Cardiovascular Diseases Commons^™

Blood Pressure Surge With Alarm Is Reduced After Exercise And Diet Intervention In Firefighters, Deborah L Feairheller, Macie Smith, Megan Carty, Emily H Reeve

College of Population Health Faculty Papers

BACKGROUND: Cardiac-related incidents are a public health concern for tactical occupations, and cardiovascular disease rates are higher in these populations compared with civilians. Research is needed to examine blood pressure (BP) responses in firefighters. The pager alert is one occupational hazard, and it is unknown if lifestyle change can reduce the systolic surge response.

PURPOSE: To measure BP surge with alarm in firefighters to determine whether the magnitude is lower after a 6-week tactical exercise and Mediterranean-diet intervention.

METHODS: SBP and DBP and BP surge levels, circulating markers, vascular health, and fitness were analyzed. BP surge with alarm was captured …

Institute Of Cardiovascular Science And Medicine Faculty Of Medicine The University Of Hong Kong

Journal of the Hong Kong College of Cardiology

No abstract provided.

Abstracts For Lectures

Journal of the Hong Kong College of Cardiology

No abstract provided.

9th Asian Preventive Cardiology And Cardiac Rehabilitation Conference Symposia

Journal of the Hong Kong College of Cardiology

No abstract provided.

9th Asian Preventive Cardiology And Cardiac Rehabilitation Conference

Journal of the Hong Kong College of Cardiology

No abstract provided.

Role Of Macrophages In Regression Of Myocardial Fibrosis Following Alleviation Of Left Ventricular Pressure Overload, Lily Neff

MUSC Theses and Dissertations

Antecedent conditions that affect the heart, such as aortic stenosis (AS), can develop into left ventricular pressure overload (LVPO). LVPO is associated with increased myocardial interstitial fibrosis, specifically fibrillar collagen, that leads to increased myocardial stiffness. Patients undergoing surgical aortic valve replacement (SAVR) to correct AS demonstrate significant but incomplete regression of fibrosis. Although current therapies normalize hemodynamic load, treatments that regress collagen content within the myocardium remain a critical need. To elucidate cellular mechanisms of this persistent fibrosis in LVPO, we utilized a transverse aortic constriction (TAC) and removal of the constriction (unTAC) murine model. Outputs were assessed for: …

A Design, Development, And Evaluation Of Bio-Patch For Myocardial Tissue Repair, Yaya Zhang

Theses and Dissertations (ETD)

Introduction. Ischemic heart disease (IHD) is a major concern of human health issue. The structural repair and functional recovery of injured hearts is a major challenge in the clinical setting. Preclinical studies over last 10 years have demonstrated the potential of using stem cells to treat IHD, but the efficacy of this therapy is jeopardized by uncontrollable migration and low survival of the injected stem cells. An approach based on tissue engineering enabling target-specific stem cell delivery such as cardiac patches has emerged as an alternative solution for stem cell therapy for IHD. It employs scaffold materials to engulf various …

Implementing A Self-Measured Blood Pressure Monitoring Process, Alecia Christensen

Student Scholarly Projects

Practice Problem: Because of the prevalence of hypertension worldwide, it is prudent for all patients to have the knowledge and ability to self-monitor their blood pressure. Patients monitoring their own blood pressure and communicating the readings with healthcare providers facilitates a more comprehensive plan of care.

PICOT: The PICOT question that guided this project was: In adults 18-90 years old with primary hypertension (P), will a self-measured blood pressure monitoring that includes a monthly telehealth visit with a provider (I), compared to blood pressure monitoring at routine office visits (C), decrease patients' systolic blood pressure readings by five mmHg …

Assessment Of Predictors Of Early Postoperative Complications After Primary Robotically Assisted Roux-En-Y Gastric Bypass: A Multicenter, Retrospective Cohort Study, Pouya Iranmanesh, Shinil K Shah, Mickael Chevallay, Christian Toso, Stefan P Mönig, Monika E Hagen, Erik B Wilson, Minoa K Jung

Faculty, Staff and Student Publications

BACKGROUND: Robotic Roux-en-Y gastric bypass (RRYGB) is performed in an increasing number of bariatric centers worldwide. Previous studies have identified a number of demographic and clinical variables as predictors of postoperative complications after laparoscopic Roux-en-Y gastric bypass (LRYGB). Some authors have suggested better early postoperative outcomes after RRYGB compared to LRYGB. The objective of the present study was to assess potential predictors of early postoperative complications after RRYGB.

METHODS: A retrospective analysis of two prospective databases containing patients who underwent RRYGB between 2006 and 2019 at two high volumes, accredited bariatric centers was performed. Primary outcome was rate of 30 …

Giant Cell Arteritis In An Elderly Female With Pulmonary Tuberculosis, Ashwin Parchani, Ashish Baweja, Harnoor Singh, Yatharth Malik, Vinod Gupta, Minakshi Dhar, Monika Pathania

Faculty, Staff and Student Publications

Giant cell arteritis (GCA) is a type of systemic vasculitis that primarily affects people over the age of 50 and affects the medium to large arteries. GCA's clinical manifestations can be varied and non-specific, similar to those observed in atherosclerosis. Here, the authors present a case of an elderly woman with pulmonary tuberculosis with GCA masquerading as atherosclerosis.

Heart Failure-Type Symptom Score Trajectories In Ckd: Findings From The Chronic Renal Insufficiency Cohort (Cric) Study, Carl P Walther, Julia S Benoit, Nisha Bansal, Vijay Nambi, Sankar D Navaneethan, Cric Study Investigators

Faculty, Staff and Students Publications

RATIONALE & OBJECTIVE: Quality of life in chronic kidney disease (CKD) is impaired by a large burden of symptoms including some that overlap with the symptoms of heart failure (HF). We studied a group of individuals with CKD to understand the patterns and trajectories of HF-type symptoms in this setting.

STUDY DESIGN: Prospective cohort study.

SETTING & PARTICIPANTS: 3,044 participants in the Chronic Renal Insufficiency Cohort (CRIC) without prior diagnosis of HF.

PREDICTORS: Sociodemographics, medical history, medications, vital signs, laboratory values, echocardiographic and electrocardiographic parameters.

OUTCOME: Trajectory over 5.5 years of a HF-type symptom score (modified Kansas City Cardiomyopathy Questionnaire …

Reclassification Of Pre-Heart Failure Stages Using Cardiac Biomarkers: The Aric Study, Xiaoming Jia, Mahmoud Al Rifai, Chiadi E Ndumele, Salim S Virani, James A De Lemos, Emmanuel Lee, Amil M Shah, Justin B Echouffo-Tcheugui, Biykem Bozkurt, Ron Hoogeveen, Elizabeth Selvin, Christie M Ballantyne, Vijay Nambi

Faculty, Staff and Students Publications

BACKGROUND: The recent heart failure (HF) guideline recommends the inclusion of cardiac biomarkers in defining Stage B HF.

OBJECTIVES: The authors evaluated the impact of incorporating cardiac biomarkers to reclassify HF in 5,324 participants (mean age: 75.8 years) without prevalent HF enrolled in the ARIC (Atherosclerosis Risk In Communities) study and assessed prognosis of Stage B using cardiac biomarkers.

METHODS: Using N-terminal pro-B-type natriuretic peptide (/mL or ≥125 pg/mL), high-sensitivity troponin T (/L or ≥14 ng/L), and abnormal cardiac structure/function by echocardiography, individuals were classified as Stage A

RESULTS: Overall, 4,326 (81.3%) individuals were classified as Stage B

CONCLUSIONS: Incorporating …

Decellularized Heart Extracellular Matrix As A Biomimetic Substrate For Alleviating Hipsc-Cardiac Fibroblast Activation And Enhancing Isogenic Cardiac Organoids, Charles Kerr

MUSC Theses and Dissertations

Cardiovascular disease is the constant leading cause of death worldwide. While substantial efforts have been undertaken to improve disease outcomes, the lack of adequate human cardiac tissue models exacerbates research and development costs and clinical trial failures, hampering novel therapeutic discovery. To address this, human engineered cardiac microtissues composed of human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM) show potential in recapitulating hallmark qualities of natural human myocardium for novel therapeutic testing, disease modeling and cardiotoxicity screening. However, as these models are engineered in vitro, they are limited in their capacity to fully recapitulate myocardium and are vulnerable to influences …

Single-Center Contemporary Clinical Outcomes After Endovascular Treatment In Patients With De Novo Femoropopliteal Lesions Between 2017 And 2019, Kazunori Horie, Akiko Tanaka, Masataka Taguri, Norio Tada

Faculty, Staff and Student Publications

Background: Drug-coated balloons (DCBs) and drug-eluting stents (DES) were available for treating femoropopliteal disease since 2017 and 2019. However, there are few reports to investigate whether approval of DCB and DES improved primary patency in clinical practice.

Materials and Methods: We divided consecutive 407 patients into 2017 (n=93), 2018 (n=128), and 2019 (n=186) groups, undergoing endovascular therapy (EVT) for de novo femoropopliteal lesions in our hospital. We retrospectively compared clinical characteristics, procedure, and one-year patency between the three groups.

Results: Baseline characteristics were not different except for the lower rate of popliteal lesions in 2017 (p=0.030). Use of DCB increased …

The Effects Of Demographics And Risk Factors On The Morphological Characteristics Of Human Femoropopliteal Arteries, Sayed Ahmadreza Razian, Majid Jadidi, Alexey Kamenskiy

UNO Student Research and Creative Activity Fair

Background: Disease of the lower extremity arteries (Peripheral Arterial Disease, PAD) is associated with high morbidity and mortality. During disease development, the arteries adapt by changing their diameter, wall thickness, and residual deformations, but the effects of demographics and risk factors on this process are not clear.

Methods: Superficial femoral arteries from 736 subjects (505 male, 231 female, 12 to 99 years old, average age 51±17.8 years) and the associated demographic and risk factor variables were used to construct machine learning (ML) regression models that predicted morphological characteristics (diameter, wall thickness, and longitudinal opening angle resulting from the …

Utilizing Telehealth To Decrease Hospital Readmissions For Heart Failure Patients, Madison Geib, Jo Loomis

DNP Qualifying Manuscripts

Abstract

Background: Without proper education, heart failure (HF) is very difficult to manage. A lack of education and proper management of HF can lead to frequent hospital readmissions, decreased quality of life, and early morbidity and mortality.

Objective: Through literature review, this paper aims to identify the benefits of implementing telehealth education for HF patients in order to decrease hospital readmissions.

Methods: A range of relevant articles were analyzed and summarized in this literature review. An extensive literature search was performed and systematic reviews, meta-analyses, critically appraised research studies, qualitative, and peer-reviewed research studies were included.

Results: Ten articles met …

High Output Heart Failure, A Lethal And Forgotten Cause Of Heart Failure, Neiberg A. Lima Md, Ian Detroyer Bs, Saman Razzaq Md, Oluwale Adegbala Md, Preeti Ramappa Md

Medical Student Research Symposium

Introduction

Cardiac output (CO) is usually low or normal in patients with heart failure. However, some patients have a high CO deemed high-output heart failure (HOHF). HOHF is not well characterized and continues to be under-recognized clinically. At the Detroit VA, we conducted a quality improvement project to define the characteristics of this unique patient population, identify predictors and increase awareness of this entity.

Methods

Patients with HOHF were compared to patients with heart failure with preserved ejection fraction (HFpEF) and normal CO. HOHF was defined as CO >8 L/minute on right heart catheterization performed between 2008-2021. Retrospective data regarding …

Towards Standardized, Safe And Efficacious Screening Approaches To Patients With Lower Extremity Peripheral Arterial Disease In The Setting Of Lower Extremity Arthroplasty, Zaina N. Khoury, Adam Pearl, Ahmad Hassan, Mohamed Awad, Khaled Saleh

Medical Student Research Symposium

INTRODUCTION: Peripheral arterial disease (PAD) impedes recovery from lower extremity arthroplasties (LEA) and increases risk of complications/mortality, yet there aren’t standards for screening PAD patients pre-LEA. This review proposes some.

METHODS: This review searched databases for articles containing relevant terms. Non-English articles, those unrelated to LEA, and duplicates were excluded. Articles were cross-referenced to find other relevant papers for a total of 111.

RESULTS: Up to 49.2% of PAD patients have CAD. Wagner grade III/IV ulcers increase amputations and decrease wound closures. The Wound, Ischemia, and Foot Infection (WIfI) system provides more accurate, and therefore actionable, assessment. Overlooking PAD in …

Ttr Amyloidosis: Current State Of Affairs And Promise For The Future, Yevgeniy Brailovsky, Indranee Rajapreyar, Rene Alvarez

Division of Cardiology Faculty Papers

No abstract provided.

Adverse Outcomes Of Atrial Fibrillation Ablation In Heart Failure Patients With And Without Cardiac Amyloidosis: A Nationwide Readmissions Database Analysis (2015-2019), Waqas Ullah, Max Ruge, Md, Alexander G. Hajduczok, Kirpal Kochar, Daniel R. Frisch, Behzad B. Pavri, René J Alvarez, Indranee N. Rajapreyar, Yevgeniy Brailovsky

Jefferson Hospital Staff Papers and Presentations

AIMS: Atrial fibrillation (AF) in patients with cardiac amyloidosis (CA) has been linked with a worse prognosis. The current study aimed to determine the outcomes of AF catheter ablation in patients with CA.

METHODS AND RESULTS: The Nationwide Readmissions Database (2015-2019) was used to identify patients with AF and concomitant heart failure. Among these, patients who underwent catheter ablation were classified into two groups, patients with and without CA. The adjusted odds ratio (aOR) of index admission and 30-day readmission outcomes was calculated using a propensity score matching (PSM) analysis. A total of 148 134 patients with AF undergoing catheter …

Genetic Architecture Of Spatial Electrical Biomarkers For Cardiac Arrhythmia And Relationship With Cardiovascular Disease, William J Young, Jeffrey Haessler, Jan-Walter Benjamins, Linda Repetto, Jie Yao, Aaron Isaacs, Andrew R Harper, Julia Ramirez, Sophie Garnier, Stefan Van Duijvenboden, Antoine R Baldassari, Maria Pina Concas, Thuyvy Duong, Luisa Foco, Jonas L Isaksen, Hao Mei, Raymond Noordam, Casia Nursyifa, Anne Richmond, Meddly L Santolalla, Colleen M Sitlani, Negin Soroush, Sébastien Thériault, Stella Trompet, Stefanie Aeschbacher, Fariba Ahmadizar, Alvaro Alonso, Jennifer A Brody, Archie Campbell, Adolfo Correa, Dawood Darbar, Antonio De Luca, Jean-François Deleuze, Christina Ellervik, Christian Fuchsberger, Anuj Goel, Christopher Grace, Xiuqing Guo, Torben Hansen, Susan R Heckbert, Rebecca D Jackson, Jan A Kors, Maria Fernanda Lima-Costa, Allan Linneberg, Peter W Macfarlane, Alanna C Morrison, Pau Navarro, David J Porteous, Peter P Pramstaller, Alexander P Reiner, Lorenz Risch, Ulrich Schotten, Xia Shen, Gianfranco Sinagra, Elsayed Z Soliman, Monika Stoll, Eduardo Tarazona-Santos, Andrew Tinker, Katerina Trajanoska, Eric Villard, Helen R Warren, Eric A Whitsel, Kerri L Wiggins, Dan E Arking, Christy L Avery, David Conen, Giorgia Girotto, Niels Grarup, Caroline Hayward, J Wouter Jukema, Dennis O Mook-Kanamori, Morten Salling Olesen, Sandosh Padmanabhan, Bruce M Psaty, Cristian Pattaro, Antonio Luiz P Ribeiro, Jerome I Rotter, Bruno H Stricker, Pim Van Der Harst, Cornelia M Van Duijn, Niek Verweij, James G Wilson, Michele Orini, Philippe Charron, Hugh Watkins, Charles Kooperberg, Henry J Lin, James F Wilson, Jørgen K Kanters, Nona Sotoodehnia, Borbala Mifsud, Pier D Lambiase, Larisa G Tereshchenko, Patricia B Munroe

Faculty, Staff and Student Publications

The 3-dimensional spatial and 2-dimensional frontal QRS-T angles are measures derived from the vectorcardiogram. They are independent risk predictors for arrhythmia, but the underlying biology is unknown. Using multi-ancestry genome-wide association studies we identify 61 (58 previously unreported) loci for the spatial QRS-T angle (N = 118,780) and 11 for the frontal QRS-T angle (N = 159,715). Seven out of the 61 spatial QRS-T angle loci have not been reported for other electrocardiographic measures. Enrichments are observed in pathways related to cardiac and vascular development, muscle contraction, and hypertrophy. Pairwise genome-wide association studies with classical ECG traits identify shared genetic …

Downregulated Klf2 In Polycythemia Vera And Essential Thrombocythemia Induces Prothrombotic Gene Expression, Jihyun Song, Soo Jin Kim, Jahnavi Gollamudi, Perumal Thiagarajan, Josef T Prchal

Faculty, Staff and Students Publications

Thromboses are major causes of morbidity and mortality in polycythemia vera (PV) and essential thrombocythemia (ET) diseases associated with JAK2V617F mutation. However, the molecular mechanism(s) of increased thrombosis in PV and ET remain unknown. Kruppel-like factor 2 (KLF2) is a transcription factor that regulates expression of genes associated with inflammation and thrombosis; the absence of KLF2 in neutrophils causes thrombosis by inducing tissue factor. We studied the role of KLF2 in regulating prothrombotic gene expression in PV and ET. Neutrophils and platelets KLF2 expression in PV and ET was lower than the controls. Furthermore, in patients with thromboses, KLF2 transcripts …

Recurrent Spontaneous Coronary Artery Dissection: A Case Of Triple Trouble, Sumit Khurana, Jessica Kaushal, Dhruv Markan, John C. Wang, Antony Kaliyadan, Christopher Haas, Amrit Devkota

Journal of Community Hospital Internal Medicine Perspectives

SCAD (Spontaneous Coronary Artery Dissection) is a rare disorder which rarely recurs. It is increasingly diagnosed as a cause for acute coronary syndrome (ACS) with limited insight into its pathophysiology and treatment. Lack of randomized trials and consensus guidelines make this a unique and challenging disease to manage. We describe a complex case of recurrent idiopathic SCAD with prior history of NSTE-ACS (Non-ST elevation Acute Coronary Syndrome) and discuss its management based on current clinical practices.

A Rare Find: Pericardial Carcinomatosis And Pre-Tamponade Secondary To Gastric Cancer, Humza Malik, Alex Glaser, Mehnaz Rahman, Jasmine Taylor, Xavier Diaz-Hernandez, Archit Shukla

School of Medicine Faculty Publications

American College of Cardiology Conference ACC.23, March 4 - 6, 2023, New Orleans, LA

Squamous Cell Carcinoma With Suspected Metastases To The Myocardial Wall As Evidenced By Contrast Transthoracic Echocardiogram., Trent Davidge, Shashitha Gavini, Thomas H. Fox, Mehnaz Rahman

School of Medicine Faculty Publications

American College of Cardiology Conference ACC.23, March 4 - 6, 2023, New Orleans, LA

A Case Of Bartonella Vinsonii Endocarditis Of Non-Native Pulmonic Valve In A Patient With Tetralogy Of Fallot., Emily Riley, Jesus C. Jaile Iv, Sergio Bartakian

School of Medicine Faculty Publications

American College of Cardiology Conference ACC.23, March 4 - 6, 2023, New Orleans, LA

Fluid Management In Septic Patients With Pulmonary Hypertension, Review Of The Literature, Blerina Asllanaj, Elizabeth Benge, Jieun Bae, Yi Mcwhorter

School of Medicine Faculty Research

The management of sepsis in patients with pulmonary hypertension (PH) is challenging due to significant conflicting goals of management and complex hemodynamics. As PH progresses, the ability of right heart to perfuse lungs at a normal central venous pressure (CVP) is impaired. Elevated pulmonary vascular pressure, due to pulmonary vasoconstriction and vascular remodeling, opposes blood flow through lungs thus limiting the ability of right ventricle (RV) to increase cardiac output (CO) and maintain adequate oxygen delivery to tissue. In sepsis without PH, avoidance of volume depletion with intravascular volume replacement, followed by vasopressor therapy if hypoperfusion persists, remains the cornerstone …

Aspirin With Or Without Statin In Individuals Without Atherosclerotic Cardiovascular Disease Across Risk Categories, Safi U. Khan, Ahmad N. Lone, Neal S. Kleiman, Adeel Arshad, Vardhmaan Jain, Mahmoud Al Rifai, Hassaan B. Arshad, Sourbha S. Dani, Amit Khera, Salim S. Virani

Office of the Provost

Background: The effects of aspirin in adults without atherosclerotic cardiovascular disease (ASCVD), stratified by statin use across different ASCVD risks, remain uncertain.
Objectives: The purpose of this study was to examine the effects of aspirin in adults without ASCVD, stratified by statin use across different ASCVD risks.
Methods: We searched databases through March 2022 and selected randomized controlled trials of aspirin without ASCVD and follow-up of ≥1 year. We used random-effects models and estimated relative and absolute risks for cardiovascular outcomes, major bleeding, and mortality over 5 years. We calculated absolute risk differences assuming constant relative risks (RRs) across statin …

Identification And Management Of Atherosclerotic Cardiovascular Disease Risk In South Asian Populations In The U.S., Anandita Agarwala, Priyanka Satish, Mahmoud Al Rifai, Anurag Mehta, Miguel Cainzos-Achirica, Nilay S. Shah, Alka M. Kanaya, Garima V. Sharma, Dave L. Dixon, Salim S. Virani

Office of the Provost

South Asians (SAs, individuals with ancestry from Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka) are among the fastest growing ethnic subgroups in the United States. SAs typically experience a high prevalence of diabetes, abdominal obesity, and hypertension, among other cardiovascular disease risk factors, which are often under recognized and undermanaged. The excess coronary heart disease risk in this growing population must be critically assessed and managed with culturally appropriate preventive services. Accordingly, this scientific document prepared by a multidisciplinary group of clinicians and investigators in cardiology, internal medicine, pharmacy, and SA-centric researchers describes key characteristics of traditional and …

The Impact Of Bicuspid Aortic Valve Leaflet Fusion Morphology On The Ascending Aorta And On Outcomes Of Aortic Valve Replacement, Steve Bibevski, Mark Ruzmetov, Juan F Plate, Frank G Scholl

The Texas Heart Institute Journal

BACKGROUND: Patients with bicuspid aortic valves (BAVs) tend to develop dilation of the ascending aorta. The aim of this study was to analyze the impact of leaflet fusion pattern on aortic root diameter and outcomes in patients undergoing surgery for BAV vs tricuspid aortic valve (TAV) disease.

METHODS: This is a retrospective review of 90 patients with aortic valve disease (mean [SD] age, 51.5 [8.2] years) who underwent aortic valve replacement for BAV (n = 60) and TAV (n = 30). Fusion of right-left (R/L) coronary cusps was identified in 45 patients, whereas the remaining 15 patients had right-noncoronary (R/N) …