bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of hybrid telerehabilitation and telecare in heart failure patients with implanted left ventricular assist device LVAD
Authors: Piotrowicz E , Kowalik I , Chwyczko T , Piotrowicz R 
Published: October 2024

Abstract

Background
Left ventricular assist device (LVAD) implantation is increasingly used as a treatment option for patients with advanced heart failure (HF). There is a need to provide patients with LVAD with long-term care, preferably at home. The implementation of home-based telerehabilitation (HTR) and telecare offers new opportunities in this field.

Purpose
The purpose of this study was to assess feasibility and safety of HTR and telecare in HF patients with implanted LVAD and evaluate patients’ acceptance of and adherene to HTR.

Methods
The study enrolled 30 HF patients with recent implanted LVAD (21 Heart Mate III, 9 Heart Ware) (29 males, 19–67, mean 59 years) who underwent a 12-week telecare and HTR program based on walking, respiratory and resistance training, five times weekly. HTR was telemonitored with a device adjusted to register electrocardiogram (ECG) recording and to transmit data via mobile phone network to the monitoring center. The moments of automatic ECG registration were pre-set and coordinated with exercise. The influence on physical capacity was assessed by comparing changes in peak oxygen consumption (VO2 peak; [ml/kg/min]) and workload duration (t; [sec]) in cardiopulmonary exercise test.

Results
HTR resulted in a significant physical capacity improvement pVO2 12.5±2.9 vs 15.1±3.0 (p&lt;0.001), and workload duration t 628±204 vs 728±222 (p&lt;0.001) in cardiopulmonary exercise test. There were neither deaths nor adverse events during HTR. Patients accepted HTR, including the need for interactive everyday collaboration with the medical team from monitoring center. All patients completed HTR.

Conclusions
HTR is a feasible, safe form of rehabilitation, well accepted by patients. The adherence to HTCR was high.
Associated factors and percentage of cardiac recovery among patients using LVAD: a meta-analysis of 31 studies
Authors: Hasabo E A , Isik B , Bakr M S , Eljack M M F , Neirokh D , Nosir M Y , Ayhan C , Alzomor H , Sawabi R , Sultan S , Caliskan K , Soliman O 
Published: October 2024

Abstract

Introduction
Patients with advanced heart failure use left ventricular assist devices (LVAD) to improve their outcomes and enhance the reverse remodeling of the heart. There has been no previous meta-analysis on the percentage of cardiac recovery after LVAD. This study aims to find the pooled percentage of cardiac recovery after LVAD.

Methods
A systematic search was done in PubMed, Scopus, Web of Science, Embase, and Cochrane from inception to December 2023. We used the relevant keywords to include studies that reported the percentage of people who achieved cardiac recovery after LVAD. The percentage of participants using LVAD and achieving cardiac recovery was extracted from the studies. RevMan 5.4 was used for meta-analysis.

Results
Thirty-two studies totaling 39215 patients were included. Different types of LVAD were used among participants. Across studies, different definitions for cardiac recovery were used, and the most used one is device explant following cardiac recovery and achieving left ventricular ejection fraction (LVEF) ≥ 40% after using LVAD. The pooled percentage of people who achieved cardiac recovery was 5.06%, 95% CI [4.17, 5.95], and the result was heterogeneous (I2 = 94%, p &lt; 0.00001).
Shorter duration of heart failure, female gender, younger age, presence of Implantable cardioverter-defibrillator (ICD) and low left ventricular end-diastolic diameter (LVEDD) were the most common mentioned factors associated with cardiac recovery.

Conclusion
Low cardiac recovery was found in patients using LVAD, and several factors were associated with cardiac recovery. Further action could be taken to improve the recovery among this population.
National trends of left ventricular assist device therapy in Germany
Authors: Seoudy H , Voran J C , Frank J , Kreidel F , Panholzer B , Huenges K , Lutter G , Sommer W , Warnecke G , Frank D 
Published: October 2024

Abstract

Background
The prevalence of advanced heart failure (HF) is increasing and prognosis remains poor. Although heart transplantation is still considered to be the gold standard for the treatment of advanced HF in selected patients, its use is limited by organ donor shortage and a growing burden of cormorbidities among potential recipients. The 2021 European Society of Cardiology (ESC) guidelines recommend consideration of long-term mechanical circulatory support with a left ventricular assist device (LVAD) in eligible patients with advanced heart failure (HF) who are refractory to medical/device therapy.

Purpose
The purpose of this study was to evaluate the national trends of LVAD in Germany. The main hypothesis was that LVAD therapy is still underutilized.

Methods
From the national database of the German Federal Statistical Office (DESTATIS), we identified all patients who underwent LVAD implantation in Germany between January 2011 and December 2022 (n = 9,232). We compared temporal trends and in-hospital outcomes.

Results
From 2011 to 2022, number of LVAD implantation was highest in the year 2017 (n = 914) and steadily decreased over the following years (2022: n = 617). Mean age of LVAD recipients was 56.2 years (2011-2015) and increased to 58.4 years (2020-2022). The majority of LVAD recipients are male (84,8 %), and this trend has been stable during the entire time period. In-hospital mortality after LVAD remains high, but has been decreasing (25.8% during 2011-2015 compared to 20.2% during 2020-2022).

Conclusion
Although LVAD is recommended in eligible patients with advanced HF, our study suggests an underutilization of LVAD in this patient population and especially in female patients.
Left atrial strain is associated with cardiovascular outcomes in children with congenitally corrected transposition of the great arteries
Authors: Iturralde Chavez A , Stephens S , Pignatelli R H , Penny D J , Doan T T 
Published: October 2024

Abstract

Background
The assessment of the systemic right ventricular (sRV) function in congenitally corrected transposition of the great arteries (ccTGA) by echocardiography is restricted by its complex geometry.

Purpose
To determine the utility of left atrial strain (LAS) and sRV longitudinal strain (sRV-LS) in the prediction of outcomes in children with ccTGA.

Methods
This nested case-control study included all patients &lt;21 years old with unrepaired ccTGA at our tertiary pediatric institution who had an echocardiogram prior to cardiovascular outcomes (milrinone-dependent heart failure, ventricular assistant device, heart transplant or death). LAS (both R wave and P wave references) and sRV-LS were measured using TomTec AutoStrain. To account for potential confounders, cases and controls were matched (1 cases vs 3 controls) by age ± 1 year and tricuspid regurgitation (TR) severity (none/mild vs. moderate/severe). Univariable conditional logistic regression was employed to assess the association between LAS and sRV-LS with outcomes among matched patients.

Results
Of 101 patients (64% male) with echocardiogram performed at 1.78 years old (IQR 0.02, 9.80), 14 (14%) developed an outcome. Baseline characteristics, LAS, and sRV-LS are depicted in Table 1. LAS and sRV-LS were not discriminative between age-matched cases and controls. In the matched cases and controls for TR severity, each unit-increase in LAS conduit phase (LAScd R and LAScd P) was associated with 18% and 22% higher odds of outcomes respectively, although these did not achieve statistical significance (LAScd R OR 1.2, 95% CI 1.0-1.4, p=0.09; LAScd P OR 1.2, 95% CI 1.0-1.5, p=0.08, Table 2).

Conclusions
After controlling for TR severity as a potential confounding factor, the conduit phase of LAS by both R wave and P wave references may have clinical implications as predictors of cardiovascular outcomes in patients with ccTGA. Larger and more well-powered studies are needed to further evaluate this association and studying longitudinal changes in LAS may provide insight in the development of outcomes in this population.
Outcomes of bariatric surgery in obese patients with heart failure:a meta-analysis
Authors: Ahmed H , Mahmoud Ismayl M I , Manvir Mangat M M , Anirudh Palicherla A P , Thomas Rees Checketts T K , Rama Ellauzi R E , Ahmed El-Shaer A E , Jalal Dufani J D , Ahmed Aboeata A A , Nandan Anavekar N A , Andrew Goldsweig A G 
Published: October 2024

Abstract

Background
Patients with heart failure possess an increased risk for adverse outcomes with noncardiac surgery (1). While bariatric surgery is frequently performed in patients with obesity, there remains a limited understanding of the impact of bariatric surgery in obese patients with heart failure.

Purpose
The purpose of this study was to compare outcomes of bariatric surgery versus nonsurgical management in obese patients with heart failure.

Methods
We searched PubMed, EMBASE, and the Cochrane Library, through February 2024, for studies evaluating outcomes in obese patients with heart failure who underwent bariatric surgery compared to nonsurgical management. Outcomes assessed were postoperative atrial fibrillation, all-cause mortality, and hospital readmission. We used a fixed-effect model to calculate hazard ratios (HR) with 95% confidence intervals (CI) in R studio for outcomes assessed. In outcomes where significant heterogeneity was found (P&lt; 0.05 and I2 &gt; 60%), a random effects model was used.

Results
A total of 3 studies were identified, consisting of 260,186 patients. Compared to nonsurgical management, bariatric surgery was associated with a significant reduction in postoperative atrial fibrillation (HR 0.72; 95% CI: 0.62-0.84), all-cause mortality (HR 0.50; 95%CI 0.35-0.72), and hospital readmission (HR 0.73; 95% CI 0.69-0.78) in obese patients with heart failure.

Conclusion
Our study suggests that bariatric surgery significantly reduces post-operative atrial fibrillation, mortality, and hospital readmission among obese patients with heart failure.Our findings demonstrate that bariatric surgery should be considered as a viable intervention in obese patients with heart failure. Further studies are warranted to confirm our findings.Forest Plots of Outcomes Assessed
Metabolic profiling in new on-set non-ischemic dilated cardiomyopathy
Authors: Chen X , Kang Y U , Yang Z X , Zhang Q 
Published: October 2024

Abstract

Background
Dilated cardiomyopathy is known as the most common cardiomyopathy with no therapy directly targeted the pathogenesis. The metabolic is a promising tool for better understanding of the difference in metabolites between health and disease and offering therapeutic targets, but the understanding of the specific metabolic processes distinguishing new on-set DCM from normal individuals remains insufficient.

Aim
To investigate the targeted blood metabolic profiling distinctions between new on-set Dilated Cardiomyopathy (DCM) and normal group.

Methods
We analyzed 231 plasma metabolites by liquid chromatography ⁄ mass spectroscopy and gas chromatography ⁄ mass spectroscopy in 48 patients with new on-set DCM(the duration of DCM diagnosis was less than 6 month before enrollment) and 48 age-, sex- and body mass index-matched normal controls.

Results
Twenty-four metabolites were significantly different between DCM and control individuals when adjusted by sex, age and smoking [false discovery rate (FDR) &lt; 0.05]. Plasma levels of guanidinoacetate, hypoxanthin were reduced while levels of 6-methyladenosine, 1-methyladenosine and others were increased in patients with DCM when compared to controls (figure 1), while Taurine, L-kynurenine and Methylmalonate were the most significant metabolites between the two groups (figure 2) .

Conclusions
Metabolic processes were strongly enhanced in DCM and may be used to distinguish new on-set DCM from normal individuals. And it identififies biologically active metabolites that could serve as markers of New-onset DCM and impart protective or harmful effects on cardiac structure and function.
Differences in clinical features of patients with heart failure and reduced, mildly reduced, and preserved ejection fraction in a contemporary cohort: is the clinical profile changing?
Authors: Anguita Gamez M , Gonzalez Manzanares R , Bonilla Palomas J L , Recio Mayoral A , Cequier Fillat A , Muniz Garcia J , Rodriguez Padial L , Romero Rodriguez N , Elola Somoza F J , Anguita Sanchez M 
Published: October 2024

Abstract

Introduction
Heart failure is a serious health problem and continues to have a high mortality and incidence of decompensations, despite advances in its management. The type of HF, defined by the LVEF value, has a great influence on treatment, since not all drugs and procedures have been shown to improve prognosis in the different subtypes of HF (reduced-HFrEF, mildly reduced-HFmrEF, and preserved-HFpEF). In addition, there are differences in clinical characteristics and comorbidities that may also influence these aspects, although the demographic and social changes that have occurred in recent years may have changed this perspective.

Purpose
To analyze in a contemporary registry of HF patients followed in specialized HF units in Spain the differences in clinical and demographic characteristics and comorbidities among the three subtypes of HF.

Methods
We analyzed data from the registry of the SEC-Excelente-IC quality accreditation program of the Spanish Society of Cardiology, with 1716 patients with HF included between 2019 and 2021 by 45 specialized HF units accredited by the SEC. Patients were included consecutively in two 1-month cutoffs (March and October) in that period. The clinical and demographic characteristics and comorbidities of the patients were compared according to the type of HF.

Results
Of the 1716 patients, 55.5% were HFrEF, 11.9% HFmrEF and 32.6% HFpEF. Figure 1 shows the main demographic and cardiovascular characteristics of the three subgroups. The median LVEFs were 30% (23-35), 45% (42-48) and 58% (53-65), respectively. Figure 2 shows the prevalence of major comorbidities. Patients with HFpEF were older and female in higher proportion, and presented a significantly higher prevalence of atrial fibrillation, valvular heart disease, obesity, hypertension, and anemia. Patients with HFrEF had a higher prevalence of coronary artery disease, smoking, admissions for HF in the previous year, and left bundle branch block. There were no differences between the three groups in the remaining comorbidities, including chronic kidney disease and chronic respiratory diseases. The characteristics of HFmrEF were intermediate between HFrEF and HFpEF (figures 1 and 2).

Conclusions
In our contemporary cohort of real-life HF patients, slight differences were observed between the 3 types of HF, particularly in relation to age, proportion of women, and prevalence of cardiac diseases. However, the prevalence of most of the major comorbidities did not show significant differences between the 3 groups, suggesting that a shift toward greater similarity in clinical characteristics between the 3 types of HF may be occurring.
Non-linear causal effects of kidney function on the risk of heart failure: a Mendelian randomization study
Authors: Liu J , Huang H , Lu X , He Y , Chen S , Wu W , Liang G , Zhou Y , Chen J , Tang N , Liu Y 
Published: October 2024

Abstract

Background
Kidney insufficiency is defined as the early stage of heart failure, but Mendelian randomization (MR) analyses based on several large heart failure cohorts suggest no linear causal effect between kidney function and heart failure (HF), inconsistent with observational studies evidence. However, whether there is a non-linear causal relationship between kidney function and HF has not been reported.

Methods and Results
Observational and non-linear MR analyses were performed using individual-level data from a UK Biobank cohort of white British ancestry subjects (N = 386,304). There were non-linear observational associations of between kidney function as assessed with estimated glomerular filtration rate (eGFR) and HF (P for nonlinear &lt;0.001). Non-linear MR analyses showed a U-shaped association between genetically predicted eGFR values (both creatinine- and cystatin C-based eGFR) and the risk of HF (Quadratic P value &lt; 0.05) and the risk of HF increased with both reduced and supranormal eGFR levels (β1 = -1.70E-05, P1-value = 0.004; β2 = 3.56E-06, P2-value = 0.004).

Conclusion
This study observed a non-linear U-shaped genetic relationship between eGFR and HF outcomes, indicating that both reduced and supranormal eGFR may be causally linked to a higher risk of HF.Central Illustration
Development and validation of a predicting model for risk of rehospitalization within 30 days in heart failure patients with preserved ejection fraction
Authors: Zhu Y L , Liu Z C , Huang H B , Wu M X , Zhang L L , Liao M , Zhao W J , He W F , Tan D , Zeng J P 
Published: October 2024

Abstract

Objective
This study aimed to develop and validate a predicting model for risk of rehospitalization within 30 days post discharge in patients diagnosed with Heart Failure with Preserved Ejection Fraction (HFpEF).

Methods
Clinical data of 9555 HFpEF patients registered in the heart failure registry from 2014 to 2022 at our hospital were analyzed. A total of 8160 patients (from 2014-2021) were designated as the training set, and 1395 patients (from 2022) as the validation set. A predictive model was established based on risk factors associated with 30-day rehospitalization due to heart failure identified by the Least Absolute Shrinkage and Selection Operator (LASSO) regression and logistic regression analysis. The model's stability was ensured through Bootstrap internal validation and Temporal validation external validation.

Results
LASSO and logistic regression analyses identified eight risk factors associated with increased risk of 30-day rehospitalization, including New York Heart Association (NYHA) classification, albumin, c-reactive protein, N-terminal pro b-type natriuretic peptide (NT-proBNP) divided by 100, anemia, pleural effusion, atrial fibrillation, and pulmonary hypertension. The established predictive model demonstrated good discriminative ability in the internal validation with an Area Under the Curve (AUC) value of 0.714, and a 95% confidence interval (CI) of 0.693-0.736 after 500 Bootstrap replicates. In the Temporal validation external validation, the model exhibited robust stability with an AUC value of 0.740 and a 95% CI of 0.693-0.781. When compared to analogous models from prior studies, present model showcased superior predictive accuracy in that both Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI) values were positive and within their respective 95% confidence intervals (P-values &lt;0.05).

Conclusion
This study successfully developed and validated a predictive model for 30-day rehospitalization due to heart failure in patients diagnosed with HFpEF. This model might allow the timely identification of high-risk HFpEF patients for 30-day rehospitalization due to heart failure and optimizes the patient management accordingly.
Phenotype of patients with severe aortic stenosis and small aortic annulus: how does it impact on hemodynamics and on transcatheter aortic valve implantation outcomes
Authors: Niro L , Danojevic S , De Raffele M , Ferrer-Sistach E , Teis A , Vilalta V , Fernandez-Nofrerias E , Carrillo-Suarez X , Bayes-Genis A , Delgado V 
Published: October 2024

Abstract

Background
Discordant grading of severe aortic stenosis can result from a tight aortic valve area (&lt;1cm2) with a low transvalvular mean gradient (&lt;40 mmHg). Small aortic annulus dimensions and low flow status may contribute to discordant grading of severe aortic stenosis. However, the frequency of patients with small aortic annulus and discordant grading, along with their characteristics and outcomes after intervention, remains unknown.

Purpose
To investigate the frequency of discordant grading severe aortic stenosis in patients with a small aortic annulus and to evaluate their clinical characteristics, as well as outcomes after transcatheter aortic valve implantation (TAVI).

Methods
Patients with an aortic annulus diameter &lt; 23 mm determined by cardiac computed tomography who underwent TAVI between 2018 to 2023 were retrospectively evaluated. Patients were followed for the occurrence of the composite endpoint of of all-cause mortality, rehospitalizations for heart failure, non-fatal myocardial infarction, and non-fatal stroke.

Results
Among 230 patients with severe aortic stenosis and a small aortic annulus, 52 (23%) had discordant gradient (24 with low flow low gradient (LFLG) and 28 with normal flow low gradient (NFLG)) while 120 (52%) exhibited normal flow high gradient (NFHG) and 58 (25%) had low flow high gradient (LFHG). The majority of the patients were female (Table 1). Differences were noted among the three groups regarding aortic transvalvular gradients, stroke volume index and ejection fraction. During a median follow-up of 2 years, the composite endpoint occurred in 20% of the total cohort. Patients with discordant grading severe aortic stenosis experienced the worse outcome (Figure1).

Conclusions
Most patients with severe aortic stenosis and small annulus have high gradient and only 23% of patients presented discordant grading. Patients with discordant grading severe aortic stenosis showed worse outcomes, suggesting potential delays in referral due to challenges in diagnosing severe aortic stenosis among patients with small aortic annulus.Basal clinical characteristicsKaplan-Meier survival curves