Cardiovascular Diseases Commons^™

Cardiac Magnetic Resonance Imaging For The Investigation Of Cardiovascular Disorders Part 1: Current Applications, Ajit H Goenka, Scott D Flamm

The Texas Heart Institute Journal

Cardiac magnetic resonance imaging is a robust noninvasive technique for investigating cardiovascular disorders. The evolution of cardiac magnetic resonance and its widening span of diagnostic and prognostic applications have generated excitement as well as uncertainty regarding its potential clinical use and its role vis-à-vis conventional imaging techniques. The purpose of this evidence-based review is to discuss some of these issues by highlighting the current (Part 1) and emerging (Part 2) applications of cardiac magnetic resonance. Familiarity with the versatility and usefulness of cardiac magnetic resonance will facilitate its wider clinical acceptance for improving the management of cardiovascular disorders.

Outcome-Driven Thresholds For Ambulatory Pulse Pressure In 9938 People Recruited From 11 Populations, Yu-Mei Gu, Lutgarde Thijs, Yan Li, Kei Asayama, José Boggia, Tine W. Hansen, Yan-Ping Liu, Takayoshi Ohkubo, Kristina Björklund-Bodegård, Gladys E. Maestre

School of Medicine Publications

Evidence-based thresholds for risk stratification based on pulse pressure (PP) are currently unavailable. To derive outcome-driven thresholds for the 24–h ambulatory PP, we analyzed 9938 people randomly recruited from 11 populations (47.3% women). After age stratification (≥60 years) and using average risk as reference, we computed multivariable-adjusted hazard ratios (HRs) to assess risk by tenths of the PP distribution or risk associated with stepwise increasing (+1 mm Hg) PP levels. All adjustments included mean arterial pressure. Among 6028 younger participants (68,853 person-years), the risk of cardiovascular (HR, 1.58; P=0.011) or cardiac (HR, 1.52; P=0.056) events increased only in the top …

Galectin-1 In Early Acute Myocardial Infarction, Suhail Al-Salam, Satwat Hashmi

Department of Biological & Biomedical Sciences

Myocardial infarction (MI) is the most serious manifestation of coronary artery disease and the cause of significant mortality and morbidity worldwide. Galectin-1(GAL-1), a divalent 14.5-kDa protein, is present both inside and outside cells, and has both intracellular and extracellular functions. Hypoxia inducible factor-1 alpha (HIF-1α) is a transcription factor mediating early and late responses to myocardial ischemia. Identification of the pattern of expression of GAL-1 and HIF-1α in the heart during the first 24 hours following acute MI will help in understanding early molecular changes in this event and may provide methods to overcome serious complications. Mouse model of MI …

Maternal Biomarkers Of Endothelial Dysfunction And Preterm Delivery, Xinhua Chen, Theresa O Scholl

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Endothelial dysfunction is key to the development of atherosclerosis. Preterm delivery foreshadows later maternal cardiovascular disease (CVD), but it is not known if endothelial dysfunction also occurs. We prospectively measured circulating biomarkers of endothelial dysfunction in pregnant women with preterm or term delivery.

METHODS: We conducted a case-control study nested within a large prospective epidemiological study of young, generally healthy pregnant women. Women who delivered preterm (gestation, n = 240) and controls who delivered at term (n = 439) were included. Pregnancies complicated by preeclampsia were analyzed separately. Circulating endothelial dysfunction biomarkers included soluble intercellular adhesion molecule-1 (sICAM-1), vascular …

Milk Consumption And Cardiovascular Risk Factors In Older Chinese: The Guangzhou Biobank Cohort Study, Yangbo Sun, Chaoqiang Jiang, Kar Keung Cheng, Weisen Zhang, Gabriel M. Leung, Tai Hing Lam, Mary Schooling

Publications and Research

Background
Dairy products consumption is increasingly common globally. Most of the evidence concerning dairy products comes from observational studies in western populations which are inevitably open to confounding. To triangulate the evidence concerning dairy products, we examined the associations of whole cow’s milk consumption with cardiovascular risk factors in a non-Western setting with a different pattern of milk consumption and cardiovascular diseases from Western populations.

Methods
We used multivariable censored linear or logistic regression to examine cross-sectionally the adjusted associations of whole cow’s milk consumption (none (n = 14892), 1–3/week (n = 2689) and 3+/week (n = 2754)) with cardiovascular …

A Systematic Review Of Internet-Based Worksite Wellness Approaches For Cardiovascular Disease Risk Management: Outcomes, Challenges & Opportunities, Ehimen Aneni, Lara Roberson, Arthur Agatston, Theodore Feldman, Maribeth Rouseff, Thinh Tran, Khurram Nasir

All Publications

No abstract provided.

Project Title Improving Pci Door-To-Balloon Times Through Team Collaboration, Diane Rydzy Rn, Kenneth Forte Dnp, Rockman Ferrigno, Stuart Zarich

Posters

Objective: To utilize a team approach in identifying areas of improvement to reduce median door-to-balloon times (D2B) for heart attack patients

Leptin Regulates Cd16 Expression On Human Monocytes In A Sex-Specific Manner, Joseph G. Cannon, Gyanendra Sharma, Gloria Sloan, Christiana Dimitropoulou, R. Randall Baker, Andrew Mazzoli, Barbara Kraj, Anthony Mulloy, Miriam Cortez-Cooper

School of Medical Diagnostics & Translational Sciences Publications

Fat mass is linked mechanistically to the cardiovascular system through leptin, a 16 kDa protein produced primarily by adipocytes. In addition to increasing blood pressure via hypothalamic-sympathetic pathways, leptin stimulates monocyte migration, cytokine secretion, and other functions that contribute to atherosclerotic plaque development. These functions are also characteristics of CD16-positive monocytes that have been implicated in the clinical progression of atherosclerosis. This investigation sought to determine if leptin promoted the development of such CD16-positive monocytes. Cells from 45 healthy men and women with age ranging from 20 to 59 years were analyzed. Circulating numbers of CD14++16++ monocytes, which are primary …

The Role Of Angiotensinogen In Atherosclerosis And Obesity, Congqing Wu

Theses and Dissertations--Nutritional Sciences

Angiotensinogen is the only known precursor in the renin-angiotensin system, a hormonal system best known as an essential regulator of blood pressure and fluid homeostasis. Angiotensinogen is sequentially cleaved by renin and angiotensin- converting enzyme to generate angiotensin II. As the major effector peptide, angiotensin II mainly function through angiotensin type 1 receptor.

Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and more recently renin inhibitors are widely known as the 3 classic renin-angiotensin system inhibitory drugs against hypertension and atherosclerosis. Here, we developed an array of regents to explore the effects of angiotensinogen inhibition. First, we demonstrated that genetic deficiency of …

Cardiac Troponin Assessment Following Atrial Fibrillation Ablation: Implications For Chest Pain Evaluation, Jason C. Rubenstein, Jason T. Jacobson, Jeffrey J. Goldberger, Rod Passman, Alan H. Kadish, Michael H. Kim

Office of the President Publications and Research

Background: The range of elevation of troponin I (tI) that is within expected limits from left atrial radiofrequency ablation for atrial fibrillation (AF) is not well described, though such information may be of clinical value.

Objectives: Identify the expected range of tI values post-atrial fibrillation (AF) ablation.

Methods: 31 patients undergoing AF ablation had a single tI level drawn the day following the procedure. Clinical variables were also collected, such as ablation type and radiofrequency (RF) time.

Results: Paroxysmal AF was present in 23 patients, and 8 had chronic AF. The average RF time was 2627.8 …

Autologous Platelet Rich Plasma (Platelet Gel): An Appropriate Intervention For Salvaging Cardiac Myocytes Under Oxidative Stress After Myocardial Infarction, Barbara Y. Hargrave

Bioelectrics Publications

Background: The prompt restoration of blood flow (reperfusion) to the ischemic myocardium after an acute myocardial infarction is critical to the survival of non damaged heart tissue. However, reperfusion is responsible for additional myocardial damage. Our objective was to investigate the role of autologous platelet rich plasma or platelet gel prepared using nanosecond pulsed electric fields (nsPEFs) in improving left ventricular mechanical function after ischemic reperfusion.

Methods: The hearts of nine adult female New Zealand White rabbits were perfused using the Langendorff model. The hearts were exposed to global ischemia for 30 min and reperfused for 60 min. The hearts …

An Analysis Of Abnormal Electrocardiograms In First And Second Year Medical School Students, Molly Anne Kalish

PCOM Biomedical Studies Student Scholarship

The high stress level placed upon medical school students, particularly during their first and second didactic years, may have a negative effect on their health. Although surveys and subjective questionnaires have been used to evaluate the effects medical school has upon a student’s cardiovascular health, there has been little clinical data obtained to confirm this notion. The aim of this longitudinal study was to demonstrate whether any abnormal cardiovascular parameters, specifically QTc wave interval, cardiac axis vector and blood pressure abnormalities, could be documented to occur in two different classes of medical students during their first two years. Such information …

The Effects Of Dihydrobiopterin And Tetrahydrobiopterin On Hydrogen Peroxide And Nitric Oxide Release During Extracorporeal Shockwave Lithotripsy (Eswl), Brittany Deiling

PCOM Biomedical Studies Student Scholarship

ESWL is an effective, non-invasive therapy utilized to fragment stones in the kidney and subsequently be cleared in the urinary tract. Although lithotripsy provides a safer alternative to invasive treatments for removing stones, ESWL may cause vasoconstriction after ESWL treatment, reducing renal blood flow, which can cause kidney damage leading to acute to chronic hypertension clinically. This may be due to kidney vascular endothelial dysfunction, which is characterized as increased oxidative stress and decreased endothelial nitric oxide synthase (eNOS)-derived nitric oxide (NO) bioavailability. We hypothesized that ESWL would decrease NO and increase hydrogen peroxide (H₂O₂) in …

A Review Of Common Drug-Drug And Food-Drug Interactions Associated With Cardiovascular Medications, Raymond Kho, Sarah Kim, Stacy Lee, Laura Tsu

Pharmacy Faculty Articles and Research

This home-study CPE activity has been developed to educate pharmacists on the common drug-drug and food-drug interactions associated with cardiovascular medications.

Atlas-Based Quantification Of Cardiac Remodeling Due To Myocardial Infarction, Xingyu Zhang, Brett R. Cowan, David A. Bluemke, J. Paul Finn, Carissa G. Fonseca, Alan H. Kadish, Pau Medrano-Gracia

Office of the President Publications and Research

Myocardial infarction leads to changes in the geometry (remodeling) of the left ventricle (LV) of the heart. The degree and type of remodeling provides important diagnostic information for the therapeutic management of ischemic heart disease. In this paper, we present a novel analysis framework for characterizing remodeling after myocardial infarction, using LV shape descriptors derived from atlas-based shape models. Cardiac magnetic resonance images from 300 patients with myocardial infarction and 1991 asymptomatic volunteers were obtained from the Cardiac Atlas Project. Finite element models were customized to the spatio-temporal shape and function of each case using guide-point modeling. Principal component analysis …

Do N3 Fatty Acid Supplements Effect Depressive Symptoms Post Cardiovascular Event In Men And Women Ages 40 And Older?, Lindsey G. Caton

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not n-3 fatty acids have an effect on depressive symptoms post cardiovascular event in men and women ages 40 and older.

STUDY DESIGN: Systematic review of three English language random controlled trials published between 2011-2012.

DATA SOURCES: Two randomized controlled trials published after 2011 comparing the effects of n-3 fatty acid supplementation on depressive symptoms post cardiovascular event and one randomized controlled trial comparing n-3 fatty acid supplementation effects on depressive symptoms in elderly patients with diagnosed depression. The studies were obtained using the …

Is Apixaban Effective For The Prevention Of Stroke In Patients With Non-Valvular Atrial Fibrillation?, Amira Moore

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this EBM review is to determine whether or not Apixaban is effective for the prevention of stroke in patients with non-valvular atrial fibrillation.

STUDY DESIGN: Review of three English language primary studies published all published in 2011.

DATA SOUCRES: Three double-blind randomized control trials found using the Cochrane Database and PubMed.

OUTCOME(S) MEASURED: Outcomes measured were occurrence of stroke (TIA or CVA), systemic embolism, major bleeding or clinically relevant non-major bleeding, and incidence of death.

RESULTS: Apixaban 2.5mg and 5mg were both superior to Warfarin in the prevention of stroke or …

Is L-Carnitine Effective In Reducing Mortality After An Acute Myocardial Infarction?, Jeremiah Spearman

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not L-carnitine decreases mortality rates post MI.

STUDY DESIGN: Review of three randomized controlled trials published in 1996, 2000, and 2012, all English language.

DATA SOURCES: Three double blind, randomized controlled clinical trials comparing mortality rates in patients post MI who were treated with L-carnitine or a placebo. All articles were found using PubMed and EBSCO.

OUTCOMES MEASURED: In the Singh et al. study the outcomes were total cardiac events that included death and nonfatal infarctions, cardiac enzymes activity, infarct size, and any …

Alternative Treatment With Red Yeast Rice To Reduce Hyperlipidemia, Lisa Froemke

Physician Assistant Scholarly Project Posters

• First line treatment of cardiovascular disease is lifestyle modification followed by the pharmacologic intervention of HMG-CoA reductase inhibitors or statins

• Statins are commonly associated with intolerable side effects such as myalgia leading to medication non-compliance

• RYR preparations claim to inhibit cholesterol synthesis without causing myalgia

• RYR preparations have naturally occurring monacolins such as monacolin K which is chemically identical to lovastatin

• RYR is not regulated by the FDA leading to questionable manufacturing practices producing varying ingredient composition

• The purpose of this study is to investigate the role RYR in hyperlipidemia treatment compared to statins …

New Age Anticoagulants: A Safer And More Effective Alternative To Warfarin?, Benjamin Johnson

Physician Assistant Scholarly Project Posters

Atrial fibrillation is the most common sustained heart rhythm in the United States with estimated prevalence rates of 8.8/100 (Wolf, Abbott, & Kannel, 1991). The largest risk for patients with atrial fibrillation is that of ischemic stroke from embolization of an atrial clot, thus the long standing treatment for this arrhythmia is aggressive anticoagulation. For decades this has been accomplished with the use of warfarin, however, the increased risk of hemorrhage combined with the inconvenience of weekly blood testing has prompted the development of potentially safer and more effective alternatives. A systematic review of the literature identified studies that examined …

Acute Myocardial Infarction: Are We Overlooking Nstemi?, Kevin D. Swenson

Physician Assistant Scholarly Project Posters

• Acute myocardial infarction (AMI) is one of the leading causes of death in the United States.

• The purpose of this study was to examine methods of clinical differentiation between ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) and then to compare the various treatment methods and subsequent outcomes in STEMI versus NSTEMI.

• A compilation of systematic reviews, medical journals, practice guidelines, medical texts and meta-analyses were researched for the purpose of this study.

• NSTEMI patients are older, have more comorbidities and present with more atypical symptoms than STEMI patients.

• NSTEMI patients are treated less aggressively …

Assessing Prevalence Of Known Risk Factors In A Regional Central Kentucky Medical Center Heart Failure Population As An Approach To Assessment Of Needs For Development Of A Program To Provide Targeted Services To Reduce 30 Day Readmissions, Christeen Ivy Broaddus

DNP Projects

Abstract

Objectives:

1. Determine demographic, physiologic, and laboratory characteristics at time of admission of the heart failure (HF) population in a regional acute care facility in Central Kentucky through review of patient electronic medical records.
2. Determine which HF population characteristics are significantly associated with readmissions to the hospital.
3. Provide identification of the statistically significant common characteristics of the HF population to this facility so that they may work towards development of an electronic risk for readmission predictive instrument.

Design: Retrospective chart review.

Setting: Regional acute care facility in Central Kentucky.

Participants: All patients (n = 175) with a diagnosis or history …

Effect Of Chronic Angiotensin Ii Infusion On Plasma Tnfalpha And Il 6 Levels In Adiponectin Deficient Mice, Alexis O'Brien, Minnette Smith, Jaya Pamidimukkala

College of Osteopathic Medicine (TUN) Publications and Research

Chronic low grade inflammation plays an integral part in the development of many types of cardiovascular diseases. Adipose tissue is a well known source of many proinflammatory mediators. Adiponectin (APN) is one of the few proteins secreted by the adipose tissue that is known to have anti-inflammatory properties. Our research goal is to understand if APN deficiency contributes to a proinflammatory milieu especially when provided with an appropriate stimulus. Angiotensin II (ANGII) is a well known prohypertensive agent. Recently, ANGII has emerged as a growth factor and stimulator of proinflammatory cytokine expression in cardiovascular & renal tissue. The present study …

Lifetime Racism And Blood Pressure Changes During Pregnancy: Implications For Fetal Growth, Clayton J. Hilmert, Tyan Parker Dominguez, Christine Dunkel Schetter, Sindhu K. Srinivas, Laura M. Glynn, Calvin J. Hobel, Curt A. Sandman

Psychology Faculty Articles and Research

Objective: Research suggests that exposure to racism partially explains why African American women are 2 to 3 times more likely to deliver low birth weight and preterm infants. However, the physiological pathways by which racism exerts these effects are unclear. This study examined how lifetime exposure to racism, in combination with maternal blood pressure changes during pregnancy, was associated with fetal growth. Methods: African American pregnant women (n = 39) reported exposure to childhood and adulthood racism in several life domains (e.g., at school, at work), which were experienced directly or indirectly, meaning vicariously experienced when someone …

Older Couples With And Without Cardiovascular Disease: Testing Associations Between And Among Affective Communication, Marital Satisfaction, Physical And Mental Health, Josh Novak, James M. Harper, Jonathan G. Sandberg

Faculty Publications

The American Heart Association (Go et al., 2013) estimated that about 2,150 Americans die each day from cardiovascular disease (CVD). For those 65 years of age or older, the total cost of heart related services in 2009 was $121.2 billion (Go et al., 2013). Many people live with the chronic conditions of cardiovascular disease (Petersen et al., 2005). Researchers have identified the genetic, medical, and lifestyle habits of those with CVD, yet there is a dearth of literature focusing on the relational/social aspects of cardiovascular disease and how such factors are associated with the risk, presentation, and maintenance of cardiovascular …

Examining The Effect Of Race On The Relationship Between Posttraumatic Stress Disorder And Metabolic Syndrome In Women, Leia Harper

Theses and Dissertations

Posttraumatic stress disorder (PTSD) is a psychiatric condition affecting approximately 8% of the adult U.S. population with rates twice as high in women than men. Increasingly, evidence has suggested a close relationship between PTSD and increased risk of metabolic diseases. However, the literature on PTSD and metabolic disease risk factors has been limited by the lack of investigation of the potential influence of race on this relation. The current study examined the possible effect of race on the relation between PTSD and metabolic risk. Data for this study were provided from sample of that included 50 African American women and …

Comparison Of Two Different Sprint Interval Training Work-To-Rest Ratios On Acute Metabolic And Inflammatory Responses, Christopher R. Harnish

Theses and Dissertations

High intensity exercise is believed to yield greater results on health and human performance than moderate intensity exercise. Extensive research indicates that not only do high-intensity interval training (HIT) and sprint interval training (SIT) produce significant improvements in cardiovascular fitness and disease, they may be more effective at improving long-term metabolic function, including insulin sensitivity (Si), by producing more mitochondria. Moreover, compliance rates for HIT and SIT participation are reported to be the same or better than traditional moderate intensity exercise. Because lack of time is often cited as major hindrance to exercise participation, SIT is also seen as a …

Risk Factors Of Cvd Mortality Among The Elderly In Beijing, 1992 - 2009: An 18-Year Cohort Study, Tao Zhou, Xia Li, Zhe Tang, Changchun Xie, Lixin Tao, Lei Pan, Da Huo, Fei Sun, Yanxia Luo, Wei Wang, Aoshuang Yan, Xiuhua Guo

Research outputs 2014 to 2021

Few researchers have examined the effects of multiple risk factors of cardiovascular disease (CVD) mortality simultaneously. This study was to determine the associations of combined lifestyle and other factors with CVD mortality among the elderly (n = 3,257), in Beijing, China, through data mining of the Beijing Longitudinal Study of Aging (BLSA). BLSA is a representative cohort study from 1992 to 2009, hosted by Xuan Wu Hospital. Competing risk survival analysis was conducted to explore the association between risk factors and CVD mortality. The factors focused mainly on lifestyle, physical condition, and the model was adjusted for age and gender. …

The Identity Of The Heart Patient In The Context Of The Gift Economy: Heartnet And Media Framing, Lynsey Uridge

Theses: Doctorates and Masters

This health communication research examines the identity levels of the heart patient on a therapeutic website HeartNET through an empirical investigation of site interactions as manifestations of a gift economy. The thesis also explores the media’s representation of heart health in both television and print.

This research utilised a longitudinal qualitative ethnographic and netnographic approach involving twenty-six participants who completed two in-depth interviews. The first one-on-one interview occurred during the early stages of the participants’ heart journey, explored their heart story and use of interactive technology for heart health support. The second interview occurred six to twelve months later, and …