bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of ADRB1 gene polymorphism with dilated cardiomyopathy
Authors: Chernova A , Nikulina SY , Kuznecova OO
Published: April 2021

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Aim

To evaluate the Association of rs1801252 polymorphism of the ADRB1 gene with dilated idiopathic cardiomyopathy (DCMP) and myocardial dilation of ischemic origin (DMI).

Subjects and methods

The study included patients with ICMP and MD IG in the number of 221 people. The average age of the subjects was in the range of 55.30 ± 9.69 years.

We divided the patients into 2 groups: the first – patients diagnosed with idiopathic dilatation cardiomyopathy and the second-patients with myocardial dilatation of ichemic origin. The number of patients in the first group was 111, including 99 men (89.2%) and 12 women (10.8%). The average age of patients in this group is 51.73 ± 9.74 years, in men 51.00 ± 8.96 years, in women 57.75 ± 3.71 years.

The second group included patients with myocardial dilatation of ischemic origin. Their number is 110 people, including 100 men (91.5%) and 10 women (8.5%). The average age of respondents is 58.68 ± 8.38 years, for men 58.29 ± 8.46 years, for women 62.90 ± 6.29 years.

The control group included patients who had no manifestations of cardiovascular diseases. Their number is 121 people (average age 53.6 ± 4.8 years).

The patients underwent laboratory and instrumental studies, as well as molecular and genetic studies of the A145G polymorphism of the ADRB1 gene (rs1801252 ). All patients underwent coronary angiography. Based on the anamnesis data and instrumental studies, those patients who could be said to have no risk factors for the development of dilatation of the heart cavities were identified in the first group. And those patients who were reliably diagnosed with CHD were in the second group, that is, dilatation of the heart cavities is due to a previous myocardial infarction, existing angina pectoris.

Results

In the group with DCMP 70.3% of patients were carriers of the common homozygous A145A genotype, the heterozygous A145G genotype-27.0%, and the rare homozygous G145G genotype-2.7%. In the control group 71.9% of patients were identified as carriers of a homozygous genotype by a common allele, and 25.3% were carriers heterozygous genotype, and homozygous genotype for a rare allele – 2.7%. Statistical analysis showed no achievement of statistical significance level across any of the genotypes. In the group with DM IG, there was no association with the rs1801252 polymorphism of the ADRB1 gene.

Conclusion

A statistically significant association of rs1801252 of the ADRB1 gene with DCMP was not found. The association of DM IG c rs1801252 could not be confirmed.
Iatrogenic bradyarrhythmia: previous conduction disturbances predicted need for permanent pacing
Authors: Esteves AF , Parreira L , Marinheiro R , Fonseca M , Farinha JM , Pinheiro A , Ferreira J , Mesquita D , Amador P , Lopes A , Fonseca N , Caria R
Published: April 2021

Funding Acknowledgements

Type of funding sources: None.

Background

In bradyarrhythmia due to negative chronotropic medication, the need for permanent pacing after drug discontinuation is not always straightforward.

Purpose

Evaluate prevalence and predictors of the need of permanent pacing in patients with symptomatic bradyarrhythmia under negative chronotropic drugs.

Methods

We retrospectively studied patients admitted to the emergency room between January 2012 and December 2018 with symptomatic bradyarrhythmia who were under negative chronotropic drugs. We analysed patient demographic factors, previous medical history or electrocardiographic abnormalities and concomitant drugs. We evaluated the laboratory results, electrocardiographic and echocardiographic parameters at admission. During follow-up we analysed mortality, re-hospitalizations and device implantation. We used cox regression to assess the predictors of device implantation.

Results

85 patients, were admitted to the emergency room, 47% male, median age 81 (76-87) years.

The majority of patients (39, 46%) were admitted with syncope/presyncope and presented with complete AV block (62 patients, 73%). 54% had previous bundle branch block and most (69%) were taking beta blockers. Of note, 17 (20%) presented with ionic disturbances.

17 (20%) patients needed temporary pacing and 60 (71%) patients needed permanent pacing, implanted during index-hospitalization in 78 (92%) patients. Intra-hospital mortality was 5%.

During a median follow-up of 66 months, 31 (36%) patients were re-hospitalized and 7 (8%) needed device implantation. Global mortality was 26%.

In univariate analysis, previous bundle branch block predicted the need for permanent pacing, while presence of atrial fibrillation, antipsychotic/antidepressant use, acute kidney failure and hypo/hyperkalaemia precluded its requirement.

In multivariate analysis, previous bundle branch block was the only independent predictor of the need for permanent pacing.

Conclusion

In this group of patients with iatrogenic symptomatic bradyarrhythmia, the need for permanent pacing was independently associated with the presence of previous conduction disturbances. Univariate analysisHR (95% CI), p-valueMultivariate analysisHR (95% CI), p-valueAge in years0.987 (0.959-1.016), 0.3330.988 (0.955-1.024), 0.514Previous bundle branch block2.197 (1.137-4.246), 0.0192.081 (1.042-4.156), 0.038Previous atrial fibrillation0.559 (0.321-0.974), 0.0400.903 (0.491-1.662), 0.743Use of antipsychotic/antidepressant drugs0.429 (0.202-0.908), 0.0270.717, (0.276-1860), 0.494Acute kidney failure0.500 (0.281-0.889), 0.0180.950, (0.455-1.984), 0.891Hypo/hyperkalaemia0.359 (0.163-0.792), 0.0110.470, (0.172-1.288), 0.142
Systolic blood pressure and outcome in patients admitted with acute heart failure: a pooled analysis from 4 randomized clinical trials
Authors: Grand J , Miger K , Sajadieh A , Kober L , Torp-Pedersen C , Ertl G , Sendon JL , Maggioni AP , W Nielsen O
Published: April 2021

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): The Danish Heart Foundation

Background

In acute heart failure (AHF), low systolic blood pressure (SBP) has been associated with poor outcome. Less is known of the risk related to normal versus elevated SBP and interaction with left ventricular ejection fraction.

Purpose

The aim of the present study was to assess the association between baseline SBP and short- and long-term outcome in a large cohort of AHF-patients.

Methods

A pooled cohort of four randomized controlled trials investigating the vasodilator serelaxin versus placebo in patients admitted with AHF and an SBP from 125 to 180 mmHg. Endpoints were 180-day all-cause mortality and a short-term composite endpoint (worsening heart failure, all-cause mortality or hospital readmission for HF through Day 14). Left ventricular ejection fraction (LVEF) was categorized into HFrEF (<40%) and HFpEF (= >40%). Multivariable Cox regression was used and adjusted for age, sex, baseline body mass index, HFrEF, serum estimated glomerular filtration rate, allocated treatment (placebo/serelaxin), diabetes mellitus, ischemic heart disease, and atrial fibrillation/flutter.

Measurements and Main Results

A total of 10.533 patients with a mean age of 73 (±12) years and median SBP of 140 (130-150) mmHg were included within mean 8.2 hours from admission. LVEF was assessed in 8493 (81%), and of these, 4294 (51%) had HFrEF. Increasing SBP as a continuous variable was inversely associated with 180-day mortality (HRadjusted: 0.93 [0.88-0.98], p = 0.004 per 10 mmHg increase) and with the composite endpoint (HRadjusted: 0.90 [0.85-0.95], p < 0.0001 per 10 mmHg increase). A significant interaction was observed regarding LVEF, revealing that SBP was not associated with mortality in patients with HFpEF  (HRadjusted: 1.01 [0.94-1.09], p = 0.83 per 10 mmHg increase), but SBP was associated with increased mortality in HFrEF (HRadjusted: 0.80 [0.73-0.88], p < 0.001 per 10 mmHg increase) (Figure).

Conclusions

Elevated SBP is independently associated with favorable short- and long-term outcome in AHF-patients. The association between SBP and mortality was, however, not present in patients with preserved LVEF. Abstract Figure. Survival plots by SBP and LVEF
Age independently predicts hemodynamic, but not arrhythmic STEMI-related complications. Data from a cohort study on 848 STEMI patients
Authors: Serban RC , Hadadi L , Sus I , Lakatos EK , Demjen Z , Ceamburu A , Scridon A
Published: April 2021

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Romanian Ministry of Education and Research, CNCS-UEFISCDI

BACKGROUND

Age is one of the most relevant prognostic factors in patients presenting with ST-segment elevation myocardial infarction (STEMI). However, it remains unknown whether this impaired prognosis is due to the occurrence of hemodynamic and/or arrhythmic STEMI-related complications. Understanding the mechanisms involved in STEMI-related complications with advancing age could significantly improve outcomes in this high-risk population.

PURPOSE

We aimed to investigate the contribution of advanced age to the occurrence of hemodynamic and arrhythmic complications in STEMI patients.

METHODS

A total of 848 consecutive patients treated by primary percutaneous coronary intervention for STEMI were evaluated. Heart failure, cardiogenic shock, asystole, inotropic and diuretic use, and kidney dysfunction were used as in-hospital markers of hemodynamic complications. Ventricular fibrillation, conduction disorders, cardiac stimulation, and antiarrhythmic drugs use were used as markers of arrhythmic complications. The relationship between age and the occurrence of hemodynamic and arrhythmic complications was evaluated. The contribution of age to in-hospital death was also assessed.

RESULTS

In-hospital death occurred in 50 (5.8%) patients; patients who deceased were significantly older than their non-deceased counterparts (70.9 ± 10.9 vs. 61.2 ± 11.8 years; p< 0.0001). There was no association between age and the occurrence of any of the evaluated arrhythmic complications (all p >0.05). However, patients who presented hemodynamic complications were significantly older than those who did not (all p< 0.05). Age >60 years was a significant predictor of hemodynamic complications (p< 0.0001) with 61.7% sensitivity and 60.4% specificity. The association between age and hemodynamic complications remained significant after correction for additional risk factors (i.e., hypertension, diabetes mellitus, pre-existing heart failure, Killip class on admission, symptom onset-to-cardiac catheterization laboratory time interval).

CONCLUSIONS

In the present study, age was identified as an independent predictor of STEMI-related hemodynamic, but not arrhythmic complications. These data indicate that whereas age does not seem to affect the occurrence of STEMI-related rhythm disorders, patients above the age of 60 should particularly benefit from closer follow-up and more intensive strategies to prevent life-threating hemodynamic complications.
Acute coronary syndrome in nonagenarians: gender gap?
Authors: Echarte-Morales JULIO , Martinez Gomez E , Cepas-Guillen PEDRO , Llagostera M , Tundidor Sanz ELENA , Viana Tejedor ANA , Vidal PABLO , Caldentey Adrover G , Borrego Rodriguez JAVIER , Macaya Miguel CARLOS , Flores Umanzor E , Sabate MANEL , Fernandez-Vazquez FELIPE
Published: April 2021

Funding Acknowledgements

Type of funding sources: None.

Background

Ischemic heart disease in the elderly people has increased accordingly with rising hope of life. In patients with acute coronary syndrome (ACS) women have a higher mortality than men. However, it is unknown if these differences remain in nonagenarians.

Purpose

The aim of the study was to evaluate the therapeutic strategies and mortality at 1 year according to gender.

Methods

We retrospectively included in a multicenter study  all consecutive patients > 90 yo admitted with non-ST segment elevation (NSTEMI) or ST segment elevation MI (STEMI) between 2005 and 2018. Strategies treatment and mortality at 1 year by gender were evaluated.

Results

680 patients were included (92.6 ± 2.4 years, 59% women) (Table 1). Women presented a greater prevalence of hypertension arterial. Conservative treatment was more frequent in women (73.5% vs 66.2%, p = 0.04) (Image 1), in particular in STEMI subgroup (p = 0.01). They had less capacity functional evaluated by Barthel index (p <0.01) and higher number of infections during admission than men (17.45% vs. 11.7%, p <0.01). The mortality evaluated at 12 months was similar in both groups (p = 0.38), with a trend of better prognosis in women who underwent percutaneous coronary intervention (PCI) (p = 0.08).

Conclusions

Women had lower functional capacity than men, which could explain that they were more likely to be treated with conservative strategy. Mortality was similar in both genders, however, in the subgroup of patients undergoing PCI, was achieved a trend of lower mortality in women. WomenMenPPatients402.0 (59,1%)278.0 (40,9%)Age92.5 ± 2,292.6 ± 2,50.82STEMI189.0 (47%)120.0 (43%)0.32Hypertension331.0 (82,6%)208.0 (74,8%)0.01CKD84.0 (20,9%)59.0 (21,2%)0.91COPD17.0 (4,2%)54.0 (19,4%)<0.01Barthel index75.084.0<0.01Atypical symptoms82.0 (20,4%)42 (15,1%)0.08GRACE175.0171.00.02LDL97.086.0<0.07PCI44,8%54,3%0.04All cause mortality150.0 (37,3%)113.0 (40,6%)0.38Cardiovascular mortality97.0 (67,8%)63.0 (58,3%)0.12
Factors influencing the survival rate of patients after acute coronary syndrome and percutaneous coronary intervention, 5-year follow-up
Authors: Musikhina N , Kostousova A , Petelina T , Gorbatenko E
Published: April 2021

Funding Acknowledgements

Type of funding sources: Public hospital(s). Main funding source(s): Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science

Introduction

Reduction in mortality from acute coronary syndrome (ACS) is an important medical and social problem. Determination of survival predictors can improve the effectiveness of secondary prevention and medical care provision in patients with ACS.

Aim

To determine the factors influencing 5-year survival in patients after ACS and percutaneous coronary intervention (PCI).

Methods

The study presents data obtained as a result of a registry study The analysis included 135 with ACS and PCI. Patients were contacted and examined in a year, and then 5 years after. The laboratory parameters (lipids, markers of inflammation and endothelial dysfunction) were determined upon admission to the hospital and after 60 months. The probability of 5-year survival for patients undergoing ACS and PCI was assessed by Kaplan-Mayer method. Log-rank test was used to compare the survival rate for the entire follow-up period in two groups. The Cox regression model was used to assess the impact of independent factors on survival and to predict risk of event.

Results

During the follow-up period, 18 people died (the average age of the deceased was 60.9 ± 13.5 years; of the living, 60.0 ± 8.9 years). Survival after 1 year was 97.1%, after 5 years-86.7%. According to the results of the Cox regression analysis, the risk of death increased in the presence of chronic kidney disease (CKD) (HR 15.1; 95 % CI 4.30-52.93; p = 0.001); diabetes mellitus (DM) (HR 3.67; 95% CI 1.18-11.43; p = 0.025) and a history of stroke (HR 9.07; 95% CI 1.85-44.60; p = 0.007). The prognosis was negatively affected by high pulse blood pressure (PBP) ≥ 60 mm Hg (HR 4.68; 95% CI 1.60-13.72; p = 0.005), heart rate >80 beats per minute (OR 4.34; 95% CI 1.51-12.26; p = 0.006). Significant risk factors for death from all causes were the number of platelets (OR 1.011 95% CI 1.003-1.019; p = 0.010), the level of homocysteine (OR 1.172 95% CI 1.008 - 1.364; p = 0.040), and an increase in matrix metalloproteinase-9 (MMP-9) >249 ng/ml (OR 7.052; 95% CI 1.346 - 36.950; p = 0.021).

Conclusions

According to a register study, the survival rate of patients after ACS and PCI after 5 years depended on the presence of comorbid pathology (CKD, DM, and a history of stroke). Factors that had a negative impact on the prognosis were high indicators of PBP and heart rate, as well as laboratory markers of cellular (platelets) and vascular inflammation (homocysteine, MMP9).
Using of optical coherent tomography in the determination of the causes of non-obstructive coronary artery myocardial infarction
Authors: Leonova I , Feoktistova V , Boldueva S , Evdokimov D
Published: April 2021

Funding Acknowledgements

Type of funding sources: None.

The widespread use of coronary angiography (CAG) in patients with acute coronary syndrome led to the understanding that in some patients myocardial infarction (MI) occurs against angiographically unchanged or slightly modified coronary arteries (CA). In such cases, the so-called "type 2 IM" is diagnosed in some patients, however, to determine the true cause of MI, a modern method of investigation such as optical coherence tomography (OCT) is needed to visualize the intima of the CA and detect a minimal atherosclerotic process.

The purpose of the study was to establish the etiology of MI without obstructive coronary artery disease (MINOCA) using OCT.

Materials and methods

160 conclusions of the OCT were analyzed. In 9 (6%) cases, the study was conducted in patients who underwent proven MI (mean age 43,1 ± 13,2, 8 males, 1 female) who had no hemodynamically significant CA stenosis according to CAG data.

Results

in 2 cases (22%) patients had ST elevation MI, thrombotic occlusion of the CA (in one case, thrombaspiration was performed). In both patients, spontaneous dissection of the intima of the unmodified CA was detected in the OCT. The remaining 7 patients had non ST elevation MI, and in 2 cases, a diagnosis of type 2 MI was established: in both patients, atherosclerotic plaque was visualized, narrowing the lumen of the CA less than 50%, in one case MI developed against a background of hypertonic crisis, in another - against a background of spasm of CA. In the remaining 5 patients, OCT revealed subintimal atheromatosis, with elements of local dissection of the intima. Thus, in 78% of patients atherosclerosis of CA of different severity (from the subintimal deposition of lipids to the development of atherosclerotic plaque, narrowing the clearance of the SC by less than 50%) was diagnosed. In the analysis of risk factors for coronary heart disease (CHD), 57% of patients with atheromatous CA had more than 2 risk factors for CHD: 3 (42%) smoked, 5 (71%) - obesity, 4 (57% ) - had arterial hypertension, 3 (42%) had dyslipidemia, 1 (14%) had type 2 diabetes. In the group of patients with spontaneous intima dissection of the CA, 1 patient (woman) did not have CHD risk factors, the 2-nd suffered from obesity and hypertension. For all patients a lifestyle correction was recommended; statins, disaggregants were prescribed, patients with spontaneous dissection of CA had recommendation of examination in the medical-genetic center.

Conclusion

Based on the results of the study, in most cases, the cause of IMBOC development was atherosclerotic lesion of the coronary arteries, which is not always visualized with standard coronary angiography. Basically, the patients were young and middle-aged. Most patients had different risk factors for coronary heart disease.
Time to percutaneous coronary intervention in patients with ST-elevation myocardial infarction undergoing successful systemic fibrinolysis: does early or late make a difference?
Authors: Jackson-Pedroza C , Gallardo-Grajeda A , Dattoli-Alejo C , Gopar-Nieto R , Alfaro-Ponce D , Ruiz-Fuentes O , Pina-Fregoso V , Arias-Mendoza A , Araiza-Garaygordobil D
Published: April 2021

Funding Acknowledgements

Type of funding sources: None.

OnBehalf

PHASE-MX

Background/Introduction: Early routine angiography with subsequent Percutaneous Coronary Intervention (PCI) (if needed) after fibrinolysis reduced the rates of reinfarction and recurrent ischemia compared with a ‘watchful waiting’ strategy. A crucial issue is the optimal time delay between successful lysis and PCI, there is a wide variation in delay in trials from a median of 1.3 h to 17h (CAPITAL AMI, GRACIA-1 and STREAM trials). At present a time window of 2-24h after successful lysis is recommended.

Purpose

  To analyze the incidence of major cardiovascular outcomes in patients with ST-segment elevation myocardial infarction (STEMI) according to the timing of PCI after lysis (pharmacoinvasive strategy, less/more than 24h).

Methods

A retrospective analysis of the PHASE-MX study (ClinicalTrials.gov Identifier: NCT03974581) including patients with STEMI whom underwent pharmacoinvasive strategy during the first 12h since symptom onset. Patients were further stratified according to the time from the use of fibrinolysis to sheat insertion (<24h or >24h) in the completion of pharmacoinvasive strategy. The primary composite endpoint included the occurrence of cardiovascular death, cardiogenic shock, recurrent myocardial infarction or congestive heart failure at 30 days of follow-up.

Results

A total of 171 patients were included, of whom 34 underwent PCI after fibrinolysis in less than 24 hours and 137 underwent PCI in more than 24 hours (95% CI 24-120h). Mostly were male (86.4%), mean age was 56.4 ±12.1 years. The primary composite endpoint occurred in 2 patients (5.8%) in PCI < 24 hours and 12 patients (8.6%) in PCI >24 hours (p 0.58). PCI in <24h after lysis was not associated with a reduced risk of the primary endpoint (HR 0.66 95%CI: 0.14-2.97).

Conclusion

In patients with successful fibrinolysis undergoing to PCI the first 24 h was not associated with a reduced risk of cardiovascular death, cardiogenic shock, recurrent MI or congestive heart failure at 30 days comparing with PCI after 24 h. Abstract Figure. Kaplan-Meier in primary endpoint
Admission lactate level and the GRACE 2.0 score are independent and additive predictors of 30-day mortality of STEMI patients treated with primary PCI - preliminary results of a real-world registry
Authors: Szabo D , Szabo A , Kugler S , Pinter A , Juhasz V , Ruppert M , Olah A , Edes IF , Becker D , Merkely B , Hizoh I
Published: April 2021

Funding Acknowledgements

Type of funding sources: None.

Background

In many of the current risk estimation algorithms for patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI), heart rate and systolic blood pressure are key predictors. Yet, these parameters may also be influenced by the actual medical treatment / circulatory support, thereby decreasing the discriminatory power of the models. 

Purpose 

We aimed to investigate whether venous lactate level, a marker of microcirculatory failure, may have an added prognostic value beyond conventional predictors.

Methods

In a pilot real-world registry, 174 cases were studied. Venous blood gas analysis was performed in all patients at hospital admission. Nested logistic regression models were built using the extensively validated "Global Registry of Acute Coronary Events" (GRACE) 2.0 score alone (base model) or with the addition of venous lactate level (expanded model) using 30-day all-cause mortality as outcome measure. Independence of predictors (lack of collinearity) was evaluated  by the variance inflation factor (VIF). Instead of the insensitive c-statistic, difference in performance of the nested models was analyzed by the likelihood ratio test and the integrated discrimination improvement (IDI).

Results

The VIF was 1.0684, indicating independence of the measured lactate values from  the calculated GRACE 2.0 scores. Both base and expanded models showed high discriminatory power: c-statistic = 0.88 and 0.89, respectively, p = 0.68). Nevertheless, addition of venous lactate level to the GRACE 2.0 score improved predictions of 30-day mortality significantly as assessed by  both likelihood ratio test (chi-square = 8.97, p = 0.0027) and IDI (IDI = 0.1029, 95% CI: 0.0002-0.2055, p = 0.0494). 

Conclusions

Venous lactate level may be an independent predictor of 30-day mortality of STEMI patients treated with primary PCI. The addition of this marker to the GRACE 2.0 model may improve mortality prediction of these patients. Abstract Figure.
High density lipoprotein cholesterol and alcohol consumption: are they related?
Authors: Santos MR , Pereira A , Sousa JA , Mendonca F , Monteiro JP , Temtem M , Sousa AC , Rodrigues M , Henriques E , Ornelas I , Drumond A , Mendonca MI , Palma Dos Reis R
Published: April 2021

Funding Acknowledgements

Type of funding sources: None.

OnBehalf

GENEMACOR

Introduction

High density lipoprotein cholesterol (HDL-C) is known to be inversely related to coronary artery disease (CAD). Previous observational studies have consistently reported that individuals with moderate alcohol consumption have a lower risk of cardiovascular disease compared with that of nondrinkers and heavy drinkers. The beneficial effects of moderate drinking appear to be mediated in large part by alcohol-induced increases in HDL-C concentrations.

Objective

To evaluate if a moderate alcohol consumption (30-50g a day) is associated with higher levels of HDL-C in coronary patients.

Materials and methods

1676 patients selected from GENEMACOR study population, with at least one > 75% coronary stenosis by angiography (median age 53.3 ± 7.9 years, 78.6% male, median HDL 43.0 ± 11.1 mg/dL). Population was divided according to the HDL level quartiles (1st quartile HDL < 35.3 mg/dL; 2nd quartile HDL 35.3 – 42 mg/dL; 3rd quartile HDL 42 – 49 mg/dL; 4th quartile HDL > 49 mg/dL). Population of the 1st and 4th quartiles (825 patients, median age of 53.3 ± 8.0 years and 78.7% male) were adjudicated and prospectively followed-up by 5.0 ± 4.2 years. X2 and T student tests were used to analyze the demographic, laboratorial, angiographic and anthropometric characteristics of the population.

Results

420 (50.9%) patients were included in the 1st quartile group (median age 53.2 ± 7.9 years, 85.7% men) and 405 (49.1%) patients were included in the 4th quartile group (median age 53.4 ± 8.0 years, 71.4% men). The mean HDL level was higher in the population with moderate alcohol consumption (mean HDL 43.7 ± 15mg/dL in patients with alcohol consumption <30g/day, mean HDL 48.8 ± 16mg/dL in patients with moderate alcohol consumption and mean HDL 41.6 ± 15mg/dL in patients with alcohol consumption >50g/day). From 104 (median age 51.9 ± 7.9 years, 96.2% male) patients with a moderate alcohol consumption, 62.5% vs 37.5% were in 4th HDL quartile, p 0.01.

Conclusion

We conclude that in our population, a moderate alcohol consumption is associated with higher levels of HDL-C. However, even if there is a causal association between alcohol consumption and higher HDL cholesterol levels, it is suggested that efforts to reduce coronary heart disease risks concentrate on the control of another risk factors.
Trends in mortality related to pulmonary embolism in the DACH countries: data from the WHO Mortality Database
Authors: Hobohm L , Sebastian T , Valerio L , Mahmoudpour H , Vatsakis G , Johner F , Keller K , Muenzel T , Kucher N , Konstantinides S , Barco S
Published: April 2021

Funding Acknowledgements

Type of funding sources: None.

Background

Little is known about the burden imposed by pulmonary embolism for Germany, Austria and Switzerland (DACH countries).

Purpose

We aimed to assess pulmonary embolism-related mortality and time trends for the DACH countries based on data from the WHO Mortality Database.

Methods

We analysed vital registration data from the WHO Mortality Database (2000–2016) covering subregions of the WHO European Region: Germany, Switzerland and Austria (DACH countries). Deaths were considered pulmonary embolism-related if International Classification of Disease-10 code for acute pulmonary embolism or any code for deep or superficial vein thrombosis was listed as the primary cause of death.

Results

Between 2000 and 2016, age-standardised annual pulmonary embolism-related mortality rates decreased linearly from 15.6 to 7.8 deaths per 1000 population. In the 5-year period between 2012 and 2016 an average of 9127 pulmonary embolism-related deaths occurred annually in the DACH countries with a population of 98 273 329. Interestingly, pulmonary embolism-related mortality rates were considerable higher among women aged 15-55 years compared to age-matched men. Between 2012 and 2016, Germany showed the highest age-adjusted mortality rate (9.2 to 10.8 per 100000 inhabitants) compared to Switzerland 4.9-5.3 per 100000 inhabitants) and Austria (5.2 to 6.0 per 100000 inhabitants). Moreover, this means that the age-adjusted mortality rate in Germany was higher than the West-European average.

Conclusion

The observed decreasing trends in pulmonary embolism-related mortality might reflect improved management of the disease including new treatment options as well as advances in imaging technologies. However, pulmonary embolism remains a substantial contributor to total mortality, especially among women aged 15–55 years. For this reason, campaigns to increase physician and public awareness are urgently required for further improvement of the management and treatment of this preventable thrombotic disorder, which still remains the leading preventable cause of death.
Atherosclerosis as a risk factor in the prognosis of the survival of patients with COPD
Authors: Kotlyarov S , Kotlyarova A
Published: April 2021

Funding Acknowledgements

Type of funding sources: None. Main funding source(s): no

OnBehalf

no

Atherosclerosis is one of the key medical problems, as it contributes greatly to the structure of morbidity and mortality. Atherosclerosis rarely occurs in isolation, and is often combined with other diseases, including chronic obstructive pulmonary disease (COPD). The study of the significance of atherosclerosis and other key risk factors in the prognosis of COPD was carried out. 

Materials and methods

a study of the nature of the course of COPD for 15 years was carried out at three time control points (2005, 2008 and 2020). The presence of diseases associated with atherosclerosis in history, the severity of dyspnea according to the modified MRC scale and body mass index were taken into account. To assess the significance of the factors, a long-term survival analysis was performed using the Kaplan-Meier method. The statistical significance of the differences between the curves was assessed using the Log-rank test and the Breslow (Generalized Wilcoxon) and Tarone-Ware tests. To assess the influence of various factors and their combinations on long-term survival, a multivariate analysis was carried out using the Cox regression model (proportional hazards model). 

Results and discussion

The study included 170 men, with an average age of 60.09 ± 1.31 years. All patients smoked, the pack-years index was 43.78 ± 1.02. Of the 170 patients included in the study, 119 died by the third time point, which was 70%. The life expectancy of deceased patients averaged 70.48 ± 0.63 years. The main causes of death in patients with COPD are cardiovascular diseases caused by atherosclerosis, cancer, and respiratory failure. The most common cause of death in patients with COPD (68%) is diseases of the circulatory system associated with atherosclerosis. It was found that the presence of atherosclerosis in the anamnesis decreases the survival rate over a 15-year period. The graphs of the Kaplan-Meier survival curve depending on the presence of concomitant cardiovascular diseases in the anamnesis confirm the significance of the differences (p = 0.0194). It was also shown that an increase in the severity of dyspnea is associated with an increased risk of adverse outcomes (p <0.001; ROC analysis, AUC = 0.737 ± 0.038). The analysis of survival using the construction of Kaplan-Meier curves showed that BMI <21 is associated with a poor prognosis (p <0.001; ROC analysis, AUC = 0.827 ± 0.043). The results of the Cox regression model showed that a history of atherosclerosis is a significant predictor of a poor prognosis in patients with COPD in a 15-year follow-up. It was shown that a history of atherosclerosis increases the risk of death in patients with COPD by 1.734 times. 

Thus, concomitant cardiovascular diseases of atherosclerotic genesis, severe dyspnea and low body weight are a significant factor in the poor prognosis of COPD and should be taken into account when monitoring patients.
Genetically predicted circulating vitamin C in relation to cardiovascular disease
Authors: Yuan Shuai , Zheng Ju-Sheng , Mason Amy M , Burgess Stephen , Larsson Susanna C
Published: April 2021

Aim

We conducted a two-sample Mendelian randomization (MR) study to assess the associations of genetically predicted circulating vitamin C levels with cardiovascular diseases (CVDs).

Methods and results

Ten lead single-nucleotide polymorphisms associated with plasma vitamin C levels at the genome-wide significance level were used as instrumental variables. Summary-level data for 15 CVDs were obtained from corresponding genetic consortia, the UK Biobank study, and the FinnGen consortium. The inverse-variance-weighted method was the primary analysis method, supplemented by the weighted median and MR-Egger methods. Estimates for each CVD from different sources were combined. Genetically predicted vitamin C levels were not associated with any CVD after accounting for multiple testing. However, there were suggestive associations of higher genetically predicted vitamin C levels (per 1 standard deviation increase) with lower risk of cardioembolic stroke [odds ratio, 0.79; 95% confidence interval (CI), 0.64, 0.99; P = 0.038] and higher risk of atrial fibrillation (odds ratio, 1.09; 95% CI, 1.00, 1.18; P = 0.049) in the inverse-variance-weighted method and with lower risk of peripheral artery disease (odds ratio, 0.76, 95% CI, 0.62, 0.93; P = 0.009) in the weighted median method.

Conclusion

We found limited evidence with MR techniques for an overall protective role of vitamin C in the primary prevention of CVD. The associations of vitamin C levels with cardioembolic stroke, atrial fibrillation, and peripheral artery disease need further study.
Breastfeeding and Responsive Parenting as Predictors of Infant Weight Change in the First Year
Authors: Hails Katherine A , Whipps Mackenzie D M , Gross Rachel S , Bogen Debra L , Morris Pamela A , Mendelsohn Alan L , Shaw Daniel S
Published: April 2021

Objective

To test breastfeeding duration and responsive parenting as independent predictors of infant weight change from birth to 12 months, and to test the moderating effect of a tiered parenting intervention on relations between breastfeeding and responsive parenting in relation to infant weight change.

Methods

Mother–infant dyads (N = 403) were participants in the ongoing Smart Beginnings (SB) randomized controlled trial testing the impact of the tiered SB parenting model that incorporates two evidence-based interventions: Video Interaction Project (VIP) and Family Check-Up (FCU). The sample was low income and predominantly Black and Latinx. Responsive parenting variables (maternal sensitivity and intrusiveness) came from coded observations of mother–infant interactions when infants were 6 months. Continuous weight-for-age (WFA) z-score change and infant rapid weight gain (RWG) from 0 to 12 months were both assessed.

Results

Longer breastfeeding duration was significantly associated with less WFA z-score change. The relationship between breastfeeding duration and WFA z-score change was significant only for infants in the intervention group. Intrusive parenting behaviors were also associated with greater WFA z-score change after accounting for breastfeeding duration.

Conclusions

This study is one of the first to test both breastfeeding and parenting in relation to infant weight gain in the first year. Findings may have implications for family-focused child obesity prevention programs.
From Physical to Metaphysical Necessity
Authors: Roberts Alexander
Published: April 2021

Let Nomological Bound be the thesis that there is nothing objectively possible beyond what is physically possible. Nomological Bound has struck many as a live hypothesis. Nevertheless, in this article I provide a novel argument against it. Yet even though I claim that Nomological Bound is false, I argue that the boundaries of objective possibility can still be characterized intimately in terms of physical necessity. This is philosophically significant, for on a natural understanding it constitutes the powerful anti-sceptical result that those who believe in physical necessity should not harbour any scepticism towards merely metaphysical possibilities.
The relativistic jet dichotomy and the end of the blazar sequence
Authors: Keenan Mary , Meyer Eileen T , Georganopoulos Markos , Reddy Karthik , French Omar J
Published: April 2021

Our understanding of the unification of jetted AGN has evolved greatly as jet samples have increased in size. Here, based on the largest-ever sample of over 2000 well-sampled jet spectral energy distributions, we examine the synchrotron peak frequency – peak luminosity plane, and find little evidence for the anticorrelation known as the blazar sequence. Instead, we find strong evidence for a dichotomy in jets, between those associated with efficient or ‘quasar-mode’ accretion (strong/type II jets) and those associated with inefficient accretion (weak/type I jets). Type II jets include those hosted by high-excitation radio galaxies, flat-spectrum radio quasars (FSRQ), and most low-frequency-peaked BL Lac objects. Type I jets include those hosted by low-excitation radio galaxies and blazars with synchrotron peak frequency above 1015 Hz (nearly all BL Lac objects). We have derived estimates of the total jet power for over 1000 of our sources from low-frequency radio observations, and find that the jet dichotomy does not correspond to a division in jet power. Rather, type II jets are produced at all observed jet powers, down to the lowest levels in our sample, while type I jets range from very low to moderately high jet powers, with a clear upper bound at L 300MHz ∼1043 erg s−1. The range of jet power in each class matches exactly what is expected for efficient (i.e. a few to 100 % Eddington) or inefficient ( <0.5% Eddington) accretion on to black holes ranging in mass from $10^7{\, {\rm to}\,}10^{9.5}\, {\rm M}_\odot$.
Observed CN and HCN intensity ratios exhibit subtle variations in extreme galaxy environments
Authors: Ledger B , Wilson C D , Michiyama T , Iono D , Aalto S , Saito T , Bemis A , Aladro R
Published: April 2021

We use both new and archival ALMA data of three energy lines each of CN and HCN to explore intensity ratios in dense gas in NGC 3256, NGC 7469, and IRAS 13120-5453. The HCN (3–2)/HCN (1–0) intensity ratio varies in NGC 3256 and NGC 7469, with superlinear trends of 1.53 ± 0.07 and 1.55 ± 0.05, respectively. We find an offset to higher HCN (3–2)/HCN (1–0) intensity ratios (∼0.8) in IRAS 13120-5453 compared to NGC 3256 (∼0.3−0.4) and NGC 7469 (∼0.3−0.5). The HCN (4–3)/HCN (3–2) intensity ratio in NGC 7469 has a slope of 1.34 ± 0.05. We attribute the variation within NGC 3256 to excitation associated with the northern and southern nuclei. In NGC 7469, the variations are localized to the region surrounding the active galactic nucleus. At our resolution (∼700 pc), IRAS 13120-5453 shows little variation in the HCN intensity ratios. Individual galaxies show nearly constant CN (2–1)/CN (1–0) intensity ratios. We find an offset to lower CN (2–1)/CN (1–0) intensity ratios (∼0.5) in NGC 3256 compared to the other two galaxies (∼0.8). For the CN (3–2)/CN (2–1) intensity ratio, NGC 7469 has a superlinear trend of 1.55 ± 0.04, with the peak localized towards the active galactic nucleus. We find high (∼1.7) CN (1–0)/HCN (1–0) intensity ratios in IRAS 13120-5453 and in the northern nucleus of NGC 3256, compared to a more constant ratio (∼1.1) in NGC 7469 and non-starbursting regions of NGC 3256.
Compaction-driven black hole growth
Authors: Lapiner Sharon , Dekel Avishai , Dubois Yohan
Published: April 2021

We study the interplay between galaxy evolution and central black hole (BH) growth using the NewHorizon cosmological simulation. BH growth is slow when the dark-matter halo is below a golden mass of $M_{\rm v}\sim 10^{12}\, \rm M_\odot$, and rapid above it. The early suppression is primarily due to gas removal by supernova (SN) feedback in the shallow potential well, predicting that BHs of ${\sim}10^5\, \rm M_\odot$ tend to lie below the linear relation with bulge mass. Rapid BH growth is allowed when the halo is massive enough to lock in the SN ejecta by its deep potential well and its heated circumgalactic medium (CGM). The onset of BH growth between these two zones is triggered by a wet-compaction event, caused, e.g. by mergers or counter-rotating streams. It brings gas that lost angular momentum into the inner-$1\, {\rm kpc}$ ‘blue nugget’ and causes major transitions in the galaxy structural, kinematic, and compositional properties, including the onset of star-formation quenching. The compaction events are confined to the golden mass by the same mechanisms of SN feedback and hot CGM. The onset of BH growth is associated with its sinkage to the centre due to the compaction-driven deepening of the potential well and the associated dynamical friction. The galaxy golden mass is thus imprinted as a threshold for rapid BH growth, allowing the AGN feedback to keep the CGM hot and maintain long-term quenching. AGN feedback is not causing the onset of quenching; they are both caused by a compaction event when the mass is between the SN and hot-CGM zones.
FirstLight IV: diversity in sub-L* galaxies at cosmic dawn
Authors: Ceverino Daniel , Hirschmann Michaela , Klessen Ralf S , Glover Simon C O , Charlot Stéphane , Feltre Anna
Published: April 2021

Using a large sample of sub-L* galaxies, with similar UV magnitudes, MUV ≃ −19 at z ≃ 6, extracted from the FirstLight simulations, we show the diversity of galaxies at the end of the reionization epoch. We find a factor ∼40 variation in the specific star formation rate (sSFR). This drives a ∼1 dex range in equivalent width of the [O iii]λ5007 line. Variations in nebular metallicity and ionization parameter within H ii regions lead to a scatter in the equivalent widths and [O iii]/H α line ratio at a fixed sSFR. [O iii]-bright ([O iii]/H α>1) emitters have higher ionization parameters and/or higher metallicities than H α-bright ([O iii]/H α<1) galaxies. According to the surface brightness maps in both [O iii] and H α, [O iii]-bright emitters are more compact than H α-bright galaxies. H α luminosity is higher than [O iii] if star formation is distributed over extended regions. [O iii] dominates if it is concentrated in compact clumps. In both cases, the H α-emitting gas is significantly more extended than [O iii].
Galactic open cluster Cepheids – a census based on Gaia EDR3
Authors: Zhou Xiaoyue , Chen Xiaodian
Published: April 2021

In the Gaia era, the membership analysis and parameter determination of open clusters (OCs) are more accurate. We performed a census of OC’s classical Cepheids based on Gaia Early Data Release 3 (EDR3) and obtained a sample of 33 OC Cepheids fulfilling the constraints of the spatial position, proper motion, parallax, and evolution state. 13 of 33 OC Cepheids are newly discovered. Among them, CM Sct is the first first-crossing Cepheid with direct evidence of evolution. DP Vel is likely a fourth- or fifth-crossing Cepheid. Based on independent distances from OCs, W1-band period–luminosity relation of Cepheids is determined with a 3.5 per cent accuracy: 〈MW1〉 = −(3.274 ± 0.090)log P − (− 2.567 ± 0.080). The $Gaia$-band period–Wesenheit relation agrees well with Ripepi et al. (2019). A direct period–age relation for fundamental Cepheids are also determined based on OC’s age, that is log t = −(0.638 ± 0.063)log P + (8.569 ± 0.057).
A giant molecular cloud catalogue in the molecular disc of the elliptical galaxy NGC 5128 (Centaurus A)
Authors: Miura R E , Espada D , Hirota A , Henkel C , Verley S , Kobayashi M I N , Matsushita S , Israel F P , Vila-Vilaro B , Morokuma-Matsui K , Ott J , Vlahakis C , Peck A B , Aalto S , Hogerheijde M R , Neumayer N , Iono D , Kohno K , Takemura H , Komugi S
Published: April 2021

We present the first census of giant molecular clouds (GMCs) complete down to 106 M⊙ and within the inner 4 kpc of the nearest giant elliptical and powerful radio galaxy, Centaurus A. We identified 689 GMCs using CO(1–0) data with 1 arcsec spatial resolution (∼20 pc) and 2 km s−1 velocity resolution obtained with the Atacama Large Millimeter/submillimeter Array. The I(CO)-N(H2) conversion factor based on the virial method is XCO = (2 ± 1) × 1020 cm−2(K km s−1)−1 for the entire molecular disc, consistent with that of the discs of spiral galaxies including the Milky Way, and XCO = (5 ± 2) × 1020 cm−2(K km s−1)−1 for the circumnuclear disc (CND; within a galactocentric radius of 200 pc). We obtained the GMC mass spectrum distribution and find that the best truncated power-law fit for the whole molecular disc, with index γ ≃ −2.41 ± 0.02 and upper cut-off mass $\sim \! 1.3\times 10^{7}\, \mathrm{M}_{\odot }$, is also in agreement with that of nearby disc galaxies. A trend is found in the mass spectrum index from steep to shallow as we move to inner radii. Although the GMCs are in an elliptical galaxy, the general GMC properties in the molecular disc are as in spiral galaxies. However, in the CND, large offsets in the line-width-size scaling relations (∼0.3 dex higher than those in the GMCs in the molecular disc), a different XCO factor, and the shallowest GMC mass distribution shape (γ = −1.1 ± 0.2) all suggest that there the GMCs are most strongly affected by the presence of the active galactic nucleus and/or shear motions.
ProteinTools: a toolkit to analyze protein structures
Authors: Ferruz Noelia , Schmidt Steffen , Höcker Birte
Published: April 2021

The experimental characterization and computational prediction of protein structures has become increasingly rapid and precise. However, the analysis of protein structures often requires researchers to use several software packages or web servers, which complicates matters. To provide long-established structural analyses in a modern, easy-to-use interface, we implemented ProteinTools, a web server toolkit for protein structure analysis. ProteinTools gathers four applications so far, namely the identification of hydrophobic clusters, hydrogen bond networks, salt bridges, and contact maps. In all cases, the input data is a PDB identifier or an uploaded structure, whereas the output is an interactive dynamic web interface. Thanks to the modular nature of ProteinTools, the addition of new applications will become an easy task. Given the current need to have these tools in a single, fast, and interpretable interface, we believe that ProteinTools will become an essential toolkit for the wider protein research community. The web server is available at https://proteintools.uni-bayreuth.de.