bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of rehabilitation in post-COVID compared with post-cardiosurgery patients. A single Center experience
Authors: Villani GQ , Rosi A , Corbellini D , Schettino V , Bosoni A , Covini I , Ambiveri G 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
The COVID 19 disease is frequently associated with significant disability related to intensive care unit-acquired weakness, decontitioning, myopathies and neuropathies. However there are no data on the results of a specific rehabilitative treatment in this group of patients.
The aim of our work was to evaluate the effectiveness f a personalized rehabilitative therapy in group of post-COVID patients (A, 47 patients, average age 65.3± 11.6 y, 27 M,) comparing the results with a group of post-cardiosurgical patients COVID 19 negative (B, 47 patients, average age 63.5± 10.3 y, 29 M) evaluating the degree of clinical complexity (Rehabilitation Complexity Scale, RCS-E V13) and the degree of autonomy recovery (Six-minute walking test SMWT, Barthel Index, BI) pre and post-treatment.
In Group A patients the Rehabilitation program is associated with a significant improvement in autonomy recovery (BI admission 29.7 ± 20 vs discharge 72.7 ± 28.6 p &lt;0.005, SMWT admission 146 ± 25 vs 318 ± 18 m, p &lt;0.005) and in clinical complexity (RCS admission 10.9 ± 1.1 vs discharge 5.3, p&lt; 0.05)

Conclusions
Post-COVID patients show a greater loss of autonomy than post-cardiosurgery patients. Rehabilitative treatment has proven effective in ensuring adequate functional recovery with similar results to those obtained in the population of cardiological subjects COVID 19 negative.
Group A vs Group B Group A Group B p pre-rehabilitation hospital stay (days) 31 ± 5 8 ± 2 0.005 RCS admission 10.9 ± 1.1 11.6 ± 1.2 ns BI admission 29.7 ± 20 47.7 ± 19 0.05 SMWT admission (m) 146 ± 25 255 ± 18 0.05 Rehabilitation duration (days) 29.7 ± 12.8 29.6 ± 10.1 ns RCS discharge 5.3 ± 2 6.5 ± 2 ns BI discharge 72.7 ± 28 71.5 ± 22.5 ns SMWT discharge (m) 385 ± 18 410 ± 25 ns RCS rehabilitation complexity scale, BI: Barthel Index, SMWT: six-minute walking test
Anxiety and depression in patients hospitalized in cardiology
Authors: Mzoughi K , Zairi I , Saadaoui A , Ben Mrad I , Kraiem S 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Anxio-depressive disorders represent one of the psychiatric manifestations most frequently observed in hospitalized patients. Different factors can be involved in the onset or worsening of these disorders.

Purpose
The aim of our study was to evaluate the prevalence of of anxiety and depression in hospitalized cardiology patients and to determine their predictors.

Methods
This was a cross-sectional and descriptive study with a prospective data collection that included 150 patients hospitalized in the cardiology department of Habib Thameur hospital between November and December 2016. Anxiety and depression were assessed using the Hospital Anxiety Depression questionnaire validated in Arabic.

Results
Patients mean age was 60 ± 11.2 years with a gender ratio of 2.7. Seventy-nine percent of the patients had a school education, 85.3% were married and 46% were active workers.
Cardiovascular risk factors were dominated by arterial hypertension found in 56.7% of patients, followed by diabetes in 55.3%, dyslipidemia in 54.7% and active smoking in 43.3%. The most frequent reason for hospitalization was acute coronary syndrome, which was found in 52.7% of cases. The mean length of hospital stay was 13.7 ± 9.3 days.
The prevalence of anxiety symptoms and depression symptoms was 55.3% and 40%, respectively.
In multivariate analysis, age over 65 and active smoking were significantly associated with anxiety symptoms (OR = 0.345, 95% CI 0.150-0.790; p = 0.012 and OR = 0.44, 95% CI, respectively 0.194-0.90;
p = 0.045). Independent factors significantly associated with depression symptoms in hospitalized cardiology patients were age greater than 65 years and a hospital stay of more than 7 days (OR = 0.171, respectively, 95% CI 0.067-0.438; p = 0.0001 and OR = 0.462, 95% CI 0.08-0.466; p = 0.001).

Conclusion
Given the high prevalence of anxiety and depression in patients hospitalized in cardiology, the systematic identification of the factors associated with these disorders would facilitate screening and ensure their early management.
Factors associated with poor tensional control in the elderly
Authors: Bargaoui Z , Mzoughi K , Labbene S , Zairi I , Kraiem S , Aouina O 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Hypertension is a major cardiovascular risk factor, responsible for significant morbidity and mortality. Despite therapeutic progress, blood pressure control remains insufficient.

Purpose
The aim of our study was to identify the factors associated with poor blood pressure control in the elderly.

Methods
This was a descriptive study with a prospective data collection including 101 hypertensive treated subjects, aged 65 years and over, followed on outpatient basis between November and December 2019 at the cardiology consultation either at the Habib Thameur hospital or at the Materi hospital.

Results
Median age was 73 and sex ratio 0.57. The major cardiovascular risk factor was diabetes in 60.4% of cases, followed by dyslipidaemia 48.5% and smoking 40.6%. A history of coronary syndrome was present in 36.6% of cases, followed by atrial fibrillation in 19.8% and 12.9% had a history of ischemic stroke. Thirty-three percent realized regular physical activity and 31% had a high-sodium diet. Four percent of our patients were completely dependent. Among our patients aged 80 and over, 68.2% were frail.
The prevalence of poor blood pressure control was 59%.
Adherence to treatment was satisfactory in 75.2% of cases.
Twelve percent of patients had information about their condition and 89% knew the dosage and schedule for their medication.
In multivariate analysis, the factors associated with poor blood pressure control were: non-compliance with treatment (adjusted OR = 0.19; p = 0.013), frailty (adjusted OR = 7.194; p = 0.004), the number of antihypertensive tablets (Adjusted OR = 0.382; p = 0.008), non-use of thiazide diuretics (adjusted OR = 25.903; p = 0.001) and the patient"s lack of knowledge of antihypertensive treatment (adjusted OR = 0.56; p = 0.008).

Conclusion
Detection of the risk of non-compliance, the use of thiazide diuretics, reducing the number of antihypertensive tablets, screening for frailty and informing the patient about his treatment are necessary to improve blood pressure control in the elderly.
The Pandora"s box of frailty assessments, which is the best for clinical purpose? A critical review
Authors: Baritello O , Salzwedel A , Suendermann S , Niebauer J , Voeller H 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Assessment of frailty is recommended for patients undergoing elective transcatheter aortic valve implantation (TAVI) to appreciate post-interventional prognosis. Several studies investigated frailty in this population using single markers (e.g. gait speed), clinical judgment scales (e.g. Rockwood) or composite indexes (e.g. Fried). However, there is a lack of consensus on the most appropriate tool for assessment of frailty in clinical practice.

Purpose
To evaluate which frailty assessment is the most used and meaningful for post-interventional prognosis in older TAVI patients.

Methods
A systematic search was performed in PubMed (May 2020). We included randomized controlled trials or observational studies (prospective or retrospective) without time restrictions investigating the association of frailty and 1-year all-cause mortality in older (≥70 years) TAVI-patients.

Results
60 studies (151,723 patients) were included. Studies heterogeneity (methods) was considerable. 40 different frailty assessments were identified. The most used single marker (Table) was gait speed (5-meter walk test), investigated in 16 observational studies (8/8 prospective/retrospective with 5,747/40,535 patients). 11 studies found mortality prediction by reduced gait speed, with hazard ratios (HR) between 1.36 (95% confidence interval (CI) 1.23-1.50) and 14.71 (95%CI 6.50-33.30) as well as an Odds Ratio (OR) of 2.34 (95%CI 1.03-5.32). Frailty in composite indexes (Table) predicted mortality in 10 of 11 observational studies 4-items index: HR 1.84 (95%CI 1.23-2.69) to 3.05 (95%CI 1.24-7.46), 5-items index: OR 1.63 (95 CI 1.12-2.37) to 2.75 (95%CI 1.55-4.87).

Conclusion
Predominantly, single markers, especially gait speed, are used to assess frailty in TAVI-patients. Composite indexes seem to be relieble as well and should be considered for prediction of 1-year mortality.
Review results Single marker of frailty Total studies Predictive for 1-y mortality Gait speed (GS) 16 (46582) 11 (41376) Activities of Daily Living (ADL) 14 (6600) 6 (1405) Serum albumin (SA) 15 (49334) 13 (48729) Handgrip strength 10 (5912) 5 (1105) Composite indexes 4-items (GS, HG, SA, ADL) 6 (1957) 6 (1957) 5-items (GS, HG, exhaustion, low PA, weight loss) 5 (3014) 5 (3014) Clinical judgment scale Clinical Frailty Scale (CFS) 9 (6415) 5 (4316) Numbers indicate number of studies and (number of patients)
Attainment of the 2019 ESC/EAS recommended LDL-C goal in Greek patients with established atherosclerotic cardiovascular disease
Authors: Ioannidis A , Pechlevanis A , Paraskelidou M 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
The novel 2019 ESC/EAS Guidelines on lipids recommend a more intensive reduction on LDL-C for patients with established atherosclerotic cardiovascular disease (ASCVD) in comparison with the 2016 edition.

Purpose
This cross-sectional observation study aims to assess whether patients on lipid lowering therapy, as a secondary prevention measure, are aware of the new set goals and if they achieved them.

Methods
Patients with known ASCVD, taking currently any statin, visiting the Emergency Department of a tertiary hospital in northern Greece were invited to participate by answering a short questionnaire followed by a phone call to provide the exact lab results or other details. Data were analyzed with the SPSS software version 20.0 for Windows (SPSS Inc., Chicago, Illinois, USA)

Results
In total 459 eligible patients (37.9% female) were enrolled from January to October 2020 (mean age 68 ± 12 years old). Mean duration of statin prescription was about 11 years (11.2 ± 6 years). The majority (431, 93.9%) of the patients reported lab tests yearly. The majority of the participants (406, 88.5%) were taking a statin as monotherapy of either low (11, 2.4%), medium (174, 37.9%) or high (221, 48.1%) potency. One tenth (50, 10.9%) were prescribed a combination of ezetimibe with a medium or high potency statin. Lastly, only three patients (0.7%) were prescribed a PCSK9 inhibitor. Approximately, one out of six patients had a LDL-C lower than 55mg/dL (78, 17.0%). As expected, the higher the potency of the statin, the higher the percentage of patients reaching the goal: low (1 of 11 patients, 9.1%), medium (21 of 174 patients, 12.1%) and high potency (45 of 221 patients, 20.4%). Moreover, nine out of the fifty the patients (18.0%) on ezetimibe combination therapy achieved the LDL-C goal. Lastly, two of the three patients (66.7%) on a PCSK9 inhibitor had attained the desired LDL-C level. No information could be collected regarding why patients not reaching the goal were not offered a statin of higher potency and/or dosing, a combination with ezetimibe or a PCSK9 inhibitor, accordingly. Disturbingly enough, none of the patient was aware that the LDL-C goals recommended by scientific societies had been lowered in 2019, although 71 patients (15.5%) could recall discussing LDL-C goals with their physician, even though none of the patients recalled the limit of 55mg/dL. The majority of the patients (427, 93.0%) reported that they would like to know their personal LDL-C goal.

Conclusions
Greek patients with established ASCVD taking statins are overall unaware of the novel set LDL-C goals. Hardly acceptable attainment of the LDL-C goal was observed. Further research is warranted to assess the barriers that obstruct a satisfactory goal achievement.
Abstract Figure. Patients achieving LDL-C goal
Post cardiac surgery Mediastinitis : Risk factors and therapeutic management
Authors: Mleyhi S , Messai M , Miri R , Ben Mrad M , Ziadi J , Ghedira F , Ben Omrane S , Kalfat T , Derbel B , Denguir R 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background : Despite the progress in therapy and patient management in cardiac surgery, postoperative mediastinitis remains serious complication. Our study aims to study the incidence of mediastinitis after cardiac surgery and to identify the risk factors.

Methods
We conducted a retrospective, descriptive study including patients who had undergone cardiac surgery by sternotomy during a period of 5 years ( 2015 – 2019)and who meet the definition of mediastinitis proposed by the "Centers of disease control and disease". We collected the demographic characteristics of the patients and operative operative data of the first intervention as well as those relating to mediastinitis.

Results
25 patients ( 2.93%) among 1042 patients operated for cardiac surgery during the cited period presented mediastinitis. The main clinical signs were : surgical wound infection (80%), fever (40%) and sternal instability (30%). Biological tests showed : hyperleukocytosis and high C-Reactive Protein in 22.7 % and 58.1 % of cases respectively. Gram-positive cocci are largely predominant and one case of Candida mediastinitis was found. type 1 diabetes and coronary artery bypass grafting were significantly associated with the occurrence of mediastinitis with P &lt;0.01. The mean duration of intra venous antibiotic therapy was 21 days.
92 % of patients operated on for mediastinitis are cured, 4 % had a recurrence of infection and 4 % died.

CONCLUSION
Mediastinitis after heart surgery is rare but serious. The main risk factors are insulin-dependent diabetes and coronary bypass surgery. The curative treatment is heavy and it is based on a rigorous and long medico-surgical care.
Impact of cardiac physiotherapy on the functional capacity of elderly people in primary care
Authors: Lopes Do Nascimento L , Viana DQO , Rodrigues LNTR 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Primary health care (PHC) is the first level of health care, and it includes health promotion and protection, as well as the prevention of aggravations from chronic diseases and comorbidities. The cardiovascular physiotherapy program in PHC is an important ally in prevention chronic diseases and maintaining functional capacity. Purpose: to evaluate the impact of a cardiovascular physiotherapy program on a functional capacity of elderly people in primary care. Methods: This is a randomized clinical trial, carried out with 30 elderly people who attended the FISIOCAP (cardiovascular physiotherapy program in primary care) program for at least 6 months. The assessment of functional capacity was performed through the six-minute walk (6MWT) and 1-min sit-to-stand test (1-MSTS). The patients were submitted to a supervised exercise program lasting 90 minutes, twice a week, for a period of 16 weeks. Each session consisted of a warm-up phase (10 minutes), conditioning (60 minutes), calm down (10 minutes) and health education (10 minutes). At the end of 16 weeks, the elderly underwent a reassessment on the 1MSTS and 6MWT. Results: After the cardiovascular physiotherapy program, the participants increased the distance covered by the 6MWT by 19% (p = 0.002) and significantly exceeded the distance covered predicted for gender and age. In 1MSTS, the participants obtained a significant improvement in the number of repetitions in the test (25.25 ± 5.72 to 27.67 ± 5.55, p = 0.04). Conclusion: The cardiovascular physiotherapy program significantly benefited the functional capacity of elderly patients attending PHC.
Digital secondary prevention follow-up after percutaneous coronary intervention (PCI) at home: what are the users perspectives?
Authors: Elstad HL , Edvardsen A , Astin F , Steinsbekk A , Atar D , Lie I 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Private hospital(s). Main funding source(s): LHL Hospital Gardermoen Bergesen Foundation
Digital Secondary Prevention Follow-up After Percutaneous Coronary Intervention (PCI) at Home:
What are the Users Perspectives?
Background
Secondary prevention for patients with established CHD is the mainstay of cardiovascular rehabilitation, but is not accessible to all eligible patients. Digital delivery offers a way to widen participation in secondary prevention to PCI patients, but little is known about users’ preferences.
Purpose
The purpose of this qualitative study was to explore service users, carers and health professionals views about potential challenges experienced in secondary prevention after PCI and preferences for support to inform the development of a digital home program.
Methods
A series of three focus group interviews were conducted in a broad user panel with former PCI patients (4), next-of-kin (1) and interdisciplinary health care professionals (4) between March 2017 and September 2019. Data was audiotaped, transcribed verbatim and analysed using content analysis.

Results
Three main themes and sub-themes on challenges and preferences for digital follow-up were identified: (1) Technology: feasibility including safety, integration with known platforms, functionality, and user-friendly navigation were major assets, as well as the capability of monitoring medication adherence, smoking cessation and physical activity. (2) Communication: interactive, direct, clear, supportive, encouraging, visualizing, humorous, using virtual meeting rooms, as well as including direct responses on patients’ self-motivation and achieved goals and (3) Health information: basic step-by-step facts and questions-and-answers (FAQ), being practical, visual, and including side effects of medications and health services navigation.

Conclusion
User perspectives from former patients, next-of-kin and health care professionals reveal a preference for digital secondary prevention which offers functionality, communication, and health information during follow-up at home after a PCI.
Higher consumption of red and processed meat is associated with adverse cardiovascular magnetic resonance morpho-functional phenotypes: A study of 19,408 UK Biobank participants
Authors: Raisi-Estabragh Z , Mccracken C , Gkontra P , Jaggi A , Ardissino M , Cooper J , Biasiolli L , Aung N , Piechnik SK , Neubauer S , Munroe PB , Lekadir K , Harvey NC , Petersen SE 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation Clinical Research Training Fellowship No. FS/17/81/33318 European Union’s Horizon 2020 research and innovation programme under grant agreement No 825903 (euCanSHare project).

Background
Multiple epidemiological studies link greater red and processed meat consumption with poorer cardiovascular outcomes. However, the impact of these exposures on directly measured cardiovascular phenotypes has not been examined in large cohorts. Limited existing studies suggest that the observed associations may be mediated by cardiometabolic diseases and/or novel mechanisms acting via the heart-gut axes. However, few studies systematically examine potential confounding and mediating mechanisms.

Purpose
We assessed, in the UK Biobank, the association between meat intake and cardiovascular structure and function incorporating a comprehensive range of confounders and mediators.

Methods
We studied 19,408 participants with cardiovascular magnetic resonance (CMR) data. We determined average daily red and processed meat intake using food frequency questionnaires. We used oily fish as a comparator linked to favourable cardiac health. We considered conventional CMR measures (ventricular volumes, left ventricular mass, ejection fraction, stroke volume), novel CMR radiomics features (shape, texture), and arterial stiffness metrics (arterial stiffness index, aortic distensibility). Multivariable linear regression models were used to investigate associations between meat/fish intake and cardiovascular phenotypes, adjusting for age, sex, deprivation, educational level, smoking, alcohol intake, and exercise. In separate models, we investigated the mediating role of cardiometabolic morbidities.

Results
Higher intake of red and processed meat was associated with an adverse overall pattern of right and left ventricular remodelling, poorer cardiac function, and higher arterial stiffness. Conversely, higher oily fish intake was associated with a healthy cardiovascular phenotype (better ventricular function, greater arterial compliance). Radiomics analysis showed association of the different dietary habits with unique overall geometry of the ventricles and myocardial texture. These associations were partially mediated by cardiometabolic morbidities.

Conclusions
Higher red and processed meat consumption is associated with adverse cardiovascular phenotypes. These relationships are not fully explained by mediation through cardiometabolic morbidities suggesting importance of alternative disease pathways. Understanding these potential novel disease mechanisms is important for optimising cardiovascular disease prevention strategies.
Cardiorespiratory fitness and left atrial strain in atrial fibrillation: A comparative study
Authors: Mishima RS , Ariyaratnam JP , Malik V , Pitman BM , Elliott AD , Sanders P 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Atrial fibrillation (AF) is the most common clinically relevant arrhythmia, and its occurrence is associated with pathological left atrial (LA) remodelling. In these patients, low cardiorespiratory fitness (CRF) is associated with increased AF recurrence. Speckle tracking derived LA strain (LAS) permits chamber function quantification and provides angle-independent and highly reproducible measurements of chamber deformation. However, the relationship between CRF and LA function, amongst AF patients is poorly understood.

Purpose
To compare LA function amongst AF patients stratified by cardiorespiratory fitness.

Methods
Consecutive AF patients referred for treadmill exercise stress test (EST) and transthoracic echocardiogram (TTE) between March and December 2020 were screened for inclusion. Treadmill EST was symptom limited and age and gender predicted CRF was calculated with conventional formulas. Speckle tracking software was used to obtain LAS from apical 4 and 2 chamber views and mean measurements for LASr and LASb were calculated. Those achieving &lt;100% (low CRF) and ≥100% (high CRF) of predicted CRF were compared.

Results
After exclusions, 141 patients in sinus rhythm were included in the analysis. Baseline characteristics were not significantly different between groups. Ejection fraction (63.6 ± 4.7% vs 64.8 ± 8.4%, p = 0.3) and LA volume index (33.1 ± 6.9 vs 31.4 ± 9.4 mL/m2, p = 0.3) were not different between groups. Both LASr (22.9% ± 7.4% vs 27.6% ± 11.4%, p = 0.02) and LASb (8.2% ± 4.7% vs 12.1% ± 6.8%, p = 0.004) (figure 1) were significantly higher in the fitter group.

Conclusion
Patients with higher CRF showed improved LA function as per strain measurement in the absence of AF. The relationship between CRF and left atrial function warrants further research.
Abstract Figure. LASr and LASb by CRF