bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do air pollutants levels during the previous 48 hours predict out-of-hospital cardiac arrest incidence compared to same-day pollutants levels?
Authors: Roca Guerrero C , Garcia-Garcia C , Baneras-Rius J , Sionis-Green A , Sanchez-Salado J C , Izquierdo-Ribas M , Moreno-Monterde E , Cubells-Pastor M , Lopez-Sobrino T , Ortiz-Perez J T , De Diego-Soler O , Andrea-Riba R 
Published: May 2024

Abstract

Funding Acknowledgements
None.

Introduction
Association between air pollutants (APs) levels and out-of-hospital cardiac arrest (OHCA) at the same day of the measurements have been previously described. Whether APs levels measured during the previous 48 hours may predict OHCA occurrence is not known.

Purpose
To analyse whether same-day APs levels compared to APs levels during the previous 48 hours are associated with OHCA incidence.

Methods
OHCA admissions on five Cardiac Intensive Care Units of our city were assessed during September-2020 to December-2021.
Free access data regarding particulate matter (PM10), carbon monoxide (CO), nitrogen dioxide (NO2) and ozone (O3) levels during the same period were also registered. APs measures occurred each hour daily at three different spots, delivering more than 31000 measurements.
APs levels during the previous 48 hours and during the index day were compared between OHCA-free days (OHCA-Fd) and OHCA-days.

Results
179 patients were included. Main demographic characteristics are shown on table 1. Daily OHCA incidence and APs mean levels/month are shown in Table 2.
As shown at table 3 same-day higher NO2 and lower O3 levels were found on OHCA-days compared to OHCA-fd: 41 ±10 vs. 36 ±9 µg/m3, p=0.016 for NO2 and 45 ±13 vs. 51 ±11 µg/m3, p= 0.003 for O3.
As shown on Table 2 same day mean O3 levels were also higher from April to September compared to the rest of the year (p&lt;0.001). OHCA incidence was lower in this same period (p&lt;0.001).
There wasn’t any association between OHCA incidence and APs (NO2, O3, PM10 and CO) measured at any moment during the event's prior 48 hours.

Conclusions
Same-day higher NO2 and lower O3 levels were associated to a higher OHCA incidence in our city. On the other hand, association between OHCA and NO2, O3, PM10 or CO measurements during the previous 48 hours was not found in our cohort.
Reducing production of NO2 (i.e., reducing fossil-fuel consumption) may reduce OHCA risk during that same day.
Echocardiographic image monitoring during Impella use: our experience
Authors: Legarra P , Garcia Ugaldebere J , Jimenez O , Lanaspa A , Ugarriza J , Segur M , Borderias T , Sanchez G , Villabona C , Martinez J , Munarriz A 
Published: May 2024

Abstract

Funding Acknowledgements
None.

Introduction
Impella CP is a type of percutaneous left ventricular (LV) mechanical circulatory support located inside LV and placed through the aortic valve. There is little information about the incidence of valvular complications related to its use or other complications assessable by echocardiography.

Purpose
To determine the existence of complications assessable by echocardiography in patients treated with Impella CP in our centre.

Methods
Retrospective analysis of patients treated with Impella CP in 2020 and 2021 in our centre. Baseline clinical characteristics were studied and pre- and post-procedure echocardiograms of these patients were reviewed.

Results
A total of 32 echocardiograms were analysed in 16 patients with a mean age of 70 years. Clinical and echocardiographic features are described in table 1. After device removal, the presence or degree of aortic regurgitation did not change in the patients, including 2 patients who had moderate aortic regurgitation pre-implantation. However, on echocardiograms after device removal, intraventricular thrombus was detected in 2 patients, who also had severe LV systolic dysfunction and who had the longest duration in days of implantation (6 and 7 days). The mean number of days of implantation was 1.68 days.

Conclusion
Echocardiography is a useful tool for the management and detection of complications during the time of support with Impella CP, such as valve dysfunction and the presence of intraventricular thrombus. In our centre, the use of Impella is not related to the onset or worsening of aortic valve pathology.
Exploring biomarkers as predictors of left ventricular recovery in a national registry of takotsubo syndrome patients (RETAKO)
Authors: Rivas Garcia A , Lopez Flores L , Marin Andreu P , Lopez Flores C , Andres M , Perez Castellanos A , Uribarri A , Nunez Gil I J , Garcia Rubira J C , Almendro Delia M 
Published: May 2024

Abstract

Funding Acknowledgements
None.

Introduction
Tako-Tsubo Syndrome (TTS) is characterized by transient dysfunction of the left ventricle (LV) of uncertain etiology, although considered a benign entity, TTS has a mortality rate and complications similar to STEMI patients (1). Late LV recovery (&gt;10 days) has been associated with a worse prognosis. Currently, there is no data on biomarkers that can predict the disease's progression.

Purpose
We aim to correlate different biomarkers with LV recovery in TTS patients.

Method
We used data from the National Multicenter Registry on Tako-Tsubo Syndrome (RETAKO). Information on biomarkers, including NT-proBNP, C-reactive protein (CRP), leukocytes, and platelets, was collected both upon admission and at peak values. Early recovery was considered when it occurred within the first 10 days after the index event. A non-parametric correlation analysis was conducted to assess the predictive capacity of different biomarkers on LV recovery.

Results
Out of a total of 1,463 patients, 373 (25.5%) experienced late LV recovery. The average age was around 73 years, with the majority of the sample being women (86%). Significant differences were observed between the groups in NT-proBNP, CRP, and peak values of leukocytes and platelets, with higher levels in the late recovery group. In the linear correlation analysis, a significant association was found between late recovery and higher levels of NT-proBNP, peak leukocytes and platelets, however it was not statistically significant for the levels of CRP.

Conclusions
In a large national cohort of TTS patients, higher levels of NT-proBNP, peak of leukocytes and platelets during the hospital stay were significantly associated with late LV recovery. This recovery appears to depend on the degree of LV dysfunction and the inflammatory response.Biomarkers table 1
The role of cardiac rehabilitation in patients following acute coronary syndrome
Authors: Paula S , Figueiredo M , Coelho M , Santos M , Almeida S , Almeida L 
Published: May 2024

Abstract

Funding Acknowledgements
None.

Introduction
The benefits of cardiac rehabilitation in patients with acute coronary syndrome (ACS) are well established. Although there are limited centres with cardiac rehabilitation and patients, especially from peripheral hospitals, wait a long time to enter the programme and many of them don’t even enter these programmes.

Purpose
Characterize the patient population that go to cardiac rehabilitation and evaluate short- and long-term outcomes.

Methods
Multicenter retrospective study, patients with the diagnosis of ACS and data collected from 1/01/2015 to 31/12/2021. Patients were divided into 2 groups (G). G1 – Patients with cardiac rehabilitation programmed and/or planned; G2 – Patients not referenced for cardiac rehabilitation. We further analyse patients according to MACE events, group A without MACE; group B with MACE.

Results
11992 patients were enrolled, only 3162 (26.4%) patients were referenced for cardiac rehabilitation. G1 was younger 63.5 ± 12.4 (p&lt;0.001), had more males 76.7% (p&lt;0.001) and more smokers 38.0% vs 25.3% (p&lt;0.001), but less patients with arterial hypertension (AH) 65.1% vs 70.9% (p&lt;0.001), diabetes mellitus (DM) 29.5% vs 32.8% (p&lt;0.001), dyslipidemia 57.0% vs 61.2% (p&lt;0.001), previous heart failure 4.8% vs 7.9% (p&lt;0.001) and chronic kidney disease (CKD) 3.8% vs 7.3% (p&lt;0.001). G1 had although more patients with symptoms of angina 29.2% vs 23.3% (p&lt;0.001) and previous MI 20.5% vs 17.6% (p&lt;0.001). Regarding MACE events G1 had better outcomes 1.3% vs 6.1% (p&lt;0.001). Considering MACE events, group B was older 74±12 years (p&lt;0.001), male gender was predominant (62.5%) and had more patients with AH 76.9% vs 68.8% (p&lt;0.001), DM 45.1% vs 31.1% (p&lt;0.001), CKD 14.6% vs 5.6% (p&lt;0.001) and pacemaker (PM) or ICD devices 3.8% vs 1.7% (p&lt;0.001).
Independent predictors of MACE achieved through logistic regression analysis are gender p&lt;0.001, OR 0.325, CI (95%) 0.158-0.672; CKD p= 0.042, OR 4.027, CI 1.019-15.911; time from symptoms to 1st contact ≥ 120min p=0.032, OR 2.088, CI 1.067-4.087; usage of inotropic medications p&lt;0.001, OR 6.383, CI 2.995-13.602; left ventricular ejection fraction &lt;30% vs ≥30% p=0.002, OR 4.172, CI 1.722-10.108; need of invasive mechanical ventilation p&lt;0.001, OR 6.593, CI 2.812-15.457 and need of temporary PM p&lt;0.001, OR 12.372, CI 4.025-38.031.

Conclusion
In these study population, patients with less cardiovascular (CV) risk factors and comorbidities were more often assigned to cardiac rehabilitation programmes. Not unpredictable patients with more comorbidities suffered more from MACE events. Survival analysis also showed that CV mortality and re-admission at 1 year were higher in patients not assigned for cardiac rehabilitation.
Incremented Amyloid-beta values predict mortality during long-term follow-up in patients with acute myocardial infarction, both STEMI and NSTEMI
Authors: Aleksova A , Fluca A L , Janjusevic M , Barbati G , D'errico S , Sinagra G 
Published: May 2024

Abstract

Funding Acknowledgements
None.

Background
Both the amyloid-β (Aβ) isoforms, namely Aβ1-40 and Aβ1-42 are implicated in the pathogenesis of Alzheimer’s disease through different mechanisms. While Aβ42 easily forms oligomers in brain, Aβ1-40 is more abundant in circulation where it exerts a pro-inflammatory role. Recently, Aβ1-40 has raised interest in the cardiovascular field for its contribution to atherosclerosis, more specifically through plaque formation and destabilization. However, to date, the prognostic role of Aβ1-40 in patients with acute myocardial infarction (AMI) is limited to NSTEMI.

Purpose
Since there is a need for better risk stratification of AMI patients, we analyzed the impact of plasma Aβ1-40 on long-term mortality in a cohort of real-world patients with AMI, including STEMI and NSTEMI. Further, we sought to identify predictors for elevated Aβ1-40 levels.

Methods
Blood samples were obtained from patients hospitalized for AMI and Aβ1-40 levels were evaluated with Human Aβ40 ELISA Kit. The endpoint was all-cause mortality.

Results
Our population included 1119 consecutive patients, with a mean age of 67 years, 72% male, 2/3 of them had a first ischemic event and 68.4% had STEMI diagnosis. The median plasma Aβ1-40 concentration on admission was 86.9 [54.5-128.9] pg/ml and there was no difference in Aβ1-40 levels between NSTEMI and STEMI (93.6 [61.2-130.9] Vs. 85.3 [52.9-128.7] pg/ml, respectively, p=0.1). At logistic regression multivariate analysis, higher Aβ1-40 levels were predicted by older age, worse left ventricular systolic function, HbA1C &gt; 39 mmol/mol and GFR&lt;60ml/min/m 2 (Fig.1a). From the final multivariable model, a nomogram for prediction of high levels of Aβ1-40 was computed (Fig.1b). One hundred ninety-three patients (17.2%) died, during the median follow-up of 57 [30 - 80] months. Patients who died had significantly higher levels of Aβ1-40 compared to alive patients (113.1 [67.9 – 159.5] Vs. 83.9 [52.5 – 122.6] pg/ml, p&lt;0.01). Higher plasma Aβ1-40 values were associated with increased mortality risk, in both STEMI and NSTEMI (p&lt;0.01) (Fig.2a). Further, at Cox multivariate analysis including the whole population, Aβ1-40 levels were predictive of mortality (HR 1.03, p=0.02), together with older age, higher Il-1β, GFR&lt;60ml/min/m 2 and worse left ventricular systolic function (Fig.2b). The predictive value of our final model was superior to GRACE score for up to 60 months (AUC 0.830 (0.793 – 0.868) Vs 0.797 (0.756 – 0.837), respectively, p=0.03, Fig.2c), after which they were comparable.

Conclusions
Elevated levels of Aβ1-40 values are independent predictors of long-term mortality in a real-world cohort including both STEMI and NSTEMI patients.
Clinical characteristics and outcome of non-acute myocardial syndrome cardiogenic shock in comparison to its ischaemic aetiology
Authors: Sokolski M , Krupka D , Chelmonski A , Mazur K , Barteczko B , Kupiec A , Bochenek M , Biegus J , Zymlinski R , Gozdzik W , Przybylski R , Kuliczkowski W 
Published: May 2024

Abstract

Funding Acknowledgements
None.

Background
The mortality in cardiogenic shock (CS) remains high but the report mostly concerns CS in the course of acute myocardial syndrome (ACS). There is limited data about non- ischaemic CS.

Purpose
The aim of this study was to analyse the clinical characteristics, treatments and outcomes in patients with non-ACS CS in comparison to ischemic aetiology CS.

Methods
80 patients with an average age of 62 ± 13 years (81 % male) with CS admitted in 2021 and 2022 to tertiary hospital were divided into 2 subgroups: non-acute myocardial infarction cardiogenic shock (non-ACS-CS) consisted of 16 individuals (20%) and CS in the course of ACS (ACS-CS) consisted of 64 (80%) individuals. The main cause of CS in non-ACS group was worsening of previously diagnosed heart failure 11 (14%).

Results
Patients from non-ACS group were younger 52±16 vs. 65±11 years old, p=0.005. There were no differences in baseline heart rate 90 [72;100] vs. 95 [80;107] beats per minute and mean artery pressure 89 [73;97] vs. 80 [70;97] mmHg for non-ACS-CS vs. ACS-CS, respectively all p&gt;0.05. Patients from non-ACS-CS group had lower baseline troponin level 0.29 [0.04;0.96] vs. 7.05 [0.69;57.4] ng/mL, p=0.003, white blood cell count 11 [9;13] vs. 15 [10;19] × 109/L; p=0.035, procalcitonin 0.06 [0.05;0.28] vs. 0.69 [0.10;2,48] ng/mL, p=0.001 and higher pH 7.4 [7.3;7.5] vs. 7.2 [7.0;7.4], p=0.012 in blood gas analysis when compared with ACS-CS. There were no significant differences in the severity of the shock according to Society for Cardiovascular Angiography and Interventions (SCAI) SHOCK classification among the groups: from C: 1 (6%) vs. 6 (10%), D: 11 (69%) vs. 27 (42%), E: 4 (25%) vs. 31 (48%), respectively for non-ACS vs. ACS-shock. The non-ACS-CS was more often treated with V-A ECMO 10 (63%) vs. 20 (32%) in ACS-CS, p=0.024. The overall number of in-hospital deaths was 57 (71%). The non-ACS-CS group had significantly lower in-hospital mortality 8 (50%) compared to the ACS-CS patients 49 (77%), p=0.034.

Conclusion
Patients experiencing non-ACS-CS were younger, have lower levels of inflammatory markers and a higher pH in blood gas analysis at admission. Despite more favourable biomarker profile non-ACS-CS group was treated more aggressively and had significantly lower in-hospital mortality rates when compared with patients facing ACS-CS, which indicates the need to look at CS differently depending on its aetiology.
Aortic valve laceration following rotational atherectomy: a case report
Authors: Othman Farrah , Yong Gerald , Whelan Alan , Ihdayhid Abdul Rahman 
Published: May 2024

Background
Iatrogenic aortic valve injury during cardiovascular catheterization interventions is extremely rare. Severe aortic regurgitation that ensues can be catastrophic and the management is typically with surgical valve replacement or repair. Percutaneous management of native pure aortic regurgitation is difficult due to anatomical challenges and the limitations of current transcatheter heart valve technology to anchor in the absence of leaflet or annular calcification.

Case Summary
An 82-year-old female underwent rotational atherectomy (RA) for a severely calcified stenosis of the left anterior descending artery. The patient was discharged well following placement of two drug eluting stents. She represented to hospital 7 days later with acute pulmonary oedema. Bedside transthoracic echocardiography demonstrated new, severe AR with preserved left ventricular size and function. Review of the prior percutaneous coronary intervention revealed significant trauma to the aortic valve during RA, with contrast seen refluxing into the LV during diastole, evolving throughout the procedure. Given the patient was not an operative candidate, an oversized transcatheter aortic valve was successfully implanted. In the post-operative setting, the patient suffered a stroke. Extensive hypoattenuated leaflet thickening (HALT) and thrombus was seen on dedicated 4D CT imaging. She made full neurological recovery and valve function returned to normal following a period of anticoagulation.

Conclusion
Although iatrogenic aortic valve laceration is rare, this case highlights several important learning points including the importance of good guide catheter support during RA; the feasibility of Transcatheter Aortic Valve Replacement for pure native AR; and the detection and management of HALT.
Standardized ketogenic dietary preparation for metabolic PET imaging in suspected and known cardiac sarcoidosis
Authors: Hutt Erika , Goldar Ghazaleh , Jaber Wael A , Cremer Paul C 
Published: May 2024

Abstract

Aims
A major limitation of cardiac positron emission tomography (PET) with F18-fluorodeoxyglucose (F18-FDG) for the evaluation of cardiac sarcoidosis (CS) is associated with physiologic myocardial glucose uptake. The optimal dietary protocol to suppress physiologic myocardial F18-FDG uptake is not well-established. We aimed to evaluate the diagnostic performance of a novel dietary preparation using a ketone-based infant formula.

Methods and results
Between 2018 and 2021, consecutive studies using a ketogenic dietary preparation were identified (n = 198). The rate of non-diagnostic studies due to failure to suppress myocardial glucose was 7.1% (n = 14) with a similar incidence in diabetics (n = 6, 8.1%). Among studies reported to have no inflammation (n = 137), 130 studies (66%) had mean myocardial standardized uptake value (SUV) less than or equal to mean blood pool SUV.

Conclusion
Patient preparation with a ketone-based infant formula resulted in low rate of inappropriate myocardial glucose suppression in patients undergoing F18-FDG cardiac PET to evaluate CS.
Medical treatment of heart failure with renin–angiotensin–aldosterone system inhibitors and beta-blockers in aortic stenosis: association with long-term outcome after aortic valve replacement
Authors: Hopfgarten Johan , James Stefan , Lindhagen Lars , Baron Tomasz , Ståhle Elisabeth , Christersson Christina 
Published: May 2024

Abstract

Aims
There is a lack of robust data on the optimal medical treatment of heart failure in patients with severe aortic stenosis, with no randomized controlled trials guiding treatment. The study aimed to study the association between exposure to renin–angiotensin–aldosterone system (RAS) inhibitors or beta-blockers and outcome after aortic valve replacement in patients with aortic stenosis and heart failure.

Methods and results
The study included all patients with heart failure undergoing aortic valve replacement for aortic stenosis in Sweden between 2008 and 2016 (n = 4668 patients). Exposure to treatment was assessed by a continuous tracking of drug dispensations, and outcome events were all-cause mortality and hospitalization for heart failure collected from national patient registries. After adjustment for age, sex, atrial fibrillation, hypertension, diabetes mellitus, and prior myocardial infarction, Cox regression analysis showed that RAS inhibition was associated with a lower risk of all-cause mortality in patients with reduced left ventricular ejection fraction (LV-EF) [hazard ratio (HR) 0.58, 95% confidence interval (CI) 0.51–0.65] and preserved LV-EF (HR 0.69, 95% CI 0.56–0.85). Beta-blockade was associated with a lower risk of all-cause mortality in patients with reduced LV-EF (HR 0.81, 95% CI 0.71–0.92), but not in preserved LV-EF (HR 0.87, 95% CI 0.69–1.10). There was no association between RAS inhibition or beta-blockade and the risk of hospitalization for heart failure.

Conclusion
The RAS inhibition was associated with a lower all-cause mortality after valve replacement in patients with both reduced and preserved LV-EF. Beta-blockade was associated with lower all-cause mortality only in patients with reduced LV-EF.
UV damage induces production of mitochondrial DNA fragments with specific length profiles
Authors: Waneka Gus , Stewart Joseph , Anderson John R , Li Wentao , Wilusz Jeffrey , Argueso Juan Lucas , Sloan Daniel B 
Published: May 2024

Abstract
UV light is a potent mutagen that induces bulky DNA damage in the form of cyclobutane pyrimidine dimers (CPDs). Photodamage and other bulky lesions occurring in nuclear genomes can be repaired through nucleotide excision repair (NER), where incisions on both sides of a damaged site precede the removal of a single-stranded oligonucleotide containing the damage. Mitochondrial genomes (mtDNAs) are also susceptible to damage from UV light, but current evidence suggests that the only way to eliminate bulky mtDNA damage is through mtDNA degradation. Damage-containing oligonucleotides excised during NER can be captured with antidamage antibodies and sequenced (XR-seq) to produce high-resolution maps of active repair locations following UV exposure. We analyzed previously published datasets from Arabidopsis thaliana, Saccharomyces cerevisiae, and Drosophila melanogaster to identify reads originating from the mtDNA (and plastid genome in A. thaliana). In A. thaliana and S. cerevisiae, the mtDNA-mapping reads have unique length distributions compared to the nuclear-mapping reads. The dominant fragment size was 26 nt in S. cerevisiae and 28 nt in A. thaliana with distinct secondary peaks occurring in regular intervals. These reads also show a nonrandom distribution of di-pyrimidines (the substrate for CPD formation) with TT enrichment at positions 7–8 of the reads. Therefore, UV damage to mtDNA appears to result in production of DNA fragments of characteristic lengths and positions relative to the damaged location. The mechanisms producing these fragments are unclear, but we hypothesize that they result from a previously uncharacterized DNA degradation pathway or repair mechanism in mitochondria.
The Untapped Potential of Comparative Biology in Aging Research: Insights From the Extraordinary-Long-Lived Naked Mole-Rat
Authors: Buffenstein Rochelle , Amoroso Vince G 
Published: May 2024

Abstract
The search for solutions to the vagaries of aging has, historically, been akin to searching at night in the bright light under street lamps by utilizing the few preexisting and well-established animal model systems. Throughout my career as a comparative biologist, I have ventured into the darkness across 4 continents and studied over 150 different animal species, many of which have evolved remarkable adaptations to survive on the harsh and rugged fitness landscape that exists outside of the laboratory setting. In this Fellows Forum, I will discuss the main focus of my research for the last 25 years and dig deeply into the biology of the preternaturally long-lived naked mole-rat that makes it an ideal model system for the characterization of successful strategies to combat aging.