Cardiology Commons^™

Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson

Master's Projects and Capstones

Abstract

Problem: Heart failure (HF), also known as congestive heart failure (CHF), is the number one diagnosis-related group (DRG) for people 65 years of age and older in the United States. This disease group is complicated and debilitating, requiring frequent hospitalizations with high mortality rates. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified CHF as an area for improvement in hospitals.

Context: This was a quality improvement project for an integrated medical center in the Central Valley, California with over 19,000 HF patients. In 2018, for patients 65 years and older, HF is the third-most admitted DRG …

Implementing Evidence-Based Dietary Instruction Strategies In A Specialty Care Clinic, Jacobie Landers

Doctor of Nursing Practice

Cardiovascular disease is a significant health concern that increases risks for stroke, escalates the development of renal disease, and significantly increases morbidity and mortality risk. Dietary changes can significantly reduce complications in patients with heart and vascular disease. This project was designed to effectively implement and sustain provider and cardiovascular staff instructions on dietary modifications to improve hypertension control and lower cholesterol in patients with cardiac disease using staff support. The project facilitated provider evaluation of patients’ dietary habits to promote wellness in a patient population which was not receiving dietary education. Project interventions included establishing structured methods of providing …

The Epidemiology Of Infective Endocarditis Among People Who Inject Drugs In London, Ontario., Brian Hallam

Electronic Thesis and Dissertation Repository

Infective endocarditis is an infectious disease that affects the valves of the heart. Injection drug use is currently a leading risk factor among patients with endocarditis. We conducted a prospective study using data from hospital chart records among patients with endocarditis in London, Ontario, which has a relatively high prevalence of people who inject drugs to assess the severity of the issue and the major risk factors of mortality pertaining to this population. This study had a sample size of 353 and included a review of the incidence of admissions of endocarditis, as well as a survival analysis, using both …

Bayesian Analytical Approaches For Metabolomics : A Novel Method For Molecular Structure-Informed Metabolite Interaction Modeling, A Novel Diagnostic Model For Differentiating Myocardial Infarction Type, And Approaches For Compound Identification Given Mass Spectrometry Data., Patrick J. Trainor

Electronic Theses and Dissertations

Metabolomics, the study of small molecules in biological systems, has enjoyed great success in enabling researchers to examine disease-associated metabolic dysregulation and has been utilized for the discovery biomarkers of disease and phenotypic states. In spite of recent technological advances in the analytical platforms utilized in metabolomics and the proliferation of tools for the analysis of metabolomics data, significant challenges in metabolomics data analyses remain. In this dissertation, we present three of these challenges and Bayesian methodological solutions for each. In the first part we develop a new methodology to serve a basis for making higher order inferences in metabolomics, …

A Study Of Acoustically Activated Nanodroplets, Songita Choudhury

Theses & Dissertations

Current treatment of acute myocardial infarction (AMI), which is the main pathophysiological event leading to death in the United States, has advanced considerably with the introduction of emergent percutaneous interventions, but there remains an urgent need for novel techniques to rapidly and accurately detect infarcted or ischemic tissue that results from AMI. Ultrasound contrast agents, also known as microbubbles (MB), have become commonplace in echocardiography. However, MBs are purely intravascular tracers and unable to cross endothelial barriers due to size. The limitations of MBs, namely size and short circulation times within the human body, led to the development of phase-change …

Intestinal Permeability And Microbial Dysbiosis In Acute Coronary Syndrome (Miacs Study), Tarik Alhmoud

Biomedical Sciences ETDs

Background: Acute Coronary Syndrome (ACS) is a leading cause of morbidity and mortality. Metabolic syndrome and obesity are major risk factors for atherosclerosis and ACS. Dysbiosis plays an important role in metabolic syndrome and obesity. Studies show a markedly increased risk of heart attacks in patients with high levels of the pro-atherogenic metabolite trimethylamine-N-Oxide (TMAO). TMAO is produced by the intestinal microbial flora through metabolism of dietary phospholipids; Gram-negative bacteria (Phylum Proteobacteria) is the major source of TMAO metabolism. Patients with obesity and metabolic syndrome have a defective intestinal tight-junctional (TJ) barrier, which allows paracellular permeation of luminal antigens such …

Extraction And Analysis Of Vector Flow Imaging Data In A Pediatric Population, Bailey Stinnett

Biomedical Engineering Undergraduate Honors Theses

Vector flow imaging (VFI) is a new ultrasound technology that provides real time, angle-independent visualization of flow velocities in the heart and great vessels. Thus far, VFI has been used for superficial applications due to the limited penetration depth of available transducer probes; however, this depth in smaller pediatric patients enables adequate aortic views. In this project, VFI was used to study pediatric aortic stenosis (PAS)—a congenital heart defect that results in the narrowing of the aorta and/or aortic valve. The decision to refer PAS patients for surgical or catheter-based intervention is initially based on Doppler ultrasound. VFI is potentially …

Effects Of A Phase Ii Cardiac Rehabilitation Program On Patient Depression, Michael R. Legal, Dnp, Msn-Ed, Rn, Ccrn-K

Doctor of Nursing Practice Projects

Background: Screening for depression upon intake and completion of a Phase II cardiac rehabilitation (CR) program may influence the type of interventions implemented by CR staff and reduce depression.

Objectives: We examined patients before and after a Phase II CR program who self-reported as depressed using the CES-D score and also assessed scores by procedure, gender and age. We further identified the types of interventions used for those who were depressed.

Methods: We conducted a pre-post intervention study. Using a convenience sample, data were collected on CES-D scores before and after the program and by type of procedure, gender, and …

Meditation As A Tool For Blood Pressure Management, Maggie Ray

Thinking Matters Symposium Archive

PURPOSE: Appraise existing evidence about meditation and blood pressure in persons with cardiac risk factors and offer evidence-based recommendations about the use of meditation in management of blood pressure

Aggressive Diuresis And Severity-Adjusted Length Of Hospital Stay In Acute Congestive Heart Failure Patients, Muhammad U. Butt

Theses and Dissertations--Clinical Research Design

To see if aggressive diuresis in first twenty four hours is associated with a comparable number of total days in the hospital as compared to non-aggressive diuresis. In this retrospective cohort study, we compared the length of hospital stay of consecutive patients admitted in one year based on their diuresis during the first twenty-four hours of hospitalization: aggressive diuresis (group 1) i.e. > 2400mL versus non-aggressive diuresis (group 2) i.e. ≤ 2400mL urine output. Patients were excluded if in cardiogenic shock, had creatinine level above 3 mg/dL on admission, or on dialysis. A total of 194 patients were enrolled (29 in …

Sedentary Time And The Cumulative Risk Of Preserved And Reduced Ejection Fraction Heart Failure: From The Multi-Ethnic Study Of Atherosclerosis, Brandi Scot Rariden

UNF Graduate Theses and Dissertations

ABSTRACT

Purpose: The purpose of this study was to examine the relationship between self-reported sedentary time (ST) and the cumulative risk of preserved ejection fraction heart failure (HFpEF) and reduced ejection fraction heart failure (HFrEF) using a diverse cohort of U.S. adults 45-84 years of age.

Methods: Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), we identified 6,814 subjects (52.9% female). All were free of baseline cardiovascular disease. Cox regression was used to calculate the hazard ratios (HR) associated with baseline ST and risk of overall heart failure (HF), HFpEF, and HFrEF. Weekly self-reported ST was dichotomized …

Patient-Specific Quantification Of The Relationship Between The Left Atrium Pressure And The Ostial Diameter Of The Left Atrial Appendage, Sky Tianqi Gao

Electronic Theses and Dissertations

The left atrial appendage has been a historically understudied region of the heart until fairly recently with the new understanding of its role in the stroke pathway of patients with atrial fibrillation. The goal of this study is to take a look at the biomechanical behavior of the left atrium and left atrial appendage under normal physiological loading conditions using material properties taken from biaxial stretch tests. Several different options for material properties models were tested and biaxial stretch test data of cadaveric human tissue samples for the left atrium and appendage were fit to a Fung-type strain-energy function for …

Effects Of The Na-Cl Co-Transporter (Ncc) In Western Diet Induced Metabolic And Cardiac Dysfunction, Zachary S. Cutter

Theses and Dissertations

Interleukin-18 (IL-18) is a pro-inflammatory cytokine known to be involved in maintaining metabolic homeostasis; however, also capable of inducing cardiac dysfunction. Additionally, IL-18, has been shown to bind to a novel receptor, the Na-Cl Co-transporter (NCC). We hypothesized that NCC mediates IL-18 metabolic and cardiac signaling in mice. Using male C57BL/6J mice, we compared the metabolic and cardiac function changes after at least 8 weeks of high-saturated fat high sugar diet (Western Diet) in NCC knockout (NCCKO), IL-18 knockout (IL-18KO), and wild-type mice. We show that NCCKO mice have significantly increased body weight gain from baseline, no difference in fasting …

Drug Therapy Vs. Ablation Therapy For Patients With Atrial Fibrillation, Jessica Ansara

Theses and Graduate Projects

The prevalence of atrial fibrillation is 6.5 percent in the adult population in the United States, in an attempt to treat this patient population, there are numerous options and this study attempts to find the optimal treatment plan that has the least Atrial fibrillation(AF) reoccurrence, best quality of life and is the most effective. This is a Systematic Review comparing catheter ablation therapy vs. drug therapy in treating patients with atrial fibrillation. The search engines used in this analysis include PubMed, UpToDate, Google Scholar and Academic Search Premier. A total of 19 articles were analyzed and data was extracted, and …

The Neuroprotective Effects Of Targeted Temperature Management On Post-Cardiac Arrest Patients, Timothy Hovde

Physician Assistant Scholarly Project Papers

Novel methods of ensuring survival following cardiac arrest and resuscitation are of supreme importance to the medical community. Targeted temperature management (TTM) has become increasingly utilized pre-hospital, in emergency departments, and within intensive care units to increase the likelihood of survival to hospital discharge. TTM has further been used to attempt to improve neurological functioning. The efficacy and mechanism behind TTM remains poorly understood. In several patient populations it also remains unproven. The purpose of this study is to assess the physiological mechanism, survival, neurological recovery and methodology of TTM use and implementation.

Literature review was utilized to assess the …

Impaired Cardiorespiratory Fitness Following Thoracic Radiotherapy, Justin M. Canada

Theses and Dissertations

Cancer (CA) is the second leading cause of death in the United States preceded only by cardiovascular disease (CVD). Over the past 30 years, the 5-year survival rate for all cancers combined has increased by more than 20%. This improved survival rate is due to early diagnosis and advances in treatment involving a multimodality treatment approach that includes radiotherapy [RT] with about half of all CA patients receiving some type of RT sometime during the course of their treatment. Cardiotoxicity is one of the most important adverse reactions of RT and leads to a meaningful risk of CVD-related morbidity and …

Role Of Sex Chromosomes In Sexual Dimorphism Of Angii-Induced Abdominal Aortic Aneurysms, Yasir Alsiraj

Theses and Dissertations--Pharmacology and Nutritional Sciences

Abdominal aortic aneurysms (AAAs), a permanent dilation in the abdominal region of the aorta, is a highly sexually dimorphic disease. AAAs prevalence is ranging from 4-10 fold higher in males than females. Defining the mechanistic basis for reduced (in females) or increased (in males) AAA formation and progression may uncover potential therapeutic targets. The majority of studies examining sexual dimorphism focus on the role of sex hormones. However, genes residing on sex chromosomes, in addition to sex hormones, may contribute to sexual dimorphism of AAAs. For example, the X chromosome contains about 5% of the whole genome, but the role …

In Developing Countries, Does The Implementation Of Basic Cardio-Pulmonary Resuscitation Education In The Community Improve Patient Outcomes?, Ashley Gross

Theses and Graduate Projects

Circulatory shock and cardiovascular diseases contribute to significant mortality globally, with an increased burden in developing countries. The compilation of these studies and anecdotal support gathered while in Nicaragua supports the impact education on high-quality CPR among the community can have on out-of- hospital cardiac arrest patient outcomes. Even though some studies showed guideline-compliant CPR does not improve all patient outcomes, we cannot estimate the time it will take a patient to achieve ROSC. Therefore, educating the public and refining the skills of health care professionals can have a significant positive impact on out-of-hospital cardiac arrest patient outcomes if there …