Medical Specialties Commons^™

Jacc: Advances Expert Panel Perspective: Shared Decision-Making In Multidisciplinary Team-Based Cardiovascular Care, Elizabeth M Perpetua, Roseanne Palmer, Viet T Le, Sana M Al-Khatib, Craig J Beavers, Joshua A Beckman, Biykem Bozkurt, Megan Coylewright, Caroline Lloyd Doherty, Kimberly A Guibone, Marian Hawkey, Patricia A Keegan, James N Kirkpatrick, Jessica Laperle, Sandra B Lauck, Glenn Levine, Brian R Lindman, Michael J Mack, Andrea L Price, Susan Strong, Janet F Wyman, Quentin R Youmans, Martha Gulati

Faculty, Staff and Students Publications

Shared decision-making (SDM) and multidisciplinary team-based care delivery are recommended across several cardiology clinical practice guidelines. However, evidence for benefit and guidance on implementation are limited. Informed consent, the use of patient decision aids, or the documentation of these elements for governmental or societal agencies may be conflated as SDM. SDM is a bidirectional exchange between experts: patients are the experts on their goals, values, and preferences, and clinicians provide their expertise on clinical factors. In this Expert Panel perspective, we review the current state of SDM in team-based cardiovascular care and propose best practice recommendations for multidisciplinary team implementation …

Microbiomes In Birds: A Review Of Links To Health And Reproduction, Mary Ann Ottinger, Shailaja Mani, Sonja Krüger, Brent Coverdale, Sandi Willows-Munro, Leigh Combrink

Faculty, Staff and Students Publications

Microbiomes have emerged as a key component essential for maintaining the health of an organism. Additionally, the roles of microbiomes are multifaceted, some unique to specific body areas and organs while others, particularly the gut microbiome, having broader effects on the entire organism. Comparative literature is emerging that compares microbiomes across mammals and birds. Domestic poultry have been the most extensively studied relative to their role in production agriculture. These data have provided a great deal of information about the effects of diet and nutritional requirements relative to the gut microbiome, productivity, and resilience to diseases. Conversely, limited research has …

Homozygous Missense Variants In Ykt6 Result In Loss Of Function And Are Associated With Developmental Delay, With Or Without Severe Infantile Liver Disease And Risk For Hepatocellular Carcinoma, Mengqi Ma, Mythily Ganapathi, Yiming Zheng, Kai-Li Tan, Oguz Kanca, Kevin E Bove, Norma Quintanilla, Sebnem O Sag, Sehime G Temel, Charles A Leduc, Amanda J Mcpartland, Elaine M Pereira, Yufeng Shen, Jacob Hagen, Christie P Thomas, Nhu Thao Nguyen Galván, Xueyang Pan, Shenzhao Lu, Jill A Rosenfeld, Daniel G Calame, Michael F Wangler, James R Lupski, Davut Pehlivan, Paula M Hertel, Wendy K Chung, Hugo J Bellen

Faculty, Staff and Students Publications

PURPOSE: YKT6 plays important roles in multiple intracellular vesicle trafficking events but has not been associated with Mendelian diseases.

METHODS: We report 3 unrelated individuals with rare homozygous missense variants in YKT6 who exhibited neurological disease with or without a progressive infantile liver disease. We modeled the variants in Drosophila. We generated wild-type and variant genomic rescue constructs of the fly ortholog dYkt6 and compared their ability in rescuing the loss-of-function phenotypes in mutant flies. We also generated a dYkt6

RESULTS: Two individuals are homozygous for YKT6 [NM_006555.3:c.554A>G p.(Tyr185Cys)] and exhibited normal prenatal course followed by failure to thrive, …

Aging Atlas Reveals Cell-Type-Specific Effects Of Pro-Longevity Strategies, Shihong Max Gao, Yanyan Qi, Qinghao Zhang, Youchen Guan, Yi-Tang Lee, Lang Ding, Lihua Wang, Aaron S Mohammed, Hongjie Li, Yusi Fu, Meng C Wang

Faculty, Staff and Students Publications

Organismal aging involves functional declines in both somatic and reproductive tissues. Multiple strategies have been discovered to extend lifespan across species. However, how age-related molecular changes differ among various tissues and how those lifespan-extending strategies slow tissue aging in distinct manners remain unclear. Here we generated the transcriptomic Cell Atlas of Worm Aging (CAWA, http://mengwanglab.org/atlas ) of wild-type and long-lived strains. We discovered cell-specific, age-related molecular and functional signatures across all somatic and germ cell types. We developed transcriptomic aging clocks for different tissues and quantitatively determined how three different pro-longevity strategies slow tissue aging distinctively. Furthermore, through genome-wide profiling …

A Multimodal Deep Learning Tool For Detection Of Junctional Ectopic Tachycardia In Children With Congenital Heart Disease, Yilong Ju, Jamie L S Waugh, Satpreet Singh, Craig G Rusin, Ankit B Patel, Parag N Jain

Faculty, Staff and Students Publications

BACKGROUND: Junctional ectopic tachycardia (JET) is a prevalent life-threatening arrhythmia in children with congenital heart disease. It has a marked resemblance to normal sinus rhythm, often leading to delay in diagnosis and management.

OBJECTIVE: The study sought to develop a novel multimodal automated arrhythmia detection tool that outperforms existing JET detection tools.

METHODS: This is a cohort study performed on 40 patients with congenital heart disease at Texas Children's Hospital. Electrocardiogram and central venous pressure waveform data produced by bedside monitors are captured by the Sickbay platform. Convolutional neural networks (CNNs) were trained to classify each heartbeat as either normal …

Perinatal Mental Healthcare Utilization Among Patients With Placenta Accreta Spectrum, Sarah R Casey, Alison N Goulding, Christina C Reed, Amir A Shamshirsaz, Hennie A Lombaard, Michael A Belfort, Lisa M Noll, Karin A Fox

Faculty, Staff and Students Publications

No abstract provided.

Patient Perspectives On Using Telemedicine During In-Center Hemodialysis: A Qualitative Study, Trenton M Haltom, Susie Q Lew, Wolfgang C Winkelmayer, Glenn M Chertow, Allison Jaure, Kevin F Erickson

Faculty, Staff and Students Publications

RATIONALE & OBJECTIVE: In the wake of the coronavirus disease 2019 (COVID-19) pandemic, the United States federal government expanded originating telemedicine sites to include outpatient dialysis units. For the first time, nephrology practitioners across the United States could replace face-to-face visits with telemedicine for patients receiving in-center hemodialysis. This study describes patients' perspectives on the use of telemedicine during in-center hemodialysis.

STUDY DESIGN: A qualitative study.

SETTING & PARTICIPANTS: Thirty-two patients from underserved populations (older, less educated, unemployed, persons of color) receiving in-center hemodialysis who used telemedicine with their nephrologist during the COVID-19 pandemic.

ANALYTICAL APPROACH: Telephone semistructured interviews were …

T-Bet Regulates Ion Channels And Transporters And Induces Apoptosis In Intestinal Epithelial Cells, Lang Chen, Hongwei Yi, Qingtian Li, Tianhao Duan, Xin Liu, Linfeng Li, Helen Y Wang, Changsheng Xing, Rong-Fu Wang

Faculty, Staff and Students Publications

T-bet, encoded by TBX21, is extensively expressed across various immune cell types, and orchestrates critical functions in their development, survival, and physiological activities. However, the role of T-bet in non-immune compartments, notably the epithelial cells, remains obscure. Herein, a Tet-O-T-bet transgenic mouse strain is generated for doxycycline-inducible T-bet expression in adult animals. Unexpectedly, ubiquitous T-bet overexpression causes acute diarrhea, intestinal damage, and rapid mortality. Cell-type-specific analyses reveal that T-bet-driven pathology is not attributable to its overexpression in CD4

Exome Sequencing Identifies Novel Genes Underlying Primary Congenital Glaucoma In The National Birth Defects Prevention Study, Elizabeth E Blue, Kristin J Moore, Kari E North, Tania A Desrosiers, Suzan L Carmichael, Janson J White, Jessica X Chong, Michael J Bamshad, Mary M Jenkins, Lynn M Almli, Lawrence C Brody, Sharon F Freedman, Jennita Reefhuis, Paul A Romitti, Gary M Shaw, Martha Werler, Denise M Kay, Marilyn L Browne, Marcia L Feldkamp, Richard H Finnell, Wendy N Nembhard, Faith Pangilinan, Andrew F Olshan, National Institutes Of Health Intramural Sequencing Center, University Of Washington Center For Mendelian Genomics, National Birth Defects Prevention Study

Faculty, Staff and Students Publications

Background: Primary congenital glaucoma (PCG) affects approximately 1 in 10,000 live born infants in the United States (U.S.). PCG has a autosomal recessive inheritance pattern, and variable expressivity and reduced penetrance have been reported. Likely causal variants in the most commonly mutated gene, CYP1B1, are less prevalent in the U.S., suggesting that alternative genes may contribute to the condition. This study utilized exome sequencing to investigate the genetic architecture of PCG in the U.S. and to identify novel genes and variants.

Methods: We studied 37 family trios where infants had PCG and were part of the National Birth Defects Prevention …

Author Reply To Letter By Topkan Et Al Regarding Delays In Starting Postoperative Radiotherapy, Kelsey A Duckett, Byung Joo Lee, Bhisham S Chera, Sidharth V Puram, Vlad C Sandulache, Russel Kahmke, Shaun A Nguyen, Brian Nussenbaum, Anthony J Alberg, Chanita Hughes Halbert, Katherine R Sterba, Evan M Graboyes

Faculty, Staff and Students Publications

No abstract provided.

Clinical Exome Sequencing Uncovers Genetic Disorders In Neonates With Suspected Hypoxic-Ischemic Encephalopathy: A Retrospective Analysis, Christian M Parobek, Roni Zemet, Matthew A Shanahan, Brian A Burnett, Elizabeth Mizerik, Jill A Rosenfeld, Liesbeth Vossaert, Steven L Clark, Jill V Hunter, Seema R Lalani

Faculty, Staff and Students Publications

Hypoxic-ischemic encephalopathy (HIE) occurs in up to 7 out of 1000 births and accounts for almost a quarter of neonatal deaths worldwide. Despite the name, many newborns with HIE have little evidence of perinatal hypoxia. We hypothesized that some infants with HIE have genetic disorders that resemble encephalopathy. We reviewed genetic results for newborns with HIE undergoing exome or genome sequencing at a clinical laboratory (2014-2022). Neonates were included if they had a diagnosis of HIE and were delivered ≥35 weeks. Neonates were excluded for cardiopulmonary pathology resulting in hypoxemia or if neuroimaging suggested postnatal hypoxic-ischemic injury. Of 24 patients …

Evaluation Of Tibial Slope On Radiographs In Pediatric Patients With Tibial Spine Fractures: An Age- And Sex-Matched Study, Chang Ho Shin, Akbar N Syed, Morgan E Swanson, Indranil V Kushare, Kevin G Shea, Asteroid, Theodore J Ganley, Soroush Baghdadi, Aristides I Cruz, Henry B Ellis, Peter D Fabricant, Theodore J Ganley, Daniel W Green, Alicia Kerrigan, Julia Kirby, Mininder Kocher, Indranil V Kushare, R Jay Lee, James P Macdonald, Scott D Mckay, Shital N Parikh, Neeraj M Patel, Yi-Meng Yen, Gregory A Schmale, Kevin G Shea, R Justin Mistovich

Faculty, Staff and Students Publications

BACKGROUND: A recent study has reported that the radiographic measurement of posterior tibial slope (PTS) is larger in male pediatric patients with tibial spine fractures (TSF) than in controls. However, they found no difference in PTS between female patients and controls.

PURPOSE: (1) To identify whether PTS is larger in female pediatric patients with TSF than in female controls and (2) to validate the relationship between PTS and pediatric TSF in male patients.

STUDY DESIGN: Cross-sectional study; Level of evidence, 3.

METHODS: After an a priori power analysis, 84 pediatric patients with TSF (50 female patients and 34 male patients) …

Anticoagulant Medications: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation Collaborative Consensus Conference, Katherine Cashen, Arun Saini, Leonardo R Brandão, Jennifer Le, Paul Monagle, Katie M Moynihan, Lindsay M Ryerson, Alison Gehred, Elizabeth Lyman, Jennifer A Muszynski, Peta M A Alexander, Heidi J Dalton

Faculty, Staff and Students Publications

OBJECTIVES: To derive systematic-review informed, modified Delphi consensus regarding the medications used for anticoagulation for pediatric extracorporeal membrane oxygenation (ECMO) for the Pediatric ECMO Anticoagulation CollaborativE (PEACE).

DATA SOURCES: A structured literature search was performed using PubMed, EMBASE, and Cochrane Library (CENTRAL) databases from January 1988 to May 2021.

STUDY SELECTION: Included studies assessed anticoagulation used in pediatric ECMO.

DATA EXTRACTION: Two authors reviewed all citations independently, with a third reviewer adjudicating any conflicts. Eighteen references were used for data extraction as well as for creation of recommendations. Evidence tables were constructed using a standardized data extraction form.

DATA SYNTHESIS: …

Management Of Extracorporeal Membrane Oxygenation Anticoagulation In The Perioperative Period: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation Collaborative Consensus Conference, Ariane Willems, Marc M Anders, Alejandro V Garcia, Adam M Vogel, Andrew R Yates, Jennifer A Muszynski, Peta M A Alexander, Katherine Steffen, Sitaram Emani, Alison Gehred, Elizabeth Lyman, Lakshmi Raman

Faculty, Staff and Students Publications

OBJECTIVES: To derive systematic review-informed, modified Delphi consensus regarding the management of children on extracorporeal membrane oxygenation (ECMO) undergoing invasive procedures or interventions developed by the Pediatric Anticoagulation on ECMO CollaborativE (PEACE) Consensus Conference.

DATA SOURCES: A structured literature search was performed using PubMed, EMBASE, and Cochrane Library (CENTRAL) databases from January 1988 to May 2021.

STUDY SELECTION: ECMO anticoagulation and hemostasis management in the perioperative period and during procedures.

DATA EXTRACTION: Two authors reviewed all citations independently, with a third independent reviewer resolving any conflicts. Seventeen references were used for data extraction and informed recommendations. Evidence tables were constructed …

Central Venous Pressure And Impaired Renal Function In Children And Young Adults With Cardiovascular Disease, Jillian Olsen, Hari Tunuguntla, Alexander Alali, Swati Choudhry, Kyle D Hope, Kriti Puri, Joseph A Spinner, Ayse Akcan-Arikan, Jack F Price

Faculty, Staff and Students Publications

BACKGROUND: Traditionally, low cardiac output has been considered the primary hemodynamic driver of renal function and injury. Adult data suggest that central venous pressure (CVP) is a more important factor.

OBJECTIVES: The authors hypothesized that in children with cardiovascular disease, higher CVP predicts lower estimated glomerular filtration rate (eGFR) and worsening renal function (WRF).

METHODS: We performed a single-center cohort study of patients aged 3 months to 21 years with biventricular circulation undergoing cardiac catheterization. Pearson's correlation and linear and Cox regression analyses were performed to determine associations with eGFR at the time of catheterization and WFR within 180 days …

Acute Kidney Injury In Patients With Cirrhosis: Acute Disease Quality Initiative (Adqi) And International Club Of Ascites (Ica) Joint Multidisciplinary Consensus Meeting, Mitra K Nadim, John A Kellum, Lui Forni, Claire Francoz, Sumeet K Asrani, Marlies Ostermann, Andrew S Allegretti, Javier A Neyra, Jody C Olson, Salvatore Piano, Lisa B Vanwagner, Elizabeth C Verna, Ayse Akcan-Arikan, Paolo Angeli, Justin M Belcher, Scott W Biggins, Akash Deep, Guadalupe Garcia-Tsao, Yuri S Genyk, Pere Gines, Patrick S Kamath, Sandra L Kane-Gill, Manish Kaushik, Nuttha Lumlertgul, Etienne Macedo, Rakhi Maiwall, Sebastian Marciano, Raimund H Pichler, Claudio Ronco, Puneeta Tandon, Juan-Carlos Q Velez, Ravindra L Mehta, François Durand

Faculty, Staff and Students Publications

Patients with cirrhosis are prone to developing acute kidney injury (AKI), a complication associated with a markedly increased in-hospital morbidity and mortality, along with a risk of progression to chronic kidney disease. Whereas patients with cirrhosis are at increased risk of developing any phenotype of AKI, hepatorenal syndrome (HRS), a specific form of AKI (HRS-AKI) in patients with advanced cirrhosis and ascites, carries an especially high mortality risk. Early recognition of HRS-AKI is crucial since administration of splanchnic vasoconstrictors may reverse the AKI and serve as a bridge to liver transplantation, the only curative option. In 2023, a joint meeting …

Spinal Cord Watershed Infarction After Surgery, Gia Nguyen, Giang-Kim Nguyen, Fanny Emilia Morón

Faculty, Staff and Students Publications

Spinal cord watershed infarction is a rare phenomenon due to the rich collateral blood supply to the organ. It often occurs in elderly patients with preexisting atherosclerotic disease in the setting of global hypoperfusion, such as thoracoabdominal surgery, dissection, coagulopathies, or idiopathic. We present a case of spinal cord infarction (SCI) in both longitudinal and transverse watershed areas as a complication of postoperative blood loss. In addition, we demonstrate the imaging evolution of spinal cord infarct in the subacute phase with peripheral enhancement due to the breakdown of the blood-spinal cord barrier.

Gender And Emergency Physicians’ Experiences Of Leading Decision Making About Restraint Use: A Qualitative Study, Anita Chary, Beatrice Torres, Elise Brickhouse, Datonye Charles, Ynhi Thomas, Michelle Suh

Faculty, Staff and Students Publications

No abstract provided.

Achieving Equitable Cardiovascular Care For All: Acc Board Of Trustees Health Equity Task Force Action Plan, Paul L Douglass, Dipti Itchhaporia, Biykem Bozkurt, Robert O Roswell, Akshay Khandelwal, Quinn Capers, Kathryn Berlacher, Modele O Ogunniyi, Alison L Bailey, Phillip D Levy, Aubrey J Grant, Jack Tocco, Angela Natcheva, Akua G Asare, Ami B Bhatt, Jennifer H Mieres, Maghee F Disch, Melvin R Echols

Faculty, Staff and Students Publications

Advancements in cardiovascular (CV) disease management are notable, yet health inequities prevail, associated with increased morbidity and mortality noted among non-Hispanic African Americans in the United States. The 2002 Institute of Medicine Report revealed ongoing racial and ethnic health care disparities, spearheading a deeper understanding of the social determinants of health and systemic racism to develop strategies for CV health equity (HE). This article outlines the strategic HE approach of the American College of Cardiology, comprising 6 strategic equity domains: workforce pathway inclusivity, health care, data, science, and tools; education and training; membership, partnership, and collaboration; advocacy and policy; and …

Association Of High-Density Lipoprotein Parameters And Risk Of Heart Failure: A Multicohort Analysis, Ambarish Pandey, Kershaw V Patel, Matthew W Segar, Michael D Shapiro, Christie M Ballantyne, Salim S Virani, Vijay Nambi, Erin D Michos, Michael J Blaha, Khurram Nasir, Miguel Cainzos-Achirica, Colby R Ayers, B Daan Westenbrink, Jose L Flores-Guerrero, Stephan J L Bakker, Margery A Connelly, Robin P F Dullaart, Anand Rohatgi

Faculty, Staff and Students Publications

Background: High-density lipoprotein (HDL) is commonly characterized by its cholesterol concentration (HDL-C) and inverse association with atherosclerotic cardiovascular disease.

Objectives: The authors sought to evaluate the association of HDL particle concentration (HDL-P), HDL particle size (HDL-size), HDL-C, and cholesterol content per particle (HDL-C/HDL-P) with risk of overall heart failure (HF) and subtypes.

Methods: Participants from the Atherosclerosis Risk In Communities Study, Dallas Heart Study, Multi-Ethnic Study of Atherosclerosis, and Prevention of Renal and Vascular End-stage Disease studies without HF history were included. Associations of HDL-P, HDL-size, HDL-C, and HDL-C/HDL-P with risk of overall HF, HF with reduced and preserved ejection …

A Klf2-Bmper-Smad1/5 Checkpoint Regulates High Fluid Shear Stress-Mediated Artery Remodeling, Hanqiang Deng, Jiasheng Zhang, Yewei Wang, Divyesh Joshi, Xinchun Pi, Sarah De Val, Martin A Schwartz

Faculty, Staff and Students Publications

Vascular remodeling to match arterial diameter to tissue requirements commonly fails in ischemic disease. Endothelial cells sense fluid shear stress (FSS) from blood flow to maintain FSS within a narrow range in healthy vessels. Thus, high FSS induces vessel outward remodeling, but mechanisms are poorly understood. We previously reported that Smad1/5 is maximally activated at physiological FSS. Smad1/5 limits Akt activation, suggesting that inhibiting Smad1/5 may facilitate outward remodeling. Here we report that high FSS suppresses Smad1/5 by elevating KLF2, which induces the bone morphogenetic protein (BMP) pathway inhibitor, BMP-binding endothelial regulator (BMPER), thereby de-inhibiting Akt. In mice, surgically induced …

Thrombosis Risk Prediction In Lymphoma Patients: A Multi-Institutional, Retrospective Model Development And Validation Study, Shengling Ma, Jennifer La, Kaitlin N Swinnerton, Danielle Guffey, Raka Bandyo, Giordana De Las Pozas, Katy Hanzelka, Xiangjun Xiao, Cristhiam M Rojas-Hernandez, Christopher I Amos, Vipul Chitalia, Katya Ravid, Kelly W Merriman, Christopher R Flowers, Nathanael Fillmore, Ang Li

Faculty, Staff and Students Publications

Venous thromboembolism (VTE) poses a significant risk to cancer patients receiving systemic therapy. The generalizability of pan-cancer models to lymphomas is limited. Currently, there are no reliable risk prediction models for thrombosis in patients with lymphoma. Our objective was to create a risk assessment model (RAM) specifically for lymphomas. We performed a retrospective cohort study to develop Fine and Gray sub-distribution hazard model for VTE and pulmonary embolism (PE)/ lower extremity deep vein thrombosis (LE-DVT) respectively in adult lymphoma patients from the Veterans Affairs national healthcare system (VA). External validations were performed at the Harris Health System (HHS) and the …

Cell-Type Resolved Transcriptomic Approaches For Dissecting Selective Vulnerability In Neurodegeneration, Caleb A Wood, Nicholas M Tran

Faculty, Staff and Students Publications

No abstract provided.

Response To: “Quantifying The Effect Of Vaccination On Transmission In Modelling Studies”, Sarah M Bartsch, Kelly J O'Shea, Ulrich Strych, Maria Elena Bottazzi, Bruce Y Lee

Faculty, Staff and Students Publications

No abstract provided.

Consensus Guidelines For The Monitoring And Management Of Metachromatic Leukodystrophy In The United States, Laura A Adang, Joshua L Bonkowsky, Jaap Jan Boelens, Eric Mallack, Rebecca Ahrens-Nicklas, John A Bernat, Annette Bley, Barbara Burton, Alejandra Darling, Florian Eichler, Erik Eklund, Lisa Emrick, Maria Escolar, Ali Fatemi, Jamie L Fraser, Amy Gaviglio, Stephanie Keller, Marc C Patterson, Paul Orchard, Jennifer Orthmann-Murphy, Jonathan D Santoro, Ludger Schöls, Caroline Sevin, Isha N Srivastava, Deepa Rajan, Jennifer P Rubin, Keith Van Haren, Melissa Wasserstein, Ayelet Zerem, Francesca Fumagalli, Lucia Laugwitz, Adeline Vanderver

Faculty, Staff and Students Publications

Metachromatic leukodystrophy (MLD) is a fatal, progressive neurodegenerative disorder caused by biallelic pathogenic mutations in the ARSA (Arylsulfatase A) gene. With the advent of presymptomatic diagnosis and the availability of therapies with a narrow window for intervention, it is critical to define a standardized approach to diagnosis, presymptomatic monitoring, and clinical care. To meet the needs of the MLD community, a panel of MLD experts was established to develop disease-specific guidelines based on healthcare resources in the United States. This group developed a consensus opinion for best-practice recommendations, as follows: (i) Diagnosis should include both genetic and biochemical testing; (ii) …

Artificial Intelligence To Classify Acquired Intestinal Injury In Preterm Neonates-A New Perspective, Alain Cuna, Muralidhar H Premkumar, Venkatesh Sampath

Faculty, Staff and Students Publications

No abstract provided.

The Impact Of Von Willebrand Factor On Fibrin Formation And Structure Unveiled With Type 3 Von Willebrand Disease Plasma, Marina Martinez-Vargas, Justin Courson, Luis Gardea, Mehmet Sen, Andrew Yee, Rolando Rumbaut, Miguel A Cruz

Faculty, Staff and Students Publications

Normally, von Willebrand factor (VWF) remains inactive unless its A1A2 domains undergo a shear stress-triggered conformational change. We demonstrated the capacity of a recombinant A2 domain of VWF to bind and to affect fibrin formation, altering the fibrin clot structure. The data indicated that VWF contains an additional binding site for fibrin in the A2 domain that plays a role in the incorporation of VWF to the polymerizing fibrin. This study is to examine the hypothesis that active plasma VWF directly influence fibrin polymerization and the structure of fibrin clots. The study used healthy and type 3 von Willebrand disease …

The Multifaceted Life Of Macrophages In White Adipose Tissue: Immune Shift Couples With Metabolic Switch, Qun Wang, Sean M Hartig, Christie M Ballantyne, Huaizhu Wu

Faculty, Staff and Students Publications

White adipose tissue (WAT) is a vital endocrine organ that regulates energy balance and metabolic homeostasis. In addition to fat cells, WAT harbors macrophages with distinct phenotypes that play crucial roles in immunity and metabolism. Nutrient demands cause macrophages to accumulate in WAT niches, where they remodel the microenvironment and produce beneficial or detrimental effects on systemic metabolism. Given the abundance of macrophages in WAT, this review summarizes the heterogeneity of WAT macrophages in physiological and pathological conditions, including their alterations in quantity, phenotypes, characteristics, and functions during WAT growth and development, as well as healthy or unhealthy expansion. We …

The Role Of Sleep In Cardiovascular Disease, Vita N Jaspan, Garred S Greenberg, Siddhant Parihar, Christine M Park, Virend K Somers, Michael D Shapiro, Carl J Lavie, Salim S Virani, Leandro Slipczuk

Faculty, Staff and Students Publications

Purpose of review: Sleep is an important component of cardiovascular (CV) health. This review summarizes the complex relationship between sleep and CV disease (CVD). Additionally, we describe the data supporting the treatment of sleep disturbances in preventing and treating CVD.

Recent findings: Recent guidelines recommend screening for obstructive sleep apnea in patients with atrial fibrillation. New data continues to demonstrate the importance of sleep quality and duration for CV health. There is a complex bidirectional relationship between sleep health and CVD. Sleep disturbances have systemic effects that contribute to the development of CVD, including hypertension, coronary artery disease, heart failure, …

More Than Just Teeth: How Oral Health Can Affect The Heart, Steven Hopkins, Saivaroon Gajagowni, Yusuf Qadeer, Zhen Wang, Salim S Virani, Jukka H Meurman, Roman Leischik, Carl J Lavie, Markus Strauss, Chayakrit Krittanawong

Faculty, Staff and Students Publications

Epidemiological evidence has revealed a potential relationship between periodontal disease and cardiovascular disease (CVD). Consensus regarding a link between these pathologies remains elusive, however, largely secondary to the considerable overlap between risk factors and comorbidities common to both disease processes. This review article aims to update the evidence for an association by summarizing the evidence for causality between periodontitis and comorbidities linked to CVD, including endocarditis, hypertension (HTN), atrial fibrillation (AF), coronary artery disease (CAD), diabetes mellitus (DM) and hyperlipidemia (HLD). This article additionally discusses the role for periodontal therapy to improved management of the comorbidities, with the larger goal …