bluuebunny/crossref_metadata_2025_split huggingface dataset:
Air pollution and cardiovascular mortality in Poland: a panel time-series analysis of 80 million person-years (EP-PARTICLES study)
Authors: Kuzma L , Kurasz A , Swieczkowski M , Dobrzycki S 
Published: November 2023

Abstract

Introduction
Air pollution is one of the leading environmental risk factors affecting the population worldwide. Studies so far mostly analysed urban and industrial areas excluding smaller towns and villages due to a lack of monitoring stations and recognition of these areas as potentially free from pollution. Our analysis focuses on Eastern Poland, one of the poorest regions of the EU, with a population of nearly 8 million people with almost half living in rural areas. We investigate the impact of "Polish smog" a new type of air pollution which - due to its composition and the conditions in which it is formed - is characterized by extremely adverse cardiovascular health effects.

Purpose
Analysis of the short and mid-term impact of air pollution on cardiovascular (CV) mortality.

Methods
We collected daily data on air pollution from the Voivodeship Inspectorate for Environmental Protection for the years 2010-2020 and used an algorithm developed in collaboration with the Department of Atmospheric and Climate Modeling at the Polish Academy of Sciences to model the average daily concentrations of pollutants in locations without available data. Causes of death with ICD-10 codes from I00 to I99 were extracted for analysis. We estimated county-specific associations of air pollution concentration with mortality using panel standard time-series with Poisson distribution regression models, adjusting for weather conditions, and short- and long-term trends in mortality. Odds ratios (ORs) with interquartile ranges (IQRs) were reported for each type of air pollutant and lag structure was analysed.

Results
We observed 831,246 deaths, including 377,344 due to CV diseases. The overall standardized death rate (SDR) was 533.3 cases/100,000 inhabitants/year, with an increasing trend over each year. The IQR increase in concentrations of PM2.5 (OR=1.034, 95%CI 1.029-1.04, P&lt;0.001), benzo(a)pyrene (BaP) (OR=1.015, 95%CI 1.011-1.02; P&lt;0.001), SO2 (OR=1.008, 95%CI 1.006-1.01; P&lt;0.001), and NO2 (OR=1.013, 95%CI 1.01-1.016; P&lt;0.001) were associated with an increase in CV mortality on the day of the exposure and this effect was persistent up to LAG6. The detrimental influence of pollutants was also observed in the mid-term [lag0-30 (BaP-OR=1.028, 95%CI 1.022-1.034; P&lt;0.001), (PM2.5-OR=1.056, 95%CI 1.047-1.064; P&lt;0.001), (SO2-OR=1.014, 95%CI 1.011-1.017; P&lt;0.001), (NO2-OR=1.037, 95%CI 1.031-1.043; P&lt;0.001)].

Conclusion
The mortality rate due to CV diseases continues to rise. Our study highlights the negative impact of air pollution, both in the short and long term. Areas previously assumed to be free from pollution may actually be at high risk, emphasizing the need for careful monitoring of air quality. Further research should focus on identifying the most vulnerable areas and developing effective strategies to prevent the adverse health effects of air pollution on public health.
Did COVID-19 pandemic affect deaths from cardiovascular diseases in Japan?
Authors: Kokubo M , Shimizu A , Kamihara T , Hirashiki A , Arai H 
Published: November 2023

Abstract

Background
According to the vital statistics report by the Ministry of Health, Labour and Welfare, the total number of deaths in Japan had decreased in 2020 (1,384,544) for the first time in 11 years, and underlying reasons include the decrease of approximately 16,000 deaths from respiratory diseases. The number of deaths subsequently increased in 2021 (1,439,809), and this increase was attributable in part to the outbreak of the Delta variant of the coronavirus disease 2019 (COVID-19). To the best of our knowledge, effects of the COVID-19 pandemic and the new normal of life with COVID-19 (e.g., avoiding crowds, wearing masks, and practicing hand hygiene) on the number of deaths from cardiovascular diseases, which have been the second leading cause of death in Japan, have not been studied thus far.

Purpose
To investigate the association between deaths from cardiovascular diseases and COVID-19 in Japan.

Methods
Data from the demographic survey conducted by the Ministry of Health, Labour and Welfare and analyzed, Japan was retrospectively analyzed.

Results
The number of deaths from cardiovascular diseases decreased in 2019 (207,714) and 2020 (205,596) when compared with those recorded in the previous year; however, the deaths started to increase again in 2021 (Fig 1.). Next, we analyzed deaths at ≥65 years of age. With reference to 2017, the rate of increase in the number of deaths in individuals aged ≥85 years was ≥10%, showing that the increased total number of deaths was due to the increase of deaths in those aged ≥85 years. Among causes of death, heart failure showed a particularly large increase. Deaths in other age groups showed almost no changes or decreases, except for deaths in individuals aged 70–74 years showing a ≥20% increase (Fig 2.). Thus, we looked into changes in the number of deaths in groups of individuals aged 65–69, 70–74, and 75–79 years. Deaths from acute myocardial infarction showed particularly large decreases in both ranges of 65–69 years and 75–79 years. As the number of deaths at 65–69 years of age tended to decrease, deaths from other heart diseases also decreased more or less. As the number of deaths at 75–79 years of age showed almost no changes, deaths from ischemic heart disease and heart failure increased slightly. In contrast to the data for the younger and older age groups, deaths at 70–74 years from almost all causes including acute myocardial infarction, heart failure, ischemic heart diseases, and arrhythmia increased in number.

Conclusion
The number of deaths from heart diseases decreased in 2020 compared to that in the prior year; however, the decrease was not fully explainable on the basis of the COVID-19 pandemic because deaths from heart diseases already tended to decrease in 2019. Furthermore, the number of deaths from heart diseases increased in people aged 70–74 years as well as those aged ≥85 years. The underlying reason is currently unknown; thus, continued monitoring is necessary.figure1figure2
Effect of high-gravity acceleration forces and anti-gravity maneuver for cardiac function in fighter pilots
Authors: Soh M , Park J , Shin J 
Published: November 2023

Abstract

Background
Environmental factors such as hypoxia and gravity affect to the human cardiovascular system. It’s more important for fighter pilots who are exposed to high altitude, harsh gravitational (G) acceleration, and perform anti-G maneuvers similar to the Valsalva maneuver. Experimental studies examining how high gravitational acceleration and anti-gravity maneuver affect cardiac function are rare.

Purpose
This study aimed to investigate the effect on cardiac function of fighter pilots exposed to high G acceleration forces.

Methods
From July 2019 to June 2020, fighter pilots underwent regular health check-up and echocardiogram. Data from trainees who did not experience a flight were used for control group. Echocardiographic data included left ventricle (LV) chamber size, systolic function, and diastolic function, as well as right ventricle systolic pressure (RVSP), inferior vena cava (IVC) collapsibility, and the tricuspid annular plane systolic excursion (TAPSE) to evaluate right heart function. The multiple linear regression analysis for TAPSE was performed with total flight time as an independent continuous variable in fighter pilots.

Results
We enrolled 29 fighter pilots (41±10years-old; male, 100%; mean flight time 1821±1186 hours) and 16 trainees (36±17years-old; male, 100%). There was no significant difference in age, blood pressure, LVEF, RVSP, and the IVC collapsibility between fight pilots and trainees. In multivariate linear regression analysis for fighter pilots, TAPSE was affected by total flight time with positive correlation.

Conclusion
The experience of fighter pilots exposed to the high G acceleration forces and anti-G maneuver might be associated with right heart function change, but not associated with the prominent cardiac structural changes.
Prognostic significance of left atrial volume index after myocardial infarction
Authors: Trninic D , Jovanic J J 
Published: November 2023

Abstract

Background
Left atrial (LA) volume has been characterized as a strong predictive factor of cardiovascular and cerebrovascular occurrences after myocardial infarction (MI).

Purpose
The aim of our study was to examine the prognostic significance of the left atrial volume index (LAVI) in the occurrence of atrial fibrillation, heart failure and stroke after MI.

Methods
Our study is prospective and includes one hundred patients with acute MI, who underwent primary percutaneous angioplasty immediately after admission to the hospital.. LA volume was measured 48 hours after admission to the hospital, using the Biplane Simson method, which was indexed to body surface area. The patients were followed for 12 months on average.

Results
The average value of LAVI was higher in patients who had heart failure, atrial fibrillation and stroke after MI. AMI patients who developed heart failure during the observed period had a mean LAVI of 29.9ml/m2 ±6.7, and patients without heart failure had a mean LAVI of 24.0ml/m2 ± 2.0 (p &lt;0.001). Mean LAVI in patients with atrial fibrillation was 33.6ml/m2 ±8.1, and without atrial fibrillation 25.1ml/m2 ± 2.9 (p &lt;0.001). Patients who had a stroke during the observed period had a mean LAVI 35ml/m2 ± 6.9, and patients without a stroke had a mean LAVI 26.3ml/m2 ±5.2 (p &lt;0.001). The results of the univariable logistic regression are presented.

Conclusion
LAVI value has a statistically significant effect on predicting the occurrence of heart failure, atrial fibrillation and stroke after MI. LAVI is a strong predictive factor after myocardial infarction.
VE/VCO2 slope in cardiopulmonary exercise testing was associated with left ventricular diastolic dysfunction in patients with reduced ejection fraction
Authors: Ojima S , Kubozono T , Kawasoe S , Kawabata T , Salim A A , Ikeda Y , Ohishi M 
Published: November 2023

Abstract

Background
Heart failure with reduced ejection fraction (EF) was well-known as a poor prognosis. VE/VCO2 slope and peak oxygen uptake (VO2) by cardiopulmonary exercise testing (CPET) is a useful parameter for predicting cardiovascular disease prognosis. Furthermore, though there are some reports that CPET parameters are associated with indicators of diastolic dysfunction, each of these indicators has some limitations. Recently, recommendations for the evaluation of left ventricular diastolic function by echocardiography were reported from the ASE/EACVI. However, there are no reports to examine the association between exercise tolerance indices and diastolic dysfunction based on these recommended variables.

Purpose
To examine the relationship between CPET parameters and diastolic dysfunction using the recommendation from ASE/EACVI in cardiovascular diseases patients with reduced EF

Methods
We recruited 214 patients who performed both CPET and echocardiography. EF&lt;50% was 115 patients. All patients underwent 0W warm-up and 10W ramp on an upright electrical bicycle ergometer. We defined peak VO2&lt;14 ml/min/kg as low peak VO2, and VE/VCO2&gt;34 as high VE/VCO2 slope. Diastolic dysfunction was assessed using the recommendations for the evaluation of diastolic function by ASE/EACVI. We used this recommendation algorithm to estimate grading LV diastolic function in patients with depressed LVEF. Grading 3 shows the most severe diastolic dysfunction.

Results
Mean age was 55±15 years old, and the portion of women was 30%.
The portion of Grading 3 diastolic dysfunction was 18%. In univariable logistic regression analysis for diastolic dysfunction, Log BNP, and high VE/VCO2 slope were significantly associated with diastolic dysfunction. In multivariable logistic regression analysis, each Model, LogBNP and high VE/VCO2 slope were independent factors for severe diastolic dysfunction [adjusted age and sex, Model 1: LogBNP (OR 2.42, CI 1.44-4.05, p&lt;0.001), low PeakVO2. Model2: LogBNP (OR 2.23, CI 1.31-3.78, p=0.003), high VE/VCO2 slope (OR 3.30, CI 1.06-10.3, p=0.039)].
We performed receiver operating characteristics (ROC) curve analysis on the ability of BNP, and VE/VCO2 slope. The area under the ROC curve (AUC) for BNP was 0.77, with the discriminating sensitivity and specificity at 0.67 and 0.86, respectively (cut-off value 234 pg/mL). On the other hand, the AUC for the high VE/VCO2 slope was 0.75, with the discriminating sensitivity and specificity at 0.81 and 0.67, respectively (cut-off value 30).

Conclusion
In patients with depressed EF, high VE/VCO2 slope was significantly associated with diastolic dysfunction assessed by the recommendations from the ASE/EACVI.
Impact of short-term exercise training on QT dispersion and double product in diabetic patients after surgical aortic valve replacement
Authors: Stoickov V , Deljanin Ilic M , Tasic I , Stoickov M , Golubovic M , Stoickov I , Kostic S , Stoickov F 
Published: November 2023

Abstract

Background
QT dispersion (QTd) represents the heterogeneity in the repolarization of the ventricular myocardium and electrical instability of the myocardium, reflecting the increased tendency towards ventricular arrhythmias. Abnormally high QTd has been correlated with risk of cardiac death.

Purpose
The aim of this study was to establish the influence of short-term exercise training on QT dispersion and double product (DP), in diabetic patients after surgical aortic valve replacement (SAVR).

Methods
The study involved 147 patients after SAVR, in the sinus rhythm without AV blocks or branch blocks. Average age of patients was 59.3 years. 45 patients were with diabetes mellitus, and 102 were without diabetes. Patients were similar as to age and baseline stress test duration. In all subjects clinical examination, standard ECG and exercise test on treadmill according to Bruce protocol, were performed and after that patients were included in program of physical training for three weeks. Patients were instructed to follow a training program using the bicycle ergometer (10 min, 2 times a day), gymnastic exercises and walking. The patients continued to take the same medicaments in same doses. From standard ECG corrected QT dispersion (QTdc) was calculated.

Results
Before starting with the program of physical training, patients with diabetes had significantly higher values of QTdc (83.4 ± 15.3 vs 74.6 ± 16.9 ms; p&lt;0.005) in comparison to those without diabetes. After three weeks, significant reduction of QTdc was found (from 83.4 ± 15.3 to 77.3 ± 15.4 ms; p&lt;0.02 in patients with diabetes and from 74.6 ± 16.8 to 68.7 ± 17.1 ms; p&lt;0.005 in patients without diabetes). After three weeks, significant reduction of DP was found (from 11763.8 ± 779.9 to 11314.8 ± 635.8 beat/min x mmHg; p&lt;0.005 in patients with diabetes and from 114376.4 ± 792.3 to 10034.2 ± 521.3 beat/min x mmHg; p&lt;0.001 in patients without diabetes). In diabetic patients, after program of physical training, significant reduction of glycemia was found (from 7.0 ± 2.3 to 5.9 ± 1.5 mmol/L; p&lt;0.005), of total cholesterol from 5.2 ± 1.3 to 4.6 ± 1.1 mmol/L (p&lt;0.025), of LDL cholesterol from 3.2 ± 0.8 to 2.8 ± 0.6 mmol/L (p&lt;0.05). After three weeks, both groups of patients in the exercise test reached a significantly longer time (p&lt;0.001).

Conclusions
The study showed that patients with diabetes have a higher value QTdc, probably due to diffuse interstitial fibrosis. Short-term exercise training has favourable effects on QT dispersion and double product in patients after SAVR. In patients without diabetes physical training had more favourable effects on the followed parameters. Physical training led to the significant decrease of myocardial oxygen uptake at rest and probably decreased the possibility of arrhythmia events.
Telerehabilitation after acute coronary syndrome warrants a similar improvement in physical performance as stationary rehabilitation regardless of the age profile of the compared groups
Authors: Rechcinski T , Bralewska B , Wykrota J , Wadolowska E , Cieslik-Guerra U , Szymczyk E , Kurpesa M , Kasprzak J D 
Published: November 2023

Abstract

During the COVID-19 pandemic, the availability of cardiac rehabilitation (CR) was limited. On the other hand, during the epidemic hazard period, patients after acute coronary syndromes (ACS) required careful control and ensuring their improvement after the coronary event.
The aim of this study was to assess whether CR conducted during the epidemic threat in remote mode ensures similar improvement in physical performance as rehabilitation conducted in stationary mode before the pandemic COVID-19.

Material and methods
In this one-center study, the demographic and clinical profiles in the groups of patients after ACS who completed a stationary CR before COVID-19 era or telerehabilitation during the COVID-19 pandemic were compared. The workload on the initial and final exercise tests (ExT) obtained by patients was assessed, as well as the values of differences between the final and initial ExT were compared. 359 patients (pts) participating in stationary CR before October 2020 and 60 pts - in telerehabilitation after July 2021 were included. Both, stationary and tele- CR were performed according to the guidelines of Working Group for Cardiac Rehabilitation of the national cardiac society. Telemedic platform was used to control ECG, blood pressure and body mass of pts participating in telerehabilitation. Statistical analysis included U Mann-Whitney test, T Student test and chi square test.

Results
The improvment of physical performance did not differ significantly between both groups. The pts who completed telerehabilitation were significantly older than those who completed stationary CR. The values of other parameter, like percent of females, BMI, percent of pts with arterial hypertension and diabetes mellitus type 2 or ejection fraction of left ventricle did not differ significanty between compared groups. The results of statistical analysis are presented in the table below.

Conclusions
In our center, telerehabilitation after acute coronary syndrome guaranteed an equally good improvement in physical capacity, which was observed in stationary rehabilitation patients, regardless of the difference in the age profile of the compared groups. These results encourage popularization of the cardiac rehabilitation mode with the remote control of the ECG, blood pressure and body weight.Comparison of the study groups
Effectivity and adherence of secondary prevention on clinical outcome of rheumatic heart disease in high-burden setting: a systematic review and meta-analysis
Authors: Mendel B , Kohar K K , Yumnanisha D A Y , Taher M A T , Prakoso R P , Siagian S N S 
Published: November 2023

Abstract

Background
Rheumatic heart disease (RHD) is often diagnosed late in low-resource settings due to limited health-seeking behavior and varied presentations. Optimal delivery of regular antibiotics prescribed as secondary prevention is vital to preventing disease progression. However, poor adherence of secondary prevention remains a significant challenge to these populations.

Objective
To assess the efficacy and adherence of patients to secondary prevention of rheumatic heart disease.

Methods
This systematic review and meta-analysis was carried out according to the PRISMA statement. Literature search was performed on four databases using keywords "Rheumatic heart disease", "secondary prevention", and their synonyms. Adherence and disease progression were the primary outcome. The overall proportion was estimated with R software (version 4.1.3) using a random-effects model of proportional meta-analysis.

Results
Thirteen studies were included in this study. Benzathine Penicillin G (BPG) injection every 4 weeks was the most common secondary prophylaxis regimen used. In 2052 patients, only 46% (27-66%) patients received &gt;80% BPG prophylaxis injection. The effectiveness of secondary prophylaxis was powerful, evidenced by only 7% (2-12%) patients having disease progression of rheumatic heart disease.

Conclusions
BPG was found to be effective in the secondary prevention of rheumatic heart disease. Nonetheless, patient adherence to injection remains extremely low. Methods to improve patient adherence are imminently required.Figure 1Figure 2
Detection of hidden cases of familial hypercholesterolemia in the Netherlands: a central laboratory data-driven strategy
Authors: Ibrahim S , Nierman M C , Nurmohamed N S , Hovingh G K , Reeskamp L F , Stroes E S G 
Published: November 2023

Abstract

Introduction
Familial hypercholesterolemia (FH) is a common genetic disorder in which patients are at high risk for premature coronary artery disease (CAD) due to lifelong exposure to low-density lipoprotein cholesterol (LDL-C). Although early diagnosis and lipid lowering therapy (LLT) are essential to prevent adverse cardiovascular outcomes, FH patients remain globally underdiagnosed and undertreated, warranting novel screening methods to identify these patients. In the present study we aimed to evaluate whether existing central laboratory data can be utilized as a new method to detect undiagnosed FH patients. Additionally, we investigated the extent of underdiagnosis and undertreatment among patients with severe hypercholesterolemia in the Netherlands.

Methods
In this single-center, cross-sectional study, we selected individuals with at least one previously measured LDL-C plasma level ≥99.5th percentile for age and sex, from a central laboratory database containing lipid profiles of approximately 600.000 primary care patients. First, a blood sample was obtained to get more recent lipid values. Participating patients were subsequently asked to fill out a detailed questionnaire on medical and family history. Using these data, we calculated the Dutch Lipid Clinic Network (DLCN) criteria for each patient for the clinical diagnosis of FH.

Results
We identified a total of 5,100 patients with severe hypercholesterolemia (at least one LDL-C ≥99.5th percentile for age and sex) from the central laboratory database. Out of these, 1,206 patients (24%) participated in this study. Mean ± SD LDL-C corrected for LLT was 5.72 ± 1.83 mmol/L, 785 patients (65.1%) used LLT, and 150 patients (12.4%) had CVD in their medical history. In total, 131 patients (11%) had a persistent LDL-C ≥99.5th percentile for age and sex. DLCN criteria for phenotypic FH (DLCN score ≥6) were met by 302 patients (25%) of whom 39 patients (12.9%) had undergone prior genetic testing according to clinical guidelines. Of the 302 clinically diagnosed FH patients only 1 (0.3%) met the European Society of Cardiology (ESC) guideline recommending LDL-C targets &lt;1.8 mmol/L in FH patients.

Conclusion
These data highlight the significant underdiagnosis and undertreatment of FH in the Netherlands, despite the fact that this country has a relatively high FH identification rate. We demonstrate that the use of central laboratory data is an effective strategy for identifying previously undetected cases of FH and eagerly await the genetic confirmation of the newly identified FH patients in this study, which will provide valuable insights into the genetic basis of this disorder and help further improve patient care.