Aftab S. Chishti

Bio: Aftab S. Chishti is an academic researcher from University of Kentucky. The author has contributed to research in topics: Kidney disease & Medicine. The author has an hindex of 8, co-authored 20 publications receiving 347 citations. Previous affiliations of Aftab S. Chishti include Boston Children's Hospital.

Ambulatory systolic blood pressure and obesity are independently associated with left ventricular hypertrophic remodeling in children.

Abstract: Children with obesity have hypertrophic cardiac remodeling. Hypertension is common in pediatric obesity, and may independently contribute to hypertrophy. We hypothesized that both the degree of obesity and ambulatory blood pressure (ABP) would independently associate with measures of hypertrophic cardiac remodeling in children. Children, aged 8–17 years, prospectively underwent cardiovascular magnetic resonance (CMR) and ABP monitoring. Left ventricular (LV) mass indexed to height2.7 (LVMI), myocardial thickness and end-diastolic volume were quantified from a 3D LV model reconstructed from cine balanced steady state free precession images. Categories of remodeling were determined based on cutoff values for LVMI and mass/volume. Principal component analysis was used to define a “hypertrophy score” to study the continuous relationship between concentric hypertrophy and ABP. Seventy-two children were recruited, and 68 of those (37 healthy weight and 31 obese/overweight) completed both CMR and ABP monitoring. Obese/overweight children had increased LVMI (27 ± 4 vs 22 ± 3 g/m2.7, p < 0.001), myocardial thickness (5.6 ± 0.9 vs 4.9 ± 0.7 mm, p < 0.001), mass/volume (0.69 ± 0.1 vs 0.61 ± 0.06, p < 0.001), and hypertrophy score (1.1 ± 2.2 vs −0.96 ± 1.1, p < 0.001). Thirty-five percent of obese/overweight children had concentric hypertrophy. Ambulatory hypertension was observed in 26% of the obese/overweight children and none of the controls while masked hypertension was observed in 32% of the obese/overweight children and 16% of the controls. Univariate linear regression showed that BMI z-score, systolic BP (24 h, day and night), and systolic load correlated with LVMI, thickness, mass/volume and hypertrophy score, while 24 h and nighttime diastolic BP and load also correlated with thickness and mass/volume. Multivariate analysis showed body mass index z-score and systolic blood pressure were both independently associated with left ventricular mass index (β=0.54 [p < 0.001] and 0.22 [p = 0.03]), thickness (β=0.34 [p < 0.001] and 0.26 [p = 0.001]) and hypertrophy score (β=0.47 and 0.36, both p < 0.001). In children, both the degree of obesity and ambulatory blood pressures are independently associated with measures of cardiac hypertrophic remodeling, however the correlations were generally stronger for the degree of obesity. This suggests that interventions targeted at weight loss or obesity-associated co-morbidities including hypertension may be effective in reversing or preventing cardiac remodeling in obese children.

Prevalence of Cardiovascular Disease Risk Factors in Childhood Glomerular Diseases.

Abstract: Background Cardiovascular disease is a major cause of morbidity and mortality in children with chronic kidney disease. We sought to determine the prevalence of cardiovascular risk factors in childr...

A guideline for the inpatient care of children with pyelonephritis.

Abstract: BACKGROUND AND OBJECTIVES: Febrile urinary tract infections and pyelonephritis are common in children and frequently lead to hospitalization for management, especially in the child who appears toxi...

At the University of North Carolina

Abstract: Since beginning a tenure appointment, my research has focused on four research areas, all elements of the political tradecraft of leadership: bargaining, persuasion, operational routines, and managing subordinates. In each area, I have created new theory and brought these analytics closer to the actual practices of those who govern. I have also created innovative data resources on these core processes. This research moves the discipline closer to understanding political decision-making, innovates new theory, generates new data from “behind the scenes,” and focuses on the nature of politics. Because these activities reflect much more closely the actual practices of political leaders, contemporary leaders, both in the national government and abroad, find my scholarship useful and informative.

Environmental pollution and kidney diseases

Abstract: The burden of disease and death attributable to environmental pollution is becoming a public health challenge worldwide, especially in developing countries. The kidney is vulnerable to environmental pollutants because most environmental toxins are concentrated by the kidney during filtration. Given the high mortality and morbidity of kidney disease, environmental risk factors and their effect on kidney disease need to be identified. In this Review, we highlight epidemiological evidence for the association between kidney disease and environmental pollutants, including air pollution, heavy metal pollution and other environmental risk factors. We discuss the potential biological mechanisms that link exposure to environmental pollutants to kidney damage and emphasize the contribution of environmental pollution to kidney disease. Regulatory efforts should be made to control environmental pollution and limit individual exposure to preventable or avoidable environmental risk. Population studies with accurate quantification of environmental exposure in polluted regions, particularly in developing countries, might aid our understanding of the dose-response relationship between pollutants and kidney diseases.