Cardiovascular Diseases Commons^™

Rationale And Design Of The Children's Oncology Group (Cog) Study Alte1621: A Randomized, Placebo-Controlled Trial To Determine If Low-Dose Carvedilol Can Prevent Anthracycline-Related Left Ventricular Remodeling In Childhood Cancer Survivors At High Risk For Developing Heart Failure., Saro H. Armenian, Melissa M. Hudson, Ming Hui Chen, Steven D. Colan, Lanie Lindenfeld, George Mills, Aida Siyahian, Sarah Gelehrter, Ha Dang, Wendy Hein, Daniel M M. Green, Leslie L. Robison, F Lennie Wong, Pamela S. Douglas, Smita Bhatia

Manuscripts, Articles, Book Chapters and Other Papers

Background: Anthracyclines are widely used in the treatment of childhood cancer. One of the well-recognized side-effects of anthracycline therapy is dose-dependent cardiomyopathy that may progress to heart failure (HF) years after completion of cancer-directed therapy. This study will evaluate the efficacy of low-dose beta-blocker (carvedilol) for HF risk reduction in childhood cancer survivors at highest risk for HF. The proposed intervention has the potential to significantly reduce chronic cardiac injury via interruption of neurohormonal systems responsible for left ventricular (LV) remodeling, resulting in improved cardiac function and decreased risk of HF. The intervention is informed by previous studies demonstrating efficacy …

Pathway By Which Vagus Nerve Stimulation Of B Fibers Affects Heart Rate, Kelsey Wasilczuk, Matthew Ward, Pedro Irazoqui

The Summer Undergraduate Research Fellowship (SURF) Symposium

Heart failure (HF) affects over 5 million adults in the United States. Many HF patients have a high resting heart rate, which is correlated with a high mortality rate. In recent years, vagus nerve stimulation (VNS) has become an increasingly researched therapy to reduce the resting heart rate of HF patients. However, current dosage given during VNS is increased incrementally at the doctor’s office until side effects present themselves in a patient. In addition, the means by which the therapy works is not completely understood. To better understand the therapy’s mechanisms, the right cervical vagus nerve of several Long Evans …

Drug-Induced Nutrient Depletion, Rodney Richmond

College of Pharmacy Faculty Research ​and Publications

No abstract provided.

A Structured Telephonic Transition Program For Heart Failure Patients, Julia E. Robinson

Doctor of Nursing Practice Final Manuscripts

HF is a fatal condition affecting more than 5 million Americans leading to frequent hospitalizations, poor quality of life and death. The annual cost to the healthcare system is approximately $38 billion, ranking HF as one of the costliest conditions to manage. Significant evidence exists that HF self-care management programs improve patient self-care and decrease HF-related readmissions. Current guidelines recommend health professionals provide comprehensive HF education focused on knowledge, skills of management, and self-care behaviors.

The Iowa Model of Evidence Based Practice provided the foundation for the practice change. Structured telephonic support (STS) was based on Bandura’s Self- Efficacy behavior …

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 …

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. …

Is Vitamin D Supplementation Effective In Improving Physical Performance In Older Patients With Heart Failure Who Are Over The Age Of 50 Years?, Sahba Yazdani

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not vitamin D supplement is effective in improving physical performance in older patients with heart failure over the age 50 years

STUDY DESIGN: Review of three English language primary studies, two published in 2010 and one was published in 2013.

DATA SOURCES: Two double blind randomized controlled trials (RCT) and one cross-sectional study that investigated the use of vitamin D in improving physical performance in heart failure. Sources were selected and found using PubMed, ScienceDirect, and Cochrane databases.

OUTCOMES MEASURED: The outcomes measured were improvement of physical …

Improved Survival After Heart Failure: A Community-Based Perspective, Samuel W. Joffe, Kristy T. Webster, David D. Mcmanus, Michael S. Kiernan, Darleen M. Lessard, Jorge L. Yarzebski, Chad E. Darling, Joel M. Gore, Robert J. Goldberg

Jorge L. Yarzebski

BACKGROUND: Heart failure is a highly prevalent, morbid, and costly disease with a poor long-term prognosis. Evidence-based therapies utilized over the past 2 decades hold the promise of improved outcomes, yet few contemporary studies have examined survival trends in patients with acute heart failure. The primary objective of this population-based study was to describe trends in short- and long-term survival in patients hospitalized with acute decompensated heart failure (ADHF). A secondary objective was to examine patient characteristics associated with decreased long-term survival.

METHODS AND RESULTS: We reviewed the medical records of 9748 patients hospitalized with ADHF at all 11 medical …

Improved Survival After Heart Failure: A Community-Based Perspective, Kristy T. Webster, Samuel W. Joffe, David D. Mcmanus, Michael S. Kiernan, Darleen M. Lessard, Jorge L. Yarzebski, Chad E. Darling, Joel M. Gore, Robert J. Goldberg

Jorge L. Yarzebski

Background: Heart failure is a highly prevalent, morbid, and costly disease with a poor long-term prognosis. Evidence-based therapies utilized over the past 2 decades hold the promise of improved outcomes, yet few contemporary studies have examined survival trends in patients with acute heart failure. Objectives: The primary objective of this population-based study was to describe trends in short and long-term survival in patients hospitalized with acute decompensated heart failure (ADHF). A secondary objective was to examine patient characteristics associated with decreased long-term survival. Methods and Results: We reviewed the medical records of 9,748 patients hospitalized with ADHF at all 11 …

A Systematic Review Of Validated Methods For Identifying Heart Failure Using Administrative Data, Jane Saczynski, Susan Andrade, Leslie Harrold, Jennifer Tjia, Sarah Cutrona, Katherine Dodd, Robert Goldberg, Jerry Gurwitz

Jennifer Tjia

PURPOSE: To identify and describe the validity of algorithms used to detect heart failure (HF) using administrative and claims data sources.

METHODS: A systematic review of PubMed and Iowa Drug Information Service searches of the English language was performed to identify studies published between 1990 and 2010 that evaluated the validity of algorithms for the identification of patients with HF using and claims data. Abstracts and articles were reviewed by two study investigators to determine their relevance on the basis of predetermined criteria.

RESULTS: The initial search strategy identified 887 abstracts. Of these, 499 full articles were reviewed and 35 …

30-Year Trends In Heart Failure In Patients Hospitalized With Acute Myocardial Infarction, David Mcmanus, Marcello Chinali, Jane Saczynski, Joel Gore, Jorge Yarzebski, Frederick Spencer, Darleen Lessard, Robert Goldberg

Jorge L. Yarzebski

Despite significant advances in its treatment, acute myocardial infarction (AMI) remains an important cause of heart failure (HF). Contemporary data remain lacking, however, describing long-term trends in incidence rates, demographic and clinical profiles, and outcomes of patients who develop HF as a complication of AMI. Our study sample consisted of 11,061 residents of the Worcester (Massachusetts) metropolitan area hospitalized with AMI at all greater Worcester hospitals in 15 annual study periods from 1975 to 2005. Overall, 32.4% of patients (n = 3,582) with AMI developed new-onset HF during their acute hospitalization. Patients who developed HF were generally older, more likely …

Can Ultrafiltration Be Used As Primary Treatment Of Congestive Heart Failure?, Jennifer Tallis

PCOM Physician Assistant Studies Student Scholarship

Objective: To determine whether ultrafiltration can be used as primary treatment of Congestive Heart Failure.

Transitions Home For Patients With Heart Failure: A Pilot Program At A Critical Access Hospital, Rita M. Willey

Doctor of Nursing Practice (DNP) Projects

Background: Heart Failure (HF) disease management programs (DMP) have shown to improve outcomes. The aim of this heart failure pilot program is an evaluation program. Measurement of functional capacity utilized the Duke Activity Status Index (DASI) questionnaire. Since the DASI uses the patient’s ability to perform a set of common activities of daily living to gauge functional capacity based on the known metabolic cost of each activity in MET units, it is thought to be well suited for population studies in which assessment of functional capacity during follow-up is needed.

Setting: Rural Critical Access Hospital (CAH) with outpatient cardiology services. …

Body Mass Index, Treatment Practices, And Mortality In Patients With Acute Heart Failure, Timothy Fitzgibbons, Olga Hardy, Darleen Lessard, Joel Gore, Jorge Yarzebski, Robert Goldberg

Jorge L. Yarzebski

OBJECTIVES: Obesity is associated with an increased risk of heart failure (HF). Among patients presenting with acute HF, however, differences in clinical characteristics, treatment regimens, and short-term prognosis of varying weights are largely unknown, particularly from a broader population-based perspective. METHODS: A total of 3722 patients admitted with acute HF to 11 greater Worcester (Massachusetts, USA) hospitals during 1995 and 2000 were categorized as being lean (n = 216), normal weight (n = 1465), overweight (n = 1007), or obese (n = 1034) at the time of hospitalization. RESULTS: Obese patients with decompensated HF were significantly younger (mean age = …

Prophylactic Defibrillator Implantation—Toward An Evidence-Based Approach, Alan H. Kadish

Office of the President Publications and Research

The author discusses research on using implantable cardioverter-defibrillators for the primary prevention of sudden death.