bluuebunny/crossref_metadata_2025 huggingface dataset:
Case report of Campylobacter jejuni-associated myopericarditis: rare case of cardiac involvement by a common gastroenteritis pathogen
Authors: Miruzzi Lara , Callus Adrian , Yamagata Kentaro , Cassar Maempel Andrew
Published: February 2022

Background

Myocarditis is caused by inflammation affecting the heart muscle. The usual aetiological factor is viral, especially in immunocompetent hosts and developed countries. Campylobacter jejuni is a common cause of bacterial gastroenteritis but has rarely been associated with myocarditis.

Case summary

We report a case of a 22-year-old male admitted with pleuritic chest pain and a diarrhoeal illness. Thorough evaluation of the patient history did not reveal any sources for contracting the diarrhoea. Stool cultures confirmed that the patient had C. jejuni infection as well as myopericarditis confirmed on cardiac magnetic resonance imaging (cardiac MRI). Treatment with colchicine 0.5 mg BD, ibuprofen 600 mg TDS, and ciprofloxacin 500 mg BD orally for 5 days was started, together with an intravenous infusion of 0.9% normal saline 1 L TDS. The patient showed signs of improvement over a span of three days and the ST changes on electrocardiogram resolved.

Discussion

Although C. jejuni-associated myopericarditis is uncommon, it can be potentially life-threatening if not considered in the differential. Its diagnosis involves good history taking, examination, and investigation with electrocardiography, troponins and inflammatory markers, echocardiography, and cardiac MRI. Several mechanisms of infection have been suggested, including direct insult by toxin or bacterium as well as an immune-mediated response. Both supportive and causative treatments are important to ensure recovery while reducing the risk of complications. It is therefore crucial to ensure that the patient receives adequate follow-up to ascertain patient progress and to mitigate any complications that may arise as well as tackle patient concerns. The patient had a rapid recovery.
Successful bridge to recovery in a patient with fulminant giant cell myocarditis that developed from multiple autoimmune disorders including myasthenia gravis: a case report
Authors: Yagi Nobuichiro , Watanabe Takuya , Ikeda Yoshihiko , Fukushima Norihide
Published: February 2022

Background

A recently indicated immunotherapy strategy, combined with mechanical circulatory support (MCS), seems to improve outcomes in patients with fulminant giant cell myocarditis (GCM). However, characterizing a definitive clinical outcome of this strategy remains challenging, and the autoimmunity associated with the onset of GCM remains controversial.

Case summary

A 26-year-old man with poor control of atopic dermatitis and ulcerative colitis presented with cardiogenic shock requiring MCS. He was diagnosed with fulminant GCM; hence, immunotherapy (including steroids and intravenous immunoglobulin) was administered and an extracorporeal left ventricular assist device (LVAD) was needed. As the patient complained of prominent fatigue and double vision before myocarditis onset, and acetylcholine receptor-binding antibody titres were elevated, he was diagnosed with myasthenia gravis (MG). No anti-striational antibodies known to be associated with GCM in patients with MG were found in the patient’s serum. Cyclosporin-based immunosuppression under LVAD therapy led to an almost complete resolution of his muscle weakness, intermittent ptosis, and cardiac dysfunction along with the histopathological remission of GCM resulting in LVAD removal. He remained at home without recurrence of GCM and worsening symptoms of MG over the 6-month period following discharge.

Discussion

We describe a case of GCM with multiple autoimmune disorders, which recovered by treatment with early cyclosporin-based immunosuppressive therapy under LVAD therapy. The present case suggests the involvement of unknown anti-striational antibodies in the development of GCM in patients with MG and may provide information to guide a novel therapeutic regimen for patients with fulminant GCM requiring mechanical circulatory support.
Prevalence and distribution of coronary artery calcium in a southeast asian cohort
Authors: Wong C J , Choo H M C , Baskaran L , Koh N S Y , Huang Z , Chua T S J , Tan S Y , Huang W
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

The coronary artery calcium score (CACS) independently predicts the risk of cardiovascular disease and major adverse cardiovascular events. While previous studies have demonstrated regional and ethnic differences in coronary calcification, the distribution of CACS in Southeast Asian (SEA) adults has not been investigated.

Purpose

The aim of this study was to determine CACS distribution in a SEA cohort living in Singapore.

Methods

This study involved 4945 asymptomatic patients who underwent CT coronary angiography and calcium scoring as part of screening for cardiovascular disease. Similar to the MESA study, patients with diabetes were analyzed separately due an increased prevalence of coronary calcification. A nonparametric analytical approach was used to determine CACS distribution stratified by age, gender and ethnicity.

Results

A positive CACS was seen in 43.7% of the overall SEA cohort with a higher prevalence in males (45.2%) than females (36.7%). The onset and burden of coronary calcification was also earlier and more severe in male subjects. There were no significant differences in CACS distribution amongst the three major ethnic groups in our study (p = 0.177). The presence of coronary calcification (CACS >0) was associated with increasing age, male gender and hypertension. Ethnicity, dyslipidemia, smoking and a family history of coronary artery disease did not significantly affect the presence of CACS.

Conclusions

This study provides a reference CACS distribution in an asymptomatic SEA population. There were no significant differences in CACS distribution amongst the three major ethnic groups living in Singapore.
Hemodynamic change in patients with hypertrophic obstructive cardiomyopathy before and after alcohol septal ablation using 4D flow magnetic resonance imaging: a retrospective observational study
Authors: Suwa K , Akita K , Iguchi K , Ushio T , Maekawa Y
Published: February 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Education, Science, Sports and Culture of Japan, Grants-in-Aid for Scientific Research

Background

The hemodynamics in the left ventricle (LV) and the ascending aorta (AAO) before and after alcohol septal ablation (ASA) in patients with hypertrophic obstructive cardiomyopathy (HOCM) is elucidated.

Purpose

Our objective was to evaluate the pattern changes in AAO and intra-LV flow assessed by four-dimensional (4D) flow magnetic resonance imaging (MRI) before and after ASA and to clarify the association between 4D flow MRI-derived hemodynamic characteristics and the peak pressure gradient (PPG) in patients with drug-refractory HOCM.

Methods

In this retrospective observational study, 11 patients with HOCM underwent 4D flow MRI before and a week after ASA. The 4D flow MRI included blood flow visualization and quantification using streamline images. The combined score of vortex and helix in AAO was analyzed. The duration and phase count of the AAO vortex or helix flow [Figure 1a with vortex (yellow allow) before ASA and 1b without vortex after ASA] and the size of the intra-LV anterior vortex (Figure 1c with smaller vortex before ASA and 1d with larger vortex after ASA, both in white circle) were quantified. The correlation between the changes in hemodynamics and the resting PPG at LV outflow tract was also analyzed. We used the paired t-test for the comparison between before and after ASA and the Pearson"s correlation coefficient for the analysis.

Results

The combined score for the incidence of vortex and/or helix flow in AAO after ASA was significantly lower than that before ASA (1.45 ± 0.52 vs. 1.09 ± 0.30, p = 0.046). The duration (744 ± 291 ms vs. 467 ± 258 ms, p < 0.001) and phase count (14.8 ± 4.4 phases vs. 10.5 ± 5.8 phases, p < 0.001) of the vortex or helix flow in AAO were significantly decreased after ASA. The LV anterior vortex area after ASA was significantly larger than that before ASA (1628 ± 420 mm2 vs. 2974 ± 539 mm2, p = 0.009). The delta phase count of the AAO vortex or helix before and a week after ASA was significantly correlated with delta PPG before and a week after ASA (Figure 2a; R = 0.79,  p = 0.004) and with delta PPG before and 6 months after ASA (Figure 2b; R = 0.83, p = 0.002).

Conclusions

Lower vortex or helix flow in AAO and larger diastolic vortex flow in LV were observed after ASA, which suggests the possibility to detect the changes of aberrant hemodynamics in HOCM. Abstract Figure. Streamline images before and after ASA
The correlation between coronary artery disease and left ventricular filling pressure: which correlates more LVEDP or LV pre-A wave?
Authors: Barakat A , Amar A , Alsaadi A,R
Published: February 2022

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): Al-mouwasat University Hospital and Uneversity Heart Surgery Center, Damascus, Syrian Arab Republic.

Background

Coronary artery disease (CAD) affects left ventricular (LV) systolic and diastolic function. This  results in high filling pressure which expressed by different waves and may be assessed by invasive and noninvasive methods. Validation and comparing the correlation between CAD and different LV filling pressure waves may add a step forward in CAD diagnosis, prognosis and treatment.

Purpose

This study invasively validates the correlation between coronary artery disease (CAD) and left ventricular end-diastolic pressure (LVEDP) as well as left ventricular pre-A wave (LV pre-A wave) and compare the results.

Methods

124 patients who accepted to participate for this study underwent left heart catheterization for medical indications. This study obtained the results of LV filling pressures (LVEDP and LV pre-A wave), as well as, coronary angiography results with assessing the severity and extents (if CAD presents) by vessels number and Gensini Score (GS). Spearman r correlation were used for continuous/continuous or continuous/ordinal variables and Chi square test for nominal/nominal variables. Then we compared the results.

Results

CAD presence with elevated LVEDP incidence (OR = 4.29, relative risk = 1.85 P = 0.0123). Vessel number, plaque number and Gensini score correlations with LVEDP were (P = 0.0038 r = 0.34, P = 0.0002 r = 0.44, p = 0.0002 r = 0.43 and p = 0.0622 r = 0.22) respectively. In the same way, CAD presence with LV pre-a wave (OR = 2.75, relative risk = 1.5, P = 0.0447). Vessels number, plaque numbers and Gensini score relations with LV pre-A wave were (P = 0.0379 r = 0.23, P = 0.0004 r = 0.39, p = 0.0002 r = 0.40 and p = 0.0568 r = 0.21) respectively. All the results are summarized in Tables (1 + 2+3).

Conclusions

LV filling pressure had a significant correlation with CAD presence, vessel number and plaque number but it did not have a correlation with Gensini score. LVEDP had a stronger correlation with CAD presence, severity, sensitivity and extent but lower specificity than LV pre-A wave. Abstract Tables of results (1 + 2)  Abstract Table of result 3
Smokers paradox in non-ST elevation acute coronary syndromes: does it exist?
Authors: Dakhil Z A , Farhan HASAN
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction

In Iraq; about third of males and 4% of females are smokers. There is no data from  Middle eastern countries including Iraq on impact of smoking on prognosis in ACS

Purpose

to assess if there is smokersˈ paradox in patients with NSTE-ACS in terms of lower adverse in-hospital outcomes in smokers

Methods

Patients with NSTE-ACS were prospectively included. GRACE score was calculated. Patients were categorised into two groups: smokers vs non-smokers

Results

n.=200, 34.5% were smokers, smokers were younger 53.6 ± 11.2 vs 61.46 ± 11.2, p < 0.001. smokers were males in 89.9% vs 60.3%, p < 0.001 and were hypertensive in 55.1% vs 77.1% p = 0.001. No significant differences between two groups in having DM, IHD, positive family history of IHD nor in troponin positivity. Smokers had higher GFR 91.4 ± 21.9 vs 79.4 ± 22.1, p = 0.001 and higher haemoglobin 13.8 ± 1.9 vs 13.2 ± 2.1, p = 0.04. AF was recorded in 2.9% of smokers vs 11.5%. No statistical difference between groups regarding prescribed drugs including aspirin, P2Y12 inhibitors, B-blockers, ACEI/ARBs, CCB, nitrate, anticoagulant, statin, MRA or diuretic. Smokers were at high GRACE risk class in 21.7% vs 38.2%, p = 0.01, yet, they were catheterized in 76.8% vs 65.6% in non-smokers, p = 0.1. For those who were catheterized, timing to catheterisation did not differ with smoking, p = 0.06. There was no significant difference between the two groups regarding developing in-hospital acute heart failure, ongoing ischaemic chest pain, life-threatening arrhythmias, cardiogenic shock, stroke or death.

Conclusion

No smokersˈ paradox was observed as there were no differences in developing adverse in-hospital outcomes according to smoking status, yet smokers presented at lower risk class compared with non-smoker counterparts which can be explained by younger age and lower comorbidities in smokers. Preventive programs should be the goal to encourage smoking cessation to reduce cardiovascular diseases and mortality Abstract Figure.  Abstract Figure.
The potential beneficial effects of polysaccharide peptide on oxidative stress and lipid profile in post myocardial infarction patients: a double-blind, randomised controlled trial
Authors: Adrian L H , Sargowo D , Sugita P
Published: February 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Indonesia"s Ministry of Research and Technology grants

Background

Inflammation, oxidative stress and lipid peroxidation activities contribute to the progression of atherosclerosis leading to myocardial infarction (MI). These sustainable cascade are considered to remain, in fact after the episode of MI. Polysaccharide peptide is renowned to exert anti-oxidative and lipid-lowering effects, thus may impair subsequent post-infarction plaque accumulation.

Purpose

To evaluate the role of polysaccharide peptide of Ganoderma lucidum mycelium extracts (β-1,3/1,6-D-Glucan) as potent protective antioxidant and lipid-lowering agent in post MI patients.

Methods

This was a prospective, double-blind, placebo-controlled, randomised clinical trial in 45 post MI patients who had undergone reperfusion or conservative therapy. The eligible and consenting patients were randomly assigned (1:1 ratio) into two groups i.e. treated group (TG) and control group (CG). Treated group was given 180 mg β-1,3/1,6-D-Glucan thrice a day for 90 days, and control group received placebo. Variables measured were nitric oxide (NO), superoxide dismutase (SOD), malondialdehyde (MDA), plasma total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides. All measurements were conducted at baseline and after 90-days. All patients received guideline-driven therapy throughout the study. 

Results

There was no significant difference in the baseline characteristics between the two groups (all p > 0.05). At 90 days, allocation to polysaccharide peptide demonstrated significant increase in NO and SOD (p = 0.020, p = 0.023; respectively) and also significant reduction in MDA (p = 0.001) as compared to placebo. Treated group compared with placebo revealed significant reduction in LDL-C (p = 0.036), but not in total cholesterol, HDL-C and triglycerides (p = 0.105, p = 0.398, p = 0.843; respectively). 

Conclusions

 Polysaccharide peptide exhibits potent protective anti-oxidative and lipid-lowering properties in post MI patients. It may offer benefit on top of standard medical treatment. Abstract Figure. Results among treated and control groups  Abstract Figure. Box plot comparison among TG and CG
AEPEI scoring system to predict mortality among patients diagnosed with infective endocarditis after surgery at the philippine heart center: a retrospective analytical cross-sectional study
Authors: Gatuz M , Cuenza L
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

 Infective endocarditis (IE) is a life-threatening disease which continues to pose significant challenges in clinical practice. Surgery for IE while curative can be associated with considerable morbidity and mortality. We sought to determine the utility of a French based risk score in determining outcomes of patients with IE undergoing surgery.

Methodology

 This was a retrospective analytical cross-sectional study. Patients admitted and diagnosed with definite Infective endocarditis based on the modified Duke’s criteria at our Heart Center who underwent surgical treatment. Clinical and echocardiographic characteristics were described and the sensitivity and specificity of the AEPEI score was analyzed.

Results

 Sixty six patients were included in the study and underwent surgical intervention. The most common type of endocarditis involves the native valve (90.9%, n = 60). Multivalvular involvement was also noted in 12 patients (18.1%). Acute kidney injury and pneumonia were the most common major adverse events of patients. The post-surgery in-hospital mortality rate was 10.6%. The sensitivity and specificity of AEPEI is 100% and 50% in predicting in hospital mortality

Conclusion

 In patients with IE undergoing surgery, mortality rate in our institution is lower compared to previous data. Our results suggest that the AEPEI is a useful tool to predict in hospital mortality to help in prognostication as well as clinical and surgical decision making Abstract Figure. Baseline Characteristics
The effects of Kaatsu training on an acute angiogenic response in post-interventional rehabilitation of peripheral arterial disease patients
Authors: Wlodarczyk A , Wachsmann-Maga A , Schonborn M , Trynkiewicz A , Cebenko M , Maga P , Nowobilski R , Maga M
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Atherosclerosis as the main cause of death in adults is one of the greatest challenges of modern medicine. Peripheral arterial disease (PAD) is a condition with worldwide increasing occurrence affecting more than 20% of Europeans and North Americans in the age group> 55 years, and in the group> 70 years of age affects as much as 60% of the population. Among many treatment forms the endovascular treatment remains the most common treatment method, however the most non-invasive, but still effective is rehabilitation by physical training. Recently, innovative solutions have been introduced concerning this form of treatment by combining anaerobic interval exercises with venous blood flow restriction (BFR) and cooling.

Purpose

The aim of the research is to evaluate the endothelial and angiogenic response to the aforementioned type of exercise.

Methods

Study was divided into 2 stages: with healthy volunteers and non-CLI patients. 35 healthy volunteers  were enrolled into the 1st stage. They performed a 21-minute interval training using a cross trainer with cooling liquid pressure cuffs (arms: 40 mmHg; legs: 65 mmHg) providing vein occlusion and cooling seat. Angiogenic processes and endothelial functions were monitored by laboratory parameters - vascular endothelial growth factor (VEGF), clusters of differentiation (CD31, CD34) as well as imaging examinations – flow mediated dilatation (FMD), stiffness index (SI), reflexion index (RI), reactive hyperaemia index (RHI) and augmentation index (AI). All measurements were performed before, as well as 20 to 30 minutes after the training.

Results

All of the laboratory parameters were significantly elevated after the BFRT- CD34 (ΔCD34: 0.13 vs 0.01 p < 0,001), CD31 (ΔCD31: 1.11 vs 0.37 p < 0,001) and VEGFR (ΔVEGFR: 6.35 vs 2.86 p < 0.001).Only FMD and RI of all endothelial imaging parametrs significantly changed after BFRT compared to regular training (FMD: 8.9% vs 7.41 p < 0,001 ΔFMD: 2.89 vs 1.33 p < 0,01; RI: 63.43 vs 69.49 p < 0,001, ΔRI: 4.0 vs 2.0, p > 0,001). RHI and AI weren’t significantly influenced by any exercise type.

Conclusions

BFR training successfully stimulates acute angiogenic response and moderately influences certain endothelial functions. This 1st stage results are being now implemented into the 2nd part of project involving PAD patients.
Effect of profilin-1 on the asymmetric dimethylarginine-induced vascular lesion associated hypertension
Authors: Ni G
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

OnBehalf

Guohua Ni

Objective

Previous studies have demonstrated that the levels of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide (NO) synthesis, are strongly associated with hypertension, diabetes, and cardiovascular diseases. Proﬁlin-1, an actin-binding protein, has been documented to be involved in endothelial injury and in the proliferation of vascular smooth muscle cells (VSMCs) resulting from hypertension. However, the role of profilin-1 in ADMA-induced vascular injury in hypertension remains largely unknown.

Methods

 Forty healthy subjects and forty-two matched patients with essential hypertension were enrolled, and the related indexes of vascular injury in plasma were detected. Rat aortic smooth muscle cells (RASMCs) were treated with different concentrations of ADMA for different periods of time and transfected with profilin-1 shRNA to interrupt the expression of profilin-1. To determine the role of the Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) pathway, RASMCs were pretreated with AG490 or rapamycin. The expression of profilin-1 was tested using real-time PCR and western blot analysis. Cell proliferation was measured by flow cytometry and MTT assays.

Results

 Compared with healthy subjects, the levels of ADMA and profilin-1 were markedly elevated in hypertensive individuals, while the levels of NO were significantly decreased(P < 0.05). In vitro, studies showed ADMA induced profilin-1 expression in a concentration- and time-dependent manner in RASMCs (P < 0.05), concomitantly with promoting the proliferation of RASMCs. Furthermore, ADMA-mediated proliferation of RASMCs and up-regulation expression of profilin-1 were inhibited by blockade of the JAK2/STAT3 pathway or knockdown of profilin-1. 

Conclusions

Profilin-1 implicated in the ADMA-mediated vascular lesions in hypertension. Abstract Figure 12  Abstract Figure 3
Epidemiology of obstructive sleep apnea in older patients with stable cardiovascular disease and chronic kidney disease
Authors: Efremova E , Shutov A M , Serov V A , Gabriel" O V
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Obstructive sleep apnea (OSA) is diagnosed late, especially in older people. The presence of chronic hypoxia and glomerular hypertension decrease renal function in patients with OSAS, which causes the progression of chronic kidney disease (CKD) [3]. The aim of the study was to investigate epidemiological aspects of OSA in older patients with stable cardiovascular disease and chronic kidney disease.

Materials and methods

80 older patients with stable cardiovascular disease (43 males, mean age was 67.6 ± 6.1 years) were studied. CKD was diagnosed and classified according to the KDIGO guidelines (2012). OSA was observed according to Clinical Guidelines for Obstructive Sleep Apnea and Insomnia (U.S., 2020). Berlin Questionnaire and Epworth Sleepiness Scale, cardiorespiratory monitoring for screening and diagnosis of OSA were used. Follow-up period was 12 months.

Results

Chronic kidney disease was observed in 48 (60%) patients. There were no patients with stages 1 and 2 of CKD, stage 3a was detected in 35 (43.8%), 3b - in 10 (12.5%), stage 4 - in 3 (3.8%) patients. Significant daytime sleepiness was observed in every fourth elderly and senile patient with CKD (12; 25%). A high risk of OSA was observed in the majority of patients with CKD - 34 (70.8%). OSA was first diagnosed in 31 (64.5%) patients with CKD. Moreover, the frequency did not depend on gender (p = 0.39) and age (p = 0.48). There were no differences between elderly (60-74 years old) and senile patients (75-89 years old) in the prevalence of OSAS (p> 0.05).More than half had an average degree of OSA (19; 61.3%). Mild and severe degrees were observed with the same frequency in 6 (19.4%) older patients with CKD. Severity of OSA in men and women did not differ (p> 0.05). The average level of oxygen saturation was higher in men: 93.4 (92.4; 94.15) and 92.3 (91.7; 93.1)%, respectively, p = 0.02. There were no differences in the frequency of OSA detection depending on the stage of CKD (p> 0.05). Only 2 (6.5%) patients with OSA and CKD was consulted a somnologist after 12 months of observation

Conclusion

A high prevalence of OSA was observed in most older patients with stable cardiovascular disease and CKD (34; 70.8%), significant daytime sleepiness was observed in every fourth patient. OSA was first diagnosed in 31 (64.5%) patients with CKD, despite the high risk and clinical symptoms. The severity of OSAS did not depend on gender, age, and the presence of CKD in older patients with stable cardiovascular disease . Subsequently only 2 (6.5%) patients in a sleep consulted, which reflects a low level of overall patient health awareness and availability of quality somnological aid.
Programmed Cell Death 1 (PD-1) and Programmed Cell Death Ligand 1 (PD-L1) inhibitors and adverse cardiovascular events: a population-based study
Authors: Lee S , Zhou J , Lakhani I , Yang L , Liu T , Zhang Y , Xia Y , Wong W T , Chan E W Y , Wong I C K , Tse G , Zhang Q
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

OnBehalf

Cardiovascular Analytics Group

Background

Programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) inhibitors are major classes of immune checkpoint inhibitors that are increasingly used for cancer treatment. However, they are associated with adverse cardiovascular events.

Purpose

To evaluate the cardiotoxicity of PD-1 and PD-L1 inhibitors, the present study aims to examine the incidence of new-onset cardiac complications in patients receiving PD-1 or PD-L1 inhibitors.

Methods

Patients receiving PD-1 or PD-L1 inhibitors since their launch up to December 31st, 2019 without pre-existing cardiac complications were included. Patient data were obtained using a territory-wide electronic health record database. The primary outcome was a composite of incident heart failure (HF), acute myocardial infarction (AMI), atrial fibrillation (AF) or atrial flutter followed up to August 31st, 2020. Propensity score matching between PD-L1 and PD-1 inhibitor use with a 1:1 ratio for patient demographics and comorbidities was performed.

Results

A total of 1925 patients were included. Over a median follow-up of 136 days (interquartile range [IQR]: 42-279), 318 (16.51%) patients met the primary outcome after PD-1/PD-L1 treatment: 242 (incidence rate [IR]: 12.57%) with HF, 38 (IR: 1.97%) with AMI, 53 (IR: 2.75%) with AF, 6 (IR: 0.31%) with atrial flutter. Compared with PD-1 inhibitor treatment, PD-L1 inhibitor treatment was significantly associated with a lower risk of composite outcome after matching (HR: 0.78, 95% CI: [0.62-0.99], P value = 0.0417). Patients who developed cardiovascular complications had shorter average readmission intervals and more hospitalization episodes after treatment with PD-1/PD-L1 inhibitors both before and after matching (P value < 0.0001).

Conclusions

Compared with PD-1 inhibitor users, PD-L1 inhibitor users had a significantly lower risk of new-onset composite cardiovascular complications. Abstract Figure. Kaplan-Meier survival curve
Pharmacological evaluation of the use of dexrazoxane in preventing anthracycline induced cardiotoxicity in breast cancer
Authors: Maqsood H , Ashraf T , Younus S , Rasool M W , Hameed A
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Anthracyclines and trastuzumab are extensively used for the treatment of breast cancer but are associated with an increased risk of dilated cardiomyopathy. Dexrazoxane is an iron-chelating agent used to reduce the risk of cardiotoxicity, but it is seldom used in clinical practice.

Purpose

A meta-analysis was performed to check the efficacy of dexrazoxane in patients with breast cancer who were treated with anthracyclines with or without trastuzumab.

Methods

Online databases were searched from January 2000 up to October 31, 2019, for clinical trials on the use of dexrazoxane for the prevention of cardiomyopathy in patients with breast cancer receiving anthracyclines with or without trastuzumab. Risk ratios with 95% confidence intervals were calculated using a mixed-effects model meta-analysis.

Results

Five randomized trials and 2 retrospective trials with a total of 1,587 patients were included. Dexrazoxane reduced the risk of clinical heart failure (p < 0.001) and cardiomyopathy (p < 0.001) irrespective of previous exposure to anthracyclines. The overall survival rate, progression-free survival and the rate of partial or complete oncological response were not affected by dexrazoxane.

Conclusion

Our study concludes that dexrazoxane reduced the risk of heart failure and cardiomyopathy in the patients who were treated with anthracycline chemotherapy with or without trastuzumab and did not impact cancer outcomes significantly. However, the area of our study is limited and further studies should be done before the systematic application of this therapy in clinical practice. Abstract Figure.
Impact of the COVID-19 pandemic on cardiology services in the second year at a South Asian cardiac centre
Authors: Cader F A , Haq M M , Khan S R
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Little has been reported on the impact of the COVID-19 pandemic and the new delta variant, on cardiology services and catheterization volumes in South Asia, during the second year of the pandemic.

Purpose

We aimed to assess this impact during the second year of the pandemic on cardiology services, procedures and catheterization volumes at a tertiary cardiac centre in Bangladesh.

Methods

Data on patient visits (outpatient and emergency), admissions, procedures and catheterization volumes were collected for January to June 2020 and 2021 via hospital electronic records. Comparisons for each corresponding month were made between 2021 and 2020. The differences were expressed as a percentage (%Δ).

Results

Trends showed that admissions in cardiology and cardiac surgery units, outpatient visits, procedures and cardiac catheterization volumes had reached almost pre-pandemic levels in the first quarter of 2021, as compared to 2020. However, ER visits showed >50% reductions in February (Δ-58.7%) and March (Δ -51.9%) 2021, compared to 2020. Admissions and procedures showed a steep decline from March to April 2021, coinciding with the COVID19 surge owing to the Delta variant. A gradual increase in numbers of admissions, patient visits, and procedures were seen in May and June 2021, as compared with corresponding months in 2020. In terms of catheterization volumes, a sharp decline was seen in angiographies and percutaneous coronary intervention (PCI) from March to April 2021, similar to 2020. Cath lab procedures showed an increasing trend in May-June 2021, and were greater in numbers, compared to corresponding volumes in 2020 [May: Δ+36.9%; June: Δ+33.2% in 2021]. A greater increase was seen for PCI (May Δ+ 46.8%; June Δ+367%) than angiographies (May Δ+32.5%; June Δ+32.5%).

Conclusion

Cardiology services and cath lab volumes had reached almost pre-pandemic levels in January and February 2021. The surge caused by the delta variant resulted in reduced admissions, outpatient and cath lab volumes beginning from April 2021, however numbers remained greater in 2021 than corresponding months in March-June 2020, possibly indicating an adaptation of the healthcare system to the prevailing pandemic.
Pervasiveness of the symbiont Serratia symbiotica in the aphid natural environment: distribution, diversity and evolution at a multitrophic level
Authors: Pons Inès , Scieur Nora , Dhondt Linda , Renard Marie-Eve , Renoz François , Hance Thierry
Published: February 2022

Symbioses are significant drivers of insect evolutionary ecology. Despite recent findings that these associations can emerge from environmentally derived bacterial precursors, there is still little information on how these potential progenitors of insect symbionts circulate in trophic systems. Serratia symbiotica represents a valuable model for deciphering evolutionary scenarios of bacterial acquisition by insects, as its diversity includes gut-associated strains that retained the ability to live independently of their hosts, representing a potential reservoir for symbioses emergence. Here, we conducted a field study to examine the distribution and diversity of S. symbiotica found in aphid populations, and in different compartments of their surrounding environment. Twenty % of aphid colonies were infected with S. symbiotica, including a wide diversity of strains with varied tissue tropism corresponding to different lifestyle. We also showed that the prevalence of S. symbiotica is influenced by seasonal temperatures. We found that S. symbiotica was present in non-aphid species and in host plants, and that its prevalence in these samples was higher when associated aphid colonies were infected. Furthermore, phylogenetic analyses suggest the existence of horizontal transfers between the different trophic levels. These results provide a new picture of the pervasiveness of an insect symbiont in nature.
Correlates of Elevated C-Reactive Protein Among Black Older Adults: Evidence From the Health and Retirement Study
Authors: Farmer Heather R , Thomas Tobin Courtney S , Thorpe Roland J
Published: February 2022

Objectives

Substantial evidence documents gender and racial disparities in C-reactive protein (CRP), a measure of systemic inflammation, among older adults. Yet, the comparative approaches of these studies may obscure distinct risk and protective factors associated with elevated CRP among older Black Americans. To pinpoint opportunities for intervention, this study utilizes a “within-group approach” to identify the sociodemographic, psychosocial, behavioral, and health-related correlates of elevated CRP among older Black women and men.

Method

The sample consisted of 2,420 Black respondents aged 51 and older in the Health and Retirement Study (2006–2016). Gender-stratified, random effects logistic regression models were used to examine correlates of elevated CRP (>3.0 mg/L).

Results

More than 50% of Black women had elevated CRP, and younger age, Medicaid, lower mastery, religiosity, overweight/obesity, physical inactivity, and activities of daily living (ADLs) contributed to elevated CRP among this group. In contrast, elevated CRP was reported among only 37.25% of Black men, for whom financial distress was associated with lower odds of elevated CRP; religiosity, less neighborhood cohesion, current smoking, overweight/obesity, ADLs, and more chronic conditions were associated with greater odds of elevated CRP among this group.

Discussion

Sociodemographic factors had a limited association with elevated CRP among older Black Americans. Rather, a range of psychosocial, behavioral, and health-related factors were more influential determinants of elevated CRP among older Black Americans. Most notably, findings demonstrate distinct correlates of CRP among Black women and men, underscoring the critical need to further evaluate the risk and protective mechanisms undergirding disparities among this aging population.
Interpretable network-guided epistasis detection
Authors: Duroux Diane , Climente-González Héctor , Azencott Chloé-Agathe , Van Steen Kristel
Published: February 2022

Background

Detecting epistatic interactions at the gene level is essential to understanding the biological mechanisms of complex diseases. Unfortunately, genome-wide interaction association studies involve many statistical challenges that make such detection hard. We propose a multi-step protocol for epistasis detection along the edges of a gene-gene co-function network. Such an approach reduces the number of tests performed and provides interpretable interactions while keeping type I error controlled. Yet, mapping gene interactions into testable single-nucleotide polymorphism (SNP)-interaction hypotheses, as well as computing gene pair association scores from SNP pair ones, is not trivial.

Results

Here we compare 3 SNP-gene mappings (positional overlap, expression quantitative trait loci, and proximity in 3D structure) and use the adaptive truncated product method to compute gene pair scores. This method is non-parametric, does not require a known null distribution, and is fast to compute. We apply multiple variants of this protocol to a genome-wide association study dataset on inflammatory bowel disease. Different configurations produced different results, highlighting that various mechanisms are implicated in inflammatory bowel disease, while at the same time, results overlapped with known disease characteristics. Importantly, the proposed pipeline also differs from a conventional approach where no network is used, showing the potential for additional discoveries when prior biological knowledge is incorporated into epistasis detection.
An improved ovine reference genome assembly to facilitate in-depth functional annotation of the sheep genome
Authors: Davenport Kimberly M , Bickhart Derek M , Worley Kim , Murali Shwetha C , Salavati Mazdak , Clark Emily L , Cockett Noelle E , Heaton Michael P , Smith Timothy P L , Murdoch Brenda M , Rosen Benjamin D
Published: February 2022

Background

The domestic sheep (Ovis aries) is an important agricultural species raised for meat, wool, and milk across the world. A high-quality reference genome for this species enhances the ability to discover genetic mechanisms influencing biological traits. Furthermore, a high-quality reference genome allows for precise functional annotation of gene regulatory elements. The rapid advances in genome assembly algorithms and emergence of sequencing technologies with increasingly long reads provide the opportunity for an improved de novo assembly of the sheep reference genome.

Findings

Short-read Illumina (55× coverage), long-read Pacific Biosciences (75× coverage), and Hi-C data from this ewe retrieved from public databases were combined with an additional 50× coverage of Oxford Nanopore data and assembled with canu v1.9. The assembled contigs were scaffolded using Hi-C data with Salsa v2.2, gaps filled with PBsuitev15.8.24, and polished with Nanopolish v0.12.5. After duplicate contig removal with PurgeDups v1.0.1, chromosomes were oriented and polished with 2 rounds of a pipeline that consisted of freebayes v1.3.1 to call variants, Merfin to validate them, and BCFtools to generate the consensus fasta. The ARS-UI_Ramb_v2.0 assembly is 2.63 Gb in length and has improved continuity (contig NG50 of 43.18 Mb), with a 19- and 38-fold decrease in the number of scaffolds compared with Oar_rambouillet_v1.0 and Oar_v4.0. ARS-UI_Ramb_v2.0 has greater per-base accuracy and fewer insertions and deletions identified from mapped RNA sequence than previous assemblies.

Conclusions

The ARS-UI_Ramb_v2.0 assembly is a substantial improvement in contiguity that will optimize the functional annotation of the sheep genome and facilitate improved mapping accuracy of genetic variant and expression data for traits in sheep.
A chromosome-level genome assembly and annotation of the desert horned lizard, Phrynosoma platyrhinos, provides insight into chromosomal rearrangements among reptiles
Authors: Koochekian Nazila , Ascanio Alfredo , Farleigh Keaka , Card Daren C , Schield Drew R , Castoe Todd A , Jezkova Tereza
Published: February 2022

Background

The increasing number of chromosome-level genome assemblies has advanced our knowledge and understanding of macroevolutionary processes. Here, we introduce the genome of the desert horned lizard, Phrynosoma platyrhinos, an iguanid lizard occupying extreme desert conditions of the American southwest. We conduct analysis of the chromosomal structure and composition of this species and compare these features across genomes of 12 other reptiles (5 species of lizards, 3 snakes, 3 turtles, and 1 bird).

Findings

The desert horned lizard genome was sequenced using Illumina paired-end reads and assembled and scaffolded using Dovetail Genomics Hi-C and Chicago long-range contact data. The resulting genome assembly has a total length of 1,901.85 Mb, scaffold N50 length of 273.213 Mb, and includes 5,294 scaffolds. The chromosome-level assembly is composed of 6 macrochromosomes and 11 microchromosomes. A total of 20,764 genes were annotated in the assembly. GC content and gene density are higher for microchromosomes than macrochromosomes, while repeat element distributions show the opposite trend. Pathway analyses provide preliminary evidence that microchromosome and macrochromosome gene content are functionally distinct. Synteny analysis indicates that large microchromosome blocks are conserved among closely related species, whereas macrochromosomes show evidence of frequent fusion and fission events among reptiles, even between closely related species.

Conclusions

Our results demonstrate dynamic karyotypic evolution across Reptilia, with frequent inferred splits, fusions, and rearrangements that have resulted in shuffling of chromosomal blocks between macrochromosomes and microchromosomes. Our analyses also provide new evidence for distinct gene content and chromosomal structure between microchromosomes and macrochromosomes within reptiles.
Use of ‘omics for endometrial timing: the cycle moves on
Authors: Aplin John D , Stevens Adam
Published: February 2022

For some years, the prospect of precise and personalized timing of the endometrial cycle for optimal embryo replacement has been held out as a potential solution to low implantation rates. It is envisaged that a receptive state can be defined and reached at a predictable time, and embryo replacement performed in synchrony. In the last century, morphological changes characteristic of the mid secretory phase were defined in precisely timed cycles in women of proven fertility, but when deviations from this standardized schedule occur, their significance for implantation has remained uncertain. ‘Omics technologies have been widely advocated for staging the endometrial cycle and defining a set of biochemical requirements for implantation, but after two decades of research, improvements to pregnancy rates have not followed, and there is a striking lack of agreement regarding the molecular characterization of the receptive state. Some of the rationale underlying these problems is now emerging with the application of higher-level computational and biological methodology. Here, we consider the challenges of defining an endometrial phenotype that can support implantation and continuing pregnancy. Receptivity may be an emergent trait depending on contributions from multiple proteins that have low pathway connectivity. We recommend that authors choose language which rigorously avoids the implication that protocols for molecular staging of the mid secretory phase inherently identify a state of receptivity to the implanting blastocyst.
Pathological and clinical features of multiple cancers and lung adenocarcinoma: a multicentre study
Authors: Bertoglio Pietro , Ventura Luigi , Aprile Vittorio , Cattoni Maria Angela , Nachira Dania , Lococo Filippo , Rodriguez Perez Maria , Guerrera Francesco , Minervini Fabrizio , Gnetti Letizia , Lenzini Alessandra , Franzi Francesca , Querzoli Giulia , Rindi Guido , Bellafiore Salvatore , Femia Federico , Bogina Giuseppe Salvatore , Bacchin Diana , Kestenholz Peter , Ruffini Enrico , Paci Massimiliano , Margaritora Stefano , Imperatori Andrea Selenito , Lucchi Marco , Ampollini Luca , Terzi Alberto Claudio
Published: February 2022

OBJECTIVES

Lung cancer is increasingly diagnosed as a second cancer. Our goal was to analyse the characteristics and outcomes of early-stage resected lung adenocarcinomas in patients with previous cancers (PC) and correlations with adenocarcinoma subtypes.

METHODS

We retrospectively reviewed data of patients radically operated on for stage I–II lung adenocarcinoma in 9 thoracic surgery departments between 2014 and 2017. Overall survival (OS) and time to disease relapse were evaluated between subgroups.

RESULTS

We included 700 consecutive patients. PC were present in 260 (37.1%). Breast adenocarcinoma, lung cancer and prostate cancer were the most frequent (21.5%, 11.5% and 11.2%, respectively). No significant differences in OS were observed between the PC and non-PC groups (P = 0.378), with 31 and 75 deaths, respectively. Patients with PC had smaller tumours and were more likely to receive sublobar resection and to be operated on with a minimally invasive approach. Previous gastric cancer (P = 0.042) and synchronous PC (when diagnosed up to 6 months before lung adenocarcinoma; P = 0.044) were related, with a worse OS. Colon and breast adenocarcinomas and melanomas were significantly related to a lower incidence of high grade (solid or micropapillary, P = 0.0039, P = 0.005 and P = 0.028 respectively), whereas patients affected by a previous lymphoma had a higher incidence of a micropapillary pattern (P = 0.008).

CONCLUSIONS

In patients with PC, we found smaller tumours more frequently treated with minimally invasive techniques and sublobar resection, probably due to a more careful follow-up. The impact on survival is not uniform and predictable; however, breast and colon cancers and melanoma showed a lower incidence of solid or micropapillary patterns whereas patients with lymphomas had a higher incidence of a micropapillary pattern.
Significance of Lorentz forces on Jeffrey nanofluid flows over a convectively heated flat surface featured by multiple velocity slips and dual stretching constraint: a homotopy analysis approach
Authors: Dawar Abdullah , Wakif Abderrahim , Saeed Anwar , Shah Zahir , Muhammad Taseer , Kumam Poom
Published: February 2022

Motivated by the temporal relaxation feature of the Jeffrey model and its practical uses in the rheological modeling of several vital liquids, this study aimed to present a theoretical analysis of three-dimensional MHD Jeffrey nanofluid flows over a dual stretching surface with velocity slip conditions. By adopting the nonhomogeneous nanofluid model along with the passive control approach of nanoparticles, the current flow problem is solved semi-analytically via the homotopy analysis method for convective heating and multiple slip conditions. Dynamically, the magnetic and viscoelastic parameters have a declining effect on the velocity distributions in both directions in the existence and absence of slip effects, while the Deborah number has generally an escalating influence on the flow distributions. On the other hand, the variations of the velocity profiles in both directions are always greater in the presence of slip effect as compared to the nonslip case. Besides, the velocity stretching factor rises the velocity profiles in both directions. Furthermore, this increasing impact is dominant for the velocity distribution along the $y{\rm{-}}$direction as compared to the velocity field along the $x{\rm{-}}$direction. Thermally, the greater Biot number increases the temperature distribution. However, the bigger Schmidt number reduces the concentration distribution.