bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 846: Patient Willingness to Participate in Genetic Research After a Myocardial Infarction
Authors: Lanfear David E , Jones Philip G , Cresci Sharon , Tang Fengming , Rathore Saif S , Spertus John A 
Published: July 2021

To achieve ‘Personalized Medicine’, identifying genetic associations with outcomes is essential. However, not all patients invited to participate in such studies agree. While existing data suggests race, gender, and education may influence this decision, correlates of patient willingness to participate in genetic studies remain incompletely understood. We assessed correlates of patient participation in the genetic substudy of TRIUMPH, a prospective myocardial infarction registry ongoing at 26 US hospitals. Patients enrolled in the first wave (4/05–12/06, N=1854) were analyzed. Factors examined included sociodemographics, financial status, social support, medical literacy, health status, depressive symptoms (PHQ-9, higher scores indicate greater depression) and 26 clinical variables. Predictors of participation were identified using hierarchical logistic regression adjusting for hospital. Variation in consent rates across hospitals was quantified by the median odds ratio (MOR), which compares the odds of consent between two randomly selected patients with identical covariates chosen from different hospitals. Most subjects consented to donation and storage of their genetic material (1,513, 81.6%). Participation rates varied greatly by site, ranging from 50% to 100%. After adjustment for possible confounding by patient factors, the MOR for hospitals was 4.5. Clinical characteristics were not associated with participation in univariate analysis (all p>0.1). In multivariable analysis adjusted for hospital, the only significant predictors of consent were greater depressive symptoms (OR 1.41 per +5 PHQ points, 95% CI 1.19–1.67, p<0.0001), and gender (OR 1.54 for males, 95% CI 1.16–2.04, p=0.0027). Roughly 80% of subjects enrolled in our study consented to genetic analysis. The strongest overall factor associated with participation was hospital. While we cannot rule out confounding by unmeasured characteristics, this suggests that variation in the way information is presented, or other site-specific factors, strongly influence patient participation in genetic studies.
This research has received full or partial funding support from the American Heart Association, AHA Midwest Affiliate (Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, South Dakota & Wisconsin).
Abstract 2057: Effects Of Levosimendan On Microcirculation In Patients With Cardiogenic Shock
Authors: Wimmer Roland , Janusch Matthias , Lemm Henning , Winkler Matthias , Prondzinsky Roland , Russ Martin , Werdan Karl , Buerke Michael 
Published: July 2021

Introduction: Cardiogenic shock is characterized by low cardiac output and reduced perfusion pressure with subsequent disturbance of microcirculation. OPS vessel microscopy (orthogonal polarized spectral imaging) is a new method to visualize microcirculation.
Methods: In this study 20 Patients with severe cardiogenic shock caused by a myocardial infarction were followed three days after PCI. Group 1 got the conventional catecholamine treatment (norepinephrine and/or dobutamine), and Group 2 received in addition to this common therapy the calcium sensitizer Levosimendan (Simdax®). Five areas in the oral vestibule were recorded and averaged each 24 hours for three days. Data were transferred on a PC and analysed: The average of diameters, of flow and the cell blood velocity (CBV) were recorded. In this way the effects of Levosimendan on microcirculation were observed.
Results: An increase of the microcirculatory parameters was observed together with a progressing heart index (HI = 2.4 l/min/m2 on day 1 to HI = 3.5 l/min/m2 on day 3): the averaged vessel diameters went up significantly, also the average flow (p<0.028). In patients treated with Levosimendan microcirculation showed 24 hour infusion an increase in vessel diameters after Levosimendan (27.6 μm to 37.1 μm; p=0.013) as well as an improved flow (387x10 –9ml/s to 1049x10 –9ml/s; p=0.047). CBV also augmented in tendency (480 μm/s to 737 μm/s; p=0.054). Compared to conventionally treated patients, we observed a higher vessel diameter in the Levosimendan treated patients(27,37 μm vs. 34,65 μm; p=0,039)
Conclusion: Our data may suggest a benefit for the organ perfusion under Levosimendan treatment. OPS technology could become a new tool to follow shock patients on the intensive care unit in order to analyze therapeutic drug effects on microcirculation.
Abstract 2252: Hemodynamic and Functional Assessment of Mechanical Aortic Valves Using Combined Echocardiography and Multidetector Computed Tomography
Authors: LaBounty Troy , Agarwal Prachi P , Chughtai Aamer , Kazerooni Ella A , Wizauer Eric , Bach David S 
Published: July 2021

Introduction: Transthoracic echocardiography (TTE) can evaluate hemodynamics of mechanical aortic valve replacements (AVR), but may not be able to discriminate causes of suspected valve malfunction.
Hypothesis: Combined TTE and multidetector computed tomography (MDCT) may enhance hemodynamic and functional evaluation of AVR.

Methods: Retrospective assessment of 41 consecutive patients with AVR (27 bi-leaflet, 14 tilting-disc) and both TTE and 64-slice ECG-gated MDCT. Two cardiologists (TTE) and two radiologists (MDCT) independently, blindly evaluated studies. TTE measured cardiac index (CI), mean pressure gradient (MPG), effective orifice area (EOA), aortic insufficiency (AI), and sinotubular area (STA). Energy loss coefficient (ELCo) (correcting EOA for pressure recovery) was calculated: ELCo = (STA*EOA)/(STA-EOA). MDCT measured opening angles (OA), geometrical orifice area (GOA), and STA. Patients with elevated MPG (>15 mm Hg) were assessed for low EOA, low OA (>20° below specification), patient-prosthesis mismatch (PPM) (EOA/body surface area <0.85 cm
2
/m
2
), high CI (>4.0 L/min/m
2
), and AI.

Results: There was excellent correlation but a significant difference between the EOA and ELCo (r=0.97, p<0.001; 2.2 ± 0.8 vs. 3.1 ± 1.5 cm
2
, p<0.001). GOA was larger than and only moderately correlated with EOA (r=0.61, p<0.001; 3.6 ± 0.9 vs. 2.2 ± 0.8 cm
2
, p<0.001), with a smaller difference between GOA and ELCo (r=0.55, p<0.001; 3.6 ± 0.9 vs. 3.1 ± 1.5 cm
2
, p<0.001). Elevated MPG was observed in 16 patients, with a low EOA in 2 of these patients. Additional potential etiologies of elevated MPG included PPM in 8 patients and high CI in 4 patients; no patient had a low OA or > mild AI. Either PPM or high CI could be attributed to 12 of 16 patients with elevated gradients, while these were observed 7 of 27 patients with normal gradients (p=0.004).

Conclusion: MDCT is additive to the hemodynamic assessment from TTE, allowing for complete assessment of mechanical AVR hemodynamics and function, including detection of prosthesis OA, and enhances correction for pressure recovery using ELCo. Among patients with elevated gradient on TTE, MDCT allows further assessment to distinguish abnormal prosthesis function from other etiologies including PPM and pressure recovery.
Abstract 2362: High Serum Erythropoietin Level is Associated with Poor Prognosis in Heart Failure Patients with Systolic Dysfunction but not with Preserved Systolic Function
Authors: Matsumoto Mika , Tsujino Takeshi , Lee-Kawabata Masaaki , Naito Yoshiro , Ezumi Akira , Nakao Shinji , Goda Akiko , Yoshida Chikako , Akahori Kunihiro , Sakoda Tsuyoshi , Ohyanagi Mitsumasa , Masuyama Tohru 
Published: July 2021

Introduction: It is known that serum levels of erythropoietin (EPO) are elevated in patients with chronic heart failure (CHF) and correlate with the severity of CHF. Serum EPO levels have been examined in stable CHF patients with LV systolic dysfunction (LVSDF) but not in patients with preserved LV ejection fraction (PLVEF). Moreover, the data about EPO are also lacking in acute decompensated HF (ADHF) patients.
Hypothesis: Serum EPO levels may be different between patients with LVSDF and with PLVEF, and between patients in an acute decompensated state and in a stable, compensated state.
Methods: We studied 52 patients who were admitted to our hospital with ADHF (NYHA functional class of III or IV). There were 22 females, and mean age was 73 years. They were divided into 2 groups: LVSDF (LV ejection fraction (EF) < 45%, n = 37) and PLVEF (LVEF ≥ 45%, n = 15). Serum EPO, hemoglobin (Hb) and plasma brain natriuretic peptide (BNP) levels were measured on admission and after treatment. The estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease Study equation.
Results: On admission, serum EPO levels were higher in the LVSDF than in the PLVEF groups (84 ± 12 vs. 55 ± 9 mU/ml, p < 0.05). After treatment, NYHA functional classes equally improved to I or II, and serum EPO and plasma BNP levels decreased in both groups (LVSDF: 31 ± 5 vs. 84 ± 12 mU/ml, p < 0.05; 526 ± 82 vs. 1134 ± 163 pg/ml, p < 0.05; PLVEF: 24 ± 4 vs. 55 ± 9 mU/ml, p < 0.05; 240 ± 53 vs. 523 ± 87 pg/ml, p < 0.05). The Hb levels and eGFR were not different between the groups on admission. When plasma BNP levels were matched between the 2 groups, the same tendency was observed in the levels of EPO. The higher EPO levels (> 50 mU/ml) in ADHF were associated with higher incidence of cardiac death or HF hospitalizations (log-rank test, p < 0.05) only in the LVSDF group.
Conclusions: Serum EPO levels were higher in patients with LVSDF than in those with PLVEF in ADHF. Elevated serum EPO levels were associated with a poor prognosis in the LVSDF group, but not in the PLVEF group. Serum EPO levels may be useful prognostic value only in HF patients with LVSDF.
Abstract 2403: Inspiratory Muscle Training Decreases Central and Peripheral Sympathetic Activity Improves Reflex Vasodilatory Blood Flow in Patients with Chronic Heart Failure
Authors: Mello Priscila , Guerra Grazia , Dall’ago Pedro , Borille Suellen , Rondom Maria U , Negrao Carlos E , Mostarda Cristiano , Irigoyen Maria Claudia , Krieger Eduardo M , Consolim-Colombo Fernanda 
Published: July 2021

Background: Inspiratory muscle training (IMT) improves functional capacity of patients with CHF but the mechanisms of this effect are unknown.
Objective: We tested the hypothesis that IMT could decrease sympathetic activity and improve the reflex muscle vasodilatory response during exercise in patients (CHF) and inspiratory muscle weakness.
Methods: Six patients with CHF and inspiratory muscle weakness (maximal inspiratory pressure <70% of predicted) NYHA Class II–III, EF <35%, peak VO(2) < 20 ml/kg/min, were submitted to a IMT during 12 weeks (30 minute breathing with an inspiratory resistance of 30% of maximal inspiratory pressure). Muscle sympathetic nerve activity (MSNA) was recorded by microneurography, LF (sympathetic) and HF (parasympathetic) components of the heart rate variability and LF/HF ratio were assessed by the use of power spectral analysis of RR interval. Forearm blood flow (FBF) was measured by venous occlusion plethysmography at baseline and during hand grip (HG) manouver. Paired student t-test was used to analyze the impact of IMT in this population.
Results: Compared to baseline, IMT significantly (p < 0,05) caused: an increase in inspiratory muscle force by 130%; a 15% reduction in MSNA (40 ± 1 vs 33 ± 1 bursts/min); an increase in forearm blood flow (0.8+/−0.1 mL/min/100 g) during HG manouver; a decrease in LF% (59 ± 5 vs 39 ± 3 U); an increase in HF% (40 ± 5 vs 61 ± 3 U); a decrease in LF/HF ratio (1,74 vs 0,66).

Conclusions:
Twelve weeks of Inspiratory muscle training in patients with CHF and inspiratory muscle weakness promoted a significant improvement in cardiovascular parameters, such as increase in limb blood flow, cardiac autonomic balance and baroreflex sensitivity, associated with a decrease in peripheral sympathetic activity.
Abstract 2562: Two-Year Clinical Follow-Up of COREA-TAXUS Trial: Long-Term Safety And Efficacy of Celecoxib for 6 Months After Paclitaxel-Eluting Stents Implantation
Authors: Chung Jin-Wook , Yang Han-Mo , Kwon Dong-A , Suh Jung-Won , Park Kyung-Woo , Cho Hyun-Jai , Kim Sang-Hyun , Kim Cheol-Ho , Oh Byung-Hee , Park Young-Bae 
Published: July 2021

Background: The effect of celecoxib on restenosis after angioplasty with a Taxus stent (COREA-TAXUS) trial is an open-label randomized controlled study, where we reported celecoxib was effective in reducing 6months late loss of Taxus stent. With this cohort, we analyzed long-term clinical outcomes.
Method: Two hundred sixty seven patients underwent successful paclitaxel-eluting stents implantation for native coronary lesions. Patients were randomized to receive celecoxib (400 mg before the intervention, and 200 mg twice daily for 6 months after the procedure) or not. Clinical endpoints were cardiac death, non-fatal myocardial infarction, and revascularization of the target lesion.
Results: At 6 months, frequency of adverse cardiac events was significantly lower in the celecoxib group (5.3% versus 16.2%, P=0.005), mainly because of reduced need for revascularization of the target lesion (5.3% versus 15.4%, P=0.009). Between 6 and 24 months, frequency of adverse cardiac events was not different between the celecoxib group and the control group (1.6% versus 4.4%, P=NS: 0% versus 0% for cardiac death; 0.8% versus 0.9% for non-fatal myocardial infarction; 0.8% versus 3.5% for revascularization of target lesion, P=all NS). At 2 years, frequency of adverse cardiac events was still significantly lower in the celecoxib group (6.9% versus 19.9%, P=0.002)
Conclusion: In the COREA-TAXUS trial, the adjunctive use of celecoxib for 6 months after Taxus stent implantation was safe and clinically effective for 2 years.
Abstract 2612: Immediate Clinical And Hemodynamic Benefits Of Restoration Of Pulmonary Valvar Competence In Patients With Pulmonary Hypertension
Authors: Lurz Philipp , Nordmeyer Johannes , Coats Louise , Taylor Andrew M , Bonhoeffer Philipp , Schulze-Neick Ingram 
Published: July 2021

Background: In patients with severe pulmonary hypertension (PH), chronic pressure overload leads to right heart failure, the main reason for clinical deterioration and mortality. In the presence of pulmonary regurgitation (PR), right ventricular (RV) efficiency and cardiac output are further compromised. Therapeutic options in this patient group are limited due to the high risk of open-heart surgery in the presence of the PH. Percutaneous pulmonary valve implantation (PPVI) may offer a new treatment option for relief of PR without the risk of cardiopulmonary bypass.
Methods: Between April 2004 to December 2007, 7 patients with PH (mean PAP > 25 mmHg) due to congenital heart disease and severe PR underwent PPVI. Patients were assigned to New York Heart Association (NYHA) functional classes I – IV. Resting peripheral oxygen saturations were measured. Trans-thoracic echocardiography and magnetic resonance imaging before and after valve implantation was performed.

Results: The valve implantation procedure was feasible and uncomplicated in all 7 cases, successfully abolishing PR. There was a significant increase in diastolic (15.4±7.3 to 34.0±8.5 mmHg; p=0.007) and mean (29.7±8.1 to 41.3±12.9 mmHg; p=0.034) pulmonary artery pressures, and an improvement in NYHA functional class (from median IV to median III; p<0.008). Peripheral oxygen saturations rose from 85.9±11.0% to 91.7±8.3% (p=0.036). RV end-diastolic volumes decreased (from 157.0±44.7 to 140.3±53.3 ml/m
2
), whilst effective RV stroke volume increased (from 23.4±9.3 to 41.0±11.6 ml/m
2
). During a median follow-up of 20.3 months (range 1.3 – 47.5), competence of the bovine jugular venous valve was well maintained despite near systemic pulmonary pressures. None of the devices were explanted during follow-up.

Conclusion: Trans-catheter abolishment of PR in patients with PH is well tolerated and leads to clinical and haemodynamic improvement, most likely due to a combination of increased pulmonary perfusion pressures and RV efficiency. These findings emphasize the detrimental effects of volume overload in chronically pressure overloaded right ventricles.
Abstract 2835: Non-Cardiac Findings on Cardiovascular Magnetic Resonance Imaging Are Common: Impact of Imaging Sequences and Reading Session Format
Authors: Romney Benjamin P , Khosa Faisal , Costa Daniel N , Chan Peter , Rofsky Neil M , Manning Warren J 
Published: July 2021

Purpose The true prevalence of non-cardiac pathology on clinical cardiovascular magnetic resonance (CMR) imaging is not fully defined. While prior studies have shown few non-cardiac findings (NCFs) on CMR reports, this may be an underestimate. We sought to determine the prevalence of NCFs by using a second imaging review with specific attention to NCFs.
Materials and Methods The images from all 495 clinical CMR studies performed at our center in 2006 were independently reviewed by a radiologist for the presence of NCFs, defined as benign (e.g., pleural effusion, hiatal hernia), indeterminate (e.g. pleural effusion, enlarged lymph node), or worrisome (e.g. lung nodule, aortic dissection). Data were compared with NCFs listed in the subject’s clinical CMR report, which also included information as to whether a radiologist was physically present at the original reading session.
Results The initial clinical CMR reports included 105 NCFs (30 benign, 68 indeterminate, and 7 worrisome). On focused image review, 295 NCFs (144 [49%] benign, 137 [46%] indeterminate, 14 [5%] worrisome) were identified in 212/495 (43%) studies, with 113 studies (23%) containing indeterminate and/or worrisome NCFs. The vast majority (281/295, 95%) of NCFs were visible on either the initial scout images (186/295, 63%) or thoracic T1w axial fast spin echo images (176/295, 60%). Overall, 36% (105/295) of NCFs (21% of benign, 50% of indeterminate, and 50% of worrisome) detected on our image review were included in the original clinical CMR report. NCFs were reported more frequently when a radiologist was present for the joint CMR readout (42% 95/228;vs. 15% 10/67;, p=0.003).
Conclusion Indeterminate or worrisome NCFs are more common than previously reported, and involve nearly a quarter of clinical CMR studies. The vast majority of NCFs were visible on scout and T1w axial images. A joint reading session with cardiologists and radiologists improves the detection and reporting of NCFs. These data also highlight the importance of training CMR practitioners to identify NCFs.
Abstract 3998: Proton Pump Inhibitors Effect on Clopidogrel Effectiveness: The Clopidogrel Medco Outcomes Study
Authors: Aubert Ronald E , Epstein Robert S , Teagarden J R , Xia Fang , Yao Jianying , Desta Zeruesenay , Skaar Todd , Flockhart David A 
Published: July 2021

Background: The anti-platelet properties of clopidogrel are thought to be activated by cytochrome P450 2C19. This isoenzyme is potently inhibited by the most commonly prescribed proton pump inhibitors (PPIs) and therefore may interfere with clopidogrel activation and its anti-platelet effects.
Methods: We investigated the potential impact of PPIs on the effectiveness of clopidogrel to prevent coronary artery stent re-stenosis through a retrospective cohort study using the National Medco Integrated Database file, which covers approximately 19 million lives. We selected patients who underwent stent placement at sometime during a one-year period in 2005–2006, who started taking clopidogrel at the time of stent placement, and who were at least 80% compliant during the ensuing year (n=14,383). We followed these patients for the one-year incidence of major adverse CV events: hospitalization for stroke, MI, angina or CABG. We compared those who took clopidogrel alone (n=9862) vs. those who took clopidogrel with PPIs (n=4521), adjusting for baseline differences in age, gender and comorbidity.
Results: Stent patients with no preceding CV events taking PPIs with clopidogrel showed a 32.5% incidence of a major CV event within one year vs. 21.2% of patients not taking PPIs (adjusted OR 1.79, CI 1.62–1.97). A more pronounced effect was seen among patients with a preceding CV event; 39.8% vs 26.2% (adjusted OR of 1.86, CI 1.63–2.12).
Conclusions: Our findings suggest that the drug interaction between PPIs and clopidogrel may result in serious adverse outcomes within one year of therapy initiation, and further support investigations into the effects of cytochrome P450 2C19 genetic polymorphisms.
Abstract 4092: Initial Experience with Subxiphoid Percutaneous Epicardial Ventricular Tachycardia Ablation in Patients with Prior Cardiac Surgery
Authors: Mahapatra Srijoy , McDaniel George M , Mason Pamela K , Ailawadi Gorav 
Published: July 2021

Introduction: Epicardial ablation via subxiphoid percutaenous access improves VT ablation success rate and is growing in popularity. However, it is unclear if this technique is feasible in patients with prior cardiac surgery because of pericardial adhesions. We describe results in our initial 12 patients with previous cardiac surgery.
Methods: A total of 27 patients (11 women) underwent an epicardial VT ablation after failed antiarrhythmic drug therapy and at least one endocardial ablation. Twelve patients had undergone previous cardiac surgery (7 CABG, 3 valve only, 2 combined). The pericardium was accessed using a Tuohy needle. Then a guidewire and an irrigated tip catheter were used to free up adhesions. VT was mapped and ablated. We compared the results in patients with and without prior surgery.
Results: There was no difference in the age (62±11 vs 58±13 years, p=ns), percent women (41 vs 40%, p=ns), EF (30±9 vs 27±11, p=ns), NYHA class (2.4±1.0 vs 2.1±0.9, p=ns) or use of beta-blockers (100 vs 93%, p=ns) or ACE inhibtors (100 vs 93%, p=ns) among patients with and without prior cardiac surgery. However, patients with prior surgery were more likely to have CAD (100 vs 66% p=0.02) and be on ASA (100 vs 73%, p=0.04.) The mean procedure (298±90 vs 178±45 min, p=0.01) and fluoroscopy time (106±24 vs 45±11 min, p=0.01) was longer in patients with prior surgery versus without surgery. The entire epicardium was mapped in 15/15 (100%) of the nonsurgical patients but only in 7/11 (64%) of the surgical patients due to adhesions (p=0.02.) The acute success rate, defined as elimination of all clinical VTs, was lower in the surgical group (75 vs 100%, p=0.02). Elimination of all VTs was achieved less often in post-surgical patient than non-surgical patients (58 vs 80%, p=0.04.) There were two occurrences of RV perforation in each group both treated with conservative therapy. There were no other complications. After 7±2 months, 66% of surgical patients and 80% of non-surgical patients were VT free (p=0.04) as monitored by ICD or 1, 3, and 6 month monitor. One patient in non-surgical group died of heart failure.
Conclusion: Prior cardiac surgery does not preclude epicardial VT ablation but is associated with longer procedure times and lower success rates.