Cardiovascular Diseases Commons^™

Role Of Serum Biomarkers In Early Detection Of Diabetic Cardiomyopathy In The West Virginian Population, Adam Shaver, Alexandra Nichols, Ellen A. Thompson, Amrita Mallick, Nandini Manne, Shanmuga Sundaram, Joseph I. Shapiro Md, Komal Sodhi

Biochemistry and Microbiology

Objectives: Diabetic cardiomyopathy (DCM) is an established complication of diabetes mellitus. In West Virginia, the especially high incidence of diabetes and heart failure validate the necessity of developing new strategies for earlier detection of DCM. Since most DCM patients remain asymptomatic until the later stages of the disease when the fibrotic complications become irreversible, we aimed to explore biomarkers that can identify early-stage DCM.

Methods: The patients were grouped into 4 categories based on clinical diabetic and cardiac parameters: Control, Diabetes (DM), Diastolic dysfunction (DD), and Diabetes with diastolic dysfunction (DM+DD), the last group being the preclinical DCM group.

Results: …

Effectiveness Of Pharmacist-Led Amiodarone Monitoring Services On Improving Adherence To Amiodarone Monitoring Recommendations: A Systematic Review, Dave L. Dixon, Steven P. Dunn, Michael S. Kelly, Timothy R. Mcllarky, Roy E. Brown

Pharmacy Faculty Articles and Research

Amiodarone remains the mostly frequently used antiarrhythmic in clinical practice and is most often used to maintain normal sinus rhythm in patients with atrial fibrillation who have failed a rate control strategy. Amiodarone has superior efficacy over other antiarrhythmics, a lower risk of torsade de pointes, and a better cardiovascular safety profile in patients with structural heart disease. However, amiodarone is associated with notable noncardiac toxicities affecting the thyroid, lungs, eyes, liver, and central nervous system. Since 2000, clinicians have been advised to follow amiodarone monitoring guidelines provided by the Heart Rhythm Society. Adherence to these recommendations in clinical practice, …

Stakeholder Perspectives On Changes In Hypertension Care Under The Patient-Centered Medical Home, Alison J. O'Donnell, Hillary R. Bogner, Peter F. Cronholm, Katherine Kellom, Michelle Miller-Day, Heather F. De Vries Mcclintock, Elise M. Kaye, Robert Gabbay

Communication Faculty Articles and Research

Introduction

Hypertension is a major modifiable risk factor for cardiovascular and kidney disease, yet the proportion of adults whose hypertension is controlled is low. The patient-centered medical home (PCMH) is a model for care delivery that emphasizes patientcentered and team-based care and focuses on quality and safety. Our goal was to investigate changes in hypertension care under PCMH implementation in a large multipayer PCMH demonstration project that may have led to improvements in hypertension control.

Methods

The PCMH transformation initiative conducted 118 semistructured interviews at 17 primary care practices in southeastern Pennsylvania between January 2011 and January 2012. Clinicians (n …

Cutting The Cost Of Health Care: The Physician's Role, Herbert L Fred

The Texas Heart Institute Journal

No abstract provided.

The Mosaic Mitral Valve Bioprosthesis: A Long-Term Clinical And Hemodynamic Follow-Up, Michele Celiento, Stefania Blasi, Andrea De Martino, Stefano Pratali, Aldo D Milano, Uberto Bortolotti

The Texas Heart Institute Journal

We reviewed the cases of 100 patients (mean age, 73 ± 10 yr; 64 men) who had mitral valve replacement with a Medtronic Mosaic porcine bioprosthesis from 1995 through 2011. The mean New York Heart Association (NYHA) class was 3 ± 0.7, and 52 patients were in atrial fibrillation. Prosthetic sizes were chiefly 27 mm (50 patients) and 29 mm (40 patients). Follow-up ended in December 2012 and is 97% complete, with a cumulative duration of 611 patient-years (mean duration, 6 ± 4.6 yr; maximum, 17.7 yr). The early mortality rate was 10% (6% in elective patients); late deaths occurred …

Durability Of The Starr-Edwards Heart Valve: Early Decisions Led To Successful Results, Albert Starr, Gary L Grunkemeier

The Texas Heart Institute Journal

No abstract provided.

Alternative Surgical Approach To Repairing A Giant Sinus Of Valsalva Aneurysm, Vincenzo Giambruno, Cristina Cucchietti, Calogera Pisano, Jonathan Hyde

The Texas Heart Institute Journal

We report our method of surgically repairing an unruptured giant aneurysm of the right coronary sinus of Valsalva, a lesion that caused moderate aortic regurgitation but no symptoms in a 61-year-old woman. We excised the aneurysm, reconstructed the right sinus of Valsalva with use of a patch, performed mechanical aortic valve replacement directly through the excised aneurysm's cavity, and constructed a single bypass graft to the right coronary artery. The patient was discharged from the hospital after 5 days. Twelve months postoperatively, her clinical and echocardiographic results were normal, and she was doing well. To our knowledge, our surgical approach …

Aortic Dissection Caused By Percutaneous Coronary Intervention: 2 New Case Reports And Detailed Analysis Of 86 Previous Cases, Priyank Shah, Sharad Bajaj, Fayez Shamoon

The Texas Heart Institute Journal

Aortic dissection, a rare sequela of percutaneous coronary intervention, can be fatal when it is not recognized and treated promptly. Treatment varies from conservative management to invasive aortic repair and revascularization. We report the cases of 2 patients whose aortic dissection was caused by percutaneous coronary intervention. In addition, we present detailed analyses of 86 previously reported cases. Aortic dissection was most often seen during intervention to the right coronary artery (in 76.7% of instances). The 2 most frequently reported causes were catheter trauma (in 54% of cases) and balloon inflation (in 23.8%). The overall mortality rate was 7.1%. We …

Your Heart And Diabetes, Rodney Richmond

Faculty Research ​and Publications

No abstract provided.

Human Igg1 Antibodies Suppress Angiogenesis In A Target-Independent Manner, Sasha Bogdanovich, Younghee Kim, Takeshi Mizutani, Reo Yasuma, Laura Tudisco, Valeria Cicatiello, Ana Bastos-Carvalho, Nagaraj Kerur, Yoshio Hirano, Judit Z. Baffi, Valeria Tarallo, Shengjian Li, Tetsuhiro Yasuma, Parthasarathy Arpitha, Benjamin James Fowler, Charles B. Wright, Ivana Apicella, Adelaide Greco, Arturo Brunetti, Menotti Ruvo, Annamaria Sandomenico, Miho Nozaki, Ryo Ijima, Hiroki Kaneko, Yuichiro Ogura, Hiroko Terasaki, Balamurali K. Ambati, Jeanette H. W. Leusen, Wallace Y. Langdon, Michael R. Clark, Bradley D. Gelfand, Jayakrishna Ambati

Ophthalmology and Visual Science Faculty Publications

Aberrant angiogenesis is implicated in diseases affecting nearly 10% of the world’s population. The most widely used anti-angiogenic drug is bevacizumab, a humanized IgG1 monoclonal antibody that targets human VEGFA. Although bevacizumab does not recognize mouse Vegfa, it inhibits angiogenesis in mice. Here we show bevacizumab suppressed angiogenesis in three mouse models not via Vegfa blockade but rather Fc-mediated signaling through FcγRI (CD64) and c-Cbl, impairing macrophage migration. Other approved humanized or human IgG1 antibodies without mouse targets (adalimumab, alemtuzumab, ofatumumab, omalizumab, palivizumab and tocilizumab), mouse IgG2a, and overexpression of human IgG1-Fc or mouse IgG2a-Fc, also inhibited angiogenesis in wild-type …

The Value Of Contrast Echocardiography, Shannon C. Treiber, Bijoy K. Khandheria

Journal of Patient-Centered Research and Reviews

Purpose

There is much evidence-based research proving the effectiveness of contrast echocardiography, but there are still questions and concerns about its specific uses. This study tested the effectiveness of contrast echocardiography in defining the left ventricular endocardial border.

Methods

From 30 patients, a total of 60 echocardiograms –– 30 with and 30 without use of contrast –– were retrospectively reviewed by four blinded cardiologists with advanced training in echocardiography. No single cardiologist reviewed contrast and noncontrast images of the same patient. Each set of 30 echocardiograms was then studied for wall-motion scoring. Visualization of left ventricular wall segments and a …

Development And Validation Of A Preprocedural Risk Score To Predict Access Site Complications After Peripheral Vascular Interventions Based On The Vascular Quality Initiative Database, Daniel Ortiz, Maharaj Singh, Arshad Jahangir, Suhail Allaqaband, Anjan Gupta, Tanvir Bajwa, Mark W. Mewissen

Journal of Patient-Centered Research and Reviews

Purpose

Access site complications following peripheral vascular intervention (PVI) are associated with prolonged hospitalization and increased mortality. Prediction of access site complication risk may optimize PVI care; however, there is no tool designed for this. We aimed to create a clinical scoring tool to stratify patients according to their risk of developing access site complications after PVI.

Methods

The Society for Vascular Surgery’s Vascular Quality Initiative database yielded 27,997 patients who had undergone PVI at 131 North American centers. Clinically and statistically significant preprocedural risk factors associated with in-hospital, post-PVI access site complications were included in a multivariate logistic regression …

Non-Hdl-C Or Apolipoprotein-B Versus Ldl-C Screening For Evaluation And Treatment Of Atherosclerotic Cardiovascular Disease, Grant Coauette

Physician Assistant Scholarly Project Posters

• Lowering low-density lipoprotein cholesterol (LDL-C) concentration in the population has been a goal of researchers and clinicians to prevent atherosclerotic cardiovascular disease (ASCVD).

• Controversy surrounds using [LDL-C] as the primary lipid biomarker to evaluate the risk of cardiovascular events. An article search dating back to 2005 of PubMed and The Cochran Library was conducted.

• The purpose of this investigation was to determine if LDL-C should be the primary lipid biomarker used to determine ASCVD treatment and prevention. This investigation researched other lipid biomarkers and targets to determine clinical relevance and if the level of those markers more …

Screening For Cardiovascular Disease In Children, Jesse Fladmark

Physician Assistant Scholarly Project Posters

Introduction: Cardiovascular disease is one of the leading causes of death in the world with significant burden on the health care system.

Review of Literature: The focus of this paper is to look at previous studies, mostly systematic reviews and metaanalysis, in search of various clinical screening methods in the pediatric population for determining cardiovascular disease risk. Waist to height ratio can be used to screen children for cardiovascular disease with a specificity of 96% when using 0.55 as the cut-off point. An increase in waist circumference along with increased BMI places a child at a much higher risk of …

Serum Biomarkers Compared To Neural Imaging In The Differentiation Of Stroke Etiologies, Kevin Conboy

Physician Assistant Scholarly Project Posters

• Stroke is a leading cause of disability and morbidity and the fourth leading cause of death in the United States, and the second leading cause of death worldwide.

• Early restoration of blood flow is the most effective treatment of ischemic stroke by intravenous thrombolytic therapy within 3-4.5hrs of symptom onset.

• Patient outcomes have been shown to improve with earlier thrombolytics, each 15 minute increment increases survival by 3.0-4.0%.

• Non-contrast CT is the current standard for differentiation of stroke. It is beneficial due to speed of acquisition and its high sensitivity in ruling out hemorrhagic stroke.

• …

Patient Self-Management: Impact Of Racism-Related Vigilance In The Management Of Hypertension In African-Americans, Rackelle N. Wilkinson-Alston

Writing Across the Curriculum

It is important to understand the role that discrimination plays in health disparities. This paper will discuss racism-related vigilance, and its role in health outcomes in hypertensive African-Americans (AAs). This paper will also attempt to provide insight on how the absence of a culturally competent health care system may predispose AAs to developing stress-induced hypertension due to racism-related vigilance. This paper will explore how community partnership programs may be beneficial interventions for building resilience and promoting positive health behaviors among hypertensive AAs in the face of discrimination-related vigilance.

Trimethylamine N-Oxide: The Good, The Bad And The Unknown, Manuel T. Velasquez, Ali Ramezani, Alotaibi Manal, Dominic S. Raj

Medicine Faculty Publications

Trimethylamine N-oxide (TMAO) is a small colorless amine oxide generated from choline, betaine, and carnitine by gut microbial metabolism. It accumulates in the tissue of marine animals in high concentrations and protects against the protein-destabilizing effects of urea. Plasma level of TMAO is determined by a number of factors including diet, gut microbial flora and liver flavin monooxygenase activity. In humans, a positive correlation between elevated plasma levels of TMAO and an increased risk for major adverse cardiovascular events and death is reported. The atherogenic effect of TMAO is attributed to alterations in cholesterol and bile acid metabolism, activation …

Quality Of Life And Athletic Participation Assessment In Children And Adolescents With Congenital Heart Disease, Kayla Stuckey

Honors Program Theses

Just under 1% of infants are born with a heart defect [congenital heart disease (CHD)], and as a result of treatment and early diagnosis, 85% of these children survive into adulthood. Few studies have investigated the quality of life, global happiness, and athletic participation in pediatric populations, especially with respect to those who have CHD. In 2010, the number of people aged 0-18 years who had CHD was estimated to be between 1,905,000 and 2,102,000, and there are varying qualities of life that these children experience based on disease severity. In addition to patients who are born with CHD, children …

Coronary Flow Reserve In Adults With Systemic Right Or Single Ventricles, Laura J. Olivieri, Li-Yueh Hsu, Anitha S. John, Karen S. Kuehl, Andrew Arai

Pediatrics Posters and Presentations

No abstract provided.

A Feasibility Study Of A Lqts-Specific Workshop: Childrens' Problem-Solving Skills, Coping, Self-Efficacy, And Locus Of Control, Katherine L. Corvi

PCOM Psychology Dissertations

Living with a chronic medical condition in childhood and adolescence requires many critical lifestyle changes and restrictions, which may compromise psychosocial development. Social problem-solving skills have been shown to enhance the ability to cope with both minor and major daily stressors and to minimize psychological problems associated with physical health problems. The research is part of a larger study with children with long QT syndrome (LQTS) and their parents; the present study focuses on the children. This study was developed to examine the feasibility and efficacy of a problem-solving workshop to increase problem solving, self-efficacy, coping, and locus of control …