Cardiology Commons^™

Who Is Next? Evaluating Factors That May Contribute To Heart Failure, Davon Broadwater

Symposium of Student Scholars

Cardiovascular diseases are the number one causes of death globally, and for African Americans those risks are even higher. As an African American university student studying Biology, I am passionate about researching the diseases that affect my race. Current research states that behavioral factors such as obesity, tobacco use, unhealthy diet, and harmful use of alcohol should be avoided. I have chosen to research predictors of what helps patients survive if they already have heart failure. Heart failure develops gradually, where the heart becomes weaker over time and has trouble pumping blood to nourish the cells in the body. Data …

Comparative Trends In Ischemic Heart Disease Admissions, Presentation And Outcomes Due To The Covid-19 Pandemic: First Insights From A Tertiary Medical Center In Pakistan, Ali Aahil Noorali, Humza Thobani, Shiraz Hashmi, Sara Iqbal, Asma A H. Merchant, Mian Arsam Haroon, Sardar Shahmir Babar Chauhan, Saad Mallick, Nida Zahid, Yasir Khan, Osman Faheem, Saulat Fatimi

Department of Medicine

Introduction: COVID-19 has manifested a striking disarray in healthcare access and provision, particularly amongst patients presenting with life-threatening ischemic heart disease (IHD). The paucity of data from low-middle income countries has limited our understanding of the consequential burden in the developing world. We aim to compare volumes, presentations, management strategies, and outcomes of IHD amongst patients presenting in the same calendar months before and during the COVID-19 pandemic.
Methods: We conducted a retrospective cross-sectional analysis at the Aga Khan University Hospital, one of the premier tertiary care centres in Pakistan. Data were collected on all adult patients (>18 years) …

Levels Of Evidence Within Cardiovascular Medicine Research In Saudi Arabia: A Systematic Review, Sultan Alotaibi, Alexandra M. Schuster, Bernardo Perez-Villa, Jaime Hernandez-Montfort

Journal of the Saudi Heart Association

International commitments to reduce the prevalence of non-communicable disease have led the Government of Saudi Arabia to invest more in research related to cardiovascular disease. However, the strength of evidence derived from this research activities remains unclear. The aim of our study was to examine the level of evidence within clinical Cardiovascular Medicine research in Saudi Arabia. We conducted a systematic review of published articles that included a population from Saudi Arabia. Electronic databases EMBASE and MEDLINE (Ovid) were searched up to 25th of April 2021, supplemented by a second search in CENTRAL (Cochrane Central Register of Controlled Trials) and …

A Novel Missense Mutation In Tnni3k Causes Recessively Inherited Cardiac Conduction Disease In A Consanguineous Pakistani Family, Shafaq Ramzan, Stephanie Tennstedt Stephanie Tennstedt, Muhammad Tariq, Sheraz Khan, Hafiza Noor Ul Ayan, Aamir Ali, Matthias Munz, Holger Thiele, Asad Aslam Korejo, Shahid Mahmood Baig

Department of Biological & Biomedical Sciences

Cardiac conduction disease (CCD), which causes altered electrical impulse propagation in the heart, is a life-threatening condition with high morbidity and mortality. It exhibits genetic and clinical heterogeneity with diverse pathomechanisms, but in most cases, it disrupts the synchronous activity of impulse-generating nodes and impulse-conduction underlying the normal heartbeat. In this study, we investigated a consanguineous Pakistani family comprised of four patients with CCD. We applied whole exome sequencing (WES) and co-segregation analysis, which identified a novel homozygous missense mutation (c.1531T>C;(p.Ser511Pro)) in the highly conserved kinase domain of the cardiac troponin I-interacting kinase (TNNI3K) encoding gene. The behaviors of …

Comparing Sensitivity And Specificity Of Pacemaker Id Application And Cardiac Rhythm Management Device-Finder Application In Identifying Cardiac Implantable Electronic Device Manufacturer Using Chest Radiograph - An Observational Study, Pirbhat Shams, Muhammad Mehdi, Jamshed Ali, Intisar Ahmed, Sheema Saadia, Sameen Iqbal, Aamir Hameed Khan, Yawer Saeed

Section of Cardiology

Background: Smartphone-based applications to identify cardiac implantable electronic devices (CIED) are extremely useful in circumstances, where urgent device interrogation is needed, and a device identification card is not available. Few studies have provided insights regarding the utility of these applications. We have studied two widely available applications i.e., Pacemaker ID app (PMIDa) or Cardiac Rhythm Management Device-Finder (CRMD-f) to identify device manufacturers in CIEDs.
Methods: 547 patients who underwent CIED implantation from the year 2016-2020 in our institute were enrolled. There were 438 Medtronic and 109 St. Jude's devices. All chest radiographs were de-identified and resized into 225*225 pixels focusing …

Ability Of Video Telemetry To Predict Unplanned Hospital Admissions For Single Ventricle Infants., Doaa Aly, Lori Erickson, Hayley S. Hancock, Johnathan Apperson, Monica Gaddis, Girish S. Shirali, Suma Goudar

Manuscripts, Articles, Book Chapters and Other Papers

Background: Our Cardiac High Acuity Monitoring Program (CHAMP) uses home video telemetry (HVT) as an adjunct to monitor infants with single ventricle during the interstage period. This study describes the development of an objective early warning score using HVT, for identification of infants with single ventricle at risk for clinical deterioration and unplanned hospital admissions (UHA).

Methods and Results: Six candidate scoring parameters were selected to develop a pragmatic score for routine evaluation of HVT during the interstage period. We evaluated the individual and combined ability of these parameters to predict UHA. All infants with single ventricle monitored at home …

The Reel Deal: The Stacked Benefits Of A Reel Mower, John K. Hix, Simone Bailey

Advances in Clinical Medical Research and Healthcare Delivery

"Mow-lawning" is a colloquial term referred to actively cutting grass using a reel mower, typically at a faster than normal pace in order to maximize exercise benefit and minimize time, with the emphasis on the physical action of mowing and only secondarily on the resulting lawn care. While mow-lawning remains relatively uncommon in the United States, adoption of this practice by those healthy enough to engage in the level of exercise required can deliver a number of benefits that improve environmental, safety, and personal goals simultaneously. The stacking of so many benefits in one practice deserves more attention and promotion.

Development Of The Biohybrid Assay: Combining Primary Human Vascular Smooth Muscle Cells And Blood To Measure Vascular Calcification Propensity, Armand M G Jaminon, Asim C Akbulut, Niko Rapp, Rafael Kramann, Erik A L Biessen, Lieve Temmerman, Barend Mees, Vincent Brandenburg, Robert Dzhanaev, Willi Jahnen-Dechent, Juergen Floege, Jouni Uitto, Chris P Reutelingsperger, Leon J Schurgers

Department of Dermatology and Cutaneous Biology Faculty Papers

BACKGROUND: Vascular calcification is an active process that increases cardiovascular disease (CVD) risk. There is still no consensus on an appropriate biomarker for vascular calcification. We reasoned that the biomarker for vascular calcification is the collection of all blood components that can be sensed and integrated into a calcification response by human vascular smooth muscle cells (hVSMCs).

METHODS: We developed a new cell-based high-content assay, the BioHybrid assay, to measure in vitro calcification. The BioHybrid assay was compared with the o-Cresolphthalein assay and the T50 assay. Serum and plasma were derived from different cohort studies including chronic kidney disease (CKD) …

Percutaneous Coronary Intervention Versus Coronary Artery Bypass Graft In The Treatment Of Multivessel Coronary Artery Disease On Diabetes Mellitus Patients, Nguyen Vu

Theses and Graduate Projects

Objectives: This systemic review is conducted to compare between Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Graft (CABG) in the revascularization strategy of patients with diabetes mellitus (DM) and multivessel coronary artery disease (CAD) based on clinical outcomes.

Background: Diabetes mellitus approached epidemic proportions globally and was recognized as a risk factor of aggressive and multivessel CAD [1,2]. The controversy over the optimal revascularization strategy for patients with DM and multivessel CAD has been hotly debated for more than 10 years. Numerous studies and data analysis were conducted to compare between PCI and CABG based on clinical outcomes of …

In Patients With Cardiac Arrest, Does Early Defibrillation Reduce Mortality?, Nicholas Lueddecke

Theses and Graduate Projects

Background: Cardiac arrest is a devastating disorder that affects millions of people each year. Often having a sudden onset, cardiac arrest is almost certainly lethal if prompt treatment is not started. In hopes to both better understand how treatment of cardiac arrest has evolved and to quantitatively measure the outcome of defibrillation, multiple pieces of literature have been reviewed.

Methods: Articles were found that were pertinent by using PubMed and Google Scholar. Literature was obtained that researched a wide spectrum of topics relating to defibrillation and cardiac arrest that did not focus on traumatic cardiac arrests as it is beyond …

Ventricular Fibrillation Due To A Likely Pathogenic Sos1 Variant: An Unrecognized Etiology Of Infantile Sudden Death?, Christopher Follansbee, Lindsey Malloy-Walton

Manuscripts, Articles, Book Chapters and Other Papers

We present the case of a female infant presenting after a ventricular fibrillation arrest found to have ectopic atrial tachycardia (EAT). Evaluation revealed a likely pathogenic variant in SOS1 not previously reported in affected individuals. SOS1 variants are associated with Noonan syndrome, which belongs to a family of related genetic syndromes affecting the RAS/MAPK signaling pathway. To date, this is the first case reported of a ventricular fibrillation arrest in a patient with a RASopathy-related variant prior to development of the typically associated structural cardiac phenotype and may represent a previously unrecognized etiology of sudden death during infancy.

Brucella Prosthetic Valve Endocarditis: A Systematic Review, Karima Taamallah, Fatma Hammami, Hedi Gharsallah, Makram Koubaa, Mounir Ben Jemaa, Wafa Fehri

Journal of the Saudi Heart Association

Objective: Brucella prosthetic valve endocarditis is a rare but a life-threatening complication of brucellosis. It remains a diagnostic challenge. Optimal treatment of Brucella prosthetic valve endocarditis is debated. Available data is limited to case reports or small case series. The purpose of this study was to systematically review all published cases of Brucella prosthetic valve endocarditis in the literature. Method: A systematic review of PubMed database, Google, Google Scholar, and Scopus (From January 1974 to the present) for studies providing epidemiological, clinical and microbiological data as well as data on treatment and outcomes of Brucella prosthetic valve endocarditis was performed. …

Comparing Downstream Consequences Of Normal Exercise Stress Echocardiograms And Cardiac Computed Tomography Angiography Scans In Patients Suspected Of Having Of Obstructive Coronary Artery Disease: A Retrospective Cohort Study Of Tricare Beneficiaries., Cory G Madigan, Michael B Adams, Chu-Chiao Chu, Laith R Dinkha, Samuel J Farrell, Robert T Hoard, Andrea N Keithler, Kevin A Loudermilk, Jessica Rouse, Brandon L Walker, Susan G Williams, Andrew C Wyatt, Rosco S Gore, Dustin M. Thomas Md

Parkview Heart Institute

To compare overall number of downstream tests and total costs between negative exercise stress echocardiograms (ESE) or cardiac computed tomography angiography scans (CCTA) in symptomatic Tricare beneficiaries suspected of having coronary artery disease (CAD). This is a retrospective cohort study examining 651 propensity-matched patients who underwent ESE or CCTA with normal results between 2008 and 2014 at the United States' largest Department of Defense hospital. The total number of additional downstream tests over the next five years was determined. The total costs associated with each arm, inclusive of the initial test and all subsequent tests, were calculated using the 2018 …

Factors Determining Occurrence Of Arrhythmias In Patients Post-Closure Of Atrial Septal Defects, Nouran Mostafa Mansour, Raghda Ghonimy El Sheikh, Ayman Mohamed Elsaeid, Mohammed El Sayed El-Setiha, Seham Fahmy Badr

Journal of the Saudi Heart Association

Objectives: This study aimed to determine the risk factors for the occurrence of arrhythmias after either transcatheter or surgical closure of atrial septal defect. Methods: This prospective study included 150 patients admitted for transcatheter or surgical closure of atrial septal defect. Transthoracic echocardiography together with a twelve-leads ECG were done during 1 and 3 months follow up. The paired T, chi-square and Logistic regression tests were used to detect any association between any arrhythmias and factors that may affect its occurrence. Results: One-hundred and twenty-three patients had percutaneous device closure while the remaining 27 patients had surgical closure. The youngest …

Detection Of Subclinical Rheumatic Heart Disease In Children Using A Deep Learning Algorithm On Digital Stethoscope: A Study Protocol, Fatima Ali, Babar Hasan, Huzaifa Ahmad, Zahra Hoodbhoy, Zainab Bhuriwala, Muhammad Hanif, Shahab U. Ansari, Devyani Chowdhury

Department of Paediatrics and Child Health

Introduction: Rheumatic heart diseases (RHDs) contribute significant morbidity and mortality globally. To reduce the burden of RHD, timely initiation of secondary prophylaxis is important. The objectives of this study are to determine the frequency of subclinical RHD and to train a deep learning (DL) algorithm using waveform data from the digital auscultatory stethoscope (DAS) in predicting subclinical RHD.
Methods and analysis: We aim to recruit 1700 children from a group of schools serving the underprivileged over a 12-month period in Karachi (Pakistan). All consenting students within the age of 5-15 years with no underlying congenital heart disease will be eligible …

Fifteen-Year Trends In Incidence Of Cardiogenic Shock Hospitalization And In-Hospital Mortality In The United States., Mohammed Osman, Moinuddin Syed, Saikrishna Patibandla, Samian Sulaiman, Babikir Kheiri, Mahek K. Shah, Christopher Bianco, Sudarshan Balla, Brijesh Patel

Division of Cardiology Faculty Papers

BACKGROUND: There is a lack of contemporary data on cardiogenic shock (CS) in-hospital mortality trends.

METHODS AND RESULTS: Patients with CS admitted January 1, 2004 to December 31, 2018, were identified from the US National Inpatient Sample. We reported the crude and adjusted trends of in-hospital mortality among the overall population and selected subgroups. Among a total of 563 949 644 hospitalizations during the period from January 1, 2004, to December 30, 2018, 1 254 358 (0.2%) were attributed to CS. There has been a steady increase in hospitalizations attributed to CS from 122 per 100 000 hospitalizations in 2004 …

A Simple Effective Method For Frailty In Heart Failure With Impact On Clinical Outcomes In North Indian Population, Gurbhej Singh, Rohit Tandon, Neelesh C. Pandey, Namita Bansal, Abhishek Goyal, Bhupinder Singh, Shibba Takkar Chhabra, Naved Aslam, Gurpreet Singh Wander, Bishav Mohan

Journal of the Saudi Heart Association

Introduction and Objectives: Frailty has been studied extensively in elderly population as a predictor and prognostic marker for morbidity and mortality. Frailty is being increasingly recognised as a distinct pathophysiological condition which plays a major role in outcomes of various disease states including heart failure. Our aim was to study the prevalence of frailty in heart failure and see its prognostic significance in such patients. Methods: This was a prospective study conducted in an out-patient HF clinic. All consecutive patients with HF, > 25 years age, with LVEF < 40 % were included. All patients were asked a simple frailty questionnaire. Hand-dynamometer was used to assess handgrip strength in kilograms and were classified as frail, pre-frail or non-frail. The primary end point was cardiovascular mortality and hospitalization, and secondary end-point was composite of all cause mortality, hospitalization,device implantation and documented arrythmia. Results: 210 patients were studied for clinical outcomes.Mean age was 60.59+ 11.55 years with 15 % patients aged less than 50 years. Mean LVEF was 30.24+ 6.8%. Handgrip strength was poor in the frail vs non/pre-frail patients (p=0.001) with a strength >16.95 kg having sensitivity of 72% and specificity of 63% for the prediction …

Differences In Socio-Demographic And Risk Factor Profile, Clinical Presentation, And Outcomes Between Patients With And Without Rhd Heart Failure In Sub-Saharan Africa: Results From The Thesus-Hf Registry, Clovis Nkoke, Albertino Damasceno, Christopher Edwards, Beth Davison, Gad Cotter, Mahmoud Sani, Lauren Gaeta, Okechukwu S. Ogah, Charles Mondo, Gerald Yonga

Internal Medicine, East Africa

Background: Rheumatic heart disease (RHD) was found in the THESUS-HF registry to be the third most common cause of acute heart failure (AHF) in Sub-Saharan Africa.

Methods: One thousand six patients with AHF from 9 Sub-Saharan African countries were recruited in THESUS-HF, of which 143 (14.3%) had RHD-AHF. Clinical characteristics and outcomes in patients with RHD-AHF and non-RHD-AHF were compared. Kaplan-Meier plots for time to all-cause death and/or HF readmission according to the presence of RHD-AHF and non-RHD-AHF were performed and survival distributions compared using the log-rank test. Cox regression was used to determine the hazard ratio of …

Smart Watch Detection Of Supraventricular Tachycardia (Svt): First Case From Tanzania, Nadeem Kassam, Omar Aziz, Eric Aghan, Samina Somji, Hanifa Mbithe, Mustaafa Bapumia, Robert Mvungi, Salim Surani

Internal Medicine, East Africa

Smartwatches like the Apple Watch have been on the rise worldwide and their use is gaining popularity in developing countries. Their ability to detect dysrhythmias is well documented. Present practice discourages the use of these devices as a diagnostic tool. Nevertheless, atypical findings from these devices should be clinically investigated. This case demonstrates an eventual diagnosis of supraventricular tachycardia (SVT) based on an Apple watch alert which was subsequently confirmed by electrophysiological evaluation.

The Impacts Of Aging, Sedentarism, And Exercise On Neurotrophic Factor Expression And Innervation In The Heart And The Effects Of Treatment With Α-Cgrp On Heart Function, Gabriel Almeida Alves

Dissertations

Neurotrophic factors (NFs) are important molecules responsible for development, differentiation, regeneration, and maintenance of new and mature neurons. Neurotrophic factors act as neurocytokines and may assist with the regulation of axonal and dendritic arrangements and synaptic plasticity between neurons themselves or with other non-neural target tissues. In this study, we analyze the levels of two NFs: glial cell line-derived neurotrophic factor (GDNF) and nerve growth factor (NGF). Cardiomyocytes produce these neurotrophic factors which assist with the innervation pattern of the heart. The heart is innervated by the two branches of the autonomic nervous system; namely the sympathetic nervous system and …

Outcome Of Surgical Ultrasonic Aspirator Use For Patients With Severe Mitral Annular Calcification For Mitral Valve Replacement, Zachary Appel, James K. Wu Md

Research Scholars

No abstract provided.

Blood Pressure Thresholds In Pregnancy For Identifying Maternal And Infant Risk: A Secondary Analysis Of Community-Level Interventions For Pre-Eclampsia (Clip) Trial Data, Jeffrey N. Bone, Laura A. Magee, Joel Singer, Hannah Nathan, Rahat Qureshi, Charfudin Sacoor, Esperança Sevene, Andrew Shennan, Mrutyunjaya B. Bellad, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

Background: Blood pressure measurement is a marker of antenatal care quality. In well resourced settings, lower blood pressure cutoffs for hypertension are associated with adverse pregnancy outcomes. We aimed to study the associations between blood pressure thresholds and adverse outcomes and the diagnostic test properties of these blood pressure cutoffs in low-resource settings.
Methods: We did a secondary analysis of data from 22 intervention clusters in the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomised trials (NCT01911494) in India (n=6), Mozambique (n=6), and Pakistan (n=10). We included pregnant women aged 15-49 years (12-49 years in Mozambique), identified in their …

A Classification And Prediction Hybrid Model Construction With The Iqpso-Svm Algorithm For Atrial Fibrillation Arrhythmia, Liang-Hung Wang, Ze-Hong Yan, Yi-Ting Yang, Jun-Ying Chen, Tao Yang, I-Chun Kuo, Patricia Angela R. Abu, Pao-Cheng Huang, Chiung-An Chen, Shih-Lun Chen

Department of Information Systems & Computer Science Faculty Publications

Atrial fibrillation (AF) is the most common cardiovascular disease (CVD); and most existing algorithms are usually designed for the diagnosis (i.e.; feature classification) or prediction of AF. Artificial intelligence (AI) algorithms integrate the diagnosis of AF electrocardiogram (ECG) and predict the possibility that AF will occur in the future. In this paper; we utilized the MIT-BIH AF Database (AFDB); which is composed of data from normal people and patients with AF and onset characteristics; and the AFPDB database (i.e.; PAF Prediction Challenge Database); which consists of data from patients with Paroxysmal AF (PAF; the records contain the ECG preceding an …

Anaesthetic Management Of Tracheal Injury Following Blunt Neck Trauma: An Unusual Late Presentation, Muhammad Saad Yousuf, Mohammad Bin Pervez, Saulat Fatimi, Khalid Samad

Department of Anaesthesia

Tracheal injuries, following blunt neck trauma, are life-threatening surgical emergencies with high risk of mortality. A high index of suspicion is necessary to avoid missing an occult injury because delays in diagnosis and definitive treatment are associated with poorer outcomes. We, herein, report a case of a 28-year man who presented in Emergency Department 15 days after blunt neck trauma from an accident involving electric cable. Anaesthetic challenges, airway management and importance of effective close loop communication, during repair of complex tracheal reconstruction, will be discussed in this case report.

Mechanical Circulatory Support Using Impella Devices For Cardiogenic Shock, Gabriella Gormas, James K. Wu Md

Research Scholars

No abstract provided.

Angiovac Outcome Analysis In Tricuspid Valve Endocarditis, Maya Parekh, James K. Wu Md

Research Scholars

No abstract provided.

Evaluating Patient Outcomes Following Redo Sternotomies In Cardiac Surgery, Sajan Patel, James K. Wu Md

Research Scholars

No abstract provided.

Concurrent Primary Cardiac Tumors In A High-Risk Patient Presenting With Tamponade., Jay V Gopal, Lauren Crowley, Shawn M Quinn, Timothy S Misselbeck, Joseph B Zackary

Department of Emergency Medicine

Primary cardiac tumors are rare, particularly in the elderly population. The patient described in this report presented with symptoms of dyspnea on exertion, leg swelling, and weight gain and was found to have two histologically distinct cardiac masses: atrial myxoma with concurrent aortic fibroelastoma. Given her history of cirrhosis and end-stage renal disease, the patient was a poor surgical candidate but opted for excision of both masses. The patient eventually succumbed to her cirrhosis six weeks after presentation. In this report, we advocate for further research into medical management for the unique presentation of concurrent primary cardiac tumors in high-operative-risk …

The Design And Rationale Of A Multicenter Real-World Trial: The Southeastern Collaboration To Improve Blood Pressure Control In The Us Black Belt – Addressing The Triple Threat, Tina O Findley, Hope Northrup

Faculty, Staff and Student Publications

The incidence of congenital heart defect (CHD) has increased over the past fifty years, partly attributed to routine fetal anatomical examination by sonography during obstetric care and improvements in ultrasound technology and technique. Fetal findings on ultrasound in addition to maternal biomarkers are the backbone of first- and second-trimester screening for common genetic conditions, namely aneuploidy. Since the introduction of non-invasive prenatal testing (NIPT) using next-generation sequencing to sequence cell-free fetal DNA, the detection rate of common trisomies as well as sex chromosomal aneuploidies have markedly increased. As the use of NIPT continues to broaden, the best means of incorporating …

The Cgas–Sting Pathway In Diabetic Retinopathy And Age-Related Macular Degeneration, Shannon Erhardt, Mingjie Zheng, Xiaolei Zhao, Tram P Le, Tina O Findley, Jun Wang

Faculty, Staff and Student Publications

The neural crest (NC) is a multipotent and temporarily migratory cell population stemming from the dorsal neural tube during vertebrate embryogenesis. Cardiac neural crest cells (NCCs), a specified subpopulation of the NC, are vital for normal cardiovascular development, as they significantly contribute to the pharyngeal arch arteries, the developing cardiac outflow tract (OFT), cardiac valves, and interventricular septum. Various signaling pathways are shown to orchestrate the proper migration, compaction, and differentiation of cardiac NCCs during cardiovascular development. Any loss or dysregulation of signaling pathways in cardiac NCCs can lead to abnormal cardiovascular development during embryogenesis, resulting in abnormalities categorized as …