Cardiovascular Diseases Commons^™

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

Touro College of Osteopathic Medicine (Middletown) Publications and Research

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

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

The School of Health Sciences Publications and Research

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

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

Online Theses and Dissertations

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

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

Online Theses and Dissertations

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

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

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

The School of Health Sciences Publications and Research

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

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

The School of Health Sciences Publications and Research

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

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

The School of Health Sciences Publications and Research

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

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

The School of Health Sciences Publications and Research

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

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

The School of Health Sciences Publications and Research

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

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

Physician Assistant Scholarly Project Posters

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

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

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

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

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

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

Physician Assistant Scholarly Project Posters

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

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

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

Physician Assistant Scholarly Project Posters

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

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

Physician Assistant Scholarly Project Posters

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

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

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

Physician Assistant Scholarly Project Posters

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

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

Touro College of Osteopathic Medicine (Middletown) Publications and Research

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

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

The Science Journal of the Lander College of Arts and Sciences

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

Lifestyle Contributors To Cardiovascular Disease Risk, Adam J. Berrones

Theses and Dissertations--Kinesiology and Health Promotion

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

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

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

Theses and Dissertations--Pharmacy

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

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

Theses and Dissertations--Pharmacology and Nutritional Sciences

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

Development And Application Of Gadolinium Free Cardiac Magnetic Resonance Fibrosis Imaging For Multiscale Study Of Heart Failure In Patients With End Stage Renal Disease, Tori A. Stromp

Theses and Dissertations--Physiology

Cardiac magnetic resonance (CMR) is a powerful tool to noninvasively image ventricular fibrosis. Late gadolinium enhancement (LGE) CMR identifies focal and, with T1 mapping, diffuse fibrosis. Despite prevalent cardiac fibrosis and heart failure, patients with end stage renal disease (ESRD) are excluded from LGE. Absence of a suitable diagnostic has limited the understanding of heart failure and obstructed development of therapies in the setting of ESRD. A quantitative, gadolinium free fibrosis detection method could overcome this critical barrier, propelling the advancement of diagnostic, monitoring, and therapy options. This project describes the development of a gadolinium free CMR technique and application …

The Relationship Of Social Support In Self-Care, Depressive Symptoms, And Quality Of Life Outcomes In Patients With Heart Failure, Shannon C. Shumaker

Theses and Dissertations--Nursing

The purpose of this dissertation was to evaluate outcomes associated with social support in patients with heart failure and their caregivers. Specific aims were to: 1) examine the association of depressive symptoms with self-care in patients with HF; 2) evaluate the psychometrics properties of the Multidimensional Scale of Perceived Social Support (MSPSS) instrument as a measure of perceived social support in patients with heart failure; and 3) determine whether patient and caregiver perception of relationship quality measured at baseline upon enrollment predicted quality of life at baseline in both patient and caregiver using a multilevel dyadic analysis in patient and …

Ppap2b Expression Limits Lesion Formation In Murine Models Of Atherosclerosis, Paul A. Mueller

Theses and Dissertations--Physiology

Coronary artery disease (CAD) is the leading cause of death in both men and women worldwide and is defined as a narrowing of the coronary arteries due to accumulation of atherosclerotic plaques. Genome-wide association studies have identified risk loci within the gene PPAP2B that confers increased risk of developing CAD. Evidence suggests these aforementioned SNPs are regulating PPAP2B expression in a cis-manner through the interruption of transcription factor binding sites. PPAP2B encodes the lipid phosphate phosphatase 3 enzyme that plays a key role in degrading bioactive lysophosphatidic acid (LPA). LPA has a plethora of effects on vascular tissue and is …

Central Neural Mechanisms Of Salt-Sensitive Hypertension, Robert Larson

Dissertations, Master's Theses and Master's Reports

Hypertension (HTN) is a major risk factor for the development of cardiovascular disease, and it’s estimated that over 80 million adults in the United States have HTN. Essential HTN often demonstrates sensitivity to salt, and reductions in dietary salt attenuate high blood pressure in this population. Evidence indicates that the paraventricular nucleus (PVN) of the hypothalamus is a key driver of HTN due to excess salt intake. The cellular mechanisms whereby PVN neuronal activity is augmented in response to salt are largely unknown. Previous work from our lab has demonstrated that small conductance calcium activated potassium (SK) channel function is …

A Feasibility Study Of Lqts-Specific Problem-Solving Workshop: Parents' Problem-Solving Skills, Coping, Hope, And Worry, Elizabeth A. Phelps

PCOM Psychology Dissertations

Long-QT Syndrome (LQTS) is an inherited cardiac condition that predisposes individuals to cardiac arrhythmias and is a potentially fatal disorder that affects approximately 1 in 2,000 people. The triggers are difficult to avoid and may cause children and their families to make major life changes to avoid scenarios that can precipitate cardiac events. Parent may become more aware of the risks and may be hypervigilant of their child’s surroundings and exposure to potential triggers. Social problem-solving skills have been shown to enhance the ability to cope with both minor and major daily stressors and minimize psychological problems associated with physical …

Does Ivabradine Improve Quality Of Life In Cardiovascular Disease Patients?, Daniel E. Lynch

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this review is to determine whether ivabradine therapy can improve the quality of life in cardiovascular disease patients.

Study Design: The studies included in this review are one randomized control study and two double blind randomized control studies from 2008, 2010, and 2012.

Data Source: The three studies in this review were obtained by performing a PubMed search using the keywords “ivabradine” and random control trial.” All articles were published in English and in peer-reviewed journals.

Outcomes Measured: The three studies ascertained whether there was a decrease in hospitalization events within coronary artery disease and heart …

Is Polidocanol Foam Sclerotherapy Effective In Treating Varicose Veins As Compared To Conventional Treatments?, Sachi Patel

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Polidocanol foam sclerotherapy is effective in treating varicose veins as compared to conventional treatments.

STUDY DESIGN: Review of three randomized controlled trials. All three studies are published in English between 2008 – 2012.

DATA SOURCES: Three randomized control trials were found using PubMED and Medline. The sources were selected based on the outcomes measured and how the studies and outcomes mattered to patients (POEMS).

OUTCOMES MEASURED: The patients’ assessment for quality of life analyzed by logistic regression model, Chronic Venous Insufficiency Questionnaire (CVIQ), EQ-5D model, Visual …

A Feasibility Study Of A Lqts-Specific Workshop: Childrens' Problem-Solving Skills, Coping, Self-Efficacy, And Locus Of Control, Katherine L. Corvi

PCOM Psychology Dissertations

Living with a chronic medical condition in childhood and adolescence requires many critical lifestyle changes and restrictions, which may compromise psychosocial development. Social problem-solving skills have been shown to enhance the ability to cope with both minor and major daily stressors and to minimize psychological problems associated with physical health problems. The research is part of a larger study with children with long QT syndrome (LQTS) and their parents; the present study focuses on the children. This study was developed to examine the feasibility and efficacy of a problem-solving workshop to increase problem solving, self-efficacy, coping, and locus of control …

The Healthy Heart Program At The University Of Montana: A Program Review, Laura B. Porisch

Graduate Student Theses, Dissertations, & Professional Papers

Porisch, Laura, M.S., Spring 2016 Health and Human Performance

Abstract—The Healthy Heart Program at the University of Montana: A Program Review

Chairperson: Steven Gaskill

Purpose: The purpose of this paper is to identify whether the Healthy Heart Program at the University of Montana is successful at facilitating lifestyle behavior changes. Methods: Six participants from Spring of 2015 were interviewed 3-4 months post and again 9-10 months post participation in the program. Interview questions focused on whether participants were working toward goals as well as their opinion of the program and what could be done to improve it. Additionally, 18 participants …

Probing Allosteric, Partial Inhibition Of Thrombin Using Novel Anticoagulants, Stephen S. Verespy Iii

Theses and Dissertations

Thrombin is the key protease that regulates hemostasis; the delicate balance between procoagulation and anticoagulation of blood. In clotting disorders, like deep vein thrombosis or pulmonary embolism, procoagulation is up-regulated, but propagation of clotting can be inhibited with drugs targeting the proteases involved, like thrombin. Such drugs however, have serious side effects (e.g., excessive bleeding) and some require monitoring during the course of treatment. The reason for these side effects is the mechanism by which the drugs’ act. The two major mechanisms are direct orthosteric and indirect allosteric inhibition, which will completely abolish the protease’s activity. Herein we sought an …

Exploring The Role Of Intersectionality On Cardiovascular Disease Risk In Sexual Minorities, Leia Harper

Theses and Dissertations

Background: Previous research has shown that sexual minority individuals (SM) are twice as likely to smoke, twice as likely to be overweight or obese, and less likely to be physically active than heterosexual persons; all of which place SMs at an increased risk for cardiovascular disease (CVD). While information on CVD risk by race/ethnicity and socioeconomic status is well documented, there is scant literature examining race, gender, and the potential CVD risk in SMs. The purpose of this study was to examine CVD risk in sexual minorities.

Method: The current study used data from the National Longitudinal Study of Adolescent …