bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two-dimensional echocardiography compared to cardiac computed tomography for assessment of left ventricular volume and function in patients with anteroapical aneurysm
Authors: Nemchyna O , Solowjowa N , Dandel M , Hrytsyna Y , Knierim J , Soltani S , Schoenrath F , Falk V , Knosalla C 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. Two-dimensional (2D) echocardiography is widely accepted method for the assessment of left ventricular (LV) morphology and function after myocardial infarction and for initial preoperative evaluation of patients planned for surgical ventricular repair (SVR). Magnetic resonance imaging and cardiac computer tomography (CT) provide more accurate measurements, but not always available.
Purpose. The aim of this study was to compare 2D-echocardiography and CT for preoperative assessment of patients with LV aneurysm in order to optimize the perioperative management in SVR.
Methods. Patients (n = 179, mean age 62.6 ± 11 years, 23.5% women) with LV anteroapical aneurysm due to myocardial infarction were examined by echocardiography and CT before SVR. LV end-diastolic and end-systolic volumes (LVEDV and LVESV) and ejection fraction (EF) obtained by two methods were compared pairwise. Prognostic role for the prediction of all-cause death was assessed for preoperative parameters in multivariate Cox regression model adjusted for patient age, sex, NYHA class, diabetes mellitus, renal failure, atrial fibrillation and arterial hypertension.
Results. There was a strong correlation for preoperative LVEDV and LVESV measured by echocardiography and CT (r = 0.85, r = 0.87, p &lt; 0.0001), however volumes obtained by echocardiography were smaller compared to those by CT (Table) with higher difference in patients with more dilated LV, as demonstrated by Bland-Altman analysis (Fig.). No significant difference in mean preoperative EF was observed with moderate correlation between two methods (r = 0.67, p &lt; 0.0001). In total 68 patients died during median follow up of 5.3 years (IQR: 1.7-8.7 years) after SVR. Comparable predictive value was demonstrated for LVEDV measured by CT and echocardiography (for 10 ml increase HR = 1.04, p = 0.004 and HR = 1.06, p = 0.0001), as well as for LVESV (for 10 ml increase HR = 1.04, p = 0.001 and HR = 1.07, p = 0.0001) and for EF (for 5% increase HR = 0.83, p = 0.004 and HR = 0.81, p = 0.004).
Conclusion. In patients with LV aneurysm 2D-echocardiography may be used for the assessment of LV volumes and function and have similar prognostic role compared to CT in patients evaluated for SVR. Underestimation of LV volumes by echocardiography must be considered, especially in patients with more dilated LV.
Comparison of CT and echocardiography Parameter CT Echo Mean difference p-value LVEDV, ml LVESV, ml EF, % 289 ± 104 198 ± 97 34 ± 12 222 ± 81 149 ± 67 35 ± 9 67 ± 56 49 ± 51 -0.9 ± 9.2 &lt;0.0001 &lt;0.0001 0.215 Abstract Figure. Bland-Altman plots for LVEDV and LVESV
Natural history and disease progression of early cardiac amyloidosis evaluated by echocardiography
Authors: Itzhaki Ben Zadok O , Eisen A , Shapira Y , Monakier D , Iakobishvili Z , Schwarzenberg S , Abelow A , Ofek H , Kazum S , Hamdan A , Bental T , Sagie A , Kornowski R , Vaturi M 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Since the diagnosis of cardiac amyloidosis (CA) is often delayed, echocardiographic findings are frequently indicative of already advanced cardiomyopathy.

Aims
to describe early echocardiographic features in patients subsequently diagnosed with CA and to delineate disease progression.

Methods
Pre-amyloid diagnosis echocardiographic studies were screened for structural and functional parameters and stratified according to the pathogenetic amyloid subtype (immunoglobulin light-chain (AL) or amyloid transthyretin (ATTR)). Abnormalities were defined based on published guidelines.

Results
Our cohort included 75 CA patients of whom 42 (56%) were diagnosed with AL and 33 (44%) with ATTR. Forty-two patients had an earlier echocardiography exam available for review. Patients presented with increased wall thickness (1.3 (IQR 1.0, 1.5)cm) ≥3 years before the diagnosis of CA and relative wall thickness (RWT) was increased (0.47 (IQR 0.41, 0.50)) ≥7 years pre-diagnosis. Between 1 to 3 years before CA diagnosis restrictive left ventricular (LV) filling pattern was present in 19% of patients and LV ejection fraction (LVEF)≤50% was present in 21% of patients. Right ventricular dysfunction was detected concomitantly with disease diagnosis. The echocardiographic phenotype of ATTR versus AL-CA showed increased RWT (0.74 (IQR 0.62, 0.92) vs. 0.62 (IQR 0.54, 0.76), p = 0.004) and LV mass index (144 (IQR 129, 191) vs. 115 (IQR 105, 146)g/m2,p = 0.020) and reduced LVEF (50 (IQR 44, 58) vs. (60 (IQR 53, 60)%, p = 0.009) throughout the time course of CA progression, albeit survival time was similar.

Conclusions
Increased wall thickness and diastolic dysfunction in CA develop over a time course of several years and can be diagnosed in their earlier stages by standard echocardiography
Abstract Figure. Schematic proposed timeline of CA
Serial right ventricular assessment in patients with hypoplastic left heart syndrome patients (HLHS): a cardiovascular magnetic resonance study
Authors: Sobh M , Gabbert D , Uebing A , Voges I 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Patients with hypoplastic left heart syndrome (HLHS) are at risk for right ventricular (RV) dysfunction over the course of the three-stage surgical palliation with the final step being the completion of the total cavopulmonary connection (TCPC). However, less is known about RV function during follow-up after TCPC completion. We assessed RV function by analysing serial cardiovascular magnetic resonance (CMR) studies in a large cohort of HLHS patients.

Methods
CMR studies from 95 HLHS patients (67 males) were retrospectively analysed. Short axis cine images were used to measure RV end systolic and end diastolic volumes and ejection fraction (RVEF). Oblique cine images showing the atria and right ventricle in a similar manner like a standard "4-chamber view" were used to measure tricuspid annular plane systolic excursion (TAPSE) and long axis strain (LAS).

Results
From the 95 patients, all had at least two and 32 patients had three CMR scans. The first scan was performed at a mean age of 4.9 ± 2.8 years, the second scan at a mean age of 9.3 ± 4 years and the third at a mean age of 14.3 ± 3.7 years. The mean values of RV end diastolic and end systolic volume indexed to body surface area (REDVi, RVESVi) as well as RV ejection fraction (RVEF) at the three time points were: 1) REDVi 92.6 ± 21.9 ml/m2, RVESVi 43 ± 15.1 ml/m2, RVEF 54.2 ± 7.1%; 2) REDVi 93.9 ± 25.6 ml/m2, RVESVi 44.6 ± 18.3 ml/m2, RVEF 53.6 ± 7.8%; 3) REDVi 110.9 ± 41.9 ml/m2, RVESVi 58.1 ± 35 ml/m2, RVEF 50.1 ± 10.1%. There was a statistically significant increase in RVEDVi and RVESVi from the first and the second scan to the third scan (p &lt; 0.01). RVEF was lower at the time of the third scan compared to the first and second scan, but this difference was not statistically significant. TAPSE increased slightly from the first to the third scan (p &lt; 0.05). There was no change in stroke volume and LAS from the first to the third scan. Strong correlations were found between RVEF and LAS as well as between RVEF and TAPSE (r = 0.49 and r=-0.50; p &lt; 0.001, respectively).

Conclusion
Serial assessment of CMR studies in HLHS patients after TCPC completion could demonstrate an increase in indexed RV volumes over time, whereas RV stroke volume, RVEF and LAS largely remain stable.
Evolution of biventricular T1 values in patients with right-sided congenital heart disease
Authors: Burdet O , Pavon AG , Bouchardy J , Blanche C , Monney P , Hugelshofer S , Schwitter J , Rutz T 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Conflicting reports exist on the prevalence and clinical impact of interstitial fibrosis in right ventricular (RV) congenital heart disease (CHD). This study evaluates the longitudinal evolution of native myocardial T1 relaxation time (T1) in RV CHD.

Methods
On a 1.5T scanner, an ECG-triggered modified Look-Locker inversion recovery sequence (scheme 3(3)3(3)5) was acquired on a short-axis basal slice covering the RV and left ventricle (LV) on two consecutive CMR exams. Global and segmental (LV = 6, RV = 4) RV and LV T1 values were calculated (Figure).

Results
Mean time between CMR exams for 36 included patients (age 34 ± 2y) was 22 ± 2 months. All LV segments and 81/88% of RV segments of first and second CMR could be analyzed, respectively. T1 increased mildly but not significantly (table). There was no relationship of T1 to pulmonary regurgitation fraction, pulmonary stenosis or RV enddiastolic volume (p &gt; 0.05). Global RV T1 of the second CMR was related to RV ejection fraction (RVEF): r = 0.353, 3.0 ± 1.4, p = 0.038. T1 of the infero-septal LV segment of first and second CMR, global LV T1 of second CMR and increase of T1 of global LV, anterior, antero-lateral and –septal LV segments, were related to age at CMR: r = 0.333 - 0.463, p &lt; 0.05, respectively.

Conclusions
Native T1 values increased mildly in patients with stable RV CHD, which was not statistically significant probably due to the short to median follow-up. Global RV T1 appears to be related to RVEF which could be sign of increasing interstitial fibrosis whereas the relationship of LV T1 to age might be a physiological finding.
First CMR native T1 (ms) Second CMR native T1 (ms) p LV Global 1007 ± 37 1014 ± 39 0.413 LV Anterior 994 ± 53 999 ± 54 0.710 LV Antero-lateral 965 ± 63 981 ± 58 0.186 LV Infero-lateral 1000 ± 52 1004 ± 63 0.695 LV Inferior 1035 42 1037 ± 50 0.744 LV Infero-septal 1028 ± 35 1036 ± 43 0.282 LV Antero-septal 1016 ± 38 1024 ± 48 0.347 RV Global 1091 ± 90 1096 ± 85 0.410 RV Inferior 1112 ± 104 1115 ± 118 0.696 RV Infero-lateral 1061 ± 130 1077 ± 115 0.425 RV Antero-lateral 1046 ± 127 1080 ± 109 0.088 RV Anterior 1088 ± 156 1108 ± 154 0.410 Abstract Figure. Determination of biventricular T1 values
Permanent pacemaker implantation following mitral valve surgery: a retrospective cohort study of risk factors and long-term outcomes
Authors: Helmers Mark R , Shin Max , Iyengar Amit , Arguelles Gabriel R , Mays Jarvis , Han Jason J , Patrick William , Altshuler Peter , Hargrove W Clark , Atluri Pavan 
Published: February 2021

AbstractOBJECTIVESConduction disturbances requiring permanent pacemaker (PPM) implantation remain a complication following valvular surgery. PPMs confer the risk of infection, tricuspid valve regurgitation and pacing-induced cardiomyopathy. Literature examining PPM placement in mitral valve surgery (MVS) is limited.METHODSOur institutional mitral valve (MV) database was retrospectively reviewed for adult patients undergoing surgery from 2011 to 2019. Patients with preoperative PPM were excluded. Patients were stratified by the receipt of PPM following their index operations. Multivariable logistic regression was performed to determine patient and operative risk factors for PPM. Subgroup analysis was performed on patients who underwent isolated MVS. Kaplan–Meier analysis and a multivariable Cox proportional hazards model were utilized to assess the association between PPM implantation and long-term survival.RESULTSA total of 3391 (2991 non-PPM and 400 PPM) patients met the study criteria. Significant predictors of PPM included increased decade of age (odds ratio: 1.23; 95% confidence interval: 1.12–1.35), concomitant aortic (1.44; 1.10–1.90) and tricuspid valve procedures (2.21; 1.64–2.97) and prior history of myocardial infarction (1.48; 1.07–1.86). In the isolated MV repair population, annuloplasty with ring prosthesis was associated with PPM (3.09; 1.19–8.02). Patients in the replacement population did not have significant identifiable risk factors. There was no survival difference found, and postoperative PPM placement was not found to be an independent predictor of mortality.CONCLUSIONSOur primary aim was to elucidate predictors for PPM implantation in MVS and found increasing age and concomitant procedures to be risk factors. Receipt of PPM is associated with worse long-term survival but does not independently predict survival. Among patients undergoing isolated MV repair, use of an annuloplasty ring confers a higher risk of PPM compared to an annuloplasty band.
Pulmonary valve replacement following repair of tetralogy of Fallot: comparison of outcomes between bio- and mechanical prostheses
Authors: Kim Dong-Hee , Choi Eun Seok , Kwon Bo Sang , Yun Tae-Jin , Cha Seul Gi , Baek Jae Suk , Yu Jeong Jin , Kim Young-Hwue , Park Chun Soo 
Published: February 2021

Abstract

OBJECTIVES
The aims of this study were to evaluate and compare the outcomes after pulmonary valve replacement (PVR) with a mechanical prosthesis (MP) and a bioprosthesis (BP).

METHODS
From 2004 through 2017, a total of 131 patients, who had already been repaired for tetralogy or Fallot or its variants, underwent their first PVR with an MP or a BP. Outcomes of interests were prosthesis failure (stenosis &gt;3.5 m/s, regurgitation &gt;mild or infective endocarditis) and reintervention.

RESULTS
The median age at PVR was 19 years. BP and MP were used in 88 (67.2%) and 43 (32.8%) patients, respectively. The median follow-up duration was 7.4 years, and the 10-year survival rate was 96.4%. Risk factors for prosthesis failure were smaller body surface area [hazard ratio (HR) 0.23 per 1 m2, P = 0.047] and smaller prosthesis size (HR 0.73 per 1 mm, P = 0.039). Risk factors for prosthesis reintervention were smaller body surface area (HR 0.11 per 1 m2, P = 0.011) and prosthesis size (HR 0.67 per 1 mm, P = 0.044). Probability of prosthesis failure and reintervention at 10 years were 24.6% (19.5% in BP vs 34.8% in MP, P = 0.34) and 7.8% (5.6% in BP vs 11.9% in MP, P = 0.079), respectively. Anticoagulation-related major thromboembolic events were observed in 4 patients receiving an MP.

CONCLUSIONS
MP might not be superior to BP in terms of prosthesis failure or reintervention. MP should be carefully considered for highly selected patients in the era of transcatheter PVR.
Can we modulate the breastfed infant gut microbiota through maternal diet?
Authors: Sindi Azhar S , Geddes Donna T , Wlodek Mary E , Muhlhausler Beverly S , Payne Matthew S , Stinson Lisa F 
Published: February 2021

ABSTRACTInitial colonisation of the infant gut is robustly influenced by regular ingestion of human milk, a substance that contains microbes, microbial metabolites, immune proteins and oligosaccharides. Numerous factors have been identified as potential determinants of the human milk and infant gut microbiota, including maternal diet; however, there is limited data on the influence of maternal diet during lactation on either of these. Here, we review the processes thought to contribute to human milk and infant gut bacterial colonisation and provide a basis for considering the role of maternal dietary patterns during lactation in shaping infant gut microbial composition and function. Although only one observational study has directly investigated the influence of maternal diet during lactation on the infant gut microbiome, data from animal studies suggests that modulation of the maternal gut microbiota, via diet or probiotics, may influence the mammary or milk microbiota. Additionally, evidence from human studies suggests that the maternal diet during pregnancy may affect the gut microbiota of the breastfed infant. Together, there is a plausible hypothesis that maternal diet during lactation may influence the infant gut microbiota. If substantiated in further studies, this may present a potential window of opportunity for modulating the infant gut microbiome in early life.
Genetic analysis of four consanguineous multiplex families with inflammatory bowel disease
Authors: Ben-Yosef Noam , Frampton Matthew , Schiff Elena R , Daher Saleh , Abu Baker Fadi , Safadi Rifaat , Israeli Eran , Segal Anthony W , Levine Adam P 
Published: February 2021

Abstract

Background
Family studies support a genetic predisposition to inflammatory bowel diseases (IBD), but known genetic variants only partially explain the disease heritability. Families with multiple affected individuals potentially harbour rare and high-impact causal variants. Long regions of homozygosity due to recent inbreeding may increase the risk of individuals bearing homozygous loss-of-function variants. This study aimed to identify rare and homozygous genetic variants contributing to IBD.

Methods
Four families with known consanguinity and multiple cases of IBD were recruited. In a family-specific analysis, we utilised homozygosity mapping complemented by whole-exome sequencing.

Results
We detected a single region of homozygosity shared by Crohn's disease cases from a family of Druze ancestry, spanning 2.6 Mb containing the NOD2 gene. Whole-exome sequencing did not identify any potentially damaging variants within the region, suggesting that non-coding variation may be involved. In addition, affected individuals in the families harboured several rare and potentially damaging homozygous variants in genes with a role in autophagy and innate immunity including LRRK1, WHAMM, DENND3, and C5.

Conclusion
This study examined the potential contribution of rare, high-impact homozygous variants in consanguineous families with IBD. While the analysis was not designed to achieve statistical significance, our findings highlight genes or loci that warrant further research. Non-coding variants affecting NOD2 may be of importance in Druze patients with Crohn's disease.
Is There a Hidden Burden of Disease as a Result of Epigenetic Epithelial-to-Mesenchymal Transition Following Chlamydia trachomatis Genital Tract Infection?
Authors: Horner Patrick J , Flanagan Heather , Horne Andrew W 
Published: February 2021

Abstract
Chlamydia trachomatis (CT), the most common bacterial sexually transmitted infection worldwide, has been widely researched for its involvement in many disease pathologies in the reproductive tract, including pelvic inflammatory disease, ectopic pregnancy, and tubal factor infertility. Recent findings, through the efforts to understand the pathogenesis of CT, suggest that CT can induce the process of epithelial-to-mesenchymal transition (EMT) through epigenetic changes in the epithelium of the female reproductive tract. This literature review aims to analyze the evidence for CT’s ability to promote EMT and to pinpoint the areas that merit further investigation.
Participation in household decision making and justification of wife beating: evidence from the 2018 Mali Demographic and Health Survey
Authors: Seidu Abdul-Aziz , Dzantor Selorm , Sambah Francis , Ahinkorah Bright Opoku , Ameyaw Edward Kwabena 
Published: February 2021

Abstract

Background
We assessed the association between women's participation in household decision making and justification of wife beating among married women ages 15–49 y in Mali.

Methods
We employed a cross-sectional study design among 7893 women of reproductive age involving a two-stage sampling technique using version 6 of the Mali Demographic and Health Survey (MDHS) data, which was conducted in 2018.

Results
Approximately 37% participated in at least one household decision while 23.4% reported that they would not justify wife beating in any of the stated circumstances. Women who participated in at least one household decision had lower odds (adjusted odds ratio [AOR] 0.834 [confidence interval {CI} 0.744 to 0.935]) of justifying wife beating. With respect to the covariates, we found that women 45–49 y of age had lower odds of justifying wife beating compared with those ages 15–19 y (AOR 0.569 [CI 0.424 to 0.764]). Women with higher education (AOR 0.419 [CI 0.265 to 0.662]) and those whose husbands had secondary education (AOR 0.825 [CI 0.683 to 0.995]) had lower odds of justifying wife beating. Women who lived in urban areas were less likely to justify wife-beating (AOR 0.328 [CI 0.275 to 0.390]) compared with those who lived in rural areas.

Conclusion
This study suggests that participation in household decision making is associated with a significantly lower rate of justifying wife beating in Mali. These results underscore the need for various interventions to empower women to increase women's participation in decision making to reduce justification of domestic violence.
Steal syndrome from a superficial circumflex iliac perforator artery flap in a patient with a hypoplastic posterior tibial artery and severe diabetic peripheral artery disease
Authors: Murphy Grant A , Singh-Moon Rajinder P , Rowe Vincent L , Patel Ketan M , Mazhar Amaan , Cuccia David J , Armstrong David G 
Published: February 2021

Abstract
The use of free flaps in lower extremity reconstructive surgery has seen growing adoption for treating tissue loss in patients with diabetes mellitus and peripheral artery disease as a means for limb preservation. The superficial circumflex iliac perforator artery (SCIP) flap is one of the most commonly utilized flaps in foot reconstruction and has demonstrated benefits over amputation. Patients with impaired vascular and neurologic function are predisposed to complications following lower extremity reconstructive surgery, particularly ischemia in the angiosomes of the arteries used for flap anastomosis. We present the case of a patient who underwent successful SCIP flap reconstruction of the calcaneus but developed gangrene in the forefoot region supplied by a hypoplastic posterior tibial artery in subsequent months. The changes in tissue oxygenation and hemoglobin distribution of the foot are shown using spatial frequency domain imaging throughout the flap healing process and eventual tissue necrosis.
Laboratory Predictors of COVID-19 Pneumonia in Patients with Mild to Moderate Symptoms
Authors: Li Jiaxia , Wan Li , Feng Yuan , Zuo Huilin , Zhao Qian , Ren Jiecheng , Zhang Xiaochu , Xia Mingwu 
Published: February 2021

AbstractObjectiveThis research aims to develop a laboratory model that can accurately distinguish pneumonia from nonpneumonia in patients with COVID-19 and to identify potential protective factors against lung infection.MethodsWe recruited 50 patients diagnosed with COVID-19 infection with or without pneumonia. We selected candidate predictors through group comparison and punitive least absolute shrinkage and selection operator (LASSO) analysis. A stepwise logistic regression model was used to distinguish patients with and without pneumonia. Finally, we used a decision-tree method and randomly selected 50% of the patients 1000 times from the same specimen to verify the effectiveness of the model.ResultsWe found that the percentage of eosinophils, a high–fluorescence-reticulocyte ratio, and creatinine had better discriminatory power than other factors. Age and underlying diseases were not significant for discrimination. The model correctly discriminated 77.1% of patients. In the final validation step, we observed that the model had an overall predictive rate of 81.3%.ConclusionWe developed a laboratory model for COVID-19 pneumonia in patients with mild to moderate symptoms. In the clinical setting, the model will be able to predict and differentiate pneumonia vs nonpneumonia before any lung computed tomography findings. In addition, the percentage of eosinophils, a high–fluorescence-reticulocyte ratio, and creatinine were considered protective factors against lung infection in patients without pneumonia.