bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 98: New Technique of Gas Adiabatic Expansion for Brain and General Hypothermia in Rabbit
Authors: Fontaine Guy H , Lapostolle Frederic , Pages Alban , Piquet Julie , Lalot Adrien , Didon Jean Philippe , Schmid Johan Jacob , Jouven Xavier , Chachques Jean Charles 
Published: April 2024

Background:
Irreversible brain damage is a major issue in the acute treatment of OHCA. Brain protection by fossa nasalis cooling on the field has been reported. We propose a new technique to produce cooling by adiabatic gas expansion. Preliminary in vitro and animal studies have demonstrated that Carbon Dioxyde was able to produce significant cooling. The purpose of this work was to quantify the amount of cooling produced by this method on a rabbit model.

Method:
Study population consisted of 8 New-Zealand rabbits 3.5 kg studied under ketamine anesthesia without ventilation. Three lead ECG were displayed and sampled. Temperatures in °C, were measured by thermocouples every minute: close to the injector exit located inside a 12mm Ø, 2mm thick PVC canula inserted in the mouth up to the oropharynx, in the mouth close to the canula, in the nasopharynx (equivalent to tympanic) and in the rectum. Temperature curves were displayed on line on a computer screen. Data were processed by Statistica v6.0. A p value ≤ 0.05 was considered as significant. After stabilization of temperatures, gas regulated at around 500 psi was delivered during a period of 13 ± 2.7 min and expanded at the exit of the injector.

Results:
The initial 90% drop of temperature was obtained near the injector in 3 ± 1.47 minutes. The table below compares the temperatures recorded at the Start of cooling and at the End of this experiment.

A significant low temperature was observed near the injector (-16.9°C), the nasopharynx (37.7°C) and the oropharynx (31.2°C). A tendency not reaching statistical significance was obtained on the core temperature (39.4°C).
No adverse side effect was observed during and after the experiment especially no injury to the throat by direct visual inspection.

Discussion:
Core temperature drop was similar to that reported in pigs after nasopharynx PFC evaporation (Yu et al Crit Care Med. 2010). The lowest temperature (-16.9°C) was recorded as expected at the exit of gas, however, oral and nasal temperatures remained within tolerable values. Stronger effect on nasal temperature can be due to better mechanical contact of the canula against the upper oropharynx wall. Non-significant core cooling was probably due to the limit imposed by distance despite normal blood circulation. Nevertheless, a clear tendency was obtained as previously observed with other techniques of fossa nasalis cooling.

Conclusion:
This study demonstrates for the first time that carbon dioxyde adiabatic expansion in the mouth is effective for brain and body hypothermia in a rabbit model. This new technique which is simple, not expensive and easy to use by a lay person opens new vistas for the treatment of OHCA which can be started intra-arrest before CPR.
Abstract 18356: Autologous Intracoronary Stem Cell Therapy is Safe and Feasible for Children With Dilated Cardiomyopathy: A Randomised Controlled Cross-Over Pilot Study
Authors: Pincott E. Sian , Ridout Deborah , Brocklesby Margaret , McEwan Angus , Muthurangu Vivek , Burch Michael 
Published: April 2024

Meta-analysis of adult stem cell therapy studies post myocardial infarction has shown moderate & sustained improvement of function. Positive results have also been seen in adult dilated cardiomyopathy (DCM) & chronic ischaemic heart failure. The place of stem cells in pediatric heart failure is unknown.
This randomised, blind, crossover placebo controlled trial sought to evaluate the potential use of stem cells in the management of pediatric heart failure & is the first of its kind within the pediatric population.

Methods & results:
Ten children (mean age 7.2y, range 2.2-14.1y, 6 male) with DCM were recruited from Heart Failure clinic. Patient profiles on study entry: NYHA/Ross class 3-4, ejection fraction (EF) on MRI mean 40% (range 30-48%). On enrolment patients were randomised to receive stem cell or placebo intracoronary injection & MRI, with cross-over of intervention at 6 months & final MRI assessment at 1 year. Bone marrow processing was performed using standard techniques. The mononuclear cells, obtained within 1.5 hours of aspiration, were divided to provide 1ml for coronary injection & 1ml for phenotyping. Intracoronary injections & MRI were performed under the same anaesthetic. Mononuclear cell count mean was 51.7 x 106/ml (range 11.8-115.1 x 106/ml).

Nine patients completed the protocol, the tenth patient had Duchenne Muscular Dystrophy (DMD) & did not undergo general anaesthesia, this data was excluded from the group analysis and is presented separately. There were no withdrawals, morbidity or mortality.
Primary end point, freedom from death or transplant, was achieved in all patients. Secondary end points, indexed end diastolic volume (EDV) 6 months post cell infusion for n=9, was reduced in 7 & unchanged in 2 (P=0.01 for comparison of means), end systolic volume (ESV) decreased in 6 following cell injection. (P=0.05 for comparison of means). EDV increased in 5 patients following placebo. EF did not change significantly. EDV reduced in all patients with an injected cell count >34.2 x 106.

Conclusion:
This pilot study demonstrates that intracoronary injection of autologous stem cells is safe & feasible in children. Encouraging data on EDV were generated, larger scale studies will be required to measure clinical effect.
Abstract 18492: Effectiveness of Lifestyle Intervention by Obesity Status: Does One Size Fit All?
Authors: Azar Kristen M , Xiao Lan , Ma Jun 
Published: April 2024

Most U.S. adults are overweight or obese with severe obesity projected to increase 130% within 2 decades. Little is known about the effectiveness of efficacious lifestyle intervention by severity of obesity once adapted to real-world settings. This study compared by baseline body mass index (BMI) category (25-≤30, 30-≤35, or 35+) the effects of 2 primary care-based lifestyle interventions among overweight or obese adults with pre-diabetes and/or metabolic syndrome randomized to receive usual care alone (n = 81) or usual care plus a coach-led (n = 79) or self-directed (n = 81) behavioral weight-loss intervention.

Each used a Diabetes Prevention Program-based 12-week core curriculum plus technology-mediated coach contact and self-monitoring for a total of 15 months. Between-group differences at 15 months were evaluated by intention-to-treat and tests of group by baseline BMI category interactions in repeated-measures (3, 6 and 15 months) mixed models (SAS, version 9.2). Compared to usual care, the coach-led intervention resulted in significantly greater reductions from baseline to 15 months in BMI (primary outcome) and weight for all categories, in waist circumference (WC) for BMI 25≤30 and 35+, and in fasting plasma glucose levels for BMI 30≤35 and 35+ (largest
P
= .02). In contrast, self-directed intervention led to greater improvements than did usual care in BMI (
P
= .03) and weight (
P
= .02) only for BMI 25≤30, in WC for BMI 30≤35 (
P
= .03), and in glucose levels for BMI 35+ (
P
= .02). Moreover, BMI and weight (
P
= .01) and WC (
P
= .04) reductions for BMI 35+ were significantly greater in the coach-led vs. self-directed intervention.

Overweight participants (BMI 25 ≤ 30) responded comparably to interventions, both of which were more effective than usual care.
In conclusion, baseline BMI may influence treatment effectiveness. Clinicians and researchers should take an individual’s baseline BMI into account when developing or recommending a weight-loss treatment strategy.
Abstract 18828: Comprehensive Lipidomic Analysis of Myocardial and Circulating Acylcarnitine Levels in Patients With Advanced Heart Failure Before and After Mechanical Unloading and Controls
Authors: Moore D’Vesharronne , Jiang Hongfeng , Cremers Serge , Wu Christina , Akashi Hirokazu , Takayama Hiroo , Naka Yoshifumi , George Isaac , Goldberg Ira , Schulze Paul Christian 
Published: April 2024

Background:
Advanced heart failure (HF) is associated with myocardial metabolic derangements and insulin resistance. Acylcarnitine (AC) accumulation has been suggested to be a marker of abnormal fatty acid metabolism and mitochondrial dysfunction. We hypothesized that ACs accumulate in the failing myocardium and blood of patients with HF compared to controls.

Methods:
Myocardial and plasma samples were obtained from HF patients during ventricular assist device (VAD) placement and explantation. Control (CON) samples were obtained from hearts not used for heart transplantation. CON plasma was collected from healthy donors. After methanol extraction of total lipids, ACs were measured by LC/MS/MS (MS ACQUITY UPLC).

Results:
Our study included 11 patients with HF (age 61±8 yrs, EF 17±5%, BMI 28±4 kg/m2) before and after LVAD placement and 6 CON (age 41 ±2 yrs, EF>60%, BMI 26±5 kg/m2).

Free carnitine levels decreased in failing myocardium compared to CON (15.7±11.8 vs 16.2±93.0 ng/mg, p<0.001) without plasma changes. Total ACs decreased in failing myocardium compared to CON (45.9±35.9 vs 132.2±94.0 ng/mg, p<0.01). Of note, the cardiac AC/carnitine ratio was higher in HF compared to CON (387% of con, p<0.001) and remained unchanged post-VAD.
Circulating total AC levels were higher in HF compared to CON (7.7±2.8 vs 4.7±2.7 ng/ml, p<0.05) with a decrease post-VAD (5.7±1.6 ng/ml, p<0.05 vs pre-VAD). Short chain (C2+C3), medium chain (C4-C12) and long chain ACs (C14-C18) were found increased in HF plasma (+162%, +158% and +174% vs CON, respectively; all p<0.05) with subsequent decrease post-VAD (-73%, -66% and -81% vs pre-VAD, respectively; all p<0.05). The circulating total AC/free carnitine ratio trended to be higher in HF (1.0±0.3 vs 0.7±0.4 in CON, p=0.1) without changes post-VAD.

Conclusion:
Metabolic derangements in HF include changes in circulating and cardiac ACs with a distinct response to mechanical unloading. An increased ACs/carnitine ratio suggests impaired fatty acid metabolism and mitochondrial dysfunction leading to accumulation of ACs in the failing myocardium. These novel findings implicate abnormal AC metabolism in the metabolic abnormalities and insulin resistance of patients with advanced HF.
Abstract 18873: Protection of CD39 Transgenic Mice From Cerebral Ischemic Injury
Authors: Baek Amy , Petrovic-Djergovic Danica , Liao Hui , Ray Jessica , Sutton Nadia , Kanthi Yogendra , Pinsky David 
Published: April 2024

Cerebral tissue damage after an ischemic event can be exacerbated by inflammation and thrombosis. Elevated levels of extracellular ATP and ADP are associated with cellular injury and promote inflammation and thrombosis. Ectonucleoside triphosphate diphosphohydrolase 1 (CD39), an enzyme expressed on the plasmalemma of leukocytes and endothelial cells, suppresses platelet activation and leukocyte infiltration by phosphohydrolyzing ATP and ADP.
To investigate the effects of increased CD39 in an in vivo model of cerebral ischemia, we developed a transgenic mouse expressing human CD39 (hCD39). A floxed stop sequence was inserted prior to the transcriptional start site of hCD39, generating a mouse in which the expression of hCD39 can be controlled in a tissue-specific manner with specific Cre recombinase mice. Here, we generated mice that express hCD39 globally, using an EIIA-Cre mouse. Bone marrow analysis showed similar endogenous CD39 mRNA between transgenic (TG) and wild type (WT) mice while expression of the human transgene was >3,600-fold greater than the mouse gene (p<0.0001, n=3). Cerebral ischemia was induced using a photothrombotic model of middle cerebral artery (MCA) occlusion, which is clinically relevant to ischemic stroke. After 48 hours, mice underwent brain MRI and infarct volumes were quantified. TG hCD39 mice had 37.8% smaller infarct volumes (p<0.05, n=5). A second cohort of mice was assessed for neurological deficits - TG mice showed lower deficits compared to WT (1.0 vs 1.5 based on an established 5-point scale p<0.02, n=8). Western blot analysis of non-ischemic hemispheres showed that TG mice had significantly more CD39 expression than WT mice (5.4-fold, n=3, p<0.0001) Leukocytes from ischemic and contralateral hemispheres were purified for flow cytometric analysis. While contralateral hemispheres had the same numbers of macrophages and neutrophils (CD45+/ F4/80+ and CD45+/Ly6g+ respectively), ischemic hemispheres from TG mice had 64% fewer infiltrating macrophages and 68% fewer neutrophils (p<0.001, n=8).
This is the first report of transgenic overexpression of CD39 in mice imparting a protective phenotype following stroke, with reduced leukocyte infiltration, smaller infarct volumes and decreased neurological deficit.
Abstract 19099: Epicarial Progenitors Contribute to Neonatal Mammalian Heart Regeneration
Authors: Kimura Wataru , Muralidhar Shalini A , Sadek Hesham O 
Published: April 2024

Heart failure is a costly and deadly disease affecting over 5 million Americans. At the core of the pathophysiology of heart failure is the inability of the adult mammalian heart to regenerate following injury. In sharp contrast to the adult mammalian heart, we recently showed that the neonatal mammalian heart is capable of complete regeneration, including re-vascularization of the myocardium, following resection of the ventricular apex or myocardial infarction (MI). However, this remarkable regenerative capacity is lost by 7 days post natally. The regenerative response of the neonatal mouse heart is mediated mostly by proliferation of pre-existing cardiomyocytes, which is in line with the mechanism of zebrafish heart regeneration. We also have shown that neonatal heart injury is associated with epicardial activation, which is also a hallmark of zebrafish heart regeneration. However, the lineage contribution of epicardial cells during neonatal mouse heart regeneration remains to be determined.
We performed genetic lineage tracing data using Capsulin (Cap)MerCreMer knock-in mouse crossed with Rosa26/tdTomato reporter mouse, in which epicardial cells are specifically and irreversibly labeled by tamoxifen pulse at postnatal day 0, revealed the contribution of neonatal epicardium to multiple lineages of the heart, including the majority of interstitial fibroblasts, vascular endothelial and smooth muscle cells both during normal post natal growth and after injury.. Considering that embryonic epicardial cells contribute to fibroblasts, vascular endothelial/smooth muscle cells and in contrast adult epicardium only contribute to interstitial fibroblasts and very rarely to vascular smooth muscle cells after the injury, it appears that lineage contribution of epicardial cells is highly correlated with the capacity for neovascularization following cardiac injury. These findings uncover a novel and important role of Capsulin positive epicardium derived cells in vasculogenesis during neonatal heart development and regeneration, and opens the door for future studies to better understand the dynamics of Capsulin expression and function in the post-natal mammalian heart.
Abstract 84: Effects of Edaravone on Brain Apoptotic Gene in CA/CPR Rats
Authors: Chen Meng H , Xie Lu 
Published: April 2024

Edaravone(3-methyl-1-phenyl-2-pyrazolin-5-one), a strong novel free radical scavenger, is used in clinically as a novel neuroprotective agent for the treatment of patients with acute ischemic stroke. We assessed the hypothesis that the neuroprotective effect of edaravone corresponding with brain apoptosis could improvethe survival outcomes in a rat model of cardiac arrest/cardiopulmonary resuscitation (CA/CPR).
Adult male Sprague-Dawley rats were divided into saline, edaravone groupssubjected to sham group (sham surgery, n=10), saline group (CA for 5 min following CPR and intravenous ejection of saline 1.5 ml/kg, n=20), edaravone (CA for 5 min following CPR and intravenous ejection of edaravone 3 mg/kg, n=20)groups. The resuscitated animals were observed for 72 h after the restoration of spontaneous circulation. The rat survival time, survival rate was assessed and the expression of caspase-3, caspase-8, Bax and Bcl-2mRNA at 12, 24, 48 and 72 hours in hippocampus was measured by real time-PCR.
Edaravone markedly enhanced the survival time and rate of rats (Kaplan-Meier analysis) after CA/CPR compared to saline group [(70.00±26.69) h, 95% CI (17.67-122.33)] vs[(23.00±3.91) h, 95% CI (15.33-30.67)] and (45% vs. 25%, χ2=4.900, P=0.027). The expression of apoptotic gene mRNA was significant upregulation (except caspase-8 and Bax in edaravone group at 72 h) in both the saline and edaravone groups (P<0.05) compared to sham group. Edaravone significantly decreased the expression of caspase-3, caspase-8 and Bax mRNA (P<0.05) and facilitate Bcl-2 expression (P<0.05) compared to saline group (Tab1-4). This study suggests that (i)CA/CPR results in upregulation of pro-and anti-apoptosis; (ii)edaravone suppresses the up-regulation of the pro-apoptotic gene expression and facilitates the expression of anti-apoptotic gene in the hippocampus, involved in the improvement of the survival outcomes after CPR.
Abstract 9364: Drug Eluting Stents Appear Superior to Bare Metal Stents for Vein Graft Pci in a Propensity Matched Cohort
Authors: Safwan Kassem , Jones Dan , Rathod Krishna , Gallagher Shaun , Guttmann Oliver , Weerackody Roshan , Jain Ajay , Knight Charles , Mathur Anthony , Wragg Andrew 
Published: April 2024

Background:
Research trials have shown improved short-term outcome with drug-eluting stents (DES) over bare metal stent (BMS) in Saphenous vein graft (SVG) PCI, primarily by reducing target vessel revascularization (TVR) for In-Stent Restenosis (ISR).

Because of the high event rates in these patients it is not clear if these benefits are maintained long term. We compared the outcomes in patients undergoing SVG stent implantation treated with DES or BMS, over a prolonged follow-up period using a propensity matched analysis.

Methods:
Clinical information was analysed from a prospective database on 512 patients who underwent PCI for SVG lesions between 2003 and 2010. 293 patients had PCI with BMS and 219 with DES. Propensity scores representing the estimated probabilities of patients receiving either DES or BMS were developed based on 15 observed baseline covariates in a logistic regression model with stent type as the dependent variable. The nearest-neighbour-matching algorithm with Greedy 5-1 Digit Matching was used to produce two patient cohorts of 219 patients each balanced for baseline factors.

We assessed major adverse cardiac events (MACE) ) out to a median of 3.3 years (IQR: 2.1-4.1)
MACE defined as •All Cause mortality •Myocardial infarction (MI)
•Target vessel revascularisation (TVR)
•Stroke Results There was a significant difference in MACE between the two groups in favour of DES (17.9% DES v 31.2% BMS group [P=0.04] over the 5-year follow-up.
MACE was driven by ISR in both groups and the difference between groups was due to increased TVR in the BMS group. There was no difference in death, MI or stroke.(Figure 1)
Adjusted Cox analysis confirmed a decreased risk of MACE for DES compared with BMS 0.75 (95% confidence intervals 0.52-0.94) with no difference in the hazard of all cause mortality (HR: 1.08 95% CI: 0.77-1.68).

Conclusion:
In our cohort of patients who had PCI for treatment of SVG disease the use of DES resulted in lower MACE rate compared to BMS over a 5-year follow-up.
Abstract 10111: Transcatheter Aortic Valve Implantation Without Intensive Care Unit Admission is Possible in Selected "Low Risk" Patients
Authors: Leclercq Florence , Iemmi Anais , Macia Jean Christophe , Lattuca Benoit , Agullo Audrey , Gervasoni Richard , Schmutz Laurent , Gandet Thomas , Nogues Erika , Nagot Nicolas , Albat Bernard , Cayla Guillaume 
Published: April 2024

Introduction:
Admission to the intensive care unit (ICU) after transcatheter aortic valve implantation (TAVI) is a standard of care.

Hypothesis:
We assessed the hypothesis that TAVI can be performed safely without ICU admission in patients considered at low risk using simple clinical, ECG and echographic criteria.

Methods:
In this prospective monocentric cohort study we included all consecutive patients who underwent a TAVI procedure between December 2014 and May 2015. Low risk group included patients with LVEF > 40 %, transfemoral (TF) access, absence of severe pulmonary disease, stable hemodynamic state and absence of complications occurring until 2 hours after the procedure. High risk group included all other patients. Patients were admitted to the ICU or conventional cardiology unit depending on their risk evaluation. In-hospital major adverse events (VARC-2 criteria) were recorded in the two groups

Results:
On the 144 patients included, 67 were men (46.5 %), median age was 85 years (80-88) and median Euroscore II was 4.2 (3-6.9). The balloon expandable Edwards Sapien 3 valve was mainly used (n=118; 82%), with TF approach (n=136; 94.4% ) and general anesthesia (n=138; 95.8%). Of the 46 low risk patients (31.9%), only 1 was secondarily transferred to ICU due to non compressive pericardial effusion (minor complication) giving a negative predictive value of our triage strategy of 97.8% (CI:88.5-99.9). Conversely, of the 98 high risk patients, 40 developed major complications, mainly conductive disturbances. Positive predictive value was 40.8% (CI: 31.0-51.2). (Table 1)

By univariate analysis, the main pre procedural predictive factors of complications were use of self expandable prosthesis (p<0.00005) and right bundle branch block (p<0.004).
In conclusion, our results suggested that TAVI can be performed safely without ICU admission in selected patients. This new “minimalist” strategy may optimize efficiency and cost effectiveness of the procedure.
Abstract 11472: Higher Level of Chronic Illness Management in Heart Transplant Centers is associated With Better Patient Survival: The Intercontinental BRIGHT Study
Authors: De Geest Sabina M , Denhaerynck Kris , Berben Lut , Vanhaecke Johan , Russell Cynthia , Dobbels Fabienne ,   on behalf of the BRIGHT study team
Published: April 2024

Innovation in care processes based on chronic illness management (CIM) has shown to improve outcomes in chronically ill. We hypothesized that higher level of CIM in post-heart transplant (HTx) follow-up care is associated with better patient survival.
The BRIGHT study, a multi-center, cross sectional study included a convenience sample of 36 HTx centers in 11 countries and 4 continents. Patients were selected by stratified random sampling. CIM was assessed both by clinicians’ report (N=82, mean age: 47.6±10.2 y., 85% f.) (55 item CIMI BRIGHT instrument) and patients’ report (N=1026, mean age: 54.0±13.2 y., 27% f., mean years post-HTx; 3.4±1.4)(11 item PACIC scale). CIM data were aggregated at center level. Three groups were built: (1) positive deviants: both patients’ and clinicians’ median CIM scores above median CIM score of 36 centers;(2) negative deviants: both median CIM scores below median of all centers; (3) mixed group: incongruence in median CIM scores between patients and clinicians. Center's mean patient survival at 1, 3, 5, 10 and 15 years was reported by the HTx center director using a structured questionnaire. We used mixed regression analysis, contrasting positive to negative deviants in a confounder-adjusted analysis.
We found major variability in CIM scores (PACIC mean 39±10.5; CIMI BRIGHT mean 165±17.1, range: 136-197) and mean survival rates (1 year: 84%±5.3 ; 5 year 73%±15.8) among HTx centers. Thirty-two percent of centers were positive deviants, 32% negative deviants and 36% belonged to the mixed group. Figure 1 shows center's mean patient survival at 1, 3, 5, 10 and 15 years for the 3 groups. As hypothesized, mortality was lower in positive vs. negative deviants especially at 1 year post-HTx (p<0.008).
The association between higher levels of CIM and lower mortality in HTx patients highlights a potential pathway for improving outcomes after HTx by investing in innovative systems of care based on principles of CIM.