bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 19135: Safety and Efficacy of Intramyocardial Delivery of Stem Cells in Ischemic Heart Failure: An Individual Patient Data-Based Meta-Analysis
Authors: Gyöngyösi Mariann , Pokushalov Evgeny , Bergmann Martin W , Kastrup Jens , Atsma Douwe , Sylven Christer , Maurer Gerald 
Published: April 2024

Background. Intramyocardial stem cell delivery mode might be the choice for regeneration of chronic myocardial ischemia and/or left ventricular (LV) dysfunction.

Methods. Individual patient data-based meta-analysis includes data of 383 patients (part of MESS database, clinicaltrials.gov
NCT01098591
) with ischemic cardiomyopathy (iCMP) and treated either with autologous stem cell (SC) (bone marrow mononuclear or mesenchymal stem cells) using percutaneous 3D NOGA-guided delivery (n=290) or randomized to controls (n=93), data received from 5 European centers.

Results. The average follow-up (FUP) was 6.4±2.2 months. The baseline end-diastolic volume (189±73 ml vs 201±71 ml) and ejection fraction (EF) (41.4±14.5% vs 42.5±18.7%) were similar in SC treated vs controls. Procedural complication occurred in 2.1% of patients, and 80.8x10^6 cells were delivered in 11.2±2.5 myocardial sites. Compared with controls, intramyocardial delivery of SC improved (p<0.001) LV EF (mean difference 4.6%; 95% confidence interval /CI/ 6.4% to 2.7%); reduced infarct size (-2.22%; 95% CI -3.54% to -0.90%) and size of stress-induced myocardial ischemia (-5.6; 95% CI -7.38% to -3.88%). The CCS angina status (-1.0; 95% CI -0.68 to -1.06) and NYHA (-0.74; 95% CI -0.54 to -0.93) improved significantly (p<0.001) post SC therapy as compared with controls. Kaplan-Meier analysis resulted in a significant better survival (98.8% vs 93.5%, p<0.01) and MACCE-free survival (97.9% vs 78.5%, p<0.001) rate in SC-treated patients vs controls. Multivariate analysis resulted in a lower baseline EF and higher total number of intramyocardial delivered SC as significant predictors for improvement in EF, while norminal regression analysis revealed SC therapy as significant predictor for MACCE-free survival in patients with iCMP.
Conclusion. Meta-analysis of 3D NOGA endocardial mapping guided transendocardial stem cell treatment proves the safety and efficacy of this cardiac regeneration strategy in patients with chronic ischemia and low EF.
Abstract 19327: Reduced Handgrip Strength Predicts Clinical Outcomes in Patients with Advanced Heart Failure Undergoing Ventricular Assist Device Placement
Authors: Chung Christine J , Wu Christina , Ferreira Orlanda , Jones Meaghan , Kato Tomoko S , Takayama Hiroo , Naka Yoshifumi , Forman Daniel E , Mancini Donna M , Schulze Paul Christian 
Published: April 2024

BACKGROUND: Heart failure (HF) is a systemic syndrome associated with derangement of skeletal muscle structure and metabolic function which contributes to diminished exercise tolerance, patient frailty and increased morbidity and mortality. The objective of this study was to evaluate handgrip strength as a marker of muscle function and frailty for prediction of clinical outcomes after ventricular assist device (VAD) implantation in patients with advanced HF.
METHODS: Handgrip strength was measured in 53 patients with advanced HF 2.6±5.2 days prior to VAD implantation and over 6 months following surgery. We analyzed dynamics in laboratory values, post-operative complications and 30-day mortality.
RESULTS: There was no difference in grip strength of the dominant versus non-dominant hands at baseline and up to 6 months after VAD implantation. Baseline handgrip strength correlated with levels of albumin (r=0.29, p=0.04). Handgrip strength progressively improved, with a statistically significant increase seen at four months and sustained at 6 months following VAD implantation (non-dominant hand: 13±28% increase at 4 months and 18±34% at 6 months, p<0.05 versus baseline). Receiver operating characteristic curve analysis determined that handgrip strength<30% of body weight distinguished patients with greater likelihood of early post-operative mortality with a sensitivity of 72% and specificity of 80% (area under curve 0.8). Patients with handgrip strength<30% of body weight had 83% survival during the first 30 days after VAD implantation compared to 100% in those with handgrip strength >30% of body weight.
CONCLUSION: Patients with advanced HF lose the difference in grip strength between the dominant and non-dominant hands seen in normal reference populations further supporting the existence of a global myopathy in advanced HF. Non-dominant handgrip strength less than 30% of body weight is associated with higher mortality in the early postoperative period following VAD implantation. These findings indicate that measures of skeletal muscle function and patient frailty may have important prognostic value in the pre-operative evaluation of patients with HF undergoing VAD placement.
Abstract 19469: Outcomes in Extended-Criteria Caradiac Transplantation: A 10-Year Experience
Authors: Owen Ashleigh A , Samsky Marc , Patel Chetan , Hernandez Adrian F , Jentzer Jacob , Schulte Phillip , Felker G. M , Rosenberg Paul B , Milano Carmelo A , Rogers Joseph G 
Published: April 2024

INTRODUCTION: Extended criteria cardiac transplant (ECCT) provides cardiac replacement therapy in patients (pts) with end-stage heart failure who are ineligible for standard criteria transplantation (SCCT). While ECCT provides lower survival, short term outcomes are adequate for pts with advanced age or comorbidities. Long term outcomes after ECCT have not been defined and determining clinical variables associated with improved survival after ECCT will improve risk stratification.
METHODS: 454 pts undergoing cardiac transplantation at Duke University Medical Center from January 2000 until December 2009 were retrospectively analyzed. Each patient was identified as either SCCT (n=370) or ECCT (n=84). Baseline clinical variables included demographics, renal function, and need for circulatory support prior to transplant. Comparisons were made between SCCT and ECCT patients pre-transplant and at years 1 and 5. Survival analysis was performed using standard Kaplan-Meier methods. A Cox proportional hazards model was developed to identify predictors of survival.
RESULTS: Significant differences (P<0.001) in clinical variables between SCCT and ECCT groups included age (53 y vs 66 y), presence of diabetes (25% vs 46%) and ischemic disease (43% vs 70%). Renal function was worse in the ECCT group when assessed by BUN (19 vs 25, p<0.001) but serum creatinine (Cr) was equivalent (1.2 vs 1.3, p=0.027). Mean follow up was 4.7 years and survival is shown in Figure 1. Only serum Cr prior to transplant had a statistically significant effect on survival regardless of the criteria used (p=0.001, HR 1.7, 95% CI 1.25, 2.30).
CONCLUSION: ECCT pts have lower survival than SCCT pts and this risk persists after adjusting for covariates. Serum Cr is an independent predictor of survival in all transplant recipients. Given the detrimental impact of transplant medications on renal function, consideration of Cr should be incorporated in to risk-stratification for patients undergoing ECCT.
Abstract 19645: Cardiac Effects of Physiological Hypertrophy in a Murine Model of Calcium Channel Overexpression
Authors: Barr Larry , Zhang Hongyu , Berretta Remus , Molkentin Jeffery D , Houser Steven R 
Published: April 2024

Background —

The L-type calcium channel (LTCC) is integral for calcium entrance into the cardiomyocyte to induce CICR from the SR. We have developed a mouse model with inducible, cardiac-specific expression of the β2a subunit of the LTCC (β2a), leading to pathological hypertrophy akin to post-MI heart failure. Chronic exercise is known to cause physiological hypertrophy in normal hearts, leading to enhanced contractile state and thickened heart tissue, without a pathological phenotype. We administered chronic physiological hypertrophy in the form of swim training on the β2a line and its WT counterpart, analyzing the cardiac changes.

Methods and Results —

β2a (n=8) and WT (n=16) FVB mice aged 4 months were swam twice a day, four hours apart, for 21 days. They swam for 10min sessions on Day 1, with each subsequent day increasing the session time by 10 min until 90min sessions were reached. ECHO was performed at beginning and end of swim training, then terminal HW/BW ratio was determined. EF and FS increased significantly with swimming in WT (EF [%] pre-swim: 57.21±2.02 vs. post-swim: 69.98±2.88; FS [%] pre-swim: 29.53±1.34 vs. post-swim: 39.27±2.42) and from sedentary counterparts. β2a mice showed no significant change after swimming (EF [%] pre-swim: 69.8±1.75 vs. post-swim: 74.06±2.72; FS [%] pre-swim: 38.24±2.38 vs. post-swim: 42.40±2.22) and no change from sedentary β2a mice. Both ECHO parameters were significantly greater in β2a mice versus WT before swimming, but not after. There was a significant difference in HW/BW ratio in WT exercised mice versus sedentary (HW/BW [mg/g] swim: 4.63±0.2 vs. sed: 5.75±0.19) that was not present in exercised versus sedentary β2a mice (HW/BW [mg/g] swim: 5.98±0.31 vs. sed: 5.96±0.25).

Conclusions —

Chronic exercise may not affect mice with pathological hypertrophy through overexpressed LTCC but causes physiological hypertrophy in their wild type counterparts.
Abstract 204: Incidence Rate of Shockable Cardiac Arrest Varies Considerably Among Facilities
Authors: Kaneko Hiroshi , Hatanaka Tetsuo , Nagase Aki , Sakamoto Tetsuya , Marukawa Seishiro 
Published: April 2024

Introduction: Despite wide proliferation of AEDs in public facilities in Japan, only ∼1% of patients with out-of-hospital cardiac arrest receive defibrillation attempts using on-site AEDs. In the decision-making process as to what specific facilities may merit the placement of on-site AEDs, each facility needs to estimate a site-specific incidence rate of cardiac arrest. We hypothesized that the incidence of cardiac arrest per person-year differs significantly across types of facilities.
Methods: Locations of cardiac arrest from 2003 through 2010 were abstracted from the database of the Fire Department of Nagoya City (population of 2.2 million; ∼2,000 cardiac arrests annually). The locations of cardiac arrests were tallied and grouped into 36 facility categories consistent with the Fire Service Act, and the number of cardiac arrests within each category was determined. Data on the number of visitors/workers/residents for each category were obtained from governmental databases and annual financial reports. The incidence rate was calculated as the number of cardiac arrest per 1 billion person-years.
Results: In 18 facility categories, the database for cardiac arrest and the database for numbers of visitors/workers/residents coincided in the categorization rules. For each of the categories, the incidence rate of cardiac arrest with initial shockable rhythm was calculated (the top 7 categories are shown in the table).
Conclusions: The incidence rate of shockable cardiac arrest varies considerably among facilities. Such variation in the incidence rate may reflect divergence among facilities in terms of characteristics of visitors/workers/residents, average duration of stay, intensity of physical or emotional activities, etc. These incidence rates, combined with the expected numbers of visitors/workers/residents, may be used to estimate anticipated numbers of shockable cardiac arrests per facility and the need for placing on-site AEDs.
Abstract 208: Innovative Web-Based e-Registry Enhances Survival After Out-of-Hospital Cardiac Arrest
Authors: Ko Patrick Chow-In , Chiang Wen-Chu , Chiu Allen Wen-Hsiang , Lin Chi-Hung , Lin Hsien-Tang , Chen Qing-Mei , Xiong Guang-Hua , Hsiao Ying-Wen , Ma Matthew Heui-Ming 
Published: April 2024

Introduction:
Patient and prehospital predictors of survival after OHCA include ventricular fibrillation, witnessed arrest, and receiving bystander cardiopulmonary resuscitation. Whether systems-based approaches on Emergency Medical Service (EMS) such as new registry or reform could improve survival have not been well studied.
Hypothesis:
An innovative web-based e-registry may enhance survival after OHCA.
Methods:
An urban EMS with 2.62 million residents in 272 squared km was studied. Traditionally the EMS operated an OHCA Registry by manual-traced paper archives that coordinated data collections across dispatch center, ambulance teams and receiving hospitals. After a 2-year redesign, a computerized Web e-Registry in 2010 was established. The ambulance team initiated an individual patient data block right after an OHCA event, and that data block was immediately pushed to the customized webpage of receiving hospital so that they could easily upload patient outcomes anytime online, and periodically update patient status to the Web system. Health Bureau tracked the compliance with data uploading among receiving hospitals. Fire Department staff reviewed and uploaded prehospital and defibrillator data to the Web. The outcomes of 2-hour sustained return of spontaneous circulation (2hr ROSC), survival to discharge, and favorable Cerebral Performance Category 1 and 2 at discharge (fCPC), and data-missing rate for 4 years before the e-Registry (n=7,499) were compared to those 1 year after (n=1,777).
Results:
After e-Registry, for arrest of shockable rhythm, fCPC increased by 9.5% (95% CI: 4.2-16.1%); for non-shockable arrest, 2hr ROSC (4.2%, 95% CI: 1.4-7.1%) and fCPC (0.7%, 95% CI: 0.2-1.4%) increased significantly. After adjusting for patient and EMS variables, e-Registry was associated with fCPC (adjusted odds ratio: 1.9, 95% CI: 1.1-3.6) for shockable arrest, 2hr ROSC (adjusted OR: 1.2, 95% CI: 1.1-1.4) and fCPC (adjusted OR: 2.3, 95% CI: 1.1-5.1) for non-shockable arrest. Outcomes data-missing rate was significantly reduced by 5.3% (95% CI: 2.8-7.9%).
Conclusions:
Compared to paper archives, systems-based intervention by launching web-based e-registry may enhance favorable CPC after OHCA and reduce outcomes data-missing rate.
Abstract 245: Clinical Use of Miniaturized Chest Compressor for Cardiopulmonary Resuscitation
Authors: Wang Xiuhua , Zhang Chao , Chen Wei 
Published: April 2024

Introduction: During cardiopulmonary resuscitation (CPR), high quality chest compression is the most important factor for successful resuscitation. In the present study, we investigated the effectiveness of a mechanical miniaturized chest compressor (MCC) on successful resuscitation in human patients.
Hypothesis: We hypothesized that MCC is safe and equally as effective for CPR when compared with conventional manual chest compression.
Methods: This is a retrospective study comparing the effectiveness of MCC between 2 separate cohorts of patients. From May 2011 - April 2012, MCC was used in all out of hospital cardiac arrest (CA) patients brought to our emergency room, except those who were 18 years old or under and patients of trauma and terminal stage diseases. A total of 25 patients were included in MCC group. Another 22 patients with similar conditions received conventional manual chest compression from May 2010 - April 2011 that were included as the control group. MCC device was used with a fixed compression rate of 100/min and compression depth between 3.8 and 5 cm. Manual chest compression was performed based on the current CPR guidelines. ACLS guideline procedures were followed in all patients. The protocol was continued until successful resuscitation or for a total of 30 mins. Successful resuscitation was defined as return of spontaneous circulation with blood pressure > 90/60 mmHg for more than 30 mins.
Results: Mean age, gender and duration from CA to CPR did not differ significantly between MCC and manual groups. The success of resuscitation was numerically greater in MCC group when compared with the manual group (Table). There was no single incidence of rib fracture in patients treated with MCC.
Conclusion: MCC is safe and as effective as manual chest compression. It may, therefore, provide a new option for CPR.
Abstract 262: Impact of the Motive of Participants on Training Effect of CPR
Authors: Kato Suzuka , Suzuki Masaru , Hori Shingo ,   Tokyo Fire Dept, Japan,   Tokyo Disaster Prevention and Emergency Med Service Association
Published: April 2024

Introduction: CPR by lay people improves survival in out-of-hospital cardiac arrest (OHCA). CPR training for lay people plays a crucial role to maximize an opportunity of an effective bystander CPR. Fire Department has concentrated its efforts on growing the training popular in citizens in Japan.Some people participated in the training of their own accord, while others participated by the direction of their business companies. Aim was to elucidate a relationship between the motive of the participated people to the first aid training held by the fire department and the training effects.
Methods: Tokyo Disaster Prevention and Emergency Medical Service Associate has conducted the first aid training for common people including CPR and AED training, in which a total of 3,862 adults were participated into the training between January and April 2012. Of those, 1,203 adult office workers (age: 20-49 years, 783 male, 723 compulsory participants and 420 participants of their own accord) were analyzed in this study. An anonymous questionnaire survey including their satisfaction for the course and trainer, self-checking of skill performances regarding to CPR and intention to perform bystander CPR was conducted.
Results: Satisfaction with the course and the trainer was higher in the participants of their own accord compared to the compulsory participants (Kruskal-Wallis test P=0.001, P=0.001). When skills of chest compression and artificial breathing were evaluated by themselves, the evaluations were better in the participants of their own accord (P=0.04, P=0.01). Comparing their perceptions regarding their AED skills, there was no significant difference (P=0.13). Answers to the question about their intensions to perform CPR for OHCA demonstrated that the participants of their own accord would actually perform CPR more frequently (17.9% vs 11.3%, P<0.001).
Conclusion: Expectation that a common lay people actually perform CPR during OHCA event is likely to depend on their motivation of the CPR ability. Their motivation also related with their perceptions of the CPR skills. It suggested that continued appealing works to the willing and perception of participants is indispensable to maximize the effectiveness of CPR training.
Abstract 263: Changes in Cerebral Oxygen Metabolism and Hemodynamics During ECPR with Therapeutic Hypothermia Measured by Near Infrared Spectroscopy
Authors: Kawamorita Tsuyoshi , Yagi Tsukasa , Soga Taketomo , Hirose Harumi , Watanabe Kazuhiro , Kikushima Kimio , Yoshino Atsuo , Sakatani Kaoru , Nagao Ken 
Published: April 2024

(Background) For protection of the brain, hypothermia is a helpful therapeutic approach in patients who remain comatose after return of spontaneous circulation (ROSC). The 2010 CPR Guidelines recommend that extracorporeal cardiopulmonary resuscitation (ECPR) using an emergency cardiopulmonary bypass (CPB) should be considered for patients with cardiac arrest. However, it is not yet clear whether this therapy can improve cerebral circulation and oxygenation in these patients. To clarify this issue, we evaluated change of cerebral blood oxygenation (CBO) during ECPR using near-infrared spectroscopy (NIRS).
(Methods) Between November 2009 and June 2011, we employed NIRS (NIRO-200NX, Hamamatsu Photonics, Japan) to measure CBO in the bilateral frontal lobe in patients transported to the ER after out-of-hospital cardiac arrest. Enrollment criteria were: aged 18-74 years; cardiac arrest witnessed by bystanders; presumed cardiac etiology of cardiac arrest according to the Utstein style guidelines; estimated time interval from collapse to paramedic’s arrival at patient’s side within 15 min; defibrillation using automated external defibrillator by bystander and/or emergency medical personnel; and persistent cardiac arrest on arrival at the ER.
(Results) Fifteen patients met the above criteria. The tissue oxygenation index (TOI) on arrival at the ER was 36.5%. This increased to 67.8% during ECPR (P<0.001). The patients whose TOI subsequently decreased had a favourable neurological outcome (figure).
(Conclusion) The increase of TOI during ECPR might reflect an improvement in cerebral blood flow, while the decrease of TOI after ECPR might reflect oxygen utilization of the brain tissue as a result of neuronal cell survival. NIRS may be useful for monitoring cerebral hemodynamics and oxygen metabolism during CPR.
Abstract 265: For How Long a Period Have Medical Students and Nurses Retained ACLS Skills?
Authors: Kikuchi Migaku , Matsushima Hisao , Tosaki Yukiko , Tomizawa Ikue , Taguchi Isao , Abe Shichiro , Ono Kazuyuki , Inoue Teruo 
Published: April 2024

OBJECTIVE: To evaluate whether the period of retention of ACLS skills is different between medical students and registered nurses.
METHODS: A prospective observational study was performed. Medical students and registered nurses were trained both BLS and ACLS based on the American Heart Association (AHA) 2005 Guidelines tools, and evaluated by skill performance tests based on the AHA 2005 BLS and ACLS tools in simulated environment, at immediately and 3 months after training. The registered nurses were similarly evaluated also at 9 months after training.
RESULTS: A total of 197 medical students enrolled was trained, being assigned to 30 groups. Twenty four registered nurses in a general ward were trained, being assigned to 6 groups. In 3 months after training, the medical students retained the core skills of chest compression, which included the correct rate and adequate depth of chest compressions, delivering 30 compressions and 2 ventilations, and resuming chest compressions after shocks, whereas checking breathing, 2 ventilations with bag-valve-mask, or checking carotid pulse was done in only 33% of all groups. The airway management and drug use in the secondary ACLS survey and the effective communication and team dynamics were done in 30%-50% of all groups. The registered nurses also retained the core skills of chest compression and drug use in 3 months after training. Especially, effective communication and team dynamics were well-retained in all groups. In 9 months after training the registered nurses also retained, whereas both opening airway and first 2 ventilations were done in 50% of all groups. Checking carotid pulse or checking breathing was little done for at least 5 seconds but no more than 10 seconds.
CONCLUSIONS: Through BLS and ACLS training, the registered nurses have well retained resuscitation skills, but they also have well demonstrated effective communication and team dynamics for longer period than medical students. Medical students are required short interval of retraining ACLS skills with team dynamics, similarly healthcare providers without performing resuscitation as daily work may be. In addition to this, it should be important to apply effectively different way to teach ACLS skills, such as e-learning or self-training.