bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combinations of mineral and bone disorder markers and risk of death and hospitalizations in the international Dialysis Outcomes and Practice Patterns Study
Authors: Fuller Douglas S , Dluzniewski Paul J , Cooper Kerry , Bradbury Brian D , Robinson Bruce M , Tentori Francesca 
Published: October 2019

AbstractBackgroundPrior studies have developed a chronic kidney disease–mineral and bone disorder (CKD-MBD) composite score based on combinations of calcium (Ca), phosphorus (P) and parathyroid hormone (PTH) that have been shown to be associated with an increased risk of clinical outcomes in the USA. We examined this association in a contemporary, international cohort of hemodialysis patients.MethodsWe studied 19 313 patients surviving ≥12 months in the Dialysis Outcomes and Practice Patterns Study Phases 3–5 (2005–15) from Europe, Canada and the USA. The CKD-MBD composite score was defined as the number of markers above target levels (P, 3.5–5.5 mg/dL; Ca, 8.4–10.2 mg/dL; PTH, 150–600 pg/mL). Using Cox models, we estimated hazard ratios (HRs) for death and a composite event (death or hospitalization), contrasting MBD 2/3 (2–3 parameters above target) with MBD 0 (all in target), adjusted for a disease risk score (DRS).ResultsMBD 2/3 above target was observed in 10–14% of patients across regions and was associated with greater DRS-adjusted mortality {HR 1.41 [95% confidence interval (CI) 1.10–1.82]} and composite events [HR 1.23 (95% CI 1.10–1.38)] in the USA compared with MBD 0; the mortality association was stronger for patients ≥ 65 years of age [HR 1.82 (95% CI 1.28–2.58)] compared with patients &lt;65 years of age [HR 1.11 (95% CI 0.80–1.55)]. HRs observed in Canada and Europe were generally consistent but weaker. Estimates for MBD 2/3 outside target (above or below) were slightly lower in all regions.ConclusionsSimultaneous consideration of Ca, P and PTH may help in identifying patients on dialysis with a higher risk of major clinical outcomes related to CKD-MBD.
The effect of climate change on the escape kinematics and performance of fishes: implications for future predator–prey interactions
Authors: Domenici Paolo , Allan Bridie J M , Lefrançois Christel , McCormick Mark I 
Published: October 2019

AbstractClimate change can have a pronounced impact on the physiology and behaviour of fishes. Notably, many climate change stressors, such as global warming, hypoxia and ocean acidification (OA), have been shown to alter the kinematics of predator–prey interactions in fishes, with potential effects at ecological levels. Here, we review the main effects of each of these stressors on fish escape responses using an integrative approach that encompasses behavioural and kinematic variables. Elevated temperature was shown to affect many components of the escape response, including escape latencies, kinematics and maximum swimming performance, while the main effect of hypoxia was on escape responsiveness and directionality. OA had a negative effect on the escape response of juvenile fish by decreasing their directionality, responsiveness and locomotor performance, although some studies show no effect of acidification. The few studies that have explored the effects of multiple stressors show that temperature tends to have a stronger effect on escape performance than OA. Overall, the effects of climate change on escape responses may occur through decreased muscle performance and/or an interference with brain and sensory functions. In all of these cases, since the escape response is a behaviour directly related to survival, these effects are likely to be fundamental drivers of changes in marine communities. The overall future impact of these stressors is discussed by including their potential effects on predator attack behaviour, thereby allowing the development of potential future scenarios for predator–prey interactions.
Complementary Use of Various Types of Anthropogenic Habitats by Scolia hirta (Hymenoptera: Scoliidae) and Scolia sexmaculata
Authors: Twerd Lucyna , Sobieraj-Betlińska Anna , Banaszak Józef 
Published: October 2019

AbstractScolia hirta (Schrank) and Scolia sexmaculata (O.F. Müller) are Palearctic, parasitic Aculeata inhabiting forests and forest steppes. At present, the abundance and dispersal of these species are increasing considerably in Poland and other European countries, allowing observation of their possible habitat preferences. The analysis of the preferences of S. hirta and S. sexmaculata was conducted in Northern and North-Eastern Poland based on the evaluation of their occurrence in six types of habitats: (A) psammophilous and xerothermic grasslands, (B) old fields, (C) city outskirts, (D) sites in housing/industrial zones, (E) sand quarries, (F) post-industrial wastelands, and in a total of three types of landscape: 1) semi-natural, 2) urban, and 3) industrial. We demonstrated that the habitat most frequently colonized by S. hirta is post-industrial wastelands, while S. sexmaculata were most often sampled in old fields, with the frequency of 100% and 94.11%, respectively. At the same time, the abundance of the species in these habitats was also the highest, with a mean of 8.00 and 10.88 individuals, respectively. Moreover, S. hirta was relatively frequently found in the urban landscape (67% in city outskirts and 88.23% in the housing/industrial zones), while S. sexmaculata colonized these areas to a considerably low degree (25% in city outskirts and 29.41% in the housing/industrial zones). We also established that the occurrence of the species was affected by the forest cover in the closest vicinity of the study sites, which significantly modified the habitat preference of the species analyzed.
The impact of visceral and general obesity on vascular and left ventricular function and geometry: a cross-sectional magnetic resonance imaging study of the UK Biobank
Authors: van Hout Max J P , Dekkers Ilona A , Westenberg Jos J M , Schalij Martin J , Scholte Arthur J H A , Lamb Hildo J 
Published: October 2019

Abstract

Aims
We aimed to evaluate the associations of body fat distribution with cardiovascular function and geometry in the middle-aged general population.

Methods and results
Four thousand five hundred and ninety participants of the UK Biobank (54% female, mean age 61.1 ± 7.2 years) underwent cardiac magnetic resonance for assessment of left ventricular (LV) parameters [end-diastolic volume (EDV), ejection fraction (EF), cardiac output (CO), and index (CI)] and magnetic resonance imaging for body composition analysis [subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT)]. Body fat percentage (BF%) was assessed by bioelectrical impedance. Linear regressions were performed to assess the impact of visceral (VAT) and general (SAT and BF%) obesity on cardiac function and geometry. Visceral obesity was associated with a smaller EDV [VAT: β −1.74 (−1.15 to −2.33)], lower EF [VAT: β −0.24 (−0.12 to −0.35), SAT: β 0.02 (−0.04 to 0.08), and BF%: β 0.02 (−0.02 to 0.06)] and the strongest negative association with CI [VAT: β −0.05 (−0.06 to −0.04), SAT: β −0.02 (−0.03 to −0.01), and BF% β −0.01 (−0.013 to −0.007)]. In contrast, general obesity was associated with a larger EDV [SAT: β 1.01 (0.72–1.30), BF%: β 0.37 (0.23–0.51)] and a higher CO [SAT: β 0.06 (0.05–0.07), BF%: β 0.02 (0.01–0.03)]. In the gender-specific analysis, only men had a significant association between VAT and EF [β −0.35 (−0.19 to −0.51)].

Conclusion
Visceral obesity was associated with a smaller LV EDV and subclinical lower LV systolic function in men, suggesting that visceral obesity might play a more important role compared to general obesity in LV remodelling.
3037The prognostic significance of grade of ischemia in patients with STEMI: a substudy of the randomized trial of primary PCI with or without routine manual thrombectomy (TOTAL trial)
Authors: Leivo J , Anttonen E , Jolly S S , Dzavik V , Koivumaki J , Tahvanainen M , Koivula K , Nikus K , Wang J , Cairns J A , Niemela K , Eskola M 
Published: October 2019

Abstract

Background
The importance of grade of ischemia (GI) classification in the risk assessment of patients with ST-elevation myocardial infarction has been shown previously. Grade 3 ischemia (G3I) is defined by the Sclarovsky-Birnbaum grading system as ECG with ST-elevation and distortion of the terminal portion of the QRS complex in two or more adjacent leads, while grade 2 ischemia (G2I) is defined as ECG with ST-elevation without QRS distortion.

Methods
In a substudy of the international, multicenter, prospective, randomized Trial of Routine Aspiration Thrombectomy with PCI versus PCI Alone in Patients with STEMI (TOTAL), we studied the prognostic impact of the grade of ischemia classification on the outcome in patients with STEMI (n=7,211). The primary outcome was a composite of death from cardiovascular causes, recurrent MI, cardiogenic shock, or New York Heart Association (NYHA) class IV heart failure within one year.

Results
The primary outcome occurred in 153 of 1,563 patients (9.8%) in the G3I group vs. 364 of 5,648 patients (6.4%) in the G2I group (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.29 to 1.88; p<0.001). The rates of cardiovascular death (4.8% with G3I vs. 2.5% with G2I; HR, 1.92; 95% CI, 1.45 to 2.54; p<0.001) and all-cause mortality (5.2% with G3I vs. 3.3% with G2I; HR, 1.62; 95% CI, 1.25 to 2.10; p<0.001) were also higher in patients with G3I. The rate of stroke or TIA were similar within the two groups (1.1% with G3I vs. 1.0% with G2I; HR, 1.13; 95% CI, 0.66 to 1.95; p=0.650). The grade of ischemia (G3I vs G2I) was shown to be an independent predictor of primary outcome in adjusted multivariable analysis (adjusted HR, 1.43; 95% CI, 1.18 to 1.74; p<0.001).

Conclusions
STEMI patients with G3I in the presenting ECG proved to have an increased rate of cardiovascular death, recurrent MI, cardiogenic shock, or NYHA class IV heart failure within one year compared to patients with G2I.

Acknowledgement/Funding
Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital, The unit of Heart Center Co. [Z60064]
3150Predictors as exercise intolerance and myocardial fibrosis of clinical outcomes in patients with hypertrophic cardiomyopathy
Authors: Hwang J W , Kim S.U.N.G.M , Park S.U.N.G.-J , Kim E U N K , Chang S.U.N.G.-A , Lee S.A.N.G.-C , Choe Y.E.O.N.H , Park S W O O , Kim D.A.R.A.E , Choi J.I.N.-O.H , Kim H A J , Ok S.E.O.N.H 
Published: October 2019

Abstract

Reduced exercise capacity is common in patients with hypertrophic cardiomyopathy (HCMP), affecting patients along a broad spectrum of clinical severity. Replacement fibrosis is associated with worse outcomes in patients with HCMP. The aim of study was to evaluate cardiopulmonary exercise test (CPET) and cardiac magnetic resonance (CMR) to predict clinical outcomes in HCMP patients.
We enrolled 371 patients with HCMP and normal left ventricular (LV) systolic function (ejection fraction >50%), who underwent both CPET and CMR. CMR at 1.5 T, including late gadolinium delayed enhancement (LGE), was carried out to define the amount of myocardial fibrosis. The primary outcome was hard events including cardiac death, myocardial infarction, cardiac transplantation, sustained ventricular tachycardia, cerebral stroke, and heart failure requiring hospitalization.
During follow-up (6.1±2.6 years), there were 74 hard events. The patients were older (56.11±10.37 vs. 52.19±11.17, p=0.006) in the group with hard events. Exercise intolerance as peak oxygen consumption (peak VO2) showed in the group with hard events (25.60±6.01 vs. 30.18±6.81, p<0.001). In addition, the amount of myocardial fibrosis as LGE was larger (27.67±23.07 vs. 18.09±15.80, p=0.001). Larger left atrium size as volume index (LAVI) (50.01±18.14 vs. 41.55±16.48, p<0.001), increased LV filling pressure as E/e' (13.80±5.43 vs. 11.50±4.48, p=0.001) and higher level of NT-proBNP in laboratory finding (941.01±895.22 vs. 575.68±910.76, p=0.003) were showed in the group with hard events. Multivariable Cox-proportional analysis with adjustment as age and gender showed that peak VO2 [hazard ratio (HR) = 0.926, 95% confidence interval (CI) 0.872–0.984, p=0.013], LGE (HR=1.022, 95% CI 1.000–1.055, p=0.05) and LAVI (HR=1.03, 95% CI 1.007–1.053, p=0.009) could predict the clinical outcome as hard events. The incremental prognostic value for the prediction of hard events of peak VO2, LGE and LAVI over clinical variables was from 0.759 to 0.772 as the value of area under the curves (AUC).
This study demonstrated that the exercise intolerance, progression of myocardial fibrosis, and abnormal diastolic parameters could be significant predictors of clinical outcome in the patients with HCMP. CPET and CMR may help us to monitor and manage cardiac events in these patients.

Acknowledgement/Funding
None
4098Reduced skeletal muscle mass is associated to worsened long-term clinical outcomes in patients with coronary artery disease: a quantitative analysis by computed tomography
Authors: Kang D O , Park S Y , Park Y , Jang W Y , Kim W , Choi B G , Na J O , Choi C U , Kim E J , Rha S.-W , Park C G , Hong S.-J , Seo H S 
Published: October 2019

Abstract

Background
Sarcopenia is closely associated to poor clinical outcomes in patients with atherosclerotic cardiovascular disease (ASCVD). However, it is unclear whether the skeletal muscle mass at baseline has quantitative effect on future cardiovascular outcomes.

Purpose
We investigated the quantitative effect of skeletal muscle mass on future cardiovascular outcomes in patients with coronary artery disease (CAD).

Methods
Total 475 patients those who underwent successful percutaneous coronary intervention (PCI) for CAD and performed computed tomography (CT) scan within 30 days of PCI were enrolled. The cross-sectional area of skeletal muscle at the first lumbar vertebra (L1) level was measured. Whole study population was divided into 4 groups according to the sex-specific quartiles of skeletal muscle index (SMI). Primary outcome was all-cause mortality and secondary outcome was major adverse cardiovascular event (MACE) within 3 years of follow-up.

Results
Mean follow-up duration was 4.11±3.02 years and average time period from the date of PCI to CT scan was −3.33±11.72 days. The incidence of 3-year all-cause mortality (23.2% vs. 9.9% vs. 6.6% vs. 4.4%, p<0.001) and MACE (42.9% vs. 24.0% vs. 14.3% vs. 6.2%, p<0.001) was significantly higher in the group of lower quartiles of L1-SMI. In the fully adjusted multivariable analysis, lower quartiles of L1-SMI was an independent predictor of higher risk of all-cause mortality and MACE (lowest vs. highest quartile; OR: 4.90, 95% CI: 1.54 to 15.5, p=0.007; and OR: 12.3, 95% CI: 4.99 to 30.4, p<0.001, respectively).
Results of 3-year clinical outcomes SMI Q1 (n=124) SMI Q2 (n=116) SMI Q3 (n=112) SMI Q4 (n=123) Log-rank p-value All-cause mortality 27 (23.2) 11 (9.9) 7 (6.6) 5 (4.4) <0.001 Non-fatal MI 9 (8.7) 3 (3.0) 2 (2.0) 3 (2.6) 0.038 Repeat revascularization 20 (24.9) 15 (15.2) 7 (7.1) 4 (3.8) <0.001 Total MACEs 47 (42.9) 26 (24.0) 15 (14.3) 7 (6.2) <0.001 Data are expressed as n (%). MACE = major adverse cardiovascular event; MI = myocardial infarction; SMI = skeletal muscle index; Q = quartile.
Impact of reduced skeletal muscle on CAD

Conclusion
Skeletal muscle mass at baseline is a powerful predictor of future adverse clinical outcomes in patients with CAD undergoing successful PCI. Quantitative assessment of skeletal muscle mass at L1 level by CT scan provides prognostic implication for future cardiovascular risk stratification.

Acknowledgement/Funding
National Research Foundation of Korea (NRF-2016R1A2B3013825), Ministry of Future Creation and Science of Korea (2018K000255)
4250Sports-related sudden cardiac arrest in Germany
Authors: Bohm P , Scharhag J , Schmied C , Meyer T 
Published: October 2019

Abstract

Background
Knowledge about causes of sports-related sudden cardiac arrest (SrSCA) may influence national strategies to prevent such events.

Purpose
We established a prospective registry on SrSCA to estimate the incidence and in particular describe the etiologies of SrSCA in the general population in Germany.

Methods
The registration of SrSCA based upon 4 pillars: a) a web-based platform to record SrSCA cases in competitive and recreational athletes, b) media-monitoring and c) a cooperation with the German Resuscitation Registry as well as d) 15 institutes of forensic medicine.

Results
After an observation period of 6 years, a total of 349 cases was recorded (mean age 48.0±12.7 years) of which 109 subjects survived. Most of the cases occurred during non-elite competitive or recreational sports. Bystander cardiopulmonary resuscitation (CPR) was initiated in 262 cases (75%), however rhythm analysis and defibrillation (if indicated) was mainly performed by medical service. In subjects ≤35 years, premature coronary artery disease (CAD) and sudden arrhythmic death syndrome (SADS) prevailed, followed by myocarditis. In athletes ≥35 years, CAD predominated.

Conclusion
The prevalence of cardiac pathologies in young athletes seems to vary across different countries. CAD represents the most common cause of SrSCA in the general population of Germany, highlighting the need for a targeted cardiovascular risk evaluation including young athletes. Public education on basic life support including the appropriate use of an automated external defibrillator (AED) may further decrease the burden of sudden cardiac death.

Acknowledgement/Funding
Funding from the German Heart Foundation
4259Discovery of the first genome-wide significant risk loci for syncope and collapse
Authors: Ahlberg G , Hadji-Turdeghal K , Andreasen L , Hagen C M , Ghouse J , Baekvad-Hansen M , Bybjerg-Grauholm J , Hougaard D M , Hedley P , Haunsoe S , Svendsen J H , Jepps T A , Skov M W , Christiansen M , Olesen M S 
Published: October 2019

Abstract

Background
Syncope is a common condition in the general population causing frequent hospitalisation and visits to the emergency department. Family aggregation and twin studies have previously indicated that syncope and collapse has a heritable component.

Purpose
We investigated whether common genetic variants predispose to syncope and collapse.

Methods
We used genome-wide association data on syncope and collapse for 408,961 individuals with European ancestry from the UK Biobank study. In a replication study, the Integrative Psychiatric Research Consortium (iPSYCH) cohort (n=86,189) was used to investigate the risk of incident syncope stratified by genotype carrier status.

Results
We report on a genome-wide significant locus on chromosome 2q32.1 with the lead SNP rs12465214 (odds ratio [OR] = 1.13, 95% confidence interval [CI] = 1.10–1.17, P=5.8x10–15; Figure 1a). This association was replicated in the iPSYCH cohort, where homozygous carriers of the C allele conferred an increased hazard ratio (HR=1.30, CI: 1.15–1.46, P=1.68x10–5; Figure 1b). LD score regression demonstrated a significant genetic correlation (rg) with coronary artery disease (rg=0.41, P=6.99x10–15) and related phenotypes such as angina and hypertension (Figure 1c). Analyses of eQTL (P=4x10–8) and epigenetic chromatin states revealed that variation in this locus likely affects expression of the gene ZNF804A, which resides in its proximity (Figure 1d). A qPCR analysis showed that ZNF804A was mostly expressed in the brain. A lower level of ZNF804A expression was also detected in the cerebral arteries. ZNF804A was not expressed in heart tissue.
Figure 1

Conclusion
rs12465214 is associated with syncope and collapse. Variation in this locus likely modulates the expression of the nearby gene ZNF804A through eQTLs and chromatin interactions. ZNF804A is mainly expressed in the brain and cerebral arteries. However, the precise function of ZNF804A is unknown. Furthermore, syncope and collapse is a polygenetic trait and share a significant genetic overlap with coronary artery disease, angina and hypertension.

Acknowledgement/Funding
This work was supported by grants from The John and Birthe Meyer Foundation, The Research Foundation of the Heart Centre, Rigshospitalet, The Research
4305The interrelation of left ventricular geometry with myocardial work
Authors: Sahiti F , Morbach C , Tiffe T , Cejka V , Breunig M , Eichner F , Gelbrich G , Heuschmann P U , Stoerk S 
Published: October 2019

Abstract

Introduction
A novel echocardiographic method to non-invasively determine myocardial work based on speckle-tracking derived longitudinal strain and blood pressure has recently been validated and offers new opportunities to study mechanistic associations. Left ventricular (LV) dilation and LV hypertrophy are acknowledged precursors of myocardial dysfunction and ultimately heart failure, but the mechanisms are still not well understood. We aimed to assess the association of LV geometry and myocardial work in a non-diseased population.

Methods
The Characteristics and Course of Heart Failure STAges A/B and Determinants of Progression (STAAB) cohort study carefully characterized a representative sample of the population of a medium-sized town in Germany, aged 30–79 years. By off-line analysis of the standardized, quality-controlled transthoracic echocardiograms the following parameters describing myocardial work can be derived. Global constructive work (GCW): work performed during shortening in systole and adding negative work during lengthening in isovolumic relaxation; global wasted work (GWW): negative work performed during lengthening in systole adding work performed during shortening in isovolumic relaxation; global work efficiency (GWE): GCW/(GCW+GWW). Further, LV volumes and mass were measured and indexed to body surface area.

Results
Myocardial work analysis was performed in 1568 individuals, who were in sinus rhythm, had preserved LV ejection fraction (EF), and were free from significant valvular disease (50.3% female, aged 53±12 years). In linear regression, we included age, sex, LVEF, low-density lipoprotein (LDL), glycosylated hemoglobin (HbA1c), heart rate, body mass index, hypertension as well as LV mass index (LVMi) and LV end-diastolic volume index (LVEDVi) as parameters of LV geometry. We found increasing LVEDVi (52±10 mL/m2), associated with higher GWW (+0.35, p<0.001) and lower GWE (–0.01, p<0.05), while increasing LVMi (73±17 g/m2) was associated with both, higher GWW (+0.23, p<0.01) and GCW (+1.6, p<0.05) resulting in a lower GWE (–0.09, p<0.01).

Conclusion
The new echocardiography-based method to non-invasively assess myocardial work offers new insights into the relationship of LV geometry and myocardial work in a non-diseased population. While larger LV volumes were associated with more wasted work, higher LV mass was associated with an increase in both constructive and wasted work. Both alterations of LV geometry adversely affected myocardial work efficiency. This new echocardiographic method is change-sensitive and thus holds promise to further explore the relationship of LV geometry with myocardial work in different disease entities.

Acknowledgement/Funding
Funding of the STAAB cohort study in the frame of the Comprehensive Heart Failure Center, BMBF 01EO1004 and 01EO1504