bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 2341: Myocardial Ultrasound Tissue Characterisation in Children after Kawasaki disease
Authors: Leonardi Benedetta , Giglio Vincenzo , Pasceri Vincenzo , de Zorzi Andrea , Sanders Stephen P 
Published: July 2021

Background: Reports of late follow-up of patients with Kawasaki Disease (KD), even with no epicardial coronary artery disease, have demonstrated abnormal vascular reactivity and myocardial perfusion. Left ventricular (LV) function is usually normal in KD patients during long-term follow-up. However, data regarding the myocardial properties of these children are lacking. Ultrasound tissue characterization (UTC), under some circumstances, appears to be predictive of subsequent development of myocardial dysfunction.
Methods and Results: We performed UTC analysis in 22 asymptomatic KD patients, mean age 6.6±3.4 years, 17 males, with a mean follow-up of 4.8±3.4 years after the illness. Coronary aneurysms were present in 8 patients (mean age 7.8±5.3 years). Cyclic variation of integrated backscatter (cvIBS) and calibrated integrated backscatter (cIBS) were assessed in 16 LV myocardial segments. Tissue Doppler imaging (TDI) at the mitral annulus was performed to assess LV diastolic function. All UTC and TDI data were compared to 22 age-matched controls, mean age 6.6±3.4 years. All patients had normal LV systolic function and wall motion score index (WMSI) compared to controls (EF 60.3±4.0% vs 60.8±4.4%, p=0.64, WMSI 1 vs 1, p=NS respectively). Myocardial velocities in systole and diastole by TDI did not differ significantly between patients and controls. CvIBS and cIBS mean values showed significant differences, for all segments sampled, between patients and controls (7.8±0.8 dB vs 8.9±0.6 dB, p<0.001, and 28.6±3.2 dB vs 25.2±1.0 dB p< 0.001 respectively). Neither cvIBS nor cIBS differed significantly between patients with and without aneurysms (7.9±0.8 dB vs 7.8±0.8 dB, p=0.84, and 30.3±4.3 dB vs 27.7±2.3 dB, p=0.20 respectively).
Conclusions: We detected widespread differences in myocardial physical properties between KD patients and controls late after the acute disease, despite normal LV function and independent of demonstrable coronary abnormalities. These differences could be related to cellular damage induced by occult myocardial ischemia or could represent abnormalities of small myocardial vessels. Further studies are needed to confirm these findings in a larger group of patients and to determine the clinical significance.
Abstract 2406: Comparison Of Invasive Procedures And Medical Treatment In Patients With ST-segment Elevation Myocardial Infarction: Impact Of Initial Admission To Hospitals With Versus Without Catheterization Laboratory. Results From The German ACOS Registry.
Authors: Skarlos Alexandros , Gitt Anselm K , Juenger Claus , Wienbergen Harm , Zahn Ralf , Senges Jochen , Zeymer Uwe 
Published: July 2021

Introduction: The aim of this analysis was to evaluate the rate of invasive and revascularization procedures and adherence to guideline recommended therapies in patients with STEMI initially admitted to hospitals with and without catheterization laboratory in clinical practice.
Methods: Between 07/2000 and 12/2002 16817 patients with an acute coronary syndrome from 154 hospitals have been included in the ACOS registry. 8303 of these patients presented with ST-segment elevation myocardial infarction. 6351 patients (76,5%) were initially admitted to a hospital with catheterization laboratory, 1952 (23,5%) in a hospital without catheterization laboratory.

Results: We observed significant differences for treatment during the first 48h and revascularization procedures (table

). In the univariate analysis the total in-hospital and 1-year mortality was significantly lower in patients with initial admission to hospitals with catheterization laboratory (8.8% vs. 11.5%, p<0.001 and 13.7% vs. 19.9%, p<0.0001). However, this was statistically significant after adjustment for age, gender, history of myocardial infarction, diabetes, renal insufficiency, heart rate < 100/min and systolic blood pressure > 100 mmHg for 1-year-mortality only (Odds ratio 0.75; 95% CI 0.65 – 0.88) and not for in-hospital mortality (Odds ratio 0.91; 95% CI 0.76 – 1.10).

Conclusions: In clinical practice patients with STEMI admitted to hospitals with catheterization laboratory are treated with significantly higher rates of reperfusion and guideline recommended adjunctive therapies. This is associated with a lower 1-year mortality.
Abstract 2416: Gender Disparities In Treatment After Coronary Artery Bypass: A New Twist On An Old Problem
Authors: Doering Lynn V , Cross Rebecca L , Irwin Michael R , Magsarili Marise C , Cowan Marie J 
Published: July 2021

Background: Treatment disparities that disadvantage women following coronary artery bypass graft (CABG) surgery have been reported. However, postoperative treatment of depression has not been assessed in this population. The purpose of this study was to evaluate treatment rates for depression and routine postoperative therapies in men and women after CABG.
Methods: Within the first month after post-CABG hospital discharge, 206 patients (age 66 ± 11 years, 99 [48%] men) from three cardiac surgery centers were evaluated for the presence of major depression using structured clinical interviews (Structured Clinical Interview for DSM [SCID] or Diagnostic Interview and Structured Hamilton [DISH]). Medical records were reviewed and patients were queried to identify postoperative use of antidepressants, aspirin, statins, beta blockers and angiotensin converting enzyme inhibitors. Gender comparisons were conducted by t-tests and chi-square. Odds ratios (OR) and confidence intervals (CI) for treatments by gender were generated by multivariate logistic regression.
Results: Rates of major depression were similar in men and women (19 [19%] vs. 18 [17%], p = .66), but men were less likely than women to receive antidepressants (3 [3%] vs. 12 [11%], p = .03). Even when antidepressant use was considered together with age, depression status, and other medications, the disparity favoring its use in women remained (OR = 5.87, CI = 1.2 – 29.1, p =.03). Women were less likely than men to receive statins (OR = 0.3, CI = 0.14 – 0.92, p =.03) and aspirin (OR = 0.3, CI = 0.14 – 0.67, p =.003).
Conclusion: For both men and women, major depression after CABG is undertreated. While women remain less likely than men to receive standard therapies for coronary artery disease after CABG, men are less likely than women to receive antidepressants. Because depression is associated with increased cardiac mortality and morbidity, these findings emphasize the importance of its identification and treatment in all CABG patients. Clinicians should guard against gender bias in assessing the need for antidepressant treatment, as well as in the application of more routine therapies.
Abstract 2438: Local Bipolar Atrial Electrogram Monitoring during the Extensive Encircling Pulmonary Vein Isolation: Implications of the ``QS Pattern” in the Local Bipolar Atrial Electrogram after the Ablation
Authors: Otomo Kiyoshi , Taniguchi Hiroshi , Nagata Yasutoshi , Uno Kikuya , Iesaka Yoshito 
Published: July 2021

BACKGROUND During the extensive encircling pulmonary vein (PV) isolation (EEPVI) for atrial fibrillation (AF), it is crucial to recognize whether or not a sufficient lesion was created by an ablation in each ablation site. The local electrogram (EG)-based criteria to predict a sufficient local lesion formation, however, remain to be established. This study was performed to define local EG-based criteria for the local lesion formation during the EEPVI for AF.
METHODS Among 31 patients (pts) with AF who had successful EEPVI during coronary sinus pacing, bipolar local EGs at 2271 ablation sites (73+/-19 sites/pt, posterior wall (PW) of the left atrium (LA)/anterior LA-PV junction=976/1295 sites) before and after energy delivery were reviewed. In EEPVI, ipsilateral PVs, antral regions and parts of the PW of the LA were isolated as a whole by linear ablation at the PW of the LA and semi-linear ablation at the anterior LA-PV junction. Each energy application was performed with a temperature controlled mode (maximal temperature: 55 degrees Celsius, maximal output: 35 watt) and duration of 25 to 35 seconds.
RESULTS After the ablation, all PVs, antral regions and parts of the PW of the LA were successfully isolated in all 31 pts (duration of each energy application: 31+/-3 sec/site, total energy application time: 37+/-10 min/pt). After the effective ablation at each site, the local EGs exhibited predominant reduction in the amplitude of positive deflection (Ap) as compared to that of negative deflection (An) (% reduction in Ap vs An: 91+/-10 vs 30+/-59%; p<0.01, Ap/An ratio before vs after ablation: 2.3+/-3.4 vs 0.3+/-0.1; p<0.01) as well as total amplitude reduction (67+/-22%) and EG widening (57+/-43%), and the morphology of the local EG changed to the ``QS” or ``rS” patterns. At 25 sites without those morphological changes, residual LA-PV conduction gaps were observed and additional ablations were required to achieve a complete EEPVI in 20 pts.
CONCLUSION We propose that a morphological change of local EGs to ``QS” or ``rS” patterns with predominant attenuation of positive deflection of local EGs can reflect sufficient local lesion formation and can be one of the practical endpoints for energy delivery at each ablation site during the EEPVI.
Abstract 2506: Long-Term Effect of Robotic-Assisted Left Ventricular Epicardial Leads for Cardiac Resynchronization Therapy on Mortality
Authors: Choi Andrew D , Kristof-Kuteyeva Olga , Garcia Wallacy , DeRose Joseph J , Balaram Sandhya , Steinberg Jonathan S 
Published: July 2021

INTRODUCTION: In cardiac resynchronization therapy (CRT), our group has previously reported on positive clinical response and reverse remodeling using a novel robotically assisted left ventricular (LV) epicardial lead placement approach for pts with primary lead implant failure. In addition, CRT via transvenous approach is associated with an approximate 20% mortality rate at 18 mos. Long term mortality via robotic placement is unknown.
METHODS: We evaluated 71 pts (70 ± 11 yrs, 48 [68%] male) who underwent robotic LV lead placement after failed transvenous LV lead placement. Leads were placed based on Tissue Doppler Imaging to localize the site of latest mechanical activation. The Social Security Death Index was queried to identify mortality.

RESULTS: All pts had successful lead placement and were discharged in stable condition. During a follow-up (f/u) of 27 ± 16 mos, there were 18 deaths (25%) after 17.3 ± 14.5 mos (range 1.3 – 50.2 mos) (Figure

). These pts were older (77 ± 6 v. 68 ± 11 yrs; p < 0.001), with a lower EF (13 ± 7% v. 18 ± 9%; p < 0.05) and carried a greater symptom burden by NYHA class (3.6 ± 0.5 v. 3.1 ± 0.5; p = 0.02) when compared to those alive. There was no difference in pts with respect to HF duration, cardiomyopathy etiology or atrial fibrillation prevalence. A significant improvement in symptoms by NYHA class (3.1 ± 0.5 to 2.3 ± 0.7; p < 0.001) was seen at 8 ± 3 mos.

CONCLUSION: Pts undergoing robotic LV lead implant show symptomatic improvement, and have a similar mortality rate to transvenous placement during f/u. Those at greatest risk for death include older pts with a very low EF; risk/benefit for these pts should be carefully considered before undergoing implant.
Abstract 2541: The Impact of Arterial Remodeling on the Occurrence of Complicated Plaque Features: An in vivo MRI study
Authors: Saam Tobias , Underhill Hunter R , Chu Baocheng , Takaya Norihide , Cai Jianming , Nikolaou Konstantin , Reiser Maximilian F , Yuan Chun , Hatsukami Thomas S 
Published: July 2021

PURPOSE: Positive Remodeling is considered to be a feature of the vulnerable atherosclerotic plaque. Via magnetic resonance imaging (MRI), we sought to determine the relationship between the prevalence of complex carotid atherosclerotic lesions (AHA-LT6+luminal surface defect, hemorrhage/thrombus or calcified nodule) and arterial remodeling.
METHODS&MATERIALS: 175 subjects with 1–99% stenosis as measured by duplex ultrasound had their bilateral carotid arteries imaged at 1.5T. After excluding arteries with previous endarterectomy or poor image quality, there were 260 arteries available for analysis. AHA-LT6, lumen, wall, total vessel (lumen=wall) areas and normalized wall index (NWI = wall area/total vessel area) were determined by the consensus opinion of 2 experienced carotid MRI reviewers.

RESULTS: There was a highly significant negative correlation between minimum lumen area
and
AHA-LT6, and highly significant positive correlations between maximum wall area / maximum NWI
and
AHA-LT6 (see Table

). No significant correlation between occurrence of complicated plaque features and maximum total vessel area was observed. Furthermore, arteries with AHA-LT6 had significantly smaller minimum lumen areas, larger mean wall areas and larger maximum NWIs than arteries without AHA-LT6 (p<.001). No significant difference between arteries with and without AHA-LT6 was found for the total vessel area.

CONCLUSIONS: Occurrence of complicated AHA Type VI lesions is related to arterial lumen
and
wall dimensions. The absence of a significant correlation between total vessel area and AHA Type VI lesions suggests that outward remodeling has a minor role in the development of these complicated lesions in carotid arteries.

Correlation of Quantitative Plaque Area Measurements with the Occurrence of Complicated Plaque Featu
Abstract 2586: Tricuspid Valve Repair During Left Ventricular Assist Device Insertion
Authors: Comas George , Glithero Kyle J , Naseem Tariq , Jan Azam , Naka Yoshifumi 
Published: July 2021

Purpose Right ventricular (RV) failure is associated with significant post-operative morbidity and mortality after left ventricular assist device (LVAD) insertion. Concomitant tricuspid valve repair (TVR) in the setting of tricuspid regurgitation (TR) is frequently performed to improve RV function after LVAD insertion. This study compared outcomes of patients with TR after LVAD insertion with and without TVR.
Methods This was a retrospective case control study of 70 patients with matched degrees of TR undergoing LVAD implantation from 2000 to 2006 (Heartmate1, Heartmate2, DeBakey MicroMed). The TVR group consisted of patients undergoing LVAD insertion with TVR (n=24). The control group consisted of patients undergoing LVAD insertion without TVR (n=46). TR was quantified as 0 (none) to 4+ (severe) on echocardiography preoperatively and postoperatively. RV dysfunction score was defined as 0 (none), 1 (mild), 2 (moderate), or 3 (severe) on echocardiography. Postoperative clinical parameters, complications, and outcomes were evaluated.
Results The TVR group and control group were similar in age (55y±15 vs 53y±12 respectively), gender distribution (18/24 male vs 42/46 male), ejection fraction (16%±5 vs 16%±6), LVAD score (preoperative measure of risk assessment 0–10), TR, mean PAP, CVP, and peak RV systolic pressure. In the TVR group, TR decreased from 2.0±0.8 to 0.7±0.5 post-operatively (p<0.001). In the control group, TR also decreased from 2.2±0.7 to 1.3±0.8 (p<0.001). In the TVR group, RV dysfunction score fell from 2.1±0.6 to 1.4±1.0 (p=0.01). In the control group, RV dysfunction score fell from 2.1±0.8 to 0.8±1.1 (p=0.049). Bypass time was higher in the TVR group (124±33min vs 66±46min). Incidence of acute renal failure (ARF) was lower in the TVR group (OR 0.2, p=0.02). There were no differences between the two groups regarding need for post-operative RVAD, early extubation, ICU LOS, bridge to transplant rate, or 30 day mortality.
Conclusion Patients with TR requiring LVAD insertion had no improved survival when TVR was performed simultaneously. Bypass time was prolonged when TVR was performed. Patient groups with and without TVR had similar decreases in TR and improvement in RV dysfunction. Incidence of ARF was lower in the TVR group.
Abstract 373: A Novel Haplotype In The G(alpha)s Gene Alters Gene Expression And Responsiveness To Receptor Stimulation And Predicts Cardiac Performance In Humans
Authors: Frey Ulrich H , Leineweber Kirsten , Adamzik Michael , Kottenberg-Assenmacher Eva , Jakob Heinz , Siffert Winfried , Peters Juergen 
Published: July 2021

Background: Transgenic mice with cardiac Gαs overexpression exhibit enhanced inotropic and chronotropic responses to sympathetic stimulation, but develop cardiomyopathy with age. In contrast, chronic beta-adrenergic receptor blockade (beta-AR) mitigates cardiac dilation and depressed left ventricular function in these models. We tested the hypothesis that naturally occurring variants in regulatory regions of the human gene GNAS encoding Gαs result in altered Gαs expression and signal transduction properties in humans.
Methods and results: Sequencing the promoter and intron 1 of GNAS revealed 11 single nucleotide polymorphisms resulting in three common haplotypes. In reporter assays haplotype *3 constructs exhibited significantly higher promoter activity compared to haplotype *1 and *2 constructs. In hearts from 54 patients under chronic beta-AR blockade scheduled for coronary artery bypass grafting (CABG) Gαs mRNA expression was more than 50% higher in homozygous *3 carriers (*3/*3) than in heterozygous (*3/−) and negative *3 (−/−) carriers (Gαs/Actin, 0.16±0.06 vs. 0.10±0.03 vs. 0.09±0.04; p=0.002). Consistent with increased Gαs expression, functional studies showed that *3/*3 carriers had higher basal activities of adenylyl cyclase (AC, 32.4±12.9 vs. 29.1±7.9 vs. 25.5±5.3 pmol/min/mg; p=0.019) and maximal isoproterenol-stimulated activities were markedly higher for the *3/*3 compared to *3/− and −/− carriers (79.3±29.7 vs. 66.7±16.2 vs. 57.3±11.1 pmol/min/mg; p=0.002). Direct AC stimulation with Forskolin was unaffected by GNAS haplotypes. Hemodynamic measurements in 137 bypass patients under chronic beta-AR blockade revealed a higher cardiac index (2.2±0.2 vs. 1.9±0.1 vs. 1.8±0.1 l min-1 m-2; p=0.025) in *3/*3 carriers. This was also in line with a lower NYHA functional class (1.8±0.2 vs. 2.2±0.1 vs. 2.3±0.1; p=0.040) and NT-proBNP levels (339±87 vs. 746±110 vs. 1365±259 pg/ml; p=0.002).
Summary: Increased Gαs expression due to a functional haplotype results in altered signal transduction properties and may have salutary effects on cardiac performance in CABG patients under chronic beta-AR blockade. Our data therefore could help to translate results from transgenic mice to genotype-phenotype correlations in humans.
Abstract 2626: Intramyocardial High-Energy Phosphate Depletion during Ventricular Fibrillation Correlates with Electrocardiographic Change
Authors: Salcido David D , Menegazzi James J , Logue Eric S , Suffoletto Brian P , Sherman Lawrence D 
Published: July 2021

Background: Ventricular fibrillation (VF) is highly energy-wasteful, producing no perfusion. High-energy phosphates (HEPs) deplete rapidly during VF, adding to metabolic/ischemic stress and adversely affecting VF. We have shown that the scaling exponent (ScE) of the VF waveform predicts rescue shock outcome and can be used to guide decision-making during CPR.
Hypotheses: We hypothesized that intramyocardial HEPs would rapidly diminish during untreated VF, and that this decrease would correlate with changes in the ScE.

Methods: We anesthetized and instrumented 18 domestic swine (26.6 ± 1.9 kgs). We systematically assigned them (6 per group) to 5, 10, or 15 minutes of untreated VF, which was induced with a transthoracic shock. At the predetermined timepoint open-chest biopsies were taken from the left ventricle. Biopsied tissue samples were immediately flash frozen in a slurry of dry ice and isopentane (-90
o
C), and HEPs were extracted with 1% trichloroacetic acid. Levels of ATP and ADP were measured luminometrically with an ADP/ATP ratio kit. ATP and ADP levels were assayed in duplicate, and the average recorded (reported in nmol/mg myocardial tissue). Fifteen seconds of ECG signal was digitally recorded (for ScE analysis) immediately prior to biopsy. ScE values were paired with ATP and ADP for calculation of linear regression. HEPs vs. time were compared with ANOVA.

Results: Mean ATP/ADP were 1.20/0.21 at 5 min, 0.94/0.12 at 10 min, and 0.45/0.11 at 15 min. ATP correlated with ScE (r=.63, p=0.009) but ADP did not (r=.35, p=0.17). Both ATP (p=0.004) and ADP (p=0.024) differed over time.
Conclusions: HEPs rapidly diminish during untreated VF. ATP depletion correlates with ScE change.
Abstract 2687: Arterial Stiffness Determines Baseline Coronary Flow And Flow Reserve In Untreated Patients With Arterial Hypertension
Authors: Ikonomidis Ignatios , Lekakis John , Triantafyllidi Helen , Papadopoulos Costas , Georgoula Georgia , Paraskevaidis Ioannis , Kremastinos Dimitrios T 
Published: July 2021

Arterial stiffness is a marker of subclinical atherosclerosis with prognostic significance. Coronary microcirculation is disturbed in patients with arterial hypertension. We investigated whether the arterial stiffness may determine baseline coronary flow and flow reserve (CFR) in never-treated hypertensives.
METHODS: We studied 100 untreated consecutive patients (mean age: 55±11 years 53 male and 47 females), with newly diagnosed arterial hypertension and 20 controls matched for sex, age and atherosclerotic factors, Exclusion criteria were history of diabetes, familiar hyperlipidemia, CAD, cardiomyopathy and chronic obstructive pulmonary disease. We measured a) Carotid to femoral artery pulse wave velocity (PWV) as an estimate of arterial stiffness using the Complior apparatus b) Peak Systolic (Vs) and diastolic (Vd) coronary blood flow velocity , Vd/Vs ratio, Deceleration Time (DT-Vd) and time integral (VTI-Vd) of Vd using a 7MHZ transducer by means of colour-guided Doppler echocardiography at the distal tract of the LAD c) Ratio of VTI-Vd after adenosine infusion (140μg/kg/min) to VTI-Vd at baseline to assess coronary flow reserve (CFR)
RESULTS: All patients had normal LVmass (men<134gr/m2, women <110gr/m2) and had higher PWV (10.4±1.7 vs. 8.2±1.4 m/s, p<0.001) and lower CFR, Vd/Vs and DT-Vd (2.6±0.6 vs 3.4±0.7, p<0.001, 1.78±0.31 vs. 1.97±0.38, p=0.04 and 973±226 vs. 1113±332 ms, p<0.001 respectively) than controls. Increasing PWV was related to decreasing Vd/Vs (r=-0.65, p<0.001) , DT-Vd (r=-0.8, p<0.001), CFR (r=-0.7, p<0.001) and VTI-Vd post adenosine (r=-0.24, p=0.034). In multivariate regression analysis, PWV and smoking were the most important determinants of CFR among age, sex, body mass index, mean blood pressure and hyperlipidemia (b: - 2.21, p<0.001 and b: - 2.68, p=0.032 respectively). Patients with CFR>2 had significantly lower PWV, than those with CFR<2 (n=20) (10±1.5 vs. 12±2 m/s p<0.001). By ROC analysis, a PWV>10.7 m/sec predicted a CFR < 2 with a 84% and 80% sensitivity and specificity respectively.
CONCLUSIONS: Arterial stiffness determines with baseline coronary flow and flow reserve in never treated hypertensives with no evidence of LV hypertrophy.