bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ventricular Tachycardia and Early Fibrillation in Patients With Brugada Syndrome and Ischemic Cardiomyopathy Show Predictable Frequency-Phase Properties on the Precordial ECG Consistent With the Respective Arrhythmogenic Substrate
Authors: Calvo David , Atienza Felipe , Saiz Javier , Martínez Laura , Ávila Pablo , Rubín José , Herreros Benito , Arenal Ángel , García-Fernández Javier , Ferrer Ana , Sebastián Rafael , Martínez-Camblor Pablo , Jalife José , Berenfeld Omer 
Published: August 2015

Background—
Ventricular fibrillation (VF) has been proposed to be maintained by localized high-frequency sources. We tested whether spectral-phase analysis of the precordial ECG enabled identification of periodic activation patterns generated by such sources.

Methods and Results—

Precordial ECGs were recorded from 15 ischemic cardiomyopathy and 15 Brugada syndrome (type 1 ECG) patients during induced VF and analyzed in the frequency-phase domain. Despite temporal variability, induced VF episodes lasting 19.6±7.9 s displayed distinctly high power at a common frequency (shared frequency, 5.7±1.1 Hz) in all leads about half of the time. In patients with Brugada syndrome, phase analysis of shared frequency showed a V
1
–V
6
sequence as would be expected from patients displaying a type 1 ECG pattern (
P
<0.001). Hilbert-based phases confirmed that the most stable sequence over the whole VF duration was V
1
–V
6
. Analysis of shared frequency in ischemic cardiomyopathy patients with anteroseptal (n=4), apical (n=3), and inferolateral (n=4) myocardial infarction displayed a sequence starting at V
1
–V
2
, V
3
–V
4
, and V
5
–V
6
, respectively, consistent with an activation origin at the scar location (
P
=0.005). Sequences correlated with the Hilbert-based phase analysis (
P
<0.001). Posterior infarction (n=4) displayed no specific sequence. On paired comparison, phase sequences during monomorphic ventricular tachycardia correlated moderately with VF (
P
<0.001). Moreover, there was a dominant frequency gradient from precordial leads facing the scar region to the contralateral leads (5.8±0.8 versus 5.4±1.1 Hz;
P
=0.004).

Conclusions—
Noninvasive analysis of ventricular tachycardia and early VF in patients with Brugada syndrome and ischemic cardiomyopathy shows a predictable sequence in the frequency-phase domain, consistent with anatomic location of the arrhythmogenic substrate.
Left Ventricular Systolic Dysfunction by Longitudinal Strain Is an Independent Predictor of Incident Atrial Fibrillation
Authors: Russo Cesare , Jin Zhezhen , Sera Fusako , Lee Edward S. , Homma Shunichi , Rundek Tatjana , Elkind Mitchell S.V. , Sacco Ralph L. , Di Tullio Marco R. 
Published: August 2015

Background—
The increasing prevalence of atrial fibrillation (AF) represents a public health issue. Identifying new predictors of AF is therefore necessary to plan preventive strategies. We investigated whether left ventricular (LV) systolic dysfunction by global longitudinal strain (GLS), a predictor of cardiovascular events, may predict new-onset AF in a population setting.

Methods and Results—

Participants (n=675; mean age, 71±9 years; 60% women) in sinus rhythm from the population-based Northern Manhattan Study (NOMAS) underwent 2- and 3-dimensional echocardiography as part of the Cardiac Abnormalities and Brain Lesions (CABL) study. LV systolic function was assessed by LV ejection fraction and speckle-tracking GLS. During a mean follow-up of 63.6±18.7 months, 32 (4.7%) new confirmed cases of AF occurred. Lower GLS (adjusted hazard ratio/unit decrease, 1.22; 95% confidence interval, 1.04–1.43;
P
=0.015) and increased left atrial volume index (LAVi; adjusted hazard ratio/unit increase, 1.12; 95% confidence interval, 1.07–1.17;
P
<0.001) were significantly associated with incident AF, whereas LV ejection fraction was not (
P
=0.176). Abnormal GLS (>–14.7%) was associated with risk of new-onset AF with an adjusted hazard ratio of 3.2 (95% confidence interval, 1.4–7.5;
P
=0.007). The coexistence of abnormal GLS/abnormal LAVi was associated with a 28.6% incidence of AF (adjusted hazard ratio, 12.1; 95% confidence interval, 3.3–44.8;
P
<0.001) compared with participants with normal GLS/normal LAVi (AF incidence, 2.0%). AF incidence was intermediate in those with either abnormal GLS or abnormal LAVi (9.3% and 11.1%, respectively). GLS prognostic value for incident AF was incremental over risk factors and LAVi.

Conclusions—
LV systolic dysfunction by GLS was a powerful and independent predictor of incident AF. GLS assessment may improve AF risk stratification in addition to established parameters.
Assessment of Fractional Flow Reserve in Patients With Recent Non–ST-Segment–Elevation Myocardial Infarction
Authors: Layland Jamie , Rauhalammi Samuli , Watkins Stuart , Ahmed Nadeem , McClure John , Lee Matthew M.Y. , Carrick David , O’Donnell Anna , Sood Arvind , Petrie Mark C. , Teng Yue May Vannesa , Eteiba Hany , Lindsay Mitchell , McEntegart Margaret , Oldroyd Keith G. , Radjenovic Aleksandra , Berry Colin 
Published: August 2015

Background—
The use of fractional flow reserve (FFR) in acute coronary syndromes is controversial. The British Heart Foundation Fractional Flow Reserve Versus Angiography in Guiding Management to Optimize Outcomes in Non-ST-Elevation Myocardial Infarction (FAMOUS-NSTEMI) study (NCT01764334) has recently demonstrated the safety and feasibility of FFR measurement in patients with non–ST-segment–elevation myocardial infarction. We report the findings of the cardiac magnetic resonance (CMR) substudy to assess the diagnostic accuracy of FFR compared with 3.0-T stress CMR perfusion.

Methods and Results—

One hundred six patients with non–ST-segment–elevation myocardial infarction who had been referred for early invasive management were included from 2 centers. FFR was measured in all major patent epicardial coronary arteries with a visual stenosis estimated at ≥30%, and if percutaneous coronary intervention was performed, an FFR assessment was repeated. Myocardial perfusion was assessed with stress perfusion CMR at 3 T. The mean age was 56.7±9.8 years; 82.6% were men. Mean time from FFR evaluation to CMR was 6.1±3.1 days. The mean±SD left ventricular ejection fraction was 58.2±9.1%. Mean infarct size was 5.4±7.1%, and mean troponin concentration was 5.2±9.2 μg/L. There were 34 fixed and 160 inducible perfusion defects. There was a negative correlation between the number of segments with a perfusion abnormality and FFR (
r
=−0.77;
P
<0.0001). The overall sensitivity, specificity, positive predictive value, and negative predictive value for an FFR of ≤0.8 were 91.4%, 92.2%, 76%, and 97%, respectively. Diagnostic accuracy was 92%. The positive and negative predictive values of FFR for flow-limiting coronary artery disease (FFR≤0.8) in patients with non–ST-segment–elevation myocardial infarction (n=21) who underwent perfusion CMR before invasive angiography were 92% and 93%, respectively. Receiver operating characteristic analysis indicated that the optimal cutoff value of FFR for demonstrating reversible ischemia on CMR was ≤0.805 (area under the receiver operating characteristic curve, 0.94 [0.9–0.99];
P
<0.0001).

Conclusions—
FFR in patients with recent non–ST-segment–elevation myocardial infarction showed high concordance with myocardial perfusion in matched territories as revealed by 3.0-T stress perfusion CMR.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT02073422.
Optical Coherence Tomography Guided Percutaneous Coronary Intervention With Nobori Stent Implantation in Patients With Non–ST-Segment–Elevation Myocardial Infarction (OCTACS) Trial
Authors: Antonsen Lisbeth , Thayssen Per , Maehara Akiko , Hansen Henrik Steen , Junker Anders , Veien Karsten Tange , Hansen Knud Nørregaard , Hougaard Mikkel , Mintz Gary S. , Jensen Lisette Okkels 
Published: August 2015

Background—
Incomplete strut coverage has been documented an important histopathologic morphometric predictor for later thrombotic events. This study sought to investigate whether optical coherence tomography (OCT)–guided percutaneous coronary intervention with Nobori biolimus-eluting stent implantation in patients with non–ST-segment–elevation myocardial infarction would provide improved strut coverage at 6 months in comparison with angiographic guidance only.

Methods and Results—

One hundred patients were randomized 1:1 to either OCT-guided or angio-guided Nobori biolimus-eluting stent implantation. Postprocedure OCT was performed in all patients. In the OCT-guided group, prespecified criteria indicating additional intervention were related to (1) stent underexpansion, (2) strut malapposition, (3) edge dissection(s), and (4) residual stenosis at the distal or proximal reference segment(s). A final OCT was performed in case of reintervention. Six-month OCT follow-up was available in 85 patients. Twenty-three (46%) OCT-guided patients had additional postdilation or stenting. The percentage of acutely malapposed struts was substantially lower in the OCT-guided group (3.4% [interquartile range, 0.3–7.6] versus 7.8% [interquartile range, 2.3–19.4];
P
<0.01). At 6-month follow-up, the OCT-guided group had a significantly lower proportion of uncovered struts; 4.3% [interquartile range, 1.2–9.8] versus 9.0% [interquartile range, 5.5–14.5],
P
<0.01. Furthermore, OCT-guided patients had significantly more completely covered stents: 17.5% versus 2.2%,
P
=0.02. The percentages of malapposed struts and struts being both uncovered and malapposed at follow-up were comparable between groups.

Conclusions—
OCT-guided optimization of Nobori biolimus-eluting stent implantation improves strut coverage at 6-month follow-up in comparison with angiographic guidance alone.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT02272283.
Association Between Chest Compression Interruptions and Clinical Outcomes of Ventricular Fibrillation Out-of-Hospital Cardiac Arrest
Authors: Brouwer Tom F. , Walker Robert G. , Chapman Fred W. , Koster Rudolph W. 
Published: August 2015

Background—
Minimizing pauses in chest compressions during cardiopulmonary resuscitation is a focus of current guidelines. Prior analyses found that prolonged pauses for defibrillation (perishock pauses) are associated with worse survival. We analyzed resuscitations to characterize the association between pauses for all reasons and both ventricular fibrillation termination and patient survival.

Methods and Results—

In 319 patients with ventricular tachycardia/fibrillation out-of-hospital cardiac arrest, we analyzed recordings from all defibrillators used during resuscitation and measured durations of all cardiopulmonary resuscitation pauses. Median durations were 32 seconds (25th and 75th percentile, 22 and 52 seconds) for the longest pause for any reason, 23 seconds (25th and 75th percentile, 14 and 34 seconds) for the longest perishock pause, and 24 seconds (25th and 75th percentile, 11 and 38 seconds) for the longest nonshock pause. Multivariable regression models showed lower odds for survival per 5-second increase in the longest overall pause (odds ratio, 0.89; 95% confidence interval, 0.83–0.95), longest perishock pause (odds ratio, 0.85; 95% confidence interval, 0.77–0.93), and longest nonshock pause (odds ratio, 0.83; 95% confidence interval, 0.75–0.91). In 36% of cases, the longest pause was a nonshock pause; this subgroup had lower survival than the group in whom the longest pause was a perishock pause (27% versus 44%, respectively;
P
<0.01) despite a higher chest compression fraction. Preshock pauses were 8 seconds (25th and 75th percentile, 4 and 17 seconds) for shocks that terminated ventricular fibrillation and 7 seconds (25th and 75th percentile, 4 and 13 seconds) for shocks that did not (
P
=0.18).

Conclusions—
Prolonged pauses have a negative association with survival not explained by chest compression fraction or decreased ventricular fibrillation termination rate. Ventricular fibrillation termination was not the mechanism linking pause duration and survival. Strategies shortening the longest pauses may improve outcome.
Distribution of Short‐Term and Lifetime Predicted Risks of Cardiovascular Diseases in Peruvian Adults
Authors: Quispe Renato , Bazo‐Alvarez Juan Carlos , Burroughs Peña Melissa S. , Poterico Julio A. , Gilman Robert H. , Checkley William , Bernabé‐Ortiz Antonio , Huffman Mark D. , Miranda J. Jaime ,   PERU MIGRANT Study,   CRONICAS Cohort Study Group
Published: August 2015

Background
Short‐term risk assessment tools for prediction of cardiovascular disease events are widely recommended in clinical practice and are used largely for single time‐point estimations; however, persons with low predicted short‐term risk may have higher risks across longer time horizons.

Methods and Results

We estimated short‐term and lifetime cardiovascular disease risk in a pooled population from 2 studies of Peruvian populations. Short‐term risk was estimated using the atherosclerotic cardiovascular disease Pooled Cohort Risk Equations. Lifetime risk was evaluated using the algorithm derived from the Framingham Heart Study cohort. Using previously published thresholds, participants were classified into 3 categories:
low short‐term and low lifetime risk, low short‐term and high lifetime risk
, and
high short‐term predicted risk
. We also compared the distribution of these risk profiles across educational level, wealth index, and place of residence. We included 2844 participants (50% men, mean age 55.9 years [
SD
10.2 years]) in the analysis. Approximately 1 of every 3 participants (34% [95%
CI
33 to 36]) had a high short‐term estimated cardiovascular disease risk. Among those with a low short‐term predicted risk, more than half (54% [95%
CI
52 to 56]) had a high lifetime predicted risk. Short‐term and lifetime predicted risks were higher for participants with lower versus higher wealth indexes and educational levels and for those living in urban versus rural areas (
P
<0.01). These results were consistent by sex.

Conclusions
These findings highlight potential shortcomings of using short‐term risk tools for primary prevention strategies because a substantial proportion of Peruvian adults were classified as low short‐term risk but high lifetime risk. Vulnerable adults, such as those from low socioeconomic status and those living in urban areas, may need greater attention regarding cardiovascular preventive strategies.
Youth, suicide attempts and low level of education: A Danish historical register-based cohort study of the outcome of suicide attempt
Authors: Christiansen Erik , Agerbo Esben , Larsen Kim Juul , Bilenberg Niels , Stenager Elsebeth 
Published: August 2015

Background: In Denmark, it is a political goal that 95% of all young people should complete an upper secondary education. For some young people, this goal can be difficult to achieve. An association has been established between suicidal behaviour and school performance. Aim: We hypothesise that young people who have attempted suicide have a lower chance of finishing secondary education. Methods: We used Danish historical population registers to perform a longitudinal cohort design and extended Cox regression modelling to estimate crude and adjusted estimates of the effect of suicide attempt on secondary education. We used the birth cohorts 1983–1989, and all subjects were followed from birth until the end of 2011 ( n = 355,725). Results: For suicide attempters, the likelihood of completing secondary education was one-third of non-attempters (crude hazard ratio = 0.38). A part of the impact can be explained by confounding factors. Individuals with a suicide attempt at age 16–20 years or with multiple suicide attempts were most likely not to complete secondary education. Compared to mentally ill non-attempters, suicide attempters with mental illness were more likely not to finish secondary education. Conclusion: A suicide attempt is not necessarily causal for not finishing secondary education, but it is a marker, and it predicts an increased likelihood of not finishing secondary education. We need to identify individuals at risk for suicide attempts and subsequently provide the necessary support. Completing secondary education is important, as it provides better chances of employment, higher wages and more opportunities for individuals in the future.
Anti-atherogenic properties of high-density lipoproteins in psychiatric patients before and after two months of atypical anti-psychotic therapy
Authors: Hussein Osamah , Izikson Lidia , Bathish Yunis , Dabur Enas , Hanna Alaa , Zidan Jamal 
Published: August 2015

Some of the medications used for the management of schizophrenia are associated with clinically significant increases in weight and adverse alterations in serum lipid levels. The aim of the study was to investigate the effect of short-term (two months) treatment with atypical anti-psychotics on coronary heart disease risk factors, including the functional properties of high-density lipoprotein (HDL), in psychiatric patients. Nineteen patients diagnosed with schizophrenia, schizoaffective, and bipolar disorder and ten healthy volunteers were enrolled in the study. In the present study blood was drawn at baseline and after two months of atypical anti-psychotic treatment. Wilcoxon non-parametric-test was used to examine differences in the psychotic group before and two months after treatment. Waist circumference and oxidative stress in psychiatric patients were higher compared with the control group. Serum-mediated cholesterol efflux capacity was lower in psychotic patients compared to controls. Two months of anti-psychotic therapy was associated with increased abdominal obesity, decreased paraoxonase lactonase activity, but with no further change in serum-mediated cholesterol efflux from macrophages. Psychotic patients have low serum-mediated cholesterol efflux from macrophages as a parameter of HDL functionality. Atypical anti-psychotic treatment for two months increased metabolic derangements in these patients but without further decrement in serum-mediated cholesterol efflux.
Differentiated effects of the multimodal antidepressant vortioxetine on sleep architecture: Part 1, a pharmacokinetic/pharmacodynamic comparison with paroxetine in healthy men
Authors: Wilson Sue , Højer Astrid-Maria , Buchberg Jeppe , Areberg Johan , Nutt David J 
Published: August 2015

We compared the effect of vortioxetine, paroxetine and placebo after three days of dosing on sleep architecture. This was a randomised, double-blind, four-way crossover, placebo-controlled, multiple-dose study in 24 healthy young men. Subjects received 20mg vortioxetine, 40mg vortioxetine, 20mg paroxetine or placebo for three consecutive days in four different periods with at least three weeks between them. Polysomnography and blood sampling for pharmacokinetic analysis were performed on the pre-dose night and nights 1 and 3 of dosing in each period. Plasma concentrations of vortioxetine and paroxetine during the polysomnography measurement were used to estimate SERT occupancies using published relationships in healthy subjects. All three active treatments significantly increased REM onset latency and decreased time spent in REM sleep. In the pharmacokinetic/pharmacodynamics analysis significant relationships were found between REM onset latency and time spent in REM sleep and vortioxetine/paroxetine exposure. The relation between REM suppression parameters and SERT occupancy was significantly different between vortioxetine and paroxetine, despite the same SERT occupancy. This indicates that vortioxetine has a different clinical pharmacological profile from paroxetine, which may explain the differences in adverse effect profile of the two drugs, for instance the lower incidence of nausea, weight gain and sexual dysfunction with vortioxetine.
Endovascular treatment of acute and chronic portal vein thrombosis in patients with cirrhotic and non-cirrhotic liver
Authors: Rosenqvist Kerstin , Eriksson Lars-Gunnar , Rorsman Fredrik , Sangfelt Per , Nyman Rickard 
Published: August 2015

Background Treatment of patients with portal vein thrombosis (PVT) differs due to different etiology and wide range of symptoms but certain patients seems to benefit from endovascular intervention. Purpose To assess the safety and efficiency of endovascular treatment of acute and chronic PVT in patients with cirrhotic and non-cirrhotic liver. Material and Methods Twenty-one patients with PVT treated with an endovascular procedure in 2002–2013 were studied retrospectively. Data on etiology, onset and extension of thrombus, presenting symptoms, methods of intervention, portal pressure gradients, complications, recurrence of symptoms, re-interventions, clinical status at latest follow-up, and survival were collected. Results Four non-cirrhotic patients with acute extensive PVT and bowel ischemia were treated with local thrombolysis, in three combined with placement of a transjugular intrahepatic portosystemic shunt (TIPS) placement. Three recovered and have survived more than 6 years. In six non-cirrhotic patients with chronic PVT and acute or threatening variceal bleeding recanalization and TIPS were successful in three and failed in three. Eleven cirrhotic patients with PVT and variceal bleeding or refractory ascites were successfully treated with recanalization and TIPS. Re-intervention was performed in five of these patients and five patients died, three within 12 months of intervention. Four cirrhotic patients had episodes of shunt-related encephalopathy and three had variceal re-bleeding. Conclusion TIPS was found to be effective in reducing portal hypertension in patients with PVT. In patients with extensive PVT and bowel ischemia treatment with TIPS combined with thrombolysis should be considered.
Peroneal tendon pathology evaluation using the oblique sagittal plane in ankle MR imaging
Authors: Park Hee Jin , Lee So Yeon , Kim Eugene , Kim Mi Sung , Chung Eun Chul , Choi Seon Hyung , Yun Ji Sup 
Published: August 2015

Background Because peroneal tendons course from the lateral side of the proximal fibula through the posterior side of the distal fibula, correct diagnosis of the tendon pathology on an orthogonal sagittal plane can be difficult. Purpose To evaluate the diagnostic usefulness of oblique sagittal imaging (peroneal view) for evaluation of peroneal tendon pathology. Material and Methods This retrospective study included 69 patients at our institution who underwent routine ankle magnetic resonance imaging (MRI) using the peroneal view. Twenty-three patients underwent arthroscopy. Anatomic identification of the peroneal tendons on orthogonal sagittal MRI sequences and peroneal views were evaluated. Two radiologists evaluated the peroneal tendons based on an entire length view, an entire width view, and margin sharpness using a 4-point scale. Diagnostic accuracy using orthogonal sagittal and peroneal views was evaluated by calculating sensitivity, specificity, and accuracy. Arthroscopic or clinical findings were used as the reference standard. Results Total anatomical scores on the peroneal view were higher than those of the orthogonal sagittal views ( P < 0.001). Both readers were able to identify anatomy of the tendon using the full length, full width and sharp margin, and determined that the peroneal view was better when compared with the orthogonal sagittal views ( P < 0.001). Although the sensitivity and accuracy of the peroneal view in the diagnosis of peroneal tendon injury were slightly higher than orthogonal view, the values were not statistically significant. Conclusion Peroneal views provide better anatomic evaluation of the peroneal tendons itself, although cannot show significant superiority in the diagnostic performances.