bluuebunny/crossref_metadata_2025_split huggingface dataset:
P661 Relationship between streptococcal infective endocarditis and preneoplastic colorectal lesions
Authors: Vilardell P , Moral S , Bosch D , Frigola J M , Morales M , Albert X , Robles R , Ramos R , Graterol F , Brugada R 
Published: January 2020

Abstract

Background
Colorectal cancer is associated with infective endocarditis (IE), due to specific gut pathogens like streptococcus Gallolyticus that use the tumor presence as a point of blood entry. However, the association between streptococcal IE and pre-cancerous lesions such as dysplastic adenomas is unknown.

Objectives
To determine the association with pre-neoplastic colorectal lesions and streptococcal IE.

Methods
Two hundred eighty consecutive patients with IE were included in a protocol of clinical, microbiological and imaging follow-up, between January 2008 and December 2018. Precancerous lesions were divided as high and low-grade dysplasia based on World Health Organization criteria. Colorectal cancer was defined as the presence of malignant cell beyond the muscularis mucosa.

Results
A colonoscopy was performed in 81 patients (29%) and 26 of them (32%) presented colorectal lesions: 10 (38%) colorectal cancer and 16 (62%) precancerous lesions (12% high degree (n = 2); 88% low degree (n = 14)). Both, colorectal cancer (20% vs 11%; p = 0.02) and preneoplastic lesions (44% vs 8%; p &lt; 0.001) were associated with higher incidence of streptococcus Gallolyticus IE (Figure 1). Additionally, the subgroup of precancerous lesions with low degree also showed this association (43% vs 9%; p = 0.001).

Conclusions
Precancerous colorectal lesions are also associated with streptococcus Gallolyticus IE, even low-grade lesions. Hence, it is necessary to rule out occult neoplastic and preneoplastic colorectal lesions with colonoscopy in these patients.
Figure 1: Relationship between S. Gallolyticus IE and colorectal lesions.
a Statistical significance between colorectal cancer and S. Gallolyticus IE.
b Statistical significance between preneoplastic colorectal lesions and S. Gallolyticus IE.
Abstract P661 Figure.
P662 Synchrony between the right and left heart systems is recovered after TAVI in patients with severe aortic stenosis
Authors: Ota T , Murakami Y , Kozuka Y , Ohshiro C , Kihara N , Takagi Y 
Published: January 2020

Abstract

Funding Acknowledgements
Young Investigator Grant of Japanese Society of Cardiovascular Anesthesia
Background / Introduction
Evidences have shown that cardiac function decline and systolic phase change are caused by massive afterload of the stenosed aortic valve in patients with severe aortic valve stenosis. As a result of the reduction of the left ventricular afterload by valve replacement, the cardiac function recovers. However, it has not been clarified yet how the changes in cardiac function affect the relationship between the right and left heart systems, as well as the systole phase.
TAPSE and MAPSE are known as indices of simple cardiac function evaluation by measuring the movement distance of the atrioventricular annulus. We obtained these indices (i.e. TAPSE, MAPSE) within the same heartbeat using speckle tracking analysis of the atrioventricular annulus and evaluated the changes in cardiac function and phase between the right and left heart systems.
Purpose
To reveal the relationship of cardiac function and time phase between the right and left heart systems by evaluating the maximum movement distance and time of the atrioventricular annulus within the same heartbeat and the same view in patients with severe aortic valve stenosis before and after TAVI.
Methods
A prospective cohort study was conducted. We recruited and analyzed 44 patients with severe aortic valve stenosis who received TAVI treatment, able to record baseline before treatment and follow-up 6 months and 12 months after treatment at our hospital from March 2017 to May 2019. Patients were excluded if more than 2 degree of atrioventricular valve regurgitation or incomplete data. The apical four-chamber view was used for speckle tracking analysis with the origin of the apical extension and region of interest (ROI) of the mitral annulus and tricuspid annulus. For each patient before treatment, at 6 months and 12 months after treatment, the maximum contraction distance (DM), maximum contraction time (TM) of the mitral valve annulus, maximum contraction distance (DT) and maximum contraction time (TT) of the tricuspid annulus were measured. Maximum contraction distance ratio (DM/ DT) and maximum contraction time ratio (TM/ TT) were calculated. For statistical analysis, t-test and ANOVA were used, and a significance threshold of p &lt;0.05 was applied.
Results
TM/ TT decreased at 12 months after TAVI, and DM/ DT increased significantly at 6 months and 12 months after TAVI when compared to baseline before treatment.

Conclusions
In patients with severe aortic valve stenosis, the correction of cardiac function difference between the right and left heart systems occurs from 6 months after TAVI. Moreover, the correction of contraction phase difference between the right and left heart systems at 12 months after TAVI. Thus, the synchrony between the right and left heart system is recovered 12 months after TAVI.
Abstract P662 Figure.
P668 Echocardiographic description of mitral annular disjunction in mitral valve prolapse and implication in arrhythmic risk stratification
Authors: Venner C , Boddaert M , Selton-Suty C , Filippetti L , Sellal J M , Mandry D , Marie P Y , Huttin O 
Published: January 2020

Abstract

Introduction
Mitral annular disjunction (MAD) is an anatomical variation of the mitral annulus, characterized by an atrial displacement of the leaflet’s hinge points. It is associated with severe ventricular arrhythmias (VA) in mitral valve prolapse (MVP).

Purpose
The aim of this study was to assess MAD in MVP by echocardiography, analyze the reproducibility of measurements and evaluate its importance for arrhythmic risk stratification along with strain analysis of myocardial deformation.

Methods
Two hundred and sixty patients with MVP were included. MAD was evaluated and measured by two observers in the parasternal long axis and in the apical views. Myocardial longitudinal strain was analyzed by speckle-tracking.

Results
Ninety four patients (36.2%) of MVP patients presented MAD. These patients were younger (53.7 ± 15.1 vs 58.4 ± 17.6, p = 0.033) with higher rate of atypical chest pain (21.3% vs 11.5%, p = 0,041) and bileaflet prolapse (50.5% vs 32.3%, p = 0.004). Para-sternal long-axis view was the incidence of choice to detect MAD with a moderate inter-observer concordance (Kappa of 0.55), good correlation (r = 0.69, p &lt; 0.01) and inter-class correlation coefficient (0.82; 0.67 – 0.90). Twenty patients (7.7%) had a history of severe VA. Among them, no difference was noted in terms of presence (35% vs 36.3%, p = 0.911) or length of MAD (11.1 ± 2.5 vs 11.2 ± 3.1, p = 0.937). However, deformation analysis showed reduced global longitudinal strain (18.6 ± 3.1 vs 21.3 ± 3.3%, p = 0.001) and higher mechanical dispersion values (46 ± 13 vs 37.4 ± 12.9 ms, p = 0.002)in comparison to the rest of the MVP population.

Conclusion
No significant association was found between severe VA and the presence or severity of MAD in MVP patients. Increased mechanical dispersion and reduced global longitudinal strain may be helpful for arrhythmic risk stratification.
Abstract P668 Figure. Comparison of MD and GLS
P670 RV function in adult patients with repaired tetralogy of Fallot: assessment by three-dimensional echocardiography, comparison to CMR findings and relationship to pulmonary artery distensibility
Authors: Capotosto L , Galea N , Francone M , Marchitelli L , Tanzilli G , Viceconte N , Mangieri E , Gaudio C , Miraldi F , Vitarelli A 
Published: January 2020

Abstract

Purpose
The purpose of this study was to examine right ventricular (RV) function by three-dimensional speckle-tracking echocardiography (3DSTE) in patients after correction of tetralogy of Fallot (TF), the accuracy of 3DSTE compared to cardiovascular magnetic resonance (CMR) findings and assess pulmonary arterial (PA) distensibility in order to achieve a more comprehensive understanding of the matching between RV performance and PA load.

Methods
Twenty-one patients (mean age 39 ± 16 years) with repaired TF and twenty-one age-matched healthy subjects selected as controls were studied. CMR findings were available in 14 patients. RV volumes, RV ejection fraction (RVEF) and RV longitudinal and circumferential strains were calculated by three-dimensional echocardiography and three-dimensional speckle tracking echocardiography. The main pulmonary artery was interrogated by color, pulsed, and continuous-wave Doppler. Pulmonary regurgitation (PR) was assessed by color-flow mapping and graded as none, mild, or greater than mild using the measurement of the regurgitant jet width in relation to the outflow tract diameter. Right pulmonary artery (PA) was visualized from suprasternal view by two-dimensional echocardiography. Tissue Doppler Imaging (TDI) mode was activated in B-mode imaging to examine arterial motion, then mode was changed to color-mode with the beam line aligned perpendicular to the superior and inferior walls of the right PA. PA distensibility and strain were determined. Data analysis was performed offline.

Results
Overall, 3D RVEF and RV longitudinal strain were reduced in TF patients compared to the control group. Nine patients had moderate or moderate-to-severe PR. PA strain and distensibility were decreased (p = 0.003) compared with controls, both in the presence and absence of PR. PA strain had a positive correlation with RVEF (r = 0.79, p &lt; 0.005) and RV strain (r = 0.82, p &lt; 0.001). RV end-diastolic and end-systolic volumes by 3DE correlated with the respective parameters by CMR (r = 0.88,p &lt; 0.001 and r = 0.87,p &lt; 0.005 respectively). Patients with moderate-to-severe PR had more prominent PA strain changes (p = 0.02).

Conclusions
Three-dimensional right ventricular ejection fraction and RV strain are impaired in patients with repaired TF, in agreement with CMR data. Reduced PA strain is associated with reduced RV 3DSTE parameters and is more pronounced in the presence of pulmonary regurgitation.
P671 Can catestatin be used as an alternative or addition to cardiac remodeling ultrasound traditional criteria in patients with essential hypertension?
Authors: Gubareva E , Kryukov N , Gubareva I 
Published: January 2020

Abstract

Funding Acknowledgements
Samara Governor Grant in the field of science and technics 2018
Essential hypertension (EH) is one of the most important risk factor for major cardiovascular diseases and remains one of the most important medical and social problems in the world. Left ventricle hypertrophy, caused by chronic increased blood pressure, is an important independent risk factor for sudden death, myocardial infarction, stroke and other cardiovascular complications.
Catestatin is a peptide, belonging to the buffer system "catecholamines-catestatin" and changes of its concentrations contribute to early EH pathogenesis.
The aim of the research was to evaluate correlations of catestatin concentrations with cardiac remodeling ultrasound traditional criteria in patients with EH of different cardiovascular risk.
Material and methods. The study included 180 male patients in age from 30 to 50 years with a diagnosis of EH, who signed an informed consent to participate in the study. Patients were divided into 4 groups – group 1 (n = 28) – EH of an average risk of cardiovascular complications (CVC), group 2 (n = 76) – EH of a high risk of CVC, group 3 (n = 31) – EH of very high risk of CVC and the group of contril – 45 almost healthy men with normal and optimal blood pressure. Transthoracic echocardiography and sonography of the brachiocephalic trunk arteries were performed.
The results. Intra-group analysis of the data revealed a statistically significant negative correlation of catestatin concentrations and carotid intima-media thickness of the common carotid artery on the left in group 2 (r=-0,246; p = 0,040). In patients with EH catestatin and left ventricle end-diastolic volume correlations were revealed (r = 0,827; p = 0,011). Intra-group correlation analysis revealed a statistically significant correlation of catestatin concentrations and left ventricle posterior wall thickness (r=-0,523; p = 0,045), interventricular septum thickness (r=-0,523, p = 0,045) in diastole in group 2; with left ventricle posterior wall thickness (r = 0,258; p = 0,035) and interventricular septum thickness (r = 0,254; p = 0,038) in systole in group 3.
Correlation analysis of the data discovered a statistically significant negative relationship between catestatin concentrations and left ventricle remodeling (r=-0,171, p = 0,042). In patients with normal heart geometry, statistically significant (p = 0,04) higher concentrations of catestatin were obtained in comparison with patients with left ventricle remodeling (9,05 ± 5,12 vs. 7,49 ± 3,62 ng/ml, respectively).
The conclusion. The decrease of catestatin concentrations in patients with EH of a high and very high risk of CVC is associated with cardiovascular remodeling, mediated by hypertenstion. Catestatin can be used in addition to cardiac remodeling ultrasound traditional criteria in patients with essential hypertension.
P672 Predictors of ventricular arrythmias and mortality after implantation of primary prevention antitachycardia devices
Authors: Dias Ferreira Reis J P , Moura Branco L , Rio P , Galrinho A , Portugal G , Monteiro A , Lousinha A , Valente B , Silva Cunha P , Oliveira M , Ferreira R 
Published: January 2020

Abstract

Background
Patients (pts) with reduced left ventricular (LV) systolic function have high risk of sudden cardiac death and benefit from implantable cardioverter-defibrillators (ICDs/CRT-Ds). However, the risk for arrhythmic events and device therapies is extremely heterogeneous in this population, so more accurate tools for risk stratification are required.

Purpose
To assess predictors of mortality and arrhythmic events in pts receiving primary prevention ICDs/ CRTs.

Methods
Retrospective analysis of 150 pts submitted to primary prevention ICD/ CRT-D implantation with remote monitoring between 2014-2018. Demographic, clinical and echocardiographic data from implantation and follow-up period were retrieved. Arrhythmic events and device therapies were retrieved from remote monitoring and clinic visits. Univariate analysis was performed followed by a multivariate Cox analysis to evaluate predictors of events. p &lt; 0.05 were considered significant.

Results
150 pts, 80.7% male, with a mean age of 64.30 ± 12.9 years (Y) and a mean follow-up (FU) time of 38 ± 15 months. 66% of pts implanted an ICD. 52.0% of pts presented with an ischemic cardiomyopathy and 41.3% had atrial fibrillation. 35.3% had chronic kidney disease (GFR &lt; 60mL/min) and 24.0% were diabetic. Mean BNP value of 449.6 ± 631.3pg/mL and mean peak VO2 of 15.3mL/kg/min. Mean LV ejection fraction (LVEF) during FU of 35.9 ± 12.1% and a mean average global longitudinal strain (GLS) of -8.7 ± 5.5%. 63pts (42.0%) suffered a ventricular arrhythmia, mostly non-sustained ventricular tachycardia, of which 47.6% received appropriate therapies. Mortality rate of 13.3% during follow-up (20 pts). Baseline diabetes (p = 0.040) and post-procedural pulmonary artery systolic pressure (PASP) (p = 0.002) were independent predictors of overall mortality in the follow-up. Male gender (p = 0.041), baseline diabetes (p = 0.011) and atrial fibrillation (p = 0.038) were associated with ventricular events. In patients with CRT-D, a percentage of biventricular pacing superior to 95% was found to be protective against ventricular arrhythmias. Interestingly despite being associated with a higher overall mortality (p = 0.028), a reduced LVEF wasn’t related to the arrhythmic burden of our population, neither the GLS nor the LV mechanical dispersion were predictors of ventricular arrhythmias.

Conclusion
Baseline diabetes and PASP were independent predictors of mortality in our population of ICD/CRT-D pts implanted in primary prevention setting. An increased percentage of biventricular pacing was associated to improved clinical outcomes in patients receiving cardiac resynchronization therapy. Identification of predictors of events in this population can help individualize its management.
P674 Epicardial fat volume is associated with the risk of atrial fibrillation recurrence following pulmonary vein isolation
Authors: Bordi L , Kovacs I , Korodi S Z , Hodas R , Benedek T , Benedek I 
Published: January 2020

Abstract

Funding Acknowledgements
Plaqueimage

Background
Atrial fibrillation (AF) is the most common supraventricular rhythm disturbance and pulmonary vein (PV) isolation has an important role in rhythm control treatment strategies of this disease. Various anatomical and clinical characteristics have been well established as predictors of the risk of recurrence following ablation procedures, but the role of epicardial fat tissue (EFT) in the recurrence of AF has not been elucidated so far.

Purpose
To investigate the influence of left atrial size and EFT volume in the recurrence of AF after pulmonary vein ablation, during a 6-month follow-up.

Methods
A total of 40 patients, 52.5% with paroxysmal and 47.5% with chronic AF underwent PV isolation using radiofrequency and cryoablation techniques. EFT was determined using cardiac computed tomography angiography (CCTA) associated with advanced image post-processing techniques.

Results
In patients who developed AF recurrence at 6 months after AF ablation, the volume of EFT and of left atrium were significantly larger than in the group who maintained sinus rhythm (202.5 ± 64.56 ml vs. 138 ± 55.74 ml, p = 0.01 for EFT, and 149.3 ± 4.66 ml vs. 90.63 ± 5.19 ml, p &lt;0.0001 for left atrial volume, respectively). The left ventricular ejection fraction was significantly lower in patients with AF recurrence (50.25 ± 6.54% vs. 54.22 ± 3.95%, p = 0,04). The analysis of AF recurrence between the two different ablation techniques did not show any difference in recurrence rates between radiofrequency and cryoablation methods (29% vs. 23%, respectively p = 0.73). At the same time, recurrence rates after AF ablation were not influenced by the main cardiovascular risk factors (age, hypertension, dyslipidemia and smoking) and was not associated with different risk scores (CHA2DS2-VASc and HAS-BLED).

Conclusion
Patients with AF recurrence after pulmonary vein ablation present significantly higher EFT or left atrial volumes compared to patients who maintained sinus rhythm. This indicates the inflammatory mediated response, usually accompanied by an increased amount of EFT, could be associated with the risk of AF recurrence following catheter ablation of the pulmonary veins.
P677 When to look for wtTTR amyloidosis in heart failure: increasing chances of positive gammagraphic study
Authors: Ibero J , Riesgo A , Rodriguez M , Morales M , Muniz J , Salterain N , De La Fuente A , Refoyo E , Hernandez A , Lecumberri R , Garcia Velloso M J , Diaz I , Gavira J J 
Published: January 2020

Abstract

Introduction
Wild type transtirretin (wtATTR) amyloidosis has become increasingly recognized as a major cause for heart failure (HF). Diagnosis requires complex work up such as DPD scintigraphy (DPDs). Availability of DPDs is limited urging to identify factors to increase its diagnostic rentability.

Methods
Retrospective study of HF patients between 2013 and 2019 with suspected wtATTR and DPDs was performed. Baseline characteristics, biomarkers, EKG findings, TTE parameters (LVEF, LV diastolic function, TAPSE, interventricular septum (IVS), LV mass (LVM), relative LV wall thickness (RWT), indexed LVTD volume and diameter, indexed LA diameter (iAPLAD)) and DPDs results were studied. Two groups were created according to DPDs (SP those with positive results for amyloidosis and SN those with negative results). For statistical SPSS v.21 was used.

Results
37 patients were studied. In our population 54% had positive DPDs for amyloidosis. Among SP patients 50% were classified as grade 2 of Perugini classification meanwhile 50% were grade 3; mean value of heart to contralateral ratio was 2,73 ± 0,8. There were no differences in NYHA classification. Differences among SP and SN patients are reflected in Table 1.

Conclusions
In our population SP was found to have higher biomarkers values and higher IVS, LVM, RWT and iAPLAD with poorer RV function. Further investigation is needed in order to confirm our result and identify prognostic factors.
Table 1: Results Total (37) PS (20) PN (17) p value Age (Y) 78 ± 7,9 80 ± 6,5 75,29 ± 8,7 0,05 Gender (male) (%) 30 (8) 19 (95) 11(64) 0,11 Carpal tunnel sdr (%) 3(8) 3 (15) 0 (0) 0,09 Systolic blood pressure (x ± sd) 127 ± 21 118 ± 18 138,5 ± 19 &lt;0,01 ProBNP (x ± sd) 3596 ± 4002 4615 ± 4538 1761 ± 1927 &lt;0,05 Troponin T (x ± sd) 132 ± 360 66,4 ± 35 43 ± 39 0,09 Pseudoinfarction pattern (%) 26 (70) 17 (85) 9 (52) &lt;0,05 IVS (mm) (x ± sd) 14,6 ± 4,5 16,6 ± 5,3 13 ± 3 &lt;0,01 LVM (g/m2) (x ± sd) 142,5 ± 68 180 ± 80 111 ± 32 &lt;0,01 RWT (x ± sd) 0,68 ± 0,42 0,8 ± 0,24 0,56 ± 0,5 &lt;0,01 LVEF (%) (x ± sd) 57,4 ± 11 54 ± 12 60 ± 10 0,12 iAPLAD (mm/m2) (x ± sd) 25,4 ± 6 28,7 ± 6 22,7 ± 4,3 &lt;0,01 TAPSE (mm) (x ± sd) 18,6 ± 5 16,1 ± 4 20,6 ± 5 &lt;0,05 IVS = interventricular septum; LVM = left ventricular mass; RWT = relative wall thickness; iAPLAD= indexed anteroposterior left atrium diameter.