bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of atherosclerotic coronary artery disease in master athletes with exercise-induced ventricular arrhythmias: implications for pre-participation screening
Authors: Graziano F , Millin A , Cozza E , Mattesi G , Pergola V , Motta R , Micchi A , Ciccio' C , Zamboni F , Zorzi A 
Published: June 2024

Abstract

Background
The leading cause of sudden cardiac death in master athletes (≥35 years) is coronary atherosclerotic disease (CAD). During pre-participation screening (PPS), the primary indication for investigating CAD in this population is ST-segment depression at exercise test (ET); a second most debated indication is represented by high-risk premature ventricular beats (PVBs), which are considered another potential marker of ischemic heart disease. However, the prevalence of coronary artery disease in master athletes with PVBs is still unknown.

Purpose
The aim of this study was to evaluate the prevalence of CAD in master athletes who underwent coronary computed tomography (CCT) due to high-risk PVBs during PPS (emerging indication), and to compare this population to age-, gender- and risk factors-matched group of athletes who underwent CCT due to ST segment depression during ET (traditional indication).

Methods
We retrospectively enrolled master athletes with no baseline ECG abnormalities and no previous history of heart disease who underwent CCT due to non-common PVBs during PPS. We compared them with a control group of athletes with ST-segment depression during PPS. The entity of the disease was assessed using the CAD-RADs scoring system (0= no plaque, 1=minimal stenosis 1-24%, 2=mild stenosis 25-49%, 3= moderate stenosis 50-69%, 4A= severe stenosis 70-99%, 4B= severe stenosis 70-99% left main stem &gt;50% or 3 vessels ≥70%, 5= total occlusion).

Results
The population resulted to be composed by 70 Caucasian athletes, median age 53 (44-59 years, 88% male), 73% practiced endurance sports. Thirty-five of them underwent CCT for ST-segment depression and 35 for high-risk PVBs. A CAD-RADs of 0 was detected in 63% of athletes, 1-2 in 25.6%, 3 in 5.7%, and 4A-4B in 5.7%. A CAD was found in 37% of athletes investigated for PVB at ET and the same prevalence was found among subjects with ST-depression (p=0.8). Between athletes with moderate-severe CAD, 75% had one or more cardiovascular risk factors, while 25% had no risk factors.

Conclusions
The prevalence of CAD in master athletes resulted to be equivalent in case of PVBs and ST-segment depression and, in the majority of cases, was a mild disease. Despite a coronary artery stenosis &gt;50% was detected just on 12% of athletes who underwent CCT for these indications, however in both groups (PVB and ST-segment depression) the severity of CAD increased with the rise of cardiovascular risk factors. Therefore, the systematic execution of CCT among master athletes with non-common PVBs does not seem justified, but the indication should be reserved for selected cases with cardiovascular risk factors.
Pro-inflammatory cytokines are elevated two-years after acute severe COVID-19: a pre-vaccine, two-years, five-point longitudinal assessment of individuals with Long COVID
Authors: Luz Goulart C , Alex Bezerra Da Silva Maciel A B S M , Anna Gabriela Rezende A G R , Jefferson Valente J V , Bernardo Maia Da Silva B M S , Vanderson Sampaio V S , Allyson Guimaraes A G , Guilherme Peixoto Tinoco Areas G P T A , Fernando Fonseca De Almeida E Val F F A V 
Published: June 2024

Abstract

Introduction
Coronavirus disease 2019 (COVID-19) may cause Long covid, which affects millions of people worldwide. It may include cardiovascular, respiratory, cognitive and musculoskeletal alterations, altogether resulting in decreased functional outcomes and physical activity intolerance. One hypothesis is a lingering pro-inflammatory profile. Acute COVID-19 manifests with elevated plasma proinflammatory cytokines, including interleukin 1β (IL-1β) and tumor necrosis factor α (TNF-α). These cytokines have been associated to cardiovascular problems previously. However, no study has been carried out that followed these patients for 24 months and demonstrated the pro-inflammatory response from acute COVID-19 to post-acute sequelae of COVID-19 (PASC).

Objective
To assess the level of pro-inflammatory cytokines (IL-1 β and TNF-α) at the following times: acute phase (Day 1, Day 7, Day 14), convalescent phase (Day 120) and PASC (24 months, post-acute phase, D720).

Methods and results
Clinical and laboratory exploratory cohort nested study of surviving participants after pre-vaccine, acute SARS-CoV-2 infection with severe clinical presentation in a city, Amazonas, Brazil. This study consisted of a longitudinal assessment of participants up to 24 months after acute infection. The measurement of circulating cytokines in the patients' serum samples was performed using the Flow Cytometry CBA (Cytometric Bead Array) technique with the Cytometric Bead Array (CBA) Human Inflammatory Cytokine Kit (Becton, Dickinson and Company BD Life Sciences – Biosciences 2350, Qume Drive, San Jose) following the guidelines described by the manufacturer. 80 adult patients were included. Average age 55±14 years, 45/80 (56%) of the sample were women and 33/50 (41%) had systemic arterial hypertension at baseline. Regarding the prevalence of Long covid after 2 years of primary infection, 51/80 (63%) reported having remained with one or more symptoms. The most common symptoms were fatigue (63.7%), heart palpitation (38.7%) and dyspnea on exertion (36.6%). The pro-inflammatory cytokine profile of the study participants is characterized in Figure 1. The longitudinal assessment of cytokine levels among participants showed significantly higher levels of IL-1β between D1 and D120 (p&lt;0.0001); D1 and D720 (p&lt;0.0001). In relation to TNF-α on D7 and D720 (p&lt;0.001).

Conclusion
Our results indicate that even after more two years of COVID-19 infection the cytokine profile from this evaluation showed substantially elevated levels of IL-1β and TNF-α in participants with PASC, which could ultimately lead to new or worsening cardiovascular problems in this population.
Lipoprotein(a), are its levels really invariable?
Authors: Del Valle Tabernero P , Diaz Rojo A , Gadella Fernandez A , Berenguel Senen A , Gonzalez Pigorini A , Boillot C , Ramon Ensenat J , Villafafila Martinez L , Martinez Palomares J M , Navarro Pelegrini N , Aguinaga Mendibil A , Morante Perea M C , Cabello Rodriguez A , Gigante Miravalles E , Rodriguez Padial L 
Published: June 2024

Abstract

Background
In the studies available today lipoprotein(a), Lp(a), has been described as a genetic determined cardiovascular risk factor that usually stays constant through time and therefore it´s not affected by drug therapy or lifestyle changes.

Purpose
This study tries to evaluate the presence of changes in Lp(a) levels depending on the moment of extraction (acute event vs ambulatory stable period) seen as now a days there are no clear guidelines about when is the best moment to evaluate this particular cardiovascular risk in our patients.

Methods
Based on a cohort of 344 patients included in the cardiac rehabilitation program of our hospital in between December 2022 and October 2023. We assessed the changes in Lp(a) levels of the 80 patients, admitted after an acute coronary event, that had a Lp(a) determination upon admission for the primary event and at the first ambulatory visit during cardiac rehabilitation.

Results
Of the 80 patients that were included in the final analysis 21,3% were women, 57,5% active smokers, 52,5% hypertensive, 22,5% diabetic, 53,8% dyslipidemic, 27,5% suffer from obesity and 11,3% had a previous history of coronary disease. Regarding the primary event that led to referral to cardiac rehabilitation 47,5% suffered an STEMI and 43,75% had more than one coronary artery affected.
When analyzing the Lp(a) levels upon admission and during cardiac rehabilitation a statistically significant difference was found regarding the presence of changes (Wilcoxon p = 0,000; Z = -3,896). We observed a median of change of 4,9 with an interquartile range of 51. The minimum change observed was of – 90 nmol/L and the maximum of +206 nmol/L.
In the adjacent figure (picture 1) we can appreciate the individual changes in each and every one of the patients included in the analysis.

Conclusions
Based on the results observed in our sample we can conclude that there is a statistically significant difference between Lp(a) levels upon admission for an acute event and Lp(a) levels during cardiac rehabilitation in the ambulatory setting. However, there is still need for more studies to seek clarification upon the matter of when is the best clinical state/moment to evaluate cardiovascular risk, due to this biomarker, in our secondary prevention patients.
Lp(a) and vascular inflammation: data from perivascular fat attenuation index measurements
Authors: Simantiris S , Antonopoulos A S , Skoumas I , Andrikou I , Grigoriou K , Dima I , Antoniades C , Cokkinos D , Tousoulis D , Tsioufis K , Vlachopoulos C 
Published: June 2024

Abstract

Introduction/Purpose
Elevated lipoprotein(a) [Lp(a)] values consist an independent cardiovascular risk factor. So far, there are no approved pharmaceutical treatments available to reduce Lp(a) in clinical practice, while antisense oligonucleotides which can induce a drastic reduction of Lp(a) are under phase III clinical study. Based mainly on in-vitro studies, Lp(a) induces inflammation in the vascular wall through deposition in the endothelium, activation of the endothelium, and attraction of monocytes to the vascular wall. However, the relationship of Lp(a) with vascular inflammation is not well documented by clinical data. In the present study, we investigated the relationship of Lp(a) levels with coronary inflammation based on the perivascular fat attenuation index (FAI) from coronary computed tomography angiography (CCTA) images.

Materials and methods
In the present study, 40 participants under optimal hypolipidemic treatment who underwent CCTA for clinical reasons were enrolled. Exclusion criteria included history of autoimmune disease with active systemic therapy, chronic treatment with any anti-inflammatory agents, active malignancy, and history of acute coronary syndrome, reperfusion, or NYHA class III/IV heart failure. CCTA images were analyzed for vascular inflammation based on the FAI of perivascular adipose tissue around the right coronary artery.

Results
The group of participants was divided into 2 subgroups, one with Lp(a)≥ 50 mg/dl (n=14) and one with Lp(a)&lt; 50 mg/dl (n=26). There was no statistically significant difference between the 2 subgroups in the incidence of classic cardiovascular risk factors or LDL cholesterol levels. However, patients with elevated Lp(a) had greater FAI values around the right coronary artery (-69.17 vs. -75.26 HU, p= 0.02) (Figure 1).

Conclusions
Higher serum Lp(a) values were associated with increased FAI values around the right coronary artery on CCTA images. These pilot findings highlight the potential role of Lp(a) in vascular inflammation, which should be further explored in future studies.
Sarcopenic obesity - a hidden problem in cardiovascular risk
Authors: Bernardes P , Marinheiro R , Sousa A R , Ferreira C , Madeira M , Ferreira J , Coelho R , Quintal J , Pohle C , Rato Q , Seixo F 
Published: June 2024

Abstract

Introduction
Sarcopenic obesity is defined as the coexistence of body fat accumulation and muscle loss. It seems to be a more severe disorder than obesity alone.

Purpose
We aimed to determine the prevalence of probable sarcopenic obesity among the Portuguese elderly and the association between sarcopenic obesity and cardiovascular (CV) risk.

Methods
A prospective study based on the information collected through the application of the SARC-F questionnaire. SARC-F was used as a screening tool to identify probable sarcopenic patients (SARC-F ≥4). Obesity was defined as a body mass index (BMI) ≥ 30 Kg/m2.

Results
We prospectively evaluated 215 participants, aged 65-90 years, recruited at a local cardiovascular screening event in May 2023; 54% were male.
We found that 26% were probable sarcopenic and 27,4% had a BMI &gt; 30 kg/m2. The prevalence of sarcopenic obesity in our population was 13% and 61% of them were women. Also, there was a significant association between a higher body mass index and sarcopenia for SARC-F ≥4 (OR: 4,1; p-value &lt; 0,001).
There wasn’t a statistically significant difference in the prevalence of hypertension (64.3% vs 54.8%, p= 0,461), diabetes mellitus (64.3% vs 51.6%, p= 0,325), smoking (39.3% vs 35.5%, p= 0,763), hypercholesterolemia (64.3% vs 38.7%, p= 0,05) and sedentary lifestyle (100% vs 97%, p= 0,338) between individuals with probable sarcopenic obesity and obese adults with no sacopenia.
Cardiovascular risk, assessed by SCORE2 and SCORE2-OP, in the probable sarcopenic obesity group was statistically significantly higher than in obesity group with SARC-F &lt;4 (U = 91, p-value &lt; 0,001). Image 1.

Discussion and Conclusion
Using SARC-F as a screening tool for sarcopenia, this study found a similar prevalence of sarcopenic obesity, when comparing to the global numbers of this major health challenge.
Although there wasn’t a statistically significant difference in the prevalence of individual risk factors between groups, we conclude sarcopenic obese patients had a higher cardiovascular risk score when compared with obese patients, which is in agreement with its close relationship with cardiovascular disease.
Since sarcopenia is not taking into account when cardiovascular risk is assessed, we demonstrate that screening tests for sarcopenia may be useful to add information to CV risk. More studies are needed to assess if sarcopenia is associated with an effective higher CV risk in a long-term follow-up, in addition to the tools that are used nowadays.
Evaluating the prevalence, screening, and management of diabetes mellitus in general cardiology patients
Authors: Pinter J , Lakos B , Szikszai E A , Farkas A S , Farkas A 
Published: June 2024

Abstract

Introduction
Diabetes mellitus (DM) is a major cardiovascular risk factor that not only increases the incidence but also adversely affects the prognosis of various cardiovascular morbidities. Current literature lacks comprehensive data on the glycaemic status among the typical patient population in general cardiology wards.

Purpose
This study assessed the prevalence, screening practices, and treatment trends of dysglycaemia (comprising both DM and preDM) in patients hospitalized in a general cardiology department.

Methods
Data from 952 consecutive patients admitted to our Cardiology Ward between January 1, 2017, and December 31, 2019, were retrospectively analysed. The diagnostic criteria for DM and preDM were based on the rigorous guidelines recommended by the American Diabetes Association. McNemar test was utilized when comparing treatment modifications post-therapy revision.

Results
The age of the patients was 69.2±12.8 years (mean±SD) in the cohort. The most common cardiovascular diagnoses among our patients were hypertension, ischaemic heart disease, heart failure, and atrial fibrillation. At admission, 36% of the patients had already been diagnosed with dysglycaemia. Treatment revision in known diabetic patients, due to suboptimal DM treatment, resulted in a significant reduction in the usage of insulin and sulphonylurea (from 34% to 27% and from 23% to 10%, respectively; p&lt;0.01), and a notable increase in SGLT2-I therapy (5% to 12%; p&lt;0.01) at discharge. 54% of patients without a prior carbohydrate metabolism disorder diagnosis underwent HbA1c testing or an oral glucose tolerance test, revealing 233 new cases of DM or preDM, accounting for 71% of the 329 screened patients. Consequently, 60% of the hospitalized patients had DM or preDM diagnosis at discharge. Metformin therapy was commenced in 50% of the newly diagnosed dysglycaemic patients.

Conclusions
The present study indicates that nearly two-thirds of hospitalized cardiology patients suffer from dysglycaemia, with many cases undetected or not being on optimal medical treatment prior to hospital admission. Our results highlight the critical need for systematic diabetic screening in cardiology patients, and also emphasise the necessity to update the medical therapies for diabetic patients by transitioning to more optimal antidiabetic treatment. Our findings underscore the need for adopting a cardiometabolic approach in routine cardiology care.
Effects of rotating shift work schedule on blood pressure dipping profile in healthy nurses
Authors: Ioannidis A , Tsaloglidou A , Papadopoulos C , Pantelas N , Tsounis D , Giournta A M , Gournaki E , Sidera C , Markidou E , Kafkia T 
Published: June 2024

Abstract

Background/Introduction
The impact of rotating shift work on cardiovascular health has been a subject of increasing interest, particularly in professions such as nursing where irregular work hours are common. The prevalence of non-dipping blood pressure (BP) in healthy population is estimated to be around 10-20%.

Purpose
This study aims to investigate the effects of a rotating shift work schedule on the BP dipping profile in a cohort of healthy nurses.

Methods
A cross sectional observational study was conducted among a group of healthy nurses working in an intensive care unit. Ambulatory blood pressure monitoring (ABPM) was employed to assess the participants' BP profiles on the non-working day following a morning, afternoon, or night shift. The wake and sleep periods used were reported in sleep diaries and confirmed by a smartwatch that has demonstrated accuracy in detecting sleep and awake status.

Results
The sample of the study consisted of 22 nurses (19 female and 3 male) with mean age 42±8.2 years. A total of 46 ABPM recordings were interrogated with average 24-hour, average asleep and average awake BPs within normal limits for both systolic and diastolic BP. The average sleep time was 6.4±0.7 hours. The mean decrease in systolic and diastolic BP was 12.4±5.1% and 13.2±5.4 % respectively with smaller reductions after a night shift (see Picture 1). Nine nurses (40.9%) presented a non-dipper profile in at least one ABPM recording, even though no nurse was a constant non-dipper.

Conclusion(s)
Healthy nurses working on a rotating shift schedule manifest a blunted BP dipping profile. The findings suggest that rotating shift work may contribute to disruptions in BP parameters, potentially increasing the risk of cardiovascular complications. Further research is needed to elucidate the underlying mechanisms and to develop targeted interventions aimed at mitigating these adverse effects on the cardiovascular health of shift-working professionals.
Exploring predictors and correlations of COVID-19 impact in revascularized patients
Authors: Musayev O , Dashdemirov R , Ibrahimov F , Musayev K , Alimli Z , Gafarova M , Mushtagzadeh N 
Published: June 2024

Abstract

Background/Introduction
In the context of the global COVID-19 pandemic, this retrospective study delves into the repercussions of the virus on individuals with a history of revascularization. Our investigation centers on understanding the correlation between COVID-19 status and an extensive spectrum of risk factors, elucidating their impact on clinical outcomes in COVID-positive populations.

Purpose
To highlight the multifaceted impact of COVID-19 on individuals with a history of revascularization, emphasizing the correlation between COVID-19 status, diverse risk factors, and clinical outcomes. This study underscores the imperative for tailored risk assessment and management strategies, particularly in a primary care setting.

Methods
A cohort of 1768 patients, revascularized two years prior to the pandemic, was categorized into COVID-negative (n=1148) and COVID-positive (n=620) groups. Comprehensive retrospective data on various risk factors, including hypertension, diabetes, smoking status, stroke history, family history, and chronic kidney disease (CKD), were collected. Clinical outcomes, meticulously documented, encompassed hospitalization, mortality, repeat revascularization, and control coronary angiography (CAG). Statistical analyses, including correlation assessments, were conducted, focusing on the COVID-positive subgroup.

Results
Within the COVID-positive subgroup of 620 revascularized patients, our analysis uncovered significant correlations between COVID-19 status and risk factors. Notably, increased hospitalization rates showed significant associations with stroke (ρ = 0.125**, p= 0.002), diabetes (ρ = 0.140**, p = 0.000), and CKD (ρ = 0.095*, p= 0.018). Additionally, a higher risk of death correlated with stroke (ρ = 0.080*, p = 0.047) and chronic kidney failure (ρ = 0.200**, p = 0.000).

Conclusion(s)
This study contributes to the growing body of knowledge in preventive cardiology by highlighting the intricate interplay between COVID-19, risk factors, and clinical outcomes in individuals with a history of revascularization. The observed correlations underscore the necessity for tailored risk assessment and management strategies in the primary care of this vulnerable population during the ongoing pandemic.