Cardiology Commons^™

Reactive Hyperemia Occurs Via Activation Of Inwardly-Rectifying Potassium Channels And Na+/K+-Atpase In Humans, Anne R. Crecelius, Jennifer C. Richards, Gary J. Luckasen, Dennis G. Larson, Frank A. Dinenno

Anne R. Crecelius

Rationale: Reactive hyperemia (RH) in the forearm circulation is an important marker of cardiovascular health, yet the underlying vasodilator signaling pathways are controversial and thus remain unclear. Objective: We hypothesized that RH occurs via activation of inwardly rectifying potassium (KIR) channels and Na+/K+-ATPase and is largely independent of the combined production of the endothelial autocoids nitric oxide (NO) and prostaglandins in young healthy humans. Methods and Results: In 24 (23±1 years) subjects, we performed RH trials by measuring forearm blood flow (FBF; venous occlusion plethysmography) after 5 minutes of arterial occlusion. In protocol 1, we studied 2 groups of 8 …

Low-Density Lipoprotein Cholesterol Lowering Therapies: What Is On The Horizon?, Ramprasad Gadi, Vincent M. Figueredo, M.D.

Division of Cardiology Faculty Papers

Elevated low-density lipoprotein cholesterol (LDL-C) levels are associated with an increased risk for cardiovascular disease (CVD). Statins have been the cornerstone of lipid therapy to lower LDL-C for the past two decades, but despite significant clinical efficacy in a majority of patients, a large residual risk remains for the development of initial or recurrent atherosclerotic CVD. In addition, owing to the side-effects, a significant percentage of patients cannot tolerate any statin dose or a high enough statin dose. Thus, novel therapeutic agents are currently being developed to lower LDL-C levels further. This review will highlight these novel therapeutic agents including …

Double Inferior Venacava With Anomalous Hemiazygos Vein – A Case Report, Sumathilatha Sakthi Velavan, Bedia Castellanos, Sushama Rich, Robert B. Goldberg, Carlos Quinteros, Ramona Baez

Touro College of Osteopathic Medicine (New York) Publications and Research

Objective: Duplication of the inferior vena cava (IVC) is a rare variation that is caused by an alteration in the embryogenesis of the cardinal venous system. It is found in 0.3 to 3% of the population. There are various types of double IVC and this case is reported since it is unique among them. Materials and methods: During dissection of an eighty seven year old female cadaver, presence of an IVC was noted on either side of the abdominal aorta. The course and the termination of both the IVCs were dissected. The azygos and the hemiazygos veins were traced into …

Hyperplastic Cardiac Sarcoma Recurrence, M. A. Shariff, J. A. Abreu, F. Durrani, E. Daniele, K. C. Bowman, S. Sadel, K. T. Asgarian, J. T. Mcginn Jr., J. P. Nabagiez

Journal Articles

Primary cardiac sarcomas are rare tumors with a median survival of 6-12 months. Data suggest that an aggressive multidisciplinary approach may improve patient outcome. We present the case of a male who underwent resection of cardiac sarcoma three times from the age of 32 to 34. This report discusses the malignant nature of cardiac sarcoma and the importance of postoperative multidisciplinary care.

Acute Surgical Pulmonary Embolectomy: A 9-Year Retrospective Analysis, A. R. Hartman, F. Manetta, R. Lessen, R. Pekmezaris, A. Kozikowski, L. Jahn, M. Akerman, M. L. Lesser, L. R. Glassman, M. Graver, J. S. Scheinerman, R. Kalimi, R. Palazzo, S. Vatsia, G. Pogo, M. Hall, P. J. Yu, V. Singh

Journal Articles

Acute pulmonary embolism is a substantial cause of morbidity and death. Although the American College of Chest Physicians Evidence-Based Clinical Practice Guidelines recommend surgical pulmonary embolectomy in patients with acute pulmonary embolism associated with hypotension, there are few reports of 30-day mortality rates. We performed a retrospective review of acute pulmonary embolectomy procedures performed in 96 consecutive patients who had severe, globally hypokinetic right ventricular dysfunction as determined by transthoracic echocardiography. Data on patients who were treated from January 2003 through December 2011 were derived from health system databases of the New York State Cardiac Surgery Reporting System and the …

Right Heart Transvalvular Embolus With High Risk Pulmonary Embolism In A Recently Hospitalized Patient: A Case Report Of A Therapeutic Challenge, G. K. Acharya, A. M. Adedayo, H. Prabhu, D. R. Brinster, P. Mir

Journal Articles

Thrombus-in-transit is not uncommon in pulmonary embolism but Right Heart Transvalvular Embolus (RHTVE) complicating this is rare. A 54-year-old obese male with recent hospitalization presented with severe dyspnea and collapse. Initial investigations revealed elevated d-dimer and troponin. CTA showed saddle pulmonary embolus and bedside echocardiogram revealed right ventricular (RV) pressure overload and dilatation (RV > 41 mm), McConnell's sign, and mobile echodensity attached to tricuspid valve. Patient was immediately resuscitated and promptly transferred for surgical embolectomy under cardiopulmonary bypass. A long segment of embolus traversing through the tricuspid valve and extensive bilateral pulmonary artery embolus were removed. IVC filter was placed …

Microvolt T-Wave Alternans In Patients Undergoing Elective Coronary Artery Bypass Grafting: A Pilot Study, G. Khoueiry, M. Abdallah, M. Shariff, M. Kowalski, J. Lafferty

Journal Articles

INTRODUCTION: We designed a prospective observational study targeting a selective population of patients undergoing elective coronary artery bypass grafting with normal systolic function. In this study we looked at the prevalence of pre-operative microvolt T-wave alternans and if it predicts atrial fibrillation after surgery. METHODS: The inclusion criteria included all patients referred to the cardiothoracic outpatient clinic for elective bypass, who can perform aerobic exercise, with a recent exercise stress test exercising at least to 85% of the maximal predicted heart rate (220 - age) and with non-limiting chest pain at maximal exercise. Twenty patients met the inclusion/exclusion criteria between …

Antiplatelet Therapy Duration Following Bare Metal Or Drug-Eluting Coronary Stents: The Dual Antiplatelet Therapy Randomized Clinical Trial, D. J. Kereiakes, R. W. Yeh, J. M. Massaro, P. Driscoll-Shempp, I. T. Meredith, J. Ormiston, J. F. Tanguay, S. Windecker, K. N. Garratt, L. Mauri, +9 Additional Authors

Journal Articles

IMPORTANCE: Despite antirestenotic efficacy of coronary drug-eluting stents (DES) compared with bare metal stents (BMS), the relative risk of stent thrombosis and adverse cardiovascular events is unclear. Although dual antiplatelet therapy (DAPT) beyond 1 year provides ischemic event protection after DES, ischemic event risk is perceived to be less after BMS, and the appropriate duration of DAPT after BMS is unknown. OBJECTIVE: To compare (1) rates of stent thrombosis and major adverse cardiac and cerebrovascular events (MACCE; composite of death, myocardial infarction, or stroke) after 30 vs 12 months of thienopyridine in patients treated with BMS taking aspirin and (2) …

Fractured Inferior Vena Cava Filter Strut Presenting With St-Segment Elevation And Cardiac Tamponade, D. Khurana, J. Raza, S. Abrol, N.L. Coplan

Journal Articles

No abstract provided.

Sleep Deficiency And Deprivation Leading To Cardiovascular Disease, M. Kohansieh, A. N. Makaryus

Journal Articles

Sleep plays a vital role in an individual's mental, emotional, and physiological well-being. Not only does sleep deficiency lead to neurological and psychological disorders, but also the literature has explored the adverse effects of sleep deficiency on the cardiovascular system. Decreased quantity and quality of sleep have been linked to cardiovascular disease (CVD) risk factors, such as hypertension, obesity, diabetes, and dyslipidemia. We explore the literature correlating primary sleep deficiency and deprivation as a cause for cardiovascular disease and cite endothelial dysfunction as a common underlying mechanism.

Sleep Disorders, Obesity, Hypertension, And Cardiovascular Risk, S. I. Mcfarlane, O. Ogedegbe, A. N. Makaryus, C. Agyemang, G. Jean-Louis

Journal Articles

No abstract provided.

Left Ventricular Metastasis From A Primary Pancreatobiliary Tumor, A. N. Makaryus, L. Boxt

Journal Articles

Metastatic disease to the heart is not uncommon. We describe a case of a man in his 60s with an unusual metastasis to the heart and detail its intracardiac location by means of cardiac computerized tomography (CCT) and transthoracic echocardiography. To our knowledge, this is the first report of a pancreatobiliary tumor metastasizing exclusively to the left ventricle (LV) of the heart.

A Case Of Ventricular Fibrillation Triggered By Ventricular Premature Depolarizations Exiting From Different Sites Of The Purkinje Network, S. E. Mountantonakis, H. Ismail, D. Lin

Journal Articles

No abstract provided.

Age Influences Inflammatory Responses, Hemodynamics, And Cardiac Proteasome Activation During Acute Lung Injury, H. M. Linge, J. Y. Lee, K. Ochani, K. Koga, N. Kohn, K. Ojamaa, S. R. Powell, E. J. Miller

Journal Articles

Background: Acute lung injury (ALI) is a significant source of morbidity and mortality in critically ill patients. Age is a major determinant of clinical outcome in ALI. The increased ALI-associated mortality in the older population suggests that there are age-dependent alterations in the responses to pulmonary challenge. The objective of this observational study was to evaluate age-dependent differences in the acute (within 6 hours) immunological and physiological responses of the heart and lung, to pulmonary challenge, that could result in increased severity. Methods: Male C57Bl/6 mice (young: 2-3 months, old: 18-20 months) were challenged intratracheally with cell wall components from …

Use And Outcomes Associated With Bridging During Anticoagulation Interruptions In Patients With Atrial Fibrillation: Findings From The Outcomes Registry For Better Informed Treatment Of Atrial Fibrillation (Orbit-Af), B. A. Steinberg, E. D. Peterson, S. Kim, L. Thomas, B. J. Gersh, G. C. Fonarow, P. R. Kowey, K. W. Mahaffey, M. W. Sherwood, J. Ansell, +2 Additional Authors

Journal Articles

BACKGROUND: Temporary interruption of oral anticoagulation for procedures is often required, and some propose using bridging anticoagulation. However, the use and outcomes of bridging during oral anticoagulation interruptions in clinical practice are unknown. METHODS AND RESULTS: The Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry is a prospective, observational registry study of US outpatients with atrial fibrillation. We recorded incident temporary interruptions of oral anticoagulation for a procedure, including the use and type of bridging therapy. Outcomes included multivariable-adjusted rates of myocardial infarction, stroke or systemic embolism, major bleeding, cause-specific hospitalization, and death within 30 days. Of …

A Qualitative Study Of How Children Experience And Live With Long Qt Syndrome, Patrick Mcelwaine

PCOM Psychology Dissertations

Long QT syndrome (LQTS) is an inherited and potentially fatal disorder affecting approximately 1 in 2,000 people. Children often experience anxiety and a sense of loss of control as they try to manage the medical, social, and psychological stress that accompanies being diagnosed with LQTS. The present study utilized a qualitative research design to examine how children experience and live with long QT syndrome. Semistructured interviews were conducted with eight children between the ages of 7 to 12 who were diagnosed with LQTS. This period in a child’s life is very important for developing social skills and self-esteem as peers …

Rate Control Of Atrial Arrhythmias Can Be Achieved By Selective Cardiac Neurostimulation, Mark Marchitto, Aditya C. Sharma, Jeffrey P. Moak, Dingchao He, Conor Hynes, Gregory Trachiotis, Andy Blichard, Erin Montague, Xiyan Li, Gene Bornzin, Charles I. Berul, Richard A. Jonas, Marco A. Mercader

GW Research Days 2015

Introduction: Atrial arrhythmias (AA) occur in up to 40% of patients recovering from open-heart surgery (OHS). Pharmacologic treatment has been the main strategy used for the control of post-operative AA, but is associated with hypotension, pro-arrhythmia and myocardial dysfunction. There is a need for a reversible, modulated solution to rate control. We demonstrated the efficacy of vagal stimulation at inferior right fat pad (FP) to slow the ventricular response (VR) of atrial fibrillation (AF) and junctional ectopic tachycardia (JET). We hypothesized that the VR response to AA could be improved by alterations in 1) the site of stimulation (anterior right …

Screening For Sleep Apnea In The Heart Failure Population, Loreen M. Williams

Doctor of Nursing Practice (DNP) Projects

Background: Sleep disordered breathing (SDB) occurs in over half of the estimated 5.1 million people in the U.S. diagnosed with heart failure (HF). Evidence shows that treatment of SDB in this population decreases not only morbidity and mortality rates, but the overall cost burden of the disease as well. The routine use of a sleep apnea screening protocol in the HF population can help identify patients in need of treatment. Methods: A project was conducted at an urban community heart failure clinic to evaluate provider preference of three evidence-based screening tools to be included in the implementation of a comprehensive …

The Association Between Environmental Cadmium Exposure And All-Cause Mortality And Cardiovascular Disease In A Cohort Of Elderly Western Australian Women, Kane Deering

Theses : Honours

Introduction: Recent research suggests an association between environmental cadmium exposure and increased risk of, and death from, cardiovascular disease, the number one cause of mortality in Australia and worldwide. However, the research to date is neither comprehensive nor have there been any studies conducted on an Australian population. This study identified whether increasing concentrations of urinary cadmium in elderly West Australian women was associated with an increased odds of incidence of, and deaths from CVD, as well as all-cause mortality.

Method: Cadmium excretion was measured in urine samples collected at baseline (1998) from 1359 women from Perth who …

Measuring Adherence To Evidence-Based Practice Guidelines For The Management Of Hypertension In Women, Cristina M. Jorgensen

DNP Projects

Approximately 1 in 3 adults In the United States (U. S.) with approximately half being women have hypertension, a significant risk factor for cardiovascular disease (CVD) and stroke (Nwankwo, Yoon, Burt, & Gu, 2013). Nearly 70% of people who had a first heart attack, 80% of those who had a first stroke, and 75% of those who had congestive heart failure (CHF) have hypertension (Mozaffarian et al., 2013). Hypertension was the underlying or contributing cause of more than 375,000 deaths in 2011. Despite multiple publications of national hypertension guidelines, only 50% of adults with hypertension have their blood pressure under …