Publications by authors named "Melissa C Caughey"
Impaired mucociliary transport is a distinguishing sign of cystic fibrosis, but current methods of evaluation are invasive or expose young patients to ionizing radiation. Contrast-enhanced ultrasound imaging may provide a feasible alternative. We formulated a cationic microbubble ultrasound contrast agent, to optimize adhesion to the respiratory mucus layer when inhaled.
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- Peripheral artery disease (PAD) is linked to higher rates of hospital readmission for acute decompensated heart failure (ADHF), especially in patients with chronic kidney disease (CKD), which complicates heart failure outcomes.
- A study from the Atherosclerosis Risk in Communities (ARIC) examined over 1,000 hospitalizations and found that patients with PAD had worse health profiles and higher 1-year readmission rates, regardless of CKD presence.
- The findings suggest that patients with both PAD and ADHF should receive more comprehensive medical management to improve their long-term health outcomes.
Article Synopsis
- The study investigates if inhaling endotoxin (LPS) causes immediate changes in cardiovascular function due to systemic inflammation.
- Fifteen adult volunteers inhaled a specific amount of LPS, with blood and lung samples taken before and after exposure to assess various cardiovascular measures.
- Results showed that while LPS inhalation increased levels of certain immune cells, it did not lead to significant changes in blood pressure or heart function in healthy adults, indicating the need for further research on other particulate matter components.
Background: Intracranial vessel tortuosity is a key component of dolichoectasia and has been associated with atherosclerosis and adverse neurologic outcomes. However, the evaluation of tortuosity is mainly a descriptive assessment.
Purpose: To compare the performance of three automated tortuosity metrics (angle metric [AM], distance metric [DM], and distance-to-axis metric [DTA]) for detection of dolichoectasia and presence of segment-specific plaques.
Article Synopsis
- Prevention strategies for standard modifiable cardiovascular risk factors (SMuRFs) are crucial for improving outcomes in cardiovascular disease, but acute myocardial infarction (AMI) can still occur in individuals without SMuRFs.
- A study analyzed AMI hospitalizations from 2000 to 2014 and found that 3.6% of patients had no documented SMuRFs, often receiving fewer medical treatments and procedures.
- Patients without SMuRFs had significantly higher mortality rates within 28 days and 1 year after hospitalization for AMI compared to those with SMuRFs, highlighting the need for better early risk identification and tailored treatment strategies for this group.
Comparing Focused-Tracked and Plane Wave-Tracked ARFI Log(VoA) In Silico and in Application to Human Carotid Atherosclerotic Plaque, Ex Vivo.
IEEE Trans Ultrason Ferroelectr Freq Control
July 2023
A significant risk factor for ischemic stroke is carotid atherosclerotic plaque that is susceptible to rupture, with rupture potential conveyed by plaque morphology. Human carotid plaque composition and structure have been delineated noninvasively and in vivo by evaluating log(VoA), a parameter derived as the decadic log of the second time derivative of displacement induced by an acoustic radiation force impulse (ARFI). In prior work, ARFI-induced displacement was measured using conventional focused tracking; however, this requires a long data acquisition period, thereby reducing framerate.
View Article and Find Full Text PDFImpact of Diabetes on Outcomes in Patients Hospitalized With Acute Myocardial Infarction: Insights From the Atherosclerosis Risk in Communities Study Community Surveillance.
J Am Heart Assoc
May 2023
Background Diabetes is associated with increased risk of acute myocardial infarction (AMI). The demographic trends, clinical presentation, management, and outcomes of patients with diabetes who are hospitalized with AMI have not been recently reported. Methods and Results The ARIC (Atherosclerosis Risk in Communities) study conducted hospital surveillance of AMI in 4 US communities.
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- A study examines the impact of aortic stenosis (AS) on patients hospitalized for acute decompensated heart failure (ADHF), focusing on demographics and mortality outcomes from 2005 to 2014.
- In the analyzed population, AS was found in about 12.1% of patients with low left ventricular ejection fraction (LVEF) and 18.7% with higher LVEF, with lower prevalence in Black patients compared to White patients.
- The severity of AS was linked to increased 1-year mortality rates, suggesting that even mild or moderate AS has significant implications for patient outcomes in the ADHF population.
Background: Neighborhood socioeconomic status (SES) is associated with worse health outcomes, yet its relationship with in-hospital heart failure (HF) outcomes and quality metrics are underexplored. We examined the association between socioeconomic neighborhood disadvantage and in-hospital HF outcomes for patients from diverse neighborhoods in the Get With The Guidelines-Heart Failure registry.
Methods: SES-disadvantage scores were derived from geocoded US census data using a validated algorithm, which incorporated household income, home value, rent, education, and employment.
Article Synopsis
- The study investigated how obstructive coronary artery disease (CAD) affects patients with acute decompensated heart failure (ADHF) and looked for differences in outcomes between those with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF).
- It analyzed data from 934 patients admitted with ADHF, finding that obstructive CAD was more common in HFrEF patients, which also correlated with higher short-term mortality rates, especially in those with significant arterial blockages.
- The results suggest that patients with ADHF and obstructive CAD require targeted interventions and stronger preventive measures due to their increased risk of death shortly after hospitalization.
Cardiac involvement has been noted in COVID-19 infection. However, the relationship between post-recovery COVID-19 and development of de novo heart failure has not been investigated in a large, nationally representative population. We examined post-recovery outcomes of 587,330 patients hospitalized in the United States (257,075 with COVID-19 and 330,255 without), using data from the National COVID Cohort Collaborative study.
View Article and Find Full Text PDFBackground: Polyvascular disease is associated with increased mortality rates and decreased quality of life. Whether its prevalence or associated outcomes differ for patients hospitalized with heart failure with reduced vs preserved ejection fraction (HFrEF vs HFpEF, respectively) is uncertain.
Methods: The Atherosclerosis Risk in Communities (ARIC) study conducted hospital surveillance of acute decompensated heart failure (ADHF) from 2005-2014.
Outcomes of decreasing versus increasing cardiac troponin in patients admitted with non-ST-segment elevation myocardial infarction: the Atherosclerosis Risk in Communities Surveillance Study.
Eur Heart J Acute Cardiovasc Care
December 2021
Background: The fourth universal definition of myocardial infarction requires an increase or decrease in cardiac troponin for the classification of non-ST-segment elevation myocardial infarction. We sought to determine whether the characteristics, management, and outcomes of patients admitted with non-ST-segment elevation myocardial infarction differ by the initial biomarker pattern.
Methods: We identified patients in the Atherosclerosis Risk in Communities Surveillance Study admitted with chest pain and an initially elevated cardiac troponin I, who presented within 12 hours of symptom onset and were classified with non-ST-segment elevation myocardial infarction.
Background: Bedside evaluation of congestion is a mainstay of heart failure (HF) management. Whether detected physical examination signs have changed over time as obesity prevalence has increased in HF populations, or if the associated prognosis differs for HF with reduced or preserved ejection fraction (HFrEF or HFpEF) is uncertain.
Methods: From 2005 to 2014, the ARIC study (Atherosclerosis Risk in Communities) conducted adjudicated hospital surveillance of acute decompensated HF.
An expanding number of therapies are now indicated for comorbidity management in heart failure with preserved ejection fraction (HFpEF). Whether comorbidity burdens differ for patients with HFpEF who are hospitalized for acute decompensated heart failure (ADHF) versus those with chronic stable heart failure (CSHF) who are hospitalized for other causes is uncertain. Since 2005, the Atherosclerosis Risk in Communities (ARIC) study has conducted adjudicated community surveillance of hospitalized heart failure.
View Article and Find Full Text PDFAims: Shock index (SI), defined as the ratio of heart rate (HR) to systolic blood pressure (SBP), is easily obtained and predictive of mortality in patients with ST-segment elevation myocardial infarction. However, large-scale evaluations of SI in patients with non-ST-segment elevation myocardial infarction (NSTEMI) are lacking.
Methods And Results: Hospitalizations for acute myocardial infarction were sampled from four US areas by the Atherosclerosis Risk in Communities (ARIC) study and classified by physician review.
Aims/hypothesis: Type 2 diabetes is a heterogeneous disease process with variable trajectories of CVD risk. We aimed to evaluate four phenomapping strategies and their ability to stratify CVD risk in individuals with type 2 diabetes and to identify subgroups who may benefit from specific therapies.
Methods: Participants with type 2 diabetes and free of baseline CVD in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial were included in this study (N = 6466).
Objectives: This study evaluated the application of a biomarker-based risk score to identify individuals with dysglycemia who are at high risk for incident heart failure (HF) and to inform allocation of effective preventive interventions.
Background: Risk stratification tools to identify patients with diabetes and pre-diabetes at highest risk for HF are needed to inform cost-effective allocation of preventive therapies. Whether a biomarker score can meaningfully stratify HF risk is unknown.
Background/objectives: Obesity increases with age, is disproportionately prevalent in black populations, and is associated with heart failure with preserved ejection fraction (HFpEF). An "obesity paradox," or improved survival with obesity, has been reported in patients with HFpEF. The aim of this study was to examine whether racial differences exist in the temporal trends and outcomes associated with obesity among older patients with HFpEF.
View Article and Find Full Text PDFBackground Acute myocardial infarction (AMI) with in-hospital onset (AMI-IHO) has poor prognosis but is clinically underappreciated. Whether its occurrence has changed over time is uncertain. Methods and Results Since 1987, the ARIC (Atherosclerosis Risk in Communities) study has conducted adjudicated surveillance of AMI hospitalizations in 4 US communities.
View Article and Find Full Text PDFObjectives: This study investigates the prevalence and prognostic significance of mitral regurgitation (MR) in acute decompensated heart failure (ADHF) patients.
Background: Few studies characterize the burden of MR in heart failure.
Methods: The ARIC (Atherosclerosis Risk In Communities) study surveilled ADHF hospitalizations for residents ≥55 years of age in 4 U.