bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 2711: The Modification Of Collagen Type I Turnover Is Associated With Long-term Response To Cardiac Resynchronization Therapy
Authors: Lopez-Salazar Begoña , Macias Alfonso , Gavira Juan Jose , Diez-Martinez Javier , Garcia-Bolao Ignacio 
Published: July 2021

We investigated whether modification of collagen type I turnover is related to the long-term response to cardiac resynchronization therapy (CRT).
Methods and Results: Serum carboxy-terminal propeptide of procollagen type I or PICP (a marker of collagen type I synthesis), carboxy-terminal telopeptide of collagen type I or CITP (a marker of collagen type I degradation), matrix metalloproteinase (MMP)-1, -2, -9 and tissue inhibitor of MMP (TIMP)-1, were measured in 54 patients (35 responders) at baseline and after 1 year of CRT. At baseline, PICP and the ratio PICP: CITP were higher (p < 0.01) in responders than in nonresponders. At 1-year, both PICP (p < 0.005) and the ratio PICP:CITP (p < 0.05) decreased in responders, while increased in nonresponders (p < 0.005 and p < 0.05, respectively). MMP-1 (p < 0.05), MMP-9 (p < 0.005), and the ratio MMP-1:TIMP-1 (p < 0.01) increased, while TIMP-1 decreased (p < 0.005) in responders, but remained unchanged in nonresponders. The ratio PICP:CITP correlated inversely with ejection fraction (r = -0.501, p < 0.01) and directly with left ventricular end-diastolic diameter (r = 0.376, p < 0.05) in responders after CRT. Direct correlations were found between MMP-1, and -9 and ejection fraction (r = 0.315, p < 0.05, r = 0.516, p < 0.01) in responders after CRT.
Conclusions The ability of CRT to modify collagen type I turnover (i.e. decreasing synthesis and increasing degradation) is associated with its long-term response.
Abstract 2750: Multi-detector Computed Tomography Is An Accurate Screening Imaging Modality For Detection Of Thrombus In Patients Undergoing Catheter Ablation Of Atrial Fibrillation
Authors: Martinez Matthew W , Kirsch Jacobo , Williamson Eric E , Cha Yong-Mei , Friedman Paul A , Asirvatham Samuel J , Ommen Steve R , Callahan Mark J , Syed Imran S , Feng DaLi , Beinborn Douglas S , Packer Douglas L , Brady Peter A 
Published: July 2021

Introduction Multi-detector computed tomography (MDCT) is commonly used to identify pulmonary vein and left atrial anatomy prior to catheter ablation for atrial fibrillation (CAAF). Additionally, transesophageal echocardiography (TEE) is utilized to exclude left atrial/left atrial appendage thrombus (ICT). Whether MDCT alone can be used to exclude thrombus obviating the need for TEE is unknown.
Methods All Pts referred for CAAF at Mayo Clinic between March 2004 and October 2006 were included. Clinical data (including CHADS score), 64 slice MDCT (non-ECG gated), TEE and intra-cardiac echocardiograph (ICE) were all performed and recorded. Image data was reviewed independently and blinded. The left atrial appendage (LAA) was defined as fully opacified or underfilled. An underfilled LAA was further interrogated using a region of interest over the filling defect and mean attenuation in Hounsfield Units (HU) were recorded.
Results In total 400 Pts (mean age 56 ± 10 yrs; 76% male; EF 56 ± 10 % ) were included. 362 had no ICT by TEE nor filling defect by MDCT. 38 patients had an underfilled LAA in whom ICT was confirmed by TEE in 7. Sensitivity and specificity of MDCT for ICT was 100% and 92% respectively with a NPV of 100%. In 19 Pts with underfilled LAA’s, a mean LAA emptying velocity was found to be significantly reduced at 26 cm/s (6 – 61 cm/s). Those with a thrombus had a mean attenuation value below 70 HU. CHADS2 score was higher (2.0 versus 1.0) in Pts with LAA filling defect versus those without LAA filling defect. All Pts with confirmed thrombus were taking Warfarin. ICT was not seen in any Pts aged <52 yrs with CHADS score ≤1.
Conclusions Sensitivity and specificity of MDCT for detection of LAA thrombus is high. LAA filling defects on MDCT correlate with low emptying velocities by TEE and low attenuation value in HU. These data would suggest that in the absence of MDCT filling defect, no further imaging is required. TEE should be utilized prior to CAAF to investigate MDCT filling defects.

Multidetector Computed Tomography for the Detection of LAA Thrombus
Abstract 2779: Two- Dimentional Imaging Of Lipids Deposited In The Coronary Plaques By Near-infrared Fluorescence Angioscopy
Authors: Uchida Yasumi 
Published: July 2021

Background: The lipids deposited deep in the vascular wall are hardly detectable by any available imaging modalities including IVUS and OCT. Since near-infrared (NIR) light penetrates relatively deeply into the tissues, we devised a near-infrared fluorescence angioscope (NIRFA) for two dimensional imaging of lipids deposited even in deep layers of vascular wall.
Aim: To examine feasibility of NIRFA for imaging of lipids in coronary arterial wall in man.
Methods: NIRFA is composed of a quartz fiberscope incorporated in 5F balloon catheter, fluorescence exciter, fluorescence emitter, ICCD and recorder. NIR exciter filter of 710nm and emitter filter of 780nm were employed since among the major 30 substances composing atherosclerotic plaques, free cholesterol and cholesteryl esters alone exhibit NIR autofluorescence while oxLDL and TG not.

In vitro study: Coronary artery removed from human cadaver was perfused with saline and an angioscope was introduced into it for imaging of lipids and the obtained NIR images were compared with histology.

Clinical study: During routine coronary angiography, lipid deposition in the coronary artery was surveyed by NIRFA in 7 patients with coronary artery disease.

Results:

In vitro study. Coronary segments without lipid deposition by histology did not exhibit autofluorescence. Those with lipid deposition by histology, the lipids deposited within 700μm in depth from luminal surface exhibited autofluorescence. Deposited lipids not forming lipid pool exhibited strong and homogenous autofluorescence. Lipid pool exhibited no or weak autofluorescence surrounded by strong ones, indicating it is filled with oxLDL and/or TG.

Clinical study. Autofluorescence was frequently detected not only in yellow plaques but also in white plaques by conventional angioscopy and hard plaques by IVUS.

Also, autofluorescence was frequently detected in apparently normal coronary segments.
Conclusion: The results indicate that this NIRFA is feasible for two dimensional imaging of lipids deposited even in deep layers of coronary arterial wall which are not detectable by conventional angioscopy, OCT and IVUS.
Abstract 2815: Validation of Rapid Automated Tissue Synchronisation Imaging Techniques for Assessment of Cardiac Dyssynchrony in both Sinus and Non-Sinus Rhythm
Authors: McCormack Cameron , Wai Bryan , Muir Tracey , Ord Michelle , Anavekar Nagesh , Kearney Leighton G , Srivastava Piyush M 
Published: July 2021

Background: Intraventricular dyssynchrony predicts left ventricle remodelling and clinical response following cardiac resynchronisation therapy. Currently, no consensus exists as to the most appropriate methodology for assessing dyssynchrony. Tissue Velocity Imaging (TVI) based septal to lateral delay (SLD) >65ms (Bax et al) and 12 segment dyssynchrony index (DI) (Yu et al) are most commonly used. These methods are time consuming and involve multiple manual calculations. Automated dyssynchrony assessment with Tissue Synchronisation Imaging (TSI) may provide a more rapid estimation of dyssynchrony.
Aims: To assess the validity of automated TSI (TSI auto) based dyssynchrony measures in comparison to established TVI techniques.
Methods: We randomly selected echocardiograms of 51 subjects (Sinus rhythm (SR) n=35, AF/paced n=16) from our heart failure service and compared TSI auto to conventional TVI methods (SLD and DI). For TSI auto, 6 basal and 6 mid segments were defined and dyssynchrony parameters calculated with the Echopac 6 software.

Results: The mean age of the group was 66±11 years, 86% were male. The majority had ischaemic aetiology (69%) and the mean LVEF was 35.2±1.3%. Mean QRS duration was 138±6ms (LBBB 54%) and 69% were in SR. Bland-Altman analysis of TVI and TSI auto DI showed excellent agreement (Limits of agreement (LOA): -8.7 to 15.9, p=0.16) (Figure

). Agreement between SLD techniques was acceptable (LOA: -169 to 137 p=0.9). ROC curves were constructed for TSI auto (AUC SR 0.9, non-SR 0.917).

Conclusions: Automated TSI provides an accurate and efficient means of measurement of intraventricular dyssynchrony in both sinus and non sinus rhythm.
Abstract 2848: Medication Knowledge And Assistance In Older Chronic Heart Failure Patients.
Authors: Gallagher Robyn , Donoghue Judith , Chenoweth Lynn , Stein-Parbury Jane 
Published: July 2021

Medication knowledge and assistance in older chronic heart failure (CHF) patients. Medication adherence is central to the optimal management of CHF. Little is known about older patients’ knowledge of their medications or the factors that contribute to this knowledge.
Aim: To describe and identify the predictors of medication knowledge in older CHF patients.

Method: Subjects (
n
= 62) aged over 55 years with moderate heart failure (New York Heart Association Class II and III) who identified as self-managing were recruited from hospital or rehabilitation.

Interviews occurred at home four weeks post-discharge using a medication checklist and the Self-Efficacy in Chronic Illness Scale (Lorig et al, 2001). Multiple regression analysis determined the predictors of medication knowledge.

Results: Patients were aged mean 78.4 years (sd 8.54 years), mostly male (57%) and had an average 8 (median, range 3–22) medications to take daily, of which 6 (median, range 3–14) were for CHF. Most managed their own medications (54%) but more than a quarter (28%) were assisted by reminding, dispensing and supervision. Compliance with medications was high (84%), although only half (53%) knew the name, main purpose and side effect of their medications. Patients with better self-efficacy (β = 2.88) and no help with medication (β = -21.05) had better medication knowledge (model
F
= 13.6,
p
= .000,
R
= .61,
r
2
= .37).

Conclusion: Older CHF patients have poor knowledge of their medications, which may be improved by promoting overall self-efficacy for disease management. Less knowledgeable patients received appropriate assistance with medications, but the consequence may be less knowledge and thus warrants further investigation.
Abstract 2853: The Prevalence of Ion Channel Disorders in Victims of Sudden Adult Death Syndrome
Authors: Chlebinska Agnes C , Basavarajaiah Sandeep , O’Sullivan Ann , Sharma Sanjay 
Published: July 2021

Objectives: Sudden adult death syndrome (SADS) accounts for at least 4% of all sudden cardiac deaths in the United Kingdom and is often attributed to an ion channel disorder. The precise prevalence of and hence efficacy of effectiveness for screening for ion channel disorders utilising non-invasive cardiac tests in first degree relatives of victims of SADS is unknown. The aim of this study was to identify the prevalence of ion channel disorders in victims of SADS.
Methods: Between March 2006 and March 2007, 17 families of victims of SADS were evaluated in a tertiary inherited cardiac clinic. A total of 46 individuals underwent 12-lead ECG, echocardiography, exercise stress testing, 24 hour Holter and, when applicable, an Ajmaline provocation test and/or cardiac magnetic resonance scan.
Results: All family members had a structurally normal heart. An ion channel disorder was identified in 7 out of 17 (41%) families. Of these, 5 (71%) families exhibited the Brugada phenotype and 2 families manifested the long QT syndrome phenotype. A total of 11 of 46 (24%) asymptomatic family members were identified with an ion channel disorder.
Conclusions: Non-invasive cardiac evaluation of first-degree family members of victims of SADS in a tertiary inherited cardiac diseases clinic suggests that ion channel disorders, particularly Brugada’s syndrome, account for at least 40% of all SADS deaths in the UK.
Abstract 2970: Mechanism of Increased Susceptibility of Youth to Sudden Death with Chest Wall Impact (Commotio Cordis)
Authors: Madias Christopher , Dau Nathan , Maron Barry J , Estes N.A. Mark , Bir Cynthia , Mark Link S 
Published: July 2021

Background. Commotio cordis (CC), sudden cardiac death secondary to blunt, innocent-appearing chest wall blows in sports and other daily activities, is being reported with increasing frequency. Children and adolescents are most at-risk for this phenomenon. In an experimental animal model, it has been shown that ventricular fibrillation (VF) can be induced with a baseball blow to the chest wall during the vulnerable period of repolarization. We hypothesized that in this model, larger subjects would require higher impact velocities to induce VF.
Methods. Under general anesthesia, 41 juvenile swine (16 to 55 kg) were placed prone in a sling and received chest wall blows at 30 to 60 mph with a lacrosse ball aimed directly over the cardiac silhouette. Impacts were timed to occur during the vulnerable period for VF (10 –30 ms prior to the T-wave peak). Animals were divided into 4 groups based on weight (16 to 25kg, 26 to 35kg, 36 to 45kg, and 46 to 55kg) and the frequency of VF was analyzed.

Results. In 419 impacts, the smallest animals (16 to 25kg) were most vulnerable to VF and incidence of VF decreased incrementally as animal size increased. Impacts at 30 mph only induced VF in the smallest animals. In the largest animals (46 to 55kg), VF was only induced at impacts of 60 mph (figure

).

Conclusion. Impact velocity and subject size are important variables in the generation of CC. In this animal model, smaller animals are more vulnerable to generation of VF across a wider range of impact velocities. These data might underlie the higher vulnerability to CC that has been observed in children and young adults and has implications for the prevention of CC with chest wall protectors.
Abstract 2973: Effects Of Cardiac Resynchronization Therapy On The Mitochondrial Proteome In A Canine Model Of Heart Failure
Authors: Agnetti Giulio , Elliott Steven T , Kane Lesley A , Yung Christina , Chakir Khalid , Samantapudi Daya , Guarnieri Carlo , Caldarera Claudio M , Kass David A , Van Eyk Jennifer E 
Published: July 2021

Cardiac resynchronization therapy (CRT) is a procedure used in the clinics to ameliorate the symptoms associated with heart failure-induced conduction disturbances and ventricular dyssynchrony. The molecular modifications underlying the beneficial effects of CRT have not been completely clarified. Recent investigations suggest that CRT may reduce apoptosis of cardiac myocytes. Mitochondria are likely to be major players in this benign transition due to their role in both energy production and apoptosis regulation. Therefore the proteome of cardiac mitochondria was investigated in a canine model for heart failure alternatively submitted to CRT.
Methods and results: Mitochondria-enriched fractions obtained from sections of the left ventricular free wall of dyssynchrony-induced heart failure (DHF) dogs alternatively submitted to CRT were analyzed through two-dimensional gel electrophoreisis (2DE). Roughly 1200 protein spots were visualized on the 2D gels after silver staining. Software-assisted differential display analysis indicated that the density of almost 50 protein spots was significantly changed upon CRT. These spots were selected and identified through mass spectrometry. Among other changes six forms of ATP synthase beta subunit were decreased 2- to 3-fold (0.0001≤p≤0.047), as well as four forms of cytochrome C (2-fold decrease, 0.002≤p≤0.047). The existence of multiple forms of a protein suggests for the presence of post-translational modifications (PTM). Therefore the phosphorylation (a common PTM) status of mitochondrial proteome was also monitored by combining the differential-in-gel electrophoresis (DIGE) technology with alkaline phosphatase teatment. ATP synthase beta subunit was differently phosphorylated in CRT samples comparing to DHF as indicated by the change in its isoelectric point upon treatment with alkaline phosphatase.
Conclusions: The proteomic investigation of mitochondria revealed a previously unseen presence of PTM mechanisms at the mitochondria level in heart failure and CRT. Phosphorylation mechanisms in the mitochondria may play a prominent role in modulating cardiac function, as observed for the beneficial effects of CRT.
Abstract 3035: Decrease Of Aortic Valve Area In A Hypercholesterolemic Rabbit Model Is Reversed By Short-term ApoAI-treatment
Authors: Speidl Walter S , Ibanez Borja , Santos-Gallego Carlos G , Garcia Mario J , Fuster Valentin , Goldman Martin E , Badimon Juan J 
Published: July 2021

Background. Aortic valve stenosis (AVS) is the second most common indication for heart surgery. Althoug recent observations linked AVS and atherosclerosis, medical treatment of AVS is limited. ApoAI-Milano (ApoAI-M) is a mutant form of ApoAI. We have recently shown that ApoAI-M rapidly regressed established atherosclerotic lesions in a hypercholesteremic rabbit model. The aim of this study was to test whether hypercholestermia decreases AVA in rabbits and whether this can be reversed by short-term ApoAI-M-treatment.
Methods. We used transthoracic echocardiography (Philips HD 11 XE echograph with a 12-MHz phased-array probe) to compare AVA, as determined by continuity equation, of 14 white New Zeeland rabbits, fed with atherogenic diet (0.2 % of cholesterol) for nine month, with 6 healthy controls. The hypercholesterolemic animals were then randomized into ApoAI-M (ETC-216; Pfizer): 2 injections (75mg/Kg) in 4 days, or placebo. Six days after the last dose, we assessed aortic valve morphology by echocardiography and histopathology.
Results. Hypercholesteremic diet resulted in a markedly reduced AVA compared to controls (0.17±0.02cm2 vs. 0.21±0.03cm2, p<0.01). ApoAI-M treatment increased AVA by 27 % (p<0.05) whereas placebo had no effect, resulting in significantly higher AVA in treated rabbits (0.22±0.03cm2 vs 0.16±0.02cm2, p<0.005). Histopathologic cross-examination showed markedly reduced thickness of aortic valve leaflets in ApoAI-M-treated rabbits.
Conclusion. We show that reduction of AVA can be induced experimentally in hypercholesterolemic rabbits and can be investigated by transthoracic echocardiography. In addition, this study provides for the first time evidence that AVA can be increased pharmacologically, namely by treatment with ApoAI-M.
Abstract 3056: Ischemia on Presentation Stratifies Mortality Risk in Surgery for Acute Type A Dissection
Authors: Augoustides John G , Geirsson Arnar , Szeto Wilson Y , Walsh Lisa , Cornelius Brittany , Pochettino Alberto , Bavaria Joseph E 
Published: July 2021

Introduction: The mortality risk of surgery for acute type A dissection (ATAD) depends on the clinical presentation in published risk models. The identified risk factors predominantly relate to preoperative ischemia whether generalized due to systemic hypotension and/or regional due to aortic branch occlusion. A focus on preoperative ischemia might further clarify mortality risk after surgery for ATAD.
Hypothesis: Ischemia, whether generalized (due to systemic hypotension) and/or regional (due to local arterial malperfusion), stratifies mortality risk after operative repair of ATAD.
Methods: With IRB approval, all patients undergoing operative repair of ATAD (January 1993 – December 2004) were studied. Perioperative data of interest were abstracted from the medical records and archived electronically. The standardized operative protocol included aortic arch repair with deep hypothermic circulatory arrest and retrograde cerebral perfusion. Statistical significance was defined as a probability value of < 0.05.
Results: The study cohort = 221. Average age was 61.6 ± 15.2 years. The cohort was divided into 2 groups: ischemia 42.1% (93/221) and no ischemia 57.9% (128/221). The ischemia subgroup was further divided as follows: generalized 36.6% (34/93); regional 41.9% (39/93); both 21.5% (20/93). Thirty-day mortality was 12.7% (28/221)): 85.7% (24/28) of all deaths were in the ischemic subgroup (p<.05). Mortality was 8.3 fold higher in the presence of ischemia: ischemia 25.8% (24/93) versus no ischemia 3.1% (4/128) (p<.05). The mortality in ischemia subgroups was as follows: generalized 17.6% (6/34); regional 25.6% (10/39); and, both 40% (8/20). All intraoperative deaths occurred in the ischemia group [17.8%(5/28) of all deaths]. Causes of death were grouped as follows: neurological 7/28 (25%: all in ischemia group); cardiac 7/28 (25%: 6/7 in ischemia group); bleeding 3/28 (10.7%: all in ischemia group); multisytem organ failure 11/28 (39.3%: 8/11 in ischemia group).
Conclusions: Preoperative ischemia is the major risk for mortality after operative repair for ATAD. Perioperative interventions to minimize ischemia and optimize organ protection should reduce the high mortality in the subgroup with ischemia on presentation.
Abstract 3091: Prediction of Major Adverse Cardiac Events in Patients Presenting With Chest Pain In Outpatient Clinic By Adenosine Stress Magnetic Resonance
Authors: Chan Wing Sze , Luk Ching Hon , Tse Hung Fat 
Published: July 2021

Background: This study was designed to determine the diagnostic value of adenosine cardiac magnetic resonance (CMR) in low to moderate total number cardiac risk factor (TLCRF) patients presenting with chest pain in outpatient clinic. We hypothesized that adenosine CMR has a high negative predictive value in development of CAD or future adverse cardiac events.
Methods: Adenosine stress CMR was performed on 315 pts who presented initially to outpatient clinics with chest pain. Ten patients confirmed to have previous myocardial infarction defined by delay CMR were excluded. Three patients were excluded due to suboptimal image quality. Patients were followed up during outpatient visits or contacted through telephone interview to determine the incidence of significant CAD defined as coronary artery stenosis >50% on angiography, new myocardial infarction (MI), or cardiovascular death.
Results: Totally 302 patients (M: F = 242:60; mean age= 58±12; mean baseline TLCRF= 2.5 ± 1) underwent rest and adenosine stress CMR. With a follow up period of 29 ± 6 months, there were 32 adverse event (30 patients underwent coronary percutaneous angioplasty due to unstable angina and 2 new MI) and 3 cardiovascular deaths. Adenosine perfusion abnormalities had 100% sensitivity and 89% specificity in detecting subsequent CAD and the most accurate component of the CMR examination in predicting events. Despite TLCRF and abnormal CMR can significantly predicting the prognostic outcome (p=0.04 Vs p=0.001 respectively), multivariate analysis showed that the abnormal CMR was the strongest predictor of the event rate (adjusted hazard ratio 1.45 per 10% increase, p=0.02). Three patients with normal adenosine study had a subsequent diagnosis of CAD and underwent successful angioplasty.
Conclusions: Among the low to moderate cardiac risk patients who presented with chest pain in outpatient clinics, adenosine CMR examination has a high sensitivity and specificity in predicting the future development of significant CAD. It implies the potential application of CMR in CAD screening in general population.