bluuebunny/crossref_metadata_2025_split huggingface dataset:
P2494Cardiovascular disease burden attributed to high blood pressure in Chinese adults with type 2 diabetes
Authors: Bragg F , Halsey J , Guo Y , Chen Y , Bian Z , Clarke R , Li L , Chen Z 
Published: October 2019

Abstract

Background
Cardiovascular diseases (CVD) are the most common cause of death among people with diabetes, reflecting in part co-existence with other CVD risk factors, including high blood pressure. However, controversy persists about the nature of the relationship of blood pressure with risk of CVD in individuals with diabetes, and about the associated disease burden.

Methods
We analysed data from 26,315 men and women aged 30–79 years with type 2 diabetes but no prior history of CVD, who were recruited into the China Kadoorie Biobank in 2004–2008 from 10 diverse areas in China. During ∼10 years' follow-up 1,190 major coronary events (MCE), 4,362 ischaemic stroke (IS), 469 intra-cerebral haemorrhage (ICH) events and 4,503 deaths (including 1,807 CVD deaths) were recorded. Usual systolic (SBP) and diastolic (DBP) blood pressure and uncontrolled hypertension were related to risks of incident CVD and all-cause mortality, after adjustment for relevant confounders.

Results
Overall, 75.7% of participants had prior doctor-diagnosed (24.8%) or screen-detected (67.7%) hypertension, compared with 54.3% among those without diabetes. The age-adjusted prevalence of hypertension was higher among men and in rural areas. Among those with previously diagnosed hypertension, 39.3% reported use of anti-hypertensive medications (on average, 1 agent) and 8.5% had controlled hypertension (<130/80 mmHg). Usual SBP was continuously and positively associated with the risk of CVD, with no evidence of a threshold throughout the range examined (120–180 mmHg). Each 10 mmHg higher SBP was associated with a 27% higher risk for CVD death (HR 1.27, 95% CI 1.25–1.30). Strong positive associations were also seen for MCE (1.16, 1.12–1.21), IS (1.15, 1.13–1.18), and ICH (1.46, 1.34–1.60). Overall, uncontrolled hypertension accounts for an estimated 39% (32–45%), 30% (21–38%), 24% (20–28%) and 48% (34–58%) of CVD deaths, MCE, IS and ICH, respectively, among Chinese adults with diabetes.

Conclusion
Hypertension is common but frequently undetected and uncontrolled among adults with type 2 diabetes in China. Effective diagnosis and management of hypertension among individuals with diabetes would be expected to achieve substantial reductions in CVD morbidity and mortality.

Acknowledgement/Funding
Wellcome Trust, MRC, BHF, CR-UK, Kadoorie Foundation, MoST, NSFC
P2495Poor cardiorespiratory fitness in adolescence predicts cardiomyopathy risk in mid-life
Authors: Robertson J , Schaufelberger M , Lindgren M , Adiels M , Aberg M , Rosengren A 
Published: October 2019

Abstract

Background
Cardiorespiratory fitness and physical activity have well–known cardio–protective effects. Along with reports on declining levels of physical activity globally, heart failure caused by cardiomyopathy is increasing among young people. Still, it is unknown whether poor fitness in adolescence can be associated with cardiomyopathy in adulthood.

Purpose
To study a possible link between cardiorespiratory fitness in adolescence and being diagnosed with cardiomyopathy in adulthood.

Methods
A nationwide register-based prospective cohort study of 1,668,893 young men (mean age 18.3 years, SD 0.7), enlisting for compulsory military service 1969–2005. Body mass index (BMI) and blood pressure were registered at baseline, along with test results for fitness. Values were trichotomized and about 13.5% were classified as having poor cardiorespiratory fitness. Cardiomyopathy diagnoses were identified from the National Hospital Register and Cause of Death Register, during an up to 46-year follow-up, and divided into categories: 1) dilated, 2) hypertrophic, 3) alcohol/drug-induced, and 4) other. Hazard ratios (HR) were calculated with Cox proportional hazards models.

Results
During follow-up (median 27 years; interquartile interval 19–35 years), 4,477 cases of cardiomyopathy were registered, of which 2,631 (59%) were dilated, 673 (15%) were hypertrophic, and 480 (11%) were alcohol/drug-induced. Poor cardiorespiratory fitness was strongly associated with elevated risk of both dilated (HR 1.59, 95% confidence interval (CI) 1.38–1.83) and alcohol/drug–induced cardiomyopathy (HR 2.32, 95% CI 1.68–3.20), adjusted for BMI, age at conscription, conscription year, test center, and baseline comorbidities (diabetes, hypertension, congenital heart disease).

Conclusion
The present study shows that poor cardiorespiratory fitness in adolescence may be associated with both dilated and alcohol/drug–induced cardiomyopathy in adulthood. This strengthens the evidence of fitness as a cardio–protective factor, and brings further support to the importance of interventions promoting physical activity already in childhood.

Acknowledgement/Funding
The Swedish Research Council, The Swedish Heart and Lung Foundation
P2499Effects of aerobic and resistance exercise on skeletal muscle of infarcted rats
Authors: Gomes M J , Lima A R R , Pagan L U , Damatto F C , Oliveira L R S , Souza L M , Rodrigues E A , Pontes T H D , Sodre F S S , Murata G M , Fernandes A A H , Zornoff L A M , Okoshi K , Okoshi M P 
Published: October 2019

Abstract

Background
Skeletal muscle changes contribute to reduced physical performance after myocardial infarction (MI). Exercise has been recommended to stable patients. However, the effects of resistance exercise after MI are not clear. We compared the effects of aerobic and resistance exercise initiated during compensated cardiac remodeling in infarcted rat gastrocnemius muscle.

Methods
Three months after MI induction, Wistar rats were divided into four groups: Sham (n=20); sedentary MI (MI-S, n=9); aerobic exercised MI (MI-A, n=9); and resistance exercised MI (MI-R, n=13). Exercised rats trained three times a week for 12 weeks on a treadmill or ladder. Energy metabolism, oxidative stress markers, and antioxidant enzyme activities were assessed by spectrophotometry. Satellite cells activation markers (MyoD, NCAM, and myosin heavy chain neonatal isoform) were assessed by immunofluorescence or Western blot (Pax-7). Statistical analysis: ANOVA or Mann Whitney.

Results
Physical aerobic capacity was greater in MI-A and strength gain higher in MI-R. Cardiac structures and left ventricular function evaluated by echocardiogram did not differ between infarcted groups. Histological analysis showed that MI size and gastrocnemius cross sectional area did not differ between infarcted groups. Oxygen reactive species production was higher in MI-S than Sham and lipid hydroperoxide concentration was lower in MI-A than the other groups. Catalase activity was higher and glutathione peroxidase lower in infarcted groups than Sham. Superoxide dismutase activity was higher in Sham and MI-R than MI-S. Skeletal muscle metabolism enzyme activity did not differ between groups, except for increase pyruvate kinase in MI-S against the other groups, and β-hydroxyacyl CoA dehydrogenase in MI-S against Sham. Satellite cell activation and protein expression of MAPK and NF-kB did not differ between groups.

Conclusion
Aerobic and resistance exercise respectively improves physical capacity and muscle strength without changing echocardiographic parameters of infarcted rats. Myocardial infarction increases oxygen reactive species production and changes antioxidant enzyme activity and glucose and fatty acid metabolism. Aerobic exercise is superior to resistance exercise against oxidative stress reducing muscle lipid hydroperoxide concentration and attenuating change in glutathione peroxidase activity.

Acknowledgement/Funding
Financial support: Fapesp, CNPq, Capes, and UNESP
P2500The high-sensitivity cardiac troponin I and T response following strenuous activity is attenuated by smokeless tobacco:The North Sea Race Endurance Exercise Study (NEEDED) 2014
Authors: Skranes J , Kleiven O , Aakre K M , Skadberg O , Melberg T H , Omland T , Orn S 
Published: October 2019

Abstract

Background
Use of snus, a smokeless oral tobacco product, is increasing among athletes and recreational exercisers in Scandinavia. Strenuous physical activity is associated with an acute increase in high-sensitivity cardiac troponins (hs-cTn) in healthy individuals. Current smoking is associated with lower baseline hs-cTn concentrations in current smokers in the general population, but whether tobacco affects the hs-cTn response to exercise remains unknown.

Methods
We measured serial cTnI and cTnT concentrations in 1002 healthy recreational athletes before, 3 and 24 h after a 91 km bicycle race. Self-reported snus habits were reported as: non-current (n=794) and current (n=118). The association between snus use and change in log hs-cTnI and hs-cTnT (differences between concentrations at baseline and 3 h (Δ3 h) and 24 h (Δ24 h)) were assessed by multivariable linear regression analysis.

Results
Current snus use was associated with lower cTnI (current users of snus vs non-current: median, 1.7 ng/l; interquartile range (IQR), 1.6–2.3 vs 2.0 ng/L; IQR 1.6–3.2; p=0.020) and cTnT (current users of snus vs non-current: median, 3.0 ng/L, IQR, 3.0–3.5 vs 3.0 ng/L, IQR 3.0–4.3; p=0.021) concentrations at baseline. Both in unadjusted and fully adjusted linear regression models, users of snus had significantly lower Δ3 h and Δ24 h cTnI and cTnT concentrations (Table).
Association between snus use and change in concentrations of hs-cTnI and hs-cTnT (95% CI) Model 1 Model 2 Model 3 Model 4 ΔcTnI 3 h   Current snus −28% (−46% to −10%), p=0.003 −33% (−51% to −14%), p=0.001 −31% (−49% to −13%), p=0.001 −29% (−47% to −11%), p=0.002 ΔcTnI 24 h   Current snus −38% (−62% to −15%), p=0.002 −36% (−59% to −12%), p=0.003 −32% (−56% to −9%), p=0.007 −30% (−54% to −7%), p=0.010 ΔcTnT 3 h   Current snus −28% (−10% to −46%), p=0.003 −33% (−51% to −14%), p=0.001 −31% (−49% to −13%), p=0.001 −29% (−47% to −11%), p=0.002 ΔcTnT 24 h   Current snus −20% (−4% to −36%), p=0.015 −23% (−39% to −8%), p=0.004 −21% (−36% to −5%), p=0.009 −19% (−34% to −14%), p=0.013 Model 1 unadjusted; Model 2 adjusted for sex and age; Model 3 adjusted for Model 2 and systolic blood pressure, body mass index, low-density lipoprotein and estimated glomerular filtration rate; Model 4 adjusted for the same variables as in Model 3 but also race duration and resting heart rate.

Conclusion
The exercise-induced cTn response in healthy recreational cyclist is attenuated in users of smokeless tobacco compared to never users. These findings extend observations of lower hs-cTn concentrations in tobacco smokers in the general population.

Acknowledgement/Funding
Operating grant from North Sea Race, Abbot Diagnostics, Lærdal Foundation. PhD fellowship from South-Eastern Norway Regional Health Authority.
P2518Failure of completion of post-myocardial infarction rehabilitation programme - Who and why? Single center experience with novel Coordinated Comprehensive Care program in Poland
Authors: Telec W , Kalmucki P , Krysztofiak H , Szyszka A , Baszko A 
Published: October 2019

Abstract

Background
Rehabilitation after acute myocardial infarction is a well-proven strategy to improve outcomes and reduce complications rate. Poland recently introduced a novel, fully-reimbursed Coordinated Comprehensive Care (CCC) program after myocardial infarction, a significant portion of which comprises access to free-of-charge cardiac rehabilitation.

Purpose
The purpose of the study was to analyze all patients qualified for the Coordinated Comprehensive Care Program and evaluate reasons for not completing rehabilitation. We compared two groups of patients - those who completed the rehabilitation and those that did not - in terms of clinical, demographic and laboratory characteristics.

Methods
All patients (n=169) referred from the cardiology department for the CCC program were included in the study. They were divided into two groups, depending on single, strict criterium of completion or non-completion of the rehabilitation program. Demographic, clinical and laboratory data were collected and analyzed.

Results
The majority of the patients (n=100, 59.2%) did not undergo cardiac rehabilitation. 61 of them were not qualified for rehabilitation programme by the consortium of doctors: 33 of them due to the need for further invasive treatment, the remainder 28 were disqualified due to severe comorbidities. 32 patients did not commence the program despite referral and encouragement, mostly (n=25) due to personal reasons, 7 patients did not specify reasons for not participating in the rehabilitation. 7 patients were lost to follow-up.
Patients who completed rehabilitation (n=69, 40.8%) were younger that those who did not (64.4±9.8 vs. 67.1±9.5 years, respectively; p=0.076), had significantly higher baseline LVEF (49.1±9.4 vs. 44.7±11.9%, p<0.03), and had lower serum creatinine level (0.99±0.28 vs. 1.15±0.59 mg/dl; p<0.03). There were more patients with LVEF<35% (n=23; 23%) in the no-rehabilitation, than in the other group (n=5; 7.25%; p<0.01).
Rehabilitation completed (n=69) Rehabilitation NOT completed (n=100) p Gender – male 40 (35.4%) 73 (64.6%) <0.05 LVEF- % 49.12 (±9.43) 44.69 (±11.97) <0.03 No. of patients with EF <35% 5 (7.25%) 23 (23%) <0.01

Conclusion
Although fully-reimbursed cardiac rehabilitation is provided for all patients following acute myocardial infarction, there is a significant number of patients who fail to complete the programme. This group comprises more male patients with worse clinical and laboratory test results, especially LVEF and renal function. Efforts should be made to address the problem and modify the programme accordingly.
P2545Long-term use of anabolic-androgenic steroids in male weightlifters is associated with left ventricular systolic dysfunction
Authors: Abdullah R , Bjornebekk A , Dejgaard L , Hauger L , Edvardsen T , Haugaa K , Almaas V 
Published: October 2019

Abstract

Background
Illicit use of anabolic-androgenic steroids (AAS) is widespread and has adverse psychological and cardiovascular effects. Few well-powered studies have explored the effect of long-term AAS-use on left ventricular systolic function.

Purpose
To explore the relationship between long-term use of AAS and left ventricular mass and systolic function.

Methods
We included male weightlifters with a history of >1 year of cumulative AAS-use and male weightlifters unexposed to AAS. We performed echocardiography in all and assessed left ventricular mass using 2D echocardiographic linear measurements and Cube formula, left ventricular ejection fraction (EF) ad modum Simpson, and left ventricular global longitudinal strain (GLS) by speckle-tracking echocardiography.

Results
We recruited 100 male weightlifters, 58 of whom were previous or current AAS-users with mean±SD AAS-use of 10.4±7.0 years, and 42 unexposed weightlifters. There were no difference in age (35.5±9.2 vs. 35.3±7.5 years, p=0.8) nor body mass index (BMI) (BMI 31.4±5.0 vs. 30.1±3.5, p=0.6) between AAS-exposed and unexposed weightlifters. Compared with unexposed weightlifters, AAS-exposed weightlifters demonstrated thicker interventricular septum (11.2±2.4 vs. 9.2±1.3 mm, p<0.001), thicker left ventricular posterior wall dimension (10.1±2.1 vs. 8.9±1.3 mm, p<0.001), and higher left ventricular mass index (99.7±25.4 vs. 78.4±12.1 g/m2, p<0.001). Both left ventricular EF and left ventricular GLS were decreased in AAS-exposed weightlifters compared with unexposed weightlifters (49±9 vs. 53±6%, p=0.02, and −15.6±2.6 vs. −18.3±2.1%, p<0.001) (Figure).

Conclusion
AAS use in male weightlifters was associated with increased left ventricular mass and impaired left ventricular systolic function. Our results suggest considerable adverse cardiac effects of AAS use, but the results need confirmation in prospective observational trials.
P2556TXNDC5 is a novel therapeutic target of atrial fibrosis and fibrillation
Authors: Wu P C , Lin B C , Yeh Y H , Chen W J , Yang K C 
Published: October 2019

Abstract

Background
Atrial fibrillation (AF), one of the most common cardiac arrhythmias, increases the risk of stroke, systemic embolization and cardiovascular mortality. Atrial fibrosis, a hallmark of chronic AF, provides substrates to initiate/propagate fibrillation waves in the atria. There, however, lacks effective and specific therapeutics targeting atrial fibrosis. We have recently identified an endoplasmic reticulum (ER) protein thioredoxin domain containing 5 (TXNDC5) as a critical mediator of cardiac ventricular fibrosis. We hypothesized that TXNDC5 could also play an important role in the pathogenesis of atrial fibrosis and fibrillation.

Purpose
To determine the role of TXNDC5 in atrial fibrosis and fibrillation.

Methods and results
TXNDC5 transcript and protein levels were both significantly upregulated in the atrial tissue from patients with AF. In addition, TXNDC5 mRNA expression levels were positively correlated with those of transcripts encoding transforming growth factor β1 (TGFβ1) and extracellular matrix (ECM) proteins in human atrial tissue. Knockdown of TXNDC5 in human atrial fibroblasts (hAF) attenuated TGFβ1–induced hAF activation, proliferation and ECM protein upregulation, whereas overexpression of TXNDC5 was sufficient to trigger hAF activation, proliferation and ECM protein production. Further experiments revealed that the fibrogenic effects of TXNDC5 were dependent on c-Jun N-terminal kinase (JNK) signaling. Furthermore, using α-MHC-TGFβcys33ser mice, a transgenic mouse model with cardiac-specific overexpression of constitutively active TGFβ, which develop extensive atrial fibrosis and inducible AF, we showed that TXNDC5 was strongly upregulated in the fibrotic atria of α-MHC-TGFβcys33ser mice and specifically enriched in collagen-secreting atrial fibroblasts. Targeted deletion of TXNDC5 (Txndc5−/−) in α-MHC-TGFβcys33ser mice considerably mitigated the extent of atrial fibrosis. In addition, transesophageal atrial burst pacing induced AF in 75% (3 out of 4) α-MHC-TGFβcys33ser mice, whereas knockout of Txndc5 markedly reduced the inducibility of AF (25%, 3 out of 12) in α-MHC-TGFβcys33ser mice (Figure).
TXNDC5 KO Reduces AF Inducibility

Conclusion
The present study revealed that ER protein TXNDC5 augments atrial fibrosis by promoting cardiac fibroblast proliferation and ECM protein production via JNK signaling activation. Targeted deletion of Txndc5 protects against TGFβ induced atrial fibrosis and AF. Targeting TXNDC5, therefore, could be a promising new therapeutic approach to treat or prevent atrial fibrosis and AF.
P2574Sexual activity and dysfunction in adult patients with congenital heart disease
Authors: Diller G P , Helm P , Gundlach C , Baumgartner H , Bauer U M M 
Published: October 2019

Abstract

Background
Although the number of adults with congenital heart disease (CHD) is increasing, there is little research into the impact of CHD on sexual activity and -dysfunction. Whether and to what extent sexual function is discussed with patients in clinical practice is also unknown.

Purpose
To study the current knowledge level, problems, wishes and fears of adult CHD patients regarding sexual activity.

Methods
Patients recruited via the German National Register for Congenital Heart Defects were invited to an online survey about sexual function. Overall, 4,484 patients (2,264 female) were invited to the survey and 873 patients (502 female) participated (19.5%). Patients were divided into four groups based on the underlying CHD severity classification: simple CHD (136 patients), moderate CHD (354 patients), complex CHD (340 patients).

Results
301 (35.6%) patients reported that they had very rarely or no sex at all in the six months preceding the survey (simple CHD: 25.7%, moderate CHD: 33.6%, complex CHD: 38.2%, other CHD: 39.5%). Based on the last six months, 71.2% of the surveyed male patients estimated the probability of having and maintaining an erection as high or very high (simple CHD: 85%, moderate CHD: 71.4%, complex CHD: 69.7%). In addition, 60.6% of the interviewed male patients reported to be almost always or always able to get a full erection sufficient for sexual intercourse. In contrast, 14.6% of the male patients already had erectile dysfunction, but did not discuss this issue with their physician. Overall, only 3.5% of the male patients stated that they were offered a consultation regarding erectile dysfunction by their treating physician. In contrast, 29.6% of the male patients would like to receive such counseling during routine medical examinations. In the last six months, 56.4% of the interviewed female patients, reported no difficulties with lubrication. 44% of the female patients already received advice from their physician on sexuality, contraception and pregnancy and 64.5% of the female patients would like to receive additional medical advice and information on sexuality, contraception and pregnancy in the context of routine medical check-ups.

Conclusions
This study reveals important issues regarding sexual function in male and female adult patients with CHD. The study reveals important gaps in counselling patients regarding sexual issues beyond contraception and pregnancy.
P2586Cardiac progenitor cell exosome-associated periostin triggers reentry of cardiomyocytes into cell cycle
Authors: Balbi C , Bolis S , Barile L , Vassalli G 
Published: October 2019

Abstract

Introduction
Nanovesicles known as exosomes (Exo) from cardiac-derived progenitor cells (CPCs) are cardioprotective and improve cardiac function after myocardial infarction; however the mechanisms of benefit are incompletely understood, especially with respect to endogenous cardiomyocytes (CM) renewal. Periostin (POSTN), a secreted extracellular matrix protein, is emerging as a matricellular factor that can trigger CM proliferation. We have identified POSTN as a protein secreted by CPC and enriched in their exosomal fraction.

Purpose
We sought to determine whether Exo-CPC can induce proliferation of CM and to explore the role of exosomal POSTN in inducing reentry of CM into the cell cycle.

Methods
Exo were isolated from CPC condioned medium by density gradient ultracentrifugation. Fractions were analyzed by Western blotting for the presence of POSTN as well as specific Exo markers (TSG101, CD9). POSTN-depleted Exo (ExoCPC_SiPOSTN) were obtained by transfecting CPC with specific siRNA. Active DNA synthesis was assessed on primary cell culture of rat neonatal CM by EdU incorporation. H9C2 cardiomyocytic cells were used to assess by real-time RT-PCR the expression of downstream genes Hippo/Yes-associated protein (YAP) signaling pathway.

Results
Western blotting analysis allowed to specifically determining the presence of Exo markers and POSTN in the different fractions of secreted vesicles. Smaller fractions (f1-f3) have the highest amount of TSG101 and CD9 as well as POSTN, thus suggesting that CPC secrete POSTN associated with Exo. The silencing of POSTN in cells resulted in a 60% reduction of Exo-associated POSTN compared to naïve ExoCPC. ExoCPC but not ExoCPC_SiPOSTN, were able to increase phosporylation of AKT and ERK in H9C2 cells. YAP phosporylation and its degradation was decreased resulting in the activation of the downstream gene AurBKinase. By real-time PCR, AurBKinase expression was increased by 2.6 folds with ExoCPC and 1.5 folds with ExoCPC_SiPOSTN compared to cells not exposed to Exo. ExoCPC were able to increase 1.5 fold EdU incorporation in cardiac troponin-positive primary rat CM. ExoCPC_SiPSTN did not affect proliferation.
Schematic figure

Conclusion
These results suggest that POSTN may promote cardiomyocyte proliferation through the direct activation of the AKT/ERK/Hippo-Yap pathway. Exosomes released by CPC are an important source of POSTN and may have a potential for promoting cardiac regeneration.

Acknowledgement/Funding
This work has been supported by The Swiss National Science Foundation under grant n° 310030_169194