Cardiovascular System Commons^™

Near Real-Time Adaptive Isotropic And Anisotropic Image-To-Mesh Conversion For Cerebral Aneurysm Simulations, Kevin Garner, Chander Sadasivan, Nikos Chrisochoides

Computer Science Faculty Publications

This paper presents two performance optimization techniques for a mesh adaptation method that is designed to help streamline the discretization of complex vascular geometries within the numerical modeling process. This method is integrated into a pipeline with an image-to-mesh conversion tool to generate adaptive anisotropic meshes from segmented medical images. The pipeline is shown to satisfy quality, fidelity, smoothness, and robustness requirements while providing near real-time performance for medical image-to-mesh conversion. Tested with two brain aneurysm cases and utilizing up to 96 CPU cores within a single, multicore node on Purdue University’s Anvil supercomputer, the parallel adaptive anisotropic meshing method …

Balloon Aortic Valvuloplasty As A Bridge Therapy In Acute Valve Syndrome: A Narrative Review Of Evidence Gaps And Future Directions, Omar Saleh, Omar Jafar, Nicholas Valle, Shirish Yasa, Saleh Mostafa, Raymond L. Benza, Deepak R. Talreja, Benjamin D. Peterson, Matthew R. Summers

Department of Medicine Faculty Publications

Acute valve syndrome (AVS) represents a high-acuity, decompensated presentation of severe aortic stenosis (AS), often manifesting as acute heart failure, cardiogenic shock, or cardiac arrest. Transcatheter aortic valve replacement (TAVR) remains the only durable therapy for severe AS in patients with prohibitive surgical risk, yet AVS patients may be too unstable for standard preprocedural planning. Balloon aortic valvuloplasty (BAV) has re-emerged as a bridge strategy that can provide rapid hemodynamic stabilization and permit subsequent valve replacement. Registry analyses report lower mortality in emergent TAVR compared with BAV, but these comparisons are confounded by procedural indication and unmatched AS severity. Smaller …

Endothelin-1 In The Failing Fontan: Pathobiology, Precision Therapeutics, And Future Trial Design, Iman Maiza

Department of Pediatrics Faculty Publications

The Fontan circulation, devised as definitive palliation for single-ventricle congenital heart disease, imposes systemic venous hypertension, loss of pulmonary arterial pulsatility, and restricted preload reserve. These hemodynamic trade-offs progressively injure the pulmonary vasculature, liver, and lymphatic system, producing late morbidities including elevated pulmonary vascular resistance, Fontan-associated liver disease (FALD), protein-losing enteropathy, and arrhythmias. Endothelin-1 (ET-1), a potent vasoconstrictor and profibrotic mediator, plausibly unifies these complications. Mechanistic studies demonstrate ET-1 upregulation in failed Fontan lungs, activating PLC–Ca²⁺, RhoA/ROCK, and MAPK/ERK cascades to drive vasoconstriction and remodeling. In cirrhotic livers, ET-1 localizes to stellate cells, promoting contraction and fibrogenesis, mechanisms biologically relevant …

Stim1-Dependent Treg Dysfunction Promotes Cardiometabolic Hfpef: Insights From Patients And Animal Studies, Balaji Srinivas, Alluri Kiran, Hongmei Peng, Jiang Xu, Paula Fortuno, Jennifer May, Ismail El Moudden, Nour-Eddine Rhaleb, John M. Herre, Raymond L. Benza, Khalid Matrougui

Department of Biomedical and Translational Sciences Faculty Publications

Background

Heart failure with preserved ejection fraction (HFpEF) arises from chronic cardiometabolic and vascular stress and is increasingly recognized as an inflammatory syndrome with immune dysregulation. Regulatory T cells (Tregs) are critical modulators of cardiovascular inflammation, yet the mechanisms driving Treg dysfunction in HFpEF remain poorly defined. stromal interaction molecule 1 (STIM1)-dependent calcium signaling is a key stress-responsive pathway in immune cells; however, its role in Treg maladaptation during HFpEF remains unknown.

Methods

Circulating Tregs from patients with and without HFpEF were analyzed for abundance, STIM1 expression, and stress-associated signaling pathways. To establish causality, mice with Treg-specific deletion of STIM1 …

Distribution And Morphology Of Catecholaminergic Axons And Terminals In Flat-Mounts Of The Whole Left Ventricles Of Rats: Tracing, Digitization And 3d Scaffold, Emily Liu

Honors Undergraduate Theses

Cardiac sympathetic innervation plays a vital role in regulating various heart functions, and its remodeling has been linked to a range of cardiovascular diseases. To understand cardiac sympathetic innervation and remodeling, it is important to elucidate the topographical distribution and morphology of sympathetic axons in the whole left ventricle. However, immunohistochemistry (IHC) on whole heart tissues presents challenges due to their thickness, as conventional methods label only small sections. This disrupts tissue integrity and neural connections. To overcome this, we developed a whole flat-mount technique to process the rat heart (ventricle thickness: 3 mm). We performed cardiac sympathetic nerve imaging …

Donor-Derived Cell-Free Dna In Antibody-Mediated Rejection: An Analysis Of The Surveillance Heartcare Outcomes Registry, Paul J. Kim, Amit H. Alam, Jeffrey J. Teuteberg, Kiran K. Khush, Sean P. Pinney, Richard K. Cheng, Amin Yehya, Jeremy Kobulnik, Kevin M. Pinney, Kris A. Oreschak, Christopher R. Ensor Pharmd, Steven Fan, Marcus A. Urey, Palak Shah, Shelley A. Hall

Department of Medicine Faculty Publications

Background

Donor-derived cell-free DNA (dd-cfDNA) has emerged as a biomarker for antibody-mediated rejection (AMR), but its performance characteristics have not been evaluated in a large contemporary heart transplant population.

Objectives

The study aimed to characterize the incidence and timing of biopsy-proven AMR and evaluate the performance characteristics of dd-cfDNA for AMR.

Methods

The authors included 2,240 subjects from the SHORE (Surveillance HeartCare Outcomes Registry) registry transplanted between 2017 and 2022 with verified biopsy, dd-cfDNA, echocardiographic, and donor-specific antibody (DSA) data. They evaluated the performance characteristics of dd-cfDNA for AMR and the incidence of AMR in different clinical contexts.

Results

AMR …

Transatrial Balloon-Expandable Valve Implantation For Severe Mitral Annular Calcification With Native Leaflet Sealing, Omar Saleh, Rishab Agarwal, Israa Saleh, Nicholas Valle, Joshua Dolsen, Raymond L. Benza, Deepak R. Talreja, Clinton D. Kemp, Matthew R. Summers, Christopher M. Sciortino

Department of Medicine Faculty Publications

Background: Severe mitral annular calcification (MAC) limits mitral intervention options. Transseptal valve-in-MAC (ViMAC) transcatheter mitral valve replacement (TMVR) risks neo-left ventricular outflow tract (neo-LVOT) obstruction and paravalvular leak, while surgical replacement requires extensive annular reconstruction.

Case Summary: We report 3 high-risk patients with severe MAC (computed tomography [CT]-based MAC scores 7-10) who underwent open transatrial valve-in-MAC TMVR via a balloon-expandable valve after CT-based simulation and multidisciplinary heart review identified increased risk of valve malapposition or neo-LVOT obstruction precluding transseptal approach. Native anterior mitral leaflet tissue was preserved, everted, and fixed to the bioprosthetic valve cuff, creating a seal to address …

The Gendered Heart: Closing The Gender Gap In Heart Disease Diagnosis And Treatment, Aiden Varghese

Undergraduate Research Posters

Cardiovascular disease (CVD) continues to be the primary cause of death for both men and women in the United States, being characterized and treated in a historically male-centric manner. This research paper will address the disparities in risk factors for heart disease between genders, gender differences in diagnosis, and gender differences in management/treatment, thereby demonstrating the critical importance of incorporating sex specific factors into the field of cardiology. It has been demonstrated that lifestyle changes such as physical activity and smoking cessation can reduce CVD risk universally. This signifies a necessary shift toward being proactive in the prevention of CVD. …

Intraoperative Positioning System-Guided Antegrade In Situ Laser Fenestration In An Aortic Model, Emily Burnett, Emidio Germano, Allie Olmstead, Benjamin Samberg, Robert Meisner, Hannah Hofacker, Michael Bronez, Vikash Goel, Animesh Rathore

Department of Medicine Faculty Publications

Objective

Fenestrated endovascular aneurysm repair (fEVAR) is routinely being used for visceral vessel incorporation in complex aneurysmal pathology; however, it is associated with prolonged procedure times, high radiation exposure, high contrast use, and multiple staged procedures. To combat these limitations, Centerline Biomedical developed the three-dimensional surgical navigation and visualization technology: intraoperative positioning system (IOPS). We previously presented our IOPS-guided antegrade in situ laser fenestration in a standard aortic model. This case report details our experience using IOPS guidance during a fEVAR procedure in a representative thoracoabdominal aortic aneurysm phantom model.

Methods

A silicone thoracoabdominal aortic segment was three-dimensional printed based …

Permanent Pacemaker Implantation Following Transcatheter Aortic Valve Replacement: Incidence, Predictors, And Association With Reduced Ischemic Stroke Risk, Omar Saleh, Nicholas J. Valle, Shinjer Li, Saleh Mostafa, Israa Saleh, Raymond Benza, Deepak R. Talreja, Matthew R. Summers

Department of Medicine Faculty Publications

Background

Development of conduction abnormalities requiring pacing after transcatheter aortic valve replacement (TAVR) is relatively common. The effects of post-TAVR permanent pacemaker (PPM) implantation on mortality, ischemic stroke, and cardiovascular outcomes remain incompletely characterized. AIMS: To evaluate the incidence, predictors, and cardiovascular outcomes of post-TAVR permanent pacemaker implantation, including its association with 1-year ischemic stroke risk.

Methods

Adults undergoing TAVR (2008-2019; n = 1101) were evaluated. Patients with prior PPM (n = 104) and/or valve-in-valve or redo TAVR (n = 11) were excluded. PPM placement was identified post-indexed TAVR admission based on procedure codes, including both in-hospital and post-discharge implantations. …

Combined Snare And Buddy-Balloon Strategy For Failed Valve Crossing In Valve-In-Valve Transcatheter Aortic Valve Replacement, Hira Sarfraz, Muhammad U. Javed, Parth K. Parikh, Joshua A. Cohen, Raymond L. Benza, Matthew R. Summers, Deepak R. Talreja

Department of Medicine Faculty Publications

Background Retrograde valve crossing during valve-in-valve transcatheter aortic valve replacement (ViV TAVR) may fail despite modern delivery systems. Case Summary A 67-year-old man with a degenerated 27-mm Magna Ease bioprosthesis and unfavorable aortic geometry (kinked ascending aorta at a prior surgical graft site) underwent ViV TAVR, where retrograde valve crossing failed despite multiple stiff guidewires and snare traction alone. Successful delivery of a 29-mm Evolut FX+ was ultimately achieved by combining gooseneck-snare traction for coaxial realignment with a partially inflated Tyshak buddy balloon acting as a mechanical ramp across the surgical valve frame. Discussion This case demonstrates a structured, stepwise …

Open Transatrial Valve-In-Mitral Annular Calcification Mitral Valve Replacement With An Autologous Anterior Leaflet Sealing Skirt, Omar Saleh, Nicholas Valle, Rishab Agarwal, Israa Saleh, Joshua Dolsen, Connor Mckechnie, Dhruvi Patel, Deepak R. Talreja, Matthew R. Summers, Christopher M. Sciortino

Department of Medicine Faculty Publications

[Central Message] In patients undergoing ViMAC, surgical fixation of the native anterior mitral leaflet to a BEV cuff creates an autologous seal, reducing risk of paravalvular leak and neo-LVOT obstruction.

Glucagon-Like Peptide Receptor Agonists (Glp-1ras) As Cardiovascular Risk Modifiers In Obstructive Sleep Apnea And Obesity: A Real-World Study, Jaeun Ahn, Junmin Song, Kyle Admire, Yu Chang, Kuan-Yu Chi, Nathaniel T. Gordon, Joshua M. Sill

Department of Medicine Faculty Publications

Introduction

Obstructive sleep apnea (OSA) is a well-established risk factor for cardiovascular disease. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated potential in reducing cardiovascular risk and improving OSA severity. However, a significant knowledge gap remains regarding the impact of GLP-1RAs on cardiovascular events in OSA patients.

Methods

We examined patients with a BMI over 30 diagnosed with OSA between January 2010 and November 2021 without a previous diagnosis of heart failure, pulmonary hypertension, or myocardial infarction. Two cohorts were created: those prescribed GLP-1RAs within 1 year of their OSA diagnosis and patients who were never prescribed GLP-1RAs. Propensity score matching …

An Analysis Of Heart Failure Among Cancer Patients In The United States Between 1999 And 2020, Abes A. Bautista Neughebauer, Deepak Talreja, Apostolos Gaitanidis

Department of Medicine Faculty Publications

Background: Cancer and heart failure (HF) are highly prevalent in the population and can co-exist, due to shared risk factors and an aging population. The HF-related mortality burden in cancer patients across in the United States (US) remains poorly understood. The goal of this study is to evaluate the patterns of HF-related deaths among cancer patients in the United States.

Methods: A retrospective analysis was performed using the Centers for Disease Control and Prevention (CDC) WONDER Multiple Cause of Death database between years 1999 and 2020. HF-related deaths were defined as death certificates listing HF as a contributing cause of …

Comparative Analysis Of Left Ventricular Sympathetic Axons In Shr And Wky Rats, Parker R. Tyson

Honors Undergraduate Theses

Hypertension is a leading cause of cardiovascular morbidity and mortality and is strongly associated with dysregulation of the sympathetic nervous system, which plays a central role in controlling heart rate, vascular tone, and blood pressure. Although increased sympathetic activity has been widely documented in hypertensive disease, the precise structural organization of sympathetic innervation within the hypertensive heart remains incompletely characterized. This study investigates whether chronic hypertension is associated with structural remodeling of sympathetic axons in the left ventricle by comparing autonomic innervation patterns between spontaneously hypertensive rats (SHR) and normotensive Wistar Kyoto rats (WKY). Hearts were collected following transcardial perfusion …

Percutaneous Closure Of Ventricular Septal Rupture After Myocardial Infarction:, Thomas A. Cook, Simone K. Schumaecker, Anjani Patibandla, Nicholas J. Valle, Matthew R. Summers

Department of Medicine Faculty Publications

BACKGROUND: Ventricular septal rupture (VSR) following acute myocardial infarction is a rare but deadly complication with mortality rates exceeding 90% when left untreated. Coronary ischaemia leads to myocardial necrosis and friability resulting in septal rupture, most commonly 3-5 days post-infarction. The sudden development of a left-to-right shunt causes volume overload in the right ventricle, pulmonary vasculature, and left atrium, precipitating biventricular failure, and cardiogenic shock. Management requires careful consideration of timing and modality of closure along with stabilization with mechanical circulatory support in severe cases.

CASE SUMMARY: A 65-year-old female presented with anterior ST-segment elevation myocardial infarction complicated by VSR …

Microarray Analysis Of Human Abdominal Aortic Aneurysm With Emphasis On Cardiovascular Genes Revealed Differentially Expressed Genes, Song Lu, Li Ping Li, John V. White, Xiaoying Zhang, Ifeyinwa Nwaneshiudu, Adaobi Nwaneshiudu, Nectaria Ntaoula, John Gaughan, Dimitri S. Monos, Wan-Lu Lin, Charalambos C. Solomides, Emilia L. Oleszak, Chris D. Platsoucas

Biological Sciences Faculty Publications

Background/Aim: We examined gene expression profiles in abdominal aortic aneurysm (AAA) lesions vs. normal aortas by cDNA microarray and real-time quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR).

Materials and Methods: Phosphorus (32P)-labeled cDNA from AAA specimens (mean AAA size 6.65 cm) and normal aortas were hybridized with a 588-gene microarray primarily of the cardiovascular system. The results were validated by qRT-PCR.

Results: A total of 35 out of the 588 genes were differentially expressed, with either log2 ratio of AAAs/controls ≥1 (upregulated; 20 genes) or ≤−1 (downregulated; 15 genes) in AAA lesions vs. normal aorta, and 25 of these were significantly …

Startle Habituation And Vagally Mediated Heart Rate Variability Influence The Use Of Emotion Regulation Strategies, Xiao Yang, Fang Fang, Angela Ximena Babb

Psychology Faculty Publications

Emotion regulation refers to the processes through which people modulate their emotional experiences and expressions, and difficulties in these processes underpin many forms of psychopathology. According to the process model, emotion regulation encompasses five classes of strategies, commonly grouped into antecedent-focused strategies (e.g., cognitive reappraisal) and response-focused strategies (e.g., expressive suppression). These strategies involve both explicit and implicit processes, which can be objectively assessed using physiological indices. The present study examined the effects of startle habituation and vagally mediated heart rate variability (vmHRV) on the use of cognitive appraisal and suppression. Forty-nine college-aged participants were recruited, and their resting heart …

Current Insight Into Ldlr And Pcsk9 Genetic Variants: Investigating Genetic Keys To Cholesterol In A Cohort Of Stroke Patients From Yogyakarta, Indonesia, Loury Priskila, Lenggana Relung Atmadi, Arya Taksya Bagaskara, Andreas Mercyan Anggitama

Makara Journal of Health Research

Background: Stroke is the second leading cause of mortality worldwide. In Yogyakarta, Indonesia, the incidence of stroke (14%) is higher than the national average. We therefore investigated the roles of LDLR rs688 (C/T) and PCSK9 rs562565 (A/G) polymorphisms in familial hypercholesterolemia as predictors of first-time ischemic stroke.

Methods: In this case-control study, 119 first-time ischemic stroke patients were divided into dyslipidemia (N = 71) and non-dyslipidemia groups (N = 48). The DNA of the nucleotide polymorphisms LDLR rs688 (C/T) and PCSK9 rs562556 (A/G) was extracted and analyzed using the PCR-RFLP method, and statistical analyses were performed to evaluate …

Investigating The Cardiovascular And Autonomic Responses To Energy Drink Consumption: The Role Of Energy And Calorie Content, Sophia Schmidt

Honors Theses

Energy drinks (EDs) are among the most consumed functional beverages, often marketed to enhance focus, alertness, and physical performance. Despite their popularity, the combined cardiovascular and autonomic effects of caffeine and sugar during exercise remain poorly understood. The purpose of this study was to examine the acute cardiovascular, metabolic, and autonomic responses to sugar-sweetened (ED-S), non-nutritive sweetened (ED-NNS), and placebo beverages during submaximal cycling in healthy young males.

Nine male participants (age 22.2 ± 2.4 yrs; BMI 26.2 ± 2.9 kg/m²) completed three experimental visits in a randomized, repeated-measures design. Each visit involved ingestion of one drink (ED-S, ED-NNS, or …