bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 10868: Risk Factors and Long-Term Outcomes of Cardiogenic Shock in Young Patients with Myocardial Infarction - The Mass General Brigham Young-MI Registry
Authors: Siddiqi Hasan K , Defilippis Ersilia M , Biery David W , Singh Avinainder , Wu Wanda , Divakaran Sanjay , Berman Adam N , Bohula Erin , Stewart Garrick , DI CARLI MARCELO , Bhatt Deepak L , Blankstein Ron
Published: March 2022

Introduction:
Cardiogenic shock complicating acute myocardial infarction (CS-AMI) is associated with high morbidity and mortality, yet data among younger individuals are limited.

Methods:
Retrospective cohort study of consecutive AMI patients aged 18-50 years admitted to 2 tertiary care academic centers from 2000-2016. CS was determined by physician review of electronic health records (EHR) using the SCAI CS classification system. Baseline characteristics, treatment and outcomes including all-cause mortality (ACM), cardiovascular mortality (CVM) and 1-year hospitalization for heart failure (HHF) were adjudicated by physicians using EHR and death records. Mahalanobis distance matching was used to define a comparator group in the non-CS cohort.

Results:
The study included 2097 AMI patients (mean age 44 ± 5.1 years, 74% white, 81% male), with CS-AMI identified in 148 (7%) patients. There were no significant differences in age, sex or race between groups, although CS-AMI patients were more likely to have public or no insurance (p=0.02). Independent factors associated with CS-AMI included female sex, STEMI at presentation, out of hospital cardiac arrest, left main coronary disease, diabetes and peripheral artery disease. Over a median follow up of 11.2 years, compared to 461 matched non-CS-AMI patients and controlling for relevant covariates, CS-AMI patients had significantly higher ACM (aHR 2.84, p<0.001), CVM (aHR 4.09, p<0.001), and 1-year HHF (aHR 6.18, p=0.001) (Figure 1). In landmark analyses, CS-AMI patients who survived to discharge continued to have significantly higher risk of CVM (aHR 2.76, p=0.016) compared with matched non-CS AMI patients. All results were similar in the full cohort comparison.

Conclusion:
Cardiogenic shock is infrequent amongst young AMI patients, but associated with substantially higher overall and post-discharge mortality, and 1-year heart failure hospitalizations after AMI compared to those without cardiogenic shock.
Abstract 10869: Using All-Cause Mortality to Determine the Best Method for Indexation of Echocardiographic Measures According to Body Size in Obese and Non-Obese Patients
Authors: Fung Angus , Soundappan Dhnanjay , Loewenstein Daniel , Playford David , Strange Geoff , Kozor Rebecca , Otton James , Ugander Martin
Published: March 2022

Introduction:
Body surface area (BSA) is the most widely accepted metric for body size indexation of cardiac measures to improve diagnosis, but its use in obesity is questioned. Furthermore, big data analyses comparing indexation metrics are limited.

Hypothesis:
All-cause mortality can be used to identify an optimal indexation metric for transthoracic echocardiographic (TTE) measures that will be a better predictor of survival than BSA regardless of obesity (body mass index [BMI] ≥30kg/m2).

Methods:
Patients (n=11621) with no prior cardiac surgery, with all TTE measures of interest available, were selected from the National Echo Database Australia. Cox regression survival analysis for all-cause mortality (Wald chi-square) was analyzed for TTE measures both unindexed and indexed to different indexation metrics.

Results:
For both non-obese (n=7684, median BMI 25 kg/m2, age 65 years, 42% female, 4.2 years follow-up, 1586 deaths) and obese patients (n=3937, BMI 34 kg/m2, age 63 years, 42% female, 4.5 years follow-up, 607 deaths), indexation of cardiac sizes (atrial areas, left ventricular mass and diameter, and aortic sinus diameter) to BSA had better prognostic performance (higher chi-square) vs unindexed measures. Indexing by height^2.7 performed worse than BSA. Cardiac output had the best prognostic performance when indexed by weight^3 vs all other metrics (>3-fold higher chi-square). Stroke volume performed better unindexed than when indexed for body size.

Conclusions:
When using all-cause mortality as the arbiter of appropriateness among both non-obese and obese patients, indexation by BSA improved prognostic performance, cardiac output performed best when indexed by weight^3, and stroke volume performed best unindexed.
Abstract 10877: Heterogeneity and Overlap of the Relationships Between Progression of Arterial Stiffness with the Development of Hypertension as Well as with That of Diabetes
Authors: Nakano Hiroki , Shiina Kazuki , taka taka , Fujii Masatsune , IWASAKI YOICHI , Matsumoto Chisa , Yamashina Akira , Chikamori Taishiro , Tomiyama Hirofumi
Published: March 2022

Background:
While co-existence of hypertension and diabetes is frequent, it has not been clarified whether arterial stiffness, a risk for cardiovascular disease, has independent bi-directional relationships with the development of hypertension and with that of diabetes. The present prospective observational study examined whether the increased arterial stiffness is independently related to the development of hypertension alone, that of diabetes mellitus alone and their coexistence and also examined vis versa.

Methods:
A total of 3194 Japanese middle-aged men without hypertension and diabetes at the start of this study (41±9 years old) were included. At the annual health check-ups, the blood pressure, serum glycohemoglobin A1c levels (HbA1c), and brachial--ankle pulse wave velocity (baPWV) were measured annually for 9 years’ period.

Results:
At the end of the study period, 434 participants were diagnosed as having hypertension alone, 19 as having diabetes (HbA1c
>
6.5%) alone / 90 as having impaired glucose metabolism (impG) (HbA1c
>
6.1%) alone, and those as having both co-existence (19 for diabetes / 41 for impG). The baPWV showed significant odds ratios for new onset of hypertension alone (1.53, P<0.01) and new onset of both co-existence (1.81, P=0.05), but not for that of diabetes alone / impG alone. Conversely, mean blood pressure, but not HbA1c, had a significant odds ratio for the high baPWV (
>
1400cm/sec) at the end of study period (1.33, P<0.01). The generalized linear model analyses demonstrated a significant longitudinal association of the baPWV with the presence of hypertension alone (beta = 5.0 x 10
-3
, P<0.01) and both co-existence (beta = 8.0 x 10
-3
, P<0.01), but not that of diabetes / impG alone. The mean blood pressure, but not HbA1c, also have a longitudinal association with high baPWV (beta = 0.11, P<0.01).

Conclusions:
In Japanese middle-aged men, the elevated blood pressure and increased arterial stiffness may have a vicious cycle in the development of hypertension, and the precede of arterial stiffness for the development of diabetes may be a crossing phenomenon for this vicious cycle. Thus, arterial stiffness may be a key element to increase cardiovascular risks in hypertension rather than in diabetes mellitus.
Abstract 10916: Management of Chronic Hypertension Prior to Pregnancy Among Women Veterans
Authors: Harding Ceshae C , Goldstein Karen M , Goldstein Sarah A , Wheeler Sarahn M , Mitchell Nia S , Copeland Laurel A
Published: March 2022

Introduction:
Maternal chronic hypertension (MCH), defined as chronic hypertension affecting pregnancy, has increased rapidly in prevalence among civilians. Although women Veterans have more risk factors for chronic hypertension than civilian women, little is known about MCH in this group.

Methods:
This descriptive, observational study used data from the Surgical Treatment Outcomes for Patients with Psychiatric Disorders (STOPP) project, which includes 11 million Veterans with and without mental illness using the Veterans Health Administration. Women Veterans aged 18-60 years at time of pregnancy identification were included if they had chronic hypertension before pregnancy in fiscal years 2010-2019. We identified chronic hypertension and first pregnancy based on diagnosis codes and defined uncontrolled blood pressure as ≥140/90 mm Hg on at least one measurement in the year prior to pregnancy. For antihypertensive medications (AHMs) that are recommended or not recommended for use in pregnancy, multivariable logistic regression was used to assess the association of comorbidities with (a) non-recommended AHM received 0-6 months before pregnancy, (b) non-recommended AHM received during pregnancy (c) recommended AHM received 0-6 months before pregnancy, and (d) recommended AHM received during pregnancy.

Results:
In total, 9.9% (4,302/43,251) of women Veterans who became pregnant had MCH, with mean age 37.0 years (SD=8.2). Among those with MCH who met inclusion criteria, 62% (N=1,839) had uncontrolled blood pressure in the year prior to pregnancy. Furthermore, 20% (N=611) received a non-recommended AHM 0-6 months before pregnancy, 19% (N=564) received a non-recommended AHM during pregnancy, 26% (N=784) received a recommended AHM 0-6 months before pregnancy, and 33% (N=995) received a recommended AHM during pregnancy. Chronic kidney disease (OR 3.0, 95% CI: 1.6-5.6) and diabetes (OR 2.5, 95% CI:1.9-3.2) were most strongly associated with use of a non-recommended AHM during pregnancy.

Conclusion:
Interventions are needed among women Veterans to decrease the prevalence of MCH, increase blood pressure control prior to pregnancy, and ensure antihypertensives not recommended for use in pregnancy are transitioned to safe alternatives.
Abstract 10921: The Relationship Between Lipoprotein(a) and Cardiovascular Events in Chronic Kidney Disease Patients Hospitalized for Acute Coronary Syndrome
Authors: Li Qing , Yinong Chen , Yu Luyao , Zhu longyang , Zheng jingang , Sun Yihong
Published: March 2022

Introduction:
Patients with chronic kidney disease (CKD) have the high risk of residual cardiovascular events after statin therapy, hence whether elevated lipoprotein(a) [Lp(a)] levels leading to worse outcomes is unclear.

Hypothesis:
High Lp(a) levels are associated with higher risk of major adverse clinical events (MACE) in patients with CKD and acute coronary syndrome (ACS).

Methods:
Patients with CKD (estimated glomerular filtration rate < 60mL/min/1.73m
2
) hospitalized for ACS were enrolled in China-Japan Friendship Hospital from January 2015 to December 2019. Patients were divided into 2 groups according to median levels of Lp(a). The MACE were a composite endpoint of cardiac death, non-fatal myocardial infarction, and non-fatal ischemia stroke. Multivariate Cox regression analysis and restricted cubic spline curve were performed to explore the relationship between Lp(a) levels and MACE.

Results:
A total of 434 ACS patients with CKD were enrolled, with 37.8% were women. The median Lp(a) concentration was 16.7mg/dL. During a median follow-up of 2.8 years, patients had higher risk of MACE (45.2% vs. 14.7%, log rank
p
< 0.001) in the high Lp(a) group than the low Lp(a) group. The relationship between Lp(a) and MACE appeared to be nonlinear. Multivariable Cox regression analysis showed that high Lp(a) value was an independent predictor of MACE compared with low Lp(a) value (HR = 3.33, 95% CI 2.20-5.05,
p
< 0.001). The receiver operating characteristic curve analysis showed that adding Lp(a) concentration to original risk model improved the prognostic model, with area under the curve increasing from 0.69 to 0.74.

Conclusions:
In ACS patients with CKD, high Lp(a) concentrations predict the risk of cardiac death, non-fatal myocardial ischemia and non-fatal ischemia stroke at 2-years follow-up.
Abstract 10922: Depression and Heart Rate Variability in Individuals with Heart Failure - Results from the Myovasc Study
Authors: Ghaemi Kerahrodi Jasmin , Prochaska Juergen , Buch Gregor , Zeid Silav , Coboeken Katrin , Velmeden David , Soehne Jakob , Schuch Alexander , Beutel Manfred E. , Muenzel Thomas , Gori Tomaso , Wild Philipp , Michal Matthias
Published: March 2022

Introduction:
Depression and cardiovascular disease represent two of the most common causes of disability and mortality. In patients with heart failure (HF), depressive symptoms are related to worse outcomes. Reduced heart rate variability (HRV), as a marker for cardiac autonomic dysfunction, is proposed to mediate the relation between depressive symptoms and cardiovascular health.

Hypothesis:
This explorative study aims to identify HRV parameters that are related to the somatic-affective and cognitive-affective dimension of depression in subjects with HF, separatly for HF with reduced (HFrEF; EF < 50 %) and preserved ejection fraction (HFpEF; EF > 50%).

Methods:
We examined the association between depressiveness as assessed by the Patient-Health-Questionnaire-9 (PHQ-9) and HRV parameters from 24h-Holter ECG recording in the MyoVasc study (NCT04064450; N=3,289), a prospective cohort study on chronic HF. HRV parameters related to PHQ-9 have been selected via elastic net regression. Multivariable linear regression analysis adjusted for age, sex, established cardiovascular risk factors, comorbidities, medication and NTpro-BNP has been performed.

Results:
In the analysis sample (HRV analysis in N=1,001), 29.8% had mild depressive symptoms (PHQ-9 = 5-9) and 10.2% had major depressive symptoms (PHQ-9 ≥ 10). Elastic net selected 10 HRV parameters. The severity of depression according to PHQ-9 sum scores correlated with triangular index (HRVi) (coefficient estimate (β)) = -0.02, 95% CI: -0.04, -0.006, p = 0.01), acceleration capacity (β = 0.021, 95% CI: 0.004, -0.04, p = 0.02), deceleration capacity (β = -0.02, 95% CI: -0.04, -0.003, p = 0.02), IRRR (β = -0.02, 95% CI: -0.04, -0.003, p = 0.02), SDANN (β = -0.02, 95% CI: -0.04, -0.004, p=0.02) and ULF (β = -0.03, 95% CI: -0.05, -0.01, p = 0.002). Cognitive dimension of depression correlated with HRVi in subjects with HFrEF (β = -0.08, 95% CI: -0.15, -0.008, p = 0.03). Somatic dimension of depression correlated with acceleration capacity in HFpEF (β = 0.06, 95% CI: 0.0025, 0.11, p = 0.04).

Conclusions:
HRV parameters were consistently more reduced in individuals with more depressive symptoms. Interestingly, HRV parameters differ regarding the cognitive and somatic dimension of depression in individuals with HF.
Abstract 10923: Heart Rate Turbulence and Severity of Atherosclerotic Coronary Lesion in Patients with History of Myocardial Infarction
Authors: Kevorkov Amayak , Tursunov Ergashali
Published: March 2022

Introduction:
Prediction of adverse outcomes in patients after myocardial infarction (MI) remains a serious and not completely resolved problem, which pushes researchers to search for new technologies. One of the relatively promising non-invasive methods for predicting sudden coronary death in patients with coronary heart disease may be an assessment of heart rate turbulence (HRT).

Hypothesis:
to study the association between components of heart rate turbulence (HRT) and severity of atherosclerotic coronary lesion assessed by the SYNTAX and SYNTAX II Scores in patients with a history of myocardial infarction.

Methods:
study enrolled 106 patients with a history of MI in the mean age of 63.6±8.3 years (median age 64 [58; 69] years). The severity of coronary lesions was estimated by diagnostic selective coronary angiography with an assessment of SYNTAX and SYNTAX II Scores. All patients underwent 24-h Holter ECG monitoring. HRT was determined using two indicators: Turbulence Onset (To, %) and Turbulence Slope (Ts, ms/RRi).

Results:
after HRT quantification measurements were as follows: To= -1.28±1.75% (-1.09 [-2.21; -0.40]); Ts= 4.98±4.51 ms/RRi (3.66 [1.65; 7.24]). Mean SYNTAX Score was 16.8±8.5 (16.0 [10.0; 21.5]); SYNTAX Score II PCI - 30.8±8.9 (30.2 [24.7; 37.0]); SYNTAX Score II CABG - 23.8±7.7 (23.6 [19.0; 29.1]); 4 year PCI mortality - 9.4±9.1% (6.9 [4.4; 11.9]); 4 year CABG mortality - 5.0±3.7% (4.1 [2.8; 6.4]). Spearmen analysis revealed positive correlation between To (r=0.266; p=0.047) and SYNTAX Score II PCI and estimated 4-year PCI mortality rate (r=0.267; p=0.047). Negative correlation relationships were observed between Ts indicator and SYNTAX Score II PCI (r= -0.539; p<0.001), SYNTAX Score II CABG (r= -0.318; p=0.017), 4-year PCI mortality rate (r= -0.539; p<0.001) and 4-year CABG mortality rate (r= -0.348; p=0.008). There were no significant correlations between the rests of the analyzed indicators.

Conclusions:
Components of HRT have an association with SYNTAX and SYNTAX II scores. In patients with a history of MI, progressive impairment of baroreflex activity, as evidenced by changes in HRT parameters may indicate a more pronounced lesion of coronary arteries.
Abstract 10926: Importance of Mitochondrial DNA Damage in Cigarette Smoke Extract-Induced Activation of Innate Immune System
Authors: Ueda Keitaro , Ishida Mari , SAKAI CHIEMI , Kobayashi Yusuke , Yoshizumi Masao , Ishida Takafumi
Published: March 2022

Objective:
Smoking is a well-known risk factor for atherosclerosis, yet the mechanism by which smoking causes atherosclerosis remains unclear. It has been reported that inflammation and DNA damage are involved in the formation and development of atherosclerosis. We have previously reported that nuclear DNA damage was increased in peripheral mononuclear cells of smokers compared to those of non-smokers, and that DNA damage was accumulated in atherosclerotic lesions. In this study, to clarify the mechanism by which smoking induces inflammation in vascular endothelial cells, we investigated the effect of cigarette smoke extract (CSE) on both nuclear and mitochondrial DNA damage and the subsequent cellular response in human umbilical vein endothelial cells (HUVEC).

Methods and Results:
CSE increased double-strand breaks in HUVEC. Notably, this increase was detected relatively late (after 3 days of CSE exposure) compared to other genotoxic agents. CSE also increased oxidative DNA damage both in the nucleus and mitochondria and induced mitochondrial dysfunction. Mitochondrial dysfunction decreased cytosolic protein levels of ICAD, an inhibitor of caspase-activated DNase (CAD), which causes nuclear DNA fragmentation, and increased CAD in the nucleus, suggesting that this is one of the mechanisms of nuclear DNA double-strand breaks. In addition, continuous stimulation by CSE induced the accumulation of cytosolic DNA. Interestingly, real-time PCR analysis revealed that the accumulated DNA in the cytosol was derived not only from the nucleus but also from mitochondria. We further examined whether DNA accumulated in the cytosol activated cytosolic DNA-sensing pathways. The production of cGAMP, a second messenger in cGAS (a DNA-sensing receptor) signaling, was increased by CSE. We also found that the mRNA expression of IL-6 was increased by CSE, and that the increase was suppressed by si-cGAS.

Conclusions:
This study showed that continuous exposure to CSE induces not only nuclear but also mitochondrial DNA damage, which leads to cytosolic DNA accumulation, and evokes chronic inflammation via the cGAS-STING pathway.
Abstract 10927: Development and Psychometric Testing of A Heart-Healthy Information Questionnaire
Authors: Choo Jina , Moon Jihyun , Noh Songwhi , Shin Yura
Published: March 2022

Introduction:
Acquiring sufficient information about cardiovascular prevention is a prerequisite for individuals’ decision making to practice heart-healthy lifestyle behaviors. However, no well-validated instrument currently exists to measure the knowledge about information on heart disease symptoms, risk factors, and benefits of heart-healthy behaviors for cardiovascular prevention targeting healthy people. We used systematic scale development procedures to create a scale of the Heart-Healthy Information Questionnaire (HHIQ) based on the Information-Motivation-Behavioral skills model and recent scientific guidelines of cardiovascular prevention.

Methods:
Standard scale development methods were used to create items and test their psychometric properties. Participants were 1,315 people without cardiovascular diseases, who were residing in Seoul Metropolitan city.

Results:
We created preliminary 70 items using a 3-point True/False format with a Don’t know option. The items were two times reviewed by a panel of eight experts in terms of the relevance and clarity of the items, and 54 items were selected by using the cut-off score of content validity index (0.8 or greater). Next, we administrated the questionnaire of 54 items for 1,315 participants, and finally selected 50 items by using the cut-off scores of difficulty index (
<
0.95), discrimination index (
>
10), and item-total correlation (tetrachoric coefficient
>
0.2). The Kuder-Richardson formula 20 coefficient for the HHIQ indicated good internal consistency (0.85), and the test-retest reliability coefficient with a 15-day interval also indicated that it had good stability (0.78). Finally, individuals (n = 107) who were informed from heart-healthy education sessions showed significantly higher scores of the HHIQ than those (n = 1,208) who were not informed (p = 0.009). A total score of the HHIQ was significantly correlated with a total score of the Heart Disease Facts Questionnaire (r = 0.61, p < 0.001) and significantly correlated with a total score of the Evaluation Tool for Metabolic Syndrome Modification Lifestyles (r = 0.23, p < 0.001).

Conclusion:
The HHIQ may be useful to evaluate the knowledge levels of heart-healthy information in the areas of cardiovascular prevention
Abstract 10934: Validity and Reliability of the Korean Version of the Revised Self-Care of Heart Failure Index V7.2
Authors: An Minjeong , Kim JinShil
Published: March 2022

Background:
The psychometric properties of the Korean version of the revised Self-care of Heart Failure Index (K-SCHFI v7.2) remain undetermined.

Objectives:
To examine validity (construct and predictive validity) and reliability of the 29-item K-SCHFI v7.2 in Korean patients with heart failure (HF).

Methods:
Using a cross-sectional, descriptive design, data on self-care and depressive symptoms were obtained for this psychometric testing. Construct validity was tested with confirmatory factor analysis (CFA) and predictive validity was tested through relationships between each self-care scale and depressive symptoms. Reliability was tested with Cronbach’s alpha and McDonald’s omega coefficients.

Results:
Patients with HF participated from four university-affiliated hospitals in South Korea (N = 207; mean age, 59.67 ± 13.87 years; male, 63.6%). CFA supported the construct validity of the K-SCHFI v7.2 (CFI from .931 to .977; RMSEA from .033 to .065), specifically, Self-Care Maintenance (CFI = .950, TLI = .931, SRMR = .063, RMSEA = .048); Symptom Perception (CFI = .931, TLI = .908, SRMR = .047, RMSEA = .065); and Self-Care Management (CFI = .977, TLI = .966, SRMR = .040, RMSEA = .033). Validity was further supportive with the relationships between the self-care and depressive symptoms, with patients with more depressed symptoms having poorer self-maintenance (t = 2.34, p = .018) and self-management (t = 2.00, p = .048). Reliability estimates were marginally satisfactory, with Cronbach's α and McDonald’s omega coefficients of .66 and .72 (Self-Care Maintenance), .78 and .82 (Symptom Perception), and .66 and .70 (Self-Care Management), respectively.

Conclusion:
Validity of the revised K-SCHFI v7.2 was supportive with a sound model fit and the relations to the depressive symptoms. Reliability of each scale was marginally supportive through the alpha and McDonald’s coefficients, while validation is required using a larger sample.
Abstract 10937: Incidence of Cardiac Complications During Index Hospitalisation with COVID-19 in Australia: AUS-COVID Study
Authors: Bhatia Kunwardeep S , Sritharan Hari P , Justin Chia , Ciofani Jonathan , Allahwala Usaid , Chui Karina , Nour Daniel , Vasanthakumar Sheran , Kandadai Dhanvee , Bhagwandeen Rohan , Brieger David , Choong Christopher , Delaney Anthony , Dwivedi Girish , Harris Benjamin , Hillis Graham , Hudson Bernard , Javorsky George , Jepson Nigel , Kanagaratnam Logan , Kotsiou George , Lee Astin , Lo Sidney , Macisaac Andrew I , McQuillan Brendan , Ranasinghe Isuru , Walton Tony , Weaver James , Wilson William , Yong Andy , Zhu John , van Gaal William , Kritharides Leonard , Chow Clara K , Bhindi Ravinay
Published: March 2022

Introduction:
Cardiac complications of COVID-19 include acute cardiac injury, myopericarditis, cardiomyopathy and arrhythmias. This study aimed to describe the incidence of cardiac complications in patients admitted to hospital with COVID-19 in Australia.

Methods:
AUS-COVID is a multicentre observational cohort study across 21 Australian hospitals including all index hospitalisations with laboratory-proven COVID-19 in patients aged 18 years or older. All consecutive patients entered in the AUS-COVID Registry by 28
th
January 2021 were included in the present study.

Results:
Six hundred and forty-four hospitalised patients (62.5 ± 20.1 years old, 51.1% male) with COVID-19 were enrolled in the study. Overall in-hospital mortality was 14.3%. Twenty (3.6%) patients developed new atrial fibrillation or flutter during admission and 9 (1.6%) patients were diagnosed with new heart failure or cardiomyopathy. Three (0.5%) patients developed high grade atrioventricular (AV) block. Two (0.3%) patients were clinically diagnosed with pericarditis or myopericarditis. Among the 295 (45.8%) patients with at least one troponin measurement, 99 (33.6%) had a peak troponin above the upper limit of normal (ULN). In-hospital mortality was higher in patients with raised troponin (32.3% vs 6.1%, p<.001). New onset atrial fibrillation or flutter (6.4% vs 1.0%, p=.001) and troponin elevation above the ULN (50.3% vs 16.4%, p<.001) were more common in patients 65 years and older. There was no significant difference in the rate of cardiac complications between males and females.

Conclusions:
Among patients with COVID-19 requiring hospitalisation in Australia, troponin elevation was common but clinical cardiac sequelae were uncommon. The incidence of atrial arrhythmias and troponin elevation was greatest in patients 65 years and older.
Trial registration:
AUS-COVID. ACTRN12620000486921. http://www.anzctr.org.au/
Abstract 10942: Comparison of Long-Term Prognostic Impact of 6 Major Cardiovascular Drugs in Patients Following Coronary Intervention; Analysis from the Registry Database with the 35-Year History
Authors: Yasuda Hidetoshi , Iwata Hiroshi , Koike Takuma , Chikata Yuichi , Funamizu Takehiro , Doi Shinichiro , Shitara Jun , Endo Hirohisa , Wada Hideki , Naito Ryo , Ogita Manabu , Dohi Tomotaka , Kasai Takatoshi , Okazaki Shinya , Miyauchi Katsumi , Daida Hiroyuki , Minamino Tohru
Published: March 2022

Introduction:
The evidence-based optimal medical therapy has been encouraged in the treatment of patients with coronary artery disease. However, as follow-up periods are limited (-5 years) in the most of randomized trials, prognostic efficacy of drugs in longer time period has not been fully evaluated. Therefore, this registry-based study aimed to simultaneously address the long-term prognostic impact of 6 major classes of cardiovascular (CV) drugs, beta-blockers (BBs), calcium channel blockers (CCBs), angiotensin converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), Statins and Non-aspirin antiplatelets following percutaneous coronary intervention (PCI).

Methods and Results:
This is an analyses of single center prospective registry with lengthy history launched in 1984. Consecutive 6,299 patients underwent first PCI between 1984 and 2018 were included and CV mortality was set as the endpoint. Median and the range of follow-up period is 8.8, 0-28.9 years, respectively. Cox proportional hazard analyses adjusted by age, gender, BMI, diabetes and cardiac and renal function simultaneously evaluated the prognostic impacts of 6 major CV drugs in the entire population and patients with acute coronary syndrome (ACS). Among 6 drugs, ARBs (Hazard Ratio (HR): 0.72, 95% confidence interval (95% CI): 0.55-0.93, p=0.01), Non-aspirin antiplatelets (0.67, 0.53-0.86, p=0.002) and Statins (0.56, 0.44-0.7, p<0.001) were significantly associated with reduced risk of CV mortality in the entire PCI population (
Figure A
). In ACS patients (n=1,790), only Statins at PCI predicted the reduced risk of CV mortality (HR: 0.44, 95%CI 0.28-0.68 p<0.001) (
Figure B
).

Conclusions:
This long-term PCI registry-based analyses demonstrated the significant prognostic efficacy of ARBs, antiplatelets other than aspirin and statins. In ACS patients, only Statins, not other 5 classes of major CV drugs, were associated with reduced risk of CV mortality.
Abstract 10944: A Network Analysis to Identify Pathophysiological Pathways Associated with Systolic Function Recovery After Myocardial Infarction
Authors: Wohlfahrt Peter , Melenovsky Vojtech , Novosadova Vendula , Jenca Dominik , Mrazkova Jolana , Sramko Marek , Zelizko Michael , Kotrc Martin , Zareie Ashkan , Trufen Carlos E , Pitha Jan , Adamkova Vera , Kautzner Josef , Jarolim Petr
Published: March 2022

Introduction:
Identification of factors involved in early stages of left ventricular systolic function recovery after acute myocardial infarction (AMI) can provide a basis for novel therapies. We aimed to characterize proteomic biomarkers and underlying mechanistic pathways associated with improvement of left ventricular systolic function.

Hypothesis:
Proteomic biomarkers and protein-protein interaction pathways differ between patients with and without systolic function recovery after AMI.

Methods:
Patients with ejection fraction (EF) <40% at hospital discharge were selected from a prospective registry of AMI patients (n=819). We used matched case-control design. Cases were patients with EF<40% at hospital discharge, but EF>50% at the follow-up visit 3-6 months after discharge (EF recovery group). Controls were patients with EF<40% both at hospital discharge and follow-up visit. Controls were matched for age, gender, and discharge EF. Blood samples were drawn within 24h since hospital admission. We used proximity extension assays (Olink, Uppsala) to measure plasma biomarkers and protein-protein interaction network to identify pathophysiological pathways distinguishing cases and controls.

Results:
In total, 41 cases and 41 controls (mean age 59±10 years, 73% males) were included. At baseline, study groups did not differ in the main clinical variables. Of the 362 biomarkers tested, and after adjustment for age, gender and baseline EF, 44 proteins were differentially expressed, of which 2 (interleukin 6 and stem cell factor) showed association with EF recovery after false discovery rate correction. In the Reactome pathway analysis, Interleukin-6 family signaling was the most significant pathway associated with systolic function recovery.

Conclusions:
We identified the Interleukin-6 family signaling pathway with IL-6 and leukemia inhibitory factor (LIF) as potential early factors supporting recovery of systolic function after AMI.
Abstract 10952: Increased Hepatic T1 Mapping Prediction of Elevated Right Atrial Pressure in Patients with Dilated Cardiomyopathy
Authors: Watanabe Tomohiko , Kanzaki Yumiko , Tsuda Kosuke , Sakane Kazushi , Yokoyama Ryo , Hoshiga Masaaki
Published: March 2022

Introduction:
Elevated right atrial pressure (RAP) exhibits residual congestion and poor clinical outcomes in patients with heart failure (HF). In HF patients, persistent high RAP causes liver damage, which leads to liver fibrosis. Recent advances in T1 mapping of the liver using MRI allow the quantification of liver fibrosis.

Hypothesis:
Hepatic T1 mapping value may predicts high RAP in patients with chronic HF.

Methods:
We examined the data from the consecutive 40 patients with DCM ( 60 ± 13 years, 27 men) who underwent 3 Tesla cardiac and liver MRI, which were conducted within seven days of right heart catheterization. RV end-diastolic volume (RVEDV), end-systolic volume (RVESV), RV ejection fraction (RVEF), right atrial (RA) and left atrial (LA) volume, left ventricular end-diastolic volume (LVEDV), end-systolic volume (LVESV), LV ejection fraction (LVEF) and LV mass index (LVMI) were calculated from cine cardiac MRI. Native T1 mapping image (T1 short modified look locker inversion recovery-ShMOLLI- sequence) was acquired the heart and the liver (Figure A). Patients were divided into two groups according to RAP; high ( ≥ 8 mmHg; n=10) and low ( <8 mmHg; n=30).

Results:
Ten patients had high RAP. There were no significant differences in LVEDV,LVESV, LVEF, LVMI, RVEDV, RVESV and RVEF between patients with high RAP group and those without ( 192 ± 54 ml vs 212 ± 57 ml; 136 ± 49 ml vs 154 ± 51 ml; 30 ± 9 % vs 28 ± 8 %; 79 ± 21 g/m
2
vs 81 ± 22 g/m
2
; 45 ± 27 ml vs 46 ± 19 ml; 27 ± 18 ml vs 25 ± 15 ml; 42 ± 19% vs 46 ± 18%, respectively). The hepatic T1 mapping value was higher in the high RAP group ( 845 ± 47 ms vs 759 ± 90 ms, p < 0.01) and exhibited a positive correlation with RAP ( R = 0.34, P < 0.05). The hepatic T1 mapping value of ≥ 820ms was the optimal cutoff values for identifying high RAP ( T1: sensitivity, 89%; specificity, 72%; AUC, 0.80, Figure B).

Conclusion:
Increased native T1 mapping value of the liver may be helpful in non-invasively estimating elevated RAP.
Abstract 10954: Quantification of Myocardial Perfusion Reserve Using a Cardiac-Centered Camera: First Comparison with Invasive Indexes of Coronary Microvascular Disease
Authors: djaileb loic , Phan Sy Olivier , De Leiris Nicolas , Canu Marjorie , Seiller Alexandre , Broisat Alexis , Vanzetto Gerald , GHEZZI Catherine , Fagret Daniel , Riou Laurent , Barone Gilles
Published: March 2022

Introduction:
– The invasive quantification of coronary flow reserve (CFR), the index of microcirculatory resistance (IMR), and fractional flow reserve (FFR) allows to assess coronary physiology. Although semi-conductor (CZT) SPECT myocardial perfusion reserve (MPR) has been previously compared with FFR, there are no data documenting the relationships between CZT SPECT MPR on one hand and CFR and/or IMR on the other hand. We assessed the performances of noninvasive CZT SPECT MPR in comparison with invasively determined FFR, CFR, and IMR.

Methods:
– Rest and dipyridamole-induced stress myocardial blood flow and MPR were quantified using
99m
Tc-SestaMIBI and a Discovery NM 530c camera in 26 patients with suspected or known coronary artery disease who underwent conventional invasive coronary angiography. Thermodilution-derived resting and adenosine-induced hyperemic mean transit times, distal intracoronary pressures, and mean aortic pressures were assessed for the quantification of FFR, CFR, and IMR values.

Results:
– Only 2/35 vessels presented with a pathological (<0.8) FFR. A moderate yet significant correlation was observed between regional CZT SPECT MPR and CFR (r=0.40,
P
=.02). The sensitivity, specificity, positive and negative predictive value, and accuracy of regional CZT SPECT MPR
vs
CFR were 69% [44-86%], 94% [74-100%], 91% [65-100%], 77% [56-90%], and 82% [65-93%], respectively. In territories without underlying CAD (n=32), CZT SPECT MPR values were significantly higher in those with CFR≥2 and IMR<25 (negative composite criterion, n=14) than in those with CFR<2 and IMR≥25 (positive composite criterion, n=8, CZT SPECT MPR, 2.6 [2.1-3.6]
vs
1.6 [1.2-1.8]),
P
<.01). Regional CZT SPECT MPR displayed sensitivity, specificity, positive and negative predictive value, and accuracy of 87% [53-99%], 100% [78-100%], 100% [64-100%], 93% [70-99%], and 95% [77-99%] for the diagnosis of a positive composite criterion, respectively.

Conclusions:
– CZT SPECT MPR presented a moderate, significant correlation with thermodilution CFR and good diagnostic performances for the detection of patients at high risk of cardiovascular events (low CFR and high IMR) in the absence of obstructive CAD.
Abstract 10955: The Effects of Acute and Chronic Selective Phosphodiesterase 1 Inhibition in Associated Smooth Muscle Cell-Specific Aging Features
Authors: Golshiri Keivan , Ataei Ataabadi Ehsan , de Vries René , zhang Lei , Chalgeri Suman , Lin Amy , Snyder Gretchen , Davis Robert , Danser Jan H , Roks Anton
Published: March 2022

Introduction:
Aging-related vascular smooth muscle cell (VSMC) remodeling plays an essential role in cardiovascular diseases. Reduced NO-cGMP pathway signalling is a major feature and pathogenic mechanism underlying VSMC dysfunction. Recently, we found that phosphodiesterase (PDE) 1, an enzyme that hydrolyzes and inactivates the cyclic nucleotides cAMP and cGMP, is a potential treatment target for restoring age-related deficits in VSMC signalling. We here tested the effects of PDE1 inhibition in SMC-specific Ercc1 DNA repair mutant mice, a model of isolated, accelerated SMC aging.

Design and Method:
SM22α
Cre+
Ercc1
fl/-
(SMC-KO) and SM22α
Cre+
Ercc1
fl/+
littermate (SMC-LM) mice receive either vehicle or the PDE1 inhibitor lenrispodun (dose 40mg/kg/day) in drinking water for 8 weeks. Reactive hyperemia was measured
in-vivo
at the age of 14 and 25 weeks. Mice were sacrificed at 26 weeks. The endothelium-dependent (ED) and -independent (EI) relaxation of the thoracic aorta was assessed by wire myography. Moreover, we investigated the effect of PDE1 inhibition on the expression of selected PDEs involved in the vasculature by qPCR.

Results:
Reactive hyperemia was dramatically reduced in vehicle-treated SMC-KO vs. SMC-LM at the age of 25 weeks (P=0.0002) but was preserved in lenrispodun-treated SMC-KO mice. In vehicle-treated SMC-KO mice, the ED and EI relaxations were greatly diminished compared to SMC-LM (ED: 23.92±4.34 vs. 68.04±4.86, P<0.0001; EI: 57.93±5.31 vs. 87.43±4.01, P=0.0004). Acute administration of lenrispodun in the organ bath improved both ED and EI responses (ED: 38.61±4.04, P=0.001; EI 69.99±4.29 P=0.01) while the relaxations remained unchanged after chronic lenrispodun treatment. In addition, lenrispodun upregulated PDE1a mRNA expression in SMC-KO, while no changes were observed in other PDEs.

Conclusions:
PDE1 inhibition may therapeutically be useful in restoring age-related vascular dysfunction by preserving microvascular function and potentiating NO-cGMP signaling. Yet, its chronic effects might be counteracted by the upregulation of PDE1a in vasculature. These results warrant further pharmacodynamic profiling of PDE enzyme regulation during chronic PDE1 inhibitor treatment.
Abstract 10959: Phenotypic Age Mediates the Effects of Life's Simple 7 on Reduced Mortality Risk in the US Adults
Authors: Yang Haiming , Wang Yueqing , Xiao Meng , Zhao Yuxuan , Song Mingyu , Yu Huan , liao chunxiao , Pang Yuanjie , Yu Canqing , Gao Wenjing , Li Shengxu , Huang Tao , Lv Jun , Chen Wei , Qi Lu , Li Liming , Sun Dianjianyi
Published: March 2022

Background:
Phenotypic age, a newly developed marker for biological aging, improves risk prediction for adverse health events than chronological age. "Life’s Simple 7" (LS7) is a set of 7 recommended healthy lifestyle metrics proposed by the AHA to improve cardiovascular health. It is unknown, however, whether phenotypic age mediates the protective effects of healthy lifestyles on cardiovascular disease (CVD)- and all-cause mortality.

Methods:
Prospective analyses were performed using NHANES 1999-2010 data (6 cycles) on 9842 adults with linked death records till Dec 31, 2015. Adjusted hazard ratios (aHR) were estimated for phenotypic age, LS7-score, and LS7’s individual components for all-cause and cardiovascular mortality. Mediation analyses were performed using structural equation modeling.

Results:
One point increment in LS7-score was associated with a 0.92 (95% CI 0.87-0.98) year younger in phenotypic age, independent of general demographic characteristics and chronological age. During a median of 10.33-year follow-up, 1616 deaths were recorded, 323 being cardiovascular. One year increment in phenotypic age was associated with a higher risk of all-cause (aHR=1.05, 95% CI 1.04-1.05) and cardiovascular (1.04 [1.03-1.06]) mortality. The mediation analysis revealed that phenotypic age was estimated to mediate 66% and 42% of the total effects of LS7 on all-cause and cardiovascular mortality, respectively.

Conclusion:
Our data indicate that adherence to LS7 guidelines significantly slows down biological aging, which results in a prolonged lifespan as well as a reduced risk of cardiovascular mortality.
Abstract 10970: Added Predictive Value of Right Ventricular Ejection Fraction Compared with Conventional Echocardiographic Measurements in Patients Who Underwent Diverse Cardiovascular Procedures
Authors: Fabian Alexandra , Tolvaj Máté , Tokodi Marton , Lakatos Balint K , Ujvari Adrienn , Zhubi Bakija Fjolla , Ladanyi Zsuzsanna , Tarcza Zsofia , Merkely Béla , Kovacs Attila
Published: March 2022

Introduction:
Right ventricular (RV) ejection fraction (EF) assessed by 3D echocardiography is a powerful measure to detect RV dysfunction. However, its prognostic value in routine clinical practice has been scarcely explored. Accordingly, we aimed at investigating whether RVEF is associated with 2-year all-cause mortality in patients who underwent diverse cardiovascular procedures and to test whether RVEF can overcome conventional echocardiographic parameters in terms of outcome prediction.

Methods:
One hundred and seventy-four patients were retrospectively identified who underwent clinically indicated transthoracic echocardiography comprising 3D acquisitions. The patient population consisted of heart failure with reduced ejection fraction patients (44%), heart transplanted patients (16%), and severe valvular heart disease patients (39%). Beyond conventional echocardiographic measurements, RVEF was quantified by 3D echocardiography. The primary endpoint of our study was all-cause mortality at two years.

Results:
Twenty-four patients (14%) met the primary endpoint. Patients with adverse outcomes had significantly lower RVEF (alive vs. dead; 48±9 vs. 42±9%, p<0.01). However, tricuspid annular plane systolic excursion (21±7 vs. 18±4mm), and RV systolic pressure (36±15 vs. 39±15mmHg) were similar. By Cox analysis, RVEF was found to be associated with adverse outcomes (HR [95% CI]: 0.945 [0.908 - 0.984], p<0.01). By receiver-operator characteristic analysis, RVEF exhibited the highest AUC value compared with the other RV functional measures (0.679; 95% CI: 0.566 - 0.791).

Conclusions:
Conventional echocardiographic measurements may be inadequate to support a granular risk stratification in patients who underwent different cardiac procedures. RVEF may be a robust clinical parameter, which is significantly associated with adverse outcomes.
Abstract 10978:
Ecklonia Stolonifera
Okamura Extract Suppresses Cardiac Hypertrophy and Systolic Dysfunction Through P300-HAT Inhibition
Authors: Katagiri Takahiro , Funamoto Masafumi , Shimizu Kana , Shimizu Satoshi , Sunagawa Yoichi , Katanasaka Yasufumi , Miyazaki Yusuke , Hasegawa Koji , Morimoto Tatsuya
Published: March 2022

Introduction:
Heart failure is the leading cause of death in the world. Cardiomyocyte hypertrophy is observed during the development of heart failure, suggesting that its inhibition is a potential target for the prevention and treatment of heart failure. In this study, we screened a natural compound library using cultured cardiomyocytes and found that
Ecklonia stolonifera
Okamura extract (ESE) suppressed cardiomyocyte hypertrophy.

Hypothesis:
ESE, a perennial brown alga, has been reported to have various bioactive effects, such as antioxidant and anti-inflammatory activity, but its effect on heart failure is still unclear. Therefore, we investigated whether ESE has an inhibitory effect on cardiomyocyte hypertrophic response and on the progression of heart failure in post-myocardial infarction (MI) rats.

Methods and Results:
First, primary cultured cardiomyocytes from neonatal rats were treated with ESE and then stimulated with phenylephrine (PE) for 48 hours. ESE (1000 μg/mL) significantly suppressed PE-induced increases in cardiomyocyte surface area, hypertrophic response gene transcription, and acetylation of histone H3K9. An
in vitro
p300-HAT assay indicated that ESE directly inhibited p300-HAT activity (IC50: 505 μg/mL). Next, one week after the ligation of the left anterior descending artery, rats with moderate MI (left ventricular fractioning shorting (LVFS) <40%) were randomly assigned to three groups: vehicle (saline) (n=9), ESE (0.3 g/kg) (n=10), or ESE (1 g/kg) (n=10). Daily oral administration was repeated for 8 weeks. After treatment, LVFS was significantly higher in the ESE (1 g/kg) group (23.3 ± 0.7%, p<0.05) than in the vehicle group (16.6 ± 1.3%). ESE treatment significantly suppressed MI-induced increases both in myocardial cell diameter and in the mRNA levels of hypertrophic response genes. ESE also inhibited MI-induced perivascular fibrosis and the acetylation of histone H3K9.

Conclusion:
These results suggest that ESE suppresses both hypertrophic responses in cardiomyocytes and the development of heart failure by inhibiting p300-HAT activity. Further studies are needed to clarify the effectiveness of ESE for heart failure therapy.
Abstract 10985: Replacing Dietary Carbohydrates and Refined Grains with Different Alternatives and Risk of Cardiovascular Diseases in a Multi-Ethnic Asian Population
Authors: Lim Charlie G , van Dam Rob M
Published: March 2022

Introduction:
Cardiovascular diseases (CVDs) are a major cause of deaths worldwide, but prospective data on dietary risk factors for CVD in South and Southeast Asian populations are sparse.

Objective:
We aimed to evaluate the relation between macronutrient and food intakes and incidence of major adverse cardiovascular events (MACE) in a multi-ethnic Asian population.

Methods:
We used data from the Singapore Multi-ethnic cohort (
n
= 12,408), a prospective cohort of ethnic Chinese, Malay and Indian adults aged 21–65 years recruited between 2004 to 2010. Dietary intakes were assessed using a validated food frequency questionnaire, and the incidence of MACE was ascertained through data linkage with national registries. Cox proportional hazards model was used to evaluate the associations between dietary intakes and MACE risk.

Results:
Over 125,241 person-years, 746 incident cases of MACE were documented. We observed a direct association between carbohydrate intake and MACE risk (HR 1.35, 95% CI 1.07, 1.71 highest vs. lowest quartile,
P
-trend 0.001). Replacing 5% of energy from carbohydrate with polyunsaturated fat (HR 0.79, 95% CI 0.69, 0.91), but not saturated fat (HR 0.95, 95% CI 0.83, 1.08), was significantly associated with a lower MACE risk. In terms of food groups, replacing 1 serving per day of refined grains with fruit (HR 0.93, 95% CI 0.87, 0.99), vegetables (HR 0.93, 95% CI 0.86, 1.00), and dairy (HR 0.93, 95% CI 0.87, 0.99) was associated with lower MACE risk. Cholesterol intake was associated with a higher MACE risk in ethnic Indians (HR 2.37, 95% CI 1.52, 3.71 highest vs. lowest quartile,
P
-trend <0.001), but not in ethnic Malay or Chinese (
P
-interaction 0.016).

Conclusions:
Moderating carbohydrate intakes by increasing polyunsaturated fat intake and replacing refined grains with fruits, vegetables, and dairy may lower CVD risk in Asian populations.