bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 2187: The Balance Of Pro-inflammatory And Ant-inflammatory Circulating Cytokine mRNA Gene Expression In CHF Patients With And Without Cachexia Compared To Healthy Control Subjects.
Authors: Sandek Anja , Wüst Joe , Bauditz Juergen , von Haehling Stephan , Swidsinski Alexander , Doehner Wolfram , Rauchhaus Mathias , Lochs Herbert , Volk Hans D , Anker Stefan D 
Published: July 2021

Background: Chronic heart failure (CHF) is a state of chronic inflammation. High serum levels of TNF alpha and the presence of cardiac cachexia are known to predict poor survival in CHF. Abnormal balance of pro- and anti-inflammatory circulating cytokine mRNA gene expression is thought to contribute to cachexia in humans, but has never been studied in CHF patients.
Methods and Results: We studied 7 patients with cardiac cachexia (age 70±4 years, LVEF 28±2%, peak VO2 12.7±1.6 mL/kg/min, all >6% weight loss in previous 6–24 months), 19 noncachectic CHF patients (age 68±2 years, LVEF 31±2%, peak VO2 14.7±1.1 mL/kg/min) and 17 control subjects of similar age and gender (peak VO2 25.1±1.7 mL/kg/min, LVEF 71±2%). The mRNA gene expression of circulating mononuclear blood cells for pro-inflammatory mediators that have been implicated in the wasting process of ageing (TNF, STAT-1, STAT-3, SOCS-1 and SOCS-3) as well as anti-inflammatory cytokines (IL-10, tumor growth factor (TGF) beta were investigated by real time polymerase chain reaction. Values for the house keeping gene and genes of interest were calculated from double determinations within 40 cycles. We found higher TNF expression in cachectic compared to noncachectic CHF patients (log mean −0.5±0.17 vs. −1.2±0.12, p=0.002, ANOVA-p=0.0071) and control subjects (log mean −1.2±0.1, p=0.006). In contrast, there was no change in IL-10 gene expression in cachectic patients compared to noncachectic patients and controls (log mean −2.6±0.2 vs. −3.0±0.09 vs. −2.9±0.1, all p>0.13). Consequently TNF/IL-10 expression ratio was highest in cachectic patients (308±138 vs. 132±55 in noncachectic CHF patients vs. 101±37 in controls, p<0.004). There were no differences in gene expression of STAT-1, STAT-3, SOCS-1, SOCS-3 between cachectic and noncachectic individuals (all p>0.17). Similarly, no differences were found for gene expression of TGF beta (p>0.15).
Conclusion: The balance between the pro-inflammatory cytokine TNF and the anti-inflammatory cytokine IL-10 on the level of mRNA expression of circulating mononuclear cells is significantly disturbed. Proinflammatory cytokine imbalance in cardiac cachexia may be important for the pathophysiology of body wasting and may represent the activated immune reflex.
Abstract 2214: The Aptamer ARC1779 Is A Potent And Specific Inhibitor Of von Willebrand Factor (vWF) Mediated Ex Vivo Platelet Function In ST-elevation (STEMI) and non-ST elevation (NSTEMI) Acute Myocardial Infarction (AMI)
Authors: Jilma Bernd , Mayr Florian B , Spiel Alexander O , Merlino Patricia G , Marsh Harold N , Schaub Robert , Gilbert Jim 
Published: July 2021

Background: ARC1779 is an aptamer which blocks the A1 domain binding of the vWF A1 domain to platelet GPIb receptors that is now in development for the treatment of AMI. vWF is increased in the elderly and in the setting of AMI, as reflected in higher vWF levels in circulation and in increased shear-dependent platelet function as measured by the platelet function analyzer (PFA-100) and cone and plate analyzer (IMPACT). Conventional therapy of AMI partially reduces platelet activation and aggregation, but does not address excessive vWF activity or platelet adhesion.
Methods: We studied the ex vivo dose response curves for ARC1779 on PFA-100 and IMPACT platelet function tests, agonist-induced platelet aggregation, and vWF activity (free A1 domain sites) of patients with AMI on standard treatment including aspirin and clopidogrel (n=40), young (n=20) and elderly controls (n=20).
Results: ARC1779 fully blocked collagen ADP induced platelet plug formation as measured by PFA-100 with an IC100 of ~ 1–2 mcg/mL with citrate anticoagulation, and 3–5 mcg/mL with hirudin anticoagulation. ARC1779 fully blocked shear-dependent platelet adhesion measured by the IMPACT analyzer with an IC100 of ~ 1 mcg/mL with citrate anticoagulation. In contrast to GPIIb/IIIa antagonists, ARC1779 did not inhibit platelet aggregation by ADP, collagen or arachidonic acid at concentrations (10mcg/mL) that fully inhibited vWF dependent platelet function. ARC1779 fully blocked vWF activity ex vivo with an IC90 of ~ 1 mcg/mL in young controls and 6 – 8 mcg/mL in STEMI and NSTEMI patients.
Conclusions: ARC1779 potently and specifically inhibits vWF activity and vWF dependent platelet function, even in the setting of AMI where vWF activity is increased. ARC1779 represents a novel therapeutic principle (vWF antagonism) and a novel therapeutic class (aptamers). Potent and specific inhibition of VWF makes ARC1779 a promising development candidate for patients with AMI.

Results
Abstract 2292: Torsional Deformation Delay: a Novel Echocardiographic Index of Left Ventricular Peak Rotation Sequence Between Basal and Apical Level.
Authors: Chrzanowski Lukasz , Uznanska Barbara , Plewka Michal , Lipiec Piotr , Drozdz Jaroslaw , Krzeminska-Pakula Maria , Kasprzak Jaroslaw D 
Published: July 2021

Purpose: left ventricular (LV) torsion (TOR) results from oppositely directed rotation (ROT) at the basal (BAS) and apical (AP) level. Speckle Tracking Echocardiography (STE) allows TOR assessment, but little is known of LV ROT temporal distribution. The aim was to evaluate the sequence of BAS and AP level ROT and to identify associated echocardiographic parameters.

Methods: 48 patients (PTS) were studied (mean age 54±13 years, 23 men). LV systolic function was normal in 23 PTS (LVEF 60% or more), and various degrees of dysfunction were present in 25 PTS (mean LVEF 40±10%). Digital short axis loops at BAS and AP level were analyzed using STE algorithm to measure ROT in degrees (°). After adjustment for heart rate, Torsional Deformation Delay (TDD) was calculated as the difference between the time from the onset of QRS complex to the peak average systolic ROT at BAS and AP level (figure

).

Results: mean TOR, BAS ROT and AP ROT was 14.3±7.3°, −6.8±4.7° and 7.5±6.1° respectively. Mean TDD was 19±107 ms (range from −285 to 248 ms); negative TDD indicated shorter time to BAS peak ROT. No difference of mean TDD was found between PTS with normal and decreased LVEF. TDD outside the range of −28 ms to 28 ms, derived by ROC analysis, was shown to have 96% specificity in detecting PTS with LVEF <60%. It was also associated with higher LV mass index as compared to TDD ranging from −28 to 28 ms (130 g/m2 vs 100 g/m2, p=0.025).
Conclusions: a novel TDD index allows evaluation of LV ROT temporal distribution between BAS and AP level. TDD values outside the range of −28 ms to 28 ms are associated with decreased LVEF and presence of LV hypertrophy. Further studies are required to assess the role of TDD in cardiac imaging.
Abstract 2457: Left Ventricular Assist Device Therapy with the HeartMate II Continuous Flow Rotary Pump as a Bridge to Heart Transplantation
Authors: Pagani Francis D , Miller Leslie W , Russell Stuart D , John Ranjit , Aaronson Keith D , Conte John V , Naka Yoshifumi , Delgado Reynolds M , MacGillivray Thomas E , Farrar David J , Frazier O. H 
Published: July 2021

Background: The HeartMate (HM) II continuous flow rotary pump represents a new generation of implantable left ventricular assist device (LVAD) that has recently completed clinical evaluation in an FDA-approved study for bridge to transplantation (BTT). Through a continued access protocol (CAP), an additional cohort of patients has undergone implantation of the HMI II device. We report on a comparative analysis of outcomes from both the primary and CAP cohorts.
Methods: In a prospective, multi-center study, 297 patients with refractory heart failure and on intravenous inotrope therapy underwent implantation of the HM II to evaluate safety and efficacy as a BTT (n=133 patients-primary study cohort; n=164 patients-CAP; 61 patients in the CAP cohort completed 6 mo followup).

Results: Baseline demographics, hemodynamics, renal and hepatic function were not significant between groups (Table 1

). Number of patients with positive outcomes at 6 mo (transplant, cardiac recovery, alive on LVAD) were similar between cohorts (79% vs 80%). HM II therapy improved 6 minute walk distance at 3 month followup (by 250±232 m vs 226±180 m), and quality of life (Minnesota Living with Heart Failure; by 37% vs. 41%) to similar degrees for each cohort. The incidence of significant adverse events (pump replacements, 5 vs. 1; postoperative bleeding requiring surgery, 31% vs 23%; ischemic and hemorrhagic stroke, 8.0% vs 9.8%; need for RVAD, 4% vs 8%) were not significant between groups.

Conclusions: Outcomes from patients implanted with the HMII device during CAP were similar to outcomes of patients implanted in the primary cohort. These analyses validate the original findings regarding efficacy and risk profile of the HM II continuous flow LVAD in this patient population as a BTT.

table 1
Abstract 2467: Stentless Aortic Valve Replacement Increased the Requirement for Permanent Pacemaker
Authors: Lehr Eric , Allen Elizabeth , Mullen John , MacArthur Roderick , Ross David , Koshal Arvind , Gelfand Elliot , Modry Dennis , Wang Shao Hua 
Published: July 2021

BACKGROUND: Stentless aortic valve prosthesis are thought to provide a superior hemodynamic profile compared to mechanical or other tissue valve replacements. Unlike other aortic valve prostheses, stentless valves are most commonly implanted in the subcoronary position, potentially resulting in the placement of sutures in the atrio-ventricular node of the heart’s conduction system. We assessed the incidence of permanent pacemaker insertion following aortic valve replacement.
METHODS: We performed a retrospective cohort analysis of all patients who underwent aortic valve replacement at the University of Alberta Hospital between January 1996 and December 2004. The primary outcome was heart block requiring permanent pacemaker insertion. Binary logistic regression analysis was performed to assess the influence of a number of factors on the requirement for permanent pacemaker insertion.
RESULTS: In total, 1,451 patients underwent aortic valve replacement (69% male, age 17–92). Permanent pacemaker insertion was required in 32 (5.0%) of 644 patients receiving mechanical valves and in 24 (4.4%) of 543 patients who had a stented tissue aortic valve replacement. In contrast, 27 (10.2%) of 264 patients who had a stentless bioprosthetic valves implanted developed heart block necessitating permanent pacemaker insertion (P = 0.02). Logistic regression demonstrated that implantation of a stentless tissue valve and postoperative inotropic support were the only two significant predictors of the development of heart block following aortic valve replacement.
CONCLUSIONS: Aortic valve replacement with a stentless valve prosthesis increases the risk of heart block and the requirement for permanent cardiac pacing.

Multivariate predictors of requirement for permanent pacemaker
Abstract 2514: Automatic Biventricular Capture Verification Based On Morphological Analysis of the Intracadiac Electrogram Signal
Authors: Lian Jie , Garner Garth , Muessig Dirk 
Published: July 2021

Objective: We test a new biventricular capture verification algorithm, which can be used to adjust the pacing output in right ventricle (RV) and left ventricle (LV), to ensure the safety and efficacy of the cardiac resynchronization therapy (CRT).
Methods: The algorithm calculates a novel index called ASCI, which measures the morphological similarity between the intracardiac electrogram (IEGM) signal and a template waveform representing captured paces. Ventricular capture (CAP) is verified if ASCI is greater than a predefined threshold, whereas non-capture (NC) is declared otherwise. CRT pacemakers were implanted in 6 dogs. During a mean follow-up of 23 days, 175 biventricular threshold tests were conducted by running a customized program, with various combinations of pace/sense polarities. Wideband RV and LV IEGM were recorded and downloaded for off-line analysis by the algorithm. Template signals for each pace/sense configuration in each chamber were created from the average of 4 captured beats. Each pace was annotated for CAP or NC by visual examination of the IEGM and based on stored data log of the pacing parameters.

Results: A total of 9991 CAP paces (5104 RV, 4887 LV) and 4474 NC paces (2136 RV, 2338 LV) were eligible for morphology analysis. In both RV and LV, the calculated ASCIs were well separated for CAP and NC paces (Figure

): 0.83 ± 0.12 (RV CAP), 0.85 ± 0.11 (LV CAP), -0.06 ± 0.13 (RV NC), -0.07 ± 0.14 (LV NC). The classification accuracy of the algorithm remained >= 99% for any ASCI threshold value choosing between 0.18 and 0.52.

Conclusion: This study demonstrated the feasibility to perform automatic biventricular capture verification based on morphology analysis of the IEGM.
Abstract 2578: Acceleration and Deceleration Slope of Longitudinal Early Mitral Annulus Velocity Distinguishes Primary from Secondary Constrictive Pericarditis
Authors: Dal-Bianco Jacob P , Ling Lieng H , Bellavia Diego , Barnes Marion E , Oh Jae K 
Published: July 2021

Background: Assessment of coexisting pericardial and myocardial disease in constrictive pericarditis (CP) remains a diagnostic challenge and decision for pericardiectomy depends on the degree of pericardial versus myocardial restraint limiting left ventricular (LV) filling. Early diastolic longitudinal mitral annulus velocity (Ea) can help to differentiate CP from restrictive cardiomyopathy. Recently, acceleration rate of Ea has been shown to be an index of LV myocardial relaxation. We therefore assessed acceleration (Ea-AR) and deceleration (Ea-DR) rate of Ea in patients with CP before and after pericardiectomy.
Methods: We retrospectively studied patients (n=42) with surgically confirmed CP who underwent radical pericardiectomy between 2003–2006 at Mayo Clinic Rochester. Ea-AR and Ea-DR slopes were measured before (pre-Echo) and after (post-Echo) pericardiectomy. Patients were divided into primary CP (idiopathic & acute pericarditis with presumed normal myocardial function) and secondary CP (cardiac surgery & chest irradiation with presumed abnormal myocardial function).
Results: Ea-AR and Ea-DR changed significantly after pericardiectomy in primary CP patients, however remained similar in secondary CP patients. Diagnostic accuracy of Ea-AR, Ea-DR and Ea to discriminate primary versus secondary CP by ROC analysis was 0.88, 0.80 and 0.81 respectively.
Conclusion: Assessment of Ea-AR and Ea-DR in patients with CP is useful to discriminate primary from secondary CP and may help to predict coexistence of myocardial disease: Prepericardiectomy Ea-AR and Ea-DR appear to reflect the interaction of intrinsic myocardial relaxation with enhanced early LV filling. The lack of decrease of Ea-AR and Ea-DR in patients with secondary CP seems to indicate a primarily restrictive component. The significant decrease of Ea-DR in patients with primary CP after pericardiectomy could reflect abolition of a predominant pericardial limitation to LV filling.

Early Diastolic Longitudinal Mitral Annulus Motion before and after Pericardiectomy
Abstract 2658: Does Aortic Valve Morphology Influence The Natural History Of Aortic Regurgitation?
Authors: Alguersuari Joan , Sambola Antonia , Tornos Pilar , Evangelista Arturo 
Published: July 2021

BACKROUND: The influence of the morphology of aortic valve on the natural history of aortic regurgitation (AR) is uncertain.
OBJECTIVE: To assess the natural history of AR in patients with bicuspid aortic valve (BAV) comparing with tricuspid aortic valve (TAV).
METHODS AND RESULTS: Ninety-five patients with asymptomatic severe chronic AR were prospectively studied. Follow-up period was 7+/- 2 years. Forty-one patients (42%) had BAV and were significantly younger than patients with TAV (39 +/- 11 vs 47 +/- 14 years, p=0.001). Mean ascending aortic diameter (AAD) was significantly larger in BAV (42 +/- 7 vs 37 +/- 5 mm, p=0.0001). Differences in AAD persisted until the end of the follow-up (47 +/- 6 vs 40 +/-5 mm, p=0.0001). The percentatge of increase in AAD was 12 +/- 5% in BAV and 8 +/- 5% in TAV with yearly increase of 0.83 mm in BAV and 0.42 mm in TAV. The changes in left ventricle diameters, mass index, wall stress, regurgitant fraction and ejection fraction were similar in BAV and TAV. Patients with BAV did not need surgery earlier due to AR than patients with TAV (4.7 +/- 2 vs 4.8 +/- 3 years). At 5 years follow-up 11 patients with BAV (27%) and 10 patients with TAV (23%) needed surgery.
CONCLUSIONS: Patients with BAV are younger, had a larger AAD and a higher rate of AAD enlargement than patients with TAV. The morphology of the aortic valve (BAV vs TAV) had no infuence in the progression of AR and the impact on left ventricular function.
Abstract 2723: Large Genomic Deletions in Plakophilin-2 are a Rare Cause of ARVD/C and ARVD/C-like Disease.
Authors: van der Smagt Jasper J , Cox Moniek G , Nelen Marcel R , van Tintelen J P , Entius Marc M , Wiesfeld A C , van Gelder I C , de Jong Gert J , Doevendans Pieter , Hauer Richard N 
Published: July 2021

Introduction: Plakophilin-2 (PKP2) is the major genetic determinant of ARVD/C in the Netherlands. Mutations have been found in 43 out of 82 index cases (52%), diagnosed in accordance with the 1994 Task Force criteria (TFC). A total of 15 different mutations were detected, most of them nonsense (7), frameshift (2) and splice mutations (3), suggesting haploinsufficiency (loss of function) of PKP2 as the predominant mechanism in the etiology of ARVD/C. Since many of these mutations are probably functional null alleles, it was hypothesized that large deletions within - or encompassing - the PKP2 gene can also predispose to ARVD/C.
Aim: to determine whether large deletions in PKP2 underlie apparently PKP2 negative ARVD/C cases.
Methods: a multiple ligation-dependent probe amplification kit was developed to determine copy number of all 14 exons of the PKP2 gene. In total 120 patients were included that had been referred for PKP2 testing, and that had tested negative with direct sequencing or denaturing gradient gel electrophoresis. Twenty-six patients had definite ARVD/C (TFC: ≥ 4 pts), 11 patients scored 3 pts and 83 patients scored less than 3 pts or had insufficient clinical data.
Results: a single deletion was detected encompassing the first 4 exons and promoter region of the PKP2 gene. The patient, a 35 year old male, had experienced near-syncope during exercise. Mild dilation of the right ventricle (1 pt), negative T-waves in V1-V5 (1 pt) and short VT’s with LBBB morphology during exercise testing were found (1 pt). There were frequent PVC’s. The father also carried the deletion. A third degree paternal relative died suddenly at age 28 during exercise.
Conclusion: large genomic deletions of PKP2, that go unnoticed with sequencing, can cause ARVD/C-like disease. Comprehensive testing of PKP2 should include assessment of copy number. However, the frequency of large deletions seems to be low. Since the detected deletion includes the promoter and the transcription initiation site, no protein can be derived from the affected allele. This patient demonstrates that complete loss of one PKP2 allele does not necessarily lead to more severe ARVD/C. This is in keeping with the concept of haploinsufficiency and the assumption that many PKP2 mutations cause functional null alleles.
Abstract 2742: The Comparison Of Direct Measurement Of Central Blood Pressure And Noninvasive Evaluation By Radial Artery Tonometry.
Authors: Takazawa Kenji , kobayashi hiroshi , kino mineko , aizawa akira 
Published: July 2021

Background and objectives: New devices including radial applanation tonometer have been developed for central blood pressure measurement. The devices can noninvasively calculate the central blood pressure. To investigate the accuracy of estimated central blood pressure, this study demonstrates the comparison of catheter based central blood pressure and radial applatnation tonometer based central blood pressure.
Materials and Methods: Seventy two patients (64 ± 10 years old) underwent cardiac catheterization were recruited for this study. Ascending aortic pressure was measured using a pressure guide wire (RADI Medical Systems), and recorded on a laptop personal computer through a SEIREG polygraph (Siemens). Radial arterial pulse waves were simultaneously measured noninvasively using applanation tonometry technique by HEM-9000AI (Omron Healthcare Co.,Ltd.) and SphygmoCor (AtCor Medical Pty Ltd.). The measurements were performed before and after administration of vasodilator (nicorandil or glycerol trinitrate) or antihypertensive (nicardipine hydrochloride) drugs. The central blood pressure calculated by HEM-9000AI (cSBP) and SphygmoCor (aSBP Sphy) was compared respectively with that by catheter (aSBP).
Results: cSBP and aSBP Sphy indicated significant correlation with aSBP (r=0.94, 0.93, respectively, p=0.001). The regression line slope of cSBP to aSBP was 0.92 and that of aSBP Sphy to aSBP was 0.76. A significant difference was observed between aSBP and aSBP Sphy, but was not observed between aSBP and cSBP. Bland-Altman test showed that the difference of cSBP to aSBP was - 0.4 ± 9.6 mmHg and that of aSBP Sphy to aSBP was -9.0 ± 10.3 mmHg. It shows significant difference between cSBP to aSBP error and aSBP Sphy to aSBP error (p<0.05).
Conclusion: The central blood pressure measured by HEM-9000AI is very close to that by catheter. These findings indicate that noninvasive central blood pressure measurement by radial applanation tonometry is accurate enough for clinical applications.
Abstract 2851: Temporal QT Variability from Bipolar Ventricular Tip-to-Ring Electrograms Predicts Sustained Ventricular Tachyarrhythmia.
Authors: Tereshchenko Larisa G , Fetics Barry J , Domitrovich Peter P , Berger Ronald D 
Published: July 2021

We assessed the hypothesis that ventricular tachycardia / ventricular fibrillation (VT/VF) risk stratification based on the repolarization assessment of intracardiac electrograms (EGMs) from implantable devices is feasible.
Methods: Bipolar right ventricular tip-to-ring EGMs were recorded at rest (mean heart rate 66 ± 16 bpm) for 5.5 ± 2.6 minutes in 75 patients (58 ± 14 years, 72% men) with ischemic (60%) and non-ischemic (40%) cardiomyopathy who underwent single-chamber Medtronic ICD implantation for primary (77%) or secondary (23%) prevention of SCD. QT variability index (QTVI), variability of Tpeak-Tend area index, and T-wave alternans (TWA) were calculated as previously described elsewhere. Only 41 out of 75 recordings (55%) were eligible for analysis as determined by data quality requirements of the custom software (less than 10% non-analyzable beats or 5% ectopic beats). The endpoint was appropriate ICD therapy for VT/VF during follow-up > 6 months.
Results: During mean follow-up of 12 months (range 6–19 months), 12 patients had appropriate ICD therapy. The survival analysis showed that the top quartile of QTVI (> - 0.5) predicts an event-free survival rate from appropriate ICD therapies (p = 0.027). Neither increased Tpeak-Tend area variability nor TWA was associated with a significant increased risk for VT/VF.
Conclusions: In this prospective study, temporal QT variability measured from right ventricular tip-to-ring EGMs is associated with increased risk of sustained VT/VF events. Repolarization lability may be present throughout the ventricular myocardium, such that single-site EGMs may provide an effective means for VT/VF risk stratification.