bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 4200: Global Diastolic Strain Rate During Isovolumic Relaxation Time is a Robust Echocardiographic Parameter of Poorer Outcome in Patients With Non-ischemic Dilated Cardiomyopathy
Authors: Inoue Katsuji , Okayama Hideki , Nishimura Kazuhisa , Nagai Takayuki , Suzuki Jun , Ogimoto Akiyoshi , Ohtsuka Tomoaki , Higaki Jitsuo , Saitoh Makoto , Hiasa Go , Yoshii Toyofumi , Yamada Tadakatsu , Sumimoto Takumi , Funada Junichi 
Published: July 2021

[Background] An impairment of the global left ventricular (LV) relaxation is potential to identify patients at a risk of increased incidence of morbidity and mortality in patients with congestive heart failure (CHF). Previous reports have demonstrated that tissue Doppler and speckle tracking imaging methods serve as a quantitative assessment of LV relaxation using strain rate (SR) during isovolumic relaxation time (IVR).
[Aim] This study was aimed to characterize the ability of global SR during IVR (SR-IVR) using speckle tracking imaging in predicting the outcome in patients with non-ischemic dilated cardiomyopathy (DCM).
[Method] This study included 52 consecutive patients with DCM (38 male, 57+/−14 years) without overt CHF at the enrollment. We excluded patients with atrial fibrillation, complete left bundle branch block and predominant valvular heart diseases. The color-coded tissue Doppler and two-dimensional images were obtained with GE Vivid 7 in the 3 apical views for analyzing the global indexes of LV dyssynchrony (Ts-SD: standard deviation of time to peak systolic velocity in 12 LV model) and relaxation (SR-IVR: averaged longitudinal SR during IVR in 18 LV model). In addition, the levels of B-type natriuretic peptide (BNP) were also measured. Cardiac events were defined as the composite incidence of sudden cardiac death, hospitalization for worsening heart failure, and refractory CHF such as NYHA class III or IV despite of optimal medical therapy during the follow-up period.
[Results] The mean values of LV ejection fraction (EF), Ts-SD, SR-IVR and BNP were 37.8%, 36.3 ms, 0.15/s and 274 pg/ml, respectively. SR-IVR was closely associated with LV end-systolic volume index (ESVI), Ts-SD and BNP (p<0.01 for all). During the follow-up period (mean, 22+/−14 months), 15 patients had cardiac events and the negative value of SR-IVR was observed in 8 out of 15 patients with cardiac events. Multivariate analysis showed that among age, EF, ESVI, Ts-SD and SR-IVR, SR-IVR was the only independent echocardiographic predictor of cardiac events in this study population (β= 0.486, p< 0.01).
[Conclusion] The reduction and negative value of global SR-IVR was shown to be a robust echocardiographic parameter for poorer outcomes in patients with DCM.
Abstract 4246: Dobutamine-induced Reserve of the Two-dimensional Longitudinal Strain Rate Predicts Clinical and Neurohumoral Improvement After Levosimendan Treatment in Acutely Decompensated Chronic Heart Failure
Authors: Bistola Vasiliki , Paraskevaidis Ioannis , Ikonomidis Ignatios , Parissis Ioannis , Filippatos Gerasimos , Kremastinos Dimitrios T 
Published: July 2021

Objective: Levosimendan improves symptoms and the hemodynamic profile in patients with acutely decompensated chronic heart failure (ADCHF). We aimed to investigate:

the association of low dose dobutamine (DSE)-induced changes of two-dimensional strain parameters with the corresponding changes of left ventricular ejection fraction (LVEF) and left ventricular outflow tract velocity time integral (LVOT VTI) in patients with ADCHF, and

whether left ventricular contractile reserve assessed by both conventional and speckle tracking echocardiography is associated with clinical and neurohumoral improvement after levosimendan treatment.

Methods: Thirty one consecutive patients with ADCHF (mean age 65 ± 10 years, NYHA class 3.6 ± 0.3, LVEF 22 ± 6%) were studied by DSE (peak dose 20 μg/kg/min) prior to 24-hour infusion of levosimendan (0.01 μg/kg/min, without bolus). The LVEF, LVOT VTI, mean longitudinal, circumferential and radial strain and strain rate using speckle tracking imaging were measured.
Results: Twenty-three patients (74%) had evidence of contractile reserve (increase of LVEF > 10% and LVOT VTI > 20% after peak dobutamine dose, CR+), and 8 (26%) showed no reserve (CR−). CR+ versus CR- patients demonstrated greater improvement of NYHA class (mean NYHA change: −1.0±0.5 vs −0.5±0.3 NYHA class, p=0.01), and reduction of b-type natriuretic peptide levels (− 34±30 vs + 4±31%, p <0.01) 48 hours after completion of treatment. By multivariate analysis, mean longitudinal systolic strain rate reserve (resting - peak longitudinal strain rate ΔLSR (%)) was the best predictor of improvement of NYHA class (p= 0.039) and BNP (p= 0.042) after levosimendan administration among the reserve of: LV FS, EF, LVOT VTI, longitudinal strain, circumferential and radial strain and strain rate.
Conclusion: Dobutamine-induced reserve of 2-dimentional speckle tracking longitudinal systolic strain rate is associated with clinical and neurohumoral improvement after treatment with levosimendan in patients with ADCHF.
Abstract 4309: Ventricular Elastic Support Therapy (VEST) Reduces Transmural Pressure and Myocardial Strain
Authors: Fedak Paul W , Meek Cheryl , Sas Rozsa , Belenkie Israel , Tyberg John V 
Published: July 2021

Background: Transmural pressure (TMP) determines myocardial strain and chamber dimensions. Epicardial ventricular support may improve mechanical function and promote reverse remodeling by reducing TMP. HeartNet (Paracor Medical Inc) is an elastic intra-pericardial ventricular support device currently evaluated in the PEERLESS-HF clinical trial. To explore the mechanism of action of VEST, we directly measured the in vivo effects of HeartNet on regional hemodynamics and myocardial strain.
Methods: We instrumented open-chest anesthetized dogs (n=6) with flat silastic-balloon epicardial pressure transducers, intravascular pressure catheters, aortic flow probes, and sonomicronometry crystals. The pericardium was re-approximated. We obtained pericardial, epicardial, LV, and aortic pressures. We measured epicardial segment length (end-diastolic myocardial strain) and LV dimensions throughout the cardiac cycle. Loading conditions were altered by volume infusion, caval occlusion, and LAD ligation to induce regional ischemia / dysfunction. Parameters were obtained in every animal with and without the HeartNet in situ (applied at 45% baseline stretch) and compared.
Results: HeartNet epicardial support was 2.8±0.2 mmHg (mean at end-diastole) and was maintained throughout the cardiac cycle and over a wide range of physiologic filling conditions (LVEDP 0 –15 mmHg) indicating that the device is compliant, elastic, and self-adjusting. TMP and end-diastolic strain were significantly reduced (P<0.01) supporting a mechanism of action for the device. After LAD ligation, HeartNet also reduced TMP (−38±8%, P<0.0001) and end-diastolic strain over the anterior wall. Negative regional stroke work was also lowered (−56±2%, P<0.001) suggesting improved overall ventricular mechanical efficiency. Aortic pressure and LV stroke volume (20±2 vs 22 ±3 mL, P=0.20) was maintained.
Conclusions: These are the first in vivo data to demonstrate that ventricular elastic support therapy improves regional myocardial mechanics throughout the cardiac cycle by reducing transmural pressure and end-diastolic strain. Elastic support therapy may provide significant benefits on acute hemodynamics and chronic remodeling in the failing heart.
Abstract 4344: Biventricular Pacemaker Therapy Corrects Dyssynchrony in Non-Obstructive Hypertrophic Cardiomyopathy
Authors: Ahmed Ibrar , Abozguia Khalid , Nallur-Shivu Ganesh , Phan Thanh T , Maher Abdul , Stegemann Berthold , Katra Rodolphe , Patel Kiran , Leyva Francisco , Sanderson John , Pellerin Denis , Elliott Perry , Frenneaux Michael 
Published: July 2021

Background. Previous studies have reported dyssynchrony using Tissue Doppler in patients with hypertrophic cardiomyopathy (HCM). In this study we assessed dyssynchrony using speckle tracking echocardiography (STE) in patients with non-obstructive hypertrophic cardiomyopathy vs a healthy control group and in a subgroup of highly symptomatic patients evaluated the acute effects of biventricular pacing on STE and Tissue Doppler (TDI) derived measures of dyssynchrony.
Methods. We studied 48 healthy controls (age 48 ±18yrs, 22 males, LVEF 63 ±5%, QRS 86 ±7ms) and 57 patients with HCM (age 54 ±11yrs, 38 males, LVEF 61 ±7%, QRS 110 ±36ms). A subgroup of 15 symptomatic patients with HCM (Peak VO2<60% predicted) underwent biventricular pacing (age 53 ±12yrs, 12 males, LVEF 61 ±7%, QRS 110 ±32ms). Echocardiography was performed with the pacemaker off (VVi30) and on (DDDR, AV delay 90ms, LV-RV delay 0 – 4ms). Using STE, the standard deviation (SD) in time to peak longitudinal strain (Tϵ-SD), the time to peak longitudinal systolic velocity (Ts) for each of 18 left ventricular segments and the SD of this timing (Ts-SD) was derived. Using TDI dyssynchrony was assessed from the SD of Ts for the basal six segments and the maximum difference in Ts between any two basal segments (Ts-peak[basal]).

Results. Using STE, Tϵ-SD (54.99 ±33.61ms vs 24.55 ±21.18ms p<0.001), Ts-SD (71.06 ±32.32ms vs 46.17 ±21.50ms p<0.001) and Ts (155.74 ±23.14ms vs 123.71 ±11.25ms p<0.001) were greater in HCM than in controls. Using STE we demonstrated that biventricular pacing significantly reduced Tϵ-SD and Ts-SD to values similar to those observed in controls (Ts-SD p=0.13). Using TDI we demonstrated that biventricular pacing significantly reduced Ts, Ts-SD, and Ts-peak[basal]. See Table

. (All values expressed as mean ±SD)

Conclusion. Cardiac resynchronisation therapy significantly reduced dyssynchrony in symptomatic patients with non-obstructive HCM as demonstrated using STE and TDI.

Table
Abstract 4394: Chronic Administration of Urocortin 2 Prevents the Development of Heart Failure in an Animal Model of Hypertensive Heart Disease
Authors: Meili-Butz Silvia , Studer Marco , John Dietlinde , Morandi Christian , Pfisterer Matthias , Buser Peter , Vale Wylie W , Peterson Kirk L , Brink Marijke , Dieterle Thomas 
Published: July 2021

Background: Recently, novel corticotropin-releasing factor (CRF)-related peptides named Urocortin (Ucn) 1, 2, and 3 were described. Available data suggest that the Ucns are part of a peripheral CRF system modulating cardiovascular function and mediating cardiovascular responses to stress. Chronic Ucn2 administration induced sustained blood pressure lowering and prevented the development of left ventricular hypertrophy (LVH) in an animal model of hypertensive heart disease. However, no data are available whether chronic administration of Ucn2 may prevent the progression from LVH to heart failure.
Methods: Experiments were performed in Dahl salt-sensitive rats. Animals were fed a high salt diet containing 4% NaCl to induce arterial hypertension, LVH, and heart failure. From the phase of LVH on (after 7 weeks of high salt diet), animals were injected with either Ucn2 at a dose of 2.5 μg/kg body weight or vehicle b.i.d. Animals underwent repetitive tail cuff blood pressure measurements and echocardiographic analysis of LV dimension and function at baseline (prior to first injection of Ucn2) and after 5 weeks of b.i.d. treatment with Ucn2.

Results: Results are given in the following table

as mean (± SD). No differences in heart weight/body weight ratios between Ucn2- and vehicle treated animals were found after 5 weeks of treatment.

Conclusion: Chronic CRF receptor stimulation by Ucn2 in the severely hypertensive Dahl salt-sensitive rat, an animal model of hypertensive heart disease, prevents the progression from LVH to LV dilatation and the deterioration of LV function. Thus, chronic administration of Ucn2 might represent a novel approach to the prevention of heart failure.
Abstract 4403: Significant Single Nucleotide Polymorphism Associated with Atrial Fibrillation Located on Chromosome 4q25 in a Whole Genome Association Study and Association with Left Atrial Gene Expression
Authors: Chung Mina K , Van Wagoner David R , Smith Jonathan D , Wirka Robert C , Topol Eric J , Desai Milind Y , Prcela Lisa , Hazen Stanley L , Barnard John 
Published: July 2021

Introduction: Heritability studies of atrial fibrillation (AF) suggest a complex genetic basis for common AF. Recently a locus on chromosome 4q25 was associated with AF in a genome-wide association study (GWAS), but the mechanism by which this locus is associated with AF is unknown.
Methods: To identify genetic variations associated with AF, we performed an analysis of AF as a secondary phenotype from a case-control GWAS of myocardial infarction. 210,178 autosomal SNPs of high quality were genotyped in 138 AF cases and 546 controls. Stratified score tests of the trend/additive model and general genotypic model were performed for each SNP. Genomic control and multidimensional scaling were used to control and assess population stratification. The SNP meeting genome-wide significance was genotyped in 46 left atrial appendage tissue samples for which we obtained expression levels for 22,184 transcripts. Cis expression traits within 1 megabase of the top SNP were tested for association with the SNP genotypes.

Results: One SNP (rs4611994) met our per-SNP genome-wide significance thresholds (both a conservative Bonferroni threshold or a more liberal FDR-based threshold) for association with AF, which was in perfect linkage disequilibrium with the locus on chromosome 4q25 found in the deCODE genetics AF study (r
2
with SNP rs2200733=1.0). This SNP yielded an AF odds ratio of 2.28 under the additive model, with a p-value using genomic control/general genotype model of 5.0E-08, and a minor allele frequency 0.13 in controls and 0.25 in AF cases, and a genome-wide p-value of 0.046 by permutation analysis. In the 46 left atrial tissue samples, cis analysis demonstrated significant association between rs4611994 genotype and expression of LRIT3 (Leucine-rich repeat, immunoglobulin-like domain and transmembrane domain-containing protein 3) with q-value 2.22E-03 and the C isoform of PITX2 with q-value 7.50E-03.

Conclusions: Our GWAS for common AF has replicated the AF-associated locus on chromosome 4q25. The genotype at this locus was correlated with cis regulation of the LRIT3 and PITX2C transcripts, suggesting these genes as candidates for mechanistic studies.
Abstract 4609: Evidence of Need for a More Comprehensive Approach to Dietary Self-Management for Patients with Heart Failure and Diabetes
Authors: Payne-Emerson Heather , Song Eun Kyeung , Heo Seongkum , Moser Debra K , Chung Misook L , Dunbar Sandra B , Pressler Susan J , Lennie Terry A 
Published: July 2021

Background: Type 2 diabetes (DM) is a common comorbidity in patients with heart failure (HF). Nutritional management is a key strategy in achieving blood glucose control and decreasing the risk of microvascular complications. The ability of patients with HF to nutritionally self-manage multiple comorbidities is unknown.
Purpose: To compare nutritional intake of a group of patients with HF and DM with a group without DM.
Methods: A total of 174 patients (66 with DM, age 60± 12 yrs, 35% female, 57% NYHA class III/IV) recruited from HF clinics completed detailed 4-day food diaries that were reviewed by a registered dietitian. Nutrition Data System software was used to determine carbohydrate (total and subtype), protein, fat, cholesterol, and sodium intake. Fasting blood glucose was obtained on a subset of 123 patients. Between-group comparisons were made using independent sample t-tests.
Results: Patients with DM consumed a lower percentage of calories from carbohydrate (44% vs. 49%, p=.003) and a greater percentage of calories from protein (19% vs. 16%, p<.001) and fat (38% vs. 35%, p=.049) compared to patients without DM. With respect to carbohydrate subtypes, patients with DM consumed 30% less sucrose (29g vs. 42g, p<.001) and 39% less fructose (14g vs. 23g, p<.001) than patients without DM, but a similar amount of starch (93g vs. 95g). There were no differences in sodium (3472mg vs. 3209mg), cholesterol (321mg vs. 285mg) or saturated fat (12% vs. 11% of kcal) intake between groups with and without DM. A total of 60% of patients with DM had fasting blood glucose levels >120mg/dl and 40% had a fasting levels > 140mg/dl.
Conclusions: Patients with HF and DM primarily limited dietary sugar intake, with only moderate success. Nutritional management of HF has focused on the single nutrient sodium with limited success; these data suggest that teaching for DM may be similarly focused on the single nutrient sugar. This indicates that new, more comprehensive, approaches are needed to help patients meet the challenge of nutritionally managing multiple comorbidities.
This research has received full or partial funding support from the American Heart Association, AHA Great Rivers Affiliate (Delaware, Kentucky, Ohio, Pennsylvania & West Virginia).
Abstract 4726: How Reliable is Left Atrial Volume in Estimating Left Atrial Pressure in Advanced Heart Failure Patients? Three-Dimensional Echocardiographic and Catheterization Studies
Authors: Evangelista Antonietta , Mukherjee Jayanta , Ordway Linda , Scali Maria Chiara , Caselli Stefano , Torromeo Concetta , Gaudio Carlo , DeCastro Stefano , DeNofrio David , Nesser H. Joachim , Kuvin Jeffrey T , Patel Ayan R , Pandian Natesa G 
Published: July 2021

Previous work has suggested that left atrial (LA) size reflects LA pressure but direct correlative studies of pressure and volume are scant. Furthermore, evaluation of LA size has typically been based on 1-dimensional measures or 2D echo-derived LA area or volume. The aim of this study was to explore whether 3D LA volume could accurately indicate LA pressure in advanced heart failure (HF) patients, in whom filling pressure estimation is clinically relevant. We studied 32 patients with advanced HF both with 3D echo (3DE) performed simultaneously or close to the time of pulmonary capillary wedge pressure (PCWP) measurement by cardiac catheterization. From full volume 3D data sets of the left heart, maximum LA volume (MaxLAV) and minimum LA volume (MinLAV), and volumes indexed to body surface area (MaxMAVI and MinLAVI) were calculated. Mean PCWP was obtained from standard invasive recordings.
Results: The mean LVEF was 23±8. The MaxLAV was 101±38 ml with a range of 34 to 173. MaxLAVI was 50±16 ml/m2 with a range of 19 to 81. MinLAV was 76±37 with a range of 19 to 145. MinLAVI was 38±16 ml/m2, with a range of 12 to 72. The PCWP (mm Hg) was 21±8 with a range of 2 to 34. The correlation between PCWP, and MaxLAV, MaxLAVI, MinLAV and MinLAVI were respectively r=0.193, p=0.28; r=0.25, p=0.16; r=0.24, p=0.17; and r=0.31, p=0.08. Within the group, there were some patients with normal or low PCW but with larger LA volumes (>median) while some patients with high filling pressures did not necessarily have higher LA volumes.
Conclusion: In advanced HF patients, maximum or minimum LA volumes do not correlate with PCWP. LA remodeling and depletion of LA volume reserve in these patients is most likely responsible for the lack of correlation. Thus, in advanced HF patients, LA volume cannot be used to assess left heart filling pressure.
Abstract 4781: Rate of Progression and Functional Significance of Aortic Valve and Root Calcification Up To 8 Years Following Total Aortic Root Replacement Using a Homograft Versus Freestyle Prosthesis: Results From a Prospective Randomized Trial
Authors: El-Hamamsy Ismail , Zaki Mohamed , Stevens Louis M , Clark Lucy , Rubens Michael , Yacoub Magdi H 
Published: July 2021

Introduction - Aortic root calcification is a major limitation following root replacement. The aims of this analysis were to compare the rate of progression of root calcification between homografts and xenografts (Medtronic Freestyle) up to 8 years postoperatively and to determine its functional significance.
Methods - Between 1997 and 2003, 161 patients were prospectively randomized to undergo homograft (Group H) or Freestyle (Group F) total aortic root replacement. Of those, 99 patients underwent a total of 248 electron beam computed tomography (EBCT) studies at 0.5, 1, 1.5, 2, 3 and 8 years (n=17 patients at 8 years). Aortic root calcium scores were calculated using Agatston scores.

Results - Mean calcium scores in Group H at 1, 2, 3 and 8 years were 550±95, 1026±160, 1440±256 and 3876±604 Hounsfield Units (HU), versus 397±84, 556±125, 683 ±151 and 2518±495 HU in Group F. Mixed effects models show higher calcium scores in Group H at 1, 2 and 3 years, with a trend at 8 years (p=0.11). Group H presents a significantly more rapid early rate of progression (slope from 0 to 3 years; p=0.02) and progress similarly to Group F thereafter (slope from 3 to 8 years; p=0.3) (Figure 1

). Echocardiographic evaluation of patients at 8 years showed no correlation between EBCT scores and aortic valve dysfunction.

Conclusion - Homograft roots have a higher propensity to calcifiy than Freestyle prostheses, which follows a time-dependent progression marked by rapid early calcification. Despite the high calcium scores, no correlation with prosthetic valve function was identified at 8 years.
Abstract 4827: Role of Left Ventricular Dyssynchrony in Functional Mitral Regurgitation in Patients with Dilated Cardiomyopathy: A Comparison Study with Geometric Parameters of Mitral Apparatus Estimated with 3d Echocardiography
Authors: Choi Woonggil , Kim Soohyun , Woo Seongill , Kim Deahyuk , Park Keumsoo , Lee Woohyung , Kwan June 
Published: July 2021

Objective: Functional mitral regurgitation (FMR) occurs commonly in patients with dilated cardiomyopathy (DCM). The aim of this study was to compare the roles of Left Ventricle(LV) dyssynchrony and geometric parameters of mitral apparatus as determinants of FMR in patients with DCM.

Methods: Fourteen DCM patients without FMR and 15 DCM patients with FMR (ERO = 0.11 ± 0.029 cm
2
) were enrolled. Effective regurgitant orifice (ERO) area and tissue Doppler-derived dyssynchrony index (DI: the standard deviation of time to peak myocardial systolic contraction of eight segments) were measured. The estimated DIs were corrected by the cycle length (CL) of each patient (cDI (%) = DI/CL*100). Using real-time 3D echocardiogrphy, mitral tenting area (MVT) and the degrees of displacement of anterior (APMD) and posterior (PPMD) papillary muscles were estimated. All geometric measurements were corrected (c) by the height of each patient.

Results: There was no significant (p > 0.05) difference in LV Ejection Fraction and cLVEDV between two patient groups. cDI, cMVT, cAPMD and cPPMD significantly (p < 0.05) increased in the patient with FMR comparing with those in patients without FMR. cDI (r = 0.42), cMVT (r = 0.74), cAPMD (r = 0.63) and cPPMD (r = 0.64) showed significant (p < 0.05) correlations with ERO. cMVT was found to the strongest independent predictor of ERO with multivariate regression analysis, whereas cDI did not enter into the model.
Conclusions: The degree of MV tenting rather than LV dyssynchrony was found to be the main determinant of FMR in DCM. However LV dyssynchrony also has a minor independent association with FMR.