in the French population by 20-30%. Research has been gathered from many medical journals to create a larger and more accurate perspective to determine if alcohol has any effect on coronary heart disease. Experiments …

Lifestyle Contributors To Cardiovascular Disease Risk, Adam J. Berrones

Theses and Dissertations--Kinesiology and Health Promotion

Aortic stiffness is an independent risk factor that has prognostic value regarding future cardiovascular disease (CVD) events such as myocardial infarction, strokes, and heart failure. Although death rates due to coronary heart disease have declined in recent years, the leading global killer remains CVD and prevalence is still high. Understanding lifestyle contributors associated with aortic stiffness would provide the public with insight into targeting key health-related behaviors.

The purpose of this observational study was to examine the association of physical activity, physical function, and dietary quality as independent factors contributing to aortic stiffness in apparently healthy middle aged men. Fifty-two …

Vena Cava Filter Utilization And Retrieval: A Quality Of Care Issue, Joshua Brown

Theses and Dissertations--Pharmacy

Vena cava filters (VCFs) are mechanical devices implanted in the inferior vena cava to trap thrombi from travelling to the pulmonary circulation, resulting in pulmonary embolism. VCFs are available as permanent or non-permanent, retrievable devices and are generally indicated for use in patients unable to receive systemic anticoagulation or at exceedingly high risk for pulmonary embolism (PE). Retrievable devices allow for removal of the VCF once the contraindication to anticoagulation or high risk of PE has abated. Since the introduction of retrievable VCFs in the early 2000’s, use of VCFs has increased three-fold, with >85% of all VCFs placed being …

The Role Of Pxr And Ikkβ Signaling In Cardiometabolic Disease, Robert N. Helsley

Theses and Dissertations--Pharmacology and Nutritional Sciences

Cardiovascular disease (CVD) is the leading cause of death worldwide and is partially attributed to perturbations in lipid metabolism. Xenobiotics, such as pharmaceutical drugs and environmental chemicals, have been associated with increased risk of CVD in multiple large-scale human population studies, but the underlying mechanisms remain poorly defined. We and others have identified several xenobiotics as potent agonists for the pregnane X receptor (PXR), a nuclear receptor that can be activated by numerous drugs as well as environmental and dietary chemicals. However, the role of PXR in mediating the pathophysiological effects of xenobiotic exposure in humans and animals remains elusive. …