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Item Atypical depression and double depression predict new-onset cardiovascular disease in U.S. adults(Wiley, 2018-01) Case, Stephanie M.; Sawhney, Manisha; Stewart, Jesse C.; Psychology, School of ScienceBACKGROUND: Although depression is a risk factor for cardiovascular disease (CVD), it is unknown whether this risk varies across depressive disorder subtypes. Thus, we investigated atypical major depressive disorder (MDD) and double depression as predictors of new-onset CVD in a nationally representative sample of U.S. adults. METHODS: Prospective data from 28,726 adults initially free of CVD who participated in Wave 1 (2001-2002) and Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were examined. Lifetime depressive disorder subtypes (Wave 1) and incident CVD (Wave 2) were determined by structured interviews. RESULTS: We identified 1,116 incident CVD cases. In demographics adjusted models, the atypical MDD group had a higher odds of incident CVD than the no depression history (OR = 2.19, 95% CI: 1.71-2.81, P < .001), dysthymic disorder only (OR = 1.61, 95% CI: 1.08-2.39, P = .019), and nonatypical MDD (OR = 1.46, 95% CI: 1.11-1.91, P = .006) groups. Likewise, the double depression group had a higher odds of incident CVD than the no depression history (OR = 2.17, 95% CI: 1.92-2.45, P < .001), dysthymic disorder only (OR = 1.59, 95% CI: 1.16-2.19, P = .004), and MDD only (OR = 1.46, 95% CI: 1.20-1.77, P < .001) groups. Relationships were similar but attenuated after adjustment for CVD risk factors and anxiety disorders. CONCLUSIONS: Adults with atypical MDD or double depression may be subgroups of the depressed population at particularly high risk of new-onset CVD. Thus, these subgroups may (a) be driving the overall depression-CVD relationship and (b) be in need of earlier and/or more intense CVD primary prevention efforts to reduce their excess CVD burden.Item Genome-wide association study of brain arteriolosclerosis(Sage, 2022) Shade, Lincoln M. P.; Katsumata, Yuriko; Hohman, Timothy J.; Nho, Kwangsik; Saykin, Andrew J.; Mukherjee, Shubhabrata; Boehme, Kevin L.; Kauwe, John S. K.; Farrer, Lindsay A.; Schellenberg, Gerard D.; Haines, Jonathan L.; Mayeux, Richard P.; Schneider, Julie A.; Nelson, Peter T.; Fardo, David W.; Radiology and Imaging Sciences, School of MedicineBrain arteriolosclerosis (B-ASC) is characterized by pathologically altered brain parenchymal arterioles. B-ASC is associated with cognitive impairment and increased likelihood of clinical dementia. To date, no study has been conducted on genome-wide genetic risk of autopsy-proven B-ASC. We performed a genome-wide association study (GWAS) of the B-ASC phenotype using multiple independent aged neuropathologic cohorts. Included in the study were participants with B-ASC autopsy and genotype data available from the NACC, ROSMAP, ADNI, and ACT data sets. Initial Stage 1 GWAS (n = 3382) and Stage 2 mega-analysis (n = 4569) were performed using data from the two largest cohorts (NACC and ROSMAP). Replication of top variants and additional Stage 3 mega-analysis were performed incorporating two smaller cohorts (ADNI and ACT). Lead variants in the top two loci in the Stage 2 mega-analysis (rs7902929, p = 1.8×10−7 ; rs2603462, p = 4×10−7 ) were significant in the ADNI cohort (rs7902929, p = 0.012 ; rs2603462, p = 0.012 ). The rs2603462 lead variant colocalized with ELOVL4 expression in the cerebellum (posterior probability = 90.1%). Suggestive associations were also found near SORCS1 and SORCS3. We thus identified putative loci associated with B-ASC risk, but additional replication is needed.Item The Impact of Tele-Health Education in Decreasing the Knowledge Deficit Regarding Coronary Artery Disease in a Rural Area(2014-04-14) Crecelius, Teela D.Background: The objective of this study was to evaluate if using an educational tele-health intervention will reduce the knowledge deficit by a significant amount. Methods: Using a pre-test post-test design, the study examined the effect of a brief multimedia health education curriculum on knowledge related to coronary artery disease. Specifically, each participant experienced an educational intervention consisting of a 5-minute tele-health video as well as a pamphlet explaining the pathophysiology, risk factors, and prevention of coronary artery disease. To assess change, the project included a pre- and post-survey that assessed participant knowledge related to coronary artery disease. Results: Upon determining that the data followed a normal distribution, a paired-sample t-test was performed to compare mean scores from pre- to post-test. Post-test scores (M = 6.38, SD = 1.04) were significantly greater than pre-test scores (M = 5.54, SD = 1.20), t(12) = -2.51, p = 0.03, d = 0.75.Cohen’s d indicates that participants improved their knowledge by three-fourths of a standard deviation, which, according to Cohen (1988), is classified as a medium-sized effect. Conclusion: Tele-health does significantly improve knowledge base when comparing pre-test and post-test scores. Using tele-health could potentially be a useful avenue to provide medical education to rural populations in the United States.Item Indiana State Board of Health Monthly Bulletin, 1909 Vol. 12 No. 4(1909) Barnard, H. E.; Buehler, Eugene; Hartford City Gazette; Coyner, A. G.; Fairfield, W.J.Item Right subclavian steal associated with aberrant right subclavian artery(American Society of Neuroradiology, 1988) Rowe, David M.; Becker, Gary J.; Scott, John A.; Conces, Dewey J., Jr.; Radiology and Imaging Sciences, School of MedicineItem A study of blood flow in normal and dilated aorta(2013-12) Deep, Debanjan; Yu, Huidan (Whitney); Zhu, Likun; Wasfy, Tamer; Anwar, SohelAtherosclerotic lesions of human beings are common diagnosed in regions of arte- rial branching and curvature. The prevalence of atherosclerosis is usually associated with hardening and ballooning of aortic wall surfaces because of narrowing of flow path by the deposition of fatty materials, platelets and influx of plasma through in- timal wall of Aorta. High Wall Shear Stress (WSS) is proved to be the main cause behind all these aortic diseases by physicians and researchers. Due to the fact that the atherosclerotic regions are associated with complex blood flow patterns, it has believed that hemodynamics and fluid-structure interaction play important roles in regulating atherogenesis. As one of the most complex flow situations found in cardio- vascular system due to the strong curvature effects, irregular geometry, tapering and branching, and twisting, theoretical prediction and in vivo quantitative experimental data regarding to the complex blood flow dynamics are substantial paucity. In recent years, computational fluid dynamics (CFD) has emerged as a popular research tool to study the characteristics of aortic flow and aim to enhance the understanding of the underlying physics behind arteriosclerosis. In this research, we study the hemo- dynamics and flow-vessel interaction in patient specific normal (healthy) and dilated (diseased) aortas using Ansys-Fluent and Ansys-Workbench. The computation con- sists of three parts: segmentation of arterial geometry for the CFD simulation from computed tomography (CT) scanning data using MIMICS; finite volume simulation of hemodynamics of steady and pulsatile flow using Ansys-Fluent; an attempt to perform the Fluid Structure Simulation of the normal aorta using Ansys-Workbench. Instead of neglecting the branching or smoothing out the wall for simplification as a lot of similar computation in literature, we use the exact aortic geometry. Segmen- tation from real time CT images from two patients, one young and another old to represent healthy and diseased aorta respectively, is on MIMICS. The MIMICS seg- mentation operation includes: first cropping the required part of aorta from CT dicom data of the whole chest, masking of the aorta from coronal, axial and saggital views of the same to extract the exact 3D geometry of the aorta. Next step was to perform surface improvement using MIMICS 3-matic module to repair for holes, noise shells and overlapping triangles to create a good quality surface of the geometry. A hexahe- dral volume mesh was created in T-Grid. Since T-grid cannot recognize the geometry format created by MIMICS 3-matic; the required step geometry file was created in Pro-Engineer. After the meshing operation is performed, the mesh is exported to Ansys Fluent to perform the required fluid simulation imposing adequate boundary conditions accordingly. Two types of study are performed for hemodynamics. First is a steady flow driven by specified parabolic velocity at inlet. We captured the flow feature such as skewness of velocity around the aortic arch regions and vortices pairs, which are in good agreement with open data in literature. Second is a pulsatile flow. Two pulsatile velocity profiles are imposed at the inlet of healthy and diseased aorta respectively. The pulsatile analysis was accomplished for peak systolic, mid systolic and diastolic phase of the entire cardiac cycle. During peak systole and mid-systole, high WSS was found at the aortic branch roots and arch regions and diastole resulted in flow reversals and low WSS values due to small aortic inflow. In brief, areas of sudden geometry change, i.e. the branch roots and irregular surfaces of the geom- etry experience more WSS. Also it was found that dilated aorta has more sporadic nature of WSS in different regions than normal aorta which displays a more uniform WSS distribution all over the aorta surface. Fluid-Structure Interaction simulation is performed on Ansys-WorkBench through the coupling of fluid dynamics and solid mechanics. Focus is on the maximum displacement and equivalent stress to find out the future failure regions for the peak velocity of the cardiac cycle.