bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 3573: Higher Soluble Thrombomodulin is Associated with Risk of Coronary Artery Calcification: Longitudinal Analysis of the Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Vaidya Dhananjay , Cushman Mary , Holvoet Paul , Polak Joseph F , McClelland Robyn L , Szklo Moyses , Ouyang Pamela 
Published: July 2021

Background. A prior cross sectional study reported that higher soluble thrombomodulin (sTM) was associated with subclinical atherosclerosis only in the presence of higher soluble intercellular adhesion molecule-1, sICAM-1. We evaluated this interaction longitudinally with regard to coronary artery calcium (CAC) in the MESA cohort.
Methods: MESA is a multi-center longitudinal study with baseline measurements of endothelial biomarkers in a random sample (n=1000) of the baseline cohort. In the random sample, 374 men and 496 women had CT measurement for CAC (Agatston score) at baseline and a median follow-up of 2.9 years. Among those with no baseline CAC (n=490), we estimated the relative risk of detectable CAC at follow-up using general linear models with Gaussian error and robust standard errors. Among those with detectable baseline CAC (n=380), change in CAC on follow-up was modeled using robust regression that down-weights outliers. Models with log(sTM) as predictor were adjusted for follow-up time, sex, ethnicity and baseline age, BMI, smoking, diabetes, systolic blood pressure, total cholesterol, use of BP or lipid-lowering medications and for hormone replacement (HRT) in women in separate models. Interactions between sTM and sICAM-1, sex and ethnicity was assessed.
Results: The median [interquartile range] of sTM was 38 [28 to 47] ng/mL for persons with incident detectable CAC, and 30 [23 to 41] ng/mL in those without (rank sum p <0.001). On adjustment, a 2-fold higher sTM at baseline (e.g., from 23 to 46 ng/mL) was associated with a 1.36-fold increased risk of detectable CAC on follow-up (95% CI: 1.03, 1.79, p=0.031). Among those with baseline detectable CAC, the rank correlation between sTM level and change in CAC score was 0.10 (p = 0.042), however, on adjustment, a 2-fold higher sTM was associated with a non-significant 0.86 Agatston units greater CAC change (p = 0.84). Higher sICAM-1 did not modify the association of sTM with CAC incidence (interaction p = 0.15) or change (interaction p = 0.26). There was no significant heterogeneity by sex, or ethnicity, or confounding by HRT in women.
Conclusion: High circulating levels of sTM were independently associated with incident calcification of the coronary arteries.
Abstract 3634: Association of Weight Loss and Changes in Left Ventricular Geometry and Function - Results of the longitudinal population based MONICA/KORA-Survey
Authors: Stritzke Jan , Markus Marcello R , Lieb Wolfgang , Luchner Andreas , Döring Angela , Keil Ulrich , Schunkert Heribert 
Published: July 2021

Background: Obesity is related to left ventricular (LV) hypertrophy and diastolic dysfunction. However it remains unclear if changes in life style resulting in loss of body weight also have beneficial effects on left ventricular remodeling. In this study we evaluated the effects of weight loss on left ventricular geometry and function during ten years of follow-up.
Methods: Subjects (n=1005, aged 25 to 74 years) who originated from a gender and age stratified random sample of German residents of the Augsburg area were examined by standardized echocardiography at baseline and again after ten years. The associations between weight loss and long-term changes of left ventricular end-diastolic diameter (LVEDD), wall thickness (WT), left ventricular mass (LVM), and left atrial diameter (LA) were assessed. Mean relative changes and odds ratios were computed by statistical models adjusting for gender, age, body height, systolic blood pressure and body weight at baseline.
Results: After ten years of follow-up 305 individuals presented with a loss of body weight (−3.5+/−3.4kg on average). Whereas 700 subjects presented with an increase of body weight (+5.4+/−4.7kg). Ageing related changes in LV geometry were significantly different in the two groups. Specifically, individuals with weight loss displayed a favorable geometry with relative changes of WT (+5.9% [CI-95% 4.3, 7.5] vs. + 8.1% [7.0, 9.2], p=0.024), LVEDD (−0.6% [−1.5, 0.2] vs. 30.8% [0.2, 1.4], p=0.008), LVM (+6.5% [4.3, 8.8] vs. +11.9% [10.4, 13.5], p<0.001) and LA (−0.9% [−2.1, 0.2] vs. +2.5% [1.7, 3.3], p<0.001), as compared to individuals with weight gain. Moreover, the risk for incident left ventricular hypertrophy (OR 2.5 [1.5– 4.3], p=0.001) and incident diastolic dysfunction (OR 1.9 [1.1–3.4], p=0.023) was significantly higher in individuals presenting with an increase in body weight.
Conclusions: As compared to weight gain, weight loss is associated with a significant deceleration of left ventricular remodeling during ageing of the heart. Nevertheless, even in the weight loss group there was no regression in left ventricular mass detectable. Consequently, early interventions especially in young obese individuals are essential for prevention of premature onset of cardiac remodeling.
Abstract 3644: Moderate Alcohol Consumption Is Associated With Improved Endothelial Function
Authors: Suzuki Keiko , Elkind Michell S , Boden-Albala Bernadette , Jin Zhezhen , Di Tullio Marco R , Sacco Ralph L , Homma Shunichi 
Published: July 2021

Background and Purpose: Moderate alcohol intake is protective against coronary artery disease. Endothelial dysfunction contributes to atherosclerosis and the pathogenesis of cardiovascular disease. Effects of alcohol consumption on endothelial function may be relevant to these cardiovascular outcomes, but very few human studies have examined the effect of alcohol consumption on endothelial function assessed by flow-mediated dilation (FMD) of the brachial artery.
Methods: In the population-based Northern Manhattan Study (NOMAS), we performed a cross-sectional analysis of lifetime alcohol intake and brachial artery FMD during reactive hyperemia using high-resolution B-mode ultrasound images among 883 stroke free participants (mean age 66.7 years, women 56.6%, Hispanic 67.5%, black 17.5%, and white 14.9%).
Results: The mean brachial FMD was 5.68% and the median was 5.52%. Reported lifetime alcohol consumption was as follows:147 (16.7%) non-drinkers (<1drink/month), 616 (69.8%) >1drink/mo to 2drinks/day, 59 (6.7%) >2 to 5drinks/day, 60(6.8%) >5drinks/day. Compared to non-drinkers, those who drank >1 drink/mo to 2 drinks/day were more likely to have FMD above the median (5.5%) of FMD (unadjusted OR 1.7, 95% CI 1.2–2.5, p=0.004). In multivariate analysis, the relationship between moderate alcohol consumption and FMD remained significant after adjusting for multiple traditional cardiovascular risk factors, including age, body mass index, hypertension, diabetes and smoking (adjusted OR 1.5, 95%CI 1.1–2.2, p=0.02). No beneficial effect on FMD was seen for those who drank more than 2 drinks/day.
Conclusion: Consumption of up to 2 alcoholic beverages per day independently was associated with improved FMD compared to nondrinkers in this multiethnic population compared to non-drinkers. The effect on FMD may represent an important mechanism in explaining the protective effect of alcohol intake on cardiovascular disease.
Abstract 3666: Remaining Lifetime Risks for Cardiovascular Disease Death by Risk Factor Burden at Selected Ages in Black and White Men and Women
Authors: Berry Jarett D , Garside Daniel B , Cai Xuan , Dyer Alan R , Lloyd-Jones Donald M 
Published: July 2021

BACKGROUND: Although the effect of risk factor (RF) burden at age 50 years has been reported, the effect of RF burden measured at other ages on lifetime risk for cardiovascular diseases (CVD) is unknown and no data are available for non-whites.
METHODS: Using limited access data from the National Heart Lung and Blood Institute, we pooled participants from the Framingham Heart Study, the Framingham Offspring Study, the Atherosclerosis Risk in Communities Study, the Cardiovascular Health Study, and the Chicago Heart Association Detection Project in Industry with RFs measured at or near ages 45, 55, and 65 years for blacks and whites separately in sex-stratified analyses. Blood pressure and cholesterol levels, smoking, and diabetes status were used to stratify the pooled cohort into 5 risk strata. Lifetime risks for CVD events to 85 years of age were estimated for men and women, with death free of CVD as a competing event.

RESULTS: We included 21,534 men (15.7% black) and 24,063 women (9.3% black) who were followed for 651,144 person-years. With more adverse levels of single risk factors, lifetime risks were greater for both men and women in both races. Compared with white participants with ≥2 major RFs, those with all optimal RF levels had substantially lower lifetime risks (see Table

). There was a similar pattern of results observed in blacks for lifetime risks for CVD death. Additional analyses of the endpoints of fatal/non-fatal coronary heart disease and fatal/non-fatal stroke revealed a similar pattern of results.

CONCLUSIONS: Remaining lifetime risks for CVD are dramatically higher with greater RF burden at all ages studied. The absence of established RFs is associated with very low remaining lifetime risk for CVD, particularly for men and women at age 65 years.
Abstract 3710: Stanford GEMS (Girls health Enrichment Multisite Studies): Long-Term Efficacy of After-School Dance and Screen Time Reduction in Low-Income African-American Girls
Authors: Robinson Thomas N , Matheson Donna M , Kraemer Helena C , Obarzanek Eva , Wilson Darrell M , Haskell William L , Pruitt Leslie A , Thompson Nikko S , Haydel K. Farish , Fujimoto Michelle , Varady Ann , Killen Joel D 
Published: July 2021

Objective: To test the efficacy of a 2-year, community- & family-based intervention to reduce weight gain in low-income, preadolescent African-American girls
Design: 2 arm, parallel group, randomized controlled trial Setting: Low-income areas of Oakland, CA Participants: 8 –10 year old African-American girls
Interventions: Girls were randomized to a 2 year, culturally-tailored after school dance program and a home/family-based intervention to reduce screen media use (dance/TV) versus an information-based community health education (HE) active-placebo comparison intervention Primary
Outcome: Change in body mass index measured up to 5 times over the course of the study
Results: 261 girls were randomized (134 dance/TV, 127 HE) and 225 (86.2%) completed 1 or more follow-up measures (118 dance/TV, 107 HE; mean ± SD follow-up = 25.7 ± 8.5 mos and 25.2 ± 9.6 mos, respectively). Intent-to-treat analysis found no statistically significant differences between groups in BMI change (mean difference in changes= .04 kg/m2 per year, 95% confidence interval [95% CI] =−.19 to .27; P=.72). Similar results were found for waist circumference and triceps skinfold. Compared to girls in HE, girls in the dance/TV group significantly reduced fasting total cholesterol levels (difference in changes = −3.49 mg/dl per year, 95% CI −5.28 to −1.70; P<.001), fasting LDL-cholesterol (−3.02, 95% CI −4.74 to −1.31; P<.001) and depressive symptoms (P<.05). Changes between groups were not statistically significant for HDL-cholesterol, triglycerides and insulin, resting blood pressure and heart rate, dietary energy and fat, accelerometer-measured physical activity, and screen time. Moderator analysis indicated the dance/TV reduction intervention was significantly more effective than HE in reducing BMI gain for girls with single parent families, more screen time and more depressive symptoms at baseline.
Conclusions: A culturally-tailored after school dance and screen time reduction intervention did not slow BMI increases more than a health education intervention in low-income African-American girls. The dance/TV intervention resulted in greater reductions in fasting total and LDL-cholesterol and depressive symptoms, but not in other cardiovascular disease risk factors.
Abstract 71: Is the new Basic Life Support protocol (2005) easier to learn?
Authors: Betlehem Jozsef , Nagy Gabor , Marton Jozsef , Gondocs Zsigmond 
Published: July 2021

Objectives: The effective learning of basic life support (BLS) skills in the process of training is always an important expectation during the course. Each assessment of BLS training is a complex, continuous action where the evaluation should not be subjective by using the examiner’s experiences only. In order to reach the reliable standard of pedagogical assessment, our department developed a score to ensure more objectivity on BLS examination.
Methods: The developed scoring tool which is consistent with the steps of 2000 and 2005 ERC BLS protocols was introduced at the faculty. After a trial period we assessed in a cross sectional study design 156 students in 2005/2006 first semester based on 2000 ERC BLS, and 207 students in 2006/2007 first semester based on 2005 ERC BLS protocol. The volunteers are between the age 18 and 25 years, and all students studied the same BLS protocol in 28 hours/semester. The data were analyzed by Chi Square test and cross tabulation with SPSS 11.00.
Results: The positive results in all steps of 2005 BLS protocol were correlating with successful of BLS exams significantly. Comparing the five steps of 2005 BLS protocol to 2000 BLS protocol, the checking for responsiveness (p=0,001), shouting for help (p=0,013), checking for breathing (p=0,000; Phi 0,068 vs 0,459), chest compression (p=0,000; Phi: 0,443 vs 0,472), breathing (p=0,000 Phi: 0,360 vs 0,764), seemed to be influencing the successful exams in the 2005 ERC BLS protocol significantly, which made it easier to learn the new protocol, too. There was not significant correlation between the genders in case of 2000 or 2005 BLS protocol.
Conclusions: Our earlier developed score is useful in evaluating the 2005 BLS protocol and the new protocol can be learned more successfully.
2007 Katharine A. Lembright Award and Lecture—Stage D Heart Failure: Quality-of-Life Outcomes After Transplantation and Mechanical Support
Authors: Grady Kathleen 
Published: July 2021

Approximately 5 million individuals have heart failure in the United States. The 1-year mortality rate for patients with New York Heart Association class IV heart failure is 50%. Treatment options for patients with refractory symptoms and stage D heart failure include heart transplantation and mechanical circulatory support devices. Improved outcomes have been demonstrated in these advanced heart failure patients who undergo surgical therapies. Prolongation of life is relevant only if quality of life (QOL) is improved.
Improvement in QOL outcomes has been demonstrated before and after heart transplantation, including improved outcomes when bridged to transplantation with left ventricular assist devices (LVADs). While listed for transplantation, worse QOL is significantly related to more symptoms, psychological distress, and functional disability. Patients who are bridged to heart transplantation with an LVAD report significantly improved QOL and decreased symptoms from before to early after LVAD implantation, as well as fairly good and stable QOL outcomes through 1 year after implantation.
At 1 year after transplantation, better QOL is significantly related to less psychological distress, functional disability, and symptom distress; older age; and fewer complications. At 5 to 10 years after heart transplantation, QOL is positive and stable. Improved QOL is significantly related to biopsychosocial variables, including less depression, more positive emotions, more social support, and less fatigue. Thus, for stage D heart failure patients, heart transplantation conveys significant short-and long-term QOL benefit, including in those patients who are bridged to transplantation with an LVAD.
2007 James B. Herrick Award and Lecture—The Road Ahead
Authors: Holmes David 
Published: July 2021

The road ahead always starts from where it began. For the field of interventional cardiology, the road began 30 years ago this past September, when a 38-year-old physician treated a 38-year-old man for symptomatic coronary artery disease. After this “disruptive” experience, using “disruptive” technology, by a “disruptive” young physician, the landscape has never been the same.
Andreas Gruentzig, that physician, revolutionized the practice of modern cardiovascular care, not just with the introduction of percutaneous transluminal coronary angioplasty, but even more with the concept that a person could work safely in an awake patient within a vascular tree to achieve a specific goal. This sentinel event spurred the development of an extensive family tree of discipline, including intravascular ultrasound; angioscopy; percutaneous treatment of structural heart disease, including among others valvular heart disease, hypertrophic obstructive cardiomyopathy, and atrial fibrillation; ablation; and treatment of carotid and peripheral arterial disease and, more recently, stroke.
In addition, Dr Gruentzig can be said to have encouraged the development of less invasive surgical revascularization approaches, such as “mid-cab” coronary bypass graft surgery. Now that we have broken the barrier of working therapeutically within the vascular tree, the road ahead will include continual assignments and miniaturization of techniques for identification, prevention, and treatment of disease. That road ahead will only be limited by our ability to imagine and create and then our ability to document improved outcome for society, in both individuals and as a whole.
2008 Charles T. Dotter Memorial Lecture—More Surprises From the Healthy Donut
Authors: Rubin Geoffrey 
Published: July 2021

In 1990, magnetic resonance imaging (MRI) techniques for imaging the cardiovascular system were ascendant, generating considerable enthusiasm throughout the imaging community. Simultaneously, computed tomography (CT) was considered to play a minimal role in cardiovascular imaging. However, the introduction of spiral CT and subsequent birth of CT angiography (CTA) in 1991 transformed the field by offering greater spatial detail, more reliable image quality, and a less complex workflow than MRI.
In 1998, multidetector-row CT (MDCT) revolutionized CTA by allowing high spatial resolution imaging of large vascular territories, including “whole-body” three-dimensional angiograms in less than 20 seconds. The volumetric acquisitions of CTA allowed the analysis of the arterial wall, juxta-arterial structures, and the arterial lumen, while revealing limitations of intra-arterial angiography, the previously undisputed standard for vascular imaging. MDCT also provided key breakthroughs for improving the temporal resolution of CT, enabling cardiac and coronary CTA to be performed on widely available scanning platforms.
Throughout the current decade, CT advances have followed a near exponential trajectory, and the question “Can we reliably perform coronary CTA?” has been replaced by “What impact does management based on CT findings have on patient outcomes?” In just 2 years, an unprecedented diversity in novel CT technology has emerged, including multiple x-ray sources, wide-area detectors, and energy-discriminating detectors that promise extraordinary advances in the assessment of tissue composition, fine detail visualization, tissue perfusion, functional characterization, artifact suppression, and radiation dose minimization. Together, we will explore the past, present, and future of CT in the diagnosis and characterization of cardiovascular health and disease.
Abstract 5918: Length of Stay for Acute Heart Failure: Effects of Cohorting Patients on Variability
Authors: Saltzberg Mitchell , Albert Maria , Mahoney Donna , Bouffard Lynne , Weintraub William 
Published: July 2021

Background: Quality metrics for heart failure (HF) are increasingly utilized as an indicator of quality care. Mean length of stay (LOS) is a commonly utilized metric that is made available to the public but variability in LOS is not reported. Efforts to cohort HF pts in the hospital improve quality of care but the effect on LOS is less well defined.
Methods: As part of an ongoing performance improvement project at ChristianaCare, LOS was evaluated using standard descriptive statistics. A LOS distribution was also generated monthly to visualize LOS variability. Comparisons were made for HF pts cohorted on a dedicated HF unit (HFU) vs. all other units (Other) and by inclusion/exclusion of HF pts with prolonged LOS > 10 days to reduce the effects of outliers.
Results: 71 % of all HF patients were discharged in < 5 days, 82 % in < 10 days. Mean LOS (March 07–March 08) for HF was 6.63 days overall (6.1 HFU vs. 7.2 other; p = 0.05). After exclusion of long LOS HF pts, mean LOS fell to 4.4 days (4.3 HFU vs. 4.5 Other; p = 0.06). Median LOS for all HF patients was 5.0 days regardless of location. The standard deviation of LOS was significantly lower for HFU patients (4.5 vs. 11.5 days, p < 0.02) The LOS graph (Graph 1) highlights the wide variability in LOS and how mean statistics may be misleading.
Conclusions: Mean LOS can be misleading as a metric for quality of HF care provided as outliers significantly impact this value. Other statistics and graphical displays can more accurately reflect quality of care. In addition, cohorting of HF patients significantly reduces overall variability in LOS and suggests a more consistent approach to acute HF care.
Abstract 5933: Reduced Number of Gap Junctions at the Intercalated Disc in the Ventricles of Boxer Dogs Afflicted with Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC)
Authors: Oxford Eva M , Maass Karen , Moise N. Sydney , Delmar Mario 
Published: July 2021

ARVC is an inherited myocardial disease associated with sustained monomorphic ventricular tachycardia, sudden cardiac death, and replacement of RV myocardium with fatty or fibro-fatty tissue. Lethal arrhythmias often occur in young patients, before apparent structural damage. It has been hypothesized that loss of Cx43 gap junctions (GJ) may act as a substrate for ventricular arrhythmias in these patients. An inherited form of ARVC is present in the boxer, with clinical symptoms and pathological features similar to those of humans. Here, we used transmission electron microscopy (TEM) to assess the ultrastructure of the intercalated disc (ID) in ARVC-afflicted boxers. Samples from the right and left ventricles (RV and LV) of 1 unafflicted beagle, and 3 ARVC afflicted boxers were examined by TEM. Samples from beagle tissue showed normal morphology, good alignment of the sarcomeres and myofibrils, and attachment of myofibrils to the ID. Samples from the ARVC-afflicted boxer lacked myofibril organization, with few attachments to the ID. Within RV and LV longitudinal sections from one afflicted and one control animal, three parameters were measured: ID length, individual GJ length, and number of GJ per ID. No significant differences were found in the length of IDs or of GJs from RV or LV samples of ARVC vs. control. ID length (μm) was 26.8 +/− 5.4 and 44.9+/− 10.6 in control RV and LV, respectively. ID length in afflicted samples was 31.2+/− 5.0 and 52.3+/−13.5 (pNS). GJ length (μm) was .5+/−.03 and .5+/.05 for RV and LV of the control group, and .4+/−.07 and .6+/−,13 in samples obtained from RV and LV of ARVC afflicted animals (pNS). However, our data indicated a significant (p<.01) decrease in the number of GJ per ID in the ARVC sample by over 80% (5.7+/−.4 RV, 5.8+/− 1.4 LV in control; 1.1+/−.16 RV, 1.5+/−.2 LV in ARVC). Our results suggest that ARVC, both in humans and in boxer dogs, associates with a loss of GJ, which may act as a substrate for lethal arrhythmias. In contrast to human ARVC, no desmosomal protein mutations have been linked to boxer ARVC. This suggests a different genetic basis and yet, a common molecular pathway for ARVC in both species. As such, boxers represent a valuable model to understand the mechanisms leading to malignant ventricular arrhythmias in ARVC patients.
This research has received full or partial funding support from the American Heart Association, AHA Founders Affiliate (Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, Vermont).