Cardiology Commons^™

Impact Of Comorbid Heart Failure Among Hospitalized Patients With Sarcoidosis: A United States Population-Based Cohort Study, Bruce Adrian Casipit, Kevin Bryan Lo, Carlo Gabriel Casipit, Abdiodun Idowu, Aman Amanullah

Einstein Health Papers

BACKGROUND: There is paucity of data regarding the impact of concomitant heart failure (HF) on the in-hospital outcomes among hospitalized sarcoidosis patients. We aim to investigate the factors associated with concomitant HF and its impact on in-hospital outcomes among hospitalized sarcoidosis patients.

METHODS: We utilized the 2018-2020 National Inpatient Sample (NIS) Database in conducting this study. Multivariable logistic and linear regression models were used to examine the factors associated with HF and hospital-associated outcomes among patients with sarcoidosis.

RESULTS: A total of 36,864 hospitalized patients with sarcoidosis were identified, of which 24.78 % (n = 9135/36,864) had concomitant HF. Factors …

Biological Age Mediates The Effects Of Perceived Neighborhood Problems On Heart Failure Risk Among Black Persons, Ganga Bey, James Pike, Priya Palta, Anthony Zannas, Qian Xiao, Shelly-Ann Love, Gerardo Heiss

Faculty, Staff and Student Publications

OBJECTIVE: We assessed whether biological age, measured by the epigenetic clock GrimAge, mediates the association of objective and subjective neighborhood disadvantage with incident HF among Black persons.

METHODS: Participants were 1448 self-reported Black adults (mean age (standard deviation, SD) = 64.3 (5.5)) dually enrolled in two community-based cohorts in Jackson, Mississippi, the ARIC and JHS cohorts, who were free of HF as of January 1, 2000. Incident HF events leading to hospitalization through December 31, 2017, were classified using ICD-9 discharge codes of HF. Multilevel age- and sex-adjusted Cox causal mediation models were used to examine whether biological age (at …

Randomized Controlled Trial Of Mechanical Thrombectomy Vs Catheter-Directed Thrombolysis For Acute Hemodynamically Stable Pulmonary Embolism: Rationale And Design Of The Peerless Study., Carin F Gonsalves, C Michael Gibson, Stefan Stortecky, Roger A Alvarez, Daren M Beam, James M Horowitz, Mitchell J Silver, Catalin Toma, John H Rundback, Stuart P Rosenberg, Craig D Markovitz, Thomas Tu, Wissam A Jaber

Heart and Vascular Articles

BACKGROUND: The identification of hemodynamically stable pulmonary embolism (PE) patients who may benefit from advanced treatment beyond anticoagulation is unclear. However, when intervention is deemed necessary by the PE patient's care team, data to select the most advantageous interventional treatment option are lacking. Limiting factors include major bleeding risks with systemic and locally delivered thrombolytics and the overall lack of randomized controlled trial (RCT) data for interventional treatment strategies. Considering the expansion of the pulmonary embolism response team (PERT) model, corresponding rise in interventional treatment, and number of thrombolytic and nonthrombolytic catheter-directed devices coming to market, robust evidence is needed …

Whole-Genome Sequencing Uncovers Two Loci For Coronary Artery Calcification And Identifies Arse As A Regulator Of Vascular Calcification, Paul S De Vries, Matthew P Conomos, Kuldeep Singh, Christopher J Nicholson, Deepti Jain, Natalie R Hasbani, Wanlin Jiang, Sujin Lee, Christian L Lino Cardenas, Sharon M Lutz, Doris Wong, Xiuqing Guo, Jie Yao, Erica P Young, Catherine Tcheandjieu, Austin T Hilliard, Joshua C Bis, Lawrence F Bielak, Michael R Brown, Shaila Musharoff, Shoa L Clarke, James G Terry, Nicholette D Palmer, Lisa R Yanek, Huichun Xu, Nancy Heard-Costa, Jennifer Wessel, Margaret Sunitha Selvaraj, Rebecca H Li, Xiao Sun, Adam W Turner, Adrienne M Stilp, Alyna Khan, Anne B Newman, Asif Rasheed, Barry I Freedman, Brian G Kral, Caitlin P Mchugh, Chani Hodonsky, Danish Saleheen, David M Herrington, David R Jacobs, Deborah A Nickerson, Eric Boerwinkle, Fei Fei Wang, Gerardo Heiss, Goo Jun, Greg L Kinney, Haakon H Sigurslid, Harshavardhan Doddapaneni, Ira M Hall, Isabela M Bensenor, Jai Broome, James D Crapo, James G Wilson, Jennifer A Smith, John Blangero, Jose D Vargas, Jose Verdezoto Mosquera, Joshua D Smith, Karine A Viaud-Martinez, Kathleen A Ryan, Kendra A Young, Kent D Taylor, Leslie A Lange, Leslie S Emery, Marcio S Bittencourt, Matthew J Budoff, May E Montasser, Miao Yu, Michael C Mahaney, Mohammed S Mahamdeh, Myriam Fornage, Nora Franceschini, Paulo A Lotufo, Pradeep Natarajan, Quenna Wong, Rasika A Mathias, Richard A Gibbs, Ron Do, Roxana Mehran, Russell P Tracy, Ryan W Kim, Sarah C Nelson, Scott M Damrauer, Sharon L R Kardia, Stephen S Rich, Valentin Fuster, Valerio Napolioni, Wei Zhao, Wenjie Tian, Xianyong Yin, Yuan-I Min, Alisa K Manning, Gina Peloso, Tanika N Kelly, Christopher J O'Donnell, Alanna C Morrison, Joanne E Curran, Warren M Zapol, Donald W Bowden, Lewis C Becker, Adolfo Correa, Braxton D Mitchell, Bruce M Psaty, John Jeffrey Carr, Alexandre C Pereira, Themistocles L Assimes, Nathan O Stitziel, John E Hokanson, Cecelia A Laurie, Jerome I Rotter, Ramachandran S Vasan, Wendy S Post, Patricia A Peyser, Clint L Miller, Rajeev Malhotra

Faculty, Staff and Student Publications

Coronary artery calcification (CAC) is a measure of atherosclerosis and a well-established predictor of coronary artery disease (CAD) events. Here we describe a genome-wide association study (GWAS) of CAC in 22,400 participants from multiple ancestral groups. We confirmed associations with four known loci and identified two additional loci associated with CAC (ARSE and MMP16), with evidence of significant associations in replication analyses for both novel loci. Functional assays of ARSE and MMP16 in human vascular smooth muscle cells (VSMCs) demonstrate that ARSE is a promoter of VSMC calcification and VSMC phenotype switching from a contractile to a calcifying …

Resuscitative Endovascular Balloon Occlusion Of The Aorta And Resuscitative Thoracotomy Are Associated With Similar Outcomes In Traumatic Cardiac Arrest, Ezra Y Koh, Erin E Fox, Charles E Wade, Thomas M Scalea, Charles J Fox, Ernest E Moore, Bryan C Morse, Kenji Inaba, Eileen M Bulger, David E Meyer

Faculty, Staff and Student Publications

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive alternative to resuscitative thoracotomy (RT) for patients with hemorrhagic shock. However, the potential benefits of this approach remain subject of debate. The aim of this study was to compare the outcomes of REBOA and RT for traumatic cardiac arrest.

Methods: A planned secondary analysis of the United States Department of Defense-funded Emergent Truncal Hemorrhage Control study was performed. Between 2017 and 2018, a prospective observational study of noncompressible torso hemorrhage was conducted at six Level I trauma centers. Patients were dichotomized by REBOA or RT, and baseline …

Teen Pregnancy Involvement Among African, Caribbean And Black Adolescent Boys And Girls: A Scoping Review, Andrea Vacirca, Titia A L Sulzer, Thomas Mesnard, Aidin Baghbani-Oskouei, Laura Ocasio, Thanila A Macedo, Hence J M Verhagen, Robert Rhee, Gustavo S Oderich

Faculty, Staff and Student Publications

We describe a case of an abdominal aortic aneurysm (AAA) and angulated proximal neck treated with a Gore Excluder conformable endoprosthesis and show relevant technical pitfalls in the deployment of the graft main body. An 82-year-old man presented with a 71-mm asymptomatic AAA with an angulated infrarenal proximal neck (75°) and was referred to our unit. The patient was treated with a 26-mm Gore Excluder conformable device, which was deployed slightly above the renal arteries after precatheterization of the lowest renal artery. The graft was then repositioned with support of the introducer sheath and a stiff guide wire. The proximal …

Atrial Appendage Accessory Pathway Ablation: Tips For Recognition And Approach To Ablation, Nikola Dragisic, Emily R. Backes, Lindsey Malloy-Walton, Philip M. Chang

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Clinical Trials In Cardiogenic Shock: Challenges And Solutions For The Future, Anju Bhardwaj, Sahoor Khan, Shashank Sinha, Preethi Pirlamarla, Rajiv Sankaranarayanan, Alexander Hajduczok, Holger Thiele, Navin Kapur

Division of Cardiology Faculty Papers

No abstract provided.

A Case Report Of Myocardial Infarction In A Young Transgender Man With Testosterone Therapy: Raising Awareness On Healthcare Issues In The Transgender Community And A Call For Further Research, Paul J Connelly, Joanna Osmanska, Matthew M Y Lee, Christian Delles, Margaret B Mcentegart, John Byrne

Faculty, Staff and Student Publications

BACKGROUND: People who are transgender may utilize masculinizing or feminizing gender-affirming hormonal therapy. Testosterone and oestrogen receptors are expressed throughout the cardiovascular system, yet the effects of these therapies on cardiovascular risk and outcomes are largely unknown. We report the case of a young transgender man with no discernible cardiovascular risk factors presenting with an acute coronary syndrome.

CASE SUMMARY: A 31-year-old transgender man utilizing intramuscular testosterone masculinizing gender-affirming hormonal therapy presented with central chest pain radiating to the left arm. He had no past medical history of hypertension, dyslipidaemia, diabetes, or smoking. Electrocardiography demonstrated infero-septal ST depression, and high-sensitivity …

Association Between E-Cigarette Use And Myocardial Infarction: A Systematic Review And Meta-Analysis, Muhammad Talal Ashraf, Asim Shaikh, Muhammad Shakeel Khuzzaim Khan, Naseer Uddin, Muhammad Arham Bin Kashif, Syed Hassan Ahmed Rizvi, Hammad Khalid, Stafford Jude Sam, Affan Sohail

Department of Medicine

Background: The popularity of e-cigarettes has risen dramatically over the last few years, particularly among the younger population. Although the use of combustible cigarettes has established evidence to be associated with the development of several adverse cardiopulmonary diseases, the investigations regarding the prospective long-term effects of e-cigarette use on the cardiovascular system have just begun. We set to investigate if there is an association between the history of MI and e-cigarette use among smokers and non-smokers?
Methods: The current review aims to assess the association of myocardial infarction with e-cigarette consumption. PubMed, Google Scholar, and Cochrane Central Register of Controlled …

A Systematic Review And Meta-Analysis Of The Prevalence And Risk Factors In Cardiac Implantable Electronic Device Malfunction, Abdullah Saeed, Abdullah Alshafea, Monerah Alqthami, Abdulrahman Bin Saeed, Foton A. Alahmri, Norah S. Alqahtani, Fatimah A. Al-Muslat, Atheer Alqahtani

Journal of the Saudi Heart Association

Introduction: Cardiac implantable electronic devices (CIED) include permanent pacemakers (PPMs), implantable cardioverter defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. They treat several cardiac issues and are dependent on batteries; however, similar to any medical equipment, they can fail. The prevalence and risk factors for CIED malfunction must be understood for earlier detection and better patient outcomes. Material and methods: A comprehensive search was conducted through electronic bibliographic sources (PubMed and Cochrane) until January 2023 in order to identify reviews, cohort studies and case reports pertaining to CIED. The primary outcome is the probability of CIED malfunction. The secondary outcome …

Heartburn's Hidden Impact: A Narrative Review Exploring Gastroesophageal Reflux Disease (Gerd) As A Cardiovascular Disease Risk Factor, Jacob J. Gries, Bing Chen, Salim S. Virani, Hafeez Ul Hassan Virk, Hani Jneid, Chayakrit Krittanawong

Office of the Provost

Gastroesophageal reflux disease (GERD) is a very common disease with an estimated 442 million cases worldwide. It is a well-documented independent risk factor for many gastrointestinal pathologies, however, its role in cardiovascular disease (CVD) is unclear, despite its high prevalence in patients with CVD. Although traditionally considered a causative agent of noncardiac chest pain, a common imitator of cardiac chest pain, or an incidentally shared comorbidity in patients with CVD, a number of studies have implicated GERD and its therapies as risk factors for CVD. This narrative review will explore the relationship between GERD and CVD, including medical and mechanical …

Prevalence Of Central Venous Stenosis Among Black And White Eskd Patients With Dysfunctional Dialysis Access, Vipul Chitalia Md, Jonathan Ravid, Arinze Nkiruka, Kristina Yamkovoy, Matthew Diamond, Rohit Pillai, Tyler J. Ryan, Saran Lotfollahzadeh, Janice Weinberg, Alik Farber, Rajendran Vivendhan, Jean Francis, Nathanael Fillmore, Najia Idrees

Journal of Health Disparities Research and Practice

In the United States, significant racial and ethnic disparities exist in chronic kidney disease (CKD) and its management. Hemodialysis constitutes the main stay of renal replacement therapy for end-stage kidney disease (ESKD), which is initiated using central venous catheters (CVC) in most CKD patients in the United States. Black ESKD patients have higher usage and greater time on CVC for hemodialysis compared to White patients. This trend places Black patients at a potentially higher risk for CVC-related complications such as central venous stenosis (CVS). We posited that Black patients would have a higher prevalence and a greater risk of CVS. …

Treatment Of Refractory Ventricular Tachycardia With Radiofrequency Ablation And Temporary Mechanical Circulatory Support, Som P. Singh, Alejandro Vidal Margenat, David L. Boone, Ellen Condoure, Ramesh Hariharan

The VAD Journal

Catheter-based radiofrequency ablation has long been recognized as an effective treatment for refractory ventricular tachycardia (VT). A 57-year-old male with severe coronary artery disease underwent percutaneous mechanical circulatory support because of worsening cardiogenic shock after failed revascularization attempts. Despite aggressive medical management, the patient experienced refractory VT episodes, leading to the decision to proceed with radiofrequency catheter ablation. Notably, the Impella 5.5 device (Abiomed) provided critical left ventricular support during the ablation procedure. This case underscores the potential benefits of Impella support during radiofrequency ablation of complex ventricular arrhythmias.

Defying The Vicious Cycle: An Intriguing Case Of Brash Syndrome, Ahmed Shehadah, Himal Kharel, Pulkit Gandhi

Advances in Clinical Medical Research and Healthcare Delivery

BRASH Syndrome is a rare and life-threatening condition marked by the combination of bradycardia, renal failure, atrioventricular (AV) nodal blockade, shock, and hyperkalemia. This case report presents a 79-year-old female with acute kidney injury, hyperkalemia, and severe bradycardia without typical EKG changes associated with hyperkalemia. The aim of this article is to provide a comprehensive overview of BRASH syndrome, including its clinical manifestations, underlying pathophysiology, diagnostic approaches, and management strategies. The patient's presentation, laboratory findings, and response to treatment support the diagnosis of BRASH syndrome. The syndrome's pathogenesis involves a vicious cycle of bradycardia, renal failure, AV nodal blockade, and …

The Prevalence And Impact Of Obesity On The Outcomes Of Patients Undergoing Transcatheter Mitral Valve Repair Using Mitraclip - A National Inpatient Sample Analysis 2016 To 2020., Garba Rimamskep Shamaki, Favour Markson, Osarenren Idemudia, Andrew Murphy, Tamunoinemi Bob-Manuel, Akanimo Antia, David Corteville

Advances in Clinical Medical Research and Healthcare Delivery

Background: Low Body Mass Index (BMI) is associated with poor outcomes in patients who undergo various cardiac interventions. Studies on patients with elevated BMI have produced mixed results. Our study aims to evaluate the impact of obesity on the in-hospital outcomes of patients undergoing transcatheter mitral valve repair using MitraClip in the United States.

Methods: The National Inpatient Sample (NIS) database (2016-2020) was analyzed to identify patients who underwent transcatheter mitral valve repair using MitraClip. Patients less than 18 years, with protein-energy malnutrition and rapid weight loss, were excluded. Our final study population was classified into Obese (BMI ≥ 30 …

Kounis Syndrome – Anaphylaxis-Induced Acute Coronary Syndrome, Austin T. Thacker Do, Brachman Herzig Oms, Brendan Robinson Do, Ahad Anjum Do

Advances in Clinical Medical Research and Healthcare Delivery

Kounis syndrome is an underdiagnosed condition in which anaphylaxis triggers vasospastic acute coronary syndrome, either with or without underlying coronary artery disease. The prevalence of this syndrome among hospitalized patients for allergic/hypersensitivity/anaphylactic reactions in the United States is 1.1%, with a 7% rate of all-cause inpatient mortality. This article presents an anaphylaxis-induced acute coronary syndrome case in a patient with underlying coronary artery disease. The pathophysiological mechanism of anaphylactic-induced acute coronary syndrome involves the inflammatory mediators of type I hypersensitivity reactions.

Minoca - A Rarity Of It's Own And The Importance Of Cardiac Mri, Abdullah A. Orakzai, Deeptanshu Jain Md, Muhammad Osama, Syeda Sarah Raza, Soon-Il Song

Advances in Clinical Medical Research and Healthcare Delivery

Myocardial infarction with non-obstructive coronary arteries (MINOCA) disease is a diagnostic dilemma with clinical evidence of acute myocardial infarction (AMI) with normal coronary arteries. MINOCA is a complex issue; the management of the patients needs to be focused on identifying the core problem. Cardiac magnetic resonance (CMR) imaging is a non-invasive diagnostic tool that can play an important role in enabling clinicians to build a differential diagnosis in patients with MINOCA and also identify other non-ischemic aetiologies of myocardial injury. We present a challenging case of a patient with MINOCA with MI in small proximal septal artery distribution revealed on …

Prevalence And Predictors Of Venous Stenosis Following First Transvenous Cardiac Implantable Electronic Device Implantation., ​Qayoom Yousuf, Aamir Rashid, Imran Hafeez, Hilal Rather, Ishrath Syed, Altaf Hussain Mir, Suheel Ahmad Mir, Ajaz ​ Lone

Journal of the Saudi Heart Association

Objectives: Very few studies have been done on Venous stenosis following the first transvenous cardiac device implantation. We aimed to assess the prevalence and predictors of Venous stenosis/Occlusion following the first transvenous cardiac device implantation with venous angiography at one year of follow-up. Methods: This study was a single-center prospective, observational study. Demographic, clinical, procedural, and device data was collected. All patients underwent a preimplant contrast and repeated venography at twelve months to look for upper limb venous anatomy, obstruction, or collaterals. Results: A total of 146 patients were included in the final analysis. 60 (41 %) patients developed some …

Hospital Outcomes Of Spontaneous Coronary Artery Dissection With Concurrent Ventricular Arrhythmias, M. C. Tan, Y. H. Yeo, Q. X. Ang, Justin Z. Lee, Eric H. Yang, Joanne Mazzarelli, J. R. Exequiel Pineda, Wilbur Su, Kwan S. Lee

Cooper Medical School of Rowan University Departmental Research

Background

Methods

Multidisciplinary Care For Women With Aortic Disease: The Way To Improve Disparities, Rana O Afifi

Faculty, Staff and Student Publications

No abstract provided.

Clinical Practice Implementation To Address Ascvd Risk: A Practice Change In Primary Care, Elizabeth Wooten

Student Scholarly Projects

Practice Problem: Heart disease stands as the leading cause of mortality in the United States. While healthcare providers strive to identify and optimize prevention strategies, particularly in high-risk patient populations, notable gaps in care persist, notably in the management of modifiable risk factors such as low-density lipoprotein cholesterol (LDL). By harnessing the power of artificial intelligence (AI) integrated software within clinical settings, we can revolutionize the landscape of this devastating chronic disease.

PICOT: The PICOT question that guided this project was: In Primary Care Advanced Practice Providers (APP) caring for high-risk and/or very high-risk patients with atherosclerotic cardiovascular disease (ASCVD) …

Hybrid Repair Of A Thoracoabdominal Aortic Aneurysm In Female Patient With Loeys-Dietz Syndrome, Sabine Helena Wipper, Tilo Kölbel, Bernhard Dorweiler, Julia Dumfarth, Alexandra Gratl, Olaf Gorny, Anthony L Estrera, Harleen K Sandhu, E Sebastian Debus

Faculty, Staff and Student Publications

No abstract provided.

Outcomes Of Cardiothoracic Surgery In Women With Turner Syndrome, Lucas Ribé, Ferial D Shihadeh, Rana O Afifi, Anthony L Estrera, Siddharth K Prakash

Faculty, Staff and Student Publications

BACKGROUND: To describe short- and mid-term surgical outcomes of patients with Turner syndrome (TS) after cardiovascular interventions.

METHODS: All individuals >12 years of age at the time of surgical repair for cardiovascular disease (valve or coarctation repairs, aortic disease, aortic dissection) from 2002 to 2022 were eligible. The primary endpoint was complications or death within 30 days of intervention. Secondary outcomes included late complications and reinterventions within six months. Combined data from the University of Texas Health Science Center at Houston and the Turner Syndrome Society of the United States were included in the analysis.

RESULTS: We identified 22 patients …

Nonlinear Model Predictive Control Of Vagal Nerve Stimulation To Regulate Hemodynamic Variables, Oluwasanmi Adeodu, Michelle Gee, Babak Mahmoudi, Rajanikanth Vadigepalli, Mayuresh Kothare

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Various pre-clinical investigations indicate that the electrical stimulation of the cervical branch of the vagus that innervates the heart has therapeutic value in the management of various cardiac diseases. In theory, the design of a closed-loop control mechanism that automatically adjusts vagal nerve stimulation (VNS) parameters based on real-time physiological feedback can eliminate intra-patient variability in VNS outcomes and therefore represents a major step towards patient-specific therapy. This study develops a nonlinear model predictive control (NMPC) approach for VNS of a pulsatile, human cardio-baroreflex system. The manipulated variables are the frequency and amplitude of a charge-balanced biphasic current. The effects …

Position Statement On In-Hospital/Clinic Point-Of-Care Coagulation Testing For Anticoagulation Monitoring In Saudi Arabia, Fakhr Al Ayoubi, Malak Al Mashali, Mohamed Hassan Abdallah, Mohamed Al Sheef, Tarek Owaidah

Journal of the Saudi Heart Association

Objectives: Hospital overload is a persistent occurrence in daily practice. Interventions such as point-of-care testing (POCT) are needed to alleviate the pressure faced by healthcare providers and administrators. Methods: An invited panel of experts from Saudi Arabia was formed under the auspices of the Saudi Heart Association in order to discuss local treatment gaps in the management of patients receiving anticoagulation therapy. This was done in a series of meetings, which resulted in the development of official recommendations for the implementation of POCT for anticoagulation monitoring in the country. Recommendations were based on a comprehensive literature review and international guidelines …

Trend Of Outcome Metrics In Recent Out-Of-Hospital-Cardiac-Arrest Research: A Narrative Review Of Clinical Trials, Natalie N Htet, Daniel Jafari, Jennifer A Walker, Ali Pourmand, Anna Shaw, Khai Dinh, Quincy K Tran

Faculty, Staff and Student Publications

Cardiopulmonary resuscitation (CPR) research traditionally focuses on survival. In 2018, the International Liaison Committee on Resuscitation (ILCOR) proposed more patient-centered outcomes. Our narrative review assessed clinical trials after 2018 to identify the trends of outcome metrics in the field OHCA research. We performed a search of the PubMed database from 1 January 2019 to 22 September 2023. Prospective clinical trials involving adult humans were eligible. Studies that did not report any patient-related outcomes or were not available in full-text or English language were excluded. The articles were assessed for demographic information and primary and secondary outcomes. We included 89 studies …

Eicosanoid And Eicosanoid-Related Inflammatory Mediators And Exercise Intolerance In Heart Failure With Preserved Ejection Fraction, Emily S Lau, Athar Roshandelpoor, Shahrooz Zarbafian, Dongyu Wang, James S Guseh, Norrina Allen, Vinithra Varadarajan, Matthew Nayor, Ravi V Shah, Joao A C Lima, Sanjiv J Shah, Bing Yu, Mona Alotaibi, Susan Cheng, Mohit Jain, Gregory D Lewis, Jennifer E Ho

Faculty, Staff and Student Publications

Systemic inflammation has been implicated in the pathobiology of heart failure with preserved ejection fraction (HFpEF). Here, we examine the association of upstream mediators of inflammation as ascertained by fatty-acid derived eicosanoid and eicosanoid-related metabolites with HFpEF status and exercise manifestations of HFpEF. Among 510 participants with chronic dyspnea and preserved LVEF who underwent invasive cardiopulmonary exercise testing, we find that 70 of 890 eicosanoid and related metabolites are associated with HFpEF status, including 17 named and 53 putative eicosanoids (FDR q-value < 0.1). Prostaglandin (15R-PGF2α, 11ß-dhk-PGF2α) and linoleic acid derivatives (12,13 EpOME) are associated with greater odds of HFpEF, while epoxides (8(9)-EpETE), docosanoids (13,14-DiHDPA), and oxylipins (12-OPDA) are associated with lower odds of HFpEF. Among 70 metabolites, 18 are associated with future development of heart failure in the community. Pro- and anti-inflammatory eicosanoid and related metabolites may contribute to the pathogenesis of HFpEF and serve as potential targets for intervention.

Tert Immunohistochemistry As A Surrogate Marker For Tert Promoter Mutations In Infiltrating Gliomas, Gillian Gordon Perue, Hao Ying, Antonio Bustillo, Lili Zhou, Carolina M Gutierrez, Hannah E Gardener, Judith Krigman, Angus Jameson, Chuanhui Dong, Tatjana Rundek, David Z Rose, Jose G Romano, Ayham Alkhachroum, Ralph L Sacco, Negar Asdaghi, Sebastian Koch

Faculty, Staff and Student Publications

BACKGROUND: Guideline-based hypertension management is integral to the prevention of stroke. We examine trends in antihypertensive medications prescribed after stroke and assess how well a prescriber's blood pressure (BP) medication choice adheres to clinical practice guidelines (BP-guideline adherence).

METHODS AND RESULTS: The FSR (Florida Stroke Registry) uses statewide data prospectively collected for all acute stroke admissions. Based on established guidelines, we defined optimal BP-guideline adherence using the following hierarchy of rules: (1) use of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker as first-line antihypertensive among diabetics; (2) use of thiazide-type diuretics or calcium channel blockers among Black patients; (3) …

Pakistan Study Of Premature Coronary Atherosclerosis In Young Adults (Pak-Sehat): A Prospective Longitudinal Study Protocol Investigating The Prevalence, Severity And Determinants Of Atherosclerotic Cardiovascular Disease In The Young Adult Pakistani Population, Bashir Hanif, Sana Sheikh, Ghazal Peerwani, Miguel Cainzos-Achirica, Wajiha Javed, Jaffer Bin Baqar, Zainab Samad, Faiza Bashir, Salim S. Virani, Khurram Nasir

Section of Cardiology

Introduction: Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity, mortality and health expenditures worldwide. Despite having higher ASCVD in the Pakistani population, data on subclinical coronary atherosclerosis in young Pakistanis remain scarce. The PAKistan Study of prEmature coronary atHerosclerosis in young AdulTs (PAK-SEHAT) aims to assess the prevalence, severity and determinants of subclinical coronary atherosclerosis among Pakistani men (35-60 years) and women (35-65 years) free of clinically symptomatic ASCVD and will assess 5-year rates of ASCVD events.
Methods and analysis: PAK-SEHAT is an ongoing prospective cohort study with 2000 participants from all provinces of Pakistan who will be …