bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paeoniflorin alleviates endothelial dysfunction caused by overexpression of soluble fms-like tyrosine kinase 1 and soluble endoglin in preeclampsia via VEGFA upregulation
Authors: Zhang Jin , Hua Wei , Zhao Xinyuan , Yang Fan , Guo Ting , Zhang Jianhua , Zheng Xuerong , Liang Wanqi 
Published: February 2021

ABSTRACTThis study assessed the protective effects of paeoniflorin against preeclampsia-related endothelial damage (ED). Human umbilical vein endothelial cells (HUVECs) isolated from healthy puerperae were identified by immunofluorescence assay. After paeoniflorin treatment, HUVECs were induced by soluble fms-like tyrosine kinase 1 (sFlt-1) and soluble endoglin (sEng) to establish ED. Cell viability, migration, invasion, tube formation, and apoptosis were assessed by (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) tetrazolium MTT assay, Scratch assay, Transwell assay, tube formation assay, and flow cytometry. VEGFA expression in HUVECs was analyzed by Western blot. HUVECs were successfully isolated and identified as Von Willebrand factor (vWF) positive. Individual treatment or cotreatment of sFlt-1 and sEng inhibited migration, invasion and tube formation, enhanced apoptosis, and decreased VEGFA expression in HUVECs. Paeoniflorin pretreatment partially reversed the effects delivered by cotreatment of sFlt-1 and sEng in HUVECs. Paeoniflorin alleviated preeclampsia-related ED caused by overexpression of sFlt-1 and sEng by upregulating VEGFA.
Investigation of Phenolic Content in Five Different Pine Barks Species Grown in Turkey by HPLC-UV and LC–MS
Authors: Şeker Mehmet Emin , Çelik Ali , Dost Kenan , Erdoğan Ayşegül 
Published: February 2021

Abstract
Investigation of phenolic content from different pine bark species grown in Turkey was performed using a reversed-phase high pressure liquid chromatography with ultraviolet (RP-HPLC-UV) method. All phenolic constituents were separated in &lt;26 min on reversed-phase C18 column with gradient mobile phase that consists of orthophosphoric acid, methanol and acetonitrile. Detections were made on an UV detector at 280 nm and at a flow rate of 1 mL/min. Samples were prepared according to Masqueller’s conventional sample preparation method with slight modifications. To avoid the reduction in extraction efficiency the sample preparation step was carried out under argon atmosphere. The linearity of the method was between 0.9994 and 0.9999. The detection limits for the five phenolic constituents ranged from 0122 to 0.324 mg/L. Catechin and taxifolin were found in all pine barks at a concentration of 0.065 ± 0.002–1.454 ± 0.004 and 0.015 ± 0.001–23.164 ± 0.322 mg/g, respectively. Epicatechin was determined in four pine barks between 0.027 ± 0.001 and 0.076 ± 0.002 mg/g, ferulic acid in two pine barks between 0.010 ± 0.001 and 0.022 ± 0.001 mg/g and epicatechin gallate in only one of the pine barks at 0.025 ± 0.001 mg/g. Finally, the total amount of phenolic compounds and antioxidant capacities of the pine barks were found to be very high.
Sensitive Analysis of Metoprolol Tartrate and Diltiazem Hydrochloride in Human Serum by Capillary Zone Electrophoresis Combining on Column Field-Amplified Sample Injection
Authors: Li Ning , He Shujuan , Li Chunlan , Yang Fatang , Dong Yuming 
Published: February 2021

Abstract
A sensitive capillary zone electrophoresis (CZE) combined with field-amplified sample injection (FASI) method was investigated to simultaneously determine diltiazem (DI) hydrochloride and metoprolol (ME) tartrate in human serum. This method was validated by linearity, limits of detection (LOD), stability, precision and accuracy, and the related parameters are linearity (r2 &gt; 0.9980), intra- and inter-day precisions (intra-day relative standard deviation (RSD) is 2.3–3.4%, and inter-day RSD is 3.8–7.5%) and the LOD (0.02 ng/mL for ME tartrate and 0.01 ng/mL for DI hydrochloride). So the proposed method is rapid, sensitive and accurate for determination of these two anti-anginal drugs in human serum. As for enrichment conditions, it was helpful to add phosphoric acid and isopropanol into samples for enrichment efficiency. A model was established to illustrate the possible enrichment mechanism of analytes, and a theory of half-width was also applied in CZE combined with FASI method to evaluate the peak performance.
Analysis of outcomes of a transoral circular stapled anastomosis following major upper gastrointestinal cancer resection
Authors: Foley Daniel M , Emanuwa Emudiaga J E , Knight William R C , Baker Cara R , Kelly Mark , McEwan Ricardo , Zylstra Janine , Davies Andrew R , Gossage James A 
Published: February 2021

Summary

Background
Esophageal anastomoses performed following esophagectomy and total gastrectomy are technically challenging with a significant risk of anastomotic leak. A safe, reliable, and easy anastomotic technique is required to improve patient outcomes and reduce morbidity.

Method
This paper analyses 328 consecutive patients who underwent transoral circular stapled esophageal anastomosis (ORVIL™) from a prospectively collected single-center database between December 2011 and February 2019.

Results
Two hundred and twenty-seven esophagectomies and 101 gastrectomies were performed using OrVil™ anastomoses. The mean patient age was 63.7 years. Of 328 consecutive OrVil™-based anastomoses, there were 10 clinically significant anastomotic leaks requiring radiological or operative intervention (3.05%). Twenty-eight (8.54%) patients developed anastomotic stricture, all of which were successfully treated with endoscopic balloon dilatation (a median of 1 dilatation was required per patient).

Conclusion
The OrVil™ anastomotic technique is reliable and safe to perform. This is the largest reported series of the OrVil™ anastomotic technique to date. Leak rates and anastomotic dilations were similar to other reported series. Based on our experience, we consider the use of the OrVil™ device for reconstruction after major upper GI resection to be safe and reliable.
Late improvement of left ventricular ejection fraction in patients with persistent severe systolic dysfunction under guideline-directed medical therapy
Authors: De Angelis G , Merlo M , Bertolo S , De Luca A , Paldino A , Ramani F , Barbati G , Sinagra G 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. A consistent proportion of patients with dilated cardiomyopathy (DCM) experience left ventricular reverse remodelling (LVRR) during the first 24 months of guideline-directed medical therapy (GDMT). However, important decisions, such as the need for ICD, are requested after 3 months of GDMT. The evolution of left ventricular ejection fraction (LVEF) during the first years after GDMT in DCM is unknown.
Purpose. Our study aims to investigate the proportion and characterise DCM patients experiencing late LVEF improvement.
Methods. We analysed DCM patients consecutively enrolled with short disease duration, recent initiation of GDMT (≤ 3 months) and a LVEF ≤ 35% at 6-month follow-up evaluation. LVEF &gt; 35% at 24-month was the primary end-point of the study.
Results. Among 131 patients (mean age 53 ± 14, male sex 74%), 88 (67%) improved their LVEF at 24 months above 35%. A &gt; 10% reduction of the indexed left ventricular end-diastolic diameter (LVEDDi) between enrolment and 6-month evaluation emerged as the only independent predictor of late LVEF improvement. During the subsequent follow-up, the late LVEF improvement was associated with a lower cumulative incidence of major arrhythmic events, compared to patients with persistent LVEF ≤ 35% (p = 0.010).
Conclusions. A high proportion of DCM patients improve their LVEF after more than 3-6 months of GDMT, which is associated with lower long-term arrhythmic risk. The early evaluation of dynamic parameters, such as the reduction of LVEDDi could help to identify those patients.
Baseline population characteristics Total (131) LVEF &gt; 35% at 24 months (88) LVEF ≤ 35% at 24 months (43) p Age (years) 53 ± 14 52 ± 14 54 ± 14 0.52 LVEF (%) 28.4 ± 5.6 29.2 ± 5.3 26.7 ± 5.8 0.02 LVEDDi (mm/m2) 34.9 ± 4.6 34.1 ± 4.7 36.5 ± 4.1 0.01 LVEDVi (ml/m2) 89.4 ± 34.2 83.7 ± 28.5 101.0 ± 41.5 0.01 RV dysfunction normalisation or persistence of normal RV function* 92 (84.4) 59 (84.3) 33 (84.6) 0.96 RFP disappearance* 115 (93.5) 80 (95.2) 35 (89.7) 0.25 MR improvement or persistence of mild/absent MR* 91 (72.2) 66 (78.6) 25 (59.5) 0.02 LVEF improvement* 30 (22.9) 21 (23.9) 9 (20.9) 0.7 LVEDDi reduction* 28 (23.7) 25 (32.1) 3 (7.5) 0.003 Values are presented as n (%) or mean ± SD. *Dynamic parameters are evaluated as change from enrollment to the 6-months evaluation. LVEDDi left ventricular end-diastolic diameter indexed; LVEDVi: left ventricular end diastolic volume indexed; LVEF: left ventricular ejection fraction; MR: mitral regurgitation; RFP: restrictive filling pattern; RV: right ventricular. Abstract Figure. Major outcome
Patients with heart failure with mid-range ejection fraction: role of comorbidity
Authors: Efremova E , Shutov AM 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Patients with mid-range ejection fraction (HFmrEF) are still a ‘grey area’ for clinical practice.
The aim of this study was to investigate comorbidity, quality of life and psychological status of patients with HFmrEF.
Materials and methods. One hundred and four patients patients with CHF (69 males and 35 females, mean age was 61.7 ± 9.6 years) were studied. CHF was defined according to ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure, 2016. Age-adjusted Charlson Comorbidity Index (ACCI) was calculated. Comorbidity was regarded as high at index ≥ 6 scores. Psychological state, cognitive functions, quality of life and adherence to treatment were estimated using MMPI, MMSE, SF-36 Health Status Survey, Four-Item Morisky Green Levine Medication Adherence Scale. Follow-up period was 12 months.
Results. Forty-six (44.2%) patients had HFmrEF, 58 (55.8%) - heart failure with preserved ejection fraction (HFpEF). The Charlson comorbidity index did not differ depending on left ventricular (LV) ejection fraction (EF) (5.4 ± 2.1 points for patients with HFmrEF and 4.8 ± 2.1 points for patients with HFpEF, resp., p = 0.1). LV mass index (LVMI) was more in patients HFmrEF with than in patients with HFpEF: 213.4 ± 57.7 and 176.6 ± 44.3 g/m2, resp., p = 0.009. Patients with HFmrEF had a higher functional class HF (the 6 Minute walk test - 307.4 ± 92.4 m for patients with HFmrEF and 339.0 ± 78.7 m for patients with HFpEF, p = 0.02). Twelve (11.5%) died during the 12-month follow-up. Mortality depending on LVEF did not differ. Patients with HFmrEF had lower indicators of quality of life on the physical scale: physical functioning (36.3 ± 14.2 and 48.1 ± 13.3 points resp. p = 0.006) and on the psychological health scale (33.4 ± 5.3 and 35.8 ± 6.7 points, resp.,p = 0.03) compared with patients with HFpEF. The full adherence to treatment for both groups of patients was low (30%) and did not differ. Patients with HFmrEF had a higher profile of depressive-hypochondriacal conditions, primitive and maladaptive psychological defense mechanisms compared with patients with HFpEF.
Conclusion. Patients with HFmrEF are characterized by more severe clinical course, lower quality of life and high frequency of depressive-hypochondriacal conditions, primitive and maladaptive psychological defense mechanisms in comparison with patients with HFpEF, which should be taken into account in the development of interdisciplinary approach to this category of patients.
Prognostic value of non-invasive coronary artery flow velocity assessment in elderly patients
Authors: Kalinina E , Zagatina A , Zhuravskaya N , Shmatov D 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
There is a high prevalence of coronary artery disease (CAD) in the elderly population. However, symptoms of CAD are often non-specific. Dyspnoe, non-anginal pains are among the main symptoms in older patients. Exercise tests are of limited feasibility in these patients, due to neuro-muscular weakness, physical deconditioning, and orthopaedic limitations. Pharmacological tests often are contraindicated in a substantial percentage of elderly patients. Some recent studies indicate using local flow acceleration during routine echocardiography has prognostic potential for coronary artery assessments without stress testing. The aim of the study was to define the prognostic value of coronary artery ultrasound assessment in patients ≥75 years old.

Methods
This is a prospective cohort study. Patients ≥ 75 years old who underwent routine echocardiography with additional scans for coronary arteries over a period of 24 months were included in the study. The study group consisted of 80 patients aged 75-90 years (56 women; mean age 79 ± 4). Initial exams were performed for other reasons, primarily for arterial hypertension. Fifteen patients had known CAD. Death, non-fatal myocardial infarction (MI), and revascularization were defined as major adverse cardiac events (MACE). All patients were followed up with at a median of 32 months.

Results
There were 34 patients with high local velocities in the left coronary artery. Eight deaths, two non-fatal myocardial infarctions occurred, and 13 revascularizations were performed. With a ROC analysis, a coronary flow velocity &gt;110 cm/s was the best predictor for risk of death (area under curve 0.84 [95% CI 0.74–0.92]; sensitivity 75%; specificity 88%). Only the maximal velocity in proximal left-sided coronary arteries was independently associated with death (HR 1.03, 95% CI 1.01; 1.05; p &lt; 0.002), or death/MI (HR 1.03, 95% CI 1.01; 1.04; p &lt; 0.0001). The cut-off value of 66 cm/s was a predictor of all MACE (area under curve 0.87 [95% CI 0.77–0.94]; sensitivity 80%; specificity 86%). Any causes of death or MI occurred more frequently in patients with velocities of &gt;66 cm/s (27% vs. 2%; p &lt; 0.002). The rates of MACE were 58.0% vs. 2%; p &lt; 0.0000001, respectively.

Conclusion
The analysis of coronary flow in the left coronary artery during echocardiography can be used as a predictor of outcomes in elderly patients. Maximal velocities in proximal left-sided coronary arteries is independently associated with further death or myocardial infarction.
The predictive value of left atrial expansion index and left atrial contractile strain in younger hypertensive patients with atrial fibrillation
Authors: Georgieva N , Kinova E , Borizanova - Petkova A , Krastev B , Goudev A 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

BACKGROUND
Arterial hypertension (HTN) is the most prevalent risk factor for Atrial fibrillation (AF) through structural and functional changes of the left atrium. Paroxysmal AF is mainly asymptomatic and silent forms in patients with HTN are associated with thromboembolic complications. However, prompt identification of HTN patients at risk for AF may be strategic for preventing purposes.

PURPOSE
To assess sensitive and predictive parameters for AF onset in HTN patients using two-dimensional (2D) conventional and speckle tracking echocardiography of the left atrium (LA) and left ventricle (LV).

METHODS
A total of 165 consecutive patients were screened for participation in the study. Only 80 patients met the inclusion criteria ( age below 60 years; with well controlled HTN or HTN with AF; without concomitant disease or other risk factors for AF).They were separated in two groups: 43 with HTN and 37 patients with AF and HTN. All patients underwent standard 2D echocardiography with volumetric and Speckle tracking analysis for assessment of: LV global longitudinal strain; LA total ( LATEF), passive ( LAPEF), active (LAAEF) emptying fractions; LA stiffness and expansion index; LA - reservoir (LASr), conduit (LAScd) and contractile (LASct) strain.

RESULTS
There were statistically significant differences between patents with HTN and HTN with AF group in: LASr (30.88 ± 3.99% vs. 27.89 ± 8.21 %, p= 0.049), LASct (-17.64 ± 2.04% vs. -14.4 ± 6.74 %, p= 0.007) and LA expansion index (122 ± 42% vs. 174 ± 115%; p = 0.014). There were no significant differences in other LV and LA structural and functional indices. Multiple regression analysis demonstrated that LASct ( B= - 0.043’ p= 0.001; 95%CI -0.063- -0.023) and expansion index (B= 0.023; p= 0.001, 95%CI 0.117- 0.349) are independent predictors of AF in hypertensive patients.

Conclusion
Preserved LA compliance and contractile function are essential for maintenance of sinus rhythm in younger HTN patients. These findings could be used for prediction of cardiovascular events and preventing AF onset in younger hypertensive population with a huge social impact.
More exaggerated blood pressure morning surge is associated with more deteriorated cardiac function evaluated by 3-dimensional echocardiographic examination
Authors: Park CS 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): The Korean Society of Hypertension

Background
We studied the association between the exaggerated morning blood pressure (BP) surge and cardiac function evaluated by 3-dimensional echocardiography in naïve hypertensive patient.

Methods and results
We studied longitudinal, circumferential and principal strain as well as torsion in 163 naïve hypertensive patients in whom ambulatory BP monitoring was performed. The morning surge (MS) was calculated as mean systolic BP during the 2 hours after awakening minus mean systolic BP during 1 hour included the lowest sleep BP. Patients were divided into 2 groups (MS 25 percentile). There were no differences of left ventricular ejection fraction between the groups (MS: no MS, 62.0 ± 2.4: 62.2 ± 3.3, p = 0.807) but global longitudinal (MS: no MS, -21.2 ± 1.7: -22.0 ± 2.3, p = 0.072), circumferential (MS: no MS, -30.1 ± 2.0: -31.1 ± 2.7, p = 0.045), principal strain (MS: no MS, -33.9 ± 1.7: -35.5 ± 2.8, p &lt; 0.001), twist(MS: no MS, 9.6 ± 6.1: 12.1 ± 4.8, p = 0.011) and torsion (MS: no MS, 1.23 ± 0.78: 1.49 ± 0.62, p = 0.042) were different between the groups. We also divided the groups into four according to the degree of morning surge and 4th quartile group showed more decreased cardiac functions.

Conclusion
Left ventricular mechanical parameters deteriorate from the very early stage of hypertension in the patients with morning surge. And it is more exaggerated in the higher morning blood pressure elevation group.
Abstract Figure.
Early assessment of left atrial function after cardioversion predicts recurrence of atrial fibrillation
Authors: Kupczynska K , Michalski BW , Trzos E , Miskowiec D , Szyda L , Siedlecki P , Wierzbowska-Drabik K , Lipiec P , Kasprzak JD 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The restoration of sinus rhythm (SR) improves the mechanical function of the heart.

Purpose
To assess left atrial (LA) function before and within 24 hours after successful electrical cardioversion (EC) and its prognostic value for atrial fibrillation (AF) recurrence during 24 months follow-up.

Methods
Prospective study involved 71 patients with non-valvular AF (mean age 64 ± 13 years, 61% male). All patients underwent echocardiography before and after EC. We analysed standard parameters in two-dimensional echo, pulse-wave Doppler and tissue Doppler echocardiography. Using speckle-tracking method we assessed peak atrial longitudinal strain (PALS) and peak atrial contraction strain (PACS).

Results
During follow-up we noticed AF recurrence in 48 (68%) patients. Median time to AF recurrence was 2.4 (IQR 1 to 6.9) months. Left ventricular ejection fraction as well as E/E’ and PALS assessed during AF were statistically insignificant as potential predictors in univariate regression model. Receiver operating characteristic curve analysis revealed that left atrial volume index &gt;37 ml/m² (AUC = 0.811, p &lt; 0.0001), E/A ratio &gt;2.1 (AUC = 0.828, p &lt; 0.0001), A wave ≤0.4 m/s (AUC = 0.662, p = 0.01), mean E/E’ ratio during sinus rhythm &gt;8.5 (AUC = 0.815, p &lt; 0.0001), mean A’ wave of ≤5.5 cm/s (AUC = 0.848, p &lt; 0.0001), PALS-SR ≤14.1% (AUC = 0.767, p &lt; 0.0001), PACS ≤4.3% (AUC = 0.883, p &lt; 0.0001) were the optimal cut-off values for predicting AF recurrence.

Conclusions
The assessment of LA and diastolic function conducted within 24 hours after successful cardioversion predicts long-term maintenance of sinus rhythm.
Echocardiography markers of myocardial deformation as independent predictors of sinus rhythm maintenance after catheter ablation for paroxysmal atrial fibrillation
Authors: Katbeh A , De Potter T , Geelen P , Iliodromitis K , Balogh Z , Albano M , Barbato E , Van Camp G , Penicka M 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Speckle Tracking Echocardiography (STE) provides a comprehensive and quantitative assessment of myocardial function. However, the accuracy of STE-derived indices to predict maintenance of sinus rhythm (SR) following radio-frequency catheter ablation (CA) is still under debate. Therefore, the aim of the present study is to define the accuracy of STE-derived parameters to predict long-term maintenance of SR in patients with paroxysmal AF undergoing CA.

Methods
We prospectively enrolled 218 consecutive patients (age: 62 ± 10 years, 30% females) with paroxysmal AF undergoing first-CA. All patients with preserved ejection fraction (EF ≥ 50%) underwent comprehensive transthoracic echocardiography at baseline, including assessment of left ventricular (LV) global longitudinal strain (GLS), left atrial (LA) reservoir strain (LASr), LA conduit strain (LAScd) and LA contractile strain (LASct) using two-dimensional STE in apical views.

Results
At 12 months follow up, a total of 39 (18%) patients had a documented recurrence of AF. Among imaging parameters, LASr &gt; 23% showed the largest area under the curve (0.80) to predict long-term maintenance of SR with sensitivity of 79% and specificity of 72%. Other parameters of LA function, LA diameter, maximum or minimum LA volume index, LV GLS or ejection fraction, and indices of LV diastolic function had lower area under the curve (Figure 1). Using multi-variable logistic regression, LASr (OR 1.19, 95% CI 1.10-1.23, p &lt; 0.001) and LASct (OR 1.21, 95% CI 1.07-1.37, p = 0.002) were independently associated with long-term SR while maximum or minimum LA volume index was not.

Conclusion
In patients with paroxysmal AF undergoing radio-frequency CA, preserved LA reservoir and contractile strain is independently associated with long-term maintenance of SR, whereas LA diameter or volumes were not. LA strain may therefore be useful in management of patients with paroxysmal AF.
Figure 1: Receiver-operating characteristic curves of left atrial reservoir strain (LASr), LA conduit strain (LAScd), LA contractile strain (LASct), LA emptying fraction (LAEF), LA expansion index (LAEI), LA end-systolic (LAES) and end-diastolic (LAED) volume index (VI) to predict long-term maintenance of sinus rhythm.
Abstract Figure.