Medical Specialties Commons^™

The Synergistic Effects Of Saxagliptin And Metformin On Cd34+ Endothelial Progenitor Cells In Early Type 2 Diabetes Patients: A Randomized Clinical Trial., Fiona J Dore, Cleyton C Domingues, Neeki Ahmadi, Nabanita Kundu, Yana Kropotova, Sara Houston, Carol Rouphael, Aytan Mammadova, Linda Witkin, Anamil Khiyami, Richard L Amdur, Sabyasachi Sen

Surgery Faculty Publications

AIMS: Type 2 diabetes is associated with endothelial dysfunction leading to cardiovascular disease. CD34+ endothelial Progenitor Cells (EPCs) are responsible for endothelial repair and neo-angiogenesis and can be used as a cardiovascular disease risk biomarker. This study investigated whether the addition of saxagliptin, a DPP-IV inhibitor, to metformin, may reduce cardiovascular disease risk in addition to improving glycemic control in Type 2 diabetes patients.

METHODS: In 12 week, double-blind, randomized placebo-controlled trial, 42 subjects already taking metformin 1-2 grams/day were randomized to placebo or saxagliptin 5 mg. Subjects aged 40-70 years with diabetes for < 10 years, with no known cardiovascular disease, BMI 25-39.9, HbA1C 6-9% were included. We evaluated EPCs number, function, surface markers and gene expression, in addition to arterial stiffness, blood biochemistries, resting energy expenditure, and body composition parameters. A mixed model regression to examine saxagliptin vs placebo, accounting for within-subject autocorrelation, was done with SAS (p < 0.05).

RESULTS: Although there was no significant …

Comparing Cardiac Dynamics Between Neonatal And Adult Rats, Luther Swift, Rafael Jaimes, Morgan Burke, J Hiebert, Nikki G. Posnack

GW Research Days 2016 - 2020

Background:

Cardiovascular physiology studies have been largely limited to adult models; yet, significant developmental differences exist between the immature and adult heart. The field of pediatric research has largely been limited to immortalized cardiomyocyte cell lines, which lack physiologically relevant action potentials, and primary neonatal myocytes that have a limited life span and lack physiologically relevant automaticity. As a result, our understanding of developmental changes in ion channel expression, t-tubule development, and excitation-contraction coupling have been deduced from 2D simplified cell models. To fully understand cardiac development from neonate to adult, a physiologically-relevant 3D whole heart model is needed to …

Effects Of A Phase Ii Cardiac Rehabilitation Program On Patient Depression, Michael R. Legal, Dnp, Msn-Ed, Rn, Ccrn-K

Doctor of Nursing Practice Projects

Background: Screening for depression upon intake and completion of a Phase II cardiac rehabilitation (CR) program may influence the type of interventions implemented by CR staff and reduce depression.

Objectives: We examined patients before and after a Phase II CR program who self-reported as depressed using the CES-D score and also assessed scores by procedure, gender and age. We further identified the types of interventions used for those who were depressed.

Methods: We conducted a pre-post intervention study. Using a convenience sample, data were collected on CES-D scores before and after the program and by type of procedure, gender, and …

Risk Factors For Major Early Adverse Events Related To Cardiac Catheterization In Children And Young Adults With Pulmonary Hypertension: An Analysis Of Data From The Impact (Improving Adult And Congenital Treatment) Registry., Michael L O'Byrne, Kevin F Kennedy, Joshua P Kanter, John T Berger, Andrew C Glatz

Pediatrics Faculty Publications

BACKGROUND: Cardiac catheterization is the gold standard for assessment and follow-up of patients with pulmonary hypertension (PH). To date, there are limited data about the factors that influence the risk of catastrophic adverse events after catheterization in this population.

METHODS AND RESULTS: A retrospective multicenter cohort study was performed to measure risk of catastrophic adverse outcomes after catheterization in children and young adults with PH and identify risk factors for these outcomes. All catheterizations in children and young adults, aged 0 to 21 years, with PH at hospitals submitting data to the IMPACT (Improving Adult and Congenital Treatment) registry between …

Percutaneous Management Of Ostial Stenosis Of The Left Internal Mammary Artery Graft, Tanuka Datta, Mohammed Gibreal, Ramesh Mazhari, Allen J. Solomon

Medicine Faculty Publications

A 61-year-old man, who had undergone coronary artery bypass surgery 10 years earlier, presented with a non-ST segment elevation myocardial infarction. He was treated with medical therapy and taken to the Cardiac Catheterization Laboratory. A left heart catheterization demonstrated an ostial stenosis in the left internal mammary artery graft, which was felt to be the culprit lesion. This was successfully repaired with a drug eluting stent. This case is presented as an unusual location for a de novo coronary stenosis. The pathophysiology of these lesions is not well understood.

Reduction Of Vascular Inflammation, Ldl-C, Or Both For The Protection From Cardiovascular Events?, Andromachi Reklou, Michael Doumas, Konstantinos Imprialos, Konstantinos Stavropoulos, Dimitris Patoulias, Vasilios Athyros

Medicine Faculty Publications

Background:

Low density lipoprotein cholesterol (LDL-C) and low grade arterial inflammation are key pathogenic factors for atherosclerosis and its manifestation, cardiovascular disease (CVD).

Objective:

In this narrative review we assessed if decreasing LDL-C levels or inflammation or both is more effective in reducing CVD events.

Results:

In the Scandinavian Simvastatin Survival Study (4S), all statin trials of the 90s’ and the Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk (FOURIER) the benefit came from the LDL-C reduction. In the GREak and Atorvastatin Coronary heart disease Evaluation (GREACE), the Treating to New Targets (TNT), and the Justification …

Comparison Between Different Strategies Of Rheumatic Heart Disease Echocardiographic Screening In Brazil: Data From The Provar (Rheumatic Valve Disease Screening Program) Study, B Nascimento, Craig A. Sable, M Nunes, A Diamantino, K Oliveira, Andrea Z. Beaton, +Several Additional Authors

Pediatrics Faculty Publications

Background-—Considering the limited accuracy of clinical examination for early diagnosis of rheumatic heart disease (RHD), echocardiography has emerged as an important epidemiological tool. The ideal setting for screening is yet to be defined. We aimed to evaluate the prevalence and pattern of latent RHD in schoolchildren (aged 5–18 years) and to compare effectiveness of screening between public schools, private schools, and primary care centers in Minas Gerais, Brazil.

Methods and Results-—The PROVAR (Rheumatic Valve Disease Screening Program) study uses nonexperts and portable and handheld devices for RHD echocardiographic screening, with remote interpretation by telemedicine, according to the 2012 World Heart …