bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term structural right heart remodeling following transcatheter annuloplasty for treating severe tricuspid regurgitation assessed by CT scan
Authors: Pardo Sanz A , Salido Tahoces L , Gonzalez Martin S , Hinojar Baydes R , Garcia Martin A , Gonzalez Gomez A , Garcia Sebastian C , Sanroman Guerrero M A , Fernandez-Golfin Loban C , Mestre Barcelo J L , Arteagoitia Bolumburu A , Gonzalez Leal A , Zamorano Gomez J L , Sanchez Recalde A 
Published: November 2023

Abstract

Background
Transcatheter tricuspid annuloplasty has emerged as an attractive percutaneous therapy for patients with severe symptomatic tricuspid regurgitation. Cardioband (Edwards) was the first dedicated CE marked percutaneous device for tricuspid regurgitation. Despite mid-long-term clinical safety and efficacy demonstrated in early feasibility trials and registries, there is no data about its impact on right heart structural remodeling using computed tomography (CT). Our aim was to assess right heart remodeling and changes in the tricuspid annulus (TA) one year after Cardioband implantation.

Methods
A total of 30 patients were prospectively included in the study; 21 of them had baseline and at least 1-year follow-up CT analysis. The average time from the basal CT scan and the procedure was 118±136 days, and from the intervention to follow-up CT scan was 468±251 days. 2D and 3D analyses were performed with 3mensio version 10.3 at baseline and at least 12 months after Cardioband implantation.

Results
There was a significant decrease in right ventricular dimensions at follow-up (right ventricular basal diameter was 53.65 ± 8.45 mm at baseline Vs 48.54 ± 9.12 mm at 1-year follow-up; right ventricular mid cavity diameter was 40.30 ± 9.10 mm at baseline Vs 34.22 ± 9.22 at the end of follow-up, and right ventricular longitudinal diameter was 75.43 ± 9.85 mm at baseline Vs 69.95 ± 9.96 mm at the end of follow-up, all of them were statistically significant). A reduction in right atrial dimension was also observed (longitudinal diameter 66.86 ± 7.63 mm at baseline Vs 64.89 ± 9.99 mm at the end of follow-up; transverse diameter of 61.62 ± 8.38 mm at baseline Vs 60.59 ± 8.3 mm at the end of follow-up, p&lt;0.001). There was a significant decrease in the area and diameters of the dilated TA (area at baseline 16.51 ± 3.06 cm2 vs 8.90 ± 2.71 cm2 at the end of follow-up, p=0.02; septolateral diameter 45.42 ± 5.02 mm at baseline vs 33.87 ± 5.09 mm at the end of follow-up, p=0.01).

Conclusions
Long-term favorable right ventricular chambers and TA remodeling was observed following Cardioband implantation assessed by CT scan. This finding could explain the long-term clinical benefit demonstrated in feasibility studies.Right heart remodeling after Cardioband
Timing on patent foramen ovale closure: early versus delayed closure
Authors: Jeronimo A , Nombela-Franco L , Freixa X , Tomassini F , Lopez-Tejero S , Ojeda S , Veiga G , Goncalves-Ramirez L , Garcia-Blas S , Salinas P 
Published: November 2023

Abstract

Introduction
Pivotal randomized clinical trials showed benefit in patent foramen ovale closure (PFOC) up to 9 months after a cryptogenic stroke or transient ischemic attack (TIA) [1-4]. It might be sensible to indicate PFOC also in non-recent cryptogenic strokes, but evidence is lacking.

Purpose
We aimed to compare the effectiveness of PFOC according to the time elapsed from the patient’s last episode of cryptogenic cerebrovascular event (CVE) or systemic embolism (SE).

Methods
A retrospective, international, multicentre, cohort study was performed to compare the outcomes of an early closure (EC, &lt;9 months) or delayed closure (DC, ≥9 months) of patent foramen ovale (PFO) as secondary prevention after the index event. The primary end-point was recurrence of CVE or SE after PFOC.

Results
A total of 325 and 171 patients were classified in the EC and DC groups, with a median time to PFOC of 3.4 (IQR 1.9-5.5) and 17.5 (IQR 12.2-33.4) months, respectively. No significant differences were observed regarding the type of event indicating PFOC (stroke was the most frequent (77.8% in EC group vs 79.0% in DC group), followed by TIA (19.4% vs 18.7%)); neither about neuroanatomic localization of the lesions, nor contrast transcranial Doppler patterns, nor Risk of Paradoxical Embolism (RoPE) score (7 (IQR 5-8) vs 6 (IQR 5-7), p=0.077). Echocardiographic PFO characteristics of both groups were similar, except for a larger defect size (tunnel width) in the DC group (6 (IQR 4-14) vs 12 (IQR 6-16) mm, p=0.005)). PFOC device, procedural success (99.4 in EC vs 98.8% in DC group) and periprocedural complications (2.1 vs 0.8%) were comparable in both groups. Median follow-up was 2.0 (IQR 1.3-3.8) years in the EC group and 2.2 (IQR 1.2-4.9) in the DC group (p=0.721). No significant differences were observed concerning recurrence of stroke, TIA or SE (3.9% vs 2.6%, p=0.443), time from PFOC to recurrence (0.9 (IQR 0-2.1) vs 6.1 (2.5-8.8) years, p=0.090), death (1.4% vs 1.0%, p=0.697), residual shunt 12 months after PFOC, or antithrombotic treatment during follow-up (Figure 1). Moreover, a subanalysis considering those patients with a very delayed PFOC (≥24 months) after the index event also showed no differences in recurrence rate during follow-up compared to the earlier procedures (4.2% in the &lt;24-month group vs 3.4% ≥24-month group, p=0.770).

Conclusions
No differences were observed regarding recurrences of CVE/SE in patients undergoing PFOC before and after 9 months from the index event. Despite the absence of evidence from randomized trials, this study suggests that the preventive benefit of PFOC after a cryptogenic CVE/SE may be extended beyond 9 months after the last event.Figure 1:Incidence of recurre
Feasibility and accuracy of real-time 3D-holographic graft length measurement, a sub-study of the FAST-TRACK CABG trial
Authors: Tsai T , Kageyama S , He X C , Onuma Y , Pompilio G , Andreini D , La Meir M , De Mey J , Puskas J , Narula J 
Published: November 2023

Abstract

Background
3D Hologram is an emerging tool for intuitively manipulating and visualizing CT images. Mixed reality (MR) technology can display high-definition 3D holograms while preserving situational awareness. The new MR software offers the possibility to measure 3D objects using hand gestures and voice commands. However, these measurements made on 3D holograms have not been validated.

Purpose
We aimed to assess the feasibility and accuracy of using CT-derived 3D holograms for bypass graft length measurement.

Methods
Twenty-seven consecutive cases in the FAST TRACK CABG trial were included. The post-operative CT images performed at 30 days follow-up were analyzed in an independent core lab. Two analysts blinded to clinical information performed Holographic reconstruction and measurement using the CanaLife Holo software (Medapp, Krakow, Poland). (Figure 1) Inter-observer agreement was assessed in the first 20 cases. Another analyst with full access to clinical information performed the validation measurements on the CardIQ W8 system (GE Healthcare, Milwaukee, Wisconsin). (Figure 1)

Results
A total of 62 grafts (27 left internal mammary artery grafts, 27 saphenous vein grafts, and 8 right internal mammary artery grafts) were measured. There was an excellent inter-observer agreement between the analysts in the first 47 grafts analyzed (interclass correlation 0.9879 [0.9783-0.9933]). (Figure 2A, 2B) On average, holographic reconstruction and measurement of a case took 3 minutes and 36 seconds± 50.74 seconds compared to around 10 minutes per vessel on the traditional CT system. There was no significant difference between the graft length measured by hologram and CT (188.59±51.63 mm vs. 183.95±50.93 mm, p=0.616). The length measured by hologram and CT were similar across different graft types. The measurements of hologram and CT are highly correlated (r=0.973, p &lt;0.001) with an excellent agreement (interclass correlation 0.9928 [0.9880-0.9957]). (Figure2C, 2D)

Conclusion
Holographic vessel length measurement is feasible, fast, and accurate even for tortuous coronary bypass grafts. This new methodology can empower surgeons to visualize and measure the results of their work by themselves and may provide insights for procedure evaluation. 3D Holograms can eventually empower surgeons to plan the precise length of the arterial and venous grafts to be harvested for every individual case.
Ten years follow-up after aortic valve replacement with bioprosthesis trifecta: a single center retrospective cohort
Authors: Goncalves C , Cerqueira R , Araujo J , Moreira S , Palma P , Almeida J , Amorim M J , Pinho P , Diaz S O , Barros A S , Lourenco A P , Saraiva F , Leite- Moreira A 
Published: November 2023

Abstract

Introduction
St. Jude’s Trifecta (TF) bioprosthesis were adopted at most centers due to their unique design and hemodynamic performance. However, concerns regarding durability have been raised and long-term follow-up studies (≥10 years) are scarce.

Purpose
To report hemodynamic performance as well as early and long-term results of TF valve.

Material and Methods
In this longitudinal, single-center study, consecutive patients that underwent surgical aortic valve replacement with TF, from July 2011 to June 2019 were included. Pre-, intra- and post-operative data, including routine and first outpatient ambulatory postoperative transthoracic echocardiogram (TTE) (median 4 months) were collected. Hospital mortality was defined as in-hospital or within the first 30 days after surgery. Survival and need for reoperation were accessed in December 2021. Median follow-up was 4 years and maximum was 10,5 years. Kaplan-Meier method was used for time-to-event outcomes (all-causes mortality and need for reoperation).

Results
We included 1084 patients, 54% being male, with a mean age of 74±8 years. Surgery priority was elective in 840 (78%) of cases. Most patients received a TF prothesis of size 23 (35%), followed by size 21 (30%). There were 563 (52%) multiple procedures, mostly coronary artery bypass grafting (46% within the multiple procedures). Bypass and clamping times were 86±31 minutes and 62±22 minutes, respectively for isolated procedures, and 143±27 minutes and 100±40 minutes, respectively, for multiple procedures. Hospital mortality was 6%. Excluding these patients, cumulative survival at 1-, 3-, 5- and 10-years, were, respectively, 96%, 89%, 78% and 52%. There were 27 patients who needed reoperation: 16 due to endocarditis, 5 due to structural valve deterioration (SVD) and 6 due to non-structural valve dysfunction. Freedom from reoperation at 1-, 3-, 5- and 10- years were of 99%, 98%, 98% and 95%, respectively. At follow-up TTE (n=995), transvalvular mean gradient was 11±4 mmHg and the effective orifice area mean was 2.1±0.5cm2. Patient-prosthesis mismatch occurred in 79 (9.1%), being severe in 8 (0,9%) cases.

Conclusion
Our findings confirm the satisfactory hemodynamics and safety profile of TF bioprosthesis. Long-term results are comparable with published TF series and there seems to be no particular sign of adverse valve-related events in our population.
Should women have lower thresholds for hypertension? Severe ultrastructural abnormalities in systemic arterioles of normotensive and hypertensive women
Authors: Brewster L M , Perrotta I D , Taherzadeh Z , Van Montfrans G E R T 
Published: November 2023

Abstract

Background
Hypertension in women is increasingly recognized to originate in the pre-menopause, but the factors that may affect the greater blood pressure increments observed in premenopausal women compared to age-matched men are understudied.
Uterine fibroids, occurring in 30-50% of all women, are a strong sex-specific factor associated with hypertension and early cardiovascular events, but the nature of this association is not known. To assess a possible shared pathology of smooth muscle, we studied the ultrastructure of systemic resistance arteries of women with fibroids.

Methods
Resistance-sized arteries (200 to 400 μm) were harvested from omental samples obtained during fibroid surgery. Transmission electron microscopic images were taken at different magnifications and locations of the vessel wall to assess qualitative and morphological characteristics. Mean blood pressure was calculated as DBP+1/3(SBP-DBP).

Results
Resistance arteries of 17 women (8 hypertensive, 4 treated), mean age 42 (SE 1) y, were available for analysis. None had a history of cardiovascular disease. Mean blood pressure was 91.4 mm Hg in normotensives and 119.4 in hypertensives.
The endothelium showed mitochondrial and endoplasmic reticulum stress in normotensives (Figure, Panel A), to necrosis and sloughing in hypertensives (B).
Myocyte-like cells were observed to migrate across the internal elastic lamina, forming small aggregates of subendothelial myocytes in normotensives (C), and larger subendothelial myo-intimal "cushions" in hypertensives (D).
Medial myocytes of all patients showed abnormalities similar to fibroids, with dilated sarco-endoplasmic reticulum, elongated mitochondria and myofilament loss involving focal areas or entire cells (E, clinically considered normotensive).
Untreated hypertensives had a significantly higher intima-media thickness-to-lumen ratio (%) than normotensives and treated hypertensives as expected, respectively 15.9 (1.8), 12.5 (1.6) and 13.4 (2.1).

Conclusion
To our knowledge the first ultrastructure data of systemic resistance-sized arteries in women with fibroids, show that young premenopausal women considered clinically normotensive already have severe microvascular abnormalities that may cause or reflect perturbations in microvascular function and predispose to early end organ damage.
While there is abundant clinical evidence that the association between blood pressure and cardiovascular events is stronger in women, hypertension in women is understudied. In particular women-specific risk factors are ill-understood.
Our observations are relevant to the current discussion regarding whether the clinical threshold for hypertension treatment is too high for women and whether earlier management of cardiovascular risk is needed. Further studies are warranted in a woman-specific research agenda on cardiovascular risk factors in younger premenopausal women.Figure
Improved health-related quality of life after renal denervation in patients with resistant hypertension: 3-year outcomes in the global symplicity registry
Authors: Mahfoud F , Weil J , Mancia G , Schmieder R E , Ruilope L , Schlaich M , Narkiewicz K , Williams B , Fahy M , Bohm M 
Published: November 2023

Abstract

Background
Hypertension is associated with increased mental anxiety and depression. Renal denervation (RDN) reduces blood pressure (BP) in patients with uncontrolled, resistant hypertension (rHTN). The Global SYMPLICITY Registry (GSR) DEFINE is a prospective, open-label, single-arm, all-comer worldwide study, enrolling patients to undergo RDN. Whether BP reductions after RDN improve patients’ self-reported health and quality of life through long-term follow-up remains elusive.

Purpose
To evaluate changes in self-reported health and quality of life of rHTN patients following radiofrequency RDN.

Methods
GSR DEFINE patients completed the EuroQoL five-dimensions three-level (EQ-5D) questionnaire to assess their own health state on a visual analog scale (VAS: 0 to 100, with 0 being ‘worst possible’ and 100 being ‘best possible'). Patients were also asked to assess five dimensions of quality of life including mobility, self-care, usual activities, pain/discomfort, anxiety/depression at 3 levels: no problems (score: 0), some problems (1), severe problems (2). Patients answered the questionnaire at 6, 12, 24, and 36-month follow-up after the RDN procedure. Categorical measures from the pooled results of the questionnaire between subgroups were compared using the Kruskal-Wallis test. Here we assess the self-reported health state and quality of life measures among patients with rHTN (office systolic BP ≥150 mmHg and on ≥3 antihypertensive drugs) at baseline through 36 months.

Results
At baseline, GSR patients with rHTN (n=2051) had an office systolic blood pressure (OSBP) of 175.2 ± 19.8 mmHg and a 24-h ambulatory systolic blood pressure (ASBP) of 157.4 ± 18.6 mmHg. At 36 months after RDN, rHTN patients had significant reductions in OSBP (-23.5 ± 27.0 mmHg; n=906; p&lt;0.001) and ASBP (-10.3 ± 20.9 mmHg; n=329; p&lt;0.001), respectively. Antihypertensive medication remained unchanged through 36 months. Correspondingly, patients with rHTN reported a significant improvement in the self-reported health state from baseline after RDN at each follow-up through 36 months (Figure). At baseline (n=1813), patients with rHTN reported a 0.86 ± 0.20 EQ-5D quality of life score. At 36 months (n=839), patients with rHTN reported an improved quality of life with a 0.85 ± 0.21 score which was a statistically significant change from baseline (p=0.0024).

Conclusion
Following RDN, self-reported health state and quality of life data from a large population of rHTN patients improved from baseline through 36-months. These results suggest that BP reductions following radiofrequency RDN may alleviate mental anxiety and depression associated with hypertension.
Effects of different obesity evaluation indexes on long-term blood pressure variability in adults
Authors: Huang R , Jing Z Q , Liu H Y , Li Z Y , Wu S S , Li D , Zhao F , Hao J , Yang C L , Song J S , Gu X Z 
Published: November 2023

Abstract

Background
In recent years, people have a new understanding of the treatment of hypertension. Even at the optimal blood pressure levels recommended by the guidelines, further attention to blood pressure variability is warranted. Obesity and overweight are associated with blood pressure variability, but existing studies mainly focus on the effect of traditional obesity indicators on blood pressure variability (BPV).

Objectives
To explore the correlation between the new obesity assessment indicators LAP, BRI, CVAI and blood pressure variability.

Methods
A total of 7092 subjects who had regular physical examination in a community health center, were included for analysis. We used new measures to assess obesity, including LAP, BRI, CVAI. Subjects were grouped according to the baseline CVAI quartile. We used variation independent of mean(VIM) to assess long-term variations in blood pressure. Variance analysis was used to analyze the differences among different blood pressure variables and their baseline characteristics. Stepwise multivariate linear regression and multiple logistic regression analyses were used to assess the impact of CVAI/LAP/BRI on VIM.

Results
The average age of the subjects was 60.7±6.8 years old. With the increase of CVAI and BRI, the mean blood pressure variability increased gradually. In contrast, the mean blood pressure variability decreases with increasing LAP. After adjusting for other confounding factors, multiple linear regression analysis showed that VIMSBP increased by 0.007 and 0.216 for each unit increase in CVAI and BRI, respectively. LAP found no correlation. Multiple logistic regression analysis showed that increased CVAI and BRI were risk factors for increased VIMSBP, and increased LAP was protective factor for increased VIMSBP.

Conclusion
Compared with traditional indicators, the novel obesity indicators were also associated with blood pressure variability. And it has a stronger correlation than traditional indicators.
Practice guidelines for cardiovascular disease: how is depression addressed?
Authors: Blatch Armon D , Buhayer A , Dobretz K , Mach F , Meinlschmidt G , Battegay E 
Published: November 2023

Abstract

Introduction
Multimorbidity is associated with increased mortality, decreased quality of life, and increased use of healthcare services and complicates medical decision-making. Depression is more prevalent among patients with CVD than in the general population, with a direct impact on cardiovascular outcomes and management. Clinical practice guidelines (CPGs) aim to provide the best available advice for improving patient care and outcomes.
Question: Do CPGs on CVD provide any practical guidance on depression screening and management?

Methods
National and international CPGs on CVD prevention and management published between 2012 and 2023. English language only. Databases: MEDLINE n=2432. EMBASE n=327; G.I.N. n=57; Guideline Central: n=97; Uptodate n=26; Society homepages (e.g. NICE, SIGN) n=7. Selection criteria: general management guidelines for adult patients diagnosed with a CVD, as well as disease-specific CPGs (e.g. heart failure (HF), coronary artery disease, peripheral arterial disease (PAD), ischaemic disease, stroke or hypertension (HT)) providing patient-management guidance. Eligible guidelines: evaluated for any mention of depression, with a focus on: 1) recommendations regarding depression screening and treatment; 2) drug-drug or drug-disease interactions associated with depression.

Results
43 CVD CPGs provide comprehensive management advice: 7 from CVD in general and 36 from specific disease in CVD (11 from HT, 7 from ischemic heart disease, 7 from HF, 5 from dyslipidemia, 3 from stroke, and 3 from PAD). 26 CVD CPGs mention depression as a CV comorbidity at least once: 22 in specific disease CPG and 4 in general CVD CPGs. 15 CVD CPGs advise to screen for depression: 4 from CVD in general and 11 from specific disease in CVD (4 from ischemic heart disease, 3 from HF, 2 from HT, 1 from PAD, and 1 from stroke). 8 CVD clinical practice guidelines provide advice on management of depression: 3 from CVD in general and 5 from specific disease (2 from HT, 2 from ischemic heart disease and 1 from HF). 4 CVD clinical practice guidelines advise on drug-drug or drug-disease interactions. When provided, the level and quality of guidance for treating physicians on how to screen and manage depression remains very low.

Conclusion
Management of CVD in the specific clinical setting of depression remains poorly addressed, despite it being documented that factors associated with poor adherence to CVD treatment include depression.
Future directions: The psychosocial needs of patients with CVD should be systematically assessed and addressed in an evidence-based manner. There is a need for clear practical guidance on the frequency at which a patient’s mental health should be reassessed. Patient panels can help provide practical information toward addressing depression in the development of guidelines.The AIDS CPG address depression in detail and could serve as a model for future CVD CPGs.