bluuebunny/crossref_metadata_2025_split huggingface dataset:
4096Additive effects of exercise training upon cognitive function in regular red wine consumers compared to abstainers
Authors: Nishiyama M , Campane L Z , Nucci M P , Zuben M V , Trombetta I C , Rondon E , Negrao C E , Junior E A , Laurindo F R M , Da Luz P L 
Published: October 2019

Abstract

Background
Although regular red wine (RW) consumption and physical exercise (PE) exert cardiovascular protection a possible aditive effect of both is unknown, especially regarding cognition.

Purpose
To investigate the effects of supervised PE upon cognitive function in regular RW consumers compared to abstainers (Abs)

Methods
Cognitive function was assessed by functional Cerebral Magnetic Resonance Image (fMRI) through Stroop Color Word test (Stroop) for executive function and 2-back for working memory as well as neuropsychological tests (trails A, B and Stroop1). Seventy three healthy males, aged 59±5.9 (SD) years were divided into 4 groups: 37 Abs (17 with PE, 20 without) and 36 RW drinkers (17 with PE, 19 without) and then were randomized in the pre-PE phase, either to supervised PE for 3 months, 3x week/1h duration or no PE. Cardiopulmonary exercise test (CET) was performed before and after interventions. Plasma lipids and glucose also were measured.

Results
Drinkers ingested 19.8±10.3 (SD) gr of ethanol/day as RW for an average of 26.1±15.7 years and did not change their habits during the study period. In pre-PE phase RW drinkers showed lower execution times than Abs in neurophsychological tests (trails A and B and Stroop1) and higher accuracy in the 2-back test in fMRI (p<0.05 for both). Furthermore, in post intervention phase, RW consumers with PE showed a trend towards improvement in executive function (Stroop: % accuracy 92.5±9.2 vs 95.6±5.0, p=0.05) and reduction in execution time (21.9±6 vs 19±3.4; p=0.049) as well as in neuropsychological Stroop-2 (p<0.05).In parallel there were no changes in activated cerebral áreas in either group after PE. However, there was a negative correlation between peak VO2 and activated brain areas by fMRI (Expert Analysis Tool based on the Generalized Linear Model; p<0.05) in both Abs and drinkers.
In contrast, there were no significant changes in any cognition test among abstainers regardless of PE; also there were no changes in metabolic profile. PE induced significant increments in peak VO2 in all PE groups (p<0.05).
fMRI BOLD sign during 2-back test

Conclusion
Physical exercise induced further improvement in executive function and working memory in long term RW drinkers, while no effects occurred in abstainers. Such effect was correlated with global fitness, as assessed by peak VO2.

Acknowledgement/Funding
Fundação de Amparo à Pesquisa do Estado de São Paulo; Banco Bradesco SA
4101Identification of genetic variants associated with the cardiovascular disease risk factor, low aerobic fitness - The HUNT study
Authors: Bye A , Ryeng E , Silva J J , Moreira J B , Stensvold D , Wisloff U 
Published: October 2019

Abstract

Abstract
Background: Low maximal oxygen uptake (VO2max) is a strong and independent risk factor for all-cause and cardiovascular disease (CVD) mortality. Although physical activity is a major determinant of VO2maxlevel, genetics contribution is estimated to be ∼50%.

Methods
We performed a genetic association study on 123.545 single-nucleotide polymorphisms (SNPs) and directly measured VO2max in 3470 individuals (exploration cohort). The candidate SNPs were subsequently analyzed in a separate cohort of 718 individuals (validation cohort), in addition to 7 wild-card SNPs previously associated with VO2max, but not included on the chip used in the exploration cohort. Sub-analyses were performed for each gender. In silico analysis and genotype-phenotype databases were used to predict physiological function of the SNPs.

Results
In the exploration cohort, 42 SNPs were associated with VO2max (p<5.0×10–4). Six of the candidate SNPs were also found to be associated with VO2max in the validation cohort (p<0.05, either in men, women or both), in addition to three wild-card SNPs. By using these nine SNPs we created a genetic score for inborn VO2max-level. Together, these nine SNPs explained ∼8% of the variation in VO2max, and discriminate individuals with inborn high versus low VO2max based on simultaneous carriage of multiple favorable alleles. The cumulative number of favorable SNPs correlated negatively with the presence of several CVDrisk factors, e.g. waist-circumference, visceral fat, fat %, cholesterol levels and BMI. In silico analysis indicated that several of the SNPs influence gene expression across multiple organs, including adipose tissue, skeletal muscle and heart.

Conclusion
We identified six novel genetic variants associated with VO2max, and validated three SNPs previously associated with fitness related traits.

Acknowledgement/Funding
K.G. Jebsen Foundation, the Norwegian Health Association, the Liaison Committee between the Central Norway Regional Health Authority (RHA) and NTNU
4328Short-term effects of dapagliflozin versus canagliflozin on acute decompensated heart failure in patients with type 2 diabetes
Authors: Nakagaito M , Joho S , Ushijima R , Nakamura M , Hirai T , Kinugawa K 
Published: October 2019

Abstract

Background
The CANVAS program and DECLERE-TIMI 58 reported that SGLT2i had been demonstrated to reduce hospitalization for heart failure (HF) in type 2 diabetic mellitus (T2DM) patients with high cardiovascular disease risk. However, it remains unclear whether the effectiveness of SGLT2i on acute decompensated HF is also observed in T2DM patients irrespective of acting types of SGLT2i.

Methods
In this single center, open-label, prospective study, fifty-eight T2DM patients hospitalized due to decompensated HF were enrolled (mean age 73 years, HbA1c 7.2%). After treatment for HF, 5mg/day of dapagliflozin (n=24, from February 2016 to February 2017) or 100mg/day of canagliflozin (n=34, from March 2017 to July 2018) was administered and clinical parameters about HF and T2DM were followed for 7 days. Statistical comparison of parameters between groups taking dapagliflozin or canagliflozin was performed using the two-way repeated measures analysis of variance (MANOVA).

Results
In both groups, urine glucose excretion increased significantly after administration of SGLT2i. Fasting blood glucose level tended to be decreased in both groups. Urine volume increased significantly one day after administration of SGLT2i, and returned to the baseline after one week in both groups. Interestingly, urine volume one day after administration of SGLT2i tended to increase more in the group taking canagliflozin than in the group taking dapagliflozin (interaction P value = 0.088). Importantly, plasma BNP levels and Nt-proBNP levels were decreased significantly in both groups.
Parameters before and after treatment Baseline Day 7 (Day 1) P value Interaction P value Fasting blood glucose, mg/dL All 137±57 122±51 0.013 0.900 Dapa 144±64 133±53 0.089 Cana 128±64 118±40 0.069 log BNP All 5.31±1.11 4.91±1.09 <0.001 0.102 Dapa 5.48±1.04 4.94±1.00 <0.001 Cana 5.20±1.15 4.89±1.16 <0.001 log Nt-proBNP All 7.25±1.35 6.96±1.41 <0.001 0.735 Dapa 7.54±1.16 7.22±1.25 0.048 Cana 7.04±1.45 6.79±1.50 0.005 Urine volume (Day 1), mL/24h All 1218±523 1584±614 <0.001 0.088 Dapa 1261±564 1486±568 0.038 Cana 1186±498 1654±644 <0.001 Urine volume (Day 7), mL/24h All 1218±523 1305±408 0.128 0.428 Dapa 1261±564 1295±468 0.700 Cana 1186±498 1313±367 0.097 Urine glucose, g/24h All 1.6±5.5 23.7±23.5 <0.001 0.330 Dapa 1.7±6.8 20.3±21.7 <0.001 Cana 1.5±4.6 26.0±24.7 <0.001

Conclusion
SGLT2i are useful for correcting volume overload and recovering from the decompensated state in HF patients with T2DM irrespective of acting types of SGLT2i.
P3111Empagliflozin, a SGLT2 inhibitor, attenuates endothelial dysfunction and atherogenesis by inhibiting inflammatory responses in the vasculature and adipose tissue in diabetic apolipoprotein E-deficient
Authors: Ganbaatar B , Fukuda D , Yagi S , Kusunose K , Yamada H , Soeki T , Sata M 
Published: October 2019

Abstract

Background
Inflammation and oxidative stress associated with hyperglycemia are major causes of vascular dysfunction and cardiovascular complications in diabetes. Recent studies reported that cardioprotective effects of sodium glucose co-transporter 2 (SGLT2) inhibitors, however underlying mechanisms are still obscure.

Purpose
The aim of this study was to investigate whether empagliflozin attenuates atherogenesis and endothelial dysfunction in diabetic apolipoprotein E-deficient (ApoE−/−) mice and investigated underlying mechanisms.

Methods
ApoE−/− mice were injected with streptozotocin (75 mg/kg) for 3 consecutive days. One week after last injection, a western type diet and administration of empagliflozin (20 mg/kg/day) or vehicle via oral gavage were started. Atherosclerotic plaque area was examined by en face Sudan IV staining. Lipid deposition and inflammatory features of atherosclerotic plaques was examined on lesions in the aortic root by immunohistochemical analysis. Vascular function was assessed by isometric tension recording. mRNA or protein expression level was examined by quantitative RT-PCR (qPCR) or western blot analysis, respectively. In in vitro experiments, murine macrophage cell line, RAW264.7, was used.

Results
Treatment with empagliflozin for 12 weeks significantly decreased atherosclerotic plaque size in the aortic arch compared with untreated group (p<0.01). Empagliflozin reduced blood glucose (p<0.001) and plasma lipid levels. Results of histological analyses revealed that empagliflozin decreased lipid deposition, macrophage accumulation, and the expression of inflammatory molecules in the aortic root. Empagliflozin treatment for 8 weeks significantly attenuated endothelial dysfunction as determined by vascular response to acetylcholine. qPCR results demonstrated that empagliflozin reduced the expression of inflammatory molecules such as MCP-1 (p<0.05), ICAM-1 (p<0.05) and Nox-2 (p<0.05), a major NADPH oxidase subunit, in the aorta compared with the untreated group. Furthermore, empagliflozin significantly mitigated the expression of these inflammatory molecules in fat tissues around the aortic arch as determined by qPCR. In in vitro studies, methylglyoxal (MGO), a precursor of AGEs, increased the expression of inflammatory molecules (e.g., MCP-1, IL-1b and TNF-a (p<0.05, respectively)) in RAW264.7 cells. MGO also significantly induced activation of JNK and p38 MAP kinase (p<0.001, respectively) in this cell-type.

Conclusions
Empagliflozin attenuated endothelial dysfunction and atherogenesis in diabetic ApoE−/− mice. Reduction of inflammation in the vasculature and peri-vascular adipose tissues may have a role as underlying mechanisms at least partially.
P3344Research network in Africa (RNA): observatory of hospitalizations in cardiology departments in 14 African countries (FEBRUARY Study: 2016, 2017 and 2018)
Authors: Kingue S , Kouam Kouam C , Suliman A , Antignac M , Empana J P , Jolis N , Traore A , Toure I A , Damorou J M , Sidy Ali A , Ikama S M , Niakara A , Balde D , Jouven X , Diop I B 
Published: October 2019

Abstract

Background
Epidemiological transition in the developing world has resulted in a shift from infectious to non-communicable diseases as leading causes of morbidity and mortality, cardiovascular (CV) disease (CVD) is the first cause of death in Africa. However, data regarding the characteristic of patients with CVD are scarce, especially in Sub-Saharan Africa.

Purpose
We built an observatory recording the characteristics of all patients admitted to hospital in CV departments and hospital care components in Sub-Saharan Africa (FEBRUARY Study).

Methods
We conducted a transversal and longitudinal study in CV departments of 29 hospitals from 14 African countries. FEBRUARY study was designed by a multidisciplinary collaborative team of epidemiologists, pharmacists and cardiologists from Africa and France. This ongoing observatory included all patients admitted in hospitalization during the month of February every year since 2016 and will continue every year. Data including socio-demographic and clinical characteristics, causes of admission, clinical, biological, complementary examinations, treatments, length of stay and discharge diagnosis were collected by the investigating physicians.

Results
Overall 2680 patients were admitted to hospital in February 2016 (n=736), 2017 (n=967), and 2018 (n=987) in CV departments from 14 countries: Benin, Burkina Faso, Burundi, Cameroon, Congo, Côte d'Ivoire, Gabon, Guinea, Mali, Niger, Dem. Rep of The Congo, Senegal, Togo and Sudan (figure). Men represented 58,8%. Mean age of age was 54 years and Women 52 years. The mean length of stay was 9 days, and death rate 10,1%. The main cause of admission was cardiac failure (40,3%) followed by acute coronary syndrome (10.1%) and stroke (9,3%). Among CV risk factors, high blood pressure, sedentary behavior, diabetes, active tobacco consumption and dyslipidemia were present in 46%, 19%, 13%, 11% and 6% of patients, respectively.
In a longitudinal analysis, hospital admission due coronary syndrome increased from 7% in 2016 to 10.5% in 2018 (p for trend = 0.03). Length of hospital stay and rate of hospital death remain stable.
Hospitalizations by country (FEBRUARY)

Conclusion
The FEBRUARY observatory is an important tool to describe cardiovascular characteristics of patients in transversal analysis, but also the longitudinal evolution over the coming years in Sub-Saharan Africa.
P3345Stroke and death in atrial fibrillation patients newly treated by oral anticoagulants in France: a national cohort study 2012–2016
Authors: Gabet A , Chatignoux E , Bejot Y , Olie V 
Published: October 2019

Abstract

Background
Introduction of new oral anticoagulants (OAC) lead to an increase in atrial fibrillation (AF) patients treated with those drugs. Few epidemiological data on outcomes are available in France or abroad in this population. There is an important need to follow up patients newly diagnosed for AF and treated by OAC, and estimate stroke and mortality outcomes at national level in unselected patients' population. The French “Système national des données de santé” (SNDS) gathered enough medical information on the overall French population, with complete follow-up until patient's death.

Purpose
The objective of this study was to analyze stroke and death outcomes and their determinants in a cohort of AF patients newly treated by OAC in France between 2012 and 2016.

Methods
All AF patients aged over 20 years old, residing in France, and newly treated by OAC between 2012 and 2016 were included in a cohort. The date of OAC delivery was considered as the inclusion date. Patients were followed till 31 of December 2017. Main outcomes studied were the first hospitalisation for stroke or death. We used a Fine and Gray regression model to estimate subdistribution hazard ratio (SHR) for stroke. Cox regression models were used to compute cause-specific hazard ratios (CSHR) for stroke and death respectively. Analyses were adjusted for main confounders.

Results
The total number of patients enrolled in the study for the period 2012–2016 was 662,298. Mean age at inclusion was 74.9 years old. Women accounted for 47.8% of the study population. Globally, 3.8% of patients experienced stroke after initiation of OAC and 13.9% of patients died over the study period with 1.1% of death occurring after a stroke. The median follow-up for stroke or death events was 1094 days, 1208 days for stroke and 1123 days for death. Incidence rates of stroke or death reached 53.3 [53.0–53.6] per 1,000 person-year and, 11.3 [11.2–11.5] and 44.0 [43.7–44.3] for stroke and death respectively. Advanced age, history of stroke, acute coronary syndrome (ACS), chronic kidney disease (CKD), treated hypertension, diabetes and to be included during the first year of the study period were associated with an increase in the subdistribution hazard of stroke. Significant differences were found by age group such as an increase in SHR for stroke in women aged over 85 years compared to men of the same age. Cause-specific analyzes gave similar results for stroke. History of heart failure, ACS, CKD, hemorrhages, treated hypertension and diabetes were associated with increased hazard of death. On the contrary, female sex was associated with a significant decrease in the hazard of death only.

Conclusion
Stroke incidence and mortality rate in AF patients newly treated by OAC were high. Several factors were associated with increased hazard of stroke and death but differed according to patient's age.
P3352Telemedicine transcends national boundaries in quest of creating a behemoth ami program
Authors: Mehta S , Botelho R , Fernandez F , Feres F , Abizaid A , Cade J , Perin M , Prudente M , Cavalcanti R , Dusilek C , Frauenfelder A , Matheus C , Pinto G , Mazzini J , Quintero S 
Published: October 2019

Abstract

Background
The Latin America Telemedicine Infarct Network (LATIN) has exploited the remarkable competence of telemedicine for remote guidance. In doing so, LATIN created a mammoth population-based AMI network that employed experts located several hundred miles away to guide the reperfusion strategies for almost 800,000 screened patients. In this pioneering project, telemedicine was initially utilized to guide AMI management within national confines. We speculated whether LATIN telemedicine navigation could outstrip countrywide borders.

Purpose
To maximally harness the vast possibilities of telemedicine for improving AMI care.

Methods
During its pilot phase, LATIN began as a hub and spoke, AMI system in Colombia where 20 spokes (small community health centers and rural clinics) were configured with 3 hubs that could perform Primary PCI. These sites were linked through web-based connectivity. Expert cardiologists, located 50–250 miles away in Bogota, Colombia, used sophisticated telemedicine platforms for urgent EKG diagnosis and teleconsultation of the entire AMI process. Based upon the duration of chest pain and travel time to the hub, these experts guided patients through guideline-based strategies of thrombolysis, pharmaco invasive management or primary PCI. Efficiency of the telemedicine process was measured with the new metric of time to telemedicine diagnosis (TTD). Cloud computing, GPS navigation, and numerous business intelligent tools were gradually incorporated into LATIN telemedicine. As systems became more scalable, the program was expanded to Brazil, where LATIN flourished. Over the last 18 months, LATIN telemedicine capabilities have been pressed across national boundaries. Presently, all 82 LATIN centers in Mexico are guided by experts located in Bogota, Colombia and the 7 Argentina centers channeled through Santiago, Chile.

Results
784,947 patients were screened for AMI at 350 LATIN centers (Brazil 143, Colombia 118, Mexico 82, Argentina 7). Navigation pathways are depicted in the attached figure. TTD remains extremely low in all four countries, and comparable efficiency and tele-accuracy have been achieved. With expanded geographic reach, 8,448 (1.08%) patients were diagnosed with STEMI and 3,911 (46.3%) urgently reperfused, including 3,049 (78%) with Primary PCI. Time to TTD ranged between 2.8 to 5.8 minutes, with a mean of 3.5 min. Tele-accuracy was 98.5%, D2B 51 min, and in-hospital mortality 5.2%. Various other comparative metrics for the 4 countries are being gathered and will be available at the time of presentation.

Conclusions
LATIN demonstrates the robust ability of telemedicine to transcend national boundaries to guide AMI management. This strategy can be adopted in under-developed countries in Asia and Africa to provide an umbrella of AMI care for the millions of disadvantaged patients.
P3368Mitral annulus disjunction retrospective assessment by transthoracic and transoesophageal echocardiography in a large cohort of patients with mitral valve prolapse and significant mitral regurgitation
Authors: Mantegazza V , Tamborini G , Gripari P , Ghulam Ali S , Volpato V , Italiano G , Fusini L , Muratori M , Pepi M 
Published: October 2019

Abstract

Background
The separation between the atrial wall-mitral valve junction and the left ventricular attachment (mitral annulus disjunction, MAD) is a recently discovered feature associated with Barlow's disease (BD). Correlations between MAD and morpho-functional alterations of the mitral valve (MV) apparatus have been described and different prevalence rates of MAD have been reported by several authors, analysing small sample size populations of patients with mixomatous MV prolapse (MVP).

Purpose
Aims of the study were 1) to estimate the prevalence and to assess MAD in a large cohort of patients with MVP (either BD or fibroelastic deficiency, FED) and significant mitral regurgitation with indication for surgical correction conforming to guidelines; 2) identification of any correlation between MAD and the MV anatomy, MVP aetiology and general characteristics of the study population.

Methods
A total of 979 patients presenting at our Centre from 2007 and 2018 with MVP and moderate-to-severe or severe mitral regurgitation were enrolled in the study. All patients underwent pre-operative transthoracic echocardiography (TTE) and 792 also intraoperative transoesophageal echocardiography (TOE). All recorded images and clips were saved in a central archive and were retrospectively analysed. MAD was defined as any distance observed between the atrial wall-MV junction and the left ventricular wall; it was evaluated in all available views and measured at end-systole.

Results
The overall population included 630 patients (64.4%) affected by BD and 349 (35.6%) with FED. Assessing off-line images from TTE and/or TOE, MAD was identified in 161 (16.4%) patients, respectively 21% and 8% in the BD and FED subgroups. Maximal MAD distance measured 6.6±2.2 mm at TTE and 6.7 mm ± 2.2 mm at TOE. Comparing MVP patients with and without MAD, it emerged that MAD was associated with younger age (60±14 vs 64±13 years, p<0.001) and slightly lower BMI (23.9±3.6 vs 24.5±3.6 kg/cm2, p=0.045). As concerns the MV apparatus, the presence of MAD showed a median larger MV annulus (medio-lateral diameter 41.0 [37.0–44.0] vs 39.0 [36.0–42.0] mm, p=0.001; antero-posterior diameter 38.0 [34.0–41.0] vs 36.0 [33.0–40.0] mm, p=0.001), greater incidence of bileaflet MVP (47.8% vs 25.9%, p<0.001) and mixomatous aetiology (82.0% vs 60.9%, p<0.001) and a lower prevalence of chordal rupture (61.5% vs 75.7%, p<0.001).

Conclusion
MAD significantly correlates with specific anatomical MV characteristics. Its prevalence results to be lower than reported in previous studies performed in different clinical contexts. In MVP population with surgical indication, MAD is clearly associated to BD, but it is also observed in a minority of patients with FED

Acknowledgement/Funding
None