Cardiovascular Diseases Commons^™

Comparative Outcomes Of Coil Embolization And Surgical Clipping In Elderly Patients With Subarachnoid Hemorrhage: A Systematic Review And Meta-Analysis, Yohanna Idsabella Rossi, Gabriel Bolner, Jonathan Costa Dall'acqua, Fabiana Dolovitsch De Oliveira, Lucas V. Zacaria, Taís L. Denicol, Michel Frudit, Natália Vasconcellos De Oliveira Souza

Department of Neurology Faculty Papers

BACKGROUND AND OBJECTIVES: Elderly patients with subarachnoid hemorrhage (SAH) face a disproportionately high burden of morbidity and mortality. While endovascular coiling is often favored in this population, direct comparisons with surgical clipping are limited. We conducted a meta-analysis to compare outcomes of clipping versus coiling in SAH patients aged ≥ 60 years.

METHODS: A systematic search of PubMed, Embase, and Cochrane databases identified studies comparing the two treatments in this age group. The primary outcome was a composite of unfavorable outcomes (modified Rankin Scale [mRS] > 2 and mortality). Secondary outcomes included mortality, favorable outcome (mRS 0-2), rebleeding, and hospital length …

Egg White Hydrolysate In Hypertension: A Mechanistic Investigation Of Gut Microbiota Dependent And Independent Pathways, Emerson David Nolasco

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Cardiovascular diseases are one of the leading causes of mortality worldwide in which hypertension is a risk factor. Present pharmacological interventions require long-term adherence to the therapy and are often associated with undesirable side effects. Moreover, treatments have overlooked the role of the microbiome in the development of hypertension. Egg white hydrolysate (EWH) has exhibited antihypertensive properties with potential to be used as a natural alternative for the prevention and management of hypertension. However, EWH peptide’s effect on the gut microbiome remains yet to be elucidated. Studies have described that a portion of the ingested protein can remain undigested as …

Cholesterol Crystal Embolization Induced Kidney Disease, Shohan Pervaze, Shreya Mohandas, Pushkas Gopalan, Stephen A. Morse, Siddhartha Bajracharya, Landon A. Krone, Farshid Yazdi

School of Medicine Faculty Publications

Cholesterol crystal embolization (CCE) results from the release of cholesterol crystals from ruptured atherosclerotic plaques into circulation, resulting in the occlusion of small arteries and arterioles in various organs. Ischemia triggers a systemic inflammatory response resulting in vascular obstruction and organ dysfunction. Kidneys are often involved because of the proximity to the aorta and CCE in the kidneys can result in acute, sub-acute, or chronic kidney disease. There are many known risk factors for renal involvement of CCE, including iatrogenic and spontaneous causes. The pathophysiology of CCE includes complex pathways that lead to acute and chronic effects that can have …

Metabolic Regulation Of Cardiac Fibroblast Phenotype And Function., Collin Kleis Wells

Electronic Theses and Dissertations

Cardiac fibroblasts are central effectors of cardiac repair after myocardial infarction (MI). In response to signaling cues, they differentiate to a range of phenotypes with robust capacities to synthesize and secrete extracellular matrix (ECM) and signaling molecules. Although activated fibroblast phenotypes are associated with pronounced changes in metabolism, it remains unclear how the metabolic network upholds the effector functions of fibroblasts in the post-infarcted heart. Here, we identified that critical enzymes in the phosphoenolpyruvate (PEP) cycle, i.e. pyruvate kinase muscle-2 (PKM2) and phosphoenolpyruvate carboxykinase-2 (PCK2), are elevated in the heart after MI and examined their role in regulating post-MI remodeling …

The Impact Of Estrogen Loss On Caveolin Expression And Cardiac Myocyte Remodeling In Ovariectomized Mice Following Chronic Sympathetic Stimulation, Juliana Barnie

Electronic Theses and Dissertations

Cardiovascular disease (CVDs) remains the top cause of death globally, with postmenopausal women at higher risk due to estrogen decline. Beta-Adrenergic (β-AR) signaling is a major regulator of heart function. Caveolins, structural proteins of caveolae, coordinate cell signaling activities in the heart by co-localizing with estrogen receptors and β-AR and contribute to maintaining healthy cardiac function. The caveolin scaffolding domain (CSD), a binding component of caveolin, has shown therapeutic potential in animal models of heart disease. However, most studies on CSD have been completed in male mice. This thesis evaluates the therapeutic potential of CSD in female mouse models and …

Unmasking The Heart Of Osimertinib: A Closer Look At Drug-Induced Cardiotoxicity, Muhammad Sabri, Aheed Javaid, Hussam Al Hennawi, Hamza Muhammadzai, Vamshi Mallavarapu

Abington Jefferson Health Papers

BACKGROUND: Osimertinib, a third-generation epidermal growth factor receptor tyrosine kinase inhibitor, is an effective therapy for epidermal growth factor receptor-mutated non-small cell lung cancer, but it has been associated with a higher incidence of cardiotoxicity.

CASE SUMMARY: A 91-year-old woman on osimertinib 80 mg daily presented with acute dyspnea and was found to have a newly reduced left ventricular ejection fraction of 30%. Coronary angiography excluded obstructive coronary disease. Osimertinib was discontinued, and guideline-directed medical therapy (GDMT) was initiated, resulting in left ventricular ejection fraction recovery to 60%. The patient was successfully rechallenged with osimertinib while continuing GDMT, without recurrence …

Small Current, Big Potential: Bridging Mechanistic Insight Of The Sk Channel With Translational Promise, Yang Zheng, Miao Zhang, Nipavan Chiamvimonvat

Pharmacy Faculty Articles and Research

"Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia, with a lifetime risk of approximately 1 in 4 for adults aged 40 years and above. Despite advances in clinical management, AF remains a major public health concern. Its burden extends beyond symptoms; it quadruples the risk of heart failure and increases the likelihood of stroke fivefold – strokes that are often more severe and fatal than those unrelated to AF. In the United States alone, AF-associated healthcare costs exceed $26 billion annually, and the cost is projected to grow as the population ages (Ko et al., 2025). Regarding current treatments, …

Policy Review Of The Aha Clinical Practice Guideline For Congestive Heart Failure: Evaluating Best Practices, Brenda E. Garcia

Student Scholarly Projects

Practice Problem: Congestive heart failure (CHF) is a significant public health challenge that impacts various populations and contributes to rising hospital admission rates.

PICOT: The PICOT question that guided this scholarly project was: For healthcare policymakers and interprofessional teams (P), how does a policy review of the American Heart Association’s Clinical Practice Guidelines for Heart Failure (I), guided by the CDC’s Polaris Framework (C), conducted over a 12-week period (T), evaluate alignment with evidence-based practices and potential for adoption in the care of patients with congestive heart failure (O)?

Evidence: This scholarly project focused on reviewing the current clinical guidelines …

Hospitalization Trends For Thromboembolic Events In Atrial Fibrillation: A 12-Year National Analysis, Moises Vasquez, Crystal Yan, Natacha Vargas, Samuel Vasquez, Litsa Lambrakos, Alex Velasquez, Jeffrey Goldberger, Raul Mitrani

Division of Cardiology Faculty Papers

BACKGROUND: Direct oral anticoagulants and percutaneous left atrial appendage occlusion (LAAO) devices were approved for use in 2010 and 2015, respectively. It is unknown to what extent, if any, these new stroke preventive therapies have impacted hospitalizations for thromboembolic (TE) events.

OBJECTIVES: To evaluate temporal trends in AF-related hospitalizations for acute ischemic stroke (AIS), transient ischemic attack (TIA), and systemic embolism (SEE) in the U.S. from 2010 to 2021.

METHODS: Using the National Inpatient Sample, we identified hospitalizations for TE events with comorbid AF. Data were grouped into two periods (2010-2015 and 2016-2021). Linear regression assessed trends in TE frequency. …

Anesthetic Management For Delivery In Parturients With Heart Disease: A Narrative Review, Shahab Ahmadzadeh, Drake P. Duplechin, Paris D. Bailey, Dillon T. Duplechan, Alexia J. Enache, Peyton Moore, Sahar Shekoohi

School of Medicine Faculty Publications

Cardiac disease remains a leading cause of maternal morbidity and mortality, particularly in developed countries where improved survival has increased the number of pregnant patients with congenital heart disease. The physiological changes of pregnancy, such as increased blood volume, cardiac output, and hypercoagulability, can exacerbate preexisting cardiac conditions, posing significant anesthetic challenges during cesarean delivery. This review outlines anesthetic strategies for parturients with structural or functional cardiac disease, emphasizing individualized, multidisciplinary care. We examine general and regional anesthesia approaches, intraoperative monitoring, and hemodynamic goals, including fluid balance, venous return optimization, and myocardial oxygen demand reduction. Preoperative risk stratification and coordination …

Prognostic Value Of Lipoprotein(A) For Cardiovascular Events After Lower Limb Revascularization In Diabetic Patients With Chronic Limb-Threatening Ischemia, Federico Biscetti, Maria Margherita Rando, Maria Anna Nicolazzi, Flavia Angelini, Roberto Iezzi, Luis H. Eraso, Paul J. Dimuzio, Dario Pitocco, Massimo Massetti, Antonio Gasbarrini, Andrea Flex

Department of Surgery Faculty Papers

BACKGROUND: Chronic limb-threatening ischemia (CLTI) presents a major clinical challenge in patients with Type 2 Diabetes Mellitus (T2DM), requiring lower extremity revascularization (LER) to mitigate adverse cardiovascular and limb outcomes. Lipoprotein(a) (Lp(a)) has been implicated in cardiovascular risk, but its role in patients with T2DM and CLTI undergoing revascularization remains unclear. Thus, this study aimed to investigate the prognostic value of Lp(a) levels in diabetic CLTI patients for major adverse cardiovascular events (MACE), major adverse limb events (MALE), or both after LER.

METHODS: In this prospective cohort study of 158 individuals with T2DM and CLTI undergoing LER, baseline clinical data …

Modulation Of Redox-Sensitive Cardiac Ion Channels, Rawan S. Orfali, Al Hassan Gamal El-Din, Varnika Karthik, Elisanjer Lamis, Vanna Xiao, Alena Ramanishka, Abdullah Alwatban, Osama Alkhamees, Ali Alaseem, Young-Woo Nam, Miao Zhang

Pharmacy Faculty Articles and Research

Redox regulation is crucial for the cardiac action potential, coordinating the sodium-driven depolarization, calcium-mediated plateau formation, and potassium-dependent repolarization processes required for proper heart function. Under physiological conditions, low-level reactive oxygen species (ROS), generated by mitochondria and membrane oxidases, adjust ion channel function and support excitation–contraction coupling. However, when ROS accumulate, they modify a variety of important channel proteins in cardiomyocytes, which commonly results in reducing potassium currents, enhancing sodium and calcium influx, and enhancing intracellular calcium release. These redox-driven alterations disrupt the cardiac rhythm, promote after-depolarizations, impair contractile force, and accelerate the development of heart diseases. Experimental models demonstrate …

Exploring Sex-Specific Clinical Features In Chinese Patients With Takotsubo Syndrome, Hong-Yi Duan, Ling-Lin Wang, Ling-Chun Lyu, Zhen-Hua Shi, Xiao-Ping Lin, Zheng-Yang Yu, Guo-Hua Fan, Jing Chen, Xin-Hong Yang, Wei Deng, Chang-Wu Xu, Yan Huang, Qing Zhou, Jin-Ling Chen, Hong-Ning Song, Dong Hu, Jin-Qiu Liu, Hector Barajas-Martinez, Charles Antzelevitch, Kan Liu, Hong Jiang, Dan Hu

Department of Medicine Faculty Papers

BACKGROUND: Takotsubo syndrome (TTS) is considered as a transient acute heart failure syndrome predominant in females. However, data on Chinese TTS patients are limited. Therefore, this study aimed to investigate the clinical characteristics of Chinese TTS patients, identify prognostic markers.

METHODS: A total of 258 TTS patients were enrolled. Data on clinical characteristics and in-hospital major adverse cardiovascular events (MACE) were collected and analyzed. The latter included severe heart failure, shock, malignant arrhythmia, and death.

RESULTS: The average age of TTS patients was 59.3 ± 19.2 years. Female patients accounted for 68.9%. MACE occurred in 41.4% of patients during hospitalization. …

Factors Related To Hypertension In Pediatric Patients Who Do Not Have Obstructive Sleep Apnea: A Retrospective Chart Study, Alyssa Exarchakis, Alexandra Cohen, Penghao Wang, Seema Rani, Diana Martinez

Department of Medicine Faculty Papers

Background/Objectives: The relationship between OSA and adult hypertension has been extensively studied; however, it remains understudied in pediatric patients without OSA. The aim of this study is to identify factors associated with pediatric hypertension without OSA, through an IRB-approved retrospective chart review of patients who underwent polysomnography at Nemours Children's Hospital, DE/NJ between January 2020 and July 2023. Methods: Eligibility criteria included children 8-17 years, completed PSG, and clinic visit blood pressure (BP). Anthropometrics, demographics, social determinants, and medical history were obtained from electronic medical records. Hypertension was defined as the average systolic and/or diastolic BP that is …

Shared Genetic Architecture Of Posttraumatic Stress Disorder With Cardiovascular Imaging, Risk, And Diagnoses, Jie Shen, Wander Valentim, Eleni Friligkou, Cassie Overstreet, Karmel W. Choi, Dora Koller, Christopher J. O’Donnell, Murray B. Stein, Joel Gelernter, Haitao Lv, Ling Sun, Guido J. Falcone, Renato Polimanti, Gita A. Pathak, Edward Trapido, Ariane Rung, Et Al.

School of Public Health Faculty Publications

Patients with post-traumatic stress disorder face increased cardiovascular risk. This study examines shared genetic regions between post-traumatic stress disorder and 246 cardiovascular conditions across electronic health records, 82 cardiac imaging, and health behaviors defined by Life’s Essential 8. Post-traumatic stress disorder is genetically correlated with cardiovascular diagnoses in 33 regions, imaging traits in 4 regions, and health behaviors in 44 regions. Potentially shared causal variants between post-traumatic stress disorder and 17 cardiovascular conditions were observed in 11 regions. Subsequent observational analysis in AllofUS cohort showed post-traumatic stress disorder is associated with 13 diagnoses even after accounting for socioeconomic factors and …

Cardiac Rhythm Devices In Heart Failure With Reduced Ejection Fraction – Role, Timing, And Optimal Use In Contemporary Practice European Journal Of Heart Failure Expert Consensus Document, Biykem Bozkurt, Wilfried Mullens, Christophe Leclercq, Andrea M Russo, Gianluigi Savarese, Michael Böhm, Loreena Hill, Koichiro Kinugawa, Naoki Sato, William T Abraham, Antoni Bayes-Genis, Alexandre Mebazaa, Giuseppe M C Rosano, Shelley Zieroth, Cecilia Linde, Javed Butler

Faculty, Staff and Students Publications

Guidelines for management of heart failure with reduced ejection fraction (HFrEF) emphasize personalized care, patient engagement, and shared decision-making. Medications and cardiac rhythm management (CRM) devices are recommended with a high level of evidence. However, there are significant disparities: patients who could benefit from devices are frequently referred too late or not at all. Misconceptions about device therapy and the notion that the needs of patients (especially the prevention of sudden cardiac death) can now be met by expanding drug therapies may play a role in these disparities. This state-of-the-art review is produced by members of the DIRECT HF initiative, …

Impacts Of Radiation On Metabolism And Vascular Cell Senescence, Junichi Abe, Khanh Chau, Anahita Mojiri, Guangyu Wang, Masayoshi Oikawa, Venkata S K Samanthapudi, Abigail M Osborn, Keila C Ostos-Mendoza, Karla N Mariscal-Reyes, Tammay Mathur, Abhishek Jain, Joerg Herrmann, Syed Wamique Yusuf, Sunil Krishnan, Anita Deswal, Steven H Lin, Sivareddy Kotla, John P Cooke, Nhat-Tu Le

Faculty, Staff and Student Publications

Significance: This review investigates how radiation therapy (RT) increases the risk of delayed cardiovascular disease (CVD) in cancer survivors. Understanding the mechanisms underlying radiation-induced CVD is essential for developing targeted therapies to mitigate these effects and improve long-term outcomes for patients with cancer.

Recent Advances: Recent studies have primarily focused on metabolic alterations induced by irradiation in various cancer cell types. However, there remains a significant knowledge gap regarding the role of chronic metabolic alterations in normal cells, particularly vascular cells, in the progression of CVD after RT.

Critical Issues: This review centers on RT-induced metabolic alterations in vascular cells …

Clinical Outcomes After Hospitalization For Acute Coronary Syndrome In Patients Treated With Semaglutide Versus Bariatric Surgery: A Retrospective Multicenter Analysis, Nameer Ascandar, Charles Boadu, Gauthier Stepman, George Skaf, Olugbenga Oyesanmi, Sabry Omar, Rias Ali, Michael Schandorf-Lartey

HCA Healthcare Journal of Medicine

Background

Obesity is a chronic medical condition with a rising prevalence in the United States. A wide range of morbidity and mortality is associated with obesity, with coronary artery disease being among the most common. Ischemic heart disease continues to be the primary cause of death in the United States. Taken together, interventions to minimize the detrimental effects of obesity on patients at risk of heart disease will not only benefit the patient, but the health care system as well.

Methods

In this retrospective study, we used the HCA Healthcare enterprise data warehouse to identify all adult patients who were …

"What Is Causing This Sinus Tachycardia?", Muhammad Asad Hanif, Nayab Mirza, Jaswanth Jasti

Transformative Medicine

No abstract provided.

Intermittent Fasting For Metabolic Syndrome Management, Tony Laborde

Lynchburg Journal of Medical Science

This paper reviews the potential of intermittent fasting as a non-pharmacological therapeutic approach to the treatment of metabolic syndrome (MetS). MetS is a global health problem with risk factors that include obesity, hypertension, hyperglycemia, low high-density lipoprotein (HDL) cholesterol, and high triglycerides that predispose to cardiovascular disease and type 2 diabetes. Traditional treatment approaches, including pharmacological agents and lifestyle modification, are typically of short-term benefit. Intermittent fasting, with its scheduled cycles of eating and fasting, presents another strategy for improving weight control, insulin sensitivity, lipid profiles, and blood pressure. Various intermittent fasting regimens, including time-restricted feeding and alternate-day fasting, have …