bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns of cardiac involvement in patients with long COVID syndrome using cardiovascular magnetic resonance
Authors: Puntmann V , Martin S , Vanchin B , Holm N , Giokoglu E , Hoffmann J , Karyou A , Arendt C , Khodamoradi Y , Vehreschild M , Braner A , Rohde G , Zeiher A , Vogl T , Nagel E 
Published: October 2021

Abstract

Background
Long COVID (LC) is an increasingly recognized late complication of COVID-19 infection. Cardiovascular involvement has also been implicated, however, the type and extent of the underlying cardiovascular injury remains unknown.

Purpose
To evaluate the association between ongoing symptoms and findings with cardiovascular magnetic resonance (CMR) in consecutive patients recently recovered from COVID-19 illness.

Methods
Prospective observational cohort study of patients recently recovered from COVID-19 illness and no previously known cardiovascular disease were included between April 2020 and April 2021. Demographic characteristics, cardiac blood markers, and CMR imaging a minimum of 4 weeks from the diagnosis were obtained.

Results
Of the 389 included patients, 192 (49%) were male, the mean (±standard deviation) age was 44 (±13) years and 61 (16%) required hospitalization during the acute illness. The median (IQR) time interval between COVID-19 diagnosis and CMR was 94 (71–165) days. 298 (77%) of patients continued to experience ongoing cardiovascular symptoms (long COVID, LC), including dyspnea, palpitations, atypical chest pain and fatigue at the time of CMR at least 4 weeks after the infection. In most patients, the symptoms were only effort related 137 (46%), whereas in 98 (33%) the symptoms affected the activities of daily life; 10 (3%) had severe and debilitating symptoms at rest. Compared to those with no LC (NLC, n=91), LC patients were more commonly hospitalized, had significantly higher native T1, native T2, and showed pericardial enhancement and effusion (Figure 1). There were no differences in cardiac biomarkers, left ventricular (LV) and right ventricular ejection fraction and mass. Proportionally, men and women were similarly affected (n=144 (73%) vs. n=157 (80%), p=0.18). Previous hospitalization was associated with hypertension and ongoing detectable troponin. LC status was associated with previous hospitalization and CMR findings of raised native T1 and native T2, and in females also pericardial enhancement. Severity of symptoms were associated with increased native T1 and T2 and decreased end-diastolic volume, whereas cardiac function showed no significant difference.

Conclusions
In this cohort of patients recently recovered from COVID-19 infection, ongoing cardiovascular symptoms were common. The LC status was related to previous hospitalization and CMR imaging findings of myopericardial inflammation. The extent and type of cardiovascular findings was associated with the severity of symptoms. These findings indicate the need for ongoing investigation of the long-term cardiovascular consequences of COVID-19.

Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): The German Heart Foundation (Deutsche Herzstiftung) and Bayer AG, Leverkusen, Germany Figure 1
Predictive scoring method for declining left ventricular ejection fraction in hypertrophic cardiomyopathy
Authors: Ishihara K , Kubota Y , Matsuda J , Imori Y , Tokita Y , Takano H , Shimizu W 
Published: October 2021

Abstract

Background
The transition to the dilated phase, as well as sudden cardiac death, is one of the most undesirable scenarios for patients with hypertrophic cardiomyopathy (HCM). Although the dilated phase of HCM (DHCM) is defined as left ventricular ejection fraction (LVEF) &lt;50%, the significance of mildly reduced LVEF is also in the spotlight because this status is considered as a transitional phase of DHCM. Establishing predictive scoring method for declining LVEF is expected.

Methods
Of the 319 HCM patients enrolled in the J-HCM registry from our hospital, we analyzed 168 patients (101 male and 57 female, 63.4±14.8 years), after excluding those who underwent PTSMA, who received pacemaker implantation, and who died or dropped out within 2 years. The patients were divided into two groups according to the change of LVEF from the baseline. During the follow-up period (62.0±109.9 months), LVEF decreased by ≥10% in 37 patients (Group D) whereas it did not in 131 patients (Group C). We compared clinical parameters between the two groups to identify the factors affecting the declining LVEF by ≥10% and examined whether the scoring method using those parameters can predict it.

Results
At the baseline, the percentage of male and diabetic patients was greater in group D than group C (76% vs. 55%, P=0.023 and 38% vs. 12%, P&lt;0.001, respectively). The patients with complete right bundle branch block, wide QRS complex (&gt;100msec), and atrial fibrillation tended to be more in group D than group C (all P&lt;0.1). When the scoring method with those 5 parameters was tested by giving 1 point each, the risk of the declining LVEF was tended to be higher in the patients with 2 or 3 point and significantly higher in those with 4 point compared with that in those with point 0 (OR 2.042, 95% CI 0.983–4.243, P=0.056 and OR 12.000, 95% CI 2.313–62.267, P=0.003, respectively).

Conclusions
This scoring method appeared to be useful to stratify the risk of the decrease in LVEF in patients with HCM. The validation study is warranted in a larger population.

Funding Acknowledgement
Type of funding sources: None.
Paediatric/young versus adult patients with congenital long QT syndrome or catecholaminergic polymorphic ventricular tachycardia
Authors: Lee S , Zhou J , Jeevaratnam K , Wong W T , Wong I C K , Mak C , Mok N S , Liu T , Zhang Q , Tse G 
Published: October 2021

Abstract

Introduction
Congenital long QT syndrome (LQTS) and catecholaminergic ventricular tachycardia (CPVT) are less prevalent cardiac ion channelopathies than Brugada syndrome in Asia. The present study compared paediatric/young and adult patients with these conditions.

Method
This was a territory-wide retrospective cohort study of consecutive patients diagnosed with congenital LQTS and CPVT attending public hospitals in Hong Kong. The primary outcome was spontaneous ventricular tachycardia/ventricular fibrillation (VT/VF).

Results
A total of 142 congenital LQTS (mean onset age= 27±23 years old) and 16 CPVT (mean presentation age=11±4 years old) patients were included. For congenital LQTS, arrhythmias other than VT/VF (HR=4.67, 95% confidence interval = [1.53–14.3], p=0.007), initial VT/VF (HR=3.25 [1.29–8.16], p=0.012) and Schwartz score (HR=1.90 [1.11–3.26], p=0.020) were predictive of the primary outcome for the overall cohort, whilst arrhythmias other than VT/VF (HR=5.41 [1.36–21.4], p=0.016) and Schwartz score (HR=4.67 [1.48–14.7], p=0.009) were predictive for the adult subgroup (&gt;25 years old; n=58). All CPVT patients presented before the age of 25 but no significant predictors of VT/VF were identified. A random survival forest model identified initial VT/VF, Schwartz score, initial QTc interval, family history of LQTS, initially asymptomatic, and arrhythmias other than VT/VF as the most important variables for risk prediction in LQTS, and initial VT/VF/sudden cardiac death, palpitations, QTc, initially symptomatic and heart rate in CPVT.

Conclusion
Clinical and ECG presentation vary between the pediatric/young and adult congenital LQTS population. All CPVT patients presented before the age of 25. Machine learning models achieved more accurate VT/VF prediction.

Funding Acknowledgement
Type of funding sources: None. Kaplan-Meier survival curve for LQTSKaplan-Meier survival curve for CPVT
Racial disparities in renal outcomes of pulmonary hypertension hospitalizations: analysis of 2016 to 2018 National Inpatient Sample
Authors: Thyagaturu H , Bolton A , Kumar A , Shah K , Li S 
Published: October 2021

Abstract

Background
Although the prevalence of pulmonary hypertension among black and white individuals are similar, black individuals have been reported to have worse prognosis. However, data on renal outcomes and racial disparities in pulmonary hypertension patients are extremely limited.

Purpose
To investigate the racial differences in acute renal failure outcome of pulmonary hypertension hospitalizations.

Methods
We queried 2016–2018 National Inpatient Sample (NIS) database to identify pulmonary hypertension patients using appropriate ICD-10 codes. Race variable in the database was used to categorize pulmonary hypertension patients into Blacks and Others groups (Whites, Hispanics, Asian or Pacific Islanders). We used Chi-square test to evaluate the difference between binary variable, and Student's t- test for differences between continuous variables. Multivariate logistic regression was used in outcomes analysis to adjust for potential hospital and patient level confounders.

Results
Among the total 1,362,765 pulmonary hypertension patients across three years, 68% (906,994) were Whites, 18.9% (251,530) were Blacks, 7.8% (104,169) Hispanics and 2% (30,139) Asian or Pacific Islanders. Blacks with pulmonary hypertension were younger (mean age, 64.1 vs. 73.1 years; p&lt;0.01), more females (57.4% vs. 42.5%; p&lt;0.01), higher prevalence of diabetes (47.2% vs. 39.9%; p&lt;0.01), systolic heart failure (31.2% vs. 25.1%; p&lt;0.01), chronic kidney disease (43.2% vs. 36.4%; p&lt;0.01), end-stage renal disease (17.1% vs. 6.8%; p&lt;0.01), obesity, obstructive sleep apnea and anemia compared to Other races. After adjusting for hospital and patient level confounders including above mentioned comorbidities, Blacks had higher odds of acute renal failure compared to Others [Adjusted Odds ratio: 1.15 (1.11 – 1.18); p&lt;0.01]. Blacks with pulmonary hypertension were also associated with unadjusted longer length of stay (7.0 vs. 6.4 days; p&lt;0.01) and similar total hospitalization charges (USD: $78,408 vs. $80,076; p=0.18) compared to Others.

Conclusions
Racial minorities are underrepresented among patients with pulmonary hypertension. Blacks with pulmonary hypertension have higher co-morbidity and are associated with worse in-hospital renal outcomes compared to other races. They are also associated with longer length of stay. Vigilant renal functions monitoring, and early nephrologists involvement are needed during hospitalization to prevent worse renal outcomes in this patient population.

Funding Acknowledgement
Type of funding sources: None.
Diagnostic potential of a novel fluoroscopic video analysis workstation (Radwisp) in patients with acute pulmonary thromboembolisms
Authors: Okumura Y 
Published: October 2021

Abstract

Background
Pulmonary thromboembolisms (APEs) are one of the leading causes of death, and they are increasing worldwide. Contrast-enhanced chest computed tomography (CT) is the most robust imaging tool for diagnosing APEs, but a fluoroscopic video analysis workstation (Radwisp™) was newly developed to evaluate the pulmonary circulation without using contrast medium (Figure), and it can be useful as a diagnostic device in APEs. Nonetheless, it has not been validated whether Radwisp has the potential to accurately diagnose APEs.

Methods
In this study, 10 consequence suspected APE patients (male:female ratio, 1:1, mean age 68.5±16 years) in our hospital were enrolled between January 2020 and April 2021. All patients were suspected of having APEs from their symptoms and physical examinations, and therefore, were scheduled for contrast-enhanced CT and cineradiographic imaging based on standard X-rays on the same day. The cineradiographic images were taken with a 20 second breath-hold followed by breathing. The cineradiographic X-ray images were moved to the fluoroscopic video analysis workstation (Radwisp™). Blinded to the patient information and contrast-enhanced CT images, four cardiologists evaluated the presence or absence of APEs, and if APEs were diagnosed, the extent of pulmonary artery filling defects due to thrombi, solely from the Radwisp-based images. We compared the findings from the Radwisp-based images to those from the contrast-enhanced CT imaging.

Results
Of a total of 10 patients, 7 were diagnosed with APEs from the contrast-enhanced CT imaging, while 3 were not. All images were created within 5 minutes and the image quality was high even during breathing. three doctors accurately diagnosed 7 patients with APEs and 3 without APEs. In all 7 patients, contrast-enhance CT imaging after treatment (rivaroxaban 30mg for average 12±4 days) identified full recovery of the pulmonary circulation over both lungs, which was correctly identified on the Radwisp image by 3 doctors.

Conclusions
In this validation study, the diagnostic accuracy of the Radwisp™ for APEs was reliably high. In addition, this imaging could correctly identify filling defects in pulmonary arteries. This novel Radwisp-based imaging can be a simple and reliable diagnostic tool for identifying not only APE patients, but also the severity of the pulmonary circulation caused by thrombi, and its therapeutic effects, especially in patients with severe dyspnea and renal disfunction. Radwisp™ can enable further diagnosis of the site of embolism and determination of therapeutic effect. Further studies will be needed to obtain a consistent diagnostic accuracy of APEs in patients with other pulmonary diseases.

Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Paramevia Pte. Ltd A Radwisp analysis show pulmonary defect
Aortic atherosclerotic plaques: the role of anticoagulation
Authors: Silverio Antonio P , Rodrigues T , Cunha N , Couto Pereira S , Brito J , Valente Silva B , Alves Da Silva P , Beatriz Garcia B , Martins M , Oliveira C , David C , Caldeira D , J Pinto F , G Almeida A 
Published: October 2021

Abstract

Introduction
Aortic atherosclerotic plaques (AAPs) are one of the major causes of spontaneous and iatrogenic stroke and peripheral emboli, carrying an high morbidity and mortality. Transoesophageal echocardiography (TOE) plays a key rule on detecting AAP. The therapeutic approach of this patients (pts) is not well stablished.

Purpose
To evaluate the impact of anticoagulation (ACO) therapy on major events in asymptomatic pts with AAP detected in TOE.

Methods
Single-center retrospective study of consecutive patients submitted to TOE between 2010 and 2019 with documentation of AAP. Plaques were described as complex (1) &gt;4mm, (2) ulcerated and (3) mobile thrombi. The plaque location was also documented. We consulted pts data charts for clinical characterization and events recording during the follow up. Major events were defined as stroke, bleeding, hospital admissions (either cardiovascular (CV) and non-CV) and death. Statistical analysis was performed using Cox regression and Chi-square tests.

Results
We enrolled 177 pts with a mean age of 70±10.5 years, 63.8% males, 31.1% diabetic, 73.4% hypertensive, 54.2% with dyslipidaemia, 62.7% obese, 25.4% with peripheral arterial disease, 25.9% with previous stroke and 55.4% with supraventricular arrhythmia. Most of pts had plaques &gt;4mm (80.8%), mobile thrombi in 11.9% and ulcerated plaques in 7.3%; most of the plaques were located in proximal descending aorta (50.3%) and aortic cross (38.4%). Regarding baseline therapy, 52% were under ACO and 50.3% under statin. The main indication of ACO was atrial fibrillation (45.8%).
During follow up (mean time: 1613±1255 days), 61.5% pts died (10.7% from CV causes, 13% with unknown cause), 17.5% had a stroke, 5.7% had other embolic event (lower limbs emboli, unilateral amaurosis and ischemic colitis). Bleeding occurred in 18.3% pts; 47% pts were hospitalized (28.3% from CV cause).
Adjusting for age and comorbidities, there were no significant differences between the group with and without ACO. ACO therapy prevented death from any cause, being also an independent predictor (p=0.08, OR 0.489, IC 95% 0.288–0.831) when adjusted for comorbidities and age. ACO was associated with bleeding events (p=0.003), but not with stroke or hospitalization from any cause (p=NS).

Conclusion
In this subset of pts, ACO therapy prevented death from any cause in pts with AAP. This may have therapeutic implications when approaching this pts, although larger studies to confirm these results are needed.

Funding Acknowledgement
Type of funding sources: None. Non-CV death and anticoagulation
Association of rs10507391 polymorphism with the development of acute cerebrovascular event
Authors: Chernova A , Nikulina S , Nikulin D 
Published: October 2021

Abstract

Purpose
To study SNP rs10507391 association (A&gt; T) with development of Acute Cerebrovascular Event in the patients with cardiovascular pathology and risk factors of its development who are representatives of the east Siberian population.

Material and methods
260 patients with Acute Cerebrovascular Event participated in a research (age [57.0; 51.0–62.0]) and 272 patients of control group (age [55.0; 51.0–62.0].). Among the patients who transferred Acute Cerebrovascular Event, 157 men and 103 women. The control group included 170 men and 102 women. Inspection of the main group included: collecting complaints, anamnesis, clinical examination, computer tomography of a brain, electrocardiography, echo, ultrasonic of arteries, daily monitoring of arterial blood pressure and cardiac rhythm, analysis of a coagulant system of blood. Patients of the main group had the following cardiovascular pathology and risk factors: arterial hypertension, supraventricular tachycardia, dislipidemiya, atherosclerosis brachiocephalic of arteries, disturbances of a system of a hemostasis. The control group is examined within the international HAPIEE project. The molecular and genetic research was conducted by PCR method in real time. Statistical processing of material was carried out with use of set of the Statistica for Windows 7.0, Excel and SPSS 22 application programs.

Results
When studying SNP rs10507391 association (A&gt; T) connection between a rare genotype of a TT and an allele of T and the increased risk of Acute Cerebrovascular Event is established with development of Acute Cerebrovascular Event in all analyzed groups and subgroups of patients.

Conclusion
A genotype of a TT and an allele of T of SNP rs10507391 (A&gt; T) increases risk of development of an acute disorder of cerebral circulation in patients regardless of the previous cardiovascular pathology and risk factors, including at patients with arterial hypertension, supraventricular tachyarrhythmias, atherosclerosis the brachiocephalic of arteries, disturbance of lipidic exchange and the system of a hemostasis.

Funding Acknowledgement
Type of funding sources: None.
Management strategies for acutely decompensated aortic stenosis
Authors: Orzalkiewicz M , Donati F , Santona L , Marcelli C , Chietera F , Bendandi F , Bruno A G , Ghetti G , Taglieri N , Palmerini T , Marrozzini C , Galie N , Saia F 
Published: October 2021

Abstract

Background
Uncertainty exists over the optimal treatment strategy for patients presenting with acutely decompensated severe aortic stenosis (AS). The available options include a bridging balloon aortic valvuloplasty (BAV) or a direct transcatheter aortic valve implantation (TAVI).

Purpose
Our study compares TAVI outcomes in patients treated with two different strategies in acutely decompensated severe AS: bridged TAVI vs direct TAVI.

Methods
In this observational study all patients admitted with decompensated severe AS who underwent balloon aortic balloon valvuloplasty (BAV) and/or TAVI on the index admission were included. Comparison was made between bridged TAVI group (defined as initial BAV followed by TAVI) and direct TAVI group (TAVI on the index admission without bridging BAV). For this analysis we excluded patients in cardiogenic shock. Baseline characteristics, echocardiographic and periprocedural data were recorded in hospital database. Major adverse cardiovascular events (MACE) were defined as death, major bleeding, rehospitalisation for heart failure, or stroke). The follow-up data was obtained by outpatient visits and/or telephone calls.

Results
178 patients with acutely decompensated AS were analysed: 58 bridged TAVI, 23 direct TAVI, 9 bridged SAVR and 88 destination BAV (defined as BAV non followed by a definite treatment). There was no statistically significant difference between bridged TAVI and direct TAVI group in mean age (83.6±6.6 vs 80.4±8.3 years), the prevalence major comorbidities (coronary, respiratory, neurological or peripheral vascular disease), renal function (eGFR 43.4±18.9 vs 45.2±20.9 ml/min/m2), the mean LV ejection fraction (53.4±13.8 vs 48.6±14.6%) or aortic valve gradient (39.4±13.0 vs 34.1±12.3mmHg), respectively. Direct TAVI patients had a higher mean surgical risk scores (STS 6.1±3.7 vs 9.1±7.0%, logES 18.8±11.5 vs 30.8±20.9%, p=0.01) and higher prevalence of significant aortic regurgitation (5% vs 43%, p=0.0001). The femoral TAVI access was used in 98% of bridged and 78% of direct TAVI patients (p=0.006). The estimated 1-year survival and 1-year MACE-free survival did not differ significantly between the bridged TAVI and direct TAVI groups (86.8% vs 78.3%, p=0.20 and 79.7% vs 64.2%, p=0.11, respectively).

Conclusions
A large proportion of patients admitted with acutely decompensated AS were not eligible for definite treatment. There is no difference in procedural success, 1-year all-cause mortality and 1-year major adverse cardiovascular events between the bridged TAVI or direct TAVI strategies in acute decompensated aortic stenosis allowing to personalize treatment strategy for individual patient.

Funding Acknowledgement
Type of funding sources: None. Table 1. Clinical and procedural data
Does incidental calcium deposition in non-cardiac CT scans predict cardiovascular morbidity and mortality in young adults? A retrospective study
Authors: Aker A , Khalaili L , Naoum I , Abedalghani A , Zoubi R , Haber C C , Kassem S 
Published: October 2021

Abstract

Background
The calcium score in cardiac CT scan represents an effective tool in the diagnosis of coronary artery disease. However, few studies have examined the value of incidental arterial calcification (AC) in non-cardiac CT scans, especially in young adults with no prior cardiovascular morbidity.

Purpose
To evaluate the association between incidental AC and the incidence of cardiovascular events, as well as the association between atherosclerotic risk factors and AC in young adults with no known cardiovascular disease.

Methods
A retrospective study in patients aged 40–50 years old with no history of cardiovascular disease that underwent chest CT scan between 1.9.2012–31.8.2013 for reasons not related to cardiovascular disease. We assessed the presence of AC in the aorta and coronary arteries and its association with the rates of coronary catheterization for acute coronary syndrome (CCACS), emergency room (ER) visits or hospitalizations for cardiovascular disease and cardiac mortality. Furthermore, we examined the association between atherosclerotic risk factors (hypertension, smoking, hyperlipidemia and diabetes) and AC.

Results
308 patients were included in the study, 150 men and 158 women with average follow-up period of 7.2+0.29 years. AC was found in 88 (28.6%) patients. AC was more frequent in men than in women (35% vs. 20.9%, OR=2.18, P=0.006). Patients with AC underwent more CCACS than those without (11.6% vs. 0.5%, OR = 29.1, P=0.0001). Patients with AC had more ER and hospital admissions (33.7% vs. 14.4%, P&lt;0.0001, OR=3). Individuals with hypertension, smoking, and hyperlipidemia exhibited higher rates of AC (OR=2.66, 4, and 1.9, respectively). A statistically significant excess mortality in those with AC was not demonstrated (P=0.076).

Conclusion
AC appears to be associated with cardiovascular morbidity and increased incidence of CCACS. Primary preventive strategies in patients with AC may reduce cardiovascular morbidity.

Funding Acknowledgement
Type of funding sources: None.