Medical Specialties Commons^™

Home Blood Pressure Monitoring To Improve Hypertension Control: A Narrative Review Of International Guideline Recommendations, John Andraos, Luma Munjy, Michael S. Kelly

Pharmacy Faculty Articles and Research

Home blood pressure monitoring (HBPM) is a convenient way to assess out-of-office blood pressure control and is recommended by numerous international guidelines to aid clinicians in the diagnosis and management of essential hypertension. Although available guidelines recommend the use of HBPM in patients receiving antihypertensive medication, their specific recommendations regarding optimal monitoring schedule, duration, and clinician interpretation of home blood pressure readings may differ among guidelines. Purpose: The purpose of this article is to review available international hypertension guideline recommendations related to the use of HBPM to improve hypertension control among patients receiving antihypertensive therapy. We also briefly highlight …

Outcomes Of Pacing In Egyptian Pediatric Population, Ahmed Nabil Ali, Samir S. Wafa, Hosni Hosni Arafa, Rania Samir

Journal of the Saudi Heart Association

No abstract provided.

Predictors Of Persistent Functional Tricuspid Regurgitation After Transcatheter Closure Of Atrial Septal Defect And Its Relationship To Tricuspid Valve Remodeling, Marwa Desoky Abohamar, Medhat Mohamed Ashmawy, Hanan Kamel Kasem, Ehab Abdelwahab Hamdy, Raghda Ghonimy El Sheikh

Journal of the Saudi Heart Association

No abstract provided.

Ecg Localization In St-Elevation Myocardial Infarction: Spotting The Zebra Among The Horses, Jaskaran Singh Gujral, Abhinav Shrivastava

Journal of the Saudi Heart Association

No abstract provided.

Value Of Pathological Q Waves And Angiographic Collateral Grade In Patients Undergoing Coronary Chronic Total Occlusion Recanalization: Cardiac Magnetic Resonance Study, Khaled Abdel-Azim Shokry, El-Sayed Mohamed Farag, Ahmed Mohamed Salem, Ismail Mohamed Ibrahim, Mahmoud Abel-Aziz, Ahmed El Zayat

Journal of the Saudi Heart Association

No abstract provided.

Clinical Overview Of Myocardial Infarction Withoutobstructive Coronary Artey Disease (Minoca), Fahad Shamsi, Khwaja Y. Hasan, Shahrukh Hashmani, Syed F. Jamal, Samer Ellaham

Journal of the Saudi Heart Association

No abstract provided.

Surgical Site Infections Following Pediatric Cardiac Surgery In A Tertiary Care Hospital: Rate And Risk Factors, Milad A. Alshaya, Nouf S. Almutairi, Ghassan A. Shaath, Rahmah A. Aldosari, Sadeem K. Alnami, Alaa Althubaiti, Riyadh M. Abu-Sulaiman

Journal of the Saudi Heart Association

No abstract provided.

Hypertension Management: Improving Medication Adherence Through The Use Of Daily Text Messages, Gaelle Bulabula

Evidence-Based Practice Project Reports

Hypertension (HTN) is the leading cause of hospitalization and is responsible for approximately 50% of cardiovascular and cerebrovascular events (Al-Noumani, et al., 2018). Uncontrolled HTN can lead to comorbidities including ischemic heart disease, renal disease, or life-threatening arrythmias (World Health Organization [WHO], 2019). The leading cause of HTN is medication non-compliance (Varleta, et al., 2017). The purpose of this evidence-based practice project was to determine the effectiveness of daily text messages on antihypertensive medication adherence. A comprehensive review of literature generated ten high-level evidence studies demonstrating that daily text messages near each medication dosing time is best practice for improving …

Biochemical And Echocardiographic Markers For The Early Detection Of Cardiotoxicity Under Monoclonal Antibodies Therapy, Ionela-Emilia Popovici, Angela Cozma, Olga Hilda Orasan, George Ciulei, Ana Maria Poenar, Cristina Buchman, Simina Tarmure, Sorina Secara, Adela Sitar-Taut, Teodora Alexescu, Andrada Lazar, Vasile Negrean, Lucia Maria Procopciuc

Journal of Mind and Medical Sciences

The progress made over the past years in the field of cancer therapy has led to a significant decrease in cancer mortality, but these therapies have many adverse effects, cardiovascular effects being among the most frequent ones. For increasing lifelong expectancy of surviving cancer patients, cardiac monitoring represents an important task. Current studies and practice recommend echocardiography using strain analysis for monitoring the cardio toxic effects of cancer therapy. The potential of combining imaging techniques with biomarkers for the early detection and diagnosis seems a promising path for future research.

Regional Variations In Heart Failure Quality And Outcomes: Get With The Guidelines-Heart Failure Registry, Luke C Cunningham, Gregg C Fonarow, Clyde W Yancy, Shubin Sheng, Roland A Matsouaka, Adam D Devore, Hani Jneid, Anita Deswal

Faculty, Staff and Students Publications

Background

Regional patient characteristics, care quality, and outcomes may differ based on a variety of factors among patients hospitalized for heart failure (HF). Regional disparities in outcomes of cardiovascular disease have been suggested across various regions in the United States. This study examined whether there are significant differences by region in quality of care and short‐term outcomes of hospitalized patients with HF across the United States.

Methods and Results

We examined regional demographics, quality measures, and short‐term outcomes across 4 US Census Bureau regions in patients hospitalized with HF and enrolled in the GWTG‐HF (Get With The Guidelines–Heart Failure) registry …

Late Gadolinium Enhancement Magnetic Resonance Imaging Evaluation Of Post-Atrial Fibrillation Ablation Esophageal Thermal Injury Across The Spectrum Of Severity, Qussay Marashly, Chaitra Gopinath, Alex Baher, Madan Acharya, Mobin Kheirkhahan, Benjamin Hardisty, Mossab Aljuaid, Ibrahim Tawhari, Mark Ibrahim, Alan K Morris, Eugene G Kholmovski, Brent D Wilson, Nassir F Marrouche, Mihail G Chelu

Faculty, Staff and Students Publications

Background Esophageal thermal injury (ETI) is a byproduct of atrial fibrillation (AF) ablation using thermal sources. The most severe form of ETI is represented by atrioesophageal fistula, which has a high mortality rate. Late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) allows identification of ETI. Hence, we sought to evaluate the utility of LGE-MRI as a method to identify ETI across the entire spectrum of severity. Methods and Results All AF radiofrequency ablations performed at the University of Utah between January 2009 and December 2017 were reviewed. Patients with LGE-MRI within 24 hours following AF ablation as well as patients …

A Case Of Abdominal Compartment Syndrome In Cardiac Surgery: A Rare, Potentially Fatal Complication., Michelle Chen, K. Gage Parr

Anesthesiology and Critical Care Medicine Faculty Posters and Presentations

No abstract provided.

The Effectiveness Of A Nurse Practitioner (Np) Led Clinic For Heart Failure (Hf) Patients Following Hospital Discharge In A Rural Community Setting, Tami Collins, Michelle Renaud

College of Health Sciences Posters

Purpose: To explore if patient participation in the NP led HF clinic may reduce 30-day HF readmissions while providing HF specific education, recognition of symptoms/ management, teaching self-care, while ensuring that continued follow up occurs.

Research Questions: 1) Is there a significant difference between readmission rates in patients followed in the HF clinic compared to general HF follow up? 2) Is there a significant difference in patient knowledge including HF symptoms, self-management for patients followed in the NP led HF clinic for a minimum of 30 days? 3) How satisfied are patients that followed in the NP led HF clinic …

Periprocedural And In-Hospital Outcomes Among Percutaneous Coronary Intervention In Saphenous Vein Graft: A Retrospective Observational Study At A Tertiary Care Hospital In South Asian Country, Abdul Baqi, Sheema Saadia

Section of Cardiology

Background: Saphenous vein graft (SVG) may occlude either early or several months to years after coronary artery bypass graft (CABG) surgery. Doing re-do CABG surgery is associated with higher complication and mortality rate as compared to percutaneous coronary intervention (PCI) in SVG. However, PCI of SVG is associated with more periprocedural and in-hospital complications as compared to PCI of native coronary arteries. Due to the scarcity of local data in this regard, this study was designed to estimate the periprocedural and in-hospital outcomes among PCI in SVG.
Objectives: We aim to study the periprocedural and in-hospital outcomes among patients who …

Nanoanalytical Analysis Of Bisphosphonate-Driven Alterations Of Microcalcifications Using A 3d Hydrogel System And In Vivo Mouse Model, Jessica L. Ruiz, Joshua D. Hutcheson, Luis Cardoso, Amirala Bakhshian Nik, Alexandra Condado De Abreu, Tan Pham, Fabrizio Buffolo, Sara Busatto, Stefania Frederici, Andrea Ridolfi, Masanori Aikawa, Sergio Bertazzo, Paolo Bergese, Sheldon Weinbaum, Elena Aikawa

Publications and Research

Vascular calcification predicts atherosclerotic plaque rupture and cardiovascular events. Retrospective studies of women taking bisphosphonates (BiPs), a proposed therapy for vascular calcification, showed that BiPs paradoxically increased morbidity in patients with prior acute cardiovascular events but decreased mortality in event-free patients. Calcifying extracellular vesicles (EVs), released by cells within atherosclerotic plaques, aggregate and nucleate calcification. We hypothesized that BiPs block EV aggregation and modify existing mineral growth, potentially altering microcalcification morphology and the risk of plaque rupture. Three-dimensional (3D) collagen hydrogels incubated with calcifying EVs were used to mimic fibrous cap calcification in vitro, while an ApoE−/− mouse was used …

Pvn Activity In Cardiac Sympathetic Afferent Reflex (Csar) Control And Cardiovascular Function, Shane H. Boomer

Honors Thesis

Regulation of blood pressure is essential in bodily health. Hypertension and hypotension can be associated with varying diseases that could potentiate further disease. From this, understanding the mechanisms that regulate blood pressure is important within medicine. In my study, I will be focusing on a cardiovascular reflex that is less well understood, the cardiac sympathetic afferent reflex (CSAR). In particular, this work will examine sex differences in this reflex in overall function and in the involvement of an area of the brain called the paraventricular nucleus (PVN). We will test the hypothesis that there will be a significant difference between …

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, …

Mechanical Support Of Superior Cavopulmonary (Glenn) Physiology To Heart Transplantation, Edo K S Bedzra, Aliessa P. Barnes, Brian Birnbaum, James D. St. Louis

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

The Impact Of 2020 And The Future Of Cardiology Training: How Do We Innovate?, Prasanti Alekhya Kotta, Brittany Corso, Yevgeniy Brailovsky, Estefania Oliveros

Division of Cardiology Faculty Papers

No abstract provided.

A Phase Ii Study Of Autologous Mesenchymal Stromal Cells And C-Kit Positive Cardiac Cells, Alone Or In Combination, In Patients With Ischaemic Heart Failure: The Cctrn Concert-Hf Trial, Roberto Bolli, Raul D Mitrani, Joshua M Hare, Carl J Pepine, Emerson C Perin, James T Willerson, Jay H Traverse, Timothy D Henry, Phillip C Yang, Michael P Murphy, Keith L March, Ivonne H Schulman, Sohail Ikram, David P Lee, Connor O'Brien, Joao A Lima, Mohammad R Ostovaneh, Bharath Ambale-Venkatesh, Gregory Lewis, Aisha Khan, Ketty Bacallao, Krystalenia Valasaki, Bangon Longsomboon, Adrian P Gee, Sara Richman, Doris A Taylor, Dejian Lai, Shelly L Sayre, Judy Bettencourt, Rachel W Vojvodic, Michelle L Cohen, Lara Simpson, David Aguilar, Catalin Loghin, Lem Moyé, Ray F Ebert, Barry R Davis, Robert D Simari

Faculty, Staff and Student Publications

AIMS: CONCERT-HF is an NHLBI-sponsored, double-blind, placebo-controlled, Phase II trial designed to determine whether treatment with autologous bone marrow-derived mesenchymal stromal cells (MSCs) and c-kit positive cardiac cells (CPCs), given alone or in combination, is feasible, safe, and beneficial in patients with heart failure (HF) caused by ischaemic cardiomyopathy.

METHODS AND RESULTS: Patients were randomized (1:1:1:1) to transendocardial injection of MSCs combined with CPCs, MSCs alone, CPCs alone, or placebo, and followed for 12 months. Seven centres enrolled 125 participants with left ventricular ejection fraction of 28.6 ± 6.1% and scar size 19.4 ± 5.8%, in New York Heart Association …

Three-Year Outcomes From The Liberty 360 Study Of Endovascular Interventions For Peripheral Artery Disease Stratified By Rutherford Category., Stefanos Giannopoulos, Jihad Mustapha, William A Gray, Gary Ansel, George Adams, Eric A Secemsky, Ehrin J Armstrong

Heart and Vascular Articles

PURPOSE: To report the 3-year results of the LIBERTY 360 study, which investigated outcomes of endovascular treatment of symptomatic peripheral artery disease (PAD).

MATERIALS AND METHODS: The LIBERTY trial (

RESULTS: The 36-month KM survival rates were 86.0% in RC 2-3, 79.8% in RC 4-5, and 62.0% in RC 6 groups. The KM estimates of freedom from major amputation at 36 months were 98.5% in RC 2-3, 94.0% in RC 4-5, and 79.9% in RC 6. The 36-month KM estimates for freedom from TVR/TLR were 71.1% in RC 2-3, 64.2% in RC 4-5 and 61.9% in RC 6 groups. Patients …

Performance And Determinants Of Serum Creatinine And Cystatin C-Based Gfr Estimating Equations In South Asians, Yeli Wang, Andrew S. Levey, Lesley A. Inker, Saleem Jessani, Rasool Bux, Zainab Samad, Ali Raza Khan, Amy B. Karger, John C. Allen, Tazeen H. Jafar

Community Health Sciences

Introduction: The creatinine-based Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimated glomerular filtration rate (eGFR) equation was calibrated for the general Pakistan population (eGFRcr-PK) to eliminate bias and improve accuracy. Cystatin C-based CKD-EPI equations (eGFRcys and eGFRcr-cys) have not been assessed in this population, and non-GFR determinants of cystatin C are unknown.
Methods: We assessed eGFRcys, eGFRcr-cys, and non-GFR determinants of cystatin C in a cross-sectional study of 557 participants (≥40 years of age) from Pakistan. We compared bias (median difference in measured GFR [mGFR] and eGFR), precision (interquartile range [IQR] of differences), accuracy (percentage of eGFR within 30% of mGFR), …

Clinical And Economic Burden Of Stroke Among Young, Midlife, And Older Adults In The United States, 2002-2017, Safi U Khan, Muhammad Zia Khan, Muhammad U Khan, Muhammad Shahzeb Khan, Mamas A Mamas, Muhammad Rashid, Ron Blankstein, Salim S Virani, Michelle C Johansen, Michael D Shapiro, Michael J Blaha, Miguel Cainzos-Achirica, Farhaan S Vahidy, Khurram Nasir

Faculty, Staff and Students Publications

OBJECTIVE: To assess trends of stroke hospitalization rates, inpatient mortality, and health care resource use in young (aged ≤44 years), midlife (aged 45-64 years), and older (aged ≥65 years) adults.

PATIENTS AND METHODS: We studied the National Inpatient Sample database (January 1, 2002 to December 31, 2017) to analyze stroke-related hospitalizations. We identified data using the

RESULTS: Of 11,381,390 strokes, 79% (n=9,009,007) were ischemic and 21% (n=2,372,383) were hemorrhagic. Chronic diseases were more frequent in older adults; smoking, alcoholism, and migraine were more prevalent in midlife adults; and coagulopathy and intravenous drug abuse were more common in young patients with …

Fontan-Associated Dyslipidemia, Adam M. Lubert, Tarek Alsaied, Joseph J. Palermo, Nadeem Anwar, Elaine M. Urbina, Nicole M. Brown, Craig Alexander, Hassan Almeneisi, Fred Wu, Andrew R. Leventhal, Nael Aldweib, Michael Mendelson, Alexander R. Opotowsky

Gill Heart & Vascular Institute Faculty Publications

Background

Hypocholesterolemia is a marker of liver disease, and patients with a Fontan circulation may have hypocholesterolemia secondary to Fontan-associated liver disease or inflammation. We investigated circulating lipids in adults with a Fontan circulation and assessed the associations with clinical characteristics and adverse events.

Methods and Results

We enrolled 164 outpatients with a Fontan circulation, aged ≥ 18 years, in the Boston Adult Congenital Heart Disease Biobank and compared them with 81 healthy controls. The outcome was a combined outcome of nonelective cardiovascular hospitalization or death. Participants with a Fontan (median age, 30.3 [interquartile range, 22.8–34.3 years], 42% women) had …

Angiotensin Converting Enzyme Inhibitors And Angiotensin Receptor Blockers In Acute Heart Failure: Invasive Hemodynamic Parameters And Clinical Outcomes., Kevin Bryan Lo, Hesam Mostafavi Toroghi, Grace Salacup, Jiahui Jiang, Ruchika Bhargav, Eduardo Quintero, Kira Balestrini, Anum Shahzad, Roy O Mathew, Peter A Mccullough, Janani Rangaswami

Department of Medicine Faculty Papers

There are limited data regarding the use of angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARBs) in acute heart failure (AHF). The purpose is to determine the patterns of ACEi/ARB use at the time of admission and discharge in relation to invasive hemodynamic data, mortality, and heart failure (HF) readmissions. This is a retrospective single-center study in patients with AHF who underwent right heart catheterization between January 2010 and December 2016. Patients on dialysis, evidence of shock, or incomplete follow up were excluded. Multivariate logistic regression analysis was used to analyze the factors associated with continuation of ACEi/ARB use on discharge …

Sudden Cardiac Death: Epidemiology, Pathogenesis And Management, Akshay Kumar, Dor Mordehay Avishay, Calvin Richard Jones, Juber Dastagir Shaikh, Roopvir Kaur, Michael Aljadah, Asim Kichloo, Nimisha Shiwalkar, Suresh Keshavamurthy

Surgery Faculty Publications

Sudden cardiac death (SCD) is an unexpected sudden death due to a heart condition, that occurs within one hour of symptoms onset. SCD is a leading cause of death in western countries, and is responsible for the majority of deaths from cardiovascular disease. Moreover, SCD accounts for mortality in approximately half of all coronary heart disease patients. Nevertheless, the recent advancements made in screening, prevention, treatment, and management of the underlying causes has decreased this number. In this article, we sought to review established and new modes of screening patients at risk for SCD, treatment and prevention of SCD, and …

Interplay Between Oxidative Stress, Sirt1, Reproductive And Metabolic Functions, Faiza Alam, Hareem Syed, Sofia Amjad, Mukhtiar Baig, Taseer Ahmed Khan, Rehana Rehman

Department of Biological & Biomedical Sciences

Silent information Regulators (SIRT1) gene stimulates antioxidants' expression, repairs cells damaged by oxidative stress (OS), and prevents the cells' dysfunction. In particular, the role of different Sirtuins, particularly SIRT1 in reproduction, has been widely studied over the past decade. Decreased SIRT 1 causes mitochondrial dysfunction by increasing Reactive Oxygen Species (ROS), lipid peroxidation, and DNA damage in both male and female gametes (Sperms and Oocytes), leading to infertility. In the female reproductive system, SIRT1 regulates proliferation and apoptosis in granulosa cells (GCs), and its down-regulation is associated with a reduced ovarian reserve. SIRT1 also modulates the stress response to OS …

Loss Of Bone Morphogenetic Protein-Binding Endothelial Regulator Causes Insulin Resistance, Hua Mao, Luge Li, Qiying Fan, Aude Angelini, Pradip K Saha, Huaizhu Wu, Christie M Ballantyne, Sean M Hartig, Liang Xie, Xinchun Pi

Faculty, Staff and Students Publications

Accumulating evidence suggests that chronic inflammation of metabolic tissues plays a causal role in obesity-induced insulin resistance. Yet, how specific endothelial factors impact metabolic tissues remains undefined. Bone morphogenetic protein (BMP)–binding endothelial regulator (BMPER) adapts endothelial cells to inflammatory stress in diverse organ microenvironments. Here, we demonstrate that BMPER is a driver of insulin sensitivity. Both global and endothelial cell-specific inducible knockout of BMPER cause hyperinsulinemia, glucose intolerance and insulin resistance without increasing inflammation in metabolic tissues in mice. BMPER can directly activate insulin signaling, which requires its internalization and interaction with Niemann-Pick C1 (NPC1), an integral membrane protein that …

Prevalence Of Cardiovascular Risk Factors In A Nationally Representative Adult Population With Inflammatory Bowel Disease Without Atherosclerotic Cardiovascular Disease, Tanushree Agrawal, Isaac Acquah, Amit K. Dey, Kerri Glassner, Bincy Abraham, Ron Blankstein, Salim S. Virani, Michael J. Blaha, Javier Valero-Elizondo, Nehal Mehta

Office of the Provost

Background and aims: Chronic inflammation is associated with premature atherosclerotic cardiovascular disease (ASCVD). We studied the prevalence of cardiovascular risk factors (CRFs) amongst individuals with IBD who have not developed ASCVD.
Methods: Our study population was derived from the 2015 - 2016 National Health Interview Survey. Those with ASCVD (defined as myocardial infarction, angina or stroke) were excluded. The prevalence of CRFs among individuals with IBD was compared with those without IBD. The odds CRFs among adults with IBD was assessed using logistic regression models.
Results: In our study population of 60,155 individuals, 786 (1.3%) had IBD. IBD was associated …

Sex Differences In Ischemic Stroke Outcomes In Patients With Pulmonary Hypertension, Tiberiu A Pana, Dana K Dawson, Mohamed O Mohamed, Fiona Murray, David Fischman, Michael Savage, Mamas A Mamas, Phyo K Myint

Division of Cardiology Faculty Papers

BACKGROUND: The association between systemic hypertension and cerebrovascular disease is well documented. However, the impact of pulmonary hypertension (PH) on acute ischemic stroke outcomes is unknown despite PH being recognized as a risk factor for acute ischemic stroke. We aimed to determine the association between PH and adverse in-hospital outcomes after acute ischemic stroke, as well as whether there are sex differences in this association. METHODS AND RESULTS: Acute ischemic stroke admissions from the US National Inpatient Sample between October 2015 and December 2017 were included. The relationship between PH and outcomes (mortality, prolonged hospitalization >4 days, and routine home …