bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 2399: Low Hospital Mortality Of Acute Myocardial Infarction In Cslinical Practice Due To Optimized Guideline Oriented Treatment: Results Of The Optami-registry
Authors: Gitt Anselm K , Wienbergen Harm , Zeymer Uwe , Towae Frank , Gottwik Martin G , Breithardt Guenter , Senges Jochen 
Published: July 2021

Background: Hospital mortality of STEMI in recent randomized trials as ASSENT IV ranges between 3.5 and 6.0%. Although registry data have shown a constant improvement of myocardial infarction outcome over the past years due to better implementation of guidelines for the management of acute myocardial infarction, hospital mortality in clinical practice still was much higher than in the selected patient population of randomized trials. Can ongoing registries in clinical practice as quality assurance programmes further reduce hospital mortality of acute myocardial infarction?
Methods: The OPTAMI Register (Optimized Therapy of Acute Myocardial Infarction) enrols consecutive patients with STEMI or NSTEMI in 33 Centres (27 with cathlab facilities) in Germany to document patient characteristics, acute therapy as well as hospital outcome. All centres are provided benchmark reports for internal quality control.
Results: Out of 1139 enrolled patients, 629 (55%) presented with STEMI and 510 (45%) with NSTEMI. Patients with NSTEMI were older, more often female and had a significantly higher prevalence of relevant comorbidities. OPTAMI documented an extraordinary high rate of primary PCI in STEMI as well as a high rate of early invasive strategy with PCI <48h in NSTEMI. In both groups, adherence to guidelines for the acute adjunctive medical treatment including antiplatelet therapy, betablockers, ACE-inhibitors and statins was higher than ever documented in any German MI registry. Hospital mortality was 4.0% in consecutive patients with STEMI and 3.9% in consecutive patients with NSTEMI.
Conclusion: Preliminary data of the ongoing OPTAMI Registry demonstrate that in selected cnetres (mainly with cath lab facilities) hospital mortality in clinical practice can be reduced to levels of randomised controlled trials by adherence to practice guidelines for the management of acute myocardial infarctions.
Abstract 2461: Low Thromboembolism and Pump Thrombosis Potential of the HeartMate II (HM) LVAD
Authors: Boyle Andrew J , Russell Stuart D , Teuteberg Jeffrey J , Moazami Nader , Moore Stephanie A , Slaughter Mark , Farrar David J , John Ranjit 
Published: July 2021

Introduction: The HM continuous flow LVAD has been shown to have good reliability and an excellent safety profile when used as a bridge to transplantation (BTT). Initially, there were concerns that the continuous flow and design of the HM might pre-dispose patients to thromboembolic events or pump thrombosis and therefore oral anticoagulation with coumadin was recommended. Our study evaluates the risk of thromboembolism and pump thrombosis related to the degree of anticoagulation as reflected by the International Normalized Ratio (INR).
Methods: We evaluated all patients enrolled in the HM BTT pivotal trial from 1 to 6 months post-implant in order to eliminate perioperative events unrelated to anticoagulation. All patients were on aspirin and some also on persantine. An INR was measured monthly per protocol. Each individual INR sample from each time interval was assigned to ranges of INR values. Adverse events analyzed were ischemic (I) and hemorrhagic (H) stroke, pump thrombosis (T), and GI bleeding (G). Patients with adverse events were associated with the most recent INR at the start of the time interval.
Results: The median duration of support for 189 patients was 132 days (range: 1–672 days) (cumulative: 96.9 patient years). There were 7 (3.7 %) patients with thrombotic events and 11 (5.8 %) patients with hemorrhagic events. The only pump thrombosis occurred with an INR > 2.5 (0.5 %).
Conclusions: The rates of thromboembolism, including stroke and pump thrombosis appear to be low with the HM as BTT. The thrombotic events appear to be offset by an equivalent number of hemorrhagic events. There appears to be no correlation between the degree of anticoagulation with warfarin, as reflected by the INR, and the frequency of thrombotic or hemorrhagic events. Therefore, particularly in patients having recurrent episodes of bleeding, the risk of lowering the target INR appears to be small.
Abstract 364: Ottawa Heart Genomic Study: Discovery Of Novel Genes For Coronary Artery Disease By Genome-wide Association Utilizing The 500k SNP Array
Authors: Stewart Alexandre F , McPherson Ruth , Williams Kathryn , Kavaslar Nihan , Rutberg Julie , Doelle Heather , Ewart Gwen , Wells George , Roberts Robert 
Published: July 2021

Purpose: To identify genes predisposing to Coronary Artery Disease (CAD). Methods: We selected the unbiased approach of using the genome wide scan association case control method. Using the Affymetrix 500K SNP array that that average a marker every 6,000 base pairs, we estimated that to detect a Minor Allele Frequency (MAF) of ≥ 10%, an odds ratio for risk of > 1.3 with 90% power would require 14,000 subjects (9,000 cases and 5,000 controls). Phase I consists of genotyping of 1,000 cases of early onset CAD and 1,000 asymptomatic older controls. Phase II will determine whether SNPs showing an association in Phase 1 are replicated in 8,000 cases and 4,000 controls. The phenotype is confirmed or excluded by coronary arteriograms obtained by catheterization or multi-slice CT. Cases with diabetes mellitus are excluded.
Results: Initiated in 2005, over one billion genotypes have been performed and analyzed for 1,054 controls and 997 cases completing Phase I. Starting with data on 500,668 SNPs, control genotypes that were monoallelelic (21,668 SNPs) or not in Hardy Weinberg equilibrium were excluded using a false discovery rate (FDR) Q value <0.001 (1,473 SNPs). Individual SNPs with call rates <95% (30,826 SNPs) in cases and controls were excluded, leaving 446,701 SNPs. Fisher’s exact test was used to compare genotypes between cases and controls (FDR Q value <0.05), identifying 2,819 significant SNPs. SNPs with a MAF < 0.01 in both cases and controls (598 SNPs) were removed leaving 2,221 significant SNPs. 14 SNPs in exons were non-synonymous, i.e. cause amino acid substitutions. 53 clusters of SNPs (defined as ≥3 SNPs) within genes and 45 between genes were identified, including one at 9p21.3 that was replicated in multiple independent populations (McPherson et al., Science Express 2007 - in press). In addition, 13 SNPs were identified on the X chromosome. There was no evidence of stratification in our population. SNPs showing significant association with CAD are being assessed in an independent population during Phase II.
Conclusions: This is the first genome wide scan for CAD genes utilizing 500,668 markers. Phase I has identified many genes not previously known to be associated with CAD.
Abstract 2640: Clinical Characteristics and Risk Stratification in Symptomatic and Asymptomatic Patients with Brugada Syndrome - Multi-center Study in Japan-
Authors: Takagi Masahiko , Yokoyama Yasuhiro , Aonuma Kazutaka , Aihara Naohiko , Hiraoka Masayasu 
Published: July 2021

Background Neither the clinical characteristics nor risk stratification of symptomatic and asymptomatic patients with Brugada syndrome have been clearly determined. We compared clinical and ECG characteristics of symptomatic and asymptomatic patients with Brugada syndrome to identify new markers for distinguishing high- from low-risk patients.
Methods A total of 216 consecutive individuals with Brugada syndrome (mean age 52±14 years, 197 males) were enrolled in the Japan Idiopathic Ventricular Fibrillation Study (J-IVFS). Clinical and ECG characteristics were compared among 3 groups of patients: VF group; patients with aborted sudden death and documented VF (N=34), Syncope (Sy) group; patients with syncope without documented VF (N=70), and Asymptomatic (As) group; subjects without symptoms (N=112). Comparisons were made among the 3 groups as well as between the symptomatic (VF/Sy) and asymptomatic (As) groups. Short-term prognosis was also compared among the 3 groups, and between the VF/Sy and As groups.
Results 1) Clinical characteristics: incidence of past history of AF was significantly higher in the VF and Sy groups than in the AS group (26, 26, and 12 %, respectively; [p=0.04]), though no other clinical parameters differed among the groups. 2) On resting 12-lead ECG, r-J interval (interval from QRS onset to J point) in lead V2 and QRS duration in lead V6 were highest in the VF group (104, 98, and 92 msec in V2 [p<0.001]; 106, 103, and 94 msec in V6 [p<0.0001], respectively, VF vs. Sy vs. As). 3) Positive late potential and inducibility of VF by EPS did not differ in incidence among the 3 groups. 4) Clinical follow-up: during a mean follow-up of 36±16 months, incidence of cardiac events (sudden death and/or VF) was higher in the VF/Sy groups than in the As group (29, 8, and 0 %, respectively [p<0.001]). Multivariate analysis showed that the frequencies of r-J interval ≥ 90 msec in lead V2 and QRS duration ≥ 90 msec in lead V6 were significantly higher in patients with cardiac events (p=0.02, 0.02, respectively).
Conclusions In symptomatic patients, prolonged ventricular depolarization in precordial leads of the ECG was prominent in the VF group, and this sign can be used to distinguish high- from low-risk patients with Brugada syndrome.
Abstract 2655: Correlates Of Aortic Valve Calcification In Aortic Stenosis: Insights From The Astronomer Study
Authors: Chan Kwan , Tam James , Sochowski Randall , Dumesnil Jean , Giannoccaro Peter , Jue John , Pandey Shekhar , Joyner Cam , Teo Koon 
Published: July 2021

Aortic valve calcification (AVC), a common finding in aortic stenosis (AS), is a predictor of rapid AS progression and increased risk of cardiac events. We evaluated clinical, echocardiographic and biochemical correlates of AVC to gain insight into pathogenesis and to identify potential targets for intervention.
Methods: The ASTRONOMER study (Aortic Stenosis Progression
Observation: Measuring Effects of Rosuvastatin) is a randomized trial to assess cholesterol lowering using rosuvastatin on AS progression in mild to moderate AS. Patients with indication for cholesterol lowering were excluded. Severity of AVC was classified as none, mild, moderate and severe according to published criteria.

Results: 272 patients (167 men, 105 women; mean age 58.1±13.6 years) have been enrolled with peak and mean AV gradients 41±11 and 23±8 mmHg respectively. Patients with none or mild AVC were compared with patients with moderate or severe AVC (Table

). ACE-I= angiotensin converting enzyme inhibitor, BAV=bicuspid aortic valve, BP=blood pressure, HDL-C=high-density lipoprotein cholesterol, LDL-C= low-density lipoprotein cholesterol, MAC=mitral annular calcification. Regression analysis showed that AVC was associated with age (p<0.001), male sex (p=0.01), systolic BP (p=0.002), LDL-C (p=0.05), MAC (p=0.01) and tricuspid AV (p=0.001). With adjustment for age, correlates of AVC were male sex with odds ratio (OD) 2.04, p<0.01, systolic BP (OD=1.02, p=0.096), and LDL-C (OD 1.44, p=0.077).

Conclusions: In patients with AS, age and male sex are the main correlates of AVC. After adjusting for age, AVC is not associated with AV morphology but appears to be related to male sex, BP and LDL-C. Thus BP and LDL-C are promising modifiable targets to prevent AVC which in turn should reduce AS progression.
Abstract 2721: Linkage of Left Ventricular Outflow Tract Obstruction to Xq28 in 3 French-Canadian Pedigrees
Authors: Provost Sylvie , Chetaille Philippe , Siles Ana , Thibeault Maryse , Bureau Nathalie , Riopel Kathleen , Mercier Jocelyne , Poisson Virginie , Leclerc Séverine , Jaeggi Michelle , Houde Christine , Miro Joaquim , Bigras Jean-Luc , Dubé Marie-Pierre , Richter Andrea , Andelfinger Gregor 
Published: July 2021

BACKGROUND: Statistical genetic analysis of cohorts with left ventricular outflow tract obstruction (LVOTO) shows high heritability of such lesions. We have identified three X-linked French-Canadian pedigrees with a total of 54 family members with multiple cases of LVOTO and septal defects.
AIMS: The aim of this study was to evaluate the three pedigrees with LVOTO and septal defects for genetic linkage to the X chromosome.
METHODS: Detailed family history, physical exam, ECG, echocardiography and chart review was performed. Informed consent was obtained from all participants. Genomic DNA was isolated from peripheral blood samples. Twenty-four STR markers from the X chromosome were genotyped. We used a dominant genetic model with the following penetrances: 0.99 for homozygous women, 0.75 for heterozygous women, 0.99 for hemizygous men. Phenocopy rate was set to 0.01 and disease allele frequency to 0.001. Reference allele frequencies from the Quebec population were used. Analyses were performed with MLINK and MERLIN.
RESULTS: Sixteen family members were affected (13 males, 3 females). Predominant lesions were atrial (n = 5) and ventricular (n = 6) septal defects, coarctation (n = 4) and aortic lesions (stenosis (n = 4), bicuspid/abnormal aortic valve (n = 6)), as well as mitral valve lesions (n = 4). Males had a high incidence of supraventricular arrhythmias postoperatively (4 with atrial flutter/fibrillation, one with ICD implantation). LOD scores above 2 were obtained in parametric two-point linkage analysis for 3 markers in the Xq28 region. Multipoint non-parametric linkage analysis confirmed these results with a NPL score of 9.1 (P < .00001) over a STR marker in intron 13 of the F8C gene. Haplotype analysis allowed the definition of a candidate interval flanked by marker DXS8069 spanning to the telomeric end of Xq.
CONCLUSIONS: By analysing 3 multi-generation French-Canadian pedigrees, we mapped a syndrome of LVOTO and septal defects to the Xq28 region. Further work will refine our candidate region with dense SNP coverage to search for a shared haplotype identical by descent between the three French Canadian families, to complete the sequencing of candidate genes including FLNA, and to search for a possible founder effect in our population.
Abstract 2805: Persistent Gender Bias in the Use of Percutaneous Coronary Intervention at the Acute Stage of MI from 1995 to 2005: Results from the French USIK, USIC 2000 and FAST-MI Registries
Authors: DANCHIN Nicolas , SIMON Tabassome , ELTCHANINOFF Helene , GILARD Martine , OLTEAN Ioana , LECLERCQ Florence , MULAK Geneviè ve , CAMBOU Jean-Pierre 
Published: July 2021

Percutaneous coronary intervention (PCI) is an essential step in the management of patients with STEMI or NSTEMI. Previous data have evidenced a gender bias in the use of PCI in people admitted for AMI.
Aim: to assess whether PCI was used differently in men and women with AMI and if there have been changes in this regard over the last 10 years.
Methods: USIK 1995, USIC 2000 and FAST-MI are 3 nationwide French registries conducted 5 years apart, using a similar methodology in patients admitted to CCU over a one-month period. For the present analysis, all 7528 patients admitted for AMI (STEMI and NSTEMI) < 48 hours from symptom onset were included.
Results: 2152 patients were included in 1995, 2317 in 2000 and 3059 in 2005. Women represented 29%, 27% and 32% of the populations, respectively in the 3 periods. Overall, women were 10 years older than men (no difference between the 3 periods); PCI was used in 53% of men and 39% of women (p<0.001). Use of PCI during the initial hospital stay increased from 1995 to 2005, but the difference between men and women persisted (1995: 12% v. 20%; 2000: 45% v. 62%; 2005: 52% v. 69%)(p<0.001 at all time points). In the whole population, female gender was an independent predictor of a lower use of reperfusion therapy (OR: 0.70; 95% CI: 0.62– 0.79, p<0.001), together with older age, history of peripheral arterial disease, history of congestive heart failure, and earlier time period (1995 v 2000 v 2005) (logistic regression analysis). In each of the 3 periods, female gender remained associated with lower use of reperfusion, with odds ratios of similar magnitude (1995: OR: 0.54, 95% CI: 0.41– 0.71; 2000: OR 0.50, 95% CI: 0.41– 0.60; 2005: OR: 0.48, 95% CI: 0.41– 0.56). A striking decrease in 30-day mortality was observed in women (1995: 21%, 2000: 12%, 2005: 8.5%). This decrease, however, was found predominantly in women who underwent PCI (14%, 6% and 4%, respectively), compared with women without PCI (22%, 17%, 14%, respectively).
Conclusion: In spite of a much higher use of PCI over the past 10 years, a definite gender bias persists. This finding is all the more preoccupying as the reduction in early mortality over this period of time has been observed mainly in women with PCI.
Abstract 2835: Waveform Characteristics of Ventricular Fibrillation Are Altered in Post-Myocardial Infarction Swine
Authors: Indik Julia H , Donnerstein Richard L , Feigelman Justin , Hilwig Ronald W , Zuercher Mathias , Kern Karl B , Berg Marc D , Berg Robert A 
Published: July 2021

Background: In ventricular fibrillation (VF) of short duration chest compressions do not improve survival prior to defibrillation. We have previously shown that in an acute myocardial infarction (MI), frequency characteristics are markedly depressed and are poor surrogates for VF duration. We hypothesized that the VF waveform further evolves post-MI, after a myocardial scar has formed.
Methods: Acute myocardial infarction was induced in nine swine by occlusion of the mid left anterior descending artery. After a two week recovery period, VF was induced and compared to VF in 16 control swine over the first five minutes. VF waveforms were analyzed for frequency content (mean, median, dominant and bandwidth), slope (the median of the absolute value of the difference in voltage every 5 ms), and AMSA (the summed product of amplitude and frequency).
Results: Myocardial scar was confirmed in all MI swine postmortem. All frequency characteristics were significantly altered in post-MI swine (p<0.01). At 4 minutes, VF mean frequency in controls was 10.3 ± 0.5Hz compared to 9.1± 0.5Hz in post-MI swine (mean ±SEM, p=0.007), with similar differences for median and dominant frequencies. Bandwidth was markedly decreased and at 4 minutes was 3.2 ± 0.2Hz in controls compared to 2.1 ± 0.2Hz in post MI swine (p<0.001). However, slope and AMSA were similar in both groups.
Conclusions: Frequency content of VF remains altered post MI compared to control swine, with reductions in mean, median and dominant frequencies and larger reductions in bandwidth. Amplitude based measures such as AMSA and slope, however, are not significantly altered and may serve as better predictors of time in VF.
Abstract 2959: TGF-beta Is A Promising Biomarker For Monitoring The Aortic Root Dilatation And Losartan Therapy In Marfan Syndrome
Authors: Matt Peter , Habashi Jennifer , Holm Tammy , Klein Erin , Gamradt Matt , Zerkowski Hans-Reinhard , Carrel Thierry , Huso David , Van Eyk Jennifer , Dietz Harry 
Published: July 2021

Objectives: Aortic root dilatation is the main cause of morbidity and mortality in Marfan syndrome (MFS), a disorder caused by mutations in the gene encoding fibrillin-1 and consequent dysregulation of TGF-beta signaling. The aim of this study was to discover a serological biomarker for the aortic root dilatation in a mouse model of MFS, that was also responsive to losartan therapy.
Methods: Serum samples from mice heterozygous for a fibrillin-1 missense mutation (C1039G/+) and wild-type mice treated with losartan or placebo were obtained at 10 weeks, 6 months and 10 months of age. Total (acid activated) TGF-beta 1 serum concentrations were measured by ELISA. Echo measurements of the aortic root were obtained from a parasternal long axis view at 10 months of age.
Results: Mean TGF-beta serum concentrations were higher in C1039G/+ mice compared to wild-type mice (p=0.01; 80.0 ng/ml (n=5) vs. 58.3 ng/ml (n=4) at 10 weeks, 117.4 ng/ml (n=11) vs. 87.0 ng/ml (n=6) at 6 months, 137.5 ng/ml (n=3) vs. 103.0 ng/ml (n=2) at 10 months, respectively). Losartan-treated C1039G/+ mice had significantly lower mean TGF-beta serum levels compared to C1039G/+ mice with placebo (p=0.007; 92.9 ng/ml (n=5) vs. 117.4 ng/ml (n=11) at 6 months, 101.2 ng/ml (n=13) vs. 137.5 ng/ml (n=3) at 10 months, respectively). Mean TGF-beta serum concentrations in losartan-treated C1039G/+ mice and wild-type mice with placebo were not significant different (p=0.3; 92.9 ng/ml (n=5) vs. 87.0 ng/ml (n=6) at 6 months, 101.2 ng/ml (n=13) vs. 103.0 ng/ml (n=2) at 10 months, respectively). Echo analyses revealed significantly smaller mean aortic root diameters in 10 months old wild-type and losartan-treated C1039G/+ mice compared to age-matched C1039G/+ mice with placebo (p=0.001; 1.94 mm (n=2) and 2.06 mm (n=13) vs. 2.4 mm (n=3), respectively).
Conclusions: TGF-beta serum levels are higher in C1039G/+ mice compared to wild-type mice. Losartan treatment of C1039G/+ mice reduces TGF-beta serum concentrations and aortic root diameters towards wild-type levels. Serum TGF-beta is a promising biomarker for prognostication and monitoring the therapeutic response to losartan therapy in Marfan syndrome.
Abstract 3240: High Speed Rotational Coronary Venous Angiography Improves Delineation of Coronary Venous Anatomy during Cardiac Resynchronization Therapy
Authors: Kofune Masayoshi , Watanabe Ichiro , Ashino Sonoko , Okumura Yasuo , Kawauchi KIazunori , Kofune Tatsuya , Ohkubo Kimei , Hashimoto Kenichi , Shindo Atsushi , Sugimura Hidezou , Nakai Toshiko , Saito Satoshi , Hirayama Atsushi 
Published: July 2021

Background: The implantation of the left ventricular lead for biventricular devices can be challenging due to anatomic variation in the branching pattern of the coronary sinus (CS). Standard coronary venous (CV) angiography (SCVA) provides a static, fixed projection of the CV tree. Typically multiple contrast injections are obtained to gain a better understanding of vessels overlap and foreshortening. But, even in this situation, the site of side branch takeoff, its angulation and course cannot be reliably predicted - particularly in the presence of complex branching patterns. High-speed rotational CV angiography (RCVA) permits a dynamic, multi angle visualization of the CV anatomy.
Objective: To compare RCVA with SCVA during cardiac resynchronization therapy.
Methods: Digitally acquired RCVA from 10 patients were analyzed. RCVA uses a rapid isocentric rotation over a 180° arc, RAO 54° to LAO 54° in 4 sec, acquiring 121 frames /angiogram with a single injection of 20 ml of contrast (Infinix, Toshiba). The CV anatomy assessed by RCVA was compared with 2 static perpendicular views: RAO 45° and LAO 45°.

Results: Three-dimensional models of the venous tree were reconstructed (Figure

), and the rotational images were analyzed using a full range of gantry angles, providing the operator with considerably more information about the CV anatomy than SCVA images.

Conclusion: RCVA provides a better understanding of the CV anatomy and the special relationship of its branches. The SCVA view which optimally displayed the appropriate CS branch for left ventricular lead implantation was often different from the conventional RAO and LAO views.