Cardiology Commons^™

Pathways From Socioeconomic Factors To Major Cardiovascular Events Among Postmenopausal Veteran And Nonveteran Women: Findings From The Women's Health Initiative, Hind A Beydoun, May A Beydoun, Rebecca L Kinney, Simin Liu, Rona Yu, Matthew Allison, Robert B Wallace, Qian Xiao, Longjian Liu, Philippe Gradidge, Su Yon Jung, Hilary A Tindle, Shawna Follis, Robert Brunner, Jack Tsai

Faculty, Staff and Student Publications

BACKGROUND: Cardiovascular disease (CVD) remains a leading cause of death for women in the United States, with veterans being at potentially higher risk than their nonveteran counterparts due to accelerated aging and distinct biopsychosocial mechanisms. We examined pathways between selected indicators of socioeconomic status (SES) such as education, occupation, household income, and neighborhood SES and major CVD events through lifestyle and health characteristics among veteran and nonveteran postmenopausal women.

METHODS AND RESULTS: A total of 121 286 study-eligible WHI (Women's Health Initiative) participants (3091 veterans and 118 195 nonveterans) were prospectively followed for an average of 17 years, during which …

Perspectives Of Policymakers On Barriers To And Enablers Of The Uptake Of Cardiac Rehabilitation In Saudi Arabia: A Qualitative Study, Ahmed Mohammed Almoghairi, Jane O’Brien, Jed Duff

Journal of the Saudi Heart Association

• Objectives: This study aimed to identify the barriers to and enablers of secondary prevention care and cardiac rehabilitation (CR) utilization by patients with coronary heart disease (CHD) following percutaneous coronary intervention (PCI) from the perspective of policymakers.
• Methods: A qualitative study involving an interpretive descriptive design was conducted through recorded semi-structured interviews with key decision-makers in cardiology care in Saudi Arabia. The analysis was guided by the updated Consolidated Framework for Implementation Research (CFIR), which informed the resulting themes.
• Results: Interviews were conducted with nine key decision-makers: four directors of major cardiac centers, four heads of cardiac rehabilitation units, and …

Venous Thromboembolism Prophylaxis In Orthopedic Surgery: A Narrative Review, Jacob Lahti, Sarah Gallitto, Thomas C. Varkey

Annual Research Symposium

This poster highlights current and updated guidelines for chemical and mechanical prophylaxis for venous thromboembolism in patients undergoing major and minor orthopedic surgery. Existing and new potential therapies were reviewed, as well as an analysis into the lack of high-quality risk-prediction score calculators to improve personalization of prophylaxis regimens. Alongside a summary of existing and potential new prophylaxis protocols, a call to action to improve validity of said risk score calculators so as to improve patient outcomes and personalized medicine is made.

Reply To Author Regarding The Letter “Postoperative Atrial Fibrillation After Cardiac Surgery”, Yasuhiko Imashuku, Susumu Hiraoka, Motoi Inoue, Takayoshi Mizuno, Misuzu Oyagi, Hirotoshi Kitagawa

Journal of the Saudi Heart Association

No abstract for this article type.

Postoperative Atrial Fibrillation After Cardiac Surgery, Mesut Engin, Abdulkerim Özkan, Abdurrahman Demirel

Journal of the Saudi Heart Association

No abstract for this article type.

Guideline-Directed Medical Therapy After Hospitalization For Acute Heart Failure: Insights From The Connect-Hf, Satoshi Shoji, Lisa Kaltenbach, Bradi B. Granger, Gregg C. Fonarow, Hussein R. Al-Khalidi, Nancy M. Albert, Javed Butler, Larry A. Allen, David E. Lanfear, Jennifer T. Thibodeau, Brittany M. Chapman, Sandra M. Oliver-Mcneil, G. Michael Felker, Ileana L. Piña, Christopher B. Granger, Adrian F. Hernandez, Adam D. Devore

Division of Cardiology Faculty Papers

BACKGROUND: Significant gap remains in the implementation of guideline-directed medical therapy (GDMT) in patients with heart failure after a hospitalization. We aimed to evaluate the use and titration of GDMT at discharge and over a 12-month period after hospital discharge and to identify factors associated with GDMT use and titration.

METHODS AND RESULTS: The CONNECT-HF (Care Optimization Through Patient and Hospital Engagement Clinical Trial for Heart Failure) trial evaluated the effect of a hospital and postdischarge quality improvement intervention in participants with heart failure with reduced ejection fraction. In this secondary analysis, we examined use and titration to at least …

Impact Of Aetiology On Short- And Long-Term Outcomes In Open Descending And Thoracoabdominal Aneurysm Repair, Joshua R. Chen, Christopher D. Pritting, Vishal N. Shah, Colin King, Jacqueline Mcgee, Konstadinos A Plestis

Department of Surgery Faculty Papers

OBJECTIVES: We analysed the impact of chronic type B aortic dissection (cTBAD) and degenerative aneurysm (DA) on the short- and long-term outcomes of patients undergoing open descending thoracic aortic aneurysm and thoracoabdominal aortic aneurysm repair.

METHODS: We performed a retrospective analysis of a prospectively maintained aortic database. From 1999 to 2023, 245 patients underwent open descending thoracic aortic aneurysm or thoracoabdominal aortic aneurysm repair. We compared preoperative comorbidities, postoperative complications and operative and long-term mortality for patients with cTBAD (120 patients, 49%) and DA (125 patients, 51%).

RESULTS: Patients with cTBAD were significantly younger, more likely to be male and …

A Retrospective Validation Of The Hear Score., Jordan Luli, Andrew Scheidemantel, Katelyn Bennett, Jessalyn Schafer, Andrew Costa, Marie Lockhart, Kevin Stiver

Heart and Vascular Articles

Studies have proposed the history, electrocardiogram, age, risk factors (HEAR) score to risk-stratify patients with chest pain in the emergency department. This paper assessed the utility of the HEAR score for ambulatory patients with chest pain. The findings demonstrate patients with low and high HEAR scores can be safely managed in the outpatient setting.

Prepared To Protect: Improving Cardiac Emergency Response In Youth Club Sports, Melissa Garcia

Nursing | Student Research Posters

Sudden cardiac arrest (SCA) is a medical emergency where the heart unexpectedly stops beating due to an electrical malfunction. A person experiencing a cardiac arrest collapses, loses consciousness, and ceases breathing (American Heart Association, 2022).

Exercise offers numerous benefits to the cardiovascular system and a person’s overall health. However, there are incidents of sports-related cardiac arrest in apparently healthy athletes, including children and young adults. Athletes may be exposed to dehydration, adrenic surges, electrolyte imbalances, acid/base disturbances, and trauma which increases their risk of experiencing a cardiac event (Wasfy et al., 2016).

Sudden cardiac arrest is the leading cause of …

Caffeine And Arrhythmias: A Critical Analysis Of Cardiovascular Responses And Arrhythmia Susceptibility, Adel Khalifa Sultan Hamad

Journal of the Saudi Heart Association

Caffeine is a frequently consumed stimulant in different foods and beverages: coffee, tea, chocolate, sodas, and energy drinks. While its effects on the cardiovascular system have been extensively studied, there remains controversy surrounding its potential risks, particularly in patients with heart disease. This review provides a complete overview of caffeine's pharmacological properties, sources, and cardiovascular effects, particularly emphasizing its arrhythmogenic potential. The proarrhythmic potential of caffeine, particularly on atrial fibrillation and ventricular arrhythmias, is conducted. It explains the mechanism of action, including adenosine receptor antagonism, phosphodiesterase inhibition, calcium mobilization, and catecholamine release of caffeine. Epidemiological evidence and mechanistic insights are …

The Power Of Prevention: Integrating Dental And Cardiovascular Care With The Baledoneen Method™, Amy Doneen Dnp

Metro Denver Dental Society Articulator Magazine

This article details the BaleDoneen Method™ which offers a collaborative, science-based approach to preventing and managing cardiovascular disease (CVD) by targeting the root causes of arterial plaque formation. This method integrates dental care by addressing high-risk periodontal pathogens, recognizing the critical connection between oral health and vascular health, and emphasizes the importance of personalized care to reduce systemic inflammation and cardiovascular risk.

Improved Robustness For Deep Learning-Based Segmentation Of Multi-Center Myocardial Perfusion Cardiovascular Mri Datasets Using Data-Adaptive Uncertainty-Guided Space-Time Analysis., Dilek M Yalcinkaya, Khalid Youssef, Bobak Heydari, Janet Wei, C Noel Bairey Merz, Robert Judd, Rohan Dharmakumar, Orlando P Simonetti, Jonathan W Weinsaft, Subha V Raman, Behzad Sharif

Heart and Vascular Articles

BACKGROUND: Fully automatic analysis of myocardial perfusion cardiovascular magnetic resonance imaging datasets enables rapid and objective reporting of stress/rest studies in patients with suspected ischemic heart disease. Developing deep learning techniques that can analyze multi-center datasets despite limited training data and variations in software (pulse sequence) and hardware (scanner vendor) is an ongoing challenge.

METHODS: Datasets from three medical centers acquired at 3T (n = 150 subjects; 21,150 first-pass images) were included: an internal dataset (inD; n = 95) and two external datasets (exDs; n = 55) used for evaluating the robustness of the trained deep neural network (DNN) models …

Ten-Year Review Of St-Segment Elevation Myocardial Infarction (Stemi) In Tanzania: A Single Center Retrospective Review, Nadeem Kassam, Mohamed Varwani, Mzee Ngunga, Jeilan Mohamed, Mangaro Mabusi, James Orwa, Salim Surani, Robert Mvungi, Nasiruddin Jamal

Internal Medicine, East Africa

Introduction: Ischemic Heart Disease (IHD) is an emerging epidemic in sub-Saharan Africa (SSA). Although the true burden may be underreported in the African continent, it still remains one of the leading causes of death among adults aged above 60 years. ST-Segment Elevation Myocardial Infarction (STEMI) is a clinically time-sensitive fatal sequela of IHD with timely reperfusion by primary Percutaneous Coronary Intervention (PCI) being the gold standard of care. There has been steady progress in coronary care services in Tanzania, alongside a rise in IHD-related risk factors. However, data on this is limited. This study aimed to examine trends in …

Apoa2 Increases Cholesterol Efflux Capacity To Plasma Hdl By Displacing The C-Terminus Of Resident Apoa1, Snigdha Sarkar, Jamie Morris, Youngki You, Hannah Sexmith, Scott E. Street, Stephanie M. Thibert, Isaac K. Attah, Chelsea M. Hutchinson Bunch, Irina V. Novikova, James E. Evans, Amy S. Shah, Scott M. Gordon, Jere P. Segrest, Karin E. Bornfeldt, Tomas Vaisar, Jay W. Heinecke, W. Sean Davidson, John T. Melchior

Saha Cardiovascular Research Center Faculty Publications

Abstract The ability of high-density lipoprotein (HDL) to promote cellular cholesterol efflux is a more robust predictor of cardiovascular disease protection than HDL-cholesterol levels in plasma. Previously, we found that lipidated HDL containing both apolipoprotein A-I (APOA1) and A-II (APOA2) promotes cholesterol efflux via the ATP-binding cassette transporter (ABCA1). In the current study, we directly added purified, lipid-free APOA2 to human plasma and found a dose-dependent increase in whole plasma cholesterol efflux capacity. APOA2 likewise increased the cholesterol efflux capacity of isolated HDL with the maximum effect occurring when equal masses of APOA1 and APOA2 coexisted on the particles. Follow-up …

Untargeted Lipidomics Reveals Novel Hdl Metabotypes And Lipid-Clinical Correlates, Peer W. F. Karmaus, Scott M. Gordon, Marcus Y. Chen, Alison A. Motsinger-Reif, Rodney W. Snyder, Timothy R. Fennell, Suramya Waidyanatha, Reshan A. Fernando, Alan T. Remaley, Michael B. Fessler

Saha Cardiovascular Research Center Faculty Publications

Plasma high-density lipoprotein (HDL), originally studied for its role in lipid transport, is now appreciated to have wide-ranging biological functions that become defective during disease. While >200 lipids have collectively been detected in HDL, published HDL lipidomic analyses in different diseases have commonly been targeted to prespecified subsets of lipids. Here, we report the results of untargeted lipidomic analysis of HDL isolated from 101 subjects referred for computed tomographic coronary imaging for whom multiple additional clinical and lipoprotein metadata were measured. Unsupervised clustering of the total HDL lipidome revealed that the subjects fell into one of two discrete groups, herein …

Tissue Plasminogen Activator Associated Pulmonary Hemorrhage In Patient With Acta2-Associated Arteriopathy, Travis G. Hughes, Mark A. Wurth, Mary Burchett Sheppard

Saha Cardiovascular Research Center Faculty Publications

Pulmonary hemorrhage after administration of tissue plasminogen activator (tPA) is a rare complication. We present a 15- year-old boy with a heterozygous pathogenic variant in ACTA2 who presented with right brachial artery aneurysm thrombosis treated initially with tPA, resulting in pulmonary hemorrhage. We hypothesize that the underlying pulmonary abnormalities caused by the pathogenic ACTA2 variant may be a risk factor for pulmonary hemorrhage after tPA administration. (J Vasc Surg Cases Innov Tech 2024;10:101558.)

Quality Of Life After Myocardial Infarction In The Pakistani Population – Insights From A Single-Center Cohort Study, Javerya Hassan, Manzar Abbas, Hajra Arshad, Angelina Jessani, Izza Tahir, Shiza Qazi, Jasmit Shah, Zul Merali, Zainab Samad

Brain and Mind Institute

Background Health-related Quality of life (HRQoL) assessment is essential for optimizing patient care, treatment adjustments, and medical decision-making, particularly in post-Myocardial Infarction (MI) patients, but limited data exists on HRQOL post-MI from Pakistan. This study aimed to assess HRQoL and its determinants in the Pakistani population.

Methods A single-center cross-sectional study was conducted at a tertiary care hospital in Karachi, Pakistan. Patients≥18 years old with a primary diagnosis of acute MI (ICD-9 codes: 410.0-410.9 and ICD-10 codes: 121.0- 121.9) discharged from the Cardiology Service from January 2019 to December 2020 who could be contacted and consented to participate were included. …

Impact Of An Interdisciplinary Team On Patients Seen At A Heart Failure Clinic, Nilda Pelegrino, Faaria Quadri, Elaina Rosario, Jacqualine Igwe, Sandra Chaparro, Lourdes Labrada, Sara Panella, Maria Pulido, Stephen Breazeale, Zhenwei Zhang

Nursing & Health Sciences Research Journal

Background: Heart failure is a complex clinical syndrome that requires the involvement of interdisciplinary teams to address patient needs and optimize therapy. Interdisciplinary teams, including physicians, advanced practice practitioners, and pharmacists, play a crucial role in implementing guideline-directed medical therapy and addressing barriers to self-care that ultimately improve patients’ overall survival. This study assessed the impact of an interdisciplinary team on patients’ heart failure outcomes compared to patients solely managed by clinical cardiologists. Methods: This was a single-center retrospective chart review study of Baptist Health patients seen at the heart failure clinic. The study compared patients seen by an interdisciplinary …

Exercise Therapy Rescues Skeletal Muscle Dysfunction And Exercise Intolerance In Cardiometabolic Hfpef, Heather Quiriarte, Robert C. Noland, James E. Stampley, Gregory Davis, Zhen Li, Eunhan Cho, Youyoung Kim, Jake Doiron, Guillaume Spielmann, Sujoy Ghosh, Sanjiv J. Shah, Brian A. Irving, David J. Lefer, Timothy D. Allerton

School of Graduate Studies Faculty Publications

Exercise intolerance, a hallmark of heart failure with preserved ejection fraction (HFpEF) exacerbated by obesity, involves unclear mechanisms related to skeletal muscle metabolism. In a “2-hit” model of HFpEF, we investigated the ability of exercise therapy (voluntary wheel running) to reverse skeletal muscle dysfunction and exercise intolerance. Using state-of-the-art metabolic cages and a multiomic approach, we demonstrate exercise can rescue dysfunctional skeletal muscle lipid and branched-chain amino acid oxidation and restore exercise capacity in mice with cardiometabolic HFpEF. These results underscore the importance of skeletal muscle metabolism to improve exercise intolerance in HFpEF.

The Norwood With Blalock-Taussig-Thomas Shunt—Worth A Second Look?, Manasa Gadiraju, Dhaval Chauhan, Alexandra Schray, James O'Brien, Edo Bedzra

Manuscripts, Articles, Book Chapters and Other Papers

Background: Shunt repair for the Norwood procedure with either the right ventricle to pulmonary artery shunt (RVPAS) or the modified Blalock-Taussig-Thomas Shunt (BTTS) varies by institution and surgeon preference. Shunt choice has been informed by landmark trials including the Single Ventricle Reconstruction trial and modern outcomes data may engender future complementary studies. Methods: We conducted a retrospective analysis of all patients who underwent the Norwood procedure from 2014–2022 at a single center to compare outcomes by shunt type. The primary outcome measure was freedom from death or transplant. Secondary outcome measures included hospital length of stay, complications, and unplanned interventions. …