Nevada nursing professor awarded National Institutes of Health grant to study detection of ischemia

December 13, 2010

RENO, Nev. - University of Nevada, Reno Orvis School of Nursing researcher Michele Pelter has been awarded $377,000 from the National Institutes of Health to study detection of ischemia, a condition that can lead to heart attacks.

Over the two-year course of the study, Pelter will work with two local cardiologists, Dr. Richard Ganchan and Dr. Anita Kedia, who will serve as consultants on the study. She wants to see if different monitoring of patients experiencing symptoms of possible ischemia could lead to better care.

Ischemia occurs when there is a plaque rupture, and the body responds by forming a clot in an effort to stop the bleeding. But, this causes blockage in the coronary artery, the heart starts to suffer from lack of blood flow, and if the clot doesn't dissolve itself or isn't cared for medically, it can lead to a heart attack.

"The rupture creates a local injury and sets in motion a series of physiological processes," Pelter explains. "Sometimes the clot gets washed away, but then it does it again. It can come and go."

Because of this phenomenon of "coming and going" and the various locations the clots can occur, Pelter wants to see if a different form of monitoring would provide more complete information on which the physicians could base their care, resulting in better care being received.

An EKG is used to monitor patients experiencing chest pain or other possible related symptoms. But, an EKG can utilize varied numbers of "leads" or electrodes attached to the body, ranging from two to 12. Currently, the prescribed standard of care calls for two leads, or points of monitoring.

"If the electrode isn't where the blockage is, it can get missed," Pelter said. "Sometimes a 12-lead EKG will be done once a day, or with symptoms, but since the blockages sometimes come and go, if the 12-lead monitor isn't hooked up at the right time, detection of the blockage may be missed."

In Pelter's study, patients will be hooked to a "Holter," a small device that straps on to the chest, which will record results from a 12-lead EKG that will monitor the patient continuously for 48 hours. She wants to see if physicians would possibly prescribe different care if this method of monitoring were used.

"Perhaps there will be ischemia detected with this form of monitoring that would have resulted in different care, such as medication being prescribed to dissolve the clots early, or possibly more invasive procedures, if needed," she said.

Pelter explained that in medicine, "You don't just change the current standard of care unless there is research that indicates there is a better one. Currently, patients are getting very good care, the best care that is known. But, maybe this type of monitoring would enable physicians to provide even better care. We will see."

Pelter says that the 12-lead constant monitoring can be cumbersome to work around when trying to care for patients, as well as expensive. But, one benefit is that it is noninvasive. If there is research indicating that this form of monitoring results in better assessment of ischemia and identifies high-risk patients who might benefit from more aggressive treatment, it could change the current standard of care.

Pelter will meet with the cardiologists throughout the study and will have a Data Safety Monitoring Board, which will meet every few months to check on how the study is going and ensure patient safety. Pelter is grateful to those who have agreed to serve on the board and collaborate with her on the study.

"Having Dr. Richard Ganchan and Dr. Anita Kedia, two excellent cardiologists, agree to work with me on this was key to being able to do this important research and get the funding to do it," she said.

Pelter, currently assistant professor of nursing at Nevada's Orvis School of Nursing, is also an alum of the school and a native Nevadan. After earning her bachelor's degree of nursing at Nevada, she went on to earn her master's and doctorate degrees at the University of California, San Francisco, where she was part of a research team for 10 years before returning to Reno in 2004. She joined the University of Nevada, Reno in 2008, after serving as director of nursing research at Renown Regional Medical Center for four years.
Photo Cutline: Michele Pelter, assistant professor at Nevada's Orvis School of Nursing, has been awarded $377,000 from the National Institutes of Health to study detection of ischemia, a condition that can lead to heart attacks.

Nevada's land-grant university founded in 1874, the University of Nevada, Reno has an enrollment of more than 17,000 students. The University is home to one the country's largest study-abroad programs and the state's medical school, and offers outreach and education programs in all Nevada counties. For more information, visit

Media Contact:
Claudene Wharton
Media Relations Officer
University Media Relations
University of Nevada, Reno/108
Reno, NV 89557
775-784-1169 phone
775-784-1422 fax

University of Nevada, Reno

Related Health Articles from Brightsurf:

The mental health impact of pandemics for front line health care staff
New research shows the impact that pandemics have on the mental health of front-line health care staff.

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.

New measure of social determinants of health may improve cardiovascular health assessment
The authors of this study developed a single risk score derived from multiple social determinants of health that predicts county-level cardiovascular disease mortality.

BU study: High deductible health plans are widening racial health gaps
The growing Black Lives Matter movement has brought more attention to the myriad structures that reinforce racial inequities, in everything from policing to hiring to maternal mortality.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

E-health resource improves men's health behaviours with or without fitness facilities
Men who regularly used a free web resource made significantly more health changes than men who did not, finds a new study from the University of British Columbia and Intensions Consulting.

Mental health outcomes among health care workers during COVID-19 pandemic in Italy
Symptoms of posttraumatic stress disorder, depression, anxiety and insomnia among health care workers in Italy during the COVID-19 pandemic are reported in this observational study.

Mental health of health care workers in china in hospitals with patients with COVID-19
This survey study of almost 1,300 health care workers in China at 34 hospitals equipped with fever clinics or wards for patients with COVID-19 reports on their mental health outcomes, including symptoms of depression, anxiety, insomnia and distress.

Health records pin broad set of health risks on genetic premutation
Researchers from the University of Wisconsin-Madison and Marshfield Clinic have found that there may be a much broader health risk to carriers of the FMR1 premutation, with potentially dozens of clinical conditions that can be ascribed directly to carrying it.

Attitudes about health affect how older adults engage with negative health news
To get older adults to pay attention to important health information, preface it with the good news about their health.

Read More: Health News and Health Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to