Medical Specialties Commons^™

Body Composition In Patients With Obesity-Related Heart Failure With Preserved Ejection Fraction: A Comparison Study, Hannah Salmons, Syed Imran Ahmed, Hayley E. Billingsley, Alex Reavey-Cantwell, Roshanak Markley, Michele Golino, Marco Giuseppe Del Buono, Juan Ignacio Damonte, Sebastian Pinel, R. Lee Franco, Antonio Abbate, Carrie P. Earthman, Salvatore Carbone

EVMS School of Health Professions Faculty Publications

Background

Appendicular lean mass index is a major determinant of cardiorespiratory fitness in patients with obesity-related heart failure with preserved ejection fraction (HFpEF). Moreover, appendicular lean mass index can be used to diagnose sarcopenia and sarcopenic obesity in this population. We aimed to validate the ability of segmental single-frequency bioelectrical impedance analysis (SF-BIA) to assess body composition compared with dual-energy x-ray absorptiometry (DXA) in patients with HFpEF and obesity, with a focus on appendicular lean mass index for its critical role in diagnosing sarcopenia and sarcopenic obesity.

Methods

We analyzed 62 euvolemic patients from a heart failure outpatient clinic with …

Not Your Average Syncope: A Case Of Bifascicular Block, Shuchita Jhaveri, Maria Amigo, Zahoor Khan, Marloe Prince

Gulf Coast Division GME Research Day 2025

No abstract provided.

When The Chest And Heart Connect: A Rare Case Presentation Of Left Ventricular Pseudoaneurysm, Victor Delprincipe, Aditya Sharma, Wendy Phillips, Malik Amir, Sanjeev Nair

North Texas Research Forum 2025

We present a rare case of left ventricular pseudoaneurysm (LVPA) resulting from a prior cavity that persisted after surgical treatment of empyema via video-assisted thoracoscopic surgery (VATS) that ultimately lead to chronic inflammation of pericardium, resulting in obtuse marginal artery occlusion causing pseudoaneurysm. Computed tomography angiography (CTA) of the chest suggested that this cavity may have intermittently formed a fistula with the left ventricle, contributing to blood loss and progressive pseudoaneurysm formation. The case highlights the complex interplay between thoracic structures and cardiac pathology in the development of LVPA, with diagnostic and therapeutic challenges addressed.

Thyroid Storm And High Output Heart Failure, A Perfect Storm, Gunjan Mundhra, Haris Ahmed, Rebecca Schuyler, Karina Bidani, Justin Gisel

South Atlantic Division GME Research Day 2025

No abstract provided.

A Rare Case Of Right Sided May-Thurner Syndrome Diagnosis And Treatment, Sania Moonnumackel, Akhil Gade, Anand Karthik, Machaiah Madhrira

North Texas Research Forum 2025

Introduction: May-Thurner Syndrome (MTS) is a phenomenon commonly described as acquired stenosis of the left common iliac vein secondary to compression by the right common iliac artery. Right sided MTS is a rare syndrome that can happen due to a left sided inferior vena cava (IVC) and abdominal aorta with a high bifurcation which results in the right common iliac vein being compressed by the left internal iliac artery. It is a rare presentation of this condition which can commonly be missed and management guidelines are less defined compared to classic MTS. Case Report: A 63-year- old female with past …

Left-Sided Mitral Valve Thrombosis In A Young Patient: Successful Thrombolytic Management, Ashkan Nasr, Luay Alalawi, Thomas Alexander, Vishesh Persaud, Medha Chunduru, Mahmood Ahmed

Gulf Coast Division GME Research Day 2025

No abstract provided.

Pacing-Induced Cardiomyopathy After Leadless Pacemaker Placement, Kathleen Mattingly, Ann Opondo, Abdullah Elnaji, Heena Patel, Jonathan Grube, Heather Reed, Justin Reed

North Florida Division GME Research Day 2025

No abstract provided.

Bradycardia In A Renal Transplant Patient Receiving Rabbit Antithymocyte Globulin, John Mathew, Victor Delprincipe, Seline Haci, Karthik Anand, Rangina Farhad

North Texas Research Forum 2025

Rabbit antithymocyte globulin (rATG) is widely used for induction and treatment of acute T-cell mediated rejection in renal transplant patients. Bradycardia is reported as a rare side effect of this medication (citation). With the increasing number of transplanted kidneys in today's world, there is greater need to understand the adverse effects of these drugs in transplant recipients.. Here we report a case of symptomatic bradycardia in a renal transplant patient receiving rATG for acute T-cell mediated rejection.

Early Palliative Care In Heart Failure, Meadow Stempek, Beverly Balfe, Jennifer Tantarelli

Articles, Abstracts, and Reports

No abstract provided.

Optimizing Discharge Education For Patients With Heart Failure, Connie-Rose Pangan

Nursing | Senior Theses

Noncompliance can be a result of a lack of comprehension of discharge instructions and a lack of concise, effective educational resources. Due to this deficit, patients with heart failure are less likely to comply with their discharge protocol and are therefore more likely to be readmitted to the hospital. The aim of the study is to consolidate a teaching method that accommodates one's existing educational barriers, implement follow-up to increase knowledge retention and improve self care, and prevent readmission among HF patients. Two hundred hospitalized, English-speaking patients with heart failure above 65 years old across 20 US Hospitals will be …

Biochemical And Biophysical Properties Of Failing Myocardium In Rare Patient Populations, Gregory Nathaniel Milburn

Theses and Dissertations--Physiology

Heart failure has diverse underlying etiologies, complicating research. While some types, like ischemic disease or inherited mutations, are well-studied, research on rarer forms has lagged. Understanding the molecular drivers in these populations may enhance diagnostics and therapies. This work examines two rare groups: patients with ATTR cardiac amyloidosis and those receiving mechanical assist device support. We show that myocardium from patients with amyloidosis has increased fibrosis and reduced force production without changes in cross-bridge kinetics. Additionally, we show that the passive stiffness of amyloidosis myocardium is not different from non-failing myocardium, indicating increased ventricular wall thickness may cause restrictive filling. …

Unintentional Lead Dislodgement In Twiddler’S Syndrome, Howard Tan, Ashok Chaudhary, Nishant Nerella, Suman Pasupuleti

West Florida Division GME Research Day 2025

No abstract provided.

Development Of Intra-Hospital Ceftriaxone Resistance Of Serratia Marcescens Endocarditis, Mahyar Doraji, Michael Denney, Adeel Malik, Praveen Chekka, Nishant K. Nerella

West Florida Division GME Research Day 2025

No abstract provided.

Beyond Avnrt: A Case Of Coexisting Adenosine-Sensitive Focal Atrial Tachycardia, Kareem Elgendi, Brandon Quintana, Christopher Wilson, Marsall Marcus

West Florida Division GME Research Day 2025

No abstract provided.

Evaluating The Predictive Power Of Grace And Timi Risk Scores In Patients With Autoimmune Collagen Vascular Disorders Presenting With Nstemi And Stemi, Masi Javeed, Camila Jaramillo, Rias Ali, Serena Wasilewski, Olu Oyesanmi

West Florida Division GME Research Day 2025

No abstract provided.

A Unique Case Of Multi-Culprit Thrombosis In A Patient Presenting With Stemi, Charles Boadu, Erlyana Clarke Shaw, Vindhya Pandyaram, Tochukwu Nzeako, Masi Javeed, Peter Di Martino

West Florida Division GME Research Day 2025

No abstract provided.

Right Radial Artery Occlusion Post-Impella Removal: A Case Of First Radial Stenting Following Axillary Impella Placement, Sacha Saba, Joshini Simon, Mohamed Tashani, Jeffery Steinhoff, Jesse Klein

West Florida Division GME Research Day 2025

No abstract provided.

The Final Beat: A Case Report On Recurrent Endocarditis And The Ethical Dilemmas Of Surgical Futility, Jenie Yeh, Marek Solomianko, Robert Sanchez

West Florida Division GME Research Day 2025

No abstract provided.

Serglycin Controls Megakaryocyte Retention Of Platelet Factor 4 And Influences Megakaryocyte Fate In Bone Marrow, Joshua Lykins, Isabelle C. Becker, Virginia Camacho, Hammodah Rawhi Hammodah Alfar, Joonwoo Park, Joseph Italiano, Sidney W. Whiteheart

Saha Cardiovascular Research Center Faculty Publications

Megakaryocytes (MKs) produce platelets, and similar to other hematopoietic progenitors, they are involved in homeostatic aspects of their bone marrow niche. MKs release and endocytose various factors, such as platelet factor 4 (PF4)/CXCL4. Here, we show that the intra-α-granular proteoglycan, serglycin (SRGN), plays a key role in this process by retaining PF4, and perhaps other factors, during MK maturation. Immature, SRGN–/– MKs released ~80% of their PF4, and conditioned media from these cells negatively affected wild-type MK differentiation in vitro. This was replicated in wild-type MKs by treatment with the polycation surfen, a known inhibitor of glycosaminoglycan (GAG)/protein interactions. In …

Abcg5/Abcg8-Independent Mechanisms Fail To Maintain Sterol Balance In Mice Fed A High-Cholesterol Diet, Garrett B. Anspach, Rupinder Kaur, Isha Chauhan, Erika L. Savage, Brittney Poole, Victoria P. Noffsinger, Xiaoming Fu, Zeneng Wang, Clairity Voy, Ryan E. Temel, Scott M. Gordon, Robert N. Helsley, Gregory A. Graf

Saha Cardiovascular Research Center Faculty Publications

The ABCG5/ABCG8 (G5G8) sterol transporter opposes the accumulation of dietary xenosterols but is also the primary mediator of biliary cholesterol secretion. In humans and in mouse models of disrupted biliary cholesterol secretion, fecal neutral sterols (FNSs) remain constant, indicating the presence of an alternate pathway for cholesterol excretion. Transintestinal cholesterol elimination or excretion (TICE) is thought to compensate for biliary disruptions and G5G8 insufficiency. We sought to measure the compensatory increase in intestinal cholesterol secretion and provide mechanistic insight for how TICE maintains sterol balance in the absence of hepatic G5G8. Differences were not observed in FNSs between control, acute, …

Incidence Of Bleeding And Performance Of The Precise-Dapt Score In Predicting Bleeding In Patients On Dual Antiplatelet Therapy After Treatment For Acute Coronary Syndrome In Kenya, Peter Mugo, Jeilan Mohamed, Miriam Msunza, James Orwa, Mzee Ngunga

Internal Medicine, East Africa

Introduction: Dual Antiplatelet Therapy (DAPT) plays an important role in the secondary prevention of ischemic events after treatment for acute coronary syndrome (ACS). The long-term use of DAPT is associated with an increased risk of bleeding, which affects morbidity and mortality. Risk stratification scores have been developed to predict this risk and provide a balance against the risk of ischemic events. The aim of this study was to determine the incidence of bleeding in a cohort of patients in Kenya on DAPT and assess the performance of the PRECISE-DAPT Score in predicting the risk of bleeding.

Methods: This was a …

Comparison Of Clinical Outcomes Between Provisional Stenting And Two-Stent Approach For True Left Main Bifurcation Lesions In The Era Of Imaging Guided Percutaneous Coronary Intervention, Ming Leo Lau, Ho Fai Daniel Fong, Nim Pong Kwong

Journal of the Hong Kong College of Cardiology

Background

Currently there are two strategies in Percutaneous Coronary Intervention (PCI) of the true left main (LM) bifurcation lesions: provisional stenting and two-stent technique. The optimal treatment strategy for true LM bifurcation lesions is undetermined. In addition, the percentage of use of imaging-guiding in these studies was low. We would like to undertake a retrospective cohort study to compare the clinical outcomes of provisional stenting versus two-stent technique in treating the true LM bifurcation lesions with the help of intravascular imaging.

Methods

Data of consecutive patients undergoing PCI of true LM bifurcation lesions in Yan Chai Hospital from January, 2018 …

An Unusual Cause Of Acute Constrictive Pericarditis, Yue Hin Tang, Raymond Chi Yan Fung

Journal of the Hong Kong College of Cardiology

Constrictive pericarditis, a condition where the pericardium thickens and constricts, has long been considered as a chronic sequela of prior insults to the pericardium such as heart surgery, repeated pericarditis, tuberculosis infection, radiation exposure, etc. Susceptible populations are thus expected to be middle-aged.

We present a case in which a young gentleman was diagnosed with acute constrictive pericarditis due to Adult-onset Still’s disease with macrophage activation syndrome. This case illustrated that constrictive pericarditis could happen in acute settings and thus the importance of cardiologists to maintain open-minded in search of a diagnosis

Machine Learning-Based Risk Stratification For Limb-Related Outcomes In Peripheral Artery Disease Patients Undergoing Percutaneous Transluminal Angioplasty, Yujia Zhang, Zhoudong Jing, Zhiqiang Liu, Angel Lai, Guangming Tan, Bryan P Yan

Journal of the Hong Kong College of Cardiology

Background: Patients with peripheral artery disease (PAD) remain at high risk of mortality and major adverse limb events (MALE) after endovascular revascularization, yet outcome prediction tools are limited. We apply machine learning (ML) to improve prognostic stratification in this population. Methods: PAD patients undergoing percutaneous transluminal angioplasty (PTA) between 2007 and 2024 were included. The primary endpoint was 1-year major adverse limb events (MALE) or all-cause death. Data were divided into training (70%) and testing (30%) sets. Six ML models were developed, and performance was evaluated using the area under the receiver operating characteristic curve (AUC). Feature importance and risk …

Iatrogenic Femoral Arteriovenous Fistula After Leadless Pacemaker Implantation Treated With Balloon-Expandable Stent: A Report Of Three Cases, Cheuk Yin Lai, Timothy Ho Him, Mark Tk Tam, Guang-Ming Tan, Bryan P Yan

Journal of the Hong Kong College of Cardiology

Endovascular covered stenting is a minimally invasive option for treating iatrogenic femoral access site complications, including arteriovenous femoral fistula (AVF). Reports on AVF repair mainly concern small bore devices, but large bore devices such as leadless pacemakers post unique challenges. We present 3 cases of iatrogenic femoral AVF after large-bore, 27Fr access sheath insertion for leadless pacemaker implantation. Both underwent endovascular balloon-expandable covered stenting, with resolution of AVF and durable long-term results. As patients referred for leadless pacemaker implantations are often frail with co-morbidities, endovascular stenting is an appealing alternative to open surgical repair for AVF.

Novel Insights Into Beta Cell Er Stress Chop And It's Role In Hfpef Development, Balaji Srinivas, Paula Fortuno, Hongmei Peng, Jiang Xu, Hamid Suhail, Hani N. Sabbah, Nour-Eddine Rhaleb, Khalid Matrougui

Department of Physiological Sciences Faculty Publications

Introduction: Heart failure with preserved ejection fraction (HFpEF) is a multifactorial cardiovascular disorder characterized by diastolic dysfunction and often associated with hypertension and metabolic disturbances. We aimed to determine the inter-relationship between C/EBP homologous protein (CHOP) in b-cells and HFpEF development.

Methods: Eight-week-old male mice b-cell^flox/flox and b-cell^CHOP-/- were randomly divided into four groups: control b-cell^flox/flox and b-cell^CHOP-/- mice subjected to standard diet and water. b -cell^flox/flox and b-cell^CHOP-/- mice fed a high-fat diet (HFD) and L-NAME (0.5 g/L) for five weeks. A comprehensive cardiovascular, metabolic, and histological evaluation was conducted.

Results: Following …

Meta-Analysis Of The Effect Of Vagus Nerve Stimulation On Functional Heart Failure Outcomes, Ariana B. Labrada

Honors Undergraduate Theses

Globally, Heart Failure (HF) is a significant cause for concern. Vagus Nerve Stimulation (VNS) is an emerging therapy for patients with HF. It involves the activation of efferent vagal signals, which result in the release of acetylcholine (ACh). In practice, VNS has obtained relatively mixed results in clinical trials so far. In order to ascertain the extent of the effects VNS has on functional clinical outcomes, this meta-analysis consolidates studies that involve patients with Heart Failure with reduced Ejection Fraction (HFrEF) and Heart Failure with preserved Ejection Fraction (HFpEF). Outcomes were measured through the change in mean heart rate (HR) …

Previously Undescribed Transient Trifascicular Block: Left Septal Fascicular Block Associated With Left Anterior Fascicular Block And Complete Right Bundle Branch Block, Kjell Nikus, Jani Rankinen, Raine Virtanen, Yochai Birnbaum, Andrés Ricardo Pérez-Riera

Faculty, Staff and Students Publications

Exercise-induced complete right bundle branch block (CRBBB) remains a rare finding during a treadmill test. Both exercise-induced CRBBB and left anterior fascicular block (LAFB) have been associated with coronary artery disease, more specifically with stenosis of the left anterior descending coronary artery. Left septal fascicular block (LSFB) has been associated with acute and chronic coronary syndromes. We describe a patient case with severe left main coronary artery disease. In an exercise test, a rare combination of these three ventricular conduction disorders developed. In a second exercise test after coronary bypass surgery, LAFB and typical CRBBB developed without LSFB.

The Uses Of Right Heart Catheterization In Cardio-Pulmonary Disease: State-Of-The-Art, Bhavesh Katbamna, Lingling Wu, Mario Rodriguez, Phillip King, Joel Schilling, Jamal Mahar, Ajith P Nair, Hani Jneid, Elizabeth S Klings, Gerald L Weinhouse, Sula Mazimba, Marc A Simon, Markus Strauss, Chayakrit Krittanawong

Faculty, Staff and Students Publications

The right heart catheterization (RHC) remains an important diagnostic tool for a spectrum of cardiovascular disease processes including pulmonary hypertension (PH), shock, valvular heart disease, and unexplained dyspnea. While it gained widespread utilization after its introduction, the role of the RHC has evolved to provide valuable information for the management of advanced therapies in heart failure (HF) and cardiogenic shock (CS) to name a few. In this review, we provide a comprehensive overview on the indications, utilization, complications, interpretation, and calculations associated with RHC.

Baroreflex Function In Cardiovascular Disease, Husam M Salah, Richa Gupta, Albert J Hicks, Kiran Mahmood, Nicholas A Haglund, Amarinder S Bindra, Steve M Antoine, Rachel Garcia, Amin Yehya, Dmitry M Yaranov, Pujan P Patel, Jason P Feliberti, Allman T Rollins, Vishal N Rao, Laurie Letarte, Vikram Raje, Amit H Alam, Patrick Mccann, Nirav Y Raval, Brian Howard, Marat Fudim

Faculty, Staff and Students Publications

The baroreflex system is involved in modulating several physiological functions of the cardiovascular system and can modulate cardiac output, blood pressure, and cardiac electrophysiology directly and indirectly. In addition, it is involved in regulating neurohormonal pathways involved in the cardiovascular function, such as the renin-angiotensin-aldosterone system and vasopressin release. Baroreflex dysfunction is characterized by sympathetic overactivation and parasympathetic withdrawal and is associated with several cardiovascular diseases, such as hypertension, heart failure, and coronary artery disease. Targeting the baroreflex system via invasive (eg, baroreflex activation therapy and endovascular baroreceptor amplification) and noninvasive approaches (eg, slow breathing exercises and exercise training) has …