bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insomnia due to hypertriglyceridemia can be treated by rosuvastatin/ezetimibe
Authors: Fazio G 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Metabolic syndrome associated with elevated fasting triglyceridemia (TG) is often associated with insomnia. The new guidelines of ESC for dyslipidemia advice the statin and/or ezetimibe treatment like fist line therapy in patients with hypertriglyceridemia, also before then fibrates or omega 3.
We examined the impact of rosuvastatin/ezetimibe treatment in reduction of insomnia in patents with hypertriglyceridemia.

Methods
In this study was enrolled a group of 148 patients with hypertriglyceridemia and insomnia. Patients were screened for severe insomnia, defined by a score of four or more on the three Hamilton Depression Rating Scale (HDRS) sleep items, and for HTG characterized by TG≥200mg/dL. The duration of sleep was evaluated with smartwatch every 7 days.
Mean age was 61,12 years. All patient was admitted in ambulatory of cardiology and were in wash out treatment for dyslipidaemic syndrome. In all we added 20 mg of rosuvastatin plus 10 mg of ezetimibe daily to therapy and reassessed patients after 30 days.

Results
Rosuvastatin/ezetimibe treatment was effective as add-on therapy in reduction of insomnia . All treated patients reported an improvement in symptoms. After 30 days, insomnia disappeared in 69% of patients and was reduced in 21% of patients.
The number of the sleeping hours improved from 5:35 min to 7:25 minutes.
Therapy was well tolerated in 99% of patents, and stopped only in 2 cases.

Conclusions
Our initial experience with rosuvastatin/ezetimibe in hypertriglyceridemia treatment suggests that this therapy may play a role in the treatment of insomnia
Are you short of breath? comparing functional capacity using new york heart association class and cardiopulmonary exercise testing
Authors: Hammett R , Fleri Soler J , Gauci M , Desira J , Abela M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
New York Heart Association (NYHA) scale is used to assess symptom severity in heart failure patients. Despite it being used routinely in clinical practice, it is heavily dependent on patient and physician subjectivity. Cardiopulmonary exercise testing (CPET) provides a potentially more objective and reproducible measure of functional capacity.

Purpose
To assess functional capacity in NYHA 1 versus NYHA 2-4 patients. Investigators also wanted to explore any relationship between NYHA class and CPET variables in heart failure patients.

Method
A retrospective analysis of patients who underwent CPET between 2021 & 2022 was performed. The patients were grouped according to NYHA score and ejection fraction (EF). A separate subgroup analysis was carried out in NYHA 1, comparing patients with an EF &lt; 35% and EF &gt; 35%.

Results
A total of 160 patients were included, a dominant male (81.3%) Caucasian (95%) population with an average age of 53.9 years. 13.8% had an EF &lt;35%. 51.9% had ischaemic cardiomyopathy. 103 (64.4%) patients had a NYHA score of 1, the rest had a NYHA score of 2-3. There was no significant difference between demographic parameters and co-morbidities between the groups.
Figure 1 depicts CPET parameters comparing NYHA 1 vs NYHA 2-4 groups. VO2 MAX and % VO2 Max Predicted were significantly higher in NYHA 1 vs NYHA 2-4 (Figure 1). NT-proBNP levels were lower in the NYHA 1 group (378 pg/mL vs 850 pg/mL, p=0.023). Further analysis of the NYHA Class 1 group, comparing EF&lt; 35% and &gt;35% was carried out. It was discovered that despite being assigned the same NYHA Class, the EF &lt;35% group had significantly lower VO2 max, % predicted VO2 max and VE/VCO2.
EF was an important predictor of CPET performance in NYHA 1 patients. Those with an EF &lt;35% had a lower VO2 max (p=0.001), low % VO2 Max predicted (p=0.005) and higher VE/VCO2 (p=0.002). NT-proBNP was also higher in this subgroup (p=0.047).

Conclusion
NYHA is an effective tool at assessing symptom severity in heart failure patients, albeit subjectively. CPET is particularly useful in NYHA 1 patients as it can give an objective assessment of functional capacity in these asymptomatic individuals. Future studies should explore the possible role of CPET in determining suitability for advanced heart failure therapies in NYHA 1 heart failure patients.
Traditional media or chatbot: how can we reach older adults with the COVID-19 information they need?
Authors: Olszewski R , Cwiklinska K , Brzezinski J , Owoc J , Manczak M , Zaremba M , Targowski T , Jeziorski K 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): WHO Reference, 2022/1216167-0, Promoting health and well-being and Flagship initiative- Empowerment through Digital Health. “Older people and COVID-19- new challenges for public health in Poland”.

Background
The current epidemiological situation related to the COVID-19 pandemic is one of the biggest public health challenges and is associated with many negative phenomena such as the spread of misinformation. Older adults (especially with cardiovascular diseases) with their specific needs, concerns and preferred sources of information are the most vulnerable group in the rapidly evolving world.

Objective
Identify areas of interest, preferred sources of information related to the COVID-19 pandemic among older adults and verify their e-health competencies.

Material and method
The study was conducted between February 2022 and July 2022. Both groups of older and younger adults completed a self-administered questionnaire that addressed respondents' interests, questions and sources of information about COVID-19 that they used. Additionally, respondents filled out the PL- eHEALS questionnaire to measure e-health competencies.

Results
The study included a total of 573 participants (older adults - 303 participants, young adults - 270). The three issues that attracted the largest interest among the elderly were COVID-19 treatment methods (45.5%) COVID-19 symptoms (36.6%) and the impact of COVID-19 on chronic diseases (35%). The main source of information about COVID-19 was television (84.5%). As much as 84% of the elderly have never interacted with a chatbot and only 18% believe it could be a reliable source of information on COVID-19. The e-health competencies of the elderly were significantly lower than the younger generation’s (Fig. 1).

Conclusions
This study found intergenerational differences in COVID-19 information needs. Older adults need basic information about COVID-19 and prefer using traditional media.
Echocardiography in the pre-participation screening: an old topic revisited
Authors: Palermi S , Donati F , Guicciardi C , Lodi E , Fernando F , Modena M G , Biffi A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Preparticipation screenings (PPs) have been conceived for the potential to prevent sudden cardiac death (SCD) in young athletes by early identification of hidden cardiac diseases. Commonly used protocols include family history collection, physical examination and resting electrocardiogram (ECG). Transthoracic echocardiography has been hypothesized to have a primary role in the PPs. The aim of the present study was to evaluate the additional role of echocardiogram in identifying cardiovascular (CV) abnormalities that might be undetected by commonly used PPS.

Methods
We retrospectively reviewed Ferrari Formula Benessere, a corporate wellness program - database and analyzed data recorded from 2017 to 2022 to compare two medical models: a "standard" PPS including medical history, physical examination, ECG and exercise stress testing (EST) versus an "advanced" PPS comprising history, physical examination, ECG, EST and echocardiography.

Results
From an initial sample size of 7500 subjects, we included 500 subjects (420 male, 33.69 ± 7.9 mean aged) enrolled for the first time in the corporate wellness program between 2017 and 2022. 339 (67.8%) subjects had no abnormal findings at "standard" PPS and, even if would have not required further evaluation, performed an echocardiography anyway ("advanced" PPS): 31 (9.1%) showed some abnormal CV findings at echocardiography, such as patent foramen ovalis or bicuspid aortic valve.

Conclusions
Screening echocardiogram showed an additional value in detect subjects with CV abnormalities, otherwise undiagnosed with "standard" PPS protocol.
Sleep well, but be active. Effect of sleep and sedentariness on incidence of diabetes
Authors: Liu K , Marques-Vidal P 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Faculty of Biology and Medicine of Lausanne, the Swiss National Science Foundation.

Background
Both long/short sleep and inactivity have been associated with the development of diabetes. However, their effects have seldom been jointly assessed.

Purpose
We aimed to determine the individual effect of long/short sleep and of inactivity on diabetes risk using data from a population-based prospective study in Switzerland.

Methods
Participants devoid of diabetes were included. Incident diabetes was defined based on either fasting plasma glucose (FPG), or glycated hemoglobin (HbA1c), or any diagnostic criterion (FPG, HbA1c or medical diagnosis). Sleep and sedentary levels were assessed by questionnaire. Sleep was categorized into short (&lt;7 hours/day), adequate (7-9 hours/day) and long (&gt;9 hours/day). Follow-up was conducted for 10 years.

Results
Data from 3355 participants was analyzed. There were 136, 110 and 142 incident cases of diabetes as defined by FPG, HbA1c or any diagnostic criterion, respectively. On bivariate analysis, participants who developed diabetes had a higher level of sedentariness but no differences were found regarding sleep duration or prevalence of short or long sleepers. Similar results were obtained after adjusting for age, gender, education, smoking and body mass index (see table).

Conclusion
The findings of the study revealed that being sedentary, but not long hours sleep, is related to a higher risk of developing diabetes.
Genotyping of patients with severe dyslipidemia in a screening program for familial hypercholesterolemia. Studio Gioconda
Authors: Fernandez Olmo R , Marchal Martinez J , Martin Alcolea M , Torres Llergo J , Fernandez Anguita M , Garcia Ruano A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Familial hypercholesterolemia (FH) is one of the diseases of genetic origin that produces early cardiovascular disease (CVD), because the levels of low-density lipoproteins (LDL) are increased from an early age. In addition, when there are genetic variants in certain genes, the cardiovascular prognosis worsens. The objective of our work, was to evaluate those conditions that influence the genotyping of severe dyslipidemia in the context of a FH detection program.

Material and methods
We prospectively included all patients in the HF screening program at our center from February 1 to September 30, 2022. It was performed from Clinical Analysis, with an alarm system to detect severe dyslipidemia in patients over 18 years of age (LDL &gt;190 mg/dl) in coordination with the Cardiology and Genetics Cardiovascular Prevention Unit, to select cases suitable for genetic study (Lipid Score of the Dutch Guidelines ³6 points).

Results
n = 353. Mean age 52.2 years. 51.6% women. 30% were hypertensive, 6% diabetic, 36% obese and 24% smokers. 33% had a family history (FaH) of CVD, 60% FaH of severe dyslipidemia and 10% FaH&lt;18 years-LDLhigh. 2.6% had had a previous coronary event. Only 13% were on lipid-lowering treatment. The mean LDL-C levels were 207mg/dl and the rest of the lipid profile are shown in Table 1. 26.4% of patients underwent genetic study, 6.2% had pathogenic variants and 14% variants of uncertain significance (VUS). Patients with some genetic variant had higher levels of LDL (217 vs209 mg/dl;p0.016), Lp(a) (92vs40mg/dl;p0.003) and Non-HDL (248 vs 236 mg/dl;p0.015), were younger (45 vs. 52 years; p0.019) and FaH&lt;18 years-LDLhigh (43vs8%;p&lt;0.001). Patients with pathogenic variants had higher levels of LDL (219vs201 mg/dl;p0.008), Lp(a) (102vs43mg/dl;p&lt;0.001) and Non-HDL (270vs236mg/dl;d&lt;0.001), were younger (32vs52years;p0.003), FaH of&lt;18 years-LDLhigh (100% vs9%:p&lt;0.001) and CVD FaH (100% vs32%;p&lt;0.014), with no differences between patients with pathogenic variants and VUS in terms of lipid levels, but if age [pathogenic variants (32 years) vs VUS (50 years);p 0.016].

Conclusions
In our study, 20% of probable diagnoses of FH present some type of genetic variant, influenced by age, LDL levels, Lp(a), Non-HDL and FaH of CVD and dyslipidemia.
Relationship between NT-proBNP and myocardial deformation in obese patients with acute myocardial infarction
Authors: Tomoaia R , Beyer R S , Zdrenghea D , Dadarlat-Pop A , Cismaru G R , Gusetu G R , Minciuna I A , Fringu F I , Simu G R , Gurzau D , Caloian B , Comsa D H , Rosu R , Pop D 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): This research was funded by “Iuliu Haţieganu” University of Medicine and Pharmacy, Dept. of Cardiology, Cluj-Napoca, Romania, grant number 1529/66/18.01.2019.

Introduction
In addition to promoting coronary artery disease, obesity increases the risk of cardiovascular complications. The obesity paradox, however, refers to the observation that a high body mass index (BMI) may be protective of outcomes following an acute myocardial infarction (AMI). In patients with AMI, both NT-proBNP and novel echocardiographic markers (global longitudinal strain - GLS) provide additional information; nevertheless, there is limited research on the association between these parameters and obesity in this clinical setting.

Material and methods
This was a prospective study that included 55 patients admitted with AMI and preserved or mildly reduced LVEF (&gt;40%), which all underwent successful percutaneous revascularization. At 48 hours after PCI, echocardiography was performed using a Vivid E95 scanner and the automated function-imaging (AFI) tool was used to determine GLS. NT-proBNP was measured using ELISA. All patients were divided into two groups according to their BMI (group 1 included 18 patients with normal BMI&lt;25 kg/m2, and group 2 included 37 obese patients, with a BMI&gt;30 kg/m2).

Results
The mean age of the patients was of 66±14 years, 58% were male and 65.5% had STEMI. Other than obesity, there was no difference between groups in the other cardiovascular risk factors (smoking, dyslipidemia, arterial hypertension, diabetes, age, gender). In both groups, the anterior descending coronary artery was the most frequent culprit vessel (44% vs. 40%, p=0.9). The majority of the patients had single- or two- vessel coronary artery disease (72% vs. 73%), but there were no differences between groups (p=0.74). The values of NT-proBNP were significantly lower in the obese group (300 [117-713] vs. 756 [450-1800] pg/mL, p=0.02). However, regarding the echocardiographic evaluation of myocardial function, there was no difference between the values of GLS (-10.5% vs. -10.8%, p=0.77) or LVEF (56.7% vs. 49.2%, p=0.27) among groups. GLS showed a stronger correlation to NT-proBNP values in the normal weight group (r=0.63) than in the obese group (r=0.27).

Conclusion
Despite the fact that increased BMI is linked to lower values of NT-proBNP following AMI, non-obese patients do not demonstrate more impaired myocardial longitudinal function. These findings might offer more insights on the perspectives of obese AMI patients.
Performance of the 2-minute stand up test and the association with peak oxygen consumption in cardiopathes
Authors: Nascimento De Almeida C N A , Cristiane Maria Costa Dias C M C , Mauricio Milani M M , Fernanda Matos Oliveira F M O , Marlus Karsten M K , Eduardo Sahade Darze E S D , Luiz Eduardo Fonteles Ritt L E F R 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Fundo de amparo a pesquisa do estado da Bahia.

Introduction
The two minute sit-to-stand test (STST) quantifies the getting up and sitting down movement in 2 minutes. Its use has not yet been well established in patients with heart disease.

Purpose
To develop and validate an equation to estimate peak oxygen uptake (peak VO2) based on performance in STST.

Methods
Cross-sectional study with patients over 18 years with heart disease referred to a cardiovascular rehabilitation program, who were submitted to STST and Cardiopulmonary Exercise Test. Pearson's correlation analysis, multiple linear regression and ROC curve were used for statistical analysis. The association between determined and estimated peak VO2 was evaluated by the Bland-Altman analysis. p &lt;0.05 was adopted as statistically significant.

Results
158 participants were included, with a mean age of 60±14 years, 75.3% male, 75.6% with coronary artery disease and 24.4% with chronic heart failure. The average left ventricular ejection fraction was 57±16 %. The tests resulted in mean peak VO2 of 19.2±6.4 mL.kg-1.min-1, and mean STST performance was 32±12 repetitions. There was a correlation between peak VO2 and STST (r=0.65; R2=0.57; p&lt;0.001). Performance on STST ≥ 32 was the best cutoff point to predict peak VO2 ≥ 20mL-kg-1min-1 (AUC = 0.80; 95%CI 0.74-0.87; p&lt;0.001), sensitivity 71% (CI95 %; 0.58-0.81) and specificity 81% (95% CI; 0.69-0.89). The resulting equation was: peak VO2 = 21.4 - (0.16*age) + (0.26* STST) - (3.1*sex); male=0, female=1. The peak VO2 estimated by the equation (19.3±5.1 mL-kg-1min-1) was not different (p&gt;0.05) from the peak VO2 determined (19.71±6.8 mL-kg-1min-1).

Conclusions
STST was moderately correlated with peak VO2. The validated equation accurately estimated the peak VO2. The STST is useful in the assessment of patients with heart disease, helping to estimate peak VO2 and identify patients with peak peak VO2peak ≥ 20mL-kg-1min-1.
Does inclusion of cognitive measures improve the predictive performance of SCORE2 for future cardiovascular events in older adults?
Authors: Bobak M , Dalecka A , Pikhart H , Lu W 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): National Institute for Research of Metabolic and Cardiovascular Diseases (Programme EXCELES, ID Project No. LX22NPO5104) - Funded by the European Union – Next Generation EU.

Introduction
The cardiovascular disease (CVD) risk prediction model SCORE2 uses several biomedical and behavioural factors. It is likely that other factors also contribute to CVD risk prediction. Cognitive impairment and CVD are associated and share several risk factors. While the causality of this relationship remains unclear, adding cognitive measures to risk prediction may improve the prediction of future CVD events.

Objective
We tested the hypothesis that including simple measures of cognitive functions improve the prediction of SCORE2 for future CVD events among middle aged and older subjects.

Methods
We used data on 13,391 Polish, Lithuanian and Czech adults without CVD at baseline (45–69 years) from the Health, Alcohol and Psychosocial factors In Eastern Europe cohort. Incident cases of myocardial infarction (MI), stroke, CVD mortality and composite (fatal and non-fatal) CVD events were identified over a 10-year follow-up. Baseline cognitive measures included immediate and delayed word recall (verbal memory and learning), animal naming (verbal fluency) and letter cancellation (attention, mental speed and concentration). Using competing-risks regression, relationships between cognitive functions and CVD outcomes were examined. Improvement in Area Under Curve Receiver Operator Characteristic (AUC-ROC) was used to compare predictive performance for CVD events of models including SCORE2 variables combined with cognitive tests vs SCORE2 alone.

Results
The incidence rates of MI, stroke, CVD mortality and composite CVD events were 5%, 4%, 4% and 11%, respectively. In multivariable analyses, all four cognitive measures were inversely associated with CVD outcomes; e.g. one standard deviation increase in immediate word recall score was associated with a 28% and 17% reduction in risk of CVD mortality and composite CVD events, respectively (all p-values &lt;0.001). Adding cognitive measures to SCORE2 variables slightly improved the AUC-ROC for prediction of MI, CVD mortality and composite CVD events. For example, for the composite CVD measure, inclusion of all four cognitive measures increased the AUC-ROC from 0.6948 to 0.7030 (p&lt;0.001) and similar improvement was seen for word recall. The results were consistent across countries.

Conclusion
Inclusion of a simple cognitive test in the assessment of cardiovascular health is feasible and it may improve prediction of future CVD risk, although in our data the improvement was not clinically important (despite being statistically significant). Further studies are needed to assess this proposition in larger prospective datasets.
Prevalence of left atrial thrombus in anticoagulated patients undergoing elective electrical cardioversion
Authors: Aguila Gordo D , Piqueras Flores J , Negreira Caamano M , Mateo Gomez C , Martinez Del Rio J , Soto Perez M , Blanco Lopez E , Cubides Novoa A F , Soto Martin P , Concepcion Suarez R , Freites Esteves A , Moron Alguacil A , Andres Sierra M , Jimenez Rubio B 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction and objectives
The prevalence of left atrial (LA) thrombus in patients with atrial fibrillation (AF) or atrial flutter (AFL) on guideline-directed anticoagulation is nor well known, moreover, evidence on the presence of left atrial thrombus with different anticoagulation therapies provides heterogeneous results.

Methods
Ambispective, observational, single-center study that consecutively included 271 patients undergoing elective electrical cardioversion (ECV) for AF or AFL &gt;48 hours of onset. A transoesophageal echocardiogram (TOE) was performed in all patients within 24 hours prior to ECV. Patients with &lt;3 weeks of anticoagulation and those in sinus rhythm on admission were excluded, and the clinical characteristics and presence of atrial thrombus were analyzed in 172 patients.

Results
The main baseline characteristics are shown in Picture 1. A total of 66.5% of the patients were receiving treatment with direct oral anticoagulants (NOAC) dabigatran (15.9%); rivaroxaban (28.3%); apixaban (31.2%) and edoxaban (23.9%). The remaining 33.5% were anticoagulated with vitamin K antagonists (VKA). Eight thrombi were detected in the left atrial appendage (prevalence 4.7%), and on 2 occasions the presence of thrombus could not be ruled out, and CVE was also suspended. No statistically significant differences were observed between the prevalence of thrombus and the type of anticoagulant (NOAC vs VKA 4.5% vs 4.9%; p= 0.56) or between the different NOACs (p=0.61). Of the 8 patients with left atrial thrombus, anticoagulant treatment was modified in 3 of them. Control TOE was performed (median until new TOE 64 days), and resolution was verified in 3 cases (all under treatment with NOAC), of which 2 patients had maintained their previous anticoagulant treatment.

Conclusions
Anticoagulated patients scheduled for elective ECV present a prevalence of left atrial thrombus close to 5%. No differences were observed with respect to the anticoagulation treatment received.