bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimizing support before and after cardiac resynchronization therapy implantation in co-creation with patients with heart failure, informal caregivers, and healthcare professionals
Authors: Westland Heleen , van Rijn Michelle , Meine Mathias , Jaarsma Tiny 
Published: June 2024

Abstract

Aims
To optimize support by healthcare professionals to enhance physical activity, HF-related symptom monitoring, and management in patients with heart failure before and after cardiac resynchronization therapy (CRT) implantation in co-creation with patients, informal caregivers, and healthcare professionals.

Methods and results
A qualitative and co-design approach was used to develop support strategies collaboratively with end-users. Seventeen semi-structured interviews were conducted to explore patients’ expectations and factors influencing physical activity and symptom management. The qualitatively obtained insights informed the development of support strategies using an ideas group with patients, informal caregivers, and healthcare professionals.
Four themes emerged from the interviews: (1) expecting and hoping to regain energy and fitness; (2) difficulties and opportunities to become more active; (3) impact of CRT on sense of safety; and (4) dealing with continuing bothersome symptoms. Several strategies were brainstormed, prioritized, and prototyped, including optimization of CRT information, a peer contact list, expansion of the post-CRT implantation consultation to ask questions and share concerns, and a group meeting with peer patients, partners, and healthcare professionals.

Conclusion
Patients expected and hoped to have positive effects from CRT, but not all patients experienced improvement after CRT. To improve patients’ physical activity, feelings of insecurity, symptom monitoring, and thoughtful response to symptoms, support must include providing information and support to increase their knowledge and discuss experiences and physical and mental concerns.
Risk-factor dependant regulation of the miR-483-3p in metabolic HFpEF and pre-diabetes
Authors: Swaminathan K , Otvos J , Paolo F , Kirchhoff M , Kabisch S , Alogna A , Kraenkel N 
Published: June 2024

Abstract

Background
Prediabetes and the metabolic phenotype of heart failure with preserved ejection fraction (HFpEF) are two related diseases with high metabolic predisposition and prevalence. We previously described an increase in the micro-RNA miR-483-3p in M2-type macrophages and in endothelial cells in human patients with type 2 diabetes mellitus (T2DM) associated with reduced endothelial regenerative capacity. The miR-483-3p may also be relevant in metabolic HFpEF, but individual cardio-metabolic risk factors causing the upregulation of miR-483-3p have not been specified.

Purpose
We aimed to understand the relevance of the miR-483-3p in metabolic HFpEF and to identify the cardiovascular risk factors causing miR-483-3p upregulation in humans and in a large animal model of metabolic HFpEF.

Methods
M2-type macrophages were cultured from blood samples of healthy donors, individuals with prediabetes and patients with established T2DM (n=51, 63% female, age 41-75 years). Expression of hsa-miR-483-3p and hsa-miR-21-5p (housekeeping control) were determined by reverse transcription quantitative real time polymerase chain reaction (RT-qPCR) and correlated with donor characteristics (age at inclusion, biological sex, systolic and diastolic blood pressure, glycated haemoglobin (HbA1C), fasting glucose, fasting triglycerides (TG), high- and low-density lipoproteins, waist circumference). Cultured human aortic endothelial cells (EC) and M2-type primary macrophages were exposed to the fatty acid palmitate, bacterial lipopolysaccharides (LPS), tumour necrosis factor alpha (TNF-α) for 24 h prior to analysis of expression of the miR-483-3p.

Results
M2 macrophages of individuals with fasting plasma TG levels above 170mg/dL expressed more miR-483-3p (2.0±0.4-fold versus individuals below 170mg/dL TG, p=0.04). Consistently, miR-483-3p was upregulated in M2 macrophages and ECs by palmitic acid (M2: 13.5±7.1-fold versus control; EC: 1.7±0.3-fold versus control, p=0.01). In a porcine model of metabolic HFpEF, the miR-483-3p increased steadily over the initial 12 weeks of high sucrose/high cholesterol diet and subcutaneous deoxycorticosterone acetate application, maintaining a plateau for the following 2 months (57-fold to 300-fold of baseline, n=3). Higher cellular expression of the miR-483-3p in response to TNF-α (M2: 35.5±16.2-fold versus control, p=0.001; EC: 2.2±0.7-fold versus control, p=0.01) and LPS (M2: 31.1±13.4-fold versus control, p=0.005; EC: 1.7±0.4-fold versus control, p=0.01) indicate a potential role of inflammation.

Conclusion
The miR-483-3p is upregulated in individuals of the human pre-diabetic continuum, associated with triglyceride/fatty acid levels, as well as in a porcine model of metabolic HFpEF. Future studies need to evaluate whether miR-483-3p is a treatable target for maintaining endothelial function under pro-inflammatory and dyslipidaemic conditions in human patients at risk to develop HFpEF and T2DM.
Advantages of timely diagnosis of cardiac myxoma
Authors: Svanidze T , Saralidze T , Papuashvili K , Noniashvili M , Mamatsashvili I , Jgarkava M 
Published: June 2024

Abstract
Cardiac myxomas (M) are the most common benign primary tumor of the heart. They are biologically benign, but "functionally malignant" because of the potential for embolization. They arise most commonly from the left atrium, but it can involve any of the cardiac chambers.
Our purpose was to study patients with M.
Among 3150 patients, examined by us during last 3 years by Transthoracic echocardiography (TTE), we observed 7 cases of M. All patients were women, one 91 old, others - at the age of 62-75 years old. All of them had atrial M. One was right atrial M, and 6 –left atrial M.One case involves a 91- year-old female, who appeared in clinic due to severe COVID-19 infection. She presented with fatigue, fever of unknown origin, transient ischemic attack and shortness of breath. ECG showed sinus rhythm, P-78’, without signs of acute ischemia. In this case left atrial M represented a mass of 30×60 mm attached to the upper part of intra-atrial septum causing mitral valve obstruction (Fig.1). Patient had preserved ejection fraction (EF)-50% and diastolic dysfunction was observed due to pseudonormalisation. Normal size right ventricle, TAPSE-21mm, moderately dilated left atrium, fibrotic mitral valve leaflets and calcification of annulus with moderate regurgitation +2/+4, calcification of aortic valve with mild stenosis (Vmean-18mmHg, AVA-1.5cm²) and moderate regurgitation +2/+4 was also observed. Moderate pulmonary artery hypertension (pulmonary artery syst. pressure PASP - 55mmHg) was also revealed.
In the second case a patient with right atrial M was asymptomatic, she admitted clinic due to ischemic stroke. ECG was in normal range. TTE revealed moderate enlargement of right atrium and preserved EF - 53%. Diastolic dysfunction was presented by impaired relaxation. In the rest 5 cases patients applied to us with cardiologic problems. They had chronic heart failure (HF), NYHA class III, left atrial M, atrial fibrillation (AF) and arterial hypertension (AH). In all these cases the patients had moderate enlargement of both atria and right ventricle and moderate hypertrophy of left ventricle. EF was mildly reduced (46-48%).
All 7 patients were treated with rivaroxaban to prevent thromboembolic complications. In first two cases patients’ outcome was depended on the course and severity of the main disease and at this stage surgery was not applied. In 5 patients with AF, AH, HF and left atrial M was considered surgical intervention (Fig.2).
Our study showed that in some cases M has asymptomatic course, though it can cause thromboembolic complications. In other cases M depending on its size and location causes significant damage of heart mechanical and/ or electrical function. Thus routine TTE examination of patients in general practice is necessary. Timely diagnosis of cardiac M is important because these patients require long term anticoagulation treatment for the prevention of life-threatening complications. Fig.1; Fig.2. Left atrial myxoma
Increased incidence of arrhythmias, heart failure and thrombosis in COVID-19 patients after the first 3 months post-infection: a population-based cohort study
Authors: Degano I R , Tintore C , Camps-Vilaro A , Subirana I , Elosua R , Marrugat J 
Published: June 2024

Abstract

Background
Studies on long-term outcomes have shown that coronavirus disease 19 (COVID-19) survivors have a higher risk of cardiovascular disease (CVD) events at 1-year. However, most studies have analyzed outcomes at 1-year excluding or not the first 21-30 days, but there is no information for other follow-up periods.

Purpose
Our aim was to examine CVD outcomes during the first 3 months after infection/inclusion and from 4 to 12 months, in COVID-19 patients compared to individuals that did not had COVID-19, by sex.

Methods
Data were obtained from the Data analytics program for health research and innovation (PADRIS) from Catalonia, North-Eastern Spain. PADRIS includes data from the Catalan health system, covering 7.9 million inhabitants. Selected individuals were ≥45 years old with a positive COVID-19 PCR/antigen/rapid test in March-May 2020. We also included randomly selected individuals without a positive/suspicious COVID-19 test. Follow-up was obtained until January 31st, 2021 for CVD events (atrial fibrillation(AF)/flutter/tachycardia, bypass/revascularization, heart failure, peripheral artery disease, stroke/transient ischemic attack, and thrombosis), and until March 31st, 2021 for mortality. CVD event incidence was compared with Cox proportional hazards regression.

Results
We included 173,782 individuals, of those 30,831 had COVID-19. Median follow-up was 335 days for CVD outcomes and 392 days for mortality. Incidence of CVD outcomes and mortality had a large increase in COVID-19 individuals during the first 100 days of follow-up. In the whole follow-up, and in the first 3 months, having COVID-19 was associated with lower time to all CVD events and mortality in females and males (Figures 1 and 2). During the first 3 months, the CVD events with the highest risk increase were thrombosis in females and AF/flutter/tachycardia in males. In the period from 4 months to the end of the follow-up, there was an increased risk of heart failure in females (1.73 [1.23-2.43]). While in males, there was an increased risk of AF/flutter/tachycardia (1.61 [1.10-2.36]) and of thrombosis (2.85 [1.18-6.86]).

Conclusions
Our findings suggest that incidence of some CVD outcomes associated with COVID-19 may decrease after 3 months. However, control of arrhythmias, heart failure, and thrombosis could be necessary after this period depending on the sex. CVD outcome incidence in females CVD outcome incidence in males
Reassessing the association between age at menarche and cardiovascular disease: observational and Mendelian randomisation analyses
Authors: Tschiderer L , Peters S A E , Van Der Schouw Y T , Seekircher L , Willeit P , Onland-Moret N C 
Published: June 2024

Abstract

Background
Observational studies have shown a non-linear U-shaped association between age at menarche and cardiovascular disease (CVD).

Purpose
The aim of this study was to reassess the observational association between age at menarche and CVD and investigate whether the causal relationship between age at menarche and CVD is non-linear.

Methods
We included women from the UK Biobank and EPIC-CVD study without a history of myocardial infarction or stroke at baseline. In observational analyses, we estimated study-specific hazard ratios (HRs) for myocardial infarction, ischaemic stroke, and haemorrhagic stroke using Cox-regression before meta-analysing them. In addition, we conducted non-linear Mendelian randomisation analyses based on fractional polynomials and performed linear Mendelian randomisation analyses using inverse-variance weighted regression.

Results
Our analyses included 283,210 women without a history of myocardial infarction or stroke at baseline, of which 8,468 had a myocardial infarction, 5,501 an ischaemic stroke, and 1,887 a haemorrhagic stroke. Mean age at menarche was 13.1 (SD 1.6) in the UK Biobank and 13.0 (SD 1.6) years in EPIC-CVD. The association between age at menarche and myocardial infarction and ischaemic stroke was U-shaped with higher risks in women aged &lt;12 and ≥16 compared to those aged 13 years at menarche. We found no statistically significant association with haemorrhagic stroke. Our Mendelian randomisation analysis based on fractional polynomials suggested no non-linear relationship between genetically proxied age at menarche and any CVD endpoint, but each year higher genetically proxied age at menarche was statistically significantly related to a lower risk of myocardial infarction (HR 0.92 [95% CI 0.86-0.99]), but not to ischaemic (1.00 [0.91-1.09]) and haemorrhagic stroke (1.02 [0.89-1.17]).

Conclusion
In conclusion, although the observational association between age at menarche and myocardial infarction and ischaemic stroke was non-linear, our analysis revealed no indication of a non-linear relationship between higher genetically proxied age at menarche and risk of myocardial infarction, and there appeared to be no causal link with ischaemic and haemorrhagic stroke.
Lipoprotein (a): what role in long-termprognosis of patients with acute myocardial infarction
Authors: Quintal J , Coelho R A , Pohle C L , Ferreira J S , Bernardes P , Duarte T , Goncalves S , Seixo F 
Published: June 2024

Abstract

Background
Lipoprotein(a) is a known risk factor for atherosclerotic coronary heart disease. This genetically regulated protein is constant throughout the individual lifetime and therefore a single measurement may estimate the individual risk of coronary artery disease (CAD). Nonetheless, its impact on long-term prognosis of patients (pts) with acute myocardial infarction (AMI) is not well stablished.

Aim
To assess whether lipoprotein(a) (Lpa) level can predict long-term prognosis of pts hospitalized for acute myocardial infarction, based on all-cause mortality, readmission due to acute coronary syndrome (ACS) and readmission due to major cardiovascular disease(CVD).

Methods
We performed a single-center retrospective cohort study. Consecutive pts admitted in our center between 1 November 2021 and 31 October 2022 with ACS were included (n=390). Patient without Lpa measurement at admission were excluded (n=62). Patients were divided in 2 groups according to Lpa level upon hospital admission: gA - normal Lpa level (Lpa &lt; 30mg/dL) - and gB– high Lpalevel (Lpa≥ 30mg/dL). Cardiovascular risk factorsand relevant comorbidities were assessed in both groups.
The type ofACS, the number of affected coronary arteries, left ventricle ejection fraction (LVEF), Kilipp Kimball (KK)class, the presence of significant arrhythmias, high-sensitivity troponin (hs-TnI) and NT-proBNP levels were evaluated in both groups. Long term prognosis analysis included long-term all cause mortality, hospital readmission due to ACS and hospital readmission due to major CVD.

Results
The study included 328 pts, with a mean age of 66 (± 12) years-old and a 71.6% male prevalence. Regarding baseline characteristics of individuals, gB had a higher prevalence of dyslipidemia (31.3%vs 28.9, p=0.015), chronic kidney disease (11.6 vs 5%, p=0.029) and CAD(32.7 vs 22.9%, p=0.049).
There were no significant differences inACS type, LVEF, KK class, hs-TnI and NT-proBNP levels. Group B had a higher prevalence of 3 vessel disease(26.9 vs 17.6%, p=0.045) while 1 vessel disease was more common in gA (48.9 vs 37.9%, p=0.05). There was a higher tendency for arrythmias within 48h of ACS in gA (22.2 vs 13.6%, p=0.045).
In-hospital mortality was similar between the groups (gA3.9 vs gB3.4%, p=0.816). During a median follow-up time of 18 (0-25) months, 27 deaths were verified. Mortality was not statistically different between the groups (gA 10.6 vs gB 6.5%, p= 0.816). Readmissions duetoACS(gA2.3 vs gB6.4%, p=0.073)and CVD (gA9.9 vs gB12.2%, p=0.477) were also similar in both groups.

Conclusions
This study suggests that, although lipoprotein(a) is a well-known risk factor for CAD development, a single measurement above the cut-off of 30mg/dL may not be associated with a poorer long-term cardiovascular prognosis in pts with AMI. Further studies are needed to provide robust data and reliable recommendations on this theme.
The long-term prognosis of unrecognized myocardial infarction in women and men from the general population
Authors: Van Oortmerssen J A E , Tilly M J , Ikram M K , Boersma E , Roeters Van Lennep J E , Kavousi M 
Published: June 2024

Abstract

Background
Unrecognised myocardial infarction (MI) is a subclinical MI that escapes detection during its acute phase and is associated with an adverse prognosis, similar to clinically recognized MI. Previous studies have suggested the unfavourable outlook for men, and to a lesser extend in women. However, thorough investigation regarding sex differences in prognosis of unrecognised MI for various major adverse outcomes is limited.

Purpose
This study sought to assess sex differences in the long-term prognosis of unrecognised MI with respect to subsequent clinically recognised MI, heart failure, atrial fibrillation, stroke and all-cause mortality.

Methods
In a population-based cohort study, encompassing three cohorts with extensive follow-up time, MI status was established at baseline by electrocardiography (ECG) and data from medical records. Participants were followed for the outcomes of interest and censored at the incidence date, loss to follow-up, death, or to 1 January 2015, whichever occurred first. Additionally, participants in the unrecognised MI group were censored once recognised MI occurred. Per outcome of interest, multivariable Cox proportional hazards regression analyses were performed to calculate hazard ratios (HR) and corresponding 95% confidence intervals (CI), using participants without MI at baseline as reference group. All analyses were stratified for sex.

Results
Of the 12,409 participants at baseline, 519 (4.2%) had experienced unrecognised MI (mean age 70 years, 52% women) and 678 (5.5%) recognised MI (mean age 69 years, 28% women). Mean follow-up time was 10.2 years (± 7.9). Unrecognised MI showed a similar association with subsequent recognised MI in women and men (women; HR 1.57 [95% CI 1.05-2.35], men; HR 1.55 [95% CI 1.10-2.18]). In contrast, associations of unrecognised MI with heart failure (women; HR 1.03 [95% CI 0.77-1.39], men; HR 1.59 [95% CI 1.17-2.15]), atrial fibrillation (women; HR 0.89 [95% CI 0.64-1.25], men; HR 1.83 [95% CI 1.35-2.48]), stroke (women; HR 1.21 [95% CI 0.89-1.64], men; HR 1.87 [95% CI 1.35-2.59]) and all-cause mortality (women; HR 1.09 [95% CI 0.94-1.27], men; HR 1.37 [95% CI 1.16-1.62]) were statistically significant solely in men.

Conclusions
Unrecognised MI determined by ECG is associated with an increased risk of subsequent recognised MI in both sexes. Additionally, in men, it is associated with an increased risk of heart failure, atrial fibrillation, stroke, and all-cause mortality. Future research should prioritize accurate MI diagnosis via ECG and identify key predictors for adverse outcomes, aiding targeted management efforts.
ACS Program. Improving secondary prevention in patients admitted due to a myocardial infarction. First year experience
Authors: Gual M , Valverde J , Santalo M , Ferrer M , Gonzalez Freixa C , Sionis A 
Published: June 2024

Abstract

Background
Ischaemic heart disease is one of the leading causes of mortality in developed countries. Despite great advances in treatment and preventive measures in patients with myocardial infarction, cardiovascular risk still persists, with rates of new cardiovascular events being up to 10% in the first 12 months and even 20% in the first 5 years after the first admission. Stablishing standardized follow-up pathways in patients discharged to home and starting secondary prevention measures with special emphasis in targeting dyslipidemia is of main importance.

Purpose
The ACS Program was born with the aim to reorganize the outpatient Clinic Follow-up of patients with myocardial infarction in our area. With this aim, a structured pathway has been stablished (scheduled appointments with a cardiovascular specialized nurse and doctor and lab tests in the first 3, 6 and 12 months).

Methods
Descriptive study of all patients admitted to ACS Program since November 2022 to September 2023.

Results
170 patients have been admitted to the Program. Mean age is 62 years (SD 10 years). 70% of patients are male. The Average time since the patient is discharged to home until the first visit is 8,4 days (SD 5 days). More than a half of patients undergo a lab test in the first quarter (85%). 54% of patients achieve LDLc levels &lt;55mg/dl in the first quarter. Moreover, 84% of patients achieve cLDL levels below 70mg/dl in the first three months. 30 and 90 day readmission rates are 3.7% and 7.4%, respectively. Mortality rates were low (0.3%, mean follow up 6 months), if we compare with global mortality rates of ichaemic heart disease in our centre (10%) (p&lt;0,05). Finally, high intensity statins and ezetimbe prescription have increased since the Program began (80% versus 30%, p &lt; 0.05).

Conclusions
Stablishing an organized follow-up pathway in patients discharged to home after a myocardial infarction permits achieving better cLDL control with low readmission rates and little time to first medical contact