Cardiology Commons^™

Long-Term Follow-Up Of Cardiac Function And Quality Of Life For Patients In Nsabp Protocol B-31/Nrg Oncology: A Randomized Trial Comparing The Safety And Efficacy Of Doxorubicin And Cyclophosphamide (Ac) Followed By Paclitaxel With Ac Followed By Paclitaxel And Trastuzumab In Patients With Node-Positive Breast Cancer With Tumors Overexpressing Human Epidermal Growth Factor Receptor 2, Patricia A. Ganz, Edward H. Romond, Reena S. Cecchini, Priya Rastogi, Charles E. Geyer Jr., Sandra M. Swain, Jong-Hyeon Jeong, Louis Fehrenbacher, Howard M. Gross, Adam M. Brufsky, Patrick J. Flynn, Tanya A. Wahl, Thomas E. Seay, James L. Wade Iii, David D. Biggs, James N. Atkins, Jonathan Polikoff, John L. Zapas, Eleftherios P. Mamounas, Norman Wolmark

Markey Cancer Center Faculty Publications

Purpose

Early cardiac toxicity is a risk associated with adjuvant chemotherapy plus trastuzumab. However, objective measures of cardiac function and health-related quality of life are lacking in long-term follow-up of patients who remain cancer free after completion of adjuvant treatment.

Patients and Methods

Patients in NSABP Protocol B-31 received anthracycline and taxane chemotherapy with or without trastuzumab for adjuvant treatment of node-positive, human epidermal growth factor receptor 2–positive early-stage breast cancer. A long-term follow-up assessment was undertaken for patients who were alive and disease free, which included measurement of left ventricular ejection fraction by multigated acquisition scan along with patient-reported …

Emergency Department Repair Of Blunt Right Atrial Rupture Utilizing Cardiopulmonary Bypass, Samuel P. Carmichael, Michael C. Bounds, Alexis E. Shafii, Phillip K. Chang

Internal Medicine Faculty Publications

Blunt cardiac injury (BCI) with free wall rupture carries a high risk of pre-hospital death. Cardiopulmonary bypass (CPB) has been utilized as a bridge to repair of cardiac lesions in select patients. We present an interesting case of emergency department repair of right atrial rupture with cardiopulmonary bypass.

Influence Of Longitudinal Position On The Evolution Of Steady-State Signal In Cardiac Cine Balanced Steady-State Free Precession Imaging, Tyler J. Spear, Tori A. Stromp, Steve W. Leung, Moriel H. Vandsburger

Saha Cardiovascular Research Center Faculty Publications

Background: Emerging quantitative cardiac magnetic resonance imaging (CMRI) techniques use cine balanced steady-state free precession (bSSFP) to measure myocardial signal intensity and probe underlying physiological parameters. This correlation assumes that steady-state is maintained uniformly throughout the heart in space and time.

Purpose: To determine the effects of longitudinal cardiac motion and initial slice position on signal deviation in cine bSSFP imaging by comparing two-dimensional (2D) and three-dimensional (3D) acquisitions.

Material and Methods: Nine healthy volunteers completed cardiac MRI on a 1.5-T scanner. Short axis images were taken at six slice locations using both 2D and 3D cine bSSFP. 3D acquisitions …

Computational Sensitivity Investigation Of Hydrogel Injection Characteristics For Myocardial Support, Hua Wang, Christopher B. Rodell, Madonna E. Lee, Neville N. Dusaj, Joseph H. Gorman Iii, Jason A. Burdick, Robert C. Gorman, Jonathan F. Wenk

Mechanical Engineering Faculty Publications

Biomaterial injection is a potential new therapy for augmenting ventricular mechanics after myocardial infarction (MI). Recent in vivo studies have demonstrated that hydrogel injections can mitigate the adverse remodeling due to MI. More importantly, the material properties of these injections influence the efficacy of the therapy. The goal of the current study is to explore the interrelated effects of injection stiffness and injection volume on diastolic ventricular wall stress and thickness. To achieve this, finite element models were constructed with different hydrogel injection volumes (150 µL and 300 µL), where the modulus was assessed over a range of 0.1 kPa …

Status Of Early-Career Academic Cardiology, A Global Perspective, Carl W. Tong, Meena S. Madhur, Anne K. Rzeszut, Marwah Abdalla, Islam Abudayyeh, Erick Alexanderson, Jonathan Buber, Dmitriy N. Feldman, Rakesh Gopinathannair, Ravi S. Hira, Andrew M. Kates, Thorsten Kessler, Steve W. Leung, Satish R. Raj, Erica S. Spatz, Melanie B. Turner, Anne Marie Valente, Kristin West, Chittur A. Sivaram, Joseph A Hill, Douglas L. Mann, Andrew M. Freeman

Internal Medicine Faculty Publications

Early career academic cardiologists, whom many believe are an important component of the future of cardiovascular care, face a myriad of challenges. The Early Career Section Academic Working Group of the American College of Cardiology (ACC) along with senior leadership support, assessed the progress of this cohort from 2013–2016 with a global perspective. Data consisted of accessing National Heart Lung and Blood Institute (NHLBI) public information, American Heart Association and international organizations providing data, and a membership-wide survey. Although NHBLI increased funding of career development grants, only a small number of early career ACC members have benefited as funding of …

Calpain Inhibition Attenuates Adipose Tissue Inflammation And Fibrosis In Diet-Induced Obese Mice, Latha Muniappan, Aida Javidan, Weihua Jiang, Shayan Mohammadmoradi, Jessica J. Moorleghen, Wendy S. Katz, Anju Balakrishnan, Deborah A. Howatt, Venkateswaran Subramanian

Saha Cardiovascular Research Center Faculty Publications

Adipose tissue macrophages have been proposed as a link between obesity and insulin resistance. However, the mechanisms underlying these processes are not completely defined. Calpains are calcium-dependent neutral cysteine proteases that modulate cellular function and have been implicated in various inflammatory diseases. To define whether activated calpains influence diet-induced obesity and adipose tissue macrophage accumulation, mice that were either wild type (WT) or overexpressing calpastatin (CAST Tg), the endogenous inhibitor of calpains were fed with high (60% kcal) fat diet for 16 weeks. CAST overexpression did not influence high fat diet-induced body weight and fat mass gain throughout the study. …

Inhibition Of Cholesterol Biosynthesis Through Rnf145-Dependent Ubiquitination Of Scap, Li Zhang, Prashant Rajbhandari, Christina Priest, Jaspreet Sandhu, Xiaohui Wu, Ryan E. Temel, Antonio Castrillo, Thomas Q. De Aguiar Vallim, Tamer Sallam, Peter Tontonoz

Saha Cardiovascular Research Center Faculty Publications

Cholesterol homeostasis is maintained through concerted action of the SREBPs and LXRs. Here, we report that RNF145, a previously uncharacterized ER membrane ubiquitin ligase, participates in crosstalk between these critical signaling pathways. RNF145 expression is induced in response to LXR activation and high-cholesterol diet feeding. Transduction of RNF145 into mouse liver inhibits the expression of genes involved in cholesterol biosynthesis and reduces plasma cholesterol levels. Conversely, acute suppression of RNF145 via shRNA-mediated knockdown, or chronic inactivation of RNF145 by genetic deletion, potentiates the expression of cholesterol biosynthetic genes and increases cholesterol levels both in liver and plasma. Mechanistic studies show …

Deletion Of The Nr4a Nuclear Receptor Nor1 In Hematopoietic Stem Cells Reduces Inflammation But Not Abdominal Aortic Aneurysm Formation, Hua Qing, Karrie L. Jones, Elizabeth B. Heywood, Hong Lu, Alan Daugherty, Dennis Bruemmer

Pharmacology and Nutritional Sciences Faculty Publications

Background: The NR4A3 orphan nuclear hormone receptor, NOR1, functions as a constitutively active transcription factor to regulate inflammation, proliferation, and cell survival during pathological vascular remodeling. Inflammatory processes represent key mechanisms leading to abdominal aortic aneurysm (AAA) formation. However, a role of NOR1 in AAA formation has not been investigated previously.

Methods: Inflammatory gene expression was analyzed in bone marrow-derived macrophages isolated from NOR1-deficient mice. Low-density lipoprotein receptor-deficient (LDLr^−/−) mice were irradiated and reconstituted with hematopoietic stem cells obtained from NOR1−/− or wild-type littermate mice. Animals were infused with angiotensin II and fed a diet enriched in saturated …

No Difference In Myosin Kinetics And Spatial Distribution Of The Lever Arm In The Left And Right Ventricles Of Human Hearts, Divya Duggal, S. Requena, Janhavi Nagwekar, Sangram Raut, Ryan Rich, Hriday Das, Vipul Patel, Ignacy Gryczynski, Rafal Fudala, Zygmunt Gryczynski, Cheavar Blair, Kenneth S. Campbell, Julian Borejdo

Physiology Faculty Publications

The systemic circulation offers larger resistance to the blood flow than the pulmonary system. Consequently, the left ventricle (LV) must pump blood with more force than the right ventricle (RV). The question arises whether the stronger pumping action of the LV is due to a more efficient action of left ventricular myosin, or whether it is due to the morphological differences between ventricles. Such a question cannot be answered by studying the entire ventricles or myocytes because any observed differences would be wiped out by averaging the information obtained from trillions of myosin molecules present in a ventricle or myocyte. …

Secondhand Smoke Exposure And Preclinical Markers Of Cardiovascular Risk In Toddlers, Judith A Groner, Hong Huang, Mandar S. Joshi, Nicholas Eastman, Lisa Nicholson, John Anthony Bauer

Pediatrics Faculty Publications

Objective: Links between secondhand smoke (SHS) exposure and cardiovascular disease in adults are well established but seldom reported during childhood. Although rates of smoking have decreased, young children from low-income backgrounds remain likely to be exposed to SHS. The purpose of this study was to investigate relationships between SHS exposure in young children and several preclinical markers of cardiovascular risk that have been established as relevant to adult populations.

Methods: 139 children, 2–5 years of age, were enrolled in a cross-sectional study. SHS exposure was objectively determined by hair nicotine level; a comprehensive panel of clinical markers (AM blood pressure, …

The Dual Role Of Group V Secretory Phospholipase A2 In Pancreatic Β-Cells, Preetha Shridas, Victoria P. Noffsinger, Andrea C. Trumbauer, Nancy R. Webb

Saha Cardiovascular Research Center Faculty Publications

Purpose

Group X (GX) and group V (GV) secretory phospholipase A₂ (sPLA₂) potently release arachidonic acid (AA) from the plasma membrane of intact cells. We previously demonstrated that GX sPLA₂ negatively regulates glucose-stimulated insulin secretion (GSIS) by a prostaglandin E2 (PGE2)-dependent mechanism. In this study we investigated whether GV sPLA₂ similarly regulates GSIS.

Methods

GSIS and pancreatic islet-size were assessed in wild-type (WT) and GV sPLA₂-knock out (GV KO) mice. GSIS was also assessed ex vivo in isolated islets and in vitro using MIN6 pancreatic beta cell lines with or without GV sPLA …

Capsule Endoscopy In Left Ventricular Assist Device Patients: Retrospective Review Of Efficacy And Necessity, Gaurang N. Vaidya, Michael Krease, Ali Dahhan, Rajakrishnan Vijayakrishnan, Thomas Abell, Emma Birks, Dmitry Abramov

The VAD Journal

Introduction: Capsule endoscopy (CE) is mainstream in the evaluation of obscure gastrointestinal bleeding (GIB) in the general population. However, the diagnostic and therapeutic impact of CE in LVAD patients susceptible to transient bleeding remains largely unexplored. This study aimed to assess the benefits of CE in the evaluation of LVAD associated GIB.

Methods: Retrospective review of patients implanted with a continuous flow LVAD who underwent inpatient capsule endoscopy (CE) between January 2014 and May 2017 at our center. Identification of lesions with high bleeding potential or presence of frank blood were considered abnormal findings on CE study.

Result: Twenty-five inpatients …

Cardiac-Specific Inactivation Of Lpp3 In Mice Leads To Myocardial Dysfunction And Heart Failure, Mini Chandra, Diana Escalante-Alcalde, Shenuarin Bhuiyan, Anthony Wayne Orr, Christopher Kevil, Andrew J. Morris, Hyung Nam, Paari Dominic, Kevin J. Mccarthy, Sumitra Miriyala, Manikandan Panchatcharam

Internal Medicine Faculty Publications

Lipid Phosphate phosphatase 3 (LPP3), encoded by the Plpp3 gene, is an enzyme that dephosphorylates the bioactive lipid mediator lysophosphatidic acid (LPA). To study the role of LPP3 in the myocardium, we generated a cardiac specific Plpp3 deficient mouse strain. Although these mice were viable at birth in contrast to global Plpp3 knockout mice, they showed increased mortality ~ 8 months. LPP3 deficient mice had enlarged hearts with reduced left ventricular performance as seen by echocardiography. Cardiac specific Plpp3 deficient mice had longer ventricular effective refractory periods compared to their Plpp3 littermates. We observed that lack of Lpp3 enhanced cardiomyocyte …

Causes, Timing, And Impact Of Dual Antiplatelet Therapy Interruption For Surgery (From The Paris Registry), Mikkel Schoos, Jaya Chandrasekhar, Usman Baber, Aarti Bhasin, Samantha Sartori, Melissa Aquino, Birgit Vogel, Serdar Farhan, Sabato Sorrentino, Annapoorna Kini, Mitchell Kruckoff, David J. Moliterno, Timothy D. Henry, Giora Weisz, C. Michael Gibson, Ioannis Iakovou, Antonio Colombo, P. Gabriel Steg, Bernhard Witzenbichler, Alaide Chieffo, David Cohen, Thomas Stuckey, Cono Ariti, George Dangas, Stuart Pocock, Roxana Mehran

Internal Medicine Faculty Publications

Temporary interruption of dual antiplatelet therapy (DAPT) is not infrequently required in patients undergoing percutaneous coronary intervention (PCI). We sought to describe the procedures and outcomes associated with DAPT interruption in patients treated with DAPT following successful PCI from the Patterns of non-adherence to anti-platelet regimens in stented patients registry (n = 5018). DAPT interruption was prespecified as physician recommended cessation forcohort, 490 patients (9.8%) experienced 594 DAPT interruptions over 2 years following PCI. Only 1 antiplatelet agent was interrupted in 57.2% cases and interruption was frequently recommended by noncardiologists (51.3%). Where type of surgery was reported, majority of DAPT …

Anticoagulation Monitoring In Left Ventricular Assist Device (Lvad) Patients, Adam Sieg, Jennifer Gass, Phillip Weeks, Indranee Rajapreyar, Igor Gregoric

The VAD Journal

The use of left ventricular assist devices (LVAD) provides a treatment strategy for advanced heart failure patients to prolong life and serve as a mediator (bridge to transplant) until an organ becomes available in patients considered suitable candidates for heart transplantation. The use of LVAD therapy is complicated by the constant risk of bleeding and thrombotic events. We reviewed and analyzed the effectiveness of our current heparin protocol with respect to overall anticoagulation and time in therapeutic range (TTR). Our analysis demonstrated that patients did not achieve therapeutic anticoagulation for at least 24 hours following initiation of heparin and that …

Body Size Predicts Cardiac And Vascular Resistance Effects On Men's And Women's Blood Pressure, Joyce M. Evans, Siqi Wang, Christopher Greb, Vladimir Kostas, Charles F. Knapp, Qingguang Zhang, Eric S. Roemmele, Michael B. Stenger, David C. Randall

Biomedical Engineering Faculty Publications

Key Points Summary

• We report how blood pressure, cardiac output and vascular resistance are related to height, weight, body surface area (BSA), and body mass index (BMI) in healthy young adults at supine rest and standing.
• Much inter-subject variability in young adult's blood pressure, currently attributed to health status, may actually result from inter-individual body size differences.
• Each cardiovascular variable is linearly related to height, weight and/or BSA (more than to BMI).
• When supine, cardiac output is positively related, while vascular resistance is negatively related, to body size. Upon standing, the change in vascular resistance is positively related to size. …

Targeting Hepatic Heparin-Binding Egf-Like Growth Factor (Hb-Egf) Induces Anti-Hyperlipidemia Leading To Reduction Of Angiotensin Ii-Induced Aneurysm Development, Seonwook Kim, Lihua Yang, Seongu Kim, Richard G. Lee, Mark J. Graham, Judith A. Berliner, Aldons J. Lusis, Lei Cai, Ryan E. Temel, Debra L. Rateri, Sangderk Lee

Saha Cardiovascular Research Center Faculty Publications

Objective

The upregulated expression of heparin binding EGF-like growth factor (HB-EGF) in the vessel and circulation is associated with risk of cardiovascular disease. In this study, we tested the effects of HB-EGF targeting using HB-EGF-specific antisense oligonucleotide (ASO) on the development of aortic aneurysm in a mouse aneurysm model.

Approach and results

Low-density lipoprotein receptor (LDLR) deficient mice (male, 16 weeks of age) were injected with control and HB-EGF ASOs for 10 weeks. To induce aneurysm, the mice were fed a high fat diet (22% fat, 0.2% cholesterol; w/w) at 5 week point of ASO administration and infused with angiotensin …

Right Ventricle Chest Compressions: Do We Need A New Paradigm For Lvad Patients Needing Resuscitation? A Case Report., Arvind Bhimaraj, Erik E. Suarez, Jerry D. Estep

The VAD Journal

The use of chest compressions in patients with left ventricular assist devices (LVAD) have been viewed to cause a potential damage to the outflow graft and hence have been a topic of controversy. We report a case of a LVAD patient who needed chest compressions during resuscitation for severe right ventricular failure. With the presence of trans-esophageal echocardiogram we noticed that the chest compressions did not need to be full ACLS compressions but modified to gentle right ventricular (RV) compressions in order to move blood into a normally functioning LVAD. We report this as a call for the LVAD medical …

Mobilization Studies In Mice Deficient In Sphingosine Kinase 2 Support A Crucial Role Of The Plasma Level Of Sphingosine-1-Phosphate In The Egress Of Hematopoietic Stem Progenitor Cells, Mateusz Adamiak, Lakshman Chelvarajan, Kevin R. Lynch, Webster L. Santos, Ahmed Abdel-Latif, Mariusz Z. Ratajczak

Gill Heart & Vascular Institute Faculty Publications

Sphingosine-1-phosphate (S1P) is a bioactive lipid involved in cell signaling and, if released from cells, also plays a crucial role in regulating the trafficking of lympho-hematopoietic cells, including primitive hematopoietic stem/progenitor cells (HSPCs). It has been demonstrated that S1P chemoattracts HSPCs, and its level in peripheral blood creates a gradient directing egress of these cells during mobilization. In this paper we analyzed hematopoiesis in mice deficient in sphingosine kinase 2 (Sphk2-KO mice) and studied the effect of this mutation on plasma S1P levels. We found that Sphk2-KO mice have normal hematopoiesis, and, in contrast to Sphk1-KO mice, the circulating S1P …

Left Ventricular Assist Device Is A Viable Therapy In End Stage Hypertrophic Cardiomyopathy, Mirnela Byku, Michael Nassif, Eric Novak, Akinobu Itoh, Greg Ewald, Shane J. Larue

The VAD Journal

Left Ventricular Assist Device (LVAD) therapy use is increasing rapidly in advanced heart failure (HF). Little data exists on the application of this therapy in patients with advanced HF due to Hypertrophic Cardiomyopathy (HCM). Altered ventricular geometry, thickened septum and reduced LV end-diastolic diameter (LVEDD) in HCM may lead to increased suction events, arrhythmias and inflow cannula malfunction.

We hypothesized that patients with end stage HCM benefit from LVAD therapy and have a similar rate of complications to those with ischemic or dilated CM.

Between 2009 and 2014, 5 patients with end stage HCM (HCM and EF

We conclude that …

Prevalence And Prognostic Features Of Ecg Abnormalities In Acute Stroke: Findings From The Siren Study Among Africans, Abiodun M. Adeoye, Okechukwu S. Ogah, Bruce Ovbiagele, Rufus Akinyemi, Vincent Shidali, Francis Agyekum, Akinyemi Aje, Oladimeji Adebayo, Joshua O. Akinyemi, Philip Kolo, Lambert Tetteh Appiah, Henry Iheonye, Uwanuruochi Kelechukwu, Amusa Ganiyu, Taiwo O. Olunuga, Onoja Akpa, Ojo Olakanmi Olagoke, Fred Stephen Sarfo, Kolawole Wahab, Samuel Olowookere, Adekunle Fakunle, Albert Akpalu, Philip B. Adebayo, Kwadwo Nkromah, Joseph Yaria, Philip Ibinaiye, Godwin Ogbole, Aridegbe Olumayowa, Sulaiman Lakoh, Benedict Calys-Tagoe, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Background

Africa has a growing burden of stroke with associated high morbidity and a 3-year fatality rate of 84%. Cardiac disease contributes to stroke occurrence and outcomes, but the precise relationship of abnormalities as noted on a cheap and widely available test, the electrocardiogram (ECG), and acute stroke outcomes have not been previously characterized in Africans.

Objectives

The study assessed the prevalence and prognoses of various ECG abnormalities among African acute stroke patients encountered in a multisite, cross-national epidemiologic study.

Methods

We included 890 patients from Nigeria and Ghana with acute stroke who had 12-lead ECG recording within first 24 …

Exploring Overlaps Between The Genomic And Environmental Determinants Of Lvh And Stroke: A Multicenter Study In West Africa, Abiodun M. Adeoye, Bruce Ovbiagele, Philip Kolo, Lambert Appiah, Akinyemi Aje, Oladimeji Adebayo, Fred Sarfo, Joshua Akinyemi, Gregory Adekunle, Francis Agyekum, Vincent Shidali, Okechukwu Ogah, Dan Lackland, Mulugeta Gebregziabher, Donna K. Arnett, Hemant K. Tiwari, Rufus Akinyemi, Ojo Olakanmi Olagoke, Ayodipupo Sikiru Oguntade, Taiwo Olunuga, Kelechi Uwanruochi, Carolyn Jenkins, Patrick Adadey, Henry Iheonye, Lukman Owolabi, Reginald Obiako, Samuel Akinjopo, Kevin Armstrong, Albert Akpalu, Adekunle Fakunle

Epidemiology and Environmental Health Faculty Publications

Background

Whether left ventricular hypertrophy (LVH) is determined by similar genomic and environmental risk factors with stroke, or is simply an intermediate stroke marker, is unknown.

Objectives

We present a research plan and preliminary findings to explore the overlap in the genomic and environmental determinants of LVH and stroke among Africans participating in the SIREN (Stroke Investigative Research and Education Network) study.

Methods

SIREN is a transnational, multicenter study involving acute stroke patients and age-, ethnicity-, and sex-matched control subjects recruited from 9 sites in Ghana and Nigeria. Genomic and environmental risk factors and other relevant phenotypes for stroke and …

Lisinopril Or Coreg Cr In Reducing Cardiotoxicity In Women With Breast Cancer Receiving Trastuzumab: A Rationale And Design Of A Randomized Clinical Trial, Maya Guglin, Pamela Munster, Angelina Fink, Jeffrey Krischer

Internal Medicine Faculty Publications

Background—Trastuzumab (TZB) is an established therapy for HER2 positive breast cancer. The use of TZB is commonly associated with cardiotoxicity manifesting as asymptomatic decrease in left ventricular ejection fraction (LVEF) or overt heart failure. Several studies demonstrated favorable effects of angiotensin converting enzyme (ACE) inhibitors and beta blockers (BB) in the prevention of chemotherapy-induced cardiotoxicity. We hypothesize that patients, randomized to receive an ACE inhibitor or a beta-blocker during trastuzumab therapy for breast cancer, will maintain a higher LVEF than patients randomized to placebo.

Methods and Results—We designed a prospective, multicenter, randomized, phase II placebo-controlled clinical trial to …

Paranormal Activity: Para-Esophageal/Gastric Hemorrhage In A Patient With A Heartmate Ii Lvad, Anna Stone, Ashwin Ravichandran

The VAD Journal

In this report we present an unusual case of non-traumatic, spontaneous para-esophageal/para-gastric hemorrhage requiring multiple units of red blood cells in a female patient with a continuous flow left ventricular assist device. She presented with dysphagia and atypical chest pain 18 months post implantation, on the recommended anticoagulation regimen for HeartMate II support of ASA 81mg and international normalized ratio goal (INR) of 2-3 and was successfully managed with conservation support, volume resuscitation and multiple transfusions. Non-traumatic causes of acute bleeding, including acquired platelet dysfunction are considered.

The Use Of Intraosseous Needles For Injection Of Contrast Media For Computed Tomographic Angiography Of The Thoracic Aorta, Michael A. Winkler, Cynthia Talley, Connor Woodward, Alexander Kingsbury, Frank Appiah, Hossam Elbelasi, Kevin P. Landwehr, Xingzhe Li, Dominik Fleischmann

Radiology Faculty Publications

Background

The objective of this study is to evaluate the safety and quality of computed tomographic angiography of the thoracic aorta (CTA-TA) exams performed using intraosseous needle intravenous access (ION-IVA) for contrast media injection (CMI).

Methods

All CTA-TA exams at the study institution performed between 1/1/2013 and 8/14/2015 were reviewed retrospectively to identify those exams which had been performed using ION-IVA (ION-exams). ION-exams were then analyzed to determine aortic attenuation and contrast-to-noise ratio (CNR). Linear regression was used to determine how injection rate and other variables affected image quality for ION-exams. Patient electronic medical records were reviewed to identify any …

Fatal Flaw - Driveline Fracture As A Rare But Serious Complication Of Mechanical Circulatory Support With Left Ventricular Assist Devices, Yuri Boyechko, Thomas Tribble, Maya Guglin

The VAD Journal

Background: Patients with advanced heart failure have seen decreased mortality and improved quality of life due to mechanical circulatory support with left ventricular assist devices (LVAD). Regardless of such outcomes, many complications still exist and remain a significant cause of morbidity and mortality. Our purpose is to study the prevalence, clinical course, and outcomes specifically of patients with LVAD driveline (DL) fractures.

Methods: This single-center, retrospective review included all patients at our institution who had continuous flow LVADs and experienced DL fracture/injury from January 2012 - December 2015.

Results: Thirteen of 110 LVAD patients (11.8%) had DL fractures (Table 1). …

Qt Prolongation Is Associated With Increased Mortality In End Stage Liver Disease, Sun Moon Kim, Bennet George, Diego Alcivar-Franco, Charles L. Campbell, Richard Charnigo, Brian P. Delisle, Jonathan Hundley, Yousef Darrat, Gustavo Morales, Samy-Claude Elayi, Alison L. Bailey

Internal Medicine Faculty Publications

AIM

To determine the prevalence of QT prolongation in a large series of end stage liver disease (ESLD) patients and its association to clinical variables and mortality.

METHODS

The QT interval was measured and corrected for heart rate for each patient, with a prolonged QT cutoff defined as QT > 450 ms for males and QT > 470 ms for females. Multiple clinical variables were evaluated including sex, age, serum sodium, international normalized ratio, creatinine, total bilirubin, beta-blocker use, Model for End-Stage Liver Disease (MELD), MELD-Na, and etiology of liver disease.

RESULTS

Among 406 ESLD patients analyzed, 207 (51.0%) had QT prolongation. …

Plasma Cross-Gestational Sphingolipidomic Analyses Reveal Potential First Trimester Biomarkers Of Preeclampsia, Aneta Dobierzewska, Sony Soman, Sebastian E Illanes, Andrew J. Morris

Saha Cardiovascular Research Center Faculty Publications

Introduction

Preeclampsia (PE) is a gestational disorder, manifested in the second half of pregnancy by maternal hypertension, proteinuria and generalized edema. PE is a major cause of maternal and fetal morbidity and mortality, accounting for nearly 40% of all premature births worldwide. Bioactive sphingolipids are emerging as key molecules involved in etiopathogenesis of PE, characterized by maternal angiogenic imbalance and symptoms of metabolic syndrome. The aim of this study was to compare the cross-gestational profile of circulating bioactive sphingolipids in maternal plasma from preeclamptic (PE) versus normotensive control (CTL) subjects with the goal of identifying sphingolipids as candidate first trimester …

Acute Effects Of Implantable Cardioverter-Defibrillator Shocks On Biomarkers Of Myocardial Injury, Apoptosis, Heart Failure, And Systemic Inflammation, Jordan Brewster, Travis Sexton, Gary Dhaliwal, Richard Charnigo, Gustavo Morales, Kevin Parrott, Yousef Darrat, John C. Gurley, Susan S. Smyth, Claude S. Elayi

Internal Medicine Faculty Publications

Background: Implantable cardioverter‐defibrillator (ICD) shocks are potentially associated with myocardial injury, altered hemodynamics, apoptosis, and inflammatory signaling. Their precise cellular impact can be explored after defibrillation testing (DFT) via biomarkers. We evaluated changes in biomarkers after ICD shocks during DFT.

Methods: We prospectively enrolled outpatients presenting for first implantation of a cardiac device. Biomarkers indicative of myocardial injury, inflammation, and apoptosis were measured before and after implantation, and compared between patients receiving DFT (DFT+) to those not (DFT−).

Results: Sixty‐three patients were enrolled, 40 in the DFT+ group and 23 in the DFT− group. Average levels of troponin I, hsCRP, …

Reversible Mitral Regurgitation As A Complication Of Impella® 5.0, Katrina A. Bidwell, Andrew R. Kolodziej, Maya E. Guglin

The VAD Journal

The Impella® is a ventricular assist device used for temporary left ventricular support and has been approved for use since 2008. In this report we present a case of a patient who experienced mitral regurgitation as a complication shortly after placement of an Impella® as well as a brief literature review. To our knowledge this is the first such case demonstrating resolution of iatrogenic mitral regurgitation with removal of the device as opposed to permanent damage.