bluuebunny/crossref_metadata_2025_split huggingface dataset:
May Measurement Month 2019: an analysis of blood pressure screening results from Ecuador
Authors: Peñaherrera Ernesto , Ramírez Maria , Peñaherrera Rubén , Duarte Yan C , Cáceres Silvia , Avila Elisa , Jarrin Estefania , Ullauri Vladimir , Aucancela Hugo , Bayas Miguel , Oña Freddy , Arteaga Fabricio , Ruales Jose , Liendo Kisbel , Avila Jessenia Bravo , Hidalgo Eric , Clarke Jonathan , Poulter Neil R , Beaney Thomas 
Published: May 2021

Abstract
Arterial hypertension is a growing burden worldwide, leading to over 10.8 million deaths each year. In Ecuador, it is the main risk factor for the major cause of death, coronary, and cerebrovascular disease [GBD 2017 Risk Factor Collaborators. Global, regional, and national comparative risk assessment of 84 behavioral, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018;392:1923–1994]. The May Measurement Month Campaign in 2019 (MMM19) is a global initiative of the International Society of Hypertension aimed at raising awareness of high blood pressure (BP) and to act as a temporary solution to the lack of screening programs worldwide. A volunteer cross-sectional survey was carried out in May 2019 across 42 health centres in Ecuador. The average age was 51 (SD ±17.6) years. Blood pressure measurement, the definition of hypertension (mean of the second and third BP measurement ≥140/90 mmHg or who were medicated for high BP), and statistical analysis followed the standard MMM protocol. In total, 15 885 volunteers participated in MMM19. After multiple imputation, 6654 (41.9%) had hypertension. Of individuals not receiving antihypertensive medication, 2383 (20.5%) were hypertensive. Of individuals receiving antihypertensive medication, 1004 (23.5%) had uncontrolled BP. May Measurement Month 2019 was the largest BP screening campaign done in Ecuador. In the survey, including 6654 participants with hypertension, only 49.1% had their BP values controlled (&lt;140/90 mmHg). May Measurement Month 2019 demonstrated a high prevalence of hypertension among volunteer screenees in our country. The high percentage of persons untreated or with uncontrolled hypertension while on pharmacologic treatment suggest that appropriate screening can help to identify a significant number of people with high BP. These data should attract the attention of health care providers and the healthcare system in Ecuador.
May Measurement Month 2019: an analysis of blood pressure screening results from Nigeria
Authors: Wahab Kolawole W , Kolo Philip M , Odili Augustine , Iwuozo Emmanuel , Ifebunandu Ngozi , Ademiluyi Babatunde , Okunola Oluyomi , Sani Mahmoud U , Akinlade Mathias , Isezuo Simeon , Ale Olagoke K , Beaney Thomas , de la Rosa Consuelo Nohpal , Clarke Jonathan , Poulter Neil R , Omotoso Ayodele B 
Published: May 2021

Abstract
The aim of this study is to estimate the frequency of undetected hypertension across the six geopolitical zones of Nigeria. We conducted an opportunistic screening of adults aged at least 18 years in the month of May 2019. Participants were recruited by trained volunteers using the May Measurement Month protocol. Blood pressure (BP) was measured using validated digital and mercury sphygmomanometers. We defined hypertension as BP ≥140/90 mmHg or the use of BP-lowering medication. A total of 3646 participants (52.8% females) with a mean age of 44.5 ± 15.7 years were screened. Hypertension was present in 39.2% of the participants but only 55. 4% of these were on antihypertensive medications. Only 46.8% hypertensives who were on medications had their BP controlled (&lt;140/90 mmHg). Previous history of hypertension in pregnancy, alcohol intake and smoking were associated with increased mean systolic and diastolic BPs. The frequency of Nigerians with hypertension is high while only about half of those on antihypertensive medications are controlled. A multi-pronged approach to reduce the burden of hypertension is needed.
Functional study of a N-terminal CPVT mutation RyR2R420Q in patient specific hiPSC-CMs model
Authors: Yin L , Joanne P , Perrier R , Gerbaud P , Lechene P , Alvarez JL , Benitah JP , Gomez AM 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): ANR (Agence Nationale de la Rercherche)
Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a lethal genetic arrhythmia that manifests by syncope or sudden death in children and young adults under stress conditions without obvious cardiac structural abnormality. A novel CPVT mutation located in the RyR2 N terminal portion has been identified in a Spanish family (RyR2R420Q). According to the studies of RyR2 function in HEK293 cell line, this mutation presented gain of function at low cytosolic intracellular Ca2+ concentration ([Ca2+]i) and loss of function at high [Ca2+]i. Moreover, KI mice heterozygous for this mutation presented bradycardia and sino-atrial node (SAN) dysfunction. Here we generated induced pluripotent stem cell (hiPSC) from two brothers (one with mutation, the other without mutation as control) of this family and differentiated them into cardiomyocytes (hiPSC-CM). In order to verify that the differentiated cells were well cardiomyocytes, we did immunofluorescence labelling to detect the α-actinin expression and found that around 90% cells were α-actinin positive in both groups of hiPS-CMs. Then the calcium transient was studied by confocal microscopy and the action potential (AP) by micro-electrode technique. The characteristics of spontaneous AP of mutated cells were mostly similar to that of control cells, but more mutated cells presented proarrhythmic behaviors under adrenergic stimulation. hiPSC-CM are immature cardiomyocytes and contract spontaneously. In order to be able to analyze [Ca2+]i transient characteristics, we paced the cells at a constant rate of 1 Hz by field stimulation through two Pt electrodes. Sarcoplasmic reticulum (SR) Ca2+ load was estimated by rapid caffeine (10 mM) application. hiPSC-CMs from the RyR2R420Q carrier presented smaller SR Ca2+ load than those from the control person, whereas their fractional release (the [Ca2+]i transient normalized by the amount of Ca2+ stored in the SR) was higher than that in control group, indicating a gain-of-function mutation. Even if SR Ca2+ load was smaller in RyR2R420Q cells, they often presented proarrhythmogenic behavior such as Ca2+ waves. The fact was further enhanced during β-adrenergic stimulation, pointing to this model as a valuable tool to study the CPVT disease in human cells.
Three-dimensional vectorcardiographic characteristics of breast cancer patients treated with chemotherapy
Authors: Liu T , Wang Y , Yin X , Liang X , Chen Y , Pan S , Chen Z , Geng X 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Patients receiving chemotherapy for breast cancer (BC) may develop cardiac electrophysiological abnormalities. The aim of this study is to examined possible alterations in cardiac electrophysiological parameters detected by three-dimensional vectorcardiograms (3D-VCGs) in BC patients who received chemotherapy.

Methods
This was a prospective single-center cohort study conducted. Patients with BC referred for chemotherapy from May 1, 2019, to October 1, 2019 were invited to participate in the study. 3D-VCG and echocardiography were recorded at rest four times (baseline, after the first cycle, after third cycles and at the end of the regimen, respectively).

Results
A total of 63 patients were included. Compared with baseline, decreases in 3-dimensional maximum T vector magnitude (TVM) (0.29 ± 0.10 vs. 0.25 ± 0.10mV; p &lt; 0.05) and 3-dimensional T/QRS ratio (0.26 ± 0.11 vs. 0.21 ± 0.11; p &lt; 0.05) were observed by the end of chemotherapy regimen, while echocardiographic parameters showed no significant variation before and after chemotherapy (all P &gt; 0.05). Maximum TVM showed a significant positive correlation with left ventricular ejection fraction (LVEF) (all p &lt; 0.05). Furthermore, the cut-off value with 0.23 of 3-dimensional T/QRS ratio (the area under the curve [AUC] 0.725) for differentiating LVEF reduction ≥10% following initiation of chemotherapy. The AUC of the front plane T/QRS ratio and horizontal plane T/QRS ratio for the detection of an LVEF reduction ≥10% was 0.725 and 0.763, respectively.

Conclusions
3D-VCGs can be used to detect electrophysiological abnormalities in BC patients receiving chemotherapy. Subclinical cardiac dysfunction can be revealed by 3D-VCGs before alterations in traditional echocardiographic parameters.
The impact of hydroxychloroquine and azithromycin on the corrected qt interval in patients with the novel coronavirus disease 2019
Authors: Murat B , Murat S 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Although long-term use of HCQ and AZT has been reported to cause QT prolongation and malign arrhythmia, there is not enough data about the effect of short-term use on arrhythmia. Purpose: The aim of this study was to assess the effect of HCQ alone and HCQ + AZT on corrected QT (QTc).Methods: A baseline ECG and on-treatment ECGs were retrospectively collected in COVID-19 patients who received HCQ and/or AZT. Also peak QTc intervals of monotherapy and combination therapy was compared. Results: Of the 155 patients included, 102 (65.8%) were using HCQ, 53 (34.2%) were using HCQ + AZT combination. The use of both HCQ alone and HCQ + AZT combined therapy significantly prolonged the QTc and the QTc interval was significantly longer in patients received combination therapy. QTc prolongation caused early termination in both groups, 5 (4.9%) patients in the monotherapy group and in 6 (11.3%) patients in the combined therapy group.Conclusion: Patients who received HCQ for COVID-19 were at high risk of QTc prolongation, and concurrent treatment with AZT was associated with greater changes in QTc. Comparison of baseline characteristics a Characteristic Total (n = 155) Hydroxychloroquine (n = 102) Hydroxychloroquine /Azithromycin (n = 53) P value Length of stay at ward, SD 9.54 ± 4.28 9.64 ± 4.31 9.31 ± 4.25 0.88 Length of stay Intensive care unite,SD 7.92 ± 3.76 7.18 ± 3.18 8.46 ± 4.15 0.29 Radiographic findings of pneumonia 118(76.1%) 76(74.5%) 42(49.2%) 0.32 Mechanically ventilation 16(10.3%) 7(6.9%) 9(17.0%) 0.049 In hospital death 19(12.3%) 10(9.8%) 9(17.0%) 0.15 ECG findings median(IQR) (ms) Baseline QRS duration 91.0(80.0-103.0) 92.5(80.75-105.50) 90.0(80.0-102.5) 0.5 Posttreatment QRS peak 97.0(86.0-109.0) 97.5(88.0-109.25) 95.0(85.5-109) 0.68 ΔQRS 4.0(0.0-9.0) 2.0(0.0-8.25) 5.0(1.0-9.5) 0.14 Baseline QTc duration 407.0(385.0-426.0) 408.0(389.25-427.50) 404.0(384.0-420.0) 0.1 Posttreatment QTc peak 437.0(414.0-460.0) 428.0(412.75-449.25) 456.0(422.0-467.5) &lt;0.001 ΔQTc 27.0(13.0-45.0) 18.0(11.0-30.0) 46.0(40.5-54.5) &lt;0.001 Baseline PR duration 145.50(128.7-160.0) 147.0(135.0-160.0) 144.0(120.0-160.0) 0.53 Posttreatment PR peak 159.0(140.0-170.0) 159.0(141.0-168.50) 156.0(139.5-171.0) 0.97 ΔPR 7.0(1.0-13.0) 5.0(0.0-12.25) 10.0(5.0-15.0) 0.022 QTc peak day 5.0(4.0-5.0) 5.0(4.0-6.0) 4.0(3.0-5.0) 0.022 Drug withdrawl due to QRS prolongation 11(7.1%) 5(4.9%) 6(11.3%) 0.12
Relationship between heart rhythm turbulence and ventricular arrhythmia in patients with multivessel lesion of coronary arteries
Authors: Kevorkov AG , Tursunov EY , Rasulov AS 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): MoH Research Grant "Development of methods for differentiated prevention and treatment of potentially dangerous heart rhythm disorders"
Prediction of adverse outcomes in patients after myocardial infarction (MI) remains a serious and not completely resolved problem, which pushes researchers to search for new technologies. One of the relatively promising new non-invasive methods for predicting sudden coronary death in patients with coronary heart disease and ventricular arrhythmias (VA) may be an assessment of heart rate turbulence (HRT). Given its important prognostic role, primarily in patients after MI, the aim of this work was to study the relationship between HRT and cardiovascular remodeling in patients with VA with history of MI and multivessel nature of coronary lesions.

Materials and research methods
123 patients with history of MI, aged 38 to 76 years (average age 61.0 ± 7.6 years), were included into the study. The multivessel nature of coronary lesions was established based on the results of diagnostic selective coronary angiography. All patients underwent Holter monitoring of the electrocardiogram (HMECG). HRT was determined using two indicators, in accordance with the guidelines: Turbulence Onset (To, %) and Turbulence Slope (Ts, ms/RRi).

Results
Potentially dangerous ventricular arrhythmias (PDVA) were noted in more than half of the examined patients (n = 67; 54.5%). In analyze of the structure of PDVA, II class of VA, as the highest class, was not observed in any of the examined patients, class III was detected in 35% of cases, IVA – in 37.5%, and IVB – in 27.5%. In assessing the frequency of VAs, according to the Bigger classification, frequent PVC &gt;10 VA/hour was detected in 41.5% of patients.
The analysis of the HRT indicators did not reveal a decrease in the mean values both To (-1.2 ± 1.5%) and Ts (3.9 ± 3.1 ms/RRi) indicators in the main group of patients. However, after appropriate separation of the main group, 21.1% of them had disorders of only one (category 1; 15.4%) or both of the HRT indicators (category 2; 5.7%). Category 0 included patients without any disorder of HRT indicators. In analysis of the relationship between the PDVA and the category of HRT reduction, a significant interrelation between them was revealed (Table 1).

Result
Our study demonstrates presence of strong interrelation between HRT parameters disorder and severity of PDVA. Thus, study of HRT in patients after MI could be a strong and independent predictor of cardiovascular events including sudden cardiac death. Abstract Figure. Tab. 1. Interrelation between HRT and VA
Sudden cardiac death risk stratification in patients with a preserved or mildly reduced ejection fraction: role of cardiac magnetic resonance and electrophysiological study
Authors: Buia V , Muca M , Bastian D , Walaschek J , Rittger H , Bayer T , Vitali-Serdoz L 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

BACKGROUND
Patients presenting with syncope of suspected arrhythmogenic origin or symptomatic documented non sustained ventricular tachycardia (NSVT) may represent a population with higher risk for sudden cardiac death (SCD). However today there are still no defined criteria to stratify the risk of SCD in this population.

PURPOSE
To assess the prognostic value of magnetic resonance (MRI) and electrophysiological study (EPS) in the risk stratification for SCD of patients with a preserved or mildly-reduced ejection fraction (EF) that may benefit from implantable cardiac defibrillator (ICD) therapy.

METHODS
We selected ischemic and non-ischemic patients with a preserved or mildly-reduced ejection fraction who came to our attention either after a probably arrhythmogenic syncopal event or a documented NSVT between 12/2018 and 09/2020. Patients with other ICD indications following current guideline-criteria were excluded (id est Brugada syndrome, Long QT and hypertrophic cardiomyopathy). All patients underwent an echocardiography, a coronary angiography, and an MRI with gadolinium, those among them with a positive LGE also underwent an induction EPS. Non inducible patients were followed-up clinically or with an implantable event-recorder, while inducible patients received an ICD.

RESULTS
In our observational study seventeen patients with preserved or only mildly-reduced EF were enrolled (13 males and 5 females; mean age 68 years). Among these patients, nine were identified with an underlying myocardial scar with positive Late-Gadolinium-Enhancement (LGE) in MRI. Based on the clinical orientation and the MRI LGE pattern patients were divided in ischemic group (5 patients) and non-ischemic group (4 patients). All 9 patients underwent an induction EPS. Three of them, 2 with non-ischemic and 1 with an ischemic pattern, demonstrated a reproducible inducibility of a sustained ventricular tachycardia or ventricular fibrillation and were implanted with an ICD. During our follow-up two of the three patients had an adequate shock within a year from the ICD implantation. Among the 6 patients with negative induction EPS there were no clinical events in the follow up, except one death for unknown causes.

CONCLUSION
Our preliminary results demonstrated that in patients with ischemic or non ischemic cardiopathy with preserved or mildly reduced EF, a positive MRI LGE pattern and the inducibility of ventricular arrhythmias during induction EPS identify a population at higher risk for clinical recurrence of ventricular arryhthmic events. Further investigation is needed to validate this combined diagnostic strategy as new SCD prevention tool.
Main determinants of physician-driven amiodarone discontinuation in clinical practice
Authors: Mihajlovic M , Mihajlovic A , Marinkovic M , Kovacevic V , Simic J , Mujovic N , Potpara T 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Amiodarone is the most prescribed antiarrhythmic drug, but drug-related side effects sometimes result in drug discontinuation. Not infrequently, physicians discontinue amiodarone without a medical reason. We explored the determinants of such permanent drug discontinuation.

Methods
A single-centre, longitudinal study included consecutive patients newly prescribed or already taking amiodarone when first seen in our health centre from January 2013 to December 2017. Baseline data were retrieved from the hospital electronic database and patients were scheduled for a follow-up visit in January to March 2019.

Results
Of 1212 patients taking amiodarone (mean age 64.2 ±11.2 yrs; female n= 358, 29.5%; median follow-up 22.5 months), the drug was permanently discontinued in 489 (40.3 %), see Figure. On univariate Cox regression analysis, female sex (HR 1.55; 95%CI 1.0-2.3; p = 0.032), non-multimorbidity (2.9; 2.0-4.3; p &lt; 0.001), LV EF (1.0; 1.0-1.1; p &lt; 0.001), NOAC therapy (1.9; 1.2-3.0; p = 0.003) and AF ablation (2.7; 1.5-4.6; P &lt; 0.001) were associated with amiodarone discontinuation. Age (0.9; 0.9-0.9; p &lt; 0.001), CAD (0.3; 0.2-0.5; p &lt; 0.001), HF (0.5; 0.3-0.9; p = 0.020), ventricular arrhythmias (0.1; 0.0-0.3; p &lt; 0.001), stroke (0.2; 0.1-0.9; p = 0.045), CKD (0.5; 0.3-0.9; p = 0.011), ICD (0.1; 0.0-0.6; P = 0.014), LV diastolic (0.9; 0.9-0.9; p = 0.001) and systolic diameter (0.9; 0.9-0.9; p &lt; 0.001), polypharmacy (0.5; 0.3-0.7; P &lt; 0.001), VKA therapy (0.6; 0.4-0.9; p = 0.027), aspirin (0.57; 0.4-0.9; p = 0.011), loop diuretic (0.5; 0.3-0.7; p &lt; 0.001), spironolactone (0.4; 0.2-0.7; p &lt; 0.001) and statin (0.6; 0.4-0.9; p = 0.009) therapy were associated with drug continuation. Multivariable risk factors for amiodarone discontinuation are showed in Table.

Conclusion
Study showed that within the first two years of treatment, despite persistent indication, amiodarone was discontinued in 1 out of 10 patients in the absence of side effects, mostly in younger patients with less comorbidities, which may not always be justified. There is a need for qualitative research to elucidate the reasons for such physicians’ decisions. Table.Multivariable Cox Proportional HAZARD Regression analysis of permanent Amiodarone discontinuation due to physician decisionVariableHR95% CIP valueAge0.9700.95-0.990.003VT/VF/electrical storm0.1390.04-0.450.001VKA therapy0.5980.38-0.940.026Ablation of AF2.5391.38-4.690.003Number of comorbidities ≤32.0241.26-3.270.004VT ventricular tachycardia; VF: ventricular fibrillation.Abstract Figure.
Withdrawal of anti-arrhythmic therapy after cavo-tricuspid isthmus ablation of typical atrial flutter
Authors: Couto Pereira S , Rodrigues T , Brito J , Silverio Antonio P , Valente Silva B , Alves Da Silva P , Cunha N , Nunes-Ferreira A , Bernardes A , Lima Da Silva G , Cortez-Dias N , Pinto FJ , De Sousa J 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Medical management of typical atrial flutter (AFL) is sometimes unsuccessful and may have adverse effects. Symptom control using radiofrequency cavo-tricuspid isthmus ablation (CTA) is a feasible alternative, given the fact that it is a simple procedure with a low rate of complications. However, in some patients (pts), new atrial arrhythmias may develop and the decision of anti-arrhythmic therapy (AAT) withdrawal is usually patient-based.

Purpose
To predict the recurrence of atrial arrhythmias (AR) after CTI ablation between pts that suspended AAT and those that maintained AAT.

Methods
Single-center retrospective study of pts with typical AFL submitted to ablation between 2015 and 2019. Pts clinical characteristics, current and follow up therapy were collected. Holter and/or 7-day event loop recorder were performed during the follow up to identify AR. For statistical analysis, we applied Chi-square, Mann-Whitney and Cox regression to identify predictors of AR.

Results
CTA ablation was performed in 476 pts (mean age: 66.3 ± 11.7 years, 79.8% males). At time of ablation most pts were in EHRA II class (70.8%) and 44.6% of pts had at least mild left atrial dilatation on transthoracic echocardiography. The mean follow up time was 2.8 years.
Two-hundred sixty-nine pts (57,6%) were under anti-arrhythmic therapy (AAT) before the ablation. After the procedure, 58 pts withdrawn AAT before AR and 8 pts after AR. During the follow-up period, we observed AR of typical AFL in 17 pts (3.6%), atypical AFL in 35 pts (7.4%) and AF in 118 pts (24.8%).
There were no statistically significant differences regarding AR between pts that maintained and suspended AAT (p = NS). Concerning the pts that suspended AAT, thyroid disfunction (p = 0.012), higher CHADs-VASc score (p = 0.033), ischemic cardiomyopathy (p = 0.001) and tobacco abuse (p = 0.005) were predictors of AR, being the last two also independent predictors (HR 0.243; 95%CI 0.76-0.778, p = 0.017; HR 4.449; 95%CI 1.128-17.553, p = 0.033, respectively).

Conclusion
After CTA ablation, AF is the most frequent recurrent arrhythmia. Interestingly, the withdrawn of AAT didn’t seem to predict the recurrence of arrhythmic events. The decision of stopping AAT must be individualized regarding patients’ clinical characteristics. Abstract Figure 1: AAT withdrawal and AR