bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychological assessment of depression and anxiety in patients with implantable cardioverter-defibrillator: DEFibrillator-related distress and depression survey in Chiba 2
Authors: Kondo Y , Miyazawa K , Nakano M , Kajiyama T , Nakano M , Kobayashi Y 
Published: October 2021

Abstract

Background
Despite the established treatment for life-threatening arrhythmias, the implantable cardioverter-defibrillator (ICD) therapy has emerged as a major determinant of psychological distress. Previous studies have showed several approaches to assess the ICD-specific psychological distress, however, the risk factors affecting psychological functioning are relatively variable across studies, and are not well studied in Japanese population. Therefore, we prospectively investigate the risk factors affecting the psychological functioning and assess the impact of ICD therapy in Japanese patients with ICD.

Methods
We prospectively enrolled consecutive 136 patients in the present study. At the time of ICD implantation and 1 year later, all patients completed the Florida Shock Anxiety Scale (FSAS), which is a tool designed to provide a quantitative measure of ICD shock-related anxiety. In addition, patients were also examined by psychiatrists using two assessment scales, Montgomery-Åsberg Depression Rating Scale (MADRS) and Hospital Anxiety and Depression Scale (HADS).

Results
The FSAS score was significantly correlated with the MADRS and HADS scores (Figure). During 1-year follow-up, 11 patients (8.1%) received ICD therapy. Younger age was significantly associated with the FSAS and MADRS scores at registration, but ICD therapy was the only independent factor associated with the increased risk of the FSAS score at 1 year later (p-value = 0.012).

Conclusions
ICD therapy has a strong impact on psychological distress in time course of ICD implantation. To reduce unnecessary shock therapy and optimal intervention by healthcare professionals may lead to the improvement of ICD-related psychological functioning.

Funding Acknowledgement
Type of funding sources: None. Figure 1. Correlation between MADRS and HADS scoreFigure 2. FSAS, MADRS and HADS scores
Cardiovascular risk prediction in type 2 diabetes: a comparison of 22 risk scores in primary care setting
Authors: Dziopa K D , Asselbergs F W A , Gratton J G , Chaturvedi N C , Schmidt A F S 
Published: October 2021

Abstract

People with type 2 diabetes (T2DM) remain at high risk for cardiovascular disease (CVD) CVD treatment initiation and intensification are guided by risk prediction algorithms. The majority of CVD risk prediction tools have not been validated in T2DM.
We compared the performance of general and diabetes specific cardiovascular risk prediction scores for cardiovascular disease (CVD ie coronary heart disease and stroke), CVD+ (including atrial fibrillation and heart failure), and their individual components, in type 2 diabetes patients (T2DM).
Scores were identified through a systematic review and included irrespective of the type of predicted CVD, or inclusion of T2DM patients. Performance was assessed in a contemporary sample of 203,172 UK T2DM.
We identified 22 scores: 11 derived in the general population, 9 in T2DM patients, and 2 excluded T2DM patients. Over 10 years follow-up, 63,000 events occurred. The RECODE score, derived in people with T2DM, performed best for both CVD (c-statistic 0.731 (0.728,0.734), and CVD+ (0.732 (0.729,0.735)). Calibration slopes (1 indicates perfect calibration) ranged from 0.38 (95% CI 0.37; 0.39) to 1.05 (95% CI 1.03; 1.07). A simple, population specific recalibration process considerably improved performance, now ranging between 0.98 and 1.03. Risk scores performed badly in people with pre-existing CVD (c-statistic ∼0.55).
CVD risk prediction scores performed worse in T2DM than in the general population, irrespective of derivation population, and of original predicted outcome. Scores performed especially poorly in patients with established CVD. A simple population specific recalibration markedly improved score performance and is recommended for future use.

Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): NPIF programme
Analysis of LpA levels in young patients after ACS: getting to know less famous risk factors
Authors: Luna M , Rodriguez Cordoba A , Rodriguez Capitan J , Martinez Carmona J D , Diaz Exposito A , Marquez Camas P , Garcia Rodriguez L , Palma Marti L , Angullo Gomez M , Doncel Abad M V , Berteli Garcia G , Mendez Natera R , Grande Prada D , Melgar Melgar A , Gomez Doblas J J 
Published: October 2021

Abstract

Introduction
Lipoprotein A (LpA) has been shown to be an emerging risk factor, proposing that values greater than 60 mg/dl increases cardiovascular risk. There are few data about LpA values in young patients who have suffered a major cardiovascular event.

Purpose
The objective of this work was to describe the LpA values observed in young patients admitted for acute coronary syndrome in our center, and subsequently to compare these values according to the patients' previous cardiovascular risk.

Methods
This is a descriptive and observational study, in which all male patients under 65 years and women under 70 years who have suffered STEMI or NSTEMI from November 2019 to February 2021 admitted to our center were consecutively included. In addition to LpA values, the following variables were recollected: age, sex, high blood pressure, diabetes mellitus, dyslipidemia, stroke, chronic kidney injury, smoking, alcoholism, toxics, total cholesterol and SCORE risk.

Results
159 patients were included. The mean of LpA value was 41,08 mg/dl (standard deviation 38, range 1–155, percentile 25th: 9,7; percentile 50th: 28,8; percentile 75th: 59,1). 24,5% presented levels of LpA greater than 60 mg/dl. The percentage of patients with LpA levels &gt;60 mg was 32,4% in low SCORE group and 22,4% in greater than low SCORE group without significant differences.
The table compares the LpA values according to the cardiovascular risk SCORE those patients presented before the acute coronary syndrome (low SCORE vs moderate, high or very high SCORE). As we can see in the table, we found a trend to present higher LpA values in patients with low SCORE risk compared to those with higher than low SCORE risk, without reaching statistical significance.

Conclusions
In a sample of young patients with acute coronary syndrome, the LpA mean was 41,08 mg/dl. 24,5% of patients had values of LpA greater than 60 mg/dl. No significant differences were found according to the SCORE prior to the event, although there was a non-significant trend towards a higher LpA in patients with low SCORE.

Funding Acknowledgement
Type of funding sources: None. Table 1. LpA values
Characteristics and prognosis of patients with elevated triglycerides in acute myocardial infarction: observational data from a large database over a 17 years period
Authors: Zeller M , Chague F , Maza M , Bichat F , Beer J C , Masson D , Cottin Y , Farnier M ,   RICO survey
Published: October 2021

Abstract

Background and aim
From a large database of a regional registry, we aimed to address the prevalence, characteristics and prognosis of patients with elevated triglycerides (TG) in patients hospitalized for an acute myocardial infarction (MI).

Methods
From the multicenter database (RICO survey), all consecutive patients hospitalized for an acute MI (2001–2017) and alive at discharge were included. Patients with TG &gt;500 mg/dL, lost to follow-up (FU), or under chronic fibrate treatment were excluded. Patients with high TG (&gt;200 mg/dL) on admission were compared to those with TG ≤200 mg/dL. Endpoints were recurrent ischemic events (i.e. recurrent MI, angina, unstable angina, stroke or urgent revascularization (PCI or CABG)) at 1-year FU.

Results
Among the 10667 patients included, 1886 (17.7%) had elevated TG. When compared with patients with TG ≤200 mg/dL, patients with high TG were younger (59 vs 69 y, p&lt;0.001), had a higher BMI (28 vs 26 kg/m2, p&lt;0.001), were more frequently men (77 vs 68%, p&lt;0.001), diabetic (27 vs 21%, p&lt;0.001), and smokers (42 vs 28%, p&lt;0.001). The rate of statin therapy at discharge was similar for the 2 groups (79 vs 77%, p=0.285), as well as SYNTAX score and rate of multivessel disease (p=0.368 and p=0.791). In high TG group, LDL cholesterol was higher (130 vs 120 mg/dL, p&lt;0.001) and HDL-cholesterol was lower (37 vs 46 mg/dL). At 1-Y FU, recurrent ischemic events were more frequent in elevated TG patients (11.2 vs 9.1%, p=0.004). In multivariate logistic regression analysis, high TG (OR (95% CI): 1.356 (1.095–1.679)) remains an independent estimate for recurrent ischemic event, even after adjustment for confounding (GRACE score, diabetes, obesity).

Conclusions
In our large population-based cohort, elevated TG are common in acute MI, and associated with residual risk of recurrent ischemic events, beyond traditional prognostic markers. Our data may help to identify candidates for targeted therapies to reduce recurrent ischemic risk after MI.

Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Amarin
Sympathetic nerve activity changes following acute exposures to electronic and tobacco cigarette smoking in humans
Authors: Dimitriadis K , Narkiewicz K , Leontsinis I , Konstantinidis D , Mihas C , Andrikou I , Thomopoulos C , Tousoulis D , Tsioufis C 
Published: October 2021

Abstract

Background/Introduction
Tobacco cigarette (TC) smoking acutely increases blood pressure and sympathetic nerve activity, whereas there are scarce data on the impact of electronic cigarette (EC).

Purpose
The aim of the study was to assess the acute effects of TC, EC and sham smoking on blood pressure, heart rate and sympathetic nervous system in healthy subjects.

Methods
We studied 12 normotensive male habitual smokers (mean age 33 years) free of cardiovascular disease. The study design was randomized and placebo controlled with 3 experimental sessions (sham smoking, tobacco cigarette smoking, and e-cigarette smoking) in random order, each session on a separate day. Subjects smoked 2 tobacco cigarettes containing 1.1 mg nicotine or simulate smoking (sham smoking) with the 2 cigarettes separated by 5 minutes. Additionally, participants smoked e-cigarettes for a period of 5 and 30 minutes. In all occasions, sympathetic drive was assessed by muscle sympathetic nerve activity (MSNA) (baroreflex-dependent) and skin sympathetic nerve activity (SSNA) (baroreflex-independent) based on established methodology (microneurography).

Results
After the first and second TC smoking, there was significant increase in mean arterial pressure (MAP) (by 6 and 8 mmHg, respectively, overall p&lt;0.001) and heart rate (by 8 and 12 beats/minute, respectively, overall p&lt;0.001) compared to baseline. Similarly, EC smoking at 5 and 30 minutes compared to baseline was accompanied by augmentation of MAP (by 6 and 10 mmHg, respectively, overall p&lt;0.001) and heart rate (by 5 and 9 beats/minute, respectively, overall p&lt;0.001). Sham smoking was accompanied by a reduction in MAP after the first and second cigarette compared to baseline (by 2 and 4 mmHg, respectively, p=0.001), whereas there was no significant difference in heart rate (p=NS). The first and second TC smoking was characterized by lower muscle MSNA (by 6 and 6 bursts/minute, respectively, overall p&lt;0.001) compared to baseline, whereas SSNA was increased (by 9 and 10 bursts/minute respectively, overall p&lt;0.001). Additionally, EC smoking at 5 and 30 minutes caused a decrease in MSNA (by 8 and 8 bursts/minute, respectively, overall p&lt;0.00) and an augmentation in SSNA (by 7 and 9 bursts per minute, respectively, overall p&lt;0.001) compared to baseline. Sham smoking had no significant effect on MSNA and SSNA (p=NS for both).

Conclusions
Sympathetic, pressor and heart rate unfavorable responses to EC smoking are similar to those elicited by TC in healthy subjects. Our findings provide novel insights into the negative impact of EC on cardiovascular system and support opinions recommending great caution concerning EC use.

Funding Acknowledgement
Type of funding sources: None.
One-year impact of bariatric surgery on echocardiographic markers of vascular disease: results from the prospective FatWest study
Authors: Cramariuc D , Grymyr L M D , Nadirpour S , Nedrebo B G , Kovac N , Gerdts E 
Published: October 2021

Abstract

Background
Aortic root plaque and aortic valve sclerosis (AVS) are known echocardiographic markers of atherosclerosis. Obesity increases the atherothrombotic risk, while large surgical weight loss improves the cardiovascular risk profile. It is unclear whether the severity of vascular disease associated with severe obesity changes after bariatric surgery.

Purpose
To assess the 1-year impact of bariatric surgery on aortic root wall thickness (ART) and AVS.

Methods
91 severely obese patients (43±10 years, preoperative body mass index [BMI] 41.7±4.9 kg/m2, 55% hypertensive, 17% diabetic) underwent echocardiography preoperatively and 14 months after Roux-en-Y bypass surgery in the prospective FatWest (Bariatric Surgery on the West Coast of Norway) study. We measured the end-diastolic maximum ART and categorized AVS as mild, moderate or severe based on combined aortic cusp thickness and hyperechoic valve lesions. Left ventricular (LV) structural remodelling was assessed by LV mass and geometry. In 52 patients with clinical signs of obstructive sleep apnea, preoperative polysomnography data including apnea-hypopnea index and mean nightly oxygen saturation were evaluated.

Results
Preoperatively, 39% had mild-moderate AVS, and an average ART of 4.9±1.7mm (Figures 1–2). Presence of AVS at baseline was associated with higher LV mass, while ART was higher in men, older patients and increased with lower nightly oxygen saturation (r=−0.29, p&lt;0.05). During the first preoperative 14 months, patients experienced a 12.9±3.8kg/m2 BMI and 0.6±1.9mm ART reduction, and AVS prevalence lowered by 45% (Figures 1 and 2). In backward stepwise multivariate regression analyses with adjustment for changes in clinical variables, LV mass and geometry, less ART reduction at 14 months was independently predicted by higher age, higher postoperative BMI and presence of AVS (R2 0.53, all p&lt;0.05). Persistent AVS was associated with higher age and preoperative diabetes (R2 0.24, p&lt;0.05).

Conclusion
In patients undergoing bariatric surgery, a reduction in echocardiographic markers of vascular disease was observed 1 year postoperatively, particularly in younger, non-diabetic patients.

Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Helse Vest Figure 1Figure 2
Cardiac phenotypes in the acute-phase of microscopic polyangiitis involves dilatation of the left atrium caused by LV diastolic dysfunction
Authors: Kinoshita N , Nawata T , Okuda S , Kubo M , Wada Y , Kobayashi S , Tanaka N , Yano M 
Published: October 2021

Abstract

Background
Microscopic polyangiitis (MPA) is a type of primary systemic vasculitis that affects various organs, especially the lungs and kidneys. However, few reports regarding cardiac features of MPA patients were found.

Purpose
We aim to investigate the echocardiographic parameters of acute-phase MPA.

Methods and results
This single-center retrospective study included 15 patients with MPA (Mean age at 72.2±7.1 years, women 73.3%) who underwent echocardiography within two weeks of commencing steroid therapy for induction or reinduction. The echocardiography parameters of the patients were compared with those of 30 age and sex-matched controls. In the MPA group, the commonly affected organs were kidneys (93.3%) and lungs (46.7%); 5 patients (33.3%) had a history of hypertension, which had a similar frequency as the control group. No significant difference in left ventricular (LV) diameter, LV ejection fraction, e', or inferior vena cava diameter was observed between the two groups. However, the MPA group showed significantly higher left atrial (LA) diameter (p=0.033) and LA volume index (p=0.001), as well as higher early diastolic filling velocity (E-wave, p=0.015; E/A, p=0.043; E/e', p=0.041), diastolic pulmonary venous flow velocity (p=0.013), trans-tricuspid pressure gradient (p=0.019), and shorter deceleration time (p=0.038), associated with mildly thicker ventricular walls of left ventricle (LV) than the control group. Moreover, serum levels of C-reactive protein showed significant correlation between E wave (r=0.58, p=0.023), E/A (r=0.67, p=0.006), and deceleration time (r=−0.69, p=0.005) in the MPA group. These results may indicate that in MPA, increased LV stiffness, rather than impairment of LV relaxation was contributed to LV diastolic function, resulting in LA enlargement.

Conclusion
Patients with acute-phase MPA had LA dilatation associated with LV diastolic dysfunction. This finding indicates the importance of cardiac assessment in patients with MPA.

Funding Acknowledgement
Type of funding sources: None.
Endothelial glycocalyx integrity and microvascular perfusion are associated with novel echocardiographic markers and carotid intima-media thickness in patients with psoriasis
Authors: Ikonomidis I , Pavlidis G , Thymis J , Rafouli-Stergiou P , Makavos G , Kostelli G , Vrettou A R , Frogoudaki A , Katsimbri P , Lambadiari V , Parissis J , Iliodromitis E , Theodoropoulos K , Kapniari E , Papadavid E 
Published: October 2021

Abstract

Background/Introduction
Psoriasis has been associated with vascular and myocardial dysfunction through mechanisms of inflammation and oxidative stress.

Purpose
We aimed to evaluate sublingual microvascular perfusion and glycocalyx barrier properties in psoriasis patients, as well as their correlation with coronary microcirculatory function and markers of myocardial deformation and atherosclerosis (carotid intima-media thickness, cIMT).

Methods
We examined 297 patients with psoriasis and 150 controls, adjusted for age, sex, and atherosclerotic risk factors. Perfusion boundary region (PBR), a marker of glycocalyx barrier function, was measured non-invasively in sublingual microvessels with a diameter ranging from 5–25μm using a dedicated camera (Sidestream Dark Field imaging, Microscan, GlycoCheck). Increased PBR indicates reduced glycocalyx thickness. Indexes of microvascular perfusion, including red blood cell (RBC) filling percentage and functional microvascular density, were also calculated. We measured coronary flow reserve (CFR), cIMT and markers of myocardial deformation by speckle tracking imaging utilizing echocardiography [peak twisting, the percentage changes between peak twisting, and untwisting at mitral valve opening (%dpTw-UtwMVO), at peak (%dpTw-UtwPEF), and the end of early LV diastolic filling (%dpTw-UtwEDF)].

Results
Psoriasis patients had higher PBR5–25 compared to controls (2.13±0.29 versus 1.78±0.25μm, p&lt;0.05). There was an inverse association of PBR5–25 with perfused microvascular density (r=−0.42, p&lt;0.001) and RBC fraction (r=−0.80, p&lt;0.001). In psoriatic population, PBR5–25 was inversely correlated to CFR (r=−0.30, p=0.045). Increased values of PBR5–9 were associated with reduced untwisting at the end of the mitral inflow E wave (r=−0.24, p=0.006) and reduced %dpTw-UtwMVO (r=−0.35, p&lt;0.001). Furthermore, decreased RBC filling percentage and perfused microvascular density were related to worse LV longitudinal strain and increased cIMT (p&lt;0.05). Finally, a positive correlation between perfused microvascular density and %dpTw-UtwMVO was observed in patients with psoriasis (p&lt;0.05).

Conclusion
Endothelial glycocalyx thickness is reduced in patients with psoriasis and is associated with impaired coronary and myocardial function, and vascular atherosclerosis.

Funding Acknowledgement
Type of funding sources: None.
Cognitive dysfunction and adverse events during oral anticoagulant: a prospective cohort study
Authors: Massoure P , Nguyen C 
Published: October 2021

Abstract

Background
Oral anticoagulants (AC), represent the leading cause of iatrogenic morbimortality in France. AC are widely prescribed among the elderly. The assessment of the cognitive dysfunction (CD) is not included within the common thrombotic and bleeding risk scores.

Purpose
The objective of this study was to examine an association between CD and adverse events (AE) in patients receiving oral AC.

Methods
A prospective monocentric cohort study was conducted in patients (≥60 years-old) on oral AC. Death, hemorrhages, falls, hospital readmission, thromboembolic events were collected over 6 months follow-up. Patients were included during an hospitalization for any medical or surgical condition and divided in three groups, according to their Mini Mental State Examination (MMSE): Group 1 (absence of CD) MMSE ≥27, Group 2 (mild CD) 24&lt;mmse&lt;26, &gt;≤MMSE≤26, Group 3 (significant CD) MMSE ≤23.

Results
Among 120 patients (mean age: 82,2±8,8 years), the all-causes mortality (n=25) was significantly higher in the Group 3 (n=17, p=0,006); this also applies to the incidence of falls (n=34, p=0,009) or major hemorrhages (n=10, p=0,023). There was no thromboembolic event. Minor hemorrhages and hospital readmissions were not different in the 3 groups. Multivariate analysis shows a significant risk of mortality (OR 4.3, (p=0,025, IC [1,20–15,42]) in group 3.

Conclusion
After 6 months of follow up, the cognitive dysfunction was associated with mortality, major hemorrhages and falls among the elderly receiving oral AC. A systematic assessment of cognitive functions of these patients seems to be essential to analyze the global risk and the risks related to the AC treatment.&lt;/mmse&lt;26,&gt;

Funding Acknowledgement
Type of funding sources: None.