Cardiovascular System Commons^™

Association Between Left Ventricular Mechanics And Diffuse Myocardial Fibrosis In Patients With Repaired Tetralogy Of Fallot: A Cross-Sectional Study, Christopher M. Haggerty, Jonathan D. Suever, Arichanah Pulenthiran, Abba Mejia-Spiegeler, Gregory J. Wehner, Linyuan Jing, Richard J. Charnigo, Brandon K. Fornwalt, Mark A. Fogel

Biomedical Engineering Faculty Publications

Background: Patients with repaired tetralogy of Fallot (TOF) have progressive, adverse biventricular remodeling, leading to abnormal contractile mechanics. Defining the mechanisms underlying this dysfunction, such as diffuse myocardial fibrosis, may provide insights into poor long-term outcomes. We hypothesized that left ventricular (LV) diffuse fibrosis is related to impaired LV mechanics.

Methods: Patients with TOF were evaluated with cardiac magnetic resonance in which modified Look-Locker (MOLLI) T1-mapping and spiral cine Displacement encoding (DENSE) sequences were acquired at three LV short-axis positions. Linear mixed modeling was used to define the association between regional LV mechanics from DENSE based on regional T1-derived diffuse …

Simultaneous Uplc–Ms/Ms Analysis Of Two Stable Isotope Labeled Versions Of Sucrose In Mouse Plasma And Brain Samples As Markers Of Blood-Brain Barrier Permeability And Brain Vascular Space, Ekram Ahmed Chowdhury, Saad Alqahtani, Raktima Bhattacharya, Reza Mehvar, Ulrich Bickel

Pharmacy Faculty Articles and Research

Blood Brain Barrier (BBB) permeability is frequently compromised in the course of diseases affecting the central nervous system (CNS). Sucrose is a low molecular weight, hydrophilic marker with low permeability at the naive BBB and therefore one of the widely used indicators of barrier integrity. Our laboratory recently developed a highly sensitive UPLC-MS/MS method for stable isotope labelled [13C12]sucrose in biological matrices. Correction of total brain concentration for contribution of intravascular space is required in such experiments in order to accurately measure BBB permeability, and it is often accomplished by vascular perfusion with buffer solutions prior to brain sampling. The …

Ambulatory Systolic Blood Pressure And Obesity Are Independently Associated With Left Ventricular Hypertrophic Remodeling In Children, Linyuan Jing, Christopher D. Nevius, Cassi M. Friday, Jonathan D. Suever, Arichanah Pulenthiran, Abba Mejia-Spiegeler, H. Lester Kirchner, William J. Cochran, Gregory J. Wehner, Aftab S. Chishti, Christopher M. Haggerty, Brandon K. Fornwalt

Biomedical Engineering Faculty Publications

Background: Children with obesity have hypertrophic cardiac remodeling. Hypertension is common in pediatric obesity, and may independently contribute to hypertrophy. We hypothesized that both the degree of obesity and ambulatory blood pressure (ABP) would independently associate with measures of hypertrophic cardiac remodeling in children.

Methods: Children, aged 8–17 years, prospectively underwent cardiovascular magnetic resonance (CMR) and ABP monitoring. Left ventricular (LV) mass indexed to height^2.7(LVMI), myocardial thickness and end-diastolic volume were quantified from a 3D LV model reconstructed from cine balanced steady state free precession images. Categories of remodeling were determined based on cutoff values for LVMI and …

Mechanisms Of Left Ventricular Thrombus Formation In Heart Failure With Reduced Ejection Fraction: Novel Insights From Two-Dimensional Speckle Tracking Echocardiography, Dhruv Chawla, Tracy Hammonds, Tadele Mengesha, Matt Umland, Khawaja Afzal Ammar, Vinay Thohan

Journal of Patient-Centered Research and Reviews

Background: Patients suffering from heart failure with reduced ejection fraction (HFrEF) are at increased risk for left ventricular (LV) thrombus and subsequent thromboembolism, yet anticoagulation is not routinely recommended for left ventricular ejection fraction (LVEF) alone. We sought to determine the role of two-dimensional speckle tracking echocardiography (2D-STE) to quantify regional changes in cardiac function associated with LV thrombus, which may prospectively guide anticoagulation.

Purpose: Help enable cardiovascular clinicians to use 2D-STE to evaluate regional strain patterns among patients with HFrEF with and without LV thrombus. Our results suggest that statistically lower regional longitudinal strain patterns in a well-matched cohort …

Assessment Of Chronic Disease To Determine Appropriateness Of Implantable Cardioverter-Defibrillator Therapy, Bilal M. Omery, Maharaj Singh, Randy S. Turkel, Robyn Shearer, Arshad Jahangir, M. Eyman Mortada, Jasbir S. Sra, Indrajit Choudhuri

Journal of Patient-Centered Research and Reviews

Background: Implantable cardioverter-defibrillator (ICD) therapy is considered appropriate when a patient is felt to have a reasonable expectation of 1-year survival. Chronic diseases have been estimated to be associated with greater than 10% annual mortality and may reduce benefits of ICD therapy. Frailty has been estimated to be associated with greater than 20% annual mortality and has been suggested to contraindicate ICD therapy.

Purpose: Determine a risk score that may identify patients in whom ICD implantation may not be appropriate.

Methods: Patients who received an ICD for primary and secondary prevention from 2008 through 2013 at the Aurora Health Care …

Relative Associations Of Age, Height, And Weight On Sinus Of Valsalva And Mid-Ascending Aorta: An Imaging And Epidemiology Study, Mirza Nubair Ahmad, Syed Haris Pir, Mirza Mujadil Ahmad, Sharmeen Hussaini, Bijoy K. Khandheria, A. Jamil Tajik, Khawaja Afzal Ammar

Journal of Patient-Centered Research and Reviews

Background: Prior studies show ascending aorta diameter varies with age, height and weight, but they did not evaluate relative influence of these variables on aortic diameter. Since height is genetically determined, and genetic disorders like Marfan syndrome are predominantly associated with sinus of Valsalva (SOV) dilation, we hypothesized height may have stronger association with SOV.

Purpose: Based on anecdotal observation, since age, weight and obesity are acquired attributes, we hypothesized age, weight and body mass index may have greater association with mid-ascending aorta (MAA) diameter, even in normal patients.

Methods: We evaluated echocardiographic studies of patients ≥ 15 years old …

Dilemma During Ultrasound-Guided Internal Jugular Venous Catheterization, Sanjay Dwarakanath, Monica Cheriyan, Annette Rebel

Anesthesiology Faculty Publications

The presence of Internal Jugular Valves can pose a diagnostic and procedural challenge during ultrasound-guided cannulation. After ruling out dissection, thrombus, or ultrasound artifacts, it can still be accessed and successfully cannulated with appropriate precautions including use of Live ultrasound, positioning, use of soft-tipped catheters, and minimizing duration of catheter placement.

Psychological Well-Being’S Link With Cardiovascular Health In Older Adults, Julia K. Boehm, Jackie Soo, Ying Chen, Emily S. Zevon, Rosalba Hernandez, Donald Lloyd-Jones, Laura D. Kubzansky

Psychology Faculty Articles and Research

Introduction

Favorable cardiovascular health (FCH) is associated with healthy longevity and reduced cardiovascular mortality risk. However, limited work has investigated the distribution of FCH in older age or considered the antecedents of FCH. Based on prior work linking psychological well-being with cardiovascular endpoints, higher psychological well-being was hypothesized to be associated with increased likelihood of maintaining FCH over time.

Methods

Data were from the English Longitudinal Study of Ageing. The first study wave (2002–2003) included men and women aged ≥50 years. The analytic sample (N=4,925) was restricted to individuals without baseline cardiovascular disease and with clinical data from three follow-ups …

Influence Of Differential Calcification In The Descending Thoracic Aorta On Aortic Pulse Pressure, Mirza Mujadil Ahmad, Syed Haris Ahmed Pir, Mustafa Noor Muhammad, Sharmeen Hussaini, Immad Arif Kiani, Mirza Nubair Ahmad, Imaad Razzaque, Muhammad Nabeel Syed, Rafath Ullah, Suhail Allaqaband, Anjan Gupta, Steven C. Port, Khawaja Afzal Ammar

Journal of Patient-Centered Research and Reviews

Purpose: Multiple studies have shown pulse pressure (PP) to be a strong predictor of aortic calcification. However, no studies are available that correlate PP with aortic calcification at the segmental level.

Methods: We identified 37 patients with aortic PP measured during cardiac catheterization. Their noncontrast chest computed tomography scans were evaluated for the presence of calcium in different segments (ascending aorta, arch of aorta [arch], descending aorta) and quantified. Patients with calcification (Calcified Group A) were compared against patients without calcification (Noncalcified Group B) in terms of PP, calcification and compliance.

Results: The mean of the total calcium score was …

Body Size Predicts Cardiac And Vascular Resistance Effects On Men's And Women's Blood Pressure, Joyce M. Evans, Siqi Wang, Christopher Greb, Vladimir Kostas, Charles F. Knapp, Qingguang Zhang, Eric S. Roemmele, Michael B. Stenger, David C. Randall

Biomedical Engineering Faculty Publications

Key Points Summary

• We report how blood pressure, cardiac output and vascular resistance are related to height, weight, body surface area (BSA), and body mass index (BMI) in healthy young adults at supine rest and standing.
• Much inter-subject variability in young adult's blood pressure, currently attributed to health status, may actually result from inter-individual body size differences.
• Each cardiovascular variable is linearly related to height, weight and/or BSA (more than to BMI).
• When supine, cardiac output is positively related, while vascular resistance is negatively related, to body size. Upon standing, the change in vascular resistance is positively related to size. …

Local Anesthesia Toxicity, Nicole Mccleery

Nursing Student Class Projects (Formerly MSN)

Local anesthesia (LA) provides a way to relieve temporary pain in a small part of the body and has been used for over 100 years (Fencl, 2015). LA also prevents the passage of surgical stimuli into the central nervous system (CNS) making a surgical procedure less painful for the patient (Noble, 2015). According to Noble, “altering the passage of stimuli from smaller diameter neurons in a confined area with lower drug dosages is called LA, such as the injection of LA around a surgical incision” (Noble, 2015, p.325). LA can be used in a variety of settings, such as in …

Association Of Altered Collagen Content And Lysyl Oxidase Expression In Degenerative Mitral Valve Disease, K-Raman Purushothaman, Meerarani Purushothaman, Irene C. Turnbull, David H. Adams, Anelechi Anyanwu, Prakash Krishnan, Annapoorna Kini, Samin K. Sharma, William N. O'Connor, Pedro R. Moreno

Pathology and Laboratory Medicine Faculty Publications

Background—Collagen cross-linking is mediated by lysyl oxidase (LOX) enzyme in the extracellular matrix (ECM) of mitral valve leaflets. Alterations in collagen content and LOX protein expression in the ECM of degenerative mitral valve may enhance leaflet expansion and disease severity.

Methods—Twenty posterior degenerative mitral valve leaflets from patients with severe mitral regurgitation were obtained at surgery. Five normal posterior mitral valve leaflets procured during autopsy served as controls. Valvular interstitial cells (VICs) density was quantified by immunohistochemistry, collagen types I and III by picro-sirius red staining and immunohistochemistry, and proteoglycans by alcian blue staining. Protein expression of LOX …

Impaired Right Ventricular Contractile Function In Childhood Obesity And Its Association With Right And Left Ventricular Changes: A Cine Dense Cardiac Magnetic Resonance Study, Linyuan Jing, Arichanah Pulenthiran, Christopher D. Nevius, Abba Mejia-Spiegeler, Jonathan D. Suever, Gregory J. Wehner, H. Lester Kirchner, Christopher M. Haggerty, Brandon K. Fornwalt

Biomedical Engineering Faculty Publications

Background: Pediatric obesity is a growing public health problem, which is associated with increased risk of cardiovascular disease and premature death. Left ventricular (LV) remodeling (increased myocardial mass and thickness) and contractile dysfunction (impaired longitudinal strain) have been documented in obese children, but little attention has been paid to the right ventricle (RV). We hypothesized that obese/overweight children would have evidence of RV remodeling and contractile dysfunction.

Methods: One hundred and three children, ages 8–18 years, were prospectively recruited and underwent cardiovascular magnetic resonance (CMR), including both standard cine imaging and displacement encoding with stimulated echoes (DENSE) imaging, which allowed …

A Cadaveric Study Of Coronary Artery Variations, Mitchell Lee Milanuk

Theses & Dissertations

Coronary artery diseases, such as angina or myocardial infarction, are extremely prevalent and impact millions of people worldwide. Underlying the diseases, and how they affect each individual in a distinct manner, is the individual’s coronary artery anatomy. The aim of the present study is to have an intimate knowledge of the normal and variant anatomy of the coronary arteries. As an attempt to gain such knowledge, complete analysis of the anatomical variations of coronary arteries was performed. Classical cadaveric dissection of sixty human hearts was performed in the gross anatomy laboratory at the University of Nebraska Medical Center (UNMC). Precise …

Effects Of Ankle Weights On Metabolic Response And Muscle Activity On A Lower Body Positive Pressure Treadmill 2017, Saige Hupman

Master's Theses

Lower body positive pressure (LBPP) treadmills are growing in popularity for rehabilitative use, as the benefits of exercising at partially supported body weight may induce faster recovery. It is unknown if there are certain practices that increase exercise intensity while maintaining positive effects of LBPP. Adding ankle weights when walking or running could increase intensity of rehabilitation programs while maintaining the comfort of supported body weight. PURPOSE: To measure metabolic response (VO2, RER, HR, Caloric expenditure), RPE, and lower limb electromyography (EMG) amplitudes of LBPP treadmill walking and running with and without ankle weights. METHODS: Sixteen participants (Age: 21.94 ± …

The Relationship Between Ratings Of Perceived Exertion And Heart Rate In Ncaa Division Iii Male Soccer Players 2017, Samuel J. Guider

Master's Theses

Every sport has specific physical demands of the human body. The amount of physiological load that an athlete endures during a bout of exercise can be described as training load (TL). Accurate calculation of training loads within athletes is important when it comes to strength and power development, as well as injury prevention and monitoring fatigue. Common methods used to calculate training loads for athletes include rating of perceived exertion (RPE) based methods, heart rate (HR) based methods, rate of oxygen consumption (VO2) methods, and blood lactate methods. Specifically with NCAA male soccer athletes, HR based methods and RPE based …

May 2017, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

No abstract provided.

Shear Driven Micro-Fluidic Pump For Cardiovascular Applications, Nihad E. Daidzic

Aviation Department Publications

A valveless shear-driven micro-fluidic pump design (SDMFP) for hemodynamic applications is presented in this work. One of the possible medical and biomedical applications is in-vivo hemodynamic (human blood circulation) support/assist. One or more SDMFPs can be inserted/implanted into vascular lumens in a form of a stent/duct in series and/or in parallel (bypass duct) to support blood circulation in-vivo. A comprehensive review of various micro-pump designs up to about mid 2000’s is given in [1,2]. Many of micropump designs considered are not suitable for in-vivo or even in-vitro medical/biomedical applications.

Operating principles, design, and SDMFP features are given in [3]. A …

Genomic Contraindications For Heart Transplantation., Danton S. Char, Gabriel Lázaro-Muñoz, Aliessa Barnes, David Magnus, Michael J. Deem, John Lantos

Manuscripts, Articles, Book Chapters and Other Papers

Genome sequencing raises new ethical challenges. Decoding the genome produces new forms of diagnostic and prognostic information; however, the information is often difficult to interpret. The connection between most genetic variants and their phenotypic manifestations is not understood. This scenario is particularly true for disorders that are not associated with an autosomal genetic variant. The analytic uncertainty is compounded by moral uncertainty about how, exactly, the results of genomic testing should influence clinical decisions. In this Ethics Rounds, we present a case in which genomic findings seemed to play a role in deciding whether a patient was to be listed …

A Rare Case Of Vascular Ring And Coarctation Of The Aorta In Association With Charge Syndrome., Jonathan B. Wagner, Joshua Q. Knowlton, Peter Pastuszko, Sanket Shah

Manuscripts, Articles, Book Chapters and Other Papers

A male neonate presented with CHARGE syndrome, a multiorgan genetic disorder involving the Coloboma of the eyes, congenital Heart defects, nasal choanal Atresia, growth and development Retardation, Genitourinary disorders, and Ear anomalies and deafness. Moreover, he had a rare case of vascular ring-consisting of a right aortic arch with retroesophageal brachiocephalic artery-combined with coarctation of the mid-aortic arch. He underwent both vascular ring and aortic arch repair at our institution. To our knowledge, this is the 4th documented case of this exceedingly rare type of aortic arch anomaly combined with aortic arch obstruction. Moreover, it is the first confirmed case …