bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mitral regurgitation severity assessment after percutaneous edge-to-edge mitral valve repair: guidelines-recommended integration versus volumetric assessment
Authors: Shekel E , Shuvy M , Danenberg H , Planer D , Gilon D , Leibowitz D , Beeri R 
Published: October 2021

Abstract

Background
Percutaneous edge-to edge mitral valve repair (PMVr) using the MitraClip device is a common method for treating mitral regurgitation (MR) when mitral valve operation is contra-indicated or deemed too risky. The evaluation of residual MR post PMVr is crucial for understanding the benefit and prognostic effect on patients. The common methods used today, based on color flow Doppler and the appearance of the color Doppler jet, may be misguiding because of the multiple jets created by the PMVr technique. Also, flow acceleration induced by the reduced systolic orifice may exaggerate systolic flow acceleration and thus jet area.

Purpose
We hypothesized that the guidelines-recommended method to assess MR may underestimate the effect of PMVr in reducing MR.

Methods
Patients undergoing PMVr in a large-volume PMVr centre were recruited between 2015–2019. Post procedural MR was evaluated using the integrated qualitative approach as recommended by the guidelines. In addition, MR volume for each patient was calculated by subtracting the forward stroke volume (calculated by multiplying LVOT area with the velocity time integral of LVOT systolic flow) from the total stroke volume (using the biplane method of discs), We compared the two methods for concordance.

Results
Overall, 112 cases were enrolled. In 59% of cases, the calculated volumetric residual MR was lower than the MR assessed by the integrated method. In 25.1% of patients the grade of MR was identical in both methods. In 16.2% the MR was more severe when calculated by the volumetric method (p&lt;0.001, Kappa measure of agreement = 0.053–0.074). The reduction in residual MR degree using the volumetric approach was mostly observed in patients classified as “moderate” by the integrated qualitative approach. When considering basic characteristics and cardiac function of the patients, we did not find any sub-group of patients in whom the tendency for this mistake was higher.

Conclusion
Because of multiple jet origins and clip-induced flow acceleration, the integrated method to assess MR severity, based mainly on color Doppler, is not ideal in patients after PMVr. In most cases, MR severity after MitraClip is over-estimated by the integrated, guideline-recommended integrative method when compared with a volumetric method. This is especially relevant for patients classified with “moderate” MR. This study suggests that quantitative methods, not based on colour Doppler, should be used to assess MR severity after PMVr

Funding Acknowledgement
Type of funding sources: None.
Percutaneous left atrial appendage occlusion: impact on left atrial deformation indices
Authors: Dippenaar A , Saaiman J A , Heradien M , Van Der Bijl P 
Published: October 2021

Abstract

Background
Percutaneous left atrial appendage occlusion (LAAO) is an accepted alternative to thromboprophylaxis in atrial fibrillation (AF) patients who are: i) intolerant to oral anticoagulation (OAC) (e.g. life-threatening haemorrhage), ii) non-adherent to OAC, or iii) at a high bleeding risk with OAC. Improvement in LA mechanics was shown post-LAAO in the LAFIT-LARIAT study, using the Lariat device (SentreHEART, Redwood City, CA, USA). No significant change was seen in LA mechanics after LAAO with the Watchman device (Boston Scientific, St. Paul, MN, USA) in the LAFIT-Watchman study. The impact of LAAO with the Amplatz or Amulet device (Abbot Vascular, St. Paul, MN, USA) on LA deformation mechanics, has not been investigated.

Purpose
To evaluate the impact of LAAO with the Amplatz or Amulet device on echocardiographic LA deformation indices.

Methods
All patients undergoing percutaneous LAAO from 2013 to 2021 at a single centre were included from an ongoing clinical registry. LA reservoir, conduit and contractile strain and strain rate were assessed with two-dimensional speckle tracking echocardiography from an apical four-chamber view. Conduit and contractile strain and strain rates were only recorded for patients without AF at the time of echocardiography. Changes in LA deformation indices over time were compared with a linear mixed model.

Results
32 LAAO recipients (mean age 72±12 years, 63% male) were analysed. 5 (16%) patients had AF pre- or post-procedure. After a mean follow-up of 17 months, the mean LA reservoir strain increased from 11.8±7.7% to 12.9±9.1% (P=0.49), the mean LA conduit strain increased from 6.8±6.0% to 8.0±7.4% (P=0.42) and the mean LA contractile strain decreased from 5.7±5.2% to 5.3±5.4% (P=0.77). During the same time interval, the mean LA reservoir strain rate decreased from 0.68±0.44/s to 0.64±0.47/s (P=0.70), the mean LA conduit strain rate increased from −0.52±0.43/s to −0.44±0.32/s (P=0.42) and the mean LA contractile strain rate decreased from −0.77±0.55/s to −0.83±0.53/s (P=0.66).

Conclusions
No statistically significant improvement in LA mechanical function was seen after LAAO with the Amplatz or Amulet device, although a trend towards improved strain was observed for reservoir and conduit strain, with a worsening in contractile strain. Different LAAO devices therefore appear to have divergent effects on LA deformation, the clinical implications of which require further study.

Funding Acknowledgement
Type of funding sources: None.
Pulmonary hypertension is associated with systemic arterial hypertension among patients with normal diastolic function
Authors: Itelman E , Segal M , Kuperstein R , Feinberg M , Segev A , Segal G , Maor E , Grossman E 
Published: October 2021

Abstract

Introduction
The association of pulmonary and systemic arterial hypertension is believed to be mediated through hypertensive left heart disease. The purpose of the current study was to investigate whether pulmonary arterial hypertension (PAH) is associated with systemic arterial hypertension among patients with apparently normal left heart diastolic function.

Methods
Consecutive patients who had echocardiographic evaluation between 2007 and 2019. Patients with disease states that are known to be associated with PAH including diastolic dysfunction were excluded from the analysis. Estimated right ventricular systolic pressure (RVSP) was extracted for all patients from the echocardiographic reports. PAH was defined as estimated RVSP &gt;40 mmHg. Multivariate logistic regression models were applied.

Results
Final study population included 25,916 patients with a median age of 59 (IQR 44–69), of whom 12,501 (48%) were male and 13,265 (51%) had systemic arterial hypertension. Compared with normotensive patients, hypertensive patients were 3.2 times more likely to have PAH (95% CI; 2.91–3.53, p&lt;0.001). A multivariate model adjusted for clinical and echocardiographic parameters that are known to be associated with PAH demonstrated that hypertensive patients are almost 3 times more likely to have PAH (95% CI 2.45–3.15, p&lt;0.001). The association was significant in multiple subgroups but was more significant among women compared with men (OR 3.1 vs. 2.4, p for interaction &lt;0.001).

Conclusions
PAH is associated with systemic arterial hypertension irrespective of left heart disease. The association is more pronounced among women.

Funding Acknowledgement
Type of funding sources: None. Estimated RVSP &gt;40 by Systolic BP
Exercise intensities modulate cognitive function in spontaneously hypertensive rats through oxidative mediated synaptic plasticity in hippocampus
Authors: Lee C C , Wu D Y , Lee T M 
Published: October 2021

Abstract

Background
Oxidative damage in the brain may lead to cognitive impairments. There was considerable debate regarding the beneficial effects of physical exercise on cognitive functions because exercise protocols have varied widely across studies.

Purpose
We investigated whether different exercise intensities alter performance on cognitive tasks.

Methods
The experiment was performed on spontaneously hypertensive rats (6 months at the established phase of hypertension) distributed into 3 groups: sedentary, low-intensity exercise, and high-intensity exercise.

Results
Systolic blood pressure measurements confirmed hypertension in spontaneously hypertensive rats. In comparison to normotensive Wistar-Kyoto rats, sedentary spontaneously hypertensive rats had similar escape latencies and a similar preference for the correct quadrant in the probe trial. Compared to the sedentary group, the low-intensity exercise group had significantly better improvements in spatial memory assessed by Morris water maze. Low-intensity exercise was associated with attenuated reactive oxygen species, as measured by dihydroethidine fluorescence and nitrotyrosine staining in the dentate gyrus of the hippocampus. This was coupled with increased numbers of neurons and dendritic spines as well as a significant upregulation of synaptic density. In contrast, the beneficial effects of low-intensity exercise are abolished in high-intensity exercise as shown by increased free radical levels and an impairment in spatial memory.

Conclusions
We concluded that exercise is an effective strategy to improve spatial memory in spontaneously hypertensive rats even at an established phase of hypertension. Low-intensity exercise exhibited better improvement on cognitive deficits than high-intensity exercise by attenuating free radical levels and improving downstream synaptic plasticity.

Funding Acknowledgement
Type of funding sources: None.
Method for predicting meteopathies in patients with arterial hypertension
Authors: Terentjev K , Andronov S , Lobanov A , Popov A , Grishechkina I , Yakovlev M , Rachin A , Fesyun A , Lebedeva O , Zaichev A ,   the laboratory for studying the mechanisms of action of physical factors
Published: October 2021

Abstract

Background
Climatotherapy, as part of the spa stage of treatment, with arterial hypertension can give both positive and negative effects in the event of meteopathic reactions. The risk of meteopathies is especially high in patients coming from northern and eastern regions.

Purpose
Was to predict periods of increased risk of meteopathy development.

Methods
The study lasted 22 months, from January 01, 2019 to October 31, 2020 in the city of Gelendzhik (44 ° 36 'north latitude 38 ° 08' east longitude). The source of meteorological data: the site Gismeteo.ru, the Gelendzhik weather station and the ambulance data of the cities of Gelendzhik (12,268 requests) and Novorossiysk (12,226) in total (24,494 requests), the ambulance crews of which serve the area. Nonlinear logit regression using the maximum likelihood method was used to calculate the model.

Results
A prognostic model was built to increase the risk of developing a hypertensive crisis in the studied population; the main indicators of climatic and geomagnetic conditions were used as the studied variables. The sensitivity of the used logistic regression method was 56.0%, and the specificity was 77.3%. The overall accuracy of the model under study was 76.0%. In the winter period, according to the compiled prognostic model, no more than 75.0% of days are accompanied by a low risk of developing hypertension, in the spring period their share decreases to 59.0%, in the summer it is 89.0%, and in the autumn period - 77. 0%.

Conclusion
The developed logistic regression models make it possible to more accurately calculate the individual risks of developing a hypertensive crisis in patients with arterial hypertension and develop an individual treatment strategy.

Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): state assignment of the Ministry of the Russian Federation
Comparison of a self-automated blood pressure measurement according to the American Heart Association recommendation versus a routine practice, a randomized-controlled trial
Authors: Suntornlekha N , Chai-Adisaksopha C , Jesadaporn P , Mekara W , Kuanprasert S 
Published: October 2021

Abstract

Background
Home blood pressure monitoring is currently a gold standard for guiding an adjustment of antihypertensive medications. According to the American Heart Association (AHA), the self-automated blood pressure (BP) measurement may represent accurate home BP. However, there is a limited data in real-world practice

Objective
To explore the accuracy of a self-automated BP measurement in representing the actual home BP monitoring, in comparison with a single spot-arm automated BP measurement, which is routinely used in the clinical setting.

Methods
We conducted a single center, randomized cross-over trial. At the Cardiology clinic, hypertensive patients aged between 18 and 80 years, who were able to perform self-automated BP measurement, were included in the study. The patients were categorized into two groups using different BP measurement methods: a self-automated BP measurement according to the AHA Recommendation 2017 and a single spot-arm automated BP measurement, and then crossed over to alternative methods. All participants were instructed to rest at least 5 minutes prior to undergo BP measurement in both methods. The data of BP measurements were subsequently compared with the standard home BP monitoring.

Results
Overall, 190 patients underwent randomization. Mean differences of systolic blood pressure (SBP) in the self-automated AHA measurement and the single spot-arm measurement, compared with the standard home BP monitoring, were 3.57 mmHg (95% confidence interval (CI); 1.39 to 5.74 mmHg) and 9.44 mmHg (95% CI; 7.03 to11.86 mmHg), respectively (P&lt;0.001) (table1). Mean differences of diastolic blood pressure (DBP) in the self-automated AHA and the single spot-arm measurements, compared with the standard home BP were −1.51 mmHg (95% CI; −2.76 to −0.25) and 2.69 mmHg (95% CI; 1.07–4.31), respectively (P&lt;0.001) (table 1). White coat hypertension was detected in 7 (3.72%) of patients by AHA measurement and 17 (9.04%) by the single-spot arm measurement (P=0.008).

Conclusion
The self-automated BP measurement according to the AHA Recommendation 2017 was more accurate than the single spot-arm automated BP measurement in representing the actual home BP monitoring and reduced the possibility of the white coat effect.

Funding Acknowledgement
Type of funding sources: None. Table 1
The impact of physical activity on arterial stiffness and inflammation; results from the “Corinthia” study
Authors: Theofilis P , Oikonomou E , Vogiatzi G , Lazaros G , Mystakidi V X , Goliopoulou A , Anastasiou M , Tsalamandris S , Chasikidis C , Papakonstantinou M , Fountoulakis P , Christoforatou E , Siasos G , Tousoulis D 
Published: October 2021

Abstract

Background
Diminished physical activity (PA) is associated with cardiovascular morbidity and mortality. Arterial stiffness and inflammation are associated with atherosclerosis and are established risk factors for cardiovascular disease.

Purpose
We investigated the association of PA status on arterial stiffness and inflammation.

Methods
Classification of PA was performed in 2053 participants of the cross-sectional “Corinthia” study using the International Physical Activity Questionnaire (IPAQ). In accordance with the standard IPAQ scoring procedures, participants were classified into one of the following groups: upper tertile: “vigorous” PA-IPAQ 2, middle tertile: “moderate” PA-IPAQ 1 or lower tertile: “low” PA-IPAQ 0. Arterial stiffness was estimated via carotid-femoral pulse wave velocity (cfPWV) estimation and inflammatory burden was assessed via high sensitivity C reactive protein (hsCRP) measurement.

Results
Participants with low PA had impaired cfPWV values (IPAQ 0: 9.5±3.2 m/s vs. IPAQ 1: 8.7±2.4 m/s vs. IPAQ 2: 8.7±2.2 m/s, p&lt;0.001) (Figure 1, Panel A) while abnormal cfPWV –adjusted for age and blood pressure- were more frequently encountered in low PA individuals (IPAQ 0: 14% vs. IPAQ 1: 7.8% vs. IPAQ 2: 7.3%, p=0.001) (Figure 1, Panel B). Participants characterized as having vigorous physical activity had the lowest inflammatory burden, as estimated by hsCRP (IPAQ 0: 4.8±6.4 g/l vs. IPAQ 1: 4.6±5.2 g/l vs. IPAQ 2: 3.6±4.2 g/l, p=0.001) (Figure 1, Panel C). Importantly, results remained unaffected even after adjustment for confounders (Figure 1, Panel D). A correlation analysis between the total weekly physical activity (expressed as MET minutes/week) and arterial stiffness was performed demonstrating a statistically significant negative correlation was noted (r=−0.120, p&lt;0.001) (Figure 1, Panel E).

Conclusion
A significant association between physical activity, arterial stiffness and inflammation was observed, even after adjusting for known cardiovascular risk factors. Our findings should raise public awareness about the beneficial effects of exercise on cardiovascular health.

Funding Acknowledgement
Type of funding sources: None. Figure 1
Cardiovascular predictors associated with poor short-term prognosis in patients diagnosed with SARS-CoV-2 in Spain
Authors: Esteban-Lucia L , Devesa-Arbiol A , Zambrano Chacon M A , Venegas Rodriguez A M , Gonzalez-Rodriguez M , Maure-Blesa L , Avila-Barahona P , Pello-Lazaro A M , Gonzalez-Lorenzo O , Fernandez-Roblas R , Villar-Alvarez F , Ibanez B , Tunon J , Acena Navarro A , Franco Pelaez J A 
Published: October 2021

Abstract

Background
On January 2020, the first patient with coronavirus 2 (SARS-CoV-2) was detected in Spain. Since then, 3 280 000 cases have been confirmed and 75.305 people have died. We aimed to clarify the epidemiological and clinical characteristics related with poor short-term prognosis in patients diagnosed with SARS-CoV-2.

Methods
Observational, retrospective single-center study including consecutive patients (≥40yo) diagnosed with SARS-CoV-2 through PCR, since March 2nd to 20th 2020 in our center in Spain. The primary endpoint (PE) was the combined of all-cause death or need for orotracheal intubation within the first 30 days of infection symptoms.

Results
704 patients were included (table). A follow-up period of thirty-days was fully completed in 692 of 704 patients (98.3%). At the end of this period, 148 patients (21.4%) met the PE; they were older, more frequently male, obese and smokers. Patients who met the PE had a higher prevalence of hypertension, diabetes, dyslipidemia, ischemic heart disease, heart failure, peripheral and cerebrovascular disease, cancer and lung pathologies. They received more frequently therapies with renin-angiotensin system inhibitors, betablockers, calcium channel blockers and statins, as well as antiplatelet and anticoagulant therapies
Multivariate analysis showed that age (OR 1.99 for every 10 years, 95% CI [1.637–2.4], p&lt;0.001), female sex (OR 0.49, [0.30–0.80], p=0.004), diabetes (OR 2.09, [1.17–3.71], p=0.012), lung disease (OR 1.99, [1.14–3.44], p=0.014) and body mass index (OR 1.33 for each 5 kg/m2 increased, [1.05–1.68], p=0.017) were predictors of the PE. Hypertension was not significantly related to the PE (OR 1.55, [0.93–2.60], p=0.09)

Conclusion
In our group of patients with SARS-CoV-2, age, male sex, diabetes, lung disease and obesity were found to be independent predictors of the combined of all case death or need for orotracheal intubation within the first 30 days of infection symptoms. Larger studies are needed to confirm these results.

Funding Acknowledgement
Type of funding sources: None. Description of studied populationOdds-ratio and CI for the combined PE
Association between ankle-brachial index and cardiovascular mortality in a cohort from the United States of America
Authors: Penson P , Henney N C , Banach M 
Published: October 2021

Abstract

Background
Ankle-brachial index (ABI) is a non-invasive and accessible indicator of peripheral arterial disease (PAD) which shares pathophysiological mechanisms with coronary and cerebral atherosclerosis.

Purpose
This study investigated associations between ABI and cardiovascular (CV) mortality in a longitudinal cohort study.

Methods
Ankle-brachial index was measured in 7571 participants of the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2004. Participant data were linked with National Death Index mortality data until December 2015. Participants were categorised as having low ABI, &lt;0.9, indicative of PAD; or normal ABI 0.9–1.4. Cox Proportional Hazards Regression was used to investigate associations between ABI, CV mortality, adjusting for demographic variables (age, sex, educational status, ethnicity & poverty-income ratio) and traditional CV risk factors (HDL-C, LDL-C, triglycerides, systolic blood pressure, body mass index & diabetes)

Results
Individuals with low ABI were on average older (mean ± SD; 71.1±11.6 v. 59.3±12.8 years) and had higher systolic blood pressure (142.8±24.3 v 131.1±20.8) than those with normal ABI.
Low ABI (&lt;0.9) was associated with increased odds of cardiovascular mortality (Odds Ratio (OR) 3.092, 95% CI 1.81–5.28, p&lt;0.001) after adjustment for all variables. Adjusted survival curves are shown in the figure, below.
In a subgroup analysis of individuals with nominally normal ABI (0.9–1.4), ABI, treated as a linear variable was negatively associated with cardiovascular mortality, OR 0.185 (95% CI 0.051–0.067, per 1 unit change in ABI, P=0.01) after adjustment for demographic variables.
In a subgroup analysis of individuals with low ABI, antihypertensive use was associated with lower odds of CV death (OR 0.246 (95% CI 0.091–0.663, p=0.006) independently of demographic variables, systolic blood pressure, LDL-C and use of statins and antiplatelets.

Conclusion
We have demonstrated strong associations between ABI and CV mortality. Our results suggest that ABI should be investigated as an additional tool in routine CV risk prediction, and highlight the importance of risk-factor management in PAD patients.

Funding Acknowledgement
Type of funding sources: None. Survival curves for low and normal ABI
Change in framingham cardiovascular disease risk between 2003 and 2014 in the hong kong population health survey
Authors: Sung B Y C , Tang E H M , Bedford L , Wong C K H , Tse E T Y , Yu E Y T , Cheung B M Y , Lam C L K 
Published: October 2021

Abstract

Background
The Framingham Risk model estimates a person's 10-year cardiovascular disease (CVD) risk.

Purpose
We aimed to calculate the change in sex-age specific Framingham CVD risk in the Hong Kong Population Health Survey (PHS) 2014/15 in comparison with the survey in 2003–05 (PHS2003/2004 & Heart Health Survey (HHS) 2004/2005).

Methods
Subjects aged 30–74 years from PHS2014/15 (n=1,662, n=4,445,869 after population weighing) and PHS2003/2004 & HHS2004/2005 (n=818, n=3,495,074 after population weighing) with complete data for the calculation of Framingham CVD predicted risk were included. The sex-specific CVD risks of participants were calculated based on their age, total cholesterol and high-density lipoprotein, mean systolic blood pressure, smoking habits, diabetic status, and treatment for hypertension. The mean sex-age specific CVD risks were then calculated, and the differences in CVD risk between the two surveys were analysed using ANOVA.

Results
There was no significant difference in 10-year CVD risks between the 2003–2005 and 2014/15 study populations (10.2% vs. 10.6%, p=0.29). After adjusting to a standard population (US Census 2000), the age-standardized CVD risk was lower in 2014–2015 than in 2003–05 (10.0% vs. 10.7%, p=0.017). More participants aged 65–74 were classified as high risk during 2003/04 (PHS2003/2004 & HHS2004/2005: 66.8% vs. PHS2014/15: 53.1%, p=0.026). This might be due to the decrease in the proportion of smokers among men (2003–2005: 30.5% vs. 24.0% in 2014–15, p&lt;0.001).

Conclusions
Between 2003/04 and 2014/15, there was a small decrease in age-standardized 10-year CVD risk, which might be related to the reduction in smoking. However, more effort in targeting multiple CVD risk factors simultaneously is needed to achieve a greater reduction in CVD risk.

Funding Acknowledgement
Type of funding sources: None.