Circulatory and Respiratory Physiology Commons^™

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 …

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 …

Induction Of Myelopoiesis By Candida Dubliniensis Drives Protective Trained Immunity Against Sepsis In A Card9-Dependent Manner, Shannon Esher Righi, Elizabeth A. Lilly, Amanda J. Harriett, Patrick W. Daly, Maryjane Jones, Chad Steele, Mairi C. Noverr, Paul L. Fidel

School of Dentistry Faculty Publications

Trained immunity is a long-term functional reprogramming of innate cells that allows for the formation of immune memory akin to adaptive responses, but with a more rapid nonspecific response. We recently identified an anti-inflammatory trained immunity response, termed trained tolerogenic immunity (TTI), induced by low virulence Candida dubliniensis, that protects against acute lethal polymicrobial sepsis via myeloid-derived suppressor cells (MDSCs). Trained immunity and MDSCs arise following hematopoietic stem and progenitor cell (HSPC) expansion in the bone marrow. Here, we show that C. dubliniensis induces inoculum-dependent protection and HSPC expansion, whereas depletion of HSPCs following C. dubliniensis immunization abrogates protection. We …

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 …

Orthostatic Hypotension In Older Adults And Its Economic Impact On The Healthcare System: A Systematic Literature Review, Olushola E. Ilogho, Jennifer Broyles, Viet Le, Denise Rizzolo

Lynchburg Journal of Medical Science

ABSTRACT

Orthostatic Hypotension (OH) has been shown to lead to poor quality of life, falls, and death. Literature suggests that falls from OH may be preventable, therefore opportunities to reduce its associated cost to the healthcare system exist. This literature review aims to evaluate the importance of diagnosing and treating OH in older adult patients. OH is the drop in blood pressure upon changing to an upright position. This acute hemodynamic drop in blood pressure causes hypoperfusion in the brain, leading to dizziness, syncope, and falls. An extensive literature search for publications in PubMed and Cumulative Index in Nursing and …

The Science Of Sound: Studying The Cognitive, Emotional, And Physiological Effects Of Frequency, Genre, And Music, Jett Yarborough

Senior Honors Theses

Music influences emotion, physiology, and cognition, yet little is known about how the frequency it is tuned to affects these influences. Prior research has shown that music tuned to 432 Hz can reduce stress, lower blood pressure, and improve sleep. My colleagues and I conducted two studies to investigate this. Our research found that music tuned to 432 Hz promotes a significant increase in memory retention and induces a state of focus and relaxation. These results suggest that shifting from the standard tuning frequency of 440 Hz to 432 Hz could have a profoundly positive impact on our daily lives. …

Association Of Estimated Plasma Volume Status With Invasive Hemodynamics And Adverse Clinical Outcomes In Patients With Pulmonary Hypertension And Chronic Kidney Disease, Andrew Geller, Jose Manuel Martinez Manzano, Esteban Kosak Lopez, Phuuwadith Wattanachayakul, John Malin, Raul Leguizamon, Tara John, Rasha Khan, Ian Mclaren, Alexander Prendergast, Simone Jarrett, Kevin Bryan Lo, Christian Witzke

Einstein Health Papers

Identifying noninvasive measures to assess intravascular volume status and risk stratify patients with pulmonary hypertension (PH) and chronic kidney disease (CKD) is needed. We assessed the predictive value of estimated plasma volume status (ePVS) using the Strauss-derived Duarte formula in PH-CKD patients. This single-center retrospective cohort analysis included patients with PH and CKD Stage 3b (CKD3b), Stage 4 (CKD4), or Stage 5 (CKD5) who underwent right heart catheterization from 2018 to 2023. Patients were categorized into low ePVS (< 6.2) and high ePVS (≥ 6.2) using Youden's J statistics. We used the Cox-proportional hazards model, adjusting for age, sex, and body mass index, to investigate the association between …

Trajectory Of Iron And Red Cell Parameters In Moderately Anemic Iron-Deficient Pregnant Women Receiving Daily Iron-Folic Acid Supplementation: A Prospective Cohort Study, J. P. Akshaykirthan, Manjunath S. Somannavar, S. Yogeshkumar, M. S. Deepthy, Umesh Charantimath, Amaresh Patil, Mrutyunjaya B. Bellad, Richard Derman, Shivaprasad S. Goudar

Global Health Articles

Background/Objectives: The objective is to study the trajectories of hematologic and biochemical markers in moderately anemic pregnant women receiving oral iron supplementation throughout pregnancy. Methods: This prospective cohort study was conducted from August 2021 to September 2023 involving 315 pregnant women from rural areas of Belgaum, Karnataka, India, with hemoglobin levels between 7.0 and 9.9 g/dL and serum ferritin < 30 ng/mL and/or TSAT < 20%. Participants received iron-folic acid supplementation (IFAS) as per Anaemia Mukt Bharat guidelines. Blood samples were collected to measure various hematologic and iron markers and compared across each visits. Results: We report a complete adherence rate of 95.3% for iron and 97.8% for folic acid supplementation throughout pregnancy and also observed significant improvements in hemoglobin (9.36 (8.55, 9.74) to 12.03 (11.49, 12.72)) g/dL, hematocrit (29.93 ± 2.87 to …

Bilateral Pulmonary Embolism With Bi-Atrial Cardiac Thrombi Entrapped In A Patent Foramen Ovale, Denise Mourad, Fahd Eissa Mohamed, Yashi Ballal, Elie Mrad, Natasa Petreska, Sachin Singh, Paritharsh Ghantasala

Journal of Community Hospital Internal Medicine Perspectives

Bi-atrial thrombi with bilateral pulmonary embolism (PE) through a patent foramen ovale (PFO) is rare and life-threatening, requiring urgent management due to embolization risk. We present a 53-year-old female with left lower extremity extensive deep vein thrombosis (DVT), bilateral PE, and bi-atrial thrombi straddling a PFO. She underwent thrombectomy, PFO closure, and pulmonary embolectomy but later experienced recurrent DVT and PE. Anticoagulation was limited due to bleeding risk given a recent neurosurgery. Literature lacks clear guidelines for managing such cases necessitating individualized treatment. This case highlights the complexity of bi-atrial thrombi with PFO and the need for further research to …

Cardiomyocyte Regeneration Therapy And Its Effect On Lvef And Scar Size- A Systematic Review And Meta-Analysis, Mahnoor Mahnoor, Syed Irtaza Hassan, Muhammad Bakhtiar, Salal Sharjeel, Roha Daneyal, Muhammad Ibrahim, Raheel Iftikhar

Kimmel Cancer Center Faculty Papers

BACKGROUND: Myocardial infarction (MI) results in loss of cardiomyocytes leading to heart failure. Despite advancements in pharmacotherapy and interventions such as revascularization, ischemic heart failure remains a challenge. Recent advancements in stem cell therapies, genetic engineering and bioengineering have shown to improve cardiac function and quality of life.

METHODOLOGY: Following PRISMA guidelines, randomized controlled trials clinical trials from last 12 years were systematically reviewed. All the patients included in these studies had ischemic heart failure and were subjected to different types of stem cell therapies. Protocol for this meta-analysis is registered on PROSPERO (Registration no: CRD42023399263). Data extraction and Quality …

Integrated Systems Biology Identifies Disruptions In Mitochondrial Function And Metabolism As Key Contributors To Hfpef, Andrew A. Gibb, Kyle Lapenna, Ryan B. Gaspar, Nadina R. Latchman, Yinfei Tan, Carmen Choya-Foces, Jake E. Doiron, Zhen Li, Huijing Xia, Michael P. Lazaropoulos, Mariell Conwell, Thomas E. Sharp, Traci T. Goodchild, David J. Lefer, John W. Elrod

School of Graduate Studies Faculty Publications

Heart failure with preserved ejection fraction (HFpEF) accounts for ∼50% of HF cases. The ZSF1-obese rat model recapitulates clinical features of HFpEF including hypertension, obesity, metabolic syndrome, exercise intolerance, and diastolic dysfunction. We utilized a systems-biology approach to define the metabolic and transcriptional signatures to gain mechanistic insight into pathways contributing to HFpEF development. Male ZSF1-obese, ZSF1-lean hypertensive controls, and WKY (wild-type) controls were compared at 14 weeks of age for extensive physiological phenotyping and left ventricle (LV) tissue harvesting for unbiased-metabolomics, RNA-sequencing, and mitochondrial morphology and function. Utilizing ZSF1-lean and WKY controls enabled a distinction between hypertension-driven molecular changes …

Using Atrial Pacing Trials After Tavr To Assess Conduction Abnormalities And Predict Need For Pacemaker Implantation, Hemish M. Philip, Matthew R. Summers, Shirish R. Yasa, Hasani Amir, Daiwik P. Munjwani, Thomas A. Cook, Matthew G. Jackson

Cardiovascular Research Symposium

Abstract:

Background: Transcatheter Aortic Valve Replacement (TAVR) is the standard of care for many patients with severe aortic stenosis who cannot undergo surgical intervention. However, conduction disturbances remain a frequent complication, particularly with self-expanding valves. This often leads to permanent pacemaker implantation (PPI). At Sentara Heart Hospital, atrial pacing at 140 bpm is standard practice during TAVR to assess AV conduction.

Objective: This study aims to evaluate whether preserved 1:1 atrioventricular (AV) conduction during routine atrial pacing at 140 bpm after self-expanding TAVR predicts a low likelihood of requiring PPI, thus yielding a high negative predictive value (NPV).

Methods: We …

Development Of Overt Hypo-Attenuated Leaflet Thickening Following Transcatheter Aortic Valve Replacement, Stephonda Lewis, Hemish M. Philip, Matthew Summers

Cardiovascular Research Symposium

Background: Transcatheter aortic valve replacement (TAVR) is a cornerstone therapy for severe aortic stenosis. Up to one-third of patients develop hypoattenuated leaflet thickening (HALT) within the first year post-TAVR. HALT, a form of leaflet thrombosis, can progress to leaflet immobility and structural deterioration. Despite its significance, no unified approach exists for screening or management of HALT after TAVR.

Case Presentation: A 64-year-old woman presented with shortness of breath on exertion. Exam revealed a 3/6 systolic murmur, and echocardiogram confirmed severe aortic stenosis. She underwent TAVR with resolution of symptoms and was discharged on clopidogrel (Plavix) as single antiplatelet therapy. Two …

Enhancing Cataract Surgery Outcomes: Optimal Use Of Pre- And Post-Operative Eye Drops, Keith Skolnick M.D., Anu Valiaveedu

Mako: NSU Undergraduate Student Journal

Many preoperative and postoperative cataract patients struggle with comprehending the use of prescription medication as directed. Language barriers and low health literacy levels are major factors contributing to improper use of prescriptions. To increase patients comprehension, the Fort Lauderdale Eye Institute employed an educational intervention consisting of a live presentation and an instructional video. Results found that 44% of patients were hesitant to ask questions to clinical staff, 32% felt overwhelmed, and nearly 70% lacked confidence in using their prescribed eye drops. Following the intervention, 91% of patients reported increased confidence in their medications, and most indicated that the video …

Effectiveness Of Glucagon-Like Peptide 1 Receptor Agonists In The Treatment Of Heart Failure, Lisa Kristen Schloemann

SIU Journal of Medical Science Scholarly Works

ABSTRACT

Purpose: The purpose of this article is to review the use of glucagon-like peptide 1 receptor agonists (GLP-1 RA) in heart failure (HF) treatment considering the HF phenotype and comorbidities, including type 2 diabetes mellitus (DM) and obesity.

Method: A PubMed and Google Scholar literature search was conducted with search terms, HF and GLP-1 RA. Seven pertinent articles were retrieved and served as the basis for this clinical review.

Results: The efficacy of GLP-1 RA therapy in patients with heart failure with reduced ejection fractions (HFrEF) is unclear, with one study showing increased adverse cardiac events including tachyarrhythmias, and …

Bcg Vaccine-Induced Innate And Adaptive Pulmonary Immunity Correlating With Protective Efficacy Against Mycobacterium Tuberculosis In The Lungs, Mayank Khanna, Alistair J. Ramsay

School of Graduate Studies Faculty Publications

Background/Objectives: Effective prophylaxis for Mycobacterium tuberculosis (Mtb) requires greater understanding of immune correlates of protection. With renewed interest in BCG as an Mtb vaccine, particularly via the intravenous (IV) route, our objective was to characterize both innate and adaptive immune correlates of vaccine-induced pulmonary immunity as potential biomarkers for protective efficacy in a murine model of Mtb infection. Methods: Mice were given BCG via different routes and some boosted with recombinant virus constructs encoding Mtb Ag85B. Responding innate lymphoid cell (ILC) populations, T cells and B cells were analyzed by fluorescence activated cell sorting (FACS) for surface markers and by …

Role Of Cardiac Ketone Body Metabolism In Myocardial Perfusion And Exercise Performance., Kara R. Gouwens

Electronic Theses and Dissertations

Cardiorespiratory fitness, a crucial determinant of overall health and a strong predictor of all-cause mortality, is largely dependent on the capacity of the cardiovascular system to deliver oxygen and nutrients. The heart, as the central pump, requires a continuous and adaptable oxygen supply, particularly during increased workload such as occurs with exercise. Impaired myocardial blood flow (MBF) in response to increased demand can lead to ischemia, limiting exercise capacity and potentially causing severe cardiac events. Interestingly, changes in myocardial metabolism and cardiac work correlate with changes in MBF. Therefore, understanding the regulation of MBF, especially the link between local cardiac …

The Glymphatic System And Sleep: Functional Relevance For Brain Homeostasis And Beyond, David Gozal

Marshall Journal of Medicine

It has been less than 15 years since the glymphatic system was identified. The discovery has revolutionized the understanding of the unique functions of cerebrospinal fluid (CSF) and the extracellular fluid within the central nervous system (CNS) and their unique connectivity to the rest of the body. The role of sleep in regulating glymphatic clearance from the brain and the potential reciprocal role of the glymphatic system in modulating regional neuronal activities, including sleep states, is rapidly emerging. It is shedding light on the role of sleep and the glymphatic system as toxic waste clearance facilitators for the brain, revealing …

The Effect Of Tranexamic Acid On Blood Coagulation In Primary Total Hip Arthroplasty Using Rotational Thromboelastometry: A Randomized Controlled Trial, Uzung Yoon, David Beausang, Elia Elia, Marc Torjman, Jeffrey Mojica, James J. Purtill, David Nazarian, P. Maxwell Courtney, Yoogoo Kang

Department of Anesthesiology Faculty Papers

BACKGROUND: Tranexamic acid (TXA), is commonly administered prophylactically to reduce blood loss in patients undergoing total hip arthroplasty (THA). However, its effect has never been studied. We hypothesized that no difference exists in the degree of fibrinolysis and blood loss between patients receiving prophylactic TXA and placebo.

METHODS: This double-blinded randomized-controlled trial included 50 patients undergoing primary THA in 2021-2023. Clinicaltrials.gov (NCT03897621). Rotational-thromboelastometry (ROTEM) were performed to test blood coagulability using non citrated whole blood (NATEM) and blood treated with TXA (T-APTEM). The intervention group received TXA intravenously. The placebo group received 0.9% sodium chloride solution. The primary outcome measure …

Exploring The Effect Of Led-To-Photodetector Spacing On Subcutaneous Photoplethysmography For Continuous Blood Pressure Measurement, Dario Cabal, Brian Nguyen, David B. Green, Kevin Kilgore, Varun Thakkar, Michael J. Fu, Steve J. Majerus

Student Scholarship

Photoplethysmography (PPG) is widely used to measure heart rate, blood oxygenation, and more recently, blood pressure. Implanted PPG systems offer the possibility to measure similar real-time measures of cardiovascular health, however, the detection method may vary due to a lack of capillary vessels for PPG sensors to observe in muscle tissue. To improve volumetric blood detection in large muscles, without relying on the capillary density of skin, a flexible PPG sensor was developed. The sensor included multiple spacing of illuminating infrared (IR) light emitting diodes (LEDs) and a single IR photodetector. This arrangement was expected to enable detection of blood …