Cardiovascular Diseases Commons^™

New Developments In Understanding Cardiovascular Disease And The Implications For Social Work, Jill Littrell

jill l littrell Dr.

Cardiovascular disease is now viewed as an inflammatory disease. An index of chronic inflammation (viz., C-Reactive Protein) is as good a predictor of heart attacks as are fats in blood. The data suggest that stressful events are so closely associated with chronic inflammatory states, that the body’s stress response can be viewed as an inflammatory state. This paper summarizes and explains the link between stress and cardiovascular disease. Negative health outcomes, particularly for cardiovascular diseases, are higher among those of lower socio-economic status. Differential stress among socio-economic tiers is considered as an explanation for the disparities. The literature linking cardiovascular …

Syndecan 4 Is Required For Endothelial Alignment In Flow And Atheroprotective Signaling, Nicolas Baeyens, Mary Jo Mulligan-Kehoe, Federico Corti, David D. Simon, Tyler D. Ross, John M. Rhodes, Thomas Z. Wang

Dartmouth Scholarship

Atherosclerotic plaque localization correlates with regions of disturbed flow in which endothelial cells (ECs) align poorly, whereas sustained laminar flow correlates with cell alignment in the direction of flow and resistance to atherosclerosis. We now report that in hypercholesterolemic mice, deletion of syndecan 4 (S4−/−) drastically increased atherosclerotic plaque burden with the appearance of plaque in normally resistant locations. Strikingly, ECs from the thoracic aortas of S4−/− mice were poorly aligned in the direction of the flow. Depletion of S4 in human umbilical vein endothelial cells (HUVECs) using shRNA also inhibited flow-induced alignment in vitro, which was rescued by re-expression …

The Role Of Mcl-1 In The Heart: Gateway From Life To Death, Xi Wang

Theses and Dissertations (ETD)

MCL-1 is an essential BCL-2 family member that promotes the survival of multiple cellular lineages, but its role in cardiac muscle has remained unclear. Here, we have demonstrated that cardiac-specific ablation of Mcl-1 results in a rapidly fatal, dilated cardiomyopathy preceded by loss of myofibrils and cardiac contractility, abnormal mitochondria ultrastructure, defective mitochondrial respiration, and impaired autophagy. Genetic ablation of both pro-apoptotic effectors (Bax and Bak) could largely rescue the lethality and impaired cardiac function induced by Mcl-1 deletion. However, Mcl-1-, Bax-, and Bak-deficient hearts still revealed mitochondrial ultrastructural abnormalities and displayed deficient mitochondrial respiration, and are hypersensitive to chronic …

Group Iv Cytosolic Phospholipase A2Α Is Critical For The Development Of Angiotensin Ii-Induced Hypertension And Associated Pathogenesis, Nayaab Shehbaz Khan

Theses and Dissertations (ETD)

Angiotensin II (Ang II) activates cytosolic phospholipase A2α and releases arachidonic acid (AA) from tissue phospholipids. AA metabolites mediate or modulate one or more renocardiovascular effects of this peptide and have been implicated in hypertension. Since AA release is the rate limiting step in eicosanoid production, it is possible that cPLA2α might play a central role in the development of Ang II-induced hypertension. To test this hypothesis, we investigated the effect of Ang II infusion for 13 days by micro-osmotic pumps (700 ng/kg/min), on systolic blood pressure and associated pathophysiological changes in wild type (cPLA2α+/+) and cPLA2α-/- mice. Ang II …

Is Postpartum Depression A Disease Of Modern Civilization?, Jennifer Hahn-Holbrook, Martie Haselton

Psychology Faculty Articles and Research

Access to calorie-dense foods, medicine, and other comforts has made modern humans healthier than our prehistoric ancestors in many respects. However, the epidemics of obesity, diabetes, and cardiovascular disease suggest that there are also drawbacks to modern living. Here, we address the question of whether the dramatic cultural changes that have occurred over the past century have inflated rates of postpartum depression, adding postpartum depression to the list of diseases of modern civilization. We review evidence from cross-cultural, epidemiological, and experimental studies documenting associations between postpartum depression and modern patterns of early weaning, diets deficient in essential fatty acids, low …

Regulation Of C-Reactive Protein Gene Expression And Function, Avinash N. Thirumalai

Electronic Theses and Dissertations

Human C-reactive protein (CRP) is the prototypic acute phase protein whose serum concentration increases rapidly during inflammation. CRP is also associated with atherosclerosis; it is deposited at lesion sites where it may interact with modified lipoproteins. There are 2 major questions regarding CRP: 1. How is the serum concentration of CRP regulated? 2. What are the functions of CRP in atherosclerosis?

Our first aim was to determine the role of the constitutively expressed transcription factor Oct-1 in regulating CRP gene expression. We found that Oct-1 overexpression inhibited (IL-6+IL-1β)- induced CRP gene expression; maximal inhibition required the binding of Oct-1 to …

Assessment Of American Heart Association’S Ideal Cardiovascular Health Metrics Among Employees Of Large Health Care Organization: The Baptist Health South Florida Employee Study, Khurram Nasir, Emir Veledar, Ehimen Aneni, Sankalp Das, Maribeth Rouseff, Thinh Tran, Don Parris, Leah Holzwarth, Henry Guzman, Theodore Feldman, Michael Ozner, Jonathan Fialkow, Bernie Fernandez, Arthur Agatston

All Publications

No abstract provided.

Heart Of The Matter, Children's Mercy Hospital

Our Story Continues

The Ward Family Heart Center at Children’s Mercy has received approval to begin performing pediatric heart transplants, making it the first healthcare facility in the Kansas City region to offer the life-saving procedure to pediatric patients.

Leading the Children’s Mercy heart transplant team are two nationally recognized experts:

James D. St. Louis, MD, is a board-certified thoracic and cardiac surgeon with more than 15 years of pediatric experience. Dr. St. Louis previously was the Director of Pediatric Cardiac Transplantation at the University of Minnesota Amplatz Children’s Hospital.

Aliessa P. Barnes, MD, is a board-certified pediatric cardiologist specializing in pediatric heart …

Discordant Documentation Of Obesity Body Mass Index And Obesity Diagnosis In Electronic Medical Records, Jennifer T. Fink, George L. Morris Iii, Maharaj Singh, David A. Nelson, Renee E. Walker, Ron A. Cisler

Journal of Patient-Centered Research and Reviews

Purpose: This study examined concordance between presence of obesity body mass index (BMI), defined as BMI ≥ 30, in the patient’s electronic medical record (EMR) and a documented diagnosis of obesity.

Methods: We conducted a retrospective review of the EMR in a large health care system for a 1-year period (2012). A total of 397,313 patients met the study criteria of having at least one physician visit, being at least 18 years of age, and not being pregnant. Of those, 158,327 (40%) had a recorded BMI ≥ 30. We examined the EMR of these obese patients to determine whether a …

Trends And Characteristics Associated With The Risk Of Re-Hospitalization In Patients Discharged From The Hospital After Acute Myocardial Infarction, Mayra Tisminetzky, Han-Yang Chen, Edgard A. Granillo, Joel M. Gore, Jorge L. Yarzebski, Darleen M. Lessard, Robert J. Goldberg

Jorge L. Yarzebski

BACKGROUND: Despite encouraging declines in short-term mortality in patients hospitalized with acute myocardial infarction (AMI), repeat hospitalizations among those discharged from the hospital after AMI remain a major clinical and public health concern. Few studies, however, have described the relatively contemporary magnitude, factors associated with, as well as decade long trends in repeat hospitalizations for cardiovascular disease (CVD) and other causes in patients discharged from the hospital after AMI. METHODS: We reviewed the medical records of 6,018 residents of the Worcester (MA) metropolitan area who were hospitalized for AMI in 6 biennial periods between 1999 and 2009. Re-hospitalizations for any …

30-Year Trends In Patient Characteristics, Treatment Practices, And Long-Term Outcomes Of Adults Aged 35 To 54 Years Hospitalized With Acute Myocardial Infarction, Mayra Tisminetzky, David Mcmanus, Joel Gore, Jorge Yarzebski, Andrew Coles, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

Much of our knowledge about the characteristics, clinical management, and postdischarge outcomes of acute myocardial infarction (AMI) is derived from clinical studies in middle-aged and older subjects with little contemporary information available about the descriptive epidemiology of AMI in relatively young men and women. The objectives of our population-based study were to describe >3-decade-long trends in the clinical features, treatment practices, and long-term outcomes of young adults aged 35 to 54 years discharged from the hospital after AMI. The study population consisted of 2,142 residents of the Worcester (Massachusetts) metropolitan area who were hospitalized with AMI at all central Massachusetts …

Decade-Long Trends In The Characteristics, Management And Hospital Outcomes Of Diabetic Patients With St-Segment Elevation Myocardial Infarction, Mayra Tisminetzky, Samuel Joffe, David Mcmanus, Chad Darling, Joel Gore, Jorge Yarzebski, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

PURPOSE: Our objectives were to describe recent trends in the characteristics and in-hospital outcomes in diabetic as compared with non-diabetic patients hospitalized with ST-segment elevation myocardial infarction (STEMI).

METHODS: We reviewed the medical records of 2537 persons with (n = 684) and without (n = 1853) a history of diabetes who were hospitalized for STEMI between 1997 and 2009 at 11 medical centres in Central Massachusetts.

RESULTS: Diabetic patients were more likely to be older, female and to have a higher prevalence of previously diagnosed comorbidities. Diabetic patients were more likely to have developed important in-hospital complications and to have …

Genome-Wide Association Study Of Saturated, Mono- And Polyunsaturated Red Blood Cell Fatty Acids In The Framingham Heart Offspring Study, Nathan L. Tintle, James V. Pottala, Sean Lacey, Vasan Ramachandran, Jason Westra, Ally Rogers, Jake Clark, Ben Olthoff, Martin Larson, William Harris, Gregory C. Shearer

Faculty Work Comprehensive List

Most genome-wide association studies have explored relationships between genetic variants and plasma phospholipid fatty acid proportions, but few have examined apparent genetic influences on the membrane fatty acid profile of red blood cells (RBC). Using RBC fatty acid data from the Framingham Offspring Study, we analyzed over 2.5 million single nucleotide polymorphisms (SNPs) for association with 14 RBC fatty acids identifying 191 different SNPs associated with at least 1 fatty acid. Significant associations (p<1×10⁻⁸) were located within five distinct 1 MB regions. Of particular interest were novel associations between (1) arachidonic acid and PCOLCE2 (regulates apoA-I maturation …

Technical Performance Score Is Associated With Outcomes After The Norwood Procedure., Meena Nathan, Lynn A. Sleeper, Richard G. Ohye, Peter C. Frommelt, Christopher A. Caldarone, James S. Tweddell, Minmin Lu, Gail D. Pearson, J William Gaynor, Christian Pizarro, Ismee A. Williams, Steven D. Colan, Carolyn Dunbar-Masterson, Peter J. Gruber, Kevin Hill, Jennifer Hirsch-Romano, Jeffrey P. Jacobs, Jonathan R. Kaltman, S Ram Kumar, David Morales, Scott M. Bradley, Kirk Kanter, Jane W. Newburger, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

Objectives: The technical performance score (TPS) has been reported in a single center study to predict the outcomes after congenital cardiac surgery. We sought to determine the association of the TPS with outcomes in patients undergoing the Norwood procedure in the Single Ventricle Reconstruction trial.

Methods: We calculated the TPS (class 1, optimal; class 2, adequate; class 3, inadequate) according to the predischarge echocardiograms analyzed in a core laboratory and unplanned reinterventions that occurred before discharge from the Norwood hospitalization. Multivariable regression examined the association of the TPS with interval to first extubation, Norwood length of stay, death or transplantation, …

Integration Of Non-Communicable Diseases Into Primary Health Care: A Snapshot From Eastern Mediterranean Region, Shehla Zaidi, Abdul Latif Khan, Aftab Ali Mukhi, Yousuf Memon, Slim Slama, Samer Jabbour

Community Health Sciences

No abstract provided.

In-Hospital Depression Predicts Early Hospital Readmission After An Acute Coronary Syndrome: Preliminary Data From Trace-Core, David Mcmanus, Jane Saczynski, Molly Waring, Milena Anatchkova, Richard Mcmanus, Robert Goldberg, Jeroan Allison, David Parish, Hamza Awad, Jerry Gurwitz, Arlene Ash, Catarina Kiefe

Richard H. McManus

Background: Hospital systems, patients and providers seek to avert rehospitalizations within 30 days for patients admitted with an acute coronary syndrome (ACS). Rehospitalizations within 30 days of discharge are often considered preventable and to reflect poor in-hospital management or discharge practices. However, independent associations of psychosocial factors with early rehospitalization in patients admitted with an ACS have not been examined. Methods: A multi-racial cohort of 1,540 patients admitted with an ACS reported psychosocial factors via standardized questionnaires in an in-hospital interview. One month following discharge, patients were interviewed via phone and reported hospital readmissions. We used logistic regression models to …

Septal Myectomy In Obstructive Hypertrophic Cardiomyopathy High Risk Patients, Heather Geist, Matthew W. Martinez Md, James K. Wu Md

Department of Medicine

No abstract provided.

Therapeutic Hypothermia Following Cardiac Arrest, Cassandra Patrick

Nursing Student Class Projects (Formerly MSN)

According to the Sudden Cardiac Arrest Foundation (2014), each year, 424,000 people in the U.S. (more than 1,000/day) experience EMS-assessed out-of-hospital non-traumatic sudden cardiac arrest. This is roughly equivalent to the number of people who die from Alzheimers’ disease, assault with firearms, breast cancer, cervical cancer, colorectal cancer, diabetes, HIV, house fires, motor vehicle accidents, prostate cancer and suicides combined (Sudden Cardiac Arrest Foundation, 2014). It is estimated that the likelihood of surviving an out-of-hospital cardiac arrest (OHCA) to hospital discharge can be as low as 6% to 8% (Williams, Calder, Cocchi & Donnino, 2013). Additionally an estimated 200,000 hospitalized …

Takotsubo Cardiomyopathy, Kari Patterson

Nursing Student Class Projects (Formerly MSN)

Term Takotsubo was introduced in 1991 to describe the shape of the left ventricle during an episode of cardiomyopathy. Takotsubo is a Japanese term for a narrow-necked fishing pot used to catch octopus. The left ventricle assumes the shape of the octopus pot during Takotsubo cardiomyopathy. Takotsubo cardiomyopathy is commonly known as Broken Heart Syndrome due to its association with an emotional stressor. Mimics acute coronary syndrome without coronary artery blockage/stenosis. Affects more women than men. Occurs mainly in postmenopausal women (women over the age of 50) Believe a hormonal effect on catecholamine release plays a role.

Atrial Fibrillation Post-Lung Lobectomy, Laura Adorni

Nursing Student Class Projects (Formerly MSN)

According to the American Heart Association, atrial fibrillation affected 2.66 million individuals in the United States in 2010 and is expected to double by year 2050 (Sanoski, 2010, p. S11). Post-operative atrial fibrillation (POAF), a classification of atrial fibrillation (AF), can occur after thoracic surgery and is an ongoing source of morbidity and mortality (Imperatori et al., 2012). There is a 10-20% occurrence rate of POAF after non-cardiac surgery, such as a lung lobectomy, and a 40% incidence rate after a pneumonectomy (Omae & Kanmura, 2012, p. 429). Cardiovascular events such as heart failure, cerebral infarction, renal failure, and infection …

Cerebral Venous Sinus Thrombosis (Cvst), Meghan N. Delong

Nursing Student Class Projects (Formerly MSN)

Cerebral venous sinus thrombosis (CVST) is an uncommon condition with incidence resulting in approximately 1-3 % of all strokes. Cerebral venous sinus thrombosis remains often unrecognized initially due to its vague manifestations of symptoms which range from isolated headaches to focal neurological signs and symptoms. CVST is slightly more common in women, particularly in the age group of 20 to 35, due to pregnancy, puerperium and oral contraceptive use (Stam, 2005).

Accurate Intervention In Visceral Aneurysms, Megan Hoying

Nursing Student Class Projects (Formerly MSN)

A 30 year old male presented to the ED with a one week history of fever, abdominal pain, and poor PO intake due to nausea and emesis. He was given a GI cocktail and sent home for a presumed diagnosis of gastritis. After having persistent pain the patient returned to the ER the following day and was admitted for further testing. The patient died 3 days later. This is an interesting case presentation, and was in no way straightforward.

Cardiomems Heart Failure System: Keeping Patients Out Of The Hospital, Michelle Leyland

Nursing Student Class Projects (Formerly MSN)

It is well known that heart disease is the leading cause of death in the United States, with about 670,000 new diagnoses of congestive heart failure (CHF) each year (Suh et al., 2011). CHF results from a number of different causes, produces many different symptoms and occurs when the heart muscle cannot efficiently pump blood to the rest of the body (Suh et al., 2011). In the United States, heart failure (HF) and associated hospitalizations are leading contributors to high health care costs (Feltner et al., 2014). Up to one fourth of patients hospitalized with HF are readmitted within 30 …

Myocardial Infarction (Mi) In Women, Samuel Agyenim Boateng

Nursing Student Class Projects (Formerly MSN)

Cardiovascular disease (CAD) is the most common cause of death for men and women in the US. The disease has been extensively studied in males (Gulati & Bairey Merz, 2012, p. 141). CVD poses an obvious challenge to the health of women. Coronary heart disease (CHD) is described as a "modern epidemic" (Banner, 2010, p. 3123). Although, the prevalence of CVD has prompted many studies for prevention and treatment, little is known about CVD in women. It Is now known that the mortality rates In women have surpassed that of men. Recent reports Indicate that CVD killed more women in …

Spontaneous Coronary Artery Dissection Among Women, Stacy Hudepohl

Nursing Student Class Projects (Formerly MSN)

It has been noted that women often place their own health care on the bottom of their priority lists. Many times, they ignore simple pain and dismiss symptoms that may be troubling to health care providers. Health care providers especially to young women may dismiss complaints of chest pain as heartburn or anxiety. Changes seen in pregnancy and with menses can mimic some of these same complaints. As both an female professional in health care and as a patient it is very easy to get busy with the day and not recognize simple signs and symptoms that may lead to …

Enterococcus Faecalis Endocarditis: A Case Study, Torri Curtis

Nursing Student Class Projects (Formerly MSN)

Infectious endocarditis is an uncommon disease of the heart stemming from a bacterial or fungal infection on the endocardial surface of the heart or heart valve (Pierce, Calkins, & Thornton, 2012). From review of the literature, infective endocarditis is fairly uncommon and may be difficult to initially diagnose. Per Sabe, Shrestha, and Menon, occurrence of infective endocarditis (IE) is nearly 0.9-6.2 per 100,000 persons per year (2013). Several preexisting conditions such as aging, heart valve disease, implantable cardiac devices, a history of heart disease such as rheumatic fever, and invasive procedures can put a patient at higher risk for IE …

Hypertrophic Obstructive Cardiomyopathy, Tiffany Branson

Nursing Student Class Projects (Formerly MSN)

Hypertrophic obstructive cardiomyopathy or HOCM, is a genetic disease that is described as hypertrophy or enlargement of the left ventricle which obstructs the blood flow to the body (Yue-Cheng et al., 2012). HOCM is a disease that cannot be cure, but can be treated. One of the main goals of treatment is to focus on treating the symptoms. HOCM can be asymptomatic or symptomatic and can cause some major complications. Some of the complications of HOCM are arrhythmias and sudden cardiac death, “which is defined as natural death to due cardiac causes, heralded by abrupt loss of consciousness within one …

Dvt And Economy Class Syndrome, Troy Perkins

Nursing Student Class Projects (Formerly MSN)

Traveling long distances can be very stressful on the body. Deep vein thrombosis (DVT) has often been linked to long air flights or long distance travel in a vehicle. DVT is a blood clot usually formed in the legs. Economy Class Syndrome (ECS) has been referred to as the formation of a DVT occurring during (or just after) a long airplane flight, especially in economy class where there is the least space allotted per passenger and one’s legs especially tend to be immobilized for lack of leg room (MedicineNet, 2012). Developing a DVT can lead to other life-threatening illnesses such …

Diagnosis, Pathophysiology, And Clinical Treatment Of A Patient With A Pheochromocytoma, Tricia L. Hale

Nursing Student Class Projects (Formerly MSN)

Hypertension is an extremely common diagnosis today. This condition can be caused by a multitude of factors, and can inversely cause numerous unfavorable processes in the body. One rare but significant source of hypertension is a tumor known as a pheochromocytoma, or PCC. This usually benign tumor is most often located on an adrenal gland, and can have a grave impact on the cardiovascular system. The tumor intermittently secretes an excess of the catecholamine norepinephrine, and if large enough, also secretes epinephrine [9]. These episodic bursts can cause extreme hypertension and tachycardia, leading to, at times fatal results. By understanding …

Impact Of Pre-Stage Ii Hemodynamics And Pulmonary Artery Anatomy On 12-Month Outcomes In The Pediatric Heart Network Single Ventricle Reconstruction Trial., Ranjit Aiyagari, John F. Rhodes, Peter Shrader, Wolfgang A. Radtke, Varsha M. Bandisode, Lisa Bergersen, Matthew J. Gillespie, Robert G. Gray, Lin T. Guey, Kevin D. Hill, Russel Hirsch, Dennis W. Kim, Kyong-Jin Lee, Andrew N. Pelech, Jeremy Ringewald, Cheryl Takao, Julie A. Vincent, Richard G. Ohye, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: To compare the interstage cardiac catheterization hemodynamic and angiographic findings between shunt types for the Pediatric Heart Network Single Ventricle Reconstruction trial. The trial, which randomized subjects to a modified Blalock-Taussig shunt (MBTS) or right ventricle-to-pulmonary artery shunt (RVPAS) for the Norwood procedure, demonstrated the RVPAS was associated with a smaller pulmonary artery diameter but superior 12-month transplant-free survival.

METHODS: We analyzed the pre-stage II catheterization data for the trial subjects. The hemodynamic variables and shunt and pulmonary angiographic data were compared between shunt types; their association with 12-month transplant-free survival was also evaluated.

RESULTS: Of 549 randomized subjects, …