Cardiovascular Diseases Commons^™

Optimizing Endothelial Cell Specific Polymersome-Based Atheroprotective Therapies, Ally C. Brawner

All Theses

Atherosclerotic cardiovascular disease is the number one cause of death in the United States and the world. Every year, billions of dollars are spent in the US alone for direct treatments of this disease, especially on prescription medicines like statins. However, these medications have been unable to curtail global mortality rates, partially because they do not target the entirety of atherosclerotic pathophysiology. A key area of this pathophysiology is that atheroprone arteries typically include pro-inflammatory endothelial cells that exhibit decreased levels of apoAI-mediated cholesterol efflux and an increased release of adhesion molecules, such as VCAM-1. The objective of my project …

Defining The Causal Contribution Of The Gut Microbiota To Cardiomyopathy Pathogenesis As A Basis For Developing Microbiome-Targeted Therapies, Xu Shi

Department of Food Science and Technology: Dissertations, Theses, and Student Research

Heart failure (HF) is a leading cause of morbidity and mortality worldwide, placing substantial clinical and economic burdens on society. Although advances in therapy have improved patient outcomes, the biological mechanisms that drive HF onset and progression remain incompletely understood. Increasing evidence suggests that the gut microbiota, the trillions of microorganisms residing in the gastrointestinal tract, plays a key role in some forms of heart disease, especially cardiovascular disease. Moreover, gut microbial dysbiosis has been associated with systemic inflammation, metabolic imbalance, and immune dysregulation, all of which contribute to the pathophysiology of HF. Cardiomyopathy, a primary disorder of the heart …

Increasing Histidyl Dipeptides In Skeletal Muscle Preserves Muscle Mass And Function In Heart Failure., Mamata Hiraman Chaudhari

Electronic Theses and Dissertations

Introduction: Heart failure is a systemic disease associated with multiple comorbidities, such as skeletal muscle wasting and cardiopulmonary disease. Muscle wasting in heart failure patients is a severe comorbidity associated with decreased exercise capacity and poor quality of life. Previous reports show that oxidative stress is increased in the skeletal muscle of heart failure patients, which can directly lead to muscle wasting. However, antioxidant intervention in these patients was unable to improve cardiac function and consequently had no effect on muscle wasting. Although oxidative stress is the primary driver of skeletal muscle atrophy, no attempt has been made to examine …

Rare Case Of Recurrent Cystic Mediastinal Mass: Giant Pericardial Cyst, Melina Tanadi, Anggraini Dwi Sensusiati Phd

Chulalongkorn Medical Journal

Pericardial cyst is unusual benign congenital malformations, with incidence of 1 person per 100.000. Although considered congenital lesion by incomplete fusion of embryogenesis, there are less frequent causes such as surgery, post trauma, and inflammatory process. Pericardial cyst can mimick malignant mediastinal tumor, cardiac chamber enlargement, bronchogenic cyst from Chest X-ray. Most of pericardial cyst are asymptomatic until they got bigger, such as dypsnea, sudden death, cardiac tamponade, rupture of the cyst. Radiology Imaging play important roles for rule out diagnostic therefore to prevent the complications. Computed tomography is modality of choice for pericardial cyst. We report a case of …

Single-Cell Transcriptomic Analysis Of Peripheral Blood Mononuclear Cells Reveals Key Immune Responses In St-Segment Elevation Myocardial Infarction, Zheng Zhang, Shengfang Wang, Yahui Liu, Gaohan Li, Qianqian Cheng, Wei Yang, Gan-Xin Yan, Chuanyu Gao

Department of Medicine Faculty Papers

BACKGROUND: Inflammation plays a crucial role in the pathogenesis of ST-segment elevation myocardial infarction (STEMI). However, the precise immunological mechanisms remain incompletely understood. Single-cell RNA sequencing (scRNA-seq) provides a powerful approach to dissect immune cell heterogeneity and dynamic changes at single-cell resolution.

METHODS: Peripheral blood mononuclear cells (PBMCs) were collected from 7 STEMI patients (within 6h after primary percutaneous coronary intervention) and 3 healthy controls. Single-cell suspensions were prepared and subjected to scRNA-seq using the 10x Genomics Chromium platform and Illumina NovaSeq 6000. Data were processed using Cell Ranger and analyzed with Seurat for quality control, clustering, and annotation. Differentially …

Diurnal Behavioral Outcomes And Bbb Integrity In Adult Male Shr And Wky Rats, Pallavi Shrivastava, Oluchukwu D. Biose, Riya Dahal, Abdallah Jwayyed, Rukayat A. Raji, Huijing Xia, Eric Lazartigues, Ifechukwude J. Biose

School of Graduate Studies Faculty Publications

Day and night neurobehavioral tests were performed for Spontaneously Hypertensive rats (SHR) and Wistar Kyoto rats (WKY) to establish an optimal testing window. Also, blood–brain barrier (BBB) integrity in brain areas related to cognition was measured to determine strain-specific differences. Six months old male SHR and WKY were randomly divided into day (i.e., 9–11 a.m.) and nighttime (i.e., 7–9 p.m.) testing regimen. Neurobehavioral tests included: Y-maze spontaneous alternation, open field, novel object recognition (NOR), and tail suspension test (TST). BBB integrity was measured in the cortex, hippocampus and striatum. WKY showed higher recognition memory at night compared to SHR and …

Hypertensive Remodelling: When Bigger Body Means Bigger Problems, Eric Lazartigues

School of Medicine Faculty Publications

No abstract provided.

Estrogen And Obesity Synergistically Suppress Protein S Via Hif1Α, Enhancing Thrombosis Potential, Mohammad A. Mohammad, Narender Kumar, Sonali Ghosh, Ashley L. Paysse, Claudia Leonardi, Vijaya Pilli, Ma Lorena Duhaylungsod, Eric Lazartigues, Diana Polania-Villanueva, Sadaf Nouman, Logan A. Barrios, Rima Chattopadhyay, Rafika Yasmin, Alaina Guilbeau, Manoj Kumar, Tina H. Nguyen, Jovanny Zabaleta, Li Li, Luis Del Valle M.D., Mallory T. Barbier, Samarpan Majumder, Laurent O. Mosnier, Samarpan Majumder

School of Graduate Studies Faculty Publications

Venous thromboembolism (VTE) is a leading cause of morbidity and mortality, with risk heightened in premenopausal women with obesity or use estrogen-based oral contraceptives. When both risk factors are present, the thrombosis risk increases substantially. Protein S (PS), an essential anticoagulant cofactor, is downregulated by both estrogen and obesity, but the molecular basis for this suppression remains poorly defined. We investigated the effect of estrogen and obesity on PS expression using plasma samples from 157 women stratified by BMI and contraceptive use, alongside 40 mice categorized as lean or obese with or without estrogen pellet treatment. The levels of PS …

Use Of Calcium Modification In Percutaneous Coronary Intervention: A Comprehensive Review, Noyan Ramazani, Ala W. Abdallah, Michael V. Dicaro, Divyansh Sharma, Aditi Singh, Kachon Lei

Department of Internal Medicine Faculty Research

Calcified coronary lesions remain a challenge in percutaneous coronary intervention (PCI) in both situations of acute myocardial infarction (MI) and stable coronary syndrome. It significantly increases the risk of procedural complications due to difficulty in equipment delivery, balloon expansion, and stent delivery. Furthermore, stent thrombosis, dissection, perforation, and future in-stent restenosis occur more frequently in calcified coronary lesions, impacting repeat target vessel revascularization and increasing the risk of future MI. With intracoronary imaging (intravascular ultrasound and optical coherence tomography), peri-procedural success for treating calcified lesions has increased significantly. Different modalities of calcium modification techniques have since been introduced. This review …

Two Cases Of Intramyocardial Dissecting Hematoma Diagnosed By Echocardiography, Jianbo Wu, Fei Bian, Xijun Zhu, Xin Du, Tao Hao, Qian Liu

Journal of Community Hospital Internal Medicine Perspectives

Intramyocardial dissecting hematoma (IDH), a rare complication of myocardial infarction, was investigated through two unique clinical cases in this study. We demonstrate echocardiography's pivotal role in emergency diagnostics by detailing its critical contribution to rapid identification. Furthermore, we propose a hypothesis regarding the anatomical subtypes of IDH, potentially offering new perspectives and insights into this rare cardiac condition.

Severe Myocarditis In The Pediatric Patient: A Simulation For Emergency Department Management, Prayerna Uppal, Anita Thomas, Robyn Wing, Lauren Kinneman, Cassandra Koid Jia Shin, Daisy Ciener, Jean I. Pearce, Claire Smith, Jennifer Reid, Kimberly Stone, Katina Summerford, Katherine Wolpert

School of Medicine Faculty Publications

Myocarditis in a pediatric patient can present with a variety of signs and symptoms, leading to a broad differential diagnosis. Delays in the correct identification of myocarditis and the initiation of appropriate interventions can have a detrimental impact on patient outcomes. In this case, a simulated five-year-old patient with myocarditis and secondary cardiogenic shock presents to the emergency department (ED). The goals of this simulation curriculum were to familiarize trainees and ED providers with the often nonspecific presentation of pediatric myocarditis, educate the care team about crucial interventions that positively or negatively impact the patient's stabilization course, and reinforce the …

Trypanosoma Cruzi Infection-Induced Changes In Cardiac Microvascular Endothelial Cell Morphology And Function, Lyndsey N. Gisclair, Douglas A. Johnston

School of Graduate Studies Faculty Publications

Introduction. Six to seven million individuals are infected with Trypanosoma cruzi, the causative agent of Chagas disease. With 12,000 deaths annually, chronic Chagas disease remains a significant global health challenge due to persistent vector transmission, increasing non-vector transmission and limited therapeutic options. Chronic Chagas cardiomyopathy is a leading cause of morbidity and mortality, yet the underlying mechanisms remain poorly understood.Gap Statement. Since its initial description more than 100 years ago, research efforts into the cardiomyopathy found in chronic Chagas disease have primarily focused on the contributions of immune cells, cardiomyocytes and cardiac fibroblasts, leaving a significant gap in understanding the …

Acute Gastropericardial Fistula With Cardiac Tamponade And Septic Pericarditis Due To Helicobacter Pylori–Induced Gastric Ulcer Perforation, Stephen J. Bordes, Christopher D. Oubre, Preethi H. Kanumuri, Nicholas Leblanc, Richard Lewis, Thomas Marsden, Terry Stelly

School of Medicine Faculty Publications

No abstract provided.

Development Of A Longitudinal, Small-Group Pocus Curriculum For Internal Medicine Residents, Shah N. Mahmud Do, Ammar W. Bhatti Do, Ariq Rahman Md, Omar Al Qassab Md, Fraser Mackay Md

The Lahey Journal

Development of a Longitudinal, Small-Group POCUS Curriculum for Internal Medicine Residents

Introduction

Point-of-Care Ultrasound (POCUS) is integral for clinicians to enhance their diagnostic and procedural skills. Unlike Emergency Medicine or Anesthesia training programs, Internal Medicine programs often lack a structured and standardized curriculum. We thus developed a longitudinal and multi-pronged POCUS curriculum aimed at building trainee competency when utilizing ultrasound for diagnostic and procedural work-up.

Methods

The curriculum encompasses the following: basics of ultrasound, ultrasound-guided procedures, thoracic ultrasound/Bed Lung Ultrasound in Emergency (BLUE), and cardiac ultrasound/Focus-Assessed Transthoracic Echocardiography (FATE). These modules were integrated into the residents’ clinic blocks. We utilized …

Selective Depletion Of Gut Gram-Negative Bacteria Attenuates Alcohol Binge-Induced Cardiovascular Dysfunction By Lowering Cardiac Anandamide Levels, Sarah E. Cohen, Meagan E. Donovan, Davin J. Gardner, Danielle Sambo, Seray B. Karagoz, Resat Cinar, David Goldman, Jason D. Gardner, Pal Pacher, Janos Paloczi

School of Graduate Studies Faculty Publications

Binge drinking contributes to an increasing number of emergency department visits in the United States. Previous work demonstrated that an alcohol binge impairs cardiac performance and exerts complex hemodynamic effects through the activation of the endocannabinoid-mediated cannabinoid type 1 receptor (CB1R) signaling pathway. Anandamide (AEA), an endogenous CB1R agonist, is synthesized in response to various stressors and tissue injury. However, the role of binge drinking in increasing myocardial AEA levels, which leads to CB1R-dependent cardiodepression, remains unclear. This work studied how endotoxins from intestinal Gram-negative bacteria affect myocardial AEA levels, which further induce CB1R-dependent cardiac dysfunction following acute alcohol intoxication. …

Two Interesting Cases Of Left Ventricular Free Wall Rupture In Myocardial Infarction, Astha Prasai, Nada Hafez, Mallory A. Balmer-Swain, Rawa Sarji

Advances in Clinical Medical Research and Healthcare Delivery

We present two interesting cases of left ventricular free wall rupture following ST elevation myocardial infarction. First case was not identified on echocardiography and angiography despite high suspicion and later underwent emergent lifesaving mediastinal exploration and repair. Second case had a delayed presentation of inferior STEMI and cardiac tamponade. These cases highlight the diagnostic challenges and variable presentations of left ventricular free wall rupture (LVFWR).

Short Term Hemodynamic Effects Of Atrial Fibrillation In A Closed-Loop Human Cardiac-Baroreflex System, Oluwasanmi Adeodu, Michelle Gee, Babak Mahmoudi, Rajanikanth Vadigepalli, Mayuresh V. Kothare

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Atrial fibrillation (AF) remains the leading cardiac cause of stroke and AF-related death rate in the United States has been increasing for over twenty years. While the effect of standalone AF on heart rate is well established, there is a lack of clarity on its impact on other critical hemodynamic metrics. This is ostensibly due to interaction with other common comorbidities, especially hypertension. In addition, AF has a complex relationship with the state of the baroreflex. Evidence indicates that baroreflex sensitivity (BRS), the ability of the intrinsic cardiac control system to initiate parasympathetic response, is suppressed during AF. Therefore, a …

Female Cardioprotection In A Mouse Model Of Alcohol-Associated Cardiomyopathy, Joshua M. Edavettal, Meagan Donovan, Nicholas R. Harris, Xavier R. Chapa-Dubocq, Keishla M. Rodríguez-Graciani, Janos Paloczi, Liz Simon, Bysani Chandrasekar, Jason D. Gardner

School of Graduate Studies Faculty Publications

Chronic alcohol misuse is the leading cause of non-ischemic dilated cardiomyopathy, and the molecular mechanisms underlying the development of alcohol-associated cardiomyopathy (ACM), particularly regarding sex-specific susceptibility and mitochondrial contributions, are not fully known. In this study, we utilized a preclinical model of chronic + binge ethanol consumption to investigate sex differences in disease severity and mitochondrial function. Male and female C57BL/6J mice were fed ethanol or control liquid diets for 30 days, with 2 binge episodes on days 10 and 30. Cardiac morphology was assessed via echocardiography and cardiac function via left ventricular pressure-volume catheterization. Mitochondrial function was evaluated ex …

Overview Of Exosomal Non-Coding Rnas In Cardiovascular Disease Using High Throughput Sequencing, Mortaza Eivazi, Leila Abkhooie, Kamran Hosseini, Parnia Mobasheran, Tahereh Ebrahimi, Vahideh Tarhriz, Eric Lazartigues

School of Graduate Studies Faculty Publications

Non-coding RNAs including miRNAs, long-ncRNAs, and circular RNAs play crucial roles in cell-to-cell communication and epigenetic regulation. They control gene expression at multiple levels, including transcriptional, post-transcriptional, and translational, thereby influencing associated signaling pathways. Encapsulated within exosomes, micro-vesicles, and apoptotic bodies, ncRNAs can be transported between cells while being protected from harsh environmental conditions. Studies have shown various expression patterns across different cell types and in various physiological and pathological states. However, the precise correlations and extent of their contribution to diseases are still under investigation. Recent studies have reported the involvement of extracellular vesicle-associated ncRNAs in the pathogenesis of …

Patient- And Proxy-Reported Outcome Measures For Use In Pulmonary Hypertension: Study Protocol For A Cosmin-Based Systematic Review, Meredith T. Yeung, Melissa Y. Chan

Internet Journal of Allied Health Sciences and Practice

Purpose: Pulmonary hypertension (PH) is a severe and progressive disease that significantly affects patients' physical, emotional, and social well-being. Despite advances in medical therapies, managing PH remains challenging, and the need for practical, patient-centred tools to evaluate therapeutic outcomes is critical. Patient-reported outcome measures (PROM) and proxy-reported outcome measures (proxy ROM) are pivotal in assessing the therapeutic impacts of interventions, including symptom relief, treatment efficacy, and quality of life. However, there has yet to be a comprehensive review of the psychometric properties of these tools in PH, hindering their optimal use in both clinical practice and research. This protocol outlines …