Cardiovascular Diseases Commons^™

Comparing The 2013 Acc/Aha & 2014 Nla Dyslipidemia Guidelines And Their Impact On Clinical Decision Making, Alexander Forbes, Kevin Grimes, Jocelyn York, Laura Tsu

Pharmacy Faculty Articles and Research

This home-study CPE activity has been developed to educate pharmacists on the similarities and differences between the 2014 NLA Recommendations for Dyslipidemia Management and the 2013 ACC/AHA Guidelines for Treatment of Blood Cholesterol.

Dopaminergic Signaling Within The Primary Cilia In The Renovascular System, Kimberly F. Atkinson, Samred H. Kathem, Xingjian Jin, Brian S. Muntean, Wissam A. Aboualaiwi, Andromeda M. Nauli, Surya M. Nauli

Pharmacy Faculty Articles and Research

Activation of dopamine receptor type-5 (DR5) has been known to reduce systemic blood pressure, most likely by increasing renal vasodilation and enhancing natriuresis in the kidney. However, the mechanism of DR5 in natriuresis and vasodilation was not clearly known. We have previously shown that DR5 is localized to primary cilia of proximal renal epithelial and vascular endothelial cells. We here show that selective activation of DR5 specifically induces calcium influx only in the primary cilia, whereas non-selective activation of dopamine receptor induces calcium fluxes in both cilioplasm and cytoplasm. Cilia-independent signaling induced by thrombin only shows calcium signaling within cytoplasm. …

The Efficacy Of Electrocardiograms As A Screening Tool To Detect Cardiac Abnormalities In Young Athletes, Cody William

Physician Assistant Scholarly Project Posters

• Sudden cardiac death (SCD) among athletes can be attributed to increased cardiovascular demands associated with vigorous exercise.

• The majority of athletes who experience sudden cardiac death are asymptomatic.

• Pre-participation history and physicals, (H&P) help to identify underlying cardiovascular disorders with the potential to increase the risk of SCD in an athlete.

• The efficacy of pre-participation H&Ps to identify underlying cardiac etiology has been debated.

• The purpose of this research is to:

---Determine incidence and cause of SCD among athletes (Table 1).

---Determine the efficacy and evidenced-based criteria for the interpretation of ECGs in athletes.

---Evaluate …

Information Maximizing Component Analysis Of Left Ventricular Remodeling Due To Myocardial Infarction, Xingyu Zhang, Bharath Ambale-Venkatesh, David A. Bluemke, Brett R. Cowan, J. Paul Finn, Alan H. Kadish, Pau Medrano-Gracia

Office of the President Publications and Research

Background: Although adverse left ventricular shape changes (remodeling) after myocardial infarction (MI) are predictive of morbidity and mortality, current clinical assessment is limited to simple mass and volume measures, or dimension ratios such as length to width ratio. We hypothesized that information maximizing component analysis (IMCA), a supervised feature extraction method, can provide more efficient and sensitive indices of overall remodeling.

Methods: IMCA was compared to linear discriminant analysis (LDA), both supervised methods, to extract the most discriminatory global shape changes associated with remodeling after MI. Finite element shape models from 300 patients with myocardial infarction from the …

Does Far Infrared Therapy Reduce The Incidence Of Arteriovenous Fistula Malfunction In Patients With Renal Disease Undergoing Hemodialysis?, Parker Barrett

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence based medicine review is to determine whether or not far infrared therapy reduces the incidence of arteriovenous fistula (AVF) malfunction in patients with renal disease undergoing hemodialysis.

STUDY DESIGN: Review of three primary randomized controlled trial studies published from 2007-2013.

DATA SOURCES: Three peer-reviewed randomized controlled trials studying the effectiveness of far infrared therapy in the preservation of native arteriovenous fistula function in patients with chronic kidney disease requiring hemodialysis. Data searches done in PubMed, CINAHL Plus and EBSCOhost.

OUTCOMES MEASURED: Primary outcome measured was episodes of AVF malfunction due to stenotic complication. …

Is Vitamin D Supplementation Effective In Improving Physical Performance In Older Patients With Heart Failure Who Are Over The Age Of 50 Years?, Sahba Yazdani

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not vitamin D supplement is effective in improving physical performance in older patients with heart failure over the age 50 years

STUDY DESIGN: Review of three English language primary studies, two published in 2010 and one was published in 2013.

DATA SOURCES: Two double blind randomized controlled trials (RCT) and one cross-sectional study that investigated the use of vitamin D in improving physical performance in heart failure. Sources were selected and found using PubMed, ScienceDirect, and Cochrane databases.

OUTCOMES MEASURED: The outcomes measured were improvement of physical …

Effects Of A Six-Week Functional Training Program On Fitness And Body Composition Of Fire Science Majors, Kristen Anne Lebrun

Online Theses and Dissertations

Introduction: The leading cause of on duty death of firefighters is sudden cardiac events. Current research has shown the effects of fire physical training programs on firefighters, but has not researched fire specific physical training programs for the fire science major population. Purpose: The purpose of this study was to examine the effects of a six-week functional program on fitness and body composition of fire science majors. Methods: Fire science college students (N = 16) volunteered to take part in a six-week fire specific fitness program. The subjects that fully completed the study (N = 12) were randomly assigned to …

Hypothyroidism And The Development Of Hypertension, Kaleb Short

All Graduate Theses, Dissertations, and Other Capstone Projects

Low thyroid hormone (TH) in adulthood is associated with increased risk of cardiovascular disease, including risk of hypertension. The Spontaneously Hypertensive Rat (SHR), exhibits alterations in thyroid function when compared to normotensive controls. Interestingly, inhibiting thyroid gland function before 4 weeks of age prevented hypertension in the SHR, indicating that TH is involved in the etiology of SHR hypertension. However, these studies utilized tail-cuff photoplethysmography (PPG), which is known to have stress-induced artifacts, and did not compare effects in the normotensive parent strain Wistar Kyoto (WKY) rat. Therefore, it is uncertain whether TH is responsible for an elevation in baseline …

Vitamin C: A Potential Regulator Of Inflammatory Response, Bassem M. Mohammed

Theses and Dissertations

Introduction: Neutrophils (PMNs) and Macrophages are the first responders recruited consecutively to the site of injury/inflammation. PMNs’ response/fate as well as macrophage reprogramming ultimately determine the course of resolution of inflammation. Physiologic wound healing has a significant inflammatory component. An exaggerated inflammation however is self-defeating leading to delayed healing. Parenteral vitamin C (VitC) attenuated inflammation in murine sepsis models and in patients with sepsis. However information about the mechanisms by which VitC regulates these events is limited.

Methods: Humanized mice lacking VitC synthesis capability (Gulo^-/-) were used. VitC sufficient and deficient mice were challenged with sterile inflammation, or …

Dual Pi3k/Mtor Inhibition With Bez235 Augments The Therapeutic Efficacy Of Doxorubicin In Cancer Without Influencing Cardiac Function, David E. Durrant

Theses and Dissertations

Cancer continues to be a leading cause death in the United States despite improved treatments. Cancerous lesions form after acquiring oncogenic driver mutations or losing tumor suppressor function in normal cells. Traditional therapies have included use of genotoxic substances that take advantage of the increased growth rate and loss of tumor suppressor function to cause cell death. One such drug is the anthracycline antibiotic doxorubicin (DOX). DOX interchelates into DNA and disrupts transcriptional machinery while also poisoning topoisomerase II. This results in single and double stranded DNA breaks, which if severe enough leads to either necrotic or apoptotic cell death. …

The Physiological Stress Response Caused By Hypoxia And Reperfusion Injury In Striped Bass (Morone Saxatilis) And Nile Tilapia (Oreochromis Niloticus), Amanda C. Reynolds

College of Graduate Studies: Theses & Dissertations

Approximately five million people in the United States are affected by cardiovascular related diseases yearly contributing to 300,000 annual deaths, making CVD the leading cause of mortality worldwide. It has been suggested that apoptosis (programmed cell death) contributes to the pathogenesis of cardiovascular diseases. When blood flow is reduced or cut off from the heart, usually by a thrombus, this results in oxygen deprivation (hypoxia) to the cardiomyocytes (heart cells). In response to this hypoxic stress, cardiomyocytes will undergo apoptosis. Since many species of fish can survive levels of hypoxia that would be fatal to mammals, fish are an ideal …

Cardiovascular Disease Risk Factors In Structural Firefighters, Nicholas W. Trubee

Theses and Dissertations--Kinesiology and Health Promotion

This dissertation is composed of two manuscripts assessing cardiovascular disease (CVD) risk in structural firefighters. Study 1 compared traditional CVD risk factors and health-related behaviors between professional and volunteer firefighters. Online questionnaires were sent to approximately 4000 firefighters in the state of Kentucky. The results indicated that 90% of volunteer and 58% of professional firefighters were classified as moderate-to-high CVD risk. Volunteer firefighters were significantly (p < 0.001) older and more likely (p = 0.026) to be current cigarette smokers. The mean body mass index among all firefighters in the sample was 30.8 kg·m^-2. Nearly 60% of volunteer firefighters were obese. Obese firefighters were more likely (p < 0.05) to have been diagnosed as diabetic or pre-diabetes compared to overweight and normal weight firefighters. These results indicate that volunteer firefighters may be at a greater CVD risk compared to professional firefighters.

Study 2 investigated the association of cardiorespiratory fitness (CRF) and body fat with arterial stiffness in professional firefighters. Forty-six …

Syndecan 4 Is Required For Endothelial Alignment In Flow And Atheroprotective Signaling, Nicolas Baeyens, Mary Jo Mulligan-Kehoe, Federico Corti, David D. Simon, Tyler D. Ross, John M. Rhodes, Thomas Z. Wang

Dartmouth Scholarship

Atherosclerotic plaque localization correlates with regions of disturbed flow in which endothelial cells (ECs) align poorly, whereas sustained laminar flow correlates with cell alignment in the direction of flow and resistance to atherosclerosis. We now report that in hypercholesterolemic mice, deletion of syndecan 4 (S4−/−) drastically increased atherosclerotic plaque burden with the appearance of plaque in normally resistant locations. Strikingly, ECs from the thoracic aortas of S4−/− mice were poorly aligned in the direction of the flow. Depletion of S4 in human umbilical vein endothelial cells (HUVECs) using shRNA also inhibited flow-induced alignment in vitro, which was rescued by re-expression …

Regulation Of C-Reactive Protein Gene Expression And Function, Avinash N. Thirumalai

Electronic Theses and Dissertations

Human C-reactive protein (CRP) is the prototypic acute phase protein whose serum concentration increases rapidly during inflammation. CRP is also associated with atherosclerosis; it is deposited at lesion sites where it may interact with modified lipoproteins. There are 2 major questions regarding CRP: 1. How is the serum concentration of CRP regulated? 2. What are the functions of CRP in atherosclerosis?

Our first aim was to determine the role of the constitutively expressed transcription factor Oct-1 in regulating CRP gene expression. We found that Oct-1 overexpression inhibited (IL-6+IL-1β)- induced CRP gene expression; maximal inhibition required the binding of Oct-1 to …

The Role Of Mcl-1 In The Heart: Gateway From Life To Death, Xi Wang

Theses and Dissertations (ETD)

MCL-1 is an essential BCL-2 family member that promotes the survival of multiple cellular lineages, but its role in cardiac muscle has remained unclear. Here, we have demonstrated that cardiac-specific ablation of Mcl-1 results in a rapidly fatal, dilated cardiomyopathy preceded by loss of myofibrils and cardiac contractility, abnormal mitochondria ultrastructure, defective mitochondrial respiration, and impaired autophagy. Genetic ablation of both pro-apoptotic effectors (Bax and Bak) could largely rescue the lethality and impaired cardiac function induced by Mcl-1 deletion. However, Mcl-1-, Bax-, and Bak-deficient hearts still revealed mitochondrial ultrastructural abnormalities and displayed deficient mitochondrial respiration, and are hypersensitive to chronic …

Group Iv Cytosolic Phospholipase A2Α Is Critical For The Development Of Angiotensin Ii-Induced Hypertension And Associated Pathogenesis, Nayaab Shehbaz Khan

Theses and Dissertations (ETD)

Angiotensin II (Ang II) activates cytosolic phospholipase A2α and releases arachidonic acid (AA) from tissue phospholipids. AA metabolites mediate or modulate one or more renocardiovascular effects of this peptide and have been implicated in hypertension. Since AA release is the rate limiting step in eicosanoid production, it is possible that cPLA2α might play a central role in the development of Ang II-induced hypertension. To test this hypothesis, we investigated the effect of Ang II infusion for 13 days by micro-osmotic pumps (700 ng/kg/min), on systolic blood pressure and associated pathophysiological changes in wild type (cPLA2α+/+) and cPLA2α-/- mice. Ang II …

Is Postpartum Depression A Disease Of Modern Civilization?, Jennifer Hahn-Holbrook, Martie Haselton

Psychology Faculty Articles and Research

Access to calorie-dense foods, medicine, and other comforts has made modern humans healthier than our prehistoric ancestors in many respects. However, the epidemics of obesity, diabetes, and cardiovascular disease suggest that there are also drawbacks to modern living. Here, we address the question of whether the dramatic cultural changes that have occurred over the past century have inflated rates of postpartum depression, adding postpartum depression to the list of diseases of modern civilization. We review evidence from cross-cultural, epidemiological, and experimental studies documenting associations between postpartum depression and modern patterns of early weaning, diets deficient in essential fatty acids, low …

Brachiocephalic Artery Cannulation In Proximal Aortic Surgery That Requires Circulatory Arrest, Mehmet Unal, Oguz Yilmaz, Ilker Akar, Ilker Ince, Cemal Aslan, Fatih Koc, Haluk Kafali

The Texas Heart Institute Journal

The brachiocephalic artery is an alternative cannulation site in the repair of ascending aortic lesions that require circulatory arrest. We evaluate the effectiveness and safety of this technique.

Proximal aortic surgery was performed in 32 patients from 2006 through 2012 via brachiocephalic artery cannulation and circulatory arrest. Twenty-four (75%) of the patients were men. The mean age was 48.69 ± 9.43 years (range, 30–68 yr). Twelve had type I dissection, 2 had type II dissection, and 18 had true aneurysms of the ascending aorta. All operations were performed through a median sternotomy. The arterial cannula was inserted through an 8-mm …

Repeated Transradial Catheterization: Feasibility, Efficacy, And Safety, Marinos A Charalambous, Savvas S Constantinides, Michael A Talias, Elpidoforos S Soteriades, Christos P Christou

The Texas Heart Institute Journal

Transradial access is an alternative to the transfemoral approach in coronary interventions. It results in less access-site bleeding, shorter hospital stays, lower costs, and less pain for the patient. However, some authors have suggested that the transradial approach might lead to radial artery occlusion, which precludes repeated same-artery catheterizations. Using data from our center, we evaluated the feasibility, safety, and efficacy of repeated transradial catheterization.

We reviewed the 3,006 transradial catheterizations performed at our center from 2006 through 2009. Patients who had undergone at least one repeated transradial catheterization were identified, their cases monitored through 2012, and their baseline characteristics …

Anticoagulation With Bivalirudin During Deep Hypothermic Circulatory Arrest In A Patient With Heparin-Induced Thrombocytopenia, Agamemnon Pericleous, Mostafa Sadek, Mary Fitzmaurice, Constance Caldwell, Kris Natividad, Konstadinos A Plestis

The Texas Heart Institute Journal

Heparin-induced thrombocytopenia is a well-recognized complication of anticoagulation with heparin. We present the case of a patient with recent heparin-induced thrombocytopenia who subsequently needed surgery on an emergency basis for acute type A aortic dissection. This article reports the successful use of bivalirudin, a direct thrombin inhibitor, as an alternative to heparin throughout cardiopulmonary bypass and deep hypothermic circulatory arrest. We contend that bivalirudin is a safe alternative to heparin when performing surgery for aortic dissection and should be considered as an option for use in patients who present with heparin-induced thrombocytopenia.