bluuebunny/crossref_metadata_2025 huggingface dataset:
The associations between motivational climate, basic psychological needs and dropout in volleyball – A comparison across competitive levels
Authors: Elsborg Peter , Appleton Paul , Wikman Johan M. , Nielsen Glen
Published: February 2022

The purpose of this study was to investigate the importance of motivational climate for the satisfaction of psychological needs and dropout in recreational, intermediate and elite volleyball. Seven thousand nine hundred thirty six volleyball players from all 321 volleyball clubs across Denmark were invited to participate in the study. Three thousand three thirty answered the questionnaire and 2150 were included in the analysis. Dropout from Volleyball was measured as the proportion of players that had stopped playing volleyball over the last year. The coach‐created motivational climate was measured using the Motivational Climate Scale for Youth Sports. The satisfaction of players’ psychological needs was measured using an adapted version of the basic psychological needs in exercise scale. The psychometric scales were validated and showed good model fit. For volleyball players of all levels, the degree of mastery climate predicted the satisfaction of the players’ basic psychological needs satisfaction during volleyball which was, in turn, associated with lower dropout rates. Performance climate had a weak negative association with the satisfaction of psychological needs on the intermediate level only. When adjusting the models for the negative association between performance climate and mastery climate this negative association became nonsignificant and a weak positive association to needs satisfaction emerged for players at the elite level. Findings confirm that the coach‐created mastery climate in volleyball teams is important for the satisfaction of players’ basic psychological needs and continuation within the sport across the recreational, intermediate and elite levels.

Highlights

Coach‐created mastery climate in volleyball teams was positively associated with the satisfaction of the players’ basic psychological and negatively associated with dropout.

These associations between coach created climate, need satisfaction and dropout were similar across different sporting levels.

Performance orientation had little influence and seemed mainly problematic if it was at the expense of mastery climate.
Spin correlation functions, Ramus-like identities, and enumeration of constrained lattice walks and plane partitions
Authors: Malyshev C , Bogoliubov N M
Published: February 2022

Relations between the mean values of distributions of flipped spins on periodic Heisenberg XX chain and some aspects of enumerative combinatorics are discussed. The Bethe vectors, which are the state-vectors of the model, are considered both as on- and off-shell. It is this approach that makes it possible to represent and to study the correlation functions in the form of non-intersecting nests of lattice walks and related plane partitions. We distinguish between two types of walkers, namely lock step models and random turns. Of particular interest is the connection of random turns walks and a circulant matrix. The determinantal representation for the norm-trace generating function of plane partitions with fixed height of diagonal parts is obtained as the expectation of the generating exponential over off-shell N-particle Bethe states. The asymptotics of the dynamical mean value of the generating exponential is calculated in the double scaling limit provided that the evolution parameter is large. It is shown that the amplitudes of the leading asymptotics depend on the number of diagonally constrained plane partitions.
Congruent numbers and lower bounds on class numbers of real quadratic fields
Authors: Kim Jigu , Lee Yoonjin
Published: February 2022

We give effective lower bounds on caliber numbers of the parametric family of real quadratic fieldsQ(t4−n2)\mathbb {Q}(\sqrt {t^4-n^2})asttvaries over positive integers for a congruent numbernn. Furthermore, we provide lower bounds on class numbers ofRichaud-Degert typereal quadratic fields of the formQ(n2k4−1)\mathbb {Q}(\sqrt {n^2k^4-1})for positive integerskkand congruent numbersnnwhose elliptic curves have algebraic rank greater than22.
Rolling backwards can move you forward: On embedding problems in sparse expanders
Authors: Draganić Nemanja , Krivelevich Michael , Nenadov Rajko
Published: February 2022

We develop a general embedding method based on the Friedman-Pippenger tree embedding technique and its algorithmic version, enhanced with a roll-back idea allowing a sequential retracing of previously performed embedding steps. We use this method to obtain the following results.

We show that the size-Ramsey number of logarithmically long subdivisions of bounded degree graphs is linear in their number of vertices, settling a conjecture of Pak [Proceedings of the thirteenth annual ACMSIAM symposium on discrete algorithms (SODA’02), 2002, pp. 321-328].

We give a deterministic, polynomial time online algorithm for finding vertex-disjoint paths of a prescribed length between given pairs of vertices in an expander graph. Our result answers a question of Alon and Capalbo [48th annual IEEE symposium on foundations of computer science (FOCS’07), 2007, pp. 518-524].

We show that relatively weak bounds on the spectral ratio

λ

/

d

\lambda /d

of

d
d

-regular graphs force the existence of a topological minor of

K
t

K_t

where

t
=
(
1
−
o
(
1
)
)
d

t=(1-o(1))d

. We also exhibit a construction which shows that the theoretical maximum

t
=
d
+
1

t=d+1

cannot be attained even if

λ
=
O
(

d

)

\lambda =O(\sqrt {d})

. This answers a question of Fountoulakis, Kühn and Osthus [Random Structures Algorithms 35 (2009), pp. 444-463].
Detecting drug diversion in health-system data using machine learning and advanced analytics
Authors: Knight Tom , May Bernie , Tyson Don , McAuley Scott , Letzkus Pam , Enright Sharon Murphy
Published: February 2022

Purpose

The theft of drugs from healthcare facilities, also known as drug diversion, occurs frequently but is often undetected. This paper describes a research study to develop and test novel drug diversion detection methods. Improved diversion detection and reduction in diversion improves patient safety, limits harm to the person diverting, reduces the public health impact of substance use disorder, and mitigates significant liability risk to pharmacists and their organizations.

Methods

Ten acute care inpatient hospitals across 4 independent health systems extracted 2 datasets from various health information technology systems. Both datasets were consolidated, normalized, classified, and sampled to provide a harmonious dataset for analysis. Supervised machine learning methods were iteratively used on the initial sample dataset to train algorithms to classify medication movement transactions as involving a low or high risk of diversion. Thereafter, the resulting machine learning model classified the risk of diversion in a historical dataset capturing 8 to 24 months of history that included 27.9 million medication movement transactions by 19,037 nursing, 1,047 pharmacy, and 712 anesthesia clinicians and that included 22 known, blinded diversion cases to measure when the model would have detected the diversion compared to when the diversion was actually detected by existing methods.

Results

The machine learning model had 96.3% accuracy, 95.9% specificity, and 96.6% sensitivity in detecting transactions involving a high risk of diversion using the initial sample dataset. In subsequent testing using the much larger historical dataset, the analytics detected known diversion cases (n = 22) in blinded data faster than existing detection methods (a mean of 160 days and a median of 74 days faster; range, 7-579 days faster).

Conclusion

The study showed that (1) consolidated datasets and (2) supervised machine learning can detect known diversion cases faster than existing detection methods. Users of the technology also noted improved investigation efficiency.
Improving the specificity of drug-drug interaction alerts: Can it be done?
Authors: Reese Thomas , Wright Adam , Liu Siru , Boyce Richard , Romero Andrew , Del Fiol Guilherme , Kawamoto Kensaku , Malone Daniel
Published: February 2022

Purpose

Inaccurate and nonspecific medication alerts contribute to high override rates, alert fatigue, and ultimately patient harm. Drug-drug interaction (DDI) alerts often fail to account for factors that could reduce risk; further, drugs that trigger alerts are often inconsistently grouped into value sets. Toward improving the specificity of DDI alerts, the objectives of this study were to (1) highlight the inconsistency of drug value sets for triggering DDI alerts and (2) demonstrate a method of classifying factors that can be used to modify the risk of harm from a DDI.

Methods

This was a proof-of-concept study focused on 15 well-known DDIs. Using 3 drug interaction references, we extracted 2 drug value sets and any available order- and patient-related factors for each DDI. Fleiss’ kappa was used to measure the consistency of value sets among references. Risk-modifying factors were classified as order parameters (eg, route and dose) or patient characteristics (eg, comorbidities and laboratory results).

Results

Seventeen value sets (56%) had nonsignificant agreement. Agreement among the remaining 13 value sets was on average moderate. Thirty-three factors that could reduce risk in 14 of 15 DDIs (93%) were identified. Most risk-modifying factors (67%) were classified as order parameters.

Conclusion

This study demonstrates the importance of increasing the consistency of drug value sets that trigger DDI alerts and how alert specificity and usefulness can be improved with risk-modifying factors obtained from drug references. It may be difficult to operationalize certain factors to reduce unnecessary alerts; however, factors can be used to support decisions by providing contextual information.
A review of SNP heritability estimation methods
Authors: Tang Mingsheng , Wang Tong , Zhang Xuefen
Published: February 2022

Over the past decade, statistical methods have been developed to estimate single nucleotide polymorphism (SNP) heritability, which measures the proportion of phenotypic variance explained by all measured SNPs in the data. Estimates of SNP heritability measure the degree to which the available genetic variants influence phenotypes and improve our understanding of the genetic architecture of complex phenotypes. In this article, we review the recently developed and commonly used SNP heritability estimation methods for continuous and binary phenotypes from the perspective of model assumptions and parameter optimization. We primarily focus on their capacity to handle multiple phenotypes and longitudinal measurements, their ability for SNP heritability partition and their use of individual-level data versus summary statistics. State-of-the-art statistical methods that are scalable to the UK Biobank dataset are also elucidated in detail.
A survey on the algorithm and development of multiple sequence alignment
Authors: Zhang Yongqing , Zhang Qiang , Zhou Jiliu , Zou Quan
Published: February 2022

Multiple sequence alignment (MSA) is an essential cornerstone in bioinformatics, which can reveal the potential information in biological sequences, such as function, evolution and structure. MSA is widely used in many bioinformatics scenarios, such as phylogenetic analysis, protein analysis and genomic analysis. However, MSA faces new challenges with the gradual increase in sequence scale and the increasing demand for alignment accuracy. Therefore, developing an efficient and accurate strategy for MSA has become one of the research hotspots in bioinformatics. In this work, we mainly summarize the algorithms for MSA and its applications in bioinformatics. To provide a structured and clear perspective, we systematically introduce MSA’s knowledge, including background, database, metric and benchmark. Besides, we list the most common applications of MSA in the field of bioinformatics, including database searching, phylogenetic analysis, genomic analysis, metagenomic analysis and protein analysis. Furthermore, we categorize and analyze classical and state-of-the-art algorithms, divided into progressive alignment, iterative algorithm, heuristics, machine learning and divide-and-conquer. Moreover, we also discuss the challenges and opportunities of MSA in bioinformatics. Our work provides a comprehensive survey of MSA applications and their relevant algorithms. It could bring valuable insights for researchers to contribute their knowledge to MSA and relevant studies.
The experimental provision of calcium increases the reproductive success of passerine birds
Authors: Briggs Kevin B , Mainwaring Mark C
Published: February 2022

The role of the availability of calcium in limiting the breeding success and intensity of eggshell specking in birds remains unclear. Experimentally, we provided blue tits (Cyanistes caeruleus) and great tits (Parus major) in woodlands with underlying calcium-rich limestone or calcium-poor gritstone with calcium during the egg stage or during the entire reproductive period and examined their breeding success and eggshell speckling. When provided with calcium during the egg stage, experimental blue tits laid larger clutch sizes with higher clutch weights than controls, whilst experimental great tits had higher fledging success than controls. When provided with calcium throughout reproduction, there was no effect of treatment on blue tit reproductive success, but experimental great tits had higher hatching success and nestling masses than controls. Additional calcium during the egg stage resulted in experimental great tits, but not blue tits, laying less speckled eggs than controls, and additional calcium throughout reproduction led to experimental blue tits and great tits laying less speckled eggs than controls. The provision of calcium led to both species generally having higher levels of reproductive success and less speckled eggs than controls, irrespective of habitat geology, meaning that calcium availability does determine avian breeding success and eggshell specking.
Non-invasive oocyte quality assessment
Authors: Sciorio Romualdo , Miranian Daniel , Smith Gary D
Published: February 2022

Oocyte quality is perhaps the most important limiting factor in female fertility; however, the current methods of determining oocyte competence are only marginally capable of predicting a successful pregnancy. We aim to review the predictive value of non-invasive techniques for the assessment of human oocytes and their related cells and biofluids that pertain to their developmental competence. Investigation of the proteome, transcriptome, and hormonal makeup of follicular fluid, as well as cumulus-oocyte complexes are currently underway; however, prospective randomized non-selection-controlled trials of the future are needed before determining their prognostic value. The biological significance of polar body morphology and genetics are still unknown and the subject of debate. The predictive utility of zygotic viscoelasticity for embryo development has been demonstrated, but similar studies performed on oocytes have yet to be conducted. Metabolic profiling of culture media using human oocytes are also limited and may require integration of automated, high-throughput targeted metabolomic assessments in real time with microfluidic platforms. Light exposure to oocytes can be detrimental to subsequent development and utilization of time-lapse imaging and morphometrics of oocytes is wanting. Polarized light, Raman microspectroscopy, and coherent anti-Stokes Raman scattering are a few novel imaging tools that may play a more important role in future oocyte assessment. Ultimately, the integration of chemistry, genomics, microfluidics, microscopy, physics, and other biomedical engineering technologies into the basic studies of oocyte biology, and in testing and perfecting practical solutions of oocyte evaluation, are the future for non-invasive assessment of oocytes.
PlasticDB: a database of microorganisms and proteins linked to plastic biodegradation
Authors: Gambarini Victor , Pantos Olga , Kingsbury Joanne M , Weaver Louise , Handley Kim M , Lear Gavin
Published: February 2022

The number of publications reporting putative plastic-degrading microbes and proteins is continuously increasing, necessitating the compilation of these data and the development of tools to facilitate their analysis. We developed the PlasticDB web application to address this need, which comprises a database of microorganisms and proteins reported to biodegrade plastics. Associated metadata, such as the techniques utilized to assess biodegradation, the environmental source of microbial isolate and presumed thermophilic traits are also reported. Proteins in the database are categorized according to the plastic type they are reported to degrade. Each protein structure has been predicted in silico and can be visualized or downloaded for further investigation. In addition to standard database functionalities, such as searching, filtering and retrieving database records, we implemented several analytical tools that accept inputs, including gene, genome, metagenome, transcriptomes, metatranscriptomes and taxa table data. Users can now analyze their datasets for the presence of putative plastic-degrading species and potential plastic-degrading proteins and pathways from those species.

Database URL:http://plasticdb.org.
Left atrial reservoir strain may be a load independent index of diastolic dysfunction in liver cirrhosis patients
Authors: Dimitroglou Y , Aggeli C , Alexopoulou A , Alexopoulos T , Patsourakos D , Polytarchou K , Kakiouzi V , Tsartsalis D , Valatsou A , Kastellanos S , Raftopoulos L , Angelis A , Mani I , Tousoulis D , Tsioufis K
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction

Cirrhotic cardiomyopathy is characterized by high cardiac output, reduced peripheral resistance and diastolic dysfunction. Specifically, diastolic dysfunction has been correlated with the prognosis in liver cirrhotis patients independently of the disease severity. Left atrial reservoir strain (LASr) is a novel index which is inversely correlated with left ventricular end-diastolic pressure, but has not been adequately studied in cirrhotic patients.

Purpose

To investigate the correlations between LASr and diastolic function or disease severity in cirrhotic patients.

Methods

  Echocardiographic analysis of 51 consecutive cirrhotic patients was performed and images were analyzed off-line. LASr was calculated semi-automatically using dedicated software and was feasible in 49 patients.  Clinical and biochemical examination was used to assess severity of liver disease by calculating MELD-Na score.

Results

Mean age was 58.0± 8.6 years, 37 (75.5%) were males, mean MELD-Na score was 15.6 ±7.5 and mean LASr was 39.7 ±12.5. LASr correlated with age (r=-0.415, p = 0.003), LAVI (r=-0.329, p = 0.022), e’ (r = 0.476, p = 0.001), E/e (r=-0.401, p = 0.004) and GLS (r=-0.388, p = 0.006), but not with ejection fraction, stroke volume or MELD-Na score.  MELD-Na score correlated with ejection fraction (r = 0.316, p = 0.029), stroke volume (r = 0.549, p < 0.001), left atrial volume index (r = 0.575, p < 0.001), GLS (r = 0.521, p < 0.001), right atrial end systolic area (r = 0.368, p = 0.011) and right ventricular diameter (r = 0.541, p < 0.001) reflecting high cardiac output state in patients with advanced cirrhosis. LASr was significantly lower in patients with E/e’ >14 (22.5 ± 13.6) when compared to patients with E/e’ 8-14 (37.3± 10.6, p = 0.039) and E/e’<8 (44.7± 12.0, p = 0.003). The two latter groups also differed significantly (p = 0.034). LASr correlation with E/e’ was the only statistically significant correlation in a multiple regression model including left ventricular end diastolic volume, ejection fraction and left atrial volume (B=-1.371, P = 0.023). Correlation of LASr with MELD-Na score remained non-significant.

Conclusion

LASr correlates inversely with E/e’ ratio in liver cirrhotic patients, but does not correlate with load dependent echocardiographic parameters and disease severity. Hence in this special population, LASr may be an earlier and more specific index of diastolic dysfunction than traditional echocardiographic indices. Further studies are needed to examine the prognostic significance of LASr in cirrhotic patients.
Phasic left atrial strain to predict diastolic dysfunction development in women: results from the prospective Berlin Female Risk Evaluation (BEFRI) follow up trial
Authors: Brand A , Romero Dorta E , Blaschke-Waluga D , Wolf A , Stangl K , Seeland U , Regitz-Zagrosek V , Knebel F , Dreger H , Stangl V
Published: February 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Supported by the DZHK (German Centre for Cardiovascular Research) and by the BMBF (German Ministry of Education and Research)

OnBehalf

BEFRI

Background/Introduction: During the past few years, left atrial strain (LAS) has been identified to be significantly associated with left ventricular diastolic dysfunction (DD). However, the predictive value of LAS reductions on the course of DD in patients without or mild DD has so far not been investigated.

Purpose

To assess the predictive impact of phasic left atrial strain (LAS) reductions on the development of left ventricular (LV) diastolic function in women with normal (DD0) or mildly impaired diastolic function in a longitudinal study design.

Methods

We reinvited 449 participants of the Berlin Female Risk Evaluation (BEFRI) study for follow-up examinations. A comprehensive clinical and echocardiographic assessment comprising the analysis of phasic LAS was performed in 256 participants. The diagnostic and predictive value of LAS analysis was assessed and compared with standard echocardiographic DD parameters using receiver operating characteristic (ROC) curve analyses and a multivariate logistic regression model. 

Results

After a mean time interval of 6.8 years, subjects with DD0 at baseline investigation and a worsening of diastolic function of at least one stage according to recent ASE / EACVI recommendations (DD_progress) showed a significantly reduced baseline LA reservoir strain (LASr) and conduit strain (LAScd) [LASr 28.1% (6.9) in DD_progress vs. 41.9% (8.5) in DD0 at follow up; and LAScd -13.2% (5.0) in DD_progress vs. -25.4% (9.1) in DD0 at follow up; p < 0.001 respectively]. With an area under the curve (AUC) of 0.89 [95% confidence interval (CI) 0.83-0.94], and 0.85 (95% CI 0.80-0.90), LASr and LAScd showed the highest discriminative value to predict DD_progress while the echocardiographic standard DD parameter left atrial volume index (LAVI) featured a limited predictive diagnostic accuracy [AUC of 0.65 (95%CI 0.52-0.72)]. In a multivariate logistic regression model controlling for age, BMI, and other standard echocardiographic DD parameters including LAVI, only LASr and LAScd remained significantly associated with DD_progress over time. 

Conclusions

In addition to improving the diagnostic accuracy of the current DD algorithm, the analysis of phasic LAS reductions may be useful to predict the development of DD in previously healthy women.
Effect of Sacubitril/Valsartan or enalapril on left ventricular longitudinal strain in patients with hematologic malignancies after bone marrow transplantation
Authors: Katogiannis K , Ikonomidis I , Stamouli M , Makavos G , Tsilivarakis D , Koliou GA , Vythoulkas D , Thymis J , Tsirigotis P
Published: February 2022

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): Hellenic Association of Lipidiology, Atherosclerosis and Vascular disease

Background and Aims

Chemotherapy is known for its potential adverse effects on myocardium. Optimal medical treatment for heart failure may reverse myocardial dysfunction in the early stages of toxicity development. We hypothesized that early initiation of treatment with enalapril or sacubitril/valsartan could prevent cardiotoxicity.

Patients and methods

60 patients (mean age 44,8± 14,1 years old, 34 male) with preserved ejection fraction, who suffered from hematologic malignancies (lymphoma, leukemia) and underwent bone marrow transplantation, were randomized to receive sacubitril/valsartan 24/26 mg bid daily or enalapril 5 mg bid daily or placebo. We measured at baseline, before transplantation, after three and after six months: i) Global Longitudinal Strain of left ventricle (LV) (GLS), ii) Left Ventricular End Diastolic Volume, Left Ventricular End Systolic Volume and Left Ventricular Ejection Fraction (LVEF Simpson’s Method).

Results

The three treatment groups had similar age, sex, atherosclerotic risk factors and cardiotoxic medication before, and after bone marrow transplantation. Compared to baseline, patients treated with sacubitril/valsartan did not show a deterioration of LV GLS at three and six months follow up (GLS=-20.2 ± 3.1% vs -19.8 ± 3.1%, p = 0.551 vs -19.6 ± 3.2%, p = 0.452, respectively). Similarly, compared to baseline, patients treated with enalapril did not show a deterioration of LV GLS at three and six months follow up (GLS=-20.7 ± 3.0% vs -20.5 ± 2.8%, p = 0.772 vs -20.3 ± 3.2%, p = 0.730, respectively). Conversely, patients treated with placebo, presented a significant impairment of LV GLS, at three and six months follow up (GLS=-20,5 ± 1.9% vs -18.5 ± 2.4%, p = 0.003 vs -18.6 ± 2.9%, p = 0.018, respectively). No significant changes were found in LVEF after treatment with sacubitril/valsartan (57,9 ± 5,6% vs 57,6 ± 6,1%, p = 0,733) or enalapril (59.2 ± 6.3% vs 60.4 ± 7.7%, p = 0.464) vs placebo (60,1 ± 5,6% vs 57,8 ± 6,6%, p = 0,166) at six months follow up.

Conclusions

Treatment with sacubitril/valsartan or enalapril prevented deterioration of myocardial deformation six months after bone marrow transplantation in patients with hematologic malignancies and preserved ejection fraction.
Early predictors of the development of pathological postinfarction left ventricular remodeling
Authors: Golubeva A , Galimskaya V , Babina A , Korenkova K , Oleinikov V
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Objective

to assess the ability of standard echocardiography parameters and parameters of myocardial deformation on the 7th-9th day of the STEMI to predict the risk of pathological remodeling in the postinfarction period.

Methods

the study included 114 patients with ST-segment elevation myocardial infarction (STEMI) mean age was 52.3 ± 8.4 years, men prevailed 100 (88%). On the 7th-9th day, echocardiography has been performed using the MyLab device (Italy) with the determination of end-diastolic and systolic volume indices (EDVi, ESVi), left ventricular myocardial mass index (LVMI). Global longitudinal (GLS), circumferential (GCS) and radial (GRS) strain (-%) have been determined using X-Strain ™ software. The development of pathological left ventricular remodeling (an increase in EDVi of more than 20% and / or ESVi of more than 15% at any visit within 48 weeks) has been considered as the end point. Multivariate Cox regression analysis was performed by including significant variables from a one-dimensional model (p <0.05), taking into account the absence of correlations between them.

Results

within 48 weeks, 45 (39%) patients developed pathological postinfarction remodeling. The following strong and independent predictors of the pathological postinfarction remodeling were included in the multivariate predictive model: GLS - RR 0.799 (95% CI 0.735-0.868) (p = 0.001), GRS - 1.047 (95% CI 1.013-1.083) (p = 0.001), EDVi - RR 1.041 (95% CI 1.015-1.07) (p = 0.026). Chi-square model 30.02, p ˂ 0.0001. Maximum likelihood ratio 385.

Conclusions

a multivariate model including GLS, GRS, and EDVi parameters on the 7th-9th day of STEMI is able to predict the development of pathological remodeling in patients within 48 weeks of the postinfarction period.
Correlation of new and traditional indicators of myocardial contractility in ST-segment elevation myocardial infarction
Authors: Golubeva A , Galimskaya V , Babina A , Donetskaya N , Korenkova K , Oleinikov V
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Purpose

to assess the relationship of indicators of global myocardial work of the left ventricle (LV) in patients with ST-segment elevation myocardial infarction (STEMI) with hemodynamic and deformation parameters that traditionally characterize the systolic function of the heart.

Methods

45 people with primary STEMI were included: 13 women and 32 men aged 38 to 66 years (52.3 ± 7.4). Myocardial infarction was confirmed by ECG, biomarkers (troponin I, CPK-MB) and by the results of coronary angiography. Echocardiography has been performed on the 7-9th day of STEMI using a Vivid GE 95 Healthcare ultrasound scanner (USA). EchoPAC software version 202 (GE Healthcare) has been used. The end-diastolic volume index (EDVi, ml / m2), end-systolic volume index (ESVi, ml / m2), LV ejection fraction (EF,%) have been assessed using the Simpson biplane method. The global longitudinal strain (GLS,%) has been determined using the speckle-tracking echocardiography method. The indicators of myocardial work have been automatically calculated: the index of global myocardial work (GWI, mm Hg%), global constructive work (GCW, mm Hg%), and global wasted work (GWW, mm Hg%), global work efficiency (GWE,%). Statistical data processing has been performed using the Statistica 13.0 software package (StatSoft Inc., USA).

Results

the average values of the determined parameters were the following: LVEF - 49.4 ± 6.7%, EDVi - 62.8 ± 12.7 ml / m2, ESVi - 32 ± 8.9 ml / m2, GLS - (-13, 5) ± 4%, GWI - 1192.4 ± 416.2 mm Hg%, GWE - 88.9 ± 6.5%, GCW - 1362.1 ± 442.5 mm Hg%, GWW - 98.5 (69; 130) mm Hg%. The values of the correlation coefficient GWI were: with EF (r = 0.26; p = 0.19), with EDVi (r = -0.3; p = 0.12), with ESVi (r = -0.35; p = 0.07), with GLS (r = 0.85; p = 0.000002). GWE had the following correlation coefficient values: with EF (r = 0.17; p = 0.39), with EDVi (r = -0.42; p = 0.026), with ESVi (r = -0.4; p = 0.025), with GLS (r = 0.74; p = 0.00001). The correlation coefficient of GCW with EF was 0.24 (p = 0.24), with EDVi - (-0.26) (p = 0.19), with ESVi - (- 0.3) (p = 0.1), with GLS - 0.85 (p = 0.000004). The correlation coefficient of GWW with EF was -0.02 (p = 0.9), with EDVi - 0.26 (p = 0.17), with ESVi - 0.2 (p = 0.3), with GLS - 0.37 (p = 0.06).

Conclusion

the analysis of the correlations between the indicators of myocardial work and the determined parameters revealed that GWE had a moderate correlation with EDVi, ESVi. Parameters GWI, GWE, GCW had a strong correlation with GLS.
Evaluation of ventricular strain values in patients after coronavirus 2019 infection
Authors: Chavez Caballero RD , Tuero E , Orlandini A
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

During the first months of coronavirus disease 2019 (COVID 19) pandemic there were several reports of myocardial involvement in recovered patients despite of symptoms presented during acute phase of the infection. That information led to a rising number of recomendations of screening for myocardial damage with different methods like electrocardiogram, echocardiography, cardiac magnetic resonance and biomarkers in the pursuit of a cardiac event free return to normal activities. Because of this and knowing the capability of strain imaging to detect subclinical myocardial damage we decided to evaluate values of left ventricular global longitudinal strain (GLS) and right ventricular free wall strain (RVFWS) in patients that were derived for echocardiographic evaluation after COVID 19 infection and their evolution.

Methods

We enrolled prospectively patients derived to our laboratory for evaluation of Doppler echocardiography after confirmed COVID 19 infection if they were in the month after clinical discharge and did not have previous known structural cardiac alterations. We obtained demographic, symptoms and echocardiographic data and calculated GLS and RVFWS. Six months after the index examination we did phone calls to asess symptoms and events. Data is presented with mean and standard deviation and percentages.

Results

Of 68 patients included 38 (55,88%) were male, mean age was 42 years (+- 12,5) and half of them were sedentary. 52 had mild symptoms during infection, 15 moderate and 1 severe that required mechanical ventilation. At the time of examination 58 were asymptomatic (85,29%) and the other complaint of dyspnea (3), weakness (8) and palpitations (6). Regarding echocardiographic data, mean eyection fraction estimated by Simpson´s biplane method was 65,6% (+- 4,33) and left atrial indexed volume 25 ml/m2 (+- 5,98). 44 patients had normal left ventricular diastolic function, 21 grade 1 dysfunction and 2  had grade 2, with mean E/e´ relation 8,52 (+-2,03). Mean pulmonary artery systolic pressure estimated was 27,4 mmHg (+- 4,1) and tricuspid anular plane systolic excursion was 23,81 mm (+-3,12). Mean GLS was – 21,52% (+- 1,91) and RVFWS was – 29,15% (+- 5,4), in 2 patients we could not measure RVFWS due to bad quality of images. Only 2 patients had GLS above – 18%, thta were the patient with severe symptoms and 1 with moderate symptoms; and 10 had RVFWS above – 23%, all of them with moderate symptoms. We could contact 60 patients (88,23%) after 6 months and none of them had cardiac events or persistence of symptoms.

Conclusions

Calculation of GLS and RVFWS in this patients was feasible. We observed abnormalities in patients with severe and moderate symptoms at the time of infection, more frequently in RVFWS, but without relation to cardiac events or symptoms on follow up. Abstract Figure. GLS and RVFWS values
Left atrial functional remodeling assessed by echocardiography in patients undergoing ablation for atrial fibrillation: correlation with the presence of fibrosis and invasive atrial pressure
Authors: Dal Porto M , Dematte" C , Maines M , Giovanelli C , Vinco G , Setti E , Cemin C , Rossi A , Benfari G , Fezzi S , Catanzariti D , Ribichini FL , Del Greco M
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Radiofrequency catheter ablation of pulmonary veins has become a common procedure for treatment of atrial fibrillation (AF). Nevertheless, the procedure is characterized by an extremely variable success rate, which reflects a great heterogeneity of factors implicated in AF recurrence and AF burden.

Purpose

We focused on the role of left atrium (LA) in patients with paroxysmal and persistent AF who underwent catheter pulmonary veins ablation procedure. In particular we paid attention to three factors: echocardiographic evaluation of LA function, LA scar evaluated by electroanatomic mapping and LA pressures (LAP) during ablation procedure. The aim of the study was to investigate the correlation between echocardiographic parameters indicating atrial dysfunction (LA volume indexed, E/E’, LAA contraction velocity, LA stiffness and LA longitudinal strain during reservoir phase (LASr)) and intraprocedural parameters (such as LAPpeak and the amount of fibrosis).

Methods

 The study included 25 patients; mean age was 63 ± 8 years; nineteen patients (76%) had paroxysmal AF, eighteen patients (72%) were in sinus rhythm at the time of ablation. The population was divided into two subgroups according to the amount of fibrosis evaluated by electroanatomic mapping: patients with fibrosis ≥ 5% of the total LA volume were considered as having an atrial scar. All patients underwent a comprehensive transthoracic echocardiography and a transesophageal echocardiography before the ablation procedure. Intraprocedural data regarding LAPpeak and electroanatomic mapping were collected. Measurements were acquired during both sinus rhythm (SR) and AF.

Results

Patients with atrial scar had similar LA volume compared to patients without scar (44  ml vs 37.4 ml, p = 0.108) , but presented a trend towards higher LAPpeak (24.3 mmHg vs 15.9 mmHg, p = 0.053) and had higher E/E’ (11 vs 7, p = 0.037) and consequently increased LA stiffness (0.72 vs 0.23, p= 0.006). Still, they had lower LASr  (16.6% vs 33.2%, p = 0.013) and tended to have reduced LAA contraction velocity (0.4 m/sec vs 0.7 m/sec, p= 0.005).

Conclusions

The present findings suggest that functional remodeling of the LA, more than morphological changes, are correlated with the presence of atrial fibrosis and elevated atrial pressure detected during ablation procedures. These parameters may represent potential criteria to guide patients’ selection for ablation procedure and deserve dedicated studies to be confirmed. Abstract Figure.
Right heart chambers geometry and function in patients with the atrial and the ventricular phenotypes of functional tricuspid regurgitation
Authors: Florescu D , Muraru D , Florescu C , Gavazzoni M , Volpato V , Caravita S , Tomaselli M , Balseanu TA , Parati G , Badano LP
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction — Atrial functional tricuspid regurgitation (A-FTR) is a recently defined phenotype of FTR associated with persistent/permanent atrial fibrillation. Differently from the classical ventricular form of FTR (V-FTR), patients with A-FTR might present with severely dilated right atrium (RA) and tricuspid annulus (TA), and with preserved right ventricular (RV) size and systolic function. However, the geometry and function of the RV, RA and TA in patients with A-FTR and V-FTR remain to be systematically evaluated.

Purpose — Accordingly, we sought to: i. study the geometry and function of the RV, RA and TA in A-FTR by two- and three-dimensional transthoracic echocardiography; and ii. compare them with those found in V-FTR.

Methods — We prospectively analysed 113 (44 men, age 68 ± 18 years) FTR patients (A-FTR = 55 and V-FTR = 58) that were compared to two groups of age- and sex-matched controls to develop the respective Z-scores.

Results — The severity of FTR, and the degree of TA dilation were similar in A-FTR and V-FTR patients. The Z-scores of RV size were significantly larger, and those of RV function were significantly lower in V-FTR than in A-FTR (p < 0.001 for all). The RA was significantly enlarged in both A-FTR and V-FTR compared to controls (p < 0.001, Z-scores > 2), with similar RA maximal volumes (RAVmax) between A-FTR and V-FTR (p = 0.2). Whereas, the RA minimal volumes (RAVmin) were significantly larger in A-FTR than in V-FTR (p = 0.001).

Conclusion — Despite similar degrees of FTR, RAVmax and TA size, A-FTR patients show larger RAVmin than V-FTR patients. Conversely, V-FTR patients show dilated, more elliptic and dysfunctional RV than A-FTR patients. Abstract Figure. A-FTR versus V-FTR  Abstract Figure. Remodelling patterns in A-FTR and V-FTR
Routine use of automated strain analysis and 3D echocardiography provides a more comprehensive assessment of cardiac chambers than conventional 2D echocardiography and is time-saving
Authors: Volpato V , Ciampi P , Johnson R , Hipke K , Tomaselli M , Oliverio G , Muraru D , Lang RM , Badano LP
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background. In most laboratories three-dimensional echocardiography (3DE) and longitudinal strain (Lstrain) analysis are not part of the routine studies. Although these modalities have been shown to provide additional clinical information and prognostic value compared to conventional two-dimensional echocardiography (2DE), their acquisition and analysis are perceived as being time-consuming.  Recently, new automated tools have been developed to perform accurate, fast and reproducible analyses of heart chambers’ geometry and function. However, their cost-effectiveness when compared to conventional 2DE remains to be demonstrated.

Aim. We designed a prospective, multicenter, observational study aimed to compare the time required for the acquisition and analysis of conventional transthoracic 2DE vs advanced echocardiography (AEcho, i.e. 3DE+ Lstrain) for the assessment of cardiac chambers and myocardial mechanics.

Methods. According to current guidelines, 196 consecutive patients referred for clinically indicated echocardiography underwent complete 2DE and Doppler echocardiography. In addition, 3DE datasets of the left atrium (LA), left and right ventricle (LV, RV) were acquired using automated 3DE software package (Heart Model). Acquisition time for both 2DE and 3DE images were recorded. Conventional 2DE analyses of LA (biplane volume), LV (biplane volumes and mass) and RV (both linear dimensions, areas, and longitudinal function) were performed following current guidelines, and the time required for acquisition and analysis was recorded. The time spent for AEcho analysis (both 3DE volumetric analysis and Lstrain of LA, LV and RV) was also recorded.

Results. Feasibility of AEcho was 86% (169 patients). The additional time for 3D dataset acquisition over conventional 2DE was 38 ± 0.16 sec. Quantitative analysis of the cardiac chambers by 2DE required an average of 5.55 ± 1.51 min vs 4.25 ± 1.23 min using AEcho (p < 0.001). Total time for both 3D dataset acquisition and AEcho assessment was 5.03 ± 1.28 min vs 5.55 ± 1.51 min of 2DE analysis alone (p < 0.001). Globally, AEcho provided a more comprehensive assessment of heart chambers than 2DE (Table). Moreover, the time spent for 3DE dataset acquisition and AEcho analysis on top of standard 2DE acquisition was significantly shorter compared to the 2DE acquisition and analysis (18:50 ± 4.23 vs 19:42 ± 4.24 min, p < 0.001) (Table).

Conclusions. Our data showed that the use of new AEcho automated tools are highly feasible resulting in significant time-savings compared to standard 2DE evaluation, while providing significant additional information. Abstract Table
Impact of post- transplant diabetes on left ventricular function following heart transplantation
Authors: Borgenvik S , Jumatate R , Giesdal G , Werther Evaldsson A , Braun O , Smith JG , Radegran G , Meurling C , Ingvarsson A
Published: February 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Orthotopic heart transplantation (OHT) is a standard treatment option for end-stage heart failure (HF). Although post-transplant diabetes (PTDM) is a main complication due to immunosuppressive corticosteroid treatment, its impact on left ventricular (LV) function following OHT has not been described.

Purpose

The purpose of this study was to analyse the possible effect of PTDM on LV function in OHT patients using conventional and speckle tracking echocardiography. Furthermore, this study aimed to compare echocardiographic LV function parameters to clinical parameters, including heart rate, blood pressure, and Hemoglobin A1C (HbA1c) in OHT recipients with or without PTDM.

Methods

We performed a retrospective study including 77 (59 males) OHT patients (PTDM n = 29) using data from the routine 3-year follow-up. The mean age of the study population was 52 ± 14 years. All patients were examined using 2-dimensional transthoracic echocardiography with an ultrasound system equipped with a S5-1 transducer. Systolic-, diastolic blood pressure, heart rate, and HbA1c levels were recorded in conjunction with the TTE examination for each participant.

Results

Participants with PTDM had impaired LV function measured by global longitudinal strain (LVGLS), increased septum diameter, and a lower diastolic EA-ratio compared to the non- PTDM patients. Additionally, a significant correlation between high HbA1c levels and poor LVGLS was detected. 

Conclusion

We found that subtle LV dysfunction, including remodeling of the heart (i.e., increased wall thickness), reduced longitudinal contractile function, and altered diastolic function, was present in OHT patients with PTDM. Our findings suggest that sub-clinical myocardial dysfunction in OHT patients with PTDM is progressive and may evolve to clinical LV dysfunction and HF. Hence, analyzing secondary cardiac effects of PTDM in OHT patients have a therapeutic and prognostic value and may influence long-term patient survival. Abstract Figure.
Left ventricular remodeling patterns in patients with moderate aortic stenosis
Authors: Stassen J , Ewe SH , Hirasawa K , Butcher SC , Singh GK , Ammanullah RA , Ding ZP , Pio SM , Chew NWS , Sia CH , Kong WKF , Poh KK , Marsan NA , Delgado V , Bax JJ
Published: February 2022

Funding Acknowledgements

Type of funding sources: Other. Main funding source(s): ESC Training Grant App000064741

Background

Moderate aortic stenosis (MAS) is associated with an increased risk of adverse events. Although left ventricular (LV) adverse remodeling is associated with worse outcomes in patients with severe AS, the prognostic significance of different patterns of LV remodeling in MAS has not been investigated.

Purpose

To investigate the association between different patterns of LV remodeling on outcomes in patients with MAS.

Methods

Patients with MAS (aortic valve area >1.0 and ≤1.5cm2) were stratified into 4 groups according to the pattern of LV remodeling: normal geometry (NG), concentric remodeling (CR), concentric hypertrophy (CH) or eccentric hypertrophy (EH). Clinical outcomes were defined as all-cause mortality and a composite of all-cause mortality and aortic valve replacement (AVR).

Results

Of 1931 patients (age 73 ± 10 years, 52% men) with MAS, 344 (18%) had NG, 469 (24%) CR, 698 (36%) CH and 420 (22%) EH. Patients with CH were more likely to be female, had more hypertension, were more symptomatic (NYHA ≥III) and had more pronounced LV diastolic dysfunction, whereas patients with EH had more coronary artery disease, were more symptomatic (NYHA ≥III) and had lower LV ejection fraction than patients with NG. Patients with CH had higher aortic mean pressure gradients and peak aortic jet velocities than patients with NG. During a median follow-up of 51 (IQR 25 - 83) months, 833 (43%) patients died. For the composite endpoint, 1286 (67%) patients underwent AVR (n = 613) or died (n = 673) during a median follow-up of 35 (IQR 14 - 60) months. Patients with CH and EH had significantly lower survival rates (p < 0.001; Figure 1) and event-free survival rates (p = 0.004) compared to patients with NG/CR. On multivariable analysis, CH was independently associated with all-cause mortality (HR:1.267; 95% CI:1.024 – 1.568; p = 0.029), whereas both CH (HR:1.293; 95% CI:1.090 – 1.533; p = 0.003) and EH (HR:1.222; 95% CI:1.013 – 1.474; p = 0.036) were associated with the composite endpoint of AVR and all-cause mortality (Figure 2).

Conclusions

In patients with MAS, different patterns of LV remodeling are observed with CH being independently associated with an increased risk of all-cause mortality. Risk stratification according to the different patterns of LV remodeling may help to identify patients with MAS who are at increased risk of adverse events and may benefit from closer follow-up. Abstract Figure. Kaplan-Meier curves  Abstract Figure. Cox regression analysis