bluuebunny/crossref_metadata_2025 huggingface dataset:
Angio-IMR identifies microvascular cardiac allograft vasculopathy in heart transplant recipients
Authors: Weiss K J , Hohendanner F , Diedrichs F , Reiber J H C , Castillo Tovar J , Falk V , Schoenrath F , Stawowy P , Just I A
Published: November 2023

Background/Introduction

Microvascular cardiac allograft vasculopathy (mCAV) is a prognostic factor for long-term survival after heart transplantation, which can be assessed by endomyocardial biopsies (EMBs). (1) Routine diagnostic follow-up consists of coronary angiography and an EMB in selected patients. Non-biopsy methods for diagnosing microvascular dysfunction (MVD) have increasingly been proven valuable in these patients and avoid the inherent risk of repeated EMB. (2) Recently, an angiography-derived index of microcirculatory resistance (angio-IMR) has been reported as a novel, post-processing pressure-wire-free tool to assess coronary microvascular dysfunction in coronary angiograms. (3) Its usefulness in heart transplant recipients remains unknown.

Purpose

This analysis aimed to compare the assessment of mCAV with angio-IMR and EMB findings.

Methods

We retrospectively evaluated coronary angiograms of 27 asymptomatic heart transplant recipients (11% female, mean age 46.6 years ± 12.3 years) who underwent simultaneous coronary angiography and right ventricular biopsy within post-transplant aftercare at our institution. We derived angio-IMR from the left anterior descending coronary artery (LAD) using two views with at least a 30° angle to each other and invasively measured mean aortic pressure (MAP). Histopathologic mCAV was routinely evaluated by light microscopy (x200) and defined as no mCAV, obstructive or non-obstructive mCAV. The correlation between time after heart transplantation and angio-IMR was using Pearson's Correlation Coefficient and angio-IMR was compared between mCAV groups using Kruskal–Wallis test, assuming statistical significance at p<0.05. (1)

Results

Three patients (11%) showed obstructive, 13 (48%) non-obstructive, and 11 (41%) showed no mCAV. The mean time after heart transplantation was 1683 days ± 1140 days. The mean angio-IMR was 38.6 mmHg*s ± 10.2 mmHg*s, with a positive correlation between angio-IMR and time since heart transplantation (r[25] = 0.695, p < 0.001, figure A [green = no; yellow = non-obstructive and red = obstructive mCav]). Compared to patients without mCAV (29.7 mmHg*s ± 5.3 mmHg*s), angio-IMR was increased in patients with non-obstructive (42.4 mmHg*s ± 6.9 mmHg*s, p = 0.002) and obstructive mCAV (54.6 mmHg*s ± 8.5 mmhg*s, p = 0.002, figure B).

Conclusion

Angio-IMR correlates with histological mCAV and time since transplantation in heart transplant recipients. This value could potentially help in the clinical routine management of these patients and avoid the inherent risk of repeated EMB.Figure AFigure B
The impact of different ages of onset on cardiopulmonary function in Chinese patients with systemic lupus erythematosus
Authors: Zhou M , Wong C K , Siu C W
Published: November 2023

Background

Despite being most prevalent in adults, systemic lupus erythematosus (SLE) can also be diagnosed in teenagers and older adults. The levels of sex hormones in people of different ages were varied and the clinical features and disease activity of SLE were affected by hormonal changes. Whether the ages of onset impact the cardiopulmonary manifestations was not well explored in patients with SLE.

Purpose

The purpose of this registry was to investigate the difference in clinical features and cardiopulmonary performance in patients with childhood-onset SLE, or young adulthood onset SLE and adulthood-onset SLE.

Methods

patients aged 18 or older and meeting the diagnostic standards of SLE which were established by the ACR in 1997 were included in this study. Patients were divided into childhood-onset (< 18 years old ), young adulthood-onset (18∼35 years old ), and adulthood-onset groups (>35 years old ) based on the different ages at diagnosis. Clinical and demographic data were collected from the clinical management system. In addition, laboratory tests, six-minute walk test (6MWT), electrocardiography, transthoracic echocardiography, and pulmonary function were performed for all patients.

Results

1054 patients with SLE were enrolled in this study. The adulthood-onset group has a higher systolic blood pressure, shorter 6MWTD, and a higher proportion of chronic kidney disease compared to the other two groups (p<0.05). In contrast, mixed connective tissue disease (MCTD) has occurred more frequently in the childhood-onset group (14.5%) compared to the other two groups (p<0.05). And thus, immunosuppressive was used more frequently in the childhood-onset group than in the other two groups (p<0.05). The left ventricular diastolic function was evaluated by the ratio of peak early to late diastolic filling velocity (E/A ratio). The E/A ratio was significantly reduced in the adulthood-onset group (1.1±0.0) than in the childhood-onset group (1.4±0.0) and the young adulthood-onset group (1.3±0.0). Moreover, patients in the adulthood-onset group presented with a larger right atrial diameter (4.4±0.0) than the childhood-onset group (4.2±0.0) and the young adulthood-onset group (4.2±0.0). The adulthood-onset group (17.4%) has a high proportion of "pulmonary hypertension" which was evaluated based on the guideline established by the European society of cardiology. An impaired forced vital capacity (FVC) and forced expiratory flow at 75% of FVC (FEF75%) were observed in the adulthood-onset group compared to the other two groups (p<0.05).

Conclusions

This registry has demonstrated that different ages of onset could impact the clinical and cardiopulmonary performance in Chinese patients with SLE. Patients in the adulthood-onset group presented higher blood pressure, shorter 6MWT, a higher proportion of chronic kidney disease, and impaired pulmonary function compared to the other two groups.Comparisons of clinical and cardiopulmo
Ventriculoarterial coupling as estimated by the PWV/GLS ratio correlates with disease severity in liver cirrhosis patients
Authors: Dimitroglou Y , Solomou E , Terentes-Printzios D , Angelis A , Valatsou A , Koukos M , Tsartsalis D , Patsourakos D , Alexopoulos T , Mani I , Alexopoulou A , Vlachopoulos C , Tousoulis D , Aggeli C , Tsioufis K
Published: November 2023

Introduction

Liver cirrhosis is characterized by vasodilation, reduced peripheral resistances and increased cardiac output. Recently, a novel parameter based on the ratio of carotid-femoral pulse wave velocity (PWV) to the absolute value of global longitudinal strain (GLS), has been proposed to estimate the relationship between left ventricle and aortic function (ventriculoarterial coupling- VAC).

Purpose

This study aimed to investigate the potential correlation between VAC, as estimated by the PWV/GLS ratio, and disease severity in patients with liver cirrhosis.

Methods

A total of 65 cirrhotic patients (mean age 59.1±8.3 years, 48 (73.8%) males) without cardiovascular disease were included in this study. PWV was calculated by dividing the estimated distance difference between the femoral and carotid arteries by the pulse transit time measured with a validated noninvasive device (simultaneous measurement with two transducers). Echocardiography was performed to determine GLS, which was calculated semi-automatically using dedicated software. Disease severity was assessed using the Model for End-Stage Liver Disease (MELD) score.

Results

The mean PWV was 7.8 ± 1.6 m/s, mean GLS was 21.1 ± 2.7%, and mean PWV/GLS ratio was 0.38 ± 0.11. Spearman’s correlation analysis showed that both PWV and GLS were significantly correlated with MELD score (rho=-0.330, p=0.007 and rho=0.276, p=0.026, respectively), indicating that patients with higher disease severity had lower PWV and higher absolute GLS values. There was also a negative correlation between PWV and GLS (rho=-0.377, p=0.002). PWV/GLS ratio was negatively correlated with MELD score (rho=-0.354, p=0.004). In addition to MELD score, PWV/GLS ratio was significantly associated with age (rho=0.281, p=0.023) and systolic blood pressure (SBP) (rho=0.445, p<0.001). A non-significant association with stroke volume (SV) was also observed (rho=-0.207, p=0.099), suggesting that cirrhotic patients with reduced afterload and increased cardiac output had lower values of the ventriculoarterial coupling index. Multivariate linear models confirmed the robustness of the association between PWV/GLS ratio and disease severity even after accounting for age, SBP, and SV (p=0.047).

Conclusions

Our findings suggest that the PWV/GLS ratio is reduced in cirrhotic patients with more severe disease. This association remains significant even after controlling for age, systolic blood pressure, and stroke volume, indicating that PWV/GLS ratio may serve as an early marker of cardiovascular dysfunction in patients with liver cirrhosis.Figure 1Table 1
The prevalence and assessment of cardiovascular symptoms as the risk factors for post-COVID syndrome at 12-month follow-up. Data from the Polish Long-COVID Cardiovascular (PoLoCOV-CVD) Study
Authors: Babicki M , Kolat D , Kapusta J , Kaluzinska-Kolat Z , Jankowski P , Mastalerz-Migas A , Banach M , Mordaka R , Chudzik M
Published: November 2023

Previous studies have indicated that after COVID-19, symptoms can persist for up to 12 months after recovery; however, the data on this are still limited.

The aim of this study was to assess the prevalence of cardiovascular symptoms at 3 and 12 months after COVID-19 and to assess whether cardiovascular co-morbidity before SARS-CoV-2 infection are the risk factors for the development of post-COVID syndrome in both hospitalized and non-hospitalized patients.

This longitudinal study was based on medical data collected during visits at 3 and 12 months after COVID-19 infection. Sociodemographic data, chronic conditions, and the most common clinical symptoms at 3 and 12 months after the disease were assessed during these in-person visits. The following symptoms were assessed as cardiovascular: palpitations/arrhythmias, anginal symptoms, dyspnea, venous thromboembolism, peripheral edema, newly diagnosed arterial hypertension, fainting/unconsciousness.

In total, 643 patients were enrolled in the final analysis.

The majority of the study group were women (63.1%), and the median age of the participants was 52 years. During the analysis of the clinical picture, after 12 months, 65.7% (62.1% – 69.6%) of patients declared the presence of at least one clinical symptom of post-COVID syndrome. The most common complaints were asthenia - 45.7% (41.9% - 49.6%) of patients, and neurocognitive symptoms - 40.0% (36.0% - 40.1%) of patients. Cardiovascular symptoms in 60.1% (56.2% – 63.8%) at 3 month FU and in 33.9% pts (31.1% – 37.9%) at 12 months FU were found (Figure 1). In a multivariate analysis, female sex (OR 1.59,p=0.012) and severe COVID-19 infection (OR 2.94,p<0.001) were associated with the persistence of clinical symptoms up to 12 months after recovery. The history of coronary artery disease, hypertension and dyslipidemia has no impact on symptoms at 12 months after the COVID-19 (Figure 2).

To conclude, cardiovascular symptoms are the most common at 3 and 12 months after SARS-CoV-2 infection. The most burdensome level of COVID-19 severity was a predictor of post-COVID syndrome, neurocognitive symptoms, and fatigue. Cardiovascular comorbidity seems has no impact for post-COVID symptoms.Figure 1Figure 2
Low-grade endotoxemia, oxidative stress and thrombotic events in patients with primary antiphospholipid syndrome
Authors: Bucci T , Ames P R J , Cardamone C , Mangoni B , Pastori D , Cammisotto V , Ciampa A , Triggiani M , Pignatelli P
Published: November 2023

Introduction

The persistence of antiphospholipid antibodies (aPL) is associated with a procoagulant state that could precipitate thrombotic events in the presence of a second pro-inflammatory stimulus, realizing thus the antiphosholipid syndrome (APS). Circulating lipopolysaccharide (LPS) is associated with systemic inflammation, enhanced oxidative stress and cardiovascular events in different clinical conditions, however, its presence and significance has not been evaluated in APS.

Purpose

To investigate the relationship between LPS, oxidative stress markers and risk of thrombotic events in the prospective multicenter ATHERO-APS study.

Methods

Baseline serum levels comparison of LPS, soluble NADPH oxidase 2-derived peptide (sNOX-dp), H2O2 production, hydrogen peroxide breakdown activity (HBA), and nitric oxide (NO) bioavailability in 97 primary APS (PAPS), 20 aPL carriers and 20 healthy controls (CTRL) matched for age, sex and BMI. In patients with high LPS levels, Cox-regression analysis was performed to assess the risk for a composite outcome of cardiovascular death, venous (VTE) and arterial thromboembolism (ATE).

Results

In the whole population (median age 51 (IQR: 45-61) years, 72% female), LPS levels were inversely correlated with HBA (Rs: -0.231, p=0.009) and NO (rS: -0.286, p=0.001) and directly correlated with sNOX-dp (rS:0.423, p<0.001) and H202 (rS: 0.211, p=0.017) (Table 1). Patients with PAPS showed a significant increased levels of LPS, sNOX-dp and H2O2 and a significant lower level of NO and HBA compared to aPL carriers and healthy CTRL. No correlation was found between LPS levels and anti-cardiolipin (aCL) IgG/IgM, anti-beta-2-Glycoprotein-I (aβ2GPI) IgG/IgM and lupus anticoagulant (LAC).

After a median follow-up of 4.7 (4.1-5.6) years, 11 composite outcomes were reported: 1 cardiovascular death (stroke related), 3 ischemic strokes, 2 myocardial infarctions, 3 peripheral ATE and 2 VTE. Patients with basal LPS levels above the median value (>20.1 pg/ml) showed a higher annual incidence of composite outcome compared to those with LPS levels below the median value (4.0% vs 0.7%, p=0.013). On Cox-regression analysis, PAPS patients with LPS above the median value showed a 5-fold increased risk of composite outcome compared to patients with LPS below the median value, after adjustment for age, sex, aCL IgG, aβ2GPI IgG and LAC (Figure 1).

Conclusion

These preliminary data suggest that in PAPS, LPS is associated with a higher risk for a composite outcome of cardiovascular death, ATE and VTE. Further studies are needed to know which pharmacological approach may counteract the prothrombotic effect of LPS.