Cardiovascular Diseases Commons^™

Exposure To High Levels Of Noise Poses Hazards And Risks For Development Of Hypertension And Heart Disease: Potential Roles Of Unrecognized Ionized Hypomagnesemia And Release Of Ceramides And Platelet-Activating Factor, Burton M. Altura, Asefa Gebrewold, Anthony Carella, Nilank C. Shah, Bella T. Altura

Touro College of Osteopathic Medicine (Middletown) Publications and Research

It has been demonstrated in numerous human and animal studies that audiogenic stress (AS) can induce elevation of arterial blood pressure and cardiac damage and that noise –induced hearing loss may be associated with alterations in magnesium (Mg) metabolism. Our laboratories, over a period of approximately 40 years, have been investigating why AS causes high blood pressure and cardiac damage. This review focuses on a number of newer discoveries on why AS causes dysfunctions of the cardiovascular system (CVS) This review discusses the pivotal physiological and biochemical importance of Mg to body health and the fact that most Americans and …

Gender Disparities In Out-Of-Hospital Cardiac Arrests, Glenn Goodwin, Dyana Picache, Nicholas Gaeto, Brian J. Louie, Tarik Reid, Paxton P. Aung, Sonu Sahni

Touro College of Osteopathic Medicine (New York) Publications and Research

Background

Despite advances in resuscitation science and public health, out-of-hospital cardiac arrest (OOHCA) has an average survival rate of only 12% nationwide, compared to 24.8% of patients who suffer from cardiac arrest while in hospital. Additionally, gender is an important element of human health, and there is a clear pattern for gender-specific survivability in cardiac arrest. This study examined differences in presentations, treatment, management, and outcomes.

Aim

The primary focus of this study was to shed light on differences in presentations, treatments, and outcomes between men and women suffering from an out-of-hospital cardiac arrest and the accompanying contributing factors.

Methods …

Comparative Effectiveness And Safety Of Empagliflozin On Cardiovascular Mortality And Morbidity In Adults With Type 2 Diabetes, Wilbert S. Aronow, Tatyana Shamliyan

NYMC Faculty Publications

Background: Based on a single placebo-controlled randomized clinical trial, empagliflozin is licensed to reduce cardiovascular death in diabetes and comorbid cardiovascular disease. Methods: We examined the comparative effectiveness of empagliflozin on mortality and cardiovascular morbidity in type 2 diabetes. We conducted random-effects direct frequentist meta-analyses of aggregate data and appraised the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Our search in PubMed, EMBASE, the Cochrane Library, clinicaltrials.gov, and PharmaPendium up to May 2017 identified 11 meta-analyses, multiple publications, and unpublished data from 29 randomized controlled trials (RCTs). Results: Empagliflozin reduces all-cause mortality [relative …

Masked Hypertension, Wilbert S. Aronow

NYMC Faculty Publications

No abstract provided.

Reduction In Dietary Sodium Improves Blood Pressure And Reduces Cardiovascular Events And Mortality, Wilbert S. Aronow

NYMC Faculty Publications

No abstract provided.

Hypertension Highlights During 2016, Wilbert S. Aronow

NYMC Faculty Publications

No abstract provided.

Correlation Between Electrocardiographic Changes And Coronary Findings In Patients With Acute Myocardial Infarction And Single-Vessel Disease, Abdallah Sanaani, Srikanth Yandrapalli, George P. Jolly, R Paudel, Howard Cooper, Wilbert Aronow

NYMC Faculty Publications

BACKGROUND: Correlation of ST-segment elevation on the 12-lead electrocardiogram (ECG) with the expected affected coronary territory is established in patients with ST-elevation myocardial infarction (STEMI). In patients with non-ST-elevation myocardial infarction (NSTEMI), correlation of ischemic ECG abnormalities with the affected coronary territory has not been well-established. We sought to investigate the correlation of electrocardiographic abnormalities with the location of 1-vessel obstructive coronary artery disease (CAD) in patients with both STEMI and NSTEMI. METHODS: In this retrospective study, the charts of all patients referred for coronary angiography in 2012 were reviewed. Patients with a single obstructive coronary artery plus angina-equivalent symptoms …

Lifestyle Measures For Treating Hypertension, Wilbert S. Aronow

NYMC Faculty Publications

No abstract provided.

Hypertension And Left Ventricular Hypertrophy, Wilbert S. Aronow

NYMC Faculty Publications

No abstract provided.

Risk Of Respiratory Syncytial Virus Hospitalization In The First And Second Years Of Life In Pediatric Patients With Congenital Heart Disease, Deborah Friedman, Pierre Wong

NYMC Faculty Publications

No abstract provided.

Complete Versus Culprit Only Revascularization In St-Elevation Myocardial Infarction-A Perspective On Recent Trials And Recommendations, Gabriela Andries, Sahil Khera, Robert Timmermans, Wilbert Aronow

NYMC Faculty Publications

The presence of multivessel coronary artery disease (CAD) is strongly associated with higher 30-day mortality, reduced myocardial reperfusion success, reinfarction, and occurrence of major adverse cardiac events (MACE) at 1 year compared with single-vessel CAD. Despite higher morbidity and mortality in patients with ST-elevation myocardial infarction (STEMI) and coexistent multivessel CAD, major guidelines recommended against percutaneous coronary intervention (PCI) on non-culprit lesions at the time of primary PCI in patients with STEMI who are hemodynamically stable. The presence of multivessel CAD often poses a therapeutic dilemma for interventional cardiologists. A few larger scale randomized controlled trials (RCTs) and meta-analyses have …

Effect Of Evacetrapib On Cardiovascular Outcomes In Patients With High-Risk Cardiovascular Disease, Wilbert S. Aronow

NYMC Faculty Publications

No abstract provided.

Brain Injury With Systemic Inflammation In Newborns With Congenital Heart Disease Undergoing Heart Surgery, R Pironkova, Joseph Giamelli, H Seiden, V Parnell, D Gruber, C Sison, K Ojamaa

NYMC Faculty Publications

The potential role of systemic inflammation on brain injury in newborns with congenital heart disease (CHD) was assessed by measuring levels of central nervous system (CNS)-derived proteins in serum prior to and following cardiac surgery. A total of 23 newborns (gestational age, 39±1 weeks) with a diagnosis of CHD that required cardiac surgery with cardiopulmonary bypass (CPB) were enrolled in the current study. Serum samples were collected immediately prior to surgery and 2, 24 and 48 h following CPB, and serum levels of phosphorylated neurofilament-heavy subunit (pNF-H), neuron-specific enolase (NSE) and S100B were analyzed. Systemic inflammation was assessed by measuring …

Treatment Of Hypertensive Emergencies, Wilbert S. Aronow

NYMC Faculty Publications

No abstract provided.

In-Hospital Outcomes And Hospitalizations For Acute Rheumatic Heart Disease: A United States National Study, Srikanth Yandrapalli, Abdallah Sanaani, Zeeshan Solangi, Merita Shehu, Sachin Sule, Wilbert S. Aronow

NYMC Faculty Posters

No abstract provided.

Chagas Heart Disease: A United States National Study, Srikanth Yandrapalli, Prakash Harikrishnan, Abdallah Sanaani, Wilbert S. Aronow, Sachin Sule, Alan L. Gass, Chhaya Aggarwal, William H. Frishman, Gregg C. Fonarow, Gregg M. Lanier, Howard A. Cooper, Julio Panza

NYMC Faculty Posters

No abstract provided.

A Case Of Intramural Coronary Amyloidosis Associated With Hemodialysis, F Ronny, George Kleinman, P Kurtin, John Fallon

NYMC Faculty Publications

Dialysis-related amyloidosis predominantly occurs in osteo-articular structures and dialysis-related amyloid (DRA) substances also deposit in extra-articular tissues. Clinical manifestations of DRA include odynophagia, gastrointestinal hemorrhage, intestinal obstruction, kidney stones, myocardial dysfunction, and subcutaneous tumors. The pathological characteristics of DRA in the heart of hemodialysis patients have rarely been reported. We report the case of a 73-year-old female with a history of cerebral palsy and end-stage renal disease status post two failed renal transplants who had been on hemodialysis for 30 years. The patient was admitted with the working diagnosis of pneumonia. An echocardiography showed markedly reduced biventricular function manifested by …

Why Do Chemotherapeutic Drugs And Radiation Induce Cardiomyopathy And Cardiac Failure In Cancer Patients: Is This A Consequence Of Unrecognized Hypomagnesemia And Release Of Ceramides And Platelet-Activating Factor?, Burton M. Altura, Nilank C. Shah, Gatha J. Shah, Bella T. Altura

Touro College of Osteopathic Medicine (Middletown) Publications and Research

The following is an excerpt from the text:

Almost four decades ago [13], two of us pointed out that there was a scattered number of clinical studies that were beginning to indicate that at least three of the chemotherapeutic drugs (i.e., cisplatin, vinbastine, and bleomycin) appeared to suggest that chemotherapeutic anticancer drugs may deplete the body of magnesium (Mg) [for references and review, see [1, 2, 3, 12]. Ever since we suggested the potential danger of these drugs to the heart and cardiovascular system[13], a growing body of evidence has borne-out these initial dangers to cancer patients [e.g., for reviews …

Why Is Cardiac Morbidity And Mortality Greater Around Christmas, New Year’S, Monday Mornings And In The Morning Hours: Potential Roles Of Unrecognized Ionized Hypomagnesemia And Release Of Ceramides?, Burton M. Altura, Joshua Burack, R. F. Tranbaugh, Z. Zisbrod, J. N. Cunningham, Nilank C. Shah, Bella T. Altura

Touro College of Osteopathic Medicine (Middletown) Publications and Research

The following is the introduction to this article: There is a growing incidence of lethal cardiac events around Christmas, New Year’s and in the morning hours from 4:00 to 10:00 a.m. which is well-established in the USA and in The Southern Hemisphere [1-7]. In addition, many cardiac deaths often occur on Mondays with no satisfactory explanation [2,3]. Many of these deaths are, for the most part, unexplained and listed as “death from “natural causes”. Although in the USA, the deaths which occur around Christmas and New Years happen in the cold –winter months, this does not account for many cardiac …

Orthogonal Decomposition Of Left Ventricular Remodeling In Myocardial Infarction, Xingyu Zhang, Pau Medrano-Gracia, Bharath Ambale-Venkatesh, David A. Bluemke, Brett R. Cowan, J. Paul Finn, Alan H. Kadish

Office of the President Publications and Research

BACKGROUND: Left ventricular size and shape are important for quantifying cardiac remodeling in response to cardiovascular disease. Geometric remodeling indices have been shown to have prognostic value in predicting adverse events in the clinical literature, but these often describe interrelated shape changes. We developed a novel method for deriving orthogonal remodeling components directly from any (moderately independent) set of clinical remodeling indices.

RESULTS: Six clinical remodeling indices (end-diastolic volume index, sphericity, relative wall thickness, ejection fraction, apical conicity, and longitudinal shortening) were evaluated using cardiac magnetic resonance images of 300 patients with myocardial infarction, and 1991 asymptomatic subjects, obtained from …

Comparison Of Inappropriate Shocks And Other Health Outcomes Between Single- And Dual-Chamber Implantable Cardioverter-Defibrillators For Primary Prevention Of Sudden Cardiac Death: Results From The Cardiovascular Research Network Longitudinal Study Of Implantable Cardioverter-Defibrillators, Pamela N. Peterson, Robert T. Greenlee, Alan S. Go, David J. Magid, Andrea Cassidy-Bushrow, Romel Garcia-Montilla, Alan H. Kadish

Office of the President Publications and Research

Background In US clinical practice, many patients who undergo placement of an implantable cardioverter‐defibrillator (ICD) for primary prevention of sudden cardiac death receive dual‐chamber devices. The superiority of dual‐chamber over single‐chamber devices in reducing the risk of inappropriate ICD shocks in clinical practice has not been established. The objective of this study was to compare risk of adverse outcomes, including inappropriate shocks, between single‐ and dual‐chamber ICDs for primary prevention.

Methods and Results We identified patients receiving a single‐ or dual‐chamber ICD for primary prevention who did not have an indication for pacing from 15 hospitals within 7 integrated health …

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 …

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.

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 …

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.

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 …

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 …

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.

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.

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.