bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 77: Tachycardia During Hypothermia as a Marker of Poor Outcomes in Cardiac Arrest Survivors
Authors: Waters Theresa , Ji Yong , Liakos Matthew , Saour Basil , Khurana Vikash , Torosoff Mikhail 
Published: April 2024

Hypothesis: Therapeutic hypothermia in cardiac arrest survivors is typically associated with bradycardia. We investigated clinical and demographic variables and outcomes associated with tachycardia in patients treated with therapeutic hypothermia.
Methods: Demographic and clinical data, and ECGs of 26 consecutive cardiac arrest survivors (9 females, 58+/-18 years old, 5 with history diabetes, and 6 with history of coronary artery disease) on admission, during and after therapeutic hypothermia were reviewed. Analyses of variance, chi-square, and logistic regression were used. The study was approved by the IRB.
Results: Tachycardia (heart rate > 100 bpm, 81% sinus, no VT-VFib) was observed in 40% of ECG tracings before or during hypothermia or after re-warming. Tachycardia was more common in females (55 vs. 32%, p=0.044), patients with pulmonary disease (39 vs. 13%, p=0.009), or when pre-resuscitation rhythm was PEA (60 vs. 27%, p=0.003) or asystole (23 vs. 15%, p=0.003). Diabetes, myocardial ischemia, LV systolic dysfunction, acute infection, renal insufficiency, treatment with ACE inhibitors or diuretics were not associated with tachycardia. There were multiple biochemical abnormalities associated with tachycardia, including decreased pH (p<0.0001) and decreased hemoglobin (p=0.028), increased glucose (p<0.001), sodium (p=0.078), potassium (p=0.044), or creatinine (p=0.108).
Tachycardia was associated with significantly increased hospital mortality (53% vs. 28%, p=0.029), regardless whether it was observed on admission (63 vs. 38%), during hypothermia (67% vs. 33%), or after the re-warming (67 vs. 33%). In multivariate logistic regression analysis only cardiac arrest rhythm (HR of death with PEA-Asystole 11.1, 95%CI 3.2-38.4, p<0.001), but not demographic or biochemical variables or tachycardia (HR 1.7, 95%CI 0.5-5.8, p=0.391) were predictive of mortality.
Conclusion: Tachycardia in cardiac arrest survivors undergoing therapeutic hypothermia is a marker of poor prognosis, likely reflective of severe metabolic abnormalities, especially in patients presenting with pulseless electrical activity or asystole. More studies of this important subject are needed.
Abstract 93: A Percutaneous Left Ventricular Assist Device Improves Survival in a Porcine Model of Cardiac Arrest and Resuscitation
Authors: Derwall Matthias , Ebeling Andreas , Föhr Philipp , Brücken Anne , Nix Christoph , Fries Michael 
Published: April 2024

Introduction: Manual chest compressions usually result in 20-30% of normal vital organ blood flow. Hence, improving circulation during cardiopulmonary resuscitation (CPR) may increase the number of successfully resuscitated patients.
Hypothesis: Optimizing intra- and post-CPR hemodynamics by using a percutaneous intravascular left-ventricular-assist device (LVAD) instead of chest compressions increases the rate of return of spontaneous circulation (ROSC).
Methods: Seven pigs were instrumented with an LVAD (Impella 2.5, Abiomed, Danvers, MA) and a pulmonary artery catheter to measure mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), mean pulmonary artery pressure (MPAP) and pulmonary capillary wedge pressure (PCWCP). Data from previous experiments (Derwall et al. Shock 2010) using conventional CPR with a piston driven chest compressor served as control (n=8).
In both groups CA was electrically induced and left untreated for 10 minutes before CPR was attempted, either by activating the LVAD at the highest possible flow, or performing chest compressions at a rate of 100/min. After two injections of 1mg adrenaline and a total of 6 minutes CPR, defibrillation was attempted. Hemodynamic values were recorded for 120 minutes before animals were weaned from the respirator.
Results: On average, the LVAD delivered 1.3 ± 0.1 L/min during CPR (34 % of baseline CO) resulting in an increase in MAP from 18 ± 10 mmHg after 10 minutes of CA to 35 ± 2 mmHg before defibrillation (see Figure ; * indicates p<0.05 for MAP at 10 vs. 16 min). MAP, HR, MPAP and PCWP did not differ before CA or after 120 minutes following CPR. While all animals (n=7) in the LVAD group presented with ROSC following CPR, only 50% (n=4) of the animals in the chest compressions group could be successfully resuscitated (p=0.035).
Conclusion: Using a percutaneous LVAD instead of conventional chest compressions did not significantly alter post-CPR hemodynamics, but improved the rate of ROSC in this model.
Abstract 9363: Intervention for Re-coarctation in the Single Ventricle Reconstruction Trial: Incidence, Risk and Outcomes
Authors: Hill Kevin D , Rhodes John F , Aiyagari Ranjit , Baker G. H , Bergersen Lisa , Chai Paul J , Fleming Gregory A , Fudge J. C , Gillespie Matthew J , Gray Robert G , Hirsch Russel , Lee Kyong-Jin , Li Jennifer S , Ohye Richard G , Oster Matthew E , Pasquali Sara K , Pelech Andrew M , Radtke Wolfgang A , Takao Cheryl M , Vincent Julie A , Hornik Christoph P 
Published: April 2024

Objectives: To determine the incidence of re-coarctation (re-CoA), risk factors and outcomes in patients with single right ventricle lesions after Norwood.
Methods: The cohort included subjects randomized to right ventricle-pulmonary artery shunt (RVPAS) or modified Blalock Taussig shunt (MBTS) in the Single Ventricle Reconstruction (SVR) Trial. Re-CoA was defined by intervention, either catheter-based or surgical. Univariate analysis and multivariable Cox proportional hazard models were performed adjusting for center.
Results: Of the 549 SVR subjects, 97 (18%) underwent 137 interventions (92 balloon aortoplasty; 45 surgical) for re-CoA. Intervention typically occurred at pre-stage II catheterization (n=71, 52%) or at stage II surgery (n=44, 32%). Median age and catheterization gradient at first intervention were 4.9 months (range: 1.1-10.5) and 17 mm Hg (range: 0-60) respectively. Center intervention rates varied from 0-50%. In multivariable analysis, re-CoA was not associated with assigned shunt type, but was associated with actual shunt type received (HR 2.0 for RVPAS vs. MBTS, p=0.02), and Norwood discharge peak echo-Doppler arch gradient (HR 1.07 per 1 mm Hg, p<0.01). No other demographic, anatomic or surgical variables predicted intervention. Subjects with re-CoA demonstrated comorbidities at pre-stage II evaluation including higher pulmonary arterial pressures (15.4 ± 3.0 vs. 14.5 ± 3.5 mm Hg; p=0.05), higher pulmonary vascular resistance (2.6 ± 1.6 vs. 2.0 ± 1.0 WU x m²; p=0.04) and increased echocardiographic volumes (end-diastolic volume: 28.0 ± 7.4 vs. 24.9 ± 8.2 ml; p=0.01). There was no difference in 12-month post-randomization transplant-free survival for those with and without re-CoA (83% vs. 86%; p=0.5).
Conclusions: Intervention for re-CoA was common and varied by center. The association with receipt of an RVPAS may be due to intra-operative cross-over because of arch anatomy that prohibited use of a MBTS. Those undergoing intervention demonstrated ventricular dilation and worsened hemodynamics prior to stage II surgery. Although intervention was not associated with increased 1-year transplant/mortality, further evaluation is warranted to evaluate effects of morbidity of re-CoA.
Abstract 18277: Bioadhesive and Biodegradable Hyaluronic Acid-Serum Hydrogel Promotes Cardiac Regeneration
Authors: Chan Angel T , Vakrou Styliani , Woldemichael Kirubel , Afzal Junaid , Rittenbach Andrew , Lin Xiaoping , Brown Sophia , Wahl Richard , O’Rourke Brian , Abraham Theodore P , Tsui Benjamin M , Steenbergen Charles J , Elisseeff Jennifer H , Abraham M. R 
Published: April 2024

Cellular cardiomyoplasty is limited by low levels of engraftment due to cell egress from injection site and death due to anoikis/necrosis.
We hypothesized that tissue-engineered scaffolds that promote rapid cell adhesion would promote transplanted cell engraftment.

We custom-designed stem cell niches, examined encapsulated stem cell viability, proliferation and
18
FDG uptake. Acute cardiac retention was measured by cut/count after transplantation of
18
FDG labeled rat cardiosphere derived cells (CDCs), in vivo transplanted cell bioenergetics by dual isotope SPECT/CT imaging of Na-Iodide symporter
+
CDCs (after
99m
Tc-pertechnetate administration), and chronic engraftment by bioluminescence imaging (BLI) of luciferase
+
CDCs; LV function was assessed by echocardiography.

Crosslinking of N-hydroxysuccinimide-derivatized hyaluronic acid with autologous serum yielded bioadhesive, biodegradable hydrogels (HA:Ser) that promoted survival and proliferation of mouse embryonic stem cells, human mesenchymal stem cells, and CDCs (viability: 99%, 93%, and 95%; proliferation: 759%, 126%, and 322%, respectively at d7; n=3,
p<
0.05). I
n vitro
18
FDG uptake revealed rapid depression (0.13±0.01%ID/μg DNA) following trypsinization and prompt restoration by encapsulation in hydrogels (0.36±0.04%ID/μg DNA; n=4,
p<
0.05); in vivo
99m
Tc uptake of encapsulated CDCs at 1hr was 2.4fold higher than transplantation of suspended CDCs. Hydrogels boosted acute cell retention following intra-myocardial transplantation (hydrogel: 92±3%; suspended cells: 15±5%), in vivo BLI revealed CDC proliferation (20%increase) in hydrogels and cell loss (99% decrease; n=3,
p
<0.05) in the suspended cell group. Echocardiogram revealed increased in LVEF of 0.69±1.9% in control, 10.33±2.1% in epicardial HA:Ser and 12.9±4.1% in intra-myocardial HA:Ser (n=7,
p
<0.05) at d28 compared to d1 post-MI. Hydrogels also induced 5fold higher angiogenesis than controls.

In conclusion, HA:Ser hydrogels can be injected intramyocardially or applied epicardially as patches to beating hearts. These hydrogels induce rapid stem cell attachment, acute retention, in vivo proliferation and improve cardiac function following myocardial infarction.
Abstract 18851: Cardiovascular Disease: The Leading Cause of Pregnancy-Related Death in California 2002-2005
Authors: hameed afshan B , Foster Elyse , McCain Christy , Morton Christine , Main Elliott 
Published: April 2024

Introduction:
The California Pregnancy-Associated Mortality Review (CA-PAMR) was started in 2006 by the California Department of Health, Maternal, Child, and Adolescent Health Division in response to rising rates of maternal mortality with the goal of understanding and reducing maternal morbidity and mortality.

Methodology:
CA-PAMR uses an enhanced surveillance methodology to identify and investigate maternal deaths, as described previously. An expert committee reviewed medical records to determine pregnancy-related deaths, their clinical causes, contributing factors and opportunities for quality improvement.

Results:
From 2002-2005, there were 2,147,492 live births and 732 women died while pregnant or within 1 year of pregnancy. Among them, 207 were determined to be pregnancy-related: 53 were from cardiovascular disease (CVD) and two-thirds (n=33) of those from cardiomyopathy (CMP).

Compared to women who died from non-cardiac causes, women who died from any CVD were twice as likely to be African-American (39% vs. 17%, p<.01) and obese (BMI>30) (42% vs. 26%, p<.05), and had documented substance abuse during pregnancy (27% vs. 10%, p<.01) and to die ≥ 42 days postpartum (31% vs. 6%, p<.01). Almost a quarter (22%) of CVD deaths had a concomitant diagnosis of hypertension or preeclampsia.
Similarly, the CMP deaths were three times as likely to be African-American (46% vs. 18%, p<.01), twice as likely to be obese (47% vs 27%, p<.05), four times as likely with substance abuse (37% vs. 9%, p<.01), and to die ≥ 42 days postpartum (46% vs. 5%, p<.01). Concomitant diagnosis of hypertension or preeclampsia occurred in 30% of CMP deaths.
Overall, for those diagnosed before death (n=29), the mean time from symptom onset to diagnosis was 26 days (range=0, 223 days) and from diagnosis to death was 79 days (range 0, 347 days). Patient and health care provider factors were identified as having contributed to 86% and 71% of the deaths respectively, and 30% of the CVD deaths were considered potentially preventable.

Conclusion:
Medical expert review of maternal deaths has provided additional insight into CVD deaths that occur during or after pregnancy. Earlier recognition and referral of a symptomatic patient by obstetric providers may help prevent serious morbidity and mortality.
Abstract 18953: Prevalence of and Risk Factors for Radial Artery Complications After Transradial Cardiac Catheterization
Authors: Ruhnau Johannes , Schröder Stephen 
Published: April 2024

Background:
In recent years, radial access for cardiac catheterization gains popularity. One of the most common complications is radial artery occlusion (RAO). There are various numbers for the prevalence of RAO in literature, ranging from 5 to 30% when using a 6F sheath.

Our study was designed to investigate the prevalence of radial artery (RA) complications (RAO, false aneurysm, arteriovenous fistula) in a single center population using a 6F sheath.

Methods:
415 patients* (pts) were examined clinically and with duplex sonography 4 - 68 weeks after cardiac catheterization (60.7% (n=254) male, median age 68 y (33 - 88).

In n=103 pts (24.6%) an intervention had been performed immediately after the diagnostics.

Results:
Patient characteristics are summarized in table 1. RAO was found in 15/418 cases (3.6%, n = 10 female, n = 5 male). Of those 10 patients, 3 showed (transient) symptoms (dysaesthesia, feeling of heaviness of the hand), cases of critical ischaemia were not found.

No false aneurysm was found, one pt showed an arteriovenous fistula in the proximal RA. One patient showed significant stenosis of the middle portion of the brachial artery in addition to RAO, another one showed a mild stenosis of the RA.
Women showed a significantly higher rate of RAO (n = 10, 66.7% in the RAO group vs. n = 154, 40.3% in the comparison group, p = 0.03). Other risk factors seem to be diabetes (n = 6, 40% vs. n = 106, 26%) and renal insufficiency (n = 3, 20% vs. n = 43, 11%), although the risk was not significantly increased. Interestingly, a coronary intervention does not seem to increase the risk of RAO (n = 2, 13% vs. n = 101, 26%).
Hypertension, dyslipidemia, present or past smoking, body height, age, and BMI did not have significant influence.

Conclusion:
Vascular complications, especially RAO, after radial access for cardiac catheterization are quite rare and remain usually asymptomatic. Women are at higher risk. Diabetic pts and pts with impaired renal function seem to be at slightly higher risk.
Abstract 19016: ALK2 and ALK3 BMP Type I Receptors Are Required for the Development of Cardiac Hypertrophy
Authors: Shahid Mohd , Spagnolli Ester , Ernande Laura , Kolodziej Starsha , Mayeur Claire , Leyton Patricio , Scherrer-Crosbie Marielle , Bloch Kenneth D 
Published: April 2024

Bone Morphogenetic Proteins (BMP) signaling is required for the development of cardiac hypertrophy. BMP signaling mediates its action via BMP type I and type II receptors. We sought to determine which type I receptors are required for cardiac hypertrophy.
We studied BMP signaling in neonatal rat cardiomyocytes (NRCs) stimulated with phenylephrine (PE) or isoproterenol (ISO). In comparison with untreated NRCs, PE (10 μM) and ISO (10 μM) induced hypertrophy, as reflected by increases in cell size (457±50 and 401±35 vs 254±23 μm2, p<0.01) and expression of the gene encoding B-type natriuretic peptide (NPPB; 4.0±1.0 and 3.2±0.8-fold, p<0.01). PE and ISO induced expression of genes specifying BMP2 (6.7±0.5 and 5.6±0.6-fold), BMP7 (4.1±0.4 and 3.6±0.9-fold), and the BMP target gene, Id-1, (3.7±0.1 and 4.2±1.0-fold, p<0.001). PE and ISO also induced phosphorylation of BMP-responsive Smads 1 and 5 and increased activity of a BMP response element-luciferase reporter (14.5±0.8 and 11.9±1.1 vs 5.4±0.4, p<0.01). Incubation of NRCs with the BMP inhibitors, LDN193189 (100 nM) or noggin (100 ng/ml), markedly suppressed the ability of PE and ISO to increase cell size, NPPB gene expression, and Smad1/5 phosphorylation. qRT-PCR analysis revealed that ALK2 and ALK3 were highly expressed in NRC, whereas ALK1 and ALK6 were expressed at very low levels. siRNA-mediated silencing of ALK2 or ALK3, but not ALK1 or ALK6, blocked PE-induced hypertrophy in NRCs. Using cardiomyocytes from ALK1flox/flox and ALK2flox/flox neonatal mice infected with Ad-Cre (to delete the floxed allele) or Ad-RFP (as a control) revealed that PE-induced hypertrophy requires Alk2 but not Alk1.
Based on these observations, we conclude that BMP signaling is upregulated in NRCs in response to hypertrophic stimuli. ALK2 and ALK3 appear to be the BMP type I receptors which are required for the development of hypertrophy in neonatal cardiac myocytes.
Abstract 19079: Cd13 and Ror2 Markers of Pre-Cardiac Mesoderm
Authors: Skelton Rhys , Brady Bevin , Weissman Irving , Elliott David A , Ardehali Reza 
Published: April 2024

The human heart has a limited regenerative capacity and there is an unmet demand for improved therapies for myocardial disease. Human embryonic stem cell (hESC) derived cardiomyocytes have potential to facilitate the development of both cell-based and pharmaceutical treatments. To date many studies have focused on the efficient generation of cardiomyocytes from hESCs. However, its clinical use has been limited by technical challenges, including the inability to isolate a pure population of cardiovascular progenitors capable of robust engraftment and regeneration. To this end, we have attempted to identify surface markers that facilitate isolation of cardiac mesoderm and cardiovascular progenitors from differentiating hESCs.
Lineage-specific reporter hESC lines (MIXL1-GFP and NKX2.5-GFP) were utilized to test prospective isolation of early cardiac progenitors using two novel cell surface markers, CD13 and ROR2. A distinct population of cells co-expressing CD13 and ROR2 was isolated after 3 days of hESC differentiation which exhibited a transcriptional profile similar to primitive streak/mesoderm cells. Gene expression analysis and immunostaining confirmed the enrichment of mesodermal cells and near complete removal of endodermal, ectodermal and undifferentiated cells. To quantify the extent of cardiovascular progenitors generated from CD13/ROR2 expressing cells, an NKX2.5-GFP reporter hESC line was used and the double positive cells were sorted after 3 days and maintained in culture for 14 days. The majority of these cells showed enrichment for cardiovascular cells based on gene and protein expression, phenotype, and transplantation studies. By enabling retrieval of early mesoderm precursors from heterogeneous differentiated hESC populations, we anticipate CD13 and ROR2 should have utility in enriching for subsequent cardiac potential_the necessary first developmental step towards creating purified cardiomyocytes from hESC.
Abstract 19107: Trends in Atrial Fibrillation Hospitalization and Cost of Care in the United States From 1998-2010
Authors: Pant Sadip , Deshmukh Abhishek , Mehta Kathan , Raina Sameer , Badheka Apurva O , Patel Nileshkumar , Arora Shilp , Shah Neeraj , Tuliani Tushar , Mehta Jawahar L , Paydak Hakan 
Published: April 2024

Introduction:
The aim of our study was to investigate time trend in atrial fibrillation (AF) related hospitalization and the cost of hospitalization over the last decade in the United States and make projections for 2020.

Methods:
The Nationwide Inpatient Sample database was used to estimate the annual number and prevalence of hospitalizations with AF from 1998-2010.

Identification of AF-related hospitalizations was based on the designation of the International Classification of Diseases (9th Edition)
Clinical Modification (ICD-9-CM) diagnosis code 427.31 (AF) as the principal discharge diagnosis.

Results:
There were total 4,676,758 AF related hospitalizations from 1998-2010 in the US. The relative percentage increase in hospitalizations from 1998 to 2010 was 46%. We used exponential model to identify the trend (R2=0.88).

Assuming a similar trend in AF hospitalization over next decade, 541,000 hospitalizations can be expected in 2020 (28% relative increment from 2010). The cost of hospitalization follows a linear trend (R2=0.98) and is expected to rise by 55% in 2020 as compared to cost of care in 2010.

Conclusions:
These data indicate that AF related hospitalizations and the cost of care has increase tremendously over the last decade and is likely to pose a large public health burden in the future.
Abstract 19160: Prevention of Strokes in Patients With Mechanical Aortic Prostheses: Use of Clopidrogel or Prasugrel and Aspirin as Sole Anticoagulants
Authors: Garcia-Rinaldi Raul , Rodriguez-Acosta Juan , Bermudez David , Quinones Shaira , Quinones Jeannette 
Published: April 2024

Objective:
Embolization from mechanical aortic- prostheses is due to platelet activation and aggregation secondary to shear forces and the release of ADP from RBC. Anti-thrombotic therapy should be directed to the prevention of platelet activation instead of the suppression of coagulation factors. We summarize the long terms results of patients with mechanical aortic prostheses treated exclusively with antiplatelet agents.

Methods:
Starting in 2001 two hundred three (203) patients average age 63.8 ± 11.8 years received mechanical aortic prostheses alone or with other cardiac or thoracic procedures received a loading dose of clopidogel (300mg) or prasugrel (60mg) and aspirin (325mg) one hour after extubation. The maintenance dose was 75mg clopidrogel or 10mg prasugrel and 81mg ASA daily. Beginning 2006 we measured platelet reactivity with Accumetrics® and Thromboelectrography (TEG).

Platelet inhibition was measured 6 hours after loading. Patients not responsive to clopidogrel were changed to prasugrel. Follow up was at 1 and every 6 months by echocardiography and platelet reactivity.

Results:
Total months at risk were 9016.7(751.5 pt-yr) average follow up is 44.4 ± 37.8 months.

34 (16.7%) patients died. Seven patients had strokes (0.93% patient-years). Five strokes occurred in patients who discontinued the antiplatelet medication, one in a patient non responsive to clopidrogel and one in a compliant patient prior to 2006. We have not observed strokes since 2007 (5½ years).
9 patients bled (4%)(1.2% pt-yr), 8 from the GI tract and 1 from a cerebral aneurysm.
One non-compliant patient formed a clot in the prosthesis.

Conclusions:
Embolism from aortic prostheses is platelet mediated and should be treated with antiplatelet agents. We employed an antiplatelet regimen of clopidrogrel or prasugrel and aspirin as sole anticoagulants in patients with aortic mechanical prostheses. It is mandatory that the patient respond to the antiplatelet agent employed. In patients non responsive to clopidrogel, prasugrel is utilized.

With this protocol the incidence of bleeding is 1.2% pt-yr, and the incidence of stroke 0.93%/ pt-yr.
Our date is suggestive that dual antiplatelet therapy medications can prevent strokes in patients with aortic mechanical prostheses.
Future Directions in Vascular and Interventional Radiology
Authors: Gomes Antoinette 
Published: April 2024

The field of vascular interventional radiology remains a fertile area of development for minimally invasive techniques to diagnose and treat vascular disease. Innovative scientists and physicians actively collaborate to develop new treatment paradigms and to refine and enhance previously developed methodology. Exciting new areas of activity, including sympathetic renal denervation for the management of refractory hypertension, the application of nanotechnology and stem cells to stent development, and new balloon catheters, will be described.
Some of the organizational and scientific challenges to the development and implementation of these novel techniques will also be addressed.