Diseases Commons^™

The Ventricular Volume Variability Study Of The Pediatric Heart Network: Study Design And Impact Of Beat Averaging And Variable Type On The Reproducibility Of Echocardiographic Measurements In Children With Chronic Dilated Cardiomyopathy., Steven D. Colan, Girish S. Shirali, Renee Margossian, Dianne Gallagher, Karen Altmann, Charles Canter, Shan Chen, Fraser Golding, Elizabeth Radojewski, Michael Camitta, Michael Carboni, Jack Rychik, Mario Stylianou, Lloyd Y. Tani, Elif Seda Selamet Tierney, Yanli Wang, Lynn A. Sleeper, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Clinical trials often rely on echocardiographic measures of left ventricular size and function as surrogate end points. However, the quantitative impact of factors that affect the reproducibility of these measures is unknown. To address this issue, the National Heart, Lung, and Blood Institute-funded Pediatric Heart Network designed a longitudinal observational study of children with known or suspected dilated cardiomyopathy aged 0 to 22 years from eight pediatric clinical centers.

METHODS: Clinical data were collected together with 150 echocardiographic indices of left ventricular size and function. Separate observers performed duplicate echocardiographic imaging. Multiple observers performed measurements from three cardiac cycles …

Carrs Surveillance Study: Design And Methods To Assess Burdens From Multiple Perspectives, Manisha Nair, Mohammed K. Ali, Vamadevan S. Ajay, Roopa Shivashankar, Viswanathan Mohan, Rajendra Pradeepa, Mohan Deepa, Hassan Mehmood Khan, Muhammad Masood Kadir, Zafar Fatmi, Srinath Srinath Reddy, Nikhil Tandon, Km Venkat Narayan, Dorairaj Prabhakaran

Community Health Sciences

Background: Cardio-metabolic diseases (CMDs) are a growing public health problem, but data on incidence, trends, and costs in developing countries is scarce. Comprehensive and standardised surveillance for non-communicable diseases was recommended at the United Nations High-level meeting in 2011.
Aims: To develop a model surveillance system for CMDs and risk factors that could be adopted for continued assessment of burdens from multiple perspectives in South-Asian countries.
Design: Hybrid model with two cross-sectional serial surveys three years apart to monitor trend, with a three-year prospective follow-up of the first cohort.Sites: Three urban settings (Chennai and New Delhi in India; Karachi in …

Influence Of Obesity, Race And Gender On Cardiac Catheterization After Stress Testing, Robert Finkelhor

Journal of Health Disparities Research and Practice

Female gender and black race have been associated with lower use of cardiac resources however; these patients also have a higher prevalence of obesity. Therefore we determined their relation to cardiac catheterization after stress testing. Clinical characteristics were determined for all patients stress tested over one year at a safety-net, urban, teaching hospital. Subsequent cardiac catheterizations were identified. Univariate and multivariate analyses were performed to determine the factors associated with catheterization. 3644 patients underwent stress testing and 484 (13%) underwent cardiac catheterization. The population was 58% female, 33% black, 53% were obese and 32% lacked insurance. Obese patients were mostly …

Feasibility And Compliance With Daily Home Ecg Monitoring Of The Qt Interval In Heart Transplant Recipients, Erik V. Carter, Kathleen T. Hickey, David M. Pickham, Lynn V. Doering, Belinda Chen, Patricia Harris, Barbara J. Drew

Collected Faculty Scholarship

Background: Recent evidence suggests that acute allograft rejection after heart transplantation causes an increased QT interval on electrocardiogram (ECG). The aims of this pilot study were to (1) determine whether heart transplant recipients could achieve compliance in transmitting a 30-second ECG every day for 1 month using a simple ECG device and their home telephone, (2) evaluate the ease of device use and acceptability by transplant recipients, and (3) evaluate the quality of transmitted ECG tracings for QT-interval measurement.

Methods: A convenience sample of adult heart transplant recipients were recruited and trained to use the device (HeartOne, Aerotel Medical Systems, …

Hypoxia-Sensitive Gene Expression In The Gastrocnemius Muscle Following Chronic Hind Limb Ischemia, Andrew Tilton

Biological Sciences

Chronic ischemia, caused by the formation atherosclerotic plaque occlusions in major conduit arteries, is the leading cause of morbidity and mortality in western societies. Vascular remodeling can help compensate for the adverse effects of atherosclerotic plaque formation. Vascular remodeling relies heavily on vascular endothelial growth factor (VEGF), a critical protein that contributes to all forms of vascular formation and remodeling including angiogenesis, arteriogenesisand vasculogenesis. VEGF itself is up-regulated by the transcription factor, hypoxia inducible factor 1 alpha (HIF-1α), which becomes activated in low oxygen environments.

Through the use of animal chronic hindlimb ischemia models, these genes can be evaluated as …

Role Of Nsmase-3/Cermide Signaling In Muscle Atrophy, Zaheen Rabbani

Kaleidoscope

No abstract provided.

Development Of A Protocol To Measure Gene Expression In The Mouse Tibia, Daniel Hoover

Biomedical Engineering

Numerous molecular factors active in bone tissue direct fracture repair and remodeling which can be altered by disease conditions such as Peripheral Arterial Disease (PAD) and Osteoporosis. Methods of molecular biology are commonly applied to investigate the expression and role of these molecular factors. This project presents a robust three-step protocol for examining gene expression in the mouse tibia. The protocol begins with isolating RNA from a flash frozen tibia sample. The isolated RNA is reverse transcribed into cDNA. Finally, PCR is performed to indentify expressed genes. Establishing this protocol will allow further research into the mechanisms of bone remodeling …

Inflammatory Biomarkers And Subclinical Atherosclerosis In African-American Women With Systemic Lupus Erythematosus (Sle), Edith Williams, Carlos Crespo, Joan Dorn

Journal of Health Disparities Research and Practice

Women with lupus are at increased risk for developing cardiovascular disease (CVD). Previous studies of atherosclerosis in SLE have not been representative of the minority groups most affected by lupus and its complications. Therefore, a study of 41 lupus cases and 83 controls was conducted to investigate the relationship between carotid atherosclerosis and inflammation in African-American women. Participation consisted of a questionnaire, physical examination, fasting blood draw, and ultrasound of the carotid arteries. There were observed differences between cases and controls with regard to carotid intima media thickness (IMT) and traditional cardiovascular risk factors, although few reached statistical significance. Tumor …

Associations Between Retinol-Binding Protein 4 And Cardiometabolic Risk Factors And Subclinical Atherosclerosis In Recently Postmenopausal Women: Cross-Sectional Analyses From The Keeps Study, Gary Huang, Dan Wang, Unab I. Khan, Irfan Zeb, Joann E. Manson, Virginia Miller, Howard N. Hodis, Matthew J. Budoff, George R. Merriam, Mitchell S. Harman, Eliot A. Brinton, Marcelle Cedars, Yali Su, Rogerio A. Lobo, Frederick Naftolin, Nanette Santoro, Hugh S. Taylor,, Rachel P. Wildman

Department of Family Medicine

Background: The published literature regarding the relationships between retinol-binding protein 4 (RBP4) and cardiometabolic risk factors and subclinical atherosclerosis is conflicting, likely due, in part, to limitations of frequently used RBP4 assays. Prior large studies have not utilized the gold-standard western blot analysis of RBP4 levels.
Methods: Full-length serum RBP4 levels were measured by western blot in 709 postmenopausal women screened for the Kronos Early Estrogen Prevention Study. Cross-sectional analyses related RBP4 levels to cardiometabolic risk factors, carotid artery intima-media thickness (CIMT), and coronary artery calcification (CAC). Results: The mean age of women was 52.9 (± 2.6) years, and the …

The Prevalence Of Essential Hypertension In Kasigau, Kenya, Lindsay Williams

Mahurin Honors College Capstone Experience/Thesis Projects

Hypertension is the leading cause of cardiovascular disease worldwide. Cardiovascular disease (CVD) is a widespread chronic non-communicable disease (NCD) which is on the rise in developing countries. Evidence based on extensive research studies on risk factors for NCDs suggests that they could be easily significantly decreased by simply controlling their risk factors. Although high blood pressure has been recognized as a leading risk factor for CVD, little research has been done to document the prevalence and incidence of essential hypertension (EH) in lower socioeconomic developing countries. One such country is Kenya. It was found in our research study that Kasigau …

Using The Framingham Risk Score To Evaluate Immigrant Effect On Cardiovascular Disease Risk In Mexican Americans, Jennifer J. Salinas, Bassent Abdelbary, Jeffrey Wilson, Monir Hossain, Susan P. Fisher-Hoch, Joseph B. Mccormick

Physician Assistant Studies Faculty Publications

Background—This study uses the Framingham Risk Score (FRS) for 10-year cardiovascular disease (CVD) to evaluate differences between Mexican American immigrants and the U.S.-born population. Methods and Results—Data from the Cameron County Hispanic Cohort (N=1,559). Average total risk scores were generated by age group for each gender. Regression analysis was conducted adjusting for covariates and interaction effects. Both women and men in the CCHC sample who were long-term immigrant residents (mean FRS scores women 4.2 with p<.001 vs. men 4.0 with p<.001) or born in the U.S. (mean FRS scores women 4.6 with p<.001 vs. men 3.3 with p<.001) had significantly higher risk scores than immigrants who had only been in this country for less than 10 years. The interaction model indicates that differences between immigrant and native-born Mexican Americans are most greatly felt at lowest levels of socioeconomic status for men in the CCHC. Conclusions—This study suggests that in terms of immigrant advantage in CVD risk, on whom, where, and how the comparisons are being made have important implications for the degree of difference observed.

Interactions Of Nitric Oxide And Superoxide Pathways In Hyperglycemic Endothelial Cells, Steven Clay Rogers

Graduate Theses and Dissertations

Cardiovascular complications arising from diabetic hyperglycemia represents one of the leading causes of death and greatest public health challenges of modern societies. Despite state-of-the-art glucose control, diabetic patients remain at a markedly increased risk of cardiovascular disease. The loss of endothelial function (the development of diabetic endothelial dysfunction) has been implicated in the development of numerous diabetic cardiovascular diseases. The endothelial cell produces many vasoactive substances, hormones and cytoprotective biological factors. Endothelial cells are also involved in and affected by the initiation of inflammatory responses through the release and interaction of cytokines and other immune system molecules. Therefore, regulation of …

The Acute Effect Of Endurance Exercise On Lipoproteins Measured By Nuclear Magnetic Resonance (Nmr) In Healthy Men, Hanaa Adnan Shaheen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Cardiovascular disease (CVD) represents a major cause of death in the United States, with abnormal levels of blood lipids and physical inactivity considered as major modifiable risk factors. The conventional lipid profile has been used to assess for CVD risk by directly measuring the concentrations of blood lipids. However, lipoprotein particle size and number obtained from a novel method, Nuclear Magnetic Resonance (NMR) may also asses for CVD risk with greater sensitivity. Exercise and increased physical activity has been shown to produce favorable effects on blood lipids and consequently reduce CVD risk. To understand this effect, it is important …

Metabolic Regulation Of Mtor Activation And Endoplasmic Reticulum Stress In The Heart, Shiraj Sen

Dissertations and Theses (Open Access)

When subjected to increased workload, the heart responds metabolically by increasing its reliance on glucose and structurally by increasing the size of myocytes. Whether changes in metabolism regulate the structural remodeling process is unknown. A likely candidate for a link between metabolism and growth in the heart is the mammalian target of rapamycin (mTOR), which couples energy and nutrient metabolism to cell growth. Recently, sustained mTOR activation has also been implicated in the development of endoplasmic reticulum (ER) stress. We explored possible mechanisms by which acute metabolic changes in the hemodynamically stressed heart regulate mTOR activation, ER stress and cardiac …

Regulation Of Protein Degradation In The Heart By Amp-Activated Protein Kinase, Kedryn K. Baskin

Dissertations and Theses (Open Access)

The degradation of proteins by the ubiquitin proteasome system is essential for cellular homeostasis in the heart. An important regulator of metabolic homeostasis is AMP-activated protein kinase (AMPK). During nutrient deprivation, AMPK is activated and intracellular proteolysis is enhanced through the ubiquitin proteasome system (UPS). Whether AMPK plays a role in protein degradation through the UPS in the heart is not known. Here I present data in support of the hypothesis that AMPK transcriptionally regulates key players in the UPS, which, under extreme conditions can be detrimental to the heart. The ubiquitin ligases MAFbx /Atrogin-1 and MuRF1, key regulators of …

St Elevation: Telling Pathology From The Benign Patterns, Waleed Tallat Kayani, Henry D. Huang, Salman Bandeali, Salim S. Virani, James M. Wilson, Yochai Birnbaum

Office of the Provost

Benefits of early reperfusion in patients presenting with acute ST elevation myocardial infarction (STEMI) are well known. The American College of Cardiology / American Heart Association guidelines recommend triage decisions are made within 10 minutes of performing initial electrocardiogram (ECG). Since many patients presenting with ischemic symptoms may have ST elevation (STE) at baseline, not all STE signify transmural ischemia. Benign patterns can be easy to find in some cases. However, patients with benign STE at baseline (left ventricular hypertrophy, early repolarization pattern) may have ongoing ischemia and present with Non-ST elevation myocardial infarction (NSTEMI) or even STEMI superimposed on …

Life-Course Origins Of Social Inequalities In Adult Immune Cell Markers Of Inflammation In Developing Southern Chinese Population: The Guangzhou Biobank Cohort Study, Douglas A. West, Gabriel M. Leung, Chao Q. Jiang, Timothy M. Elwell-Sutton, Wei S. Zhang, Tai H. Lam, Kar K. Cheng, Mary Schooling

Publications and Research

Background
Socioeconomic position (SEP) throughout life is associated with cardiovascular disease, though the mechanisms linking these two are unclear. It is also unclear whether there are critical periods in the life course when exposure to better socioeconomic conditions confers advantages or whether SEP exposures accumulate across the whole life course. Inflammation may be a mechanism linking socioeconomic position (SEP) with cardiovascular disease. In a large sample of older residents of Guangzhou, in southern China, we examined the association of life course SEP with inflammation.

Methods
In baseline data on 9,981 adults (≥ 50 years old) from the Guangzhou Biobank Cohort …

Can Kawasaki Disease Be Managed?, Alberto Coustasse, Julius Larry, Doohee Lee

Management Faculty Research

Kawasaki Disease (KD) is the leading cause of acquired cardiovascular disease among children, but management of KD has received relatively little attention. In the US alone, about 5500 cases were estimated in 2009. KD is most common among Asian and Pacific Islander children but can affect all ethnicities and races. Timely and accurate diagnosis remains critical, but difficult: the etiology of KD is unknown, and no accurate diagnostic laboratory test has been developed. Continuing medical education can help physicians, clinicians, and nurse practitioners accurately diagnose and treat KD. A registry specific to KD or a surveillance system may be necessary …

Lpl Gene Variants Affect Apoc-Iii Response To Combination Therapy Of Statins And Fenofibric Acid In A Randomized Clinical Trial Of Individuals With Mixed Dyslipidemia, Ariel Brautbar, Salim S. Virani, John Belmont, Vijay Nambi, Peter H. Jones, Christie M. Ballantyne

Office of the Provost

ApoC-III is a proatherogenic protein associated with elevated triglycerides; its deficiency is associated with reduced atherosclerosis. Mixed dyslipidemia, characterized by elevated triglyceride and apoC-III levels and low HDL cholesterol level, with or without elevated LDL cholesterol, increases cardiovascular disease risk and is commonly treated with combined statin and fibrate therapy. We sought to identify single nucleotide polymorphisms (SNPs) associated with apoC-III level response to combination therapy with statins and fenofibric acid (FA) in individuals with mixed dyslipidemia. Participants (n = 1,250) in a multicenter, randomized, double-blind, active-controlled study examining response to FA alone and in combination with statin were genotyped …

My Patient Has An Elevated Hs-Crp. What Does This Mean? What Should I Do Now, Maria Khan, Emmon Raza, Ayeesha Kamran Kamal

Section of Neurology

No abstract provided.

Improved Left Ventricular Mass Quantification With Partial Voxel Interpolation – In-Vivo And Necropsy Validation Of A Novel Cardiac Mri Segmentation Algorithm, Noel C.F. Codella, Hae Yeoun Lee, David S. Fieno, Debbie W. Chen, Sandra M. Hurtado Rua, Minisha Kochar, John Paul Finn, Robert Judd, Parag Goyal, Jesse Schenendorf, Matthew D. Cham, Richard B. Devereux, Martin Prince, Yi Wang, Jonathan W. Weinsaft

Mathematics and Statistics Faculty Publications

Background—CMR typically quantifies LV mass (LVM) via manual planimetry (MP), but this approach is time consuming and does not account for partial voxel components - myocardium admixed with blood in a single voxel. Automated segmentation (AS) can account for partial voxels, but this has not been used for LVM quantification. This study used automated CMR segmentation to test the influence of partial voxels on quantification of LVM. Methods and Results—LVM was quantified by AS and MP in 126 consecutive patients and 10 laboratory animals undergoing CMR. AS yielded both partial voxel (AS_PV) and full voxel (AS_FV) …

Artificial Devices As A Viable Alternative To The Conventional Heart Transplant, Hadassah Radzik

The Science Journal of the Lander College of Arts and Sciences

The human heart is one of the most vital organs in the body. It distributes blood throughout the body, providing the body with oxygen and nutrition, and contributes to metabolism. When the heart fails, blood flow is impaired, thereby limiting the exchange of oxygen within the cardiopulmonary system as well as diminishing oxygenation and nutrition to the other major organs and periphery. The only current proven treatment for advanced heart failure is cardiac transplant. Given the heart’s importance and the scarcity of donated organs, modern medicine has experimented with the creation of an artificial heart. Because the heart is primarily …

Benefits Versus Costs Of Statin Drugs, Sara Shilcrat

The Science Journal of the Lander College of Arts and Sciences

Statins have been prescribed to the masses as primary and secondary prevention for coronary disease caused by hypercholesterolemia after their initial discovery in the late 1980s. Their actions in reducing low-density lipoproteins and increasing high-density lipoproteins are well documented; however, many negative effects have been reported related to muscle pathology and kidney function. The goal of this study is to investigate whether the benefits of this class of drugs outweigh the costs. Intense review of the literature was conducted using scholarly articles with original research findings that were located via electronic databases such as Medline, Science Direct, Proquest Medical Library, …

Metabolic Syndrome And Incident Coronary Heart Disease In Australian Indigenous Populations, Ming Li, Brad Mcculloch, Robyn Mcdermott

Aboriginal Policy Research Consortium International (APRCi)

This report aims to compare the prediction of the metabolic syndrome (MetS) and its components for morbidity and mortality of coronary heart disease (CHD) in a cohort of Australian Aboriginal and Torres Strait Islander adults (TSIs). A total of 2,100 adults (1,283 Aborigines and 817 TSIs) was followed up for 6 years from 2000. Outcome measures were all CHD events (deaths and hospitalizations). Baseline anthropometric measurements, blood pressure (BP), fasting blood lipids and glucose were collected. Smoking and alcohol intake was self-reported. We found MetS was more prevalent in TSI (50.3%) compared to Aborigines (33.0%). Baseline MetS doubled the risk …

Spontaneous Coronary Artery Dissection: A Rare But Deadly Cause Of Acs In Younger Patients, Daniel J. Makowski Do, David A. Cox Md

Department of Medicine

No abstract provided.

Coxsackievirus B3 Infection Leads To The Generation Of Cardiac Myosin Heavy Chain-Α-Reactive Cd4 T Cells In A/J Mice, Arunakumar Gangaplara, Chandirasegaran Massilamany, Deborah M. Brown, Gustavo A. Delhon, Asit K. Pattnaik, Nora Chapman, Noel Rose, David J. Steffen, Jay Reddy

Jay Reddy Publications

Enteroviruses like coxsackievirus B3 (CVB3) are common suspects in myocarditis/dilated cardiomyopathy patients. Autoimmunity has been proposed as an underlying mechanism, but direct evidence of its role is lacking. To delineate autoimmune response in CVB3 myocarditis, we used IA^k dextramers for cardiac myosin heavy chain (Myhc)-α 334–352. We have demonstrated that myocarditis-susceptible A/J mice infected with CVB3 generate Myhc-α-reactive CD4 T cells and such a repertoire was absent in naïve mice as measured by proliferative response to Myhc-α 334–352 and IA^k dextramer staining. We also detected Myhc-α 334–352 dextramer⁺ cells in the hearts of CVB3-infected mice. The autoreactive …

What Evidence Is Available On Apixaban For The Primary Prevention Of Stroke In Patients With Atrial Fibrillation?, Justin Dang, Laura Tsu

Pharmacy Faculty Articles and Research

This drug information question and answer sheet discusses the use of apixaban (Eliquis) for the primary prevention of stroke in patients with atrial fibrillation.

Anti-Platelet Therapy In Acute Coronary Syndromes: Updates In Therapy After Stent Implantation, Ryan Mckenzie, Andrew Park, Laura Tsu

Pharmacy Faculty Articles and Research

This home-study CPE activity has been developed to educate pharmacists on updates in anti-platelet therapy after stent implantation.

Physical Activity, Sleep Patterns, And Health Outcomes In University Law Enforcement Officers, Nicole C. Koebke

Theses and Dissertations--Kinesiology and Health Promotion

Research indicates that law enforcement officers (LEOs) have a higher prevalence of developing coronary artery disease (CAD) compared to the general population. Sleep deprivation and physical inactivity have been found to be related to many risk factors for CAD. This cross-sectional study examined the health status and the relationship between sleep and physical activity outcomes versus CAD risk factors among 27 University LEOs. The subjects’ health behaviors, and CAD and metabolic syndrome risk factors were described using basic statistics. Accelerometer derived sleep and physical activity outcomes were correlated to measures of health to identify potential relationships. 33% of LEOs were …

Noninvasive Assessment And Modeling Of Diabetic Cardiovascular Autonomic Neuropathy, Siqi Wang

Theses and Dissertations--Biomedical Engineering

Noninvasive assessment of diabetic cardiovascular autonomic neuropathy (AN): Cardiac and vascular dysfunctions resulting from AN are complications of diabetes, often undiagnosed. Our objectives were to: 1) determine sympathetic and parasympathetic components of compromised blood pressure regulation in patients with polyneuropathy, and 2) rank noninvasive indexes for their sensitivity in diagnosing AN. Continuous 12-lead electrocardiography (ECG), blood pressure (BP), respiration, regional blood flow and bio-impedance were recorded from 12 able-bodied subjects (AB), 7 diabetics without (D0), 7 with possible (D1) and 8 with definite polyneuropathy (D2), during 10 minutes supine control, 30 minutes 70-degree head-up tilt and 5 minutes supine recovery. …