bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 9940: A Survey on Laypersons' Willingness in Performing Cardiopulmonary Resuscitation
Authors: Itai Junji , Otani Tadatsugu , Ohshimo Shinichiro , Shokawa Tomoki , Nishioka Kenji , Kida Yoshiko , Suzuki Kei , Inagawa Takahiro , Torikoshi Yusuke , Tamura Tomoko , Ota Kohei , Sadamori Takuma , Tsumura Ryu , Iwasaki Yasumasa , Hirohashi Nobuyuki , Tanigawa Koichi
Published: April 2024

Introduction
Although bystander cardiopulmonary resuscitation (CPR) can more than double survival from cardiac arrest, the reported prevalence of bystander CPR remains low in most countries. Reasons cited for the reluctance to perform CPR often include concerns about disease transmission related to performing mouth-to-mouth ventilation. However, a couple of studies reported that bystanders at the scene of out-of-hospital cardiac arrests most often cited other reasons such as panic or fear of causing harm for failing to perform CPR. This study was performed to investigate factors affecting laypersons' willingness in performing CPR.

Methods
Questionnaires including 10 questions regarding personnel backgrounds, knowledge regarding the use of AED, CPR training, willingness in performing CPR, and EMS dispatcher's phone advice were distributed to citizens who gathered at a ball park stadium, a typical public place in Hiroshima, Japan.

Results
Ten thousands questionnaires were distributed and a total of 5,956 were collected for analysis. As for the willingness to perform CPR, 38 % answered they would start CPR, 34 % would do it if any advice available. On the other hand, 23 % said they were not capable of performing CPR, and 4 % were not willing to do it. Of those who were not capable of performing CPR, the reasons included lack of knowledge and/or skills to perform CPR (50%), no previous CPR training (27%), and concern over harm to the victims (25%).Of those who were willing to perform CPR, 61 % answered they would prioritize rescue breathing over chest compression. In comparison of those with and without previous CPR training or knowledge of the use of AED, a significant differences were found in the willingness in performing CPR (88% vs. 58%, p <0.0001; 91% vs. 58%, p <0.0001, respectively), and doing rescue breathing (55% vs. 29%, p <0.0001; 64% vs. 57%, p <0.0001, respectively). Fifty two percent of the respondents did not know the service of dispatcher-assisted CPR.

Conclusion
Our study indicated that proper knowledge of CPR, prior CPR training, and on-site bystander CPR assistance may greatly enhance laypersons' willingness in performing CPR. More emphasis should be exerted on the roles of chest compression and the EMS dispatcher-assistance in CPR education.
Abstract 9993: Friedreich Ataxia is Associated with Endothelial Dysfunction and Increased Arterial Stiffness
Authors: Siasos Gerasimos , Gialafos Elias , Tousoulis Dimitris , Oikonomou Evangelos , Michalea Stavroula , Kollia Christina , Aggeli Constantina , Maniatis Konstantinos , Paraskevopoulos Thodoris , Zisimos Konstantinos , Kioufis Stamatios , Papavassiliou Athanasios G , Stefanadis Christodoulos
Published: April 2024

Purpose:
Friedreich's ataxia (FA) is an autosomal recessive disorder characterized by spinocerebellar degeneration and increased oxidative status. However, vascular function in the syndrome remains unknown. In this study we assessed the hypothesis that FA patients have impaired vascular function.

Methods:
Nine teen FA patients diagnosed by molecular genetic analysis (aged 30 ± 10.88 years) were compared with thirty five age and sex matched healthy subjects. Endothelial function was evaluated by flow mediated dilation (FMD) in the brachial artery and arterial stiffness was evaluated by augmentation index (AIx). Left ventricle end diastolic diameter, intra ventricular septum and posterior wall were measured by echocardiography examination and left ventricle (LV) mass was calculated by Penn’s formula. LV mass index was calculated by subdivided LV mass with body surface area.

Results:
FA patients, compared to healthy subjects, had significantly lower FMD values (4.08 ± 1.08 % vs 9.46 ± 3.76 %, p<0.001) and higher AIx values (10.93 ± 16.56 % vs 0.98 ± 14.19 %, p=0.05). FA patients also had significant thicker intra ventricular septum (9.8 ± 2.15 cm vs 8.2 ± 0.91 cm, p<0.05), posterior wall (10.12 ± 2.00 vs 8.10 ± 0.73 cm, p<0.05) and increased LV mass index (112.08±48,20 vs. 85.17±16.01, p=0.05).

Conclusion:
Friedreich's ataxia patients have impaired endothelial function, increased arterial stiffness and increased LV mass index. These results highlight the need for intense modification of cardiovascular risk factors in this population.
Abstract 18244: The Association Between South Asian Ethnicity and Long-term Survival Among Patients Undergoing Coronary Artery Bypass Grafting
Authors: Martin Billie-Jean , Norris Colleen M , Southern Danielle A , Quan Hude , Ross David B , Ali Imtiaz S , Knudtson Merill L , Bainey Kevin
Published: April 2024

Introduction: South Asians (SA) have a high burden of coronary artery disease (CAD) often requiring coronary artery bypass grafting (CABG). However, CABG outcomes in this population have not been explored. The objective of this study was to assess the survival of patients of SA descent undergoing CABG in a large, well described Canadian cohort.

Methods: All patients who underwent CABG between 1996 and 2010 were identified from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease registry. Ethnicity was determined using the Nam Pehchan surname software. Differences in long-term survival were compared between SA and European (EC) patients using adjusted and then unadjusted cox proportional hazards models. SA subjects were then matched 1:1 with EC counterparts using a non-parsimonious propensity model to balance groups; models were then re-run with the matched cohort.

Results: Of the 20608 patients undergoing CABG, 608 were SA. SA patients were younger (63.8 vs 65.8 years) and had a higher prevalence of diabetes (39.5 vs 27.7%), but a lower prevalence of smoking (13.3 vs 25.3%) than EC patients (all p<0.001). There were 5382 deaths long-term with a median follow-up of 7.2 years. Ninety-one deaths occurred in SA patients, 5291 in the EC patients. Kaplan-Meier survival analysis demonstrated a lower incidence of death in the SA patients (log rank, p<0.0001) (Figure). In the unadjusted Cox PH model, SA ethnicity was associated with reduced mortality (Hazard Ratio 0.53, 95% CI 0.43, 0.66), an association that persisted in the adjusted model (HR 0.63, 95%CI 0.51, 0.78). All SA subjects were matched to EC counterparts. In the matched cohort SA ethnicity remained associated with reduced mortality (HR 0.68, 95%CI 0.52, 0.90).

Conclusion: In a large prospective Canadian registry, SA undergoing CABG appear to have improved long-term survival compared to EC patients. The reasons behind this striking difference in mortality deserve further exploration.
Abstract 18255: MicroRNA Analysis in Experimental Models of Vein Graft Neointima Formation Indentifies a Critical Role For Mir-21 in Neointima Formation
Authors: McDonald Robert A , Wu Junxi , White Katie M , Robertson Keith E , Cooley Brain C , Lu Ruifaug , Hu Jia , Kennedy Simon , Wadsworth Roger M , George Sarah J , Wan Song , Baker Andrew H
Published: April 2024

Background:
Coronary artery bypass grafting (CABG) is an established treatment to relieve the symptoms of ischemic heart disease. However premature graft failure, in saphenous veins is a major limitation. One of the principal etiological factors responsible for vein graft failure is activation and phenotypic modulation of smooth muscle cells (SMC), resulting in accelerated rates of proliferation and migration. MicroRNAs (miRNAs) are short, single stranded, non-coding RNAs that play important roles in modulating cell phenotypes through regulation of gene expression.

Methods and results:
In order to assess the expression levels of miR-21 in the progression of vein graft neointimal formation we quantified miR-21 levels in three well-established models of vein graft disease. These were the
in vivo
porcine model of interposition graft, the isogenic mouse model, as well as the
ex vivo
human sapehnous vein model of neointimal formation. MiR-21 levels were up-regulated approximately 7-fold in both the porcine and murine models at 7 and 28 days following grafting (n=6). In surgically prepared HSV which were subjected to culture
ex vivo
we found that miR-21 levels were elevated approximately 3-fold following 7 and 14 days of culture (n=6). In situ localization in the HSV demonstrated that miR-21 was expressed most intensely in the neointimal layer of HSV which also stained positive for SMC actin. Co-localization studies in murine vein grafts revealed that miR-21 was localised to areas of the graft that stained positive for proliferating cell nuclear antigen with substantial co-staining with SMC actin. We assessed the potential functional role of miR-21 in vein graft failure using miR-21 knockout mice. Analysis of neointimal lesion size in miR-21 knockout mice revealed an 81% reduction in neointimal area compared to wild type controls (p< 0.0001, n=7-10/group).

Conclusion:
These findings demonstrate that miR-21 is up-regulated in multiple models of vein graft disease and that genetic abolition of miR-21 levels can attenuate neointimal formation in response to grafting. Therein, modulation of miR-21 expression represents a novel therapeutic opportunity in the setting of vein graft neoinitma formation.
Abstract 18296: Investigation of Hepatic and Vascular Changes Associated with Familial Combined Hypolipidemia
Authors: Arca Marcello , Minicocci Ilenia , Cantisani Vito , Poggiogale Eleonora , favari Elda , Zimetti Francesca , Montali Anna , Labbadia Giancarlo , Pigna Giovanni , Maranghi Marianna , Bernini Franco
Published: April 2024

Background
. Familial combined hypolipidemia (FHBL2, OMIM #605019), due to mutations in
ANGPTL3
gene, is a rare low-cholesterol syndrome characterized by a profound reduction of pro-atherogenic, apoB-containing and anti-atherogenic, apoAI- containing lipoproteins. FHBL2 individuals show reduced hepatic production of very low density lipoprotein, a condition predisposing to fatty liver. However, the impact of FHBL2 on risk of atherosclerosis or hepatic steatosis is unknown.

Methods and Results
. We assessed in 66 FHBL2 subjects carrying the
ANGPTL3
S17X LOF mutation (7 homozygotes and 59 heterozygotes) and 126 age- and sex-matched controls the extent of preclinical atherosclerosis, by measuring carotid intima-media thickness (IMT) and flow-mediated dilatation (FMD), as well as the prevalence of hepatic steatosis by abdominal ultrasonography. Compared with controls, homozygous, but not heterozygous, FHBL2 carriers showed increased average and maximum IMT (P<0.01). Homozygous carriers also showed lower, although not significant, FMD. Compared to controls, ApoB-depleted sera from FHBL2 individuals had a reduced capacity to promote cell cholesterol efflux (4.9 ± 1.8 % vs. 8.5 ± 1.6 %; P<0.01). This was evident with ABCA1-, SR-BI- and ABCG1-mediated pathways and was related to the number of mutated alleles. No difference in the prevalence of hepatic steatosis was found between FHBL2 and controls.

Conclusions
. Homozygous FHBL2 are at increased risk of developing early vascular atherosclerotic changes and that this might be related to the severely impaired HDL function in these subjects. FHBL2 subjects did not show increased risk of hepatic steatosis, thus supporting the notion that Angplt3 deficiency exerts its metabolic effects not impairing the secretion of TG by the liver.
Abstract 183: Life-Threatening Arrhythmias in Patients Hospitalized with Acute Coronary Syndrome: Data from Latvian Registry 2008-2010
Authors: Kalejs Oskars , Maca Aija , Zakkw Ilja , Ratobilska Svetlana , Mintale Iveta , Kamzola Ginta , Zabunova Milana , Narbute Inga , Jegere Sanda , Erglis Andrejs
Published: April 2024

Purpose. Despite the major improvements in the care of patients with acute coronary syndrome (ACS), life - threatening arrhythmia (LTA) remains a common complication of myocardial infarction (MI). We have analyzed the rate of LTA in first hours after hospitalization in patients presenting with acute coronary syndrome and receiving different treatment strategies. Materials and methods. The data from Latvian registry of ACS in years 2008-2010 were analyzed. LTA was defined: complete AV block, unsustained/ sustained ventricular tachycardia (VT), ventricular fibrillation (VF).

Results. In STEMI cohort, the incidence of LTA was significantly lower in PCI group after six hours (p<0.05) than in patients receiving thrombolysis. In first two hours LTA incidence was higher in PCI patients, what we can be explained with earlier reperfusion changes and electrical instability. In non-STEMI cohort, the incidence of LTA was significantly lower than in STEMI patients (p<0.01), but it was higher in non-invasive group compared to invasive treatment group. LTA rate was significantly

reduced in statin users (p<0.05).

Conclusions. Despite the more aggressive treatment strategy, incidence of LTA remains high in ACS patients. Arrhythmias are often observed earlier in patients after PCI and later after thrombolysis. Earlier PCI can decrease late complication rate and potentially improve

survival in STEMI patients.
Abstract 18312: Cumulative Radiation Exposure in Pediatric Patients with Congenital Heart Disease
Authors: Walsh Mark , Noga Michelle L , Rutledge Jennifer M
Published: April 2024

Introduction:
The purpose of our study is to look at cumulative radiation exposure in a contemporary cohort of patients with congenital heart disease undergoing single ventricle palliation.

Methods:
This is a single center, retrospective study of pediatric patients undergoing Fontan completion between May 2005 and May 2010. Radiation exposure from all procedures including cardiac catheterizations, CT scans, plain film radiography, and nuclear medicine scans were evaluated. Radiation dose was calculated as the dose area product (μ Gy.m
2
)

and was measured in all cardiac catheterizations and CT scans. Radiation exposure from chest radiography was estimated based on age at the time of exposure. Patients that died prior to reaching Fontan completion or who underwent cardiac transplantation were excluded from the study.

Results:
Ninety-nine patients who underwent Fontan completion at a mean age of 3.6±1.5 years (range 1.4 - 8 years) were included in the study. There were 41 females and 58 males. Fifty-four patients had a diagnosis of hypoplastic left heart syndrome and 68 of the total cohort had a dominant morphologic right ventricle. Mean number of chest x-rays was 32±8 (range 10 - 285) with a mean cumulative total exposure of 1,536 μ Gy.m
2
per patient. Mean number of cardiac catheterizations was 3.6±1.3 (range 1-8), mean fluoroscopy and cine angiography exposures per case were 1103±245 and 1412±273 μ Gy.m
2
giving a mean cumulative exposure of 9,054 μ Gy.m
2
per patient for all catheterizations. Mean number of CT scans performed was 0.44±0.4 (0-11); the mean exposure was 352 μ Gy.m
2
giving a mean cumulative total of 154 μ Gy.m
2
per person. A total of 5 lung perfusion scans were carried out. The mean cumulative total exposure for all procedures was 10,744 μ Gy.m
2
.

Conclusion:
Radiation exposure in patients with congenital heart disease undergoing single ventricle palliation is quite variable. Cardiac catheterization and chest radiography account for most of the radiation exposure. The level of exposure is below threshold levels however given the age of these patients this should be interpreted with caution. Consideration should be given to the introduction of patient radiation monitoring, notification and surveillance for long-term side effects from exposure.
Abstract 18362: Shb Deficient Mice Display an Increased GFR and Augmented Renal Arteriolar Contractions to Adenosine and Ang II
Authors: Gao Xiang , Sällström Johan , Ma Zufu , Welsh Michael , Persson A. Erik. G
Published: April 2024

BACKGROUND:
Src homology 2 domain-containing protein B (
Shb
) is an adapter protein which regulates several signal transduction cascades and endothelial cell functions. The adenosine-angiotensin II (Ado-Ang II) interaction plays an important role in the regulation of glomerular filtration rate (GFR), vascular resistance and tubuloglomerular feedback. We used
Shb
-knockout (
Shb
-/-
) and wild-type (
Shb
+/+
) mice to investigate their GFR and effectiveness of Ado and Ang II to constrict renal resistance vessels.

METHODS:
GFR was measured in conscious
Shb
-/-
and
Shb
+/+
mice using FITC-inulin. Isotonic contractions were measured in isolated and perfused renal afferent arterioles from
Shb
-/-
and
Shb
+/+
mice. Concentration responses to Ang II (10
-12
to 10
-6
M; 2 minutes each) doses or low-dose Ado (10
-8
mol/l; 15 min) alone, as well as Ado (10
-8
mol/l) in combination with cumulative application of Ang II (10
-12
to 10
-6
mol/l; 2 minutes each) were studied in both genotypes.

RESULTS:
There was a significantly increased GFR (371 ± 12 µL/min, n=11) in
Shb
-/-
comparing to
Shb
+/+
(321 ± 11 µL/min, n=8) mice. The maximal arteriolar contraction to Ang II was significantly larger in
Shb
-/-
(87 %; n=8) than in
Shb
+/+
(54 %; n=8) mice. Low-dose Ado alone contracted afferent arterioles in both genotypes (6% in
Shb
-/-
and 7% in
Shb
+/+
). Ado significantly enhanced Ang II constriction in afferent arterioles in both genotypes (to 93% in
Shb
-/-
and to 72 % in
Shb
+/+
).

CONCLUSION:
Low-dose adenosine augments Ang II arteriolar constriction effectiveness, which indicates Ado-Ang II interaction in both
Shb
-/-
and
Shb
+/+
mice. The absence of
Shb
increases GFR The underlying mechanisms remain to be resolved.
Abstract 18363: The Human Amniotic Mesenchymal Stem Cell -derived Ipscs Survive and Restore the Injured Hearts in an Immunocompetent Mouse Model of Myocardial Injury
Authors: ge Xiaohu , Chung Wook-Jin , Kim Paul J. , Gong Yongquan , Chang Paul , Robbins Robert , Dash Rajesh , Yang Phillip C.
Published: April 2024

Background:
Stem cells are known to restore the injured myocardium. This capability may improve if there is enhanced in vivo survival of the transplanted stem cells. The hAMSCs are isolated from amniotic membrane underlying the chorion of a human placenta and are located in the fetal-maternal border, demonstrating unique immunomodulatory properties characterized by CD59 +, HLA-G +, and HLA-DR- to suppress the host immune response. A single polycistronic lentivirus reprograms the hAMSCs robustly to generate MiPSCs.

Hypothesis:
The MiPSCs retain the immunomodulatory properties of hAMSCs to attenuate immune rejection in an immunocompetent mouse to restore the injured myocardium.

Methods and results:
250K MiPSCs were transplanted into the LAD ligated heart of FVB mice. 250K hAMSCs were injected into the hearts of LAD ligated immunodeficient SCID mice as control. In vivo bioluminescence (BLI) demonstrated robust viability signal in the luciferase-transduced MiPSCs for 2 weeks in FVB mice (Figure 1). When comparing the MiPSC-treated vs. the control (hAMSC-treated) mice during the 4-wk follow-up period, cardiac MRI demonstrated significantly improved LVEF (29.75 vs. 22.45%, p<0.05), decreased infarct % (21.47 vs. 31.06%, p<0.05), and increased viable myocardial volume (78.07 vs. 67.9 cm3, p<0.05). Notably, the MiPSCs did not form any teratoma.

Conclusion:
The MiPSCs exhibit unique immunomodulatory properties, which attenuate rejection by an immunocompetent mouse and significantly restore the injured heart. The MiPSCs may enable allogeneic cardiac stem cell therapy.
Abstract 18368: Role of miR-146a in Angiogenesis and Myocardial Regeneration
Authors: Widmer-Teske Rebecca , Kueppers Kai , Bielenberg Wiebke , Daniel Jan-Marcus , Troidl Christian , Nef Holger , Hamm Christian , Sedding Daniel
Published: April 2024

Background Myocardial infarction leads to cardiac remodeling and development of heart failure. Myocardial remodeling and regeneration critically depends on myocardial capillary density after myocardial infarction. However, the underlying mechanisms of myocardial angiogenesis are not well understood.

Methods and Results Here, we show that the small noncoding RNA microRNA-146a (miR-146a) is upregulated in ischemic cardiac regions in C57Bl-6 mice following LAD-ligation. In vitro, overexpression of miR-146a significantly attenuates endothelial cell proliferation and migration, abolishes endothelial capillary network formation on Matrigel, and inhibits cell sprouting from endothelial spheroids. In contrast, knock-down of miR-146a significantly augments endothelial cell proliferation, migration, network formation and sprouting. So far, IRAK1 and TRAF6, were identified by in silico predictive approaches as direct targets of miR-146a and validated by reciprocal regulation on mRNA and protein levels as well as luciferase gene reporter assays in endothelial cells. In vivo, blocking of endothelial miR-146a significantly enhances angiogenesis as determined by matrigel plug assays. Moreover, inhibition of miR-146a by systemic application of specific antagomirs enhances myocardial vascularity and limits myocardial infarct size in mice, which results in preserved cardiac function (FS: 22±4 vs. 11±2; n=6; P<0.01).

Conclusions Our findings indicate that miR-146a acts as a critical regulator of endothelial cell angiogenesis during myocardial regeneration. Moreover, miR-146a may represent an attractive target for future therapeutic interventions for the treatment of ischemic heart disease.
Abstract 18386: The Association Between Tissue Characteristics Evaluated with Optical Coherence Tomography and Mid-term Results after Paclitaxel-eluting Balloon Dilatation for In-stent Restenosis Lesions: a Comparison with Plain Old Balloon Angioplasty
Authors: Tada Takeshi , Kadota Kazushige , Kubo Shunsuke , Ozaki Masatomo , Hyoudou Yusuke , Miyake Koshi , Hayakawa Yuki , Saito Naoki , Otsuji Hideaki , Otsuru Suguru , Hasegawa Daiji , Shigemoto Yoshikazu , Habara Seiji , Tanaka Hiroyuki , Fuku Yasushi , Oka Naoki , Kato Harumi , Yamamoto Hiroyuki , Goto Tsuyoshi , Mitsudo Kazuaki
Published: April 2024

Background: The morphological assessment of neointimal tissue using optical coherence tomography (OCT) is highly significant to clarify the pathophysiology of in-stent restenosis (ISR) lesions. These OCT findings may be related to recurrence of ISR. Meanwhile, the effectiveness of paclitaxel-eluting balloon (PEB) dilatation for ISR lesions was reported recently. The aim of this study was to define the impact of OCT findings on recurrence of ISR after PEB dilatation compared with plain old balloon angioplasty (POBA).

Methods: Between July 2008 and November 2011, we performed percutaneous coronary intervention for 165 ISR lesions in 141 patients using PEB (109 lesions, PEB group) or POBA (56 lesions, POBA group). The morphological assessment of neointimal tissue at the minimum lumen area site using OCT, including restenotic tissue structure (homogeneous, heterogeneous, or layered type), restenotic tissue backscatter (high or low), visible microvessels, lumen shape, red or white thrombus, lipid-rich plaque (lipid arc more than 90 degrees) was performed. We examined the association between lesion morphologies and mid-term (6-8 months) results including ISR and target lesion revascularization (TLR) rates.

Results: The patients were 114 men and 27 women, and the mean age was 68.9 ± 9.6 years. The association of tissue structure with ISR and TLR in both PEB and POBA groups are shown in the figure. The ISR rate of lesions with high backscatter was significantly lower in the PEB group than in the POBA group (17.2% vs. 40.0%, p<0.05). Both ISR and TLR rates of lesions without lipid-rich plaque were significantly lower in the PEB group than in the POBA group (ISR: 22.7% vs. 58.3%, p<0.01; TLR: 15.9% vs. 41.6%, p<0.05). There was no significant difference in other factors between two groups.

Conclusions: The morphological assessment of ISR tissue using OCT might be useful to identify ISR lesions favorable for PEB dilatation.
Abstract 18402: Impact of the Use of Different Bleeding Scales on the Rate of 6-Month Bleeding After PCI: Results from the PARIS Registry
Authors: Vlachojannis Georgios , Weisz Giora , Witzenbichler Bernhard , Henry Timothy D , Kini Annapoorna S , Stuckey Thomas , Cohen David J , Berger Peter B , Colombo Antonio , Iakovou Ioannis , Steg Philippe Gabriel , Moliterno David J , Atoniucci David , Waksman Ron , Krucoff Mitchell , Vadde Raj , Elias Elliot , Yu Jennifer , Khalili Leila , Sartori Samantha , Baber Usman , Mehran Roxana
Published: April 2024

Background:
Multiple definitions have been used to classify bleeding, which is an important safety metric in cardiovascular clinical studies. We investigated the impact of different scales on apparent 6-month bleeding rates in a real-world registry of patients on dual antiplatelet therapy following percutaneous coronary intervention (PCI).

Methods:
PARIS is an ongoing multicenter, multinational, observational study of 5033 patients examining the modes and clinical correlates of medication non-adherence. All bleeding events were independently adjudicated according to the TIMI (Thrombolysis in Myocardial Infarction), BARC (Bleeding Academic Research Consortium) and ACUITY Acute Catheterization and Urgent Intervention Triage Strategy) bleeding classification schemes. In this analysis, we compared the bleeding rates using these bleeding scales. BARC <3 bleeding was considered minor; BARC ≥3 bleeding was considered major.

Results:
The overall incidence of minor and major bleeding at 6 months using the ACUITY classification scheme was 4.71% (n=237).; overall bleeding rates defined by the TIMI, and BARC scales were 1.21% and 4.67%, respectively (Figure). Rates of minor bleeding were 0.5%, 3.28%, and 3.18% using the TMI, BARC and ACUITY definitions; rates of major bleeding were 0.74%, 1.49% and 1.65%, respectively. Agreement between the ACUITY and BARC definitions yielded a high level of correlation (kappa 0.86, p< 0.001). TIMI bleeding, rates were excluded from this analysis do the low number of TIMI bleeds.

Conclusions:
In this real-world contemporary PCI registry, the overall incidence of any, major and minor bleeding at 6 months varied substantially between different classification schemes. These findings highlight the importance of bleeding definition selection and emphasize the problem of cross trial comparison when different definitions of bleeding are used.
Abstract 18408: The Impact of Anemia on 3-year Clinical Outcomes in Patients Undergoing Percutaneous Coronary Itervention Using Drug-eluting Stent: Insights from the CREDO-Kyoto PCI/CABG Registry Cohort-2
Authors: Ozasa Neiko , Morimoto Takeshi , Bao Bingyuan , Shizuta Satoshi , Shiomi Hiroki , Tazaki Junichi , Natsuaki Masahiro , Kimura Takeshi
Published: April 2024

OBJECTIVES:
We investigated the impact of anemia on outcomes after percutaneous coronary intervention (PCI) using drug-eluting stent (DES).

BACKGROUND:
Patients with anemia have a higher risk of adverse outcomes after PCI. However, long-term outcomes of anemia after contemporary PCI using DES have not been fully investigated.

METHODS:
We performed a retrospective cohort study of 5336 consecutive patients who underwent first PCI using DES between 2005 and 2007, to assess the impact of anemia on long-term outcomes.

RESULTS:
Anemia (hemoglobin <13g/dl for men and 12g/dl for women, respectively) were observed in 33.5% of study patients. Patients with anemia were older and more frequently women and have comorbidities such as diabetes mellitus, hypertension, and chronic kidney disease (p<0.0001). In addition, patients with anemia received more complex PCI using longer and smaller-size stents (p<0.05). Cumulative incidence of all cause death, cardiac death, and sudden cardiac death was higher in patients with anemia compared to those without anemia (16.4% vs. 3.6%; p<0.0001, 7.1% vs. 1.7%; p<0.0001, and 3.0% vs. 0.9%; p<0.0001, respectively). In adjusted analyses, anemia was associated with a significantly increased risk of all cause death (HR, 1.96; 95% CI, 1.49-2.58; p<0.0001), a trend toward high risk of cardiac death (HR, 1.36; 95% CI, 0.90-2.06; p=0.1), and sudden cardiac death (HR, 1.69; 95% CI, 0.90-3.18; p=0.09).

CONCLUSIONS:
Anemia is frequent among patients undergoing PCI using DES and significantly associated with disease severity and worse prognosis.
Abstract 18420: Regional Variations in Processes of Care and Vascular Morbidity in Diabetic Adults in the United States
Authors: Parikh Puja B , Lima Fabio , Goldsteen Raymond , Brown David L
Published: April 2024

Background
:

It is unclear whether geographic variation in processes of care and vascular morbidity exists among diabetics in the U.S. We sought to determine the extent of regional variations in processes of care and their association with vascular disease in a cohort of diabetic adults in the U.S.

Methods and Results:

The 2007 Centers for Disease Control Behavioral Risk Factor Surveillance Survey was utilized to identify a cohort of diabetic patients. Participant residence was classified based on four U.S. regions: (1) Northeast, (2) Midwest, (3) South, and (4) West. Demographic data, clinical history, processes of care (regular medical checkup, foot exam, eye exam, diabetic education, aspirin use, and antihypertensive use) and vascular morbidity for diabetics of each region were compared. Presence of vascular morbidity was based upon patient report of myocardial infarction, stroke, retinopathy, nonhealing foot sores or bilateral foot amputations. Among the 42,072 diabetics, 43.9% were from the South, while 18.7%, 18.7%, and 18.6% were from the Midwest, Northeast, and South respectively. Diabetics of each region differed significantly with respect to demographic characteristics, prior medical history, and processes of care. Vascular morbidity also differed among the regions such that the West had significantly lower rates of myocardial infarction, while the South had higher rates of stroke and diabetic retinopathy. On multivariate analysis, geographic region was found to be independently associated with processes of care. However, geographic region was not found to be independently predictive of vascular morbidity. Independent variables associated with vascular morbidity included older age (OR, 1.01; 95%CI, 1.01-1.02), male gender (OR, 1.55; 95%CI, 1.43-1.67), employment status, level of education, lower annual income, financial barriers to health care (OR, 1.48; 95%CI, 1.31-1.66), active smoking status (OR, 1.12; 95%CI, 1.03-1.23), hypertension (OR, 1.26; 95%CI, 1.16-1.37) and hypercholesterolemia (OR, 1.23; 95%CI, 1.14-1.34).

Conclusion
:

Despite significant regional differences in process of care, no regional variations in vascular morbidity were observed in diabetic adults.
Abstract 18440: Global Burden of Air Pollution on Heart Failure: A Systematic Review and Meta Analysis
Authors: Shah Anoop S , Langrish Jeremy P , Nair Harish , Hunter Amanda , Newby David E , Mills Nicholas L
Published: April 2024

Introduction
Air pollution is responsible for over a million deaths worldwide each year with predilection towards patients with chronic cardiovascular disease. We undertook the first meta-analysis to determine the association between gaseous and particulate air pollution and heart failure admissions and mortality. Methods Medline, EMBASE, CINAHL, Global health and Web of Science databases up to and including 01/02/2012 were searched for studies investigating the association between gaseous (carbon monoxide, sulphur dioxide, nitrogen dioxide, ozone) and particulate (PM2.5 and PM10) pollution and heart failure admission or mortality. Two independent reviewers extracted study information and risk estimates were meta-analysed and stratified by lag periods (days). Studies measuring air pollution up to and including a lag of seven days were included. Results 1,146 studies were identified in the primary search including a search of all relevant bibliographies. 195 articles were fully reviewed and 35 met the inclusion criteria. Except for ozone, heart failure admission or mortality was positively associated with all pollutants (Figure 1). Across all pollutants stronger associations were seen at Lag 0 with diminishing effect at longer lag times. Conclusion Gaseous and particulate air pollutants have a marked and close temporal association with heart failure admissions and mortality. The causality and biological mechanisms of this association now needs to be explored. Meanwhile, air pollution continues to remain a pervasive public health issue with significant cardiovascular consequences presenting a key target for national and international public health.
Abstract 18462: Heparin Cofactor II Promotes Angiogenesis in Response to Ischemic Hindlimb via an AMPK-eNOS-dependent Manner
Authors: Ikeda Yasumasa , Aihara Ken-ichi , Yoshida Sumiko , Sata Masataka , Akaike Masashi , Matsumoto Toshio , Tamaki Toshiaki
Published: April 2024

Background:
Heparin cofactor II (HCII) generally exerts to suppress activated thrombin by binding to dermatan sulfate at injured vascular walls. We have revealed that protective actions of HCII against cardiovascular disease in both experimental and clinical studies. In the present study, we investigated to clarify HCII effect on angiogenesis.

Methods and Results:
Male heterozygous HCII deficient (HCII+/−) mice and male littermate wild-type (HCII+/+) mice at the age of 12-16 weeks were subjected to unilateral ischemic hindlimb surgery. The analysis of laser speckle blood flow showed that blood flow recovery in response to ischemia was insufficient in HCII+/− mice compared to HCII+/+ mice. Number of capillaries and arterioles, eNOS and AMPK phosphorylation in ischemic adductor muscles were reduced in HCII+/− mice. Blood flow recovery and capillary density, as well as phosphorylation levels of eNOS and AMPK in ischemic muscles of HCII+/− mice were almost restored by administration of human purified HCII (h-HCII) protein. In in vitro studies, h-HCII treatment augmented tube formation, cell proliferation and migration of human aortic endothelial cells (HAECs). h-HCII increased the phosphorylation levels of endothelial nitric oxide synthesis (eNOS) and AMP-activated protein kinase (AMPK) in HAECs. On the other hand, h-HCII-induced tube formation, cellular migration and proliferation and eNOS phosphorylation in HAECs were abolished by compound C, an AMPK inhibitor. Thrombin-induced reduction of eNOS phosphorylation and expression was also prevented by h-HCII asministration.

Conclusion:
HCII enhances cellular activity of endothelial cells and promotes angiogenesis in response to ischemic hindlimb via an AMPK-eNOS signaling pathway. HCII potentiates to be a new therapeutic target for treatment in patients with peripheral artery disease.
Abstract 18467: Protective Effect of Nicotinamide Mononucleotide Administration Against Cardiac Ischemia/ Reperfusion Injury
Authors: Yamamoto Takanobu , Zhai Peiyong , Sadoshima Junichi
Published: April 2024

Background:
Nicotinamide adenine dinucleotide (NAD) participates in metabolic reactions as an electron-transferring molecule. In the NAD biosynthetic salvage pathway, nicotinamide phosphoribosyltransferase (Nampt) which forms nicotinamide mononucleotide (NMN) is the rate-limiting enzyme and exhibits the protective effect against ischemia/ reperfusion (I/R) injury in the hearts of mice with cardiac-specific overexpression of Nampt. In addition, administration of NMN is reported to reverse the pancreatic beta-cell dysfunction observed in Nampt heterozygous knockout mice.

Methods:
To elucidate the protective effect of NMN against cardiac I/R injury, NMN was administered to mice subjected to I/R injury either before ischemia or immediately before reperfusion. Area at risk (AAR) and infarct area (IA) were evaluated 24 hours after reperfusion.

Results:
To confirm the distribution of NMN in the heart, NAD and NADH, into which NMN is quickly converted in the heart, were measured. One hour after NMN administration (500mg/ kg body weight, i.p.), the NAD and NADH contents of the NMN group were significantly increased, whereas the NAD/NADH ratio was unchanged compared to the vehicle group(NAD: NMN=483±42 pmol/mg tissue, vehicle=183±46 pmol/mg tissue, p<0.01; NADH: NMN=262±25 pmol/mg tissue, vehicle=96±17 pmol/mg tissue, p<0.01; NAD/NADH ratio: NMN=1.85±0.09, vehicle=1.82±0.18, n.s.; n=3). In the mice administered NMN or vehicle 30 min before ischemia, IA/AAR in the NMN group was smaller than that in the vehicle group (AAR: NMN=30±1.9%, vehicle=29±1.7%, n.s.; IA/AAR: NMN=23±2.9%, vehicle=41±2.6%, p<0.01, n=6-7). On the other hand, in the mice administered NMN or vehicle immediately before reperfusion, IA/AAR in the NMN group was not different from that in the vehicle group (AAR: NMN=27±0.5%, vehicle=26±1.0%, n.s.; IA/AAR: NMN=37±1.4%, vehicle=34±2.2%, n.s., n=4).

Conclusions:
NMN administration significantly increased the NAD content in the heart and exhibited a protective effect against cardiac I/R injury. Increasing NAD content before ischemia, rather than after reperfusion, may minimize I/R injury in clinical settings, such as in acute coronary syndrome before coronary intervention.
Abstract 18480: Attenuation of Cardiac Autonomic Neuropathy and Left Ventricular Function by Inhibition of Matrix Metalloproteinase 2&9 in Diabetic Rats
Authors: Bhatt Lokesh K , Addepalli Veeranjaneyulu
Published: April 2024

Cardiovascular autonomic neuropathy (CAN) is a serious and common complication of diabetes. Along with other cardiovascular dysfunction CAN further worsen the performance of heart in diabetics. We hypothesized that MMP-2 and MMP-9 inhibition can attenuate cardiovascular autonomic neuropathy in diabetics. The present study was designed to investigate effect of MMP-2 and MMP-9 inhibition on cardiac autonomic neuropathy and left ventricular function in streptozotocin-induced (55 mg/kg i.p.) diabetic rats by analysis of heart rate variability (HRV) and left ventricular functions. Minocycline (50mg/kg) was used as a MMP-2 and MMP-9 inhibitor. Eight weeks after induction of diabetes, rats were administered Minocycline (50 mg/kg) over a four-week period. Gelatine zymography was performed to evaluate MMP-2 and MMP-9 levels in vagus nerve and heart. Diabetes resulted in reduction in heart rate (290±31 vs. 376±29 beat per min; P<0.0001). This bradycardia was partly reversed with MMP-2 and MMP-9 inhibitor Minocycline (352 ± 42 beat per min; P<0.05 vs. diabetic control). Both time- and frequency-domain parameters of HRV were significantly reduced in diabetic rats. Spectral power was reduced around 45% at high frequencies and about 65% at low frequencies in diabetic rats. This suggested a decrease of parasympathetic activity. Ratio of low/high frequency was also significantly decreased in diabetic rats suggesting decreased sympathetic tone. Standard deviation of heart rate in minocycline treated rats was significantly higher than in untreated diabetic rats (P<0.05). Significant attenuation (P<0.05) was also observed in power spectrum of treated animals. Treatment also significantly ameliorated left ventricular functions dp/dt
max
and dp/dt
min
compared to diabetic control. MMP-2 and MMP-9 levels were significantly decreased in minocycline treated group compared to diabetic control. In conclusion, inhibition of MMP-2 and MMP-9 by minocycline prevented development of cardiovascular autonomic neuropathy and ameliorated left ventricular function in streptozotocin-induced diabetes in rats.
Abstract 18488: The Impact of Mechanical Circulatory Support Type for Bridge-to-Transplantation on Post-transplant Prognosis: An Analysis of the United Network for Organ Sharing (UNOS)
Authors: Kitada Shuichi , Schulze P. Christian , Yang Jonathan A , Takayama Hiroo , Naka Yoshifumi , Mancini Donna M , Kato Tomoko S
Published: April 2024

Purpose
Mechanical circulatory support through left ventricular assist devices (LVAD) and extracorporeal membrane oxygenators (ECMO) is a reliable and useful support for bridge-to-transplantation (BTT) therapy. The purpose of this study was to investigate the impact of mechanical circulatory support on post-transplant prognosis and its changes during recent years.

Methods
The United Network for Organ Sharing (UNOS) database was used to identify adults patients (≥18 yrs) undergoing orthotopic heart transplantation (OHT) from 1987 to 2010. The cohort was separated into 5 groups according to the era of OHT: before '91, '92 to '96, '97 to '01, '02 to '06, and after '07. We compared two-year post-OHT survival of patients initially supported by an LVAD only and those with biventricular mechanical circulatory support at the time of OHT. Patients who required the additional use of ECMO during LVAD support and those with urgent assist device placement for right and left ventricule were considered as biventricular support group.

Results
A total of 17257 patients underwent OHT under mechanical circulatory support. Post-transplant mortality of patients with biventricular support was worse compared to patients with LVAD support alone after 1997 (Biventricular vs. LVAD alone, ’97-‘01, 56.3 vs. 77.0%, p=0.014; ’02-’06, 58.6% vs. 83.7%, p<0.001; ’07- 60.9% vs. 87.7%, p<0.001, respectively). Comparison among 5 groups by time period showed that post-transplant mortality of patients with LVAD support showed significant improvement after 1997. The mortality of patients with biventricular support, however, showed no improvement over time (Figure).

Conclusion
Post-transplant mortality in patients with LVAD BTT support improved significantly during the recent era of OHT. Patients undergoing biventricular support prior to OHT, especially those with hemodynamic instability requiring urgent ECMO placement on top of LVAD support remain to have poor outcome in any era of OHT.
Abstract 18506: A High Adipose Tissue Arachidonic Acid Content is Associated with a Higher Risk of Myocardial Infarction: A Danish Case Cohort Study
Authors: Nielsen Michael S , Schmidt Erik B , Gorst-Rasmussen Anders , Stegger Jakob G , Overvad Kim
Published: April 2024

Background:
Some, but not all studies have reported a positive association between the content of arachidonic acid (AA) in adipose tissue and the risk of coronary heart disease. However, unlike most other polyunsaturated fatty acids, the content of AA in adipose tissue does not seem to reflect the dietary intake of neither AA nor the endogenous source and precursor of AA, linoleic acid (LA).

Aim:

The primary aim of the study was to evaluate the association between adipose tissue AA content and the risk of myocardial infarction (MI). The secondary aim was to assess the correlation between adipose tissue AA and dietary intake of AA and LA, as assessed from a validated 192 item food frequency questionnaire.

Methods:
We conducted a case-cohort study nested within the Danish Prospective Diet, Cancer and Health (DCH) study. After appropriate exclusions, the study included 2,134 incident MI cases and 3,021 control subjects. Gluteal adipose tissue biopsies were collected at recruitment, and the fatty acid composition (in percentage of total fatty acids) was determined by gas chromatography. A weighted Cox proportional hazards model with sex-specific baseline hazards and age as time axis, was used to evaluate the association between adipose tissue AA content and the risk of MI.

Results:
In the crude analysis we observed a significant positive association between adipose AA content and the risk of MI. Although attenuated, the association remained significant when relevant potential confounders were included, where the hazard ratios (HR) of MI relative to the lowest quintile increased across quintiles; two (HR 1.16 95%CI: 0.95-1.41), three (HR 1.18 95%CI: 0.97-1.43) four (HR 1.20 95%CI: 0.97-1.49), and five (HR 1.29 95%CI: 1.03-1.61) (P for trend = 0.048). Adipose tissue AA levels were not correlated with dietary intake of AA (r = 0.03, 95%CI: -0.01, 0.06) and negatively correlated with dietary intake of LA (r = -0.12, 95%CI: -0.15, -0.08).

Conclusions:
The adipose tissue content of AA was positively associated with the risk of MI. Adipose tissue AA was not associated with dietary intake of neither AA nor LA and this apparently complex regulation of AA levels in adipose tissue is not well understood and needs to be explored further in future studies.
Abstract 18509: Right Atrial Reservoir and Booster Strain Correlate Better Than Right Atrial Area with Tricuspid Annular Plane Systolic Excursion
Authors: Gopal Aasha S , Saha Samir K , Kiotsekoglou Anatoli , Govind Satish C , Lindqvist Per , Soderberg Stefan
Published: April 2024

Background:
Mechanical and volumetric dynamics and the mutual interdependence of right sided cardiac structures (right ventricle, RV: right atrium, RA) have not been adequately studied in routine clinical practice.

Methods:
36 human subjects (56 ±10 years) referred for routine echocardiography for various clinical indications were included in the study. The echo-Doppler measurements included E/E, RV systolic pressure (pulmonary artery systolic pressure PASP), left ventricular ejection fraction LVEF%, TAPSE (tricuspid annular plane systolic excursion), RA area, RA active emptying fraction (RA AEF %), RA expansion index (RA EI), and, RA passive emptying fraction ( RA PEF%). Speckle tracking echocardiography was used to obtain RA booster, RA reservoir, and RA conduit strain (Fig) as well as RV basal, mid and apical strain.

Results:
LVEF, TAPSE, E/E, PASP, RA area were 60±8%, 23± 4 mm , 8±3, 29± 9mmHg, and 16±3 cm2 respectively. RA active emptying fraction (RA AEF %;) was 43 ±16%. RA booster, reservoir, and conduit strain respectively were -16± 3%, 33± 10%, and 15 ±7%. RV basal, mid, and apical strain were -23± 8%, -24± 6%, and -22± 7% respectively. Multiple regression analysis showed strongest correlation between TAPSE and RA AEF% (r= 0.48; p= 0.001) and between TAPSE and RA reservoir strain (r= 0.45; p= 0.001) while RA AEF and RA booster strain also correlated significantly ( r= 0.39; p = 0.01). Mid RV strain correlated with TAPSE ( r= 0.40; p= 0.005). RA area, RA expansion index showed no correlation on either RV or RA volumes or mechanics.

Conclusion:
In a group of patients with well-preserved LV and RV function and pressures, RA booster and reservoir strain predicted RV systolic function as measured by TAPSE. RA AEF% and mid RV S% significantly impacted tricuspid annular plane systolic excursion. RA area alone did not correlated with surrogate measures of right ventricular systolic function.