bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 10314: Clinical Impact of C-Reactive Protein to Albumin Ratio on Prognosis in Patients With Stable Coronary Artery Disease After Percutaneous Coronary Intervention
Authors: Anzaki Kazuhiro , Kanda Daisuke , Sonoda Takeshi , Ohmure Kenta , Ikeda Yoshiyuki , Ohishi Mitsuru
Published: June 2023

Background
: The C-reactive protein/albumin (CRP/Alb) ratio is known to be a novel marker of inflammation and is associated with outcome in septic patients. However, the effect of CRP/Alb ratio for clinical outcomes in patients with stable coronary artery disease (CAD) after percutaneous coronary intervention (PCI) has not been well evaluated.

Methods
: The subject comprised 500 consecutive stable angina patients who underwent successfully elective PCI using second-generation drug-eluting stents and intravascular ultrasound. We investigated between the clinical factors including CRP/Alb ratio and the incidences of both all-cause death and major cardiovascular and cerebrovascular events (MACCE).

Results:
Median of age was 69 years (62-76) and 356 cases (71%) were male. Thirty-seven patients (7%) died after PCI, and the incidence of MACCE including all-cause death was 47 cases (9%). Age, dyslipidemia, hemodialysis, statin use , estimated glomerular filtration rate and CRP/Alb ratio correlated significantly with all-cause death and MACCEin the univariate cox proportional hazards analysis. A multivariate Cox proportional hazards regression analysis modeling relevant factors from univariate analysis showed CRP/Alb ratio was significantly associated with both all-cause death (HR: 1.24, 95%CI: 1.11-1.35, p<0.001) and MACCE (HR: 1.21, 95%CI: 1.09-1.32, p<0.001). The optimal cut-off on the receiver-operating characteristic curve of CRP/Alb ratio for predicting for all-cause death and MACCE were both 0.30 [all-cause death; the area under the curve (AUC) = 0.75, Sensitivity = 57%, Specificity = 87%, p<0.001 and MACCE; AUC = 0.73, Sensitivity = 49%, Specificity = 87%, p<0.001). Kaplan-Meier analysis showed a significantly lower survival rate after PCI in low CRP/Alb ratio (< 0.30) group than high CRP/Alb ratio (≥ 0.30) group (p<0.001). Similarly, cumulative incidence of MACCE was significantly higher in the high CRP/Alb ratio group than in the low CRP/Alb ratio group (p<0.001).

Conclusion:
The CRP/Alb ratio may have a potential for predicting the all-cause death and MACCE in patients with stable CAD after PCI.
Abstract 10343: Prospective Multi-Modality Imaging Comparisons of Left Ventricular Quantification in Aortic Valve Regurgitation and Stenosis
Authors: Wang Tom Kai Ming K , Popovic Zoran B , Rodriguez L L , Bolen Michael A , Moennich Laurie , Rutkowski Kathryn , Griffin Brian P , Grimm Richard A , Flamm Scott D , Kwon Deborah H
Published: June 2023

Background:
Cardiac magnetic resonance (CMR) has become reference standard for chamber quantification, with complimentary utility of valvular heart disease CMR may provide additional insights to transthoracic echocardiography (TTE) into chamber remodeling in aortic valve disease. We prospectively compared chamber quantification measured by TTE and CMR between AR and AS patients.

Methods:
In this study, we prospectively recruited moderate-to-severe AR (n=101) or AS (n=44) patients undergoing clinically-indicated TTE and CMR within 3-months of each other. TTE and CMR measurements were compared using Pearson correlation coefficient and Bland-Altman plots.

Results:
AR patients were significantly younger (57±15 versus 69±15 years, P<0.001), with lower proportion of females (26% versus 43%, P=0.050), being symptomatic (42% versus 68%, P=0.004), and higher proportion having bicuspid aortic valve (45% versus 27%, P=0.064) and dilated thoracic aorta (52% versus 23%, P=0.002) than AS patients. Moderate-to-high correlations were observed by TTE- and CMR-left ventricular parameters in both valve groups (r=0.50-0.80). The Figure shows that eft ventricular volumes were significantly higher by CMR than TTE, while ejection fraction (LVEF) were similar, and left ventricular global longitudinal strain (LVGLS) was more negative by CMR-SENC technique than TTE-velocity vector imaging technique. By CMR, AR patients had significantly higher left ventricular volumes (P<0.001), lower LVEF (P=0.033) and similar LVGLS (P=0.593) than AS patients.

Conclusion:
CMR left ventricular parameters had moderate-to-high correlations but systematic differences in measurements compared in aortic valve disease patients. Expected differences were observed between CMR-derived left ventricular remodeling of AR and AS.
Abstract 10360: Polygenic Risk Score, Rare Monogenic Variants, and Family History Have Independent and Additive Effects on the Risk of Coronary Heart Disease
Authors: Saadatagah Seyedmohammad , Hamed Marwan , Miller Alexandra , Bangash Hana , Nigbur Scott , Kamzabek Arailym , Norland Kristjan , Kosel Matt , Schaid Daniel , Kullo Iftikhar J
Published: June 2023

Introduction.
We assessed the effects of a polygenic risk score (PRS), monogenic variants (Mono
+
), and family history (FamHx) on the risk of coronary heart disease (CHD) and whether incorporating a PRS into the Pooled Cohort Equations (PCE) improves risk prediction.

Method.
In 199,997 UK Biobank participants, we calculated a PRS
CHD
(metaGRS, based on ~1.6 million single nucleotide variants), identified individuals with monogenic etiology (presence of a pathogenic variant in
LDLR
,
APOB
, or
PCSK9
), and ascertained family history of CHD (CHD in a first-degree relative). Odds of CHD (myocardial infarction/ coronary revascularization/ cardiovascular death) associated with PRS
CHD
, Mono
+
, and FamHx at age 55 were computed using logistic regression analyses adjusted for age, sex, and first 4 principal components of ancestry. We combined PRS
CHD
and PCE into an integrated score (IS) and assessed net reclassification using an actionable risk threshold of 7.5%.

Results.
The odds ratio (OR) for CHD in the top 5
th
percentile of PRS
CHD
(PRS
P95
), Mono
+
, and FamHx were 3.37 (2.98 - 3.81), 2.68 (1.67 - 4.07), and 1.61 (1.47 - 1.76), respectively (all p<0.001). These effects were independent and similar in different subgroups. (
Figure 1-A
) Compared to PRS
Q2-4
Mono
-
(3 middle quintiles of PRS
CHD
and no monogenic variants), the OR for CHD ranged from 1.73 (0.28 - 5.48, p = 0.446) in PRS
Q1
Mono
+
to 5.10 (2.14 - 10.24, p <0.001) in PRS
Q5
Mono
+
. A similar pattern was seen for other combinations, indicating additive effects (
Figure 1-B
). Incorporating PRS
CHD
into PCE resulted in a net reclassification improvement of 4.56%. Compared to those with high PCE and low IS, the hazard ratio for CHD in those with low PCE and high IS was 1.48 (1.34 - 1.64, p <0.001).

Conclusion.
The CHD risk associated with PRS
CHD
, monogenic variants, and family history is independent and additive. Combining PRS
CHD
and PCE improved risk prediction, that could improve further by adding monogenic variants and family history.
Abstract 10373: Associations of Triglyceride-Glucose Index and Morning Home Blood Pressure With Microalbuminuria and Chronic Kidney Disease in the Japanese at High-Risk of Cardiovascular Disease
Authors: Nagai Michiaki , Hoshide Satoshi , Kario Kazuomi
Published: June 2023

Introduction:
Triglyceride-glucose index (TyGi) was shown to serve as a simple surrogate marker of insulin resistance, which had a significant association with impaired renal function. However, the underlying pathophysiology has not been established between insulin resistance and impaired renal function in relation to home blood pressure (BP) measurement.

Hypothesis:
We hypothesized that morning home BP level and TyGi were associated with impaired renal function in the Japanese at high-risk of cardiovascular disease. In addition, an interaction of morning home systolic BP (MSBP) with TyGi was assessed for impaired renal function.

Methods:
In the Japan Morning Surge-Home Blood Pressure Study, measurements of home BP (mean 11.2 days) were performed in the 4310 patients with one or more cardiovascular risks (64.9 years old, male 47%). TyGi was calculated as ln[fasting triglycerides (mg/dL) х fasting glucose (mg/dL)/2]. While microalbuminuria was defined as urinary albumin/creatinine ratio ≥30 mg/gCr, chronic kidney disease (CKD) was defined as estimated glomerular filtration rate <60 ml/min/1.73 m
2
.

Results:
The mean levels of MSBP and TyGi were 138±16mmHg and 8.65±0.59, respectively. While the prevalence of microalbuminuria was 25.4%, the prevalence of CKD was 22.7%. In the logistic regression analysis adjusted for confounders including age, gender, body mass index, smoking, total cholesterol, HbA1c, use of antihypertensives, use of antidiabetics, statin use, and office SBP, MSBP (OR per 1SD, 1.39, 95%CI, 1.28-1.50, p<0.001) and TyGi (OR per 1Unit, 1.31, 95%CI, 1.14-1.51, p<0.001) were significantly associated with microalbuminuria. MSBP (OR per 1SD, 1.13, 95%CI, 1.04-1.23, p<0.01) and TyGi (OR per 1Unit, 1.38, 95%CI, 1.19-1.61, p<0.001) were also significantly associated with CKD. A significant interaction of MSBP with TyGi was not observed for microalbuminuria (p=0.17) or CKD (p=0.91).

Conclusions:
MSBP as well as TyGi were significant indicators of microalbuminuria and CKD. Morning BP load and insulin resistance were additively associated with impaired renal function in the high-risk Japanese population. In addition to home BP measurements, TyGi might provide additional clinically relevant information for target renal damage.
Abstract 10423: US Counties With Low Broadband Internet Access Have a High Burden of Cardiovascular Risk Factors, Disease, and Mortality
Authors: Troy Aaron , Xu Jiaman , Wadhera Rishi
Published: June 2023

Introduction:
Nationwide broadband internet access is a major federal priority. The bipartisan infrastructure law invested $65 billion into equitable broadband expansion, driven by concern that broadband access is a social determinant of health. However, the difference in health outcomes between counties with low vs. higher broadband access has not been studied, and could provide insights on the implications of expansion efforts.

Objectives:
We evaluated demographic factors, health resources, and cardiovascular disease (CVD) burden in counties with low broadband access compared to those with higher access.

Methods:
We assessed all 3,142 US counties in 2019 and identified those with low broadband access, defined as <50% of residents having access to internet subscriptions with speeds
>
25 Mbps download /
>
3 Mbps upload, using the US Broadband Usage Percentages Dataset. We linked these data to the American Community Survey, American Health Resource File, PLACES, and CDC WONDER for demographic, health resource, CVD risk factor and outcomes, and mortality data respectively.

Results:
There were 461 counties with low broadband access and 2,650 counties with higher access. Compared to those with higher broadband access, counties with low broadband access had lower high school graduation rates (47% vs 54%, p<0.001) and were more likely to be rural (86% vs 59%, p<0.001). Low-access counties had fewer primary care physicians and fewer cardiologists, but similar hospital beds per capita (
Table
). These counties had higher rates of CVD risk factors, coronary artery disease, and stroke, as well as higher age-adjusted rates of CVD mortality and all-cause mortality (
Table
).

Conclusions:
Counties with low broadband access have lower access to physicians and significantly higher rates of CVD risk factors, CVD, and CVD mortality. Expanding access to broadband internet and telemedicine has the potential to improve access to care and reduce disparities in CVD outcomes.
Abstract 10436: Spontaneous Hemopericardium After Rivaroxaban
Authors: Nawal Saadia , Ismail Haneen , Lewis Jannet F
Published: June 2023

Direct oral anticoagulants (DOACs) such as rivaroxaban have become the drugs of choice when treating a variety of conditions requiring anticoagulation. We describe a case of a patient found to have hemopericardium with tamponade physiology on a routine echo ordered for evaluation of tachycardia. A 49-year-old man with systemic hypertension was found to have a right lower lobe pulmonary embolus (PE) during a hospitalization for diabetic ketoacidosis complicated by pneumoperitoneum s/p small bowel resection. Rivaroxaban 15 mg twice daily was initiated for treatment of PE. On day 2 rivaroxaban, patient became tachycardic. Chest CT showed a small to moderate pericardial effusion with pericardial enhancement. On day 7, a echo showed trivial pericardial effusion without hemodynamic compromise. Tachycardia persisted after hospital discharge, but patient was otherwise asymptomatic. Patient transitioned to rivaroxaban 20 daily after 3 weeks. Outpatient echo done 2 months after discharge showed a large pericardial effusion with tamponade physiology. Patient was instructed to go to hospital for admission. Labs were significant for Hgb 7.8, and elevated PT 52.50, INR 4.5 and PTT 33.80. Rivaroxaban was held, and patient was given 2 units FFP, Vitamin K 10 mg oral, Kcentra 4208 units and 2 units pRBCs. Patient underwent a pericardiocentesis with removal of 600 cc of sanguineous fluid. Fluid analysis was consistent with hemorrhagic effusion. Repeat echo showed a small residual, anterior pericardial effusion with constrictive physiology. Patient was discharged on reduced dose of rivaroxaban 10 daily and Vitamin K 5 mg daily until outpatient follow up. Our case of hemopericardium occurring in a middle-aged man without confounding issues is unusual. Although hemopericardium with DOACs have been reported, the majority of cases have occurred in patients with pre-disposing risk factors. A systemic review of 26 cases by Asad, et al. described risks associated with cardiac tamponade with DOACs. The incidence of hemopericardium and tamponade appeared highest in elderly men with renal and coagulation abnormalities. Our case highlights the importance of vigilance in patients on DOACs who present with subtle symptoms suggestive of hemodynamic compromise or instability.
Abstract 10474: Long-Term Daily Activity is Associated With Exercise Capacity and Quality of Life in Pulmonary Arterial Hypertension
Authors: Hughes Andrew M , Annis Jeffrey , Hemnes Anna R , Lindsey Alisha , Burke Kelly , Horn Evelyn M , Brittain Evan ,   PVDOMICS Study Group
Published: June 2023

Introduction:
Reduced functional capacity is a hallmark of pulmonary arterial hypertension (PAH). Six minute walk distance (6MWD) is a common measure of functional capacity. Unlike the 6MWD, daily activity monitoring integrates behavioral aspects of physical capacity. We hypothesized that daily activity is associated with 6MWD and quality of life (QOL) in patients with PAH.

Methods:
This study included patients with PAH from the NHLBI-funded Pulmonary Vascular Disease Phenomics (PVDOMICS) study. PVDOMICS collected 6MWD and QOL surveys (Minnesota Living with Heart Failure [MLHF] and Short Form-36 [SF-36]) data. Daily activity was measured using Fitbit devices which participants wore continuously for 12 weeks. Daily activity was expressed as average daily steps and graded intensity.

Results:
We enrolled 45 patients with PAH (age, 48.1
+
13.4 years) with median daily steps of 4146 (IQR: 2682-6977). Sedentary, fairly active, and very active minutes/day were 850 (IQR: 774-1093), 5.0 (IQR 2.0-7.6), and 2.1 (IQR 0.7-7.3). The median time between 6MWD and the start of daily activity monitoring was 32 days (IQR 11-53). Average daily steps correlated with 6MWD (r = 0.70, p<0.001), MLHF total score (r = - 0.46, p=0.002), MLHF physical and emotional domains, and the SF-36 physical component score. Among hemodynamic measures, average steps and fairly active minutes were most strongly associated with PA compliance (r=0.46 and r=0.64; both p<0.05). In contrast, 6MWD only correlated with the SF 36 physical component but no MLHF measures.

Conclusions:
In a geographically diverse PAH cohort, long-term daily step counts are associated with exercise capacity and QOL. Daily activity measures capture behavioral information not captured by the 6MWD and correlated with prognostic hemodynamic measures. Daily activity monitoring and 6MWD represent complementary measures for the assessment of functional capacity in patients with PAH.
Abstract 10548: Atrial Fibrillation Worsens Sports Performance in Athletes; Greatest Improvement Seen With Ablation: A Stopafib.org Survey
Authors: Khan Ali K , Lee Hyon Jae , Hills Mellanie T , Moss Melissa , Lara Brenna , Baumann Raymond , Brandt Cynthia , Lampert Rachel J
Published: June 2023

Introduction:
Anecdotally, both atrial fibrillation (AF) and medications for AF, are poorly tolerated in athletes. However, data are lacking.

Methods:
An internet-based survey, initiated via StopAfib.org, queried the impact of AF and treatment modalities on sports performance, training, and well-being. Performance, (rated in comparison to personal best), frequency of training and competition were categorized ordinally and compared prior to onset of AF symptoms versus when symptoms at worst, via paired Wilcoxon, and then compared in relation to participants’ AF treatments.

Results:
Between 5/13/19 and 2/29/20, 802 athletes responded, including 78% males, 22% female, median age 61 to 70 years
.
The most reported sports were cycling (25%) and running (20%). Median time since diagnosis was 3 to 5 years. When participants’ symptomatology was at worst, the median frequency was at least once a week, most commonly palpitations, fatigue, and decreased exercise tolerance. Development of AF was associated with declining sports performance, competition, and training frequency as shown in the table below. Of 471 participants who decreased their exercise regimen, 31% reported no change in symptoms, 56% reported a decreased frequency of AF, and 13% reported no further AF. Among athletes that received treatment, ablation was associated with the greatest improvement in sports performance compared with ablation plus medications or medications alone (see table below). Of 262 athletes currently on medication, 27% reported that it was completely effective, 58% partially effective, and 15% not effective. Of 653 athletes that have taken medication currently and/or in the past, 43% reported side effects, most commonly fatigue, low energy, or decreased athletic performance.

Conclusions:
In athletes, AF was associated with decline in sports performance. Among AF treatment modalities, ablation was associated with the greatest improvement in sports performance.
Abstract 10610: The Additive Value of Pacemakers and Icds in the Mri Environment Over 18 Years; A Large, Prospective Observational Study
Authors: Biederman Robert W , Gevenosky Loretta , WILLIAMS RONALD , Lombardi Rich , Shah Moneal , Hussain Nasir , Farah Victor , Doyle Mark
Published: June 2023

Introduction:
MRI is infrequently performed on pts with conventional PM’s and ICDs. While many studies, including
MagnaSafe
, have unequivocally supported MRI safety in pts with such devices, the clinical value has rarely been considered. Accordingly, we performed an observational, prospective study to determine the 'Additive Value' beyond safety for pts with conventional PM/ICD undergoing clinical MRI.

Hypothesis
We propose that MRI in PM/ICD pts is crucial to an existing diagnosis and often, substantially alters diagnosis and subsequent management.

Methods
An MRI Device exam (GE 1.5T,WI) pioneered by cardiologists (>95% over 15 yrs) was performed. Subsequently, a series of defining questions using Boolean Logic Construct were answered within 1 week of MRI by both MRI technologist and MRI physicians: 1) Did the primary diagnosis change? 2) Did MRI provide additional information to existing diagnosis? 3) Was the pre-MRI (tentative) diagnosis confirmed? 4) Did patient management change? If 'Yes' was answered to any of the above questions, it was considered that MRI was of value to pt diagnosisand/or impending therapy.

Results:
Avg MRI: 28±16min for 1678 consecutive pts of which 1271 (73%) were neuro/neurosurgery, 145 (8%) were musculoskeletal and 323 (19%) were CV cases. Upon review: of the neuro/neurosurgery MRIs, 1106 (87%) provided additional information. The diagnosis changed in 807 (73%), while medical therapy changed in 774 (70%). In only 135 (11%) did MRI simply confirm original diagnosis. For cardiac pts, MRI changed the original diagnosis in 213 (66%). MRI did not contribute in 97(14%) as it was uninterpretable (ICD artifact), while in 43 pts, the diagnosis did not change. Finally, in 145 musculoskeletal pts, MRI provided additional information in 139 (96%) and in 128 (88%), changed pt care, and in 3 pts (2%), simply confirmed the diagnosis. Importantly, with careful attention to device reprogramming and scanner sequences, no safety or device issues were encountered in any pt.

Conclusions
A dedicated program of utilizing MRI in PM/ICD pts adds substantial clinical value to diagnosis and subsequent management justifying inherent risk. We believe yet another impediment to the advancement of CMR-PM/ICD strategies can become routine and life-changing.
Abstract 10622: Association of Sustained Ventricular Arrhythmias and Increased Cardiac Metabolic Activity Mimicking Cardiac Sarcoidosis
Authors: Kovacs Boldizsar , Giannopoulos Andreas A , Bogun Frank , Pazhenkottil Aju P , Bonetti Nicole R , Manka Robert , Medeiros Domingo Argelia , Ruschitzka Frank , Duru Firat , Kaufmann Philipp A , Buechel Ronny R , Saguner Ardan M
Published: June 2023

Introduction:
Cardiac sarcoidosis (CS) is increasingly diagnosed using 18F-fluorodeoxyglucose positron emission tomography/CT (FDG-PET/CT). Patients with sustained ventricular tachycardia/fibrillation (VT/VF) and a positive FDG-PET/CT suggestive of CS often receive immunosuppressive therapy even in the absence of histologic documentation of non-caseating granulomas.

Hypothesis:
FDG-PET/CT performed early after sustained VT/VF can lead to increased myocardial FDG uptake mimicking CS.

Methods:
Consecutive patients with non-ischemic cardiomyopathy presenting with sustained VT/VF that underwent FDG-PET/CT immediately following the arrhythmic event were prospectively recruited. Patients with increased metabolic activity consistent with myocardial inflammation were followed. All patients received guideline-directed medical therapy, but without immunosuppressive therapy. Repeat FDG-PET/CT was performed ≥30 days after the last sustained VT/VF episode.

Results:
Six patients were enrolled with a mean age of 57.1 years (± 5.6), and a left ventricular ejection fraction of 47.5% (±14.8). Coronary artery disease and acute perimyocarditis were excluded. Initial presentation was electrical storm in 2 (33%), appropriate ICD or external shock in 3 (50%) and ATP in 1 (17%) case, respectively. Baseline FDG-PET/CT was performed a median 5.5 days (range 3-17) after sustained VT/VF termination. Distribution of metabolic activity was focal-multifocal in 4 (66%), focal-diffuse in 1 (17%) and focal in 1 (17%) case, respectively. Median SUVmax was 6.8 (range 4.9-18). No extracardiac metabolic foci were observed and histologic diagnosis of non-caseating granuloma could not be established in any patient. Repeat FDG-PET/CT (median after 139, range 38-448 days) showed complete FDG uptake regression in all patients. Final diagnosis of arrhythmogenic cardiomyopathy was made in all patients, and genetic testing was performed.

Conclusion:
Prolonged VT/VF episodes may result in increased myocardial FDG uptake, potentially leading to an overdiagnosis of CS. FDG-PET/CT to screen for CS should be performed at a VT/VF-free interval prior to immunosuppressive therapy.
Abstract 10786: Cardiac Muscle Patches Containing Four Types of Cardiac Cells Derived From Human Pluripotent Stem Cells Improve Recovery From Cardiac Injury
Authors: Lou Xi , Lou Xi , Tang Yawen , Ye Lei , Pretorius Danielle , Fast Vladimir G , Kahn-Krell Asher , Zhang Jue , Zhang Jianhua , Qiao Aijun , Kamp Timothy J , Thomson James A , Qin Gangjian , Zhang Jianyi
Published: June 2023

Introduction:
We have shown that human cardiac muscle patches (hCMPs) containing three different types of cardiac cells—cardiomyocytes (CMs), smooth-muscle cells (SMCs), and endothelial cells (ECs), all of which were differentiated from human pluripotent stem cells (hPSCs)—significantly improved cardiac function, infarct size, and hypertrophy in a pig model of myocardial infarction (MI). However, hPSC-CMs are phenotypically immature, which may lead to arrythymogenic concerns; thus, since hPSC-derived cardiac fibroblasts (hPSC-CFs) appear to enhance the maturity of hPSC-CMs, we compared hCMPs containing hPSC-CMs, -SMCs, -ECs, and -CFs (4TCC-hCMPs) with a second hCMP construct that lacked hPSC-CFs but was otherwise identical (3TCC-hCMPs).

Methods:
hCMPs were generated in a fibrin scaffold. MI was induced in SCID mice through permanent coronary artery (LAD) ligation, followed by treatment with cardiac muscle patches. Animal groups included: MI heart treated with 3TCC-hCMP; with 4TCC-hCMP; MI heart treated with no patch (MI group) and sham group. Cardiac function was evaluated via echocardiography, and cell engraftment rate while infarct size was evaluated histologically at four weeks after patch transplantation.

Results:
The results from experiments in cultured hCMPs demonstrate: 1) that structural, metabolic, and ion-channel markers for CM maturation were significantly more abundant in 4TCC-hCMPs; and 2) that conduction velocities and action-potential durations were significantly greater in hPSC-CMs from 4TCC-hCMPs (18 cm/s ± 0.72 vs. 31 cm/s ± 3.23, p<0.005, 3TCC vs. 4TCC). Furthermore, when 3TCC- and 4TCC-hCMPs were compared in a mouse MI model, measures of cardiac function ( EF: 41.55% ± 0.92 vs. 49.18% ± 0.86, p<0.05, 3TCC vs. 4TCC), infarct size (39.23% ± 4.28 vs. 22.72% ± 0.98, p<0.05, 3TCC vs. 4TCC), hypertrophy, and CM engraftment were significantly better in animals treated with 4TCC-hCMPs than in the 3TCC-hCMP-treatment group (8.56% ± 1.79 vs. 15.99% ± 1.56, p<0.05, 3TCC vs. 4TCC).

Conclusions:
These results demonstrate that the inclusion of hPSC-CFs in hCMP manufacture promotes hPSC-CM maturation and increases the efficacy of hCMPs for myocardial repair.
Abstract 10876: Thrombo-Inflammatory Biomarkers in Pulmonary Embolism as Stratified in Cancer and Non-Cancer Patient Groups
Authors: Siddiqui Fakiha , Darki Amir , Hoppensteadt Debra A , Kantarcioglu Bulent , Tafur Alfonso J , Fareed Jawed , Monreal Manuel
Published: June 2023

Introduction:
The multifactorial and complex pathophysiology of pulmonary embolism (PE) involves dysregulation of hemostatic system including fibrinolytic imbalance, endothelial compromise, and generation of thrombotic mediators, along with cellular defects and hemodynamic derangement. Cancer is prevalent in PE patients and is considered an added risk factor for the adverse outcomes. Thrombo-inflammatory biomarkers profiling provide means to risk stratify PE patients.

Hypothesis:
This study aimed to profile several of these biomarkers in normal and PE patients and to further demonstrate any potential difference between cancer and non-cancer patients.

Methods:
Four hundred patients of 18 years or older age, were included through enrolment in conjunction with IRB approved project by the pulmonary embolism response team (PERT) registry. Diagnosis of PE was confirmed by computed tomography (CT), angiography or ventilation perfusion imaging. Blood samples were drawn with in 24 hours of confirmed diagnosis of acute PE. Control plasma samples were obtained from 50 healthy individuals. All plasma samples were analyzed for D-Dimer, PAI-1 antigen, tPA, TAFI-a, vWF, CRP, troponin and IL-6 were measured by ELISA methods. Microparticles were measured using a chromogenic functional method. Individual biomarkers were compared to normal plasma and further stratified into cancer and non-cancer.

Results:
All the individual biomarkers exhibited up to 50-fold elevation in PE patients compared to normal groups. D-Dimer and CRP showed the most pronounced increase. When the PE group stratified into cancer and non-cancer patients, most of the biomarkers except D-Dimer and microparticles showed varying degree of modest elevation in the cancer group. vWF, IL6 and microparticles levels were found to be significantly different in the cancer group (p<0.050).

Conclusions:
These studies demonstrate that thrombo-inflammatory biomarkers are upregulated in PE patients. Furthermore, PE patients with cancer exhibit amplified levels of some of the markers suggesting the increased severity of pathogenesis involving thrombo-inflammatory mechanisms.
Abstract 10918: Sex Differences in the Association of Triglyceride Glucose Index in Patients With Obstructive Coronary Artery Disease
Authors: Lu Ya Wen , Tsai Chuan Tsai , Chou Ruey-Hsing , Huang Po-Hsun
Published: June 2023

Background:
Insulin resistance is associated with cardiovascular disease due to direct or associated risk factors. We aimed to investigate the association of the Triglyceride glucose (TyG) index, as the surrogate marker of insulin resistance and obstructive coronary artery disease (CAD) between sex, especially for patients without diabetes.

Methods:
Patients with stable angina pectoris requiring invasive coronary angiography were enrolled, and they were divided into two groups according to the TyG index (ln[triglyceride x fasting plasma glucose]/2). Obstructive CAD was defined according to invasive coronary angiography results.

Results:
Patients with a higher TyG index (TyG index≧8.60) were associated with higher BMI, the prevalence of hypertension (HTN), diabetes mellitus (DM), and abnormal lipid profile compared with lower TyG index (TyG index < 8.60). In women without diabetes, higher TyG index patients had a greater prevalence of obstructive CAD than the lower TyG index group (19.5% vs. 37.7%, p-value: 0.011). There was no difference in the majority of obstructive CAD in male patients between lower and higher TyG index. In multivariate logistic regression analysis, a higher TyG index remained the independent association of obstructive CAD only in women without diabetes (adjusted odds ratio (OR): 2.568, 95% CI: 1.238-5.327,
p=
0.011) but not in the DM group.

Conclusion:
Higher TyG index, a marker of insulin resistance, was significantly related to a higher risk of obstructive CAD with gender disparity in patients without diabetes. Further larger-scale studies are needed to confirm our findings.
Abstract 10921: Efficacy and Safety of Ongericimab in Chinese Patients With Homozygous Familial Hypercholesterolemia
Authors: Lin Jie , Chen Jiyan , Zhang Ruiyan , Wang Jingfeng , Bai Xuelian , Yan Hui , Yu Jianjun , Yao Sheng , feng hui , Lin Jie
Published: June 2023

Background:
Homozygous familial hypercholesterolemia (HoFH) is a rare genetic disorder with extremely high low-density lipoprotein cholesterol (LDL-C) levels that contributes to atherosclerotic cardiovascular disease and death, even in adolescent. Ongericimab, a monoclonal antibody against human proprotein convertase subtilisin/kexin type 9 (PCSK9), inhibits PCSK9-mediated degradation of LDL receptor (LDLR), and reduces LDL-C by 58.3-66.5% in Chinese patients with hyperlipidemia. Due to the high genetic heterogeneity of HoFH, the LDL-C lowering effect of Ongericimab remains elusive in Chinese population. This is the first study to assess the efficacy and safety of anti-PCSK9 antibody in Chinese patients with HoFH.

Methods:
This is a single arm, open-label phase 2 study. 31 patients (aged ≥12 years) with HoFH diagnosed by clinical or genetic criteria, on stable lipid-lowering therapies for ≥4 weeks, were enrolled to receive subcutaneous Ongericimab 450 mg every 4 weeks for 52 weeks. The primary endpoint was percentage change in LDL-C from baseline at week 12.

Results:
At the time of this interim analysis, 30 out of 31 patients completed 12 weeks treatment. All patients were on statins (77.4% on high intensity statin) and the mean (SD) baseline LDL-C was 8.6 (3.1) mmol/L. The least squares mean percentage change in LDL-C from baseline was -12.6% (95% CI: -19.7%, -5.6%; p=0.001) at week 12. Further analysis based on residual LDLR activity, the mean (SD) LDL-C change from baseline was -21.7 (28.0)% in 14 patients with defective LDLR (at least one defective allele) and -1.4 (9.6)% in 7 patients with negative LDLR (at least one negative allele), respectively (Figure 1). No serious side effects were reported.

Conclusion:
Ongericimab was well tolerated and significantly reduced LDL-C levels in Chinese patients with HoFH. Patients with defective LDLR demonstrated better response than those with negative LDLR.
Abstract 10942: The A Body Shape Index and Type 2 Diabetes Are Mutually Independent Predictors of Major Cardiovascular Events in Patients With Established Cardiovascular Disease
Authors: Sprenger Lukas , Maechler Maximilian , Vonbank Alexander , Larcher Barbara , Mader Arthur , Leiherer Andreas , Muendlein Axel , Drexel Heinz , Saely Christoph H
Published: June 2023

Introduction:
The A Body Shape index (ABSI) is a validated measure of visceral adiposity that is calculated based on waist circumference, height and BMI.

Hypothesis:
We hypothesize that ABSI is a predictor of major cardiovascular events in patients with established cardiovascular disease (CVD).

Methods:
We prospectively recorded cardiovascular events in a large cohort of 1544 patients with established CVD (1297 patients with angiographically proven stable coronary artery disease and 247 patients with sonographically verified PAD) over a mean follow-up time of 10.0±4.6 years.

Results:
At baseline, the ABSI was higher in patients with type 2 diabetes (T2DM; n=502) than in those who did not have diabetes (8.4±0.6 vs. 8.3±0.6; p<0.001). Prospectively, the ABSI significantly predicted the incidence of MACE (n=507) after adjustment for age, gender, smoking, hypertension, LDL cholesterol, HDL cholesterol, and T2DM (standardized adjusted HRs 1.14 [1.04-1.24]; p=0.004, respectively). T2DM in turn in this model also significantly predicted MACE with a HR of 1.61 [1.33-1.94]; p<0.001 after adjustment for ABSI.

Conclusions:
We conclude that ABSI and T2DM are mutually independent risk factors for MACE in patients with established cardiovascular disease.
Abstract 10952: Valve-Sparing Root Replacement in Patients With Bicuspid Aortic Valves versus Patients With Tricuspid Aortic Valves: A Meta-Analysis
Authors: Hamlin Sean , Yokoyama Yujiro
Published: June 2023

Objective:
Valve-sparing root replacement (VSRR) has been described as a treatment for aortic root dilation and aortic regurgitation (AR) in both patients with tricuspid aortic valves (TAVs) and bicuspid aortic valves (BAVs); however, varied results have been reported regarding the long term need for re-intervention and subsequent aortic regurgitation in patients with BAVs. Thus, we conducted a meta-analysis to compare the outcomes of VSRR in patients with BAVs versus patients with TAVs.

Methods:
PubMed was searched through April 2022 to identify all studies reporting comparative outcomes of VSRR in patients with BAVs versus patients with TAVs. Short term outcomes of interest were in-hospital mortality, reoperation for bleeding, and stroke and long term outcomes of interest were long-term mortality, freedom from reoperation, and freedom from AR ≥ 2.

Results:
Our analysis included 13 studies reporting outcomes of 2909 patients undergoing VSRR (n = 861 for BAV group and n = 2048 for TAV group), including 9 retrospective and 4 prospective single-institution cohort studies. No significant differences were observed in terms of in-hospital mortality (hazard ratio [HR] [95% confidence interval [CI]] = 0.49 [0.18-1.35];
P
= 0.17;
I
2
= 0%), reoperation for bleeding (HR [95% CI] = 1.06 [0.66-1.73];
P
= 0.80;
I
2
= 0%), stroke (HR [95% CI] = 2.40 [0.77-7.44];
P
= 0.13;
I
2
= 0%), and freedom from AR ≥ 2 (HR [95% CI] = 1.60 [0.69-3.72];
P
= 0.28;
I
2
= 49%), though there was a trend toward greater rates of stroke and freedom from AR ≥ 2 in the TAV group. However, there were significantly lower rates of long-term mortality (HR [95% CI] = 0.47 [0.30-0.74];
P
= 0.001;
I
2
= 0%) and higher rates of reoperation (HR [95% CI] = 2.11 [1.26,3.54];
P
= 0.004;
I
2
= 19%) in the BAV group.

Conclusion:
VSRR can be performed in patients with BAVs with similar short term outcomes and lower rates of long-term mortality compared to patients with TAV; however, greater rates of reoperation may be observed in BAV patients.
Abstract 10980: Echocardiographic Evaluation of the Left Ventricular Function in Patients With Noncompaction Cardiomyopathy: Biplane Method, Wall Motion Score or Global Longitudinal Strain?
Authors: Mohamedhoesein Sharida , Tukker Martijn , Kaya Emrah , Caliskan Kadir
Published: June 2023

Introduction:
Noncompaction cardiomyopathy (NCCM) is characterized by left ventricular (LV) hypertrabeculation. Therefore, endocardial tracing / quantification of LV function could be cumbersome.

Hypothesis:
Accurate assessment of the (subclinical) LV dysfunction in NCCM patients could improve non-invasive monitoring of disease progression, risk stratification, and treatment.
Method:
We reviewed the echocardiographic images of 67 patients (54% male, median age 48 year [22-73]. LV function was assessed by conventional biplane disk summation, wall motion score (WMS), and global longitudinal strain (GLS). LV function was considered abnormal if LV ejection fraction (LVEF) <50% and GLS >-18,9%.

Results:
LV function measured by biplane vs WMS showed significantly lower LV EF with WMS (p-value: 0,0016;
Figure
), while the average GLS in all patients was -11,0%, SD ±3,8 (normal values: -18,9%; p-value: p<0,001). By dichotomizing the group into LVEF <50% vs. ≥50%, biplane EF was abnormal in 68,7%, while this was with WMS 88,1% en GLS in 100% patients. In patient with EF <50% compared to ≥ 50% GLS in low biplane EF group was: -9.3% vs -14.5% (p<0.001). In the WMS EF was this respectively -10,3±3,6% versus -15.5± 1.5 (p<0.001).

Conclusion:
The systolic LV dysfunction in patients with NCCM noncompaction cardiomyopathy found by WMS and GLS was significantly lower compared to routine biplane EF measurement suggesting that WMS and GLS measurement are much more potential prognostic tool. Given the correct execution of WMS is limited by the assessor's experience, estimation of the LV function with GLS are probably most reliable. Future research should expel whether these results are representative in a larger group of patients and correlates with the clinically relevant endpoints.
Abstract 11: Community Interventions To Improve Out-of-hospital Cardiac Arrest Survival: Targeting Public Housing Could Be A Solution
Authors: Juul Joergensen Anne , Kjoelbye Julie S , Gregers Mads Christian Tofte , Jakobsen Louise K , Kragh Astrid Rolin , Ettl Florian , Krychtiuk Konstantin , Sulzgruber Patrick , Krammel Mario , Torp-Pedersen Christian , Kjær Ersbøll Annette , Folke Fredrik , Malta Hansen Carolina
Published: June 2023

Background:
Identifying well-suited areas for community-targeted interventions to improve bystander interventions and OHCA survival, particularly in deprived communities, has been warranted by the AHA. Public housing projects are publicly subsidized, geographically well-defined, have local leadership, and residents typically have a high prevalence of OHCA predictors. To assess the potential reach of community interventions in public housing, we investigated the incidence of OHCA in public housing projects in Vienna (Austria) and Copenhagen (Denmark) and compared it with remaining residential areas.

Methods:
Non-EMS witnessed OHCAs occurring in residential areas in Vienna (2017-2021) and Copenhagen (2016-2020) were included from the Viennese and Danish Cardiac Arrest Registry, respectively. Population density and residential areas were obtained from Urban Atlas; public housing data from City of Vienna, and the Danish National Building Foundation. We compared OHCA/km
2
and OHCA/100,000 inhabitants between public housing projects and other residential areas using Poisson regression of rates. We calculated the proportion of OHCAs occurring within 100 meters of public housing projects.

Results:
In Vienna vs. Copenhagen, 32% (1,391/4,313) vs. 35% (817/2,335) of residential OHCAs occur in public housing areas. The relative ratio of OHCA/km
2
and OHCA/100,000 inhabitants is 3-fold and 1.5-fold higher in public housing than in other housing areas, respectively (Figure 1). Including the immediate surroundings, public housing covered 64.8% vs. 56.1% of all residential OHCAs in Vienna and Copenhagen.

Conclusion:
Public housing projects in Vienna and Copenhagen had a substantially higher incidence of OHCA than other residential areas covering 1/3 of all OHCAs in residential areas and ~60% when including nearby neighborhoods. Community initiatives targeting these areas may be an efficient strategy to improve bystander interventions and survival.
Abstract 11000: Deep Learning Prediction of New-Onset Atrial Fibrillation Using Echocardiography Videos
Authors: Ulloa Cerna Alvaro E , Raghunath Sushravya , vanMaanen David , Ruhl Jeffrey , Fornwalt Brandon , Pfeifer John , Haggerty Christopher M
Published: June 2023

Introduction:
Patients at high risk of undiagnosed Atrial Fibrillation (AF) can be identified from 12-lead ECG and routed to increased monitoring via wearable devices such as a watch or an ECG patch. A similar prediction task may be feasible employing echocardiography, increasing the likelihood of detecting patients at high risk for AF. Hypothesis: We hypothesized that by leveraging a large echocardiography database, a model can be trained to accurately predict future AF onset in patients undergoing routine echocardiography.

Methods:
We collected data on patients with an echo at Geisinger (769,854 studies from 337,388 patients) and randomly grouped patients into training (80%) or testing (20%) sets. In the training cohort, studies were considered positive if they were obtained from patients with prior or new (<1 year) AF diagnosis. Alternatively, negative studies were those obtained from AF-free patients (>1 year). For testing, we selected one random echo per patient and restricted the positives to patients without prior AF diagnosis or new AF within 7 days of the echo. This was to avoid predicting positive AF at the time of echo. We tested the model on 38,808 valid studies where 5% developed AF within a year. We trained six convolutional neural networks, one per view (apical two, four and five chambers, basal and mid short-axis, and parasternal long-axis), and combined their outputs to train an XGboost model.

Results:
Among the six views, the apical four chamber yielded the best performance with an area under the ROC curve (AUROC) of 76%, followed by the apical two chamber with 65%, the apical five chamber with 58%, the parasternal long-axis with 57%, the basal short-axis with 56%, and the mid short-axis with 50%. A model combining all six planes yielded a 78% AUROC.

Conclusions:
CNN models trained on echocardiography videos can predict new-onset AF with moderate performance. We also found that views that captured the left atrium had better performance compared to those that did not.
Abstract 11018: The WATCH-IT Study: Wearable Device Use Among Primary Care and Cardiology Patients in a Large Healthcare System
Authors: Venn Rachael A , Al-Alusi Mostafa , Ashburner Jeffrey M , Atlas Steven , Chang Yuchiao , Ellinor Patrick T , Foulkes Andrea , Grayson Mia , Khurshid Shaan , McManus David , Singer Daniel E , Lubitz Steven A
Published: June 2023

Introduction:
Wearable devices such as smartwatches and fitness trackers are widely used. While marketed to consumers for general wellness, many devices measure physiologic parameters with implications for cardiovascular health. The prevalence of wearable device use in contemporary patient populations is unknown. We sought to 1) determine characteristics of current and prospective device users within a large healthcare system and 2) assess user interest in incorporating device data into the electronic health record for clinical research purposes.

Methods:
Participants were selected from a database of adults aged ≥ 18 years who received longitudinal primary or cardiac care at one of 11 hospitals within the Mass General Brigham network between 1/2010 and 7/2021. We identified living patients with an active electronic portal account for direct communication. Portal users were invited to complete a survey about use and medical applications of wearable devices. Multivariable logistic regression was used to identify factors associated with device use.

Results:
Between 11/2021 and 4/2022, 214,935 patients were contacted with 10,947 (5%) unique survey respondents. Rates of device use were similar among primary care (56%, n=4,739) and cardiology (53%, n=2,190) patients. Almost all non-users (97%, n=4,540) reported that they would use a device if not for cost. In a multivariable model, factors associated with device use included: age (odds ratio [OR] per 5-year increase 0.89, 95% CI [0.87,0.90]), female sex (1.19 [1.09, 1.29]), cardiac vs primary care (1.27 [1.16, 1.39]), median household income by zip code (OR per 1-standard deviation increase 1.10 [1.06, 1.15]), and better self-reported health (OR for “excellent” vs “poor” health 3.35 [2.27, 4.99]). Almost all users and potential users (96%, n=9,811) would share device data with researchers studying health outcomes.

Conclusion:
Among survey respondents, younger age, female sex, cardiac care, higher income, and better self-reported health were associated with wearable device use. Current and prospective device users are interested in sharing longitudinal data, which will enable further study of wearable devices and their role in care delivery, clinical outcomes, and health disparities.
Abstract 11020: Predictors of Cardiac Arrest Including Ventricular Fibrillation in Young Patients Hospitalized With Hypertrophic Obstructive Cardiomyopathy: An Artificial Neural Network Analysis Using a Nationwide Cohort
Authors: Bhanushali Aditi K , Patel Aneri , Pusa Mounika , Aggarwal Sanjana , Siddique Muhammad Saad , Javed Haris , Sura Harsh R , DHRUVE RITIKA , Sharma Marisha Rai , Desai Rupak
Published: June 2023

Background:
It is crucial for providers to screen for high-risk patients with limited data being available on young hypertrophic obstructive cardiomyopathy (YHOCM) patients. We aimed to determine predictors of cardiac arrest including ventricular Fibrillations (VF) in this population using the Artificial Neural Network (ANN) model in a national cohort.

Methods:
We identified young patients (18-44 years) with HOCM from National Inpatient Sample (2018) with relevant ICD 10 codes. ANN’s predictive factors were selected for cardiac arrest including VF. YHOCM were randomly split between training (70.8%) and testing (29.2%) datasets. Training data was used to calibrate ANN whereas testing data was used to evaluate the accuracy of the algorithm. We compared the frequency of incorrect prediction between training and testing data and measured area under the Receiver Operating Curve (AUC) to determine ANN’s efficacy in predicting cardiac arrest.

Results:
YHOCM (2280, median age 36 years, 52.4% males, 47.6% females, 50.9% Whites, 32.2% Blacks, 11.6% Hispanics) had all-cause mortality of 21.1% with compared to that of 1.1% without cardiac arrest. Training data showed a lower rate of 3.9% vs 4.7% of error in predictions vs testing, thereby depicting better accuracy. Normalized predictors are displayed in Fig 1a. The AUC was 0.799 (Fig. 1b) which shows an excellent ANN model for cardiac arrest in YHOCM hospitalizations.

Conclusions:
Our ANN model successfully revealed predictors of cardiac arrest including VF in YHOCM patients that can be utilized to improve/prevent such events in high-risk patients leading to a better quality of life and survival rates.