Circulatory and Respiratory Physiology Commons^™

Covid-19 Deliveries: Maternal Features And Neonatal Outcomes, Viviana Zlochiver, Blair Tilkens, Ana Cristina Perez Moreno, Fatima Aziz, M. Fuad Jan

Journal of Patient-Centered Research and Reviews

Integrated, data-driven criteria are necessary to evaluate delivery outcomes in pregnancies affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the ongoing COVID-19 pandemic. This study analyzed maternal demographics, clinical characteristics, treatments, and delivery outcomes of 85 ethnically diverse, adult pregnant women who tested positive for SARS-CoV-2 at the time of delivery. Median maternal and gestational ages were 27 years (interquartile range [IQR]: 23–31) and 39 weeks (IQR: 37.3–40.0), respectively. Of the 85 SARS-CoV-2–positive participants, 67 (79%) had no COVID-19 symptoms at the time of routine COVID-19 admission testing, 14 (16%) reported mild COVID-19 symptoms, and 4 (5%) presented …

Incidental Finding Of Anomalous Pulmonary Venous Return Of The Left Upper Lobe, A Rare Anatomical Variation, Anika Dutta, Loren Zuiderveld

Journal of Patient-Centered Research and Reviews

Partial anomalous pulmonary venous return (PAPVR) is a rare congenital abnormality in which 1 to 3 of the pulmonary veins connect to the right atrium rather than the left atrium. In this synthesis of the literature on PAPVR of the left upper lobe, we attempt to illustrate this clinical entity using a case detected incidentally on chest computed tomography, explain the anatomical aspects of this anomaly, and summarize the reported incidence and etiology of left-sided PAPVR. Lastly, differential diagnoses, clinical relevance, and management of left-sided PAPVR are presented. The identification of this variant is important, as it may have serious …

The Development Of An Instrument To Measure Transdermal Hydrogen Sulfide As A Way To Evaluate Microvascular Health In Humans, Benjamin Thomas Matheson

Biomedical Engineering ETDs

Hydrogen sulfide (H₂S) is a gasotransmitter critical in maintaining microcirculation homeostasis. Impaired microcirculation occurs in multiple disease states such as peripheral vascular disease, diabetes mellitus (DM), and hypertension. Early detection and identification of patients with DM who are at risk for heart attack, stroke and amputation due to microvascular disease is crucial. Human skin is an accessible vascular bed that provides an opportunity to non-invasively measure H₂S, which could be used as a biomarker to evaluate microvascular health.

In this work, a novel H₂S gas sensor, called the transdermal arterial gasotransmitter sensor (TAGS^{TM …}

Effect Of Metformin On The High-Density Lipoprotein Proteome In Youth With Type 1 Diabetes, Evgenia Gourgari, Kristen J. Nadeau, Laura Pyle, Martin P. Playford, Junfeng Ma, Nehal N. Mehta, Alan T. Remaley, Scott M. Gordon

Saha Cardiovascular Research Center Faculty Publications

Background: Youth with type 1 diabetes (T1D) have normal or elevated High-Density Lipoprotein Cholesterol (HDL-C), however, the function of HDL, partly mediated by the HDL proteome, may be impaired. Metformin can be used as an adjunct therapy in youth with T1D, but its effects on the HDL proteome are unknown.

Objective: To determine the effect of metformin on the HDL proteome.

Subjects: Youth (12-20 years old) with T1D who had a BMI > 90th percentile, HbA1c > 8.0% and Tanner stage 5.

Methods: Double-blinded, placebo-controlled randomized sub-study. We examined the effects of metformin (n = 25) or placebo (n = …

The Hippo/Yap Signaling Pathway In Cardiovascular Repair, Victor Camberos

Loma Linda University Electronic Theses, Dissertations & Projects

Following cardiovascular injury, neonatal mammalian hearts are capable of restoring damaged tissue while adult hearts cannot. Adults are hindered by their inability to replenish lost cardiomyocytes resulting in increased scar tissue formation and reduced cardiovascular function. The Hippo pathway and its downstream effector Yap1 have recently been identified as key modulators of cardiac development and regeneration in neonates. We investigated the role of Yap1 in a sheep model of cell-based cardiovascular repair in which regenerative neonatal cardiovascular progenitor cells (CPCs) were introduced following LAD ligation. Yap1 was induced in the infarcted regions of the heart following cell treatment, as shown …

Endogenous Mechanisms Regulating Myeloid Cell Mediated Inflammation During Acute Lung Injuries, Nathaniel Berg

Dissertations and Theses (Open Access)

Acute lung injuries (ALI) can result from both direct insults (e.g. pneumonia or inhalation injury), or systemic conditions such as sepsis or trauma. Current treatment options for patients are limited to supportive care and novel approaches are urgently needed. Appreciating the role of excessive inflammation that underlies the pathophysiology of ALI, we sought to identify endogenous mechanisms that dampen inflammation. Here we investigated two pathways that worked to limit excessive pulmonary inflammation in myeloid cells using a mouse model of sepsis-associated ALI. In the first approach we screened for microRNAs during the recovery phase of ALI that could potentially regulate …

Effects Of Endogenous Angiotensin Ii On Abdominal Aortic Aneurysms And Atherosclerosis In Angiotensin Ii-Infused Mice, Masayoshi Kukida, Hisashi Sawada, Satoko Ohno-Urabe, Deborah A. Howatt, Jessica J. Moorleghen, Marko Poglitsch, Alan Daugherty, Hong S. Lu

Saha Cardiovascular Research Center Faculty Publications

No abstract provided.

D-Dimer Levels And Acute Pulmonary Embolism Development In Covid-19 Patients, Vural Ahmet, Kahraman Ahmet Nedim

Journal of Mind and Medical Sciences

Objective. To identify those who develop pulmonary embolism with Ddimer levels by evaluating pulmonary CT angiographies of patients who are followed up with suspicion of coronavirus disease 2019 (COVID-19). Methods. Patients who were followed up in a community hospital with suspicion of COVID-19 and underwent Pulmonary CT angiography examination were evaluated. Clinical and demographic parameters and DDimer values for patients with and without pulmonary embolism were evaluated in the pulmonary CT angiogram. Results. During the COVID-19 pandemic, Thorax CT examination was performed in our center for suspicion or follow-up of COVID-19 infection in 3396 patients. Pulmonary CT angiography was applied …

Mechanisms Of Synthetic Cannabinoids On Cardiovascular Health, Madeleine A. Nelson

Honors Thesis

Cannabinoids encompass natural cannabis and synthetic cannabinoids. While the synthetic cannabinoids interact with the same endogenous system as cannabis, their effects are quite different and poorly understood. In addition to psychological effects that trigger their use, these substances are linked to cardiovascular morbidity. To assess the cardiovascular effect of synthetic cannabinoids, we first tested the hypothesis that intravenous administration of a synthetic cannabinoid would increase blood pressure in conscious rats. Second, we tested the hypothesis that the sympathetic nervous system is involved by injecting a ganglion blocker to see if the cardiovascular response from synthetic cannabinoids would be blocked. Third, …

Methamphetamine Associated Cardiomyopathy In Pregnancy: The Distinctions And The Implications, Ashan Hatharasinghe, Hossein Akhondi

HCA Healthcare Journal of Medicine

Introduction

Methamphetamine associated cardiomyopathy (MAC) and peripartum cardiomyopathy (PPCM) are both rare obstetric conditions. Literature regarding methamphetamine associated cardiomyopathy in the obstetric population is limited, and it can be difficult to make the distinction between the two given the similarities in clinical presentation. However similar, there are significant distinctions in the pathophysiology of these two that can help clinicians with the management process.

Clinical Findings and Outcomes

This case involves a 35-year-old Hispanic G6P5005 at 37 weeks gestation presenting with acute respiratory failure secondary to acute decompensated heart failure with reduced ejection fraction and superimposed preeclampsia leading to urgent cesarean …

Resident Heart Rate Variability During Cataract Surgery, Ahmad Baiyasi, Shibandri Das, Ferris Bayasi, Faisal Ridha Al-Timimi

Medical Student Research Symposium

Purpose: To evaluate ophthalmology resident anxiousness and cardiovascular response by tracking resident heart rate (HR) when performing cataract surgery during their last year of residency.

Methods: A prospective analysis of 31 cataract cases, completed by three residents (two females and one male), at the Kresge Eye Institute in August and September 2020 was performed. Inclusion criteria for cases included all cataract cases performed by PGY-4 residents at the Kresge Eye Institute who downloaded the Heart Graph app supported by iOS. Residents with android mobile devices were excluded from the study. Informed consent was obtained from all residents who utilized the …

Role Of P53 Deficient Clonogenic Endothelial Cells In The Pathogenesis Of Pulmonary Hypertension, Aneel Roy Bhagwani

Theses and Dissertations

Pulmonary Artery Hypertension (PAH) is a progressive disorder of the small vessels of the pulmonary vasculature. It is characterized by occlusive vascular remodeling leading to right heart failure and ultimately death. PAH pathogenesis involves a multifactorial etiology leading to formation of occlusive lesions in small (preacinary) pulmonary arteries. These lesions contain hyper-proliferative, apoptosis resistant endothelial cells (ECs), smooth muscle cells and fibroblasts. ECs play a major role in the development of PAH. These ECs in vascular lesions are primitive and express progenitor cell markers, including CD117 (c-kit).

We have isolated clonally expanded, c-kit+ ECs from the lungs of Green Fluorescent …

Global Impact Of Physical Inactivity And Implications For Public Health Nursing, Elizabeth A. Moxley, Kashica Webber-Ritchey, Laura Hayman

Faculty Articles, Papers, and Other Scholarship

Physical inactivity has been a public health problem worldwide for more than a decade. Of those who are physically active, a substantial percentage engage solely in low or very low physical activity (PA) levels. In the last 3 decades, the prevalence of PA in the United States has decreased with approximately 80% of adults not meeting the recommended guidelines for aerobic and muscle strengthening PA. The PA levels of youth have dramatically decreasedwith 85% of adolescents reporting no PA. Regular PA participation can aid in preventing chronic diseases. A strong inverse dose-response relationship exists between PA and the incidence of …

A Role For Endothelial Tissue-Nonspecific Alkaline Phosphatase In Blood-Tissue Barrier Health And Disease, Allison L. Brichacek

Graduate Theses, Dissertations, and Problem Reports (ETD)

Sepsis is a disorder that targets the microcirculation with significant effects at blood-tissue barriers such as the blood-brain barrier (BBB) and gut-vascular barrier (GVB). Intestinal barrier dysfunction is thought to be one of the most important contributors to multi-organ dysfunction in sepsis. As a common site of infection, the impaired gut allows the dissemination of bacteria, which exacerbates the disease pathophysiology, and can lead to long-term morbidity and mortality. The mechanisms that influence altered barrier permeability in the GVB in sepsis and other inflammatory disorders are not well understood. Tissue-nonspecific alkaline phosphatase (TNAP) enzyme activity, which has been shown to …

Dilemmas In Anticoagulation And Use Of Inferior Vena Cava Filters In Venous Thromboembolism; A Survey Of Respiratory Physicians, Haematologists And Medical Oncologists And A Review Of The Literature, Philip Craven, Ciara Daly, Nisha Sikotra, Tim Clay, Eli Gabbay

Research outputs 2014 to 2021

© The Author(s) 2021. Twenty percent of patients with Cancer Associated Thrombosis receive an inferior vena cava filter annually. Insertion is guided by practice guidelines, which do not specify or discuss the use of inferior vena cava filters in malignancy. Adherence to these guidelines is known to be variable. We aimed to see if there was consistent management of venous thromboembolism among Medical Oncologists/Haematologists and Respiratory Physicians, with respect to inferior vena cava filter use in the setting of suspected and confirmed malignancy. Medical Oncologists, Haematologists and Respiratory Physicians were surveyed with four theoretical cases. Case 1 concerns a patient …

Transcatheter Vs. Surgical Aortic Valve Replacement In Patients At Intermediate Surgical Risk, Nichole M. Bonzano, David M. Milligram

Physician Assistant Capstones, 2020-current

Abstract

• Objective: To compare the safety and efficacy of transcatheter aortic valve replacement (TAVR) to surgical aortic valve replacement (SAVR) in patients with severe symptomatic aortic stenosis at intermediate surgical risk.
• Design: Systematic literature review.
• Methods Literature searches were done in PubMed and Scopus search engines using key terms: TAVR, trans-catheter aortic valve replacement, SAVR, surgical aortic valve replacement, severe aortic stenosis, and intermediate risk. Filters included primary research only. Inclusion criteria were articles which studied an intermediate risk patient population (STS-PROM 3-15%), primary research, and compared outcomes of TAVR and SAVR in patients with severe aortic stenosis requiring replacement. …

Role Of The Acid Sensing Ion Channel 1a In The Systemic Circulation, Selina M. Garcia

Biomedical Sciences ETDs

Acid-sensing ion channel 1a (ASIC1a) is a non-selective cation channel that is expressed in vascular smooth muscle cells. However, little is known about the contribution of ASIC1a to vascular reactivity and cardiovascular homeostasis. We have previously shown that ASIC1a contributes to pulmonary vascular smooth muscle cell (VSMC) Ca²⁺ entry and vasoconstriction as well as chronic hypoxia-induced pulmonary hypertension. However, a role of ASIC1a in the systemic circulation is unclear. Previous reports have shown that ASIC1a is expressed in femoral and cerebral arteries, however, these studies suggest that ASIC1a contributes to vascular reactivity through neuronal regulation rather than vascular. Therefore, …

Apneic Oxygenation: An Adjunctive Therapy For Laryngoscopy During Anesthesia Induction, Yaro Hoffman

Doctoral Projects

Endotracheal intubation is an essential component within the skill set of anesthesia providers. Rapid arterial desaturation remains a primary risk factor during laryngoscopy and intubation. The risk for hypoxemia exists because during endotracheal intubation, patients are apneic or hypo-ventilating (Wong et al., 2017). Apneic oxygenation (AO) has been advocated to attenuate hypoxemia during endotracheal intubation (Pavlov et al., 2017).

The aim of this project was to assess for any knowledge deficits regarding AO among anesthesia providers and assess the willingness of these providers to include AO into their current practice. The project investigator conducted an education session involving the …

Technology Aiding In Neonatal Lung Developmental Care, Megan Kirk

Undergraduate Honors Theses

In this paper, old as well as new technological findings to decrease premature infant mortality are reviewed. This paper discusses fetal development throughout pregnancy from conception to full-term status as well as fetal lung development specifically from conception until full-term status. Several ideas to rapidly develop and mature fetal lungs are discussed such as mothers ingesting artificial surfactant supplements, either independently or coupled with antenatal corticosteroids, as well as intra-amniotic instillation prior to 28 weeks gestational. Drawbacks regarding these two are mentioned as well such as the fetus’s lungs not being mature enough to use the artificial surfactant leading into …

Proteomic Analysis Of Platelet-Rich And Platelet-Poor Plasma, Olga Miroshnychenko, Robert J. Chalkley, Ryan D. Leib, Peter A. Everts, Jason L. Dragoo

Publications and Research

Background

Autologous blood products, such as platelet-rich plasma (PRP) are commercial products broadly used to accelerate healing of tissues after injuries. However, their content is not standardized and significantly varies in composition, which may lead to differences in clinical efficacy. Also, the underlying molecular mechanisms for therapeutic effects are not well understood.

Purpose

A proteomic study was performed to compare the composition of low leukocyte PRP, platelet poor plasma (PPP), and blood plasma. Pathway analysis of the proteomic data was performed to evaluate differences between plasma formulations at the molecular level. Low abundance regulatory proteins in plasma were identified and …

Covid-19 And Arrhythmias: A Review Of Cardiac Electrophysiology Associated With Sars-Cov-2, Kashmala Khan, Francis Dimtri, Carlos Vargas, Thomas Alexander

HCA Healthcare Journal of Medicine

Coronavirus infectious disease 2019 (COVID-19) has become one of the most recognized viral illnesses to date. Most people infected with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have a benign clinical course, but there have also been catastrophic outcomes. Although, notoriously known to affect the respiratory system, extra-pulmonary manifestations have also been established. An increasing number of people have been reported to present with cardiac manifestations, which include but are not limited to arrhythmias. The cardiac conduction system can be damaged by various mechanisms in patients infected with SARS-CoV-2. In this review, we will attempt to briefly describe the arrhythmogenic …

Role Of Cerebral Vasculature And Effect Of Circulating Exosomes In Propagation Of Systemic Inflammatory Responses Into The Central Nervous System, Mahesh Chandra Kodali

Theses and Dissertations (ETD)

Sepsis-associated encephalopathy (SAE) is an acutely progressing brain dysfunction induced by systemic inflammation. The mechanism of initiation of neuroinflammation during SAE, which ultimately leads to delirium and cognitive dysfunction, remains elusive. The goal of this project was to study the molecular events of SAE to capture its onset and progression into the central nervous system (CNS), and further identify the cellular players involved in mediating acute inflammatory signaling. Gene expression profiling on the cerebral vessels isolated from the brains of the mice treated with peripheral lipopolysaccharide (LPS) revealed that the cerebral vasculature responds within minutes to acute systemic inflammation by …

Effect Of Niacin Monotherapy On High Density Lipoprotein Composition And Function, Scott M. Gordon, Marcelo J. Amar, Kianoush Jeiran, Michael Stagliano, Emma Staller, Martin P. Playford, Nehal N. Mehta, Tomas Vaisar, Alan T. Remaley

Saha Cardiovascular Research Center Faculty Publications

BACKGROUND: Niacin has modest but overall favorable effects on plasma lipids by increasing high density lipoprotein cholesterol (HDL-C) and lowering triglycerides. Clinical trials, however, evaluating niacin therapy for prevention of cardiovascular outcomes have returned mixed results. Recent evidence suggests that the HDL proteome may be a better indicator of HDL's cardioprotective function than HDL-C. The objective of this study was to evaluate the effect of niacin monotherapy on HDL protein composition and function.

METHODS: A 20-week investigational study was performed with 11 participants receiving extended-release niacin (target dose = 2 g/day) for 16-weeks followed by a 4-week washout period. HDL …

Characterizing Recurrence Following Hybrid Ablation In Patients With Persistent Atrial Fibrillation, David C. Kress, Lynn Erickson, Tadele W. Mengesha, David Krum, Jasbir Sra

Journal of Patient-Centered Research and Reviews

Purpose: It is It is widely accepted that atrial fibrillation (AF) accounts for half of arrhythmia recurrences following endocardial catheter ablation of AF. An epicardial-endocardial approach (hybrid) has emerged as an alternative to endocardial ablation alone for the treatment of AF, yet recurrence after a hybrid procedure has not been well characterized. This retrospective study is aimed at characterizing recurrence following hybrid ablation for patients with persistent AF.

Methods: Patients with persistent AF (N = 108) received both endocardial and epicardial ablation of the posterior left atrial wall using catheter ablation and a small midline surgical approach (hybrid). Presence of …

Alternative Polyadenylation Modulates Expression Of Pro-Fibrotic Proteins And Contributes To Lung Fibrosis, Junsuk Ko

Dissertations and Theses (Open Access)

Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease which affects about 5 to 8 million individuals in the world. Despite the high prevalence, there is currently no cure for IPF, and the cause of this disease is still unclear. Our laboratory and collaborators have shown that nudix hydrolase 21 (NUDT21, which is also known as cleavage factor 25, CFIm25) is a key regulator of alternative polyadenylation (APA). NUDT21 depletion causes 3’UTR shortening via APA leading to enhanced mRNA stability and protein translation. This NUDT21 reduction promotes tumor growth in glioblastoma by enhancing expression of oncogenes. Cancer and IPF share …

Myocardial Work Index: A Novel Method For Assessment Of Myocardial Function In South Asian Recreational Athletes, Shantanu Sengupta, Renuka Jain, Nitin Burkule, Susan Olet, Bijoy K. Khandheria

Journal of Patient-Centered Research and Reviews

Purpose: We used a novel noninvasive method based on speckle-tracking echocardiography to evaluate myocardial performance in South Asian recreational athletes who completed a half marathon.

Methods: Transthoracic echocardiography was performed on 24 recreational athletes 48 hours before they took part in a half marathon (premarathon), within 2 hours of half marathon completion (postmarathon), and 72 hours after completion. Clinical, laboratory, and echocardiographic variables were collected. Speckle-tracking echocardiography was performed in all subjects to characterize myocardial mechanics.

Results: Mean age of participants was 41.8 ± 7.4 years, and 23 (95.8%) were male. No subject had a prior history of coronary artery …

Modulator Therapy For Cystic Fibrosis: An Exploration Of Current Research, Jessalyn Rombocos

Senior Honors Theses

Developing a drug therapy that addresses the root cause of cystic fibrosis (CF) by increasing CFTR protein levels has long been a research challenge. After genetic therapy failed because a suitable delivery system could not be found, researchers began searching for small organic molecules that could act as chaperones for CFTR. These molecules, known as modulators, allowed CFTR to be assembled correctly and function similarly to wild type CFTR. Since 2012, four modulator drugs have been developed, tested, and approved by the FDA. In October 2019, Trikafta was approved as the first triple-combination modulator drug and has completely revolutionized CF …

Regenerative Medicine Therapy: Adipose Derived Extracellular Vesicles In Viral Myocarditis, David Gorelov, Damian N. Di Florio, Gary R. Salomon, Angita Jain, Nick E. Saikaili, Danielle J. Beetler, Swikriti Shrestha, Ming Tian, Joy Wolfram Phd, Delisa Fairweather Phd, Katelyn Bruno Phd, Judith D. Ochrietor Phd

Showcase of Osprey Advancements in Research and Scholarship (SOARS)

Objective: Myocarditis, inflammation of the heart muscle, is an autoimmune heart disease that can be caused by viruses, bacteria and toxins. Myocarditis can lead to dilated cardiomyopathy (DCM) and heart failure. Currently there are no disease-specific therapies for treating myocarditis or preventing progression to DCM. Adipose Extracellular Vesicles (AEVs) are lipid bilayer nanoparticles that are released into the outside environment of adipocytes and provide promising regenerative potential for inflammatory diseases like myocarditis.

Methods: Lipoaspirate was obtained from women and men and AEVs isolated from the lipoaspirate using tangential flow filtration. We injected wild type male BALB/c mice with 250uL AEVs …

Potential Role Of The Large Protein Titin In The Development Of Heart Failure, Mary M. Prickett

Senior Theses

I will be exploring the impact of the large protein Titin on heart failure with a preserved ejection fraction (HFpEF). It was hypothesized that myocardial Titin plays a significant role in the progression of HFpEF through isoform, N2BA and N2B, changes. It was hypothesized that an increase in the quantity of N2B Titin, less compliant, and a decrease in N2BA Titin, more compliant, will be observed as HF progresses, contributing to an increase in passive stiffness involved in heart contraction. I will cover a detailed report on the role of Titin in HFpEF and propose research methods to explore further.

Flying After Diving: Decompressions And Barotraumas., Nihad E. Daidzic

Aviation Department Publications

FAA Safety Seminar (GL1598968) held at Modern Avionics/Air Trek North at KFCM, Eden Prairie, MN at 9:00 CST on Saturday, February 29, 2020.