bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 9984: Concomitant Sleep-Disordered Breathing Increases the Recurrence of Atrial Fibrillation Following Radiofrequency Catheter Ablation of Atrial Fibrillation: Efficacy of CPAP Therapy
Authors: Naruse Yoshihisa , Tada Hiroshi , Satoh Makoto , Yanagihara Mariko , Tsuneoka Hidekazu , Hirata Yumi , Machino Takeshi , Yamasaki Hiro , Igarashi Miyako , Kuroki Kenji , Ito Yoko , Yoshida Kentaro , Sekiguchi Yukio , Aonuma Kazutaka
Published: April 2024

Background:
Recent studies have suggested an emerging link between obstructive sleep apnea (OSA) and atrial fibrillation (AF). Patients with OSA are reported to be less likely to maintain sinus rhythm after radiofrequency (RF) catheter ablation of AF. Continuous positive airway pressure (CPAP) is a well-established treatment for OSA. However, the effect of the CPAP on AF recurrences following ablation has not been clarified.

Methods:
This study prospectively included 133 patients (20 women; 57±11 years) who underwent RF catheter ablation for drug-refractory AF. At 1 week after the ablation, a standard overnight polysomnographic evaluation was performed, and the total duration and number of episodes of central or obstructive sleep apnea or hypopnea were examined. The primary endpoint was the recurrence of AF after the RF catheter ablation of AF.

Results:
The overnight polysomnography revealed no sleep-disordered breathing in 30 patients (23%; No-OSA-Gr). However, 103 (77%) patients were identified as having OSA by the overnight polysomnography. Sixty-one (59%) of those 103 patients received CPAP therapy (CPAP-Gr), and the remaining 42 (41%) did not (No-CPAP-Gr). After a mean follow-up period of 12.3±4.1 months, the prevalence of AF recurrences was 36% in the No-CPAP-Gr patients, which was greater than that in the CPAP-Gr (11%) and No-OSA-Gr (10%; p=0.003) patients. A multivariate analysis revealed that the OSA (hazard ratio [HR]= 4.082, 95% confidence interval [CI]= 1.083-15.388, P=0.038), usage of CPAP (HR= 0.236, 95% CI= 0.091-0.614, P=0.003), total duration of the AF history (HR= 1.084, 95% CI 1.024-1.144, P=0.011), and left atrial volume (HR=1.120, 95% CI=1.010-1.239, P=0.029) were independent predictors of AF recurrences. An AHI of > 10 by PSG identified an AF recurrence after the RF catheter ablation of AF with a sensitivity of 67% and specificity of 83% (area under the curve= 0.752, P=0.003).

Conclusions:
Patients with untreated OSA have a higher recurrence of AF after ablation. The CPAP treatment is effective for AF recurrences as well as for OSA patients, and should be performed after AF ablation.
Abstract 18239: Evaluation of Right Ventricular Function in Patients Undergoing Mitraclip Implantation
Authors: Di Bello Vitantonio , Giannini Cristina , De Carlo Marco , Guarracino Fabio , Pieroni Andrea , Donati Francesca , Minuti Erica , Petronio Anna S
Published: April 2024

Background: Patients with severe mitral regurgitation (MR) at high surgical risk can undergo percutaneous mitral valve repair by Mitraclip device implantation, yielding good results in terms of quality of life, MR reduction and improvement of left ventricular (LV) function. Our aim was to assess the changes in right ventricular (RV) function after Mitraclip implantation.

Methods: Forty consecutive patients affected by severe symptomatic MR underwent clinical evaluation and echocardiographic assessment before Mitraclip implantation and during follow-up at 1, 3 and 6 months.

Results: The mean age of patients was 75.8±7.5 years, 57.5% (n=23) were male with a mean logistic EuroSCORE of 32.2%±26.3 and a mean LV ejection fraction (EF%) of 38±11. All patients were symptomatic with 36 (90.0%) in NYHA classIII-IV. Thirty-one patients (77.5%) had functional MR, while 7 (22.5%) had a degenerative MR. Acute device success of implantation was achieved in all patients. One clip was placed in 29 patients (72.5%) while 2 clips were deployed in 11 patients (27.5%). Overall mortality was: 0% in-hospital, 2.9% at 1 month, and 14.7% at 1 year follow-up. We didn’t find significant changes in all others RV parameters. Furthermore no differences in RV function changes were present between degenerative and functional MR groups. A significant mild correlation was found between the improvement of NYHA class and the improvement of RV TDI S’ wave at six month follow-up (r=-0.38, p =0.04).

Conclusion: MitraClip implantation has induced a significant reduction of left ventricular volume overload. The concomitant reduction of left ventricular filling pressure, reflected nearly immediately on clinical profile and on hemodynamics of the right sections. In fact, since the first month of follow up, we observed both a significant reduction of estimated pulmonary artery systolic pressure and a significant increase of longitudinal RV systolic function as shown by the increase of TAPSE and RV S’TDI.
Abstract 18262: Comparison of Transradial Versus Transfemoral Coronary Intervention in Octogenarians with Acute Myocardial Infarction: Results from the Korea Working Group on Myocardial Infarction
Authors: Lee Hye Won , Cha Kwang Soo , Ahn Jin Hee , Choi Jung Cheon , Oh Jun-Hyok , Choi Jung-Hyun , Lee Han Cheol , Jang Hye yoon , Choi Jong Hyun , Yun Eunyoung , Hong Taek Jong ,   The Korea Working Group on Myocardial Infarction Investigators
Published: April 2024

Background:
The transradial (TR) approach is associated with fewer bleeding and vascular complications during percutaneous coronary intervention (PCI), but is more technically challenging and associated with failure in elderly patients because the elderly may be associated with advanced vascular disease with tortuosity of subclavian artery, aortic root dilation and calcification, and diffuse atherosclerosis. We compared the results of TR versus transfemoral (TF) approach in patients ≥80 years old with acute myocardial infarction (MI) who underwent PCI.

Methods and Results:
A total of 1,945 (8.9%) octogenarians were enrolled from 21,815 patients in the Korea Working Group on Myocardial Infarction Registry. TR group was consisted of 336 (17.3%) patients and TF group 1,609 (82.7%) patients. Procedural success and complications, door-to-balloon-time, in-hospital mortality and major adverse cardiovascular event (MACE, defined as death, MI, and revascularization) as well as those of one-year were evaluated. TR group had lower Killip class, but used more drug-eluting stents and longer stents compared to TF group. Extent of coronary disease and lesion severity were similar in both groups. Procedural success was not different (97.7% vs 98.3%), but in-hospital complications were significantly lower in TR group (8.1% versus 20.3%, p<0.0001). Door-to-balloon time was not different in both groups (84.5 vs 87.0 minutes, p=0.372) in 1,170 (60.2%) patients with ST-segment elevation MI. In-hospital mortality and MACE were significantly lower in TR group compared to TF group (3.4% vs 11.4%, p<0.0001; 3.4% vs. 11.4%, P<0.0001, respectively). One-year mortality and MACE were also lower in TR group (9.8% vs. 18.4%, p<0.0001; 13% vs. 21.9%, p=0.001, respectively).

Conclusion:
This study shows that, in octogenarians with acute MI who underwent PCI, TR approach for PCI was more effective than TF approach with regard to comparable procedural success, lower complications, and better clinical outcomes at one-year.
Abstract 18268: Jund is a Critical Modulator of Oxidative Stress-induced Vascular Aging
Authors: Osto Elena , Francesco Paneni , Mateescu Bogdan , Briand Sylvie , Coppolino Giuseppe , Perna Enrico , Costantino Sarah , Mocharla Pavani , Akhmedov Alexander , Kubant Ruslan , Rohrer Lucia , Matter Christian , Malinski Tadeusz , Volpe Massimo , Metcha-Grigoriou Fatima , Luescher Thomas F , Cosentino Francesco
Published: April 2024

Background.
Reactive oxygen species (ROS) are the major determinant of vascular aging. JunD, a member of the activated protein 1 (AP-1) family of transcription factors, promotes the intracellular redox homeostasis. The present study investigates the role of JunD in aging-associated endothelial dysfunction.

Methods and Results
. Blunted vasorelaxation was found in young and old

JunD
-/-

mice as compared with age-matched WT animals [maximal relaxations were 51±1.5 %vs 83±4.8 (young) and 34±2.3 vs 58±2.4 (old) for

JunD
-/-

and WT mice, respectively, n=6-8, p<0.05 vs age-matched group]. ROS scavengers superoxide dismutase (PEG-SOD) and catalase restored endothelial function. Accordingly, JunD-/- mice displayed not only an age-independent decline of NO release but also increased superoxide and peroxynitrite levels in endothelial cells assessed by chemoluminescence. Nitrotyrosine residues, identified by immunofluorescence, were also elevated. ROS scavenging enzymes manganese (Mn) and extracellular (ec) SOD, aldehyde dehydrogenase-2 and glutathione peroxidase-1(GPx-1) were downregulated in

JunD
-/-

mice. In contrast, NADPH oxidase subunit p47phox was upregulated. Furthermore, in JunD-/- mice eNOS expression and eNOS activating Ser-1177 phosphorylation were reduced. Interestingly, age-induced endothelial dysfunction was paralleled by a significant reduction of JunD protein expression in old as compared with young WT mice. In human aortic endothelial cells, siRNA-mediated JunD knockdown elicited a similar impairment of NO/O2- production, which was abolished by simultaneous silencing of p47phox. Notably, JunD mRNA expression was reduced in peripheral monocytes from old compared with young healthy blood donors (63.30 ± 6.0 vs 113.9 ± 6.7, respectively, values normalized to TBP mRNA, n=6; p< 0.0004), and correlated with gene expression of MnSOD (r=0.65, p<0.05).

Conclusions.
Aging-induced oxidative stress and endothelial dysfunction were markedly accelerated in

JunD
-/-

mice compared with age-matched WT littermates. JunD may be a crucial modulator of ROS-mediated vascular aging, representing a novel molecular target to slow down this process.
Abstract 18272: Aggravation of Myofibroblast Arrhythmogeneicity by Mechanical Stress
Authors: Grand Teddy , Salvarani Nicolò , Rohr Stephan
Published: April 2024

INTRODUCTION:
Owing to their modest membrane polarization, cardiac myofibroblasts (MFBs) induce arrhythmogenic slow conduction and ectopic activity by causing partial depolarization of electrotonically coupled cardiomyocytes (CMCs) in-vitro. We hypothesize that mechanical stress may aggravate this condition by activation of stretch activated channels (SACs) in MFBs that accentuate MFB depolarization.

METHODS:
The effects of acutely blocking SACs with streptomycin (SM) on single MFB and CMC membrane polarization (Vm) were assessed by patch clamp. Modulation of impulse conduction velocity (θ) by SM and by stretch was investigated in strands of neonatal rat ventricular CMCs or CMCs coated with MFBs using optical recording techniques. For stretch experiments, cell strands were cultured on silicon membranes.

RESULTS:
Whereas SM (50 µmol/L) had no effect on Vm of CMCs (control: -75.1±2.62mV; SM: -75.3±2.59mV, n=8 each), it caused MFBs to hyperpolarize from -33.7 ± 11.2 mV to -37.7±11.4 mV (n=8) suggesting the presence of active SACs in MFBs under control conditions. In accordance with these findings, SM exerted no effects on θ in CMC cell strands (control: 335.4±23.3 cm/sec; SM: 328.0±19.8 cm/sec; n=36 each; n.s.) but increased θ from 173.8±68.2 cm/sec to 224.9±63.3 cm/sec (n=54 each; p<0.0001) in CMC-MFB strands. Direct proof for the modulation of θ by MFB-SACs was obtained by subjecting cell strands to acute length changes. In CMC-only strands, θ was positively correlated with strand length (8% relaxation: 323.6±19.1 cm/s; control: 332.6±22.8 cm/s; 10% stretch: 340.6±22.7 cm/s; n=14) which is likely explained by changes in cell geometry. In contrast, θ of hybrid CMC-MFB strands decreased with increasing strand length (8% relaxation: 270.8±36.9; control: 248.4±48.1 cm/s; 10% stretch: 237.6±40.1, n=5) suggesting that stretch caused activation of SACs in MFBs that ultimately led to partial depolarization of coupled CMCs.

CONCLUSION:
The results demonstrate that acute stretch differentially affects θ depending on the cellular composition of cardiac tissue. Slowing of conduction is observed only in presence of MFBs which suggests that arrhythmogenic consequences of mechanical stress may be aggravated by MFBs in fibrotically remodelled myocardia.
Abstract 18298: Niferidile, New Class III Antiarrhythmic Agent: Study of Electrophysiological Effects Aad Efficacy in Patients with Supraventricular Arrhythmias
Authors: Mironov Nikolay Y , Yuricheva Yulia A , Golitsyn Sergey P , Sokolov Sergey F , Maykov Eugeniy B , Shlevkov Nikolay B , Mareev Yuriy V , Rosenstraukh Leonid V , Chazov Eugeniy I
Published: April 2024

Background.
Niferidile (Nf) is a new potassium channel blocker that inhibits transient outward and delayed rectifier currents. Preclinical studies showed that Nf increases effective refractory periods (ERP) in atria more than in ventricles. High affinity of Nf to atrial myocardium should contribute to high efficacy in supraventricular arrhythmias and to low risk of ventricular proarrhythmia.

Objectives.
To evaluate electrophysiological effects and antiarrhytmic efficacy of Nf in patients with paroxysmal supraventricular tachycardia (PSVT).

Materials and methods.
Effects of Nf (administered 20µg/kg intravenously) were studied in 28 patients (16 males) with PSVT (14 orthodromic tachycardia in WPW syndrome, 10 AV-nodal reentrant tachycardia, 4 orthodromic tachycardia due to concealed bypass tract) during endocardial electrophysiological study. Termination of sustained paroxysms of PSVT by Nf could be investigated in 23 patients and prevention of reinduction of PSVT - in 25 patients.

Results.
Nf terminated PSVT in 78.26% and prevented reinduction in 84% of patients. Nf increased ERP of right atrium (by 22.25%; p<0.01), left atrium (by 22.45%; p<0.01), right ventricle (by 12.03%; p<0.05) and accessory pathways (anterogradely by 23.64% [p<0.01]; retrogradely by 29.43% [p<0.001]). Nf did not affect sinus node and atrioventricular conduction. Nf significantly increased relative refractory period of His-Purkinje system (by 34.71%; p<0.01). Nf prolonged QT (by 24.5%; p<0.01) and QTc (by 20.11%; p<0.05) intervals. One patient developed short runs of torsade de pointes shortly after injection of drug.

Conclusion.
Prolongation of ERP, predominantly in atria and accessory pathways, and RRP in His-Purkinje system are main electrophysiological effects of Nf. New drug demonstrated high antiarrhythmic efficacy and good safety profile in patients with PSVT.
Abstract 18318: Clinical Value of Increased High-Sensitivity Cardiac Troponin T in Patients with Essential Hypertension
Authors: Setsuta Koichi , Nishizawa Akihiro , Kitahara Yasuyuki , Seino Yoshihiko , Mizuno Kyoichi
Published: April 2024

Background:
Many studies including ours have shown the existence of ongoing myocardial damage detected as increased levels of cardiac troponin T (cTnT) in patients with chronic heart failure. We previously reported elevated levels of conventional cardiac troponin T in some patients with essential hypertension (EHT), an important precursor of heart failure. However, it has remained unclear whether myocardial damage and/or injury exist and its clinical value in patients with EHT. Newly developed high sensitive cardiac troponin T (Hs-cTnT) is more sensitive for the detection of myocardial damage and/or injury.

Methods:
We measured Hs-cTnT in 103 consecutive patients with EHT without prior ischemic heart disease, myocarditis and heart failure, and left ventricular (LV) systolic (LVEF <55%) and renal dysfunction (estimated glomerular filtration rate [eGFR] <30ml/min/1.73m2), and 20 normal controls. Hs-cTnT levels were compared with clinical parameters including neurohumoral factors (plasma renin activity and plasma aldosterone, norepinephrine and B-type natriuretic peptide [BNP] concentrations) and echocardiographic findings (left atrial dimension [LAD], LVEF, LV end-diastolic diameter, Tei index and mass index, E/A ratio and E/e’).

Results:
Hs-cTnT was detectable (>0.003 ng/ml) in 61 of 103 (59%) patients, but 2 (10%) of 20 controls (p<0.0002). In patients with EHT, univariate logistic regression analyses showed that age >70 years, eGFR <60 ml/min/1.73m2, BNP >23.2 pg/ml and LAD >36mm were significantly associated with Hs-TnT detection. In multivariate logistic regression anaysis including 7 variables (age, BNP, LAD and plasma renin activity and aldosterone concentration > median value, E/A ratio < median value and eGFR <60 ml/min/1.73m2) that were associated with Hs-cTnT detection at p <0.1 in univariate analyses, BNP >23.2 pg/ml (odds ratio 4.00, p=0.01) and LAD >36mm (odds ratio 3.96, p=0.007) were independently associated with Hs-TnT detection. In 61 patients with Hs-cTnT detection, Hs-cTnT significantly correlated with BNP(r=0.28, p=0.03) alone.

Conclusion:
The results of the present study suggest the presence of minute myocardial injury that might be associated with myocardial stress in patients with EHT.
Abstract 18339: Biomarkers and Recurrence of Atrial Fibrillation After Successful Cardioversion: Results of a Meta-Analysis
Authors: Pathak Rajeev K , Abhayaratna Walter P , Mehta Abhinav , Lau Dennis , Alasady Muayad , Sanders Prashanthan
Published: April 2024

Background:
An increasing body of evidence suggests the role of inflammation in the genesis and perpetuation of atrial fibrillation (AF). However, inconsistent results have been published with regard to the role of inflammatory markers in predicting the maintenance of sinus rhythm after a successful direct current cardioversion (DCCV).

Methods:
Using Ovid and EMBASE, we searched for literature published prior to December 2011. Of the 405 studies identified, 16 studies with 1054 patients (501 with and 553 without AF relapse) were included for analysis.

Results:
Mean CRP, BNP group levels from each study were recorded and the standardized difference in mean and odds ratio was calculated. Using the fixed effects model (FEM), CRP and BNP group levels were significantly higher in patients with recurrence of AF post DCCV (odds ratio (OR) for CRP = 2.30 (CI: 1.63-3.26); for BNP = 4.44 (CI: 3.11-6.33)). There was some evidence of heterogeneity (p-value for CRP < 0.002; p-value for BNP group = 0.001). Using random effects model, the effect size for CRP increased to 2.53 (CI: 1.33-4.82) and for BNP group the effect size increased to 6.38 (CI: 1.58-25.82). Publication bias was not evident for CRP and BNP group (p-value 0.43 and 0.24 respectively).

Conclusion:
Increased CRP and BNP levels are associated with greater risk of AF recurrence after successful DCCV. The use of these markers for the prediction of those who maintain sinus rhythm after DCCV appears promising but requires further study.
Abstract 18394: Gastric Inhibitory Polypeptide is Associated with Metabolic Disorder and Cardiovascular Disease Independent of Glucose in Humans
Authors: Takata Yasunori , Funada Jun-ichi , Hiasa Go , Okayama Hideki , Osawa Haruhiko
Published: April 2024

Background
- Emerging animal studies have reported the beneficial effect of interrupting gastric inhibitory polypeptide (GIP) receptor signaling in metabolic disorders including extreme fat deposition with insulin resistance and glucose intolerance. These results propose the hypothesis that hyper GIP secretion may contribute to the development of cardiovascular disease (CVD) in humans. However, most studies have focused on incretin responses to glucose loading, and the association between endogenous GIP levels and cardiometabolic disorders has not been well defined in humans.

Methods and Results
- To examine the association between fasting GIP and cardiometabolic disorders or CVD independent of plasma glucose (PG) levels, we analysed 300 non-diabetic subjects. Furthermore we performed
in vitro
functional analysis using human macrophage cells. Simple regression analysis demonstrated that the fasting total GIP was correlated with cardiometabolic disorders such as waist to hip ratio, hyperinsulinemia, and HOMA-IR. ANCOVA and logistic analysis after adjustment for age, gender, BMI, smoking, HOMA-IR, hypertension, LDL cholesterol, HDL cholesterol, eGFR and PG, revealed that fasting GIP was increased in the subjects with CVD than non-CVD (53.7 ± 32.2 v.s. 28.2 ± 18.1,
p
<0.01), and each tertile increase in fasting GIP was associated with the prevalence of CVD (odds ratio 3.12 per tertile, 95% CI 1.73 to 5.62;
p
<0.01). Furthermore, molecular analysis revealed that GIP receptor was present in human monocyte/macrophage, T-lymphocyte, and human carotid atherosclerotic lesion.
In vitro
analysis revealed that GIP stimulation up-regulated gene expression of interleukin 6, CC chemokine receptor (CCR) 2, CCR5, and scavenger receptor type A in human THP-1 macrophages.

Conclusions
- These results suggest that oversecretion of GIP may contribute to cardiometabolic disorder, resulting in the development of CVD independent of PG in humans.
Abstract 18410: Association Between Serum Uric Acid Level and the Presence of Coronary Vulnerable Plaques
Authors: Kimura Taizo , Sato Akira , Adachi Toru , Ojima Eiji , Watabe Hiroaki , Kakefuda Yuki , Seo Yoshihiro , Aonuma Kazutaka
Published: April 2024

Background:
Uric acid may have effects on vascular remodeling and atherosclerosis. The purpose of this study was to evaluate the relationship between serum uric acid (SUA) levels and presence of coronary vulnerable plaque assessed by computed tomography angiography (CTA).

Method:
Five hundred twenty-nine patients with suspected coronary artery disease (CAD) underwent 64-slice CTA to evaluate the prevalence of CAD and plaque morphology. Coronary vulnerable plaque was defined as positive vessel remodeling (PR) (RI>1.1) and low-attenuation plaques (LAP) (<50 Hounsfield Unites). SUA level was divides into 4 groups: <5, 5 to <6, 6 to <6.8, ≧6.8 mg/dl.

Results:
The higher SUA levels were associated with the higher prevalence of coronary vulnerable plaque (P<0.001).The number of vulnerable plaques per patient was significantly higher in patients with higher SUA levels (Figure, P=0.002). In multivariate logistic analysis that adjusted for age, gender, smoking, hypertension, dyslipidemia, diabetes mellitus and estimated glomerular filtration rate, the patients whose SUA level 5 to <6mg/dl, 6 to <6.8mg/dl, and ≧6.8mg/dl had odds ratio (OR) of 1.194 (95% CI: 0.773-2.078, P=0.525), 1.306 (95% CI: 0.085-2.510, P=0.382), 2.622 (95% CI: 1.643-4.541, P=0.002) respectively, for prediction of coronary vulnerable plaque, compared with those whose SUA level was <5 mg/dl.

Conclusion:
SUA level was associated with the presence of coronary vulnerable plaques. Assessment of SUA level may be useful to identify the high risk patients with suspected CAD, and SUA may have a pathophysiologic effect on atherosclerosis.
Abstract 18419: Depletion of Endothelial Progenitor Cells is Associated with Myocardial Dysfunction in Patients with Type 2 Diabetes Mellitus Without Coronary Artery Disease
Authors: Zhao Chunting , Wang Mei , Siu Chong Wah , Yiu Kai Hang , Tse Hung Fat
Published: April 2024

Background:

Patients with type 2 diabetes mellitus (T2DM) may develop cardiomyopathy and microvascular disease and oxidative stress may contribute to it. Endothelial progenitor cells (EPCs) is responsible for angiogenesis and has been shown to be closely correlated with oxidative stress. Accordingly, the aim of the study is to evaluate the role of EPCs and oxidative stress in relation with the left ventricular (LV) function in patients with T2DM.

Methods:

Ninety patients(62±9years, 39% male) with T2DM without coronary artery disease were recruited. Transthoracic echocardiography and detailed evaluation of LV systolic function by 2D speckle tracking derived strain analysis was performed. Four subpopulation of EPCs including CD34+, CD133+, CD34+/kinase insert domain-containing receptor (KDR) + and CD133+/KDR+ EPCs were measured by flow cytometry. Furthermore, oxidative stress was assessed by superoxide dismutase (SOD).

Results:

The mean HbA1c% was 7.76% and 18.9% were on insulin therapy. Global circumferential strain was associated with CD34+ EPCs (r=-0.22 , P=0.04) and SOD (r=-0.32 , P=0.01 ) but not the other EPCs. Patients were subsequently dichotomized according to the median level of CD34+ EPCs. The two groups of subjects had similar LV ejection fraction (63±7% vs. 65±8%, P=0.30). Importantly, patients with low level of CD34+EPCs had impaired LV global longitudinal strain (-16.7±2.7% vs. -18.1±2.2%, P<0.01), circumferential strain (-17.2±2.1% vs. -18.3±2.2%, P=0.02) and radial strain (30.2±9.3% vs. 37.4±11.6%, P<0.01) compared to those with high level of CD34+EPCs. After multivariate linear regression, CD34+ EPCs was an independent predictor of the circumferential strain (β=-0.22, 95%CI -25.2∼-0.70, P=0.04) and radial strain (β=0.27, 95%CI 17.2∼139.5, P=0.02). furthermore, SOD was an independent predictor of the circumferential strain (β=-0.32, 95%CI -13.7∼-1.7, P=0.01)

Conclusions

: Both CD34+ EPCs and SOD correlated with global circumferential strain. Importantly, the number of CD34+ EPCs and SOD is independently associated with LV systolic dysfunction in patients with T2DM. The present results thus suggested that EPCs and oxidative stress contributed to the development of diabetic cardiomyopathy.
Abstract 18429: Is Metabolic syndrome post Liver Transplantation a Risk Factor for Cardiovascular Disease?
Authors: Madhwal Surabhi , Guha Avirup , Atreja Ashish , Gupta Puneet , Albeldawdi Mazen , Post Anthony , Costa Marco
Published: April 2024

Introduction:
Up to two-thirds of patients develop metabolic syndrome within five years post orthotopic liver transplant (OLT). Data on overall cardiovascular (CV) morbidity and mortality among OLT recipients, particularly those who develop metabolic syndrome, is limited and there are no specific guidelines on management of post OLT metabolic syndrome. Hypothesis: We assessed hypothesis that metabolic syndrome post OLT is associated with increased risk of CV events.

Methods:
Historical cohort study of all adult patients who underwent OLT at our institution for end-stage liver disease between from year 1987 to year 2011.Symptoms or confirmed diagnosis of coronary artery disease (with or without interventions) and stroke were categorized as CV events. CV deaths included deaths due to CV events as well as those from arrhythmias and heart failure.

Results:
From a total of 428 patients in our cohort (Male, 64%; Caucasian, 79.5%), more than half (55.8%) died in the follow-up period. Graft failure (17.9%), infection (21.4%) and CV disease (17.4%) were the top three causes of deaths. About one-third (30.3%) of patients had post transplant metabolic syndrome (DM, 46.9 %; mean HDL 40.6 +-16.7; mean triglycerides, 58.8 +_88.5; mean BMI, 29.04+_7.3). Patients with post transplant metabolic syndrome had higher incidence of myocardial infarction (14.3 % versus 3.7%, P 0.02) and overall CV events (73.4% versus 37.6%, P < 0.001) as compared to patients without metabolic syndrome. There was no difference in all-cause mortality (41.9 % versus 50%, P =0.56) or CV deaths (18.2% versus 13.3 %, P=0.79) between the two groups.

Conclusion:
Metabolic syndrome after liver transplantation is associated with twice the risk of CV events and about four times the risk of myocardial infarction, as compared to patients without metabolic syndrome. This high risk group may potentially benefit from aggressive risk reduction strategies or modification of immunosuppressive regimen.
Abstract 18434: Serial Quantification of Canine Post-Infarct Left Ventricular Remodeling Using a Novel Semi-Automated 3D Echo Speckle Tracking Algorithm
Authors: Lin Ben A , Bellavia Diego , Stacy Mitchel R , Maxfield Mark W , Dione Donald P , Sampath Smita , Zhang Ziheng , Dione Donna , Duncan James S , Sugeng Lissa , Sinusas Albert J
Published: April 2024

Background:
Left ventricular (LV) remodeling after myocardial infarction (MI) is characterized by infarct expansion, progressive LV dilation, and hypertrophy of non-infarct zones. Global ventricular remodeling is associated with poor outcomes. Existing data on the temporal dynamics of post-MI remodeling are primarily based on 2D echo estimates of LV size. Accurate and convenient 3D echo measurements would allow more reliable tracking of LV size and function in both laboratory and clinical settings.

Methods:
MI was induced in canines (N=6) with 6-hour LAD angioplasty occlusions. Transthoracic 3D B-mode echo long-axis images were obtained at baseline, 3 days, 4 weeks, and 6 weeks post-MI using a Philips iE33 system with X7-2 transducer at 41-51 fps. End-diastolic (EDV) and end-systolic (ESV) volumes were measured using a novel semi-automated 3D echo speckle tracking algorithm (4D LV-Analysis 3; TomTec Imaging Systems; Munich, Germany). ECG-gated cardiac MR images were acquired on a 1.5 T magnet at 6 weeks post-MI. Reference MRI EDV and ESV were measured using the method-of-disks with manual contours.

Results:
3D echo EDV and ESV measurements for multiple timepoints are shown in the table below. Average EDV increased from 41±14 ml at baseline to 59±12 ml at 6 weeks post-MI (p=0.02). Average ESV increased from 27±10 ml at baseline to 41±13 ml at 6 weeks post-MI (p=0.02). At 6 weeks post-MI, MRI EDV and ESV measurements were 61±6 ml and 33±7 ml, respectively, and were not significantly different from 3D echo values (p=NS for both).

Conclusions:
We have used a novel 3D echo speckle tracking algorithm to obtain 3D volumes in a semiautomated fashion. This approach should prove useful in the application of 3D echo in both laboratory and clinical settings. To our knowledge, this is the first report of serial LV remodeling by 3D echo in a post-MI canine model. We documented progressive increases in EDV and ESV that were consistent with reference MRI measurements at 6 weeks post-MI.
Abstract 18473: ApoB-100 Related Peptide Immunization Confers Protection Against Angiotension II-induced Renal Inflammatory Responses
Authors: Honjo Tomoyuki , Dimayuga Paul C , Chyu Kuang-Yuh , Zhao Xioaning , Zhou Jianchang , Yano Juliana , Lio Wai Man , Trinidad Portia , Cercek Bojan , Shah Prediman K
Published: April 2024

Background:
T cells play an important role in angiotensin II (AngII)-induced hypertension and aneurysm formation. Inflammatory responses, typified by reactive oxygen species (ROS) and Interleukin-6 (IL-6), are involved in AngII-induced hypertension and renal damage. We recently demonstrated that immunization with apoB-100 related peptide p210 reduced atherosclerosis through T cell mediated immune response in apoE (-/-) mice. We also reported that immunization with p210 reduced mean arterial blood pressure (p210 = 124±4*, cBSA = 143±6, PBS = 139±3 mmHg. *p<0.05 vs cBSA and PBS.) and aneurysm formation in AngII-infused apoE (-/-) mice. In this study, we assessed the effect of p210 vaccine on AngII-induced renal inflammatory responses in apoE (-/-) mice.

Method and Results:
ApoE (-/-) mice were immunized with p210/cBSA/Alum (p210; 100 μ g) at 7, 10, and 12 weeks of age. Mice receiving PBS or cBSA/Alum (cBSA) served as controls. At 10 weeks of age, mice were subcutaneously implanted with an osmotic pump which released AngII (1 mg/Kg/min), and were euthanized 4 weeks later. Serum creatinine level was significantly lower in p210 group (p210 = 0.7±0.1*, cBSA = 1.1±0.1, PBS = 1.4±0.1 mg/dL. N=12, 11, and 9 respectively; *p<0.05 vs cBSA and PBS.). IL-6 and monocyte chemotactic protein-1 (MCP-1) mRNA expression in kidneys were significantly down-regulated in p210 group (IL-6: cBSA = 4.1±1.1, PBS = 3.9±1.0 -fold increase compared to p210; MCP-1: cBSA = 2.4±0.6, PBS = 2.2±0.4 -fold increase compared to p210, N=8). Renal glomerular superoxide production measured by in situ dihydroethidium was significantly decreased in p210 group (cBSA = 3.8±0.7, PBS = 3.9±0.6 -fold increase compared to p210, N=4.). The expression of NOX1, a component of NADPH oxidase, mRNA in kidneys was significantly down-regulated in p210 group (cBSA = 2.6±0.5, PBS = 2.8±0.4 -fold increase compared to p210, N=8.).

Conclusion:
Immunization with p210 significantly attenuated AngII-induced renal damage. These anti-hypertensive and renal protective effects were associated with down-regulation of IL-6 and MCP-1 expression, and ROS production mediated by NADPH oxidase in kidneys.
Abstract 18495: Loss of Syndecan-1 Results in De-differentiation of Vascular Smooth Muscle Cells
Authors: Chaterji Somali , Lam Christoffer , Goel Rishi , Baker Aaron B
Published: April 2024

Introduction:
Vascular smooth muscle cells (vSMCs) display a wide phenotypic continuum, altered during the vascular remodeling process in disease or following injury. The phenotypic state of vSMCs, modulated by the cellular microenvironment, can range from a highly proliferative, extracellular matrix-synthesizing phenotype to a highly differentiated, contractile phenotype. Syndecans, heparan sulfate proteoglycans serving as cell surface co-receptors, have emerged as powerful and complex regulators of cell function. However, the ability of syndecan-1 to regulate vSMC differentiation is not yet known.

Hypothesis:
We hypothesized that syndecan-1 is a regulator of vSMC phenotype and can consequently regulate the pathophysiology of disease or vessel wall restenosis.

Methods and Findings:
To test our hypothesis, we performed gene and protein expression studies for wild-type (WT) and syndecan-1 knockout (S1-KO) mice-derived primary vSMCs. Real time RT-PCR (n=4) indicated higher levels of smooth muscle α-actin (α-SMA), calponin, myosin heavy chain (MYH) II, and desmin, and, lower levels of the embryonic form of smooth muscle MYH in WT relative to S1-KO cells, both in low serum vSMC growth medium and in differentiation medium with heparin and transforming growth factor-β1. Higher α-SMA and calponin levels were corroborated using Western blots and immunocytochemical studies. Mechanistic studies involving the serine/threonine kinase Akt (involved in vSMC survival and differentiation) and the mTOR downstream target p-S6 ribosomal protein (p-S6RP) indicated that p-Akt tripled and p-S6RP halved in WT cells (n=3). Integrated morphometric analysis indicated that S1-KO cells were 3 times larger area-wise, more circular, and less elongated, compared to WT. Further, S1-KO cells were about 1.5 times as proliferative as WT (n≥3). Immunocytochemical assessments to evaluate the effect of syndecan-1 knockout on syndecan-1 binding proteins indicated that syntenin, cortactin, and vinculin were present in significantly higher amounts in WT compared to S1-KO cells.

Conclusion:
Taken together, our results support a positive role for syndecan-1 in promoting vSMC differentiation, reducing the chances of intimal hyperplasia after vascular injury.
Abstract 185: Whole Body Periodic Acceleration (pGz) in Mice Increases Antioxidant Enzymes in the Heart
Authors: Uryash Arkady , Bassuk Jorge , Kurlansky Paul , Lopez-Padrino Jose R , Adams Jose A
Published: April 2024

BACKGROUND: Mild to moderate exercise produces cardio and neuroprotection. Exercise increases pulsatile shear stress that provide several cytoprotective and signaling substances from muscle and endothelium. Some beneficial effects of exercise on cytoprotection are derived from increased antioxidant capacity. pGz is a passive exercise strategy that moves the body in a sinusoidal head to foot motion, adding pulses to the circulation thereby increasing pulsatile, cyclical shear stress to the endothelium. pGz activates the PI3/Akt eNOS pathway and increases release of eNO and its enzyme (eNOS), and other cytoprotective signaling and substances, and decreases reperfusion injury. Optimum frequency of pGz has been established in our laboratory for various animal species and humans. We tested the hypothesis that repeated exposure to pGz in mice would increase antioxidant enzymes, and determined its time course.

METHODS: Acclimated awake mice (n=48) where exposed to shear stress at f ƒ=480 cpm, Gz ± 3mt/sec 2 (pGz) 1 hr daily sessions of 1, 2, and 4 weeks of pGz. Myocardial tissue was harvested prior to pGz (BL) and 24 hrs after the last pGz treatment for proteins via Western Blot analyses: Glutathioneperoxidase-1(GPX1), Superoxide Dismutase -1 (Cu-Zn SOD), Superoxide Dismutase -2 (mitochondrial or Mn-SOD) and Catalase (Cat) , Protein content was normalized to GAPDH.

RESULTS:One to four weeks of pGz increased GPX1, Cat and SOD1 from BL levels, whereas SOD2 remained unchanged. 4 weeks of pGz increased GPX1, Cat and SOD1, by 110%, 80% and 240% of basal enzyme levels. (Data= mean ± SEM, Figure † p< 0.01 BL vs. 1,2,4 wks)

CONCLUSIONS: One hour daily pGz increases cardiac antioxidant enzymes and may serve as a method to augment endogenous antioxidant capacity, and decrease reperfusion injury.
Abstract 18514: The Degree of Microvascular Constriction During Mental Stress Predicts the Development of Mental Stress-Induced Myocardial Ischemia
Authors: Ramadan Ronnie , Sheps David S , Bremner James D , Vaccarino Viola , Quyyumi Arshed A
Published: April 2024

Introduction:
Mental stress-induced myocardial ischemia (MSI) has been linked to a higher rate of fatal and non-fatal cardiac events in patients with CAD, independent of traditional cardiovascular risk models. Coronary vascular constriction with mental stress is a potential mechanism of MSI that may be reflected as constriction in the peripheral circulation. Moreover, peripheral arterial constriction may itself contribute to MSI by increasing afterload.

Hypothesis:
We hypothesized that a more pronounced microvascular constrictor response to mental stress will be predictive of development of MSI.

Methods:
Patients with stable CAD (n=116) underwent a standardized mental stress test using a public speaking task. Myocardial perfusion imaging with 99m-Tc-sestamibi was used for rest and stress images. MSI was defined as a summed

difference score of ≥4, based on the difference between summed stress

and rest perfusion scores. Peripheral arterial tonometry (PAT) was used to assess peripheral microvascular function during rest and mental stress. The PAT response was calculated as a ratio of the lowest pulse wave amplitude during the speaking task to the final three minutes of pulse wave amplitude during baseline rest. Univariate and multivariate logistic regression models were used to assess the association between PAT response and MSI. Models were adjusted for established CAD risk factors, and medications.

Results:
Patients with MSI (n=16, 14%) had a significantly lower PAT ratio than those without MSI (0.49 ±0.26 vs. 0.72± 0.34, p=0.01). Furthermore, the PAT response during mental stress was an independent predictor of the development of MSI, even after adjusting for aforementioned covariates (p=0.01). The peak rate-pressure product and diastolic BP during speech were similar in those with or without MSI (13580±4873 vs. 12947±2914, p=0.5; and 101±14 vs. 99±12, p=0.6, respectively). Systolic BP, diastolic BP, and heart rate changes from rest to speech were similar in those with and without MSI.

Conclusion:
The degree of peripheral microvascular constriction in response to mental stress predicts the risk of developing MSI in patients with stable CAD. Whether the PAT response during mental stress portends a worse long term prognosis needs to be investigated.
Abstract 18548: Validation of a New Imaging Parameter, Ultrasonic Intensity of Blood Speckles, Measured by Intravascular Ultrasound for Assessment of Coronary Stenosis Severity Comparing with Fractional Flow Reserve
Authors: Tanno Jun , Nakano Shinataro , komiyama Nobuyuki
Published: April 2024

Background

: Little is known regarding intravascular ultrasound (IVUS) criteria to determine functional severity of coronary stenosis. Ultrasonic intensity of blood speckles (IBS) increases as blood flow decreases below coronary stenosis in clinical observation of gray-scale IVUS. The present study was conducted to determine IVUS parameters indicating functional significance of intermediate coronary stenotic lesions.

Methods and Results

: Thirty consecutive patients with angiographically single intermediate stenotic lesion in left anterior descending coronary artery were enrolled in this study. They were evaluated by means of IVUS and intracoronary pressure measurements. In IVUS analysis conventional gray-scale images were recorded and averaged integrated backscatter (IB) values of blood speckles were measured in cross-sectional vessel lumens at left main trunk (proximal) and 5 mm distal of targeted lesion (distal) using Terumo radiofrequency IVUS (RF-IVUS) system. IBS was defined as difference of IB values between the proximal and the distal sites (distal IB - proximal IB). Fractional flow reserve (FFR) was measured at maximal hyperemia induced by intravenous adenosine infusion. FFR < 0.80 at maximum hyperemia was seen in 19 (63%) of total 30 lesions. IBS had significantly negative correlation with FFR (r = - 0.57, p = 0.001). The optimal cutoff value of IBS for FFR < 0.80 was 10.0 which was obtained from receiver operating characteristic curve (area under curve 0.88; p = 0.001) (Figure). Sensitivity and specificity at the cutoff were 85 % and 70 %, respectively. Also, IBS wasan independent determinant of FFR (H.R. 1.23; 95% confidence interval [CI], 0.008 to 0.031; p = 0.008) in multivariate analysis.

Conclusion

: IBS, a brand-new IVUS parameter, obtained by RF-IVUS analysis showed a significant correlation to FFR values and can be a predictor for functional significance of epicardial coronary stenosis.
Abstract 18556: Trends in Door-to-Balloon Time and Mortality in STEMI Patients Undergoing Primary PCI in Massachusetts
Authors: Ali Murtuza J , Zelevinsky Katya , Normand Sharon-Lise T , Lovett Ann , Nedeljkovic Zoran S , Jacobs Alice K
Published: April 2024

Background:
Recognition that primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for ST-elevation myocardial infarction (STEMI) if delivered in a timely fashion resulted in national efforts successful in reducing time to treatment. To determine whether the decreasing door-to-balloon (DTB) time is associated with a reduction in mortality, we evaluated 12,210 STEMI patients undergoing primary PCI in Massachusetts between 1/2005 and 9/2010.

Methods:
We used prospectively collected data compiled, audited, and analyzed by the Massachusetts Data Analysis Center, the state mandated PCI registry.

Results:
The mean age of the population was 61.9 years, with 29% women and 6.1% in cardiogenic shock. Between 2005 and 2010, median door-to-balloon time decreased from 85.0 to 67.5 minutes in patients presenting directly to PCI hospitals and from 153.5 to 113.0 minutes in patients requiring inter-hospital transfer for PCI. DTB time ≤90 minutes increased from 56.8% to 77.1% in patients presenting directly to PCI hospitals and from 4.3% to 23.4% in patients requiring inter-hospital transfer (Table). However, in-hospital and 30-day mortality during the study period did not significantly change (Figure).

Conclusion:
DTB time has decreased for STEMI patients in Massachusetts and more patients are achieving the guideline-recommended DTB ≤ 90 minutes. Despite these improvements, in-hospital and 30-day mortality remain unchanged. The reason for the unexpected absence of a decrease in mortality will require further study.
Abstract 18561: Late Restenosis After Treatment of Bifurcation Lesions Using the Two-stent Strategy
Authors: Habara Seiji , Kadota Kazushige , Saito Naoki , Otsuru Suguru , Hasegawa Daiji , Shigemoto Yoshikazu , Tada Takeshi , Tanaka Hiroyuki , Fuku Yasushi , Goto Tsuyoshi , Mitsudo Kazuaki
Published: April 2024

Purpose: The purpose of this study was to evaluate serial angiographic outcomes in patients with bifurcation lesions that were treated with two DESs.

Methods: From June 2004 to December 2010, 492 consecutive bifurcation lesions were treated with two DESs. We treated 217 lesions using a sirolimus-eluting stent (SES); 58 using a zotarolimus-eluting stent (ZES); 44 using a biolimus-eluting stent (BES); 40 using a everolimus-eluting stent (EES); 19 using a paclitaxel-eluting stent (PES); 66 with SES+BES; 30 with SES+PES; 7 with SES+ZES; 6 with EES+ZES. The bifurcation lesions were located in the left anterior descending coronary artery/diagonal branch (LAD/D) in 178 lesions, left main distal bifurcation (LM) in 192 lesions, left circumflex coronary artery/obtuse marginal branch (LCX/OM) in 65 lesions and right coronary artery (RCA) distal bifurcation in 57 lesions. The T-stenting technique was used to treat 251 bifurcation lesions, and the culotte stenting technique was used to treat 241 lesions. Angiographic follow-up was performed routinely 8 and 20 months after a successful procedure. Angiographic outcomes were compared between the T-stenting technique and the culotte stenting technique.

Results: Of 492 lesions, 407 (83%) underwent 8-month follow-up angiography. The incidence of binary restenosis at 8-month follow-up was 22.8% (45/197) for the culotte stenting technique and 19.5% (41/210) for the T-stenting technique (p=0.5). The incidence of target lesion revascularization at 8-month follow-up was 12.2% (24/197) for the culotte stenting technique and 11.0% (23/210) for the T-stenting technique (p=0.8). Twenty-month follow-up angiography was performed in 297 lesions (78% of lesions without restenosis at 8-month follow-up angiography). Late restenosis was observed in 17 lesions (11%) with the T-stenting technique and in 5 lesions (3%) with the culotte stenting technique (p=0.014). The incidence of target lesion revascularization at 20-month follow-up was 1.4% (2/145) for the culotte stenting technique and 6.7% (10/152) for the T-stenting technique (p=0.035).

Conclusions: The stenting technique affects the outcomes in patients with bifurcation lesions that are treated with two DESs.
Abstract 18569: Impact of ER-Stress Affecting Variant of XBP-1 Gene on Lipids, Diabetes, Chronic Kidney Disease, and Coronary Artery Disease
Authors: Nohara Atsushi , Noguchi Tohru , Inoue Takeshi , Mori Mika , Nakanishi Chiaki , Kawashiri Masa-aki , Yagi Kunimasa , Inazu Akihiro , Kobayashi Junji , Yamagishi Masakazu , Mabuchi Hiroshi
Published: April 2024

Objective:
ER function is fundamentally important in all cell types, and the key transcription factor X-box binding protein 1 (XBP-1) regulates many genes of ER-stress and also hepatic lipogenesis. A functional polymorphism (-116G>C) in the promoter region of XBP1 has been identified, and -116C allele was associated with higher ER-stress
in vitro
. CC homozygotes are quite common in Japanese (41%) compared with European (7% in NCBI database). Even though higher ER-stress would be associated with coronary risk factors, few data exist regarding clinical importance of this polymorphism as a cardiovascular risk factor.

Methods:
A total of 272 patients (137 males, mean age of 57 ± 14) suspected coronary artery disease were enrolled. Genotypes were determined by PCR-RFLP, and lipid profiles with ultracentrifugation, 75gOGTT, post-heparin lipoprotein lipase activities (PHLA), and eGFR were analyzed. Coronary stenosis index (CSI) was estimated with angiography in 125 patients (69 males, mean age of 63 ± 11, Diabetes 45%).

Results:
No difference was observed in age and sex with genotypes. CC homozygotes showed higher BMI (CC vs. GC+GG = 24.8 ± 3.3 vs. 23.4 ± 3.2,
p
<0.05). CC homozygotes showed higher apoB/LDL-C ratio (0.94 ± 0.1 vs. 0.87 ± 0.1,
p
<0.05), and higher LDL-TG (46 ± 94 vs. 28 ± 21,
p
<0.05) suggesting presence of small dense-LDL. CC homozygotes showed higher hepatic transaminases, suggesting hepatic inflammation such as NAFLD. Hypertension was more frequent in CC homozygotes (79 vs. 54%, P<0.05). Also C carriers showed lower eGFR (CC+GC vs. GG = 77.3±21 vs. 83.0±24,
p
<0.05). Unexpectedly, CC homozygotes showed higher HOMA-beta (141 ± 178 vs. 91 ± 56,
p
<0.05), and lower HbA1c (5.9 ± 1.0 vs. 6.3 ± 1.3 %,
p
<0.05). In coronary angiography, CC homozygotes showed higher CSI in non-diabetes group (21 ± 9 vs. 11 ± 11,
p
<0.005), but not significant in diabetes group.

Conclusion:
Functional XBP1 variant showed significant impacts on advanced coronary artery disease with deteriorating lipid profile, hypertension, and chronic kidney disease.