bluuebunny/crossref_metadata_2025_split huggingface dataset:
Environmental noise exposure is associated with one-year survival after a first myocardial infarction
Authors: Plomb M , Bernard N , Maza M , Pujol S , Diallo K , Chague F , Cottin Y , Mauny F , Zeller M 
Published: October 2024

Abstract

Introduction
Although several studies have shown a link between environmental noise exposure and risk of acute Myocardial Infarction (MI), only few studies have investigated its association with prognosis after MI. We aimed was to analyze the relationship between residential environmental noise exposure and one-year prognosis after a first MI.

Methods
This observational, longitudinal study was conducted from data collected by a French observatory (RICO) from 2004 to 2009. The outcome was defined by Major Adverse Cardiovascular Events (MACE). Medical data were collected from patients hospitalized for an acute MI from patients registered in the database between January 1st, 2004, and December 31st, 2008, with the following criteria: first MI, aged 18 years or older, with a valid home address and residing in a French urban unit, and who survived at least 28 days after the acute MI were included in the present study. Environmental noise and air pollutants exposure were considered at the residence of the patients. Noise exposure was quantified for two time periods: daily (LAeq,24h) and at night (Lnight) with an annual average. Two outdoor air pollutants were considered: nitrogen dioxide (NO2) and particulate matter with an aerodynamic diameter ≤ 10 µm (PM10). Air pollution exposure levels within the 30 days preceding a major cardiac event (MACE) were estimated. MACE were defined as cardiac death, re-hospitalisation for heart failure, recurrent MI, emergency revascularization, stroke, angina and or unstable angina

Results
Among the 864 subjects included, most were male (64%), the median age was at 69 y. Nineteen percent (N = 164) presented a MACE during the one year follow-up, and the most frequent were cardiac death (32%). For each 10 dB(A) increase during Lnight , the hazard ratio (HR) of MACE was 1.25 (95% IC 1.09 to 1.43), independently of air pollutants and other confounding. This effect was modified by age and gender. Conclusion and relevance: Our findings suggest for the first time a strong association between noise exposure, in particular during the night, and prognosis at one year after a first MI. If confirmed by larger prospective studies, our study could help to identify original opportunities for environment-based secondary prevention strategies.
Fear of recurrence and its association with mental health outcomes after spontaneous coronary artery dissection (SCAD)
Authors: Clarke S , Murphy B , Le Grande M , Rogerson M , Hesselson S , Iismaa S , Graham R , Hester R , Jackson A 
Published: October 2024

Abstract

Background
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction, predominantly affecting younger women with few traditional cardiac risk factors. The condition is characterised by relatively high rates of recurrence. Recent qualitative studies demonstrate that SCAD survivors often experience fears about the future, particularly relating to SCAD recurrence and death. Research in psycho-oncology demonstrates that experiencing fear of cancer recurrence predicts worse outcomes for mental health and quality of life, an association that is also likely in cardiac patients. To date, no quantitative research has investigated fear of recurrence and its association with mental health in SCAD survivors.

Purpose
The aim of this study was to investigate the prevalence of fears relating to SCAD recurrence and the association of fear of recurrence with mental health outcomes.

Methods
293 SCAD survivors completed an online questionnaire assessing the psychosocial impacts of SCAD. Participants rated whether they experienced these impacts ‘not at all’, ‘a small amount, ‘a moderate amount’ or ‘a large amount’ within the first six months of their SCAD. Items related to fears about the future, recurrence, and death were extracted for analysis. Participants also completed measures of anxiety (Generalised Anxiety Disorder-7), depression (Patient Health Questionnaire-9), distress (Cardiac Distress Inventory - Short Form), and mental health related quality of life (Short Form 12, mental health component).

Results
In the six months following their SCAD, 97.6% of survivors experienced some level of worry about having another SCAD, 95.6% were concerned about triggering another SCAD, 95.6% experienced fear of the future, and 82.6% experienced fear of dying. Reports of experiencing ‘a large amount’ of fear in these areas were 54.6%, 45.1%, 42.7%, and 30.4% respectively. The amount of worry reported about having another SCAD was significantly associated with increased levels of anxiety, depression, and cardiac distress, and reduced mental health quality of life.

Conclusions
Almost all SCAD survivors reported fears, worries, and concerns related to recurrence. Worry about SCAD recurrence was significantly associated with important mental health outcomes. Cardiac health professionals should monitor fears of recurrence in their patients, as a large amount of worry may be indicative of poor mental health, and referral to psychology services may be appropriate.Rates of fears of SCAD recurrence
Prognostic value of diffuse high-risk plaque in patients with acute myocardial infarction: a three-vessel optical coherence tomography study
Authors: Fang C , Zhao J W , Chen Y Z , Cui L N , Guo J Q , Wang Y N , Hou J B , Dai J N , Yu B 
Published: October 2024

Abstract

Background
Existing evidence has identified that high-risk plaque (HRP) characterized by a thin-cap fibroatheroma and/or a minimal lumen area ≤ 3.5 mm² were indicative of future cardiovascular events. Diffuse coronary artery disease also contributes to the poor prognosis.

Purpose
The present study aims to assess the prognostic value of diffuse HRP in patients with acute myocardial infarction (AMI) by using three-vessel optical coherence tomography (OCT).

Methods
A total of 674 patients with AMI who underwent OCT examination of three major epicardial arteries between January 2017 and December 2018 were consecutively studied. Among 2843 nonculprit lesions detected by OCT, 1375 (48.4%) HRPs were identified and divided into diffuse HRP group (lesion length &gt;20mm, n=443) and focal HRP group (lesion length ≤20mm, n=932). Patients were followed up for a median period of 5 years. Major adverse cardiovascular event (MACE) was defined as the composite of cardiac death, nonculprit lesion-related nonfatal myocardial infarction, and unplanned coronary revascularization.

Results
The average age of all enrolled patients is 56.7±11.4 years, with 74.9% of male. As compared with focal HRP group, diffuse HRP group had longer lesion length [25.8(23.0,30.8) mm vs. 13.2(9.8,16.1) mm, P&lt;0.001], longer lipid length [18.6(12.3,24.9) mm vs. 7.0(4.5,10.5) mm, P&lt;0.001], and thinner minimal fibrous cap thickness [73.3(53.3,106.7) μm vs. 93.3(60.0,130.0) μm, P&lt;0.001], whereas mean lipid arc was comparable between the two groups. The prevalence of nonculprit plaque rupture (14.2% vs. 7.8%, P&lt;0.001) was significantly higher in diffuse HRP group than that in the focal HRP group. Nonculprit lesions in diffuse HRP group had higher incidence of macrophage accumulation, microvessels, cholesterol crystals, calcification, and layered plaque phenotype than those in focal HRP group (all P&lt;0.001). The incidence of nonculprit lesion-related MACE was 4.7% in diffuse HRP group and 1.7% in focal HRP group [HR: 3.155, 95% confidence interval: 1.579 to 6.301, P=0.002].

Conclusions
In patients with AMI, diffuse HRP at nonculprit segment has higher levels of plaque vulnerability and is predictive of future adverse cardiovascular events. Further studies are warranted to investigate the individual treatment strategy of diffuse and focal HRP.Figure 1.Nonculprit plaque vulnerabilityFigure 2.MACE
Frailty and anticoagulant prescription in older hospitalized patients with atrial fibrillation: a multi-centred observational study
Authors: Nguyen T , Fujita K , Hilmer S 
Published: October 2024

Abstract

Background
Evidence of the impact of frailty on anticoagulant prescription in older people with atrial fibrillation (AF) is conflicting. Some studies suggested that oral anticoagulants (OACs) were underutilized in older people with frailty while others have not found this.

Aims
The primary aim of this study was to examine the prevalence of frailty in hospitalized older patients with AF and the association between frailty and OAC prescription during admission. The secondary aim was to examine the association between frailty and prescription of rate/rhythm control medications during admission.

Methods
This is a retrospective observational cohort study. Adults aged ≥65 years with AF admitted to six hospitals in Australia between 1 June 2022 and 31 August 2022 were eligible for this study. Frailty was defined by a Frailty Index constructed using information from the electronic medical records. Logistic regression models were applied to examine the association between frailty and the prescriptions of OACs, rate control drugs and rhythm control drugs during admission. Results are presented as odds ratios and 95% confidence intervals.

Results
A total of 685 patients were included in this analysis. They had a mean age of 82.6, and 49.8% were female. Using the cut-off point of 0.25, 42.8% of the patients were identified as being frail. Overall, 75.6% of the patients were prescribed OACs (67.9% in the frail compared to 81.4% in the non-frail, p&lt;0.001), 37.7% received rate control drugs (42.0% in the frail versus 34.4% in the non-frail, p=0.044), while 27.3% received rhythm control drugs (22.9% in the frail compared to 30.6% in the non-frail, p=0.024). The adjusted odds ratios of frailty on prescriptions during admission were 0.53 (95%CI 0.37 – 0.78) for OACs, 1.45 (95%CI 1.05 – 1.99) for rate control drugs, and 0.79 (95%CI 0.55 – 1.13) for rhythm control drugs.

Conclusion
Our study found a high prevalence of frailty in older inpatients with AF and frailty was associated with a reduced likelihood of receiving OACs. Further studies are needed to understand the reasons for under-coagulation in frail patients with AF.Prescriptions of OACs during admission
Characteristics associated with prevalent atrial fibrillation and risk profile for future atrial fibrillation among those in sinus rhythm in an elderly population in the ELSA Brasil Study
Authors: Pianca E G , Boccalon B , Foppa M , Pinto-Filho M M , Brant L C C , Ribeiro A L P , Duncan B B , Santos A B S 
Published: October 2024

Abstract

Background
Atrial fibrillation (AF) is an arrhythmia that can lead to limiting symptoms and increases the risk of stroke and heart failure (HF).

Purpose
To evaluate the association of clinical, electrocardiographic, and echocardiographic parameters with prevalent AF or flutter (AFF), and the risk profile for future AFF according to Charge-AF and EHR scores in an elderly population.

Methods
The ELSA-Brasil is a prospective cohort study designed to investigate cardiovascular disease and diabetes in 15,105 men and women, civil servants from universities or research institutions in six cities of Brazil. We included all participants in ELSA-Brasil aged 60 and over whose diagnosis of AFF could be assessed and had echocardiography performed at the study's baseline. From the initial sample with participants ≥ 60 years (n = 3,263), 400 participants were excluded due to missing data about AFF, and 775 who did not have echocardiographic studies.

Results
There were 88 (4.2%) participants with AFF at baseline among the 2,088 (65 ± 4.1 years; 53% women) included in this analysis. Those with AFF were older (66.8 ± 4.4 vs 65 ± 4.0 y-o) and had a higher prevalence of HF (16% vs 3.1%), previous myocardial infarction (14.8% vs 3.8%), left bundle branch block (LBBB: 4.6% vs 0,9%), prolonged QT interval (7.9% vs 2.0%), supraventricular extrasystoles (4.6% vs 1.2%), and sinus bradycardia (11.3% vs 2.9%). AFF individuals also presented larger left atrial volume index - LA (33.3 mL/m2 versus 27 mL/m2), left ventricular end-diastolic diameter (4,63 ± 0,6 cm versus 4,47 ± 0,4 cm) and lower left ventricular ejection fraction (LVEF: 63.6 ± 9.1% vs 67.4 ± 6.4%) that non-AFF (all p-values &lt;0.05). In multivariable analysis, prevalent HF, LBBB, larger LA, and lower LVEF were independently associated with the presence of AFF. Among those in sinus rhythm at study baseline, both risk models showed that most individuals in our sample were at low risk. In the Charge-AF, 63% of individuals were identified as presenting low risk (&lt;2.5%), and 12% of the sample was categorized as high risk, with a risk of five-year AFF greater than 5%. Similarly, in the EHR, 67% of participants were classified as low risk, and 13% were considered high risk.

Conclusion
We found that AFF was present in 4.2% of the subset of older participants in a cohort composed of free-living individuals in Brazil. The presence of AFF was associated with HF history, altered cardiac electrical activity, LA dilation, and worse LV systolic function. Among those with sinus rhythm, 12-13% were considered at high risk of developing AFF (&gt; 5% in five years) based on two clinical scores. Clinical surveillance and monitoring of electrocardiography and echocardiography parameters may help the early identification of risk factors for AFF.
Left atrial morpho-functional parameters and their correlation with other phenotypic and functional characteristics of hypertrophic cardiomyopathy
Authors: Pagourelias E , Boulmpou A , Kotzadamis D , Alexandridis G , Ntelios D , Papadopoulos C E , Vassilikos V P 
Published: October 2024

Abstract

Background
Left atrial (LA) volume index (LAVI), LA reservoir strain (LARS) and total atrial conduction time (TACT) (estimated by tissue Doppler imaging) are morphological and functional parameters reflecting LA structural and electrical remodeling, connected to atrial fibrillation development and heart failure progression in various substrates. In hypertrophic cardiomyopathy (HCM), correlation of the above-mentioned parameters with other disease characteristics is not fully investigated.

Purpose
Aim of this study was to estimate the prevalence of atrial myopathy characteristics such as increased LAVI, impaired LARS and elongated TACT in a cohort of HCM patients without AF history and investigate their correlation with other phenotypic and functional characteristics of the disease such as left ventricular (LV) hypertrophy magnitude, fibrosis extent and diastolic dysfunction grade.

Methods
We included 100 HCM patients (54±21 years, 75% male, maximum wall thickness 19±3.4mm) without history of atrial fibrillation who have consecutively undergone 2D-speckle tracking echocardiography and cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE). TACT and LARS measurement is shown on left panel. Burden of fibrosis (percentage of LV mass) was defined by LGE extent (&gt;5 standard deviations compared to nulled myocardium) in CMR slices.

Results
All HCM patients had preserved EF (60±7.5%), while 28 (28%) presented outflow tract obstruction and 10 (10%) diastolic dysfunction stage≥2. LGE was observed in 64 patients (64%) occupying 8±5% of left ventricular (LV) mass. Mean TACT was 140±22 msec, with LAVI being 32±16 mL/m2 and LARS 26±14%. Among HCM demographic, phenotypic and functional characteristics tested, age and LV mass index were found to be the only independent regressors of TACT (r=0.54, p&lt;0.0005 and r=0.44, p=0.002 respectively, right upper panel), while E/E’ (r=-0.44, p=0.003) and fibrosis extent (r=0.36, p=0.02) were the strongest predictors of LARS and LAVI values respectively (right lower panel).

Conclusions
Atrial myopathy parameters seem to correlate with various morphological and functional characteristics of HCM. Atrial electro-mechanical delay assessed through TDI based TACT correlates significantly with LVMI, whereas LARS and LAVI are strong regressors of elasticity properties, partially expressed through diastolic function and underlying fibrosis.
Pyroptosis is not likely to play a major role in anthracycline-induced cytotoxicity in H9c2 cardiomyocytes and human cardiac endothelial cells
Authors: Salim H Y , Yellon D M , Davidson S M 
Published: October 2024

Abstract

Background
Although anthracyclines are widely used as effective chemotherapeutic agents, anthracycline-induced cardiotoxicity (AIC) causes significant morbidity and mortality. The precise mechanism of AIC remains elusive, although apoptosis may be involved. Recent research suggests pyroptosis, a programmed lytic cell death pathway, might also contribute to AIC. Although studies have focused on AIC in the myocardium, emerging evidence suggests that AIC may also affect vascular cells. Furthermore, the cytotoxicity of doxorubicin (DOX) or its supposed active metabolite, doxorubicinol (DOXOL), has not been widely investigated in cardiac vascular cells.

Purpose
This study examines the hypothesis that pyroptosis plays a role in DOX and DOXOL cytotoxicity in H9c2 immortalised rat cardiac myoblasts and two types of human cardiac endothelial cells.

Methods
In vitro experiments were conducted to ascertain dose-dependent toxicity in H9c2, and cardiac endothelial cells following treatment with DOX or DOXOL.
The type of cell death was determined by assessing cell morphology and fluorescent staining with markers of apoptosis (Annexin V) and lytic cell death (Propidium Iodide PI) following DOX or DOXOL treatment in comparison to known inducers of pyroptosis (LPS & Nigericin).
Western blot experiments were conducted to study the expression of GSDMD (involved in pyroptosis), and caspase 3 (involved in apoptosis), following DOX or DOXOL. A human monocytic acute myeloid leukaemia cell line (THP-1 cells) was used as a positive control for pyroptosis.

Results
Dose-dependent cell death following DOX treatment was higher than with DOXOL in both H9c2 and cardiac endothelial cells. DOX caused apoptotic changes in all cell types. In contrast, DOXOL had weaker effects, inducing early apoptosis. No cleavage (activation) of GSDMD or caspase 3 was detected after DOX or DOXOL. Interestingly, in THP-1 cells, DOX induced predominantly apoptotic cell death, whereas DOXOL induced predominantly pyroptotic cell death, assessed both morphologically and by caspase 3 and GSDMD cleavage.

Conclusion
DOX and DOXOL primarily induce apoptotic cell death in H9c2 cardiomyocytes and cardiac endothelial cells. Interestingly, DOXOL, supposedly the active metabolite, was less cytotoxic than DOX. THP-1 cells undergo apoptotic or pyroptotic cell death with DOX or DOXOL, respectively. In conclusion, anthracycline-induced cytotoxicity is likely to be due to apoptotic injury rather than pyroptosis.
Safety and effectiveness of sodium-glucose co-transporter 2 inhibitors in active cancer patients with heart failure: results of the observational TOSCA trial
Authors: Canale M L , Fabiani I , Delle Donne M G , Barletta V , Capati E , Frediani L , Arena G , Chianca M , Zucchelli G , De Caterina R , Emdin M , Casolo G , Amoroso D , Allegrini G , Camerini A 
Published: October 2024

Abstract

Background
Sodium-glucose co-transporter 2 inhibitors (SGLT2i) currently represent a pillar of heart failure (HF) treatment. However, cancer patients have not been included in landmark randomized controlled trials (RCTs), and data on safety and effectiveness in this population are lacking.

Purpose
Purpose of present study was to evaluate safety and effectiveness of SGLT2i in active cancer patients with HF.

Methods
TOSCA is a multi-centre observational trial including patients (≥ 18 years) with active cancer (diagnosis &lt; 3 years) receiving SGLT2i for HF treatment. Patients were enrolled in two (prospective and retrospective) cohorts. The primary endpoint was safety (incidence of known and unexpected side effects). The secondary endpoint was effectiveness (ejection fraction (EF) increase, New York Heart Association (NYHA) class change, HF-related events). Exploratory endpoints included drug-drug interactions with anticancer and supportive care drugs, treatment of cancer therapy-related cardiac dysfunction (CTRCD), and changes in NT-proBNP.

Results
Eighty-three pts were enrolled (59 prospective - 24 retrospective). Median age was 71 (range 44-92) yrs, M/F 48/52%. The main cancer sites were breast, gastrointestinal tract, and hematological malignancies. Most cases (62%) received an active treatment (mainly chemotherapy) while on SGLT2i. Prevalent aetiology was drug-induced HF (37%) with reduced EF as the prevalent clinical presentation (39%). Prescribed agents were dapagliflozin in 60% and empagliflozin in 40% of cases on top of conventional guideline-directed medical therapy, with a median treatment duration of 3 (range 3-25) months. The incidence of urinary tract infection was 2.5%. No cases of genital infection, hypoglycemia, diabetic ketoacidosis, acute renal injury, thrombosis, and bone fractures were reported. Mean overall EF slightly increased (44.1% vs. 46.6%), and NYHA class improved (class improvement in 16%). Unplanned cardiology visits (1.2%), i.v. diuretics (1.2%), coronary angiography (5%), emergency access (2.5%), and new HF episodes (3.7%) rates were low. SGLT2i appeared effective in 31 cases of CTRCD. A relative reduction in mean NT-proBNP levels (2748 vs 1125pg/mL) was observed. No drug-drug interactions were reported.

Conclusions
SGLT2i appear to be safe and effective in active cancer patients with HF, with potential cardioprotective effect. No new safety warnings were recorded.