bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 2652: Detection of Transient Regional Myocardial Ischaemia in the Emergency Department Using a Novel Modification of Body Surface Electrocardiac Mapping is Superior to the Conventional 12 Lead ECG
Authors: Robinson Monique , Bannister Clare , Reddiar Richard , Curzen Nicholas 
Published: July 2021

Diagnosing transient regional myocardial ischaemia (TRMI) in patients presenting to the Emergency Department (ED) with acute chest pain is a challenge. The 12 lead ECG has established limitations and Troponin, though sensitive, is less reliable when used within 12 hours of symptom onset. The PRIME ECG Delta map is derived from 80 electrode electrocardiographic surface maps acquired (a) during chest pain and (b) when pain resolves. ST segment differences between scans are then displayed as colour changes on a torso map. In addition, the Ischaemic Burden (IB) - an index of the total extent of myocardial ischaemia -may be derived from the Delta Map.
Objectives: In a cohort presenting with cardiac-sounding chest pain: 1.To compare the sensitivity and specificity of the PRIME Delta map and the 12 lead ECG for the diagnosis of TRMI using coronary angiography as a diagnostic gold standard. 2. To evaluate whether the IB is a valuable diagnostic tool and examine its relationship with Troponin.
Methods: 80 lead ECGs were acquired for subjects with suspected TRMI when in pain and once pain free and a Delta Map derived. The IB was calculated as the sum of ST segment shift across all 80 electrodes. Subjects then underwent coronary angiography as clinically appropriate.
Results: For 51 adults studied, the PRIME Delta Map was more sensitive for the detection of TRMI than the 12 lead ECG 93% vs. 81%, p 0.04. The Delta map was also more specific for TRMI 57% vs. 29%, p= 0.03.The Delta map was superior to the 12 lead particularly for detecting lateral and posterior regions of TRMI 100 % detection vs. 75%, p= 0.02. The IB correlated with peak Troponin (r= 0.52, p= 0.0001) and was significantly higher in patients with STEMI compared to NSTEMI. ROC curve evaluation of the IB showed it was an accurate measure of myocardial ischaemia with Area Under the Curve of 0.6 (95% CI 0.38 – 0.84)
Conclusion: The PRIME ECG Delta map is a near patient, rapid, accurate and intuitive method for detecting TRMI and is superior to the 12 lead ECG. The IB derived from the Delta map might be a useful early surrogate for Troponin in patients with suspected TRMI. Used together, the Delta Map and IB could potentially facilitate more rapid identification and appropriate treatment in patients with coronary artery disease.
Abstract 4217: Prediction of Acute Coronary Syndrome Using Computed Tomography
Authors: Motoyama Sadako , Sarai Masayoshi , Harigaya Hiroto , Hara Tomonori , Inoue Kaori , Naruse Hiroyuki , Ishi Junnichi , Wong Nathan D , Hishida Hitoshi , Ozaki Yukio , Narula Jagat 
Published: July 2021

Background: Computed tomographic (CT) characteristics of culprit lesions in acute coronary syndrome (ACS) include positive remodeling (PR) and non-calcified plaques with low attenuation (NCP<30HU). Such imaging characteristics have almost always been described by evaluating the lesions that have already resulted in ACS. In a CT study, we identified the characteristics of atherosclerotic lesions which were associated with subsequent development of acute coronary syndrome (ACS).
Methods: 1067 patients who underwent CT angiography were followed for at least 12 months (mean = 28.0±10.6 months; range=12–50 months). The plaque characteristics of lesions resulting in ACS were compared with those not resulting in ACS.

Results: Twenty-six patients developed ACS after CT examination. Of these, 15 patients could be evaluated the culprit lesions. Of 1067 patients, 72 demonstrated plaque characteristics suggestive of vulnerable plaque; 45 plaques demonstrated both
PR
and NCP<30HU
(probably vulnerable)
; 27 had either PR or NCP<30HU
(possibly vulnerable).
Eight-hundred twenty patients did not demonstrate either of these characteristics
(probably stable).
Ten of 45 who had both PR and NCP<30HU developed ACS (22.2%), 1 had either PR or NCP<30HU (3.33%). Four of 820 patients with no PR or NCP<30HU (0.49%) developed ACS. PR and/or NCP<30HU was detected in 61 patients without subsequent development of ACS. Cox regression analysis was performed using 9 variables including age, gender, hypertension, hyperlipidemia, diabetes mellitus, obesity, smoking, prior myocardial infarction, and the presence of
probably
or
possibly
vulnerable plaques; the presence of
probably
or
possibly
vulnerable plaques was significant independent predictor of ACS (Hazard Ratio 14.38, p<0.001). There was significant increase in occurrence of ACS in patients with probably or possibly vulnerable plaques than patients without these plaque characteristics (15.3% vs 0.4%, loglank test p<0.001)

Conclusions: The CT-based atherosclerotic plaque characteristics responsible for subsequent ACS include NCP<30HU and positive remodeling; the presence of such plaques strongly predict development of ACS in patients with coronary artery disease.
Abstract 4487: Clopidogrel Resistance in Patients Undergoing Percutaneous Coronary Intervention: One Year Outcome
Authors: Chirumamilla Amala , Mehran Roxana , Weisz Giora , Brar Somjot S , Rabbani LeRoy , Morales Andy , Reddy Srilakshmi , Sugirtharaj Debora D , Franklin Dorothy , Fiscella Damiana , Sfakianakis Konstantinos , Collins Michael B , Leon Martin B , Stone Gregg W , Moses Jeffrey W , Dangas George 
Published: July 2021

Background: Clopidogrel therapy is critical in patients undergoing percutaneous coronary intervention (PCI). Data are lacking on long term outcomes of clopidogrel resistance (CR) and its definition.
Methods: We identified 389 patients who underwent PCI during a 6 month period. Using the VerifyNow Point-of-care assay, P2Y12 platelet reaction units (PRU) and percent inhibition of platelet activation (IPA) were measured 16 –24 hours after the loading dose of clopidogrel (600mg for patients not on clopidogrel daily, and 300mg for patients on clopidogrel 75mg daily) but before the next day clopidogrel dose. CR was defined as PRU >200, %IPA<10% or IPA<20%. Major adverse cardiac events (MACE) included death, myocardial infarction, coronary artery bypass graft surgery and unplanned repeat coronary revascularization.
Results: Mean age of patients was 65±11 years, 24% females and 31% diabetics. PRU mean value is 173±93, IPA mean value=47.5±42, CR is found in PRU>200 =36%(140), IPA<10% =8%(31), IPA <20% = 16.4%(64) patients. Presence of myocardial infarction, hypertension, hyperlipidemia, renal disease, smoking history, stable or unstable angina at admission were similar between the PRU groups and between IPA groups. Diabetes and older age were more prevalent in clopidogrel resistance patients. 1-year MACE rates are shown below.
Conclusion: Clopidogrel resistance is an important predictor of long-term MACE in patients undergoing PCI, particularly when defined as Platelet Reaction Units >200.
Abstract 4877: Clinical Phenotypes and Outcome of 101 LMNA Gene Mutation Carriers
Authors: Pasotti Michele , Serio Alessandra , Pilotto Andrea , Serafini Elena , Grasso Maurizia , Marziliano Nicola , Tagliani Marilena , Cassini Pamela , Digiorgio Barbara , Agozzino Manuela , Campana Carlo , Gambarin Fabiana , Ghio Stefano , Viganò Mario , Tavazzi Luigi , Arbustini Eloisa 
Published: July 2021

Purpose To analyze the cardiac phenotype and long-term follow-up of dilated cardiolaminopathies. Lamin A/C (LMNA) gene mutations cause a variety of phenotypes. In the cardiologic setting, patients diagnosed with idiopathic dilated cardiomyopathy (DCM) plus atrio-ventricular block (AVB) constitute the majority of reported cases.
Methods This was a longitudinal retrospective observational study conducted in 32 consecutive families in which LMNA gene defects were identified in the probands, sharing DCM phenotype.
Results Of the 171 family members, 101 were carriers of LMNA gene mutations. Sixty-five of 101 (64 %) were phenotypically affected while 36 (36 %) were only genotypically affected, including 5 with preclinical signs. The 65 patients had DCM with AVB (n=44), DCM with Ventricular Tachycardia/Fibrillation (VT/VF) (n=12), DCM with AVB and Emery-Dreifuss Muscle Dystrophy type 2 (EDMD2) (n=6), AVB plus EDMD2 (n=2), magnetic resonance imaging signs of arrhythmogenic right ventricular dysplasia associated with mild left ventricular dilation and VT (n=1). The disease was proven to be familial autosomal dominant (AD) in 23 of the 32 families; likely familial AD (based on pedigree and family history) in 8; and associated with a de novo mutation in 1. During a median follow-up of 57.4 months (interquartile range 26 –115 months) we observed 54 events in 47 DCM patients (7 had a later event excluded from the analysis) whereas no event was observed among the 36 non-affected carriers. The events were related to heart failure (HF) [15 heart transplants, 2 death from end-stage HF] and ventricular arrhythmias [17 sudden cardiac deaths (SCD) and 13 appropriate implantable cardioverter defibrillator (ICD) interventions]. By multivariable analysis, NYHA class III–IV and competitive sport ≥10 years were independent predictors of total events. By a bivariable Cox model, splice site mutations and competitive sport predicted SCD.
Conclusions DCMs caused by LMNA gene defects are highly penetrant, adult-onset, malignant diseases characterized by high rate of HF and life-threatening arrhythmias predicted by NYHA class, competitive sport activity and type of mutation.
Abstract 5659: Regular Atrial Tachycardias After Ablation Of Complex Fractionated Atrial Electrograms (CFAE) For Atrial Fibrillation: Acute Incidence And Recurrence In Clinical Follow-up
Authors: Reents Tilko , Hessling Gabriele , Fichtner Stephanie , Wu Jinjin , Estner Heidi L , von Bary Christian , Karch Martin R , Deisenhofer Isabel 
Published: July 2021

Background: The catheter ablation of atrial fibrillation (AF) can be performed by ablation of complex fractionated atrial electrograms (CFAE). Endpoint of CFAE ablation is the regularisation or termination of AF. However, the impact of regular atrial tachycardia (AT) occurring during CFAE ablation on long term outcome has not been investigated. Thus, it is not clear whether these tachycardias should be acutely targeted for ablation.
Methods: In 43 patients (31 male, age 62±9 years with paroxysmal (15 patients), persistent (25 patietns) or permanent AF (3 patients) organisation of AF to regular AT was achieved by ablation of CFAE. Mapping of AT with subsequent successful ablation was performed in 14/43 patients (33%), in the remaining 29/43 patients (67%) AT was terminated with external cardioversion or pace overdrive. After ablation procedure, patients were seen in our out-patient clinic with repetitive Holter ECG after 1, 3, and subsequently every 3 months and were intensively screened for the occurrence of regular AT.
Results: In follow-up 22/43 patients (51%) developed sustained AT necessitating in 20 patients repeat catheter ablation (12 patients) or external cardioversion (8 patients). AF had been paroxysmal in 7/22 and persisten in 15/22 patients with AT in follow-up. In 14/22 patients (63%), no attempt for ablation of AT had been made during the initial procedure, in 8/22 AT (36%) had been mapped and initially successful ablated. Of 21 patients without AT occurrence during follow-up, AF had been paroxysmal in 8/21 and persistent or permanent in 13/21 patients. AT had been mapped and ablated in 6 (29%) whereas in 15/21 patients (71%), AT had not been targeted. Ablation of AT during initial procedure, number of ablation applications, procedure and fluoroscopy duration were not predictive for freedom of AT in follow-up.
Conclusion: In our study, mapping and successful ablation of new onset regular atrial tachycardias (AT) occurring during ablation of CFAE for atrial fibrillation was not predictive for the occurrence of AT in follow-up. Thus, results after termination of AT by cardioversion was in long-term comparable to sometimes time-consuming mapping/ablation for AT.
Abstract 5709: The Pediatric Cardiac Quality of Life Inventory: A New Reliable and Valid Disease-specific Quality of Life Measure for Children and Adolescents with Congenital and Acquired Heart Disease
Authors: Marino Bradley S , Tomlinson Ryan , Wernovsky Gil , Drotar Dennis D , Hart Kim W , Buchakjian Elaine , Khoury Philip R , Baker Aimee , Coughlin Kaleigh , Shera David , Newburger Jane , Mahony Lynn , Mussatto Kathleen , Tong Elizabeth , Cohen Mitchell , Wray Jo , Gaynor James W , Helfaer Mark A , Kazak Anne E , Shea Judy A 
Published: July 2021

The Pediatric Cardiac Quality of Life Inventory (PCQLI) is a self-administered disease-specific quality of life (QOL) tool with patient and parent-proxy reporting (Child form 8 –12 yrs; Adolescent form 13–18 yrs), designed to assess the QOL of pediatric patients with congenital and acquired heart disease (CHD, AHD). Our purpose was to evaluate the reliability and validity of the PCQLI Seven centers recruited CHD and AHD patients age 8 –18 yrs. Patient-parent pairs completed the PCQLI, a generic QOL tool (PedsQL), and non-QOL questionnaires [Self Perception Profile for Children/Adolescents (SPPC/A); Youth Self Report and Child Behavioral Checklist (Achenbach)]. Test-retest reliability was evaluated by administering the PCQLI at 2 time points, and was assessed by Spearman correlation coefficient. Validity was tested by assessing:

differences in PCQLI score among heart disease subgroups;

associations between PCQLI score and the number of cardiac surgeries, catheterizations, hospitalizations, and doctor visits;

the correlation between patient and parent PCQLI scores; and

correlations between PCQLI score and the scores generated by generic QOL and non-QOL tools.

The study was completed by 1486 patient-parent pairs. Heart disease subgroups included: biventricular repair (45.4%); Fontan palliation (12.6%); unrepaired CHD (12.0%); heart transplant (4.4%); and AHD (25.6%). Correlations evaluating test-retest reliability were high (r=0.78 – 0.90). Lower PCQLI score was associated with Fontan palliation (p<0.001), as well as a greater number of cardiac surgeries, catheterizations, hospitalizations, and doctor visits (all p<0.001). Disattenuated correlations between patient and parent PCQLI scores were moderate (r = 0.51– 0.69). The PCQLI score and generic QOL score were highly associated (r = 0.62– 0.77). Lower PCQLI score was strongly associated with lower Global Self-Worth score on the SPPC/A (p<0.001), and lower Total Competency score (p<0.001), higher Syndrome Scale scores, and higher DSM Oriented Scale scores on the Achenbach (p<0.001). The PCQLI is a new disease-specific pediatric cardiac QOL tool that produces reliable and valid scores in children and adolescents age 8 –18 yrs.
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 5715: Development Of A Temporary Lead For In Utero Pacing: A New Approach For Cardiac Interventions In Fetuses
Authors: Boudjemline Younes , Rosenblatt Jonathan , Bonnet Damien , Jouannic Jean-Marie 
Published: July 2021

Background: Cardiac fetal intervention has been applied to human. It is presently limited to

the dilatation of obstructive valvular diseases and

the creation or dilatation of atrial septal defect in fetuses with hypoplastic left heart syndrome and restrictive atrial septal defect.

In this study, we propose a new application of fetal intervention represented by fetal pacing using a specially designed implantable pacing lead in the fetal lamb.
Methods and results: In twelve pregnant ewes (110 –112 days’ gestation), a 17 Gauge needle was placed in contact with cardiac chambers under echo-guidance. Using the lumen of the needle, a 3Fr unipolar pacing lead was advanced and fixed on the cardiac wall using a built-in screw. Pacing was, then, attempted using an external pacing system. Assessment of pacing was confirmed using ultrasound modalities. Pacing lead insertion was successful and uncomplicated in all 15 attempts (atrial and/or ventricular wall respectively n=3 and12) excepted one. In the first fetus, the needle was advanced too far into the right ventricle leading to pericardial bleeding after the retrieval of the needle. The fetal heart rate was overdriven in all at 220/min using the lead. After assessment, pacing lead was unscrewed and retrieved without any complication. Pregnancy was electively interrupted in 6 animals. The other six fetuses were delivered vaginally after an uneventful pregnancy and autopsy at day 3 did not show any significant injury.
Conclusion: Echo-guided fetal pacing is feasible using a specially designed lead. It enlarges present indications of human fetal cardiac interventions.
Abstract 5750: Protruding Atheroma in the Thoracic Aorta Detected by Multislice Computed Tomography Can Predict the Future Vascular Events
Authors: Takeda Yoshihiro , Hoshiga Masaaki , Morinaga Izumi , Junko Hotchi , Fujisaka Tomohiro , Yuki Takahito , Tatsugami Fuminari , Tanigawa Jun , Ishihara Tadashi , Hanafusa Toshiaki 
Published: July 2021

(Purpose) Protruding atheroma in the thoracic aorta (PATA) has been reported to be associated with coronary artery disease and future embolic disease in previous studies using transesophageal echocardiography. Recently multislice computed tomography (MSCT) has been available for the diagnosis of coronary artery disease and it can also detect PATA. The clinical impact of PATA detected by MSCT has not been examined. The purpose of this study was to investigate whether the presence of PATA by MSCT can predict future vascular events (coronary revascularization (CR) and embolic events).
(Methods) From November 2005 to March 2008, 511 consecutive patients (male 56%, age 66±11y.o.) with suspected ischemic heart disease underwent MSCT. The exclusion criteria were atrial fibrillation, renal insufficiency, or a history of CR or cardiothoracic surgery. According to the aortic plaque thickness, we divided patients into 3 groups: Group 1 (<2mm, n=332), Group 2 (2– 4mm, n=146), Group 3 (>4mm, PATA, n=33).
(Results) Risk factors were: hypertension (68%), diabetes (41%), hypercholesterolemia (57%), and smoking (44%). During follow-up period (15.6-month median), CR was required for 68 patients (59 PCI and 9 CABG). Univariate analysis showed that the patients required for CR were of significantly higher prevalence of all the risk factors, aortic plaque (Group 2, 3) and calcification of coronary artery, aortic and mitral valve. Multivariate analysis showed that requirement of CR was independently associated with aortic plaque, smoking, or coronary calcification, and PATA revealed the highest odds (odds ratio 7.4, 95% confidence interval 3.1 to 17.6) among them. Embolic events occurred in 7 patients (5 brain, 1 bowel, and 1 kidney and lower extremity) during follow-up period. By univariate analysis, only smoking and PATA revealed significantly higher prevalence in patients with embolic events (p=0.02 and<.0001, respectively). Multivariate analysis showed that PATA was an independent predictor for future embolic events (odds ratio 10.7, 95% confidence interval 1.6 to 70.4).
(Conclusions) PATA detected by MSCT can predict future vascular events. We should be aware of the presence of PATA by MSCT as a risk for the future cardiovascular events.
Abstract 22: Influence of Smoking and Sex on Genetic Associations of Body Fat Distribution: The Giant (Genetic Investigation of ANthropometric Traits) Consortium
Authors: Young Kristin L , Hadley David , Justice Anne , Winkler Thomas , Graff Misa , Ngwa Julius , Czajkowski Jake , Ahluwalia Tarunveer S , Xue L. , Qi Quibin , Mahajan Anubha , Qi Lu , Franks Paul , Monda Keri , Heard-Costa Nancy L , Kilpeläinen Tuomas O , Loos Ruth , Borecki Ingrid , North Kari , Cupples L. Adrienne 
Published: July 2021

Visceral fat and smoking are important risk factors for CVD and other long-term poor health outcomes. Central adiposity is frequently assessed in population studies using waist-to-hip ratio adjusted for BMI (WHRadjBMI). Genome-wide association studies (GWAS) have discovered loci that influence WHRadjBMI, sometimes with sex-specific effects. However, we do not know whether and how smoking behavior influences the association between genetic variants and WHRadjBMI. Our study investigates the influence of smoking and genetic variants on WHRadjBMI, with particular consideration for differential effects by sex.
Forty-one GIANT GWAS (108,397 participants) were used to investigate the influence of smoking on SNP WHRadjBMI associations using sex-stratified models considering SNP main effects adjusted for smoking status, and SNP main effects stratified by smoking status. Results from each study were meta-analyzed using an inverse-variance weighted fixed-effects model for men and women separately as well as combined.
A total of 19 SNPs reached genome-wide significance (p<5x10-8) having adjusted the SNP effect for smoking across strata (women, men, and combined), including 11 previously reported WHRadjBMI loci. For known WHRadjBMI loci, the influence of smoking varied by sex. In women, four known WHRadjBMI SNPs (TBX15, DNM3, RSPO3, and ADAMTS9) had a greater effect in smokers vs. nonsmokers (TBX15: β(SE) = 0.0506 (0.014), p = 3.84x10-4) vs. β(SE) = 0.0382 (0.0072), p = 1.14x10-7). Three of these (TBX15, DNM3, RSPO3) have been previously associated with tobacco use disorder (TUD). In men, three known WHRadjBMI loci (ADAMTS9, DNM3, ZNRF3) had a greater effect among smokers vs nonsmokers (ZNRF3: β(SE) = 0.0365 (0.0148), p = 1.37x10-2) vs β(SE) = 0.0192 (0.0088), p = 12.87x10-2). Eight of our 19 top SNPs have not been previously associated with WHRadjBMI (within 500 kb). Of these eight loci, distinct patterns of association by smoking and sex were again noted. In addition, one locus (ABCA1) has been previously associated with TUD.
In addition to identifying novel loci associated with body fat distribution, these findings underscore the importance of considering the effect of smoking when investigating the genetics of obesity related phenotypes and emphasize the need to consider sex separately when studying the effects of smoking on body fat distribution.