Cardiovascular Diseases Commons^™

Managing Intracranial Hemorrhage In Patients With A Durable Continuous Flow Left Ventricular Assist Device, Godly Jack, Phil Barker, Ryan Searcy, Jason N. Katz

The VAD Journal

Background: While intracranial hemorrhage (ICH) is a known complication of left ventricular assist device (LVAD) support, and is associated with high morbidity and mortality, optimal care pathways have neither been elucidated nor reported. We describe management of LVAD patients following ICH, with a focus on anticoagulation, operative interventions, care team designation, complications, and outcomes.

Methods: We retrospectively reviewed all durable continuous-flow LVAD implantations at our academic medical center from January 2007 to July 2018. Patients who experienced ICH after LVAD were identified. We defined baseline and ICH characteristics, medical and surgical interventions, care teams, and outcomes including death, device thrombosis, …

Navigating A Difficult Transition In Pulmonary Arterial Hypertension: A Clinical Case Study, Tina Hyman, Michael Salinero, Francisco Javier Jimenez-Carcamo, Margarita Pallares, Maribel Matos

Nursing & Health Sciences Research Journal

Over the past 20 years, Pulmonary Arterial Hypertension (PAH) patients and providers have seen an increase in options to treat PAH. Currently, there are choices for the delivery of medications approved to treat patients with PAH where at one point the only option was intravenous (IV) therapy. This case study details the transition from IV Epoprostenol to oral Treprostinil for the treatment of a 53 year old female diagnosed with severe Pulmonary Arterial Hypertension whose quality of life became unbearable by the IV medication delivery route. This patient was a synchronized swimmer in her youth and her passion for water …

Short Relative Leg Length Is Associated With Overweight And Obesity In Mexican Immigrant Women, Mireya Vilar-Compte, James Macinko, Beth C. Weitzman, Carlos M. Avendaño-Villela

Department of Public Health Scholarship and Creative Works

Background: Prior research suggests that undernutrition and enteric infections predispose children to stunted growth. Undernutrition and infections have been associated with limited access to healthy diets, lack of sanitation, and access barriers to healthcare - all associated with human rights. Stunting has also been documented to be a major determinant of subsequent obesity and non-communicable diseases. Short leg length relative to stature during adulthood seems to be a good proxy indicator tracking such barriers, and has been reported to be associated with adverse health effects during adulthood. Our objective was to examine the association between relative leg length (as measured …

Provider-Level Variation In Smoking Cessation Assistance Provided In The Cardiology Clinics: Insights From The Ncdr Pinnacle Registry, Mayank Sardana, Yuanyuan Tang, Jared W. Magnani, Ira S. Ockene, Jeroan J. Allison, Suzanne V. Arnold, Phillip G. Jones, Thomas M. Maddox, Salim S. Virani, David D. Mcmanus

Office of the Provost

Background: Studies show suboptimal provision of smoking cessation assistance (counseling or pharmacotherapy) for current smokers attempting to quit. We aimed to identify smoking cessation assistance patterns in US cardiology practices.
Methods and Results: Among 328 749 current smokers seen between January 1, 2013, and March 31, 2016, in 348 NCDR (National Cardiovascular Data Registry) PINNACLE (Practice Innovation and Clinical Excellence)‐affiliated cardiology practices, we measured the rates of cessation assistance. We used multivariable hierarchical logistic regression models to determine provider‐, practice‐, and patient‐level predictors of cessation assistance. We measured provider variation in cessation assistance using median rate ratio (the likelihood that …

Identifying The Enzyme Involved In Vacuolar Atpase Acetylation During Doxorubicin-Induced Cardiotoxicity, Rebecca Dang, Tianqing Peng

Western Research Forum

Doxorubicin is an established anticancer medication infamous for its bright colouration and extremely toxic side effects. Emerging studies support that the imbalance between acetylation and deacetylation disrupts the autophagic flux leading to doxorubicin-induced cardiotoxicity. Vacuolar ATPases are a family of electrogenic proton pumps present on the lysosomal membrane that create an acidic environment for proteases to degrade proteins. Our preliminary study found that acetylated Vacuolar ATPase subunit V₀ D1 levels increased in doxorubicin-injected mouse hearts. However, it is unknown how acetylation of subunit V₀ D1 is modulated and whether this modification plays a role in doxorubicin-induced cardiotoxicity.

The …

Is Intimate Partner Violence A Risk Factor For Cardiovascular Disease In Women? A Review Of The Preponderance Of The Evidence, Rose Eva Constantino, Alona D. Angosta, Andrew Thomas Reyes, Brayden Kameg, Linden Wu, Jordan Cobb, Vivian Hui, Daisy Palompon, Reema Safadi, Mayada Daibes, Elizabeth Schlenk

Nursing Faculty Research

This paper examines the relationship between intimate partner violence (IPV) experience in women and cardiovascular disease (CVD), and determines if there is a preponderance of literature evidence. Research is reviewed dealing with the different biopsychosocial factors affecting the relationship between IPV and CVD. As a result of our review, we propose a framework on the biopsychosocial pathway of IPV as a risk factor of CVD of women. Our proposed framework portrays how IPV experiences contribute to long-term biopsychosocial changes that increase the risk of CVD among female victims of IPV. These biopsychosocial changes include chronic inflammation and hypothalamus-pituitary-adrenal axis dysfunction, …

Xx Sex Chromosome Complement Promotes Atherosclerosis In Mice, Yasir Alsiraj, Xuqi Chen, Sean E. Thatcher, Ryan E. Temel, Lei Cai, Eric M. Blalock, Wendy Katz, Heba M. Ali, Michael C. Petriello, Pan Deng, Andrew J. Morris, Xuping Wang, Aldons J. Lusis, Arthur P. Arnold, Karen Reue, Katherine L. Thompson, Patrick Tso, Lisa A. Cassis

Pharmacology and Nutritional Sciences Faculty Publications

Men and women differ in circulating lipids and coronary artery disease (CAD). While sex hormones such as estrogens decrease CAD risk, hormone replacement therapy increases risk. Biological sex is determined by sex hormones and chromosomes, but effects of sex chromosomes on circulating lipids and atherosclerosis are unknown. Here, we use mouse models to separate effects of sex chromosomes and hormones on atherosclerosis, circulating lipids and intestinal fat metabolism. We assess atherosclerosis in multiple models and experimental paradigms that distinguish effects of sex chromosomes, and male or female gonads. Pro-atherogenic lipids and atherosclerosis are greater in XX than XY mice, indicating …

A Mendelian Randomization Study Of Coronary Artery Disease And Three Amino Acids: Alanine, Glycine, And Glutamine, Allan Uribe

Dissertations and Theses

Cardiovascular disease is the leading cause of death worldwide. Coronary Artery Disease (CAD) accounts for the majority of those deaths. Observational studies have identified risk factors that have been helpful in lowering the death rate, including hypertension, high cholesterol, diabetes, smoking, physical inactivity and poor diet. The effects of these risk factors on CAD remain unclear. To clarify the effect of three amino acids, alanine, glutamine, and glycine on CAD I applied a two sample Mendelian randomization analysis to extensively genotyped observational data. In a sample with up to 184,000 individuals and approximately 60,000 controls, SNPs that reached genome wide …

Socioeconomic Status And Risk Of Cardiovascular Disease In 20 Low-Income, Middle-Income, And High-Income Countries: The Prospective Urban Rural Epidemiologic (Pure) Study, Annika Rosengren, Andrew Smyth, Sumathy Rangarajan, Chinthanie Ramasundarahettige, Shrikant I. Bangdiwala, Khalid F. Alhabib, Alvaro Avezum, Kristina Bengtsson Boström, Jephat Chifamba, Romaina Iqbal

Community Health Sciences

Background: Socioeconomic status is associated with differences in risk factors for cardiovascular disease incidence and outcomes, including mortality. However, it is unclear whether the associations between cardiovascular disease and common measures of socioeconomic status-wealth and education-differ among high-income, middle-income, and low-income countries, and, if so, why these differences exist. We explored the association between education and household wealth and cardiovascular disease and mortality to assess which marker is the stronger predictor of outcomes, and examined whether any differences in cardiovascular disease by socioeconomic status parallel differences in risk factor levels or differences in management.
Methods: In this large-scale prospective cohort …

A Neonate With Upper Gi Bleeding, Suneeta Khemani, Huma Ghulam Qadir, Mumtaz Malik, Faiqa Hassan

Department of Paediatrics and Child Health

Bleeding in the newborn is often a serious problem because of cardiovascular effects associated with a loss of blood and/or the damaging effects of bleeding on neonatal tissues, especially the brain. Gastric polyps are described as abnormal lesions that originate in the gastric epithelium or submucosa and protrude into the stomach lumen. Clinical presentation of gastric polyps in children varies widely, from incidental endoscopic finding to massive gastrointestinal bleeding. However, acute gastrointestinal bleeding in association with hyperplastic gastric polyps has been reported very rarely. We report a case of unusual upper gastrointestinal bleeding in newborn baby on 2nd day of …

Evaluating The Epidemiology And Management Of Bovine Congestive Heart Failure, Adam Bassett

School of Veterinary and Biomedical Sciences: Dissertations, Theses, and Student Research

A form of congestive heart failure is increasingly reported as a cause of death in feedlot cattle located at moderate altitude (≤ 1,524 m.). Significant knowledge gaps exist in the epidemiology and management of this form of bovine congestive heart failure (BCHF) regarding frequency and timing of BCHF cases and ways in which beef cattle producers and veterinarians can mitigate this condition. These knowledge gaps present major barriers to understanding the mechanism of BCHF and mitigating the consequences of BCHF. The purpose of this thesis is to summarize current knowledge about BCHF, define gaps in knowledge for which more research …

Incidence And Predictors Of Obstructive Coronary Artery Disease And The Role Of Cardiac Troponin Assays In Patients With Unstable Angina, Sushan Yang, Nirmanmoh Bhatia, Meng Xu, John A Mcpherson

The Texas Heart Institute Journal

In a time when cardiac troponin assays are widely used to detect myocardial injury, data remain scarce concerning the incidence and predictors of substantial obstructive coronary artery disease that causes unstable angina. This retrospective single-center study included consecutive patients hospitalized for unstable angina from January 2015 through January 2016. Patients with troponin I levels above the upper reference limit and those who did not undergo angiography were excluded. Multivariate logistic regression analysis was used to identify predictors of obstructive coronary artery disease that warranted revascularization and of major adverse cardiac events up to 6 months after discharge from the hospital. …

Goosebumps, Efrain Rodriguez

The Texas Heart Institute Journal

No abstract provided.

Adam Christian Thebesius' Channels Into The Human Heart: The Thebesian Veins And The Thebesian Valve, Magdalena Mazurak, Jacek Kusa

The Texas Heart Institute Journal

In 1708, Adam Christian Thebesius, a 22-year-old student at Leiden University, presented his graduate thesis, Disputatio medica inauguralis de circulo sanguinis in corde. More than a doctoral dissertation, this groundbreaking work opened new channels into the study of the human coronary venous system. Thebesius' theory about the vascular communication between the coronary arteries and the chambers of the heart helped to advance understanding of hemodynamic principles and to clarify the physiologic pathways of the coronary circulation. The following article—the third in a trilogy about Lower Silesian scientists—provides an overview of the life story and achievements of this Silesian physician …

Osborn Waves: Differential Diagnosis, Akriti G Jain, Hammad Zafar, Sanjay Jain, Jason D'Souza

The Texas Heart Institute Journal

No abstract provided.

Percutaneous Coronary Intervention For Interposed Coronary Graft Stenosis After Modified Bentall Procedure In A Teenaged Boy With Takayasu Arteritis, Hiroki Ikenaga, Satoshi Kurisu, Yasuki Kihara

The Texas Heart Institute Journal

Anastomotic occlusion of an interposed coronary artery graft after a Bentall procedure is rare and catastrophic. It can lead to myocardial infarction or sudden cardiac death. We found several reports of occlusion and stenosis of a coronary-graft anastomosis, but few describe occlusion of the interposed coronary graft itself, as evaluated with use of intracoronary ultrasonography and computed tomography. We report the case of a 17-year-old boy with Takayasu arteritis who had a myocardial infarction caused by severe ostial stenosis in an interposed left coronary graft. The graft occlusion was confirmed by results of electrocardiography, aortography, and intracoronary ultrasonography. The patient …

Endoanchors Minimize Endoleaks In Chimney-Graft Endovascular Repair Of Juxtarenal Abdominal Aortic Aneurysms, Edgar Luis Galiñanes, Eduardo A Hernandez-Vila, Zvonimir Krajcer

The Texas Heart Institute Journal

Juxtarenal abdominal aortic aneurysms (AAAs) are difficult to treat because they often have little or no proximal aortic neck. Patients with this complex anatomy are not usually candidates for an endovascular aneurysm repair (EVAR). Chimney-graft EVAR has been introduced, but type Ia endoleak is a typical risk. We have begun using EndoAnchors to determine whether this risk can be reduced. From July 2013 through July 2014, we used the chimney-graft EVAR technique in 5 patients whose juxtarenal AAAs had a short or no proximal aortic neck. During the procedure, we implanted EndoAnchors as needed. Postprocedurally, at 30 days, and through …

Anomalous Origin Of The Right Coronary Artery From The Pulmonary Artery In A Neonate With Turner Syndrome And Aortic Arch Hypoplasia, Bryan P Stefek, Jason R Imundo, Joseph B Clark

The Texas Heart Institute Journal

Anomalous origin of the right coronary artery from the pulmonary artery, a rare congenital cardiac defect, is typically not diagnosed during infancy. On the other hand, Turner syndrome is usually diagnosed early, and it is classically associated with bicuspid aortic valve and aortic coarctation. Individuals with Turner syndrome are also at increased risk for coronary artery anomalies. We present a case of anomalous right coronary artery from the pulmonary artery in a week-old neonate who also had Turner syndrome, patent ductus arteriosus, transverse aortic arch hypoplasia, and impaired ventricular function. Prostaglandin therapy through the ductus increased the patient's myocardial perfusion. …

The Man With 2 Hearts: 25 Years From Heterotopic To Orthotopic Heart Transplantation, Elizabeth L Godfrey, Michael L Kueht, Abbas Rana, O H Frazier

The Texas Heart Institute Journal

Substantial technological advances in mechanical circulatory support have caused a shift in the management of end-stage heart failure. From the 1970s through the 1990s, heterotopic heart transplantation was routinely performed in patients in whom orthotopic transplantation was likely to fail. Heterotopic heart transplantation is now performed less often because modern mechanical circulatory assist devices are routinely used as bridges to orthotopic transplantation; regardless, the operation has helped numerous patients who would not otherwise have received adequate allografts. We describe the case of a man with idiopathic nonischemic cardiomyopathy who, at age 17, was given an ABO- and size-matched heterotopic allograft …

Surgical Thrombectomy For Pulmonary Embolism: Updated Performance Rates And Outcomes, Fahad Alqahtani, Muhammad Bilal Munir, Sami Aljohani, Abdul Tarabishy, Ahmad Almustafa, Mohamad Alkhouli

The Texas Heart Institute Journal

Treatments for pulmonary embolism are numerous and often complex. Current data on surgical thrombectomy are important but are not readily available. We studied the National Inpatient Sample to evaluate trends in the performance rates and outcomes of surgical thrombectomy in the United States from 2003 through 2014. We think that our findings have meaningful application to the triage and risk stratification of patients who have hemodynamically significant pulmonary embolism.