bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 3727: Meeting Quality of Care Goals for Hypercholesterolemia: Understanding Deficiencies for Women and Black Men Compared With Non-Black Men
Authors: Turner Barbara J , Hollenbeak Christopher S , Weiner Mark G , Roberts Craig S 
Published: July 2021

BACKGROUND: CAD risk reduction requires maintaining LDL cholesterol (LDL) below NCEP goals. We examined time to LDL control for women and black men versus non-black men and examined the role of demographic, clinical, or health care factors in observed differences.
METHODS: Among 35,165 patients at 6 academic primary care practices from 1/1/03 to 2/8/05, we used electronic medical records to identify 11,536 patients at increased risk of CAD due to hypertension (HTN) and age (>45 if male and >55 if female) and an LDL from 1/1/00 to 2/28/05. For 6,497 patients (56%), the last LDL was high (i.e., ≥130 mg/dl or high risk ≥100 mg/dl) before or at the start of our timeframe. We studied 5,146 patients with 2+ visits after that LDL and complete data. Hazard ratios (HR) for the outcome - LDL control - came from survival (Cox) models with censoring 6 months after the last visit or the study end if no LDL control. Models adjust for demographics (age, income, insurance), clinical factors (discordant comorbidities such as asthma, concordant comorbidities such as CAD, smoking, obesity, LDL level), health care (N of HTN drugs, visits/month, provider gender, race, type, annual patient workload), and time from high LDL to next visit in study timeframe.
RESULTS: 47% of the cohort had LDL control within two years. Median days (d) to LDL control were: 456 d for non-black men (N=1,058); 627 d for non-black women (N=1,563); 698 d for black men (N=1,114); and 828 d for black women (N=2,164) (p<0.001). Compared to non-black men, adjusted HRs of LDL control were still lower for: non-black women (0.73, CI 0.64–0.82), black men (0.73, 0.63–0.85), and black women (0.59, CI 0.51–0.67). LDL control was positively associated with discordant comorbidities, anti-HTN drugs, age 61–80 vs <50, and shorter time from high LDL to next visit. Low income, Medicaid/uninsured vs commercial insured, and very high baseline LDL were negatively associated.
CONCLUSIONS: Among HTN patients at increased risk of CAD, time to LDL control was significantly longer for all women and black men than non-black men and not due to many patient and health care factors. Access to and acceptance/persistence with lipid-lowering medication likely contribute to these important disparities in CAD risk reduction.
Abstract 3783: Antihypertensive Medications in the Department of Veterans Affairs (VA) 1999–2006
Authors: Lopez Julio R , Wong Sonya , Meier Joy L , Cunningham Fran , Siegel David 
Published: July 2021

Objective: To evaluate national antihypertensive medication use we collected data from 2003–2006 and compared it to previously collected data from 1999 –2002. We examine the cost implications of shifts in antihypertensive medications prescribed.
Methods: National VA pharmacy data were used to determine the use of beta blockers (BB), calcium channel blockers (CCB), thiazide diuretics (TD) alone or with K sparing diuretics, angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and combinations of the aforementioned classes for 2003–2006. Total number of treatment days, determined from days supply of the prescription, was used to determine patterns of use over time.
Results: Antihypertensive medication use in the VA represented more than 1.5 billion days in 2006 and increased 2.5 fold from the 577 million estimated for 1999. ACEI were most commonly used, representing 31.8% and 31.7% of treatment days in 1999 and 2006, respectively. In the ACEI class lisinopril is the most commonly used drug. Increases in use from 1999 to 2006 were 21.2% to 25.2% for BB, 14.4% to 17.8% for TD, and 1.2% to 5.2% for ARB. Decreases in use from 1999 to 2006 were 26.7% to 17.6% for CCB. The decline in CCB was inversely correlated to the increase in BB or TD (p<0.001). Shifts in medication use are estimated to save the VA $33 million annually.
Conclusions: ACEI remain the most prescribed antihypertensive drug class in the VA, followed by BB, TD, CCB, and ARBs. TD use shows a slow steady increase while CCB use continues to decline. These findings suggest that VA has increasing adherence to JNC7 and VA HTN guidelines.
Abstract 3785: Red Wine Consumption Increases Circulating Endothelial Progenitor Cells and Improves Endothelial Function in Obese Type II Diabetics
Authors: Seck Catherine L , Mueller-Ehmsen Jochen , Kreuter Gerhard , Hauser Karl-Heinz , Braun Daniela , Moog Karin , Scheid Christoph , Schneider Thorsten , Flesch Markus 
Published: July 2021

Objective: Cardiovascular risk factors are associated with decreased levels of circulating progenitor cells (CPC). The aim of this study was to determine whether the moderate consumption of red wine leads to an increase of CPCs.

Methods: CD34 positive and CD133/CD34 as well as CD117/CD34 double positive cells were measured by FACS analysis in peripheral blood of 15 obese patients suffering from type II diabetes with stable oral drug treatment (67.3 ± 2.3 years, BMI 32.3 ± 0.5 kg/ m
2
) prior to and after a six week period of drinking two units (300 ml) of red wine (Lemberger Classic, Württemberg, Germany). The drinking period was anticipated by a four week fasting period, in which no alcohol consumption was allowed at all. In addition, brachial artery flow mediated dilatation was determined prior to and after the drinking period.

Results: The six week drinking period had no effect on BMI, systolic and diastolic blood pressure, blood glucose levels, HbA1c-values and liver enzymes. There was a non-significant drop in LDL cholesterol, but no change in HDL cholesterol. Concerning CPCs, the following alterations were observed: CD34+ cells increased from 171 ± 22 to 354 ± 28 per million leucocytes. Within the CD34+ cells, the percentage of CD133+ cells increased from 30.8 ± 5.7 % to 53.1 ± 3.3 %, and the percentage of CD117+ cells increased from 38.1 ± 5.8 % to 57.5 ± 4.6 % (p<0.05 for all parameters). Brachial artery flow mediated dilatation increased from 5.57 ± 0.74 % to 11.13 ± 1.34 % (p<0.05) in response to six weeks of red wine consumption. Nitroglycerin mediated brachial artery dilatation increased from 7.45 ± 1.09 % to 11.31 ± 1.09 % (p<0.05).
Conclusion: In obese patients suffering from type II diabetes, moderate consumption of red wine leads to a significant improvement of circulating progenitor cell count and endothelial function. No adverse effects of wine consumption on metabolic and cardiovascular parameters were observed.
Abstract 3795: Readjusting The Catabolic-anabolic Balance In Heart Failure: Beneficial Effects Of Physical Exercise On Protein Catabolism In The Skeletal Muscle
Authors: Gielen Stephan , Sandri Marcus , Adams Volker , Mangner Norman , Erbs Sandra , Linke Axel , Hambrecht Rainer , Schuler Gerhard 
Published: July 2021

Background: Progressive muscle wasting frequently occurs in the course of chronic heart failure (CHF) and has recently been identified as independent predictor of mortality in clincal studies. However, the molecular mechanisms that mediate muscle catabolism are still largely unknown and no specific pharmacological agents are available to antagonize the loss of muscle mass. We therefore tested the potential of an established anabolic intervention, i.e. exercise training, to prevent cytokine-induced ubiquitin-proteasome-mediated protein degradation in the skeletal muscle of stable patients with advanced CHF.
Methods: 43 CHF-patients and 41 healthy subjects (HS) were prospectively randomized to 4 weeks of supervised bicycle ergometer training at 70% of the heart rate reserve 4 times 20 min/day or to a control group (C). Before and after the intervention a spiroergometry, echocardiography, and skeletal muscle biopsy from the vastus lateralis muscle were performed. Expression of TNF-alpha and the E3 ligase Murf-1, which tags proteins for degradation via the ubiquitin-proteasome system, were quantified by real-time PCR standardized for 18S-rRNA.
Results:

In CHF patients (age 60.3 ± 2.9 years, BMI 28.9 ± 1.7, LV-EF 27.4 ± 1.7%): training increased VO2max from 14.9 ± 3.3 to 18.1 ± 4.7 mL/min/kg (p<0.01 vs. C), and LV-EF from 26.8 ± 4.6 to 33.1 ± 5.5% (p=0.001 vs. C). At baseline Murf-1 expression was significantly higher as compared to HS. Training decreased Murf-1 expression from 0.49 ± 0.21 to 0.22 ± 0.07 rel. units (p<0.05) and TNF-alpha expression from 79 ± 7.1 to 44.7 ± 5.9 rel. units (p<0.001).

In HS (age 64.7 ± 2.7 years, BMI 26.2 ± 0.5, LV-EF 63 ± 0.8%) training increased VO2 max from 20.3 ± 2.1 to 27.9.2 ± 1.3 mL/kg min (p=0.01 vs. C). Murf-1 and TNF-alpha expression remained unchanged versus untrained HS.

Conclusions:

CHF is associated with local inflammatory and catabolic activation in the skeletal muscle as indicated by higher baseline TNF-alpha and Murf-1 levels.

Training cuts the elevated TNF-alpha and E3-ligase expressions by half within only four weeks of intervention.

These findings emphasize the role of training for the prevention of muscle atrophy and may provide a novel explanation for the prognostic benefits of exercise in CHF.
Abstract 99: Differences of B-Type natriuretic peptide and N-terminal pro B-type natriuretic peptide levels in Patients With Cardiogenic Shock
Authors: Buerke Michael , Prondzinsky Roland , Geppert Alexander , Jaral Rudolf , Huber Kurt , Russ Martin , Lemm Henning , Schlitt Axel , Werdan Karl 
Published: July 2021

Background B-Type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are frequently used in diagnosing and monitoring patients with heart failure. Recent studies have demonstrated that BNP and NT-proBNP concentrations reflect LV function and prognosis. However, the role of natriuretic peptides in patients with cardiogenic shock is unclear.
Methods. In 40 patients with cardiogenic shock due to acute myocardial infarction treatment with primary percutaneous transluminal coronary angioplasty (PCI) was performed initially with subsequent medical treatment and intraaortic balloon pump (IABP) counterpulsation. Cardiac catheterization was performed in all patients. Creatinine, Creatinine clearance, LVEDP, and survival were determined, and BNP and NT-proBNP obtained at the start, 24, 48 and 72 hours thereafter. Results. BNP was able to detect differences in treatment regarding LV-unloading. Interestingly, NT-proBNP levels were able to differentiate between survivors and non survivors (4590±1230 vs 14370±4886pg/ml, p<0.05). However, there was no significant difference between survivors and non survivors with regard to BNP levels. Clearly, elevated levels of NT-proBNP in patients with cardiogenic shock were more dependent on decreased renal function which might reflect additional organ dysfunction (24965±9567pg/ml vs 7246±2650, p<0.05).
Conclusions In myocardial infarction complicated cardiogenic shock patients concentrations of BNP and NT-proBNP provide additional information. Our data suggest that the cardiac status and improvement upon therapy can be monitored with BNP. However, NT-pro-BNP is a valuable indicator for prognosis in patients with cardiogenic shock.
2007 Charles T. Dotter Memorial Lecture—Renal Artery Stenosis and Cardiovascular Risks—The New Paradigms in Diagnosis and Treatment
Authors: Sos Thomas 
Published: July 2021

Renal artery stenosis (RAS), hypertension, and renal insufficiency are each frequently present especially in the elderly population. RAS is often present without any clinical signs or symptoms, and even when hypertension or renal insufficiency is also present, these conditions may be coincidental rather than causally related. However, when RAS is physiologically significant (10% peak systolic trans-stenotic pressure gradient), it is one of the few potentially reversible causes of renal insufficiency and hypertension.
RVH is mediated by angiotensin II, a powerful vaso-constrictor producing systemic hypertension, cellular hypertrophy, proliferation of vascular smooth muscle cells, vascular and left ventricular hypertrophy, accelerated atherosclerosis, and progressive glomerular sclerosis, independent of the level of hypertension. Physiologically significant RAS also has direct effects on sympathetic nerve activity, nitric oxide production, and intrarenal prostaglandin concentration. Patients with atheromatous RAS (ARAS) and end-stage renal disease have a significantly higher mortality rate than the general dialysis population.

Some advocate prophylactic intervention for asymptomatic and hemodynamically insignificant ARAS; however, ARAS is a
marker for
but
not an independent risk factor
for major adverse cardiac events. Aggressive statin therapy arrests progression and produces regression of coronary and carotid atheroma.

Patients with asymptomatic and hemodynamically nonsignificant ARAS should be treated with aggressive statin and glucose control therapy, aspirin, and lifestyle modifications. This would likely produce all the potential benefits of prophylactic stenting, the very long-term durability and fate of which are unknown, and without any of its known major risks such as cholesterol embolisation and the 15% to 20% restenosis that can occur even in “low-risk” patients.
In summary, appropriately selected patients with ARAS and renal insufficiency benefit from interventional therapy, whereas those with clinically and hemodynamically nonsignificant stenoses should be treated by aggressive medical therapy, including statins and life style modifications.
Abstract 5856: Long-term Outcomes and Costs of Ventricular Assist Devices among United States Medicare Beneficiaries
Authors: Hernandez Adrian F , Shea Alisa , Milano Carmelo A , Rogers Joseph G , Hammill Bradley G , Schulman Kevin A , Peterson Eric D , Curtis Lesley H 
Published: July 2021

BACKGROUND: Little is known about long-term outcomes and costs associated with VAD therapy among Medicare beneficiaries.
METHODS: Using the 100% inpatient and denominator files from 2000–2006, we identified Medicare fee-for-service beneficiaries as VAD only or VAD post-cardiotomy (at time of or within 30 days of cardiac surgery) and followed outcomes. Cumulative incidence of VAD reimplantation, explantation, cardiac transplantation, readmission and death were estimated accounting for censoring and competing risks. Cox proportional hazards model was used to determine factors associated with time-to-death. Inpatient costs–total and per survived day outside of the hospital were calculated from Medicare payments.

RESULTS: From 2000 through 2005, 2701 patients received a VAD from 549 hospitals; 1379 (51%) VADs post-cardiotomy and 1322 (49%) VAD only. Overall index hospital survival rate was 67% for VAD only and 39% for VAD post-cardiotomy. By one year these survival rates declined to 52% and 31% respectively (Figure

). Mean inpatient cost to Medicare in the first year was $178,626 (± $143,120) for VAD only and $112,013 (± $95,473) for VAD post-cardiotomy. For all VAD recipients, Medicare inpatient expenditures per day survived and out of the hospital were $1,021 for year 1 and $466 over 3 years.

CONCLUSIONS: VAD therapy is being used more commonly for end stage heart failure among Medicare beneficiaries; however, mortality and costs remains high. Advances in technology, and improved patient selection are needed before the use of VADs can expand more widely.
Abstract 5858: Role of Oxygen Tension and Oxidative Stress in Human Saphenous Vein Remodeling
Authors: Joddar Binata , Reen Rashmeet K , Firstenberg Michael , Gooch Keith J 
Published: July 2021

Vessels cultured ex vivo maintain viability and vasoactivity for weeks and can remodel in response to mechanical cues. When cultured in the presence of 5% CO2/balance air veins develop neointimal hyperplasia (IH) while arteries do not suggesting that exposure to significant increases in pO2 levels might stimulate IH. Neointimal hyperplasia (IH) is a known mechanism by which saphenous veins have a decreased patency compared to arterial conduits when used for coronary artery bypass. We sought to explore the role of oxygen tension and oxidative stress in IH. Test the hypothesis that exposure of human saphenous veins (HSV) to arterial pO2 stimulates IH via ROS-mediated pathways. Almost 40 HSV remnants acquired following CABG were cultured ex vivo with arterial (~95mmHg) pO2 or venous (~40mmHg) pO2 for 14 days. All differences reported have a p<0.05 via Student’s t-test.
Results: HSV cultured at arterial pO2 exhibited

significant IH as evidenced by disruption of the IEL, invasion of cells from the media, and a 2.8-fold greater intimal area than fresh HSV,

a 5.8-fold increase in cell proliferation compared to fresh HSV,

increased ROS levels and oxidative stress as evidenced by 4-fold increase in 4-HNE level (a marker of oxidative stress), increased DHE staining (indicative of superoxide generation), and a progressive increase in total ROS levels with time as assessed by DCF fluorescence, and

a 3-fold increase in phosphorylated p38-MAPK, which is implicated in SMC proliferation.

In stark contrast vessels culture at arterial pO2, HSV cultured with venous pO2 did not develop increased IH and were indistinguishable from fresh vessels with respect to proliferation, markers of oxidative stress, and MAPK expression levels. Supplementing culture medium with antioxidants including Tiron or NAC blocked the pO2-induced changes. These data indicate that exposure to arterial pO2 increases cellular proliferation and stimulates IH, potentially via oxidative stress or ROS signaling and also suggest that exposure to elevated arterial pO2 might stimulate pathological remodeling of veins grafted into the arterial circulation.
This research has received full or partial funding support from the American Heart Association, AHA Great Rivers Affiliate (Delaware, Kentucky, Ohio, Pennsylvania & West Virginia).
Abstract 5936: Can Apoptosis Predict Functional Recovery in Acute Myocarditis?
Authors: Abbate Antonio , Sinagra Gianfranco , Bussani Rossana , Hoke Nicholas N , Toldo Stefano , Barresi Elena , Salloum Fadi N , Silvestri Furio , Vetrovec George W , Kukreja Rakesh C , Baldi Alfonso 
Published: July 2021

Background. Acute myocarditis is characterized by acute cardiac dysfunction followed by a variable recovery over time. Recent data have shown the presence of apoptosis in acute myocarditis. We hypothesized that the presence and extent of apoptosis evaluated at endomyocardial biopsy (EMB) could predict functional recovery in patients with acute myocarditis, with more apoptosis predicting less recovery.
Methods. Sixteen patients with acute myocarditis were studied with EMB. Baseline and follow up echocardiography was obtained in all cases. The patients were retrospectively divided in 2 groups according to the final left ventricular ejection fraction (LVEF): LVEF>40% [recovery] and LVEF≤40% [no recovery]. Co-staining for DNA fragmentation (TUNEL) and caspase-cleaved cytokeratin-18 (CytoDeath) were performed to quantify the cardiomyocyte apoptosis in EMB specimens. Four subjects dying of non-cardiac causes were selected as control hearts at time of autopsy.
Results. Six patients showed functional recovery (38%) while 8 did not (62%). The apoptotic rate (AR, expressed as % of double positive cardiomyocytes on total number per field) was significantly higher in the hearts of patients with acute myocarditis (1.1%[0.7–2.2] vs 0.01%[0.01–0.01] in control hearts, p<0.001). Unexpectedly, patients with functional recovery had a significantly higher AR than patients without recovery (3.2%[1.1–8.0] vs 0.5%[0.3–1.0], p=0.001), and the AR correlated with follow-up LVEF (R=+0.54, p=0.030). Six of the 8 patients (75%) with AR above average showed functional recovery vs 0 of the 8 patients (0%) with AR below average (p=0.007).
Conclusions. This study surprisingly shows that the presence of greater apoptosis at EBM in patients with acute myocarditis predicts functional recovery at 12 months. Whether this represents a true cause-effect association or it simply represents a non-causal association remains unclear and warrants further studies.
Abstract 6073: Dexrazoxane Cardioprotection in Doxorubicin-Treated Children with Acute Lymphoblastic Leukemia: Dana-Farber Cancer Institute Acute Lymphoblastic Leukemia Consortium Protocol 95–01 Randomized Controlled Trial
Authors: Lipshultz Steven E , Scully Rebecca E , Lipsitz Stuart R , Sallan Stephen E , Silverman Lewis B , Miller Tracie L , Barry Elly V , Asselin Barbara L , Athale Uma , Clavell Luis A , Larsen Eric , Moghrabi Albert , Samson Yvan , Schorin Marshall A , Orav E. John , Colan Steven D 
Published: July 2021

Background: Doxorubicin (DOX) chemotherapy injures myocardial cells, leading to progressive cardiac dysfunction. Dexrazoxane (DZR), a free-radical scavenger, reduced troponin T (cTnT) elevation during therapy in children with acute lymphoblastic leukemia (ALL) on Dana-Farber Cancer Institute (DFCI) Protocol 95– 01. The long-term cardiac benefits of DZR are not yet known.

Methods: We centrally remeasured echocardiograms from childhood ALL survivors who were randomly assigned to DOX (n =64; 30 mg/m
2
/dose for 10 doses) with or without DZR (n =58; 300 mg/m
2
/dose) during DFCI Protocol 95– 01.

Results: Demographics and follow-up were similar in both arms (median f/u years: DOX 4.0 vs. DZR/DOX 3.7). Mean left ventricular (LV) end-systolic dimension was significantly abnormal for DOX vs. DZR/DOX at 3 years (mean Z-score: DOX 0.637 vs. DZR/DOX −0.0005, P=0.0164) and progressed at 3.5 years (0.800 vs. −0.006, P=0.0028) and 4 years (1.01 vs. 0.005, P=0.0013). DOX-group mean LV end-diastolic (ED) dimension was significantly dilated at 3.5 years (mean Z-score: DOX 0.223 vs. DZR/DOX −0.424, P=0.022) and 4 years (0.428 vs. −0.456, P=0.004). With 3.5 years follow-up, a number of non-significant trends showed DZR/DOX echo measures to be more normal: LV fractional shortening Z-score (DOX −2.092 vs. DZR/DOX −1.00); LV mass Z-score (−0.672 vs. −0.537); LVED posterior wall thickness Z-score (LVEDPWTz; −0.596 vs. −0.395). For DZR/DOX-patients, cTnT elevation (defined as >0.01 ng/ml) during DOX treatment correlated with thinner LVED posterior wall 3.5 years post treatment (mean LVEDPWTz: cTnT− =−0.011 vs. cTnT+= −1.200, P=0.0352).
Conclusions: DZR is protective against late DOX cardiotoxicity with smaller LV dimensions, consistent with less LV remodeling. LV function, thickness, and mass trended to more normal among children who received DZR and all parameters trended toward a greater DZR effect over time. Further, cTnT elevation during therapy predicted late LV wall thinning.

Table 1:

Post-treatment Mean Differences in Dimension Z-Scores