Cardiology 2022 Projects

Is cardiac stress testing in patients with advanced liver disease a high value clinical practice?

Faculty Mentor’s Name: Dr. David Winchester
Email: dwinches@ufl.edu
Phone Number: (352) 265-9076
Project Category: Clinical
International Component or Travel: No

Research Project Description:

Patients with end-stage liver disease have higher than anticipated risk of cardiovascular events when undergoing surgery. Preoperative cardiac stress testing is often performed in this population, however data on the value of this practice are lacking. This project will consist of identifying patients with advanced liver disease who underwent nuclear myocardial perfusion imaging prior to noncardiac surgery. The team will evaluate the results of those tests and subsequent risk of cardiovascular events in the perioperative period. Students will assist in data gathering and entry with the expectation of presenting aspects of the research and participating in publishing a manuscript on the results.

Selected Readings:

  1. Accuracy of stress myocardial perfusion imaging to diagnose coronary artery disease in end stage liver disease patients. Bhutani S, et al. Am J Cardiol. 2013. PMID: 23337839
  2. Revival of an old stressor: Dobutamine-stimulation for PET myocardial perfusion imaging in patients with end-stage liver disease? Schindler TH, et al. J Nucl Cardiol. 2020. PMID: 30515744
  3. Scintigraphic findings in end-stage liver disease on Tc-99m sestamibi SPECT/CT myocardial perfusion imaging. Jain T, et al. J Nucl Cardiol. 2018. PMID: 28374327

Anatomic suitability for axillary Intra-Aortic Balloon Pump Circulatory Support

Faculty Mentor’s Name: Dr. Mohammad Al-Ani
Email: mohammad.alani@medicine.ufl.edu
Phone Number: (619) 277-3186
Project Category: Clinical
International Component or Travel: No

Research Project Description:

Axillary intra-aortic balloon pump (ax-IABP) is frequently used to provide circulatory support for cardiogenic shock awaiting transplantation. The axillary approach allows for patient mobility and nutritional and physical rehabilitation. However, axillary insertion is associated with a 40% rate of device malfunction, compared to < 10% complication rate for femoral arterial access. We have clinically observed that certain individuals develop recurrent IABP device malfunction despite repositioning and/or replacement, whereas others are well supported by the device for weeks without issues. We hypothesize that vascular anatomy is a major determinant of this complication. This is a single center retrospective study of this hypothesis.

The Impact of Nutrition on Chronic Illness

Faculty Mentor’s Name: Dr. Monica Aggarwal
Email: mohammad.alani@medicine.ufl.edu
Phone Number: (352) 294-8818
Project Category: Clinical
International Component or Travel: No

Research Project Description:

Medical students can be involved in multiple projects depending on interest. Currently, we are starting a study on the role of nutrition in people who are overweight. We will be looking at different dietary patterns and their role in weight loss, inflammation and microbiota changes. This project will likely line up with the summer internship time period. Project will involve background research, IRB protocol preparation, recruitment, research evaluation, lab analysis and paper writing.

We are also writing curriculum for multiple societies on the role of nutrition in chronic illness as we as writing healthy eating education for societies such as the American Society of Preventive Cardiology. THis is another option for a student.

Lastly, we are working on assessing phytonutrient composition of foods and that nutrient composition’s effect on human health. Manipulating plants with understanding soil, nutrients, stressors and how that effects plant microbiome will be assessed and then how that nutrient composition will effect human outcomes. This project will require driving to Orlando where the farm is located.

Shared Decision Making for Complex Coronary Revascularization Using The Ottawa Personal Decision Guide

Faculty Mentor’s Name: Dr. Khanjan Shah
Email: mohammad.alani@medicine.ufl.edu
Phone Number: (352) 294-8818
Project Category: Clinical
International Component or Travel: No

Research Project Description:

Most recent coronary revascularization guidelines stress the importance of a heart team approach incorporating patient preferences when considering specific revascularization strategies. Patients are often informally asked to consider medical therapy, surgical revascularization, or percutaneous revascularization. Administration of a formal tool assessing patient understanding of options and preferences has not been utilized in this patient population. The Ottawa Personal Decision Guide is a validated tool that facilitates high quality shared decision making. The aim of our study is to formalize shared decision making with patients discussed at the UF heart team complex revascularization conference using the Ottawa Personal Decision Guide. This study will result in a descriptive analysis of patient understanding of disease and therapy options as well as recommendations on how clinicians can best use this information. The medical student will administer the guide to patients either in person or on the phone. No funding is required.