Cardiovascular System Commons^™

Cardioporation Enhances Myocardial Gene Expression In Rat Heart, Carly Boye, Sezgi Arpag, Nina Burcus, Cathryn Lundberg, Scott Declemente, Richard Heller, Michael Francis, Anna Bulysheva

Bioelectrics Publications

Damage from myocardial infarction (MI) and subsequent heart failure are serious public health concerns. Current clinical treatments and therapies to treat MI damage largely do not address the regeneration of cardiomyocytes. In a previous study, we established that it is possible to promote regeneration of cardiac muscle with vascular endothelial growth factor B gene delivery directly to the ischemic myocardium. In the current study we aim to optimize cardioporation parameters to increase expression efficiency by varying electrode configuration, applied voltage, pulse length, and plasmid vector size. By using a surface monopolar electrode, optimized pulsing conditions and reducing vector size, we …

Cardiac Arrest And Global Ischemia Reperfusion Injury: Role Of Mitochondria And Cannabinoid Receptor 2 Signaling., Jennifer L. Bradley

Theses and Dissertations

We explored the effects of cardiac arrest on mitochondria populations and heart whole tissue lysate proteomics utilizing the Weil Institute’s in vivo rat model of cardiac arrest and cardiopulmonary resuscitation. We have discovered that brain mitochondria are more sensitive to global ischemia compared to heart mitochondria. Additionally, complex I is the most sensitive electron transport chain complex to ischemic injury and is a major control point of the rate of oxidative phosphorylation following cardiac arrest and cardiopulmonary resuscitation. Preservation of brain mitochondrial activity and function during cardiac arrest may enhance outcomes and recovery.

A recent article focusing on acute myocardial …

Short-Term Fasting And Autonomic Control, Joshua Gonzalez

Dissertations, Master's Theses and Master's Reports

Obesity is a chronic metabolic disorder associated with increased risk of cardiovascular disease. Evidence suggests that chronic intermittent fasting improves cardiometabolic health and reduces arterial blood pressure. However, the mechanisms underlying the reductions in blood pressure and improved cardiovascular health observed from chronic fasting studies remain unclear. The autonomic nervous system has a central role in the regulation of blood pressure and is essential for cardiovascular homeostasis. We conducted a study to investigate how acute fasting influences autonomic control of blood pressure at rest and during stress. Twenty-five young, healthy, normal weight, normotensive participants were tested twice, once in the …

Young Healthy Adults With A Family History Of Hypertension Have Increased Microvascular Reactivity But Decreased Macrovascular Function, Evan L. Matthews, Peter A. Hosick Dr., John J. Guers

Research Data

OBJECTIVE: To determine if, like hypertensives, normotensive adults with a family history of hypertension (+FHH) display lower microvascular reactivity and conduit artery function than normotensive adults without a family history of hypertension (-FHH). METHODS: A forearm vascular occlusion test was performed on healthy normotensive adults while resting in the supine position. A near infrared spectroscopy sensor placed on the forearm measured skeletal muscle oxygen saturation kinetics to determine microvascular reactivity. Simultaneously, an ultrasound probe placed on the brachial artery above the occlusion cuff was used to assess flow mediated dilation; a test of macrovascular function. RESULTS: Twenty-two participants were included …

Modeling Action Potential Reversals In Tunicate Hearts, John W. Cain, Luran He, Lindsay D. Waldrop

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Tunicates are small invertebrates which possess a unique ability to reverse flow in their hearts. Scientists have debated various theories regarding how and why flow reversals occur. Here we explore the electrophysiological basis for reversals by simulating action potential propagation in an idealized model of the tubelike tunicate heart. Using asymptotic formulas for action potential duration and conduction velocity, we propose tunicate-specific parameters for a two-current ionic model of the action potential. Then, using a kinematic model, we derive analytical criteria for reversals to occur. These criteria inform subsequent numerical simulations of action potential propagation in a fiber paced at …

Efficacy Of Pulmonary Ultrasound Compared To N-Terminal Prohormone Brain Natriuretic Peptide As A Diagnostic Tool For Congestive Heart Failure In Patients Presenting With Acute Dyspnea In The Emergency Setting, Leah Krohn, Michael Burns

Physician Assistant Capstones, 2020-current

Objective: To determine the efficacy of using pulmonary ultrasound as a diagnostic tool in acute dyspnea of undetermined cause compared to the use of serum N-Terminal prohormone Brain Natriuretic Peptide (NT-proBNP) in the diagnosis of heart failure.

Design: Systematic literature review

Methods: Searches were conducted in PubMed and Scopus using the terms pulmonary ultrasound and congestive heart failure and studies within the last 10 years. Studies that used pulmonary ultrasound compared to BNP as a marker for the diagnosis of heart failure were included.

Results: All three studies found that the use of pulmonary ultrasound was a more specific …

Transcutaneous Energy Transmission: Can We Do It Now?, Yuriy Pya

The VAD Journal

The percutaneous driveline used in contemporary LVADs presents a continuous risk of infection for the duration of support. Minimizing infection in durable mechanical circulatory support systems requires total implantation of all components and energy transfer by means other than percutaneous drivelines. A novel coplanar energy transfer (CET) system, similar to the original transcutaneous energy transfer (TET) design, is unique by incorporating two large rings with coil-within-the-coil topology to ensure strong resonance power. The CET system consists of an internal integrated controller, a battery coupled with an internal thoracic coil ring, and the LVAD pump. External equipment includes a power transmission …

Angiotensin Inhibition And Gastrointestinal Bleeding Prevention In Patients With Left Ventricular Assist Devices, Phillip A. Weeks

The VAD Journal

Gastrointestinal bleeding remains a common complication in advanced heart failure patients following implantation of continuous-flow left ventricular assist devices. While the cause is likely multifactorial, development of arterial venous malformations in the gastrointestinal mucosa are a key factor. Inhibition of angiotensin II activity has been postulated to disrupt the signaling that promotes angiogenesis in these patients. We aim to review the theoretical basis for angiotensin receptor blockade, which has been proposed and explore the published evidence regarding this therapy and gastrointestinal bleeding in LVAD patients.

Unusual Case Of Pump Thrombosis In Lvad Patient With Covid-19 — Diagnostic Challenges, William H. Frick Md, Ryan D. Mallory, Maya Guglin, Eve Anderson, Erin N. Lushin, Rey P. Vivo, Kashif Saleem, Roopa A. Rao

The VAD Journal

We present the first reported case of left ventricular assist device (LVAD) pump thrombosis in the setting of the coronavirus pandemic. We describe the clinical features of the case which helped to differentiate coronavirus disease 19 (COVID-19) from LVAD pump thrombosis. The patient is 56-year-old female supported by destination LVAD therapy. She was originally implanted with a HeartMate II device in 2015 and underwent two pump exchanges in 2017 and 2019 for pump thrombosis, despite medication adherence. Shortly after routine lab work revealed near doubling of her lactate dehydrogenase (LDH) levels, she tested positive for COVID-19. She then developed power …

Cangrelor: Safe And Effective For Left Ventricular Assist Device Thrombosis, Roopa Rao, Eve Anderson, Mark Jones, Muhamed Safiia, Maya Guglin

The VAD Journal

Pump thrombosis is a devastating complication of left ventricular assist device implantation as it increases the risk of mortality and morbidity. Early and effective treatment is important to prevent the progression of the clot and to avoid the surgical need for pump exchange or heart transplant. The current strategies of intensifying anticoagulation therapy are not consistently effective and carry significant bleeding risks. Cangrelor is a new pharmacological agent that has been utilized as an antiplatelet agent in several cardiac procedures. In this case series, we describe the use of cangrelor for left ventricular assist device thrombosis in five patients. Cangrelor …

Long Qt Syndrome Type 2: Emerging Strategies For Correcting Class 2 Kcnh2 (Herg) Mutations And Identifying New Patients, Makoto Ono, Don E. Burgess, Elizabeth A. Schroder, Claude S. Elayi, Corey L. Anderson, Craig T. January, Bin Sun, Kalyan Immadisetty, Peter M. Kekenes-Huskey, Brian P. Delisle

Physiology Faculty Publications

Significant advances in our understanding of the molecular mechanisms that cause congenital long QT syndrome (LQTS) have been made. A wide variety of experimental approaches, including heterologous expression of mutant ion channel proteins and the use of inducible pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) from LQTS patients offer insights into etiology and new therapeutic strategies. This review briefly discusses the major molecular mechanisms underlying LQTS type 2 (LQT2), which is caused by loss-of-function (LOF) mutations in the KCNH2 gene (also known as the human ether-à-go-go-related gene or hERG). Almost half of suspected LQT2-causing mutations are missense mutations, and functional studies …

Characterizing Recurrence Following Hybrid Ablation In Patients With Persistent Atrial Fibrillation, David C. Kress, Lynn Erickson, Tadele W. Mengesha, David Krum, Jasbir Sra

Journal of Patient-Centered Research and Reviews

Purpose: It is It is widely accepted that atrial fibrillation (AF) accounts for half of arrhythmia recurrences following endocardial catheter ablation of AF. An epicardial-endocardial approach (hybrid) has emerged as an alternative to endocardial ablation alone for the treatment of AF, yet recurrence after a hybrid procedure has not been well characterized. This retrospective study is aimed at characterizing recurrence following hybrid ablation for patients with persistent AF.

Methods: Patients with persistent AF (N = 108) received both endocardial and epicardial ablation of the posterior left atrial wall using catheter ablation and a small midline surgical approach (hybrid). Presence of …

A Fatal Rectus Sheath Hematoma After A Myasthenia Crisis Case Report, Robert G. Michaud, Lesley B. Gordon

Journal of Maine Medical Center

Introduction: Rectus sheath hematomas (RSH) generally occur due to damage to the inferior epigastric artery. They are rare causes of abdominal pain or acute blood loss anemia, but are an important diagnostic consideration because they can be cryptic and are potentially fatal.

Clinical Findings: An 85-year-old female who had been admitted to the hospital for 10 days with a myasthenia crisis was found to be abruptly hypotensive with a tender abdominal mass in the left lower quadrant subtly crossing midline. She was on prophylactic anticoagulation during her hospitalization.

Main diagnosis, therapeutics, interventions, and outcomes: The patient was initially stabilized with …

Role Of Neuronal Nitric Oxide Synthase On Cardiovascular Functions In Physiological And Pathophysiological States, Ahmmed Ally, Isabella Powell, Minora M. Ally, Kevin Chaitoff, Surya M. Nauli

Pharmacy Faculty Articles and Research

This review describes and summarizes the role of neuronal nitric oxide synthase (nNOS) on the central nervous system, particularly on brain regions such as the ventrolateral medulla (VLM) and the periaqueductal gray matter (PAG), and on blood vessels and the heart that are involved in the regulation and control of the cardiovascular system (CVS). Furthermore, we shall also review the functional aspects of nNOS during several physiological, pathophysiological, and clinical conditions such as exercise, pain, cerebral vascular accidents or stroke and hypertension. For example, during stroke, a cascade of molecular, neurochemical, and cellular changes occur that affect the nervous system …

Incidental Diagnosis Of Dual Arterial Supply Of The Right Lower Lobe, Christopher Mathis

Research Days

No abstract provided.

Myocardial Work Index: A Novel Method For Assessment Of Myocardial Function In South Asian Recreational Athletes, Shantanu Sengupta, Renuka Jain, Nitin Burkule, Susan Olet, Bijoy K. Khandheria

Journal of Patient-Centered Research and Reviews

Purpose: We used a novel noninvasive method based on speckle-tracking echocardiography to evaluate myocardial performance in South Asian recreational athletes who completed a half marathon.

Methods: Transthoracic echocardiography was performed on 24 recreational athletes 48 hours before they took part in a half marathon (premarathon), within 2 hours of half marathon completion (postmarathon), and 72 hours after completion. Clinical, laboratory, and echocardiographic variables were collected. Speckle-tracking echocardiography was performed in all subjects to characterize myocardial mechanics.

Results: Mean age of participants was 41.8 ± 7.4 years, and 23 (95.8%) were male. No subject had a prior history of coronary artery …

Relation Of Flt-1 And Endothelial Function In Women Soon After Delivery: Effect Of Physical Activity And Sedentary Behavior, Chloe W. Caudell

Senior Theses

Adverse pregnancy outcomes (APOs) are believed to be caused by poor placental formation. APOs can be characterized by elevated levels of a circulating Fms-like tyrosine kinase biomarker called Flt-1, produced by the placenta when its blood vessels are shallow or inadequately formed. Flt-1 acts directly on the maternal endothelium to impair vascular function during pregnancy and contributes to maternal features of APOs. This study aimed to evaluate the relation of Flt-1 and endothelial function in women soon after delivery. This study also aimed to evaluate the relation of Flt-1 and physical activity and sedentary behavior in women during and soon …

A 12-Lead Ecg Database To Identify Origins Of Idiopathic Ventricular Arrhythmia Containing 334 Patients, Jianwei Zhang, Guohua Fu, Kyle Anderson, Huimin Chu, Cyril Rakovski

Mathematics, Physics, and Computer Science Faculty Articles and Research

Cardiac catheter ablation has shown the effectiveness of treating the idiopathic premature ventricular complex and ventricular tachycardia. As the most important prerequisite for successful therapy, criteria based on analysis of 12-lead ECGs are employed to reliably speculate the locations of idiopathic ventricular arrhythmia before a subsequent catheter ablation procedure. Among these possible locations, right ventricular outflow tract and left outflow tract are the major ones. We created a new 12-lead ECG database under the auspices of Chapman University and Ningbo First Hospital of Zhejiang University that aims to provide high quality data enabling detection of the distinctions between idiopathic ventricular …

Follow Up Care For Heart Failure Patients And Association With Hospital Readmission, Supraja Thunuguntla, Michael Machiorlatti, Sonya Rivera, Juan Cortinas Galvan, Jose Campo Maldonado

School of Medicine Publications

Background:

The CDC reports 6.5 million adults in the US have Heart failure (HF) with yearly costs topping 30 billion. HF patients admitted to Valley Baptist (VB) are readmitted 26% of the time, which is close to the national average of 23% [1]. Standard of care for HF patients is remote nursing care for 30 days from discharge. A hospitalization for any reason within 30 days is considered a “readmission”. On October 1, 2019 at VB remote nursing care changed from weekly house visits to weekly phone calls. The aim of the study is to evaluate the effectiveness of this …

Predicting Bleeding And Thrombosis Complications In Patients With Continuous Flow Left Ventricular Assist Devices, Kyle Zacholski, William Kuan, Justin Mccann Mccann, Aric Schadler, Aaron Cook, Sara Parli, Adam Sieg

The VAD Journal

Background: Left ventricular assist device (LVAD) therapy has been proven to relieve heart failure symptoms and improve survival, but is not devoid of bleeding and/or thrombotic complications. Risk stratification tools have been utilized in other cardiovascular disease populations to estimate the risk of bleeding and thrombosis with and without anticoagulation, including the HAS-BLED, HEMORR₂HAGES, CHADS₂ and CHA₂DS₂-VASc models. The study objective was to evaluate the predictive value of available risk models for bleeding and thrombotic complications in patients with an LVAD within one year of implantation.

Methods: This was a retrospective, single-center analysis …