bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychological profile of COVID-19 pneumonia survivors three month after hospitalization
Authors: Yaroslavskaya E , Guskova O , Prilenskii B , Petelina T 
Published: October 2021

Abstract

Background
COVID-19 is the highly contagious infectious disease, which affects different organs and systems. Anxiety and depression symptoms, that are common results of severe diseases, used to make recovery more difficult.

Purpose
To study the prevalence of cardiovascular diseases, signs of anxiety, depression, stress, and their relationship in patients with proven COVID-19 pneumonia 3 months after discharge depending of gender.

Methods
The study was carried out within “One-year Cardiac Follow-up of COVID-19 Pneumonia”. 103 patients (mean age 46.6±15.8 years) were divided into 2 groups: 52 men (50.9%) and 51 women. Anxiety and depression symptoms were measured by GAD-7 and PHQ-9, respectively. PSS-10 was used to measure stress symptoms. The minimum value of anxiety and depression was a total value of 5 points.

Results
48.5% of patients had cardiovascular diseases, out of which arterial hypertension (AH) was the most common (44.7%). Less common was coronary artery disease (CAD) (16.5%), which in 14.6% of patients was accompanied by AH. Chronic heart failure (CHF) NYHA class I-II was found in 19.4% of patients, and severe CHF (NYHA class III–IV) - in 4.9%. Arrhythmia was detected in 11.7% of patients. According to the clinical characteristics, no significant differences were found between the groups of men and women. AH affected 21.4% of men and 23.3% of women, CAD −10.7% and 5.8%, respectively. NYHA class I-II CHF were found in 8.7% of men and 10.7% of women, and severe CHF (NYHA class III–IV) - in 2 men and 3 women. Arrhythmia had a prevalence of less than 6% among both men and women. Anxiety or depression symptoms were reported in 29.1% and 27.2%, respectively. Combination of anxiety and depression symptoms was determined in 18.4%, symptoms of stress in 8.7% of patients. Symptoms of depression were found in women more often (p=0.023). The value of the median scores of the PHQ-9 questionnaire in the group of women was significantly higher than in the group of men (3.00 [1.00; 8.00] and 1.00 [0; 3.75], p=0.006). Depression symptoms were associated with female gender (OR 2.83; CI 95% 1.35–7.08). Despite the absence of gender differences in the prevalence of anxiety (18.4% and 10.7%, p=0.072), when comparing the values of the median scores of the GAD-7 questionnaire in the groups of men and women, the difference was statistically significant (1.00 [0; 4.00] and 3.00 [2.00; 7.00], p=0.001, respectively). Signs of stress among married people were less common in comparison with unmarried (2.9% vs 5.8%, p=0.037).

Conclusion
Three months after discharge, no significant differences in clinical characteristics between men and women were found. Signs of anxiety or depression were detected in more than a quarter of patients with proven COVID-19-associated pneumonia. Women experienced symptoms of depression 3 times more often than men. Unmarried patients tended to experience stress more often.

Funding Acknowledgement
Type of funding sources: None.
Hybrid cardiac telerehabilitation program as a potential strengthening factor in the quality of life in patients with coronary heart disease: a retrospective single-centre analysis
Authors: Cabral M , Santos R , Januario F , Antunes A , Pinto R F , Morais J 
Published: October 2021

Abstract

Cardiac rehabilitation (CR) has well known beneficial effects on physical capacity, health-related quality of life, morbidity and mortality in patients with coronary artery disease (CAD). However, underuse of CR and not sustained improvements have been noted. It has been proposed that telemonitored exercise-based CR, by the use of mobile applications, can improve patient adherence to CR programs providing better outcomes.
The aim of this study was to investigate the effects of telemonitored cardiac rehabilitation on physical capacity, health-related quality of life and control of cardiovascular risk factors among patients with CAD on phase 2 of the Cardiac Rehabilitation Program (CRP).
A retrospective study was conducted and patients in CRP between 2017 and 2020 were included. Patient selection and information collection were obtained through medical records. Outcomes were Body Mass Index, Hospital Anxiety and Depression Scale (HADS), EuroQol-5D score (EQ-5D), International Physical Activity Questionnaire (IPAQ), estimated functional capacity in cardiac stress test, lipid panel and glycated hemoglobin. Patients were divided into two groups: group 1 followed the conventional strategy and group 2 followed a hybrid telemonitored CRP, with the use of MOVIDA mobile application. Variables were analysed in the beginning (T0) and in the end (T1) of the phase 2, around 3 months after. Group comparisons tests and multivariate logistic regression were performed. A p-value less than 0.05 is statistically significant. Statistical analysis was performed using SPSS software v25.0.
We analysed 107 patients, which 93 of these were assiduous and 69 concluded the phase 2 of CRP: 44 patients in group 1 and 25 patients in group 2. Two groups have similar baseline characteristics, except for age (p=0.02). It appears that participation in the PRC led to an improvement in physical capacity, mental well-being, and in lipid panel, regardless of the strategy. The improvement in quality of life, quantified by EQ-5D, was significant only in group 2 (p=0.03). There is also no correlation between age and the differences recorded in EQ-5D (p=0.86).
We hypothesise that, when compared to conventional CRP, cardiac telemonitored exercise using modern communication methods and on-demand coaching will result in an improved behavioural change, which translates to higher quality of life. Further studies including more patients and the phase 3 of CRP are needed to confirm these results.

Funding Acknowledgement
Type of funding sources: None.
Long-term prediction of mortality and comparative treatment benefit following percutaneous or surgical revascularization
Authors: Hara H , Shiomi H , Van Klaveren D , Kent D , Steyerberg E W , Garg S , Onuma Y , Kimura T , Serruys P W 
Published: October 2021

Abstract

Background
The SYNTAX score II 2020 (SSII-2020), which was derived and externally validated from randomized trials, was designed to predict death following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) in patients with three-vessel disease and/or left main disease. We aimed to investigate its value in identifying the safest modality of revascularization in a non-randomized setting.

Methods
Five-year mortality was assessed in 7362 patients with three-vessel disease and/or left main disease enrolled in a Japanese PCI/CABG registry. New-generation drug eluting stents and imaging guidance became the default PCI strategy during enrolment of the last cohort. The discriminative ability of the SSII-2020 for 5-year mortality was assessed using Harrell's C statistic (C-index). Agreement between observed and predicted rates of all-cause mortality following either PCI or CABG and treatment benefit (absolute risk difference) for this outcome were assessed by calibration plots.

Results
The SSII-2020 had helpful discrimination (C-index = 0.72) and good calibration (intercept = −0.11, slope = 0.92) for 5-year mortality. The absolute risk difference in mortality between CABG and PCI (treatment benefit) was well calibrated when the whole population was grouped into quarters according to the predicted absolute risk difference of 5-year mortality. The observed differences in survival in favor of CABG were 4.2% (0.1 to 8.2%, log-rank p=0.05) and 8.5% (3.8 to 13.2%, log-rank p&lt;0.01) in the respective third and fourth quarters. In contrast, the observed differences in survival were not significantly different in either the first (3.0% [−0.8 to 6.8%, log-rank p=0.12]) or the second quarter (1.3% [−2.4 to 5.1%, log-rank p=0.39]).

Conclusions
The SSII-2020 is well able to predict death at 5 years – and the mortality difference between PCI and CABG, and therefore has the potential to support decision making on revascularization in patients with three-vessel disease and/or left main coronary artery disease.

Funding Acknowledgement
Type of funding sources: None.
Post-marathon decline in right ventricular radial motion component among amateur sportsmen
Authors: Lewicka-Potocka Z , Dabrowska-Kugacka A , Lewicka E , Kaleta-Duss A M , Danilowicz-Szymanowicz L , Kubik M , Faran A , Szymeczko P , Galaska R , Fijalkowski M , Raczak G 
Published: October 2021

Abstract

Introduction
Running the marathon may be followed by post-exercise “cardiac fatigue” manifesting as transient right ventricular (RV) systolic and diastolic impairment. It is the thin-walled RV that is predominantly affected by the exercise-induced overload, with little if any, impact on the left ventricle (LV) [1]. The 2-D echocardiographic (ECHO) assessment of RV is challenging and may be incomplete since conventional measures reflect only the longitudinal motion (displacement of tricuspid annulus towards the apex) [2]. The mechanics of RV can be separated into two more components, anteroposterior (stretching RV wall by contracting septum) and radial (internal relocation of the RV free wall) [2]. The significance and relative contribution of motion components to global RV function may not be equal, and their interplay can vary depending on concomitant diseases [3].

Purpose
We aimed to analyse the pathophysiology of RV exhaustion associated with a marathon run with 3-D ECHO, which allows precise estimation of all RV motion components and their contribution to RV global function.

Methods
The study included 34 healthy males (mean age of 40±8 years), amateurs, who finished the marathon in northern Poland. The 3-D ECHO was performed 2 weeks before (stage I), at the marathon finish line (stage II) and 2 weeks after the competition (stage III). According to the ReVISION method (Right ventricular separate wall motion quantification) the global RV function was decomposed to longitudinal (L_), anteroposterior (AP_) and radial (R_) [3]. By dividing componential ejection fractions (EF) with global RV EF, L_EFi, AP_EFi, and R_EFi ratios were obtained.

Results
When comparing results from stage I and III there were no significant differences (Table 1). The analysis revealed post-run decline in RV EF with no changes in LV EF. The quantification of the RV motion components showed reduction in R_EF after the marathon with no changes in AP_EF or L_EF. The relative contribution of componential EF to global RV function were permanent and was not influenced by the competition.

Conclusions
Marathon run resulted in transient RV dysfunction arising from decline in radial shortening. Noteworthy, the componential interplay between wall motion compartments was preserved in pre- and post-run assessment. The ReVISION method enables the comprehensive analysis of the competing RV.

Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): The study was supported by the project POWR.03.05.00-00-z082/18 co-financed by the European Union through the European Social Fund under the Operational Programme Knowledge Education Development 2014–2020
The impact of anxiety level on medical decisions of non-COVID patients during the pandemic outbreak
Authors: Koren O , Abu Rajab S , Barbour M , Shachar M , Shahar A , Zubidat K , Slim W , Igbariya D , Rozner E , Turgeman Y , Mader E 
Published: October 2021

Abstract

Background
High anxiety levels (HAL) were widely reported in patients during the COVID outbreak. We assess whether HAL influenced medical decision-making (MDM) of Non-COVID patients.

Method
We prospectively recruited patients with cardiovascular complaints during February and September 2020. We assessed anxiety levels using the GAD-7, Beck Inventory, the cardiac anxiety questionnaires, and a newly designed MDM questionnaire.

Results
We recruit 287 patients. The mean age was 52.6±14.9 (females represent 36.2%). HAL was reported in 261 (90.3) patients and was more prevalent in old (p&lt;0.001 for all questionnaires), married, and unemployed patients (significant p-value for all). Cardiovascular comorbidities and a history of anxiety, depression, and psychiatric disorder were independent factors for HAL (p&lt;0.001 for all). Coronary catheterization was performed more in HAL (p&lt;0.001 for all), yet the rate of significant coronary artery disease was lower than in patients with low anxiety level (LAL) (p&lt;0.001 for all). 161 (56.9) patients reported that their MDM was affected (&lt;0.001), and 149 (76.8) patients indicated that they would have gone earlier to the hospital if not the pandemic (p=0.03 for high DM-19 score). Patients with HAL seek medical care longer than LAL patients (p=0.02). Correlation analysis revealed a positive correlation between MDM and HAL (p&lt;0.001 for all).

Conclusion
Our study shows a strong and positive correlation between anxiety level and MDM. Old patients with cardiovascular comorbidities and a history of mental disorders were at particularly high risk for HAL and sought medical treatment significantly longer than LAL patients.

Funding Acknowledgement
Type of funding sources: None.
Speckle tracking echocardiography as a promising tool for the prognostic assessment of patients with sarcoidosis
Authors: Pastore M C , Cameli P , Mandoli G E , D'Alessandro M , De Carli G , Vigna M , Bergantini L , Patti G , Bargagli E , Cameli M 
Published: October 2021

Abstract

Background
Sarcoidosis is a chronic granulomatous disease characterized by multiorgan inflammatory involvement and recurrent relapses with significant impact on morbidity and mortality. The prognostic assessment of these patients is still challenging. Although the international guidelines didn't recommend basic transthoracic echocardiography (TTE) for diagnostic and prognostic assessment of sarcoidosis, speckle tracking echocardiography (STE) has emerged as more sensitive for the early detection of cardiac sarcoidosis and outcome.

Purpose
This prospective study aimed to assess the potential value of STE parameters for the prediction of major adverse cardiac events (MACE) and sarcoidosis relapse.

Methods
Consecutive patients with confirmed diagnosis of sarcoidosis who underwent transthoracic echocardiography (TTE) and subsequent pulmonary function tests (PFTs) were enrolled. Patients with acute events or treatment escalation between TTE and PFTs and previous cardiac surgery were excluded. All patients were followed for sarcoidosis relapse requiring increase in step-up therapy and MACE (cardiovascular death, cardiovascular hospitalizations, arrhythmias).

Results
172 patients were included (111 females, 57.4±12.6 years); 56 patients showed extrapulmonary localizations of sarcoidosis; at baseline, 99 patients were on steroid and/or immunosuppressive therapy. During a median follow up of 2217 days, 8 deaths (3 cardiovascular deaths), 23 MACE and 36 sarcoidosis relapses were reported. Patients with MACE were older (p=0.0022), but didn't show significant differences in PFTs and sarcoidosis phenotype. LV global longitudinal strain (GLS) was the only echocardiographic index to show significant differences (lower values) in patients with MACE (p=0.025). LV GLS ≤17.13% (absolute value) was identified as a fair predictor of MACE both with ROC curves (AUC=0.64) and Kaplan Meier analysis (Fig. 1).
No significant differences of demographic, clinical, functional, and therapeutic data were observed between patients with/without sarcoidosis relapse. TTE revealed a significant reduction of LV ejection fraction (p=0.0432), tricuspid annular plane systolic excursion (TAPSE, p=0.0272) and global peak atrial longitudinal strain (PALS, p=0.0012) in patients with relapse. Among these 3 parameters, PALS ≤28.5% showed to be the best predictor of sarcoidosis relapse with ROC (AUC=0.7155) and Kaplan Meier curves (Fig. 2).

Conclusions
Our results highlight a potential role of LV GLS and PALS as prognostic markers in sarcoidosis, suggesting the use of STE in the clinical management of these patients, regardless the evidence or the suspect of cardiac localizations of the disease.

Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
Left ventricular diastolic function in patients with breast cancer treated with anthracycline-based chemotherapy
Authors: Mincu R , Lampe L , Rassaf T , Totzeck M 
Published: October 2021

Abstract

Background
Despite major progress in novel breast cancer therapeutic regimens, anthracycline-based chemotherapy (ANT) remains among the most effective therapies. Cardiotoxicity, one of the most severe adverse events of ANT, has been defined as a reduction in left ventricular ejection fraction (LVEF) or global longitudinal strain (GLS). However, the role of early diastolic dysfunction has been insufficiently researched. We aimed to determine if diastolic dysfunction could early diagnose and predict ANT cardiotoxicity.

Methods
Studies that reported on echocardiographic parameters of diastolic function before and at the end of ANT in breast cancer patients without cardiac disease were included. We evaluated parameter derived from pulsed wave Doppler interrogation of the mitral valve inflow (E/A ratio and mitral E-wave deceleration time (EDT)) and tissue Doppler (mean velocities of the mitral ring in the early diastole (E') and E/E' ratio).

Results
A total of 892 patients from 13 studies were included. E/A ratio was significantly reduced at the end of ANT (OR 2.34, 95% CI [1.49, 3.68], p&lt;0.001), while EDT was not significantly influenced (OR 0.74, 95% CI [0.50, 1.08], p=0.121). Tissue Doppler velocity of the mitral ring E' and the LV filling pressure analysed through E/E' ratio did not show significant changes after ANT (OR 2.32, 95% CI [0.94, 5.72], p=0.068, and OR 0.79, 95% CI [0.56, 1.12], p=0.197, respectively). A modest reduction in LVEF and global longitudinal strain (GLS) was observed at the end of the ANT therapy with a difference in means of 3.77% and −1.08%, respectively. Patients receiving ANT doses over 400 mg/m2 doxorubicin or epirubicin therapeutic equivalent doses showed a significant change in E/A and E' after the therapy. Cardioprotective therapy like carvedilol, nebivolol and spironolactone did not have a significant impact on the parameter of diastolic function.

Conclusion
ANT has a modest early impact on LV diastolic function in patients with breast cancer without cardiac disease and cannot be validated as an early diagnostic or prognostic tool of ANT-induced cardiotoxicity. Randomized studies on larger population, using new parameter e.g. left atrial function parameter and multimodality imaging are required.

Funding Acknowledgement
Type of funding sources: None.
Safety of Digoxin in Nonagenarian Patients with Atrial Fibrillation. Lessons from a Spanish multicenter registry
Authors: Dominguez Erquicia P , Raposeiras Roubin S , Abu-Asi E , Cespon Fernandez M , Alonso Rodriguez D , Camacho Freire S J , Curbelos Fernandez N , Lopez Masjuan Rios A , Melendo Viu M , Iniguez Romo A 
Published: October 2021

Abstract

Background
The association between digoxin and mortality is an unclear issue. In older patients with atrial fibrillation (AF), where the use of digoxin is frequent, the evidence of its safety is very scarce.

Aim
Our aim is to assess the safety of digoxin in nonagenarian patients with AF in terms of mortality.

Methods
We evaluated data from 795 patients ≥90 years old of a multicenter Spanish retrospective registry of nonagenarian patients with non-valvular AF and rate control. We analyzed the relationship between digoxin and mortality with a Cox proportional-hazards model and Kaplan-Meier survival curves.

Results
The follow-up was 27.7±18.3 months. Mean age was 92.5±3.8 years (inter quartilile range 90.0–112.7), and 71% of patients were female. Digoxin was not associated with increased risk of mortality (aHR 1.16; 95% CI: 0.96–1.41, P=0.128) in the total sample. However, we found a significant increase in mortality in the group with estimated glomerular filtration rate (eGFR) &lt;30 ml /min/1.73 m2 (aHR 2.01; 95% CI: 1.13–3.57, P=0.018), but not in the other subgroups of eGFR (30–59/≥60 ml/min/1.73 m2). When exploring the risk of mortality according to gender, the male subgroup was associated with an increase in mortality (aHR 1.48; 95% CI: 1.02–2.14, P=0.041). This was not observed in female subgroup (aHR 1.03; 95% CI: 0.81–1.29, P=0.829). Based on the presence or absence of a history of heart failure (HF), we did not find significant differences in the association between digoxin and all-cause mortality (aHR 1.20; 95% CI: 0.87–1.65, P=0.268 vs aHR 1.15; 95% CI: 0.90–1.47, P=0.273, respectively).

Conclusions
In our large registry of nonagenarian patients with AF, we did not find an association between digoxin and mortality in the total sample. However, in the subgroup analyses, we found an increase in mortality with the use of digoxin in men and in patients with an eGFR&lt;30ml /min/1.73 m2.

Funding Acknowledgement
Type of funding sources: None. Kaplan-Meier estimates survival functionMortality by subgroups
Latent class cluster analysis of knowledge on acute myocardial infarction symptoms and risk factors in community residents
Authors: Liu Y , Ma J , Zhang N , Xiao J.-Y , Wang J.-X , Li X.-W , Wang J , Zhang Y , Gao M.-D , Zhang X , Wang Y , Wang J.-X , Xu S.-B , Gao J 
Published: October 2021

Abstract

Background
Knowledge of Acute Myocardial Infarction (AMI) symptoms and risk factors (RF) have been studied worldwide in various populations. However, the studied specific symptom and RF of different surveys varies, the number of surveyed symptom and RF varies, and the criteria for judging good/high knowledge and bad/low knowledge are different (group classification criteria include the number, the percentages or the scores), which makes the results difficult to compare.

Purpose
The aim was to identify clusters of knowledge on symptoms and modifiable RFs using Latent Cluster Analysis, and to further compare characteristics and the awareness of the need for prompt treatment among different clusters.

Methods
A structured questionnaire was used to interview 4122 community residents over 35 years old on their knowledge about AMI symptoms and RFs. Latent GOLD Statistical Package was used to identify and classify the respondent subtypes (latent classes) of the knowledge on AMI symptoms or modifiable RFs. An individual's class membership probabilities are computed from the estimated model parameters and the observed scores. The multivariable logistic regression was performed in order to identify factors that predicted High knowledge membership.

Results
Two and three distinct clusters were identified in terms of knowledge of symptoms and RFs. 62.7% (Symptom High Knowledge Cluster) and 39.5% (RF High Knowledge Cluster) of the respondents were able to identify most symptoms and modifiable RFs. A number of common differences were observed with respect to higher probability of having high knowledge on symptom and RF, which was mostly better among those with higher education and average monthly income, insured, having annual physical examination, have disease history of AMI RFs, AMI history in immediate family member or acquaintance and have been exposed to AMI related public education. There was also significant difference in awareness of the prompt treatment in case of AMI occurs among different symptom or RF clusters.

Conclusions
A moderate or relatively low knowledge regarding AMI symptoms and modifiable RFs was observed in our study. Identification of Symptom or RF knowledge clusters can be a way to detect specific targeted groups that are most likely to possess lower knowledge of AMI with readily identifiable characteristics, which may facilitate health education and further reduce the pre-hospital delay and improve patient outcomes.

Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Key Project of Scientific and Technological Support Plan of Tianjin in 2020 Cluster category chartProfile plot