bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of left ventricular systolic dysfunction on occurrence of pulsus tardus in patients with aortic stenosis
Authors: Ishizaka S , Iwano H , Kamiya K , Nagai T , Motoi K , Chiba Y , Tsujinaga S , Kaga S , Anzai T 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The time between left ventricular (LV) and aortic systolic pressure peaks (TLV-Ao) which could reflect pulsus tardus (PT) is reported to be a marker of severity and be associated with poor prognosis in patients with aortic stenosis (AS). Despite its worldwide recognition, physiological mechanism of PT has not been well elucidated. We hypothesized that not only severity of the AS but also LV systolic dysfunction could be associated with occurrence of PT.

Methods
TLV-Ao and mean trans-aortic valvular pressure gradient (mean PG) were measured by simultaneous pressure tracing of left ventricle and basal aorta in 74 AS patients with at least moderate severity (78 ± 8 years old). Effective orifice area index (EOAI) was estimated by using continuity equation from transthoracic echocardiography and severe AS was defined as EOAI ± 0.60 cm²/m². Global longitudinal strain (GLS) was measured by using speckle-tracking method and expressed as an absolute value.

Results
TLV-Ao, mean PG, and EOAI was 87 ± 30 msec, 51 ± 21 mmHg, and 0.51 ± 0.14 cm² respectively. A weak correlation was observed between EOAI and TLV-Ao (Figure). In 9 out of 17 moderate AS patients (A in Figure), TLV-Ao was prolonged over the previously reported cut-off value (≥66 msec), on the other hand, it was not prolonged in 11 out of 57 severe AS patients (D in Figure). When the patients were divided by TLV-Ao of 66 msec, mean PG was not different between patients with prolonged TLV-Ao and those without in moderate AS patients (Figure, A vs B; NS), whereas GLS was significantly reduced in prolonged TLV-Ao group (P = 0.0383). In patients with severe AS, mean PG was significantly higher (P &lt; 0.0001) in patients with prolonged TLV-Ao than in those without (Figure, C vs D), whereas GLS was comparable between the groups. In overall patients, multivariable analysis revealed that not only mean PG (β=0.54) but also GLS (β=-0.23) was an independent determinant of TLV-Ao.

Conclusion
The occurrence of pulsus tardus could be associated not only with severity of the AS but also with LV systolic dysfunction in patients with AS.
Abstract Figure
Effects of heat-not-burn compared to combustible cigarettes on coronary flow, myocardial work index and vascular function
Authors: Ikonomidis I , Katogiannis K , Vlastos D , Kostelli G , Kourea K , Tsoumani M , Parissis J , Thymis J , Andreadou I , Alexopoulos D 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Aim/Introduction:
Heat-not-burn cigarette (HNBC) constitutes a non-combustible smoke product.

Purpose
We compare the effects of heat-not-burn and conventional cigarettes on coronary flow, myocardial and vascular function, platelet activation and oxidative stress.

Methods
We compared the effects of HNBC to those of tobacco cigarette (TCig), on arterial stiffness, oxidative stress, and platelet activation, acutely and after 1 month of switching to HNBC, as well as on endothelial, myocardial, and coronary function after 1 month of switching to HNBC. In the acute study, 50 smokers were randomized into smoking a single Tcig or an HNBC and after 60 minutes were crossed over to the alternate smoking (HNBC or Tcig). For the chronic phase, 75 smokers were examined. Of those, 50 were switched to HNBC and 25 continued Tcig for 1 month. Pulse wave velocity (PWV) and biomarkers [malondialdehyde (MDA), protein carbonyls (PC), and thromboxane B2 (TXB2)] were assessed in the acute and chronic study. Myocardial deformation [global longitundinal strain (GLS), myocardial work index (GWI) and wasted myocardial work (GWW)], coronary flow reserve (CFR) by Doppler echocardiography, total arterial compliance (TAC), and flow-mediated dilation (FMD) were additionally assessed in the chronic study.

Results
Compared to baseline, TCig smoking acutely increased exhaled CO, PWV, MDA, and TxB2 (p &lt; 0.05), while no changes were observed after HNBC. Compared to resuming Tcig smoking, switching to HNBC for 1 month improved CO (mean change: -55% vs -2.4%), FMD ( +55% vs +15%), CFR (+46% vs +4%), TAC (+9% vs -0.5%), GLS (+6% vs +1%), GWW (-19% vs +0.5%), MDA (-19% vs 1 %), and TxB2 (-12% vs 4%) (p &lt; 0.05 for all comparisons).

Conclusions
HNBCs exert a less detrimental effect on vascular, cardiac and platelet function than combustible tobacco.
Tissue doppler imaging of left atrial appendage during transoesophageal echocardiography predicts successful cardioversion in patients with atrial fibrillation
Authors: Kostakou P , Kostopoulos V , Stamatelatou M , Tryfou E , Mihas K , Damaskos D , Tsougos E , Olympios C , Kouris N 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Restoration of sinus rhythm in patients with atrial fibrillation (AF) prevents from thromboembolic events, decreases the risk for cardiomyopathy and improves quality of life.

Purpose
This study aimed to determine whether Tissue Doppler Imaging (TDI) during transesophageal echo (TEE) could predict successful electrical cardioversion (CV) of AF lasting more than 48 hours but less than 6 months.

Methods
One hundred patients, 74 men and 26 women of mean age 64.7 ± 9.8 years old with non-valvular AF were included. Pulse wave (PW) Doppler velocities as well as TDI velocities of the medial and lateral walls of the left atrial appendage (LAA) were recorded during TEE before cardioversion. Synchronized electrical cardioversion was occurred within 12 hours after TEE using 100-200 Joules. We also evaluated LA size and the global strain of LAA.

Results
Sinus rhythm restoration was succeeded in 80% of patients and maintained until discharge, 48 hours later. TDI velocities &gt; 8cm/s were correlated with successful cardioversion (sensitivity 70% and specificity 63%) and were more predictive compared to PW Doppler velocities of &gt; 40cm/s. TDI recordings at the medial LAA wall were more accurate, with less artefacts and better positioning of the sample volume. Global longitudinal strain was not significantly correlated with CV outcome.

Conclusion
Our results indicate that TDI velocities of the LAA walls more than 8cm/s could be used as a cut-off value predicting successful cardioversion of AF.
Is warfarin associated with higher risk of thrombus in left atrial appendage than direct oral anticoagulants?
Authors: Kagawa E , Kato M , Oda N , Kunita E , Nagai M , Shiota H , Dote K 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Thrombus in left atrial appendage (LAA) is associated with cardiogenic ischemic stroke, and anticoagulation therapy is utilized to prevent thromboembolism.

Purpose
This study is to investigate the incidence of thrombus in left atrial appendage detected by transoesophageal echocardiography (TOE) under anticoagulation therapy with warfarin or direct oral anticoagulants (DOAC).

Methods
Between 2005 and 2016, the patients who underwent TOE under anticoagulation therapy due to atrial fibrillation more than one month were enrolled in this study. The patients were divided into 2 groups according to whether treated with warfarin or DOAC and baseline characteristics and incidence of LAA thrombus were assessed.

Results
Among the 313 study patients, 243 (78%) were treated with warfarin. The patients treated with warfarin were elder (median 73 y vs. 67 y [interquartile range 66 – 78 y vs. 58 – 72 y], P &lt; 0.01), the body mass index was lower (23.2 vs. 24.0 [21.0 – 25.4 vs. 21.3 – 26.9], P = 0.03). The prevalence of male sex (64% vs. 71%, P = 0.26) were similar between the 2 groups. The previous history of hypertension (69% vs. 59%, P = 0.10), diabetes (24% vs. 19%, P = 0.32), vascular disease (30% vs. 26%, P = 0.52), and ischemic stroke were similar between the 2 groups (30% vs. 23%, P = 0.22). The prevalence of CHA2DS2-VASc score &gt; 1 (84% vs. 59%, P &lt; 0.01) and the d-dimer level (0.7 vs. 0.5 mcg/ml [0.5 – 1.8 vs. 0.5 – 0.5 mcg/ml], P &lt; 0.01) were higher in the warfarin groups than those of the DOAC. The velocity of LAA was slower in the warfarin group than those of DOAC (35 vs. 55 cm/s [21 – 54 vs. 38 – 68 cm/s], P &lt; 0.01). The incidence of detection of LAA thrombus was 19% in the warfarin group and 3% in the DOAC group (P &lt; 0.01). In the warfarin group, the PT-INR were lower in the patients with LAA thrombus (1.38 vs. 1.66 [1.11 – 1.92 vs. 1.34 – 2.03], P = 0.03).

Conclusions
The higher risk of ischemic stroke and out of range PT-INR may be the cause of the higher incidence of LAA thrombus in the patients treated with warfarin than those with DOAC.
Abstract Figure.
Acute change in left atrial performance in patients with atrial fibrillation undergoing catheter ablation using AutoStrain
Authors: Katbeh A , De Potter T , Geelen P , Nagumo S , Balogh Z , Albano M , Van Camp G , Penicka M 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): International PhD Program in Cardiovascular Pathophysiology and Therapeutics CardioPaTh

Background
Radio-frequency catheter ablation (CA) is associated with changes of left atrial (LA) structure and function. However, the data on the accuracy of automated analysis of LA strain (LAS) are unavailable. Therefore, the aim of the present study was to compare automated with manual LAS analysis in patients with atrial fibrillation (AF) undergoing CA during sinus rhythm.

Methods
We prospectively enrolled 36 consecutive patients (age: 62 ± 22 years, 33% female) with symptomatic AF and preserved left ventricular (LV) ejection fraction (≥50%) undergoing the CA during sinus rhythm. All patients underwent comprehensive echocardiography at 1-day pre-CA and at 1-day post-CA. Reservoir and contractile LAS were assessed using both the automated and the manual technique as average of segmental values in apical four-chamber (4CH) view using the onset of QRS as a reference point.

Results
Radio-frequency CA was associated with significant decrease in magnitude of reservoir and contractile LAS in all patients, and increase in LA end-systolic (max) and end-diastolic (min) volume index (all p &lt; 0.001) (figure 1). The correlation between (semi-) automated and manual LAS assessment was excellent in all measurements (figure 2). The manual correction was needed in 7 out of 36 patients (19%). Despite this, the time needed to perform AutoStrain-derived analysis was significantly lower than the time needed for the manual LAS analysis (12 ± 3 ms vs. 40 ± 5 ms, p &lt; 0.01). Moreover, in 10 randomly selected patients, the AutoStrain showed significantly lower interobserver variability than the manual LAS analysis (3.1% vs. 6.7%, p &lt; 0.01).

Conclusion
The AutoStrain-derived LAS analysis showed a high correlation with manual LAS analysis. Moreover, the AutoStrain technique was associated with significantly shorter analysis time and lower interobserver variability compared with the manual technique.
Abstract Figure.
Patients with a DPP6 risk- haplotype for familial idiopathic ventricular fibrillation have normal left systolic function but abnormal deformation
Authors: Bruin De- Bon H , Wilde AAM , Amin AS , Ten Sande JN , Van Der Ree MH , Postema PG , Bouma BJ 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
An aberrant DPP6 mutation haplotype on chromosome 7 is associated with familial idiopathic ventricular fibrillation in severely affected Dutch families with numerous cases of sudden cardiac death (SCD) So far, no clinical parameters could be linked to predict SCD risk other than this genetic predisposition. In various other cardiac disease, global longitudinal strain (GLS) and mechanical dispersion (MD), both markers of left ventricular (LV) dysfunction, are predictive tools for patients at risk for ventricular arrhythmias (VA) and SCD. The goal of the current study was to investigate whether LV dysfunction, detected by GLS and MD, is present in patients with DPP6 haplotype.

Method
DPP6 risk-haplotype carriers with sufficient echocardiographic images were included as cases (n = 31, 15 males mean age 41 ± 11 years) and individuals evaluated during cascade screening who were tested but appeared not to be affected as controls (n = 14, 7 males, mean age 39 ± 12 years). Echocardiographic bi-plane ejection fraction (LVEF), GLS and MD of the left ventricular were determined.

Results
LVEF was similar between DPP6 cases (57.3%) and controls (60.5%, p = 0.07). In contrast, the GLS of the LV (-18.0%) of DPP6 cases was significant lower compared to controls (-21.1%, p &lt; 0.0001). MD in DPP6 cases (43.4ms) was significantly higher than in controls (26.7ms, p &lt; 0.0001).

Conclusion
DPP6 risk- haplotype carriers have similar LVEF, but significant lower LV-GLS and higher mechanical dispersion than controls. These findings can be used for clinical discrimination. Whether these markers can be used for prediction of clinical events has to be determined after a longer follow up.
echocardiographic characteristics controls DPP6 p-value LVEF (%) 60.5 57.3 0.07 GLS LV (%) -21.2 -18.0 0.0001 MD ( ms) 26.7 43.4 0.0001
Interatrial block is related to atrial dysfunction in hypertensive subjects
Authors: Tirapu Sola L , Loncaric F , Mimbrero M , Mendieta LG , Nunno L , Sanchis L , Doltra A , Montserrat S , Bijnens B , Sitges M 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): La Marató TV3

Background
Interatrial block (IAB), a delay of conduction of the sinus stimulus from right to left atria (LA), is defined as surface ECG P-wave duration ≥120 ms. Arterial hypertension (AH) and IAB have been related to development of atrial fibrillation.

Aim
To investigate the IAB prevalence in a cohort of AH patients and relate it to LA function.

Methods
162 patients with well-regulated AT were included. 12-lead ECG were performed and analysed with a digital caliper. 2D and 3D echocardiography were performed, and LA function assessed with speckle-tracking deformation imaging.

Results
The median age was 56 ± 6 years, 54% were males. Average duration of AH was 10 ± 6 years. IAB was seen in 25% of AH patients. The comparison between groups is shown in Table 1. There were no differences in demographic characteristics, QRS complex duration (p = 0.179) or left ventricular (LV) size and function between subgroups. LA was enlarged in IAB patients, which was coupled with impairment of the LA reservoir strain.

Conclusion
Our results show considerable prevalence of IAB in AH patients. The demonstrated LA enlargement and function impairment is not associated with LV dysfunction, therefore suggesting an independent role of IAB in atrial remodeling.
Table 1 Interatrial block P value Yes (n= 40) No (n= 142) Age 59 (54-62) 57 (53-61) 0.157 Female gender 16 (40%) 58 (48%) 0.467 Duration of Hypertension (years) 10 (6-12) 8 (5-15) 0.421 Systolic blood pressure (mmHg) 136 (125-150) 136 (127-147) 0.799 Diabetes 3 (8%) 16 (13%) 0.410 LVEDV (mL) 73 (63-91) 71 (57-87) 0.424 E/A 0.98 (0.84-1.25) 0.94 (0.79-1.11) 0.230 E/e’ 7.0 (4.9-8.9) 6.6 (5.2-8.4) 0.779 LVEF (%) 63 ± 7 64 ± 6 0.864 LV global longitudinal strain (%) 21.22 ± 2.63 21.19 ± 2.30 0.932 3D LA maximal volume (mL/m2) 36 (30-39) 30 (26-37) 0.028 3D LA minimal volume (mL/m2) 16 (12-18) 14 (11-17) 0.050 LA reservoir strain (%) 27.64 (24.90-31.23) 29.55 (26.17-32.81) 0.032 LA conduit strain (%) 13.91 (10.71-15.47) 14.37 (11.75-16.72) 0.192 LA contractile strain (%) 14.46 (11.86-16.59) 15.52 (13.66-16.96) 0.079 LVEDV Left Ventricular End Dyastolic Volume
Dynamics of left ventricle myocardial deformation, soluble ST2 and cardiotrophin-1 in hypertensive women on combined valsartan/hydrochlorothiazide therapy
Authors: Kolesnyk M , Sokolova MV , Nikityuk OV , Horlova IV 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. The treatment-induced regression of left ventricular hypertrophy (LVH) is associated with improved prognosis in patients with arterial hypertension. However, the assessment of LVH by echo is restricted by substantial measurement variability and low sensitivity to changes during follow-up. The alternative approach could be the dynamic evaluation of myocardial deformation parameters and biochemical markers of cardiac remodeling. The purpose of this study was to assess the dynamics of left ventricle (LV) myocardial deformation, soluble ST2 and cardiotrophin-1 levels in hypertensive women treated with combination of valsartan/hydrochlorothiazide.
Methods. The study involved 100 postmenopausal women (mean age – 57.7 ± 4.3 years) with uncomplicated arterial hypertension. All patients were treated with combination of valsartan (80-320 mg; average dose 195 mg) and hydrochlorothiazide (12.5 mg). Ambulatory blood pressure monitoring, conventional and 2-dimensional speckle tracking echocardiography were performed before and 6 months after treatment. The concentrations of cardiotrophin-1 and soluble ST2 were determined by ELISA method. The data are presented as median and interquartile range.
Results. Treatment with valsartan/hydrochlorothiazide was effective and well tolerated. Target blood pressure level was achieved in 64 % of the patients. The LV global longitudinal strain (GLS) raised significantly after 6 months of treatment (Table). We found the reduction of mechanical dispersion - parameter, which indirectly reflects myocardial tissue homogenicity. The levels of circulating cardiotrophin-1 and soluble ST2 decreased by 37.93% and 19.74%, respectively (p &lt; 0.0001).
Conclusions. The 6-month therapy with valsartan/hydrochlorothiazide was associated with improvement of myocardial deformation parameters with concomitant reduction of soluble ST-2 and cardiotrophin-1 levels. These markers could be more sensitive than standard parameters for hypertensive patients" follow-up. However, this approach should be confirmed in future studies.
Parameter Baseline 6-month p Office SBP, mm Hg 148 (140; 157) 135 (124; 143) &lt;0.0001 Office DBP, mm Hg 89 (82; 96) 81 (74; 87) &lt;0.0001 LV GLS, % -19.6 (-18.1; -21.1) -20.4 (-18.9; -21.8) 0.01 Mechanical dispersion, ms 43 (37; 51) 41 (37; 48) 0.04 Cardiotrophin-1, pg/ml 12.2 (9.4; 16.81) 8.5 (6.26; 10.82) &lt;0.0001 Soluble ST2, ng/ml 25.3 (17.93; 29.72) 18.2 (13.93; 25.96) &lt;0.0001 Values are given as median and interquartile range
Electromechanical changes of the myocardium after anthracycline chemotherapy
Authors: Ozbay B , Kemal H , Simsek E , Cakar B , Yavuzgil O 
Published: February 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background and objectives
The most common side effects of chemotherapeutics in breast cancer is on the cardiovascular system. Global longitudinal strain (GLS) is the only parameter recommended for follow-up in current guidelines with limited evidence. Other strain imaging parameters and electrical changes after chemotherapy is not well studied. It is not known whether electrical or mechanical changes occur initially. The aim of this study is to evaluate repolarization parameters on ECG and mechanical changes together after chemotherapy in breast cancer patients.

Subjects and method
Consecutive patients who received chemotherapy due to breast cancer were included. Strain echocardiography and ECGs were performed pre-treatment (T0) and 3rd month after chemotherapy (T2). Additionally, just in three hours of first dose of chemotherapy (T1) another ECG was performed. QT and QT correction for heart rate (QTc), QT dispersion (QT disp) and QTc dispersion (QTc disp), T wave peak to end time (Tpe) and Tpe corrected for QT-QTc measurements were performed (figüre 1 and 2). GLS, longitudinal strain for myocardial layers, circumferential strain (CS), radial strain (RS) and torsion measurements were performed. All mechanical and electrical parameters from different time intervals were compared.

Results
Thirty-five consecutive patients (35 females, mean age 48.9 ± 11.8 years) who received chemotherapy (mean doxorubicin cumulative dose 415 ± 32 mg/m2) due to breast cancer were included. There was no significant change in mean GLS values before and after treatment (T0 -%18.8 ± 6.82, T1 18.6 ± 3.5 p = 0,863 respectively). However, there was a significant decrease in CS, RS and torsion (T0 -%17,2 ± 3,5, T1-%13 ± 2,84 p &lt;0,001, T0 %45,1 ± 8,3, T1 %35,6 ±10 p &lt;0,001 and T0 %12,1 ± 3.5, T1 %7.7 ± 2.1 p &lt;0,001, respectively). QT, QTc, QTc disp and Tpe, Tpe/QTc parameters were prolonged just after chemotherapy and were still prolonged 3 months after ((QTc: T1 440.01 ± 27.63, T2 468.00 ± 38.98, T3 467.86 ± 35.09), (QTc disp T1 55.48 ± 20.22, T2 78.59 ± 16.15, T3 66.16 ± 14.62), (Tpe (QTc) T1 104 ± 18.52, T2 148.62 ± 19.16, T3 139.77 ± 21.63), (Tpe/QTc T1 0.213 ± 0.05, T2 0.281 ± 0.08, T3 0.258 ± 0.06).

Conclusion
Electrical and mechanical functions of the heart could be impaired together acutely even three months after doxorubicin chemotherapy. Cardio toxicity should be evaluated in terms of both electrically and mechanically.
Abstract Figure. ECG repolarization parameters