bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of long-term controlled therapeutic exercises on blood pressure profile parameters, elastic properties of arterial wall, metabolic and mineral indices in females with arterial hypertension
Authors: Petelina T , Bykova SG , Musikhina NA , Avdeeva KS , Zueva EV , Zyrynova LI , Shcherbinina AE 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia

Objective
To study the role of therapeutic exercises (TE) in the correction of blood pressure, stiffness of the vascular wall, metabolic indices of body structure (volume, mass, area of visceral fat) and bone mineral metabolism in postmenopausal hypertensive patients.
Methods. The study included 138 patients (mean age was 58.32 ± 7.61 years). All patients are divided into 3 groups. The first control group is 20 women without arterial hypertension and menopausе. The second group consisted of 58 patients with arterial hypertension (AH) and postmenopause who was not undergone complex of TE and the 3rd group - 60 women with AH and postmenopause who was undergone TE complex. Patients of all groups were examined in dynamics: at the starting point of the study and in 12 months after, ambulatory monitoring of blood pressure; sphygmography; densitometry and test for serum biochemistry parameters of blood samples, including sex hormones, vitamin D.
Results. In the course of the study, blood pressure, vascular wall stiffness parameters, metabolic indices of body structure and disorder parameters of bone mineral metabolism were comparable in group 2 and 3 against the background of significantly reduced levels of sex hormones. Multidirectional correlation relationships between the studied parameters are revealed. The basic therapy in combination with therapeutic exercises led to a significant decrease in blood pressure and metabolic indices of body structure (p&lt;.001) and to a persistent tendency of decrease the pulse wave velocity and increase of bone mineral metabolism in gr.3.
Conclusion. The result of the study indicates that the exercise therapy complex used in the form of regular classes can be recommended for implementation in clinical practice with the aim of comprehensively affecting the patient’s body and developing personalized treatment tactics for postmenopausal women with hypertension.
Outcomes of a Cardiac Rehabilitation (CRH) Program after phase II: what about our patients almost 4 years later?
Authors: Borrego Rodriguez J , Palacios Echevarren C , Prieto Gonzalez S , Echarte Morales JC , Bergel Garcia R , Gonzalez Maniega C , Minguito Carazo C , Benito-Gonzalez T , Larrabide-Eguren I , Toribio-Garcia I , Santos-Garcia C , Menendez Suarez P , Garcia Bueno L , Montes Montes M , Fernandez-Vazquez F 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

INTRODUCTION
CRH in patients with ischemic heart disease is recommended by the different clinical practice guidelines with an IA level of evidence, with an important role in reducing cardiovascular mortality and hospital readmissions during follow-up.

OBJECTIVE
The goal of this study is to show the 4-year clinical results of a population of patients who participated in an CRH program after an Acute Coronary Syndrome (ACS).

METHODS
Between May/2014 and September/2017, 221 patients who had recently presented an ACS completed the 12 weeks of phase II of the CRH program at our center. In May/2020 we collected epidemiological, clinical and echocardiographic information at the time of the acute cardiovascular event; and we evaluate the current vital status of the patients and the incidence of readmissions for: angina, HF, new ACS, or arrhythmic events.

RESULTS
Of the 221 patients, 182 were men (82%). The mean age of our population was 58.3 ± 7.8 years. 58% (129 patients) suffered from ST-elevation ACS. The mean time of hospital stay was 6.20 ± 2.9 days. An echocardiogram was performed at discharge, which showed an average LVEF of 56 ± 6%. Eight patients (4%) developed early Ventricular Fibrilation (VF) during the acute phase of ACS. Among the classic CVRF, smoking (79%) was the most prevalent, followed by dyslipidemia (53%) and hypertension (47%). The mean time from hospital discharge to the start of phase II RHC was 42 ± 16 days. The overall incidence of events was 9%: 10 patients suffered reinfarction during follow-up, and 7 were readmitted for unstable angina, all of whom underwent PCI; no patient was admitted for HF; and none of the 8 patients with early VF had a new tachyarrhythmia, registering a single admission for VT during follow-up. None of the patients had sustained ventricular tachyarrhythmias during exercise-training. At the mean 4.5-year follow-up, 218 patients were still alive (98%).

CONCLUSION
The incidence of CV events in the follow-up of our cohort was low, which can be explained by the fact that it is a young population, with an LVEF at low limits of normality at discharge, which is one of the most important predictors in the prognosis after an ischemic event. As an improvement, we must shorten the time until the start of phase II of the program. CRH shows once again its clinical benefit after an ACS, in consonance with the existing evidence.
Abstract Figure. Outcomes of a CRH program.
Clinical management of young competitive athletes with premature ventricular beats: a prospective cohort study
Authors: Cavigli L , Di Florio A , Fusi C , Anselmi F , Focardi M , Cameli M , Valente S , Bonifazi M , Zorzi A , Corrado D , Mondillo S , D"ascenzi F 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. Premature ventricular beats (PVBs) are not an unusual finding and their interpretation is sometimes challenging. Unfortunately, few data on the characteristics of PVBs that correlate with the risk of an underlying heart disease are available in athletes.
Objectives. The aim of this prospective study was to investigate the diagnostic and prognostic value of PVBs characteristics in competitive athletes.
Methods. From a cohort of 1,751 athletes evaluated at our sports cardiology centre, we enrolled 112 competitive athletes &lt;40 years of age (mean age 21 ± 10 years) and with no known heart disease referred for PVBs. All athletes underwent physical examination, ECG, 12-lead ambulatory ECG monitoring, exercise testing, and echocardiography. Further investigations including cardiac magnetic resonance were performed for abnormal findings at first-line evaluation or for specific PVBs characteristics.
Results. The majority (79%) of athletes exhibited monomorphic PVBs with a fascicular or infundibular pattern (common morphologies). A definitive diagnosis of cardiac disease was reached in 26 athletes (23% of the entire population) and correlated with uncommon PVBs morphology (p &lt; 0.001) and arrhythmia complexity (p &lt; 0.001). The number of PVBs/24-hour was lower in athletes with cardiac disease than in those with normal heart (p &lt; 0.05). During the follow-up a spontaneous reduction of PVBs and no adverse events were observed.
Conclusions. Infundibular and fascicular PVBs were the most common morphologies observed in athletes with ventricular arrhythmias referred for cardiological evaluation. Morphology and complexity of PVBs, but not their number, predicted the probability of an underlying disease. Athletes with PVBs and negative investigation showed a good prognosis.
Abstract Figure.
Early detection with speckle tracking echocardiography of biventricular systolic dysfunction, and its relationship with fatigue, in patients with multiple sclerosis
Authors: Michelotto E , Oliva MC , Amoruso MT , Giovannetti G , Battista C , Andreani M , Mazzilli D , Amico AP , Tota A , Megna M , D"agostino C , Palmieri VO , Colonna P 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Fatigue is a frequent and debilitating symptom of multiple sclerosis (MS), affecting 90% of patients. Symptoms seems multifactorial, but little is known about the contribution of cardiovascular morpho-functional alterations linked to comorbidities, to lifestyle, to MS itself or to drugs (i.e. mitoxantrone).

Aim
to investigate the presence of cardiac alterations in MS patients, and to evaluate their impact on fatigue.

Methods
24 patients with relapsing-remitting MS (RR-MS) underwent an electrocardiogram (ECG), a transthoracic echocardiographic (TTE), a six minutes walking test (6MWT) with Borg scale (BS), and two fatigue self-assessment scales, the Fatigue Severity Scale (FSS) and the Modified Fatigue Impact Scale (MFIS). The patients were divided into 2 groups: group 1, without traditional cardiovascular risk factors (CVRF: smoke, hypertension, diabetes, hypercholesterolemia; n = 12, 11 females), and group 2, with at least one CVRF (n = 12, 5 females). None of the patients had ever been on mitoxantrone therapy. No new control group was studied due to the SARS-CoV-2 pandemic restrictions , so the comparison was performed with general healthy population in internationally validated previous studies.

Results
No arrhythmias were found. In both MS groups all the TTE left ventricular (LV) systolic function parameters were depressed compared to the healthy population, but only the mean global longitudinal strain (GLS), the mean longitudinal strain rate (LSR) of LV and estimated pulmonary artery systolic pressure (PAPs) were statistically significant depressed compared to the healthy general population (p &lt; 0.005): see table. This reduction was observed in both MS groups, while there were non significant differences among the two groups. TTE LV function depression significantly correlated to variation of parameters of fatigue , especially considering LV GLS in relation to BS values.

Conclusions
Subclinical biventricular systolic dysfunction is present in MS patients, and it seems to be linked to the disease itself without being influenced by CVRF. This dysfunction, detected by speckle tracking echocardiographic techniques, seems to contribute to the symptom of fatigue in patients with MS. It is important to include TTE in the workup and follow-up of MS patients, in order to promptly treat cardiac dysfunction and relieve fatigue.
Echocardiography and LV strain MS total MS no CVRF MS + CVRF Healthy population LV GLS 17.7 ± 2.2* 18.0 ± 2.1* 17.4 ± 2.4* 22.6 ± 1.7 LV LSR 1.0 ± 0.1* 1.0 ± 0.1* 1.0 ± 0.2* 1.2 ± 0.1 PAPs 25.0 ± 2.6* 24.8 ± 2.9* 25.2 ± 2.5* 14.0 ± 6.0 * p &lt; 0.05 vs healthy population
Quality of life of elderly men and women with ischemic heart disease
Authors: Ibatov A 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
The purpose. To study quality of life and emotional status of elderly men and women with ischemic heart disease (IHD).
Methods. The first group - 79 elderly (60 years and older) men with IHD (average age 64.81 ± 0.5 years) and the second group - 46 elderly women with IHD (average age 64.2 ± 0.5 years) were examined. All patients of the first and second group had the angina pectoris (II-IV functional class). A level of quality of life was estimated by Seattle Angina Questionnaire of quality of life (SAQ). A level of anxiety and the depression were examined by the Hospital Anxiety and Depression Scale (HADS), personality characteristics - by the Mini-Mult questionnaire - short form MMPI questionnaire.
Results. The groups did not differ in class of angina pectoris and treatment. The quality of life in the 1st and 2nd group was accordingly 56.2 ± 1.9 and 48.1 ± 1.6 score on Physical limitation scale (p &lt; 0.05), 44.4 ± 2.3 and 44.8 ± 3.7 score on Angina stability scale (p &gt; 0.05), 54.9 ± 2.6 and 57.8 ± 3.3 score on Angina frequency scale (p &gt; 0.05), 66.8 ± 1.4 and 62.4 ± 1.9 score on Treatment satisfaction scale (p &gt; 0.05), 54.6 ± 1.6 and 49.7 ± 2.2 score on Disease perception scale (p &gt; 0.05), 57.2 ± 1.3 and 52.6 ± 1.5 score on Total score scale of quality of life (p &lt; 0.05). The patients of 1st group had level of anxiety 6.8 ± 0.4 score and level of depression 5.3 ± 0.4 score accordingly. The patients of 2nd group had accordingly 9.2 ± 0.5 score (p &lt; 0.01) level of anxiety and 7.2 ± 0,4 score (p &lt; 0.05) level of depression. The patients of 1st and 2nd group had such personality characteristics accordingly: on scale of Hypochondriasis – 55.5 ± 0.7 and 61.9 ± 1.2 T-score (p &lt; 0.01); on scale of Depression – 48.7 ± 1.1 and 59.2 ± 1.4 T-score (p &lt; 0.01); on scale of Hysteria – 51.0 ± 0.6 and 58.9 ± 0.8 T-score (p &lt; 0.01); on scale of Psychopathic Deviate – 44.3 ± 1.2 and 50.3 ± 1.5 T-score (p &lt; 0.01); on scale of Paranoia – 51.5 ± 1.4 and 59.8 ± 1.9 T-score (p &lt; 0.01); on scale of Psychasthenia – 46.8 ± 1.2 and 55.8 ± 1.5 T-score (p &lt; 0.01); on scale of Schizophrenia – 46.9 ± 1.1 and 56.5 ± 1.6 T-score (p &lt; 0.01); on scale of Hypomania – 45.5 ± 1.9 and 52.9 ± 1.7 T-score (p &lt; 0.01).
Conclusion. The elderly women with ischemic heart with disease had worse quality of life and more expressed accentuated personality characteristics and higher levels of anxiety and depression, in comparison with elderly men. The revealed features of quality of life, personality characteristics and emotional status of elderly patients with ischemic heart with disease have to be considered in treatment and rehabilitation.
Stress cardiovascular magnetic resonance and mortality in a registry of 2496 elderly patients with chronic coronary syndrome. Prognosis and decision-making
Authors: Gabaldon-Perez A , Garcia-Blas S , Gavara J , Rios-Navarro C , Perez-Sole N , De Dios E , Marcos-Garces V , Merenciano-Gonzalez H , Monmeneu JV , Lopez-Lereu MP , Nunez J , Chorro FJ , Bonanad C , Bodi V 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. In recent guidelines, non-invasive imaging techniques play a pivotal role in the management of chronic coronary syndrome (CCS). The elderly represent a large percentage of our routine CCS population and risk stratification in this scenario is challenging. The potential of vasodilator stress cardiovascular magnetic resonance (CMR) for this purpose is unknown.
Purpose. We explore the prognostic value and the usefulness for decision-making of the ischemic burden determined by vasodilator stress CMR imaging in a large cohort of elderly patients with known or suspected CCS.
Methods. The study group was made up of 2496 patients older than 70 years submitted to vasodilator stress CMR for known or suspected CCS in our health department from 2001 to 2016 (mean age 76 ± 4 years, 52% male). Clinical and vasodilator stress CMR characteristics were prospectively recorded. The ischemic burden (number of segments with stress-induced perfusion deficit) was calculated following the 17-segment model. Its association with all-cause mortality and the effect of vasodilator stress CMR-guided revascularization (within the following 3 months) were analyzed retrospectively.
Results. During a median follow-up of 4.58 years, 430 deaths (17.2%) were recorded. A larger ischemic burden was an independent predictor of mortality: hazard ratio [95% confidence intervals]: 1.04 [1.01-1.07] for each additional ischemic segment, p = 0.006). This association also occurred in patients over 80 years of age and in women (p &lt; 0.001). Compared to non-revascularized patients, revascularization associated with worse outcomes at low ischemic burden and exerted protective prognostic effect in patients with extensive ischemia both in the whole group (p for interaction = 0.003) and in 496 patients matched 1:1 by a propensity score (p = 0.06).
Conclusions. Vasodilator stress CMR represents a valuable tool to stratify risk in elderly patients with known or suspected CCS and might be helpful to guide decision-making in this scenario.
Abstract Figure 1
Improvement of the heart failure patient process for the prevention of new events through tele-education and continuous tele-optimization of the treatment by nursing staff
Authors: Perez Serrano M , Carlos Nicolas Perez Garcia CNP , Daniel Enriquez Vazquez DEV , Marcos Ferrandez Escarabajal MFE , Jesus Diz Diaz JDD , Noemi Ramos Lopez NRL , Isidre Vila Costa IVC , Mariam Bas Villalobos MBV , Christian Bengoa Terrero CBT , Alejandra Restrepo Cordoba ARC , David Vivas Balcones DVB , Josebe Goirigolzarri Artaza JGA , Ramon Bover Freire RBF , Carlos Macaya Miguel CMM 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
patients with heart failure (HF) are especially vulnerable to SAR-CoV-2 infection especially due to their worse prognosis for this disease.

Purpose
to demonstrate that patients with HF will present similar health outcomes if their education and pharmacological treatment is optimised remotely by a nurse rather than through conventional care.

Methods
A single-centre, observational, prospective, non-randomized study was carried out in which two groups were compared. The experimental group had most of their care provided virtually by a nurse who could optimise their medication according to the clinical guides whilst the control group received conventional face-to-face care. During a follow-up period of 6 months, patients included in the study have an initial face-to-face consultation with a cardiologist and an evaluation of the patient where the treatment objectives are established. The rest of the follow-ups were done through videoconsultation with the nurse every 15 days for 6 months where the neurohormonal treatment was optimized and an educational program was carried out with different cardiovascular educational topics.

Results
Thirty-seven patients have been included. Sex: 30 men (81.0%) and 7 women (19.0%) Mean age: 67.9 years (12.8). Range 42-87 years. Etiology: 61.2% ischemic and 38.8% non-ischemic mean LVEF at inclusion = 30.2%.
A total of 17 patients have completed the study: a 13% average improvement of FEVI, a reduction of NT-proBNP of and improvement in functional heart failure class.
The primary objective was to compare the proportion of neurohormonal drugs prescribed, as well as the mean of the maximum doses reached in each after 6 months of follow-up, as well as mean ejection fraction, NYHA class and mean NT-proBNP (Table 1)

Conclusions
Telemedicine offers us valuable tools that allow us to take care of chronic patients, reducing exposure to the virus as much as possible. Efficient use of virtual tools and human resources makes close monitoring possible. Specialized nursing is a key element in the education, pharmacological optimization and monitoring of these patients.
Parámetros analíticos Valores iniciales Valores finales NT-proBNP ( pg/mL) 3469,7 (± 4057,3) 1446,4 (± 1305,2) Creatinina (mg/dL) 1,10 (± 0,24) 1,12 (± 0,39) TFG (mL/min/1,73m2 ) 65,4 (± 21,2) 62,7 (± 23, 6) Potasio (meq /L) 4,5 (± 0,5) 4,6 (± 0,4) Fevi 29,4 % (± 7,2) FEVI 42,7 % (± 9,6)
Delivering a dietetic intervention to cardiovascular patients in the Covid era
Authors: Rodgers A , Edwards W , Garrity J , Latimer D , Wilson D , Connolly S 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Department of Health

Introduction
Healthy diet and body composition are core components of cardiac rehabilitation. Following the COVID outbreak in March 2020, our face-to-face cardiac rehabilitation programme (Our Hearts Our Minds) was suspended. The programme was then quickly moved to a virtual platform to continue to deliver the programme.
Purpose
Here we describe how the OHOM programme adapted our service to deliver the dietetic assessment and intervention on a virtual platform.

Methods
Pre-Covid the dietary component of OHOM consisted of a face-to-face Initial Assessment (IA) with a dietitian, group education sessions and an End of Programme assessment (EOP). Anthropometric measures and dietary habits were assessed including adherence to the Mediterranean diet via the Mediterranean Diet Score (MDS) toolkit. Using behaviour change techniques, tailored dietary advice was provided and goals agreed to educate on healthier food choices, increase adherence to Mediterranean diet and (if appropriate) promote weight loss and reduce central obesity. The assessment and intervention is now delivered virtually via telephone or video. Anthropometrics are self-reported with tape-measures supplied to assess waist circumference and advice provided on home-weighing. MDS is still assessed. The programme includes fortnightly coaching telephone consultations to review and reset goals, the option to attend a dietitian-led virtual group education session, access to a filmed educational video and submission of food diaries via the Fitbit app.

Results
From April to November 2020, 114 patients completed the virtual programme (65 telephone, 39 video). Dietetic outcomes are outlined in Table 1 with inclusion of data for a similar period one year previously (face-to-face) for comparison. Reductions in anthropometric measures and increased adherence to a cardio-protective diet were noted and the results for the two time periods are remarkably similar.

Conclusion
Delivery of a virtual dietetic component in cardiac rehabilitation is feasible, acceptable and just as effective as face-to-face based on preliminary data.
Table 1: Dietary outcomes at IA and EOP Face-to-face assessments (April - March 2019) Virtual assessments (April - November 2020) IA EOP Change IA EOP Change Mean weight (in those with BMI &gt;25kg/m2) 86.5 85.2 -1.3 91.4 88.6 -2.8 Waist circumference (cm) 104.3 103 -1.3 107 102 -5 Mean MDS (Range 1-14) 4.4 7.5 +3.1 4.8 7.8 +3 % Consuming oily fish once per week 20 57 +37 25 68 +43 Achieving fruit and vegetable target 16 61 +45 21 57 +36
Abstract Figure. Dietitian waist circumference tutorial