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201. Accreditation status and geographic location of outpatient vascular testing facilities among Medicare beneficiaries: The VALUE (Vascular Accreditation, Location & Utilization Evaluation) Study

Author

Rundek, Tatjana, primary, Brown, Scott C, additional, Wang, Kefeng, additional, Dong, Chuanhui, additional, Farrell, Mary Beth, additional, Heller, Gary V, additional, Gornik, Heather L, additional, Hutchisson, Marge, additional, Needleman, Laurence, additional, Benenati, James F, additional, Jaff, Michael R, additional, Meier, George H, additional, Perese, Susana, additional, Bendick, Phillip, additional, Hamburg, Naomi M, additional, Lohr, Joann M, additional, LaPerna, Lucy, additional, Leers, Steven A, additional, Lilly, Michael P, additional, Tegeler, Charles, additional, Alexandrov, Andrei V, additional, and Katanick, Sandra L, additional

Published
2014
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204. Efficacy and Dose-Dependent Safety of Intra-Arterial Delivery of Mesenchymal Stem Cells in a Rodent Stroke Model

Author

Yavagal, Dileep R., primary, Lin, Baowan, additional, Raval, Ami P., additional, Garza, Philip S., additional, Dong, Chuanhui, additional, Zhao, Weizhao, additional, Rangel, Erika B., additional, McNiece, Ian, additional, Rundek, Tatjana, additional, Sacco, Ralph L., additional, Perez-Pinzon, Miguel, additional, and Hare, Joshua M., additional

Published
2014
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211. Predictors of Thrombolysis Administration in Mild Stroke

Author

Asdaghi, Negar, Wang, Kefeng, Ciliberti-Vargas, Maria A., Gutierrez, Carolina Marinovic, Koch, Sebastian, Gardener, Hannah, Dong, Chuanhui, Rose, David Z., Garcia, Enid J., Burgin, W. Scott, Zevallos, Juan Carlos, Rundek, Tatjana, Sacco, Ralph L., and Romano, Jose G.

Abstract

Supplemental Digital Content is available in the text.

Published
2018
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212. Accreditation Status and Geographic Location of Outpatient Echocardiographic Testing Facilities Among Medicare Beneficiaries: The VALUE‐ECHO Study

Author

Brown, Scott C., Wang, Kefeng, Dong, Chuanhui, Yi, Li, Marinovic Gutierrez, Carolina, Di Tullio, Marco R., Farrell, Mary Beth, Burgess, Pamela, Gornik, Heather L., Hamburg, Naomi M., Needleman, Laurence, Orsinelli, David, Robison, Susana, and Rundek, Tatjana

Abstract

Accreditation of echocardiographic testing facilities by the Intersocietal Accreditation Commission (IAC) is supported by the American College of Cardiology and American Society of Echocardiography. However, limited information exists on the accreditation status and geographic distribution of echocardiographic facilities in the United States. Our study aimed to identify (1) the proportion of outpatient echocardiography facilities used by Medicare beneficiaries that are IAC accredited, (2) their geographic distribution, and (3) variations in procedure type and volume by accreditation status. As part of the VALUE‐ECHO (Value of Accreditation, Location, and Utilization Evaluation–Echocardiography) study, we examined the proportion of IAC‐accredited echocardiographic facilities performing outpatient echocardiography in the 2013 Centers for Medicare and Medicaid Services outpatient limited data set (100% sample) and their geographic distribution using geocoding in ArcGIS (ESRI, Redlands, CA). Among 4573 outpatient facilities billing Medicare for echocardiographic testing in 2013, 99.6% (n = 4554) were IAC accredited (99.7% in the 50 US states and 86.2% in Puerto Rico). The proportion IAC‐accredited echocardiographic facilities varied by region, with 98.7%, 99.9%, 99.9%, 99.5%, and 86.2% of facilities accredited in the Northeast, South, Midwest, West, and Puerto Rico, respectively (P< .01, Fisher exact test). Of all echocardiographic outpatient procedures conducted (n = 1,890,156), 99.8% (n = 1,885,382) were performed in IAC‐accredited echocardiographic facilities. Most procedures (90.9%) were transthoracic echocardiograms, of which 99.7% were conducted in IAC‐accredited echocardiographic facilities. Almost all outpatient echocardiographic facilities billed by Medicare are IAC accredited. This accreditation rate is substantially higher than previously reported for US outpatient vascular testing facilities (13% IAC accredited). The uniformity of imaging and interpretation protocols from a single accrediting body is important to facilitate optimal cardiovascular care.

Published
2018
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214. Association of PDE11A global haplotype with major depression and antidepressant drug response

Author

Luo, Huai-Rong, Wu, Gui-Sheng, Dong, Chuanhui, Arcos-Burgos, Mauricio, Ribeiro, L., Licinio, Julio, Wong, Ma-Li, Luo, Huai-Rong, Wu, Gui-Sheng, Dong, Chuanhui, Arcos-Burgos, Mauricio, Ribeiro, L., Licinio, Julio, and Wong, Ma-Li

Abstract

Cyclic nucleotide phosphodiesterases (PDEs) hydrolyze the intracellular second messengers cAMP and cGMP to their corresponding monophosphates. PDEs play an important role in signal transduction by regulating the intracellular concentration of cyclic nucleotides. We have previously shown that the individual haplotype GAACC in the PDE11A gene was associated with major depressive disorder (MDD) based on block-by-block analysis. There are two PDE genes, PDE11A and PDE1A, located in chromosome 2q31-q32. In this study, we have further explored whether the whole region 2q31-q32 contribute to MDD or antidepressant response 278 depressed Mexican-American participants and 321 matched healthy controls. Although there is no significant interaction between the two genes, the remission rate of individual carrying the combination genotype at rs1880916 (AG/AA) and rs1549870 (GG) is significantly increased. We analyzed the global haplotype by examining 16 single-nucleotide polymorphisms (SNPs) in PDE11A and six SNPs in PDE1A. None of the haplotypes consisting of six SNPs in the PDE1A have a significant difference between depressed and control groups. Among haplotypes consisting of 16 SNPs across 440 kb in the PDE11A gene, 18 common haplotypes (with frequency higher than 0.8%) have been found in the studied population. Six haplotypes showed significantly different frequencies between the MDD group and the control group. The phylogenetic network result for the 16 SNPs showed that several historic recombination events have happened in the PDE11A gene. The frequency of one haplotype is significantly lower in the remitter group than in the nonremitter group for the depressed participants treated with either desipramine or fluoxetine. Thus, our data suggest that the PDE11A global haplotype is associated with both MDD and antidepressant drug response.

Published
2009

215. Association of PDE11A global haplotype with major depression and antidepressant drug response

Author

Luo,Huai-Rong, Wu,Gui-Sheng, Dong,Chuanhui, Arcos-Burgos,Mauricio, Ribeiro,Luciana, Licinio,Julio, Wong,Ma Li, Luo,Huai-Rong, Wu,Gui-Sheng, Dong,Chuanhui, Arcos-Burgos,Mauricio, Ribeiro,Luciana, Licinio,Julio, and Wong,Ma Li

Abstract

Huai-Rong Luo, Gui-Sheng Wu, Chuanhui Dong, Mauricio Arcos-Burgos, Luciana Ribeiro, Julio Licinio, Ma-Li WongCenter on Pharmacogenomics, Department of Psychiatry and Behavioral Science, University of Miami Miller School of Medicine, Miami, FL, USAAbstract: Cyclic nucleotide phosphodiesterases (PDEs) hydrolyze the intracellular second messengers cAMP and cGMP to their corresponding monophosphates. PDEs play an important role in signal transduction by regulating the intracellular concentration of cyclic nucleotides. We have previously shown that the individual haplotype GAACC in the PDE11A gene was associated with major depressive disorder (MDD) based on block-by-block analysis. There are two PDE genes, PDE11A and PDE1A, located in chromosome 2q31–q32. In this study, we have further explored whether the whole region 2q31–q32 contribute to MDD or antidepressant response 278 depressed Mexican-American participants and 321 matched healthy controls. Although there is no significant interaction between the two genes, the remission rate of individual carrying the combination genotype at rs1880916 (AG/AA) and rs1549870 (GG) is significantly increased. We analyzed the global haplotype by examining 16 single-nucleotide polymorphisms (SNPs) in PDE11A and six SNPs in PDE1A. None of the haplotypes consisting of six SNPs in the PDE1A have a significant difference between depressed and control groups. Among haplotypes consisting of 16 SNPs across 440 kb in the PDE11A gene, 18 common haplotypes (with frequency higher than 0.8%) have been found in the studied population. Six haplotypes showed significantly different frequencies between the MDD group and the control group. The phylogenetic network result for the 16 SNPs showed that several historic recombination events have happened in the PDE11A gene. The frequency of one haplotype is significantly lower in the remitter group than in the nonremitter group for the depressed participants treated with either desipram

Published
2009

216. Elevated stress-hemoconcentration in major depression is normalized by antidepressant treatment: secondary analysis from a randomized, double-blind clinical trial and relevance to cardiovascular disease risk.

Author

Wong, Ma-Li, Wong, Ma-Li, Dong, Chuanhui, Esposito, Karin, Thakur, Sarika, Liu, Weiqing, Elashoff, Robert M, Licinio, Julio, Wong, Ma-Li, Wong, Ma-Li, Dong, Chuanhui, Esposito, Karin, Thakur, Sarika, Liu, Weiqing, Elashoff, Robert M, and Licinio, Julio

Abstract

BackgroundMajor depressive disorder (MDD) is an independent risk factor for cardiovascular disease (CVD); the presence of MDD symptoms in patients with CVD is associated with a higher incidence of cardiac complications following acute myocardial infarction (MI). Stress-hemoconcentration, a result of psychological stress that might be a risk factor for the pathogenesis of CVD, has been studied in stress-challenge paradigms but has not been systematically studied in MDD.MethodsSecondary analysis of stress hemoconcentration was performed on data from controls and subjects with mild to moderate MDD participating in an ongoing pharmacogenetic study of antidepressant treatment response to desipramine or fluoxetine. Hematologic and hemorheologic measures of stress-hemoconcentration included blood cell counts, hematocrit, hemoglobin, total serum protein, and albumin, and whole blood viscosity.FindingsSubjects with mild to moderate MDD had significantly increased hemorheologic measures of stress-hemoconcentration and blood viscosity when compared to controls; these measures were correlated with depression severity. Measures of stress-hemoconcentration improved significantly after 8 weeks of antidepressant treatment. Improvements in white blood cell count, red blood cell measures and plasma volume were correlated with decreased severity of depression.ConclusionsOur secondary data analyses support that stress-hemoconcentration, possibly caused by decrements in plasma volume during psychological stress, is present in Mexican-American subjects with mild to moderate MDD at non-challenged baseline conditions. We also found that after antidepressant treatment hemorheologic measures of stress-hemoconcentration are improved and are correlated with improvement of depressive symptoms. These findings suggest that antidepressant treatment may have a positive impact in CVD by ameliorating increased blood viscosity. Physicians should be aware of the potential impact of measures of hemoconc

Published
2008

225. APOE ε4 carriers may undergo synaptic damage conferring risk of Alzheimer's disease.

Author

Sun, Xiaoyan, Dong, Chuanhui, Levin, Bonnie, Crocco, Elizabeth, Loewenstein, David, Zetterberg, Henrik, Blennow, Kaj, and Wright, Clinton B.

Abstract

Introduction Pathogenesis of Alzheimer's disease (AD) in apolipoprotein E ε4 ( APOE ε4) carriers remains unclear. We hypothesize that APOE isoforms have differential effects on synaptic function. Methods We compared levels of CSF neurogranin (Ng) between APOE ε4 carriers and noncarriers in 399 subjects with normal cognition, mild cognitive impairment (MCI), and AD. We examined associations between Ng levels and age, education, gender, CSF-Aβ42, and tau protein. Results Neurogranin levels were significantly higher in APOE ε4 carriers compared to APOE ε4 noncarriers with MCI. Levels of Ng between the APOE ε4 carriers and APOE ε4 noncarriers with AD did not differ. Ng levels were correlated with MMSE and levels of tau and Aβ42. Discussion Significantly higher CSF Ng levels in APOE ε4 carriers with MCI may reflect synaptic injury underlying early cognitive impairment. Neurogranin may be an early biomarker of AD and important for disease diagnosis and timing of intervention in APOE ε4 carriers. [ABSTRACT FROM AUTHOR]

Published
2016
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230. Evidence to Maintain the Systolic Blood Pressure Treatment Threshold at 140 mm Hg for Stroke Prevention: The Northern Manhattan Study.

Author

Chuanhui Dong, Della-Morte, David, Rundek, Tatjana, Wright, Clinton B., Elkind, Mitchell S. V., Sacco, Ralph L., and Dong, Chuanhui

Abstract

In 2014, the Eighth Joint National Committee revised the target maximum systolic blood pressure (SBP) from 140 to 150 mm Hg in patients aged ≥60 years without diabetes mellitus or chronic kidney disease. The evidence from cohort studies supporting this change was sparse, particularly among US minority populations. In the Northern Manhattan Study, 1750 participants aged ≥60 years and free of stroke, diabetes mellitus, and chronic kidney disease had SBP measured at baseline and were annually followed up for incident stroke. Mean age at baseline was 72±8 years, 63% were women, 48% Hispanic, 25% non-Hispanic white, and 25% non-Hispanic black. Among all participants, 40% were on antihypertensive medications; 43% had SBP <140 mm Hg, 20% had 140 to 149 mm Hg, and 37% had ≥150 mm Hg. Over a median follow-up of 13 years, 182 participants developed stroke. The crude stroke incidence was greater among individuals with SBP≥150 mm Hg (10.8 per 1000 person-years) and SBP 140 to 149 (12.3) than among those with SBP<140 (6.2). After adjusting for demographics, vascular risk factors, diastolic BP, and medication use, participants with SBP 140 to 149 mm Hg had an increased risk of stroke (hazard ratio, 1.7; 95% confidence interval, 1.2-2.6) compared with those with SBP <140 mm Hg. The increased stroke risk was most notable among Hispanics and non-Hispanic blacks. Raising the SBP threshold from 140 to 150 mm Hg as a new target for hypertension treatment in older individuals without diabetes mellitus or chronic kidney disease could have a detrimental effect on stroke risk reduction, especially among minority US populations. [ABSTRACT FROM AUTHOR]

Published
2016
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231. Sirtuin/uncoupling protein gene variants and carotid plaque area and morphology.

Author

Dong, Chuanhui, Della-Morte, David, Cabral, Digna, Wang, Liyong, Blanton, Susan H., Seemant, Chaturvedi, Sacco, Ralph L., and Rundek, Tatjana

Subjects
*SIRTUINS, *PROTEIN genetics, *MORPHOLOGY, *OXIDATIVE stress, *SINGLE nucleotide polymorphisms
Abstract

Background Sirtuins and uncoupling proteins have been implicated in cardiovascular diseases by controlling oxidative stress. Aims We sought to investigate the association of sirtuins and uncoupling proteins single nucleotide polymorphisms with total carotid plaque area and morphology measured by ultrasonographic gray scale median. Methods We analyzed 1356 stroke-free subjects (60% women, mean age = 68 ± 9 years) from the Northern Manhattan Study. Multiple linear regression models were used to evaluate the association of 85 single nucleotide polymorphisms in 11 sirtuins/uncoupling protein genes with total plaque area and gray scale median after controlling for demographics, vascular risk factors (RFs), and population stratification. We investigated effect modifications of these relationship by gender and RFs and performed stratified analysis if the interaction effect had P < 0·005. Results Among individuals with present plaque (55%), the mean total plaque area was 20·3 ± 20·8 mm² and gray scale median 90 ± 29. After adjustment, SIRT6 rs107251 was significantly associated with total plaque area (β = 0·30 per copy of T allele increase, Bonferroni-corrected P = 0·005). T allele carriers of rs1430583 in UCP1 showed a decreased gray scale median in women but not in men. The minor allele carriers of rs4980329 and rs12363280 in SIRT3 had higher gray scale median in men but not in women. Variants in UCP3 gene were significantly associated with higher mean gray scale median in individuals with dyslipidemia. Conclusion Our findings suggest that polymorphisms in SIRT6/UCP1 genes may be important for increased carotid plaque burden and echodensity, but translation of these findings to an individual risk of cerebrovascular events needs further investigation. Significant associations of rs1430583 in women, rs12363280 in men, and rs1685354 in those with dyslipidemia also deserve further investigations. [ABSTRACT FROM AUTHOR]

Published
2015
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232. Circulating suPAR in Two Cohorts of Primary FSGS

Author

Wei, Changli, primary, Trachtman, Howard, additional, Li, Jing, additional, Dong, Chuanhui, additional, Friedman, Aaron L., additional, Gassman, Jennifer J., additional, McMahan, June L., additional, Radeva, Milena, additional, Heil, Karsten M., additional, Trautmann, Agnes, additional, Anarat, Ali, additional, Emre, Sevinc, additional, Ghiggeri, Gian M., additional, Ozaltin, Fatih, additional, Haffner, Dieter, additional, Gipson, Debbie S., additional, Kaskel, Frederick, additional, Fischer, Dagmar-Christiane, additional, Schaefer, Franz, additional, and Reiser, Jochen, additional

Published
2012
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234. Determinants of enlarged perivascular spaces (ePVS) on MRI: The Florida Vascular Imaging Phenotypes (FL‐VIP) Study of AD risk.

Author

Rundek, Tatjana, Brutto, Victor Del, Goryawala, Mohammed, Saporta, Anita Seixas Dias, Merritt, Stacy S., Camargo, Christian, Agudelo, Christian, Ariko, Taylor, Dong, Chuanhui, Loewenstein, David, Duara, Ranjan, and Haq, Ihtsham U.

Abstract

Background: PVS are fluid filled compartments surrounding small intracerebral vessels. They are conduits for fluid transport, exchange, and waste clearance. Their relationship to cardiovascular markers is unknown. We tested whether ePVS counts are affected by vascular risk factors and comorbidities. Method: We analyzed nondemented subjects’ brains from the FL‐VIP (comprised of 1Florida ADRC participants with available high quality 3T MRI). ePVS were defined as parenchymal hypo/hyperintensities of <3 mm seen on a single axial T1, T2 or FLAIR section through the basal ganglia (BG) and centrum semiovale (CSO). ePVS were defined as parenchymal hyperintensities <3 mm and graded as 0 (none), 1 (<10), 2 (11‐20), 3 (21‐40), and 4 (>40). The side with highest ePVS count was graded. BG and CSO scores were summed to yield a 0‐8 total. Generalized linear models were used to estimate ePVS score associations with demographics, vascular risk factors, and vascular comorbidities (VASCom score). Result: Of 228 non‐demented participants (mean age 72±8 years; 61% women, 60% Hispanic, mean education 15±4 years, 33% ApoE4 carriers), 59% were hypertensive, 21% diabetic, 66% hypercholesteremic, and 30% obese. Mean VASCom score was 2.3±1.6. ePVS scores ranged from 0‐7 (mean 2.5±1.4), 0‐4 for BG (mean 1.3±0.7) and CSO (mean 1.2 ±0.9). Majority of subjects (73%) had a total ePVS score greater than 1. In unadjusted analysis, BG ePVS were correlated with age (r=0.27, P<0.001), hypertension (r=0.19, p=0.008), MI/CHF/Angina (r=0.14, P=0.03), and coronary bypass (r=0.20, P=0.004). CSO ePVS were correlated with age (r=0.23, P=0.0005), obesity (r=‐0.15, p=0.03), and dyslipidemia (r=‐0.14, P=0.04). In multivariable stepwise regression analyses, BG ePVS were associated with age (β=0.024 per year, p=0.0001), being Hispanic (OR=0.21, P=0.035), coronary bypass (OR=0.70, p=0.025), and hypertension (OR =0.17, p=0.079). CSO PeVS were associated with age (β=0.028 per year, P<0.001) and dyslipidemia (OR=‐0.31, P=0.02). Conclusion: ePVS were more prevalent with aging, greater vascular risk burden, and Hispanic origin. Hypertension, cardiovascular disease and prior coronary bypass surgery were associated with ePVS in BG, but not in CSO. BG ePVS may be an important marker of small vessel disease linking vascular burden and cognitive impairment. [ABSTRACT FROM AUTHOR]

Published
2021
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235. Association of enlarged perivascular spaces (ePVS) and MRI markers of small vessel disease (SVD) and neurodegeneration in the Florida Vascular Imaging Phenotypes (FL‐VIP) Study of AD Risk.

Author

Haq, Ihtsham U., Del Brutto Andrade, Victor, Goryawala, Mohammed, Saporta, Anita Seixas Dias, Merritt, Stacy S., Camargo, Christian, Agudelo, Christian, Ariko, Taylor, Dong, Chuanhui, Loewenstein, David, Duara, Ranjan, and Rundek, Tatjana

Abstract

Background: PVS are fluid filled compartments surrounding small intracerebral vessels. They are conduits for fluid transport, exchange, and waste clearance. ePVS are observed in AD, but their relation to SVD markers and neurodegeneration is unknown. We tested whether ePVS are correlated with markers of SVD but not cortical atrophy. Method: We analyzed subjects’ brains from the FL‐VIP (comprised of all 1Florida ADRC participants with high quality 3T MRI). ePVS were defined as parenchymal hypo/hyperintensities of <3 mm seen on a single axial T1,T2, or FLAIR section through the basal ganglia (BG) and centrum semiovale (CSO). ePVS were graded as 0 (none), 1 (<10), 2 (11‐20), 3 (21‐40), and 4 (>40). The side with highest ePVS count was graded. BGBG and CSO scores were summed to yield a 0‐8 ePVS total. Generalized linear models were used to estimate ePVS score associations with White‐Matter Hyperintensity Volume (WMHV), silent brain infarcts (SBIs), cerebral microbleeds (CMBs), and mean total cortical thickness. We adjusted for demographics, vascular risk factors and comorbidities, and ApoE4 status. Result: Of 228 non‐demented participants (mean age 72±8 years; 61% women, 60% Hispanic, mean education 15±4 years, 33% ApoE4 carriers), 59% were hypertensive, 21% diabetic, 66% hypercholesteremic, and 30% obese. Mean VASCom score was 2.3±1.6. 73% of subjects had a total ePVS score >1. Scores ranged from 0‐7 total (mean 2.5±1.4), 0‐4 for BG (mean 1.3±0.7) and CSO (1.2 ±0.9). In unadjusted analyses, total ePVS correlated with WMHV (r=0.46, p<0001), SBI (r=0.17, p=0.009), and CMB (r=0.16, p=0.016). BG ePVS correlated with WMHV, SBI and CMB. CSO ePVS correlated only with WMHV (r=0.32, p=0.002). In multivariable analyses, ePVS correlated with WMHV (β=4.97, p<0.001), SBI (OR=1.36, p=0.027), and CMB (OR=1.43, p=0.019). BG ePVS remained associated with WMHV, SBI and CMB; and CSO ePVS only with WMHV (β=4.70, p=0.039). Total, BG, and CSO ePVS were not associated with cortical thickness. Conclusion: BG ePVS are highly related to MRI markers of SVD, but not total cortical thickness, and therefore may be considered hallmark features of small vessel disease. CSO ePVS may not have as a prominent role in SVD. [ABSTRACT FROM AUTHOR]

Published
2021
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243. Are Initial Radiographic and Clinical Scales Associated With Subsequent Intracranial Pressure and Brain Oxygen Levels After Severe Traumatic Brain Injury?

Author

Katsnelson, Michael, primary, Mackenzie, Larami, additional, Frangos, Suzanne, additional, Oddo, Mauro, additional, Levine, Joshua M., additional, Pukenas, Bryan, additional, Faerber, Jennifer, additional, Dong, Chuanhui, additional, Andrew Kofke, W., additional, and le Roux, Peter D., additional

Published
2012
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250. Disparities and Trends in Door-to-Needle Time

Author

Oluwole, Sofia A., Wang, Kefeng, Dong, Chuanhui, Ciliberti-Vargas, Maria A., Gutierrez, Carolina M., Yi, Li, Romano, Jose G., Perez, Enmanuel, Tyson, Brittany Ann, Ayodele, Maranatha, Asdaghi, Negar, Gardener, Hannah, Rose, David Z., Garcia, Enid J., Zevallos, Juan Carlos, Foster, Dianne, Robichaux, Mary, Waddy, Salina P., Sacco, Ralph L., and Rundek, Tatjana

Abstract

Supplemental Digital Content is available in the text.

Published
2017
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