bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 17232: Amiodarone Inhibits Small Conductance Ca
2+
-Activated K
+
(SK2) Channel Expressed in HEK-293 Cells
Authors: Turker Isik , Chang Po-Cheng , Chen Zhenhui , Chen Peng-Sheng , Ai Tomohiko 
Published: April 2024

Abstract:

Introduction:
Our recent study showed that apamin-sensitive K+ currents (IKAS), mainly carried by SK2 channel, is upregulated in failing ventricles. IKAS upregulation predisposes heart failure patients to recurrent ventricular fibrillation (electrical storm) by shortening of the action potential duration after initial successful defibrillation. Amiodarone is the drug of choice for the treatment of electrical storms.

Hypothesis:
Amiodarone can inhibit SK2 currents at therapeutic concentrations.

Methods:
The pCMV6 plasmids containing human KCNN2, the gene encoding SK2 channel (transcript variant 1:
NM_021614
), were cotransfected with the pcDNA3 plasmids containing GFP into HEK-293 cells using Lipofectamine 2000. Effects of amiodarone were studied using whole-cell and inside-out mode of patch-clamp methods at 36°C. SK2 currents were induced with voltage-pulse protocols and various concentrations of intracellular Ca2+.

Results:
The whole-cell SK2 currents showed Ca2+-dependency (IKAS at +40 mV: 25.5 ± 9.7 pA/pF with 250 nM [Ca2+]i, n = 5; 60.4 ± 24.9 pA/pF with 500 nM [Ca2+]i, n = 5; 180.0 ± 16.9 pA/pF with 1 µM [Ca2+]i, n = 15). Amiodarone inhibited the SK2 currents activated with 1 µM intrapipette Ca2+ in a dose-dependent manner (IC50, 1.73 ± 0.01 µM, Hill coefficient, 1.28 ± 0.01, total n = 15), and the block was not voltage-dependent. The maximal inhibition was observed with 50 µM amiodarone, and 70.0 ± 7.2% of IKAS was inhibited with 1 µM intrapipette Ca2+ (n = 15). The inhibitory effects of amiodarone on the IKAS with 500 nM intrapipette Ca2+ was similar (66.0 ± 8.6% at 40 mV, n = 5). However, we did not observe any inhibition of the IKAS with 250 nM intrapipette Ca2+ (n = 5). Interestingly, amiodarone did not inhibit the inside-out SK2 currents (n = 3).

Conclusions:
Amiodarone inhibits SK2 channel at therapeutic concentrations. The SK2 blocking effects may explain the efficacy of amiodarone in treating electrical storm.
Abstract 17562: Poorer Survival with Insulin Therapy at Discharge in Diabetic Patients with Acute Myocardial Infarction: The FAST-MI Registry
Authors: Puymirat Etienne , Vedrenne Geraldine , Donataccio Maria Pia , Aissaoui Nadia , Machecourt Jacques , Zeller Marianne , Carrie Didier , Ferrìeres Jean , Simon Tabassome , Danchin Nicolas ,   FAST-MI investigators
Published: April 2024

The role of insulin therapy after AMI is debated. We assessed 3-year survival in survivors of AMI with diabetes, according to the prescription of insulin at discharge. All patients were included in the FAST-MI registry, a French nationwide registry of patients with AMI hospitalized in 2005 in 223 institutions.
Of the 1228 diabetic patients, 467 (38%) had insulin at discharge. These were older (70±12 vs 69±12 years, p=0.004), had a higher GRACE risk score (156 ± 33 vs 147 ± 35, p<0.001), higher admission glycemia (232 ± 110 vs 190 ± 85 mg/dL, p<0.001), higher HbA1c (8.1 ± 1.6 vs 7.2 ± 1.4, p<0.001) and longer duration of diabetes (diabetes Hx >10 years: 35% vs 16.5%, p<0.001). Type of MI did not differ (STEMI: 39% vs 44%, p=0.11). Fewer patients in the insulin group had coronary angiography (78% vs 88%, p<0.001) or PCI (53% vs 67%, p<0.001) during the hospital stay. Optimal medical therapy at discharge was prescribed in 51% vs 47% of the patients, respectively (P=0.12). Finally, other antidiabetic medications at discharge were less frequent in the insulin group (metformin: 8% vs 25%, p<0.001; sulfonylureas: 9% vs 36%, p<0.001; glitazones: 0.2% vs 3.4%, p<0.001).
Three-year survival was 66% in insulin-treated versus 80% in patients without insulin (p<0.001). Subgroup analyses confirmed higher mortality in patients with insulin at discharge in both STEMI and NSTEMI patients, in those aged 75 years or less, or in those with or without PCI.
Using Cox multivariate analysis (covariates: age, sex, risk factors, comorbidities, type of AMI, CAD extent, use of PCI, use of CABG, HbA1c and admission glycemia levels, duration of diabetes, in-hospital complications, and other discharge medications), the adjusted HR for 3-year death was 1.56 (1.15-2.10), p=0.004, for patients with insulin at discharge; when treatment with insulin within 48 hours of admission was added to the model, the HR was 1.40 (1.06-1.84), p<0.02. Finally, in propensity score matched cohorts (n=240 in each group), HR for death at 3 years was 1.41 (1.01-1.98), p=0.04 for patients receiving insulin.

Conclusion:
in this real-world nationwide registry, the prescription of insulin at discharge in diabetic patients was associated with poorer long-term survival, even after extensive multivariate adjustment for confounders.
Abstract 18244: The Association Between South Asian Ethnicity and Long-term Survival Among Patients Undergoing Coronary Artery Bypass Grafting
Authors: Martin Billie-Jean , Norris Colleen M , Southern Danielle A , Quan Hude , Ross David B , Ali Imtiaz S , Knudtson Merill L , Bainey Kevin 
Published: April 2024

Introduction: South Asians (SA) have a high burden of coronary artery disease (CAD) often requiring coronary artery bypass grafting (CABG). However, CABG outcomes in this population have not been explored. The objective of this study was to assess the survival of patients of SA descent undergoing CABG in a large, well described Canadian cohort.
Methods: All patients who underwent CABG between 1996 and 2010 were identified from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease registry. Ethnicity was determined using the Nam Pehchan surname software. Differences in long-term survival were compared between SA and European (EC) patients using adjusted and then unadjusted cox proportional hazards models. SA subjects were then matched 1:1 with EC counterparts using a non-parsimonious propensity model to balance groups; models were then re-run with the matched cohort.
Results: Of the 20608 patients undergoing CABG, 608 were SA. SA patients were younger (63.8 vs 65.8 years) and had a higher prevalence of diabetes (39.5 vs 27.7%), but a lower prevalence of smoking (13.3 vs 25.3%) than EC patients (all p<0.001). There were 5382 deaths long-term with a median follow-up of 7.2 years. Ninety-one deaths occurred in SA patients, 5291 in the EC patients. Kaplan-Meier survival analysis demonstrated a lower incidence of death in the SA patients (log rank, p<0.0001) (Figure). In the unadjusted Cox PH model, SA ethnicity was associated with reduced mortality (Hazard Ratio 0.53, 95% CI 0.43, 0.66), an association that persisted in the adjusted model (HR 0.63, 95%CI 0.51, 0.78). All SA subjects were matched to EC counterparts. In the matched cohort SA ethnicity remained associated with reduced mortality (HR 0.68, 95%CI 0.52, 0.90).
Conclusion: In a large prospective Canadian registry, SA undergoing CABG appear to have improved long-term survival compared to EC patients. The reasons behind this striking difference in mortality deserve further exploration.
Abstract 183: Life-Threatening Arrhythmias in Patients Hospitalized with Acute Coronary Syndrome: Data from Latvian Registry 2008-2010
Authors: Kalejs Oskars , Maca Aija , Zakkw Ilja , Ratobilska Svetlana , Mintale Iveta , Kamzola Ginta , Zabunova Milana , Narbute Inga , Jegere Sanda , Erglis Andrejs 
Published: April 2024

Purpose. Despite the major improvements in the care of patients with acute coronary syndrome (ACS), life - threatening arrhythmia (LTA) remains a common complication of myocardial infarction (MI). We have analyzed the rate of LTA in first hours after hospitalization in patients presenting with acute coronary syndrome and receiving different treatment strategies. Materials and methods. The data from Latvian registry of ACS in years 2008-2010 were analyzed. LTA was defined: complete AV block, unsustained/ sustained ventricular tachycardia (VT), ventricular fibrillation (VF).
Results. In STEMI cohort, the incidence of LTA was significantly lower in PCI group after six hours (p<0.05) than in patients receiving thrombolysis. In first two hours LTA incidence was higher in PCI patients, what we can be explained with earlier reperfusion changes and electrical instability. In non-STEMI cohort, the incidence of LTA was significantly lower than in STEMI patients (p<0.01), but it was higher in non-invasive group compared to invasive treatment group. LTA rate was significantly
reduced in statin users (p<0.05).
Conclusions. Despite the more aggressive treatment strategy, incidence of LTA remains high in ACS patients. Arrhythmias are often observed earlier in patients after PCI and later after thrombolysis. Earlier PCI can decrease late complication rate and potentially improve
survival in STEMI patients.
Abstract 18368: Role of miR-146a in Angiogenesis and Myocardial Regeneration
Authors: Widmer-Teske Rebecca , Kueppers Kai , Bielenberg Wiebke , Daniel Jan-Marcus , Troidl Christian , Nef Holger , Hamm Christian , Sedding Daniel 
Published: April 2024

Background Myocardial infarction leads to cardiac remodeling and development of heart failure. Myocardial remodeling and regeneration critically depends on myocardial capillary density after myocardial infarction. However, the underlying mechanisms of myocardial angiogenesis are not well understood.
Methods and Results Here, we show that the small noncoding RNA microRNA-146a (miR-146a) is upregulated in ischemic cardiac regions in C57Bl-6 mice following LAD-ligation. In vitro, overexpression of miR-146a significantly attenuates endothelial cell proliferation and migration, abolishes endothelial capillary network formation on Matrigel, and inhibits cell sprouting from endothelial spheroids. In contrast, knock-down of miR-146a significantly augments endothelial cell proliferation, migration, network formation and sprouting. So far, IRAK1 and TRAF6, were identified by in silico predictive approaches as direct targets of miR-146a and validated by reciprocal regulation on mRNA and protein levels as well as luciferase gene reporter assays in endothelial cells. In vivo, blocking of endothelial miR-146a significantly enhances angiogenesis as determined by matrigel plug assays. Moreover, inhibition of miR-146a by systemic application of specific antagomirs enhances myocardial vascularity and limits myocardial infarct size in mice, which results in preserved cardiac function (FS: 22±4 vs. 11±2; n=6; P<0.01).
Conclusions Our findings indicate that miR-146a acts as a critical regulator of endothelial cell angiogenesis during myocardial regeneration. Moreover, miR-146a may represent an attractive target for future therapeutic interventions for the treatment of ischemic heart disease.
Abstract 18386: The Association Between Tissue Characteristics Evaluated with Optical Coherence Tomography and Mid-term Results after Paclitaxel-eluting Balloon Dilatation for In-stent Restenosis Lesions: a Comparison with Plain Old Balloon Angioplasty
Authors: Tada Takeshi , Kadota Kazushige , Kubo Shunsuke , Ozaki Masatomo , Hyoudou Yusuke , Miyake Koshi , Hayakawa Yuki , Saito Naoki , Otsuji Hideaki , Otsuru Suguru , Hasegawa Daiji , Shigemoto Yoshikazu , Habara Seiji , Tanaka Hiroyuki , Fuku Yasushi , Oka Naoki , Kato Harumi , Yamamoto Hiroyuki , Goto Tsuyoshi , Mitsudo Kazuaki 
Published: April 2024

Background: The morphological assessment of neointimal tissue using optical coherence tomography (OCT) is highly significant to clarify the pathophysiology of in-stent restenosis (ISR) lesions. These OCT findings may be related to recurrence of ISR. Meanwhile, the effectiveness of paclitaxel-eluting balloon (PEB) dilatation for ISR lesions was reported recently. The aim of this study was to define the impact of OCT findings on recurrence of ISR after PEB dilatation compared with plain old balloon angioplasty (POBA).
Methods: Between July 2008 and November 2011, we performed percutaneous coronary intervention for 165 ISR lesions in 141 patients using PEB (109 lesions, PEB group) or POBA (56 lesions, POBA group). The morphological assessment of neointimal tissue at the minimum lumen area site using OCT, including restenotic tissue structure (homogeneous, heterogeneous, or layered type), restenotic tissue backscatter (high or low), visible microvessels, lumen shape, red or white thrombus, lipid-rich plaque (lipid arc more than 90 degrees) was performed. We examined the association between lesion morphologies and mid-term (6-8 months) results including ISR and target lesion revascularization (TLR) rates.
Results: The patients were 114 men and 27 women, and the mean age was 68.9 ± 9.6 years. The association of tissue structure with ISR and TLR in both PEB and POBA groups are shown in the figure. The ISR rate of lesions with high backscatter was significantly lower in the PEB group than in the POBA group (17.2% vs. 40.0%, p<0.05). Both ISR and TLR rates of lesions without lipid-rich plaque were significantly lower in the PEB group than in the POBA group (ISR: 22.7% vs. 58.3%, p<0.01; TLR: 15.9% vs. 41.6%, p<0.05). There was no significant difference in other factors between two groups.
Conclusions: The morphological assessment of ISR tissue using OCT might be useful to identify ISR lesions favorable for PEB dilatation.
Abstract 18544: Geometry and Function of Left Ventricle and Mitral Valve After Surgical Repair of Submitral Left Ventricular Aneurysms Assessed with Multi-slice Computed Tomography
Authors: Penkalla Adam J , Solowjowa Natalia , Dandel Michael , Pasic Miralem , Weng Yuguo , Hetzer Roland , Knosalla Christoph 
Published: April 2024

Objectives: Surgical repair of submitral aneurysms presents a technical challenge especially if the mitral valve (MV) apparatus is involved. We present our single center surgical experience and the potential of multi-slice computed tomography (MSCT) in the assessment of aneurysm morphology and changes in MV and LV geometry.
Methods: In 05/06-04/12, 21 patients (m:w=17:4, ages 39 to 78, mean 63 yrs; mean NYHA class 2.8) with submitral LV aneurysm were operated upon. Echocardiography and MSCT (Somatom Definition, Siemens) were performed before and after surgery. LV and aneurysm end-diastolic/end-systolic volume were measured and indexed to body surface area (LV-EDVI/LV-ESVI, A-EDVI/A-ESVI). LV ejection fraction (LVEF), cardiac output (CO) and cardiac index (CI) were calculated on the basis of MSCT data. MV geometry was characterized by mid-systolic coaptation distance (CD), tenting area (TA) and MV closure angle (MVCA).
Results: Thirty-day and 5-year survival was 88.9%±7.4% and 82.1%±9.5%. Aneurysms were localized in myocardial segments 4/10/11. Preoperative A-EDVI showed a slight systolic increase, demonstrating adverse volume shift. There was reduction of LV-EDVI (141.4±21.6 to 72.7±12.9 ml/sqm, p=0.006) and LV-ESVI (102.2±24.9 to 42.5±9.9 ml/sqm, p=0.024), LVEF improvement (32% to 45%, p=0.016) and significant increase in CO and CI after surgical repair. Mitral repair/replacement was necessary in three patients. Postoperative reduction of mitral regurgitation (from grade 0.94 to 0.24, p=0.003) corresponded with improvement of MV geometry (CD (reduced from 10.2 to 7.9 mm, p=0.06) and of TA (1.8 to 1.5 sqcm, p=0.04) and MVCA (103° to 116°, p=0.04).
Conclusions: Reconstruction of submitral LV aneurysms can be performed with good mid-term results. MSCT provides valuable information about aneurysm localization, its extent and effect on MV and LV geometry and reverse remodeling, and also functional changes after surgical restoration.
Abstract 18767: Preoperative Echocardiographic Predictors of Left Ventricular Remodeling After Surgical Correction of Mitral Regurgitation Caused by Leaflet Prolapse
Authors: MacHaalany Jimmy , Parenteau Julie , Dubois-Sénéchal Isaïe-Nicolas , Bernier Mathieu , Costerousse Olivier , Bertrand Olivier F , O'Connor Kim , Dubois Michelle , Voisine Pierre , Sénéchal Mario 
Published: April 2024

Background: This study sought to determine whether preoperative echocardiography analysis before mitral valve surgery is predictive of postoperative left ventricular dysfunction in patients undergoing valve surgery for severe mitral regurgitation caused by leaflet prolapse.
Methods: In 72 consecutive patients without coronary artery disease undergoing valve repair (n=29, 40%) or replacement (n=43, 60%), preoperative, early postoperative (1-2 days) and late postoperative (4.5 ± 2.5 months and 18 ± 8.0 months) echocardiographic parameters, including left ventricular (LV) dimensions, volumes and ejection fractions (EF) were measured. Patients were stratified and analysed in 3 different groups according to their respective baseline LVEF (group 1: EF ≥ 60, group 2: EF = 45-59%, group 3: EF < 45%).
Results: Over a mean follow-up period of 546 ± 244 days, our cohort’s echocardiographic parameters showed the following reductions from baseline: LVEF: 56% ± 8 to 53% ± 9 (p<0.0001), LV end-diastolic dimension: 58.0mm ± 8.0 to 47.0mm ± 5.0 (p<0.0001) and LV end-systolic dimension: 41.0mm ± 8.0 to 33.0mm ± 6.0 (p<0.0001) respectively. Subgroup analysis revealed that only those with LVEF ≥ 60% recovered to a completely normal EF. Additionally, two-third of the observed changes in LV diameters and volumes occurred in the first 6 months. No difference in remodelling parameters was seen during the follow-up period between patients who underwent mitral valve replacement versus mitral valve repair. Finally, multivariate analysis demonstrated that pre-operative LVEF is an independent predictor of a poor post-operative LVEF (OR = 1.504 [1.249 - 1.966; p<0.0001]).
Conclusions: In patients with pure severe mitral regurgitation due to leaflet prolapse, significant positive LV remodelling can be expected irrespective of patient’s baseline EF. Remodelling is more important in the first 6 months after surgery but is usually progressive and occurs over a long follow-up period (≥ 12 months); however, only those with baseline EF ≥ 60% will usually recover to a normal EF. This reinforces our understanding that contemplation of early surgical intervention for severe mitral regurgitation secondary to leaflet prolapse will most likely yield a favourable effect on LV remodelling.
Abstract 189: Characterizing Continuous Capnography at the Onset of Return of Spontaneous Circulation
Authors: Bluhm David C , Yuen Trevor C , Edelson Dana P 
Published: April 2024

BACKGROUND: Manual pulse checks are often unreliable and result in prolonged pauses in chest compressions, which may be deleterious to patient outcomes. Capnography has the potential to minimize these pauses, but the threshold for determining a pulse is not known.
METHODS: We conducted a prospective study of consecutive, adult, in-hospital cardiac arrests with documented return of spontaneous circulation (ROSC) at a single academic center between April 2006 and March 2012. CPR parameters and capnography were recorded using a CPR-sensing defibrillator equipped with sidestream capnography (HeartStart MRX with QCPR, Philips Healthcare; MicroStream, Oridion). All cases with continuous capnography and compression data for at least 2 minutes preceding ROSC were included in the analysis. End-tidal carbon dioxide (ETCO2) values were extracted electronically using custom software and the nadir and peak surrounding the last chest compression were manually identified.
RESULTS: A total of 69 cases met inclusion criteria. The median ETCO2 nadir was 14 mmHg (range 2 - 23), which rose to a median peak of 43 mmHg (range 21 - 98), yielding a median relative rise of 215% (range 44-1944). The figure displays the changes in ETCO2 before and after the peak. The median time from nadir to peak ETCO2 was 108 s (range 24 - 501), and the median rise was 0.25 mmHg/s (range 0.05 - 0.92). The peak occurred a median of -4.4 s relative to the last chest compression. At the end of chest compressions, the median ETCO2 was 29 mmHg (range 13 - 58), without a significant drop-off when compressions were held. At the end of chest compressions, the median ventilation and heart rate were 14/min (range 6 - 34) and 126/min (range 36 - 225), respectively.
CONCLUSION: In this sample, we found that ROSC was accompanied by an abrupt increase in ETCO2. This rise has the potential to be used as a pulse detector. Future work should assess whether the failure of this rise obviates the need for a pulse check.
Abstract 18996: Comparison of Clinical Outcomes After Stent Implantation for Left Main Trunk Disease Between First- and Second-generation Drug-eluting Stent Eras
Authors: Hyodo Yusuke , Kadota Kazushige , Fuku Yasushi , Saito Naoki , Otsuji Hideaki , Otsuru Suguru , Hasegawa Daiji , Shigemoto Yoshikazu , Habara Seiji , Tada Takeshi , Tanaka Hiroyuki , Goto Tsuyosih , Mitsudo Kazuaki 
Published: April 2024

Purpose: In Japan, zotarolimus-eluting stent (ZES) became available from May 2009 and everolimus-eluting stent (EES) from January 2010 in addition to the first-generation drug-eluting stents (DES). The aim of this study was to clarify the impact of second-generation drug-eluting stent (DES) on clinical outcomes in left main trunk disease (LMTD).
Methods: A total of 238 patients (174 men, 64 women, mean age 70.8±10.1 years) who had undergone DES implantation for LMTD were classified into two groups: group A (first-generation DES era, 168 patients, March 2003 to April 2009, median follow-up period 1489 days, interquartile range [IQR] 1165-1967) and group B (second-generation DES era, 70 patients, May 2009 to December 2010, median follow-up period 608 days, IQR 450-721), and long-term clinical outcomes were assessed. Patients who had undergone percutaneous coronary intervention in the past were excluded.
Results: In group A, SES was deployed in 142 patients and PES in 3. In group B, ZES was deployed in 35 patients and EES in 18. Bifurcation lesion was significantly higher in group B (A, 75.6% vs. B, 88.6%, p=0.038). Syntax score showed no significant difference between groups (26.6±9.6 vs. 27.2±11.4, p=0.70). Stent strategy, either single- or two-stent, showed no significant difference (two-stent strategy: 30.4% vs. 28.6%, p=0.92). The Kaplan-Meier method revealed that the event-free survival rate of target vessel failure, defined as a composite of cardiac death, myocardial infarction, and target vessel revascularization, was significantly higher in group B (p=0.029).
Conclusion: Our data indicate that the outcomes of DES implantation for LMTD are more preferable in the second-generation DES era than in the first-generation DES era.