Browsing by Subject "Heart failure (HF)"

Now showing 1 - 4 of 4
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    Feasibility of Recruiting People With Mild Cognitive Impairment in the Context of Heart Failure
    (Oxford University Press, 2024-12-31) Jung, Miyeon; Pressler, Susan; Hammers, Dustin; Apostolova, Liana; School of Nursing
    Recruiting people with mild cognitive impairment (MCI) with another chronic condition such as heart failure (HF) can be arduous. Our investigative group will discuss the challenges encountered while recruiting older adults with both MCI and HF using data from a pilot study testing the efficacy of cognitive interventions to improve cognitive function and the strategies to overcome them. Initially, eligibility criteria included age ≥65 years, HF confirmed by echocardiography, and MCI defined using a 2-step process: (1) Montreal Cognitive Assessment (MoCA) ≤23; and (2) diagnostic consensus of MCI based on the presence of cognitive impairment in the absence of functional decline. Enrollment began on 4/3/2023 by screening Cardiology and Neurology clinics patients. Only 12 participants were enrolled over the next 7 months (rate=1.5 participants/month) due to high screen failure rates (59%) owing to MoCA performances above the eligibility threshold and low recruitment rate (5%). To meet recruitment goals (8 participants/month), eligibility criteria were modified by lowering the age cutoff from 65 to 55 years and removing the MoCA screen and the MCI requirements, while adding the requirement of subjective cognitive concern allowing both those with normal cognition and MCI but not dementia. Phone recruitment was added by screening electronic health records of people who diagnosed with HF. 7 months after implementing the modifications, additional 58 participants were consented exceeding our recruitment goals (69% of those consented=MCI, 26%=normal cognition, 5%=dementia/excluded from the study). In conclusion, feasibility of our original strategies recruiting older adults with both MCI and HF was not supported.
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    Pregabalin and gabapentin-induced heart failure
    (Via Medica, 2024) Barold, S. Serge; Barold, David C.; Hon, Roxanne; Guglin, Maya; Medicine, School of Medicine
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    Structured Program for Weight Loss in Heart Failure Patients: Findings From a Cardiology-Driven Obesity Clinic
    (Elsevier, 2023-11-30) Rao, Vijay U.; Ziedonis, Kaitlin; Gunderman, David; Kumar, Ashish; Bashall, Anthony; Stark, Kathy; Chugh, Atul R.; Daly, Ryan; Kalra, Ankur; Medicine, School of Medicine
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    Transmural heterogeneity of microstructural remodeling in pacing induced heart failure measured by diffusion tensor MRI
    (Elsevier, 2013-01-30) Kung, Geoffrey L.; Ouadah, Sarah; Hsieh, Yu-Cheng; Garfinkel, Alan; Chen, Peng-Sheng; Ennis, Daniel; Medicine, School of Medicine
    Background: Diffusion tensor magnetic resonance imaging (DT-MRI) enables 3D evaluation of whole heart microstructure. DT invariants evaluate microstructural remodeling by quantifying trace (increases with decreasing cellularity), fractional anisotropy (FA, decreases with increasing fibrosis), and tissue mode (decreases with increasing fiber disarray) [1]. We have shown that DT invariant data identifies significant global microstructural remodeling (increase in trace and decrease in FA) in the pacing induced heart failure (HF) model [2]. The objective of this study was to quantify transmural microstructural remodeling between normal and HF myocardium using DT invariants. Methods: HF was induced in 10-12 month old New Zealand White female rabbits (N=8) with an epicardial pacing lead placed in the lateral LV wall and tachycardia pacing at 250 beats per minute (bpm) for 3 days, 300 bpm for 3 days, and 350 bpm for 3-4 weeks. Normal weight matched rabbits (N=5) served as controls (CNTL). Hearts were excised, formalin fixed, and DT-MRI was performed on a 7T scanner (Bruker, Billerica, MA) (24 diffusion gradient directions, 6 nulls, TE/TR=30/500 ms, b-value=1000 s/mm2, 0.5 x 0.5 x 0.75 mm resolution). Trace, FA, and mode were segmented into epicardial, midwall, and endocardial regions. Bootstrapped histograms with 95% confidence intervals (95%-CIs) of the de-correlated (via decimation by the auto-correlation length) and segmented invariant data were defined to make statistical comparisons of non-Gaussian datasets tractable. Two-group comparisons of median invariant data of each heart were used to test for significant differences (p < 0.05) between HF and CNTL in each transmural region. Results: Figure 1 depicts bootstrapped histograms with 95%-CIs for transmurally segmented invariant data across groups (HF vs CNTL). Trace significantly increased from CNTL to HF in all transmural regions (all p < 0.04). An increase in trace implies a decrease in diffusive barriers per voxel or decreased cellularity [3]. FA differences from CNTL to HF were insignificant in all regions. Increased myocyte size without significant changes in fibrosis have been histologically observed in the pacing induced HF model [4], which is consistent with an increase in trace without a change in FA. Mode significantly decreased in midwall and increased in endocardium from CNTL to HF (both p = 0.04) but did not significantly shift in epicardium. A decrease in mode implies fiber disarray as local diffusion shifts towards planar anisotropy. An increase in mode implies a loss of sheet structure as local diffusion shifts towards linear anisotropy. Conclusions: DT invariant data indentify statistically significant microstructural remodeling in the pacing induced HF model within epicardial, midwall, and endocardial regions.