• Patients with:

  • adrenal mass of any etiology

  • steroidogenesis defect ( examples: 21OH congenital hyperplasia, 11 beta congenital hyperplasia)

  • primary or secondary adrenal insufficiency

  • Cushing’s syndrome due to pituitary or ectopic ACTH production

  • Inadequate glucocorticoid, mineralocorticoid or androgen axis of unknown etiology

  • Healthy individuals

  • Patients seen for problems other than mentioned above and willing to contribute biomaterial

• Age 18-99 years

  ---

  Exclusion Criteria:
             

• Age <18 years

   

• Female patients who have axillary lymph nodes which may be benign or may have been diagnosed or suspicious for breast cancer will be candidates for enrollment.
• It is anticipated that the majority of these participants will undergo an US guided lymph node biopsy (standard of care). U.S. and CUSE/SDUV data collection from each participant will take place before or 2 weeks after lymph node biopsy/aspiration.  

• Having any condition that does not allow proper use of our imaging devices.

1. Subjects with inherited metabolic myopathy or suspected inherited metabolic myopathy who had a non-diagnostic muscle biopsy, normal plasma acylcarnitines, normal commercially available muscle biochemical assay of glycolytic enzymes and CPT2 ( “myoglobinuria panel”).

2. Subjects with muscular dystrophy and non-specific dystrophic changes on muscle biopsy, normal immunocytochemical studies for proteins associated with muscular dystrophies and at least 1 negative genetic test for the most likely candidate gene.

3. Subjects with mitochondrial myopathy and normal muscle mitochondrial DNA analysis (no pathogenic point mutations or deletions/duplications).

4. Subjects with congenital myopathies, vacuolar myopathies and other structural myopathies with at least 1 negative genetic test for the most likely candidate gene.

5. Subjects with myotonic disorders and/or periodic paralysis with negative gene test for myotonic dystrophy type 1 and/or 2, and normal sequencing of CLCN1 and SCN4A if they have a normal muscle biopsy.

• Anyone undergoing cardiac catheterization for suspected coronary artery disease over age 18.

• Patients currently on long-term antibiotics who cannot stop them for at least 2 weeks prior to providing a stool sample.
• Patients on chronic laxatives who cannot stop for at least 24 hours prior to stool collection.
• Patients who are unable to provide a stool sample to Mayo clinic within 24 hours of collection via FedEx overnight mail. (i.e., people overseas who are unable to provide a sample before leaving the USA).

Inclusion Criteria

• Male and female patients, aged 0-100 years.
• Subjects with a clinical diagnosis of interest.
• Subjects aged ≥ 18 years who are biologically related to an individual with a diagnosis of interest.
• Subjects aged ≥ 18 years who have elected to participate as a healthy donor/control.

Exclusion Criteria

• Unaffected children < 18 years of age who are not clinically diagnosed with a disease of interest.
• Patients with an allergy to subcutaneous lidocaine or bupivacaine (if undergoing a dermal punch biopsy).
• Subjects unable to consent to the study or have a parent/guardian/witness sign on their behalf.

Eligibility last updated 5/9/22. Questions regarding updates should be directed to the study team contact.

Inclusion Criteria:

• Healthy individuals not curently experiencing a chronic medical condition.

• Pregnancy 
• Weight less than 110 pounds 
• Smoker 
• Self-reported use of immunomodulatory or immunosuppresive drugs such as inhaled glucocorticoids within past 3 months
• Self-reported history of autoimmune disease.

Inclusion Criteria for Controls.

• Healthy male (N=30) and female (N=30) volunteers aged 18-80 years.

• Having capacity to provide written informed consent before participating in the study.

• Able to communicate adequately with the investigator and to comply with the requirements for the entire study.

Inclusion Criteria for Constipated Patients.

• Male and female volunteers aged 18-80 years.

• Individuals with chronic constipation for 1 year, with 2 or more of the following symptoms for 3 months or longer: <3 bowel motions/week, straining ≥ 25% of time, hard or lumpy stools ≥ 25% of time, incomplete evacuation ≥ 25% of time, feeling of anorectal blockage ≥ 25% of time.

• Having capacity to provide written informed consent before participating in the study.

• Able to communicate adequately with the investigator and to comply with the requirements for the entire study.

Exclusion Criteria for Controls (Items indicated with an asterisk are also exclusion criteria for patients).

• Clinical evidence of significant cardiovascular, respiratory, renal, hepatic, gastrointestinal, hematological, neurological, psychiatric or other disease that may interfere with the objectives of the study and/or pose safety concerns.*

• Current symptoms of a functional gastrointestinal disorder assessed by questionnaire [2, 16].

• Putative risk factors for pelvic floor trauma: i.e. six or more vaginal deliveries, birthweight >4500gms (macrosomia), or known 3rd or 4th degree perineal tear.

• Medications that are likely to alter gastrointestinal motility: e.g., opiates, anticholinergic medications, serotoninergic agents, alpha adrenergic agonists, calcium channel or b blockers; a stable dose of thyroxine will be permitted (i.e. no alterations in dose for the preceding three months).

• Active rectal inflammation, cancer; perianal sepsis; history of pelvic radiation, rectosigmoid surgery or inflammatory bowel disease.*

• Anxiety or depression as assessed by the Hospital Anxiety and Depression Questionnaire [17].

• Contraindications for MR imaging: i.e. pacemakers, aneurysm clips, cochlear implants.*

• Pregnant women, prisoners and institutionalized individuals.*

   

• Subjects with ventricular tachycardia that require an epicardial ablation approach.
• Subjects with atrial fibrillation who require the deployment of left atrial appendage occluder device (LARIAT).
• Subjects with frequent ventricular ectopic activities that require an epicardial ablation approach.
• Subjects with coronary artery disease undergoing CABG with a history of atrial fibrillation.
• Subjects with coronary artery disease who require coronary bypass surgery
• Subjects with aortic valve disease who require aortic valve replacement surgery
• Subjects who have hypertrophic cardiomyopathy who require surgical septal myomectomy.

• Subjects not requiring one of the above ablative or surgical procedures.
• Subjects not willing to provide consent.
• Subjects with concomitant mitral valvular heart disease, or congenital heart disease.
• Subjects who has mitral or tricuspid valve disease who require surgical replacement or repair

• Qualify to participate in one of the Rare Kidney Stone Registries.
• Be at least 5 years old (for SF-10)
• Are able to communicate using the English language
• Consent to participate in the study (or "assent" if under 18 years old)
• Have internet access with an email account or a valid home address

None, if inclusion criteria are met

Inclusion Criteria

• Age ≥ 18 years old.
• Able to provide informed consent to enroll in the trial, or consent through a legal guardian or power of attorney.
• Previous clinical diagnosis of HF with current NYHA Class II–III symptoms.
• At least one of the following:
  • Hospitalization for decompensated HF;
  • Acute treatment for HF with an intravenous diuretic or hemofiltration;
  • Chronic treatment with a diuretic for control of HF symptoms + left atrial enlargement or elevated E/e’ ratio (≥ 14 average, ≥ 15 septal) on echocardiography;
  • Resting PCWP ≥ 15 mm Hg or LV end-diastolic pressure > 18 mmHg at catheterization for dyspnea, and/or exercise PCWP/LV end-diastolic pressure > 25 mmHg;
  • Elevated NT-proBNP level (≥ 300 pg/ml).
• Left ventricular EF ≥  40% within 12 months with clinical stability.
• Stable cardiac medical therapy for ≥ 30 days.
• Sinus rhythm.
• Chronotropic incompetence on recent (within 6 months) clinical exercise test, defined as heart rate reserve (HRR) < 0.80 or < 0.62 if on beta blockers:
  • HRR = [observed peak HR – observed rest HR]/[predicted peak HR – observed rest HR];
  • Predicted peak HR will be calculated using the formula (220-age).
• Meet both screening criteria on clinically-performed CPX within 12 months.

• Discernable ventilatory anaerobic threshold on previous CPX study.
• Inability to exercise, or non-cardiac condition that precludes exercise testing.
• Any contraindication to a pacemaker system.
• Non-cardiac condition limiting life expectancy to less than one year.
• Significant left sided structural valve disease (> mild stenosis, > moderate regurgitation).
• Hypertrophic obstructive cardiomyopathy.
• Infiltrative or inflammatory myocardial disease (amyloid, sarcoid).
• Pericardial disease.
• Non-group 2 pulmonary arterial hypertension.
• Chronic stable exertional angina.
• Acute coronary syndrome or revascularization within 60 days.
• Other clinically important causes of dyspnea.
• Atrial fibrillation.
• PR interval > 210 msec.
• Resting heart rate (HR) > 100 bpm.
• A history of reduced ejection fraction (EF < 40%).
• Advanced chronic kidney disease (GFR < 20 ml/min/1.73m^2 by modified MDRD equation).
• Women of child bearing potential without negative pregnancy test and effective contraception.
• Severe anemia (Hemoglobin < 10 g/dL).
• Severe hepatic disease.
• Complex congenital heart disease.
• Listed for cardiac transplantation.
• Other class I indications for pacing.

Eligibility last updated 11/9/21. Questions regarding updates should be directed to the study team contact.

• Has a Mini-Mental State Examination (MMSE) score at screening of 25 to 30
• Has a global Clinical Dementia Rating (CDR) scale score at screening of 0
• Has a Logical Memory II score at screening of 6 to 18
• Has a florbetapir positron emission tomography (PET) scan that shows evidence of brain amyloid pathology at screening
• Has a study partner that is willing to participate as a source of information and has at least weekly contact with the participant (contact can be in-person, via telephone or electronic communication)

• Is receiving a prescription acetylcholinesterase inhibitor (AChEI) and/or memantine at screening or baseline
• Lacks good venous access, such that intravenous drug delivery or multiple blood draws would be precluded
• Has current serious or unstable illness including cardiovascular, hepatic, renal, gastroenterologic, respiratory, endocrinologic, neurologic, psychiatric, immunologic, or hematologic disease or other conditions that, in the investigator's opinion, could interfere with the analyses of safety and efficacy in this study
• Has had a history within the last 5 years of a serious infectious disease affecting the brain (including neurosyphilis, meningitis, or encephalitis) or head trauma resulting in protracted loss of consciousness
• Has had a history within the last 5 years of a primary or recurrent malignant disease with the exception of any in situ cancer that was appropriately treated and is being appropriately monitored, such as resected cutaneous squamous cell carcinoma in situ or in situ prostate cancer with normal prostate-specific antigen post-treatment
• Has a known history of human immunodeficiency virus (HIV), clinically significant multiple or severe drug allergies, or severe post-treatment hypersensitivity reactions (including, but not limited to, erythema multiforme major, linear immunoglobulin A dermatosis, toxic epidermal necrolysis, or exfoliative dermatitis)
• Is clinically judged by the investigator to be at serious risk for suicide
• Has a history within the past 2 years of major depression or bipolar disorder as defined by the most current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM)
• Has a history within the past 5 years of chronic alcohol or drug abuse/dependence as defined by the most current version of the DSM

Inclusion Criteria

• Patients will be recruited from those being evaluated and treated for gliomas
• MRE exams will be coordinated with and performed during scheduled standard of care imaging
• Patient ages of 18 to 99 years

Exclusion Criteria

•  Contraindications to MRI scanning are present such as
  • a cardiac pacemaker
  • intraocular or intracranial metallic object
  • other MRI incompatible devices
  • claustrophobia. 

Inclusion Criteria

• A subset of 32 healthy subjects from those participants enrolled in studies IRB 11-002121 and IRB 11-007272
• BMI 18.5-35 kg/m2 
• age 18-40 years
• non-smokers
• free of any chronic medical or psychiatric disorders
• on no medications other than birth control and second generation antihistamines
• will have a history of normal sleep patterns

Inclusion Criteria:

• Patients fulfilling the following criteria will be eligible for entry into this study:

  1. Patients with de novo MDS who have, or have previously had, Intermediate-2 or High risk disease as determined by the International Prognostic Scoring System (IPSS). Current Intermediate-2 or High risk disease is NOT a requirement.
  2. Patients must have fewer than 20% marrow blasts at the time (within 30 days) of registration and consent.
  3. Patients may have received prior therapy for the treatment of MDS, including but not limited to: growth factor, transfusion support, immunomodulatory (IMID) therapy, DNA hypomethylating therapy or cytotoxic chemotherapy prior to trial registration.
  4. Age 50.0-75.0 years.
  5. Karnofsky performance status > 70 or Eastern Cooperative Oncology Group (ECOG) ≤ 1 (see comparison scale in Appendix D).
  6. Patients are eligible if no formal unrelated donor search has been activated prior to enrollment. Patients who have started a sibling donor search or who have found a matched sibling donor are eligible.

  7. Patients and physicians must be willing to comply with treatment assignment:

     1. No intent to proceed with alloHCT using donor sources not specified in this protocol, including Human leukocyte antigen (HLA)-mismatched related or unrelated donors < 6/6 HLA related matched or < 8/8 HLA unrelated matched) or umbilical cord blood unit(s).
     2. No intent to use myeloablative conditioning regimens.
     3. Intent to proceed with RIC alloHCT if a matched sibling or matched unrelated donor is identified. There is no requirement as to the timing of the transplantation.
  8. Patients must be considered to be suitable RIC alloHCT candidates at the time of enrollment based on medical history, physical examination and available laboratory tests. Specific testing for organ function is not required for eligibility but, if available, these tests should be used to judge eligibility.
  9. Signed informed consent

• Patients with the following will be ineligible for registration onto this study:

  1. Therapy-related MDS
  2. Current or prior diagnosis of AML
  3. Uncontrolled bacterial, viral or fungal infection
  4. Concurrent malignancy other than superficial squamous cell or basal cell carcinoma of the skin
  5. Prior autologous or allogeneic HCT
  6. Human Immunodeficiency Virus (HIV) infection
  7. Fertile patients unwilling to use contraceptive techniques
  8. Patients with psychosocial conditions that would prevent study compliance

Inclusion Criteria

• All patients (pediatric patients from birth and adults with a bleeding disorder) being followed in Mayo Comprehensive Hemophilia Center.

• None 

Normal Subjects Inclusion Criteria

• Volunteers without epilepsy or CNS disease other than primary headache disorder.
• Ages  5-55 years
• Adult subjects able to tolerate an unsedated MRI on MR 41 (Siemens Skyra) and possibly a 2nd MRI on MR 37 (GE), and, further, possibly a 3rd MRI (one sequence only) on MR 41.
• Pediatric subjects (5-17 years) able to tolerate an unsedated MRI on MR 37.
• Able to tolerate a wake/sleep EEG.
• Previously received medical care at Mayo Rochester and consents to medical information review

Normal Subjects Exclusion Criteria 

• Prior history of seizures or epilepsy
• Prior history of other central nervous system disease other than primary headache disorder
• Prior intracranial surgical procedure
• Presence of implanted devices on Radiology’s list of incompatible devices or those in which non-routine MRI processes or procedures are required
• Chronic neck or back pain, restless legs syndrome, movement disorders, claustrophobia, or other medical problems that would interfere with the patient laying still in the scanner
• Does not consent to review of medical information
• Pregnancy
• Imbedded intraorbital or scalp metallic foreign body
• Weight greater than 300 pounds

Epilepsy Cases Inclusion Criteria

• Volunteers with epilepsy
• Ages 5-70 years
• Adult subjects able to tolerate an unsedated MRI on MR 41 (Siemens Skyra).
• Pediatric subjects (5-17 years) able to tolerate an unsedated MRI on MR 37.
• Previously received medical care at Mayo Rochester and consents to medical information review

Epilepsy Cases Exclusion Criteria 

• Prior history of other central nervous system disease other than primary headache disorder or epilepsy
• Prior intracranial surgical procedure
• Presence of implanted devices on Radiology’s list of incompatible devices or those in which non-routine MRI processes or procedures are required
• Chronic neck or back pain, restless legs syndrome, movement disorders, claustrophobia, or other medical problems that would interfere with the patient laying still in the scanner
• Does not consent to review of medical information
• Pregnancy
• Imbedded intraorbital or scalp metallic foreign body
• Weight greater than 300 pounds

• Clinical diagnosis of type 1 diabetes.

• Refusal of permission to use medical records for ongoing research.

• Clinical diagnosis of type 1 diabetes.

• Refusal of permission to use medical records for ongoing research.

1. Established diagnosis of granulomatosis with polyangiitis (GPA) where patients will need to meet at least 2 of the 5 for the classification of GPA, at least one of which must be criterion d or e:

   The modified American College of Rheumatology (ACR) criteria are:

   A. Nasal or oral inflammation, defined as the development of painful or painless oral ulcers or purulent or bloody nasal discharge.

   B. Abnormal chest radiograph, defined as the presence of nodules, fixed infiltrates, or cavities.

   C. Active urinary sediment, defined as microscopic hematuria (>5 red blood cells per high power field) or red blood cell casts.

   D. Granulomatosis inflammation on biopsy, defined as histologic changes showing granulomatous inflammation within the wall of an artery or in the perivascular or extravascular area. Note: Pauci-immune glomerulonephritis seen on kidney biopsy will suffice for this criterion.

   E. Positive anti-neutrophil cytoplasmic antibody (ANCA) test specific for proteinase-3 measures by enzyme-linked immunoassay.

   Patients who are myeloperoxidase (MPO) positive or ANCA negative are still eligible for this study if they meet the criteria above and are felt to have GPA.

2. Active disease within the prior 12 months (initial presentation or relapse) that at time of active disease required treatment with prednisone >20 mg/day.
3. Disease remission at time of enrollment.
4. Prednisone dose at time of enrollment of ≥ 5 mg/day and ≤ 20 mg/day.
5. Participant age of 18 years or greater.
6. If the patient is taking an immunosuppressive medication agent other than prednisone (maintenance agent) then the maintenance agent must be at a stable dose for one month prior to enrollment with no plans by the treating physician to change the dose (other than for safety purposes/toxicity) for the duration of the study (through the month 6 visit or early termination). Acceptable maintenance agents include azathioprine, leflunomide, 6-mercaptopurine, methotrexate, mycophenolate mofetil, or mycophenolate sodium. Patients may be on trimethoprim/sulfamethoxazole (TMP/SMX) for use as either a maintenance agent or for prophylaxis for infection. TMP/SMX may be used in combination with other drugs.

•  Rituximab is an acceptable maintenance agent if the last dose was given at least one month prior to enrollment and no additional doses are planned) for the duration of the study (through the month 6 visit or early termination). If a patient received rituximab and was then prescribed another maintenance agent, the patient is eligible if there are no plans by the treating physician to change the dose of the maintenance (other than for safety purposes/toxicity) for the duration of the study (through the month 6 visit or early termination).
•  If the patient is regularly taking trimethoprim/sulfamethoxazole at any dose then the patient is eligible if there no plans by the treating physician to change the dose after enrollment (other than for dose reduction or discontinuation for safety purposes/toxicity) for the duration of the study.

1. Comorbid condition that has moderate likelihood of requiring a course of prednisone within one year of enrollment (e.g. chronic obstructive pulmonary disease (COPD), asthma, adrenal insufficiency).

• Adult patients ≥ 18 years of age.
• Must be able to provide informed consent.
• Diagnosis of a rheumatic disease by a rheumatologist; i.e.:
  • Rheumatoid arthritis;
  • Psoriatic arthritis;
  • Ankylosing spondylitis;
  • Arthritis associated with inflammatory bowel disease;
  • Undifferentiated spondyloarthritis;
  • Systemic lupus erythematosus;
  • Sjogren’s syndrome;
  • Scleroderma/systemic sclerosis;
  • Polymyositis;
  • Dermatomyositis;
  • Mixed connective tissue disease;
  • Granulomatosis with polyangiitis;
  • Microscopic polyangiitis;
  • ANCA-associated vasculitis;
  • Giant cell arteritis;
  • Takayasu arteritis;
  • Polyarteritis nodosa;
  • Drug-induced rheumatic disorders.
• First-degree relative of a patient with a diagnosis of a rheumatic disease.

• Individuals who do not comprehend English:
  • Participants must be able to read and sign a consent form without the assistance of an interpreter.
• Individuals who are unable to sign consent:
  • mentally challenged;
  • declared legally incompetent.
• Individuals regarded as belonging to a vulnerable population:
  • prisoners.

• Patients age 18 years and greater and able to give informed consent.
• Planned breast procedure other than mastectomy. 
• Malignant or benign disease as operative indication.

• Antibiotic use within 14 days of operation .
• Steroid use within 14 days of operation (other than topical or inhaled steroids).
• Proton pump inhibitor medications including pantoprazole and omeprazole within 14 days of operation .
• Operation performed for clinical infection  .
• Planned mastectomy.
• Prior history of breast cancer or any other invasive cancer other than non-melanoma skin cancer .
• Documented chlorhexidine gluconate allergy.
• Male patients.
• Organ transplant and bone marrow transplant patients. 
• Vulnerable subjects (prisoners, institutionalized individuals).
• Non-English speakers without adequate interpreter assistance.
• Breast operation other than percutaneous needle biopsy within previous 3 months.

• Human subjects will be recruited in ages from 3 to 99 years of age.
• Potential subjects for the comparative studies (Aims 1 and 2) will be recruited from the daily schedules of those scanners for the brain studies. For comparative musculoskeletal exams, the MRI schedules from the Gonda and Charlton body practices will be reviewed.
• Subjects for Aim 3 maybe recruited from individuals undergoing a clinical exam or recruited from individuals not having a clinical MRI.

Exclusion Criteria:

• We will exclude in dividuals with contraindications to MRI scanning such as a cardiac pacemaker, the presence of intraocular or intracranial metallic objects, and all other devices that are incompatible with 3T MRI.


•  

• Age 18 years or older.
• Able to provide written or verbal informed consent.
• Healthy volunteers
  or patients diagnosed with suspected, possible, probable, or definite chronic liver disease by a Mayo hepatologist or liver surgeon.

• Age 17 years and younger.

Inclusion Criteria

• Age 18 years and older.
• Both males and females
• Meet clinical definition of CRS
  • nasal obstruction
  • facial congestion
  • facial pain-pressure-fullness
  • decrease in sense of smell
• Presence or absence of  nasal polyps as evidenced by a CT scan or rhinoscopy

Exclusion criteria (history suggestive or presence of)

• Cystic fibrosis
• Primary ciliary dyskinesia
• Primary immune deficiency disorder
• Pregnant at time of clinic visit
• Cigarette smoking in the last 6 months
• SNOT-22 scores greater than 21 (to exclude those currently in exacerbation)
• Oral corticosteroids in the past 2 weeks before visit
• Intramuscular corticosteroids in the past 6 weeks before visit

• Primary hyperoxaluria: Patients diagnosed with type I PH by genetic testing and part of the Rare Kidney Stone Consortium (RKSC) Primary hyperoxaluria registry
• Enteric hyperoxaluria: Patients with Roux-en-Y-gastric-bypass
• Idiopathic CaOx stone : History of passing or having surgically removed a calcium oxalate kidney stone within 5 years of recruitment
• Healthy participants with no history of kidney or bowel disease

• History of kidney or liver transplant
• History of antibiotics use within 6 months of recruitment

• Children aged 12-17.
• Adults of all ages.
• Patients with probable REM Behavior Disorder (RBD), RBD, and REM Sleep Without Atonia (RSWA) or Parkinson’s disease (PD), parkinsonism, mild cognitive impairment, dementia with Lewy bodies, multiple system atrophy, and pure autonomic failure seen in the Mayo Center for Sleep Medicine or Mayo Clinic Department of Neurology.
• Control subjects matched for age and gender with primary snoring or obstructive sleep apnea (matched for AHI of RBD/RSWA) without polysomnographic RSWA will also participate.

• Children less than 12 years of age.
• Those with developmental delay.

Eligibility last updated 12/27/22. Questions regarding updates should be directed to the study team contact.

• Females and males between the ages of 18 and 90. 
• Family or personal history of cancer and/or a family or personal history of genetic variants (deleterious or variant of unknown significance) in cancer predisposition genes.
• Participants may also be those who have tested negatively for genetic variants in cancer predisposition genes.

• This project does not involve prisoners or children.

• Strong clinical indication for MRI; in the clinical setting where MRI is the diagnostic modality of choice for a specific disease state without acceptable alternative imaging technology
• Male or Female
• 18 years of age or older
• Able to provide informed consent
• Presence of CIED

• Presence of metallic objects that represent a contraindication to MR imaging, including: MRI-unsafe intra-orbital or intra-ocular retained metal fragments, and MRI-unsafe intracranial vascular clips and coils, other MRI-unsafe devices
• Morbid obesity (abdominal diameter greater than 60 centimeters) which results in contact wiht the magnet bore.
• Pregnant at time of scanning Pacemaker or Implanted Cardiac Device that is labeled as MRI-Conditional (approved by the Food and Drug Administration for exposure to MRI)
• Pacemaker dependent and either: 1) device implanted before 2005, or 2) advisory pulse generator that may lower outputs in the setting of radiofrequency currents

 Inclusion Criteria

• Patients must have a cardiac tumor that is clinically, radiologically or pathologically suspicious for cardiac myxoma
• Patient is a good medical candidate for a standard of care surgical procedure to resect the tumor and undergo a routine blood draw
• Patient is ≥18 years of age
• Patient is willing to undergo session(s) with a genetic counselor (GC) to discuss results, should they be relevant to their medical care
• Patients must understand and provide written informed consent and HIPAA authorization prior to initiation of any study-specific procedures.

Exclusion Criteria

• Patients with conditions that would limit compliance with the study requirements or the ability to provide, willingly, written informed consent
• Women who are pregnant at the time of surgical resection of the cardiac tumor

Inclusion Criteria

• Heart Failure patients with reduced ejection fraction
• History of ischemic or idiopathic dilated cardiomyopathy (duration > 1yr) stable for > 3mo and New York Heart Association Class I-III
• Not pacemaker dependent
• Body Mass Index ≤35
• Ejection Fraction < 40%
• Current nonsmokers with < 15 pack year history
• Able to exercise

Exclusion Criteria

• History of cardiopulmonary disorders and dangerous arrhythmias
• Pregnant women
• Taking prescribed opioid medications or have had a fusion or laminectomy at L3 or above
• Have a recent drug-eluding stent
• History of spinal stenosis, lumbar radiculopathy, or peripheral neuropathy
• Must not currently be taking blood thinners or anticoagulant medications