bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microstructural characteristics of chronic infarct segments assessed using diffusion tensor imaging
Authors: Das A , Kelly C , Teh I , Stoeck C , Kozerke S , Chowdhary A , Jex N , Thiranavukarasu S , Sharrack N , Ben-Arzi H , Aldred M , Greenwood JP , Plein S , Schneider JE , Dallarmellina E 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation

Background
The microstructural changes following myocardial infarction (MI) can be characterised in-vivo with cardiac diffusion tensor imaging (cDTI) imaging, using mean diffusivity (MD), fractional anisotropy (FA), secondary eigenvector angle (E2A) and helix angle (HA) maps. In this study, we use cDTI to explore the microstructural differences between subendocardial and transmural chronic infarct segments.

Method
Twenty STEMI patients (15 men, 5 women, mean age 59) underwent 3T CMR scan at 3 months following presentation (mean interval 107 ± 18 days). Scan protocol included: second order motion compensated (M012) free-breathing spin echo DTI (3 slices, 18 diffusion directions at b-values 100s/mm2[3], 200s/mm2[3] and 500s/mm2[12], acquired resolution was 2.20x2.27x8mm3; cine gradient echo and LGE imaging. Average MD, FA, E2A and HA parameters were calculated on a 16-AHA-segmental level. HA maps were described by dividing values into left-handed HA (LHM, -90° &lt; HA &lt; -30°), circumferential HA (CM, -30° &lt; HA &lt; 30°), and right-handed HA (RHM, 30° &lt; HA &lt; 90°) and reported as relative proportions. Infarct segments were identified using LGE; patients were categorised according to the maximal transmurality of their infarct segments, into subendocardial (&lt;50% LGE) or transmural (&gt;50% LGE) MI.

Results
DTI acquisition was successful in all patients (acquisition time 13 ± 5mins). Ten patients had transmural MI. The results are shown in table 1. Transmurally infarcted segments had significantly lower FA (FA subendocardial MI = 0.27 ± 0.04, FA transmural MI = 0.23 ± 0.02, p &lt; 0.01), lower E2A (E2A subendocardial MI = 47 ± 7°, E2A transmural MI = 38 ± 6°, p &lt; 0.01) and lower proportions of right-handed cardiomyocytes (RHM subendocardial MI = 21 ± 5%, RHM transmural MI = 14 ± 5%, p &lt; 0.01) than subendocardial infarct segments.

Conclusion
Compared to subendocardial MI segments, the diffusion of water molecules is more isotropic in transmurally infarcted myocardium as evidenced by lower FA values, signifying increased structural disarray. The significantly lower E2A values suggest that laminar sheetlets of transmural infarct segments remain fixed at shallower angles during systole and are unable to reach their usual contractile configuration. The lower proportions of RHM on HA maps highlight the significantly greater loss of subendocardial cardiomyocytes in transmural infarct segments. Further studies are required to assess if these segmental changes can be predictive of long-term LV remodelling.
Left ventricular four-dimensional blood flow energetics and vorticity in chronic myocardial infarction patients with/without left ventricular thrombus
Authors: Demirkiran A , Hassell M ECJ , Garg P , Elbaz M SM , Delewi R , Greenwood JP , Piek JJ , Plein S , Van Der Geest RJ , Nijveldt R 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): The British Heart Foundation [FS/10/62/28409] and Dutch ZonMw [104003001].

Background
Left ventricular thrombus (LVT) formation is a frequent and serious complication of myocardial infarction (MI). How global LV flow characteristics are related to this phenomenon is yet uncertain. In this study, we investigated LV flow differences using 4D flow cardiovascular magnetic resonance (CMR) between chronic MI patients with LVT [MI-LVT(+)] and without LVT [MI-LVT(-)], and healthy controls.

Methods
In this prospective cohort study, the 4D flow CMR data were acquired in 19 chronic MI patients (MI-LVT(+), n= 9 and MI-LVT(-), n= 10) and 9 age-matched controls. All included subjects were in sinus rhythm. The following LV flow parameters were obtained: LV flow components (direct, retained, delayed, residual), mean and peak KE values (indexed to instantaneous LV volume), mean and peak vorticity values, and diastolic vortex ring properties (position, orientation, shape).

Results
The MI patients demonstrated a significantly larger amount of delayed and residual flow, and a smaller amount of direct flow compared to controls (p = 0.02, p = 0.03, and p &lt; 0.001, respectively). The MI-LVT(+) patients demonstrated numerically increased residual flow and reduced retained and direct flow in comparison to MI-LVT(-) patients. Systolic mean and peak LV blood flow KE values were significantly lower in MI patients compared to controls (p = 0.04, p = 0.03, respectively). Overall, the mean and peak LV vorticity values were significantly lower in MI patients compared to controls. The mean vorticity at the basal level was significantly higher in MI-LVT(+) than in MI-LVT(-) patients (p &lt; 0.01). The vortex ring core during E-wave in MI-LVT(-) group was located closer to the mitral annulus and in a less tilted orientation to the LV compared to MI-LVT(+) group (p = 0.05, p &lt; 0.01, respectively).

Conclusion
Chronic MI patients with LVT express a different distribution of LV flow components, irregular vorticity vector fields, and altered diastolic vortex ring geometric properties as assessed by 4D flow CMR. Larger prospective studies are warranted to further evaluate these initial observations.
RV function by cardiac magnetic resonance and its relationship with neutrophil/lymphocyte ratio in patients with acute inferior STEMI undergoing PPCI
Authors: Taha S , Kelany SH , D"ascenzo F , Hasan-Ali H , Ghzally Y , Abdel-Ghany M 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Although acute inferior myocardial infarction (MI) is usually regarded as being lower risk compared with acute anterior MI, right ventricular (RV) myocardial involvement (RVMI) carries an increased risk of cardiovascular (CV) morbidity and mortality in patients with inferior MI.Cardiac Magnetic resonance (CMR) is ideal for assessing the RV because it allows a comprehensive assessment of cardiovascular morphology and physiology without most of the limitations that hinder alternative imaging modalities.

Objectives
To evaluate the sensitivity of other parameters;the neutrophil/ lymphocyte ratio (NLR) and RV function using 2D speckle tracking echo compared to (CMR) among patients with inferior STEMI undergoing primary percutaneous coronary intervention (PPCI).

Methodology
40 Patients with inferior MI who had PPCI were included in the study; two groups were highlighted according to the CMR derived RVEF RV dysfunction (RVD and non-RVD). NLR and 2D speckle tracking echo were done in comparison to RVEF.

Results
out of the 40 patients, 18 (45%) patients had RVD. ST segment elevation in the right leads was significantly higher (P-value =0.03) in patients with RV dysfunction (55.6%) in comparison with patients (22.7%) who had no RV dysfunction.When comparing groups according to the complications, heart block was significantly higher in patients with RV dysfunction (P-value= 0.008) as it occurred in 5 (27.8%) patients.Echocardiography was done for all patients, and it was found that fractional area change (FAC) in the RV dysfunction group appeared to be significantly reduced compared to the group without RV dysfunction (P-value =0.03). RV longitudinal strain (LS) by speckle tracking echo was reduced with an average of -19.5 ±3.9 % in the RV dysfunction group P value 0.008.Both CMR- derived RV SV, and EF were lower among the RV dysfunction group, (26.8 ± 15.8) ml and (35.4 ± 6.9) % respectively, with large RV systolic volume, with the highly statistically significant difference in comparison to the other group (p value = 0.000). Mean N/L ratio was higher (7.3 ± 5.2 (10^3/uL)) in the group with RV dysfunction compared to (6.4 ± 4.1(10^3/uL)) in the group with non RV dysfunction group. N/L ratio for predicting RV dysfunction by CMR had a cutoff value of &gt;7.7 with low sensitivity (38.89%) and high specificity (77.27 %), while LS for predicting RV dysfunction by CMR had both high sensitivity (83.33%) and high specificity (63.64%) with P-value =0.005.

Conclusion
Our results showed that RV dysfunction in inferior MI is better detected using cardiac magnetic resonance imaging. In inferior STEMI patients who underwent primary PCI, NLR has low sensitivity but high specificity for predicting RVD when measured by cardiac MRI.
Myocardial extracellular volume by T1 mapping: a new marker of arrhythmia in mitral valve prolapse
Authors: Pavon A , Arangalage D , Hugelshofer S , Rutz T , Porretta AP , Le Bloa M , Muller O , Pruvot E , Schwitter J , Monney P 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
In MVP, MAD has been associated with myocardial replacement fibrosis and arrhythmia, but the importance of interstitial fibrosis remains unknown. We aimed to evaluate the relationship between mitral annular disjunction (MAD) severity and myocardial interstitial fibrosis at the left ventricular (LV) base in patients with mitral valve prolapse (MVP), and to assess the association between severity of interstitial fibrosis and the occurrence of ventricular arrhythmic events

Methods
Thirty patients with MVP and MAD (MVP-MAD) underwent Cardiac Magnetic Resonance (CMR) with assessment of MAD length, late gadolinium enhancement (LGE), and basal segments myocardial extracellular volume (ECV). The control group included 14 patients with mitral regurgitation but no MAD (MR-NoMAD) and 10 patients with normal CMR (NoMR-NoMAD). Fifteen MVP-MAD patients underwent 24h-Holter monitoring.

Results
LGE was observed in 47% of MVP-MAD patients and absent in controls. ECV was higher in MVP-MAD (30 ± 3% vs 24 ± 3% MR-NoMAD, p &lt; 0.0001 and vs 24 ± 2% NoMR-NoMAD, p &lt; 0.0001), even in MVP-MAD patients without LGE (29 ± 3% vs 24 ± 3%, p &lt; 0.0001 and vs 24 ± 2%, p &lt; 0.0001, respectively), Fig.1. MAD length was correlated with ECV (rho = 0.61, p = 0.0003), but not with LGE extent. Four patients had history of OHCA; LGE and ECV were equally performant to identify those high-risk patients (area under the ROC curve 0.81 vs 0.83, p = 0.84). Among patients with Holter, 87% had complex ventricular arrhythmia. ECV was above the cut-off value in all while only 53% had LGE.

Conclusion
Increase in ECV, a marker of interstitial fibrosis, occurs in MVP-MAD even in the absence of LGE, and was correlated with MAD length and OHCA. ECV should be part of the CMR examination of MVP patients in an effort to better assess fibrous remodelling as it may provide additional value beyond the assessment of LGE in the arrhythmic risk stratification.
Aortic regurgitation and left ventricle remodeling in cardiac magnetic resonance and transthoracic echocardiography
Authors: Haberka M , Balys M , Gasior Z 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Medical University of SIlesia

Background
Transthoracic echocardiography (TTE) is the main imaging modality used to assess patients with chronic aortic regurgitation (AR). However, it is not possible to provide a precise quantification in all patients. Our aim was to compare TTE and cardiovascular magnetic resonance (CMR) measurements in grading AR and left ventricle (LV) remodeling.

Methods
A total of 51 consecutive patients with isolated AR in TTE were enrolled into the study and finally forty nine individuals (age: 57.1 (14); 61% males) underwent a non-contrast CMR (2 pts excluded for CMR contraindications). AR severity grading and LV remodeling were assessed according to the current ASE guidelines, including a semi-quantitative and quantitative parameters. All CMR studies were obtained on ecg-gated cine images acquired on 1.5T system (GE Optima MR450w, GE Healthcare, Wisconsin, USA) with a dedicated cardiac coil using a non-contrast protocol, including a quantitative approach (phase-contrast velocity encoded imaging).

Results
Most of the study patients showed mild symptoms (NYHA I/II/III – 55%/38%/7%; CCS 0/I/II/III/IV – 79%/2%/12%/6%) and typical cardiovascular risk factors: hypertension (83%), dyslipidemia (91%), diabetes (12%) and obesity (16%). Twenty patients (40%) showed combined AV disease and 14 patients (28,5%) had a bicuspid AV. The AR jets were central (53%) or eccentric (47%) and multiple in 7 cases (14%). The inter-modality agreement (TTE-CMR) in AR grading was high in mild AR (91%) and low in mild-to-moderate (12%), moderate-to-severe (10%) and severe (20%) AR. The comprehensive quantitative grading with AR volume (AR vol) and regurgitant fraction (RF) were measurable in TTE in 24 cases and showed a significant association with CMR parameters (AR vol: r = 0.75; p &lt; 0.001 and RF: r = 0.55; p &lt; 0.01). Moreover, CMR revealed significantly larger LV end-diastolic volumes (EDV) (185,5 ± 61ml vs 158,4 ± 61ml; p = 0.03) and a trend towards higher left ventricle ejection fraction (59 ± 8 vs 56 ± 8%; p = 0.08). The association of AR vol and LV EDV was stronger in CMR (r = 0.85; p &lt; 0.0001) compared to TTE (r = 0.6; p = 0.001).

Conclusions
CMR provides a comprehensive assessment of AR severity and LV remodeling with a moderate agreement with TTE.
Cardiac magnetic resonance in COVID-19 positive and probable cases: A report from a high volume CMR centre in Ireland
Authors: James SI , Fallon A , Waterhouse DF , O" Hanlon R 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Coronavirus disease 2019 (COVID-19) infection can have multisystem involvements. The inflammation sequelae can cause myocarditis. The COVID-19 pandemic has impacted Ireland significantly. Understanding of myocardial involvement in COVID-19 is not fully elucidated but has been reported. The Centre for Cardiovascular Magnetic Resonance, Blackrock Clinic in Ireland is a high volume CMR centre with approximately 4500 cases per year and accepting referral from all hospital in Ireland. These analyses are to describe the CMR findings in COVID-19 positive and probable cases attending the centre.

Methods
Consecutive 65 referrals with mention of "COVID-19" from March 2020 to December 2020 was assessed. 56 cases were included in this analysis. Cases were categorised as COVID-19 positive cases or probable (viral illness like symptoms) cases. The demography and CMR parameters were collected. Serial imaging of selected cases was included. Descriptive analyses methods were applied.

Results
In the period of 10 months, there was 49 COVID-19 positive cases (65.3% male; median age 49 [32 : 61] years) and 7 COVID-19 probable cases (42.9% male; median age 39 [37 : 59] years). In the COVID-19 positive cases, 25 had normal CMR, 11 has evidence of myocarditis, 1 with pericarditis, 2 with infarction/ischaemia, 3 with dilated cardiomyopathy, 2 with hypertrophic cardiomyopathy and 5 with other findings. There were 3 COVID-19 positive cases with serial imaging showing resolving myocarditis (100% female; median age 41 [30 : 47] years). 2 professional athletes with COVID-19 positive test showed no evidence of myocarditis. There are no significant differences in the age of male COVID-19 positive versus female group (p= 0.0752). Different demography and CMR parameters and tissue characterisation are described in Table 1 and Table 2.

Conclusions
The prevalence of myocarditis in this cohort is approximately 1 in 5 (21.4%). Within the COVID-19 positive cases, the prevalence is 22.4%. These observations may reflect selection bias for CMR referral in those with cardiac symptoms or cardiac enzymes leak.
Cardiac injury after 4 months of coronavirus infection disease 2019 in mildly symptomatic patients
Authors: Rajewska-Tabor J , Elikowski W , Janus M , Rozmiarek S , Lesiak M , Pyda M 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Cardiovascular involvement during SARS-CoV-2 infection has been described previously in hospitalized patients mainly. The percentage of patients vulnerable after coronavirus infection disease 2019 (COVID-19) is still being under discussion. What remains unknown is the impact of coronary virus on heart on mildly symptomatic patients.
Aim of the study
The aim of the study was to evaluate cardiac injury 4 months after COVID-19 in mildly symptomatic patients.
Material and methods
80 patients successfully cured from COVID-19 were evaluated between 3-4 months after the disease. The study group consisted of 30 males (37.5%) and 50 females (62.5%) with the mean (SD) age 45 (11) years. All patients had laboratory tests, electrocardiogram (ECG) and cardiac magnetic resonance (CMR) done. Cardiac magnetic resonance was performed on 1,5T scanner (Aera, Siemens, Germany). During the CMR study cine imagines, T2-mapping, T1-mapping before and after gadolinium, extracellular volume (ECV) assumption and late gadolinium enhancement were done. Additionally global longitudinal strain was examined. Dedicated software (QMass, Medis, Holland) was used.

Results
During SARS-CoV-2 infection 31 patients (39%) had comorbidities, 16 patients (20%) were hospitalized for 3-5 days. 64 (80%) recovered at home, from whom 10 (12.5%) were asymptomatic. At the time of CMR, high-sensitivity troponin I (hs TnI) was in the normal range in all subjects, while 8 (10%) subjects showed slightly elevated NT pro-BNP and 11 (14%) subjects showed elevated D-dimers. Based on myocardial injury detected during CMR the patients were divided into 2 groups. CMR examination showed myocardial injury in 34 (42.5%) patients. The patients with myocardial injury had significant higher native T1 (1011ms in injured group vs 967ms in group without injury; p = 0.006) and ECV (29.5% vs 27% respectively; p = 0.003). NT pro-BNP levels were elevated in 9 patients with myocardial injury on CMR. None of the patients without myocardial injury had NT pro-BNP elevated (p = 0.007).

Conclusions
This study indicates that even in mildly symptomatic patients there are occurrences of myocardial injury. The cardiac magnetic resonance is a useful tool for diagnosing myocardial injury after COVID-19.
Stress cardiovascular magnetic resonance and mortality in a registry of 2496 elderly patients with chronic coronary syndrome. Prognosis and decision-making
Authors: Bonanad Lozano C , Gabaldon-Perez A , Garcia-Blas S , Gavara J , Rios-Navarro C , Perez-Sole N , De Dios E , Marcos-Garces V , Merenciano-Gonzalez H , Monmeneu-Menadas JV , Lopez-Lereu MP , Nunez J , Chorro FJ , Bodi V 
Published: July 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Instituto de Salud Carlos III, Fondo Europeo de Desarrollo Regional (FEDER)
Introduction and objectives. Management of the elderly with chronic coronary syndrome (CCS) is challenging. We explore the prognostic value and the usefulness for decision-making of the ischemic burden determined by vasodilator stress cardiac magnetic resonance (CMR) imaging in elderly patients with known or suspected CCS.
Methods. The study group was made up of 2496 patients older than 70 years submitted to vasodilator stress CMR for known or suspected CCS. The ischemic burden (number of segments with stress-induced perfusion deficit) was calculated following the 17-segment model. Its association with all-cause mortality and the effect of CMR-guided revascularization were analyzed retrospectively.
Results. During a median follow-up of 4.58 years, 430 deaths (17.2%) were recorded. A larger ischemic burden was an independent predictor of mortality: hazard ratio [95% confidence intervals]: 1.04 [1.01-1.07] for each additional ischemic segment, p = 0.006). This association also occurred in patients over 80 years of age and in women (p &lt; 0.001). Compared to non-revascularized patients, revascularization associated with worse outcomes at low ischemic burden and exerted protective prognostic effect in patients with extensive ischemia both in the whole group (p for interaction = 0.003) and in 496 patients matched 1:1 by a propensity score (p = 0.06).
Conclusions. Vasodilator stress CMR represents a valuable tool to stratify risk in elderly patients with CCS and might be helpful to guide decision-making in this scenario.
Determinants of quality of life in acute heart failure patients with and without comorbidities: a prospective, observational study
Authors: van den Berge Jan C , van Vark Laura C , Postmus Douwe , Utens Elisabeth M W J , Hillege Hans L , Boersma Eric , Lesman-Leegte Ivonne , Akkerhuis K Martijn 
Published: July 2021

Abstract

Aims
The relation between non-cardiac comorbidities and health-related quality of life (HRQoL) in patients with heart failure (HF) has been studied to a limited extent. To investigate the HRQoL and their determinants among HF patients with and without comorbidities.

Methods and results
TRIUMPH (TRanslational Initiative on Unique and novel strategies for Management of Patients with Heart failure) is a Dutch prospective, multicentre study enrolling 496 acute HF patients between 2009 and 2014. We included 334 patients who had completed the HRQoL questionnaires at baseline. The HRQoL was measured by the Kansas City Cardiomyopathy Questionnaire (KCCQ) en EuroQuality-of-life five Dimensions (EQ-5D). Comorbidity was defined as having a history of at least one of the following comorbidities: chronic kidney disease, diabetes mellitus, chronic obstructive pulmonary disease (COPD), and/or cerebrovascular accident. Patients with comorbidity (n = 205, 61%) had lower scores on the physical limitation scale and clinical summary score of the KCCQ (P = 0.03 and P = 0.01, respectively). Female sex, COPD, previous HF, increasing body mass index (BMI), elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP), high systolic blood pressure, and the presence of anxiety and/or depression negatively influenced the HRQoL among HF patients with comorbidity. Besides anxiety and depression, we hardly found any other determinant of HRQoL in patients without comorbidity.

Conclusion
Heart failure patients without comorbidity had better HRQoL than patients with comorbidity. Sex, previous HF, BMI, COPD, systolic blood pressure, NT-proBNP levels, and also anxiety and depression were determinants of HRQoL in patients with comorbidity. In those without comorbidity, apart from anxiety and depression, no further determinants of HRQoL were found.
Insights from the first genome assembly of Onion (Allium cepa)
Authors: Finkers Richard , van Kaauwen Martijn , Ament Kai , Burger-Meijer Karin , Egging Raymond , Huits Henk , Kodde Linda , Kroon Laurens , Shigyo Masayoshi , Sato Shusei , Vosman Ben , van Workum Wilbert , Scholten Olga 
Published: July 2021

Abstract
Onion is an important vegetable crop with an estimated genome size of 16 Gb. We describe the de novo assembly and ab initio annotation of the genome of a doubled haploid onion line DHCU066619, which resulted in a final assembly of 14.9 Gb with an N50 of 464 Kb. Of this, 2.4 Gb was ordered into eight pseudomolecules using four genetic linkage maps. The remainder of the genome is available in 89.6 K scaffolds. Only 72.4% of the genome could be identified as repetitive sequences and consist, to a large extent, of (retro) transposons. In addition, an estimated 20% of the putative (retro) transposons had accumulated a large number of mutations, hampering their identification, but facilitating their assembly. These elements are probably already quite old. The ab initio gene prediction indicated 540,925 putative gene models, which is far more than expected, possibly due to the presence of pseudogenes. Of these models, 47,066 showed RNASeq support. No gene rich regions were found, genes are uniformly distributed over the genome. Analysis of synteny with Allium sativum (garlic) showed collinearity but also major rearrangements between both species. This assembly is the first high-quality genome sequence available for the study of onion and will be a valuable resource for further research.