Heart failure, as a result of myocardial infarction, is a major cause of mortality in human. The main cause of heart failure is that when adult cardiomyocytes die in the infarct site they do not regenerate. Instead the infract site is replaced by fibroblasts and collagen scar. It is generally believed that cardiomyocytes have terminally differentiated and can not divide to replace cardiomyocytes that have lost following injury. However, recently published data have provided new evidence that there is a small but continuously turnover of cardiomyocytes in the adult heart. These new findings provide a new theory that the heart does possess a limited ability to regenerate. / I also examined the regenerative ability of cardiomyocyte in adult heart. MRL mice were used because previously it has been reported that the cardiomyocyte could proliferate in response to injury. To understand how the cardiomyocytes in the MRL mouse heart, I used a cryo-injury approach. I discovered that the cardiomyoctyes in MRL mouse hearts were capable of dividing shortly after cryo-injury. These MRL hearts healed without scarring in contrast to C57BL/6 control mice. It was discovered that BMP-2, GATA4 and Nkx2.5 were involved in the healing process. The activation of these genes induced the cardiomyocyte to re-enter the cell cycle so that new cardiomyocytes could replace the cell that have been lost in the infarct site. I also discovered that stem cells may also play a minor role in the healing process. / In summary, my research findings revealed that cardiomyocytes regeneration in the heart is a very complex process that involves the participation of many cells and signalling pathway. There findings raise many intriguing and important questions and are worthy of being addressed in the future. / Stem cell therapy has been proposed as a potential treatment for various myocardial diseases. Chen et al. (2004) found small chemical called reversine that could dedifferentiate C2C12 cells to become stem-like cells. In this study, I demonstrated that reversine could inhibit the growth of C2C12 cell. The presence of reversine in cell culture could significantly inhibit muscle-specific genes MyoD, Myogenin and Myf5 expression. These 3 muscle specific transcriptional genes are essential for maintaining muscle differentiation. The down regulation of these gene showed that reversine could dedifferentiate C2C12 cells. We also discovered that reversine-treated C2C12 cells could differentiate into cardiomyocytes when they were cocultured with cardiomyocytes or when transplanted into the infarct site of a cryo-injured heart. / To investigate the regenerative potential of cardiomyoctyes in adult heart, we tried first to uncover the signals that direct post-natal cardiomyocytes to enter into growth arrest and differentiation. In the first part of my study, I established that the cardiomycytes divided extensively in 2 day-old post-natal hearts and that the majority of these cells entered into growth arrest and terminal differentiation at day 13. Comparative proteomic techniques were used in order to identify proteins that might be associated with cardiomyocytes proliferation during terminal differentiation the mouse heart. Several proteins were found to be differently expressed and amongst them was cyclin I protein. Cyclin I was found strongly expressed in 13 day old hearts. The protein is involved in signaling growth arrested in cells. / Liu, Ye. / "November 2006." / Adviser: Lee Ka Ho. / Source: Dissertation Abstracts International, Volume: 68-09, Section: B, page: 5658. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 142-172). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Wang, Jing. / Thesis Ph.D. Chinese University of Hong Kong 2014. / Includes bibliographical references (leaves 123-151). / Abstracts also in Chinese. / Title from PDF title page (viewed on 19, September, 2016).

Heart failure is ranked as one of the leading causes of hospitalizations and mortality among adults of all racial/ethnic groups in the United States. Telemonitoring, as a homecare intervention for heart failure management, has been used across all groups although the benefit for Hispanics not established. The purpose of this retrospective, quantitative study was to determine the differences in hospital readmission between Hispanic, non-Hispanic Black, and non-Hispanic White patients with heart failure disease who either received or did not receive home telemonitoring services from a homecare agency in Connecticut. The research questions for this study examined the effect of home telemonitoring, race, age, gender, and insurance on heart failure hospitalization across the 3 groups. The chronic care model was used as the theoretical framework for this study because it offers a method for reforming healthcare to ensure optimization in chronic disease management. A purposive sample of 138 records of patients admitted between January 1, 2012 and June 30, 2017 with a diagnosis of heart failure provided the data for the study. Data were analyzed by conducting a simple and multiple logistic regression analysis. The key findings of the simple logistic analysis showed that only Hispanics who used telemonitoring were almost 4 times less likely to be readmitted to the hospital compared to Hispanics who did not use telemonitoring (p = 0.04). The multiple logistic analysis revealed race, age, gender, and insurance were not significant predictors of readmissions (p > 0.05). The findings from this study may promote positive social change by providing healthcare providers with a better understanding of the effects of home telemonitoring for treating adult Hispanic patients with heart failure disease.

Abstract African Americans are disproportionately affected by heart failure, with prevention and treatment of heart failure being a public health concern in the United States. The purpose of this retrospective quantitative study was to examine the primary variable race, specifically African Americans, and how this variable relates to 30-day readmission post discharge when controlled with geographic location (urban vs. rural), gender, and insurance status. The expanded chronic care model was used as a framework to shape health promotion, prevention efforts, and social determinants of health and to enhance community involvement related to chronic disease issues. The research questions were focused on determining a relationship among African Americans being at a higher risk for 30-day readmission than others using selected control variables. Secondary data were collected for 565 patients diagnosed with congestive heart failure from the 2015 Hospital Inpatient Discharges data set and analyzed using simple and multivariate logistic regression methods to answer research questions and test hypotheses. Key results of the simple logistic regression revealed that African Americans were 1.7 times more likely to be readmitted than other races and 1.3 times more likely to be readmitted than Caucasians. The multiple logistic regression revealed race, gender and geographic location (urban) as significant predictors of readmission among African Americans. Insurance status revealed no significance for readmission among African Americans. Implications for social change from this study may include policy implementation at the family, organizational, and societal levels, such as policy related to education on establishing a surveillance system that identifies those in the population who are at risk and more vulnerable to social and health care disparities.

Abstract not available

Chronic heart failure (HF) affects one in five Americans over age 40. It is the leading cause of emergency room visits and hospitalizations. More Medicare dollars are spent for the diagnosis and treatment of HF than any other condition. This study examined emotional representation of HF symptoms after a five-minute verbalization of feelings about these symptoms: 1) What are the characteristics of language used by participants in a verbalization of feelings related to HF symptoms? 2) How does positive affect, negative affect, heart rate (HR), blood pressure (BP), salivary alpha-amylase (sAA), and salivary cortisol (sC) vary over time after verbalization of feelings related to HF symptoms? And 3) What are the significant relationships between emotional word usage, positive and negative affect, HR, BP, sAA, and sC after verbalization of feelings about HF symptoms? A sample of sixty-adults (46 males) with symptomatic HF had a mean age of 71.99 years (SD 9.40), mean education 14.14 (SD 2.86), and Mini-Mental State Exam mean of 29.10 (SD 1.64). They were primarily Caucasian (85%) and married (56.67%) and had a mean time since diagnosis of HF of 104.75 months (SD 106.01). Participants' positive and negative emotional words usages were similar to samples with cancer, HIV/AIDES, and caregivers of chronically ill children. Positive and negative affect, BP, and HR were stable over time. Negative affect scores nearly doubled the reported means for healthy older adults. After speaking about HF symptoms, pulse pressure (F= 5.42, p= .007) and cortisol decreased (t=2.27, p= .027), whereas sAA was elevated (t= -4.31, p< .001). This finding was unexpected in a sample where 90% of the participants were treated with [beta]-blocking medications. Activation of the sympathetic nervous system (SNS) occurred after speaking about feelings related to HF in 70% of this sample. This is relevant given the role of the SNS in HF progression. This was the first study to explore relationships between a description of symptoms, hemodynamic measures, and neurohormonal responses from a verbal description of HF symptoms. This study has demonstrated that human emotions are a representation of the daily health experience of older adults with symptomatic HF. / text

Happy Hearts Automatic Referral (HHAR) was a program that referred heart failure (HF) patients to Transitional Care (TC) at Banner Health. The purpose of the human subject’s research was to examine the use of the Minnesota Living with Heart Failure® questionnaire (MLHFQ) as a survey instrument to identify moderate quality of life (QOL) in patients living with HF. The most common referral to TC prior to the project was patients with poor QOL. The project explored the influence of earlier referrals to improve QOL for participants living with HF. The MLHFQ was chosen because it is a valid and reliable instrument specific to QOL. The HF population was chosen because the most commonly referred patients to interventions such as TC are those that pose the smallest risk for readmission, have the highest risk of readmission, or have the potential to demonstrate the most significant increase in QOL. By offering TC to patients with moderate QOL, an opportunity existed to reduce advancement into a population that is characteristic of high-risk readmissions. The project identified potential participants, then administered the MLHFQ, and scored it. When scores were between 26 and 45, participants were considered qualified participants for this project. Ideally, the patient would have been enrolled in TC for 30 days and the project would have administered another MLHFQ at completion of 30 days of TC to evaluate a change in QOL; however, due to the short-term nature of this project the TC content and follow-up administration of the MLHFQ was not evaluated. Also, while this project was taking place the TC team at Banner Health was not accepting new patients. A human subject’s research approach was applied and examined the responses to the MLHFQ from a small sample of five moderate QOL participants and described the expected responses for improved QOL if a second MLHFQ was to be administered following TC. Specifically items 1, 7, 8, 14, and 19 were examined to discuss how TC interventions might have improved scores on these items. The project concluded by describing how future cycles should be completed for further research.

Thesis (Ph.D.)--University of Adelaide, Dept. of Medicine, 1999. / Appendum consists of last two leaves. Copies of author's previously published articles inserted. Bibliography: leaves 241-283.

Diss. (sammanfattning) Umeå : Univ., 2007. / Härtill 4 uppsatser.

Thesis (M.S.)--University of Michigan, 2000. / Running title: Measurement of quality-of-life in heart failure. Includes bibliographical references.