Cardiovascular Diseases Commons^™

Uhl’S Anomaly: A One And A Half Ventricular Repair In A Patient Presenting With Cardiac Arrest, Reginald Chonoune, Adam Lowry, Karthik Ramakrishnan, Gail D. Pearson, Jeffrey P. Moak, Dilip S. Nath

Pediatrics Faculty Publications

Uhl’s anomaly, first reported in 1952, is an extremely rare congenital cardiac defect characterized by partial or complete loss of the right ventricular myocardium and unknown etiology. Fewer than 100 cases have been described. The response to medical management is poor and there is no known ideal surgical approach or timing for treatment. We report the case of a previously active adolescent male presenting with cardiac arrest, who underwent successful bidirectional cavopulmonary anastomosis (“Glenn” anastomosis) with right atrial reduction and right ventricular free wall plication.

Transvenous Nonfluoroscopic Pacemaker Implantation During Pregnancy Guided By 3-Dimensional Electroanatomic Mapping, Jacob Hartz, Bradley C. Clark, Seiji Ito, Elizabeth D Sherwin, Charles I Berul

Pediatrics Faculty Publications

Patients with congenital heart disease are at ongoing risk of developing both bradyarrhythmias and tachyarrhythmias decades after surgical repair. Rarely, arrhythmias can be exacerbated during pregnancy and require emergent intervention. Here, we report unique experience with nonfluoroscopic pacemaker implantation during pregnancy. Ionizing radiation, even in low doses, is associated with an increased risk of malignancy, and a fetus may be at particularly increased risk.1, 2 Over the past 2 decades, the use of fluoroscopy in cardiac ablation procedures has become nearly obsolete with the development of 3-dimensional (3D) electroanatomic mapping software such as CARTO (Biosense-Webster, Diamond Bar, CA) …

The Effect Of Statins In Primary Prevention On All-Cause Mortality, Brian Adams

Physician Assistant Scholarly Project Posters

During routine yearly physicals, primary care providers often evaluate serum laboratory lipid levels. Many of these patients have no past medical history of cardiovascular events related to atherosclerotic disease. Some patients do not have secondary risk factors, such as diabetes mellitus or smoking history.

Previous cardiovascular events provide stronger indications for the use of HMG-CoA reductase inhibitors (statins). In the absence of these, the provider may turn to current guidelines, in this case the 2013 the American College of Cardiology and the American Heart Association published the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular …

Predictors Of High On-Aspirin Platelet Reactivity In Elderly Patients With Coronary Artery Disease., J W Zhang, W W Liu, Timothy A Mccaffrey, X Q He, W Y Liang, X H Chen, X R Feng, Sidney W Fu, M L Liu

Medicine Faculty Publications

Objectives

Previous studies have illustrated the link between high on-aspirin platelet reactivity (HAPR) with increasing thrombotic risks. The aim of our study was to investigate relative risk factors of HAPR in elderly patients with coronary artery disease.

Methods

Elderly, hospitalized coronary artery disease patients on regular aspirin treatment were enrolled from January 2014 to September 2016. Medical records of each patient were collected, including demographic information, cardiovascular risk factors, concomitant drugs and routine biological parameters. Arachidonic acid (AA, 0.5 mg/mL) and adenosine diphosphate (ADP, 5 µmol/L) induced platelet aggregation were measured via light transmission assay (LTA) to evaluate antiplatelet responses, …

Selective Autonomic Stimulation Of The Av Node Fat Pad To Control Rapid Post-Operative Atrial Arrhythmias., Marco A Mercader, Dingchao He, Aditya C Sharma, Mark C Marchitto, Gregory Trachiotis, Gene A Bornzin, Richard A. Jonas, Jeffrey P Moak

Medicine Faculty Publications

Junctional ectopic tachycardia (JET) and atrial fibrillation (AF) occur in patients recovering from open-heart surgery (OHS). Pharmacologic treatment is used for the control of post-operative atrial arrhythmias (POAA), but is associated with side effects. There is a need for a reversible, modulated solution to rate control. We propose a non-pharmacologic technique that can modulate AV nodal conduction in a selective fashion. Ten mongrel dogs underwent OHS. Stimulation of the anterior right (AR) and inferior right (IR) fat pad (FP) was done using a 7-pole electrode. The IR was more effective in slowing the ventricular rate (VR) to AF (52 +/- …

Relationship Of Common Vascular Anatomy To Cannulated Catheters., Paul Gagne, Karun Sharma

Pediatrics Faculty Publications

Superficial veins of the upper extremity are the primary location for placement of peripheral IV catheters (PIVC). It is believed that a significant portion of PIVCs placed may cross or abut valves and branching veins or occlude a significant portion of the vein, limiting the ability to aspirate blood from the PIVC. Two separate clinical investigations using ultrasound were performed to understand the potential interaction between PIVCs and the vein lumen and the venous valves and branches of the superficial veins of the upper extremity. One study with 35 adult volunteers interrogated 210 vein segments where a PIV would likely …

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 …

The Relationship Between Periodontitis And Cardiovascular Disease, Jonathan Krupka

The Science Journal of the Lander College of Arts and Sciences

The relationship between periodontal disease and cardiovascular disease has been the subject of much research in recent years. The aim of this study is to review and analyze the relevant literature regarding this relationship, with an emphasis on determining a presence of periodontal bacteria from the periodontal pocket in atheromatous plaques, and to explore the biological role of inflammatory mechanisms that may link periodontitis and cardiovascular disease. Although there seems to be conflicting reports, the overall consensus confirms the presence of periodontal bacteria, such as Porphyromonas gingivalis, in atheromatous plaques. Additionally, the presence of systemic markers of cardiovascular disease in …

Should Genetic Testing Be Recommended For Long Qt Syndrome Patients And Their Relatives?, Menachem Braun

The Science Journal of the Lander College of Arts and Sciences

No abstract provided.

Consequences Of Altered Short-Chain Carbon Metabolism In Heart Failure, Julie Horton

Electronic Theses and Dissertations

Cardiovascular disease is currently the foremost cause of death within the United States. Heart failure (HF) is a syndrome defined by the inability of the heart to adequately execute requisite pump function in order to deliver nutrients and oxygen to peripheral tissues, irrespective of etiology. One of the most common causes of HF is chronic pressure overload due to hypertension. Ischemic heart disease is also a common driver of HF, often in conjunction with hypertension. Pressure overload initially causes compensatory metabolic changes. Structural changes follow shortly thereafter typically resulting in left ventricular hypertrophy. Eventually, the heart loses the ability to …

Remote Sensing Observation Of Annual Dust Cycles And Possible Causality Of Kawasaki Disease Outbreaks In Japan, Hesham El-Askary, Nick Lahaye, Erik J. Linstead, William A. Sprigg, Magdi Yacoub

Mathematics, Physics, and Computer Science Faculty Articles and Research

Kawasaki disease (KD) is a rare vascular disease that, if left untreated, can result in irreparable cardiac damage in children. While the symptoms of KD are well-known, as are best practices for treatment, the etiology of the disease and the factors contributing to KD outbreaks remain puzzling to both medical practitioners and scientists alike. Recently, a fungus known as Candida, originating in the farmlands of China, has been blamed for outbreaks in China and Japan, with the hypothesis that it can be transported over long ranges via different wind mechanisms. This paper provides evidence to understand the transport mechanisms …

Gastrointestinal Bleeding Events And Statin Use: A Large Propensity Score-Matched Retrospective Cohort Study, Ashley I. Martinez

Theses and Dissertations--Pharmacy

Literature is conflicting regarding the association between statin use and gastrointestinal (GI) bleeding. This study sought to determine whether there is an association between statin use and GI bleeding by comparing incidence of gastrointestinal events between statin users and an active comparator group.

Data was obtained from a large administrative claims database composed of subjects enrolled in a selection of insurance plans throughout the United States from 2009-2014. New statin users (exposed) and thyroid medication users (active comparator, unexposed) were followed from the baseline period (one year prior to medication initiation) until first event, discontinuation, or disenrollment. Subjects were matched …

Protection From Aortic Aneurysm By Bmal1 Deletion From Smooth Muscle Cells, Jenny Lutshumba

Theses and Dissertations--Physiology

Abdominal aortic aneurysm (AAA) is a devastating condition that occurs primarily among older people with high mortality when a rupture occurs. Currently there is no proven pharmacological therapy for AAA due to poor understanding of the underlying pathogenesis. The brain and muscle transcription factor ARNT-like (Bmal1), which is known to regulate circadian rhythm, has been implicated in vascular pathologies including atherosclerosis and vascular remodeling, but its role in AAA has not been explored.

Vascular smooth muscle is a central player in aneurysm formation and development because it is critical in all three aortic aneurysm hallmark processes including (a) degradation of …

Assessing Provider Adherence To The 2013 Acc/Aha Hyperlipidemia Guideline, Adrienne Johnston

DNP Projects

Background: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in the United States and accounts for more than 17.3 million deaths per year with hyperlipidemia as one of the leading risk factors. The 2013 American Heart Association/American College of Cardiology (AHA/ACC) hyperlipidemia guideline recommends healthy lifestyle habits, risk estimation of the development of cardiovascular disease using a risk calculator, and intensity dosed statin therapy. There has been controversy among providers resulting in confusion and inconsistent application of the guideline. Purpose: The purpose of this project was to examine provider adherence to the AHA/ACC hyperlipidemia guideline in a primary …

Use Of Sex-Specific Clinical And Exercise Risk Scores To Identify Patients At Increased Risk For All-Cause Mortality, Paul C. Cremer, Yuping Wu, Haitham M. Ahmed, Lee M. Pierson, Danielle M. Brennan, Mouaz H. Al-Mallah, Clinton A. Brawner, Jonathan K. Ehrman, Steven J. Keteyian, Roger S. Blumenthal, Michael J. Blaha, Leslie Cho

Mathematics and Statistics Faculty Publications

Importance Risk assessment tools for exercise treadmill testing may have limited external validity. Cardiovascular mortality has decreased in recent decades, and women have been underrepresented in prior cohorts.

Objectives To determine whether exercise and clinical variables are associated with differential mortality outcomes in men and women and to assess whether sex-specific risk scores better estimate all-cause mortality.

Design, Setting, and Participants This retrospective cohort study included 59 877 patients seen at the Cleveland Clinic Foundation (CCF cohort) from January 1, 2000, through December 31, 2010, and 49 278 patients seen at the Henry Ford Hospital (FIT cohort) from January 1, …

Fructose And Its Contribution To Cardiovascular Disease And Metabolic Syndrome, Jessica Anderson

Physician Assistant Scholarly Project Posters

The incidence of obesity, cardiovascular disease, and combination of symptoms classified as “metabolic syndrome” that eventually leads to type 2 diabetes have risen dramatically over the past few decades. The current dietary guidelines that advised patients to avoid dietary fats were originally developed in the 1960’s. This led the way for food manufacturers to remove fats in processed foods and replace them with sugars, particularly fructose. At the time there was no clinical trial data that definitively supported these guidelines.

The increased use of fructose as a food additive has dramatically increased the per-capita consumption of this sugar. More recent …

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 …

Anticoagulation Therapy For The Elderly With Atrial Fibrillation, Rebecca Hoistad

Physician Assistant Scholarly Project Posters

• Atrial fibrillation increases in occurrence as we age with about 9% of patients developing it by age 90. When a patient is diagnosed with atrial fibrillation, one of the drugs that they are prescribed is an anticoagulant. The purpose of this drug is to prevent thrombus formation in addition to preventing an ischemic stroke. Today, there are many options available for anticoagulation therapy. The options include aspirin, vitamin K antagonists like warfarin, factor Xa inhibitors like rivaroxaban and apixaban, direct thrombin inhibitors like dabigatran, and antiplatelet agents such as clopidogrel.

• A review of the literature was done of …

Brugada Syndrome; Preventive Screening Measures To Decrease Associated Cardiac Deaths, Matthew Ryba

Physician Assistant Scholarly Project Posters

• Brugada syndrome is a sodium channel deficiency in the myocardium that can cause arrhythmias and sudden cardiac death. The myocardium deficient sodium channels can be inherited or affected by environment factors such as fever or medications.

• Screening for this syndrome can be challenging because many times the first symptom of Brugada syndrome is cardiac arrest. Though incidents of sudden cardiac deaths are low, sudden cardiac death can impact families and communities.

• In Italy, screening ECG’s is claimed to have reduced sudden cardiac events by 85% (Maron, 2014). Preventing sudden cardiac death in these patients through sensible, reasonable …

Contribution Of A Class Ii Ribonucleotide Reductase To The Manganese Dependence Of Streptococcus Sanguinis, John L. Smith

Theses and Dissertations

Manganese-deficient Streptococcus sanguinis mutants exhibit a dramatic decrease in virulence for infective endocarditis and in aerobic growth in manganese-limited media. Loss of activity of a manganese-dependent, oxygen-dependent ribonucleotide reductase (RNR) could explain the decrease in virulence. When the genes encoding this RNR are deleted, there is no growth of the mutant in aerobic broth culture or in an animal model. Testing the contribution of the aerobic RNR to the phenotype of a manganese transporter mutant, a heterologous class II RNR from Lactobacillus leichmannii called NrdJ that requires B₁₂ rather than manganese as a cofactor was previously introduced into an …

Dihydropyridines As Calcium Channel Blockers: An Overview, Thelma Salazar, Andres Gonzalez, Debasish Bandyopadhyay

School of Integrative Biological & Chemical Sciences (Formerly Dept. of Chemistry)

Cardiovascular disease remains one of the leading causes of death in the United States. It is estimated that 1 in every 3 American adults suffer from high blood pressure. Hypertension, a precursor to most cardiovascular diseases, continues to grow at an alarming rate and is seldom managed carefully. Attempts have been made to manage hypertension and reduce the morbidity and mortality of the cardiovascular organ through methods including diets, increased amount of exercise, and medications. Many commercial drugs have been derived from dihydropyridine due to its antihypertensive property. Dihydropyridine derivatives work by acting as calcium channel blockers blocking the intake …

Response By Bondonno Et Al To Letter Regarding Article, “Association Of Vegetable Nitrate Intake With Carotid Atherosclerosis And Ischemic Cerebrovascular Disease In Older Women”, Catherine P. Bondonno, Lauren C. Blekkenhorst, Jonathan M. Hodgson

Research outputs 2014 to 2021

No abstract provided.

Population-Based Cohort Study In Outcome Of Phased Progression Of Atherosclerosis In China (Persuade): Objective, Rationale And Design, Dong-Kai Shan, Yong Zhou, You-Xin Wang, Xiang Gao, Wei Wang, Jun-Jie Yang, Yun-Dai Chen

Research outputs 2014 to 2021

The coronary artery calcification score and pericardial fat volume have recently been reported to be strongly associated with the severity and presence of coronary atherosclerosis. However, no studies have explored the outcome of phased progression of atherosclerosis by non-contrast computed tomography in asymptomatic people in China. The population-based cohort study in outcome of phased progression of atherosclerosis in China (PERSUADE), an observational, longitudinal and prospective cohort study in a target population of healthy subjects based in Jidong Oilfield (China), prospectively analyzes the outcome of phased progression of atherosclerosis by non-contrast computed tomography in healthy population. The results of this study …

Heart Disease And African Americans, Patricia Guy-Walls, Jody Long

Research, Publications & Creative Work

Good health depends on multiple factors, including financial status. Higher socioeconomic status correlates with a lower risk of cancer, diabetes, and heart disease. Lukachko, Hatzenbuehler, and Keyes (2014) stated that the advantages of income status make a difference with health, specifically heart disease. Another significant factor affecting heart disease is health care disparity. Kahng (2010) found that the accumulative impact of health care disparities experienced over a lifetime contributes to chronic stress and heart-related problems.

Despite advancement in care, more African Americans, compared with other racial groups, die from cardiovascular disease (Centers for Disease Control and Prevention [CDC], 2016). Several …

Contribution Of Asc-Inflammasome To Vascular Endothelial Dysfunction: Role Of Rna Receptor Rig-I, Ashley Pitzer

Theses and Dissertations

Retinoic acid-inducible gene-I (RIG-I) is a putative RNA helicase and recently identified as a cytosolic RNA receptor in mammalian cells. The role of RIG-I in the regulation of vascular function under physiological and pathological conditions is unknown. Recent studies have shown that the inflammasome serves as a crucial initiator of cytokine-mediated inflammation mediating the pathogenesis of cardiovascular disease. The present study tested whether RIG-I activation triggers inflammasome formation and subsequent cytokine-mediated inflammation in the endothelium of mice coronary arteries. Using both genetic and pharmacological interventions of the RIG-I inflammasome, we first characterized whether specific activation of RIG-I via 3pRNA transfection …

Deletion Of Cardiac Mir-17-92 Cluster Increases Ischemia/ Reperfusion Injury Via Pten Upregulation, Meeta B. Prakash

Theses and Dissertations

The miR-17- 92 cluster is necessary for cell proliferation and development of the cardiovascular system. Deletion of this cluster leads to death in neonatal mice. The role of this cluster still needs to be defined following ischemia and reperfusion. Methods and Results: Adult male mice were injected with Tamoxifen- was to induce inducible cardiac-specific miR-17- 92-deficient (miR-17- 92-def: MCM:TG:miR-17- 92 flox/flox ) and wild type (WT: MCM:NTG:miR-17-92 flox/flox ) mice were subjected to 30 minutes of myocardial ischemia via left anterior descending coronary artery ligation followed by reperfusion for 24 hours. Post I/R survival (48%) and ejection fraction were reduced, …