Medical Specialties Commons^™

Audicor Remote Patient Monitoring: Fda Breakthrough Device And Technology For Heart Failure Management, Marat Fudim Md, Mhs, Michael Mirro Md, Hao-Ming Cheng Md

Parkview Heart Institute

No abstract provided.

Screening For Mixed-Etiology Pleural Effusion Using Point Of Care Ultrasound, Samuel Eglin, Abby Velarde

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

Implementation Of The National Institutes Of Stroke Scale (Nihss) In A Cardiovascular Intensive Care For Post Carotid Intervention Patients, Lisa Morgan Msn, Rn, Cnrn, Agcns-Bc

Nursing Publications, Posters, & Presentations

Poster addresses following problem: Post carotid intervention patients in the Cardiovascular Intensive Care Unit (CVICU) were not routinely assessed with the NIHSS.

Change in process implemented through improvement protocol.

APRN Implications: Improved collaboration between nursing and the medical team.

Cardiovascular Applications Of Artificial Intelligence In Research, Diagnosis, And Disease Management, Viswanathan Rajagopalan, Houwei Cao

Center for No Boundary Thinking

Despite significant advancements in diagnosis and disease management, cardiovascular (CV) disorders remain the No. 1 killer both in the United States and across the world, and innovative and transformative technologies such as artificial intelligence (AI) are increasingly employed in CV medicine. In this chapter, the authors introduce different AI and machine learning (ML) tools including support vector machine (SVM), gradient boosting machine (GBM), and deep learning models (DL), and their applicability to advance CV diagnosis and disease classification, and risk prediction and patient management. The applications include, but are not limited to, electrocardiogram, imaging, genomics, and drug research in different …

Atypical Pericardial Opportunistic Infection, Brittney Ward, David Pash, Brittney Carman

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

Strep Pyogenes: Predilection For The Pleural Space, Song Chi Lu, Md

Poster Presentations

No abstract provided.

Eisenmenger Syndrome As A Long Term Complication Of Tricuspid Atresia, Brady Howard, Md

Poster Presentations

No abstract provided.

Obstructive Sleep Apnea And Cardiovascular Disease, Evan Gagnon

Graduate Research Projects

No abstract provided.

Improving Utilization Of Palliative Care For Heart Failure Patients, Devin Tilley

Doctor of Nursing Practice Projects

The purpose of this program was to educate providers regarding palliative care for heart failure patients. Palliative care is underutilized in conjunction with usual heart failure management despite proven benefits of decreased symptom burden, reduced hospitalizations, and improved overall quality of life. Provider education has the ability to improve provider knowledge of palliative care for heart failure patients. A brief education session was given to hospital providers in an acute care setting to evaluate the benefits of provider education on palliative care utilization for heart failure patients. Findings included improved provider confidence in referring heart failure patients to palliative care. …

Intermittent Fasting And Reduction Of Cardiovascular Disease Risk, Ethan Dekam

Theses and Graduate Projects

Background: Cardiovascular disease remains one of the leading causes of death worldwide. Intermittent fasting is a unique intervention that is beginning to be studied more extensively for weight loss, positive alterations in serum lipid profile, and improvement of insulin resistance which are all modifiable risk factors for the development of cardiovascular disease.

Purpose: The research question at the center of this literature review is: does the addition of intermittent fasting reduce the risk of developing cardiovascular disease? The reduction of cardiovascular disease was studied through alterations in weight, cholesterol, and diabetic labs.

Methods: A comprehensive literature review …

Stroke Prevention In Patients With Non-Valvular Atrial Fibrillation: The Watchman Device Versus Warfarin, Emma Delaney

Theses and Graduate Projects

Atrial fibrillation is a common heart arrhythmia that leads to an increased risk of stroke. Warfarin was the original anticoagulant that would be used as the treatment for atrial fibrillation. However, there are people who have contraindications to anticoagulation or are a high fall risk and shouldn’t be on Warfarin. The Watchman Device was originally designed in 2005 as a way to close the left atrial appendage where clots are usually present with atrial fibrillation. The watchman may be a superior way to help reduce the risk of stroke compared to the traditional use of Warfarin. Purpose: Literature review …

Dual Antiplatelet Therapy With Ticagrelor Vs Clopidogrel In Patients With Acute Coronary Syndrome, Binh Vu

Theses and Graduate Projects

Background: Dual antiplatelet therapy (DAPT) is an effective secondary prevention and an essential component of treatment after patients suffering from acute coronary syndrome (ACS). Recently, clinicians rapidly switched to DAPT with ticagrelor as the preferred treatment option after it was introduced in 2011. Compared to clopidogrel, ticagrelor is not a prodrug and does not require metabolic activation to inhibit the platelet P2Y12 receptor. It is the first reversible oral P2Y12 receptor antagonist; and its effect on platelet inhibition is more pronounced compared to clopidogrel.

Purpose: The purpose of this comprehensive review was to evaluate the efficacy and safety …

3d And Bio-Printing As An Efficient And Safe Alternative To Traditional Methods And Materials In Cardiovascular Diseases, Angela Asare-Ose

Theses and Graduate Projects

Background: Cardiovascular diseases are the leading cause of death globally. Therefore, there is the need for more resources to be poured into the research of more treatment options, diagnostic methods and preventative steps for patients. Though several technological advancements are being made in the world of medicine, it is not a bad idea to look at other avenues that have great potential to improve patient outcomes in cardiovascular diseases. 3D and bioprinting, though a relatively new technology in the world of medicine, is showing a promising future. It is already being applied in the field of orthopedic surgery and …

Improving Appropriate Utilization Of Telemetry: Quality Improvement Project, Carlos Vargas, Haris Ahmed, Kashmala Khan, Francis Dimtri, Ahmed Mahmood, Jeffery S. Durbin, Christel Cuevas, Thomas Alexander

Gulf Coast Division GME Research Day 2022

No abstract provided.

A Right Atrial Mass With Fever And Cutaneous Nodules, Feng Gao, Stephanie Koh, Sara Taveras-Alam, Umair Khalid

Faculty, Staff and Student Publications

Primary cardiac tumors, although exceedingly rare, should be considered in the differential diagnosis during workup of any cardiac mass. Extranodal cardiac lymphomas have a natural aggressive course due to delayed diagnosis. We present a 71-year-old male with a dual-chamber pacemaker who presented with fevers and new cutaneous nodules. He was found to have a right atrial primary anaplastic large-cell lymphoma and had a complete metabolic response after chemotherapy. Our case highlights the importance of a multimodality approach in the diagnosis of cardiac tumors and during follow-up after treatment.

Participant Use Of Digital Diaries In Qualitative Research: A Strong Structuration Analysis, Maureen L. Seguin, Jhaki A. Mendoza, Eunice Mallari, Gideon Lasco, Arianna Maever L. Amit, Lia M. Palileo-Villanueva, Benjamin Palafox, Alicia Renedo, Martin Mckee, Dina Balabanova

Development Studies Faculty Publications

Lived experiences of chronic conditions are marked by fluidity and change, which should be considered if care is to be truly patient-centered. Seeking to capture this fluidity, we used digital diaries via mobile phones to communicate with hypertensive patients in the Philippines over approximately 12 months. This paper draws on Strong Structuration Theory to conceptualize the complex array of factors shaping participants’ usage (and non-usage) of the diaries, thereby offering a comprehensive understanding of how the diaries were perceived and used. We draw on qualitative data from 42 participants (73 baseline/follow-up interviews and 37 digital diaries), purposively selected from a …

Endothelial Cell-Derived Extracellular Vesicles Impair The Angiogenic Response Of Coronary Artery Endothelial Cells, Nigeste Carter, Allison H. Mathiesen, Noel Miller, Michael Brown, Ruben M.L. Colunga Biancatelli, John D. Catravas, Anca D. Dobrian

Bioelectrics Publications

Cardiovascular disease (CVD) is the most prominent cause of death of adults in the United States with coronary artery disease being the most common type of CVD. Following a myocardial event, the coronary endothelium plays an important role in the recovery of the ischemic myocardium. Specifically, endothelial cells (EC) must be able to elicit a robust angiogenic response necessary for tissue revascularization and repair. However, local or distant cues may prevent effective revascularization. Extracellular vesicles (EV) are produced by all cells and endothelium is a rich source of EVs that have access to the main circulation thereby potentially impacting local …

How To Alleviate Cardiac Injury From Electric Shocks At The Cellular Level, Pamela W. Sowa, Aleksander S. Kiełbik, Andrei G. Pakhomov, Emily Gudvangen, Uma Mangalanathan, Volker Adams, Olga N. Pakhomova

Bioelectrics Publications

Electric shocks, the only effective therapy for ventricular fibrillation, also electroporate cardiac cells and contribute to the high-mortality post-cardiac arrest syndrome. Copolymers such as Poloxamer 188 (P188) are known to preserve the membrane integrity and viability of electroporated cells, but their utility against cardiac injury from cardiopulmonary resuscitation (CPR) remains to be established. We studied the time course of cell killing, mechanisms of cell death, and protection with P188 in AC16 human cardiomyocytes exposed to micro- or nanosecond pulsed electric field (μsPEF and nsPEF) shocks. A 3D printer was customized with an electrode holder to precisely position electrodes orthogonal to …

Changes In Physical Activity And Relationships To Submaximal Exercise Capacity And Cardiac Function During Breast Cancer Therapy, Moriah P. Bellissimo

Theses and Dissertations

Background: Breast cancer (BC) survivors are at high risk for heart failure due to curative cancer therapies. In non-cancer populations, physical activity is a first line treatment for preventing cardiovascular disease. This study examined whether more physical activity was associated with better submaximal exercise capacity and cardiac function during the first three months of cancer therapy.

Methods: Participants included 223 women with stage I-III BC before therapy and after three months of undergoing treatment and 126 controls. Leisure time physical activity was reported using the Godin Sheppard leisure time exercise questionnaire. Cardiac function was assessed by cardiac magnetic resonance, and …

Clinical Characteristics And Prognostic Factors Of Atrial Fibrillation At A Tertiary Center Of Pakistan – From A South-Asian Perspective – A Cross-Sectional Study, Intisar Ahmed, Aiysha Nasir, Pirbhat Shams, Hunaina Shahab, Muhammad Hassan, Faryal Subhani, Ghurfan Adnan, Awais Farhad, Aamir Hameed, Yawer Saeed

Section of Cardiology

Background: There is lack of large data from South-Asian region on atrial fibrillation and it is imperative that clinical presentation, prognostic factors, management pursued, and outcomes are known for this part of the world. Once collective evidence for the region is known, region-specific guidelines can be laid forward.
Objectives: To evaluate clinical characteristics and prognostic factors of atrial fibrillation at a tertiary care center of Pakistan.
Methods: This was a retrospective study conducted at a tertiary care center of Pakistan. Period of study ranged from July-December 2018. All hospitalized patients who were admitted with atrial fibrillation as a primary or …

Severe Mixed Mitral Valve Disease Due To Massive Mitral Annular Calcification: A Case Report And Literature Review, Fateh Ali Tipoo Sultan, Sheema Saadia

Section of Cardiology

We present an unusual case of massive mitral annular calcification (MAC) leading to severe mixed mitral valve disease, viz severe mitral regurgitation and severe mitral stenosis. To our knowledge, severe mixed mitral valve disease secondary to MAC is extremely rare. The patient (a 65-year-old lady) presented with worsening shortness of breath and signs of congestive heart failure. Echocardiographic examination revealed massive mitral annular calcification. Despite the massive annular calcification, she had experienced neither embolism nor endocarditis in the past. Because of severe symptomatic mitral regurgitation and mitral stenosis, surgery was advised; however, the patient declined it.

Thyroid Steal Syndrome Secondary To Active Hyperthyroid State, Harrison Humphries, Johnathon Chung, Reza Pirzadeh, Wesley Jones, Mohamad Ezzeldin

Gulf Coast Division GME Research Day 2022

No abstract provided.

Dysregulation Of Biomarkers Of Hemostatic Activation And Inflammatory Processes Are Associated With Adverse Outcomes In Pulmonary Embolism, Iman Darwish, Jawed Fareed, Yevgeniy Brailovsky, Debra Hoppensteadt, Brett Slajus, Emily Bontekoe, Frank De Stefano, Trent Reed, Amir Darki

Division of Cardiology Faculty Papers

Introduction: The pathophysiology of pulmonary embolism (PE) represents complex, multifactorial processes involving blood cells, vascular endothelium, and the activation of inflammatory pathways. Platelet (P), endothelial (E), and leukocyte (L)-selectin molecules may play an important role in PE pathophysiology. We aimed to profile the biomarkers of inflammation, including selectins in PE patients, and compare them to healthy individuals.

Materials and methods: 100 acute PE patients and 50 controls were included in this case control study. ELISA methods were used to quantify levels of selectins, inflammatory, and hemostatic biomarkers.

Results: In PE patients, levels of selectin molecules as compared to controls convey …

Quantification Of Infarct Core Signal Using Ct Imaging In Acute Ischemic Stroke, Uma Maria Lal-Trehan Estrada, Grant Meeks, Sergio Salazar-Marioni, Fabien Scalzo, Mudassir Farooqui, Juan Vivanco-Suarez, Santiago Ortega Gutierrez, Sunil A Sheth, Luca Giancardo

Faculty, Staff and Student Publications

In stroke care, the extent of irreversible brain injury, termed infarct core, plays a key role in determining eligibility for acute treatments, such as intravenous thrombolysis and endovascular reperfusion therapies. Many of the pivotal randomized clinical trials testing those therapies used MRI Diffusion-Weighted Imaging (DWI) or CT Perfusion (CTP) to define infarct core. Unfortunately, these modalities are not available 24/7 outside of large stroke centers. As such, there is a need for accurate infarct core determination using faster and more widely available imaging modalities including Non-Contrast CT (NCCT) and CT Angiography (CTA). Prior studies have suggested that CTA provides improved …

A Case Of Protein Losing Enteropathy After Fontan Operation, Gina Kim

Capstone Showcase

Protein Losing Enteropathy (PLE) is a condition in which an excessive amount of proteins are lost through the gastrointestinal tract leading to hypoproteinemia and manifesting as edema, ascites, and diarrhea. While in most cases PLE is a treatable disorder with good outcomes, the morbidity and mortality of the disorder is significantly elevated in patients with a history of Fontan surgery–an operation used to palliate patients born with a single ventricle by rerouting venous blood return directly to pulmonary circulation. After failure of first-line therapeutics of diuretics and steroids, this case study explores the successful treatment of a 5-year-old patient with …

Percutaneous Coronary Intervention Using Second Generation Drug-Eluting Stents Vs Coronary Artery Bypass Graft In Left Main Coronary Artery And Multivessel Coronary Artery Disease, Eric Kim

Capstone Showcase

Many of the studies that are used in reference to the clinical decision making between PCI vs CABG use BMS or first-generation DES as a comparison. With the advancement of stent technology, second-generation DES have emerged with improved efficacy and overall outcome rates compared to BMS and first-generation DES. Some of the newer studies such as EXCEL1-2 , demonstrated noninferiority of second-generation DES to CABG but there are limited studies that support this conclusion. Currently, the studies remain divided in the impact of newer-generation PCIs, and 10-year follow up studies may be required to further validate noninferiority before it can …

Complexities And Complications Of Extreme Obesity, Haval Ali, Udit Naik, Michelle Mcdonald, Mohammad Almosa, Karen Horn, Alexis Staines, Louis Maximilian Buja

Faculty, Staff and Student Publications

Obesity is a common chronic disorder and has detrimental long-term consequences if left untreated. Herein, we report a case of a young lady who suffered from morbid obesity and many of its consequences, and we present a literature review of these complications. While the cause of obesity is multifactorial, the genetic component is particularly important in the pathophysiology of marked obesity. Resistance to Leptin is considered one of the main causes of obesity. There is a unique relationship between polycystic ovary syndrome and obesity, as observed in our case. Obesity is associated with cardiovascular and lung diseases such as heart …

Magi1 Inhibits Interferon Signaling To Promote Influenza A Infection, Yin Wang, Jun-Ichi Abe, Khanh M Chau, Yongxing Wang, Hang Thi Vu, Loka Reddy Velatooru, Fahad Gulraiz, Masaki Imanishi, Venkata S K Samanthapudi, Minh T H Nguyen, Kyung Ae Ko, Ling-Ling Lee, Tamlyn N Thomas, Elizabeth A Olmsted-Davis, Sivareddy Kotla, Keigi Fujiwara, John P Cooke, Di Zhao, Scott E Evans, Nhat-Tu Le

Faculty, Staff and Student Publications

We have shown that membrane-associated guanylate kinase with inverted domain structure-1 (MAGI1), a scaffold protein with six PSD95/DiscLarge/ZO-1 (PDZ) domains, is involved in the regulation of endothelial cell (EC) activation and atherogenesis in mice. In addition to causing acute respiratory disease, influenza A virus (IAV) infection plays an important role in atherogenesis and triggers acute coronary syndromes and fatal myocardial infarction. Therefore, the aim of this study is to investigate the function and regulation of MAGI1 in IAV-induced EC activation. Whereas, EC infection by IAV increases MAGI1 expression, MAGI1 depletion suppresses IAV infection, suggesting that the induction of MAGI1 may …

Cancer Treatment-Induced Nad+ Depletion In Premature Senescence And Late Cardiovascular Complications, Priyanka Banerjee, Elizabeth A Olmsted-Davis, Anita Deswal, Minh Th Nguyen, Efstratios Koutroumpakis, Nicholas L Palaskas, Steven H Lin, Sivareddy Kotla, Cielito Reyes-Gibby, Sai-Ching J Yeung, Syed Wamique Yusuf, Momoko Yoshimoto, Michihiro Kobayashi, Bing Yu, Keri Schadler, Joerg Herrmann, John P Cooke, Abhishek Jain, Eduardo Chini, Nhat-Tu Le, Jun-Ichi Abe

Faculty, Staff and Student Publications

Numerous studies have revealed the critical role of premature senescence induced by various cancer treatment modalities in the pathogenesis of aging-related diseases. Senescence-associated secretory phenotype (SASP) can be induced by telomere dysfunction. Telomeric DNA damage response induced by some cancer treatments can persist for months, possibly accounting for long-term sequelae of cancer treatments. Telomeric DNA damage-induced mitochondrial dysfunction and increased reactive oxygen species production are hallmarks of premature senescence. Recently, we reported that the nucleus-mitochondria positive feedback loop formed by p90 ribosomal S6 kinase (p90RSK) and phosphorylation of S496 on ERK5 (a unique member of the mitogen-activated protein kinase family …

Kidney Disease After Heart And Lung Transplantation, Carlos M Zapata, Hassan N Ibrahim

Faculty, Staff and Student Publications

Chronic kidney disease (CKD) is not only common after lung and heart transplantation but also is associated with increased morbidity and mortality due to multiple pre-, peri- and post-transplant factors. While the exact incidence of CKD in this population is not well-defined, it seems to have gradually increased over the years as older recipients are more frequently considered. The increasing success of the procedure and expanding transplant candidate pool has allowed many with comorbid conditions to receive a transplant, which was considered prohibitive in the past. This review presents risk factors that have been linked to CKD as well as …