bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 19806: Factors’ Influence Blood Pressure in 3-5 Year Old Preschool Children
Authors: Joiner Cynthia I , Ejem Deborah , Azuero Andres , Affuso Olivia , Hage Fadi , Turner-Henson Anne , Rice Marti
Published: March 2022

Introduction:
It is estimated that 2-3 million children in the US have diagnosed hypertension that can track to adulthood and is a risk factor for cardiovascular disease (CVD). However, the prevalence of instance elevations of blood pressure (BP) in children is estimated to greatly exceed the prevalence of hypertension. There is increasing evidence that risk factors for CVD, including hypertension and instance elevations in BP, begin in childhood. It is unclear when the elevations in BP first appear in children and what factors influence BP. Few studies have examined instance elevations in BP in preschool children and/or what factors influence BP.

Hypothesis:
The purpose of this study was to determine the prevalence of elevated BP readings in a group of rural and urban preschool children and to determine if there were differences in BP status (normal, prehypertensive, or hypertensive range) based on race, gender, location, prematurity status, or body mass index (BMI) status.

Methods:
A cross-sectional comparative design was used to address the purpose. A convenience sample of 56 3-5 year old children (27 rural, 29 urban; 37 male, 19 female; 33 Black, 21 White) were recruited from Head Start Centers. Height, weight, and BP were collected according to protocols at the Centers.

Results:
Based on pediatric percentiles, 30% of the children had elevated BP readings; 14% Pre-Hypertensive readings (6 males; 2 female; 4 Black; 4 White); 16% Hypertensive readings (6 males; 3 females; 5 Black, 4 White). Seventy-six percent of elevated BP readings were systolic BP (SBP); 47% of those with elevated BP readings had diastolic elevations, while 23.5% had elevations in both SBP and DBP. Nine participants were overweight; 5 were obese. Over 65% of the children with BP elevations were normoweight. There were no differences in BP status based on race, gender, location, prematurity or BMI Status. There was a small effect size for the relationship between race, BMI status, prematurity and BP status.

Conclusions:
Thirty percent of 3-5 year-old children in this sample had elevated BP readings, the majority of which were SBP. BP should be measured in children at each visit to health care providers and elevations in BP readings addressed early to prevent later hypertension and other CVDs.
Abstract 19824: Molecular Regulation of Novel Pro-survival Bnip3 Spliced Variant Niplet in Cardiac Myocytes Functionally Couples Er and Mitochondria
Authors: Lin Junjun , Gang Hongying , Dhingra Rimpy , Kirshenbaum Lorrie A.
Published: March 2022

Alternative splicing provides a versatile mechanism by which cells generate proteins with different or even antagonistic properties. Herein we describe a novel splice variant of the hypoxia-inducible death gene Bnip3. Sequence analysis of the new Bnip3 protein revealed an N-terminus that was identical to Bnip3 but contained an ER retention motif within the C-terminus, therefore we designated the new Bnip3 isoform NIPLET for (
N
ip-
L
ike
E
R
T
arget). While Bnip3 was predominately localized to mitochondria and promoted mitochondrial perturbations and necrosis, NIPLET was preferentially localized to the ER and opposed the cytotoxic actions of Bnip3. Interestingly, NIPLET suppressed inter-organelle calcium transfer between ER and mitochondria and mitochondrial permeability transition pore opening by a mechanism dependent upon the dynamin motor protein Mitofusin-2 (MFN2). Notably, NIPLET mutations within in the critical ER retention motif rendered NIPLET defective for interacting with MFN2 and suppression of necrosis induced by Bnip3 or hypoxia. Hence, our findings reveal a novel signaling pathway that functionally couples ER and mitochondria for cell survival to a mechanism that is mutually dependent and obligatorily linked to a novel BNIP3 protein in cardiac myocytes.
Abstract 19838: The Atypical Cadherin Fat1 Suppresses Vascular Smooth Muscle Mesenchymal Markers and Limits Atherosclerosis
Authors: Dunaway Charlene M , Chinnasamy Prameladevi , Cao Lily , Riascos-Bernal Dario F , Sibinga Nicholas E
Published: March 2022

Introduction:
Fat1 controls vascular smooth muscle cell (SMC) growth and migration. In recent studies, we found increased Fat1 expression in atherosclerotic lesions from
apoE
-/-
(KO) mice, and identified vimentin, an intermediate filament protein and mesenchymal marker, as a novel Fat1 interactor also expressed in SMCs.

Hypothesis:
Fat1 regulation of SMCs limits atherosclerosis, at least in part via Fat1 effects on vimentin.

Methods:
We generated

fat1
SMC-KO
; apoE

double knockout (DKO) mice, fed them a high fat diet for 24 weeks, and assessed atherosclerosis analyzing aortic roots and brachiocephalic arteries (BCA) for lesion area, immunohistochemical features, and gene expression.

Results:
DKO mice (N=10) exhibited larger lesions at the aortic root (80837.0±7942.4) and BCA (36017.2±10496.4) compared to KO controls (64190.2±6539.1 and 19462.9±5246.3, respectively, p<0.05). DKO lesions had larger fibrous caps (40.6±5.5%, N=7) and necrotic cores (30.3±3.2%, N=8) compared to KO samples (26.3±2.9 and 21.6±2.2%, respectively, p<0.05), plus a trend towards increased cellularity (+24%, N=7, p=0.0573). Macrophage number was not different, but SMC area (staining for SM22α) was larger in DKO lesions (1.15±0.25, vs. KO, 0.37±0.08, N=9, p<0.01). Proliferation (phospho-histone H3 staining) was also higher (DKO, 52.6±13.3 vs. KO, 31.4±10.1, N=7 p<0.05). Fat1 and vimentin expression colocalized within fibrous caps, and Fat1-deficient SMCs and lesions expressed more vimentin (>3-fold, p<0.05 by immunoblotting). By co-immunoprecipitation, Fat1 interacted with vimentin and limited its abundance in SMCs; knockdown studies suggested that increased proliferation of Fat1-deficient SMCs depends on vimentin. In addition, Fat1-deficient SMCs showed evidence of E- to N-cadherin switching and upregulation of the Snail1 transcription factor.

Conclusions:
Our
in vivo
data support a role for Fat1 in control of SMC proliferation during atherogenesis, and suggest that Fat1-vimentin interaction is important for this regulation. These findings are reminiscent of the epithelial-mesenchymal transition (EMT) program described in proper epithelial cells, suggest that components of this regulatory network are operative in SMCs, and are controlled by Fat1.
Abstract 19852: Depletion of Neurogenesis within Key Neural Stem/Progenitor Cell Pools Contributes to Brain Immaturity in Congenital Heart Disease
Authors: Morton Paul D , Korotcova Ludmila , Lewis Bobbi , Kumar Vidhi , Shaikh Fizza , Short Elena , Zhang Jiangyang , Mori Susumu , Frank Joseph A , Gallo Vittorio , Jonas Richard A , Ishibashi Nobuyuki
Published: March 2022

Objectives:
Congenital heart disease (CHD) often causes neurological deficits throughout life; primarily due to immature brain development as a consequence of restricted cerebral oxygenation during fetal life. However, the underlying cellular mechanisms remain poorly understood. The primary goal of this study is to model CHD-induced brain injury with a species similar to humans to better understand how the brain responds to these pathologies.

Methods:
Piglets were used in this study because their brains display highly evolved neocortexes. Newborn pigs were housed in a hypoxic (Hx) chamber (10.5% FiO2) for 11 days, alongside normoxic (Nx) controls. We used MRI to assess cortical folding and volume. Cell tracers (CTG) were injected into the subventricular zone (SVZ), prior to Hx exposure, to label neural stem/progenitor cells (NSPCs). t2* scans were acquired to visualize the migratory paths and destination of labeled cells. Immunostains determined the fate of labeled cells and the cellular composition of the cortex.

Findings:
Hx reduces cortical volume and folding (gyrification index) (Fig. 1a); a phenomenon commonly seen in CHD patients. The porcine SVZ shares significant anatomical/structural similarities to the human SVZ and a majority of NSPCs in the SVZ generate immature neurons that migrate to the frontal cortex where they mature into GABAergic (Calr+) interneurons. Hx reduces the capacity of neurogenesis (Sox2+Ki67+) within the SVZ and limits the contribution of SVZ-derived neurons (CTG+Dcx+) to postnatal cortical development (Fig. 1b). Finally, Hx reduces the number of immature (Dcx+) as well as mature interneurons (Calr+NeuN+) within the frontal cortex (Fig.1c).

Conclusions:
Immature brain development seen in CHD patients is due, in part, to a depletion of neuronal producing NSPCs in the SVZ. Therapies aimed at protecting these vulnerable cells or restoring neurogenic potential from the SVZ will likely improve neurological outcomes in CHD.
Abstract 19872: 30-day Readmission Rate and Center Variability for US Children Hospitalized With Heart Failure
Authors: Almond Christopher S , Rosenthal David N , Wood Matthew , Rossano Joseph W , Price Jack F , Daly Kevin P , Liu Esther , Nather Chealsea , Jensen Kristin , Shin Andrew Y
Published: March 2022

Background:
The 30-day readmission rate is a well-established performance benchmark for adult heart failure programs. Little is known about the 30-day readmission rate for pediatric heart failure programs or the variability among centers. We sought to determine the 30-day readmission rate for children admitted with acute decompensated heart failure (ADHF) to support benchmarking efforts in pediatrics.

Methods:
The Pediatric Health Information System (PHIS) database was queried to identify all children ≤21 years of age admitted between January 2009 and March 2014 with a primary or secondary diagnosis of heart failure. All-cause 30-day readmission rates were calculated, as was mean length of stay.

Results:
Over the 5-year study period, a total of 39,150 hospitalizations at 47 children’s hospitals met the inclusion criteria. Overall, 56% were infants, 25% age 1-12 years, 9% adolescents, and 9% adults, 48% were female, 72% had congenital heart disease, 28% had cardiomyopathy/myocarditis. The mean hospital length of stay was 25 days (range 11,41 days; SD 7 days). In-hospital mortality was 8.4%. Overall 30-day readmission rate was 20% (range 10%, 30%; SD 5%) and varied considerably by center (Figure).

Conclusion:
A substantial portion of children (one in five) admitted to the hospital for heart failure is re-admitted within 30 days. There is considerable center-based variation in re-admission rates. The mean hospital length of stay exceeds 3 week and also varies considerably by center.
Abstract 19880: High Failure Rate of Linox Defibrillator Leads
Authors: Van Malderen Sophie C , Szili-Torok Tamas , Yap Sing C , Bhagwandien Rohit , Wijchers Sip , Theuns Dominic A
Published: March 2022

Introduction:
Recent lead failures have resulted in large recalls with a significant global impact, not only financially, but also physically and mentally for those carrying an implantable cardiac defibrillator (ICD). Following the introduction of the ‘Linox S’ and ‘Linox SD’ ICD leads in 2006 by manufacturer ‘Biotronik’, we observed several cases with early failure. The objective of this study was to determine the failure rate of ‘Biotronik Linox’ leads implanted at our centre, and to compare them with the performance of two comparators, the Durata (St. Jude Medical) and the Endotak (Boston Scientific) lead.

Methods:
As of 2012, all ‘Linox S or SD’ (n=408), Durata (model 7122, n=340) and Endotak (model 0125, 0138 and 0158, n=343) leads were identified form the Erasmus MC prospective ICD registry. Lead failure was defined by low/high-voltage impedance, failure to capture, sense or defibrillate, or the presence of non-physiological signals not due to external interference.

Results:
A total of 1091 high-voltage defibrillation leads were implanted between April 2000 and May 2012 in 1066 patients (78% males, median age 62 years). The median time from implantation to lead failure was 3.6 years (IQR, 1.5 to 4.8 years). ‘Linox’ leads demonstrated a sudden increase in failure at 3-3.5 years after implantation and their estimated failure rates were 5.5% and 10.1%, at 5 and 8 years after implantation, respectively. Durata and Endotak demonstrated gradual malfunction and failure rates were 2.1% and 2.1%, and 0.4% and 0.8%, at 5 and 8 years, respectively. The mechanism of failure was noise in the majority of failed leads (50%) followed by impedance out-of-range (29%).

Conclusions:
‘Linox S/SD’ leads demonstrate a significant high failure rate. Remote monitoring is reasonable as electrical dysfunction (noise or impedance out-of-range) is observed in the majority of cases. National device safety and advisory committees worldwide might be facing a new challenge.
Abstract 19906: Evaluation of Approximate Entropy as a CPR Quality Measure
Authors: Salcido David D , Koller Allison C , Sundermann Matthew L , Menegazzi James J
Published: March 2022

Introduction:
The majority of standard cardiopulmonary resuscitation (CPR) quality metrics are based on univariate, linear measures of CPR process. Non-linear measures, such as approximate entropy (ApEn), which characterizes the disorder of a signal, have been utilized in other areas, such as heart rate analysis, to capture phenomena that elude standard linear measures.

Objective:
To provide a preliminary evaluation of the performance of ApEn as a CPR-quality metric.

Methods:
Case data for non-traumatic, EMS-treated out-of-hospital cardiac arrests were obtained from the Pittsburgh site of the Resuscitation Outcomes Consortium for the period spanning the years 2010 to 2014. Cases with at least 1 available defibrillator data file containing an accelerometer-derived chest compression (CC) depth channel were included. CC depth data traces were extracted with custom software created in MATLAB (2014b, The Mathworks, Nattick, MA). Individual CC for the entire length of each available file were located with a calibrated peak finding function and used to calculate individual CC depth (mm), rate (compressions/minute) and flow fraction time series, which were reported in averages over 1-minute epochs. Data from cases with multiple data files were merged to reflect the order of recordings. ApEn was calculated for each 1-minute epoch of depth and rate. Correlation coefficients were calculated to assess the relationship between ApEn, CC rate, CC depth and flow fraction overall and stratified by pre/post 5 minutes of CPR.

Results:
Of a total of 1,278 cases with defibrillator downloads, a subset of 1,266 cases had analyzable CC depth channels. A total of 1,875,209 individual CC were detected and analyzed, covering 18,719 minutes of CPR. Mean (SD) ApEn of CC rate was 0.92 (0.34) and of CC depth was 0.79 (0.23). ApEn of CC depth was weakly correlated with flow fraction (r = 0.22) and ApEn of CC rate (r = 0.27), but not CC rate or CC depth. Both before and after the 5-minute mark, ApEn correlated weakly with flow fraction (r = 0.14 vs. r = 0.24) and ApEn of CC rate ( r = 0.30 vs 0.26).

Conclusion:
ApEn was only weakly correlated with CC flow fraction, a common CPR quality measurement. Additionally, ApEn of rate and depth were not correlated with the absolute magnitude of CC rate or depth.
Abstract 19921: Influence of Obstructive Sleep Apnea in the Clinical Presentation of Acute Coronary Syndrome: Bedside Polysomnography Study
Authors: Cintra Fatima D , Maroja Fabrizio U , de Paola Angelo , Storti Luciana , Caixeta Adriano M , Leoncio Ana Paula G , Carvalho Antonio Carlos C , Tufik Sergio , Poyares Dalva
Published: March 2022

Introduction:
Obstructive Sleep Apnea (OSA) is characterized by sleep fragmentation and repetitive hypoxia during sleep and has been associated with arterial hypertension, atrial fibrillation, coronary artery disease, and cardiovascular mortality. OSA has also been extensively linked with atherogenesis.

Hypothesis:
We sought to evaluate the role of OSA on clinical and angiographic patterns in patients admitted with acute coronary syndrome (ACS).

Methods:
Patients who were admitted with ACS in intensive care unit (ICU), aged over 20 years old, and with no previous diagnosis or treatment for OSA were consecutively selected between June 2013 and June 2014. A bedside overnight full polysomnography (PSG) was performed using an EMBLA digital system® within second day of admission. All patients underwent transthoracic echocardiogram. The time between pain onset and treatment (TPT) were obtained for all patients. The sample was divided into 3 groups: G1: non OSA; G2: mild to moderate OSA and G3: severe OSA according to the apnea/hypopnea index (AHI) obtained by PSG recordings. All patients signed an informed consent form. ANOVA and GLM followed by Bonferroni test were used, p<0.05.

Results:
One hundred twenty ACS patients, 58 ± 12 y were included. Seventy-seven% underwent pharmacoinvasive strategy and 23% to primary percutaneous coronary angioplasty. Age and BMI were higher in G3 (p<0.05). The TPT and left ventricle ejection fraction were different between G1, G2 and G3 [(241.44±186.43; 202.13±132.54; 400.5±469.01), p=0.02] and [(51.29±8.95; 50.82±10.57; 45.25±7.44), p=0.04], respectively. After controlling for potential confounder, AHI was independently associated with delay in the onset treatment (p=0.004). The Syntax score was higher in G3 compared with G2 and G1 [(14.15±10.19; 14.46±11.09; 21.33±10.42), p=0.03], respectively.

Conclusion:
In ACS patients, severe OSA was associated with more complex coronary artery disease at hospital presentation, lower left ventricle ejection fraction., as well as in the delay of onset of treatment.
Abstract 19946: Airports: Out-of-hospital Chain of Survival Laboratory?
Authors: Escutnaire Joséphine , Segal Nicolas , Menay Marion , Bargain Philippe , Mannhart Patrice , Caron Jean-Luc , Villain-Coquet Laurent , Hubert Herve ,   GR-RéAC
Published: March 2022

Introduction:
Airports are experimentation locations in which automatic external defibrillators (AED) implementation efficacy (and efficiency) has been widely tested.

Hypothesis:
With a large number of passengers and a fine meshing in terms of AED availability, the aim of this study is to understand the airport cardiac arrests (ACA) in terms of care and to study their survival in such a particular location.

Methods:
Prospective descriptive and multicentre study based on the French national cardiac arrest registry (RéAC) data gathered between the 01/07/2011 and the 01/11/2014.

Results:
We analysed 78 ACA among 35667 cardiac arrests. We recorded 83.3% men. The population’s median age was 63 [52-70]. A medical aetiology was recorded in 93.6% cases and 30% had history of cardiovascular diseases. Professional first aid providers’ (generally firemen) median response time was 5 [1-10] min and mobile medical teams’ (MMT) 20 [12-30] min. Three quarter of patients were immediately cared by witnesses of which 53.8% benefited of an AED connexion ; 23.1% of them received a shock. A cardiopulmonary resuscitation (CPR) was attempted by firemen in 84.6% cases. At MMT arrival, 13.3% had a shockable rhythm and 26.7% had already sustained a return of spontaneous circulation. MMT attempted CPR in 87.2% cases and 37.2% sustained a return of spontaneous circulation (ROSC). At hospital admission, 34.6% were alive. At Day 30, 14.1% survived of which 81.9% had a good neurological outcome (CPC1-2). Among them 27.3% had a implantation of automatic defibrillator. Cardiac aetiology was proved in 28% cases and almost half of patients returned directly at home after their hospitalization.

Conclusions:
ACA victims are often cared very promptly by bystanders, professional first aid providers and medical teams. They also more often benefit of AED connexion and shock than cardiac arrest victims in the general population. Airports are indeed a location in which all the steps of the chain of survival are thoroughly and effectively implemented. As all these steps are patients’ survival key factors, this results in better outcome.
Abstract 19960: Human Cardiac Fibroblasts Increase SR-Dependency of Induced Pluripotent Stem Cell-Derived Cardiomyocyte Calcium Handling by Increasing SR Calcium Uptake and SERCA2a Expression via Direct Physical Contact
Authors: Kane Christopher , Dias Priyanthi , Gorelik Julia , Terracciano Cesare M
Published: March 2022

Introduction:
Cardiac fibroblasts can influence cardiomyocyte structure and function through direct physical interaction and/or by the secretion of soluble factors. Here we assess the relative importance of these different modalities of interaction in terms of their effects on cardiomyocyte electrophysiology.

Methods:
Ventricular fibroblasts from the explanted hearts of dilated cardiomyopathy (DCM) patients (n=4) were seeded directly onto a confluent monolayer of human induced pluripotent stem cell-derived cardiomyocytes (iPS-CMs) at a ratio of 2:1 and cultured for 24 hours. iPS-CMs alone were used as control. Ca2+ transients and action potentials were recorded optically using fluo-4 AM and di-8-ANEPPS. Data are presented as percentage change from control where appropriate.

Results:
iPS-CM Ca2+ transient duration was significantly reduced by contact with fibroblasts (-8.4±2.2% n=12 p<0.01). Sarcoplasmic reticulum (SR) Ca2+ uptake assessed by caffeine application was highly upregulated (2.07±0.12s-1 vs 0.63±0.07s-1 in control n=26, 23 p<0.001), associated with a significant increase in SR Ca2+ content (F/F0: 3.74±0.11 vs 2.97±0.11 in control n=37, 32 p<0.001) and SERCA2a protein expression (1.02±0.08 vs 0.55±0.01 n=3 p<0.01). iPS-CMs in contact with fibroblasts displayed a greater dependence on SR uptake for Ca2+ extrusion than other mechanisms (SR/NCX/Slow: 60.7/31.9/7.4% vs 23.3/70.9/5.8% in control).

Action potential duration (90%) was significantly prolonged in contact with fibroblasts (+18.8±2.5% n=22 p<0.001 vs control). Screening of culture supernatants from the co-culture has identified the presence of a number of cytokines known to affect cardiomyocyte function including IL-6 (680pg/ml), MIF (1.16ng/ml), MCP-1 (1.25ng/ml) and TGF-β. (110pg/ml).

Conclusions:
DCM fibroblasts influence iPS-CM electrophysiology through different modalities; however physical contact with fibroblasts has effects not seen with soluble mediators alone. This contact-dependent shift towards greater SR-dependency represents a novel effect of fibroblasts on cardiomyocyte Ca2+ handling. Determining whether these effects are mediated through mechanical, electrical or paracrine signalling will be the focus of future work.
Abstract 19963: Inferior Vena Cava in Patients With Vasovagal Syncope, a New Guest Actor
Authors: Herrera Jose E
Published: March 2022

Introduction:
Vasovagal Syncope presents prodromes due to autonomic activation and it can be brought by prolonged standing. This fact may be associated with failure in the venous return; therefore the object of this study is the evaluation of Inferior Vena Cava (IVC) and its flow.

Hypothesis:
IVC flow velocity is associated, with vasovagal syncope.

Methods:
Two groups were evaluated with echocardiography. Group A 12 healthy individuals, 10 women aged 39 ± 17 and 2 men aged 33 ± 11. Group B, 10 patients with Vasovagal Syncope, 8 women aged 29 ± 8 and 2 men aged 23 ± 3. IVC Echocardiography was performed according to ASE criteria. Standing sub costal view was obtained with cervical flexion. IVC diameter was measured 2 cm from right atrium entry; flow velocity was evaluated sub and post diaphragmatic, supine and standing, during expiration.

Results:
Table 1. IVC Variables Comparison between groups A and B.

Conclusions:
Group B Syncope, showed AP IVC diameter and an area significantly larger in supine and standing, sub diaphragmatic position. This fact could explain lower velocities in sub diaphragmatic supine and standing position in Group B which could explain the cause of syncope.
Abstract 20019: Incidence of Errant Shock Delivery in Out-of-hospital Cardiac Arrest Resuscitation
Authors: Koller Allison C , Salcido David D , Tisherman Sara E , Sundermann Matthew L , Menegazzi James J
Published: March 2022

Introduction:
Defibrillation is used to convert ventricular fibrillation and tachycardia (VF/VT) to a perfusing sinus rhythm. However, rhythm analysis is subjective and shocks may be delivered errantly on rhythms that do not warrant nor positively respond to defibrillation. We sought to assess the rate and factors associated with errant shock delivery.

Hypothesis:
We hypothesized that cases lacking VF/VT would receive a shock in the prehospital environment, and that errant shock delivery would occur more often in younger and female patients, as well as cases that were witnessed and those that occurred in public locations.

Methods:
We obtained IRB approval before commencing this study. Eligible cases of EMS-treated, nontraumatic OHCA spanned 2010-2014 at the Pittsburgh site of the Resuscitation Outcomes Consortium and contained at least one EMS-delivered shock. We excluded cases that did not receive any shocks. We analyzed all instances of EMS-delivered shocks in custom Matlab software. Pre- and post-shock rhythms were assessed for all shocks. Return of an organized rhythm (ROOR) was noted for every shock. Patient characteristics were obtained via patient care report review. We utilized t-tests with an alpha value of 0.05.

Results:
A total of 461 cases received at least one shock and contained a total of 1,377 analyzable shocks. Of these shocks, 1246 (90.5%) had VF/VT, and 131 (9.5%) had non-VF/VT. Errant shocks were delivered in a total of 91 (19.9%) cases. Errant shocks were most often the second shock delivered in the case. Demographic data was available for 457 (99.1%) of cases. ROOR occurred in 769 (55.8%) shocks.

Errant shock delivery was not significantly associated with patient age (p = 0.79), sex (p = 0.14), location (p= 0.83), or witnessed status (p = 0.63).

Conclusions:
Errant shock rate was 9.5% and occurred in 19.9% of all cases. These shocks were not associated with common demographic data. Further work will examine other possible causes for errant shock delivery.
Abstract 20045: One in Six South Asian Adults Develop Hypertension Over a Two Year Period: Results From the CARRS Cohort Study
Authors: Jeemon Panniyammakal , Ghosh S , Roopa S , Ajay VS , Ali MK , Deepa M , Mohan V , Kadir MH , Tandon Nikhil , Narayan KMV
Published: March 2022

Introduction:
Hypertension is a growing public health problem in South Asia. We examined hypertension prevalence, awareness, treatment, and control rates in adult participants at baseline in the CARRS cohort from three large cities in South Asia and report both incidence and predictors of incident hypertension using the longitudinal follow-up data.

Methods:
The CARRS Study recruited representative population cohorts of three metropolitan urban cities namely Chennai, Delhi and Karachi. Trained field workers collected socio-demographic and risk factor data from all eligible participants using a structured questionnaire, standardized equipment and a common study protocol. All the participants recruited at baseline were followed-up annually. Fasting blood samples were also collected at baseline and at two year follow-up for biochemical analyses of lipids, glucose and haemoglobin A1c. Blood pressure was recorded at baseline and during annual follow-up visits in the sitting position using electronic sphygmomanometer; two measurements were taken, 5 minutes apart and the mean of two was used for analyses.

Results:
In total, 16,287 participants were recruited at baseline (response rate=94.3%) and two year follow-up was completed in 12, 504 participants (response rate=79.2%). Hypertension (JNC-8) was prevalent in one of three men (30.1%, 95% CI: 28.7-31.5) and one of four women (26.8%, 95% CI: 25.7-27.9). Hypertension awareness, treatment and control was alarmingly low (Figure 1). One of six non-hypertensive adults at baseline developed hypertension (80.5 per 1000 person years, 95% CI: 76.3-85.0) over a two year period. Propensity to develop hypertension was higher in older age, men, participants from low socio-economic status, current alcohol users, individuals with overweight, pre-hypertension and dysglycemia.

Conclusion:
High incidence and poor awareness of hypertension in South Asian adult population warrants immediate policy attention.
Abstract 20055: The αvβ3 Integrin Positron Emission Tomography Radiotracer 18F-Fluciclatide is a Marker of Remodeling Following Myocardial Infarction
Authors: Jenkins William S , Vesey Alexander , Neale Anoushka , Anna Vickers , Moles Catriona , Lucatelli Christophe , Fletcher Alison , Mirsadee Saeed , Van Beek Edwin J , Rudd James H , Dweck Marc R , Newby David E
Published: March 2022

Introduction:
The integrin receptor αvβ3 is upregulated by vascular endothelial cells, macrophages and myofibroblasts during cardiac interstitial remodeling. We evaluated the role for the novel αvβ3 radiotracer 18F-fluciclatide in the non-invasive assessment of repair post-myocardial infarction.

Methods:
We performed combined PET/CT and CT-coronary angiography (CTCA) imaging of the heart following intravenous administration of 18F-fluciclatide (230mBq) in 21 patients 12±4 days after acute ST-elevation myocardial infarction, 7 stable patients with occlusion of a major coronary vessel for >6months, and 9 healthy volunteers. ECG-gated PET data was acquired over 30 minutes, 40 minutes after ligand injection. Subjects also underwent Cardiac MRI (CMR) with assessment of late gadolinium enhancement and T1 mapping.

PET data was fused with the CTCA and re-orientated into the left ventricular short-axis plane. The infarct site was identified through co-registration with CMR and delineated using regions of interest and a 16-segment approach. PET values, corrected for blood activity, were expressed as a mean tissue-to-background ratio. Myocardial extracellular volume (ECV) in a 16-segment model was quantified on CMR using T1 mapping pre-and post-gadolinium administration.

Results:
18F-fluciclatide uptake correlated with cardiac ECV (r=0.37(0.29-0.45),p<0.001), and was increased in sites of acute myocardial infarction when compared to regions of remote myocardium (1.32±0.23 vs 0.85±0.17; p<0.001), sites of established infarction in subjects with a chronically occluded coronary vessel (1.32±0.23 vs 0.70±0.14; p<0.001), and when matched with regions in control subjects (0.94±0.23 vs 0.67±0.09; p=0.003).

Conclusions:
18F-Fluciclatide uptake localises to sites of acute myocardial infarction and correlates with extracellular volume on CMR. This holds great potential in the non-invasive quantification of active myocardial remodeling.
Abstract 9777: Dietary Phosphatidylcholine and Risk of All-cause and Cardiovascular-specific Mortality Among Women and Men With Type 2 Diabetes
Authors: Zheng Yan , Li Yanping , Rimm Eric , Hu Frank , Albert Christine , Rexrode Kathryn , Manson JoAnn , Qi Lu
Published: March 2022

Introduction:
The trimethylamine-containing nutrient phosphatidylcholine is the major dietary source for gut microbiota metabolite trimethylamine-N-oxide, which has been related to cardiovascular diseases (CVD) and mortality. We recently found higher dietary phosphatidylcholine intake was associated with an increased risk of diabetes. No study has analyzed whether phosphatidylcholine intake is related to all-cause and CVD mortality in diabetic patients, who have a higher risk of CVD and premature mortality than the general population.

Methods:
In total, we included 10061 women and 3668 men with type 2 diabetes in the Nurses’ Health Study and Health Professionals Follow-up Study, respectively. Dietary intakes and potential confounders were assessed with regularly administered questionnaires.

Results:
We documented 2427 all-cause and 807 CVD deaths during up to 30-year follow-up. After multivariate adjustment for potential confounders, including age, smoking, body mass index, physical activity, dietary intakes and duration of diabetes, higher phosphatidylcholine intake was associated with an increased risk of all-cause and CVD mortality. The pooled relative risk comparing top to bottom quartiles of phosphatidylcholine intake was 1.22 (95%CI, 1.07-1.39; P for trend across quartiles=0.003) for all-cause mortality and 1.33 (1.04-1.69; P for trend=0.03) for CVD mortality.

Conclusions:
These data indicate that higher phosphatidylcholine consumption is associated with higher all-cause and CVD mortality in diabetic population, independent of other risk factors. Our findings suggest dietary modulation may be a potential interventional strategy to reduce mortality related to gut microbiota metabolites.
Abstract 9779: Abdominal Aortic Aneurysm Formation was Suppressed by an Agonist for α7 Nicotinic Acetylcholine Receptor via NF-kB Inactivation
Authors: Kojima Hiroshi , Tokunou Tomotake , Watanabe Aya , Ichiki Toshihiro , Sunagawa Kenji
Published: March 2022

Background:
Previously we reported that activation of vagal nerve by acetylcholinesterase inhibitors attenuated atherogenesis via suppression of inflammatory responses. α7 nicotinic acetylcholine receptor (nAchR) plays an important role in vagal nerve activation. We sought to determine whether AR-R17779, a selective agonist of α7 nAchR, affects the development of abdominal aortic aneurysm (AAA).

Methods and Results:
AAA was induced by topical application of calcium chloride (CaCl2) to abdominal aorta (AAA group). NaCl (0.9%) was substituted for CaCl2 as a sham operation (SHAM group). AR-R17779 was administered in drinking water (AAA/AR-R group). One and 6 weeks after the operation, aortic tissue was excised for histological and molecular analyses. Aortic diameter and macrophage infiltration into the aortic adventitia were increased in AAA group compared with SHAM group at 6 weeks. Treatment with AR-R17779 reduced the diameter of the aorta (0.73±0.10 mm vs. 1.07±0.15 mm in AAA, p<0.01) and macrophage infiltration compared with AAA group. Wavy morphology of the elastic lamellae was lost in AAA group while it was preserved in AAA/AR-R group. Expression of inflammatory cytokines (IL-1β, IL-6, MCP-1) and matrix metalloproteinase (MMP)-2 and 9 activities were enhanced in AAA group, which was suppressed in AAA/AR-R group. AR-R17779 treatment suppressed CaCl2-induced expression of cytokines, activities of MMPs and NF-κB activation (p65 phosphorylation) at 1 week when aortic dilatation had not been developed.

Conclusion:
Treatment with AR-R17779 prevented the enlargement of abdominal aorta induced by CaCl2 in association with reduced inflammation and extracellular matrix disruption via NF-kB inactivation. These findings suggest a therapeutic potential of α7nAchR activation for prevention of AAA development.
Abstract 9805: Lack of Correlation Between HDL Level and Fecal Cholesterol in Multiple Mouse Models Suggests Importance of HDL Functionality in Atherosclerosis Attenuation
Authors: Srivastava Rai Ajit K , Cefalu Angelo B , Noto Davide , Panno Donata , Giammanco Antonella Giammanco , Averna Maurizio R
Published: March 2022

To circumvent the residual cardiovascular disease burden in patients receiving statin therapy, HDL-raising was suggested as a plausible approach. However, lack of benefits of CETP inhibitors, Torcetrapib and Dalcetrapib, despite substantial increase in HDL, and lack of efficacy of CER-001, an apoA-I mimetic, proved disappointing. Paradoxically, apoA-I Milano subjects with low HDL have reduced CVD risk. These findings shifted the focus from HDL level to HDL function. Promoting reverse cholesterol transport (RCT) is one of the main functions of HDL, which is measured in an in vivo assay as macrophage-derived fecal 3H-cholesterol. Non-radioisotopic method to quantitate fecal cholesterol (chol) as an RCT index was found to correlate with macrophage radioisotopic method in mice. Using this method, we carried out a number of studies in several mouse models, including C57Bl, apoA-I-Tg, LDLr KO, and ob/ob, using tool compounds, LXR and PPAR-α agonists, known to enhance RCT. Animals were treated with LXR and PPAR-α agonists alone or in combination, and lipid profile, HDL level, serum chol efflux, fecal chol, and, in appropriate animal models, aortic lipid contents were measured. In C57Bl mice, LXR agonist, T1317, raised HDL by 30%, while feno decreased HDL by 30%, but fecal chol showed a 2-fold increase in both cases. Interestingly, combination (comb) treatment with LXR and PPAR-α agonists did not change HDL, but fecal chol increased by 4.5-fold. HDL in apoA-I-Tg mice increased by 40%, 80%, and 80% in LXR, PPAR-α, and comb treated groups; respective fecal chol increases were 1.8, 1.8, and 5-fold, suggesting a lack of correlation between HDL level and fecal chol. LXR, PPAR-α, and comb-treated ob/ob mice showed 40%, 35%, and 40% rise in HDL, but 3-, 3-, and 20-fold increases in fecal chol, respectively. No correlations in HDL level and fecal chol contents were noticed in LDLr KO mice as well. Atherosclerosis attenuation by LXR and PPAR-α agonists in LDLr KO and ob.ob/LDLr DKO mice was associated with increased fecal chol, but not HDL level. These data suggest: a) a lack of correlation between HDL level and fecal chol; b) synergistic effect of LXR and PPAR-α agonists on RCT; c) reduced lesion area associated with increased fecal chol; and d) RCT influenced by additional mechanisms.
Abstract 9809: Does Blood Transfusion Deteriorate the Prognosis in Targeted Temperature Management After Cardiac Arrest?
Authors: Kagawa Eisuke , Dote Keigo , Kato Masaya , Sasaki Shota , Kihara Yasuki
Published: March 2022

Introduction:
It is well known that blood transfusion can worsen outcomes in patients with acute coronary syndrome without cardiac arrest. However, little is known regarding patients receiving blood transfusion after cardiac arrest in the current era of targeted temperature management (TTM) and coronary reperfusion.

Hypothesis:
We assessed the hypothesis that blood transfusion worsen the prognosis of patients after cardiac arrest.

Methods:
Adult comatose survivors of cardiac arrest treated with TTM were enrolled in this study. We assessed the association between blood transfusion and 90-day survival. We constructed 90-day survival curves using the Kaplan-Meier method to assess the impact of blood transfusion after cardiac arrest. Cox proportional hazards regression was utilized to adjust for the association of blood transfusion and 90-day survival. A P < 0.05 was defined as statistically significant.

Results:
Among all study patients (N = 253), the median age was 62 years (interquartile range, 52 - 72 years), 75% were men, 51% had shockable initial rhythms, and the time interval from collapse to return of spontaneous circulation was 37 min (21 - 57 min). After hospital arrival, 60% of the study patients underwent immediate coronary angiography, 31% underwent subsequent coronary revascularization, and 99 patients (39%) received blood transfusions. The prevalence of blood transfusion were significantly higher in the patients underwent coronary revascularization (57% vs. 31%, P < 0.001). The 90-day survival curves are shown in the figure. Blood transfusion was independently associated with reduced 90-day survival (hazard ratio 0.68 [95% confidence interval, 0.47 - 0.98], P = 0.04).

Conclusions:
Blood transfusion may worsen survival in patients not treated with coronary revascularization, but not in patients treated with coronary revascularization after cardiac arrest in the current TTM era.
Abstract 9812: Cardioprotection by Postconditioning With Lactate-enriched Blood in Patients With ST-elevation Myocardial Infarction
Authors: Koyama Takashi , Munakata Masahito , Akima Takashi , Shibata Masaru , Moritani Kazunori , Kageyama Toshimi , Nagaoka Mika , Kanki Hideaki , Ishikawa Shiro , Mitamura Hideo
Published: March 2022

Objective:
The beneficial effects of reperfusion therapy for ST-elevation myocardial infarction (STEMI) are attenuated by reperfusion injury. We reported that postconditioning with lactate-enriched blood (PCLeB) resulted in excellent microcirculation recovery and less inflammation in STEMI patients in our small-scale studies (AHA 2012, ACC 14). Here we analyzed all STEMI patients treated by PCLeB in our hospitals up to now.

Methods:
We treated 66 consecutive STEMI patients (age, 65.2 ± 14.9 y; 80.3% males) using PCLeB within 12 h of MI onset (mean ischemia time, 5.0 ± 3.0 h), including 31 patients with proximal LAD occlusion. Our modified protocol aims to achieve controlled reperfusion with cellular oxygenation and minimal lactate washout. The duration of each brief reperfusion was prolonged stepwise from 10 to 60 s. Lactated Ringer’s solution (20-30 mL), containing 28 mM lactate, was injected directly into the culprit coronary artery at the end of each reperfusion, and a balloon was quickly inflated at the lesion site, trapping lactate inside the ischemic myocardium. Each brief ischemic period lasted 60 s. After 7 cycles of balloon inflation and deflation, full reperfusion was performed, and stenting was performed thereafter.

Results:
The mean peak CK and CK-MB values were 2932 ± 2098 and 306 ± 224 IU/L, respectively. The mean corrected TIMI frame count after PCI was 18.5 ± 10.2 frames (normal value, 21 frames). After excluding 6 patients with extra-cardiac inflammatory disorders, the mean peak CRP value within 7 days of MI onset was 3.4 ± 2.9 mg/dL in the remaining 60 patients. Thallium-201 scintigraphy before discharge consistently revealed well-preserved myocardial viability, which appeared disproportionate to peak CK values. Thallium images of the last 10 patients with proximal LAD occlusion are presented in the Figure as a bull’s eye display labeled with each corresponding peak CK value (IU/L).

Conclusion:
PCLeB provides good cardioprotection in STEMI patients.
Abstract 9844: Endothelial Function is Impaired in Subjects With Increased Ratio of Serum Levels of AGEs to Soluble Form of RAGE
Authors: Kajikawa Masato , Higashi Yukihito , Nakashima Ayumu , Fujimura Noritaka , Maruhashi Tatsuya , Iwamoto Yumiko , Iwamoto Akimichi , Oda Nozomu , Kishimoto Shinji , Hidaka Takayuki , Noma Kensuke , Takeuchi Masayoshi , Matsui Takanori , Yamagishi Sho-ichi , Kihara Yasuki
Published: March 2022

Introduction:
Advanced glycation end products (AGEs) and their specific receptor, the receptor for AGEs (RAGE), play an important role in atherosclerosis. Recently, a soluble form of RAGE (sRAGE) has been identified in human serum. However, the role of sRAGE in cardiovascular disease is still controversial. There is no information on the association between simultaneous measurements of AGEs and sRAGE and vascular function. In this study, we evaluated the associations between serum levels of AGEs and sRAGE, ratio of AGEs to sRAGE and vascular function.

Methods:
We measured serum levels of AGEs and sRAGE and assessed vascular function by measurement of flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation in 110 subjects who underwent health examinations. Multivariate regression analyses were performed to identify factors associated with vascular function.

Results:
Univariate regression analysis revealed that FMD correlated with age (ρ=-0.38, P<0.01), body mass index (ρ=-0.28, P<0.01), systolic blood pressure (ρ=-0.44, P<0.01), diastolic blood pressure (ρ=-0.46, P<0.01), heart rate (ρ=-0.29, P<0.01), triglycerides (ρ=-0.37, P<0.01), high-density lipoprotein cholesterol (ρ=0.19, P<0.05), glucose (ρ=-0.20, P<0.05), smoking pack-years (ρ=-0.32, P<0.01), nitroglycerine-induced vasodilation (ρ=0.40, P<0.01), serum levels of AGEs (ρ=-0.34, P<0.01) and sRAGE (ρ=0.20, P<0.05), and ratio of AGEs to sRAGE (ρ=-0.38, P<0.01). Multivariate analysis revealed that the ratio of AGEs to sRAGE remained an independent predictor of FMD (β=-0.22, P=0.03), while serum level of AGEs alone (β=-0.14, P=0.13) or sRAGE alone (β=0.13, P=0.15) was not associated with FMD.

Conclusions:
These findings suggest that sRAGE may have a counter-regulatory mechanism that is activated to counteract the vasotoxic effect of the AGEs-RAGE axis. The ratio of AGEs to sRAGE may be a new chemical biomarker of endothelial function.
Abstract 9851: Benefit of Antioxidant Peptide SS-31 Treatment in Attenuating Transverse Aortic Constriction-Induced Pulmonary Arterial Hypertension in Mice
Authors: Chung Sheng-Ying , Chua Sarah , Tsai Tzu-Hsien , Sung Pei-Hsun , Chen Yung-Lung , Leu Steve , Sheu Jiunn-Jye , Yip Hon-Kan
Published: March 2022

Introduction:
We investigated the effect of mitochondria-targeted antioxidant peptide SS-31 on transthoracic aortic constriction (TAC)-induced pulmonary arterial hypertension (PAH) in mice.

Methods and Results:
Adult-male mice (n=36) were equally divided into group 1 (sham-control), group 2 (TAC only), and group 3 (TAC-SS-31, 2 mg intra-peritoneal injection/day). By day 60, right ventricular systolic blood pressure (RVSBP) was measured prior to sacrificing the animals and the right heart and lung tissues were later collected. RVSBP was significantly higher in group 2 than in group 1, but the elevation was substantially suppressed in group 3 (p<0.0001). Pulmonary protein expressions of oxidative-stress ((NOX-1, NOX-2, oxidized protein), cytosolic cytochrome-C, inflammation (MMP-9, TNF-α, NF-κB), calcium-overload-index (TRPC1, 2, 4, 6), apoptotic (mitochondrial BAX, cleaved caspase 3 and PARP), fibrotic (Smad3, TGF-β), hypoxic (HIF-1α), DNA-damage (γ-H2AX), and endothelial function-related (eNOS, ET-1R) biomarkers showed an identical pattern, whereas the anti-fibrotic (Smad1/5, BMP-2) markers and number of small vessels showed an opposite pattern compared to that of RVSBP among the three groups (all p<0.001). The lung injury score, number of muscularized vessels in lungs, cellular expressions in PA (TRPC1+, HIF-1α+) and in lung parenchyma (γ-H2AX+, Ki-67+), showed an identical pattern, whereas the number of alveolar sacs showed an opposite pattern of RVSBP among the three groups (all p<0.001). The protein expressions of anti-oxidants (HO-1, NQO 1, GR, GPx) were significantly progressively increased from groups 1 to 3 (all p<0.001).

Conclusion:
Antioxidant peptide SS-31 effectively attenuated TAC-induced PAH in a murine model.