Cardiovascular System Commons^™

Cell-Free Mitochondrial Dna (Mtdna) Triggers Vascular Dysfunction Via Toll-Like Receptor 9 (Tlr9)-Dependent Activation Of Inflammasomes, Mohin Amin

Senior Theses

Hypertension is the leading global risk factor for mortality and is closely associated with vascular inflammation and dysfunction. Damaged mitochondria release cell-free mitochondrial DNA (cf-mtDNA), which activates toll-like receptor 9 (TLR9). The binding of TLR9 to mtDNA activates the NLRP3 inflammasome pathway, promoting the release of pro-inflammatory cytokines via gasdermin D (GSDMD), therefore worsening inflammation. However, the mechanisms linking mitochondrial injury to inflammation-induced vascular dysfunction remain unclear. We hypothesize that cf-mtDNA triggers TLR9-dependent NLRP3 inflammasome activation contributing to vascular and endothelial dysfunction. To assess that, adult male C57BL/6 were exposed to 28 consecutive days of chronic unpredictable stress (CUS) or …

What Are The Current Risks For Patients Associated With Technology Related Perfusion Practices: A Scoping Review, Jessica Steel

Student Works

Background: Advancements in medical technology, particularly in perfusion practices such as ECMO and heart-lung bypass, have improved patient care but also introduced novel risks. Technological errors—ranging from hardware malfunctions to software failures and AI model inaccuracies—can directly threaten patient safety.

Objective: To identify current trends and risks associated with technology in perfusion practices and synthesize evidence on the frequency, nature, and outcomes of technology-related errors.

Results: Evidence indicates substantial deficiencies in medical devices, predictive models, and health IT systems. AI-based predictive models frequently failed to detect critical health deterioration, missing 66% of injuries in some in-hospital mortality simulations. Adverse events …

Variant Superficial Epigastric Supply To The Anterior Abdominal Wall Arising From Inferior Epigastric Perforators: A Neonatal Case Report, Daniël J. Van Tonder, Natalie Keough, Martin Louis Van Niekerk, Albert Van Schoor

COM Scholarship

Introduction: Understanding superficial epigastric vessel anatomy is crucial for abdominal surgeries like laparoscopy, especially in neonates, to prevent injury. While standard courses are described, variations occur. This case report highlights a unique anatomical variation in the superficial epigastric artery found during the dissection of a stillborn neonatal cadaver. Case Report: In contrast to the usual origin from the femoral artery, this variation features the inferior epigastric artery penetrating the anterior abdominal wall near the umbilicus and branching superiorly to supply the superficial abdominal wall. Conclusions: This distinctive vascular configuration, which to the best of our knowledge has not been previously …

Whole-Blood, Concentrated, And Micro–Dose Del Nido Cardioplegia In Adult Cardiac Surgery: A Scoping Review, Christian Iulianelli

Student Works

1. A.     Background/Introduction: Del Nido cardioplegia was originally developed for pediatric cardiac surgery to provide prolonged myocardial protection with a single-dose strategy. Its adoption in adult cardiac surgery has led to multiple modified formulations, including whole-blood, concentrated, and bloodless strategies. Given expanding clinical use and variation in technique, a structured mapping of the adult evidence base is warranted.
2. B.     Methodology: This scoping review followed PRISMA-ScR guidance. PubMed and CINAHL were searched, yielding 88 records. After duplicate removal and screening, 18 studies met inclusion criteria. Data were charted on study design, cardioplegia formulation, patient population, myocardial biomarkers, arrhythmias, renal outcomes, transfusion requirements, …

Impella 5.5 Versus Heartmate 3 In Left Ventricular Unloading, Hannah Frederick, Douglas Tran, Erik Sorenson, H. Todd Massey, Albert Hicks, Manjula Ananthram, Bartley P. Griffith, Aakash Shah

The VAD Journal

The Impella 5.5 (Abiomed) is increasingly used as a bridge to durable left ventricular assist device (LVAD) implantation in advanced heart failure, yet most studies focus on survival and transition success rather than left ventricular (LV) unloading or valvular effects. This study addresses this gap by comparing Impella 5.5 and HeartMate 3 (HM3, Abbott) in terms of unloading and cardiac support at similar flow rates. We conducted a retrospective study of nine patients who received Impella 5.5 before HM3 implantation. The primary outcome was the degree of LV unloading, as assessed by changes in left ventricular end-diastolic diameter (LVEDD). There …

What Did We Learn About Vads In 2024-2025?, Maya Guglin

The VAD Journal

This is our 11th annual literature review on left ventricular assist devices (LVADs). Our previous reports were well received by readers.^1-10 In prior years, we also included other forms of mechanical circulatory support (MCS); however, this year, we present a separate review focused exclusively on temporary MCS.

In this article, we summarize the most interesting, from our standpoint, publications from 2024 and 2025, with some inclusion of late 2023 studies that were initially released online before print. For the first time, we provide an independent review on short-term MSC devices, including the intra-aortic balloon pump, Impella (Abiomed), and extracorporeal …

Nstemi Or Pericarditis: Which Came First?, Trisha K. Mehta, Steven Clark, Garrett Barb, Magdelynn Mege, Umber Waseem

Advances in Clinical Medical Research and Healthcare Delivery

Myocardial infarction (MI) is a common cardiac event often occurring in patients with a history of cardiovascular disease. MI is classified by the presence of ST segment elevation (STEMI) or non-ST segment elevation (NSTEMI). Pericarditis is inflammation of the pericardium usually caused by a bacterial or viral infection. The patient under discussion is an 86-year-old male with a previous history of coronary artery disease (CAD), hypertension (HTN), hyperlipidemia, and percutaneous coronary intervention (PCI). He presented with a three-week history of exertional chest pain that abated with rest and worsened while supine. EKG and laboratory findings supported a diagnosis of NSTEMI, …

Mechanical Characterization And Modeling Of Rat Myocardia Under The Influence Of Epirubicin, Abdallah Mahmoud Alkhaiyat

Theses and Dissertations

Cancer remains a predominant health challenge that is responsible for a significant portion of global morbidity and mortality. Epirubicin (EPI), a chemotherapeutic anti-cancer drug, has shown remarkable efficacy in combating various malignancies. However, it is known to have undesirable side effects on the heart, collectively referred to as cardiotoxicity. This research investigates the adverse effects of chemotherapy on cardiac contractility through an in vitro examination of the mechanics of healthy and infarcted animal heart tissues. Electrically stimulated slices of rat ventricular tissue were tested using an isometric force measurement tissue bath. The tissue slices were subjected to uniaxial stretching, allowing …

Real-Time Hemodynamic Deterioration Following Polymorphic Ventricular Tachycardia In A Patient With Preexisting Aicd Implanted With Lvad, Dhruvil Patel, Maya Guglin, Deepa Iyer, Chonyang Albert, Jagpreet Grewal, Kenneth Dulnuan

The VAD Journal

Ventricular arrhythmias (VAs) are common in patients with a left ventricular assist device (LVAD), but the literature remains inconclusive regarding the benefits of an automatic implantable cardioverter-defibrillator (AICD) in this population, especially in those with a preexisting device before LVAD implantation. Here, we report the acute hemodynamic consequences of polymorphic ventricular tachycardia in a patient with a preexisting biventricular AICD who was implanted with an LVAD (HeartMate 3). This case underscores the importance of considering AICD placement on a case-by-case basis and highlights the need for a well-designed study to establish its benefit in this population.

Sglt2 Inhibitors In Cardio-Oncology: A Systematic Review And Meta-Analysis, Luigi Spadafora, Marco Bernardi, Gianmarco Sarto, Beatrice Simeone, Erica Rocco, Salvatore Carbone, Laura Adelaide Dalla Vecchia, Roberto Franco Enrico Pedretti, Valentina Valentine, Rachele Di Mario, Maurizio Forte, Giacomo Frati, Antonio Abbate, Michele Golino, Francesco Versaci, Mariangela Peruzzi, Pierre Sabouret, Giuseppe Biondi Zoccai, Sebastiano Sciarretta

EVMS School of Health Professions Faculty Publications

Background

According to available evidence, sodium-glucose cotransporter-2 inhibitors (SGLT2i) may confer cardioprotection in patients with cancer undergoing chemotherapy.

Objectives

The objective of the study was to evaluate the impact of SGLT2i on all-cause mortality and heart failure (HF) outcomes in this population.

Methods

We searched PubMed, Cochrane CENTRAL, and Embase through August 2025 for studies of SGLT2i in adult patients with cancer. Random-effects models were used to pool effects for all-cause mortality and an HF composite (new-onset HF and/or HF hospitalization) in cancer patients >18 years. Meta-regression tested effect modification by beta-blockers, statins, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, age, and …

Influence Of Motion Artifacts On Instantaneous Frequency Based Heart Rate Variability Of Arterial Pulse Signals Measured By A Tactile Sensor: An Analytical Study, Mamun Hasan, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

Objective: Heart rate variability (HRV), quantified via the instantaneous frequency (IF) of arterial pulse signals, is a key indicator of cardiovascular (CV) regulation. This study presents a theoretical and experimental investigation of how motion artifacts (MA) influence IF-and thus HRVmeasured with a tactile sensor, emphasizing underlying mechanisms rather than population-level validation. Approach: Building on a previously developed single-degree-of-freedom (SDOF) model of the tissue-contact-sensor (TCS) stack between the sensor and the artery, MA is represented as low-frequency baseline drift and time-varying system parameters (TVSP) of the TCS stack. Analytical expressions quantify the effect of MA on the IF of each harmonic …

The Treatment Of Obesity In The Context Of The Obesity Paradox In Patients With Heart Failure: A Narrative Review, Pamela L. Alebna, Sarah Martey, Anurag Mehta, Carl J. Lavie, Salvatore Carbone

EVMS School of Health Professions Faculty Publications

Purpose of review

While excess adiposity is a known risk factor for incident heart failure ( HF), once the condition is established, observational data suggest that increased body mass index (BMI) may confer a survival advantage. This paradox has emphasized the underlying roles of cardiorespiratory fitness (CRF), and body composition, particularly lean mass (LM), in influencing clinical outcomes.

Recent findings

In this review, we explore the multifaceted nature of the obesity paradox in HF, with a focus on emerging anti-obesity incretin-mimetic therapies, such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists. These agents …

Editor's Choice - International Expert Consensus On The Management Of Acute Aortic Type B Intramural Haematoma And Penetrating Ulcer, Francesco Squizzato, Mario D'Oria, Michele Antonello, Santi Trimarchi, Kevin Mani, Andrew Holden, Tilo Kölbel, Stephan Haulon, Eric Verhoeven, Dittmar Böckler, Tim Resch, Ali Azizzadeh, Joseph Lombardi, Michele Piazza, Aaron Thomas Fargion, Alexander Zimmerman, Ali Azizzadeh, Anders Wanhainen, Andrew Holden, Antonio Freyrie, Adam W. Beck, Adi Bachar, Barend M. E. Mees, Blandine Maurel, Cristoph A. Nienaber, Christos Karkos, Daniela Branzan, Darren Schneider, Randall Demartino, Dittmar Boeckler, Domenico Angiletta, Emanuel J. R. Tenorio, Enrico Gallitto, Eric Verhoeven, Fabio Verzini, Felice Pecoraro, Filippo Benedetto, Firas F. Mussa, Francesco Squizzato, Franco Grego, Gabriele Piffaretti, Emanuele Gatta, Giovanni Pratesi, Giovanni Tinelli, Giuseppe Asciutto, Glenn Wei Leong Tan, Hence Verhagen, Giacomo Isernia, Jean-Paul P. M. De Vries, Jacob Budtz-Lilly, Jorge Fernández-Noya, Jonathan Sobocinski, Joseph Hockley, Kak Khee Yeung, Andrea Kahlberg, Kevin Mani, Joseph V. Lombardi, Luca Bertoglio, Luca Mezzetto, Ludovic Canaud, Manar Khashram, Marcelo Ferreira, Marco Virgilio Usai, Mark G. Davies, Mark Farber, Martin Czerny, Matthew R. Smeds, Mauro Gargiulo, Germano Melissano, Michel Bosiers, Michele Antonello, Michele Piazza, Miranda Witheford, Michel M.P.J. Reijnen, Marc Schermerhorn, Nikolaos Tsilimparis, Nun Dias, Jean Panneton, Kosmas Paraskevas, Gianbattista Parlani, Patrick W.H.E. Vriens, Rafael Malgor, Raffaele Pulli, Ross Milner, Salvatore T. Scali, Sani J. Laukontaus, Santi Trimarchi, Sandro Lepidi, Konstantinos Spanos, Stefano Fazzini, Theodosios Bisdas, Thomas Maldonado, Tilo Koelbel, Tim Resch, Tomasz Jakimowicz, Nicola Troisi, Isabelle Van Herzeele, Vicente Riambau, Wassim Mansour, Wouter Van Den Eynde, Yamume Tshomba

Department Surgery Faculty Publications

Objective

The aim of this study was to achieve an international expert consensus on managing acute type B penetrating aortic ulcers (PAUs) and intramural haematomas (IMHs).

Methods

A modified Delphi consensus process was employed to develop recommendations for the management of acute type B PAU and IMH. Surveys were sent to international experts practicing in high volume aortic centres worldwide. Statements were voted on using a four point Likert scale in a three round Delphi process. Statements achieving grade A (full agreement 75%) or B (overall agreement 80%, full disagreement <  5%) were included as expert recommendations. Consistency of responses was measured using Cohen's κ and the intraclass correlation coefficient.

Results

Eighty three experts were included in the final analysis: …

Endovascular Arch Repair Using A Novel Single Branch Arch Stent Graft: 30-Day Results From The Chronic Dissection Arm Of The Nexus Aortic Arch Clinical Study To Evaluate Safety And Effectiveness Investigational Device Exemption Study, Bradley G. Leshnower, Jean Panneton, Himanshu J. Patel, Adam W. Beck, Mathew Wooster, Kyle W. Eudailey, Shinichi Fukuhara, Jae Cho, Sanford Zeigler, Westley Ohman, Puja Kachroo, Derek Brinster, Shahab Toursavadkohi, Mehrdad Ghoreishi, Brandley Taylor, Frank Arko, Paul Hayes, Ross Milner

Department Surgery Faculty Publications

Objective

Moderate levels of frailty or a previous sternotomy make open repair of aortic arch pathology high risk or even preclude any treatment. This study examined 30-day outcomes from the NEXUS Aortic Arch Clinical Study to Evaluate Safety and Effectiveness investigational device exemption (TRIOMPHE IDE) study of an off-the-shelf stent-graft system for Zone 0 endovascular aortic arch repair in patients with high-risk chronic dissection.

Methods

TRIOMPHE IDE is a prospective, multicenter study evaluating the NEXUS system (Endospan) in chronic aortic dissection (n = 54). Following cervical debranching, NEXUS was delivered into the arch first, followed by an ascending aortic stent-graft. …

Radial And Carotid Arterial Pulse Signals For Assessing Cardiovascular Function At Rest And During Post-Exercise Recovery In A Heart Transplant Patient: A Case Study, Md Mahfuzur Rahman, Mamun Hasan, Jennifer F. May, John M. Herre, Leryn Reynolds, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

Aim: This study investigates the feasibility of using radial and carotid arterial pulse signals to assess cardiovascular (CV) function at rest and during post-exercise recovery in a heart transplant (HTx) patient. Method: Two micro-fabricated tactile sensors were used to simultaneously acquire arterial pulse signals at the radial artery (RA) and carotid artery (CA). Measurements were taken at rest and at multiple time points post-exercise on three subjects: an HTx patient, a percutaneous coronary intervention (PCI; coronary stent) patient and a healthy control. An SDOF-TF-based time-frequency analysis algorithm was applied to extract a comprehensive set of CV parameters, including heart rate …

What Does The Quality Of Life For Congenital Heart Defect Patients Look Like Across The Lifespan?, Kaylee F. Maynor

Undergraduate Honors Theses

Throughout history, birth defects have left a mark on patients and families across the world. From an infant's first few breaths to an elderly person's last breath, congenital heart birth defects play a major role in that person's life. There are many different types of birth defects that effect the heart. Each defect is unique and has different outcomes on the body. Some congenital heart diseases have multiple defects causing more than one complication. The treatment options for many of the common congenital heart birth defects have come a long way throughout decades of research. By diving into what heart …

Non-Invasive Detection Of Intracranial Pressure, Andrei V. Nesterenko

Honors Undergraduate Theses

Intracranial pressure is a critical metric used when managing tumors, strokes, TBIs, hydrocephalus, and other operative conditions. Traditional methods for continuous ICP monitoring, intraparenchymal catheters, epidural transducers etc., are invasive and carry a high risk of infection. Previous attempts to create accurate, easy to use, and non-invasive ICP monitoring techniques have been unsuccessful. In this study, we investigated the utility of supraorbital and posterior auricular photoplethysmography to monitor changes in ICP during orthostatic tilt and hyperventilation, which increase and decrease ICP respectively.

Through a continuous 5-minute recording on a tilt-table we characterized SOA and PAA waveforms in 12 participants (ages …

Severity And Duration-Dependent Aortic Stiffening In A Rabbit Coarctation Model Identifies Constitutive Material Parameters As Promising Regional Biomarkers For Hypertension Progression, Arash Ghorbannia, Jamasp Azarnoosh, John F. Ladisa Jr.

VMASC Publications

Coarctation of the aorta (CoA) alters hemodynamics and drives regional remodeling, yet the influence of severity and duration on constitutive properties is undefined. We quantified mechanical responses from CoA to identify constitutive parameters capturing stiffening across clinical severities and durations. Mild (≤ 12 mmHg), intermediate (13–20 mmHg), and severe (> 20 mmHg) CoA was created in rabbits for short, long, and prolonged durations (~ 1, 3, or 22 weeks, respectively). Stress–stretch curves from proximal and distal regions were fit with multiple constitutive models (Linear Elastic, Neo-Hookean, Yeoh, Ogden, Mooney–Rivlin, Holzapfel). Model performance was evaluated by normalized RMSE and R², with …

Atrial Fibrillation Detection From At-Rest Ppg Signals Using An Sdof-Tf Method, Mamun Hasan, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

At-rest PPG signals have been explored for detecting atrial fibrillation (AF), yet current signal-processing techniques do not achieve perfect accuracy even under low-motion artifact (MA) conditions. This study evaluates the effectiveness of a single-degree-of-freedom time–frequency (SDOF-TF) method in analyzing at-rest PPG signals for AF detection. The method leverages the influence of MA on the instant parameters of each harmonic, which is identified using an SDOF model in which the tissue–contact–sensor (TCS) stack is treated as an SDOF system. In this model, MA induces baseline drift and time-varying system parameters. The SDOF-TF method enables the quantification and removal of MA and …

Radial And Carotid Arterial Pulse Signals For Assessing Cardiovascular Function At Rest And During Post-Exercise Recovery In A Heart Transplant Patient: A Case Study, Md Mahfuzur Rahman, Mamun Hasan, Jennifer F. May, John M. Herre, Leryn Reynolds, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

Aim: This study investigates the feasibility of using radial and carotid arterial pulse signals to assess cardiovascular (CV) function at rest and during post-exercise recovery in a heart transplant (HTx) patient. Method: Two micro-fabricated tactile sensors were used to simultaneously acquire arterial pulse signals at the radial artery (RA) and carotid artery (CA). Measurements were taken at rest and at multiple time points post-exercise on three subjects: an HTx patient, a percutaneous coronary intervention (PCI; coronary stent) patient and a healthy control. An SDOF-TF-based time-frequency analysis algorithm was applied to extract a comprehensive set of CV parameters, including heart rate …