bluuebunny/crossref_metadata_2025_split huggingface dataset:
The feasibility of a newly developed local network system for cardiac rehabilitation (the CR-GNet) in disease management and physical fitness after acute coronary syndrome
Authors: Ando T , Watanabe T , Matsuo S , Samejima T , Yamagishi J , Bito T , Naruse G , Yoshida A , Minatoguchi S , Akiyama H , Nishigaki K , Minatoguchi S , Okura H 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Grant-in-aid from.jpgu Prefecture

Background
The newly developed Cardiac Rehabilitation.jpgu Network (CR-GNet) has been implemented to create a regional alliance network and to provide periodic follow-up examinations to enhance the disease management in patients with cardiovascular disease. The effectiveness of a network like this support system has not yet been evaluated in Japan.

Purpose
We aimed to examine the feasibility of the CR-GNet in disease management, assisting patients in attaining physical fitness and its impact on long-term outcomes after acute coronary syndrome (ACS).

Methods
We enrolled 47 patients with ACS in the CR-GNet between February 2016 and September 2019; of these, 37, 29, and 21 patients underwent follow-up assessments for exercise capacity (peak oxygen uptake) at 3 months, 6 months, and 1 year after discharge, respectively. Major adverse cardiac events (MACE) were defined as the composite of death from cardiac causes, cardiac arrest, myocardial infarction, and rehospitalization due to unstable or progressive angina. MACE were compared with controls who were not registered in the CR-GNet.

Results
The coronary risk factors, except blood pressure, improved at 3 and 6 months, and 1 year after discharge. These risk factors in each patient significantly reduced from 2.9 at admission to 1.6, 1.4, and 1.9 at 3 months, 6 months, and 1 year after discharge (p &lt; 0.05), respectively. Peak oxygen uptake was significantly higher at 3 months, 6 months, and 1 year after discharge to 17.5 ± 4.9 ml/kg/min, 17.9 ± 5.1 ml/kg/min, and 17.5 ± 5.5 ml/kg/min, respectively, than that at discharge (14.7 ± 3.6 ml/kg/min) (p &lt; 0.05). During follow-up, there was no significant difference; MACE did not occur in any patients in the CR-GNet but occurred in controls.

Conclusions
The CR-GNet is a feasible option for long-term management of ACS patients. The prognostic impact of the CR-GNet needs further investigation with a larger sample size and longer follow-up.
Table1 At admission 3 months 6 months 1 year Average number 2.9 1.6* 1.4** 1.9*** † Average number of coronary risk factors for all patients (n = 21) p = 0.004, vs. at admission; **p = 0.001, vs. at admission; ***p = 0.011, vs. at admission; †p = 0.035, vs. at 6 months
Impact of Chronic kidney disease on the outcomes of hospitalizations for implantable cardioverter defibrillator or cardiac resynchronization defibrillator placement: An analysis of Inpatient Sample
Authors: Usman M , Almani M , Fatima N , Yousuf M , Qudrat Ullah M , Edigin E 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
1. Background
Implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRT-D) are indicated in primary and secondary prevention of dysrhythmias among other indications. We sought to determine the impact of chronic kidney disease (CKD) on hospitalizations for ICD or CRT-D placement.
2. Purpose
Determine how CKD impacts in-patient mortality and cardiovascular outcomes in patients undergoing ICD or CRT-D placement while hospitalized.
3. Methods
Data were extracted from the National Inpatient Sample (NIS) 2016 - 2018 Database. The NIS was searched for patients who underwent ICD or CRT-D placement. The patients were divided into two groups based on presence or absence of CKD as secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders (A univariate screen was done to confirm the confounders affected outcomes with variables having a p less than 0.2 were included in the multivariate regression analysis). STATA software was used to for analysis.
4. Results
Of 145,550 patients admitted for ICD or CRT-D placement, 47740 (32.8%) had CKD. The adjusted odds ratio (aOR) for inpatient mortality for patients undergoing ICD or CRT-D placement with co-morbid CKD compared to those without CKD was 1.66 (95% CI 1.194 – 2.329, p = 0.003). Patients with comorbid CKD had lower odds of developing cardiogenic shock (aOR: 0.83, 95% CI 0.718 – 0.948, p = 0.007) and cardiac arrest (aOR: 0.88, 95% CI 0.766 – 0.999, p = 0.048) compared to patients without CKD. Detailed outcomes are listed in table 1.
5. Conclusion
Chronic kidney disease is a risk factor associated with increased in-patient mortality in patients admitted for ICD or CRT-D placement.
Outcome Without CKD, % With CKD, % aOR (95% CI) p-value* Primary outcome In hospital mortality 0.6 1.9 1.66 (1.194 - 2.329) 0.003* Secondary outcomes Length of stay (days), mean 7.0 9.2 -0.01 (-0.345 - 0.322) # 0.945 Total hospital charges (US$), mean 218,962 241,679 -13047 (-20924 - -5171) # 0.001* Cardiogenic shock 6.8 8.0 0.83 (0.718 - 0.948) 0.007* IABP placement 1.7 1.7 0.52 (0.399 - 0.671) &lt;0.001* Cardiac arrest 12..1 8.5 0.88 (0.766 - 0.999) 0.048* Acute renal failure 17.9 48.1 2.89 (2.648 - 3.163) &lt;0.001* Abbreviations: *; statistically significant, #; adjusted mean difference, aOR: adjusted odds ratio, CI: confidence interval, IABP: Intra-aortic balloon placement.Adjusting factors: Age, Charlson comorbidity index, patient’s insurance, location and teaching status of the admitting hospital, dyslipidemia, old myocardial infarction, cerebral infarction, hypertension, diabetes mellitus, liver disease, smoking status and obesity.
Alirocumab effectiveness and rapidity in achieving and maintaining target LDL, HDL cholesterol and triglyceride values in patients at very high cardiovascular risk
Authors: Cavarra M , Salerno E , Chiaranda" G 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Still too few patients after an acute cardiocerebrovascular event reach C-LDL values recommended by guidelines even in therapy with statins and ezetimibe, thus maintaining a high risk of new cardiovascular episodes.

Purpose
To evaluate, in a long follow-up, the effectiveness and the rapidity of alirocumab in the attainment and maintenance of LDL-cholesterol target values in patients at very high risk and intolerant to statins.

Methods
Our case studies consist of 72 patients, 80% males (58) and 20% females (14), with an average age of 61.9. 90.2% of patients were hypertensive. 5.5% had chronic kidney disease (CKD stage III). 65.2% had an ACS and the 34.7% had CeVD. 84.7% of the patients were in therapy only with ezetimibe while 15.3% in association with PUFA N-3. The average value of C-LDL was 169.2 mg/dl. The follow up was 24 months with clinical checks and C-LDL at 3,6,12 and 24 months. The dosage of alirocumab was both 75 and 150 mg

Results
At 3 months the reduction of C-LDL was 52.24%; at 6 months of 51.18%; at 12 months of 51.36% and at 24 months of 52.47%. The 37 patients who had started with 150 mg, had a very high average C-LDL base, 183.0 mg/dl, and showed a reduction of C-LDL to 3 months of 59.04%, to 6 months of 58.45%, to 12 months of 65.05%, to 24 months of 55.76%. The target value of C-LDL recommended by the ESC guidelines was reached for 42.10% at 3 months; for 52.63% at 6 months; for 63.15% at 12 months and for 73.68% at 24 months. 5.5% of patients with a CKD showed a 73.68% reduction in C-LDL values to 3 months, 65.22% to 6 months, 57.49% to 12 months and 53.95% to 24 months. The follow-up to the Tg study showed a reduction of 3.55% to 3 months, an increase of 8.75% to 6 months, a reduction of 1.65% to 12 months and 7.95% to 24 months. C-HDL values showed an increase of 4.55% at 3 months, 3.69% at 6 months, 10.97% at 12 months and 7.82% at 24 months.

Conclusions
Our case studies have confirmed the effectiveness of alirocumab in reducing C-LDL values in patients at very high cardiovascular risk and the rapidity in reaching the target value set by guidelines for the management of cardiovascular risk. Our study also confirmed the its effectiveness in increasing the values of C-HDL while it was not possible to confirm the reduction of Tg values.
% Alirocumab Efficacy C-LDL TGs C-HDL 3 MONTHS -52,24% -3,55% +4,55% 6 MONTHS -51,18% +8,75% +3,69% 12 MONTHS -51,36% -1,65% +10,97% 24 MONTHS -52,47% -7,95% +7,82% C-LDL: LDL-CHOLESTEROL TGs TRIGLYCERIDES C-HDL: HDL-CHOLESTEROL
Abstract Figure. % Alirocumab Efficacy
the impact of overweight and obesity on the development of systolic and diastolic myocardial dysfunction in patients with type 2 diabetes mellitus
Authors: Vanina D , Pokrovskaya A , Podzolkov V 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

OnBehalf
I.M. Sechenov First Moscow State Medical University

Background
Obesity and type 2 diabetes mellitus (DM) promote the development of systolic and diastolic myocardial dysfunction. The method of equilibrium radionuclide ventriculography (ERVG) can be used to estimate these dysfunctions.

Purpose
We conducted a comparative ERVG evidence-based analysis in patients with type 2 diabetes mellitus and varying degree of overweight. We analyzed the correlation between body mass index (BMI) and ERVG data.

Methods
The study included 42 patients (8 male and 34 female): group 1 – 12 patients with BMI 25.0-29.9 kg / m2, group 2 – 16 patients with BMI 30.0-34.9 kg / m2, group 3 – 14 patients with BMI 35.0-39.9 kg / m2. The average duration of type 2 diabetes mellitus was 11 ± 3.8 years. The average age of patients in each group was 65.8 ± 5 y.o., 57.7 ± 6 y.o., 64.6 ± 8 y.o. respectively. The groups were comparable in duration of type 2 diabetes mellitus, level of glycated hemoglobin, presence and severity of combined pathology. The patients with postinfarction cardiosclerosis and decompensated heart failure were excluded. The following ERVG indices of left ventricle (LV) and right ventricle (RV) were examined: systolic function – ejection fraction (EF), peak (PER) and average (AER) ejection rates, ejection within 1/3 of systole (ejec.1/3 s.), end-systolic volume (ESV), stroke volume (SV), diastolic function – peak filling rate (PFR), filling within 1/3 diastole (fil. 1/3 d.), end-diastolic volume (EDV).

Results
the EF of the LV in all examined patients was more than 40%. In group 2 we discovered an increase in the EDV and ESV indices of the LV, ESV of the RV compared to group 1 (123.8 ± 23.6 ml, 52.4 ± 14.5 ml, 66.3 ± 21.6 ml - in group 2 and 96.5 ± 22.7 ml, 37.9 ± 10.7 ml, 50.2 ± 16.7 ml - in group 1, respectively, p &lt;0.05). SV of the LV in group 3 was considerably larger compared to group 1 (76.4 ± 17.8 ml vs 59.1 ± 15.6 ml, p &lt;0.05). In all groups fil. 1/3 d. for LV and RV was below normal equal to 50% of EF. The correlation analysis revealed a negative association between fil. 1/3 d. of the RV and BMI (r = -0.46, p &lt;0.05) in group 1.

Conclusions
As long as BMI increases in patients with type 2 diabetes mellitus, there is a significant increase in the ESV of both ventricles and EDV of the LV. The most sensitive ERVG indices during the obesity progression are ESV, EDV, and filling within 1/3 diastole. The revealed diastolic dysfunctions in absence of a significant decrease in EF are a manifestation of a myocardial stiffness. Early diagnosis of these disorders and correction of treatment can improve the prognosis of patients with type 2 diabetes mellitus and varying degree of overweight.
Implementation of workplace well-being programs in the Russian Federation: development of the on-line tools package and results of its piloting
Authors: Antsiferova AA , Kontsevaya AV 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Introduction. Most of the working-age population spends a significant part of their life at workplace. On the one hand, working conditions can cause stress, and therefore an increase unhealthy lifestyle, on the other hand, the workplace is a convenient organizational model for health promotion. In 2019 a big federal project "Public health" started aimed to improve population health and one of its important components is increasing implementation of effective workplace health promotion programs. Model workplace well-being programs have been developed within the framework of the Federal Project «Public Health».
Purpose is to develop and pilot a package of tools for planning and implementing workplace well-being programs.
Methods. Planning stage of the program has to include situation analysis with three components: available infrastructure analysis, employee interviews and comprehensive program development. We developed two types of questionnaires: for employers and for employees. After testing it in paper on limited N of participants it was corrected and electronic version was developed. The link to the instrument was distributed through the regional centers for public health who are responsible for implementation workplace health promotion programs in the regions.
Results. In spring 2020, 558 completed questionnaires were received (among them 35 from employers, and 553 from employees). Among employers, 53.1% were familiar with workplace well-being programs, such programs were approved at 43.8% of enterprises. Employers believe that the most appropriate implementation of the following components are measures to increase the level of physical activity (22.9%), measures to prevent smoking (18.1%) and psychological relief (18.1%).
There was a predominance of female among surveyed employees (66,5%), the average age was 39.8 ± 10.7 years and 42.6 ± 11.1 years for men and women, respectively. The following factors worried the employees on the workplace: distance from their place of residence (12.1%), continuous tension and stress (11.3%), noise (7.8%) and other factors. The level of presenteeism (measured by Copenhagen Psychosocial Questionnaire) was also analyzed, the low level of presenteeism was 38.9% and 42.4%, and the average level was 59.9% and 55.9% for men and women, respectively.
Conclusion. We developed the set of instruments which must be useful for implementation of the workplace well-being programs. Surveys of employers contribute to obtaining a snapshot of the attitudes and priorities of employers in the region to plan targeted measures to stimulate the implementation of workplace well-being programs at the regional level. Questionnaires for employees can be used for an in-depth assessment of the priorities on the concrete workplace and development of a targeted program to the needs of a particular enterprise.
Does shift work affect blood pressure values and hypertension risk? a systematic review and meta-analysis
Authors: Gamboa Madeira S , Fernandes C , Paiva T , Santos Moreira C , Caldeira D 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): Fundação para a Ciência e Tecnologia (FCT) and Fundo Social Europeu (FSE)

Introduction
Modern societies function 24h/day which accounts for shift work (SW) encompassing already more than 20% of the European workforce. While the relationship between blood pressure (BP) and cardiovascular events is a continuous, hypertension (HTN) remains the major preventable cause of cardiovascular disease (CVD) in our continent. SW has been associated with sleep disturbances, circadian misalignment and unhealthy behaviours, possibly conducting to several chronic diseases. Therefore, we aimed to determine if shift workers have higher BP values and/or HTN risk.

Methods
This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was performed on MEDLINE, EMBASE and Cochrane electronic databases. Included studies reported HTN diagnosis using current thresholds and/or BP values, in both shift workers and in a control group of day workers. SW was categorized in 4 subgroups, focused mostly on night work. Pooled mean difference and 95% Confidence Intervals (95%IC) were estimated for continuous outcomes, Systolic BP (SBP) and diastolic BP (DBP), and pooled Odds Ratio and 95%IC were determined for HTN risk. The Newcastle-Ottawa Quality Assessment Scale was used for quality evaluation of included studies.

Results
Forty-five independent studies were included engaging 117252 workers. Of these, 41 studies were included in the meta-analysis for SBP, 39 for DBP and 14 for HTN. Most studies provided cross-sectional data (n = 42), were developed in Asia (n = 21), in an industrial setting (n = 25) and included only men (n = 26). Most studies were rated as satisfactory quality (n = 23) with confounder adjustment being the weakest parameter.
We found a statically significant increase for both systolic and diastolic BP among permanent night workers, 2.52mmHg [0.75–4.29] and 1.77mmHg [0.39–3.15] respectively. Amongst rotational shift workers, both with and without night work, we found a significant increase only for SBP, namely 1.28 mmHg [0.18–2.39] and 0.65 mmHg [0.07–1.22]. For HTN risk, none of SW types showed significant differences.

Conclusions
Certain groups of shift workers may be at special risk for increased BP. This is the first review assessing the impact of SW specifically on BP values. Although the increases were generally modest, these may play an important role among already susceptible individuals exposed overtime. The effect of SW was more consistent for SBP, which has a major impact on CVD risk. Hence, occupational health services should embrace a holistic CVD preventive approach including atypical risk factors such as SW, with active monitoring across the lifespan of more vulnerable workers.
Comparison between the 6-minute walking test (6MWT) and gait speed (GS) during outpatient cardiac rehabilitation
Authors: Rossini D , Venturini E , Barni L , Dardi O , Bonaguidi E , Cavicchioli P , Lucchesi N 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): USL TOSCANA CENTRO USL TOSCANA NORD-OVEST

Background
6MWT is the gold standard for the functional and prognostic evaluation of patients (P) undergoing cardiac rehabilitation (CR), documenting the increase in exercise capacity induced by CR intervention. However, 6MWT requires an adequate space of at least 30 meters and a non-negligible operator time. GS has been proposed as a test of rapid execution, that can be performed even in a small space. Due to the limited experiences, the aim of the present study was to validate GS in CR in comparison with 6MWT.

Material and Methods
44 P (31 males and 13 females; age 68.2 ± 11.9 years) were enrolled consecutively in an outpatient rehabilitation program; 20 of them after cardiac surgery, 18 after acute cardiac syndrome and 6 with heart failure. After evaluating equilibrium and gait with the Tinetti scale (score ≥ 19), P performed 6MWT and GS at the beginning and at the end of the CR program. The speed at GS was calculated as the average of 3 tests. Data were expressed as mean ± SD. The results of 6MWT and GS at the initial and the final evaluation were compared with Student’s t-test for paired data (statistical significance at p &lt;0.05). The Pearson correlation index (r) was calculated to evaluate the linearity relationship between distance traveled at 6MWT and velocity at GS; the statistical significance was tested with ANOVA. The Statistical Package SPSS (version 24) was used for statistical analysis.

Results
the meters traveled at the initial and the final 6MWT were 434 ± 100 and 491 ± 96 respectively (p &lt;0.001). The velocity in m/sec at the initial and the final GS was 1.68 ± 0.42 and 1.80 ± 0.44 respectively (p &lt;0.001). The correlation between meters traveled and velocity is strong at baseline (r = 0.896) and after CR (r = 0.859), with p &lt;0.001 in both cases.

Conclusions
certainly, aerobic capacity and resistance to exercise are better described by 6MWT. However, given the strong correlation between the distance traveled at 6MWT and the speed at GS, the latter test can be proposed as a tool for a rapid, precise and repeatable functional evaluation, even in clinical settings other than CR.
Digital home-based multidisciplinary cardiac rehabilitation: the way to counteract physical inactivity during the COVID-19 pandemic?
Authors: Pinto R , Lemos Pires M , Borges M , Linan Pinto M , Sousa Guerreiro C , Miguel S , Santos O , Ramalhinho M , Fiuza S , Cordeiro Ferreira M , Ricardo I , Cunha N , Alves Da Silva P , Pinto FJ , Abreu A 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Centre-based cardiac rehabilitation (CR) programs have been forced to close due to the need for physical and social distancing imposed by COVID-19 pandemic. A major problem emerges concerning the potential harmful effects resulting from the suspension of the centre-based CR programs, leading to physical inactivity and unhealthy lifestyle routines. Therefore, the development of alternative delivery models to maintain access to CR programs and to avoid physical inactivity should be organized and tested.

Purpose
To assess the physical activity (PA) levels in a group of patients with known cardiovascular disease (CVD), after completing 3-months of a home-based multidisciplinary digital CR program, organized as an alternative method to the centre-based CR suspended program.

Methods
One hundred and sixteen patients with CVD (62.6 ± 8.9 years, 95 males) who were previously attending a face-to-face CR program were included and the following parameters were assessed at baseline and 3 months: self-reported PA and sedentary behaviour, adherence to the online CR program, cardiovascular and non-cardiovascular symptoms, feelings towards the pandemic, dietary habits, risk factor control, safety and adverse events. The intervention consisted in a multidisciplinary digital CR program, including online exercise training sessions, online educational sessions, psychological online group sessions, risk factor control, nutritional and psychological consults and patient regular assessment by cardiologist and nurse.

Results
Ninety-eight CVD patients successfully completed all the online assessments (15.5% drop-out). It was observed a significant increase from moderate-to-vigorous PA (230 ± 198 mins/week to 393 ± 378 mins/week, p &lt; 0.001) and a decrease of the sedentary time at 3-months (6.47 ± 3.26 hours/day to 5.17 ± 3.18 hours/day, p &lt; 0.001). Seventy percent of the patients met the PA recommendations and 41% reached more than 300 minutes per week of moderate to vigorous PA at 3 months. Almost half of the participants (46.9%) did at least more than one online exercise training session per week and attended at least one of the online educational sessions. There were no major adverse events reported and only one minor non-cardiovascular event occurred.

Conclusion
Patients with CVD, who suspended centre-based CR due to COVID-19 pandemic and started a home-based multidisciplinary digital CR program, had a significant improvement in moderate to vigorous PA after 3 months. Therefore, home-based CR programs showed to be a good option for selected clinically stable patients, who are eligible for CR and cannot attend a centre-based CR program due to COVID-19 pandemic or eventually other reasons.