bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 1768: Magnetic Resonance Imaging Reveals Novel Phenotypic Expression of Desmosomal Mutation in First-Degree Relatives of Patients with Arrhythmogenic Right Ventricular Dysplasia (ARVD). Prevalence and Clinical Significance in Patients Evaluated For ARVD.
Authors: Tandri Harikrishna , Dalal Darshan , Jain Aditya , Judge Daniel P , Abraham Theodore , James Cynthia , Daya Samanthapudi K , Tichnell Crystal , Russell Stuart , Calkins Hugh , Bluemke David A 
Published: July 2021

Background: In this report we present the prevalence and significance of a novel MRI abnormality that we identified in desmosomal mutation positive asymptomatic relatives of arrhythmogenic right ventricular dysplasia (ARVD) patients.
Methods: MRI of 38 first-degree relatives was analyzed for abnormalities blinded to the mutation status. Focal crinkling of the right ventricle (accordion sign) was observed in 15/25 mutation positive vs. 0/13 mutation negative patients. The presence of this finding was sought in 207 patients evaluated for ARVD blinded to clinical history and was correlated with electrophysiologic findings.
Results: Mean age of the population was 32±16, 61% had a family history of ARVD. Based on non-invasive testing the 207 patients were classified into 4 groups 1) 106 normal, 2) 57 Idiopathic ventricular tachycardia (VT), 3) 33 probable ARVD, 4) 11 definite ARVD. A family history of ARVD was present in 74%, 0%, 67% and 36% respectively. 43 patients had the “accordion sign” and the prevalence in the four groups was 10%, 5%, 70% and 100% respectively. The abnormality was seen in the sub-tricuspid region in 62%, outflow tract in 30% in both regions in 8%. After excluding group 4, 48% of patients with the accordion sign had T wave inversion’s beyond V1 compared with 7% of those without the sign (p<0.001). During electrophysiologic testing, reentrant VT could be induced in 44% (7/16) of patients with accordion sign compared to 2% (1/48) without the sign (p<0.01).
Conclusion: Focal crinkling of the RV termed “Accordion sign” may represent an early manifestation of ARVD that correlates with mutation positive status and predicts inducibility of ventricular arrhythmias.
Abstract 1878: Improved Detection of Viable Myocardium by a Novel Strain Doppler Measure in Patients with Acute Myocardial Infarction
Authors: Vartdal Trond , Pettersen Eirik , Helle-Valle Thomas , Lyseggen Erik , Smith Hans-Jørgen , Andersen Kai , Smiseth Otto A , Edvardsen Thor 
Published: July 2021

BACKGROUND: Detection of viable myocardium is vital for treatment strategy during acute myocardial infarction (AMI). The aim was to study if strain Doppler echocardiography (SDE) prior to reperfusion therapy could predict viable myocardium in AMI as determined by cardiac magnetic resonance imaging (CMR).
METHODS: Twenty-five patients (58 ± 12 years, 7 women) with AMI who underwent percutaneous coronary intervention (PCI) were examined by SDE immediately prior to PCI. End-systolic longitudinal strain and duration of systolic lengthening was analyzed in 16 left ventricular segments. CMR was performed 11 ± 4 months after reperfusion therapy. Scars exceeding 50% of the segment was considered non-viable.

RESULTS: Duration of systolic lengthening in non-viable myocardial segments was 249 ± 135 ms compared to 39 ± 86 ms in viable segments (p<0.0001), with a direct relationship to scar transmurality (r=0.89, p<0.0001). A duration of systolic lengthening longer than 67.3% (~2/3) of systole (Figure

) detected non-viable myocardium by a sensitivity of 90% and a specificity of 93%. Strain demonstrated end-systolic shortening (−15 ± 6%) in viable segments in contrast to lengthening in non-viable segments (3 ± 4%, p<0.0001). End-systolic strain correlated also with the scar transmurality (r=0.71, p<0.0001).

CONCLUSION: SDE performed before reperfusion therapy in AMI can identify viable myocardium. Duration of systolic lengthening which is a novel parameter might prove to be a superior measure for predicting recovery of myocardial function.
Abstract 1940: Coagulation Activity is Increased in the Left Atrium of Patients with Paroxysmal Atrial Fibrillation
Authors: Motoki Hirohiko , Tomita Takeshi , Aizawa Kazunori , Kasai Hiroki , Izawa Atsushi , Kumazaki Setsuo , Tsutsui Hiroshi , Koyama Jun , Ikeda Uichi 
Published: July 2021

Background: Measurements of plasma markers which reflect thrombin activity (thrombin-antithrombin III complex; TAT), active fibrinolysis (plasmin-alpha 2-plasmin inhibitor complex; PIC), and platelet activity (platelet factor 4; PF4) are useful in identifying patients with various cardiovascular disorders at high risk of thromboembolism. In this study, we investigated the hemostatic status of the left atrium in patients with paroxysmal atrial fibrillation (pAF).
Methods: Patients with pAF (n=10) and chronic AF (cAF) (n=10), and control subjects without AF (n=10) were enrolled in this study. TAT, PIC, and PF4 levels were determined in specimens of blood obtained from the left atrium of AF patients who were undergoing catheter ablation. The blood specimens were also obtained from the left ventricle of control subjects.
Results: Levels of PIC and PF4 did not differ significantly among 3 groups, whereas TAT levels in the left atrium of pAF and cAF patients were significantly higher than those in the left ventricle of control subjects (pAF: 29±19ng/ml, cAF: 28±19ng/ml, control: 3.1±3.0ng/ml, p<0.01).
Conclusion: We demonstrated for the first time that coagulation system is activated in the left atrium of pAF patients as well as cAF patients. This result suggests that even in a non-paroxysmal period, pAF patients are at high risk of thromboembolism, and anticoagulation therapy is indicated in those patients.
Abstract 2002: Dual Mechanism of Blood Flow Augmentation to the Brain using an Impedance Threshold Device in a Pediatric Model of Cardiac Arrest
Authors: Alexander Carly , Yannopoulos Demetris , Aufderheide Tom , McKnite Scott , Matsuura Tim , Metzger Anja , Lurie Keith 
Published: July 2021

Background: During cardiac arrest use of an impedance threshold device (ITD) increases circulation and the chances for survival. The ITD has not been systematically evaluated during conventional CPR in a pediatric animal model. We hypothesized that the ITD increases blood flow to the brain by lowering intrathoracic pressure during the CPR decompression phase thus

enhancing venous return to the right heart and forward flow with the subsequent compression and

maintaining or lowering diastolic intracranial pressure (ICP) thus reducing resistance to forward flow. In this manner ITD use was hypothesized to mimic the ‘gasping reflex’ during CPR.

Methods: In the first study 9 female propofol anesthetized piglets (10–12 kg) were subjected to 6 min of untreated ventricular fibrillation, 6 min of conventional CPR (ventilation rate 10 bpm), then 6 min of CPR with an active ITD (resistance of −10 cm H20). A second study was similar except that a sham ITD was used in 8 piglets.
Results: After 2 min of active ITD treatment, decompression phase airway pressures (surrogate for intrathoracic pressure) (mmHg) decreased from −0.5 ± 0.2 to −2.6 ± 0.5 (mean ± SEM, p < 0.001) and common carotid blood flow (mL/min) increased by 65% (59.2 ± 16.7 to 91.1± 27.9, p = 0.02). In the sham group, airway pressures were unchanged and carotid blood flow decreased from 39 ± 2.5 to 38.8 ± 4.3 (p = 0.47). ICP decreased more rapidly in time and to a greater degree in 6/9 piglets when comparing ITD use to measurements preceding its application, contributing to an increase in cerebral perfusion (CePP) (mmHg) in 5/9 active ITD piglets, while in the sham group, CePPs remained the same or decreased in 8/8 piglets (p = 0.03). Coronary perfusion pressures (CPP) (mmHg) increased in 5/9 piglets after 2 min of the active ITD and remained the same or decreased in 8/8 piglets treated with the sham device (p = 0.03). Return of spontaneous circulation was achieved with a single shock in 4/9 active ITD piglets and 1/8 sham ITD piglets (p = 0.29).
Conclusions: Use of an active ITD during CPR in piglets significantly increased carotid blood flow and CPPs. The ITD also lowered ICP during the decompression phase, similar to the mechanism of the ‘last gasp’, thereby reducing resistance to forward blood flow to the brain.
Abstract 2051: Recombinant Factor VIIa Affects Vein Graft Patency and Flow in Rabbits
Authors: Mazer David , Leong-Poi Howard , Alfardan Zuhair , Wang Zhilan , Qiang Beiping , Mahoney James , Latter David , Strauss Bradley , Teitel Jerry 
Published: July 2021

INTRODUCTION: Recombinant factor VIIa (rVIIa) has been used to decrease postoperative bleeding in cardiac surgical patients. However, there is potential for rVIIa to interact with tissue factor expression at the site of new anastomoses resulting in early graft occlusion. This safety study tested the hypothesis that the administration of rVIIa dose-dependently reduces graft patency at the site of new vascular anastomoses comparable in size to human coronaries, in a rabbit model.
METHODS: After ACC approval, a reversed venous graft was fashioned in the right carotid artery using autologous right jugular vein with 9 – 0 sutures in 64 anesthetized and heparinized rabbits. Animals were then given either one of three doses of rVIIa (300 ug/kg, 90 ug/kg or 20 ug/kg IV) or placebo (n=16/group). The primary outcome was graft patency, measured by a blinded observer 24 hours postoperatively using vascular ultrasound (HDI 5000cv, 15 MHz probe) and/or direct inspection. Factor VII activity levels were measured from citrated plasma samples with a 1-stage prothrombin time-based assay using rabbit thromboplastin. Data was analyzed using chi-square, fishers exact test, or ANOVA where appropriate, with p<0.05 considered significant.
RESULTS: Physiologic variables (ACT, hemoglobin, pH, pCO2) and vessel diameter were similar between groups. Graft patency and flow were significantly reduced, and plasma factor VII levels significantly increased in the rVIIa treated rabbits in a dose-dependent fashion.
DISCUSSION: The study suggests that high doses of rVIIa (300 and 90 ug/kg) are associated with an increased incidence of occlusion of new vascular grafts. A clear dose-response effect was observed, suggesting that higher doses may be associated with increased thrombotic outcomes.
Abstract 2223: Shear Induced Platelet Function Is Highly Increased In Patients With Cardiac Arrest Undergoing Cardio-pulmonary Resuscitation (CPR)
Authors: Spiel Alexander O , Mayr Florian B , Frossard Martin , Kliegel Andreas , Losert Heidrun , Sterz Fritz , Laggner Anton N , Jilma Bernd 
Published: July 2021

Background: The prognosis of patients with cardiac arrest is still poor, and hardly any specific therapeutic options exist to improve outcome. Platelet activation has been observed in patients undergoing cardiopulmonary resuscitation (CPR). This may contribute to impairment of microcirculatory function and overall poor outcome despite return of spontaneous circulation. Data on direct platelet function in cardiac arrest are scarce. Platelets of patients with myocardial infarction are hyperfunctional, which predicts the degree of myocardial necrosis. Thus, we hypothesized that platelets may be even more hyper-functional in patients whose myocardial infarction causes cardiac arrest. We determined platelet function under high shear rates of patients with cardiac arrest and were further interested whether this may be related to the cause of cardiac arrest.
Methods: We conducted a prospective study in 77 cardiac arrest patients at the Emergency Department of a tertiary care hospital. Collagen adenosine diphosphate closure time (CADP-CT) was assessed by the FDA-approved platelet function analyzer (PFA-100). In addition, plasma levels of von Willebrand factor (vWf:RiCo) were measured by turbidometry. Independent staff members of the emergency department not otherwise involved in this trial diagnosed the origin of cardiac arrest.
Results: More than half of cardiac arrests were caused by myocardial ischemia. CADP-CT values (54s; 95%CI: 48–60s in 3.8% citrate) were much shorter in these patients as compared to patients with other causes of cardiac arrest (110s; 95%CI: 84–135s, p<0.001). This is substantially less than the 87s (95%CI: 80–94s) in patients with ST-elevation myocardial infarction as previously published. vWf:RiCo levels were substantially increased above the upper normal limit (180 U/dL) in all patient groups.
Conclusion: Patients with myocardial ischemia triggered cardiac arrest displayed the highest degree of platelet hyper-function under high shear rates, which was not solely due to increased vWF. Those patients may benefit from a rapid, more aggressive anti-platelet therapy than currently performed or an anti-vWF targeted therapy.
Abstract 2481: Myocardial Viability Determined by Myocardial Contrast Echocardiography is Superior to
99m
Technetium Sestamibi Single Photon Emission Computed Tomography in Predicting Hard Cardiac Events Following Acute Myocardial Infarction
Authors: Dwivedi Girish , Janardhanan Rajesh , Hayat Sajad A , Swinburn Jonathan A , Senior Roxy 
Published: July 2021

Introduction: The extent of residual myocardial viability (MV) following acute myocardial infarction (AMI) is an important determinant of outcome.
99m
technetium sestamibi single photon emission computed tomography (SPECT) is widely used to assess MV following AMI.

Hypothesis: We hypothesised that myocardial contrast echocardiography (MCE) which has a better spatial and temporal resolution compared to SPECT will be superior for predicting outcome following AMI.
Methods: Accordingly, 99 patients who underwent simultaneous resting low-power MCE & nitrate enhanced SPECT 7 days after AMI were followed up for cardiac death (CD) and AMI. Both SPECT (0=normal;1=mild reduction ;2=moderate reduction;3=severe reduction;4=absent tracer uptake) & MCE perfusion (1=normal;2=reduced;3=absent) were scored on a 16 segment left ventricular (LV) model. Contrast perfusion index (CPI) on MCE and SPECT perfusion index (SPI), both measures of MV, were calculated by adding the respective scores in the 16 LV segments divided by 16.
Results: Ninety five patients were available for the follow up (mean 46 months). There were 15 (16%) events (8 CDs & 7 AMIs). Area under the receiver operator characteristic curves for predicting CD and CD or AMI with MCE (0.82 and 0.80 respectively) were higher compared to SPECT (0.76 and 0.74 respectively). Amongst the clinical, biochemical, echocardiographic and SPECT markers of prognosis, only independent predictors of cardiac death and cardiac death or AMI were age and MV determined by MCE (p=0.01 & p=0.002 respectively).
Conclusion: MV determined by resting MCE is superior to nitrate enhanced SPECT for the prediction of hard cardiac events following AMI.
Abstract 2569: Tissue Doppler Imaging In The Evaluation Of Infarcted Segmental Myocardial Function In Stemi Reperfused Patients: Correlation With Myocardial Blush Grade.
Authors: Inches Elena , Mancone Massimo , Sardella Gennaro , Scardala Raffaele , Colantonio Riccardo , Brasolin Bruno , Caira Carmen , Fedele Francesco 
Published: July 2021

Background: The myocardial blush grade (MBG) during primary-PCI predicts long-term recovery of left ventricular function. Tissue Doppler imaging (TDI) quantitatively assess regional myocardial function by measuring systolic strain (SS). No data are available on the correlation between MBG and the infarcted segmental systolic function by TDI in STEMIpts.
Methods: We evaluated 40 STEMI pts, divided in four groups (MBG 0; MBG 1; MBG 2; MBG 3) 10 pts for each goup. Primary PCI was performed according to current standard guidelines. Coronary angiograms were analyzed off-line by two expert interventional cardiologists in a blinded manner. MBG were estimated visually. Sixteen-segments model was applied and regional myocardial function was evaluated, immediately after primary PCI, by measuring SS by TDI . Only SS value in infarcted segments was correlated with the MBG.

Results: No significative difference was observed between groups except for family history of CAD that was higher in MBG 2 group. Mean ejection fraction (39,1 ± 8,8%) and mean symptoms to balloon time(4.3 ± 1.6 h ) was similar in the population. 136 infarcted segments were studied by TDI. A significant direct correlation between the MBG and the SS (r=0.79; p<0.005) (Fig.1

). We also observed a significative difference (p<0.005) between mean SS in pts with MBG ≤0 –1 (7.6 ± 2.4%) and in pts with MBG≥2–3(22.6 ± 5.2).

Conclusions: Abnormal values of SS was observed in infarcted segments. The significant correlation observed between the MBG and SS may demonstrate that MBG represent an important predictive index not only of good reperfusion but also of rapid segmental function recovery; similarly an evaluation of SS after primary PCI could be useful to evaluate if primary percutaneus reperfusion has been effective or not.
Abstract 2691: Independent Relation Of Aortic Stiffness With Subclinical Left Ventricular Myocardial Dysfunction In Patients With Cardiovascular Risk Factors
Authors: Malshi Emona , Morizzo Carmela , Guerra Elena , Kozakova Michaela , Florescu Maria , Vinereanu Dragos , Palombo Carlo 
Published: July 2021

Introduction: increasing evidence suggests a major role of arterial stiffness in determining transition towards heart failure in patients with cardiovascular (CV) risk factors. An increased LV mass resulting from augmented LV impedance associated with aortic stiffness may partly account for this finding.
Aim of the study: to investigate the possible association of aortic stiffness with LV geometry, mass (LVM) and load-independent indices of myocardial function in patients with CV risk factors.
Materials and methods: 129 subjects were studied, 47 healthy controls (27 males, mean age 45.6 Â± 11 years) and 82 patients with at least one major CV risk factor, and without clinical CV disease or evidence of inducible myocardial ischemia (49 males, mean age 45.5 Â± 17 years). LV mass, geometry, systolic pump function, diastolic filling and intrinsic myocardial performance were assessed by a comprehensive echocardiographic study (Aloka SSD-5500, Japan) including 2-D targeted M-mode and apical 4-chamber view of the LV, transmitral Doppler, and Tissue Doppler Imaging (TDI). LV myocardial longitudinal velocities were studied at medial mitral annulus and interventricular septum (IVS) level. Carotid-femoral pulse wave velocity (PWV), an index of aortic stiffness, was measured by the foot-to-foot method (Complior, Artech, Paris).
Results: in the overall population, PWV correlated (p<0.01) directly with LVM (r=0.410) and inversely with transmitral E/A ratio (r=- 0.528), Em/Am ratio at mitral annulus (r=-0.603) and interventricular septal level (r=-0.497). No significant relations were found with indices of LV systolic function (both chamber and myocardial). In a stepwise regression analysis model (age, CF-PWV, diastolic blood pressure, LVM) only age and CF-PWV entered as independent determinants of TDI Em/Am (squared r value: 0.55, p<0.01).
Conclusion: in a population including normal subjects and patients with risk factors and free of CV disease, an increased aortic stiffness is associated with subclinical impairment of LV myocardial diastolic function independently of LV mass and blood pressure.
Abstract 2883: Long-term Survival and Cardiac Troponin T Elevation in On- and Off-pump Coronary Artery Bypass Surgery
Authors: Brown Jeremiah R , Hernandez Felix , Klemperer John D , Clough Robert A , DiPierro Francis V , Hofmaster Patricia A , Ross Cathy S , O’Connor Gerald T 
Published: July 2021

Introduction: The long-term clinical usefulness of conventional coronary artery bypass graft surgery (CCAB) and off-pump surgery (OPCAB) remains controversial. Long-term survival and cardiac troponin T (cTnT) elevation following CCAB and OPCAB has not been assessed. We tested the hypothesis that long-term survival was similar for CCAB and OPCAB patients when stratified by the presence or absence of cTnT elevation.
Methods: In this prospective cohort, we followed 1511 non-emergent patients with 2 or 3 vessel disease (778 CCAB and 733 OPCAB) from a single hospital in Northern New England by surgeons using both procedures between 2000–2004 to determine if 6-year survival was similar for CCAB and OPCAB patients. Postoperative cTnT elevation was defined at ≥1 (ng/μL). Data was linked to the Social Security Administration Death Master File. Kaplan-Meier and log-rank techniques were used. Cox’s proportional hazard models were used to calculate adjusted hazard ratios (HR) and 95% confidence intervals (95%CI), adjusting baseline patient and disease characteristics.

Results: Patients were similar with regard to baseline disease characteristics, comorbidities, cardiac history, function and anatomy. CCAB was associated with higher 6-year survival compared with OPCAB regardless of troponin elevation (Figure

, p<0.0001). Adjusted HR (CCAB cTnT <1 as referent) were 1.57 (1.05–2.36) for OPCAB cTnT<1, 1.52 (0.95–2.43) for CCAB cTnT ≥1, and 2.50 (1.37–4.58) for OPCAB cTnT≥1.

Conclusion: In summary, CCAB results in better survival over OPCAB in patients presenting with two or three vessel disease undergoing non-emergent cardiac surgery.
Abstract 2928: Sudden Arrhythmic Death Syndrome-Diagnostic Yield Of Combined Clinical & Genetic Screening In A British Specialist Clinic
Authors: Lambiase Pier D , Kaski Juan C , Firman Eileen , Elliott Perry M , Ahmed Akbar K , Chow Anthony W , Sheppard Mary , Lowe Martin D , Christiansen Michael , McKenna William J 
Published: July 2021

Introduction: Sudden arrhythmic death syndrome (SADS) arises through disorders of ion channel function or structural heart disease. It accounts for over 400 deaths in the UK per annum. To date there has been no comprehensive analysis of the diagnostic yield and efficacy of a family screening approach in SADS index cases where the post mortem heart is structurally normal after expert pathological review.

Methods: 118 SADS families where the SADS victim died between 1 and 35 years of age were evaluated in a systematic family screening programme between 2003–2006. All SADS index cases had a structurally normal heart after expert review of all available tissue. All studied relatives underwent resting, signal averaged ECG, 24h Holter, exercise ECG with V0
2
max, transthoracic echocardiography and an ajmaline challenge test after initial clinical screening. Systematic mutation analysis was performed on the known long QT (LQT)genes including SCN5A & ryanodine receptor/ARVC genes when clinically suspected.

Results: The most common modes of death were rest in 28%, sleep in 25% and exercise in 18%. Clinical screening identified an inherited electrical cause of SADS in 41 of the 118 families (35%)-20 Brugada, 18 LQT Syndrome, 3 Catecholiminergic Polymorphic Ventricular Tachycardia (CPVT). Structural heart disease was identified in 5 ARVC & 2 DCM families. 26 ICDs have been implanted in affected family members-4 LQTS, 7 Brugada, 2 CPVT, 2 ARVC, 2 DCM and 9 on clinical grounds without a definitive diagnosis. The ECG (37%) and ajmaline challenge test (49%) had the highest diagnostic yield in families with a positive diagnosis. To date, genetic testing has increased the diagnostic yield by 5% (6/118 families-2 KCNQ1, 1 HERG, 2 SCN5A, 1 ARVC ), confirming a clinical diagnosis in 6.6%–3 KCNQ1, 3 SCN5A, 1 HERG, 1 KCNH2.
Conclusions: Systematic clinical screening in relatives of SADS victims has a diagnostic yield of 35% increasing to 40% with genetic testing. Electrical causes of SADS predominate in these families. These findings demonstrate that a systematic clinical screening programme in SADS families is both achievable and effective. The full impact of gene testing (including RyR mutations) upon diagnostic yield is awaited.