Cardiology Commons^™

Curcumin Alleviates Inflammatory Effects Of Ketamine Anesthesia In Postnatal Rats, Soroush Afshar Ghahremani, Abbas Raisi, Sohrab Minaei Beirami, Houman Kahroba, Mahnaz Mardani, Omid Dezfoulian, Vahideh Tarhriz

School of Graduate Studies Faculty Publications

Curcumin has been employed in traditional medicine for over a millennium to treat various ailments, and its global use is now widespread. Chinese medicine relies heavily on curcumin as a primary element and uses it to cure infectious diseases, skin disorders, depression, and stress. It has cardioprotective, neuroprotective, and anti-diabetic properties, as well as pharmacological effects on disorders like type II diabetes, atherosclerosis, and human immunodeficiency virus replication. The anti-cancer activity of curcumin has been studied extensively with notable improvements in gastrointestinal, melanoma, urogenital, breast, and lung malignancies. We investigated the anti-inflammatory effects of curcumin on expression of tumor necrosis …

The De Winter Pattern In A Single Precordial Lead Caused By High-Grade Stenosis Of The Proximal Left Anterior Descending Artery With Plaque Rupture: A Case Report, Zhizhou Song, Yuehong Huo, Qi Wu, Xinjian Yu, Youdong Yang, Zejun Meng, Xia Li

Children’s Nutrition Research Center Staff Publications

The de Winter electrocardiogram (ECG) pattern indicates severe stenosis or occlusion of the left anterior descending artery (LAD). We present a 72-year-old female with 1.5-h chest pain. Angiography and optical coherence tomography (OCT) revealed 90 % LAD stenosis with plaque rupture, but no ST-segment elevation in the precordial leads. The de Winter pattern, characterized by upsloping ST-segment depression in V1-V6, appeared only in lead V2. Following successful percutaneous coronary intervention (PCI), the de Winter pattern disappeared. This case underscores the significance of the de Winter pattern in one precordial lead, necessitating prompt angiography and PCI for improved patient outcomes.

Navigating Economic Constraints In The Management Of Hfref - A Case Study Of An Uninsured Patient, Vamsikalayan Borra, Diana Othon Martinez, Barbara Malaga-Espinoza, Martha Solis, Nestor Gerardo Astorga, Prakhar Jain, Cesar Gutierrez

Research Colloquium

Background: Heart failure (HF) is a significant health concern, resulting in more than 500,000 new cases, 1.9 million hospitalizations, and a cost of $31 billion in the US. HF treatment aims to decrease hospitalizations, improve quality of life, and extend survival through GDMT. Social determinants of health (SoDH) have been associated with poor outcomes and higher readmission rates in HF patients. Addressing SoDH is crucial for achieving health equity and improving overall population health outcomes, per the CMS Framework for Health Equity 2022-2023. In the Rio Grande Valley, immigration is a common SoDH. It is estimated that 100,000 people are …

Heart Failure In The Setting Of Cocaine Abuse… Cause Or Progression? A Case Report., Diana Othon Martinez, Kashif Ali, Elimar Gonzalez Morales, Barbara Malaga-Espinoza, Jian Garcia, Cesar Gutierrez

Research Colloquium

Background: 1 out of 3 substance abuse emergency department visits are related to cocaine. In the US (United States), >5.5 million people consume cocaine. Hospitalizations for heart failure have a similar amount, with 5.7 million. Cocaine's cardiovascular adverse effects arise secondary to sympathetic nervous system stimulation, including decreased myocardial oxygen supply, coronary vasoconstriction, acceleration of atherosclerosis and thrombus formation. Studies have demonstrated contradictory information regarding cardiac anatomical changes (dilation/hypertrophy) secondary to chronic cocaine use. Cocaine cessation and guideline- directed medical therapy (GDMT) for HF are mainstay management. We present a case of a patient with HF and cocaine abuse.

Case …

Recurrent Atrial Myxoma And Transient Ischemic Atack, Abdel Martinez Borrego, Benito Moran Herrera, Eduardo Flores

Research Colloquium

Background: Myxomas are the most common primary cardiac neoplasms and are predominantly located in the left atrium, accounting for approximately 80% of cases. Clinical manifestations can vary widely, ranging from asymptomatic to severe, with potential embolic or obstructive symptoms. Diagnosis is typically made through echocardiography, although CT and MRI can also be useful diagnostic tools. The primary treatment is surgical resection; however, long-term follow-up is essential due to the risk of recurrence, which may occur up to 10 years after the initial surgery.

Case presentation: A 54-year-old female patient with a history of a 5x3x2 cm left atrial …

Integrating Artificial Intelligence With Electrocardiograms: A New Era In Cardiac Care, Abdel Martinez Borrego, Eduardo Flores

Research Colloquium

Background: The integration of artificial intelligence with electrocardiography has significantly transformed contemporary medical practice, representing a major advancement in cardiac care. These algorithms have enhanced the detection of subtle ECG patterns, improving the diagnosis of conditions such as arrhythmias and providing a more accurate diagnostic environment. However, challenges such as data privacy, algorithm transparency, and clinical integration remain. AI holds substantial potential for improving diagnostic accuracy, with several FDA-approved devices now available in the market aimed at enhancing patient outcomes. Future efforts should focus on further validation, implementation, and research to fully realize AI's capabilities in this field.

Methods: This …

Unveiling The Neurological Aftermath: Pres After Cardiac Arrest, Oyinlola O. Fasehun, Jessica Daza, Sriharsha Koneru, Victor Tran, Eunbee Cho, Fatimah Bello

Research Colloquium

Background: Posterior Reversible Encephalopathy Syndrome (PRES), also known as ‘Reversible Posterior Leukoencephalopathy Syndrome (RPLS)’, is a clinical radiographic syndrome originally described by Hinchey et al in 1996. PRES has been significantly underdiagnosed due to difficulty in confirmation. As such, there is currently no epidemiological data regarding its incidence, but it has been diagnosed in all age groups with a preponderance in females. A variety of medical conditions have been implicated as causes of PRES, including severe hypertension, immunosuppressive therapy, sepsis, renal diseases and autoimmune disorders. The mechanism of PRES is thought to be related to disordered cerebral autoregulation and endothelial …

A Vascular Puzzle: Identifying High-Output Heart Failure In A Patient With End-Stage Renal Disease And A Fresh Arteriovenous Fistula, Carlos Luis Alejos Aguero, Khiem Ng, Jennifer Rojas Huen, Liza Salloum, James Stone

Research Colloquium

Introduction: We present a case highlighting high-output heart failure secondary to an acquired arteriovenous fistula for dialysis. High-output cardiac failure is a less common form of heart failure characterized by the heart pumping an increased volume of blood but failing to meet the body's metabolic demands.

Case presentation: A 74-year-old female with a history of hypertension, dyslipidemia, type 2 Diabetes, and end-stage renal disease (ESRD) on hemodialysis via a left arteriovenous fistula. She presented with worsening dyspnea over 2-3 months, initially relieved post-dialysis but progressing to dyspnea at rest, orthopnea, and paroxysmal nocturnal dyspnea despite dialysis compliance. Physical exam revealed …

Cardiomyocyte-Derived Small Extracellular Vesicle: A New Mechanism Driving Diabetic Cardiac Fibrosis And Cardiomyopathy, Yu Li, Yunhui Du, Yang Liu, Xiuhuan Chen, Xinxin Li, Yanru Duan, Yanwen Qin, Huirong Liu, Xinliang Ma, Shaoping Nie, Huina Zhang

Department of Emergency Medicine Faculty Papers

Rationale: Diabetic cardiomyopathy is one of the major diabetic cardiovascular complications in which fibrosis plays a critical pathogenetic role. However, the precise mechanisms by which diabetes triggers cardiac fibrosis in the heart remain elusive. Small extracellular vesicles (sEVs) play an important role in the cellular communication. Nevertheless, whether and how diabetes may adversely alter sEVs-mediated cardiomyocyte-fibroblast communication, promoting diabetic cardiac fibrosis and contributing to diabetic cardiomyopathy, has not been previously investigated. Methods and results: High-fat diet (HFD)-induced and genetic (db/db) type 2 diabetic models were utilized. Cardiomyocyte sEVs (Myo-sEVs) were isolated by ultracentrifugation. Normal cardiomyocyte-derived Myo-sEVs attenuated diabetic cardiac fibrosis …

Novel Computed Tomography Angiography Parameter Is Associated With Low Cardiac Index In Patients With Chronic Thromboembolic Pulmonary Hypertension: A Retrospective Analysis, Estefania Oliveros, Michel Ibrahim, Carlos Manuel Romero, Paul Navo, Patricia Otero Valdes, Yevgeniy Brailovsky, Amir Darki, Riyaz Bashir, Anjali Vaidya, Paul Forfia, Chandra Dass

Division of Cardiology Faculty Papers

UNLABELLED: Chronic thromboembolic pulmonary hypertension (CTEPH) is a complication of incomplete resolution of acute pulmonary embolism. We hypothesize changes in CT Hounsfield Unit gradient (HU-Δ) created by the dispersion of IV contrast through the downstream blood pool correlate with cardiac index (CI). We sought to compare HU-Δ with invasively obtained CI.

METHODS: We completed a retrospective analysis of CTEPH patients in which individuals with low CI (<2.2-L/min/m²) were identified. Both absolute and fractional HU-Δ were derived from pulmonary CTA by subtracting the HU value of the left atrium (LA) and left ventricle (LV) from the main pulmonary artery …

Consensus Of The National Heart Center In Collaboration With The Saudi Arabian Cardiac Interventional Society On The Clinical Use Of Intracoronary Imaging, Mirvat Alasnag, Mognee Alameer, Ahmed Alshehri, Hind Alosaimi, Faisal Alqoofi, Hussain Alzayer, Wail Alkashkari, Adel Tash, Waqar H Ahmed

Journal of the Saudi Heart Association

Objectives: Studies show that intracoronary imaging (ICI)-guided PCI is associated with a significantly lower risk of stroke, Q-wave myocardial infarction, and death compared to angiography-guided PCI in the management of acute coronary syndromes, complex coronary lesions and left-main interventions. Despite these well-established clinical benefits, the utilization of ICI-guided PCI in Saudi Arabia remains suboptimal.

Methods: The National Heart Center (NHC) and the Saudi Arabian Cardiac Interventional Society (SACIS) gathered national experts to develop a consensus document on how to integrate ICI-guided PCI in routine clinical practice in Saudi Arabia. The consensus was based on the nominal group technique, whereby a …

Cardiac Manifestations And Outcomes Of Covid-19 Vaccine-Associated Myocarditis In The Young In The Usa: Longitudinal Results From The Myocarditis After Covid Vaccination (Maciv) Multicenter Study, Supriya S. Jain, Steven A. Anderson, Jeremy M. Steele, Hunter C. Wilson, Juan Carlos Muniz, Jonathan H. Soslow, Rebecca S. Beroukhim, Victoria Maksymiuk, Xander Jacquemyn, Olivia H. Frosch, Brian Fonseca, Ashraf S. Harahsheh, Sujatha Buddhe, Ravi C. Ashwath, Deepika Thacker, Shiraz A. Maskatia, Nilanjana Misra, Jennifer A. Su, Saira Siddiqui, Danish Vaiyani, Aswathy K. Vaikom-House, M. Jay Campbell, Jared Klein, Sihong Huang, Christopher Mathis, Matthew D. Cornicelli, Madhu Sharma, Lakshmi Nagaraju, Marla Johnston, Et Al

School of Medicine Faculty Publications

Background: We aimed to study the clinical characteristics, myocardial injury, and longitudinal outcomes of COVID-19 vaccine-associated myocarditis (C-VAM). Methods: In this longitudinal retrospective observational cohort multicenter study across 38 hospitals in the United States, 333 patients with C-VAM were compared with 100 patients with multisystem inflammatory syndrome in children (MIS-C). We included patients ≤ 30 years of age with a clinical diagnosis of acute myocarditis after COVID-19 vaccination based on clinical presentation, abnormal biomarkers and/or cardiovascular imaging findings. Demographics, past medical history, hospital course, biochemistry results, cardiovascular imaging, and follow-up information from April 2021 to November 2022 were collected. The …

Transcatheter Closure Of Complex Multifenestrated Atrial Septal Defect Using Three Septal Occluders: Is Three Too Many?, Hussam Al Hennawi, Appa Bandi, Ahmad Abulshamat, Shaurya Srivastava, Mohammed Qintar

Abington Jefferson Health Papers

Atrial septal defects (ASDs) are a common form of adult congenital heart disease, with surgical or transcatheter closure being the mainstay of treatment in patients with hemodynamic or clinical complications. Transcatheter repair of secundum ASD is safe and effective. Complex secundum ASDs with multifenestrated defects pose a unique challenge to transcatheter repair. We report a successful but complex transcatheter closure of an ASD using three overlapping Amplazter devices.

Chylopericardium And Superior Vena Cava Syndrome Caused By Central Venous Occlusion From Indwelling Hemodialysis Catheters, Daniel Underberg, Nicholas Demario, Sebastian Rodriguez, Khulkar Mirzozoda, Mark Decaro, Gregary Marhefka

Division of Cardiology Faculty Papers

Chylopericardium is a rare condition. Causes include superior vena cava syndrome resulting from indwelling catheters. We present a case of this condition in a 42-year-old man with end-stage renal disease treated with hemodialysis through a right subclavian vein catheter. He underwent successful endovascular stenting with resolution of his symptoms and chylopericardium.

Residual Stroke Risk Among Patients With Atrial Fibrillation Prescribed Oral Anticoagulants: A Patient-Level Meta-Analysis From Combine Af, Linda Johnson, Alexander Benz, Ashkan Shoamanesh, John W Eikelboom, Michael Ezekowitz, Robert Giugliano, Lars Wallentin, Christian Ruff, Renato Lopes, Sanjit Jolly, Richard Whitlock, Christopher Granger, Stuart Connolly, Jeffrey Healey

Division of Cardiology Faculty Papers

Background: Despite oral anticoagulation, patients with atrial fibrillation (AF) remain at risk of ischemic stroke and systemic embolism (SE) events. For patients whose residual risk is sufficiently high, additional therapies might be useful to mitigate stroke risk.

Methods and results: Individual patient data from 5 landmark trials testing oral anticoagulation in AF were pooled in A Collaboration Between Multiple Institutions to Better Investigate Non-Vitamin K Antagonist Oral Anticoagulant Use in AF (COMBINE AF). We calculated the rate of ischemic stroke/SE among oral anticoagulation-treated patients with a CHA₂DS₂-VASc score≥2, across strata of CHA₂DS₂-VASc …

Enhancement Of High-Density Lipoprotein-Associated Protease Inhibitor Activity Prevents Atherosclerosis Progression, Maura Mobilia, Alexander A. Karakashian, Khaga R. Neupane, Olivia Hage, Callie Whitus, Abigail Carter, Clairity Voy, Lance A. Johnson, Gregory A. Graf, Scott M. Gordon

Saha Cardiovascular Research Center Faculty Publications

Background and aims: Inflammatory cells within atherosclerotic lesions secrete proteolytic enzymes that contribute to lesion progression and destabilization, increasing the risk for an acute cardiovascular event. Elastase is a serine protease, secreted by macrophages and neutrophils, that may contribute to the development of unstable plaque. We previously reported interaction of endogenous protease-inhibitor proteins with high- density lipoprotein (HDL), including alpha-1-antitrypsin, an inhibitor of elastase. These findings support a potential role for HDL as a modulator of protease activity. In this study, we test the hypothesis that enhancement of HDL-associated elastase inhibitor activity is protective against atherosclerotic lesion progression.

Methods: We …

The Discover In-Hospital Cardiac Arrest (Discover Ihca) Study: An Investigation Of Hospital Practices After In-Hospital Cardiac Arrest, Luke Andrea, Nathaniel S Herman, Jacob Vine, Katherine M Berg, Saiara Choudhury, Mariana Vaena, Jordan E Nogle, Saleem M Halablab, Aarthi Kaviyarasu, Jonathan Elmer, Gabriel Wardi, Alex K Pearce, Conor Crowley, Micah T Long, J Taylor Herbert, Kipp Shipley, Brittany D Bissell Turpin, Michael J Lanspa, Adam Green, Shekhar A Ghamande, Akram Khan, Siddharth Dugar, Aaron M Joffe, Michael Baram, Cooper March, Nicholas J Johnson, Alexander Reyes, Krassimir Denchev, Michael Loewe, Ari Moskowitz

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

IMPORTANCE: In-hospital cardiac arrest (IHCA) is a significant public health burden. Rates of return of spontaneous circulation (ROSC) have been improving, but the best way to care for patients after the initial resuscitation remains poorly understood, and improvements in survival to discharge are stagnant. Existing North American cardiac arrest databases lack comprehensive data on the post-resuscitation period, and we do not know current post-IHCA practice patterns. To address this gap, we developed the Discover In-Hospital Cardiac Arrest (Discover IHCA) study, which will thoroughly evaluate current post-IHCA care practices across a diverse cohort.

OBJECTIVES: Our study collects granular data on post-IHCA …

Depressive Symptoms And Sleep Quality Mediate The Relationship Between Race And Quality Of Life Among Patients With Heart Failure: A Serial Multiple Mediator Model, Jia-Rong Wu, Debra K. Moser, Chin-Yen Lin, Ambrose A. Chiang, Barbara Riegel

UK CARES Faculty Publications

Background: Black patients with heart failure (HF) report worse quality of life (QoL) than White patients. Few investigators have examined mediators of the association between race and QoL, but depressive symptoms and sleep quality are associated with QoL.

Objective: The aim of this study was to determine whether depressive symptoms and sleep quality are mediators of the relationship between race and QoL among patients with HF.

Methods: This was a cross-sectional study. We included 271 outpatients with HF. Self-reported race (White/Black), depressive symptoms (Patient Health Questionnaire), sleep quality (Pittsburgh Sleep Quality Index), and QoL (Kansas City Cardiomyopathy Questionnaire) were collected …

Patient Denial Of Myocardial Infarction In The Prehospital Phase: Prevalence And Correlates, Mona A. Abed, Amani A. Khalil, Debra K. Moser

UK CARES Faculty Publications

Background: Limited knowledge exists regarding patients' denial of myocardial infarction (MI) before hospitalization for an MI. Objective: The aim of this study was to determine the prevalence and correlates of denial of MI in the prehospital phase of a confirmed MI. Methods: This secondary analysis included 166 hospitalized patients (mean [SD] age, 54.1 [10.5] years) who developed MI outside a healthcare facility and had high congruence between their experienced and expected symptoms. Measurements included the Denial subscale of the Brief COPE Inventory, the modified Response to Symptoms Questionnaire, and a Likert scale measuring perceived risk for MI. Patients who arrived …

Transvenous Tissue Sampling In The Diagnosis Of Intravascular Neoplasm., Christopher J Neely, Christopher M Huff, Andrew C Gordon, Raghu Kolluri, Kush R Desai

Heart and Vascular Articles

No abstract provided.