bluuebunny/crossref_metadata_2025_split huggingface dataset:
Features of the relationship between the parameters of left ventricular mechanics and the level of biomarkers of heart failure in patients with epicardial obesity
Authors: Gritsenko O , Chumakova GA 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Currently, there is no serum biomarker that is a marker of the presence of heart failure (HF) at an early stage. It is also shown that the traditional indicators used for the diagnosis diastolic dysfunction (DD) of left ventricular (LV) using echocardiography (ECG) are not informative enough. Thus, it is currently relevant to study new serum biomarkers of DD, such as sST2, as well as to study the mechanics of LV.

Objective
to study the relationship between mechanics of LV and the level of sST2 (bioamarker of HF) in patients with epicardial obesity (EO).

Materials and methods
The study included 110 men with general obesity. According to the results of echocardiography (ECG), patients were divided into 2 groups: EO (+) with epicardial fat thickness (tEAT) ≥7 mm (n = 70); EO (-) with tEAT &lt;7 mm (n = 40) without diastolic dysfunction according to the results of ECG. All patients were assessed for sST2 and NT-pro-BNP levels using enzyme immunoassay. Using speckle-tracking ECG, the mechanics of LV were studied (twist LV, peak twist ratio LV, time to peak twist of LV, peak untwist ratio LV, time to peak untwist of LV). The exclusion criteria were the presence of coronary pathology, arterial hypertension, and type 2 diabetes mellitus.

Results
In the group patients with EO ( + ) a statistically significant increase in the level of sST2 was revealed in comparison with the group of EO (-) [21,55 ng/ml (26,52; 15,40) and 9.89 ng/ml (11.12; 7.95); p = 0.001, respectively], while the levels of NT-pro-BNP in both groups were not statistically different [211.36 pg / ml (254.0; 156.0) and 204.81 pg / ml (268.0; 157.0), respectively, p = 0.85]. When determining the parameters of DD LV by ECG, there were no statistical differences between the EO (+) and EO (-) groups [e ", cm / sec 0.09 (0.11; 0.09) and 0.09 (0.11; 0.09), respectively, p = 0.63; E/e " , units, 7.80 (8.90; 6.55) in the EO (+) and 8.53 (9.70; 7.20) in the EO group ( - ), p = 0.08; left atrial volume index, ml / sq2, in the EO group (+) 28.39 (31.25; 24.17) and in the EO group(-) 27,82 (30,21; 25,66), p = 0.55; in the EO group ( + ), the maximum speed of tricuspid regurgitation, m / sec, is 2.78 (2.9; 2.58) in the EO group(-) 2,67 (2,87; 2,41), p = 0.13]. According to the results of speckle-tracking ECG in the EO (+) group, an increase peak untwist ratio LV to -128.31 (-142.0; -118.0) deg/s-1 (p = 0.002) and an increase time to peak untwist of LV of 476.44 (510.0; 411.0) msec was determined in comparison with the EO ( - ) group (p = 0.03). A significant relationship between peak untwist ratio LV and sST2 was revealed (r = 0.37; p = 0.02).

Conclusion
Thus, it can be assumed that patients with EO have DD LV at the preclinical stage, which is not diagnosed using traditional ECG indicators. The serum biomarker sST2 is an early marker of the presence of HF.
Impact of lockdown in patients with congestive heart failure during the Covid-19 pandemic
Authors: Chague F , Boulin M , Eicher JC , Bichat F , Saint-Jalmes M , Cransac-Miet A , Soudry A , Danchin N , Laurent G , Cottin Y , Zeller M 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Dijon Football Côte d"Or

OnBehalf
CLEO-CD

Background
Congestive heart failure (CHF) can be destabilized by Covid-19 (C19) lockdown.

Purpose
To evaluate the impact of lockdown in CHF patients.

Methods
150 out-patients from the HF Clinic of our hospital were invited to answer to a phone-call interview during the 7th week of first C19 lockdown .

Results
From 124 questionnaires, more than 1/5 felt worse and almost 1/4 declared a psychologic distress. CHF medications were modified in 10%. Decrease in physical activity was observed in 2/5. Almost 1/2 declared increased screen time; smokers often increased consumption. Adherence to dietary counselling was reduced by 1/6, increase in weight and HF symptoms were common. Some patients benefitted from a teleconsultation.

Conclusions
Our patients exhibited well-being impairment and unhealthy behaviours. Medication adherence was not diminished and the reduction in care access was counterbalanced by a switch toward telehealth.
Main results 124 patients 75 Male (M) 49 Female (F) p value between M and F Age, years 71.0 ± 14.0 68.9 ± 13.7 74.3 ± 14.0 0.03 Urban/Rural 82/42 49/26 33/16 0.84 HFrEF* 87 62 25 &lt;0.001 Dilated cardiomyopathy 50 37 13 0.02 Ischemic 23 18 5 0.06 Other 51 20 31 &lt;0.0001 Current NYHA class I/II/III/IV 39/48/28/9 29/29/14/3 10/19/14/6 0.66 History of NYHA III-IV class 94 62 32 0.03 Electronic device/Telemonitoring 77/28 54/18 23/10 &lt;0.001/0.66 Increase in dyspnea or edema or fatigue 27 13 14 0.07 Decrease in well-being 27 12 15 0.07 Psychological distress (#) 23 15 (20.0) 8 0.64 Weight gain &gt; 2 kg 34 22 (29.3) 12 0.68 Switch for teleconsultation (##) 16 11 (34.4) 5 1 Teleconsultation (total) 23 14 9 1 Decrease in physical activity 52 25 (33.3) 27 0.02 Increase in screen time 57 31 (41.3) 26 0.27 Increase in cigarette consumption (9 smokers) 4 3 1 1 Decrease in dietary adherence (###) 22 (17.7) 15 (20.0) 7 (14.3) 0.47 *HFrEF; # Kessler-6 score ≥ 5; ## from planned physical examination; ### salt, water, alcohol
Does breathing technique improve diastolic function of left ventricular?
Authors: Smyrnova GS , Babkina TM 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. Diastolic heart failure (HF) is an important clinical disorder mainly seen in the elderly patients with hypertensive heart disease. Early recognition and appropriate therapy of diastolic dysfunction is advisable to prevent further progression of the illness. There is no specific therapy to improve diastolic function directly. Mechanisms by which yoga may improve cardiac function and reduce myocardial stress are speculated at this time.
Purpose. The study’s purpose was to analyze the effects of full yogic breathing on diastolic function of left ventricular in patients with HF.
Methods. One hundred and two patients with chronic HF (males, 62%; mean age, 68.2 ± 4.5 years) were randomly assigned to full yogic breathing training plus standard therapy (n = 48) or standard therapy alone (n = 54). Patients in both groups were assessed at baseline and 6 months after randomization. Echocardiographic evaluation of diastolic function has been performed by measurement of transmitral flow parameters including the early (E) and late (A) diastolic filling velocities, the E/A ratio, and the E deceleration time (DT) with conventional pulsed wave Doppler. The medial and lateral early diastolic mitral annular velocities, and the E/Ea ratio were also assessed by tissue Doppler imaging.
Results. There were no significant differences in demographic and baseline characteristics between participants. By the end of the observation period significant diastolic function improvements were observed in yogic breathing group. E/A ratio (from 1.02 ± 0.9 to 1.13 ± 0.7; from 1.01 ± 0.7 to 1.08 ± 0.8) was increased, whereas E DT (from 238 ± 16 to 216 ± 17 ms; from 229 ± 20 to 221 ± 19 ms) and E/Ea ratio (from 9.87 ± 1.34 to 8.71 ± 0.79; from 9.77 ± 1.26 to 9.36 ± 0.68) were decreased in yogic breathing group compared with standard therapy alone group.
Conclusion. Yoga breathing practice for 6 months showed a significant improvement in diastolic function of left ventricular.
Effects on the left ventricular diastolic dysfunction of a cardiac rehabilitation program in chronic heart failure patients
Authors: Chaveles I , Karatzanos L , Nanas S 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

PURPOSE
The aim of the present study is to evaluate the impact of a cardiac rehabilitation program on the diastolic dysfunction, the ejection fraction (EF) of left ventricular and the volume index of the left atrium comparing 2 groups: those with restricted EF (&lt;40%) and those with intermediate and preserved EF (≥ 40%).

METHODS
In the present study 41 stable CHF patients (N = 41; 56 ±10 years [mean ± SD], 34 males and 7 females) with diastolic dysfunction, participated in an exercise rehabilitation program (3 sessions a week). Only 38 of them completed the rehabilitation program in the form of circuit-interval aerobic training, adjusted according to 70–80% of heart rate reserve, for a period of 3 months. A detailed echocardiogram was performed before and immediately after the rehabilitation program, focusing on the diastolic dysfunction assessment of the left ventricular.

RESULTS
At the end of the three months rehabilitation program, the diastolic dysfunction stage was significantly decreased (from 1.45+/- 0.72 to 1.08 +/-0.67, p = .000). The LV ejection fraction was significantly increased (from 34.97+/-10.66 to 36.68 +/-10.52, p = .002). In addition, there was a significant decrease in E/E" and RVSP (from 9.37+/-3.54 to 8.47+/-3.34 and from 28.44+/-6.86mmHg to 27.38+/-5.87 mmHg, p =.033 and p =.030, respectively). Finally, the left atrial volume and the average e" had no significant decrease.

CONCLUSIONS
Circuit training improved both diastolic and systolic dysfunction but had no significant repercussion on the left atrium volume. From this study it was concluded that a rehabilitation cardiac program can have an impact in the improvement in the diastolic dysfunction, especially in the restricted EF group, a mechanism that is essential in the pathophysiology of the CHF.
Table 1 PairedDifferences t df Sig. (2-tailed) Mean Std. Deviation Std. ErrorMean 95% Confidence Interval of the Difference Lower Upper Diast.stage b-a 0.368 .589 .096 .175 .562 3.855 37 .000 A b - A a ( m/sec) -.03816 .21084 .03420 -.10746 .03114 -1.116 37 .272 Ε/Α b - Ε/Α a .11039 .44705 .07252 -.03655 .25734 1.522 37 .136 mean e" b - a(cm/sec) .19395 2.56304 .41578 -.64850 1.03640 .466 37 .644 Ε/e "b - Ε/e "a .90026 2.50613 .40655 .07652 1.72401 2.214 37 .033 DTeb -DTe a (msec) 8.500 44.324 7.190 -6.069 23.069 1.182 37 .245 T-Test for the measured diastolic parameters (diastolic stage, E, A, E/A, mean e", E/E", DTe) for all groups (b = before, a = after).
Abstract Figure. Linear scatter plot for EF
Exercise capacity in patients implanted with left ventricular assist devices for end-stage heart failure treatment
Authors: Oesterschlink J , Wolf LK , Gilis-Januszewski J , Dumitrescu D , Mellwig KP , Schramm R , Rojas SV , Fruend A , Morshuis M , Rudolph V , Gummert JF , Fox H 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Left ventricular assist device (LVAD) is an expanding therapy in end-stage heart failure today. Although LVAD therapy bears the potential to normalize cardiac output, a majority of patients show a severely impaired physical condition at the time of LVAD implantation. To date, no validated standardized training protocol is available, and established practices to effectively improve LVAD patients’ exercise tolerance is lacking. This study sought to investigate exercise capacity quantified by cardiopulmonary exercise testing (CPX) and a standardized six-minute walk test (6MWT) in patients after LVAD implantation.

Methods
We enrolled 30 end-stage heart failure patients who had received an LVAD implantation 20.7 ± 7.6 days prior to examination, mean age 54.9 ± 7.8 years, 26 males (87 %). Exercise tolerance was assessed using cardiopulmonary exercise testing (CPX) for maximal and submaximal exercise capacity, followed by a standardized (6MWT).

Results
Patients showed peak oxygen uptake values of 8.3 ± 2.4 ml/min/kg at a mean workload of 46.7 ± 11.3 watts and a mean anaerobic threshold of 6.7 ± 1.7 ml/min/kg at a workload of 32.6 ± 6.9 watts. Mean standardized 6-minute walking distance was at 183.8 ± 71.4 meters. There were no adverse events during exercise testing.

Conclusions
Cardiopulmonary exercise testing (CPX) and standardized 6MWT show severely impaired cardiopulmonary exercise capacity in patients after LVAD implantation, warranting further studies for dedicated training protocols, specifically focusing on LVAD patients to improve exercise tolerance at an acceptable safety profile.
Cardiovascular outcomes of ferric carboxymaltose supplementation for the management of iron-deficient acute and chronic heart failure- a meta analysis
Authors: Abdul Razzack A , Kumar S , Kumar R , Khokhar HT , Pothuru S , Adeel Hassan S , Garimella R , Theja Reddy K , Mandava S 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background-Iron deficiency is prevalent in heart failure patients and is associated with unfavorable clinical outcomes, irrespective of anemia status. The 2016 European Society of Cardiology (ESC) guidelines recommended intravenous ferric carboxymaltose (FCM) for the management of acute and chronic heart failure in symptomatic HF with reduced ejection fraction (EF).
Objective- To determine whether the correction of iron deficiency with ferric carboxymaltose confers better clinical outcomes in patients with acute and chronic heart failure
Methods-Electronic databases ( PubMed, Embase, Scopus, Cochrane) were searched from inception to December 28th, 2020. Unadjusted odds ratios (OR) were calculated from dichotomous data using Mantel Haenszel (M-H) random-effects with statistical significance to be considered if the confidence interval excludes 1 and p &lt; 0.05. The primary outcome of interest was cardiac mortality. Secondary outcomes included first hospitalisation due to worsening heart failure and any other cardiovascular (CV) reason.
Results-A total of five studies with 2091( FCM = 1125; placebo = 966) patients were included. Average follow-up period was 2 years. There was no difference in terms of cardiac mortality (RR 0.93, 95% CI 0.71–1.21; p = 0.57; I2 = 0) and hospitalizations for any CV reason (RR 0.83, 95% CI 0.32–2.16; p = 0.70; I2 = 83) with either group at the end of follow-up. As compared to placebo, FCM was associated with significant reduction in hospitalization due to worsening heart failure (RR 0.64; 95% CI 0.41-0.99; p = 0.04; I2 = 56)
Conclusion- Amongst patients with iron-deficient acute and chronic heart failure, treatment with ferric carboxymaltose reduced the risk of heart failure hospitalizations, with no apparent effect on the risk of cardiac mortality and hospitalizations for any other CV cause.
Abstract Figure. A)CV death B&C)Hospitalizations-HF,CV
Nociceptive disorders in patients with microvascular angina pectoris and patients with silent myocardial ischemia
Authors: Petrova VB , Boldueva SA , Leonova IA , Petrova AB , Petrova AI 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): North-western State Medical University named after I.I.Mechnikov
The purpose of this study was to study the diagnostic value of the nociceptive flexor reflex (NFR) method in patients with MVA and patients with silent myocardial ischemia.
Materials and methods. A total of 158 people were examined, including 131 patients with ischemic heart disease and 31 healthy volunteers (control group). Patients with coronary artery disease were represented by three groups: patients with MVA - 49 people (main group), patients with angina pectoris due to atherosclerotic lesions of the coronary arteries - 40 people (comparison group 1), patients with a diagnosis of painless myocardial ischemia (SMI) - 42 people (comparison group 2). To determine pain indicators, the method of nociceptive flexor reflex (NFR) was used during electrical stimulation of the sural nerve (Nicolet Viking (USA)).
Results. The coefficient (k) of pain threshold / reflex threshold (Pb / Pr) in the control group of healthy volunteers was 0.94 ± 0.01, which corresponds to the accepted norms (1-0.9) according to literature data. In the study of NFR in patients with MVA, a decrease in the pain threshold, reflex threshold and ratio (Pb / Pr) was revealed. In the MVS group, PB= 9.5 ± 0.58 mA; Pr = 12.1 ± 0.58 mA; Pb / Pr = 0.78 ± 0.02. The pain threshold in patients with MBS turned out to be statistically significantly lower in comparison with comparison group 1 and comparison group 2 and control group (p &lt;0.01; p &lt;0.001; p &lt;0.001, respectively). The reflex threshold in patients with MVA is statistically significantly lower than in comparison group 1, comparison group 2 (SIM) and control group (p &lt;0.02; p &lt;0.001; p &lt;0.01, respectively). In patients with angina pectoris, PB = 13.8 ± 0.31 mA; Pr = 14.8 ± 0.33 mA; Pb / Pr = 0.94 ± 0.01. In patients with SIM, PB = 24.9 ± 0.99 mA; Pr = 22.9 ± 0.79 mA; Pb / Pr = 1.2 ± 0.02. There was a significant increase in the pain threshold, reflex threshold and the pain threshold / reflex threshold ratio in the group of patients with silent myocardial ischemia compared with similar indicators in the control group, the main group and comparison group 1 (p &lt;0.001; p &lt;0.001; p &lt;0.001 respectively).
Conclusions. In patients with MVA compared with healthy individuals in the control group and comparison groups, there is a decrease in NFR indices, which indicates the presence of nociceptive disorders. In patients with SIM, the reflex threshold values are lower in value than the pain threshold. Thus, in patients with SIM the muscle response occurs before the onset of the subjective sensation of pain.
Patient adherence to statin therapy within 12 months after coronary stenting depending on regular or remote monitoring
Authors: Osokina A , Filatova A , Potekhina A , Shchinova A , Provatorov S 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): Russian Ministry of Health
Background. Low adherence to statins remains a challenge in the treatment of patients with cardiovascular diseases. Some patients who underwent coronary stenting (CS) are unavailable for regular follow-up with outpatient visits. The ability to remotely monitor patients after CS may facilitate adherence to treatment, achieve target low density lipoprotein (LDL) cholesterol levels and early detection of adverse events. We aimed to evaluate the adherence to statin therapy in patients after CS receiving remote monitoring or care with outpatient visits.
Methods. We enrolled 279 consecutive stable CAD/silent myocardial ischemia patients (61.5 ± 9.5 years) who underwent CS. The patients were randomized into groups of regular outpatient visits (group 1, n = 96), remote monitoring (group 2, n = 95) and control group (group 3, n = 88). The visits (cardio exam and blood testing) and remote monitoring (videoconference, telephone care and blood tests interpretation) were performed at 1, 3, 6 and 12 months after CS for groups 1 and 2. Patients in the control group were cared by a physician at the residence place, the contact with the study coordinator was performed at baseline and 12 months after CS. Adherence to the prescribed medical therapy based on the four-item Morisky Green Levine Medication Adherence Scale was assessed at each contact with the study coordinator.
Results. Patient adherence to statin therapy 12 months after CS was 53.6% for group 1, 55.8% for group 2 and 24.4% for group 3 (p &lt; 0.05 for group 3 versus groups 1 and 2). In group 1 26.9/36.5/31.7/37.4*/41.3*% of patients achieved target LDL level at baseline/1mo/3mo/6mo/12mo, respectively (р&lt;0.05 vs. baseline). In group 2 - 35.8/36.8/40.0/51.6*/57.9*% of patients (р&lt;0.05 vs. baseline). In group 3 25.5/28.2% of patients achieved target LDL level at baseline/12mo, respectively. The significant decrease in LDL cholesterol levels between baseline and 12mo values was observed in groups 1 and 2 (p &lt; 0.05). No differences were observed in group 3.
Conclusion. The groups of patients receiving remote monitoring or care with outpatient visits demonstrate the same increase in the proportion of patients that achieved target LDL cholesterol levels within 12 months after CS. The remote monitoring is a safe strategy for improving and maintaining the adherence to statins in patients after CS.
Long-term prognosis after percutaneous or surgical revascularization in patients with diabetes mellitus and complex coronary artery disease- a systematic review and meta analysis
Authors: Abdul Razzack A , Mandava S , Pothuru S , Adeel Hassan S , Missael Rocha Castellanos D , Fernando Perez Paz M , Alsonso Elizarraras Aldrete O , Theja Reddy K , Sattar Y 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background-Whether Coronary artery bypass grafting (CABG) confers a survival benefit in patients with diabetes mellitus(DM) and complex coronary artery disease (CAD), including left main CAD and multivessel coronary disease (MVD) after a follow up period ≥ 5 years remains unknown.
Methods- Electronic databases (PubMed, Embase, Scopus, Cochrane) were searched from inception to December 12th 2020. Using a generic invariance weighted random effects model, Hazard ratios (HRs) and their 95% confidence intervals (CIs) from individual studies were converted to Log HRs and corresponding standard errors, which were then pooled. The primary outcome of interest was all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE) which was defined as a composite of death, myocardial reinfarction and stroke at ≥ 5 years.
Results-A total of 8 studies with 13336 participants(PCI = 6783, CABG = 6553)were included in our analysis. Mean age was 54.6 and 55.3 in the PCI-DES and CABG groups respectively. The 5-yr follow-up outcomes including all-cause mortality (HR 1.37; 95%CI 1.15-1.65; p = 0.0006, I2 = 0)and MACCE (HR 1.48; 95%CI 1.29-1.69; p &lt; 0.00001, I2 = 0) were significantly higher with PCI as compared to CABG. Furthermore, at &gt;5 year follow-up, all-cause mortality (HR 1.35; 95%CI 1.10-1.66; p = 0.004, I2 = 37) and MACCE (HR 1.98; 95%CI 1.85-2.12; p &lt; 0.00001, I2 = 0) had similar outcomes.
Conclusion-Amongst patients with DM and Complex CAD ( left main/MVD), CABG was associated with improved long-term mortality and freedom from MACCEs as opposed to PCI-DES. CABG is the preferred revascularization strategy in patients with complex anatomic disease and concurrent diabetes.
Abstract Figure.