Tatjana Rundek

Verified

Tatjana verified their affiliation via an institutional email.

Learn more

Verified

Tatjana verified their affiliation via an institutional email.

Learn more

• MD PhD
• Director and Professor at University of Miami

Background Age‐related changes in the systemic and cerebral vasculature adversely affect brain health and may contribute to neurodegeneration. However, the relationship between markers of systemic (arterial stiffness) and cerebral (flow pulsatility) vascular aging with neurodegeneration remains unclear. This study aimed to evaluate the associations...

Background The American Heart Association’s Life Essential 8 (LE8) are a set of eight simple health metrics used to define cardiovascular (CV) health and promote healthy behaviors. High CV health is associated with a lower risk of CV disease. Our objective is to determine whether LE8 and CV health are associated with incident dementia in diverse ad...

Background Soda consumption has been associated with vascular risk factors and events. While diet quality is understood to impact dementia risk, little is known about soda consumption in relation to dementia. We hypothesized that regular soda and diet soda consumption were associated with an increased dementia risk. Method We utilized data from 95...

Objective: To identify race/ethnic disparities in rehabilitation services after stroke and characterize the independent associations of each of race/ethnicity and rehabilitation to functional recovery post-stroke. Methods: The Transitions of Care Stroke Disparities Study (TCSD-S) is a prospective cohort study designed to reduce disparities and to o...

Background Age‐related cognitive decline (ARCD) refers to the cognitive changes that occur in individuals because of aging. Research suggests that the underlying mechanism behind ARCD is a loss of synaptic plasticity and altered dendritic spine morphology. Similarly, the cognitive changes in Alzheimer’s Disease (AD) are also thought to arise from i...

Background Neurogranin (Ng) is considered a biomarker for synaptic dysfunction in Alzheimer’s disease (AD). In contrast, the inflammasome complex has been shown to exacerbate AD pathology. Method We investigated the protein expression, morphological differences of Ng and correlated Ng to hyperphosphorylated tau in the postmortem brains of 17 AD ca...

Background Studies have shown that marital status is related to vascular outcomes but with potential variation by race/ethnicity. It remains unclear whether these associations occur in predominantly Hispanic populations. Methods In the Northern Manhattan Study prospective cohort, we assessed participants ≥40 years and stroke-free at baseline. We c...

Background Resource allocation for stroke care was impacted worldwide by the Coronavirus 2019 (COVID19) pandemic. Regionally, worsened stroke outcomes varied, however comparative year-over-year in-hospital performance metrics from the pandemic are unreported. Therefore, within the large Florida Stroke Registry (FSR), we assessed the pandemic’s effe...

Objective To determine whether a panel of immune markers adds significant information to known correlates of risk of dementia and cognitive impairment. Background The impact of immune mechanisms on dementia risk is incompletely characterized. Design/methods A subsample of the Northern Manhattan Study, a prospective cohort study in the racially/et...

Cerebral amyloid angiopathy commonly co-occurs with amyloid β plaques and neurofibrillary degeneration and is proposed to contribute to cognitive impairment. However, the interplay among these pathologic changes of Alzheimer disease is not well understood. Here we replicate and extend findings of a recent study that suggested the association of cer...

Background: Cardiovascular disease (CVD) has consistently been associated with higher depression symptoms and disorders. Conversely, fewer studies have shown that depression predicts risk of incident CVD and mortality. Objective: To examine the association of depression symptoms with incident major adverse cardiovascular events (MACE) among Hispani...

Background: Diets high in sodium and low in potassium are associated with increased blood pressure level but associations with cardiovascular disease (CVD) remain controversial. Few studies have evaluated this relationship among Hispanic/Latino adults. Objective: To assess whether dietary sodium and potassium are associated with incident CVD among...

Background: The Predicting Risk of CVD EVENTs (PREVENT) equations are a new set of sex-specific and race-free equations developed by the American Heart Association to calculate risk of cardiovascular disease, including stroke as an independent outcome. Objective: To describe the ten-year risk of stroke (ischemic and hemorrhagic) using the PREVENT e...

Background: From 2018 to 2060 the proportion of US seniors (age 65+) will increase from 16% to 23%, with much of this growth driven by Hispanic/Latino seniors. Adverse social determinants of health (SDoHs) are drivers of poor health outcomes and accelerated aging. Objective: To examine the association between SDoHs (education, income, and nativity)...

Objectives: This study identifies the association between patient perception of discharge education/resources and adequate transitions of care (ATOC) (i.e., patient achievement of at least 75% of recommended positive behaviors and activities within 30 days post-stroke hospitalization). Methods: The analysis measured the association between sufficie...

Background Arterial stiffness is a degenerative modification in the arterial wall that significantly affects normal aging. Arterial hypertension is a major risk factor for cerebrovascular impairment. Pulse wave velocity (PWV) is an established gold standard for measuring arterial stiffness. Studies demonstrated that individuals with elevated blood...

Objective Little is known about the incidence of late onset epilepsy (LOE) across different racial/ethnic groups in the USA, particularly in the Hispanic population. Stroke, a strong predictor of LOE, is more common in non‐Hispanic Blacks (NHBs) and Hispanics than in non‐Hispanic Whites (NHWs). We assessed the incidence of LOE across racial/ethnic...

Background and Purpose: Social determinants of health (SDOH), including social networks impact disability and quality of life post-stroke, yet the direct influence of SDOH on functional change remains undetermined. We aimed to identify which SDOH predict change on the modified Rankin Scale (mRS) within 90-days after stroke hospitalization. Methods:...

Objectives Limited research exists on COVID-19 associated brain fog, and on the long-term cognitive and psychiatric sequelae in racially and ethnically diverse patients. We characterize the neuropsychological sequelae of post-acute COVID-19 in a diverse cohort and investigate whether COVID-19 clinical severity remains associated with brain fog and...

Objective: Red blood cell (RBC) concentration impacts cerebrovascular disease, yet it is unclear whether RBC concentrations relate to dementia risk, particularly in racially/ethnically diverse cohorts. We investigated whether RBC concentrations associate with incident dementia risk in a diverse population of stroke-free individuals and explored whe...

Background Pulse‐wave velocity is a measure of arterial stiffness and a risk factor for cardiovascular disease. Recently, an estimated pulse‐wave velocity (ePWV) was introduced that was predictive of increased risk of cardiovascular disease. Our objective was to determine whether ePWV was associated with cerebral small‐vessel disease on magnetic re...

INTRODUCTION Arterial stiffness is linked to age‐related cognitive dysfunction. Estimated pulse wave velocity (ePWV) is associated with cerebrovascular disease. We sought to determine whether ePWV was associated with cognition in a multiethnic population. METHODS We included 1257 participants enrolled in a Northern Manhattan Study magnetic resonan...

We examined the sex-specific association between education and income with biological age (BA) and by race/ethnicity. The Klemera-Doubal method was used to calculate BA among 6,213 females and 5,938 males aged 30-75 years who were Hispanic, non-Hispanic (NH) White, NH Black (NHB), or NH Asian (NHA). Compared with a college education, less than a hi...

Background and Purpose Brain arterial luminal diameters are reliably measured with automated imaging software. Nonautomated imaging software alternatives such as a Picture Archiving Communication System are more common bedside tools used for manual measurement. This study is aimed at validating manual measurements against automated methods. Method...

Resting-state electroencephalography (rsEEG) is usually obtained to assess seizures in comatose patients with traumatic brain injury (TBI). We aim to investigate rsEEG measures and their prediction of early recovery of consciousness in patients with TBI. This is a retrospective study of comatose patients with TBI who were admitted to a trauma cente...

OBJECTIVE Hispanics/Latinos in the United States have the highest prevalence of undiagnosed and untreated diabetes and are at increased risk for cognitive impairment. In this study, we examine glycemic control in relation to cognitive aging and impairment in a large prospective cohort of middle-aged and older Hispanics/Latinos of diverse heritages....

OBJECTIVE To evaluate whether hypertensive disorders of pregnancy, including gestational hypertension, preeclampsia, and eclampsia, are associated with cognitive decline later in life among U.S. Hispanic/Latina individuals. METHODS The HCHS/SOL (Hispanic Community Health Study/Study of Latinos) is a prospective population-based study of Hispanic/L...

Background: It is unknown how cardiovascular health (CVH) relates to severe Covid-19 illness in adults without clinical cardiovascular disease (CVD). We hypothesized that more optimal Life’s Essential 8 (LE8)-quantified CVH is associated with lower risk of severe Covid-19 among US adults without clinical CVD. Methods: C4R is ascertaining Covid-19 e...

INTRODUCTION We tested the association of brain artery diameters with dementia and stroke risk in three distinct population‐based studies using conventional T2‐weighted brain magnetic resonance imaging (MRI) images. METHODS We included 8420 adults > 40 years old from three longitudinal population‐based studies with brain MRI scans. We estimated an...

Background: Mid-life obesity is associated with cognitive impairment, though the relationship for late-life obesity is equivocal, and may depend on the anthropometric measure. Objective: We examined the relationship between adiposity and cognition across age categories, cognitive domains, and by measures of obesity in a multi-ethnic population-base...

Introduction: Historically, non-Hispanic black (NHB) and Hispanic stroke survivors have been discharged at a poorer functional level than non-Hispanic whites (NHW). The purpose of this study was to examine race and ethnic differences in rehabilitation prescription and participation at time of discharge (DC) and in modified Rankin Scale (mRS) at 30-...

Introduction: While ischemic stroke (IS) in the young (18-55) is thought to have different etiologies than in older patients, a rise in vascular risk factors (VRFs) among young adults may translate to an IS risk profile similar to the older population. We aimed to examine the prevalence of VRFs and temporal trends in VRF burden among young patients...

Introduction: Apolipoprotein E4 (ApoE4) allele is linked to increased LDL-Cholesterol, one of the main risk factors for intracranial large artery stenosis (ICAS). Evidence shows that in diabetic men, intima-media thickness is significantly higher in those with ApoE4 than those with ApoE3. While the link between ApoE4 and extracranial atherosclerosi...

Introduction: Short-term dual antiplatelet therapy (DAPT) lowers the risk of early stroke recurrence after mild non-cardioembolic ischemic stroke (NCIS) and high-risk transient ischemic attack. However, DAPT benefit in moderate-to-severe NCIS is unknown. We sought to investigate time-trends and determinants of DAPT prescription after moderate-to-se...

Objective: Transition of Care Stroke Disparities Study is an observational prospective cohort aimed to investigate disparities in the transition of stroke care (TOSC) post-hospitalization to home and to identify factors associated with adequate TOSC and stroke outcomes. we have demonstrated that higher individual socioeconomic status is associated...

Background: Stroke coordinators (SC’s) are essential leaders of certified stroke centers which facilitate evidence-based stroke care, improving patient outcomes. Although this role has existed since the 1970’s, significant variability of responsibilities and staffing exists. Evidence based recommendations for SC staffing are scarce. Purpose: Utiliz...

Introduction: The Neurofilament light chain (NfL) is a neuronal cytoplasmic protein and a reliable biomarker for assessing axonal damage in neurological diseases and traumatic brain injury. Asymptomatic intracranial large artery stenosis (ILAS) has been associated with higher risk of stroke and dementia. Although widely studied in the last few year...

Antidepressants (AD), particularly selective serotonin reuptake inhibitors (SSRIs), are amongst the most frequently prescribed medications. Concerns have been raised regarding their potential increased risk of bleeding complications including intracerebral hemorrhage (ICH) as they are known to affect platelet function. In the large Florida Stroke R...

Introduction: The outcomes of endovascular thrombectomy (EVT) in SARS-CoV2 positive patients with acute ischemic stroke (AIS) are not well studied. In the large Florida Stroke Registry we compared in hospital and discharge outcomes of patients with target vessel occlusions treated endovascularly with versus without a SARS-CoV2 positive infection st...

Introduction: The wall stress is the major contributor of arterial stiffness, which is well-known risk factor for cardiovascular diseases. The interindividual variability of the Circle of Willis affects blood flow redistribution intracranially. The fetal posterior cerebral artery (fPCA) is associated with larger carotid arteries due to increased br...

Background Resting-state electroencephalogram (rsEEG) is usually obtained to assess seizures in comatose patients with traumatic brain injury (TBI) patients. We aim to investigate rsEEG measures and their prediction of early recovery of consciousness in comatose TBI patients. Methods This is a retrospective study of comatose TBI patients who were...

INTRODUCTION Neurogranin (Ng) is considered a biomarker for synaptic dysfunction in Alzheimer's disease (AD). In contrast, the inflammasome complex has been shown to exacerbate AD pathology. METHODS We investigated the protein expression, morphological differences of Ng, and correlated Ng to hyperphosphorylated tau in the post mortem brains of 17...

Background and Purpose Brain arterial diameters are markers of cerebrovascular disease. Demographic and anatomical factors may influence arterial diameters. We hypothesize that age, sex, height, total cranial volume (TCV), and persistent fetal posterior cerebral artery (fPCA) correlate with brain arterial diameters across populations. Methods Part...

Background Osteopontin is a proinflammatory cytokine associated with systemic vascular, inflammatory, and autoimmune diseases. It has been recently implicated in neuroinflammation and neurodegeneration. We hypothesized that plasma osteopontin is a deleterious neuroinflammatory marker increased in people with dementia and cerebral small vessel disea...

Background Progressive cognitive decline is a characteristic of Alzheimer’s disease (AD). Identifying reliable predictors of conversion to dementia in older adults, particularly those with mild cognitive impairment (MCI), is critical for clinicians, patients, and patient families. Method 1083 adult participants (Age: M = 73.20, SD = 6.92) were inc...

Background It is unclear whether brain artery diameters measured on conventional T2‐weighted brain MRI images relate to dementia and stroke outcomes across distinct populations. We aimed this study to evaluate the association of T2‐weighted brain artery luminal diameters with dementia and stroke in three distinct population‐based studies. Methods...

Background Alzheimer disease (AD) presents with two primary pathologies: neurofibrillary tangles (NFT) and neuritic plaques (NP). However, these hallmark pathologies typically co‐occur with pathologies from AD‐related dementias like cerebral amyloid angiopathy (CAA) [Godrich, 2022; PMID: 35142102]. While CAA is known to impact cognitive impairment,...

Objective Exercise elicits a variety of physiological responses in the body. In the brain, exercise can modulate levels of neurotransmitters and other neurochemicals as well as sparking neurogenesis and structural changes. Downstream psychological effects of exercise include changes in mood and cognition. These changes vary depending on the type of...

Objective Understanding the factors contributing to optimal cognitive function throughout the aging process is essential to better understand successful cognitive aging. Processing speed is an age sensitive cognitive domain that usually declines early in the aging process; however, this cognitive skill is essential for other cognitive tasks and eve...

Background and Objectives Red blood cell (RBC) concentrations are known to associate with ischemic stroke. It is unclear whether RBC concentrations associate specifically with small vessel disease lacunar infarcts. We investigated the hypothesis that RBC concentrations associate with both chronic covert and acute symptomatic brain MRI lacunar infar...

Background Life's Essential 8 (LE8) is a new metric to define cardiovascular health. We aimed to describe LE8 among Hispanics/Latinos and its association with incident hypertension. Methods and Results The HCHS/SOL (Hispanic Community Health Study/Study of Latinos) is a study of Hispanic/Latino adults aged 18 to 74 years from 4 US communities. At...

BACKGROUND Aortic arch plaques are associated with an increased risk of ischemic stroke in patients with cryptogenic stroke or prior embolic events. However, this relationship is unclear in the community. We investigated (1) the long-term risk of stroke and cardiovascular events associated with arch plaques and (2) whether statin therapy prescribed...

Background Brain arterial diameters (BADs) are novel imaging biomarkers of cerebrovascular disease, cognitive decline, and dementia. Traditional vascular risk factors have been associated with BADs, but whether there may be genetic determinants of BADs is unknown. Methods and Results The authors studied 4150 participants from 6 geographically dive...

Background Guideline‐based hypertension management is integral to the prevention of stroke. We examine trends in antihypertensive medications prescribed after stroke and assess how well a prescriber's blood pressure (BP) medication choice adheres to clinical practice guidelines (BP‐guideline adherence). Methods and Results The FSR (Florida Stroke...

Introduction: The prevalence of heart failure (HF) is rising, particularly in older adults. Left atrial (LA) dysfunction is commonly seen in HF, but it is unclear if it predicts onset or contributes to its development. Hypothesis: LA strain reduction is associated with incident HF in the general elderly population, independent of other risk factors...

Background Inflammation contributes to atherosclerosis but is incompletely characterized in intracranial large artery stenosis (ICAS). We hypothesized that immune markers would be associated with ICAS and modify the risk ICAS confers on future vascular events. Methods This study included a subsample of stroke-free participants in the prospective N...

Prior work in the Northern Manhattan Study (NOMAS) identified impaired cognition in cross-sectional analyses and more rapid memory decline in individuals with evidence of prior common infectious disease exposures. In this study, we sought to determine the cross-sectional relationship between prior exposure to cytomegalovirus, herpes simplex viruses...

Aims Current guidelines recommend measuring carotid intima-media thickness (IMT) at the far wall of the common carotid artery (CCA). We aimed to precisely quantify associations of near vs. far wall CCA-IMT with the risk for atherosclerotic cardiovascular disease (CVD, defined as coronary heart disease or stroke) and their added predictive values....

Cortical GABA levels are reduced in older age; age-related differences in GABA may be associated with age-related cognitive change. The nature of age-related GABA differences in the highest-functioning stratum of the oldest-old (85+) population is not yet known. We extend our previously-reported Individual Participant Data Meta-Analysis of GABA lev...

Eye tracking assessments are clinician dependent and can contribute to misclassification of coma. We investigated responsiveness to videos with and without audio in traumatic brain injury (TBI) subjects using video eye-tracking (VET). We recruited 20 healthy volunteers and 10 unresponsive TBI subjects. Clinicians were surveyed whether the subject w...

Objectives: Given Mediterranean-style diet (MeDi) reduces risk of cardiovascular events, we hypothesized MeDi may also be protective against intracranial large artery stenosis (ICAS), a common cause of stroke worldwide. Methods: This cross-sectional study included stroke-free participants of the Northern Manhattan Study, a diverse population-bas...

Background Premature ventricular contractions (PVCs) and nonsustained ventricular tachycardia (NSVT) are known to be associated with reduced left ventricular (LV) ejection fraction and adverse outcomes in patients with structural heart disease. The relationship between subclinical LV dysfunction and ventricular arrhythmias in the general population...

Background Hospital readmission is an important indicator of poor transition of care post-stroke. Data on characteristics of patients at highest risk for readmission is limited and necessary to inform effective interventions. The goal is to identify risk factors at hospital discharge that predict 30-day readmission in the Florida Stroke Registry (F...

Background: While much is known about the effects of physical exercise in adult humans, literature on the oldest-old (≥ 85 years old) is sparse. The present study explored the relationship between self-reported engagement in physical exercise and cognition in the oldest-old. Methods: The sample included 184 cognitively healthy participants (98 f...

Background: Sleep duration is associated with stroke risk and is 1 of 8 essential components of cardiovascular health according to the American Heart Association. As stroke disproportionately burdens Black and Hispanic populations in the United States, we hypothesized that long and short sleep duration would be associated with greater subclinical...

Background: Extensive evidence indicates that vasculopathy, especially the level of microcirculation, contributes to neurodegeneration in Alzheimer disease (AD). However, it is not easy to directly monitor cerebral microcirculation. The retinal microvasculature has been proposed as a surrogate measure to study cerebral vascular changes. Indeed, de...

Objective: The Transitions of Stroke Care Disparities Study (TCSD-S) is an observational study designed to determine race-ethnic and sex disparities in post-hospital discharge transitions of stroke care and stroke outcomes and to develop hospital-level initiatives to reduce these disparities to improve stroke outcomes. Materials and methods: Her...

Unlabelled: Temporal trends and factors associated with the withdrawal of life-sustaining therapy (WLST) after acute stroke are not well determined. Design: Observational study (2008-2021). Setting: Florida Stroke Registry (152 hospitals). Patients: Acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH...

Background Neurogranin (Ng) is a post‐synaptic protein involved in formation of long‐term potentials, and thus plays an important role in learning and memory. The concentration of Ng is increased in the cerebrospinal fluid (CSF) of people with Alzheimer’s disease (AD), and CSF Ng is considered to be a biomarker for synaptic dysfunction in AD. The e...

Background The 2021 Alzheimer’s Association International Conference press release forecasted global dementia cases to triple by 2050, due to the major contribution of increases in vascular risk factors. The Global Vascular Risk Score (GVRS) was developed to predict vascular events using a point‐based index for risk factor variables, though has dem...

Background The association between common carotid artery intima‐media thickness (CCA‐IMT) and incident carotid plaque has not been characterized fully. We therefore aimed to precisely quantify the relationship between CCA‐IMT and carotid plaque development. Methods and Results We undertook an individual participant data meta‐analysis of 20 prospec...

Background Arterial stiffness is a degenerative modification of the arterial wall significantly influencing normal aging, longevity, and vascular health. Hypertension is a major risk factor for the development of arterial stiffness, which can lead to changes in cerebral perfusion and cognitive dysfunction. This, in turn, can increase the risk of co...

Background: The role of diastolic blood pressure (DBP) with cognitive functioning is under-explored in relation to levels of systolic blood pressure (SBP). Methods: We studied 5466 participants from the National Health and Nutrition Examination Survey. Blood pressure was measured 3 times manually with a standardized sphygmomanometer and averaged...

Objective: To test the hypothesis that intracranial arterial calcification (IAC) is associated with intracranial large artery stenosis (ILAS) and a higher risk of vascular events and mortality. Method: We leveraged data from two cohorts, the New York-Presbyterian Hospital/Columbia University Irving Medical Center Stroke Registry Study (NYP/CUIMC...

Objective: Stroke is a global public health burden, and therefore it is critical to identify modifiable risk factors to reduce stroke incidence and improve outcomes. Depression is such a risk factor; however, the association between preexisting depression and stroke outcomes, such as independent ambulation, is not well studied, especially among ra...

Background and aims: The presence of aortic arch plaques (AAP) is significantly associated with increased cardiovascular morbidity and mortality. Few studies have examined the incidence of AAP progression and factors which may contribute to it using transthoracic echocardiography (TTE). The objective of this study was to utilize sequential imaging...

OBJECTIVES/GOALS: The goal of Miami CTSI’s Mentored Translational Research Scholars (KL2) Program is to identify outstanding early-stage investigators and prepare them to become the next generation of highly skilled independent researchers who translate fundamental knowledge and new technologies from the laboratory to the clinic and to the communit...

Objectives This study investigated video eye tracking (VET) in comatose patients with traumatic brain injury (TBI). Methods We recruited healthy participants and unresponsive patients with TBI. We surveyed the patients' clinicians on whether the patient was tracking and performed the Coma Recovery Scale–Revised (CRS-R). We recorded eye movements i...

Perivascular space (PVS) burden is an emerging, poorly understood, magnetic resonance imaging marker of cerebral small vessel disease, a leading cause of stroke and dementia. Genome-wide association studies in up to 40,095 participants (18 population-based cohorts, 66.3 ± 8.6 yr, 96.9% European ancestry) revealed 24 genome-wide significant PVS risk...

Background: Aortic valve calcification (AVC) is a common valvular abnormality that predisposes to stenosis; AVC progression and factors associated with it remain unclear. We investigated the association of clinical factors and serum biomarkers with AVC progression in a population-based cohort of older adults. Methods: Participants enrolled in bo...

Background: The American Heart Association’s Life Essential 8 (LE8) are a set of eight simple health metrics used to define cardiovascular (CV) health and promote healthy behaviors. Our objectives are to: 1) describe for the first time, LE8 among Hispanics/Latinos of diverse backgrounds and 2) determine the association between LE8 and incident hype...

Background: The impact of time to treatment on outcomes of endovascular thrombectomy (EVT) especially in patients presenting after 6 hours from symptom onset is not well characterized. We studied the differences in characteristics and treatment timelines of EVT-treated patients participating in the Florida Stroke Registry and aimed to characterize...