Cardiology Commons^™

Recurrent Non-Sustained Ventricular Tachycardias In A Patient With Suspicion Of Transthyretin Amyloid Cardiomyopathy: A Case Report, Chinar Singh, Meng Xie, Poonam Choudhry, Asif Jawaid

East Florida Division GME Research Day 2024

Objective: This case study aims to highlight the mechanisms, clinical presentation, diagnostic strategies, and management approach utilized for recurrent non-sustained ventricular tachycardias in a patient with suspected cardiac amyloidosis.

Background: Amyloidosis is a group of disorders characterized by the abnormal deposition of amyloid proteins in tissues and organs throughout the body. These proteins aggregate into insoluble fibrils that disrupt normal cellular function, leading to a range of clinical manifestations depending on the affected organs. Cardiac amyloidosis is characterized by the deposition of amyloid fibrils specifically in the myocardial tissue, leading to restrictive cardiomyopathy, progressive heart failure and arrhythmias. Ventricular tachycardia …

Digoxin Toxicity In The Setting Of Alcohol Intoxication, A Case Report, Manuel A. Jimenez, Eliann Reinhardt, Bryan Curry

East Florida Division GME Research Day 2024

No abstract provided.

Stemi Alert Notification System At Hca Florida Orange Park Hospital: A Quality Improvement Project, Jomel Jacinto, Pranav Bommineni, Steven Goodfriend, Mubbasher Syed

South Atlantic Division GME Research Day 2024

No abstract provided.

Improvement Of Hypertension Self-Care Management In African American Older Adults With Uncontrolled Hypertension Through Shared Decision-Making, Sigga Jobe

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Hypertension affects nearly half of the population in the U.S., with the prevalence disproportionately higher in African Americans (Centers for Disease Control and Prevention [CDC], 2023). Complications of uncontrolled hypertension, such as cardiovascular disorders and stroke, increase with age, prompting the importance of controlling high blood pressure in older adults. African American older adults are at higher risk of developing uncontrolled hypertension and related complications due to the lack of healthcare access, financial constraints leading to the inability to access healthier food choices, exercise capabilities, weight control, adherence to recommended medications, and knowledge deficit.

Methods: This project focused on …

Management Of Postprocedural Conduction Disturbances Using A Prespecified Algorithm In The Optimize Pro Study., Kendra J Grubb, Steven J Yakubov, Tamim M Nazif, Suneet Mittal, Hemal Gada, Douglas G W Fraser, Joshua D Rovin, Ramzi Khalil, Robert T Pyo, Samin K Sharma, Mustafa Ahmed, Jian Huang, Josep Rodes-Cabau

Heart and Vascular Articles

BACKGROUND: Lack of standardization in posttranscatheter aortic valve replacement (TAVR) conduction disturbance (CD) identification and treatment may affect permanent pacemaker implantation (PPI) rates and clinical outcomes. The safety and efficacy of a standardized TAVR CD algorithm has not been analyzed. This study analyzes the Optimize PRO post-TAVR CD management algorithm with Evolut PRO/PRO

METHODS: Optimize PRO is a prospective, postmarket study implementing 2 strategies to reduce pacemaker rates: TAVR with cusp overlap technique and a post-TAVR CD algorithm. The 2-hour postprocedural electrocardiogram (ECG) stratified patients to early discharge in the absence of new ECG changes or to CD algorithms for …

Metarnn: Differentiating Rare Pathogenic And Rare Benign Missense Snvs And Indels Using Deep Learning, Fang Li, Zenan Sun, Ahmed Abdelhameed, Tiehang Duan, Laila Rasmy, Xinyue Hu, Jianping He, Yifang Dang, Jingna Feng, Jianfu Li, Yichen Wang, Tianchen Lyu, Naomi Braun, Si Pham, Michael Gharacholou, Delisa Fairweather, Degui Zhi, Jiang Bian, Cui Tao

Faculty, Staff and Student Publications

BACKGROUND: Effective management of dual antiplatelet therapy (DAPT) following drug-eluting stent (DES) implantation is crucial for preventing adverse events. Traditional prognostic tools, such as rule-based methods or Cox regression, despite their widespread use and ease, tend to yield moderate predictive accuracy within predetermined timeframes. This study introduces a new contrastive learning-based approach to enhance prediction efficacy over multiple time intervals.

METHODS: We utilized retrospective, real-world data from the OneFlorida + Clinical Research Consortium. Our study focused on two primary endpoints: ischemic and bleeding events, with prediction windows of 1, 2, 3, 6, and 12 months post-DES implantation. Our approach first …

Predicting Endothelium-Dependent Diastolic Function (Fmd)And Its Correlation With The Degree Of Coronary Artery Disease (Cad) And Plaque Vulnerability For Cardiovascular Events, Guangming Zhang, Jing Yang, Hanghang Xing, Hongning Yin, Guoqing Gu

Faculty, Staff and Student Publications

OBJECTIVE: This study aims to investigate the correlation between vascular endothelium-dependent diastolic function (FMD) and the degree of coronary artery disease (CAD), plaque vulnerability, and its predictive value for cardiovascular events.

METHODS: Initially, patients (n=100) who were admitted from January 2020 to January 2021 and intended to undergo percutaneous coronary intervention (PCI) were selected. Further, FMD in all patients was determined before the procedure and divided into a high-FMD group (≥4.2%) and a low-FMD group (

RESULTS: No significant differences were observed concerning general information, number of coronary arteries-associated branches, lesion type, involvement of the left main stem (LM), the …

A Clot To Worry About: Venous Thromboembolism In Severe Ulcerative Colitis, Jin Yun, Do, Donald Lum

Books, Presentations, Posters, Etc.

Introduction: Patients with inflammatory bowel disease (IBD) have an estimated three-fold higher risk of venous thromboembolism (VTE) compared to the general population. We present a case of a 19-year-old female with phlegmasia curelea dolens and massive pulmonary embolism in the setting of severe ulcerative colitis. Case Presentation : • 19-year-old female with iron deficiency anemia and three-month history of hematochezia, recently started on oral contraceptive pills. • Presented with acute left lower extremity pain, swelling, and cyanosis concerning for phlegmasia curulea dolens and compartment syndrome. • Underwent emergent thrombectomy, venoplasty, and fasciotomies. • Post-operatively, course complicated by obstructive shock and …

End-Of-Life Care For Patients With End-Stage Heart Failure, Comparisons Of International Guidelines, Frederick Berro Rivera, Sarang Choi, Genquen Philip Carado, Arcel V. Adizas, Nathan Ross B. Bantayan, Gerard Jude P. Loyola, Sung Whoy Cha, John Paul Aparece, Anlene Jane B. Rocha, Siena Placino, Marie Francesca M. Ansay, Gerard Francis E. Mangubat, Mer Lorraine P. Mahilum, Abdullah Al-Abcha, Natasha Suleman, Nishant Shah, Tisha Marie B. Suboc, Annabelle Santos Volgman

Ateneo School of Medicine and Public Health Publications

Heart failure (HF) is a chronic, debilitating condition associated with significant morbidity, mortality, and socioeconomic burden. Patients with end-stage HF (ESHF) who are not a candidate for advanced therapies will continue to progress despite standard medical therapy. Thus, the focus of care shifts from prolonging life to controlling symptoms and improving quality of life through palliative care (PC). Because the condition and prognosis of HF patients evolve and can rapidly deteriorate, it is imperative to begin the discussion on end-of-life (EOL) issues early during HF management. These include the completion of an advance directive, do-not-resuscitate orders, and policies on device …

Conduction System Pacing For Heart Failure, Nathan R Smith, Patrick Lynch, Mihail G Chelu

The Texas Heart Institute Journal

No abstract provided.

Review Of Current Dual-Antiplatelet And Triple Therapy Prescribing Practices At Providence Medical Group, Gina Kim, Christine Doran, Lauren Powell

Books, Presentations, Posters, Etc.

Abstract: Approximately 10% of patients with recent percutaneous intervention (PCI) have concomitant atrial fibrillation (AF) and others may have concomitant venous thromboembolism (VTE). This makes choosing the optimal antithrombotic regimen challenging. The ACC published a 2020 decision pathway to guide safe and evidence-based use of antiplatelet and anticoagulant combinations for certain patients. These situations include patients with prior AF on anticoagulation and the need for PCI, patients with new-onset AF requiring anticoagulation in a patient already on antiplatelet therapy for coronary artery disease (CAD), patients with prior VTE on anticoagulation and the need for PCI, and patients with new or …

Unveiling The Complex World Of Extracellular Vesicles: Novel Characterization Techniques And Manufacturing Considerations, James J Lai, John J Hill, Casey Y Huang, Gino C Lee, Karol W Mai, Maggie Y Shen, Simon K Wang

Faculty, Staff and Student Publications

Extracellular vesicles (EVs) function as potent mediators of intercellular communication for many in vivo processes, contributing to both health and disease related conditions. Given their biological origins and diverse functionality from correspondingly unique "cargo" compositions, both endogenous and modified EVs are garnering attention as promising therapeutic modalities and vehicles for targeted therapeutic delivery applications. Their diversity in composition, however, has revealed a significant need for more comprehensive analytical-based characterization methods, and manufacturing processes that are consistent and scalable. In this review, we explore the dynamic landscape of EV research and development efforts, ranging from novel isolation approaches, to their analytical …

Comparing Incidence Of St Elevation Myocardial Infarction In Patients 18-44 Years Of Age During The Covid-19 Pandemic In A Large Healthcare Enterprise, Ly Tran, Rebecca Schuyler, Andrea Deneen, Mubbasher Syed

South Atlantic Division GME Research Day 2024

No abstract provided.

Post Operative Atrial Fibrillation After Coronary Artery Bypass Grafting In Octogenarians: A Systematic Review, M Eliann Reinhardt, Manuel Jimenez, Priya Mohan, Bernardo Reyes

East Florida Division GME Research Day 2024

No abstract provided.

Starting A General Cardiovascular Fellowship At Community Hospital Interestingly Improved Cath Lab Quality Metrics Across The Board, Chimbu Chinniah, George Skaf, Ziran Young, Gauthier Stepman

West Florida Division GME Research Day 2024

No abstract provided.

Remdesivir-Induced Bradycardia: A Multicenter Retrospective Analysis, Jomel Jacinto, Tharshikha Pirapakaran, Israa Algburi, Thais Schwartz, Yuhning Linda Hu

South Atlantic Division GME Research Day 2024

No abstract provided.

Mcs Assisted High Risk Multi-Vessel Percutaneous Intervention In Cardiogenic Shock Patient With Lv Thrombus, Amanpreet Kaur, Akhil Gade, Srinivasan Rajaganapathy, Ruben Abreu, Victor Delprincipe

North Texas GME Research Forum 2024

Background: Acute coronary syndrome patients presenting with Cardiogenic shock carry a very high mortality risk >70% without appropriate intervention in a timely fashion. Here we present a patient requiring an axial pump mechanical circulatory support despite having an apical thrombus. Case report: 55-year-old male with past medical history of type 2 diabetes mellitus and medication noncompliance was transferred from outside facility for high risk ACS with EKG showing ST segment elevation in inferior and anterolateral leads. Lab showed hsTroponin more than 125K, BG 556, HCO3 17, and Beta hydroxybutyrate of 41.87 indicating DKA. Emergent coronary angiography showed mid LAD artery …

A Retrospective Study On The Effect Of Raas Pathway Inhibitors At Decreasing The Risk Of Acute Coronary Syndrome In Hypertensive Patients With Rheumatoid Arthritis As Compared To Other Antihypertensives, Yousuf Sherwani, Asad Risvi, Senthil Thambidorai

North Texas GME Research Forum 2024

Rheumatoid arthritis (RA) is a chronic multi-system inflammatory disease of which is characterized by articular and extra-articular involvement. Patients with RA have a higher risk of mortality when compared with the general population, which is due predominantly to increased cardiovascular disease. Due to the higher incidence of CVD and MI in RA patients it has been postulated that enhanced systemic inflammation plays an important role in the pathogenesis of CVD in RA patients. Previous studies have shown that ant inflammatory medication such as systemic steroids and immune blockers have been shown to decrease the risk of MI in patients with …

Ai-Supported Diagnosis Of Hypertrophic Cardiomyopathy In A Patient With Adrenal Pheochromocytoma, Muhannad Akel, Ammer Haffar, Christian Zellner

West Florida Division GME Research Day 2024

No abstract provided.

A Dramatic Case Of Acute Biventricular Failure Secondary To Acute Myocardial Infraction, Heriberto Cantu, Ahmed Mahmood, Luay Alalawi, Thomas Alexander

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Anomalous Anomaly: A Rare Case Of The Rca Arising From The Mild Lad, Heriberto Cantu, Luay Alalawi, Ahmed Mahmood, Thomas Alexander

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Effects Of Menopause On Coronary Artery Disease, Angelica Gonzales

Nursing | Senior Theses

Menopausal women, 40 to 60 years old, have an increased risk of developing coronary artery disease (CAD) when they experience hormonal changes. Which then can lead to unwanted cardiac events. Within the literature review of this paper, it was found that there are factors of menopause that may further increase the risk of coronary artery disease in menopausal women. Such factors include whether a woman underwent surgical or natural menopause and the timing when menopause began. Additionally, within the review, hormone replacement therapy (HRT) was explored to determine whether the possible intervention can decrease the progression and risk of developing …

Astrocytic Mitochondrial Transfer To Brain Endothelial Cells And Pericytes In Vivo Increases With Aging, Gopal V. Velmurugan, Hemendra J. Vekaria, Samir P. Patel, Patrick G. Sullivan, W. Brad Hubbard

Neurology Faculty Publications

Intercellular mitochondrial transfer (IMT) is an intriguing biological phenomenon where mitochondria are transferred between different cells and notably, cell types. IMT is physiological, occurring in normal conditions, but also is utilized to deliver healthy mitochondria to cells in distress. Transferred mitochondria can be integrated to improve cellular metabolism, and mitochondrial function. Research on the mitochondrial transfer axis between astrocytes and brain capillaries in vivo is limited by the cellular heterogeneity of the neurovascular unit. To this end, we developed an inducible mouse model that expresses mitochondrial Dendra2 only in astrocytes and then isolated brain capillaries to remove all intact astrocytes. …

Using Digital Pathology To Analyze The Murine Cerebrovasculature, Dana M. Niedowicz, Jenna L. Gollihue, Erica M. Weekman, Panhavuth Phe, Donna M. Wilcock, Christopher M. Norris, Peter T. Nelson

Neurology Faculty Publications

Research on the cerebrovasculature may provide insights into brain health and disease. Immunohistochemical staining is one way to visualize blood vessels, and digital pathology has the potential to revolutionize the measurement of blood vessel parameters. These tools provide opportunities for translational mouse model research. However, mouse brain tissue presents a formidable set of technical challenges, including potentially high background staining and crossreactivity of endogenous IgG. Formalin-fixed paraffin-embedded (FFPE) and fixed frozen sections, both of which are widely used, may require different methods. In this study, we optimized blood vessel staining in mouse brain tissue, testing both FFPE and frozen fixed …

Home Blood Pressure Monitoring Bundle For Hypertension Outcomes In Adult Patients Receiving Care In Public Health Clinics, Christine Jennifer Victorian

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Hypertension (HTN) that is not adequately controlled leads to cardiovascular disease, stroke, and heart disease. It affects 116 million adults (47%) in the United States (U.S.). The HTN compliance rate in a South Texas public health clinic was 64%, below the national benchmark of 76%. Home blood pressure monitoring (HBPM) was recommended in a joint statement by the American Heart Association (AHA) and the American Medical Association (AMA). Literature evidence revealed that the HBPM bundle increased BP control (< 140/90 mmHg) compliance.

Methods: A quality improvement (QI) bundle was initiated to address the low HTN compliance rate from a quality management perspective. …

Effects Of Bioprosthetic Valve Fracturing On Valve-In-Valve Transcatheter Aortic Valve Implantation Transvalvular Gradients, Osama Hallak, Karley Fischer, Shaina Ailawadi, Damian Valencia, Yan Yatsynovich, Raja Nazir, Brian Schwartz

The Texas Heart Institute Journal

BACKGROUND: Valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) is quickly becoming a routine and effective means by which to treat degenerated bioprosthetic valves. A known complication of ViV-TAVI is patient-prosthesis mismatch, which substantially affects survival. Bioprosthetic valve fracture is a method by which to reduce the risk of patient-prosthesis mismatch and post-ViV-TAVI transvalvular gradients. This study sought to determine the safety and efficacy of post-ViV-TAVI bioprosthetic valve fracture.

METHODS: Patients with a history of surgical aortic valve replacement undergoing ViV-TAVI bioprosthetic valve fracture (N = 25) at the corresponding institution from 2015 to 2022 were cataloged for a retrospective analysis. …

Stroke Survivors’ Telemedicine Experiences During The Covid-19 Pandemic: A Phenomenological Investigation, Barbara Kimmel, Annette Walder, Anette Ovalle, Chethan P Venkatasubba Rao, Sean I Savitz, Mark Goldberg, Steven Warach, Salvador Cruz-Flores, Daiwai M Olson, Jane A Anderson

Faculty, Staff and Student Publications

PURPOSE: This study aimed to describe stroke survivors' experiences receiving telemedicine visits at the Lone Star Stroke Consortium during the COVID-19 pandemic.

MATERIALS AND METHODS: A qualitative descriptive phenomenological design was applied to gather patients' telemedicine experiences through in-depth interviews, using a study guide. Audio-recorded interviews were conducted via ZOOM and transcribed verbatim. Two independent reviewers used the Giorgi descriptive method to analyze the data and search for the essence of stroke survivors' follow-up telemedicine experiences during the COVID-19 pandemic.

RESULTS: Fifteen underserved patients were recruited: mean age, 51.8 (15.7), and 9 (60%) females. Three themes emerged: (1) vivid memory …

Coronary Artery Bypass Grafting In A Patient With Multivessel Disease And Dextrocardia With Situs Inversus Totalis, Rohit Shahani, Adham Ahmed, Frank M Rosell, Alexander Iribarne

The Texas Heart Institute Journal

Dextrocardia with situs inversus totalis is a rare hereditary condition characterized by reversed orientation of the major thoracic and abdominal organs. Though dextrocardia itself is not believed to increase the risk of coronary artery disease, the workup and surgical management of patients with this condition may be technically challenging to heart team clinicians. This report describes the case management of a high-risk 56-year-old man with dextrocardia who presented with multivessel coronary artery disease.

Autonomic Modulation Of Cardiac Function In Hypertrophic Cardiomyopathy, Jenna Rose Disser

Dissertations, Master's Theses and Master's Reports

Hypertrophic cardiomyopathy (HCM) is the most common genetic heart disorder. HCM is characterized by cardiac hypertrophy, fibrosis, and an increased risk of fatal arrhythmias and sudden cardiac death. Previous studies in humans with HCM have demonstrated increased cardiac norepinephrine spillover and reduced beta-1 receptor (β1R) expression in the left ventricle (LV). We have previously demonstrated that cardiac sympathetic tone is elevated in an alpha-tropomyosin mutant mouse model of HCM. We hypothesized that HCM mice would demonstrate reduced β1R expression in the LV and attenuated heart rate (HR) and dP/dt max responses to ramped infusion of the β1R agonist, dobutamine. …

Intra-Cardiac Thrombus-In-Transit: A Ticking Time Bomb, Visesh Persaud, Austin Makadia, Saiara Choudhury, Asad Chohan, Abhay Vakil

Gulf Coast Division GME Research Symposium 2024

No abstract provided.