bluuebunny/crossref_metadata_2025_split huggingface dataset:
A novel device for electrocardiographic imaging
Authors: Galizia Brito V , Gallego Sanchez V , Pozo Ocampo F , Gallego Bravo P , Exposito Pineda C , Grande Morales C , Torrebella Segui J , Datino Romaniega T , Cabrera Rodriguez J A 
Published: October 2024

Abstract

Background
Electrocardiographic imaging (ECGi) is a non-invasive imaging tool that allows 3D visualization and characterization of the electrical activity of the heart from measurements on the body surface by solving the so called "inverse problem of electrocardiography". This method helps overcome the limitations of the conventional12-lead ECG in diagnosing and locating heart arrythmias. We developed a textile 34-electrode imageless device (with no need for MRI or CT-scan).

Purpose
We aim to evaluate the feasibility and safety of the use of a novel textile imageless 34-electrode device for recording ECGi for identification of electrical activity of the heart.

Methods and results
The performance of a prototype data acquisition system (DAS) was evaluated in 158 individuals. Tests were conducted in three hospitals. The mean age was 43.32 years old (±17.44); mean height 167.31cm (±18.33); mean weight 70kg (±15.68). Almost 88% of the patients were in sinus rhythm. The relative frequencies of the targeted pathologies are listed in Figure 1. The collection of cardiac signals and posterior representation in virtual reality of a stereoscopic, holographic 3D-360º map, was achieved in 100% of the patients. Figure 2 shows the textile hardware with the silver dry electrodes and a screenshot of the software with an example of a voltage map in a patient in sinus rhythm. There were no adverse effects reported. The DAS is composed of 34 electrodes, being their distribution representative of the electrical activity on the torso. Several studies have discussed the minimum number of electrodes on the torso of the patient required to characterize the heart potentials from the electrical potentials on the torso surface through the inverse problem (1,2). We highlight that the representativeness condition of the electrical activity on the torso is crucial to appropriately estimate cardiac activity with the minimum number of leads on the DAS.

Conclusion
The use of a novel textile imageless 34-electrode device for recording ECGi for identification of electrical activity of the heart is feasible and safe.Targeted rhythmHardware and software
Cardiovascular mortality rate between 2018 and 2022 in Kyrgyz Republic
Authors: Abdurasulova A , Habib Beigh H , Abibillaev D , Kydyralieva R 
Published: October 2024

Abstract

Background
Cardiovascular diseases (CVD) are the number one cause of death in low- and middle-income countries (LMICs), including Kyrgyz Republic. According to official statistics, CVD ranks first in the structure of overall mortality, accounting for more than half (52.1% according to 2022 data) of all deaths.

Purpose
to analyze the cardiovascular mortality rate in the Kyrgyz Republic, from 2018 to 2022.

Methods
Medical and statistical information on mortality from CVD in the population was obtained from the Centre for Electronic Health (CEH) of the Ministry of Health. To conduct a comparative analysis, relative indicators per 100 thousand population were calculated. A retrospective epidemiological study of mortality from CVD including different nosological forms over period for 2018–2022 was conducted, calculating the rate of increase (decrease). An analysis of the epidemiological situation of the disease in nine administrative-territorial units of the Kyrgyz Republic was also carried out with the calculation of the average 5-year mortality ratefor the period from 2018 to 2022.

Results
Despite the decrease in morbidity, a high proportion of mortality from CVD remains in all years, more than 50%. In terms of the percentage indicator for recent years, all this time it has maintained the highest position, in contrast to diseases of other organs and systems. In the last decade, from 2012 until 2020, there was a gradual decrease in the mortality rate. Since 2020, we have seen a sharp increase in the CVD mortality rate per 100 thousand population by 19.6% compared to 2018, by 19.4% since 2019, which is associated with the influence of Covid-19 pandemic, in 2021 this indicator amounted to 297.6 cases, in 2022 - 234.5. The main contribution to population death from CVD is made by coronary heart disease (65.90%), including acute myocardial infarction, cerebrovascular diseases (21.4%), arterial hypertension (5.9%). If we analyze the mortality rate from CVD by nine administrative-territorial units, the highest rates in 2022 are observed in the Chui and Talas regions, 291.9 and 266.3 per 100 thousand population respectively; the lowest in the Osh region (207.3), Osh city (196.1) and Bishkek (208.6), which is explained by the better organization of health services in these areas.

Conclusion
CVD remains the main cause of mortality in the population of the Kyrgyz Republic. Although over the past year there has been a good decline in this indicator, in almost all regions, particularly the greatest successes have been achieved in Naryn and Issyk-Kul regions. In connection with the above, there is requirement for a clear identification of priorities when determining the strategy of treatment and preventive interventions. It is necessary to create an effective National system of care for patients with CVD with a focus on emergency cardiac care and prevention issues.
Cardiovascular risk factors and disease mortality among asian american subgroups
Authors: Aggarwal R , Wadhera R , Szarek M , Bhatt D 
Published: October 2024

Abstract

Background
Asian Americans are the fastest growing racial group in the United States. Although Asian subgroups have distinct cardiovascular (CV) risk profiles, they are often aggregated together for public health surveillance.

Purpose
We provide the first comprehensive national estimates of CV and CV risk factor mortality in Asian American subgroups to assess differences in CV risk.

Methods
We used CDC WONDER, which captures all death certificates in the US (2018-2020), as well as the American Community Survey for demographic data. Adults aged ≥18 years were included. Estimates of age-adjusted overall CV mortality, as well as heart disease, hypertension, and stroke-related mortality, were determined by ICD-10 codes. To compare the contribution of each cause of mortality among subgroups with different baseline all-cause mortality rates, proportional mortality rates were determined by race. Proportional mortality was defined as the mortality rate of each condition divided by the all-cause mortality for that race group. Differences in proportional mortality by race and ethnicity, compared with White American adults, were assessed with age-sex adjusted linear regression.

Results
The US population consisted of 12,950,565 Asian Americans (53.7% female). Among the Asian American subgroups, 25.4% were Asian Indian, 28.5% Chinese, 19.7% Filipino, 5.3% Japanese, 9.6% Korean, and 11.8% Vietnamese. A total of 160,282,147 adults were White. Age-adjusted baseline mortality rates are shown in the Table.
Compared with White adults, Asian Indian (34.5% vs 29.3%; adjusted difference 5.2%, [95% CI: 1.8%, 8.6%], P=0.009) and Filipino (32.8% vs 29.3%; adjusted difference 3.5%, [95% CI: 0.1%, 6.9%], P=0.04) adults had significantly higher proportional mortality from all CV causes. Asian Indian (26.0% vs 22.6%; adjusted difference 3.2%, [95% CI: 0.3%, 6.2%], P=0.04) adults had higher proportional mortality from heart disease than White adults, while Korean (17.3% vs 22.6%; adjusted difference -5.2%, [95% CI: -8.1%, -2.2%], P=0.01) and Vietnamese (17.5% vs 22.6%; adjusted difference -5.1%, [95% CI: -8.0%, -2.1%], P=0.01) adults had lower proportional mortality.
Every Asian American subgroup had higher proportional mortality from hypertension causes compared with White adults, except for Asian Indians (Figure). In addition, every Asian American subpopulation had higher proportional mortality from stroke compared with White adults (Figure).

Conclusions
CV risk factor and disease-related mortality varies substantially among Asian American subgroups. Public health efforts targeted to address CV health disparities among the diverse group of Asian Americans are needed.
Environmental impact analysis of ajmaline challenge protocols: a comparative assessment of carbon footprint reduction in Brugada Syndrome diagnosis
Authors: Oliveira C , Tinoco M , Calvo L , Santos L , Pinho A , Moreira H , Palma P , Rocha M , Marques C , Cabrita A , Pestana G , Madeira M , Adao L , Lebreiro A 
Published: October 2024

Abstract

Background
Climate change is an urgent public health crisis that significantly impacts disease development and health outcomes. The 2022 Lancet Countdown Report revealed that healthcare contributes with 5.2% of global emissions, prompting a call for environmentally conscious approaches. In this context, we explored the environmental impact of different ajmaline challenge protocols, aiming to contribute to a more sustainable medical landscape.

Purpose
This study aims to compare the carbon footprint of two ajmaline challenge protocols commonly used in diagnosing Brugada syndrome, an inherited cardiac disorder associated with sudden cardiac death.

Methods
We performed a retrospective and observational analysis of adult patients (pts) who underwent ajmaline testing between March 2020 and June 2023 in two hospitals. In Group A (infusion protocol), 1mg/kg of ajmaline diluted in 50 mL of 5% glucose solution was infused in 10 minutes, up to the target dose, until a positive result or termination criteria ensued. In Group B (bolus protocol), 10 mg of ajmaline were administered every 2 minutes, again up to the target dose of 1mg/kg (maximum of 100 mg) or test interruption was indicated. Greenhouse gas emissions resulting from material processing were estimated based on life cycle analyses of each product's composition. Material consumption, waste production, and direct measurement of weights were considered.

Results
A total of 101 pts were included, 49 pts in group A with a mean age of 47.3±14.3 years old and 52 patients in group B with a mean age of 43.9±16.6 years-old. No complications were observed in either group. Test performance was not evaluated, since both protocols have been previously validated.
Group A, utilizing the infusion method, exhibited a higher environmental impact, producing 18.19 kg CO2eq, compared to 6.23 kg CO2eq (p&lt;0.001) in Group B (bolus protocol). Group B not only demonstrated a 66% reduction in CO2eq emissions but also used significantly less plastic (16g vs 102g per test) and glass (1.58 kg vs 1,79Kg), emphasizing its environmental superiority.

Conclusions
Shifting from infusion to bolus in ajmaline challenge protocols results in a substantial reduction in carbon footprint. Our findings emphasize the potential impact of adopting more dematerialized approaches in cardiac testing, urging healthcare professionals to embrace sustainable practices. Despite the study's limited sample size, the global adoption of such environmentally friendly strategies promises significant positive effects on healthcare's environmental footprint.
Gender disparities in short-term outcomes of STEMI patients: the influence of universal health coverage
Authors: Qalby N , Qanitha A , Arsyad D S , Appelman J E A , Cramer M J , Doevendans P A F M , Muzakkir A F 
Published: October 2024

Abstract

Background
Even after the event, individuals recovering from ST-elevation myocardial infarction (STEMI) face lingering risks, including potential subsequent events and mortality. The introduction of Universal Health Coverage (UHC) seeks to enhance healthcare outcomes for all segments of the population.

Purpose
This study evaluates the effect of UHC on 30-day mortality in post-STEMI patients, focusing on medication access and treatment disparities. Using a gender-stratified approach, we analyze changes before and after UHC implementation to provide insights into the difference in therapy between genders and how gender influences healthcare outcomes for post-STEMI patients.

Methods
Analyzing two cohorts, Cohort 1 (211 STEMI patients, 2013-2014 pre-UHC) and Cohort 2 (365 STEMI patients, 2018-2020 post-UHC), this study employed the chi-square test to determine differences between genders and the Kaplan–Meier log-rank test to compare survival rates.

Results
Comparing pre- and post-UHC, we observed a significant increase in both medication and reperfusion therapy (p&lt;0.001). However, even in both periods, women continued to have lower rates of medication and reperfusion compared to men (Men vs Women: Before UHC 14.3% vs 0%; After UHC 58.5% vs 47.9%). Within 30 days after the STEMI event, we noted a reduction in mortality rates across genders before and after UHC implementation, yet the decrease was less pronounced in women compared to men (Before UHC: Men 13.0%, Women 22.0%; After UHC: Men 8.2%, Women 18.3%).

Conclusion
UHC led to improvements in medication and reperfusion therapy for STEMI patients. Despite this progress, persistent gender disparities were observed, with women consistently having lower treatment rates. While mortality rates reduced for both genders, the decrease was less pronounced in women, especially after the implementation of UHC. These findings emphasize the need for targeted interventions to address gender-specific healthcare discrepancies within the scope of comprehensive health coverage.Baseline characteristicsMortality outcomes within 30 Days
The genetic architecture of exercise-induced ventricular ectopy
Authors: Van Duijvenboden S , Nicholson G , Smith-Byrne K , Portas L , Atkins J , Ramirez J , Orini M , Young W J , Tinker A , Lambiase P D , Munroe P B , Doherty A 
Published: October 2024

Abstract

Background
Previously, we have shown that the frequency of exercise-induced premature ventricular contractions (PVCs) during and after exercise are associated with increased risk of major adverse cardiovascular events in asymptomatic individuals from the UK Biobank study1. The underlying mechanisms are, however, unclear. Several electrocardiographic markers associated with arrhythmogenesis have a known hereditary component, but the genetic underpinnings of exercise-induced ventricular ectopy have not been investigated.

Purpose
Our aim was to explore the genetic basis of premature ventricular ectopy during and after exercise and unveil plausible candidate genes and biological mechanisms.

Methods
We conducted a genome-wide association study (GWAS) for PVC frequency during exercise and recovery in &gt;44,000 asymptomatic individuals of European ancestry without known cardiovascular disease from the UK Biobank study. As the distribution of PVC frequency is highly skewed (e.g. absence of negative values and excess of zero values), we first applied Gaussian transformation. Simulation studies were performed to justify that this approach would lead to valid inference. In the GWAS model, we included sex, age, UK Biobank genotyping array, and the first 10 genetic principal components as covariates. Statistical power was boosted by joint analysis of exercise and recovery PVC traits using multi-trait analysis of GWAS (MTAG)2. Genetic risk scores were constructed in independent samples from UK Biobank (N=341,948) and were tested for association with heart failure and life-threatening ventricular arrhythmias.

Results
We identified 4 loci for PVC frequency during exercise, and 1 locus for PVC frequency during recovery (Picture 1). Candidate genes included CRIM1, FLNC, and BAG3 for which mutations have been linked in the pathogenesis of (arrhythmogenic) cardiomyopathy. Subjects in the top 10% of the genetic risk scores had a significantly higher risk of heart failure and life-threatening ventricular arrhythmias compared to the bottom 90%, (odds ratio (OR) (95% confidence interval): 1.14 (1.08 – 1.20), p &lt; 0.001; and 1.13 (1.02 – 1.24), p &lt; 0.001, respectively).

Conclusions
Ventricular ectopic burdens during exercise and recovery have a significant heritable component. Candidate genes highlight a possible shared genetic background with inherited cardiomyopathy and a genetic risk score was associated with heart failure and ventricular arrhythmias. These findings substantial advance our understanding of the genetic basis of exercise-induced ventricular ectopy in a population-based cohort without cardiovascular disease.Miami plot of ventricular ectopic burden
Effects of the restrictive cardiomyopathy-associated cardiac troponin I K178E mutation on cAMP signalling at the myofilament
Authors: Gee Olmedilla M , Chao Y C , Zaccolo M 
Published: October 2024

Abstract

Background
Catecholaminergic stimulation of cardiac β-adrenergic receptors (β-ARs) and subsequent cAMP signalling control cardiac inotropy and lusitropy. cAMP signalling is known to be compartmentalised to optimise sympathetic control by producing heterogeneous cAMP signals and protein kinase A (PKA) activation at distinct subcellular sites. This signalling may be disrupted in diseases such as restrictive cardiomyopathy (RCM) characterised by diastolic dysfunction, which is associated with certain mutations including the K178E missense mutation in cardiac troponin I (TPNI). The impaired ventricular relaxation associated with this mutation is thought to arise from myofilament calcium hypersensitivity, which can be modulated by PKA-dependent TPNI phosphorylation. However, a detailed understanding of the pathological effects mediated by the K178E-TPNI mutation is lacking.

Purpose
This study aims to determine whether the K178E-TPNI mutation alters local cAMP/PKA signalling at TPNI, potentially affecting myofilament calcium sensitivity and cardiac myocyte relaxation.

Methods
Real-time imaging of cAMP was carried out using the Fluorescence Resonance Energy Transfer (FRET)-based sensor CUTie (cAMP Universal Tag for imaging experiments) [1] fused to wild type (WT)- or K178E-TPNI. The sensors were expressed by transfection in neonatal rat ventricular myocytes (NRVMs) and FRET-changes were recorded at the myofilament on application of the β-AR stimulant isoproterenol (ISO). We further assessed the involvement of cAMP hydrolysing phosphodiesterases (PDEs) in the regulation of cAMP levels selectively at TPNI.

Results
The peak FRET-change and FRET-change after 5mins on ISO application were significantly higher in NRVMs expressing the mutant compared to the WT sensor, as was the rate of cAMP accumulation. A strong trend showed that the rise in FRET following PDE4 inhibition was larger in NRVMs expressing the WT compared to the mutant sensor, suggesting the involvement of this isoform in degrading cAMP locally at TPNI and reduced PDE4 activity in the presence of the K178E mutation. Co-immunoprecipitation analysis in HEK293 cells demonstrated interaction between WT-TPNI and a PDE4D isoform, and a weaker interaction of this isoform with the K178E-TPNI mutant.

Conclusions
This study shows that the K178E-TPNI mutation attenuates the TPNI/PDE4D interaction and alters the magnitude and kinetics of the local cAMP response at the myofilament. This mechanistic insight may aid the development of therapeutics targeting the TPNI/PDE4D interaction to treat RCM-associated diastolic dysfunction.The TPNI-CUTie SensorFRET Response Trace
Comparison of ICD implantation approach in children. The IChilDren study
Authors: Cledel A , Maltret A , Waldmann V , Marquie C , Koutbi L , Jesel L , Bordachar P , Blangy H , Maury P , Martins R , Amedro P , Probst V , Gourraud J B 
Published: October 2024

Abstract

Background
Without dedicated device, implantable cardioverter defibrillators (ICD) implantation in children is a real challenge for physicians. Types of implantation include transvenous, surgical and subcutaneous-ICD approach, but with a lack of reliable data comparing their respective efficacy and safety.

Objective
We here aim to compare the results of these 3 ICD implantation approaches in children.

Methods
Consecutive children (&lt;16yo) implanted with an ICD from 2005 to 2021 in 19 french tertiary centers of the French Pediatric and Congenital heart disease network, were retrospectively enrolled in the study. The primary endpoints were the occurrence of lead failure, device infection or inappropriate shock.

Results
Among 306 patients (mean age 12,6 yo), 34% received a transvenous ICD, 28% a S-ICD and 38% a surgical ICD. During a median follow-up of 4.7 years, endpoints occurred in 24.2% of the total population, more often in the surgical group (p&lt;0.05). After adjustment for age, ICD type and stratification by heart disease, there was an excess risk of lead failure or infection with the surgical ICD compared with the S-ICD (HR 7.54, 95% CI 1.73;32.91, p&lt;0.05). However, when inappropriate shocks were included, the difference was reduced (HR 2.28, 95% CI 1.03;5.04, p&gt;0.05). In addition, no significant difference between transvenous and surgical ICDs was observed in the multivariate analysis.

Conclusions
We demonstrate a high rate of complication in children implanted with an ICD. The transvenous and surgical approaches are quite similar. S-ICD appears as a promising approach with the lowest serious adverse event rate. Limitation of inappropriate shock remain the main challenge of this technique.Late complications
Muscle RING-finger proteins (MuRF) regulate protein kinase A activity via retrograde vesicular transport of PKA RI-alpha
Authors: Li N , Hammer E , Li Y , Voelker U , Fielitz J 
Published: October 2024

Abstract

Background
Muscle RING finger (MuRF) proteins are muscle-restricted E3 ubiquitin ligases that control protein degradation in striated muscles. MuRF proteins have coordinate functions for maintenance of striated muscle structure and function that depends on their target proteins. MuRF1 is a key enzyme in muscle atrophy. MuRF2 and MuRF3 bind to and stabilize microtubules which affects striated muscle differentiation and contraction. Although some MuRF-interaction partners have been described only few have been proven to be targeted for proteasomal degradation. To better understand the function of MuRF proteins, we set out to identify and functionally characterize novel MuRF target proteins.

Methods and Results
Stable isotope labeling of amino acids in cell culture followed by affinity purification and quantitative mass spectrometry analysis (SILAC-AP-MS) was used to identify the interactome of MuRF proteins. We identified the mammalian retromer subunit sorting nexin 5 (SNX5) that is involved in subcellular trafficking as a novel MuRF2 and MuRF3 interaction partner. Coimmunoprecipitation experiments and immunocytochemistry confirmed physical interaction and colocalization between SNX5 and MuRF2 or MuRF3. The interaction domains were mapped. MuRF2, MuRF3 and SNX5 were colocalized to early endosomes at microtubules in myocytes. MuRF2 mediated the ubiquitin proteasome system-dependent degradation of SNX5 in a RING-finger dependent manner, whereas MuRF3 stabilized SNX5. Using mass spectrometry, we identified the regulatory subunit of protein kinase A (PKA-RI-α) as a cargo of SNX5 coated early endosomes in myocytes. CRISPR-Cas9 and siRNA experiments showed that SNX5 regulates PKA activity by stabilizing PKA-RI-α in myocytes. Deletion of SNX5 resulted in PKA activation and inhibition of the HDAC5-MEF2 axis that disturbed myogenic differentiation.

Conclusion
MuRF2 and MuRF3 play opposing roles in SNX5-mediated retrograde transport of early endosomes along microtubules in myocytes. This mechanism is involved in regulation of PKA catalytic activity via stabilization of PKA-RI-α and controls differentiation of striated muscles.