bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 2888: Activation of the Endothelial and Coagulation Systems in Left Ventricular Assist Device (LVAD) Recipients
Authors: Panch Sandhya R , Hrabe Jennifer , Solovey Anna , Joyce Lyle D , Hebbel Robbert P , John Ranjit 
Published: July 2021

Introduction: The success of LVADs has been limited by hemorrhagic and thromboembolic complications. Understanding the timing of changes in the endothelial and coagulation systems in LVAD patients may allow for potential therapeutic interventions.
Methods: Markers of endothelial dysfunction (circulating endothelial cells [CEC], VCAM-1, E-selectin, von Willebrand antigen [VWA]), thrombin generation (prothrombin fragments 1,2 [PF1+2] and thrombin antithrombin [TAT]), and fibrinolysis (D-dimer) were studied in 20 LVAD patients on day 0 and on post-op days 1, 7, 30 and 90 as well as in 5 control patients undergoing non-LVAD cardiac surgery.

Results: Baseline values of VCAM-1, E-selectin, TAT, VWA and D-dimer were significantly higher than the normal range in LVAD patients. Further evidence of endothelial and procoagulant pathway activation were seen on post-op day 1 and day 7. D-dimer, a marker of fibrinolysis, showed significant increase on day 7 and remained elevated up to day 90 while procoagulant and endothelial cell markers decreased significantly by day 30 (Table

). In control patients, baseline levels of D-dimer, TAT, VCAM-1, E-selectin were lower and declined significantly by day 7 as compared to LVAD patients ( 2-sample t-test p values < 0.05).

Conclusions: LVAD patients show significant baseline activation of endothelial and coagulation systems which are further accentuated in the early post-op period. Persistent activation of the fibrinolytic system may allow for reduction of anticoagulation therapy in these patients. Further understanding of these abnormalities is essential to improve outcomes after LVAD placement.

Table:

Changes in Endothelial and Coagulation function markers in LVAD patients
Abstract 2890: The Long Term Outcome Of Treated Presensitized Patients Who Undergo Heart Transplantation: Is It Successful?
Authors: Kobashigawa Jon , Patel Jignesh , Kawano Matt , Wu Grace , Kittleson Michelle , Kiyosaki Krista , Moriguchi Jamie , Ardehali Abbas 
Published: July 2021

Background: Sensitized patients prior to heart transplantation are reportedly at risk for hyperacute rejection and for poor outcome after heart transplantation. It is not known whether reduction of circulating antibodies pre-transplant alters post-transplant outcome.
Methods: Between July 1993 and July 2003 we reviewed 523 heart transplant patients of which 95 had pre-transplant PRAs >10%. 21/95 were treated pre-transplant for circulating antibodies. These 21 patients had PRAs greater than 10% (majority 50%–100%) and were treated with combination therapy including plasmapheresis and intravenous gamma globulin to reduce antibody counts. The 74 untreated patients with PRAs >10% (untreated presensitized group) and those patients with PRAs <10% (control group) were used for comparison. Routine post-transplant immunosuppression included triple drug therapy (tacrolimus, mycophenolate, and corticosteroids).
Results: Circulating antibody levels pre-transplant decreased from a median of 77.5 to 29.0% (p = 0.017), which allowed a negative prospective donor specific cross match and successful heart transplantation. Compared to the untreated presensitized group, and the control group, the treated sensitized patients had similar five year survival (81.1% vs. 75.7% vs. 71.4%, p=0.523) and freedom from cardiac allograft vasculopathy (74.3% vs. 72.7% vs. 76.2%, p=0.850).
Conclusion: Treatment of sensitized patients pre-transplant appears to result in comparable long term outcome after heart transplant.
Abstract 2938: Decrease in Endocardial Radial Strain Precedes Global Left Ventricular Dysfunction in Patients With Hypertension.
Authors: Nishimura Kazuhisa , Okayama Hideki , Saito Makoto , Yoshii Toyofumi , Inoue Katsuji , Hiasa Go , Sumimoto Takumi , Kurata Akira , Suzuki Jun , Ogimoto Akiyoshi , Ohtsuka Tomoaki , Higaki Jitsuo 
Published: July 2021

Background: Recent studies have reported that endocardial radial strain was approximately two fold greater than epicardial strain in normal subjects. Hypertension is a major cause of myocardial dysfunction and heart failure, but the difference between endocardial and epicardial radial strain in patients with hypertension is unknown. Two-dimensional speckle tracking echocardiography is a novel echocardiographic method that enables angle-independent assessment. Aim: The aim of this study was to evaluate the difference between radial strain in endocardial and epicardial segments in hypertensive patients.
Method: This study enrolled 37 patients with hypertension (H group, age 63±12years, 24men) and 17 sex- and age-matched normal subjects (N group, age 61±7 years, 9 men). Conventional echocardiography was performed by a Vivid 7 dimension (GE). Endocardial and epicardial radial strains were calculated from the left ventricular (LV) short axis view at the papillary muscle level using custom software (EchoPAC (GE)).
Results: There were no significant differences in LV diastolic dimension (47±5 mm vs. 48±4 mm), LV systolic dimension (29±4 mm vs. 29±4 mm), LV ejection fraction (65±9% vs. 67±6%) and fractional shortening (38±5% vs. 39±5%) between the H and N group. LV mass index (LVMI) in the H group was significantly greater than in the N group (109±33g/m2 vs. 90±22g/m2, P<0.05). Global radial strain including endocardium and epicardium were not significantly different between the H and N group (59±20% vs. 62±17%). However, endocardial radial strain in the H group was significantly less than in the N group (48±24% vs. 62±15%, P=0.03), whereas there was no significant difference in epicardial radial strain between the two groups (38±16% vs. 28±10%). The ratio of endocardial to epicardial radial strain (Endo/Epi ratio) in the H group was significantly smaller than in the N group (1.5±1.1 vs. 2.4±1.1, P<0.01). There were significant correlations between End/Epi ratio and LVMI (r=-0.33, P<0.05), and relative wall thickness (r=-0.43, P<0.01).
Conclusion: A decrease in endocardial radial strain precedes global LV dysfunction in patients with hypertension.
Abstract 2941: Combined Assessment of Coronary Artery Stenosis and Myocardial Ischemia by Rest-Dipyridamole Stress Multidetector Computed Tomography
Authors: Carrascosa Patricia M , Capuñay Carlos , Carrascosa Jorge , Deviggiano Alejandro , Goldsmit Alejandro , Bettinotti Marcelo , Garcia Mario J 
Published: July 2021

Introduction: MDCT coronary angiography has been evolving as a noninvasive method for the assessment of coronary artery disease (CAD). More recently, It has been demonstrated that MDCT identifies reduced contrast enhancement in ischemic and/or scarred myocardial segments.
Objective: to determine the ability of rest-stress multidetector computed tomography (RS-MDCT) to detect myocardial ischemia and to assess the relationship between MDCT myocardial perfusion abnormalities and coronary artery stenosis.
Methods: Forty seven patients underwent stress/rest 99mTc sestamibi SPECT and RS-MDCT, using a 16-row detector scanner (Philips Brilliance-16). Myocardial segments were classified by SPECT as normal, ischemic or scarred. SPECT results were then compared with MDCT regional myocardial contrast enhancement. The results of MDCT coronary angiography were also analyzed in 20 patients who underwent invasive catheterization.
Results: The presence of a reduction in contrast enhancement at rest by MDCT identified scar by SPECT with 96% sensitivity and 98% specificity. A stress-induced reduction in contrast enhancement by MDCT identified ischemia by SPECT with 77% sensitivity and 99% specificity. The segment-based sensitivity and specificity for the detection of significant stenosis by MDCT were 92% and 98%, respectively.
Conclusion: Our results showed that a rest-dipyridamole stress MDCT protocol can identify the presence of myocardial ischemia as well as the severity of coronary artery stenosis in patients with suspected coronary artery disease.
Abstract 3012: Impact of Thromboaspiration during Primary PCI on Microvascular Damage and Infarct Size: Acute and Long term ce-MRI Evaluation.
Authors: Sardella Gennaro , Mancone Massimo , Scardala Raffaele , De Luca Leonardo , Ducci Chiara Bucciarelli , Di Roma Angelo , Carbone Iacopo , Fedele Francesco 
Published: July 2021

Background: In patients with ST-elevatrion myocardial infarction (STEMI), impairment of microcirculatory function is a negative independent predictor of myocardial function recovery. Compared with conventional stenting, thrombectomy during primary percutaneous coronary intervention (PCI) seems to improve the parameters of myocardial tissue perfusion. We sought to evaluate the impact of thromboaspiration on procedural outcomes and microascualr damage and infarct size by contrast enhanced-MRI (ce-MRI) as compared to conventional primary PCI.
Methods:We randomized 75 patients (mean age 64.3±10.2, 55 male) referred to our Hospital with a STEMI (<9 hours from symptoms onset) and an occlusive thrombus at basal angiography, to thromboaspiration with a manual device (Export ®-Medtronic (n=38) (group 1)) and standard PCI (n=37) (group 2). 3 days after procedure and 3 months later a ce-MRI was performed to assess the microvascular damage (as hypoenhancement (HO)) and infarct size (as hyperenhancement(HR)) in the 2 groups. The primary end points were the angiographic result in terms of the TIMI ≥ II flow , MBG ≥ 2 and ST-segment resolution (STr)≥ 70% post-stenting and the microvascular damage (grams/g) and infarct size (grams/g) evaluated by ce-MRI.
Results: No differences on baseline, clinical and angiographic preprocedural findings were observed between the two groups. After trombectomy, a TIMI II flow was present in in 38.6 vs 19.6% (p=0.054) and TIMI III was 30.7 vs 72.5% (for group 1 and 2, respectively, p<0.001). Postprocedural MBG ≥2 was 70,3% vs 28,7% (p<0.001) and 90′ ST-segment resolution was 80% vs 37.5% (for group 1 and 2, respectively, p<0.001). Ce-MRI showed an HO of 4.04±5.87g at 3 days vs 0.12±0.4g at 3 months (p= 0.04) in group 1, and 3.7±5.04 vs 2.7±2.3 (3 d and 3 m. respectively)(p=ns) in group 2. At 3 days HR was 17.39±15.6g vs 11.01±8.07g at 3 months in group 1 (p=0.04) and 14.02±7.5g vs 13.6±12.7g ( 3 d. and 3 m. respectively) (p=ns) in group 2.
Conclusion:Compared with conventional stenting, a pretreatment with thrombectomy during primary PCI, improves epicardial flow and procedural outcomes. The long term ce-MRI evaluation suggests a reduction in microvascular damage and infarct size compared with the acute evaluation in the thrombectomy group.
Abstract 3059: Role of End Diastolic Volume on cardiac function induced changes by Surgical Ventricular Restoration
Authors: Di Donato Marisa , Fantini Fabio , Castelvecchio Serenella , Bussadori Claudio , Giacomazzi Francesca , Quarenghi Matteo , Menicanti Lorenzo 
Published: July 2021

Background. LV-End diastolic volume (EDV) following surgical ventricular restoration (SVR) is highly dependent on surgical induced changes in ventricular chamber.
Aim. To investigate the role of pre and post-operative EDV on SVR induced changes in cardiac function.
Methods. We analyzed 298 patients submitted to SVR following an anterior MI. All had an echo study pre and post-operatively. SVR was conducted on arrested heart using an endoventricular sizing.
Results. Post-op EDV was directly related to pre-op EDV, r=0.63; P<.001.The larger pre-op EDV the greater surgical volume reduction (average −32%) and the greater EF improvement. At a certain range of EDV (150 –200 ml) either pre or post surgery EF does not differ significantly (34±7% and 34±7%, ns), confirming the central role of EDV.
Conclusions. EF improvement was relatively greater in patients with greater pre-op EDV and greater surgical reduction, although the absolute values of post-op EF are mainly linked to post-op EDV. Our results underline the need for a correct pre-op estimate of EDV reduction in each single patient.

Tab. 1
Abstract 3073: The Impact of Baseline Mitral Regurgitation on 1-Year Clinical Outcomes in Patients Undergoing Cardiac Resynchronization Therapy
Authors: Ando Kenji , Soga Yoshimitsu , shirai Shinichi , Sakai Koyu , Goya Masahiko , Iwabuchi Masashi , Yokoi Hiroyoshi , Yasumoto Hitoshi , Nosaka Hideyuki , Nobuyoshi Masakiyo 
Published: July 2021

Background: The impact of mitral regurgitation (MR) on long-term clinical outcomes in patients (pts) undergoing cardiac resynchronization therapy (CRT) is not well established.
Methods: We investigated 110 pts received CRT (age 71+/−10years, NYHA class 3.1+/−0.5, LVEF 26+/−7%, LVEDD 61+/−7mm, pre QRS duration 178+/−29ms) and divided into two groups, 40 pts with baseline MR grade 0 –1 (less MR group) and 70 pts with baseline MR grade 2– 4 (severe MR group). 1-year clinical data were obtained.
Results: Baseline clinical and echocardiographic characteristics were similar between two groups without baseline MR grade (0.9+/−0.3 in less MR group vs.2.2+/−0.5 in severe MR group, p<0.0001). At 1-year follow up, NYHA functional class was significantly better in less MR group than severe MR group (1.9+/−0.8 vs.2.4+/−0.6, p=0.0004). Event free survival rate from heart failure hospitalization (HFH) was significantly higher in less MR group compared to severe MR group (93% vs.75% at 1 year, Log-rank p=0.037) and event free survival rate from combined death and HFH was also significantly higher in less MR group (87% vs.69% at 1 year, Log-rank p=0.039).
Conclusion: Pts with severe baseline MR had worse clinical outcomes even if received CRT compared to less MR pts.
Abstract 3114: Antiplatelet Therapy Use and the Risk of Venous Thromboembolic Events in the Double-Blind Raloxifene Use in The Heart (RUTH) Trial
Authors: Duvernoy Claire S , Yeo Adeline A , Wong Mayme , Cox David A , Kim Hyungin M 
Published: July 2021

Background: Raloxifene (RLX) use in postmenopausal women (PMW) with osteoporosis increases risk of venous thromboembolic events (VTE) 2-fold, compared to placebo (PL). Platelet activation is involved in the pathophysiology of arterial thromboses more than venous thromboses, but some data suggest that aspirin may reduce VTE risk associated with estrogen use. This analysis examines the effects of concomitant antiplatelet (AP) therapy on VTE risk in RLX-treated women.
Methods: In RUTH, 10,101 PMW with coronary heart disease (CHD) or increased risk of CHD were randomized to either PL or RLX 60 mg/d and followed for a median 5.6 yr. Reports of clinical symptoms of VTE were supported by relevant diagnostic data and adjudicated. Concomitant use of AP agents (aspirin, clopidogrel, ticlopidine, dipyridamole) was allowed. Cox proportional hazard models, with use of warfarin, presence of fracture, and/or hospitalization as covariates, were used to estimate hazard ratios (HR) with 95% confidence intervals (CI).

Results: Overall, RLX 60 mg/d use was associated with an increased VTE risk [HR 1.44 (95% CI 1.06 –1.95)] from PL. Most women (71%) reported using aspirin, and 14.2% reported using non-aspirin AP agents. VTE risk was similar (HR = 1.04, Table

) for women who used RLX alone versus those who used RLX with AP agents. The increase in VTE risk with RLX compared to PL was similar between women who used any AP prior to VTE and those who did not (interaction P=0.29). Women who used aspirin prior to VTE had a similar increased VTE risk with RLX from PL [HR 1.57(95% CI 1.00 –2.47)], compared to women who did not use aspirin [HR 1.34 (95% CI 0.89 –2.01)] (interaction P=0.62).

Conclusion: In RUTH, PMW with CHD or at high risk of CHD treated with RLX had an increased risk of VTE compared to PL. Concomitant use of aspirin or non-aspirin AP agents with RLX therapy did not lower VTE risk from RLX alone.
Abstract 3124: Impact of Age on Outcome of Pulmonary Valve Replacement for Pulmonary Regurgitation
Authors: Frigiola Alessandra , Tsang Victor , Nordmeyer Johannes , Lurz Philipp , Bull Kate , Coats Louise , Walker Fiona , Van Doorn Carin , Bohnoeffer Philipp , Taylor Andrew M 
Published: July 2021

Objectives: Pulmonary valve replacement (PVR) for pulmonary regurgitation improves right ventricular function when performed relatively early. Effects on exercise performance are still controversial. Furthermore little attention has been given to the effects on left ventricular function.
Methods: 60 patients (mean age 20.5 ± 10.4, 27 male, 77% tetralogy of Fallot) underwent pulmonary valve replacement (PVR). Indications for intervention were presence of severe PR (regurgitant fraction ≥ 35%) and RV/LV end-diastolic volume ≥1.5. Fifty-six patients had a pulmonary homograft (mean size 21.5±1.7 mm). Magnetic resonance imaging and cardiopulmonary exercise testing (CPEX) were performed prior to and 1 year after intervention. NYHA class was also recorded.

Results: On a retrospective analysis, we found that Ve/VCO2 exercise parameter was most likely to normalize when PVR was performed at a younger age (< than 16 years, p=0.027). We therefore compared the results between the younger patients (group 1: n=24, 6 male, mean age of PVR 12±2.4 years) and the older patients (group 2: n=37, 21 male, mean age of PVR 26±10 years). Before intervention there were no differences in MR parameters. NYHA class was ≤ 2 in 83% of patients in group 1 vs 51% in group 2, p=0.01. Following PVR, only group 1 had a significant improvement in RV effective strove volume (40.9±8.7 to 47.1±7.1 mL/beat, p=0.001 vs 40.3±9.9 to 43.8±10.2, ns); in both groups there was a significant increase in LV end-diastolic volume, reflecting a better filling, and LV effective stroke volume (effSV), although these changes were more pronounced in group 1 (EDV: 11±11 vs 4±12 mL, p=0.041; effSV: 26±7 vs 19±11 mL/beat, p=0.025). Ve/VCO
2
improved significantly only in group 1 (33±3 to 30±4, p=0.015, vs 36±6 to 35±7, ns).

Conclusions: PVR leads to a better RV and LV performance when performed at a younger age. This is mirrored by an improved Ve/VCO
2
exercise parameter which is more likely to normalize when surgery is performed prior to 16 year of age.
Abstract 3152: Hyperdynamic Circulatory State And Volume Overload Without Left Ventricular Intrinsic Myocardial Dysfunction Is Detected In Normotensive Non Diabetic Patients With Morbid Obesity
Authors: Kozakova Michaela , Malshi Emona , Morizzo Carmela , Muscelli Elza , Camastra Stefania , Nannipieri Monica , Ferrannini Eleuterio , Palombo Carlo 
Published: July 2021

Background: increasing reports suggest that morbid obesity (BMI ≥ 40 kg/m2) is associated with an early impairment of intrinsic myocardial function, possibly contributing to an increased susceptibility to heart failure. However, the relative role of obesity and associated comorbidities such as HBP and diabetes in LV dysfunction is still unclear.
Aim of the study: to investigate subclinical cardiovascular involvement in patients with isolated morbid obesity as compared to age-matched lean subjects.
Methods: 38 lean healthy volunteers (BMI ≤ 25 kg/m2, 21 females, mean age 39 ± 11, BP 118 ± 9/69 ± 8 mmHg) and 29 non diabetic normotensive patients with morbid obesity (24 females, mean age 34 ± 10, BP 123 ± 10/78 ± 9 mmHg) were studied. LV geometry, pump function, midwall circumferential shortening, diastolic filling, myocardial longitudinal systolic and diastolic velocities, were evaluated by 2-D and M-mode echo, transmitral Doppler and Tissue Doppler Imaging of mitral annulus and interventricular septum and lateral wall (Aloka SSD-5500). Indices of aortic stiffness and arterial wave reflection were obtained by carotid-femoral pulse wave velocity (PWV) and carotid augmentation index (AIx). Ratio of stroke volume to pulse pressure (SV/PP) was used as an index of total arterial compliance
Results: Compared to lean subjects, obese patients had significantly (p < at least 0.05) higher HR (75 ± 10 vs 62 ± 9 bpm), LV diastolic diameter (5.5 ± 0.7 vs 5.0 ± 0.5 cm), LV mean wall thickness (0.85 ± 0.11 vs 0.73 ± 0.13), LVMI (51 ± 15 vs 34 ± 9 g/m2.7), cardiac output (6.9 ± 2.5 vs 4.9 ± 1.1 L), LV stroke work (160 ± 50 vs 135 ± 34 g-ml/beat), mitral A velocity (0.63 ± 0.14 vs 0.52 ± 0.12 m/s), E/Ea ratio (a Doppler index related to capillary pulmonary pressure: 6.6 ± 4.4 vs 4.5 ± 1.1) and SV/PP (2.0 ± 0.6 vs 1.6 ± 0.4 ml/mmHg). Total peripheral resistance was significantly lower (1199 ± 419 vs 1452 ± 360 dyn*s/cm5). No differences between groups were found for LV midwall systolic shortening, longitudinal myocardial velocities, PWV and AIx.
Conclusion: young to middle age patients with morbid obesity still free of comorbidities show an hyperdynamic circulatory state associated to volume overload, without detectable subclinical abnormalities of intrinsic myocardial function and arterial function.
Abstract 3193: First Preclinical Study of a New F-18 Labeled PET Tracer for Myocardial Perfusion Imaging
Authors: Huisman Marc , Higuchi Takahiro , Reder Sybille , Nekolla Stephan , Poethko Thorsten , Casebier David , Schwaiger Markus 
Published: July 2021

Introduction: An F-18 based myocardial perfusion imaging (MPI) tracer would increase the availability of tracers for cardiac PET/CT exams at stand-alone PET facilities.
Hypothesis: F-18 labeled BMS-747158 – 02 is a promising tracer for MPI.
Methods: All studies were carried out in healthy male Wistar rats (275 ± 25 g). The biodistribution of F-18 BMS-747158 – 02 was obtained 10 and 60 minutes post injection (p.i.). The first pass extraction fraction of the tracer was determined according to the Langendorff method. ECG gated microPET imaging (FOCUS F-120, Siemens Medical Imaging, USA) was performed, and the listmode data were sorted into dynamic sinograms corresponding to the diastolic phase of the heart cycle. After reorientation of the data time activity curves (TACs) were derived for the left ventricular cavity and myocardium, as well as tracer uptake polar maps two minutes p.i.. Rats were measured under MMF anesthesia, either during rest (n = 6) or during adenosine induced stress conditions (n = 6). Tracer retention two minutes p.i. was defined as tracer uptake divided through the integral under the input function.

Results: The biodistribution of F-18 BMS-747158 – 02 is favorable for cardiac imaging: high myocardial uptake (3.1 %ID/g) combines with low uptake in lung and liver (0.3 %ID/g and 1.0 %ID/g, respectively, 10 minutes p.i. (n = 3)). The myocardial uptake is homogeneous (the average means equal 77.4 ± 6.0 % and 77.8 ± 7.8 % of the maximum uptake for the rest and stress groups, respectively). The tracer shows a high and flow independent myocardial first pass extraction fraction, averaging 0.94 ± 0.04 (3 flow velocities, n >= 3 per group). Adenosine infusion (140 μg/kg/min) leads to a significant increase in myocardial tracer retention (1.68 ± 0.23 sec
−1
to 3.21 ± 0.92 sec
−1
; P = 0.03).

Conclusions: F-18 labeled BMS-747158 – 02 shows high extraction combined with excellent imaging characteristics in this first preclinical study of its applicability as a PET MPI agent.