bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 18150: Prediction of Imminent Deterioration of Children after Stage I Palliation Using Real-Time Processing of Physiological Data
Authors: Rusin Craig G , Acosta Sebastian I , Vu Eric L , Myers Risa B , Brady Kenneth M , Penny Daniel J 
Published: July 2021

Patients after stage 1 palliation (S1P) for hypoplastic left heart syndrome (HLHS) and related lesions are at risk of life threatening deterioration resulting in shock, cardiac arrest, & hypoxemia. We hypothesize that these sudden deteriorations may be forecast by subtle, previously unidentified changes in cardiorespiratory dynamics. Identification of these precursors may provide an opportunity for early, life-saving intervention.
We created complete high-resolution physiological recordings for all patients who had a primary admission of S1P after Jan. 1, 2013. We used the SickbayTM system (Medical Informatics Corp, Houston, TX) to collect high frequency physiological waveforms including EKG, ABP, LAP, SpO2 and Chest Impedance (60Hz - 240Hz), as well as HR, RR, Temp. and ST segment vital signs (0.5 Hz) during the patient’s interstage hospitalization. A logistic regression model was constructed to discriminate between physiological characteristics observed in the hours prior to deterioration from the characteristics observed >24 hours prior to or >96 hours after a clinical deterioration. Model validation was done using a standard bagging approach with a REPtree classifier and 10 fold cross validation.
Twenty five patients were included in the study. Of these, 15 (60%) were found to have one or more deterioration events (arrest, CPR, unplanned intubation), with 24 total events observed during the interstage period. Characteristics associated with imminent deterioration were low SpO2 and depressed ST segment. Changes in physiological dynamics could be detected 1-2 hours before overt deterioration occurs (ROC area = 0.89) (Figure 1). This altered physiological state remains for ~96 hours after deterioration.
In conclusion, it is possible to identify clinical deterioration in HLHS patients during their interstage period ~1-2 hours before overt deterioration occurs, providing an opportunity for early, life-saving intervention to be administered.
Abstract 18398: Malignant Ventricular Arrhythmias in Lamin A/C Cardiomyopathies: Prevalence, Clinical Course and Outcome
Authors: Wijchers Sip , Akca Ferdi , Caliskan Kadir , Constantinescu Alina , Manintveld Olivier , Szili-Torok Tamas 
Published: July 2021

Introduction:
Genetic mutations in the Lamin A/C (LMNA) genes have been recognized as a possible cause of familial cardiomyopathies (CMP). Ventricular Tachycardias (VT) are frequently associated with LMNA cardiomyopathy, but data is limited on time of occurrence, prevalence of and used

treatment options and their efficacy of these VTs.
The aim of this study is to describe ventricular arrhythmias in LMNA cardiomyopathy

Methods:
This was a retrospective cohort study including data from all patients diagnosed with LMNA CMP within the Erasmus MC department of cardiology, a tertiary referral centre. Follow up continued until the patient either got a heart transplantation (HTX) or died.

Results:
Twenty patients were identified with LMNA CMP. The follow up time ranged between 14 and 208 months with a median of 67. Malignant VTs were documented in 14 out of 20 (70%) patients. Five patients (25%) had documented non sustained (NS) VT before a diagnosis was made using genetic testing, whereas the remaining VTs occurred 45 ± 54 months during follow up. All patients with documented VT or frequent premature ventricular complexes showed at least 2 or more morphologies with variable coupling intervals. Pharmacological therapy was beta blockade for 80 % of the cohort. Amiodarone was used in 45% of the patients and was discontinued in another 20%. An ICD was implanted in 95% of the patients. Twelve of the 19 (63%) received appropriate therapy. Three patients (15%) underwent radio frequent catheter ablation (RFCA) for a recurrent VT. Two of whom had multiple morphologies. All three patients had VT recurrence showing different and multiple morphologies after 0, 2 and 33 months. Two of these patients died of electrical storm at 0 and 27 months after RFCA and the third received a HTX after 98 months. All patients of the total cohort that showed VT during monitoring had documented recurrences despite different treatment strategies. Five patients (25%) died after a mean of 9 ± 7 years. Three patients (15%) received a HTX.

Conclusions:
Patients with LMNA CMP have an increased risk for malignant VT with very limited treatment options. Both medical regimes as well as the few ablations had 100% recurrences. Because the VTs are multiform in nature we would advise taking a reticent stand towards RFCA
Abstract 18446: Identification of a Novel Cellular Actor Participating in Vascular Remodeling During Pulmonary Arterial Hypertension : the PW1+ Progenitor Cells
Authors: Dierick France 
Published: July 2021

AIM:
PW1+ progenitors were identified in various adult tissues and can differentiate in smooth muscle cells (SMC) in vitro. Our hypothesis is that PW1+ progenitors are recruited to participate in the vascular remodeling during pulmonary arterial hypertension (PAH).

METHODS:
PW1IRESnLacZ+/- mice express the β-galactosidase as a reporter gene for PW1 expression allowing to follow the lineage of PW1+ cells during a few days. These mice were exposed to chronic hypoxia (CH) to induce PAH, lung vessels neomuscularisation and SMC proliferation. PW1+ and β-Gal+ cells were studied by FACS and by immunofluorescence.

RESULTS:
PW1+ cells are localized in the lung parenchyma and in the perivascular zone in rodent and human lung. Two PW1+ populations were identified by flow cytometry in the mouse lung 1/ a Sca-1high/CD34high/PDGFR-α+ population which differentiates into calponin+ or α-SMA+ SMC and into vWF+ endothelial cell and 2/ a CD34-/CD146+ population expressing pericyte markers.

After 2-4 days of CH, the number of lung PW1+ cells is increased (x3.5, p<0.01) and, in small pulmonary vessels media, the proportion of β-Gal+ SMC derived from PW1+ cells is increased (64±6% vs 35±3%, p<0.05) suggesting a recruitment and differentiation of PW1+ cells into lung vascular SMC. Moreover WT mice irradiated and engrafted with GFP+/β-Gal+ bone marrow cells do not show any increase in GFP+ SMC in lung vessels and do not show any β-Gal+ cells in the lung indicating that the lung PW1+ progenitors are not derived from bone marrow .
Moreover, in the human PAH lung, PW1+ cells were observed in remodeled vascular structures: in the media of remodeled vessel and in plexiform lesions.

CONCLUSION:
These results suggest that lung resident PW1+ progenitors are recruited to participate in the vascular remodeling of small pulmonary vessels in experimental and human PAH. These progenitors show characteristics of pericytes and of vascular progenitors.
Abstract 19123: Elevated Growth and Differentiation Factor 15 (GDF15) Levels Predict Outcome in Patients With Severe Aortic Stenosis Undergoing Tavi
Authors: Krau Nora , Freitag-Wolf Sandra , Brehm Doreen , Petzina Rainer , Lutter Georg , Frey Norbert , Frank Derk 
Published: July 2021

Background:
GDF15 belongs to the transforming growth factor superfamily and has a significant role in regulating inflammatory and apoptotic pathways. GDF15 is an emerging biomarker for risk stratification in cardiovascular disease. Here we analyze its prognostic value in patients with severe symptomatic aortic valve stenosis undergoing transcatheter aortic valve implantation (TAVI).

Methods and Results:
We prospectively enrolled 217 patients undergoing TAVI (using Edwards Sapien XT prostheses) at our institution over a continuous period of 35 month (2/2011-12/2013). All patients were available for complete follow up. Clinical parameters were determined before the procedure, biomarkers (GDF15 & NTproBNP) were measured before, 3 and 7 days after TAVI.

The primary endpoint was survival time, all available prognostic factors were studied by Cox regression analysis with backward selection based on the likelihood ratio criteria.
At median follow-up of 349 d (Q1-Q3 106-660d), a total of n=66 deaths occurred. 30d mortality was 6.9%. Mean age was 81.8 years (± 6.0 y) and 55.8% were females. Mean log. Euroscore (ES) was 25.4% (± 17.2%). Median preprocedural GDF15 values were 2256 pg/ml (Q1-Q3 1585.5-3082.0). In univariate analyses, increased GDF15 levels (upper quartile compared to lower three quartiles) revealed a HR of 2.4 (CI 1.5-3.9, p<0.001) for adverse outcome. In addition, also log. ES (p= 0.001), log. ES II (p=0.018), STS-Score (p=0.019), NTproBNP (p=0.037) and atrial fibrillation (p=0.02) demonstrated statistical significance for negative outcome.
A multivariate Cox regression analysis including these factors and postprocedural aortic regurgitation, demonstrated that elevated GDF15 had a HR of 2.104 (CI 1.3-3.5; p=0.003) for negative outcome in patients undergoing TAVI, while elevated NTproBNP had HR of 1.412 (CI 0.8-2.4; p=0.212). Moreover, this analysis also revealed the log. ES as an independent risk factor (HR of 2.211, CI 1.3-3.7; p= 0.002).

Conclusion:
Increased GDF15 levels are associated with a poor prognosis in patients undergoing TAVI. Furthermore, GDF15 showed to be superior to the established biomarker NTproBNP in risk stratification of patients undergoing TAVI providing additional prognostic information.
Abstract 19808: Short Term Outcomes After Use of Bone Marrow Transplantation for Management of Heart Failure: A Meta-analysis
Authors: Loomba Rohit S , Gupta Navdeep , Aggarwal Saurabh , Ismail Imtiaz , Agarwal Anushree , Chugh Atul R , Arora Rohit R , Bolli Roberto 
Published: July 2021

The role of bone marrow cell transplant in ischemic heart failure is being increasingly recognized. Multiple studies have been published evaluating their use with varying results. We aimed to perform a meta-analysis of the published literature.
We searched Pubmed, EBSCO and Cochrane databases for terms “bone marrow transplant”, “stem cell transplant”, “heart failure”, “cardiac failure” and their combinations. Only studies comparing bone marrow cell transplantation via intracoronary route to placebo, and those with 6 month follow up data were included. Studies in language other than English were excluded.

Results:
Ejection fraction was significantly increased with the use of bone marrow cell transplant compared to placebo (mean difference 6.16% 95%CI 4.16 to 8.16, p < 0.00001). No significant differences were observed in left ventricular (LV) end-systolic volume (mean difference -1.58 ml 95%CI -4.98 to 1.82, p = 0.36), LV end-diastolic volume (mean difference -0.77 ml 95%CI -3.75 to 2.22, p = 0.61) and mortality (odds ratio 1.08 95%CI 0.26 to 4.56, p = 0.92). Results of heterogeneity analysis showed significant heterogeneity only for ejection fraction endpoint (p = 0.01).

Conclusion:
As compared to placebo, intracoronary bone marrow cell transplant is associated with improved LV ejection fraction by 6% in ischemic heart failure patients at 6 month follow up.
Abstract 20129: Polyunsaturated Fat Intake Estimated by Circulating Biomarkers is Inversely Associated with Cardiovascular Disease and All-Cause Mortality in a Large Population-Based Cohort of Swedish Women and Men
Authors: Marklund Matti , Laguzzi Federica , Vikström Max , Alsharari Zayed , Sjögren Per , Gigante Bruna , Cederholm Tommy , Leander Karin , Hellenius Mai-Lis , De Faire Ulf , Risérus Ulf 
Published: July 2021

Increased intake of certain polyunsaturated fatty acids (PUFA) in place of saturated fatty acids has shown beneficial effects on cardiovascular disease (CVD) risk, although results are inconsistent. This may partly be explained by sex differences and shortcomings with self-reported intake data.
The objective was to evaluate associations between markers of PUFA intake, from vegetable oils and fish, with CVD incidence and mortality (all-cause).
In a representative population-based prospective cohort study including 2193 women and 2039 men (all aged 60 y) in Stockholm County, Sweden, PUFA were measured in serum cholesteryl esters by gas chromatography at baseline (1997-1998). Using national registers, 484 first CVD events (male, n=294; female, n=190) and 456 deaths (n=265; n=191) were identified during follow-up (median 14.5y), in individuals without prior CVD events at baseline. Associations between PUFA intake (assessed by circulating PUFA [linoleic acid, LA; α-linolenic acid, ALA; eicosapentaenoic acid, EPA; docosahexaenoic acid, DHA]) and risk of CVD and mortality were evaluated in men and women separately and together, by Cox proportional hazard models. Hazard ratios (HR) with 95% confidence interval (95%CI) were estimated in crude models and after adjusting for BMI, sex, education, smoking, physical activity, alcohol intake, diabetes, hypertension, and hypercholesterolemia.
In the whole population, EPA and DHA were inversely associated with mortality risk in adjusted model; 1 SD increment in EPA and DHA decreased the risk of mortality by 21% (HR 0.79 [95%CI 0.65-0.96]) and 22% (0.78 [0.66, 0.93]), respectively. Among women, EPA and DHA were associated with reduced CVD risk (HR 0.79 [95% CI 0.64-0.97] and 0.74 [0.61-0.89], respectively), whereas women with high ALA levels had moderately increased risk of CVD (1.16 [1.02-1.32]). High LA levels were associated with reduced mortality in men (0.73 [0.64-0.83]).
In line with some previous studies, circulating PUFA reflecting dietary n-3 and n-6 PUFA intake were in general inversely linked with CVD and/or mortality. Sex specific relations between PUFA and CVD/mortality motivate further investigations and may partly explain previous inconsistencies regarding dietary PUFA in CVD prevention.
Abstract 20421: Polarizing State Induced by Adenosine, Lidocaine and Magnesium Administration After Prolonged Circulatory Arrest Improves Cardioprotection and Neuroprotection in a Rat Model of Cardiac Arrest With Extracorporeal Life Support
Authors: Rungatscher Alessio , Dobson Geoffrey P , Linardi Daniele , Milani Elisabetta , Tessari Maddalena , Fabene Paolo F , Tong Giang , Schmitt Katharina , Faggian Giuseppe 
Published: July 2021

BACKGROUND:
Polarized arrest, a new concept of myocardial protection, has been recently demonstrated to improve cardiac function after cardioplegic arrest during cardiac surgery. The present study investigated whether polarizing state after prolonged cardiac arrest would provide cardioprotective and neuroprotective effects after extracorporeal life support (ECLS).

METHODS AND RESULTS:
Ventricular fibrillation (VF) was induced in male Wistar rats. After 8 min of untreated VF, veno-arterial ECLS was instituted for 60 min inducing mild therapeutic hypothermia (32°C). At the beginning of ECLS animals were randomized to receive a single iv bolus of 4.5 mL/kg of polarizing solution with adenosine (47 μM), lidocaine (92 μM) and MgSO4 (1 mM) or same volume of saline as control.

Restoration of spontaneous circulation was higher in rats that received polarizing solution (p = 0.03). After 24 h survival and neurologic deficit scores were improved and histological damage scores and brain TNF-α were attenuated compared to control (all p<0.05).
Polarizing solution administration led to better recovery of left ventricle end-systolic pressure-volume relationship (Ees), preload recruitable stroke work (PRSW), end-diastolic pressure-volume relationship (EDPVR) and Tau (p<0.01).
Polarized state enhanced phosphorilation of myocardial ERK1 and 2 and Akt, resulting in a lower apoptotic index (TUNEL, p<0.01).

CONCLUSIONS:
Polarized state induced by adenosine, lidocaine and magnesium increased survival, neurologic outcome and cardiac function after prolonged cardiac arrest treated with ECLS. Moreover it improved cardioprotection through activation of the pro-survival kinases Akt and ERK1/2.
Abstract MP85: Mediterranean Diet and Incidence of Stroke in the California Teachers Study
Authors: Sherzai Ayesha Z , Ma Huiyan , Horn-Ross Pamela , Canchola Alison J , Voutsinas Jenna , Willey Joshua Z , Gu Yian , Scarmeas Nikolaos , Sherzai Dean , Bernstein Leslie , Elkind Mitchell S , Wang Sophia S 
Published: July 2021

Introduction:
A Mediterranean diet (MeDi) has been associated with a reduced incidence of cardiovascular and neurodegenerative diseases, and overall mortality, in several prospective studies. There is limited data, however, regarding the relationship between MeDi and stroke, and in particular, stroke subtypes. We hypothesized that MeDi would be associated with reduced total, ischemic, and hemorrhagic stroke incidence.

Methods:
The California Teachers Study comprises 133,478 women who enrolled in 1995 and have been continuously followed. Using linked California state hospitalization data and national death records from 1996-2011, incident strokes were identified and validated. Socio-demographic and medical risk factor data were collected from the baseline questionnaire. Diet was assessed using a food-frequency questionnaire in 113,547 women. The Mediterranean diet emphasizes plant-based foods, mono-unsaturated fats, fish and moderate alcohol intake. We used the MeDi adherence score, a nine point scale, which has been used and validated in prior studies. A higher score on the 0-9 scale represents increased adherence. Multivariable Cox proportional-hazard models adjusted for socio-demographic factors including age, ethnicity, socioeconomic status, moderate-to-strenuous physical activity, total calorie intake, body mass index, cigarette smoking, menopausal and hormonal status and vascular risk factors were used to assess the association (hazard ratios and 95% confidence intervals, HR 95% CI) between MeDi score and risk of stroke and stroke subtypes.

Results:
A total of 104,268 participants were eligible for the analysis (mean age 52 ± 13.9 years, 87.4% white, 4.6% Hispanic, 3.2% Asian and 2.1% black). The MeDi score distribution was: 0-2 (16.1%), 3 (18.2%), 4 (21.4%), 5 (20.1%), and 6-9 (24.3%). During follow-up, 3165 stroke events occurred (2270 ischemic ; 895 hemorrhagic). In the multivariable model, compared to those in the lowest MeDi score quintile (score 0-2), those in the fourth quintile (score 5: HR 0.86, 95% CI 0.75-0.98) and highest quintile (score 6 - 9: HR 0.83, 95% CI 0.73-0.95) were at lower risk of stroke (p for trend 0.009). For ischemic stroke, those in the third (HR 0.84, 95% CI 0.72-0.97), fourth (0.85, 95% CI 0.73-0.98), and highest quintile (HR 0.82, 95% CI 0.70-0.95) were all at reduced risk (p for trend 0.02). There was no association with hemorrhagic stroke.

Discussion:
Adherence to the Mediterranean diet is associated with decreased risk of total and ischemic stroke incidence among the participants of the California Teachers Study.
Abstract P154: Pericardial Adiposity Predicts Incident Diabetes: The Multi-Ethnic Study of Atherosclerosis
Authors: Alman Amy C , Jacobs David R , Allison Matthew A , Carr John J , Hsu Fang-Chi , Terry James G , Snell-Bergeon Janet K , Lewis Cora E , Bertoni Alain G , Goff David C , Ding Jingzhong 
Published: July 2021

Pericardial adipose tissue (PAT) is ectopic fat deep (epicardial adipose tissue) and superficial (paracardial adipose tissue) to the pericardium of the heart. PAT has been cross-sectionally associated with diabetes, but the association with development of diabetes is unclear. Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), we tested whether PAT at baseline was associated with incident diabetes over nearly 10 years of follow-up. The baseline visit (visit 1) was conducted between 2000-2002. Four follow-up visits were conducted at 2 year intervals with visit 5 between 2010 and 2012. Diabetes was defined as a fasting glucose ≥126 mg/dl or the use of antidiabetic medication. Diabetes-free participants at baseline were followed for incident diabetes at any subsequent visit (visits 2-5). Volume of PAT was measured from computed tomographic (CT) scans taken at visits 1 - 4. CT scans were completed on all participants at baseline. Repeat scans were performed on random halves at visits 2 and 3, and a subset at visit 4. Multivariable Cox proportional hazards models were used to assess the association between PAT and incident diabetes.
The figure presents the mean PAT by visit and the mean PAT at baseline among those without diabetes at any time during the study period and those that develop diabetes over the 10 years of follow-up. In Cox regression models adjusted for age, race, and sex, each SD increment of baseline PAT (42.0 mL) was associated with a hazard ratio (HR) for incident diabetes of 1.6 (95% CI 1.5-1.7, p<0.0001). After adjusting for baseline BMI and waist-to-hip ratio, the HR was attenuated somewhat, but remained significant: HR 1.3 (95% CI 1.2-1.4, p<0.0001). Addition of waist circumference to the model did not alter PAT results further.
We found that PAT was highly stable over time, accumulating very slowly. Its baseline value strongly predicts incident diabetes independent of overall body mass and central fatness.
Abstract 36:
FCGR2A
Promoter Methylation and Risks for IVIG Unresponsiveness in Kawasaki Disease
Authors: Kuo Ho-Chang , Hsieh Kai-Sheng , Chang Wei-Chiao ,   Kawasaki Disease Cntr, Kaohsiung Chang Gung Memorial Hosp, Taiwan
Published: July 2021

Kawasaki disease (KD) is characterized by pediatric systemic vasculitis of an unknown cause and the Fc Fragment of IgG, Low Affinity IIa, Receptor (
FCGR2A
) gene was reported to involve in increasing susceptibility of KD. Because DNA methylation is one of the epigenetic mechanisms that control gene expression, we hypothesized that methylation status of CpG islands in
FCGR2A
promoter predisposes an individual to Kawasaki disease.

We recruited 36 KD patients and 24 healthy subjects with informed consents. And eleven potential methylation loci within the targeted promoter region (chr1:161474603-161475102) of Fc Fragment of IgG, Low Affinity IIa, Receptor were selected for investigation.
Methylation at the CpG sites G, H and J displayed a strongly associations with KD, whereas CpG sites B,C,E,F,H,J and K were found to be correlated with non-responsive to IVIG treatment. In addition, CpG sites G, J and K were predicted as the significant transcription factor binding site for NF-kB, Myc-Max and SP2 respectively.

Our study reports a significant association between the promoter methylation of
FCGR2A
, susceptibility of Kawasaki disease and therapeutic outcomes of IVIG treatment. The methylation levels of CpG sites of
FCGR2A
gene promoter may be an important marker for optimizing IVIG therapy.