bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 724: The Addition of Coronary Artery Calcium Scoring (CAC) to Myocardial Perfusion Imaging (MPI) Improves Diagnostic Accuracy in the Detection of Obstructive CAD: Results of a Prospective Multicenter Trial
Authors: Thomas Gregory S , Budoff Matthew J , Mieres Jennifer H , Kazerooni Ella A , Shaw Leslee J 
Published: July 2021

Background: The PICTURE Trial evaluated the accuracy of 64-CT coronary angiography (CCTA) & MPI to invasive coronary angiography (ICA) for the detection of obstructive CAD. CCTA included an evaluation of Coronary Artery Calcium. The objective of this substudy was to evaluate the combination of measures of ischemia & atherosclerosis, with MPI & CAC respectively.
Methods: 230 patients [52% male, 56.9 yrs] referred for MPI for chest pain were prospectively enrolled at 12 sites. 22% of patients underwent ICA for either abnormal MPI or coronary CCTA. The efficacy was assessed on a per-patient basis.

Results: Of the 47 patients prospectively enrolled that underwent ICA, the prevalence of a >50% stenosis by ICA was 47% (22/47). Mean CAC for all patients was 434 +/−926. The frequency of obstructive CAD based on MPI & CAC are shown in the Figure

. The odds (95% CI) for obstructive CAD is elevated 12.73-fold (2.43– 66.55) for ≥5% myocardium with stress defects (p<0.0001). Adding stress EF to perfusion results in a diagnostic sensitivity & specificity of 76.0% & 90.9% (p<0.0001). For CAC ≥100 alone, the diagnostic sensitivity & specificity is 76% & 72.7% (p=0.001). Adding a CAC score >100 to perfusion + EF increases the odds of obstructive CAD by 2.5-fold (1.31– 4.77, p=0.006). In patients with <5% defects, the addition of a CAC score of >100 increased the odds by 4.8-fold (0.95–24.14, p=0.057). ROC analysis revealed the % myocardium with stress defects categorized obstructive CAD with an area of 0.76 (95% CI=0.62– 0.90, p=0.002). Adding CAC improved the area to 0.85 (95% CI=0.74–0.96, p<0.0001).

Conclusion: The addition of CAC to MPI improves diagnostic accuracy in the detection of obstructive CAD.

Prevalence of ≥50% Obstructive CAD by MPI & CAC
Abstract 810: Impact of Elevated Plasma Matrix Metalloproteinase-2 on Prognosis in Hypertrophic Cardiomyopathy: Evidence from Long-Term Follow-Up of Genotyped Patients
Authors: Masuta Eiichi , Ino Hidekazu , Fujino Noboru , Uchiyama Katsuharu , Hayashi Kenshi , Sakata Kenji , Tsubokawa Toshinari , Sakamoto Yuichiro , Funada Akira , Muramoto Akihiko , Yamagishi Masakazu 
Published: July 2021

Background: Previous studies suggest that production of matrix metalloproteinase-2 (MMP-2) which is responsible for cardiac remodeling could determine prognosis of hypertrophic cardiomyopahty (HCM). However, few data exist regarding the importance of MMP-2 production in clinical settings. Therefore, we determined MMP-2 levels correlated to prognosis in HCM with sarcomere gene mutations.
Methods and Results: Echocardiography and determination of plasma MMP-2 levels by enzyme-linked immunoassay were simultaneously performed in 31 HCM patients (22 women, mean age 56±12 years) with sarcomere protein gene mutation including 22 for cardiac troponin I, 5 for cardiac myosin binding-protein C, 3 for cardiac troponin T and 1 for beta-myosin heavy chain. Major cardiac events such as hospitalization due to congestive heart failure or ventricular fibrillation and mortality were prospectively examined for follow-up period of 48.4±29.1 months. When patients were divided into two groups (Group A: MMP-2 ≥800 ng/ml n=16 and Group B: MMP-2<800ng/ml n=15), there was no differences in mean age (59.4±11.7 year vs 53.1±11.3 year, p=0.13). On echocardiograms, interventricular septal thickness in group A (11.7±4.2 mm) was smaller than that in group B (15.9±4.8 mm, p<0.05) and percent fractional shortening (FS) was significantly impaired in group A (24.8±12.5%) in comparison with that in group B (37.7±8.1%, p=0.002). There was negative correlation between the MMP-2 levels and FS (p<0.001, r=0.76). The frequency of cardiac events was significantly higher in group A (10 patients of 16 patients) than in group B (1 patient of 15 patients, p=0.0012). Importantly, 5 patients of group A died, although none of groupB patients did (p=0.018).
Conclusion: These results demonstrate that the high plasma concentration of MMP-2 (≥800 ng/ml) could be a predictor of prognosis in HCM with sarcomere mutations probably through reflecting impaired left ventricular function.
Abstract 1098: Effect of Hypercholesterolemia on Myocardial Necrosis and Apoptosis in Response to Ischemia Reperfusion Injury
Authors: Osipov Robert M , Bianchi Cesario , Feng Jun , Liu Yuhong , Clements Richard T , Sodha Neel , Sellke Frank W 
Published: July 2021

OBJECTIVE: Myocardial ischemia-reperfusion(I/R) injury often results in necrosis and apoptosis and may lead to cardiac dysfunction or death. This study investigates impact of hypercholesterolemia in the setting of I/R injury on myocardium.
METHODS: The mid-left anterior descending coronary artery in normocholesterolemic (NCn=7) and hypercholesterolemic (HCn=7) Yucatan males were occluded for 60 min, followed by reperfusion for 120 min. Hemodynamic values were recorded. Monastryl blue/TTC staining was utilized to assess the area-at-risk (AAR) and necrosis. The expression of Bcl2, apoptosis inducing factor (AIF), total & cleaved caspase3, total & cleaved PARP, bad, BNIP3, Akt and phospho-Akt measured. The TUNEL staining utilized to assess the magnitude of apoptosis.
RESULTS: Hemodynamic values of MAP (p<0.01), DLVP (p<0.01), +dP/pt (p<0.01), and −dP/pt (p<0.01) were increased 1.2 fold in HC. In HC longitudinal and horizontal segmental shortening in the AAR decreased by 49% vs. 26% (p<0.01) and 68% vs. 48% (p<0.01) at the end. The AAR was similar in both groups (36% vs. 34%, p=0.61) whereas infarct size increased 45% in HC (42% vs. 61%, p=0.01). The expression of anti-apoptotic Bcl2 decreased 2.3-fold (p<0.01) whereas pro-apoptotic PARP and BNIP3 increased 2.8-fold (p<0.01) and 1.9 fold (p<0.01) respectively in HC. Ischemia decreased Akt expression 1.6-folds (p<0.01) and phospho-Akt 1.5 fold (p<0.01) in HC, whereas increased phospho-Akt 1.9 fold (p<0.01) in NC. In HC the TUNEL+ cells increased 3.8 fold (p=0.03) in the AAR.
CONCLUSIONS: This study demonstrated that hypercholesterolemia have positive ionotropic effect on myocardial function, increase infarct size in AAR, mediate pro-apoptosis and attenuate survival pathway after I/R injury.
Abstract 1147: Drug Eluting Stents Do Not Delay Early Endothelialization But Show Distinct Differences In Endothelial Function
Authors: Van Der Giessen Willem J , Sorop Oana , Krabbendam-Peters Ilona , Onuma Yoshinobu , van Beusekom Heleen M 
Published: July 2021

Late stent thrombosis and impaired endothelium dependent vasodilation in Cypher and Taxus are often attributed to delayed re-endothelialization. Data to support this hypothesis is scarce and the functional status of endothelium within these drug eluting stents is unknown. We compared 3 DES (Paclitaxel; Sirolimus (-limus via mTOR) and Tacrolimus (-limus via calcineurin)) to BMS in swine coronary arteries with respect to early endothelialization (%EC) at 5 days and function as assessed by immunocytochemistry for eNOS and vWF expression at 28 days (semiquantitative score) and in vitro vasoreactivity at 5 and 28 days.
Results. There were no significant differences in %EC between DES and BMS at 5 days (Anova, p=0.7). While vWF expression was similar for all DES, PES showed diminished eNOS expression at 28 days. Microvascular function showed no overt impairment distal to both DES in EC-dependent dilation to bradykinin at 5 and 28 days. However, eNOS blockade by L-NAME uncovered a strongly depressed NO production in both DES at 5 days which recovered at 28 days.
Conclusion. DES show no differences in re-endothelialization as compared to BMS. In vitro data showed that both DES induced a temporary reduction in NO production. However, only Paclitaxel showed a prolonged reduction in eNOS expression at 28 days.

planimetry of endothelial presence and function
Abstract 2013: Long Term Clinical Prognosis of Provocation Positive Variant Angina
Authors: lee Hyun jong , Choi Jin ho , Park Ji han , Choi Soo Hee , Gwon Hyeon-Cheol , Song Young Bin , Hahn Joo-Yong , Doh Joon-Hyung , Lee Sung yoon , Kim Myeng gon , Choi Seung Hyuk , Lee Sang Hoon 
Published: July 2021

Background Although coronary vasospasm provocation test is widely performed in daily clinical practice, data regarding the long term prognosis of variant angina is still limited.
Methods We retrospectively investigated clinical consequence of 1,736 patients who underwent elective diagnostic coronary angiography and vasospasm provocation test for the evaluation of chest pain from Sep 1994 to Dec 2006. Variant angina was defined by decrease of anterograde coronary flow less than TIMI 2, or new development of severe coronary stenosis (diameter stenosis > 90%) accompanied by typical angina pain and corresponding EKG change provoked by ergonovine intracoronary infusion, followed by nitroglycerin infusion and resolution of vasospasm. Patients who developed spontaneous spasm without provocation or underwent revascularization were excluded.
Results Provocation test was positive in 723 patients and negative in 1,013 patients. Median follow-up period was 1452 days (interquartile range: 711 − 2606), which was not different between two groups. 5-year all major adverse cardiac event (MACE)-free, death-free, and revascularization-free survival was significantly lower in positive provocation group compared to negative group (90.0% versus 95.4%, 92.9% versus 95.7%, 96.8% versus 99.6%, p<0.05 by log-rank test), and cardiac death-free survival was marginally lower in positive provocation group (96.9% versus 98.7%, p=0.051). Although positive provocation group showed higher incidence of smoking, diabetes, hypertension, and significantly fixed stenosis in major coronary arteries (frequency: 19.4% versus 8.2%), multivariate analysis using Cox proportional hazard model revealed that positive provocation test is still an independent predictor of MACE (p<0.001).
Conclusion Our result shows that positive provocation test might be associated with adverse outcome in chest pain patients. It suggests that long term medical care should be provided for patients with positive provocation test.
Abstract 2054: Neuron-specific Enolase as a Prognostic Parameter in Patients Treated with Mild Hypothermia After Cardiopulmonary Resuscitation for Out-of-hospital Cardiac Arrest
Authors: Schneider R. , Stumpf C. , Yilmaz A. , Wasmeier G.H. , Schlundt C. , Garlichs C. , Daniel W.G. , Achenbach S. 
Published: July 2021

Background: Overall prognosis in comatose survivors of Cardiopulmonary resuscitation is poor and the degree of hypoxic brain damage is usually the most important prognostic factor. Elevation of the neuron-specific enolase (NSE) as measured with 72 hours after admission has been identified as a predictor of neurologic outcome, and a threshold level of 33 ng/ml has been proposed as a highly specific cut-off value, above which neurologic outcome will be unfavourable. Therapeutic hypothermia is a new concept to improve neurologic outcome in patients after resuscitation, and the prognostic relevance of elevated NSE levels in patients treated by hypothermia has not yet been assessed.
Methods: Mild therapeutic hypothermia (33–34°C) was applied via an intravenous cooling catheter for 24 hours in 38 consecutive patients admitted after successful on-site resuscitation following out-of-hospital cardiac arrest (28 male, 10 female, age 38 – 83 years, mean age 64.4±12.7 years). 72 hours after admission, NSE level was measured. Clinical and neurologic outcome was assessed at 1 and 4 weeks.
Results: Out of 38 patients, 4 patients died within the first 72 hours. In 2 additional patients, NSE measurement was impossible because of haemolytic serum. NSE levels displayed a wide range (9.8 ng/ml − 720 ng/ml). Of the 32 patients available for analysis, 17 patients suffered severe ischemic brain damage or died during the further course (NSE 11.0 –720 ng/ml, mean 150.4±185.9 ng/ml). 15 patients recovered and had favourable neurologic outcome (NSE 9.8 – 47.9 ng/ml, mean 21.1±11.9 ng/ml). Using the recommended threshold value of 33 ng/ml, the sensitivity for ischemic brain damage was 76.5%, specificity was 80.0%, and the positive predictive value was 81.3%.
Conclusions: Based on prior experience in patients without therapeutic hypothermia, a cut-off level of 33 ng/ml has been recommended as a highly specific threshold above which neurologic outcome in patients resuscitated for out-of-hospital cardiac arrest will be poor. Our data demonstrate, however, that favourable outcome can be achieved even for higher NSE levels in patients who are treated with therapeutic hypothermia. Thus, the prognostic value of NSE in these patients must be reconsidered.
Abstract 2086: Community-Dwelling African-American Beliefs Associated with Adherence to Antihypertensive Medications: A Matter of Life and Death
Authors: Lewis Lisa M 
Published: July 2021

Medication adherence is low among hypertensive patients regardless of ethnic background. However, African-American prevalence is higher when compared to Caucasian-Americans.
Recognizing African-American perspectives about their adherence to antihypertensive medications is necessary for the development of successful interventions aimed at improving adherence to prescribed regimens. Thus, the purpose of this qualitative study was to explore community-dwelling hypertensive African-American beliefs regarding adherence to antihypertensive medications. A community and academic partnership was formed to conduct three focus groups with 40 participants at two community centers in a Northeastern urban city. Each focus group was recorded and transcribed verbatim. We analyzed the focus group data using thematic analysis. Participants had a mean age of 57 years, were mostly female (n=27), high school graduates (n=14), unemployed (n=27), and earned an annual income of $20, 000 or less (n=18). In addition, they had a mean hypertension diagnosis of 8 years with most participants reporting adherence to their antihypertensive medication regimens (n=26). Study participants described salient beliefs regarding their adherence to antihypertensive medications. Data analysis revealed an overarching theme of “it’s a matter of life and death” in which study participants were able to articulate the health benefits associated with adhering to their medications but also described the difficulties associated with adherence in relation to their social contexts. Participants identified three major difficulties associated with the remaining adherent to their antihypertensive medications. The difficulties included: (a) negotiating their limited resources, (b) negotiating their neighborhood violence, and (c) negotiating their feelings of mistrust of doctors. Although these results cannot be generalized, they do provide significant insight into the contextual factors associated with the lives of some community-dwelling hypertensive African-Americans. These findings are important because they can be used to tailor interventions to increase medication adherence in hypertensive African-Americans.
Abstract 2143: Clinical Impact of the Hot-Bath Test in Patients with Brugada Syndrome
Authors: Mori Aiko , Kusano Kengo , Nagase Satoshi , Nakamura Kazufumi , Morita Hiroshi , Ohe Tohru 
Published: July 2021

Background: Hot-bath related sudden death is sometimes observed and it is well known that fever aggravates ventricular arrhythmias in Brugada syndrome. Accordingly we examined the ECG changes during Hot-bath to identify high risk Brugada patients.
Methods: Total 31 Brugada patients [clinically documented ventricular fibrillation (VF) in 12] were examined. Waterproof Holter-ECGs (modified-NASA: the point at a maximum ST-elevation) during Hot-bath were recorded and compared with ECGs during sodium channel blocker (pilsicainide) administration. We also compared ECG changes with the clinical characteristics (SCN5A mutation, family history of sudden death and syncopal episode).
Results: Taking Hot-bath rose body temperature from 36.4±0.4°C to 38.1±1.8°C and increased ST-level significantly (0.17±0.15 to 0.31±0.25mV, P=0.0001). One patient developed VF (figure) during Hot-bath in whom ST-level was more elevated than that during pilsicainide administration. In accordance with ST-level change during Hot-bath and pilsicainide administration, we divided into two groups. Group 1 (n=11): ST-level was more elevated during Hot-bath than pilsicainide administration, and Group 2 (n=20): ST-level was less elevated during Hot-bath than pilsicainide administration. Family history of sudden death was more observed in Group1 (46%) than Group 2 (10%, P=0.02), but other parameters were not different between the groups.
Conclusion: Hot-bath aggravates ST-elevation in Brugada patients. Hot-Bath test would be useful to identify high risk Brugada patients.
Abstract 2148: Abnormal T Wave Alternans Could Provide Additional Risk Stratification in Patients with Prolonged QRS Duration
Authors: Mine Takanao , Kanemori Tetsuzou , Nakamura Hiroaki , Masuyama Tohru , Ohyanagi Mitsumasa 
Published: July 2021

QT dispersion, signal averaged electrocardiogram (SAECG) and T wave alternans (TWA) have been found to be increased susceptibility to life-threatening arrhythmias or cardiac death
(LTA/CD). Patients with heart diseases often present prolonged QRS duration (p-QRSd), however the risk stratification in patients with p-QRSd still remains. We investigated whether QT dispersion, SAECG and TWA would provide additional risk stratification in patients with p-QRSd. We studied 52 patients (47 males, mean age 66±9 yrs) with QRS duration ≥ 120ms (34 RBBB type and 18 LBBB type) who had heart diseases (45 coronary artery disease and 7 dilated cardiomyopaty). QT dispersion was measured from standard 12-lead ECG. The filtered QRS duration (f-QRS) and root mean square voltage of the terminal 40ms of the QRS complex (RMS40) were obtained by SAECG. TWA was measured with the CH 2000. TWA was considered positive when the alternans with alternans voltage ≥ 1.9μV and alternance ratio ≥ 3 was sustained ≥ 1 minute in vector magnitude, X, Y, Z, V4 or two precordal leads at heart rate ≤ 110bpm. TWA was classified negative when the alternans wasn’t presented at heart rate ≤ 110bpm and considered indeterminate if the record didn’t meet either positively or negatively. Abnormal TWA was defined as positive or indeterminate. An abnormal TWA test was present in 56% (23 patients had negative TWA, 11 had indeterminate and 18 had positive). During the follow-up periods (69±41 months), 15 patients had life-threatening arrhythmias (n=12) and/or cardiac death (n=7). Univariate analysis revealed left ventricular ejection fraction (LVEF), RMS40 and abnormal TWA (n=29) as significant variables, however there was no significant difference in LTA/CD rate between BBB types, and no associations between QT dispersion and LTA/CD. On logistic regression analysis, only LVEF (p=0.02) and abnormal TWA (p=0.02, odds ratio 9.803 [95%CI 1.430 to 67.207]) were independently associated with LTA/CD. Abnormal T wave alternans could provide additional risk stratification in patients with prolonged QRS duration.
Abstract 2390: Düsseldorfer-ABCD Trial (Autologous Bone Marrow Cells in Dilated Cardiomyopathy)
Authors: Schannwell Christiana M , Yousef Muhammad , Basalyk Carmen M , Zeus Tobias , Brehm Michael , Köstering Matthias , Strauer Bodo-Eckehard 
Published: July 2021

Heart failure is a dangerous disease with an increasing frequency. Although conventional drug therapy may delay remodeling, there is no basic therapeutic regime available for preventing or even reversing this process. Several preclinical as well as clinical trials have shown that transplantation of autologous bone marrow cells improved cardiac function after myocardial infarction and chronic heart disease (CAD). We investigated the effects of intracoronary (ic) autologous stem cell transplantation (STX) at patients with non-ischemic dilated cardiomyopathy (DCM).
Methods: A total of 10 patients with DCM were included in this study (group I). The control group also consists of 10 age and sex-matched patients with comparable ejection fraction (group II). CAD and myocarditis were excluded. All patients of group I received an ic autologous STX with mononuclear cells. Cell transplantation was performed via the ic administration route. All cells were infused directly into the dominant coronary vessel. To achieve a maximal ischemic stimulus all patients received Dobutamine intravenously and Dipipyridamol by ic application. All 20 patients were re-investigated after 3 months.
Results: Three months after ic STX, the global left ventricular ejection fraction increased in patients from 18 ± 1 up to 26 ± 3% (p < 0.01). In parallel the physical ability (functional capacity) rose from 25 to 75 watt (p < 0.01). In addition, we found an improvement of maximum oxygen uptake under stress from 1236 ± 217 up to 1473 ± 198 ml/min (p < 0.01). Furthermore we documented a reduction of arrythmia. An unchanged or even impaired left ventricular function was not observed in any patient of group I. In the control group (group II) no significant changes were documented. No side effects of ic autologous STX were found, particularly no arrythmias, no heart insufficiency, no dyspnoea and no palpitations.
Conclusion: These results show that transplantation of autologous bone marrow cells, as well as the ic approach, represents a novel and effective therapeutic procedure for the therapy of DCM. For this method of therapy, no ethical problems exist, and no side effects were observed. However, further experimental studies and controlled prospective clinical trials have to follow.