bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 1818: Beneficial Effects of Weight Loss Associated with a High Protein Diet on Cardiovascular Risk Profile, Functional Status and Quality of Life in Obese Heart Failure Patients: A Feasibility Study
Authors: Evangelista Lorraine S , Heber David , Li Zhaoping , Hamilton Michele , Fonarow Gregg C 
Published: July 2021

OBJECTIVE: Clinical management of chronic heart failure (HF) related to adequate nutritional intake currently lacks a strong scientific basis. This study was conducted to evaluate the impact of 3 diet interventions on body weight and its potential to reduce cardiovascular risks and improve functional status.
METHOD: Fourteen obese HF patients (BMI > 27 kg/m2) were randomized to1 of 3 diets: high protein (HP); low fat (LF) or average diet/control group (CG). Body anthropometrics (weight, BMI, waist circumference), indices of cardiovascular risks including (% body fat, blood pressure, cholesterol, triglycerides), and measures of functional status (6-minute walk, max VO2) were obtained at baseline and after a 12-week nutritional support program. Statistics included two-way RMANOVA.

RESULTS: There were no significant differences in age (59±10 years), gender (78% male), NYHA (43% class II; 57% class III), HF etiology (57% non-ischemic), or ejection fraction (0.26±0.07) between the groups. The HP diet resulted in moderate reductions in body weight (Figure

) and improvements in several health parameters (Table

).

CONCLUSION: The data show that in a small group of obese HF patients, a 12-week HP diet resulted in moderate weight loss that was associated with reduced cardiovascular risks and better functional status. However, the long-term effects of a HP diet remain uncertain.

Figure

Comparison of Weight Changes in the HP, LF and CG from Baseline to 12 Weeks

Mean changes in outcomes from baseline to 12 weeks, by diet group and time
Abstract 1844: Increased Mortality And Perioperative Complications In Patients After Previous Elective Percutaneous Coronary Interventions Undergoing Coronary Artery Bypass Surgery
Authors: Bonaros Nikolaos , Hennerbichler Diana , Alber Hannes , Kocher Alfred , Pachinger Otmar , Laufer Guenther , Bonatti Johannes 
Published: July 2021

Introduction. The number of patients with previous Percutaneous Coronary Interventions (PCI) referred to Coronary Artery Bypass Grafting (CABG) is continuously increasing. The relationship between previous elective PCI and the perioperative outcome after CABG remains undetermined. The aim of the study was to investigate whether patients referred to CABG after previous elective PCI have an increased perioperative risk.
Methods. Between January 2002 and May 2007, 4412 consecutive patients underwent first-time open heart surgery at our department. After excluding patients with a history of emergent PCI, we isolated 306 patients after previous elective PCI during the last 24 months before CABG (Group 1). Those patients were compared to 452 consecutive patients without history of previous PCI, who underwent CABG during the same period and who were matched for age, gender and preoperative risk factors (Group 2). Both groups were compared in terms of 30-day mortality, Major Adverse Cardiac Events (MACEs), and perioperative complications.
Results. Both groups were comparable concerning preoperative linear EuroSCORE (Group 1: 4.83±0.18, Group 2: 4.72±0.14, p=0.63). Patients with previous elective PCI before CABG had increased perioperative mortality (Group 1: 3.3% vs Group 2: 1.9%, p<0.001) and MACEs (Group 1: 7.9% vs 4.3%, p<0.001). This fact was associated with a worse logistic perioperative outcome (Group 1: 1.26±0.39, Group 2: 2.33, p=0.044). In addition, the incidence of bleeding complications (Group 1: 5.9% vs Group 2: 3.8%, p=0.017) and the number of blood products (Group 1: 1.70±0.31 vs 0.61±0.17, p<0.001) used were higher in patients of the Group 1. A higher incidence of acute renal failure (Group 1: 5.9% vs 2.7%, p=0.025) and renal replacement therapy (Group 1: 3.6% vs Group 2: 1.7%, p=0.03) was observed in patients of the same group.
Conclusions. Patients with previous elective PCI before referral to CABG have a worse perioperative outcome in terms of mortality, MACE and perioperative complications as compared to patients with no history of PCI.
Abstract 1872: New Fusion Technique Significantly Improves Image Quality and Completeness of Datasets in Real Time 3 Dimensional Echocardiography
Authors: Szmigielski Cezary , Grau Vicente , Hoeschen Martin , Noble J. A , Kerber Richard , Becher Harald 
Published: July 2021

Introduction: Real time 3 dimensional echocardiography (RT3DE) still presents a challenge for full volume acquisition in many patients because of incomplete datasets due to inadequate sector width and/or limited acoustic windows.
Hypothesis: We assessed the hypothesis that fusion of standard datasets from different transducer positions improves the completeness and image quality of RT3DE.
Methods: We studied 14 patients (mean age 47.0±22 yrs, 9 men, 5 women) referred for echocardiographic assessment of LV function. Standard full volume RT3DE was performed with an iE33 scanner with X3 probe (Philips Medical Systems, Andover, USA). We fused at least 2 standard RT3DE datasets from different transducer positions using a new, developed on site technique. All standard and fused datasets were processed with research software (Research Arena, TomTec, Germany). Readings were done by an experienced echocardiographer, who graded endocardial border definition and wall thickening: good quality: grade 2; intermediate: 1; poor or out of sector: 0. We studied separately segments in the short axis view (PSAX) and in apical views, yielding 32 segments per patient and total 896 cardiac segments for standard and fused datasets.

Results: Table 1

summarizes the segmental quality assessments using the 2 techniques, and the number of segments per patient (mean±SD). Quality gains from grade 0 to 1 and 1 to 2 in the fused images were similarly distributed among PSAX and apical segments.

Conclusions: The new fusion technique improved analysis of segmentation of the heart with RT3DE when compared with standard datasets. It increased the number of segments available for assessment and upgraded their image quality.

Table 1
Abstract 2018: Cardiac Arrest in the Emergency Department: A Report from the National Registry of Cardiopulmonary Resuscitation
Authors: Kayser Robert G , Ornato Joseph P , Peberdy Mary Ann 
Published: July 2021

Background: Little is known about cardiac arrests (CA) in the Emergency Department (ED). The objective of this study was to determine the characteristics of ED CA’s.
Methods: Included were 60,852 adult, in-patient CA index events in the National Registry of Cardiopulmonary Resuscitation. Multiple regression analysis compared ED CA with those occurring in the ICU, telemetry, or general floors. Subgroup analysis examined traumatic vs. non-traumatic ED CA and ED CA occurring after a successful pre-hospital resuscitation (recurrent) vs. primary ED CA.
Results: In multivariate analysis, ED location significantly predicted improved survival to discharge (OR 0.74, 95% CI[0.67–0.82], p<0.0001). Patients with CA occurring in the ED had better Cerebral Performance Category scores (ED 1.59, ICU 1.73, Tele 1.96, Floor 1.69, p<0.0001), shorter mean post-event length of stays (ED 8.6, ICU 17.5, Tele 16.5, Floor 14.2 days, p<0.0001) and were less likely to be declared DNR (ED 23.0%, ICU 31.7%, Tele 28.8%, Floor 31.8%, p<0.0001) than CA in other locations. Secondary analysis showed that ED patients with recurrent CA were less likely to survive to discharge (10.1% vs. 24.6%, p<0.0001) and were more likely to be declared DNR (27.9% vs. 22.2%, p<0.0006.) than primary ED CA. Mean length of stay for survivors in both groups was similar (8.85 vs. 8.54 days, p=ns). Major traumatic injury preceded 6.3% of all ED CA. Patients whose ED CA was related to traumatic injury were younger (46.2 vs. 65.0 years, p<0.001), more likely to be male (78.2% vs. 58.1, p<0.0001), less likely to have the CA caused by an arrythmia (23.6% vs. 32.5%, p<0.0008), and more likely to have the CA preceded by hypotension or shock (41.6% vs. 29.0%, p<0.0001) than ED patients whose CA was not due to traumatic injury. ED trauma CA patients had a significantly lower survival to discharge rate than ED patients whose CA was not due to trauma (7.5% vs. 23.8%, p<0.0001).
Conclusions: ED CA patients are a unique population and have better survival and neurologic outcomes compared to patients in other hospital locations. Primary ED CA patients have a better chance of survival to discharge than those who re-arrest following a successful pre-hospital resuscitation. Traumatic ED CA patients have worse outcomes than non-traumatic CA.
Abstract 2036: Severe Autonomic Failure in Diabetic Postinfarction-Patients
Authors: Schmidt Georg , Barthel Petra , Schneider Raphael , Bauer Axel , Arnoldi Elisabeth , Joeinig Anke , Ulm Kurt 
Published: July 2021

Background: Diabetic post-infarction patients are at high risk of subsequent death. Deceleration Capacity (DC) and Heart Rate Turbulence (HRT) are a risk predictors that quantify different aspects of autonomic performance (tone and reflex function). Sever Autonomic Failure (SAF) was assumed if DC and HRT were compromised. This study investigates the predictive value SAF in diabetic post-infarction patients. Patients: 416 consecutive diabetic post-infarction patients, age < <26> 75 years, in sinus rhythm were enrolled. Primary endpoint was total mortality at 5 years. Mean follow-up period was 4.4 years.
Methods: DC and HRT were determined according to the published methodology. Severe autonomic failure (SAF) was defined as DC < <26> 4.5 ms and HRT category 2. Cox-proportional hazards analyses were performed with respect to age, history of previous myocardial infarction, mean heart rate, HRV index and arrhythmia count during 24-h Holter monitoring, QRS duration and LVEF, all with prospectively defined dichotomies.

Results: During follow-up, 61 patients died. There were 36 cardiac deaths, out of which 23 occurred suddenly. 24 patients presented with SAF, 13 patients with LVEF < <26> 30%. Five-year all-cause mortality rates of patients with and without SAF were 63% and 11%, respectively (Figure

, left panel). For LVEF 30%, these figures were 51% and 15% (Figure

, right panel). Similar figures were observed for cardiac mortality. In multivariable analysis, presence of SAF indicated a hazard ratio of 5.1 (LVEF 4.2; age 3.5, mean heart rate 1.9).

Conclusion: Diabetic post-infarction patients with SAF have a poor outcome, whereas mortality rates of patients without SAF were low.
Abstract 2047: Effect of Amlodipine on the Clinical Outcome in Diabetic Patients with Coronary Artery Disease after Angioplasty : Results from the Cardiovascular Events Follow-up Trial in Kokura (CAVEFT-Kokura)
Authors: Yokoi Hiroyoshi , Iwabuchi Masashi , Yasumoto Hitoshi , Nosaka Hideyuki , Nobuyoshi Masakiyo 
Published: July 2021

Background: CAMELOT Study showed that the administration of amlodipine to diabetic patients with coronary artery disease (CAD) resulted in reduced adverse cardiovascular events, especially repeat coronary revascularization.
Objective: To compare the effects of amlodipine versus placebo on restenosis and clinical outcome after percutaneous coronary intervention (PCI) for diabetic patients.
Methods: In a prospective, double-blind design, 540 patients with 659 denovo lesions were randomized to receive 5–10mg of amlodipine or placebo. Diabetic patients were enrolled in171 patients (32%). The primary angiographic endpoint was minimal lume diameter (MLD) at 6 month assessed by follow-up (FU) quantitative coronary angiography (QCA). Clinical end points were death, myocardial infarction, coronary bypass surgery and repeat any PCI at 12 months.
Results: Angioplasty was performed in all patients without complications ;461 patients (85%) had received coronary stent implantation.FU QCA was obtained in all patients. The MLD at FU was significantly larger in the amlodipine group (1.50±0.52mm in the amlodipine group versus 1.42±0.52mm in the placebo group: p=0.035). The loss index was tendency to be lower in the amlodipine group (0.54±0.66 in the amlodipine group versus 0.61±0.56 in the placebo group: p=0.076). The binary restenosis (defined as >50% diameter stenosis at FU) rate was 22.6% in the amlodipine group versus 28.5% in the placebo group (p=0.078). The composite incidence of clinical events were occurred in 89 patients (32%) in the amlodipine group versus 102 patients (39%) in the placebo group (p=0.103). The composite incidence of clinical events in diabetic patients were occurred in 30 patients (37%) in the amlodipine group versus 51 patients (57%) in the placebo group (p=0.007).
Conclusion: Administration of amlodipine in diabetic patients resulted in reduced adverse cardiovascular events after PCI.
Abstract 2050: Differential Effects of Natriuretic Peptides on Arterial and Venous Coronary Artery Bypass Conduits
Authors: Nguyen Hao , Korach Amit , Collura Chey , Eskenazi Ben , Shapira Oz M 
Published: July 2021

Background: Long-term patency of arterial grafts used for coronary bypass grafting (CABG) is superior to that of venous grafts. Natriuretic peptides (NP’s) have a major role in vascular homeostasis. We characterized the effects of NP’s and their receptors (NPR) in commonly used CABG conduits.
Methods: The relaxation and tissue levels of cGMP in response to 3 NP’s (ANP, BNP and CNP) were assessed in pre-contracted segments of internal mammary artery (IMA), radial artery (RA) and saphenous vein (SV) obtained from the same patients (n=12) in the absence/presence of the LY83583 (Guanylyl Cyclase inhibitor) or L-NAME (Nitric Oxide synthase inhibitor). NPR expression was assessed using immunohistochemistry and Western blotting.

Results: Results are summarized in the Tables

. Maximal relaxation of the IMA and RA to ANP, BNP and CNP were similar and greater than SV, correlating with increased tissue levels of cAMP in both arterial conduits. Relaxation response to all 3 NP’s were nearly abolished in the presence of LY83583. Exposure of the conduits to L-NAME resulted in only a modest blunting of the relaxation response to the NP’s. NPR-A, NPR-B and NPR-C were strongly expressed in both the endolethium and vascular smooth muscle layer of the IMA and RA and significantly less in SV.

Conclusion: NP’s are potent vasodilators of the IMA and RA but not the SV. The relaxation response is mediated via NPRs/cGMP and the Nitric Oxide systems. These observations provide additional insight into the potential physiological mechanisms underlying the superior patency of arterial conduits and may form a basis for potential therapeutic interventions aimed to improve vein grafts performance.

Vessel Relaxation Response to NP’s

Tissue cGMP levels in response to NP’s and NPR Protein Expression
Abstract 2116: The presence of Type 2 Diabetes mellitus is strongly associated with essential hypertension
Authors: Movahed Mohamnad Reza , Hashemzadeh Mehrtash , Jamal Mazen 
Published: July 2021

Background: Diabetes (DM) and hypertension (HTN) are common risk factors for heart disease in the population. Independent association between DM and HTN has not been studied in large populations. The goal of this study was to evaluate independent association between DM and HTN using a very large data base.
Method: We used ICD-9 Codes for type 2 DM (250.00, 250.02) and HTN (401.0, 401.1, 401.9) from the Nationwide Inpatient Sample (NIS) database. We randomly selected the years 1992 and 2002 databases which are 10 years apart as two independent samples. NIS involves approximate a 20-percent sample of U.S. community hospitals and specialty hospitals. We used uni- and multivariate analysis to evaluate any association between type 2 DM and HTN adjusting for comorbid conditions.
Results: 1992 database contained a total of 6,195,744 patients. Type 2 DM occurred in 37.5% of patients with HTN vs. 11.4% of the control group (OR: 4.63, CI 4.61– 4.693, p<0.001). 2002 database contained a total of 7,853,982 patients. Type 2 DM occurred in 57.2% of patients with HTN vs. 22.9% of the control group (OR: 4.49 CI 4.47– 4.52, p<0.001). Using Multivariate analysis adjusting for age, gender, hyperlipidemia, obesity, smoking, and chronic renal failure, DM remained independently associated with HTN in both database. (for the year 1992: OR: 2.49, CI:2.47–2.51, p<0.001 and for the year 2002 OR: 2.19, CI: 2.18 –2.20, p<0.001)
Conclusion: The presence of type 2 DM is strongly associated with HTN. This association is independent of comorbid conditions and has been persistent with no significant changes in the odds ratios over a period of 10 years.
Abstract 2139: Pregnancy-related Hospitalizations Among Women With Congenital Heart Disease In California: A Population-based Analysis
Authors: Gurvitz Michelle , Stout Karen K , Canobbio Mary , Richardson Andrea , Chang Ruey Kang 
Published: July 2021

Objective: To evaluate pregnancy-related hospitalizations of women with congenital heart disease (CHD) in California
Background: It is recommended that women with complex CHD receive specialty care during pregnancy. There is a perception that these women require cesarean section (CS) for cardiac reasons, but hemodynamic changes are often less with a vaginal delivery. There are no population based studies evaluating pregnancy in CHD.
Methods: California hospital discharge data from the years 2000–2003 were analyzed. Subjects were chosen by age (12–44 years), diagnosis code for CHD and diagnosis or procedure code related to pregnancy. Among the hospitals, there were 7 self-identified specialized adult CHD centers. Descriptive statistics were used to characterize the population by age, CHD diagnosis (complex or non-complex), insurance, hospital (adult CHD center or not), and outcome (delivery, ante-partum, post-partum condition). Multivariate regression was used to determine predictors for CS.
Results: There were 1032 hospitalizations among women age 14–44 years (mean 27.7 years). Hospitalizations occurred at 210 different hospitals, with only 14% at the 7 adult CHD centers. CHD diagnoses were complex in 52% and non-complex in 48%. Among the hospitalization outcomes, 77% were deliveries (66% vaginal, 34% CS), 2% abortive and 21% ante or post partum conditions. CS rates were not statistically different between CHD centers (32%) and non-centers (34%) but were higher than the general population (21%). Women with complex CHD were more likely to have a CS (p=0.005) or an abortive outcome (p<0.001) than those with non-complex CHD. Women with complex CHD were less likely to have a CS at an adult CHD center than those women delivered at non-CHD centers (p=0.005). In regression analyses, complex CHD was the only variable associated with CS.
Conclusion: Most data on pregnancy in CHD are from single center studies, however, the majority of women with CHD delivered at non-CHD centers. Overall pregnancy outcomes did not appear different by hospital type, but the rates of CS in women with complex CHD suggests specialty care may affect mode of delivery. Understanding of the outcomes of pregnancy in women with CHD would be enhanced by detailed population-based studies.
Abstract 2159: Medial Necrosis Due to Sirolimus-Eluting Stent Implantation in Human Coronary Arteries
Authors: Inoue Katsumi , Mitsudo Kazuaki , Nobuyoshi Masakiyo 
Published: July 2021

Background: Sirolimus-eluting stents (SES) have been proven to reduce the rates of restenosis by a striking inhibition of neointimal hyperplasia. However, unusual vessel responses to SES, such as late-acquired incomplete stent apposition (ISA) have been observed, and the precise mechanism of late ISA has not been clarified.
Methods and Results: To examine the mechanism of late ISA, the temporal mode of vascular responses after SES (3 days (D) to 12 months (M), 14 lesions) and bare metal stent (BMS; 2 D to 12 M, 24 lesions) implantation was investigated histopathologically in necropsied coronary arteries. In arteries that had been implanted with SES for 4 M, the stent struts were focally covered by thin membranous tissue mainly composed of fibrin deposition. Complete coverage of BMS by neointimal tissue composed of smooth muscle cells (SMC) and extracellular matrix (ECM) was documented after 1.5 M. Only mild neointimal thickening with focal endothelialization was observed around the circumference of the lumen at the stented site of atherosclerotic plaque-free segment in 4 of 9 lesions after 4 to 12 M. In these lesions, expansion of the stent strut forced the struts contiguous to the medial layer. Remarkable loss of medial SMCs was evident not only at the sites of the stent struts that had contacted and focally compressed the medial layer, but also at the sites where there was bowing of the media into the intima between the struts. In contrast, only restricted and incomplete medial SMC depletion was observed in the BMS segments where struts compressed the medial layer. We could observe that the medial SMC depletion was present only in the portions where SES struts directly contacted the medial wall layers. Depletion of medial SMC was not clearly observed even in DES segment between 3 D and 1 M.
Conclusions: Therefore, it is possible that these phenomena concerning elimination of medial SMCs were elicited by not only mechanical injury due to stent expansion but also by the pharmacological effect of sirolimus itself. The cytostatic effects of sirolimus on neointimal formation could be complicated by these local cytotoxic effects followed by a decrease in arterial wall tension, causing stent malapposition.
Abstract 2175: Magnitude and Time Course of Platelet Inhibition with Extended Release Dipyridamole with or without Aspirin in Healthy Japanese Volunteers: The AGgrenox versus Aspirin Therapy Evaluation (AGATE-Japan)
Authors: Serebruany Victor L , Malinin Alex , Hanley Dan 
Published: July 2021

Background: Randomized trials showed greater stroke prevention with extended release dipyridamole in combination with low dose aspirin than either with aspirin or dipyridamole alone. However, most studies with this formulation (Aggrenox®) were done in Europe and North America. Considering potential inter-racial differences in drug response, we conducted a small randomized study in healthy Japanese volunteers to compare antiplatelet regimens with regard to the changes in the platelet biomarkers.
Methods: Thirty healthy volunteers (18–40 years old, 15 male and 15 female) of Japanese descend were randomized to Aggrenox® (n=17) or aspirin 81 mg (n=13 volunteers) for 30 days. Platelet function was assessed at baseline, and days 15, and 30 by conventional aggregometry, whole blood flow cytometry, and cartridge-based analyzer.
Results: Both Aggrenox® and aspirin provided sustained platelet inhibition at Day 15 and Day 30. Therapy with Aggrenox®, however, was associated with more prominent and significant inhibition of collagen-induced aggregation (p=0.08, Day 15), as well as prolongation of the closure time (p=0.001, Day 30); diminished expression of platelet endothelial cell adhesion molecule-1 (PECAM-1) (p=0.02, Day 30), glycoprotein IIb (GPIIb) antigen (p=0.001 and 0.024 for Day 15 and Day 30), and GPIIb/IIIa activity by PAC-1 antibody (p = 0.014 and 0.03), CD62 (P-selectin) (p = 0.03 for Day 15 and Day 30), as well as inhibition of protease activated receptors (PAR-1) associated with intact WEDE-15 (p = 0.002 and 0.003) and SPAN-12 (p = 0.002 and 0.04) thrombin receptors when compared with aspirin.
Conclusion: The magnitude and durability of platelet response after Aggrenox in healthy Japanese is similar to those effects observed in Caucasians and African-Americans. Larger study to assess drug efficacy and safety in the Japanese post-stroke patients is warranted.