A5083306564- Cardiovascular Function and Risk Factors
- Heart Failure Treatment and Management
- Mechanical Circulatory Support Devices
- Cardiac Structural Anomalies and Repair
- Cardiac pacing and defibrillation studies
- Sarcoidosis and Beryllium Toxicity Research
- Cardiac Valve Diseases and Treatments
- Hormonal Regulation and Hypertension
- Pulmonary Hypertension Research and Treatments
- Cardiac Imaging and Diagnostics
- Transplantation: Methods and Outcomes
- Cardiac Arrest and Resuscitation
- Cardiovascular Issues in Pregnancy
- Cardiovascular Effects of Exercise
- Amyloidosis: Diagnosis, Treatment, Outcomes
- Cardiomyopathy and Myosin Studies
- Cardiovascular and exercise physiology
- Atrial Fibrillation Management and Outcomes
- Cardiovascular Disease and Adiposity
- Cardiovascular Health and Disease Prevention
- Parathyroid Disorders and Treatments
- Cardiac Fibrosis and Remodeling
- Potassium and Related Disorders
- Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Peptidase Inhibition and Analysis
Creighton University
2020-2025
CHI Health Creighton University Medical Center - Bergan Mercy
2024
CHI Health
2023
Mayo Clinic
2008-2022
MedStar Washington Hospital Center
2017-2022
MedStar Heart & Vascular Institute
2018-2020
Catholic Health Initiatives
2020
Washington Hospital
2017-2020
MedStar Georgetown University Hospital
2019
Georgetown University
2019
Characterization of myocardial structural changes in heart failure with preserved ejection fraction (HFpEF) has been hindered by the limited availability human cardiac tissue. Cardiac hypertrophy, coronary artery disease (CAD), microvascular rarefaction, and fibrosis may contribute to HFpEF pathophysiology.We identified patients (n=124) age-appropriate control subjects (noncardiac death, no diagnosis; n=104) who underwent autopsy. Heart weight CAD severity were obtained from autopsy reports....
Background— The prevalence and clinical significance of right ventricular (RV) systolic dysfunction (RVD) in patients with heart failure preserved ejection fraction (HFpEF) are not well characterized. Methods Results— Consecutive, prospectively identified HFpEF (Framingham HF criteria, ≥50%) (n=562) from Olmsted County, Minnesota, underwent echocardiography at diagnosis follow-up for cause-specific mortality hospitalization. RV function was categorized by tertiles tricuspid annular plane...
This study sought to determine the frequency of left ventricular amyloid in heart failure with preserved ejection fraction (HFpEF). Left deposition can cause diastolic dysfunction and HFpEF. Autopsy specimens from patients antemortem diagnosis HFpEF without clinically apparent (n = 109) control subjects 131) were screened sulfated Alcian blue subsequent Congo red staining microdissection for mass spectrometry–based proteomics type. Fibrosis was assessed quantitative whole-field digital...
<h3>Importance</h3> The use of sacubitril/valsartan is not endorsed by practice guidelines for in patients with New York Heart Association class IV heart failure a reduced ejection fraction because limited clinical experience this population. <h3>Objective</h3> To compare treatment valsartan advanced and recent symptoms. <h3>Design, Setting, Participants</h3> A double-blind randomized trial was conducted; total 335 were included. began on March 2, 2017, stopped early 23, 2020, owing to...
Background— Patients with heart failure and preserved ejection fraction (HFpEF) display increased adiposity multiple comorbidities, factors that in themselves may influence cardiovascular structure function. This has sparked debate as to whether HFpEF represents a distinct disease or an amalgamation of comorbidities. We hypothesized fundamental structural functional alterations are characteristic HFpEF, even after accounting for body size Methods Results— Comorbidity-adjusted parameters...
Background— In vitro studies suggest that phosphorylation of titin reduces myocyte/myofiber stiffness. Titin can be phosphorylated by cGMP-activated protein kinase. Intracellular cGMP production is stimulated B-type natriuretic peptide (BNP) and degraded phosphodiesterases, including phosphodiesterase-5A. We hypothesized a phosphodiesterase-5A inhibitor (sildenafil) alone or in combination with BNP would increase left ventricular diastolic distensibility phosphorylating titin. Methods...
Background— Atrial fibrillation (AF) is common among patients with heart failure and preserved ejection fraction (HFpEF), but its clinical profile impact on exercise capacity remain unclear. RELAX (Phosphodiesterase-5 Inhibition to Improve Clinical Status Exercise Capacity in HFpEF) was a multicenter randomized trial testing the of sildenafil peak V O 2 stable outpatients chronic HFpEF. We sought compare features HFpEF who were sinus rhythm (SR) or AF. Methods Results— enrolled 216 HFpEF,...
The pathophysiology of heart failure with preserved ejection fraction (HFpEF) is complex but increased left ventricular (LV) diastolic stiffness plays a key role. A load-independent, non-invasive, direct measure lacking. wall strain (DWS) index based on the linear elastic theory, which predicts that impaired thinning reflects resistance to deformation in diastole and thus, myocardial stiffness. objectives this community-based study were determine distribution novel consecutive HFpEF patients...
Importance Barriers to heart transplant must be overcome prior listing. It is unclear why Black men and women remain less likely receive a after listing than White women. Objective To evaluate whether race or gender of candidate (ie, patient on the waiting list) associated with probability donor being accepted by center team each offer. Design, Setting, Participants This cohort study used United Network for Organ Sharing datasets identify organ acceptance offer US non-Hispanic (hereafter,...
Surgical operative notes play a critical role in patient care, serving as legal documents and communication tools among healthcare professionals. However, inconsistencies documentation can compromise safety continuity of care. This study aimed to evaluate improve the quality surgical at Elobeid Teaching Hospital through structured interventions. A two-phase audit was conducted hospital's Department Surgery, comprising retrospective phase followed by prospective phase. In phase, 50 were...
Background— Right ventricular (RV) dysfunction (RVD) is a poor prognostic factor in heart failure with preserved ejection fraction (HFpEF). The physiological perturbations associated RVD or RV function indexed to load (RV–pulmonary arterial [PA] coupling) HFpEF have not been defined. patients marked impairment RV–PA coupling may be uniquely sensitive sildenafil. Methods and Results— In subset of enrolled the Phosphodiesteas-5 Inhibition Improve Clinical Status And Exercise Capacity Diastolic...
Mechanisms promoting the transition from hypertensive heart disease to failure with preserved ejection fraction are poorly understood. When inappropriate for salt status, mineralocorticoid (deoxycorticosterone acetate) excess causes hypertrophy, fibrosis, and diastolic dysfunction. Because cardiac receptors protected binding by absence of 11-beta hydroxysteroid dehydrogenase, salt-mineralocorticoid-induced inflammation is postulated cause oxidative stress mediate effects. Although previous...
Aging and hypertension lead to arterial remodeling tandem increases in (Ea) ventricular (LV) systolic stiffness (ventricular-arterial [VA] coupling). Age also predispose heart failure with normal ejection fraction (HFnlEF), where symptoms during hypertensive urgencies or exercise are common. We hypothesized that: (1) chronic VA coupling occurs diastole, (2) acute changes Ea coupled shifts the diastolic pressure-volume relationships (PVR), (3) reflects LV rather than external forces...
Advanced glycation end products (AGEs) are believed to increase left ventricular (LV) and vascular stiffness, in part via cross-linking proteins. We determined whether where AGEs were increased elderly hypertensive nondiabetic dogs an AGE cross-link breaker (ALT-711) improved or function.
Exercise intolerance is a hallmark of heart failure, but factors associated with impaired exercise capacity in failure preserved ejection fraction are unclear. We hypothesized that fraction, the severity resting ventricular and vascular dysfunction impairment tolerance as assessed by peak oxygen consumption.Subjects enrolled PhosphodiesteRasE-5 Inhibition to Improve CLinical Status And EXercise Capacity Diastolic Heart Failure (RELAX) clinical trial (n=216) underwent baseline Doppler...
While neurohumoral antagonists improve outcomes in heart failure (HF), cardiac remodeling and dysfunction progress remain poor. Therapies superior or additive to standard HF therapy are needed. Pharmacologic mTOR inhibition by rapamycin attenuated adverse experimental (HF). However, these studies used doses that produced blood drug levels targeted for primary immunosuppression human transplantation therefore the immunosuppressive effects may limit clinical translation. Further, relative...