bluuebunny/crossref_metadata_2025_split huggingface dataset:
P4138Clinical differences between methamphetamine and non-methamphetamine associated non-ischemic dilated cardiomyopathy
Authors: Reddy P , O'meara K , Patel S , Chau E , Banayan A , Ng T , Elkayam U 
Published: October 2019

Abstract

Background
Methamphetamine associated cardiomyopathy (MACM) is an increasingly recognized form of dilated cardiomyopathy around the globe which remains poorly characterized.

Purpose
To compare the clinical characteristics of MACM to those of non-MA associated dilated CM (NMACM).

Methods
Consecutive patients with MACM presenting to our institution between Jun 2018 and Jan 2019 were prospectively studied and compared to an age and gender-matched cohort of dilated non-ischemic CM cases.

Results
Seventy patients were studied (35 MACM and 35 NMACM). Mean age was similar between groups (49±9 vs. 48±10 years, p=0.465) and 97% of patients were male. Median duration of MA use prior to cardiomyopathy diagnosis was 5 years (range 0–30). Patients were predominantly Hispanic in both groups (48% vs. 62%, p=0.229), but with a greater proportion of Caucasians in the MACM group compared to NMACM (26% vs 6%, p=0.045).MACM was characterized by lower left ventricular ejection fraction (LVEF) and greater left ventricular end diastolic volume (LVEDV) compared to NMACM. RV dilation was present more often in MACM cases (Table). Years of MA use was associated with greater LA volumes (R2= 0.13, p=0.048). Association with larger LVEDV and incidence of RV dilation were borderline significant (R2= 0.11, p=0.054 and p=0.058 respectively). The amount of MA used per week correlated with higher RVSP (R2=0.317, p=0.004). Polysubstance abuse was associated with greater LVEF (p=0.028), lower LVEDV (p=0.037) and lower LV mass (p=0.004).
Echocardiographic parameters MACM Non-MACM p-value LVEDV (ml) 215 (62) 181 (40) 0.009* LVESV (ml) 166 (63) 133 (41) 0.017* LVEF (%) 20 (8) 26 (10) 0.006* LV Mass (g) 311 (109) 285 (81) 0.286 LA Volume (ml) 88 (26) 85 (29) 0.670 RV Dilation (no.) 23 (65.7%) 14 (40.0%) 0.027* Reduced RV Function (no.) 21 (60.0%) 21 (60.0%) 0.596 RVSP (mmHg) 40 (14) 44 (12) 0.671 RAP (mmHg) 9 (5) 10 (5) 0.682 Intracardiac Thrombus (no.) 3 (8.6%) 2 (5.7%) 0.500 Mean values are reported with standard deviation. *p<0.05.

Conclusion
MACM is associated with higher degree of LV and RV dilatation as well as LV systolic dysfunction when compared to matched NMACM cases. Years of MA use and amount of MA consumed appear to influence severity of disease.

Acknowledgement/Funding
None
P415330-Day readmission after hospitalization for heart failure in china
Authors: Li J , Bai X K , Zhang L H , Masoudi F A , Spertus J A , Krumholz H M 
Published: October 2019

Abstract

Background
Hospital readmission after heart failure (HF) is common, costly, and potentially preventable. Current patterns of 30-day readmission rates after HF discharge and patient characteristics associated with these readmissions in China are unknown.

Purpose
To calculate the rates and timing of all-cause readmissions within 30-day after HF hospitalization and to identify patient characteristics associated with readmissions.

Methods
We included consecutive patients who were hospitalized primarily for HF and discharged alive from 52 geographically diverse hospitals in China followed for 30 days after discharge. Patients were invited for face-to-face interviews to collect information about any readmission. If a patient was unwilling or unable to attend, information was obtained by telephone contact with the patient, his or her relatives, or physicians. We fit mixed models with a logit link function accounting for patient clustering by hospital to identify patient factors associated with 30-day readmission. To estimate the variability in hospital-level, we calculated the median odds ratio (OR) from the fully adjusted hierarchical model, which represents the average likelihood of a statistically identical patient readmitted at one random hospital versus another.

Results
Among 4649 eligible patients, 4542 (97.7%) had 30-day follow-up. the median (IQR) age was 67 (57, 75) years; 62.5% were men. The length of index hospital stay was 9 (7, 13) days. Readmissions for any cause within 30 days of discharge occurred in 562 patients (12.4%), of which 30.1% occurred within 7 days of discharge and 58.9% 15 days. Half of readmission diagnosis within 30 days were HF (283, 50.4%). Prior HF (OR 1.3, 95% CI 1.09–1.55), valvular heart disease (OR 1.64, 95% CI 1.26–2.1), chronic obstructive pulmonary disease (OR 1.35, 95% CI 1.05–1.73), diabetes (OR 1.44, 95% CI 1.19–1.74) and longer length of index hospitalization stay (HR 1.02, 95% CI 1.01–1.03 per day) were associated with higher risks of 30-day readmission. The C-statistic was 0.615. The median odds ratio was 1.32 (1.05–1.48).

Conclusion
In China, one in eight patients hospitalized for HF are readmitted within 30-days, with the majority occurring within 2 weeks of discharge. Both patient characteristics and variability across hospitals accounted for the variability in readmissions, suggesting an important opportunity for improving the transitions of care in HF.
P4164Transcatheter pulmonary valve implantation versus surgical pulmonary conduit replacement in corrected tetralogy of Fallot with pulmonary atresia: a propensity matched comparison
Authors: Dorobantu D M , Taliotis D , Turner M , Parry A , Tulloh R , Stoica S 
Published: October 2019

Abstract

Background
Tetralogy of Fallot with pulmonary artesia (PA-VSD) complete repair includes the placement of a right ventricle to pulmonary artery conduit. As more and more patients survive past childhood, the need for conduit replacement has increased. Transcatheter pulmonary valve implantation (TPVI) has emerged as an alternative to the surgical pulmonary valve replacement (SPVR) in conduit failure, but comparative data are lacking.

Purpose
We aim to use data from a national procedural audit database to compare TPVI and SPVR in operated PA-VSD with conduit failure.

Method
All patients with surgically corrected PA-VSD undergoing TPVI or SPVR between 2006–2012 were included (SPVR n=103, TPVI n=31). A propensity score matching algorithm based on age, gender, known genetic mutations, MAPCAs presence of endocarditis, preoperative mechanical support, operation year and follow-up time was used and resulted in balanced groups.

Results
Median age at TPVI and SPVR were 23 years (11–51) and 12 years (0.3–55) respectively. Median follow-up was 3.7 years (1 day-12.5 years) in SPVR and 2 years (0.3–10.6) in TPVI. There were slightly more females in the TPVI group (64% vs 49% in SPVR p=0.1). There were no significant differences in procedure era (77% after 2005), MAPCAs (31%) or known genetic conditions (17%). All cases of preoperative endocarditis (n=6) and mechanical support (n=4) were in the SPVR group.
Survival, freedom from pulmonary valve replacement (PVR) and PVR free survival before and after matching at 5 years are shown in Table. After matching survival tended to be lower in TPVI (p=0.4), but without reaching statistical significance, while freedom from PVR (p=0.004, Figure) and PVR free survival (0.02) were significantly lower after TPVI, compared to SPVR.
Relative mortality by age increments Before matching After matching TPVI SPVR TPVI SPVR p value Survival at 5 years (%) 87 92 87 94 0.4 Freedom from PVR at 5 years (%) 83 96 83 100 0.004 PVR free survival at 5 years (%) 72 88 72 94 0.02

Conclusions
In our study TPVI showed comparable midterm survivable with SPVR, but significantly lower freedom from PVR, resulting in a lower PVR free survival. Further studies with longer follow-up and a prospective design are needed to investigate the factors influencing these outcomes.
P4334Effects of Asian dust on blood pressure and blood cell counts: a cross-sectional study of health check-up data
Authors: Ishii M , Seki T , Sakamoto K , Kaikita K , Miyamoto Y , Tsujita K , Masuda I , Kawakami K 
Published: October 2019

Abstract

Introduction
Asian dust (AD) is one of the health care problems because AD increases risk for mortality, respiratory, and cardiovascular disease. Previous animal studies showed that particulate matter from AD induced oxidative stress and systemic inflammation, increased blood pressure and heart rate, and decreased cardiac contraction. However, few reports show association of AD with increased blood pressure in human healthy subjects.

Purpose
The aim of this study was to investigate effects of AD on blood pressure and blood cell counts in human.

Methods
Using generalized linear models, we estimated the association between short-term exposure to AD and systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and white blood cell (WBC) count in 296,168 participants aged 20 and older (men n=168,579, 56.9%) who underwent medical check-ups and had no anti-hypertensive agents between April 2005 and March 2015 in a health check-up center in Japan. AD days were the days on which AD events occurred, which were defined as decreased visibility (<10km) due to AD monitored by local meteorological observatory. Propensity score matching analysis was performed to reduce the effects of possible confounders such as age, sex, mean temperature, humidity. In multivariable generalized linear models, data of other air pollutant such as SO2, NO2, Ox or suspended particulate matter was used as covariate.

Results
During study period, 61 AD days were observed, and there were 4,670 participants undergoing medical check-ups on AD days. In the propensity score matched population (n=4,670, each), short-term exposure to AD was significantly associated with an increased risk of higher SBP, DBP, HR, or WBC count [β=1.303, 95% confidence interval (CI) 0.577 to 2.029 for SBP, β=0.630, 95% CI 0.122 to 1.138 for DBP, β=0.987, 95% CI 0.410 to 1.563 for HR, β=150.0, 95% CI 64.9 to 235.1 for WBC]. These significant associations were also observed in two-pollutant models. In subgroup analysis according to age, AD exposure had greater impact on SBP, DBP, and HR in younger people (20 to 40 years old), but WBC count in middle-high age (51 years and older).
GLM analysis according to age category

Conclusions
The present study showed that short-term exposure to AD was associated with higher SBP, DBP, HR and WBC count. Short-term exposure to AD may exacerbate sympathetic nervous system for the young and immune system for the elderly.
P4348Early assessment of left ventricular function by layer-specific strain and its relationship to pulsatile arterial load in patients with coronary slow flow
Authors: Shi J , Xing Y M , Qian J , Yang H , Luo L , Kong D H , Pan C Z , Shu X H , Ge J 
Published: October 2019

Abstract

Background
Previous studies reported controversial Left ventricular (LV) function impairment and pathophysiology in patients with coronary slow flow (CSF). Greater arterial load has been shown to increase aortic impedance and endothelial shear stress, potentially affecting coronary anatomy and function. We investigated LV systolic function by a new layer-specific strain technology and assessed the association between pulsatile arterial load and contractility.

Methods and results
A total of 70 patients with CSF and 50 controls with normal coronary angiography were included in the study. Layer-specific longitudinal and circumferential strains were assessed from endocardium, mid-myocardium and epicardium (GLS-endo, GLS-mid, GLS-epi and GCS-endo, GCS-mid, GCS-epi) by two-dimensional speckle tracking imaging (2D-STI). Pulsatile arterial load was estimated by indexed arterial compliance (ACI). Layer-specific GLS showed a decreasing gradient from the endocardium to the epicardium in both controls and CSF group. GLS-endo and GLS-mid in CSF group were significantly lower than the control group (all P<0.05). Layer-specific longitudinal strain showed a good correlation with the number of affected coronary arteries (all P<0.05) and the mean thrombolysis in myocardial infarction frame count (TFC) (all P<0.05). ACI was lower in CSF patients (P=0.005) and ACI was correlated negatively with layer-specific GLS (all P<0.05).

Conclusion
Layer-specific evaluation of the LV provides an understanding of the layer-specific properties of the LV wall and the possible process of the LV impairment in patients with CSF. Greater pulsatile arterial load, as manifested by a lower ACI, is coupled with worse LV longitudinal function in CSF patients.
P4357Implementation of interactive mixed reality display of three-dimensional echocardiography during percutaneous structural interventions
Authors: Kasprzak J D , Kierepka M , Peruga J Z , Dudek D , Machura B , Stanuch M , Zlahoda-Huzior A , Kasprzak J I , Sorysz D , Wdowiak-Okrojek K , Lipiec P 
Published: October 2019

Abstract

Background
Three-dimensional (3D) echocardiographic data acquired from transesophageal (TEE) window are commonly used in planning and during percutaneous structural cardiac interventions (PSCI).

Purpose
We hypothesized that innovative, interactive mixed reality display can be integrated with procedural PSCI workflow to improve perception and interpretation of 3D data representing cardiac anatomy.

Methods
3D TEE datasets were acquired before, during and after the completion of PSCI in 8 patients (occluders: 2 atrial appendage, 2 patent foramen ovale and 3 atrial septal implantations and percutaneous mitral commissurotomy). 30 Carthesian DICOM files were used to test the feasibility of mixed reality with commercially available head-mounted device (overlying hologram of 3D TEE data onto real-world view) as display for the interventional or imaging operator. Dedicated software was used for files conversion and 3D rendering of data to display device (in 1 case real-time Wi-Fi streaming from echocardiograph) and spatial manipulation of hologram during PSCI. Custom viewer was used to perform volume rendering and adjustment (cropping, transparency and shading control).

Results
Pre- and intraprocedural 3D TEE was performed in all 8 patients (5 women, age 40–83). Thirty selected 3DTEE datasets were successfully transferred and displayed in mixed reality head-mounted device as a holographic image overlying the real world view. The analysis was performed both before and during the procedure and compared with flatscreen 2-D display of the echocardiograph. In one case, real-time data transfer was successfully implemented during mitral balloon commissurotomy. The quality of visualization was judged as good without diagnostic content loss in all (100%) datasets. Both target structures and additional anatomical details were clearly presented including fenestrations of atrial septal defect, prominent Eustachian valve and earlier cardiac implants. Volume rendered views were touchlessly manipulated and displayed with a selection of intensity windows, transfer functions, and filters. Detail display was judged comparable to current 2-D volume-rendering on commercial workstations and touchless user interface - comfortable for optimization of views during PSCI.

Conclusions
Mixed reality display using a commercially available head-mounted device can be successfully integrated with preparation and execution of PSCI. The benefits of this solution include touchless image control and unobstructed real world viewing facilitating intraprocedural use, thus showing superiority over virtual or enhanced reality solutions. Expected progress includes integration of color flow data and optimization of real-time streaming option.
P4363The predictive capacity of two- and three-dimensional echocardiography detected right ventricular strain in disease severity of pre-capillary pulmonary hypertension
Authors: Liu B , Wu W , Liu Z , Wang H , He J , Xiong C 
Published: October 2019

Abstract

Background
Pulmonary hypertension (PH) patients have poor prognosis due to progressive right ventricular (RV) dysfunction. As a low-cost and non-invasive tool, echocardiography is by far the most widely used technique to investigate the RV structure and function in PH patients. Recent studies showed that RV longitudinal strain (RVLS) measured by two- or three-dimensional echocardiography (2DE, 3DE) was correlated with RV function parameters and have the potential to predict the prognosis of PH patients. However, few studies have compared the value of 2DE- and 3DE- RVLS to predict disease severity of pre-capillary PH patients. Therefore, our study aims to compare the capacity of RVLS assessed by 3DE and 2DE in predicting disease severity of pre-capillary PH patients.

Methods
We consecutively enrolled 57 patients (18 males and 39 females, 35±13 years) with pre-capillary PH diagnosed by right heart catheterization in our center. Standard transthoracic echocardiography was performed in all participants. 2DE- RVLS were obtained from speckle-tracking analyses using GE EchoPAC version 201; while 3DE- RVLS were analyzed by TomTec 4D RV-Function 2.0. On the basis of the risk assessment strategy of 2015 ESC Guidelines for the diagnosis and treatment of pulmonary hypertension, all the participants were classified into low risk or intermediate-high risk groups. Linear regression analyses were performed to evaluate the correlations between RVLS and peak oxygen consumption (PVO2). In addition, receive operating characteristic curves (ROC) were used to compare the predictive values of 2DE- and 3DE-RVLS and identify the optimal cut points for the detection of low risk based on the risk assessment strategy of 2015 ESC Guidelines.

Results
Linear regression analyses showed a significant correlation between PVO2 and 2DE- RVLS (r=−0.484, P<0.001), while a relatively weaker correlation was observed between PVO2 and 3DE- RVLS (r=−0.299, P=0.024). ROC curve showed 2DE-RVEF had a better capacity to classify pre-capillary PH patients into low or intermediate-high risk groups (2DE- vs 3DE-: AUC=0.78, P=0.003 vs AUC=0.69, P=0.044). Optimal cut-offs found 2DE-RVEF <−13.85% had a 73.3% sensibility and 75.0% specificity to predict low risk.

Conclusions
Both two- and three-dimensional echocardiography detected RVLS had the potential to evaluate disease severity of pre-capillary PH patients, but the former may have a better predictive capacity.
P4370Doppler echocardiography, RV Strain and 3D RV Imaging in diagnosis of Acute mountain sickness
Authors: Amuthan V , Ananth R V A , Thinlas T , Chosdol R , Rabgais L , Vivek R 
Published: October 2019

Abstract

Introduction
Right Ventricular (RV) strain and 3D RV ejection fraction sensitivity and specificity has made it a practical and reliable test to detect Acute mountain sickness. All previous studies have been done mainly using M Mode and 2D Echo. Hence it was conceived that 3D Echocardiography would be a better option. Regardless of the type of Acute Mountain Sickness (AMS), the echocardiographic evidence is always the same: Severe Pulmonary hypertension. The visual analysis of these abnormalities requires a trained operator. This operator-dependence has promoted the search for a semiautomatic method to reduce limitations of Echocardiography and improve test accuracy

Purpose
The purpose was to study AMS by 3D Echocardiography

Methods and results
Two dimensional echocardiography with RV strain analysis by speckle tracking echocardiography along with 3D RV ejection fraction was done in nine patients with AMS who were tourists on unplanned, unacclimatized assent to Pangong lake, situated near Leh-Ladakh in the Himalayas, approximately at the height of 4350 meters above sea level and six highlanders, living in Leh-Ladakh. Figure 1A shows the map of the Pangong Lake, B. Shows features of Acute Pulmonary Edema in the Chest X-ray from a patient with AMS, C. Shows the TAPSE (Tricuspid Annular Plane Systolic Excursion) D. Shows the Speckle tracking derived RV Free Wall strain (From a software made for LV) and E: Methodology to derive 3D RV Ejection Fraction. 3D Echocardiographic Equipment with LV strain (which was modified to derive RV Free wall strain) and 3D RV Ejection Fraction software was used for acquisition of images and offline analysis was done. TAPSE, FAC, RV Free wall strain and 3D RV EF were consistently lower in patients with AMS than in persons living in high altitude (High landers). TR peak gradient, RV EDV index, RV ESV index were elevated in AMS patients compared to High landers. Table 1.
Table 1 Age Sex M/F 3D RV EF% TAPSE (mm) FAC TRP E/e' RVFW Strain RV EDVI (ml/m2) RV ESVI (ml/m2) AMS (9) 40.2±2.3 5/4 36±3.2 16±1.7 38.2±2.7 49.2±7.6 5.4±1.2 14±1.9 55±3.7 35±2.4 High Landers (6) 53.6±3.7 5/1 45±2.3 20±2.7 46.9±4.7 26.52±6.7 7±1.7 28±2.2 52±4.1 29±2.8 RV: Right Ventricle; EF: Ejection Fraction; TAPSE: Tricuspid Annular Plane Systolic Excursion; FAC: Fractional Area Change; TRP: Tricuspid Regurgitation Peak gradient; E: Mitral E Velocity; e' Medial mitral Tissue doppler e velocity; FW: Free Wall; EDVI: End Diastolic Volume Index; ESV: End systolic volume index.
Figure 1

Conclusion
Strain or myocardial deformation analysis based on two-dimensional (2D) speckle tracking and 3D RV ejection fraction is feasible even in the remote altitudes apart from standard M Mode and Doppler measurements and allow accurate quantification in analysis of acute mountain sickness.