bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification and Expression Profiles of Putative Soluble Chemoreception Proteins from Lasioderma serricorne (Coleoptera: Anobiidae) Antennal Transcriptome
Authors: Wang Gui-Yao , Chang Yan-Bin , Guo Jian-Hua , Xi Jia-Qin , Liang Tai-Bo , Zhang Shi-Xiang , Yang Meng-Meng , Hu Li-Wei , Mu Wen-Jun , Song Ji-Zhen
Published: May 2022

The cigarette beetle, Lasioderma serricorne (Fabricius) (Coleoptera: Anobiidae), is a destructive stored product pest worldwide. Adult cigarette beetles are known to rely on host volatiles and pheromones to locate suitable habitats for oviposition and mating, respectively. However, little is known about the chemosensory mechanisms of these pests. Soluble chemoreception proteins are believed to initiate olfactory signal transduction in insects, which play important roles in host searching and mating behaviors. In this study, we sequenced the antennal transcriptome of L. serricorne and identified 14 odorant-binding proteins (OBPs), 5 chemosensory proteins (CSPs), and 2 Niemann-Pick C2 proteins (NPC2). Quantitative realtime PCR (qPCR) results revealed that several genes (LserOBP2, 3, 6, and 14) were predominantly expressed in females, which might be involved in specific functions in this gender. The five LserOBPs (LserOBP1, 4, 8, 10, and 12) that were highly expressed in the male antennae might encode proteins involved in specific functions in males. These findings will contribute to a better understanding of the olfactory system in this stored product pest and will assist in the development of efficient and environmentally friendly strategies for controlling L. serricorne.
Related factors and changes of angiopoietin-like protein 2 with chronic heart failure patients participating in phase III cardiac rehabilitation
Authors: Tanaka C , Kurose S , Takao N , Miyauchi T , Iwasaka J , Shiojima I , Oike Y , Kimura Y
Published: May 2022

Funding Acknowledgements

Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): the research grant D2 from Kansai Medical University

Objectives

Angiopoietin-like protein 2 (ANGPTL2) is a protein, whose structure is similar to that of angiopoietin, but binds to a different receptor. Overexpression of ANGPTL2 promotes chronic inflammation and relates to the development of aging-related diseases. ANGPTL2 has been reported to be mainly secreted by adipose tissue. Although ANGPTL2 has been implicated in the pathogenesis of heart failure, there are no studies about serum ANGPTL2 levels in patients with heart failure participating in cardiac rehabilitation program. The aim of this study was to investigate the characteristics, related factors and changes of ANGPTL2 in patients with chronic heart failure during phase III of cardiac rehabilitation program.

Methods

The subjects included 57 patients (70.1 ± 10.2 years old; 46 men) with chronic heart failure whose serum ANGPTL2 levels were measured during the maintenance phase of cardiac rehabilitation program. Furthermore, we classified 25 patients (70.6 ± 7.5 years old; 23 men) from the 6-month course into a reduced group and an unchanged group to characterize change in ANGPTL2. We excluded patients who were admitted or discharged within 3 months of the evaluation of serum ANGPTL2. We evaluated exercise tolerance using the cardiopulmonary exercise test, grip strength, body composition using a body composition analyzer, blood examinations, and echocardiography. Serum ANGPTL2 was measured by solid-phase sandwich enzyme-linked immunosorbent assay (ELISA).

Results

The median value of ANGPTL2 was 4.05 ng/ml. ANGPTL2 was positively correlated with body weight, body mass index, body fat mass, body fat percentage, C-reactive protein (CRP) and total protein (TP) levels, and negatively correlated with skeletal muscle mass percentage and anaerobic threshold (AT). From the result of the logistic regression analysis, AT (OR=0.68, 95% CI:0.47-0.97and TP (OR=20.1, 95% CI:2.52-160.63) were extracted as independent factors related to the level of ANGPTL2. In addition, overall serum ANGPTL2 levels decreased significantly after 6 months. Changes in ANGPTL2 in the reduced group showed a positive correlation between baseline peak VO2, left ventricular ejection fraction and skeletal muscle rate, and a negative correlation with baseline ANGPTL2, CRP, body fat mass. In an unchanged group, HbA1c increased, but no significant change was observed in other factors.

Conclusions

Exercise tolerance in patients with chronic heart failure during maintenance phase might be related to the inflammation marker ANGPTL2. Serum ANGPTL2 levels with stable chronic heart failure patients decreased significantly 6 months after continued cardiac rehabilitation.
Effect of smoking on prognosis in patients with non-ischaemic cardiomyopathy
Authors: Chung I
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Cigarette Smoking is a well-known risk factor for increased cardiovascular morbidity and mortality, by causing inflammation, thrombosis, oxidation of low-density lipoprotein cholesterol, and is associated with increased myocardial fibrosis as late gadolinium enhancement on cardiac MRI. Myocardial fibrosis is a powerful factor for predicting arrhythmic deaths and mortality in heart failure patients. Little data is available on effect of smoking on non-ischaemic cardiomyopathy (NICMP). We hypothesize that smoking has an adverse effect on prognosis of patients with NICMP.

Methods

This study included 447 patients with heart failure and reduced left ventricular ejection fraction (LVEF <40%) due to non-ischemic cardiomyopathy, all have coronary angiogram to exclude significant coronary artery disease (>70% stenosis). Mean follow-up duration of 6.34 ± 4.16 years. Composite endpoints include death, ventricular arrhythmia (VA) or hospitalisations for heart failure.

Data were analysed using STATA version 16.0. Cox regression was used to explore the relationships between smoking and composite endpoints. Statistical significance was denoted as p<0.05.

Results

Mean age 63.07 ± 14.19 years, male patients 314 (72%). Mean LVEF 22.89 ± 8.50%. Patients with diabetes mellitus 38%, hypertension 76%, atrial fibrillation 38%, stroke 9%. LDL 2.78 ± 1.04 mmol/l, HbA1c 6.56 ± 1.62%. Patients taking ivabradine 9%, b-blocker 88%, Angiotensin inhibitors/Angiotensin Receptor Blocker 66%, Sacubitrial/ Valsartan 26%, spironolactone 57%, SGLT-2 inhibitor 9%. 40 patients (9%) received device therapy (AICD and Cardiac resynchronization therapy), 19% secondary prevention, 81% for primary prevention.

Smoking (100 cigarette pack year) increased the hazards for composite endpoint by 2.39, [HR (95% CI): 1.074, 5.325; p = 0.033].

Conclusion

Smoking increases the hazards for composite endpoints in patients with NICMP and smoking cessation is recommended.
Analysis of the overshoot of the respiratory exchange ratio during recovery from maximal exercise testing in patients with heart failure with reduced ejection fraction
Authors: Vecchiato M , Quinto G , Borasio N , Zanardo E , Grassi M , Battista F , Ermolao A , Neunhaeuserer D
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Transient increases (overshoot) in respiratory gas analysis parameters have been observed during recovery after maximal cardiopulmonary exercise testing (CPET), but their clinical significance is not clearly understood.(1) Respiratory exchange ratio (RER) at peak exercise (RER peak) is an objective index to evaluate exercise effort.(2) Moreover, overshoot phenomenon of the RER is commonly observed during recovery from CPET.(3) On the other hand, the overshoot of some CPET parameters during recovery has been found reduced in magnitude in patients with heart failure with reduced ejection fraction (HFrEF).(4)

Purpose

We aimed to examine the clinical significance of RER behaviour after a maximal effort and to understand if this could help in the classification of specific subpopulations of patients.

Methods

In this cross-sectional study patients with HFrEF who underwent functional evaluation with CPET between 2017 and 2020 were included. A maximal CPET with at least two minute of recorded recovery was performed and always RER achieved at peak of exercise was higher than 1.10. RER behaviour during recovery has been evaluated, assessing its maximal value (RER max), the magnitude of the RER overshoot (RER mag), the time to reach RER max during recovery and the linear slope of increase of the RER from peak exercise to RER max (RER slope). Additionally, subgroup analyses were performed.

Results

80 patients with HFrEF were included. Figure 1 shows an example of analyzed RER overshoot parameters. Principal clinical characteristics, CPET parameters and recovery metrics are shown in Table I. Significant correlations between RER recovery parameters and prognostically relevant CPET indices of cardiorespiratory fitness and efficiency were found, especially between RER mag and VO2peak (r=0.333; p=0.03), and RER mag and VE/VCO2slope (r= - 0.494; p<0.01). At multiple linear regression, VE/VCO2slope was the only determinant of RER mag. Patients in a more severe disease state (Ventilatory class III/IV and Weber’s classes C/D) present RER overshoot parameters significantly reduced compared with those in a light/moderate disease state (Ventilatory class I/II and Weber’s classes A/B), (all p=0.01).

Conclusions

The overshoots phenomena of RER during recovery from maximal exercise were associated with patients’ cardiopulmonary function, and their magnitudes were less prominent in HFrEF patients with a lower cardiorespiratory efficiency. Thus, the evaluation of the overshoot during recovery from CPET might represent an interesting clinical and prognostic tool in patients with HFrEF.
Colchicine for secondary prevention of cardiovascular disease, a cost per outcome analysis
Authors: Tsaban G , Alnsasra H , El Nasasra A , Aboalhasan E , Azuri J , Hammerman A , Arbel R
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction

Pharmacological modulation of systemic inflammation significantly reduced cardiovascular risk among patients with coronary artery disease (CAD), beyond guideline-directed therapy. However, most anti-inflammatory therapies substantially increase the risk of infections. Low-dose (LD) Colchicine is currently the only non-lipid-lowering anti-inflammatory agent effective for secondary prevention of cardiovascular diseases that does not significantly increase infection risk. The clinical cost-effectiveness of LD Colchicine to prevent major adverse cardiovascular events (MACE) remains unexplored.

Methods

We calculated the annualized number needed to treat (aNNT) to prevent MACE with LD Colchicine based on the outcome data of the LoDoCo2 trial. We then analyzed the annualized cost needed to treat (aCNT) of LD Colchicine to prevent one MACE. We estimated the aCNT by multiplying the aNNT by the annual cost of therapy. LD Colchicine costs were based on 75% of the 2021 US National Average Drug Acquisition Cost listing and EU prices.

Results

In LoDoCo2, the aNNT for avoiding MACE with LD Colchicine was 150 (95% CI: 97-524). The annual cost of LD Colchicine is $1,889 and €352 in the US and EU, respectively. The corresponding aCNTs to prevent one MACE were 282,610$ (95% CI: 184,025$-989,137$) and 82,815€ (34,154€-184,502€) in the US and EU, respectively.

Conclusion

LD Colchicine might serve as an effective treatment strategy to reduce secondary cardiovascular risk among patients with CAD. The CNTs of LD Colchicine are sensitive to the drug’s pricing and thus differ between the US and the EU.
Interleukin-6 predicts recovery of systolic function after myocardial infarction
Authors: Jenca D , Jarolim P , Melenovsky V , Mrazkova J , Sramko M , Zelizko M , Kotrc M , Franekova J , Viczenova D , Adamkova V , Kautzner J , Wohlfahrt P
Published: May 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Health of the Czech Republic

Background

Interleukin (IL)-6 is an important mediator of the inflammatory response to acute myocardial infarction (MI). Increased IL-6 levels are associated with adverse outcomes after MI. However, there are only limited data on the association of IL-6 levels with recovery of systolic function after MI.

Purpose

The aim of the present study was to evaluate the independent predictive value of IL-6 level for recovery of systolic function among patients hospitalized for their first MI.

Methods

Consecutive patients without previous history of MI or cardiomyopathy with left ventricular ejection fraction (LVEF) ≤40% measured by transthoracic echocardiography upon hospital discharge and available follow-up LVEF evaluated between 3 months and one year since hospital discharge were selected from a prospective registry of MI patients (n=1323).

Results

In total, data from 183 patients (mean age 64.2±11.2, 29% female, mean EF upon discharge 32.6±5.8) were analyzed. In the multivariate linear regression, IL-6 level measured within 24 hours from the hospital admission was positively associated with NT-proBNP, maximal hs-Troponin T a glycemia level and negatively with female gender, total cholesterol and admission systolic blood pressure. During follow-up, LVEF increased by 6.1±9.0% and LVEF recovered to value >50% in 43 (23.5%) patients. In the multivariate analysis, LVEF improvement was predicted by lower IL-6, lower maximal troponin level, female gender, lower heart rate at the time of hospital admission and Killip class I. In the ROC analysis (AUC 0.72, p<0.001), IL-6 ≤ 15.7ng/L had 51% sensitivity and 87% specificity to predict LVEF recovery.

Conclusion

The inflammatory response to MI, as assessed by IL-6, is associated with MI size, glucose and lipid metabolism and is lower in women. IL-6 independently predicts change in LVEF among patients with moderate to severe LV dysfunction. This supports previous findings that IL-6 inhibition can increase myocardial salvage after MI and identifies possible patients that may benefit from targeted therapy.
TAVI, multidimensional early benefits in elderly patients
Authors: Cunha NPD , Alves Da Silva P , Garcia B , Pinto R , Pinto F J , Abreu A
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction

Aortic stenosis is the most common valvular heart disease in Europe and in symptomatic patients, when untreated presents a high rate of morbidity and mortality. Its prevalence is estimated to grow even more, given the aging of the population. Transcatheter aortic valve implantation (TAVI) emerged as a safe and efficient procedure in patients with high or prohibitive surgical risk or in older patients, who are much often frailty, with impaired cognitive function and have poor quality of life.

Aim

To assess the acute benefits (in 1 moth) of TAVI on cognitive function, anxiety and depression and independence in activities of daily living.

Methods

Single center prospective study of patients submitted to TAVi between April 2021 and September 2021. Patients were evaluated at baseline (before TAVI) and one month after the procedure. To assess cognitive function, anxiety and depression and independence in activities of daily living we used the Mini Mental State Examination (MMSE), Hospital Anxiety and Depression Scale (HADS); Katz Index of Independence in Activities of Daily Living; and Lawton-Brody Instrumental Activities of Daily Living Scale, respectively. Paired sample t-test and Wilcoxon test were used to statistical analysis.

Results

We included 20 patients, with a mean age of 85±5,86 years, 40% (8) male. 19 patients undergone TAVI due severe native aortic stenosis and 1 due to bioprosthetic aortic valve dysfunction. The vascular access site was transfemoral in 19 patients and transapical in 1 patient. The median MMSE results were higher 1 month after TAVI (21,3 versus 23,5, p=0,012), essentially due to a better results in the temporal orientation and evocation domains (p=0,011 and p=0,022, respectively). Patients experienced lower levels of anxiety and depression after TAVI, mean score 5,4 versus 3,9 (p=NS) and 7 versus 4,25 (p=0,002) respectively for anxiety and depression, as assessed by HADS scale. No statistical difference was observed on the results of basal and post TAVI evaluation of Katz and Lawton-Brody scales.

Conclusion

In an elderly population, TAVI appears to have an early and beneficial effect on cognitive function and depression, but no benefits were observed on independence in activities of daily living.
What is the association between lifelong exercise volumes, valvular function and aortic diameters in subjects with a bicuspid aortic valve?
Authors: Schreurs BA , Hopman MTE , Van Kimmenade RRJ , Eijsvogels TMH
Published: May 2022

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): Hartstichting and Stichting Hartekind

Background/Introduction

Subjects with bicuspid aortic valve disease (BAV) have a higher risk of developing valvular and aortic complications. There is debate if hemodynamic stress associated with long-term exercise training may accelerate the development of complications. Current exercise guidelines are rather restrictive and primarily based on expert opinion. Hence, more insight is needed into the association between exercise volumes and disease characteristics in BAV subjects, especially since exercise training is a powerful strategy to improve cardiovascular health.

Purpose

To assess the association between lifelong exercise volumes and disease characteristics in BAV subjects.

Methods

We enrolled BAV subjects ≥35 years old who have not undergone an aortic valve or aorta intervention. Lifelong physical activity was determined using a validated questionnaire and quantified as Metabolic Equivalent of Task minutes per week (MET-min/wk). Participants were classified as 1) insufficiently active, 2) active, or 3) highly active, based on their lifelong physical activity volumes (<500, 500-1000 and >1000 MET-min/wk, respectively). Disease characteristics were assessed from echocardiographic images that were obtained during the most recent visit to our outpatient clinic, whereas patient characteristics were extracted from electronic health records.

Results

152 participants (54±10 years, 55% male) were included of which n=59 insufficiently active, n=47 active and n=46 very active. Median lifelong physical activity volumes were 235 [108-387], 713 [653-828] and 1499 [1198-1875] MET-min/wk (p<0.001), respectively. Subject characteristics did not differ across groups (Table 1). No difference was found in aortic valve dysfunction across exercise volume groups, measured as peak aortic valve velocity (1.8 [1.5-2.4] m/s vs. 1.7 [1.4-2.6] m/s vs. 1.8 [1.5-2.5] m/s, p = .52) and presence of moderate-severe aortic valve regurgitation (n=7 (12%) vs. n=7 (15%) vs. n=6 (13%), p=.89) Also, aortic diameters at the level of the sinus of Valsalva (36.0±4.9 mm vs 35.8±5.5 mm vs 36.7±6.1 mm, p=.69) and ascending aorta (36.5±6.3 mm vs 39.0±7.0 mm vs 37.5±7.0 mm, p=.18) did not significantly differ across groups.

Conclusion

Lifelong exercise volumes are not associated with characteristics of disease severity in BAV subjects who have not undergone an aortic valve or aorta intervention. These observations may support a less cautious approach for habitual physical activity and exercise training in BAV subjects, so they can profit from the cardiovascular health benefits of a physically active lifestyle.
Contrast induced nephropathy in interventional cardiology; identification of high-risk patients and its prevention
Authors: Shuka N , Kristo A , Gishto T , Simoni L , Hasimi E , Shirka E , Siqeca M , Lazaj J , Refatllari I , Xhafaj M , Seiti J , Mijo A , Petrela E , Goda A
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

CIN is a serious and potentially preventable complication of coronary angiography and/or percutaneous coronary interventions (PCI). The definition of CIN, its incidence and risk factors and therapeutic interventions are not well established .

Purpose

To study incidence and risk factors of CIN in patients undergoing coronary angiography and/or PCI, to investigate high-risk patients with CIN and to evaluate its preventive therapies (Hydration an Acetylcysteine).

Method

This was a prospective trial, in one center with patients undergoing coronary angiography and/or PCI, during 2010-2014. The renal function was evaluated through serum Creatinine (Cr) and GFR (Cockcroft –Gault formula ). CIN was defined as an increase in Creatinine by 25% and/or by 0.5 mg/dL at 48/72 h after the index procedures. Patients with CIN were considered high-risk when Creatinine increased more than 50% and/or by 2 mg/dL, or needing dialysis. We evaluated the major risk factors for CIN such as: Preexisting Renal Lesion (PRL), Age≥65 years, Heart Failure (HF), Diabetes Mellitus (DM), Anemia (Hb < 12 g/dL) and the Quantity of Contrast used. We evaluated the role of hydration with intravenous saline and acetylcysteine (ACC) in the prevention of CIN.

Results

Out of the 1231 patients enrolled, 804 patients fulfilled the inclusion criteria. The incidence of CIN resulted 14.4%, higher in the group of patients with risk factors for CIN (15.3%) versus without risk factors (9.1%); p=0.05. Risk factors HF (OD: 4.63; CI95%: 2.10-10.05, p<0.001), PRL (OD: 1.57; CI95%: 1.02-2.41, p=0.039) and Age ≥ 65 years (OD: 1.82; CI95%: 1.37-3.73, p=0.038 ) resulted independent risk factors, for CIN whereas Anemia (p=0.171), DM (p=0.502) and the Quantity of contrast used (p=0.479) did not result independent risk factors. Creatinine at 24 hours after the procedure resulted a predictive factor for the development of CIN. (sensitivity 64.7%, specificity 91.7%, positive predictive value 63.5%, negative predictive value 92.1% ). Creatinine > 1.5 mg/dL before the procedure resulted an independent risk factor for CIN, with a higher specificity than eGFR < 60 ml/min. The incidence of patients with CIN at high risk was 3.9% and HF resulted the only independent risk factor in this subgroup of patients (OD:4.49, CI 95%: 2.03-9.95). Intravenous hydration with saline resulted efficient in the prevention of the development of CIN (p=0.029), whereas ACC did not (p=0.485).

Conclusions

The frequency of CIN is higher in the group with risk factors. The HF, PRL, Age≥ 65 years resulted as independent risk factors for, and intravenous hydration with saline was a simple and efficient method for the prevention of CIN. Although our definition of CIN is widely used, the need for a universal definition for CIN is a contemporary need.
Non-invasive instrumental evaluation of coenzyme Q10 phytosome on endothelial reactivity in healthy non-smoking young volunteers: a double-blind, placebo-controlled cross-over clinical trial
Authors: Cicero A , Fogacci F , Di Micoli A , Veronesi M , Borghi C
Published: May 2022

Funding Acknowledgements

Type of funding sources: Public Institution(s). Main funding source(s): University of Bologna

Background

Coenzyme Q10 (CoQ10) is a natural antioxidant compound that prevents the vascular damage induced by free radicals and the activation of inflammatory signaling pathways.

Supplementation with CoQ10 is safe though its bioavailability is generally low, as far as variable depending on the pharmaceutical form of preparation. Recently, the development of phytosome technology has improved the bioavailability of CoQ10 and definitely facilitated its effective use in clinical.

Purpose and Methods

The present double-blind, randomized, placebo-controlled, cross-over clinical study aimed to investigate the effect on endothelial reactivity and total antioxidant capacity (TAC) of either acute and chronic supplementation with CoQ10 phytosome in a sample of 20 healthy young not smoking subjects.

Results

The immediate acute effect of dietary supplementation with CoQ10 phytosome on pulse volume (PV) was sustained in the actively treated group in comparison with placebo and the baseline (p< 0.05). Chronic supplementation of the tested pharmaceutical formulation of CoQ10 significantly improved mean arterial pressure and TAC compared to placebo and baseline values (p< 0.05 for both comparisons). In the actively treated group, the effect on dietary supplementation with CoQ10 phytosome on PV was also sustained when compared to the baseline (P<0.05).
Opportunistic screening for atrial fibrillation in hypertensive patients using a mobile application (prospective study of 160 cases)
Authors: El Adaoui A , Habbal R
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction

Atrial fibrillation (AF) is the most common cardiac arrhythmia,affecting between 1-4% of the general population and responsible for 10-20% of strokes.

New technologies are now available for screening for AF,but their implementation in real clinical settings has not yet been fully investigated.

Purpose

-evaluate the electrocardiogram recordings on smartphones intended for screening for AF using the KardiaMobile device, with a dedicated mobile application.

- Highlight the prevalence of AF in a moroccan hypertensive population

-Evaluate the effectiveness of computerized screening for AF in therapeutic management

Methods

Prospective screening for AF in patients aged 55 or over,known to be hypertensive for at least 5 years, was performed at the cardiology consultation services between June 2019-July 2020.A single lead ECG was acquired by placing the fingers of each hand on the electrodesThe diagnosis of the Kardia app was assessed by the consultation cardiologist,and a baseline ECG was performed for each suspected arrhythmia.CHA2DS2-VASc score was collected from each patient.

Results

A total of 160 ECGs were performed.The diagnosis of the Kardia app was provided in 93% of cases.A heart rhythm described as normal was detected in 120 consultants,AFwas suspected in 8.1% of the patients described by the device as ‘possible AF’,and confirmed by a baseline ECG in 7.5% of the patients screened.

Anti-coagulation was started in 6.2% of patients.

Conclusion

Mobile Device for screening for atrial fibrillation in a population at risk is a promising, inexpensive tool with significant prognostic benefit for the prevention of cardiovascular complications

The Kardia app is able to quickly filter and detect atial fibrillation with high sensitivity and specificity.
Prevalence of cardioprotective medication use in coronary heart disease patients in South America: systematic review and meta-analysis
Authors: Marza Florensa A , Drotos E , Gulayin P , Grobbee DE , Irazola V , Klipstein-Grobusch K , Vaartjes I
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction

Coronary heart disease (CHD) is the most common cause of death globally, and clinical guidelines recommend cardioprotective medications for patients with established CHD. Suboptimal use of these medications has been reported, but an overview from the South American region is lacking.

Purpose

Our aim is to summarize evidence on the prevalence of cardioprotective medication use for secondary prevention of CHD in South America. We also intend to explore time-trends, guideline compliance and factors associated with medication use.

Methods

We conducted a systematic review searching literature in PubMed, Embase, Cochrane, Lilacs and SciElo. We searched articles published from 2000 to 2021 that reported prevalence of secondary prevention medication use in South America. We pooled the prevalence estimates in a meta-analysis, described findings on guideline compliance, and used meta-regression models to analyse time-trends and identify factors associated with medication use.

Results

We identified 7388 publications, from which 73 were included in the review (Fig 1). Medication prevalence varied by class: beta-blockers 73.0%(95%CI 66.6%–79.1%), ACEI/ARBs 55.8% (95%CI 49.7%–61.8), antiplatelets 84.6% (95%CI 79.6%–88.5%), acetylsalicylic acid 85.1% (95%CI 79.7%–89.3%) and statins 78.5% (95%CI 70.7%–84.7%). Heterogeneity of the pooled estimates was high. Ten publications reported low medication use and nine reported adequate use. The use of beta-blockers, ACEI/ARBs and statins significantly increased from 1993 to 2020. Medication use was lower in community, public and rehabilitation settings compared to tertiary centres.

Conclusion

The use of most cardioprotective medication classes for secondary prevention of CHD in South America has increased over the last 20 years, but it could be further improved particularly in community settings.
Which subjective factors determine the self-rated negative occupational prognosis of patients in cardiac rehabilitation? A qualitative study
Authors: Brehmer N , Wolff L L , Voeller H , Salzwedel A
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Introduction

A negative self-rated occupational prognosis hinders the vocational reintegration of patients after cardiac rehabilitation (CR). Several studies reveal that these patients often show reduced physical performance as well as higher psychosocial burden. Although the current evidence indicates that self-rated (negative) occupational prognosis of the patients in CR is a multi-factorial issue, there are no studies on subjective factors determining that prognosis.

Purpose

The aim of this study was to understand what subjective factors determine a self-rated negative occupational prognosis of patients in CR.

Methods

A single-centre qualitative study using thematic analysis was conducted in the fourth quarter of 2021. Data was collected by two researchers using in-depth interviews with 20 patients with self-rated negative occupational prognosis and 5 patients with non-impaired prognosis. We interviewed working-age patients (range 18-60 years) who were admitted to a rehabilitation program usually within 14 days after an acute cardiac event. The participants were selected by theoretical sampling. All interviews were recorded, transcribed and coded. We concluded the codes in main themes.

Results

In our analysis of interview texts we extrapolated seven themes: 1) environmental factors (social support, requalification opportunities, industry-specific occupational risks); 2) personal factors (professional skills, knowledge about own impairments, attitude toward future); 3) factors that occurred before a cardiac event (previous illness, unhealthy lifestyle, familial predisposition to disease); 4) factors that occurred after a cardiac event (health stigma and discrimination, disabilities, changed personal priorities); 5) patient's health perception including physical capacity; 6) possibilities to change the working conditions; 7) heart-focused anxiety. The themes 1 to 4 can be considered as an umbrella term for multiple individual factors. However, the themes 5 to 7, which indicate specific determining subjective factors for self-rated occupational prognosis, appeared in most of the interviews.

Conclusion

We conclude that the self-rated occupational prognosis is determined by a complex set of individual factors. However, three themes – patient´s health perception, opportunity to adjust work place, and resilience towards heart-focused anxiety- were mentioned by the majority of patients regarding their self-accessed occupational prognosis. Affected patients are likely to require a multidisciplinary rehabilitation program, whereas these three themes might be addressed by social workers and psychologists.
Determinants of peak oxygen pulse in disorders of glucose metabolism
Authors: Karaduz B , Bozdemir-Ozel C , Calik Kutukcu E , Arikan H , Dagdelen S
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background/Introduction

Oxygen pulse reflects oxygen consumption per heart beat and it provides an information for stroke volume and peripheral oxygen extraction during exercise. Further this, oxygen pulse reported as prognostic for all-cause and cardiovascular mortality. Disorders of glucose metabolism (i.e., prediabetes and overt diabetes mellitus) are important risk factor for cardiovascular disease and might disrupt oxygenation.

Purpose

We aimed to investigate determinants of peak oxygen pulse in patients with prediabetes and overt diabetes mellitus.

Methods

Twenty-six patients with disorders of glucose metabolism (mean age: 48,62±7,08 years, HbA1c: 6,51±0,94) were included in the study. Laboratory parameters which very low density lipoprotein cholesterol (VLDL), low and high density lipoprotein (HDL, LDL) levels, HbA1c and C-reactive protein (CRP) levels of participiants were recorded. Patient performed a symptom limited maximal cardiopulmonary test (CPET).

Results

There was statistically significant negative correlation between oxygen pulse with VLDL (r=-512, p=0,018), CRP (r=-665, p<0.001), waist circumference (r=-471, p=0,015). Based on linear regression analysis, we found that CRP and VLDL explained %40 of variance Oxygen pulse. (R=0.637, R2=0.406, F(2-26). 6.160, p=0.009, constant=0.133).

Conclusion(s)

CRP and very low density lipoprotein cholesterol levels is independent predictors of oxygen pulse. Management of VLDL levels and inflammation can improve peripheral oxygenization in prediabetes and overt diabetes mellitus.
Prevalence of abnormal electrocardiographic findings in a brazilian cohort of young football players: B-pro foot ECG pilot study
Authors: Stein R , Ferrari F , Helal L , Dilda GD , Emed LGM , Bassan F , Aleixo HC , Martins VM , Da Silveira AD
Published: May 2022

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Hospital de Clínicas de Porto Alegre Research and Event Incentive Fund (FIPE-HCPA)

Introduction

The 12-lead resting electrocardiogram is a useful tool for diagnosing pathological conditions in athletes. The prevalence of electrocardiographic abnormalities in Brazilian soccer players are unknown.

Purpose

To describe the prevalence of abnormal electrocardiographic findings in young Brazilian soccer players based on the "2017 International Criteria for Electrocardiographic Interpretation in Athletes".

Methods

Continuous variables were displayed as mean and standard deviation or median and interquartile range, while prevalence’s with 95% confidence intervals, and stratified by race. Intra-group differences were estimated by linear models or binomial and multinomial logistic regressions. Type I error was set to set a at 0.05. An additional margin of 0.025 was considered at the discretion of the statistician conditioned to the quality of the model. All analysis were running in Stata version 16.0.0.

Results

2,581 young Brazilian soccer players from 27 clubs (mainly first division), aged 15-35 years (median: 18 years) were evaluated. 1,268 (49.1%) were Caucasians, 796 (30.8%) Mixed-Race (MR) and 517 (20.1%) Afro-Brazilians (AB). T-wave inversion (TWI) in the inferior leads (3.0%), high lateral leads (DI/aVL) (0.6%), V5 (2.3%), V6 (1.8%), and V5-V6 (1.7%) were present. Six Caucasians (0.5%) presented TWI in V1-V4. Prolonged corrected QT interval (QTc) (0.5%), QRS ≥140 ms (0.2%), "pathological" anterior Q waves (0.2%), lateral ST-segment depression (0.07%), premature ventricular contractions (0.5%), Mobitz type II atrioventricular block (0.03%), and a Wolff-Parkinson-White pattern (0.04%) were also observed. There were no athletes with short QTc interval, epsilon waves, profound sinus bradycardia (<30 beats per minute), complete left bundle branch block, third-degree atrioventricular block, or Brugada pattern (1, 2 or 3). Overall, 111/2,581 (4.3%) soccer players had electrocardiographic changes considered to be abnormal (4.4% in Caucasians, 4.5% in MR and 6.4% in AB). There was no difference between the abnormal findings among races, except for the prevalence of TWI in V6, which was higher in AB compared to Caucasians (3.1% versus 1.2%, respectively; P = 0.01).

Conclusion

To the best of our knowledge, this is the first large electrocardiographic cohort of Brazilian young soccer players to be described. In this sample, we evidence a prevalence <5% of abnormal findings according to the "2017 International Criteria for Electrocardiographic Interpretation in Athletes". Additional evaluation in all these cases is indicated.
Cholesterol and the risk of acute coronary syndrome. Mendelian randomisation in the Czech population
Authors: Hubacek JA , Adamkova V , Dlouha D , Pitha J
Published: May 2022

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Health, Czech Republic

Introduction

Increased plasma cholesterol levels are considered as a risk factor for the development of cardiovascular diseases, including acute coronary syndrome (ACS). However, observational studies in recent years have often found no increased LDL-cholesterol values in ACS patients compared to controls. Final cholesterol levels are largely modified by genetic factors, so they can be used to demonstrate (based on Mendelian randomization) whether the link between plasma cholesterol and MI risk is still present.

Methods

In our study, we analysed LDL-R (rs6511720), CILP2/PBX4 (rs16996148), APOB (rs693) and SORT-1 (rs646776) variants in a total of 939 patients with ACS and 1,191 healthy controls (post-MONICA study). Only men aged 18-65 years were included in the study.

Results

Patients with ACS had significantly lower total cholesterol levels than controls (4.8 ± 1.1 vs. 5.7 ± 1.1 mmol / L; P <0.001). Total and LDL-cholesterol were not higher in patients even after adjusting for age, BMI and dyslipidemic treatment. We confirmed a significant effect of all analysed variants on LDL-cholesterol levels (all P <0.01). None of the four analysed variants significantly affected the risk of MI (P values between 0.10 and 0.58). Individuals with at least seven cholesterol-raising alleles had a slightly increased risk of ACS compared to others (OR, 95% CI; 1.26, 1.06-1.51; P = 0.01).

Conclusion

Variants within the genes for LDL-R, CILP2 / PBX4, APOB and SORT-1 are significant genetic determinants of LDL-cholesterol levels in the population of Czech men. After a population-wide reduction in cholesterol levels, these levels no longer seem to be a serious problem in determining ACS, and interventions to reduce other types of risk should be given more attention.
Effects of heart failure and diabetes on invasive biomarkers of skeletal muscle wasting
Authors: Wood N , Straw S , Scalabrin M , Espino-Gonzalez E , Smith J , Wheatcroft S , Witte KK , Roberts L , Bowen TS
Published: May 2022

Funding Acknowledgements

Type of funding sources: None.

Background

Muscle wasting is common in patients with diabetes mellitus (DM) and chronic heart failure (HF), which exacerbates cachexia and poor quality of life. However, a gap in clinical translation remains as the mechanisms underlying muscle wasting in DM and HF remain poorly validated, with most evidence assumed from experimental small-animal models.

Purpose

Validate if markers of muscle wasting (e.g., autophagy, proteolysis, myogenesis) were correlated to muscle phenotype and clinical indices in humans with DM and HF.

Method

Male patients with DM (n=4), HF (n=4; NYHA=2), DMHF (n=7; NYHA=2) were included. DM was classified as a HbA1c level ≥48mmol/mol and HF classified as a left ventricular ejection fraction (LVEF) ≤40%, with patients on optimised medication. Muscle biopsies of pectoralis major were excised during routine pacemaker surgery and frozen at -80°C for both histological and gene expression analysis. Muscle samples were sectioned, stained, and imaged for fibre cross-sectional area and fibre type. RT-PCR gene expression was conducted for markers of muscle regeneration (myod, myogenin), protein degradation (myostatin and autophagy-related LC3B, ATG7, CTSL), and anabolic signalling (IGF-1). Statistical analysis included ANOVAs and correlation analysis to identify relationships between variables. Values of p<0.05 were accepted as significant.

Results

Groups (DM, HF, DMHF) were not different (P>0.05) in relation to age (79±9, 72±8, 72±10 years) or BMI (24.5±3.6, 28.5±4.2, 29.5±6.0) respectively. Fibre size or fibre type were not different (P>0.05) between groups. In line with this, gene expression for markers of myogenesis and anabolism as well as myostatin were not different (P>0.05) between groups, but a trend in downregulation of the proteolytic autophagy-related genes (LC3B, ATG7, CTSL) in DMHF vs DM or HF was found on average by 21, 36, and 30% respectively. Autophagy-related genes LC3B, ATG7, CTSL were positively correlated (P<0.05) to type IIa fibre numerical density (R=0.82, 0.86, 0.89) and LVEF (R=0.85, 0.92, 0.83), respectively.

Conclusion

Our findings indicate that gene expression of autophagy could represent a robust marker of muscle wasting and cardiac dysfunction in humans with DM and HF. Muscle biopsies from patients with DM and HF identified the proteolytic system of autophagy, important for cellular homeostasis, may be inhibited and this was correlated to fibre phenotype and LVEF. However, the process of muscle wasting in DM and HF within the clinical setting may not necessarily reflect those reported in animal models given various other markers were not changed.
Robojournalism – A Copyright Study on the Use of Artificial Intelligence in the European News Industry
Authors: Trapova Alina , Mezei Péter
Published: May 2022

The copyright protectability of outputs generated by, or with the help of Artificial Intelligence (AI) is a hotly debated question in academia and by many institutions. In practice, sophisticated AI algorithms have become a meaningful assistant in the European news industry for the reporting of sports (Retresco’s collaboration with the German Football Association), weather (textOmatic’s collaboration with FOCUS Online) and finance (the Guardian’s ‘Guarbot’). Furthermore, for the first time in copyright history a court in China assessed the validity of a company’s copyright claim over the articles produced by the corporation’s algorithm. The protection with copyright of this ‘robojournalism’ is no longer just a buzzwordy trend. From a technological perspective, robojournalism currently relies on assistive, generative and distributive technologies. The first two seem to be the most problematic from a copyright perspective as they challenge the well-rooted human authorship requirement. Experts have been able to agree so far that it does not look like AI technology is going to be a disruptive force in the media industry. However, researching the impact of AI in journalism matters a great deal. There are numerous benefits stemming from the use of AI in the newsroom – from expanding news coverage, through faster content production, all the way to leaving journalists more time for the more ‘creative’ and investigative tasks where the algorithm remains weak. This paper addresses, first, the protectability of the outputs of robojournalism under the existing European Union copyright laws. It then goes on to introduce findings related to the practical significance of robojournalism in the European news industry. Here, our focus is on the business, media, and communications studies’ perspectives of automated journalism. Our results demonstrate that the extent to which European journalism relies on assistive and generative technologies to produce written output does not justify, from a copyright perspective, the changing of the current anthropocentric copyright system. These findings have wider implications as AI-generated outputs have prompted many to talk about market failure if copyright (or related rights) protection was to be refused for such works.1
Leber’s hereditary optic neuropathy-associated ND6 14484T > C mutation caused pleiotropic effects on the complex I, RNA homeostasis, apoptosis and mitophagy
Authors: Liang Min , Ji Yanchun , Zhang Liyao , Wang Xuan , Hu Cuifang , Zhang Juanjuan , Zhu Yiwei , Mo Jun Q , Guan Min-Xin
Published: May 2022

Leber’s hereditary optic neuropathy (LHON) is a maternally inherited eye disease due to mitochondrial DNA (mtDNA) mutations. LHON-linked ND6 14484T > C (p.M64V) mutation affected structural components of complex I but its pathophysiology is poorly understood. The structural analysis of complex I revealed that the M64 forms a nonpolar interaction Y59 in the ND6, Y59 in the ND6 interacts with E34 of ND4L, and L60 of ND6 interacts with the Y114 of ND1. These suggested that the m.14484T > C mutation may perturb the structure and function of complex I. Mutant cybrids constructed by transferring mitochondria from lymphoblastoid cell lines of one Chinese LHON family into mtDNA-less (ρo) cells revealed decreases in the levels of ND6, ND1 and ND4L. The m.14484T > C mutation may affect mitochondrial mRNA homeostasis, supported by reduced levels of SLIRP and SUPV3L1 involved in mRNA degradation and increasing expression of ND6, ND1 and ND4L genes. These alterations yielded decreased activity of complex I, respiratory deficiency, diminished mitochondrial ATP production and reduced membrane potential, and increased production of reactive oxygen species in the mutant cybrids. Furthermore, the m.14484T > C mutation promoted apoptosis, evidenced by elevating Annexin V-positive cells, release of cytochrome c into cytosol, levels in apoptotic proteins BAX, caspases 3, 7, 9 and decreasing levels in anti-apoptotic protein Bcl-xL in the mutant cybrids. Moreover, the cybrids bearing the m.14484T > C mutation exhibited the reduced levels of autophagy protein LC3, increased levels of substrate P62 and impaired PINK1/Parkin-dependent mitophagy. Our findings highlighted the critical role of m.14484T > C mutation in the pathogenesis of LHON.
A Systematic Literature Review of the Burden of Respiratory Syncytial Virus and Health Care Utilization Among United States Infants Younger Than 1 Year
Authors: Suh Mina , Movva Naimisha , Bylsma Lauren C , Fryzek Jon P , Nelson Christopher B
Published: May 2022

Background

The burden and health care utilization (HCU) of respiratory syncytial virus (RSV) in US infants aged <1 year across health care settings are not well characterized.

Methods

We systematically reviewed studies of RSV and bronchiolitis published 2000–2021 (data years, 1979–2020). Outcomes included RSV hospitalization (RSVH)/bronchiolitis hospitalization rates, emergency department (ED)/outpatient (OP) visit rates, and intensive care unit (ICU) admissions or mechanical ventilation (MV) use among RSV-/bronchiolitis-hospitalized infants. Study quality was determined using standard tools.

Results

We identified 141 good-/fair-quality studies. Five national studies reported annual average RSVH rates (range, 11.6 per 1000 per year among infants aged 6–11 months in 2006 to 50.1 per 1000 per year among infants aged 0–2 months in 1997). Two national studies provided RSVH rates by primary diagnosis for the entire study period (range, 22.0–22.7 per 1000 in 1997–1999 and 1997–2000, respectively). No national ED/OP data were available. Among 11 nonnational studies, RSVH rates varied due to differences in time, populations (eg, prematurity), and locations. One national study reported that RSVH infants with high-risk comorbidities had 5-times more MV use compared to non–high-risk infants in 1997-2012.

Conclusions

Substantial data variability was observed. Nationally representative studies are needed to elucidate RSV burden and HCU.