Cardiovascular Diseases Commons^™

Transcatheter Tricuspid Valve-In-Valve Replacement With An Edwards Sapien 3 Valve, Pranav Loyalka, Angelo Nascimbene, Benjamin Metz, Igor D Gregoric, Ajay Sundara Raman, Biswajit Kar

The Texas Heart Institute Journal

A few case reports and case series have documented the outcomes in patients with tricuspid bioprosthetic valvular degeneration who underwent transcatheter implantation of the Medtronic Melody and the Edwards Sapien XT and Sapien 3 valves. In this report, we describe the case of a 49-year-old woman with severe bioprosthetic tricuspid valvular stenosis and multiple comorbidities who underwent transcatheter tricuspid valve replacement with a Sapien 3 valve.

Unproven Stem Cell-Based Interventions: Advancing Policy Through Stakeholder Collaboration, Kirstin R W Matthews, Ana S Iltis

The Texas Heart Institute Journal

No abstract provided.

White Blood Cell Subtypes Are Associated With A Greater Long-Term Risk Of Death After Acute Myocardial Infarction, Arthur Shiyovich, Harel Gilutz, Ygal Plakht

The Texas Heart Institute Journal

We evaluated the association between white blood cell counts and long-term mortality rates in 2,129 patients (mean age, 65.3 ± 13.5 yr; 69% men) who had survived acute myocardial infarction. We obtained white blood cell counts and differential counts of white blood cell subtypes within the first 72 hours of hospital admission. The primary outcome was all-cause death at 1, 5, and 10 years after acute myocardial infarction.

In regard to death in the long term, we found significant negative linear associations (lymphocytes), positive linear associations (neutrophils and the neutrophil-to-lymphocyte ratio), and nonlinear U-shaped associations (basophils, eosinophils, monocytes, and total …

The Two Anomalies Of Wilhelm Ebstein, Magdalena Mazurak, Jacek Kusa

The Texas Heart Institute Journal

The year 2016 was the 180th anniversary of Wilhelm Ebstein's birth and the 150th anniversary of his description of the congenital tricuspid valve malformation that came to be known as Ebstein anomaly. We present a brief history of the life and work of Dr. Wilhelm Ebstein. Despite his distinguished career, he is seemingly forgotten in his own birthplace. We include a review of the relevant historical medical literature.

Mitochondrial Dna Heteroplasmy In Cardiac Tissue From Individuals With And Without Coronary Artery Disease, Erik Hefti, Javier G. Blanco

Harrisburg University Faculty Works

The cellular environment associated with coronary artery disease (CAD) can lead to mitochondrial DNA (mtDNA) damage. Mitochondrial variants in some copies of mtDNA (heteroplasmy) and mtDNA content are potential genetic biomarkers for CAD-associated disease states. Massively parallel sequencing and qRT-PCR techniques were used to measure heteroplasmic variants and mtDNA content in heart samples from donors with (n = 8) and without (n = 7) documented CAD. Both groups showed increased numbers of heteroplasmic mtDNA variants in the control region (CR) (p < .0010, ANOVA). The donors with CAD displayed a 41.07% increase in heteroplasmic mtDNA variant number in the CR (p = .043), an 87.50% increase in the number of heteroplasmic mtDNA deletions (p = …

Uncertainty Of 1-D Fluid Models In Patients With Pulmonary Hypertension, Mitchel J. Colebank

Biology and Medicine Through Mathematics Conference

No abstract provided.

Risk Factors For Heart Failure In Patients With Chronic Kidney Disease: The Cric (Chronic Renal Insufficiency Cohort) Study., Jiang He, Michael Shlipak, Amanda Anderson, Jason A Roy, Harold I Feldman, Radhakrishna Reddy Kallem, Radhika Kanthety, John W Kusek, Akinlolu Ojo, Mahboob Rahman, Ana C Ricardo, Elsayed Z Soliman, Myles Wolf, Xiaoming Zhang, Dominic Raj, Lee Hamm

Medicine Faculty Publications

Background Heart failure is common in patients with chronic kidney disease. We studied risk factors for incident heart failure among 3557 participants in the CRIC (Chronic Renal Insufficiency Cohort) Study.

Methods and Results Kidney function was assessed by estimated glomerular filtration rate (eGFR) using serum creatinine, cystatin C, or both, and 24‐hour urine albumin excretion. During an average of 6.3 years of follow‐up, 452 participants developed incident heart failure. After adjustment for age, sex, race, and clinical site, hazard ratio (95% CI) for heart failure associated with 1 SD lower creatinine‐based eGFR was 1.67 (1.49, 1.89), 1 SD lower cystatin …

Change In Physical Activity And Sitting Time After Myocardial Infarction And Mortality Among Postmenopausal Women In The Women's Health Initiative-Observational Study., Anna M Gorczyca, Charles B Eaton, Michael J Lamonte, Joann E Manson, Jeanne D Johnston, Aurelian Bidulescu, Molly E Waring, Todd Manini, Lisa W Martin, Marcia L Stefanick, Ka He, Andrea K Chomistek

Medicine Faculty Publications

Background

How physical activity (PA) and sitting time may change after first myocardial infarction (MI) and the association with mortality in postmenopausal women is unknown.

Methods and Results

Participants included postmenopausal women in the Women's Health Initiative‐Observational Study, aged 50 to 79 years who experienced a clinical MI during the study. This analysis included 856 women who had adequate data on PA exposure and 533 women for sitting time exposures. Sitting time was self‐reported at baseline, year 3, and year 6. Self‐reported PA was reported at baseline through year 8. Change in PA and sitting time were calculated as the …

Single-Trait And Multi-Trait Genome-Wide Association Analyses Identify Novel Loci For Blood Pressure In African-Ancestry Populations., Jingjing Liang, Thu H Le, Digna R Velez Edwards, Bamidele O Tayo, Kyle J Gaulton, Jennifer A Smith, Lisa W Martin, +Several Additional Authors

Medicine Faculty Publications

Hypertension is a leading cause of global disease, mortality, and disability. While individuals of African descent suffer a disproportionate burden of hypertension and its complications, they have been underrepresented in genetic studies. To identify novel susceptibility loci for blood pressure and hypertension in people of African ancestry, we performed both single and multiple-trait genome-wide association analyses. We analyzed 21 genome-wide association studies comprised of 31,968 individuals of African ancestry, and validated our results with additional 54,395 individuals from multi-ethnic studies. These analyses identified nine loci with eleven independent variants which reached genome-wide significance (P < 1.25×10−8) for either systolic and diastolic blood pressure, hypertension, or for combined traits. Single-trait analyses identified two loci (TARID/TCF21 and LLPH/TMBIM4) …

The Impact Of Freedson Bout Vs. Non-Freedson Bout Physical Activity On Metabolic Syndrome Risk In College Students, Valerie Olijar

Masters Theses, 2010-2019

Purpose The aim of this study is to examine moderate to vigorous physical activity in Freedson bouts compared to non-Freedson bouts and their association with Metabolic Syndrome risk factors in college students.

Methods 72 subjects aged 18-26 were recruited from James Madison University. Subjects height, weight, waist circumference, blood pressure, and body composition were assessed on visit 1. Blood pressure, fasted blood glucose, and lipid profile were assessed on visit 2. Subjects wore an Actigraph GT3X+ accelerometer, which measured physical activity and sleep for 7 days and nights. Univariate Pearson correlation analyses were performed to determine the relationship physical activity …

Effect Of Cannabinoids On Osteogenic Differentiation Of Cultured Vascular Smooth Muscle Cells, Bree A. Eccles

Undergraduate Honors Theses

Vascular calcification is strongly correlated with the clinical manifestations of atherosclerosis, heart attacks and strokes. The calcification process resembles bone formation and involves the osteogenic trans-differentiation of smooth muscles cells within the arterial wall. Cannabinoid receptors are known to modulate bone formation and are present in atherosclerotic vessels, suggesting they may also play a role in modulating calcification. Therefore, we evaluated the effects of cannabinoids on the expression of osteogenic proteins by vascular smooth muscle cells undergoing calcification.

Effects Of Sodium-Glucose Cotransporter 2 Inhibitors On 24-Hour Ambulatory Blood Pressure: A Systematic Review And Meta-Analysis, William L. Baker, Leo F. Buckley, Michael S. Kelly, John D. Bucheit, Eric D. Parod, Roy Brown, Salvatore Carbone, Antonio Abbate, Dave L. Dixon

Pharmacy Faculty Articles and Research

Background-—Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a novel class of antihyperglycemic agents that improve glycemic control by increasing glycosuria. Additional benefits beyond glucose lowering include significant improvements in seated clinic blood pressure (BP), partly attributed to their diuretic-like actions. Less known are the effects of this class on 24-hour ambulatory BP, which is a better predictor of cardiovascular risk than seated clinic BP.

Methods and Results-—We performed a meta-analysis of randomized, double-blind, placebo-controlled trials to investigate the effects of SGLT2 inhibitors on 24-hour ambulatory BP. We searched all studies published before August 17, 2016, which reported 24-hour ambulatory …

Treatment Of Hypertensive Emergencies, Wilbert S. Aronow

NYMC Faculty Publications

No abstract provided.

An Exploratory Study Of The Utilization Of Evidence-Based Pharmacological Treatment On Heart Failure Patients In Mississippi And Its Impact On Readmission, Keri A. Barron

Dissertations

The purpose of this study was to explore the relationship of adherence to evidence-based guidelines for pharmacologic management by select Mississippi hospitals and their hospital readmission rates. This was an exploratory study with a retrospective design. This design offered insight into the relationship between readmissions of heart failure patients and adherence to the national guidelines for the pharmacologic treatment of heart failure. The study took place in a hospital in the southeastern section of the United States. Data were collected from a database of patients with heart failure seen between January 2011 and June 2014.

The unit of analysis for …

Comparison Of Enteral Versus Intravenous Potassium Supplementation In Hypokalaemia In Paediatric Patients In Intensive Care Post Cardiac Surgery: Open-Label Randomised Equivalence Trial (Eips), Naveed Ur Rehman Siddiqui, Quratulain Merchant, Babar Hasan, Arjumand Rizvi, Muneer Amanullah, Amina Rehmat, Anwarul Haque

Department of Paediatrics and Child Health

Objectives: The primary objective was to compare the efficacy of enteral potassium replacement (EPR) and intravenous potassium replacement (IVPR) as first-line therapy. Secondary objectives included comparison of adverse effects and number of doses required to resolve the episode of hypokalaemia.
Trial design: The EIPS trial is designed as a randomised, equivalence trial between two treatment arms.
Study setting: The study was conducted at the paediatric cardiac intensive care unit (PCICU) at Aga Khan University Hospital, Karachi.
Participants: 41 patients (aged 1 month to 15years) who were admitted to PCICU post cardiac surgery were recruited (23 IVPR arm and 18 …

A Mixed-Methods Study: Self-Efficacy And Barriers To Participation In Workplace Wellness Programs, Massiel Perez-Calhoon

Dissertations

America needs a healthy workforce to sustain the country. The scourge of obesity continues to plague Americans despite government initiatives such as the Affordable Care Act and wellness programs in the workplace to combat this epidemic. However, despite initiatives to make America healthy, barriers continued to impede the nation’s health. Lack of awareness and sensitivity to what motivates individual participants versus group participants built formidable barriers to accessing all workplace employees equitably. The purpose of this study was twofold. First, the intent of this study was to explore the relationship between self-efficacy and the impact on participation and engagement when …

Understanding The Support Needs Of Minority Women With Heart Disease, Everly Macario Sc.D., M.S., Ed.M., Heather Z. Montague Ph.D., Susan M. Campbell M.P.H., Yukari T. Schneider Ph.D., M.P.H., Jennifer H. Mieres M.D.

Journal of Health Disparities Research and Practice

Background. Cardiovascular disease (CVD) affects minority women disproportionately. WomenHeart: The National Coalition for Women with Heart Disease sought to determine effective ways to support non-Caucasian women with CVD. We surveyed women of color living with CVD to understand their unique CVD-related support needs.

Methods. 514 non-white women (100 Hispanic, 180 African American, 104 Asian, 107 Indigenous, 23 multiracial) with CVD from 46 states responded to a 55-question survey (online/telephone, English/Spanish) 8/28/15 through 9/11/15.

Results. Among respondents not currently attending support groups, 80% were interested in attending support groups. Of WomenHeart services, respondents were most interested in online message boards. Among …

Angiogenesis: An Alternate Approach To Cardiovascular Disease Treatment, Scott Ouillette

Thinking Matters Symposium Archive

Up until this point research has only focused on angiogenic activators and ineffective growth factor administration Focusing on the angiogenic switch and the use of a bioresorbable stent coated with angiogenic growth factors and anti-inhibitors for prolonged local administration would solve the problems with dosage and controlled release that could push therapeutic angiogenesis over the edge as an extremely effective treatment for cardiovascular disease

Chagas, Enfermedad Olvidada: Una Perspectiva Histórica De La Prevención Y Control Del Chagas En La Provincia De Salta, Argentina (1909 – 2017) \ Chagas, A Forgotten Disease: A Historical Perspective On The Prevention And Control Of Chagas In Salta Province, Argentina (1909 – 2017), Tara Shea

Independent Study Project (ISP) Collection

El Chagas es una enfermedad vectorial más conocida en zonas rurales de América Latina y en Argentina es endémica en la región noroeste del país (MSAL, 2017). Designada una enfermedad tropical desatendida (Neglected Tropical Disease, NTD) por la OMS, la crónica del Chagas desde su “hallazgo casual” en 1909 siempre se trató de abandono (INP, 2017; MSF, 2012; OMS, 2017; Reyes López, 2009; Stamboulian, 2015; Zabala, 2009). En toda la Argentina se identifican 1.600.000 casos y 7.300.000 personas expuestas al Chagas, dando el país una de las tasas chagásicas más altas del mundo (Bär, 2015; MSAL, 2017).1

El modo de …

Use Of P53-Silenced Endothelial Progenitor Cells To Treat Ischemia In Diabetic Peripheral Vascular Disease., Nabanita Kundu, Cleyton C Domingues, Cyril Chou, Neeki Ahmadi, Sara Houston, D Joseph Jerry, Sabyasachi Sen

Medicine Faculty Publications

Background Peripheral vascular disease is a major diabetes mellitus‐related complication. In this study, we noted that expressions of proapoptotic p53 gene and its downstream cascade gene such as p21 are upregulated in hyperglycemia. Therefore, we investigated whether p53‐ and p21‐silenced endothelial progenitor cells (EPCs) were able to survive in hyperglycemic milieu, and whether transplantation of either p53 knockout (KO) or p21KO or p53‐ and p21‐silenced EPCs could improve collateral vessel formation and blood flow in diabetic vaso‐occlusive peripheral vascular disease mouse models.

Methods and Results We transplanted p53 and p21KO mouse EPCs (mEPCs) into streptozotocin–induced diabetic (type 1 diabetes mellitus …

Secondary Prevention At The Aswan Heart Centre, Amira Athanasios

GW Research Days 2016 - 2020

Cardiovascular disease remains the leading cause of death globally, taking the lives of almost 18 million patients around the world each year. The overwhelming majority of cardiovascular deaths take place in low- to mid-income counties, suggesting that most cardiovascular deaths are preventable. In this study, current literature on secondary prevention of coronary artery disease was analyzed. Specific emphasis was given to preventative measures and successes in low income countries. Based on a literature review, a patient questionnaire to better understand patient adherence to preventative measures was created. This questionnaire focuses on patients receiving dual antiplatelet therapy post acute myocardial infarct …

Using Mobile Health (Mhealth) Technology In The Management Of Diabetes Mellitus, Physical Inactivity, And Smoking, Hasan Rehman, Ayeesha Kamran Kamal, Saleem Sayani, Pamela B. Morris, Anwar T. Merchant, Salim S. Virani

Department of Medicine

Purpose of Review: Cardiovascular mortality remains high due to insufficient progress made in managing cardiovascular risk factors such as diabetes mellitus, physical inactivity, and smoking. Healthy lifestyle choices play an important role in the management of these modifiable risk factors. Mobile health or mHealth is defined as the use of mobile computing and communication technologies (i.e., mobile phones, wearable sensors) for the delivery of health services and healthrelated information. In this review, we examine some recent studies that utilized mHealth tools to improve management of these risk factors, with examples from developing countries where available.
Recent Findings: The mHealth …

Variables Associated With Overweight/Obesity Among African-American Women With Hypertension And/Or Diabetes, Monica A. Hamilton, Dnp, Rn, Acns-Bc

Doctor of Nursing Practice Projects

BACKGROUND

Obesity is the second leading cause of preventable death next to tobacco use. Although it is prevalent in all populations, it disproportionately affects AA women. Overweight/obesity increases AA women’s chances of developing chronic illnesses such as diabetes, hypertension, heart disease, and decreases their life expectancy. The purpose of this study was to explore variables associated with overweight/obese AA women with hypertension and/or diabetes.

METHODS

A secondary data analysis was conducted using a descriptive-correlational design to analyze cross-sectional data obtained from the 2013 Behavioral Risk Factor Surveillance System (BRFSS). The sample consisted of AA women (n =1823). The dependent variable …

Long-Term Excess Risk Of Stroke In People With Type 2 Diabetes In Sweden According To Blood Pressure Level: A Population-Based Case-Control Study., C Hedén Ståhl, M Lind, A-M Svensson, M Kosiborod, S Gudbjörnsdottir, A Pivodic, Mark A. Clements, A Rosengren

Manuscripts, Articles, Book Chapters and Other Papers

AIMS: To estimate the risk of stroke in people with Type 2 diabetes with different blood pressure levels compared with the risk in the general population in Sweden.

METHODS: This prospective case-control study included 408 076 people with Type 2 diabetes, aged ≥ 18 years, and free of prior stroke, registered in the Swedish National Diabetes Register 1998-2011. Age- and sex-matched control subjects (n = 1 913 507) without stroke from the general population were included. Stroke diagnoses were retrieved using International Classification of Disease codes from the Swedish patient and death registers. Cox hazard ratios and 95% confidence intervals …

A Rare Case Of Vascular Ring And Coarctation Of The Aorta In Association With Charge Syndrome, Jonathan B Wagner, Joshua Q Knowlton, Peter Pastuszko, Sanket S Shah

The Texas Heart Institute Journal

A male neonate presented with CHARGE syndrome, a multiorgan genetic disorder involving the Coloboma of the eyes, congenital Heart defects, nasal choanal Atresia, growth and development Retardation, Genitourinary disorders, and Ear anomalies and deafness. Moreover, he had a rare case of vascular ring—consisting of a right aortic arch with retroesophageal brachiocephalic artery—combined with coarctation of the mid-aortic arch. He underwent both vascular ring and aortic arch repair at our institution.

To our knowledge, this is the 4th documented case of this exceedingly rare type of aortic arch anomaly combined with aortic arch obstruction. Moreover, it is the first confirmed case …

Transcatheter Aortic Valve Implantation In A Patient With Unicuspid Aortic Valve, Angelo Nascimbene, Pranav Loyalka, Igor D Gregoric, Ricardo Bellera, Maan Malahfji, Marija Petrovic, Biswajit Kar

The Texas Heart Institute Journal

Transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valves has been successfully performed, but there is a lack of published experience in percutaneous treatment of patients with unicuspid valves and severe aortic stenosis. We describe a case of TAVR in such a patient.

A 31-year-old woman with Turner syndrome—who had undergone coarctation repair via subclavian flap at age 7 days and an aortic valvotomy at age 6 weeks—presented with severe symptomatic aortic stenosis. She was deemed inoperable because of her severe pulmonary hypertension and numerous comorbidities; consequently, a 20-mm Edwards Sapien 3 Transcatheter Heart Valve was offered for …

Prolonged Sinus Pauses Upon Termination Of Paroxysmal Atrial Fibrillation: Abnormal Right Atrial Electrophysiologic And Electroanatomic Findings, Zhengyu Bao, Hongwu Chen, Bing Yang, Michael Shehata, Weizhu Ju, Fengxiang Zhang, Gang Yang, Kai Gu, Mingfang Li, Kejiang Cao, Xunzhang Wang, Minglong Chen

The Texas Heart Institute Journal

The efficacy of pulmonary vein antral isolation for patients with prolonged sinus pauses (PSP) on termination of atrial fibrillation has been reported. We studied the right atrial (RA) electrophysiologic and electroanatomic characteristics in such patients.

Forty patients underwent electroanatomic mapping of the RA: 13 had PSP (group A), 13 had no PSP (group B), and 14 had paroxysmal supraventricular tachycardia (control group C). Group A had longer P-wave durations in lead II than did groups B and C (115.5 ± 15.4 vs 99.5 ± 10.9 vs 96.5 ± 10.4 ms; P=0.001), and RA activation times (106.8 ± 13.8 vs …

Nina Braunwald: A Female Pioneer In Cardiac Surgery, Nikhil Sabharwal, Harmanjit Dev, Hassiba Smail, David C Mcgiffin, Pankaj Saxena

The Texas Heart Institute Journal

Nina Starr Braunwald, the first female cardiac surgeon, made headlines during a time when almost all specialty surgeons were men.

Women have typically been deterred from entering surgical specialties, in part because of their traditional dual burden of managing their households and careers. Instead, female medical students and junior doctors have tended to be more attracted to medical specialties. This was the reality during Dr. Braunwald's venture into medicine in 1949. However, she never allowed negative ideas to keep her from joining a surgical training program.

Under the mentorship of the prominent cardiac surgeons Charles Hufnagel and Andrew Morrow, Dr. …

What Makes A Medical Journal Successful? Five Crucial Components, Herbert L Fred

The Texas Heart Institute Journal

No abstract provided.

History Of Periodontitis Diagnosis And Edentulism As Predictors Of Cardiovascular Disease, Stroke, And Mortality In Postmenopausal Women., Michael J Lamonte, Robert J Genco, Kathleen M Hovey, Robert B Wallace, Jo L Freudenheim, Dominique S Michaud, Xiaodan Mai, Lesley F Tinker, Christian R Salazar, Christopher A Andrews, Wenjun Li, Charles B Eaton, Lisa W Martin, Jean Wactawski-Wende

Medicine Faculty Publications

Background

Few studies have reported associations between periodontitis and cardiovascular disease (CVD) risk in older women, which is the objective of the present investigation.

Methods and Results

Participants were 57 001 postmenopausal women ages 55 to 89 years (mean 68 years; >85% 60 and older) who were enrolled (1993–1998) in the Women's Health Initiative Observational Study, and were without known CVD when history of periodontitis and edentulism was assessed by questionnaire at study Year‐5 (1998–2003). There were 3589 incident CVD events and 3816 total deaths during a mean follow‐up of 6.7 years. In multivariable analysis, periodontitis was not associated with …