Kim A. Eagle

Bio: Kim A. Eagle is an academic researcher from University of Michigan. The author has contributed to research in topics: Aortic dissection & Myocardial infarction. The author has an hindex of 129, co-authored 823 publications receiving 75160 citations. Previous affiliations of Kim A. Eagle include University of Wisconsin Hospital and Clinics & Spaulding Rehabilitation Hospital.

Abstract 270: Self-Efficacy and Cardiovascular Health in 6th Graders: An Insight from Project Healthy Schools

Abstract: Background: Behaviors such as regular physical activity are associated with improved self-esteem among children and adolescents. However, associations between wellness behaviors (including diet) and both self-esteem and leadership among middle-school children have not been well studied. Methods: Data were collected from middle-school children enrolled in Project Healthy Schools, a school-based wellness program. Baseline data included self-reported information on diet, physical activity, and questions on self-efficacy for empathy and leadership. Physiologic data included body mass index (BMI), blood pressure (BP), heart rates (resting and one minute post exercise protocol), non-fasting lipids, glucose. Respondents were grouped into tertiles based on survey items related to empathy. Results: Data from 1,079 6th graders (mean age 11.6 years) were included. Students in the low tertile for empathy had higher BMIs than students in the middle/higher tertiles (p=0.03) with no difference between tertiles for lipids (including total cholesterol, HDL-cholesterol, triglycerides, and LDL-cholesterol). A trend towards higher glucose levels was observed among children in the lower tertile compared to the other tertiles (101.2, 99.4, and 99.5 for tertile 1, 2, and 3 respectively, p = 0.58). A similar trend was observed for systolic BP (p = 0.52) but not diastolic BP, resting HR or HR post exercise. No difference was observed between self-efficacy for leadership and any of the physiologic parameters. Those in the highest tertile for leadership self-efficacy were more likely to be physically active, averaging 4.71 (± 2.11) days of vigorous activity; a similar trend was noted for empathy. Moderate exercise (≥ 30 minutes per day) and team sports positively correlated with empathy and leadership. Conclusions: Among middle-school students, measures of empathy and leadership were associated with higher levels of physical activity and participation in team sports; but not with physiologic parameters. Given that higher levels of empathy and leadership were associated with lower BMI, it is possible that programs which improve leadership skills and promote empathy can improve healthy lifestyle habits.

Ascending Aortic Dissection, Penetrating Aortic Ulcer, and Intramural Hematoma

Abstract: Acute aortic dissection has been among the most lethal entities in the medical literature for centuries. The incidence of acute type A aortic dissection (ATAAD) is 3.5–6 in 100,000 but increases with age and demonstrates a male predominance. Risk factors in older adults include traditional cardiovascular risk factors, while younger patients are more likely to have a connective tissue disorder. Dissection begins as a tear in the intima and if it involves the ascending aorta or arch only it is classified as type A in the Stanford system. The Penn classification is used to assess the degree of organ system malperfusion present in dissection. Clinical presentation as well as biomarkers, such as D-dimer, is used for diagnosis, while confirmation is typically made with imaging including CT, TEE, and MR. Guiding principles of dissection management involve prompt recognition, transfer to intensive care for monitoring, and immediate impulse control – specifically reduction in heart rate, blood pressure, and LV ejection force, or dp/dt. Surgical repair is the mainstay of acute type A aortic dissection treatment, yet the optimal approach to surgery remains unknown. Diverse options include the extent of repair to be attempted (such as arch replacement or root replacement), use of hybrid endovascular modalities (such as frozen elephant trunk technique), cannulation site, and cerebral perfusion strategy. Other acute aortic syndromes include intramural hematoma (blood from the vasa vasorum infiltrates the medial layer) and penetrating atherosclerotic ulcer (plaque erodes through the internal elastic lamina into the media).

Abstract 19899: TEVAR in Acute Type B Aortic Dissection: Insights from the International Registry of Acute Aortic Dissection (IRAD), Interventional Cohort (IVC)

Abstract: OBJECTIVE: Thoracic endovascular aortic repair (TEVAR) has evolved in to a common therapy for complicated acute type B aortic dissection (ABAD). Recently, the International Registry of Acute Aortic Dissection (IRAD) database was expanded with an interventional cohort (IVC) to further examine details of interventional and surgical treatments. METHODS: ABAD patients treated with TEVAR enrolled in IRAD IVC were studied (n=157). Mean age at intervention was 62±13y. Intra-procedural details were analysed and related to in-hospital outcomes. Indications for TEVAR were identified in 63%, including malperfusion (41%), periaortic hematoma (18%), hypotension/shock (2%), refractory/recurrent pain and hypertension (38%), and aortic diameter > 5.0 cm (4%). RESULTS: addition to TEVAR, visceral artery stenting (including celiac, SMA and renal artery) was required in 22%. This cohort was more likely to manifest malperfusion (50 vs 14%, p=.001) and acute renal failure (46 vs 8%, p CONCLUSIONS: The extent of disease and complexity of the procedure, indicated by several patient- and TEVAR specific details, dictates adverse early outcomes in ABAD after TEVAR. Knowledge of those interventional details may be of importance in the perioperative assessment of patients presenting with ABAD.

Abstract 17109: Time Of Day Does Not Influence Mortality In Patients Undergoing Surgical Repair Of Acute Type A Aortic Dissection

Abstract: Introduction: Patients with acute conditions such as myocardial infarction and cardiac arrest have been found to have worse outcomes when occurring at off hours. Acute type A aortic dissection (TAA...

Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure

Abstract: The National High Blood Pressure Education Program presents the complete Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Like its predecessors, the purpose is to provide an evidence-based approach to the prevention and management of hypertension. The key messages of this report are these: in those older than age 50, systolic blood pressure (BP) of greater than 140 mm Hg is a more important cardiovascular disease (CVD) risk factor than diastolic BP; beginning at 115/75 mm Hg, CVD risk doubles for each increment of 20/10 mm Hg; those who are normotensive at 55 years of age will have a 90% lifetime risk of developing hypertension; prehypertensive individuals (systolic BP 120-139 mm Hg or diastolic BP 80-89 mm Hg) require health-promoting lifestyle modifications to prevent the progressive rise in blood pressure and CVD; for uncomplicated hypertension, thiazide diuretic should be used in drug treatment for most, either alone or combined with drugs from other classes; this report delineates specific high-risk conditions that are compelling indications for the use of other antihypertensive drug classes (angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, beta-blockers, calcium channel blockers); two or more antihypertensive medications will be required to achieve goal BP (<140/90 mm Hg, or <130/80 mm Hg) for patients with diabetes and chronic kidney disease; for patients whose BP is more than 20 mm Hg above the systolic BP goal or more than 10 mm Hg above the diastolic BP goal, initiation of therapy using two agents, one of which usually will be a thiazide diuretic, should be considered; regardless of therapy or care, hypertension will be controlled only if patients are motivated to stay on their treatment plan. Positive experiences, trust in the clinician, and empathy improve patient motivation and satisfaction. This report serves as a guide, and the committee continues to recognize that the responsible physician's judgment remains paramount.

Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.

Abstract: The rapid technological developments of the past decade and the changes in echocardiographic practice brought about by these developments have resulted in the need for updated recommendations to the previously published guidelines for cardiac chamber quantification, which was the goal of the joint writing group assembled by the American Society of Echocardiography and the European Association of Cardiovascular Imaging. This document provides updated normal values for all four cardiac chambers, including three-dimensional echocardiography and myocardial deformation, when possible, on the basis of considerably larger numbers of normal subjects, compiled from multiple databases. In addition, this document attempts to eliminate several minor discrepancies that existed between previously published guidelines.

ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease

Abstract: PREAMBLE......e4 APPENDIX 1......e121 APPENDIX 2......e122 APPENDIX 3......e124 REFERENCES......e124 It is important that the medical profession play a significant role in critically evaluating the use of diagnostic procedures and therapies as they are introduced in the detection, management,

ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction—Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction)

Abstract: Although considerable improvement has occurred in the process of care for patients with ST-elevation myocardial infarction (STEMI), room for improvement exists.[1–3][1][][2][][3] The purpose of the present guideline is to focus on the numerous advances in the diagnosis and management of patients