bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 1589: Pulmonary Hypertension Is Associated With Regional Right Ventricular Systolic Dysfunction And Dyssynchrony: Strain and Strain Rate Assessment Using Velocity Vector Imaging Technique.
Authors: Meng Hong , Villarraga Hector R , Lee PuWai , Aijaz Shah A , Kittipovanonth Maytinee , Seward James B , Chandrasekaran Krishnaswamy 
Published: July 2021

Background: Strain and strain rate has been shown to identify subtle contraction abnormalities of left ventricle.
Objectives: We hypothesized that S and SR derived from velocity vector imaging (VVI) will allow early identification of global and regional RV systolic function in patients with pulmonary hypertension (PHT) compared to conventional echo parameters.
Methods: 96 patients, 35 normal RV Systolic Pressure (RVSP < 30 mmHg) and 61 with PHT, {24 mild-moderate (RVSP > 60 mmHg) and 37 severe (RVSP < 60 mmHg)} underwent echo-Doppler assessment of RV. Apical 4 chamber images at end expiration were used for RV lateral wall (LW) and ventricular septal (VS) segment analysis for systolic tangential velocity (Ta V), S and SR. In addition RV end systolic and diastolic area, RV fractional area change (RV FAC), RV performance index (RIMP) and tricuspid annulus systolic excursion were measured.

Results: Peak S, systolic SR and Ta V at the basal, mid and apical segments of the RV LW and VS were depressed in patients with PHT compared with controls, Table 1

, P 0.001. Similarly, significant decrease in RIMP was seen in patients with PHT compared to controls, p <0.001. Significant correlation (p<0.001, r >0.6) was noted between the 2D FAC and S, SR. The time to peak systolic S indexed to end diastolic area (EDA) is significantly prolonged, p<0.01 in all segments in patients with PHT indicating dyssynchrony.

Conclusion: S and SR allows assesment of Regional RV systolic function otherwise difficult to assess from conventional echo-Doppler technique. PHTN is associated with not only regional RV systolic dysfunction but also with dyssynchrony. Thus, this new tool can offer new insights in the functioning of right ventricular global and regional function.

mean±SD of strain
Abstract 1614: Sequential Analysis of Immunosuppressive Therapy in Autoreactive Myocarditis - Sequential Analysis from ESETCID
Authors: Maisch Bernhard , Pankuweit Sabine , Koelsch Susanne , Hufnagel Guenther , Funck Reinhard , Grimm Wolfram , Sattler Alexander 
Published: July 2021

In the European Study on Epidemiology and Treatment of Cardiac Inflammatory Disease (ESETCID) pts with autoreactive (virus-negative) myocarditis (AM) and an ejection fraction <45% were randomised for 6 months of treatment with azathioprin (2mg/kg BW/day for 1 m and 0.85mg/kg BW/day for 5 m) + prednisolone (1.25mg/kg BW/ for 1 m and 0.3mg/kg BW/day for 5 m) or placebo on top of their heart failure treatment and followed-up for up to 8 years.

Patients: 3149 pts with dilated cardiomyopathy were screened, 103 pts (mean age 47± 9 years, 81 male, 22 female) with AM and an EF 14 infiltrating cells/mm
2
), persistence of viral or bacterial genomes for Parvo B19, coxsackie-, influenza-, adeno-, cytomegalo-, HHV 6, EBV, chlamydia and borrelia were excluded from the analysis. 56 pts (45 m) with AM were treated with verum, 47 pts ( 38m) with placebo. MACE are defined as cardiac death, heart transplantation, ICD implantation or hospitalisation for cardiac decompensation. Time to MACE is given in days to the event.

Results: Inflammation was eradicated in 63% in the treatment group, but it also vanished spontaneously in 40% in the placebo arm(p<0,05). After 12 months the Kaplan Mayer MACE curves began to diverge. At 4 years freedom from MACE was 50% in the verum and 40% in the placebo group. Respective data at 8 years were 40% and 20% freedom from MACE. NYHA-association class and Minnesota Heart Failure Score improved in treatment and placebo arms to a similar extend. Ejection fraction by echo and radioventriculography improved in both arms with a trend for immunosuppression(IS). Independent from IS pts with no inflammation in the follow-up biopsy (n=45) showed a better NYHA-class (p<0,05), ejection fraction and superior long term freedom from MACE than those with persistent inflammation..
Conclusion: Immunosuppression is superior to conventional heart failure treatment in the acute eradication of the inflammatory infiltrate iDCM patients and bears better long-term prognosis.

Results
Abstract 1632: Coronary Calcification Relates to Bone Metabolism and CD4+ T-Cell Activation
Authors: Soejima Hirofumi , Fukunaga Takashi , Oe Yoko , Fukushima Ryuichiro , Ogawa Hisao 
Published: July 2021

Background: Osteopontin (OPN) facilitates bone resorption by enhancing the binding of osteoclast to hydroxyapatite. OPN is expressed in both the intima and the medial layers when arterial calcification is present. OPN is the most abundant molecule secreted by activated T-cells. We previously demonstrated that CD4+ T-cells play an important role in acute coronary syndrome and coronary artery disease (CAD). Osteoprotegerin (OPG) is associated with the progression of vascular calcification in diabetic patients or in patients on long term hemodialysis. Either an intravenous injection of recombinant OPG protein or the transgenic overexpression of OPG has been shown to reverse osteoporosis and prevent vascular calcification. Collagen Type I constitutes the most substantive proportion of the matrix protein of bone. Analysis of a Collagen Type I breakdown product, a Cross-linked N-terminal Telopeptide of Type I Collagen (NTX), has been used to estimate rates of bone degradation. We therefore investigated whether these markers (OPN, OPG, NTX) reflected coronary calcification as detected by multislice computed tomography (MSCT) in patients with CAD and assessed the association these markers with CD4+ T-cell activation.
Methods and Results: We measured serum OPN, OPG, and NTX levels of 76 consecutive patients who received MSCT. The frequency of OPN producing CD4+ T-cells was determined with flow cytometry. Coronary calcification was present in 41 of the 76 patients. Serum OPN, OPG, and NTX levels were all significantly higher in patients with coronary calcification than in those without. Multiple logistic regression analysis revealed that age >70 years, hypertension and serum OPN level >630 ng/ml were determinants of coronary calcification independent of other coronary risk factors. The frequency of osteopontin producing CD4+ T-cells was higher in patients with coronary calcification and it was negatively correlated with serum OPG levels.
Conclusions: The presence of coronary calcification is reflected better by an osteoporosis facilitating factor (OPN) than by an osteoporosis inhibiting factor (OPG) or by a marker of the bone degradation rate (NTX). Assessment of bone metabolism could be useful for clinical determinations of coronary heart disease.
Abstract 1707: Analysis Of Extracellular Matrix Remodeling On Endomyocardial Biopsies From Patients With Inflammatory Cardiomyopathy
Authors: Lettau Olga , Rutschow Susanne , Jaeger Sebastian , Kuehl Uwe , Puhl Kerstin , Noutsias Michael , Schultheiss Heinz P , Pauschinger Matthias 
Published: July 2021

Introduction: The biopsy based analyse, with histological, immunohistological and molecular biological analysis of myocardial tissues, represents the only possible tool to investigate the basement of inflammatory cardiomyopathy. Since development of this disease assume involvement of extracellular matrix remodelling, the analyze of this process were aimed in this article.
Methods and results: Endomyocardial biopsies from patient with inflammatory cardiomyopathy (n=170) were analysed by RT-PCR, Furthermore, histological, immunohistological and biochemical methods (ELISA) were used to estimate the matrix proteins amount in myocardial tissues (n=36). All results were obtained by comparison of patient groups regarding to left ventricular ejection fraction (LVEF), EF>60 versus EF<30. EF<30 group featured significaly increased inflammation cells per surface area: CD3 (p<0.001), CD11a (p<0.02), CD45 (p<0.02), Mac1 (p<0.02) and HLA (p<0.01). The gene expression revealed an increased transcripts number of IL-2 (p<0.01), IL-5 (p<0.01), IL-6 (p<0.02), INF beta (p<0.039), Collagen type I (p<0.001), III (p<0.0014) and IV (p<0.0004) as well Laminin (p<0.001). On the protein level ICTP (p<0.04), MMP9 (p<0.04) and TIMP I (p<0.01) were significaly increased in this group in comparison with EF>60 group. The escalating number of active CD3 cells correlated positively with BNP (ρ=0.624, p<0.0091), adhesion cell number ICAM (ρ=0.682, p<0.01) and VCAM (ρ=0.475, p<0.01) and with uPA (ρ =0.265, p<0.013), as well as with increased quantity of collagen type III per section area (ρ=0.632, p<0.01). The expanded abundance of type I collagen products was clearly dependent of the expression of collagen I gene (ρ=0.575, p<0.002) and uPA (ρ=0.544, p<0.004). Precise correlation between the amount of MMP 9 protein and downward EV values (ρ=− 0.4133, p<0.0073) was also observed in the patient group with EF<30.
Conclusion: Myocardial inflammation lead to an imbalance in the MMP/TIMP system with development of myocardial fibrosis with significant correlation to LV-dysfunction. Extracellular matrix remodeling with an imbalance in the MMP/TIMP system plays an important role in the development of left ventricular dysfunction in inflammatory heart disease
Abstract 1879: Global Lv Strain Is An Accurate Measure For Scar Extent After Myocardial Infarct. A Comparison Of Longitudinal, Circumferential And Radial Strain Measurements
Authors: Vartdal Trond , Gjesdal Ola , Helle-Valle Thomas , Lunde Ketil , Hopp Einar , Smith Hans-Jørgen , Ihlen Halfdan , Edvardsen Thor 
Published: July 2021

Purpose: Recent progress by speckle tracking echocardiography (STE) provides the opportunity to assess left ventricular (LV) function in 3 dimensions. We studied LV longitudinal, circumferential and radial strain and calculated which strain parameter that correlated best to myocardial scar mass in patients with chronic ischemic heart disease.
Methods: 40 patients (aged 58 ± 10 years, 9 women) were studied 8.5 ± 5.4 months after a first myocardial infarction. LV infarct mass was estimated by late enhancement MRI and compared to global LV strain. Global LV strain is calculated by averaging all segmental peak systolic strain values by STE in a 16 segment model. Longitudinal strain was assessed from 3 apical views, and circumferential- and radial strain from 3 short axis slices (apical, mid and basal).

Results: In average, 7.9 ± 4.1 segments and a total of 34 ± 27g were infarcted. Transmural infarct (≥50% transmural) was found in 25 patients. All global strains correlated significantly with infarct mass (figure

). In a ROC analysis, longitudinal strain was superior to identify substantial (≥30g) myocardial infarcts (sensitivity = 0.80, specificity = 0.85). Circumferential strain was best to identify minor (≥5g) myocardial infarcts (sensitivity = 0.82, specificity = 0.86).

Conclusion: Assessment of strain in all 3 major dimensions reflects decreased LV function due to ischemic myocardium. Global longitudinal- and circumferential- strains are excellent markers to identify patients with myocardial infarct.

Figure:

Correlation plots
Abstract 1924: Longterm Outcome Of Pediatric Patients With Discrete Subaortic Stenosis
Authors: Drolet Christian , Miro Joaquim , Côté Jean-Marc , Gardin Letizia , Rohlicek Charles V 
Published: July 2021

INTRODUCTION: We previously reported the clinical outcomes of a large pediatric cohort with discrete subaortic stenosis (SubAS)
1
. While patients with more significant left ventricular outflow tract obstruction (LVOTO) at diagnosis progressed rapidly others with mild LVOTO at presentation showed little progression of obstruction or aortic insufficiency (AI). A limitation of our previous study was a relatively short follow-up period.

OBJECTIVE: To extend the follow-up of our previously described cohort with SubAS.
METHODS: Information was gathered retrospectively on 71 previously identified patients diagnosed with SubAS from 1985–1998.
RESULTS: Current data was available on 61/71 patients. At diagnosis the average age was 5.2±0.5 years (mean±SEM), peak LVOT Doppler gradient (Echograd) was 30±3 mmHg, and AI (all mild) was present in 25%. At last assessment the average age was 15.7±0.4 years. Twenty patients were followed only medically and were last reassessed 9.2±1.0 years after diagnosis at 15.8±0.7 years of age. The mean Echograd was unchanged from diagnosis (19±2 vs. 19±3 mmHg). The incidence of AI on echocardiography (all mild) increased from 5% to 55% although none was detectable by auscultation. Forty-one patients underwent surgery 3.0±0.5 years after diagnosis at 7.4±0.6 years of age. The Echograd at diagnosis was 35±3 and increased to 61±6 mmHg pre-operatively. Ten patients were re-operated 5.7±0.7 years after the first surgery and 2 patients had a second re-operation. The last follow up of the operated patients occurred at 15.7±0.6 years of age. At that time the Echograd was 16±3 mmHg and the incidence of AI by echocardiography had increased to 98% (36 mild & 3 moderate) but was evident on auscultation in only 25%.
CONCLUSIONS: This study represents the largest and longest contemporary follow-up of pediatric patients with discrete SubAS. Our results indicate that some patients with SubAS show significant LVOTO at diagnosis and subsequent progression. Surgery in these patients provides good relief of LVOTO but does not eliminate AI. The one third of patients presenting with mild LVOTO and AI show little progression through childhood and adolescence. We suggest that the latter can be safely followed medically. 1) Rohlicek et al. Heart 82:708;1999
Abstract 2218: Impact of Low Molecular Weight Heparin on Bleeding, Need for Transfusion and 6-month Survival in Elderly Patients (75 years of age or older) with Acute Myocardial iInfarction. Data from the FAST-MI Registry of the French Society of Cardiology.
Authors: Durand Eric , Schiele François , Simon Tabassome , Godenir Jean-Philippe , Cambou Jean-Pierre , Tabone Xavier , Mulak Geneviève , Danchin Nicolas 
Published: July 2021

There are conflicting results as regards the impact of low molecular weight heparin (LMWH) on bleeding and mortality in elderly patients.
Aim: to compare in-hospital mortality in pts with AMI according to type of heparin used.

Methods: FAST-MI is a nationwide French registry carried out over a one-month period in the fall 2005, including consecutive pts with AMI admitted to CCUs =75 years and had received heparin therapy. Of those, 301 received unfractionated heparin (UFH) only, 398 LMWH only and 185 both UFH and LMWH. UFH only patients were slightly older (83 vs 82 years, p<0.01) and patients on LMWH only more often had NSTEMI: 65% vs 55% (UFH) and 50% (UFH+LMWH), p<0.01). Major bleeding was found in 6.3% (UFH), 2.3% (LMWH) and 2.7% (UFH+LMWH) (p<0.02). Blood transfusion was used in 10% (UFH), 4.8% (LMWH) and 4.3% (UFH+LMWH) (p<0.01). After x-variate adjustment, compared with UFH only, the need for transfusion was significantly lower (p<0.03) for LMWH OR=0.45 (95%CI: 0.25–0.85) and for UFH+LMWH OR=0.44 (0.19–1.01) and major bleeding was also reduced (OR=0.39; 95%CI: 0.17–0.89, for LMWH and OR=0.47; 95%CI: 0.17–1.31, for UFH+LMWH). Six-month survival was 73% for UFH, 85% for LMWH and 82% for UFH+LMH (p<0.001, Figure

). Using Cox x-variate analysis, use of LMWH remained associated with improved 6-month survival: OR=0.65 (95%CI: 0.46–0.92) for LMWH alone, and OR=0.69 (95%CI: 0.45–1.05) for UFH+LMWH, in comparison with UFH alone.

Conclusion: in a “real world” population hospitalised for AMI, the use of LMWH was associated with a reduced risk of bleeding complications and improved survival.
Abstract 2256: Predictors of “Life-Threatening” Fast VT or VF in Arrhythmogenic Right Ventricular Dysplasia
Authors: Laidlaw Douglas W , Lucier David , Daubert James P , Marcus Frank I , Scheinman Melvin M , Zareba Wojciech , Estes N.A. Mark 
Published: July 2021

Introduction: The Multidisciplinary Study of Right Ventricular Dysplasia is an NIH-funded, multicenter, prospective registry of patients meeting Task-Force criteria for arrhythmogenic right ventricular dysplasia (ARVD). Previous studies have used the occurrence of “life-threatening” fast VT or VF as a surrogate for sudden cardiac death in patients with an ICD, however the patient characteristics associated with sudden cardiac death in ARVD remain poorly defined.
Methods: All patients in the ARVD registry that underwent implantation of an ICD were studied. Baseline characteristics of patients who received ICD therapy for fast VT/VF (with a cycle length of <250msec) were compared to those patients who did not receive ICD therapy. The cumulative risk of appropriate ICD therapy for fast VT/VF was determined by the Kaplan-Meier method for patients receiving an ICD for primary or secondary prevention.
Results: 80 patients in the ARVD registry underwent implantation of an ICD. Of those, 61 patients (76%) had an ICD implanted for secondary prevention and 19 patients (24%) for primary prevention. Over a mean follow-up of 1.7 years, 17.5% of patients experienced appropriate ICD therapy for fast VT/VF, including 18% of patients with an ICD implanted for secondary prevention and 15.8% of patients with and ICD implanted for primary prevention. Among all baseline imaging, echocardiographic, and electrcardiographic characteristics, none were significantly associated with the occurance of fast VT/VF during follow-up. In a Kaplan-Meier analysis, there was no significant diffference in the cumulative risk of ICD therapy for fast VT/VF between primary or secondary prevention cohorts (log rank p-value = 0.69).
Conclusions: In this registry of patients meeting the current Task Force criteria for ARVD, there is a high incidence of “life-threatening” fast VT/VF during follow-up, and the probability of fast VT/VF is similar in patients with an ICD for secondary prevention compared to those with an ICD for primary prevention. Furthermore, baseline characteristics do not reliably predict a future risk of life threatening arrhythmias in this cohort.
Abstract 2315: Markedly Enhanced Activity of Endothelin-1 in Transplant Coronary Arteriosclerosis
Authors: Larose Eric , Behrendt Dominik , Kinlay Scott , Selwyn Andrew , Ganz Peter , Fang James 
Published: July 2021

Background: Coronary arteriosclerosis is the principal complication limiting long-term survival after heart transplantation. In humans, the mediators responsible for vascular proliferation and vasoconstriction typical of TCA are unknown. Endothelin-1 (ET-1) is a potent vasoconstrictor and mitogen derived primarily from endothelial and mononuclear cells. We tested the hypothesis that ET-1’s biological activity is increased in TCA and that it may contribute to the pathogenesis and manifestations of TCA. We inhibited the ET
A
receptor by administering a specific antagonist BQ-123 into the coronary arteries in heart transplant recipients undergoing routine annual cardiac catheterization. We compared the coronary vasomotor responses to BQ-123 in subjects with angiographic evidence of TCA and subjects free of angiographic evidence of TCA.

Methods: BQ-123 was infused into one proximal coronary artery (40nmol/min for 60min) of 18 subjects, age 18 –75, 6 +/− 4 years after transplantation. In each patient 3 coronary segments were studied in both the infused and in a non-infused control coronary artery (Total 108 segments). Changes from baseline in diameters of the infused arterial segments were compared to those of non-infused arterial segments at 15 minute intervals. Contribution of ET-1 to coronary constrictor tone was assessed by comparing vasodilation from BQ-123 infusion to dilation from intracoronary nitroglycerin (200μg bolus).
Results: BQ-123 induced dilation in coronary arteries of transplanted patients (8.4% at 60 minutes, vs. −0.4% in noninfused arteries, p<0.001). Dilation was greater for arteries with TCA defined as angiographic diameter stenosis ≥15% (dilation 15.2% with TCA, n=10, vs. 0.6% without TCA, n=8, p=0.004). As compared to dilation from nitroglycerin indicative of overall vascular tone, ET-1 was responsible for 53.2% of vascular tone in TCA arteries but only 12.9% in arteries without TCA.
Conclusions: The endogenous biological activity of ET-1 is markedly increased in humans with TCA compared to those without evidence of TCA. This supports a role for ET-1 in the pathogenesis of TCA and suggests that therapeutic targeting of ET-1 may slow the development and manifestations of TCA in cardiac transplant recipients.
Abstract 2387: Co-Localisation of C-Reactive Protein and the Terminal Complement Complex in Dilated Cardiomyopathy - Implications for Non-Ischaemic Heart Failure
Authors: Zimmermann Oliver , Manolov Dimitar E , Kaya Ziya , Zwaka Thomas P , Bienek-Ziolkowski Magdalena , Wolf Bettina , Hombach Vinzenz , Torzewski Jan 
Published: July 2021

Background: C-reactive protein (CRP) has been suggested as a risk factor in cardiovascular disease. Recently, it has been shown that CRP binds to ligands exposed in ischaemic damaged tissue and activates the complement system. Furthermore, CRP was demonstrated to be strongly and independently associated with the occurrence of heart failure in men. In this study we have investigated the presence of CRP and the Terminal Complement Complex (C5b-9) in the myocardium of patients suffering from non-ischaemic heart failure.
Methods and Results: Endomyocardial biopsies were taken from 151 patients suffering from dilated cardiomyopathy. Biopsies were immunohistochemically analysed for the presence and distribution pattern of CRP and C5b-9. In 39 patients plasma levels of hsCRP and NT-proBNP were measured and correlated with myocardial biopsy findings. In 47 patients a positive staining for CRP and in 141 patients a positive staining for C5b-9 was detected. CRP and C5b-9 significantly co-localised within the myocardium. A negative correlation was observed for plasma hsCRP levels and myocardial CRP.
Conclusions: This study shows for the first time that CRP is frequently present in the myocardium of patients suffering from non-ischaemic dilated cardiomyopathy and co-localises with the Terminal Complement Complex. CRP may contribute to myocardial damage in dilated cardiomyopathy via activating the complement system.