bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 79: Is Harada Score a Useful Tool in Mexican Childrens with Kawasaki Disease?
Authors: Flores-Pineda Angel J , Garcia-Rodriguez Fernando , Tomala-Haz Javier E , Lara-Herrera Paola B , Salinas-Encinas Diego R , Rodriguez-Garcia Andres N , Maldonado-Velazquez Maria R , Moreno-Espinosa Sarbelio , Faugier-Fuentes Enrique 
Published: July 2021

Background/Purpose:
In developed countries Kawasaki disease (KD) is the most common cause of acquired heart disease in childhood. Haradascore is one of the most used predictive tool for coronary arteries aneurysms (CAA) development in KD. The aim of the study is to describe clinical data, treatment, and to assess the Harada score in Mexican patients with KD.

Methods:
We retrospectively indentified all patients evaluated at Hospital Infantil de Mexico Federico Gómez during a 6-yearperiod between 2008 and 2014. We reviewed demographic, clinical, laboratory, echocardiographic, and treatment data;and Harada scores were derived to evaluate efficacy in predicting risk for CAA.

Results:
In our Institution 34 cases were reported during the study period, 16 (47.1%) males, and median age of 36 (8 - 120)months. Incomplete KD was diagnosed in 6 (17.6%) cases with no significant differences in demographic data, but with alower accuracy in establishing diagnosis at admission compared with complete presentations (100% vs 66.7%, P = 0.027).Most of the patients (76.5%) received at least one antibiotic prior to admission to our Hospital.

Patients presented with history of 6 (4 - 16) days with fever and conjunctivitis. Significant differences were observed between complete and incomplete presentations regarding oral changes (100% vs 66.7%, P = .027), strawberry tongue (92.9% vs 33.3%, P = .004), pharyngitis (100% vs 33.3%, P < .001), and rash (71.4% vs 16.7%, P = .021). No significant differences were observed in laboratory results. Seven (20.6%) echocardiograms werereported with CAA, one of them found valve insufficiency, and none identified effusion. Harada score was positive in 23 (67.6%) patients, with high sensitivity (85.7%) and low specificity (37%), OR 1.36 (CI95% 0.89 - 2.06, P = .384).
In total, 32 (94.1%) patients received intravenous immunoglobulin (IVIG). Retreatment with IVIG was given in 3 (8.8%) and steroid treatment in 1 (2.9%) patient. All of the patients received aspirin.

Conclusions:
This study revealed a high incidence of CAA in our population, added to lack of suspicion and antibiotic overuse. As in Japanese and US population, Harada score is a good screening tool to identify risk for CAA development in Mexican patients.
Abstract 11591: Physiological CPR Quality Parameters and ROSC Indicators
Authors: Aelen Paul , Ordelman Simone , Woerlee Pierre , Noordergraaf Gerrit-Jan 
Published: July 2021

Introduction:
Survival of cardiac arrest depends on CPR quality with blood flow as the main parameter. Blood flow is affected (among others) by compression depth. AHA guidelines advise the same depth range for all patients while their individual optimum may vary widely. An individual and time dependent optimum, guided by a non-invasive measure of blood flow may result in an increased survival chance. We investigated surrogate parameters that reflect invasive blood flow.

Methods:
VF was induced in seven anesthetized pigs of ± 30 kg. CPR was performed at 100 cpm with a proprietary automated CPR device. Compression depth was altered every 2 minutes (sequence: 4.0, 3.25, 4.0, 5.0, 6.0, 5.0 and 4.0 cm) to obtain a large range of blood flows. After 14 minutes of CPR defibrillation was performed. After a stable ROSC period the complete sequence was repeated.

Correlation coefficients between net carotid blood flow and potential surrogate parameters were calculated for the compression period in order to see what parameters could be used to reflect CPR quality. The same analysis was done for a 6 min period around the last compression (see figure 1) to investigate what parameters could be used to detect ROSC.

Results:
Average correlation coefficients between carotid flow and surrogate parameters are shown in figure 1.

Conclusion:
DBP and CPP were the best CPR quality and ROSC indicators. Contrary to CPP, DBP has the potential to be measured non-invasively (e.g. with a cuff) which in the future might be used to steer CPR and detect ROSC.

PPG signals (i.e. a pulse oximetry sensor) had a negative correlation with flow as PPG reflects blood volume inversely. The baseline channels showed some potential to be used as ROSC detector and as CPR surrogate, especially in the infrared channel. The amplitudes of the PPG were not of use to detect ROSC or to steer CPR.
SBP, MAP, PP, ETCO2 and VCO2 have the potential to detect ROSC but are not of great use as a measure of CPR quality. For ETCO2 the low correlation is remarkable.
Abstract 12582: The Origin of Hypertension and Sympathetic Regulation in Diet Induced Obesity
Authors: Lim Kyungjoon , Barzel Benjie , Burke Sandra L , Head Geoffrey A 
Published: July 2021

Obesity is closely associated with a greater risk of developing hypertension and there is a strong link between bodyweight gain and greater blood pressure (BP). Plasma leptin levels correlate with BP and renal sympathetic nerve activity (RSNA). The central effects of leptin are mediated primarily through the arcuate (ARC) nucleus of the hypothalamus from which peripheral signals are relayed downstream, to other hypothalamic nuclei, via a network of second order neurons. Dense projections of both Neuropeptide Y (NPY) and alpha-melanocyte stimulating hormone (α-MSH) containing neurons ascend from the ARC and terminate in several hypothalamic nuclei such as the ventromedial hypothalamus (VMH) which are the key centres of energy homeostasis, hemodynamics and sympathetic tone to brown adipose and renal vasculature. It is therefore possible that a change in the activity of either POMC or, NPY neurons or both may underlie the mechanism by which sympathetic output is increased in obesity, leading to hypertension.
In the present study we assessed the contribution of α-MSH and NPY neurons in the VMH on development of diet-induced neurogenic hypertension.
New Zealand White rabbits were instrumented with a VMH cannula and a renal sympathetic nerve electrode. Blood pressure (BP) was measured by means of an intra-arterial catheter. Rabbits were injected with α-MSH, SHU9119 (MC3/4R antagonist), NPY or Leptin receptor antagonist into the VMH, 60 minutes apart using an injector.
Following 3 weeks of a high fat diet (HFD, 13.5% fat), conscious rabbits had higher BP (+7.6 ± 0.5mmHg, P<0.001) and RSNA (+4.6 ± 0.4nu, P<0.001) compared to control group (3.5% fat). α-MSH injection into the VMH increased BP (+7%) and RSNA (+35%) (P<0.001) and SHU9119 injection showed reduction (P<0.05) in BP (-7%), HR (-5%) and RSNA (-23%) in HFD rabbits. Leptin antagonist or NPY injection showed dose dependant reduction in BP (-7%), HR (-5%) and RSNA (-11%) (P<0.05) when given to HFD rabbits. NPY injection reduced BP in all groups.
We conclude that the HFD feeding may induce pathway-specific changes in the VMH and VMH is the likely origin of leptin-mediated sympathoexcitation, α-MSH hypersensitivity and altered central responsiveness to NPY.
Abstract 15675: Variability in Post-Arrest Targeted Temperature Management Practice in the US: 33°C vs. 36°C
Authors: Leary Marion , Delfin Gail , Grossestreuer Anne , Bobrow Bentley , Santos Jillianne , Buckler David , Abella Benjamin S , Blewer Audrey 
Published: July 2021

Background:
A recent study examining 33C vs 36C use in Targeted Temperature Management (TTM) after cardiac arrest showed equivalent outcomes. However, it is unclear whether providers are changing goal target temperature based on these findings.

Objectives:
To characterize the state of TTM practice in US hospitals and to assess whether institutions are using a goal temperature of 33C or 36C.

Methods:
A 10-question internet-based survey was sent to a convenience sample of healthcare providers throughout the US. Providers associated with the Penn Alliance for Therapeutic Hypothermia database, Hypothermia and Resuscitation Training Institute, and other resuscitation specific email lists were included. Participants were queried regarding their institution’s TTM protocol. Descriptive analyses were performed.

Results:
Between 12/2014-05/2015, 219 healthcare providers responded from 112 institutions in 35 states. Respondents were staff nurses (39%), advanced practice nurses (28%), physicians (22%) and other providers (11%). Respondents represented medical ICU (25%), cardiac ICU (21%), ED (15%), and other ICUs (39%).

When asked about their institution’s TTM protocol, of those who responded (204/219), 65% reported a goal temperature of 33C, 8% reported 36C, 25% reported either 33C or 36C, and 3% were unknown. When asked how the target temperature was selected, 30% stated there were only adequate data to support 33C, 3% stated there were only adequate data supporting 36C, 42% stated they were reevaluating 33C v 36C, and 25% stated unknown.
A median of 2 (IQR 2-3.5) clinicians from the same institution completed the survey. Of those, 5/39 (13%) of the respondents from the same institution did not agree on or were unsure whether their institution had a TTM protocol; 33% did not agree on the target temperature within their hospital; 64% did not agree or did not know if data supported the instruction’s choice of target temperature.

Conclusions:
Across hospitals in the US, and even within the same institution, the target temperature for post-arrest patients varies widely. More research is required to understand the choice of TTM target temperature for specific patient indications to improve outcomes.
Abstract 16458: Paracrine Crosstalk Between Paltelets And Vascular Endothelial Cell is Mediated via MicroRNAs
Authors: Dangwal Seema , Stratmann Bernd , Bang Claudia , Tschoepe Diethelm , Thum Thomas 
Published: July 2021

Majority of extracellular miRNAs constituting plasma miRNA pool are released by platelets. This study investigated the miRNA signature of leukocyte depleted platelets (LDP) isolated from T2DM or healthy subjects and explored the mechanism of miRNA mediated vascular crosstalk.
LDPs, obtained by leukocyte filtration of platelet rich plasma (PRP), were isolated from blood withdrawn from 6 T2DM patients (male, age: 54.8±7.6 yrs; HbA1c: 8.9±0.6%; BMI: 30.9±2.8kg/m2) and 10 healthy volunteers (male, age: 49.2±6.8yrs; HbA1c: 5.3±0.2%; BMI: 26.6±3.8kg/m2). Total RNA isolated from diabetic or healthy LDPs was subjected to PCR based miRNA profiling. Matrigel capillary formation and genomic BrdU incorporation were measured as readouts of angiogenesis and cell proliferation respectively. Cellular metabolic activities were measured by WST-1 assay. Student t-test was applied to compare groups and p<0.05 considered significant.
Total 735 (97%) miRNAs were detected (threshold< 29 Ct) in all LDPs. Levels of 19.5% miRNAs were decreased in T2DM platelets, whereas 7.5% miRNAs showed increase at 2-50 fold cutoff value. Compared to healthy LDPs (n=10), decreased levels of 14 highly platelet enriched miRNAs candidates including miR-21 and miR-22 were confirmed by RTPCR validation of individual T2DM LDPs irrespective of aspirin intake or presence of coronary heart disease (n=11).
Thrombin stimulation of washed healthy platelets increased miRNA release into cell supernatant and confocal microscopy confirmed the cellular uptake of platelet released micro-particles into human coronary artery endothelial cells within 2-24h. In addition, endothelial overexpression of miR-21 or miR-22 decreased cell proliferation and metabolic activity, whereas miR-22 also attenuated capillary formation capacity. MiR-21 and miR-22 modulation inversely regulated expression of cell-cycle regulator gene CDK-6 at mRNA and protein levels.
Diabetic platelets show distinct miRNA signature compared to healthy platelets and lower levels of miRNAs in diabetic platelets may represent their active secretion during diabetes. Released miRNAs may mediate crosstalk with vascular cells by influencing cellular gene expression and function upon their uptake.
Abstract 16480: Characteristics and Outcomes of Patients With Papillary Muscle Ventricular Arrhythmias
Authors: Gianni Carola , Di Biase Luigi , Mohanty Sanghamitra , Trivedi Chintan , Gökoglan Yalçin , Günes Mahmut F , Bai Rong , Al-Ahmad Amin , Burkhardt J D , Gallinghouse Joseph G , Horton Rodney , Hranitzky Patrick M , Sanchez Javier E , Natale Andrea 
Published: July 2021

Introduction:
We sought to investigate the characteristics and outcomes of patients who underwent RF ablation of PM ventricular arrhythmias (VA) in our center.

Results:
26 patients were included, median age was 66 years (16 to 85), 46% female, all with normal LVEF. PM VAs were PVCs in 68% patients, and PVC + VT in 32%. Site of origin was the LV infero-septal PM in 73%, LV antero-lateral PM in 15% and right ventricular RV septal PM in 12%.

46% of patients showed other VAs in addition to the one originating from the PMs; in 33% of these patients, additional VAs were 2 or more. These VAs were mostly PVCs (92%), localized in the LVOT (64% - 56 % in the basal LV and 44% in the aortic cusps) and the septal RVOT (36%). The only additional VT was fascicular.
All the PMs and mappable additional VAs were ablated with RF energy through an irrigated catheter and the aid of ICE; a remote magnetic navigation system (RMS) was used in half of the procedures. In one case, PVC suppression required additional epicardial ablation.
Major complications occurred in 2 patients (8%): 1 pericardial effusion (the patient underwent ablation of a crista terminalis premature atrial complex in the same procedure) and 1 pseudoaneurysm.
Acute success (PM VA suppression/non-inducibility) was achieved in 96% of patients (the patient with pericardial effusion could be anticoagulated further and the procedure was stopped). After a median follow-up period of 8 (4-14) months, long-term success (no PM VT recurrence or PVC burden reduced by 80% off antiarrhythmic drugs) was 92% after a single procedure, 96% after repeat procedures. When considering additional VAs, the only recurrence was a parahisian RVOT PVC.
No difference in acute or overall long-term success was observed when comparing RMS-guided vs standard procedures (respectively 92% vs 100 % and 100% vs 92%; P = NS).

Conclusion:
PM VAs are most commonly PVCs originating from the LV infero-septal PM and are frequently (48%) associated with an additional ventricular focus (LVOT > RVOT >> fascicular VT).

RF ablation is safe and effective in eliminating or significantly reduce the burden of PM VAs, as well the extra-PM foci that are commonly encountered in this population. RMS guided ablation is not inferior to standard ablation in this subset of patients.
Abstract 16973: Prevalence, Determinants, and Impact of Target Lesion Calcification in Patients Undergoing Percutaneous Coronary Intervention With Newer Generation Drug Eluting Stents: Findings From a Large Multiethnic Registry
Authors: Copeland-Halperin Robert S , Baber Usman , Rajamanickam Anitha , Aquino Melissa , Roy Swathi , Kovacic Jason C , Moreno Pedro , Krishnan Prakash , Sweeny Joseph , Mehran Roxana , Dangas George , Kini Annapoorna S , Sharma Samin K 
Published: July 2021

Coronary calcification increases risk for adverse events in patients undergoing PCI with bare-metal or first-generation drug-eluting stents. Newer generation devices, however, are safer and more efficacious. Whether coronary calcification relates to risk in the newer generation DES era is unclear.
We assessed the hypothesis that target lesion calcification in patients undergoing PCI with newer generation DES is associated with specific patient characteristics and clinical outcomes.
We performed a retrospective analysis of a large, multiethnic cohort of patients undergoing PCI (n=14,054) with new generation DES at a single academic center between 2009 & 2013. Coronary calcification was qualitatively assessed as none/mild, moderate or severe. Independent demographic, clinical and anatomic predictors of moderate/severe calcification were identified using logistic regression. Associations between coronary calcification and one-year MACE (death, MI or TVR) were examined using Cox modeling.
Compared to patients with none/mild (n=11,530; 82.0%) those with moderate (n=1423; 10.0%) or severe (n=1101; 8.0%) coronary calcification were older, more often Caucasian, and had more complex target lesions and greater renal dysfunction. The strongest demographic, clinical and anatomic correlates of moderate/severe calcification were Caucasian race, renal dysfunction and left main target lesion. Unadjusted MACE rates among those with none/mild, moderate and severe calcification were 9.0, 14.7, and 17.9%, respectively (p<0.001, Figure). After multivariable adjustment, hazard ratios (95% CI) for MACE associated with moderate and severe coronary calcification were 1.48 (1.27-1.72) and 1.72 (1.46-2.03), respectively.
Despite the improved safety and efficacy profile of new generation DES, moderate to severe target lesion coronary calcification is not uncommon in the contemporary DES era and remains a strong and independent predictor of MACE after PCI.
Abstract 16993: Sex Differences in Renal Transporter Profile Indicate Lower Proximal Reabsorption in Females
Authors: Veiras Luciana C , Tran An , Ralph Donna L , Castello Costa Girardi Adriana , McDonough Alicia A 
Published: July 2021

Females have lower blood pressure than males before menopause, blunted hypertensive response to AngII, and a leftward shift in pressure natriuresis. Estrogen decreases renal ACE and AT1R and increases NO and AT2R. At the renal transporter level, distal tubule Na+-Cl- cotransporter (NCC) is upregulated by estrogen and more abundant in females, while the loop of Henle (LH) Na+-K+-2Cl- cotransporter (NKCC2) is less abundant. This study aimed to compare female to male apical Na+ transporters’ abundance, distribution, phosphorylation and cleavage and to determine the functional consequences of the differences.
Sprague Dawley rats were fasted overnight then fed a 0%KCl meal before termination. The figure displays relative abundance of total and modified (P -phosphorylated, CL-cleaved, FL-full length) transporters expressed along the nephron in females versus males (defined as 1.0), determined by quantitative immunoblotting. Lower abundance of NaPi2, villin, myosin VI, together with higher NHE3-P (inactivation marker) suggest less proximal tubule (PT) reabsorption in females. Confocal immunohistochemistry confirmed that NHE3 localized to the base of the PT microvilli in females (not males) and endogenous CLi+, a marker of volume leaving the PT, was twice as high in females than males. While LH NKCC2 and its regulatory kinase SPAK were not significantly different, distal NCC, and activated NCC-P were more abundant in females, although thiazide sensitive natriuresis was not greater. ENaC α and γ subunits were more activated (-CL) in females. A saline challenge (7% of b.w. saline, i.p.) demonstrated that females excreted a saline load more rapidly than males. Taken together, these results suggest that lower proximal transporters and reabsorption provoke a volume load dependent elevation in NCC and ENaC. This profile in females likely facilitates pressure natriuresis and maintains lower blood pressures.
Abstract 17107: Distribution of Anti-inflammatory Activity During Remodeling of High Density Lipoprotein: Studies With CSL112
Authors: Diditchenko Svetlana A , Navdaev Alexei V , Spycher Martin O , Wright Samuel D 
Published: July 2021

Elevated levels of circulating inflammatory markers predict an unfavorable cardiovascular outcome in acute coronary syndrome patients. CSL112 is human apolipoprotein A-I (apoA-I), reconstituted with phosphatidylcholine to form HDL particles suitable for infusion. Addition of CSL112 to stimulated human whole blood ex vivo strongly reduces pro-inflammatory cytokine production. Infusion of CSL112 into human subjects or addition to human plasma ex vivo causes remodeling of endogenous HDL. Similar remodeling occurs upon incubation of CSL112 with purified HDL3 and results in accumulation of three HDL species: enlarged HDL (HDL2), a smaller, dense species (HDL3c), and lipid-poor apoA-I (pre-β1 HDL).
Study aim was to determine the anti-inflammatory activity of remodeled HDL species. CSL112 was incubated with HDL3 and the products of particle remodeling were purified by ultracentrifugation. The inhibitory effects on pro-inflammatory cytokine production were examined using human peripheral blood mononuclear cells (PBMC) stimulated with phytohemagglutinin-M (PHA-M) in vitro.
Lipid-poor apoA-I, HDL3c as well as parent CSL112 exerted powerful inhibitory effects on secretion of pro-inflammatory mediators (> 89.2% + 4.0% inhibition of TNF-α, IL-1β, IL-6 and Mip-1β); HDL3 and HDL2 were much less effective (< 54.1% + 3.9% inhibition). The extent of inhibition correlated positively with induction of the transcription repressor ATF3, a negative regulator of pro-inflammatory cytokine production, with lipid-poor apoA-I and HDL3c inducing higher protein levels of ATF3 in PHA-stimulated PBMC compared to control medium, HDL3 or HDL2. Anti-inflammatory activity of the remodeled species also correlated with their ability to support cellular cholesterol efflux via the ABCA1 transporter: lipid-poor apoA-I and HDL3c were potent acceptors of cholesterol; HDL2 was inactive.
The ability to generate HDL species with high cholesterol efflux and anti-inflammatory activity makes CSL112 a promising candidate for removing cholesterol and reducing inflammation in atherosclerotic plaque, thus reducing the high risk of early recurrent atherothrombotic events following acute MI (AMI). A Phase IIb trial (AEGIS-I; NCT02108262) of CSL112 in AMI patients is ongoing.
Abstract 17609: Comparison of All-cause and Bleeding-related Hospitalizations Among Non-valvular Atrial Fibrillation Patients Receiving Oral Anticoagulants
Authors: Deitelzweig Steve , Bruno Amanda , Gupta Kiran , Trocio Jeffrey , Tate Natalie 
Published: July 2021

To compare the risk of hospitalization among non-valvular atrial fibrillation (NVAF) patients newly initiated with an oral anticoagulant (OAC): apixaban, dabigatran, rivaroxaban, or warfarin.
Retrospective cohort study using Humana Medicare Advantage data from 7/1/2009 - 9/30/2014. NVAF patients ≥18 years receiving one OAC on the index date with 6 months continuous enrollment prior to index prescription date and 3 months post-index were eligible. Hospitalizations were identified by standard codes for inpatient admission. Bleeding-related hospitalizations required an additional code for major/clinically relevant non-major (CRNM) bleeding. A cox proportional hazards model was used to estimate the hazard ratios (HR) of hospitalizations adjusted for age, sex, region, comorbidities and comedications. Adherence for each OAC was also calculated using a proportion of days covered approach to understand medication taking behaviors.

Among the 53,168 patients initiated on an OAC, 2,028 (3.8%) apixaban, 5,644 (10.6%) dabigatran, 7,667 (14.4%) rivaroxaban and 37,829 (71.1%) warfarin. Patients in apixaban cohort were older (mean 75.5 years, P <0.05) with higher mean CHA
2
DS
2-
VASc score (P <0.05). Abixaban patients had a higher mean HAS-BLED score vs. dabigatran (P <0.0001), lower mean score vs. warfarin (P <0.0001) and did not differ significantly vs. rivaroxaban (P =0.46). Patients receiving apixaban had a significantly lower risk for all-cause hospitalization across cohorts, and a sig. lower risk for bleeding-related hospitalization vs. patients receiving rivaroxaban or warfarin (Table). Adherence ranged from 87.8% to 90.4% across cohorts.

In a real-world setting, initiation with apixaban was associated with a significantly lower risk for all-cause hospitalization, and a significantly lower risk of bleeding-related hospitalization compared to rivaroxaban or warfarin.
Table: Adjusted Hazard Ratios of All-cause and Bleeding-related Hospitalizations