bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 3259: Intra-Aortic Balloon Pump Insertion Prior to LVAD Implantation Improves Short-term Survival in High-Risk LVAD Recipients
Authors: Naseem Tariq M , Comas George M , Mangi Abeel A , Martens Timothy P , Cheema Faisal H , Arif Hiba , Bialo Darren A , Khalid Imran , Argenziano Michael , Naka Yoshifumi 
Published: July 2021

INTRODUCTION: Intra-aortic balloon pump (IABP) insertion can augment cardiac function in the setting of acutely decompensated heart failure. The aim of this study was to determine if IABP insertion prior to left ventricular assist device (LVAD) implantation improves outcomes in LVAD recipients.
HYPOTHESIS: We assessed the hypothesis that pre-operative IABP insertion for hemodynamic stability and improved organ perfusion would lead to better outcomes post-LVAD implant
METHODS: We have previously described a preoperative LVAD risk score (LRS), which is based on preoperative characteristics associated with inferior outcomes after LVAD insertion (e.g. previous cardiac surgery, ventilator dependence, elevated central venous pressure, elevated prothrombin time). We retrospectively reviewed the records of 245 patients undergoing LVAD implantation (Heartmate I, Heartmate II & DeBakey) at our center between 1996 and 2006, including preoperative LRS and 30-day survival. Patients were categorized as those who received an IABP prior to LVAD implant for hemodynamic stability and those who did not. Data were analyzed by Chi-square and Mann-Whitney U tests.
RESULTS: Of 245 patients having LVAD implants during the study period, 174 (71%) had a LRS of 1–5 (low-risk group), while 71 (29%) had a LRS of 6 –10 (high-risk group). A total of 95 patients received an IABP prior to LVAD insertion during this period: 54 (31%) of the low-risk patients and 41 (58%) of the high-risk patients. In the high-risk cohort, patients receiving pre-operative IABP (n = 41) had superior 30-day survival compared with patients who did not receive an IABP (n = 30) (78% vs. 57%, p < 0.05). Conversely, in the low-risk group, IABP insertion was associated with a trend toward lower 30-day survival (78% vs. 92%, p < 0.1). In the low-risk group, the rate of successful bridging to transplantation was higher in patients who did not receive pre-operative IABP support (86% vs. 69%, p < 0.01).
CONCLUSION: LVAD candidates with a high LVAD risk score, a preoperative surrogate of increased perioperative risk, have improved 30-day survival if stabilized with an IABP prior to LVAD implantation.
Abstract 3265: A Comparison of Echocardiographic and Electrocardiographic Characteristics of Patients with Apical Hypertrophic Cardiomyopathy
Authors: Binder Josepha , Grossardt Brandon R , Jost Christine Attenhofer , Klarich Kyle W , Ackerman Michael J , Tajik A. J , Ommen Steve R 
Published: July 2021

Background: Apical hypertrophic cardiomyopathy (apical HCM) is a less common subtype of HCM characterized by a focal thickening in the left ventricular apex. “Classic” ECG features have been described, however, apical HCM can persist for many years without detection. We investigated the relationship between ECG findings and echocardiographic morphometry in a large referral series of patients with apical HCM.
Methods: We enumerated all patients diagnosed with apical HCM prior to Sept. 30, 2006 using the Mayo Clinic HCM database. We compared echocardiographic measures separately for patients with positive status for two ECG indices of left ventricular hypertrophy (LVH); the Sokolow-Lyon index and the Romhilt-Estes (RE) point-score. We also compared echocardiographic measurements in patients with and without negative T-waves in the precordial leads.
Results: Apical HCM was detected in 177 patients (111 men and 68 women). Only 51% had positive Sokolow criteria and 51% had positive RE criteria. The agreement between Sokolow and RE status was high (agreement = 75.0%; kappa = 0.50; 95% CI = 0.38 – 0.62). In particular, Sokolow positive patients had increased LV ejection fraction (P = 0.02), and decreased LV end-systolic diameter (P = 0.03) compared with Sokolow negative patients. The prevalence of right atrial enlargement (47 vs. 28%; P = 0.02) and intracavity obstruction (22 vs. 8%; P = 0.01) were more common in Sokolow positive patients. Positive RE criteria was associated with a greater thickness of the basal septal and basal posterior walls (P = 0.001 and 0.02, respectively), and with a higher frequency of intracavity obstruction (21 vs. 9%; P = 0.04). Most patients (89%) exhibited at least one negative T-wave in the precordial leads; however, only 10% of patients had a negative T-wave of greater than 1.0 mV. We found that patients with an inverted T-wave larger than 0.4 mV (median) had a significantly increased LV ejection fraction (P = 0.03) compared with patients who had smaller or no negative T-waves.
Conclusions: Among patients with apical HCM, nearly half do not have ECG evidence of LVH based on classic criteria and most do not have marked T-wave inversions. However, the majority did have at least a mild expression of negative T-waves.
Abstract 3324: Assessment of Coronary Calcification by Optical Coherence Tomography in the Culprit Lesions: Comparison between Acute Coronary Syndrome and Stable Angina Pectoris
Authors: Mizukoshi Masato , Kubo Takashi , Takarada Shigeho , Kitabata Hironori , Tanimoto Takashi , Ueno Satoshi , Kuroi Akio , Arita Yuu , Ikejima Hideyuki , Ookouchi Keishi , Tsujioka Hiroto , Kashiwagi Manabu , Matsumoto Hiroki , Kataiwa Hideaki , Nakamura Nobuo , Tanaka Atsushi , Imanishi Toshio , Akasaka Takashi 
Published: July 2021

[BACKGROUND] Calcification is an important phenomenon of atherosclerosis. Histopathological and intravascular ultrasound studies suggest that the characteristics of calcification might be associated with the pathogenesis of the vulnerable plaque. Optical coherence tomography (OCT) is a high-resolution imaging modality and allows us to analyse the plaque morphology in detail. In this study, we assessed the characteristics of calcification by OCT at the sites of culprit lesions in acute myocardial infarction (AMI), unstable angina pectoris (UAP), and stable angina pectoris (SAP).
[METHOD and RESULTS] We evaluated the characteristics of calcification in the 20-mm-long culprit lesion segment per patient by OCT in 56 patients (AMI : n=21, UAP : n=14, SAP : n=21). In each patient, the number of calcium deposits, the arc, the distance from the luminal surface to each calcification were measured. Each calcium deposit was categorized into one of two groups by the arc :

spotty calcification : a small calcium deposit with an arc of less than 90 degrees ;

large calcification : a calcific lesion with an arc of more than 90 degrees.

The average number of spotty calcification per patient in AMI and UAP was significantly greater than that in SAP (AMI 1.7+/−1.3, UAP 1.9+/−1.7, and SAP 0.6+/−0.8, p=0.012; AMI vs SAP, p=0.046, UAP vs SAP, p=0.030). The average number of large calcification per patient in AMI was significantly lower than that in SAP (AMI0.2+/−0.4, UAP 0.42+/−0.7, and SAP0.9+/−0.7; AMI vs SAP, p=0.005). Consequently, the percent of spotty calcification in each culprit lesion was higher in AMI and UAP than in SAP (AMI 87.5%, UAP 81.3%, and SAP40.1%, p<0.01). The distance between the luminal surface and the inner edge of each spotty calcification was significantly shorter in AMI and UAP than in SAP (AMI 0.18+/−0.11mm, UAP 0.15+/−0.1mm, SAP 0.30+/−0.13mm, p<0.001; AMI vs SAP, p=0.007, and UAP vs SAP, p=0.001), but that of each large calcification was not significantly different among AMI, UAP, and SAP.
[CONCLUSION] In the culprit lesions of AMI and UAP, calcium deposits more spotty in size and more close to the lumen would be observed frequently. These characteristics of the calcium deposition might play an important role in the pathogenesis of the plaque vulnerability.
Abstract 3390: Marginal Overlap between Electrocardiographic Abnormalities in Patients with Hypertrophic Cardiomyopathy and Trained Athletes: Implications for Preparticipation Screening
Authors: Melacini Paola , Cianfrocca Cinzia , Calore Chiara , Bovolato Francesca , Di Paolo Fernando , Quattrini Filippo , Pelliccia Francesco , Sharma Sanjay , McKenna William J , Maron Barry J , Pelliccia Antonio , Corrado Domenico 
Published: July 2021

Background: Hypertrophic cardiomyopathy (HCM) is usually associated with ECG abnormalities such as left ventricular hypertrophy (LVH), repolarization changes, and pathologic Q waves; instead, physiologic hypertrophy in trained athletes manifests as an isolated increase of QRS amplitude. We assessed whether the ECG pattern of pathologic hypertrophy of HCM overlaps with that of physiologic hypertrophy of athlete’s heart, particularly by evaluating what proportion of individuals from both groups had pure QRS voltage criteria (Sokolow-Lyon) for LVH.
Methods: Using accepted diagnostic criteria, we examined and compared the ECG tracings of 260 consecutive patients with clinical and echocardiographic diagnosis of HCM and those of 1005 trained athletes undergoing preparticipation cardiovascular evaluation, including ECG and echocardiography.
Results: An abnormal ECG was found in 246 of 260 (94.6%) patients with HCM and in 817 of 1005 athletes (81.3%). The majority of patients with HCM had one or more of the following ECG changes: repolarization ST/T abnormalities in 209 (80%), pathologic Q waves (Q waves ≥0.04 s in duration or ≥25% of the height of the ensuing R wave) in 103 (39.6%); left atrial enlargement in 75 (28.8%), intraventricular conduction abnormalities (QRS duration ≥90 ms) in 71 (27.3%) and left axis deviation in 9 (3.5%). ECG tracings showed isolated increase of QRS voltages in 5 HCM patients (1.9%) and were completely normal in 14 (5.4%). Compared with patients with HCM, trained athletes significantly more often had isolated voltage criteria for LVH (403, 40%; p<0.0001), but less often showed negative T waves (27, 2.7%; p<0.0001), pathologic Q waves (17, 1.7%; p<0.0001), and nonvoltage criteria of LVH (13, 1.3%; p<0.0001). No athletes with isolated voltage criteria had echocardiographic evidence of HCM.
Conclusions: ECG in HCM overlaps marginally with ECG findings in trained athletes. An isolated increase of QRS voltage is an unusual pattern (1.9%) of LVH in patients with HCM, while is frequently observed in trained athletes. Systematic echocardiographic evaluation of athletes fulfilling isolated QRS voltage criteria at preparticipation screening is not justified, resulting in a considerable cost savings.
Abstract 3406: Plaque Characterization Using Different X-ray Energy By Dual Source CT And Its Comparison With Histology
Authors: Komatsu Sei , Kuhlmann Alexander , Campean Valentine , Ropers Dieter , Ropers Ulrike , Wechsel Martin , Daniel Werner G , Amann Kerstin U , Achenbach Stephan 
Published: July 2021

Background In addition to high spatial (0.4 mm) and temporal resolution (83 ms), Dual Source CT (DSCT) allows simultaneous imaging with two different x-ray energies. This may be beneficial for tissue characterization.
Objectives. To determine the accuracy of ex vivo atherosclerotic plaque characterization with DSCT and to assess the CT attenuation of various plaque components depending on X-ray energy.
Materials and Methods. 18 atherosclerotic vessels of coronary, carotid and iliac arteries obatined from autopsy were analyzed by DSCT. Each lumen of the vessels was filled with contrast media (30X Imeron 350). The collimation was 2X64X0.6 mm, rotation time was 330 msec., temporal resolution was 83 msec. Data sets were obtained using a tube voltage of 80, 100, 120, and 140 kV. The x.-ray attenuation of lipid-rich plaque, fibrous plaque, calcified plaque and contrast-enhanced lumen were determined for all x-ray energies by comparison to histology at 25 sites. In addition, cross-sectional images were reconstructed with 0.75 mm slice thickness and 0.4 mm increment. 26 slices at 10 mm interval were analyzed by comprehensive color-coding according to CT number.

Results. There were significant differences among CT attenuations of lipid-rich, fibrous and calcified plaque using 80, 100, 120, and 140 kV (Table

, p<0.01), respectively. The averaged ratio of CT attenuation of lipid-rich, fibrous plaque, and calcified plaque to the Contrast-enhanced lumen for 80kV and 140kV were −16%, 11%, 14%, respectively (p<0.05). Lipid-rich plaque was well-differentiated with lumen attenuation in all energies.

Conclusions. The relationships between lumen enhancement and each plaque component were different as changing the x-ray energy level. Using of varying x-ray energy, DSCT may able to detect atherosclerotic plaque and characterization of plaque components.

The Attenuation on Different Energy
Abstract 3459: Human Atrial Natriuretic Peptide (ANP) Gene Is Associated With Metabolic Syndrome In The French Population
Authors: Roussel Ronan , Maimaitiming Suliya , Fumeron Frederic , Hadjadj Samy , Aubert Roberte , Balkau Beverley , Marre Michel 
Published: July 2021

Background: ANP is important in hemodynamics, but also in lipolysis, particularly in overweight. Its plasmatic concentration is related to number of metabolic syndrome components. Its gene, NPPA, was considered as a candidate for susceptibility to metabolic disorders.
Aims-Methods: We assessed the effect of 3 Hapmap-tagged haplotypes-defining NPPA SNPs, G664A (rs5063), 708C>T (rs5064) and 2238T>C (rs5065) on metabolic parameters levels and metabolic syndrome and their interaction with overweight in a cohort study included 2,576 men and 2,636 women from the general population, followed for 9 years.
Results: In the whole population, there was a significant effect of the 708C>T SNP on waist girth (CC: 83.5 ± 0.1cm, CT: 83.1 ± 0.2 and TT: 81.2 ± 0.9, p=0.04) and HDL-C (CC: 1.63 ± 0.01 mM CT: 1.63 ± 0.01 and TT: 1.77 ± 0.03, p=0.04). The 708C>T SNP interacted with overweight on triglycerides (TG) and waist girth (p=0.002 and p=0.03 respectively for interaction) and in overweight subjects, was associated with TG (CC: 1.51 ± 0.03mM, CT: 1.37 ± 0.07 and TT: 1.13 ± 0.31, p=0.009) and waist girth (CC: 93.1 ± 0.2cm, CT: 92.1 ± 0.4 and TT: 89.1 ± 1.8, p=0.009). The 2238T>C SNP interacted with overweight on waist girth (p=0.08 for interaction) and in overweight subjects, was associated with waist girth (TT: 93.1 ± 0.2cm, TC: 92.4 ± 0.3 and CC: 91.1 ± 0.9, p=0.03). The overweight 708TT carriers and 2238CC carriers had a lower risk of metabolic syndrome (MS) during the 9-year follow-up (rare allele OR=0.74, p=0.043 and 0.75, p=0.017 respectively). No association was found with 664G>A. Haplotype GTC (carrying the minor allele of 708C>T) was significantly associated with lower waist girth level (p=0.007) and TG (p=0.02) in overweight subjects, and with a lower risk of developing MS during follow-up (p=0.02) in overweight subjects.
Conclusion: NPPA tagged SNPs and haplotypes are associated with cardiovascular risk in the general French population through association with lipids, waist girth levels and with incidence of MS in particular in overweight subjects.
Abstract 3484: Dietary Patterns And The Risk Of Mortality From All-causes, Cardiovascular Disease, And Cancer In Women
Authors: Heidemann Christin , Schulze Matthias B , Franco Oscar H , van Dam Rob M , Mantzoros Christos S , Hu Frank B 
Published: July 2021

Background: Few studies have investigated the impact of dietary patterns that reflect existing eating habits on the risk of all-cause or cause-specific mortality.
Objective: To prospectively examine the relation between major dietary patterns and the risk of all-cause and cause-specific mortality among women of the Nurses’ Health Study.
Methods: The participants included 72,113 women aged 35 to 55 years without a history of cancer, myocardial infarction, angina, coronary artery surgery, stroke, or diabetes at baseline. Dietary patterns were derived by factor analysis using information from five repeated, validated food frequency questionnaires that were administrated at baseline and every 2 to 4 years during the follow-up period (1984–2002). Cox proportional hazards regression was used to adjust for covariates including age, cigarette smoking, physical activity, body mass index, and further suspected risk factors.
Results: Two major dietary patterns were identified. High prudent pattern scores represented high intakes of vegetables, fruit, legumes, fish, poultry, and whole grains, whereas high western pattern scores represented high intakes of red meat, processed meat, refined grains, french fries, condiments, and sweets and desserts. During 18 years of follow-up (633,516 person-years), we ascertained 6,011 deaths, including 3,139 cancer deaths and 1,154 cardiovascular deaths. After adjustment for potential confounders, the prudent diet was inversely associated with all-cause mortality (relative risk [RR] = 0.83 for highest versus lowest quintile, 95% confidence interval [CI] = 0.76 – 0.90, p for trend < 0.0001) and cardiovascular mortality (RR = 0.72, 95% CI = 0.60 – 0.87, p for trend = 0.0007), but not with cancer mortality (RR = 0.99, 95% CI = 0.88 –1.11, p for trend = 0.87). The western pattern was directly associated with all-cause mortality (RR = 1.21, 95% CI = 1.11–1.32, p for trend < 0.0001), cardiovascular mortality (RR = 1.22, 95% CI = 1.00 –1.48, p for trend = 0.01), and cancer mortality (RR = 1.15, 95% CI = 1.02–1.29, p for trend = 0.004).
Conclusions: These data provide evidence that a high prudent pattern score and a low western pattern score may reduce the risk of total and cause-specific mortality.
Abstract 3499: Ethnic and Gender Differences in Large and Small Artery Elasticity: Results of the Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Duprez Daniel A , Herrington David , Prime Darryl , Ouyang Pamela , Barr Graham R , Bluemke David A 
Published: July 2021

Background: Arterial stiffness is a surrogate marker for cardiovascular morbidity and mortality; it may help account for ethnic and gender differences in cardiovascular risk.
Objective: We examined the large and small artery elasticity (LAE, SAE) according to ethnicity and gender in the large MESA cohort study.
Methods: A total of 3293 women and 3000 men aged 45– 84 years free of clinically recognized cardiovascular disease were recruited in 6 US communities from white, African American, Hispanic, and Chinese ethnicity. Pulse wave contour registration at the radial artery was performed in all subjects in a supine position using radial tonometry. LAE and SAE were derived from diastolic pulse contour analysis.

Results: A strong gradient of arterial elasticity was seen per decade of age, about 1.2 ml/mmHgx10 for LAE and 0.7 ml/mmHgx100 for SAE. Table 1

presents mean levels of LAE and SAE, both unadjusted and simultaneously adjusted by regression for age, race/ethnicity, gender, center and education. We also adjusted for variables used in the estimation of arterial elasticity (height, heart rate, blood pressure and BMI), thus examining the information unique to the pulse wave contour. Much of the gender difference in arterial elasticity is explained by the gender difference in height. After adjustment LAE did not differ by ethnicity, but African Americans had lower levels of SAE.

Conclusions: African Americans free of overt cardiovascular disease have lower SAE but not different LAE compared to white, Chines and Hispanic ethnicity. This reduced SAE may indicate earlier vascular disease in African Americans than in other groups.

Table 1
Abstract 3555: Increased Fatness and Reduced Fitness are Associated with Aortic Stiffness in Persons with Type 2 Diabetes and Hypertension
Authors: Stewart Kerry J , George Brian H , Potrekus Kristina , Bacher Anita C , Silber Harry A , Wang Nae-Yuh , Shapiro Edward P , Ouyang Pamela 
Published: July 2021

Background: Large artery stiffness, thought to be a marker of cardiovascular disease, is accelerated in persons with diabetes and hypertension. While reduced fatness and increased fitness are associated with lower BP, we tested the hypothesis that increased fatness and reduced fitness are each independently associated with greater aortic stiffness.
Methods: Sedentary subjects (M=60; F=29), mean (SD) age 57.1 (5.8) years, were examined at baseline as part of an exercise training study to reduce BP in persons with type 2 diabetes. Subjects were taking their usual medical therapy. For BP eligibility, subjects were required to have SBP between 120–159 and/or DBP between 80–99 mm Hg during 2 consecutive weekly visits. BP was the mean of the screening visits and a visit after qualification for the study. Aortic stiffness was assessed by carotid-to-femoral pulse wave velocity (PWV), using ultrasound probes simultaneously at each of these sites. General fatness was assessed by dual-energy x-ray absorptiometry (DEXA) and expressed as percent body fat. Abdominal fatness was assessed by magnetic resonance imaging at the level of the umbilicus and the areas for total, subcutaneous, and visceral fat were measured. Maximal oxygen uptake was obtained on a treadmill. The associations of PWV with BP, oxygen uptake, and abdominal fat were determined by stepwise regression analysis with adjustment for age and gender.
Results: PWV was 922.9 (300.0) msec, SBP was 126.9 (13.2) mm Hg, DBP was 71.8 (8.8) mm Hg, pulse pressure (PP) was 55.0 (10.4) mm Hg, percent body fat was 35.0 (6.5) %, and maximal oxygen uptake was 21.7 (5.0) ml/kg/min. In the final model, the variance in PWV was accounted for by increased PP, 8.9%; increased abdominal visceral fat accounted for an additional 6.2%; increased percent body fat, an additional 3%; and decreased maximal oxygen uptake, an additional 5.6%.
Conclusions: These data bring to light an independent relationship of aortic stiffness with increased fatness and reduced fitness. Though further work is needed to elucidate the mechanisms linking aortic stiffness, fatness, and fitness, these findings support the need for a therapeutic approach for reducing aortic stiffness that considers the potential benefits of weight reduction and exercise.
Abstract 3584: The Prevalence and Factors Associated With 1-Year Angina among Post-MI Patients
Authors: Maddox Thomas M , Reid Kimberly J , Spertus John A , Parashar Susmita , Krumholz Harlan M , Ho P. Michael , Rumsfeld John S 
Published: July 2021

Background: A primary goal of in-hospital treatment and outpatient care following myocardial infarction (MI) is the eradication of angina. However, the prevalence of angina and the factors associated with angina in the year after MI are unknown.
Methods: The primary outcome of the PREMIER multi-center prospective study was presence of angina, as measured by the Seattle Angina Questionnaire (SAQ), 1 year after MI hospitalization. Multivariable regression modeling identified the socio-demographic factors, clinical history, MI presentation, inpatient therapies and complications, and outpatient treatment characteristics associated with 1-year angina, adjusted for site. .

Results: Of 1957 patients in the cohort, 83 patients (4.2%) reported daily or weekly angina, and 306 patients (15.6%) reported less than weekly angina 1 year after their index MI. After multivariable analysis (figure

), angina 1 year after an index MI was associated with younger age, non-white race, baseline angina, history of CABG surgery, no inpatient revascularization, recurrent rest angina during MI hospitalization, persistent smoking after MI hospitalization, outpatient revascularization after MI hospitalization, and depressive symptoms (either as an inpatient or during the year after MI hospitalization).

Conclusions: Angina 1 year after MI hospitalization is associated with several modifiable factors, including persistent smoking and depressive symptoms in the year after MI discharge. Recognition of these relationships will be important in monitoring and treating at-risk patients for post-MI angina.