bluuebunny/crossref_metadata_2025_split huggingface dataset:
Native T1 and T2 mapping by CMR in a cohort of olympic athletes: does sport discipline make difference?
Authors: Monosilio S , Prosperi S , Birtolo I L , Lemme E , Di Gioia G , Mango R , Gualdi G , Pelliccia A , Squeo M R , Maestrini V 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Cardiac Magnetic Resonance (CMR) represents the gold standard for morpho-functional assessment and for myocardial tissue characterization. Although Mapping technique provided added value to tissue characterization, data on Mapping in athletes are still scarce and differences between sport disciplines have not been evaluated.

Purpose
To compare T1 and T2 Mapping values between Olympic Athletes engaged in different types of sport and a control group of sedentary subjects.

Methods
A group of Olympic athletes with unremarkable cardiovascular pre-participation screening prior the Olympic games underwent CMR without contrast administration. A group of sedentary subjects was enrolled as a control group. Cine, native T1 and T2 Mapping were analyzed. Athletes were divided in different sports categories according to the ESC classification.

Results
265 Olympic athletes (15% skill, 19% power, 25% mixed, 41% endurance - 58% male) and 21 controls were enrolled. Comparing athletes of different sport categories and sedentary controls, endurance presented the lowest value of T1 Mapping. T2 Mapping was slightly higher in endurance athletes but were within normal limits (referred to local normal range) (Table). Compared with males, female athletes had higher values of T1 native myocardial Mapping [956 (934-981) vs 941 (926-963); p=0,004], while there were no significant differences regarding T2 Mapping values (p=0,874) (Figure).

Conclusion
T1 was lower and T2 Mapping slightly higher athletes engaged in endurance compared to other sport disciplines and sedentary controls. Female athletes showed higher T1 native myocardial Mapping compared with males, while T2 Mapping did not show differences.
Atrial fibrillation - environmental and socio-economic determinants at regional level. Case of Poland
Authors: Roszkowska S 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.
The study aimed to assess the influence of environmental and socioeconomic factors on the prevalence of hospitalization for atrial fibrillation (AF).
The rate of AF hospitalizations in Poland is one of the highest in Europe. The risk of hospitalization in patients with AF is related not only to lifestyle, but also to environmental, economic, social factors and the organization of the health care system.
Using National Institute of Public Health, Central Statistical Office and Voivodeship Inspectorates for Environmental Protection in Poland data and panel data techniques (including spatial ones) the impact of environmental and socioeconomic factors on AF in Poland has been estimated. The age- and sex-standardized data on the prevalence of hospitalization due to AF in Poland in 2012-2019 on poviats level were explained using set of air quality indicators (namely PM2.5), environmental factors, organization of the health care system and regional determinants of the socioeconomic situation.
An increase in the number of physicians by 1/1000 of the population and healthcare expenditure by PLN 100 per capita resulted in a decrease of 2% (-0.002 [-0.003;-0.001]; P=0.002) and 5%(-0.005 [-0.008;-0.002]; P&lt;0.001) in the number of hospitalisations due to AF in the group under 64 years. A 1 pp increase in the proportion of green areas resulted in a 4% decrease in hospitalisations. In contrast, an increase in GDP per capita by 1 th PLN and a decrease in the proportion of people working in agriculture by 1 pp were associated with a 1%( -0.010; [-0.013;-0.007]; P&lt;0.001) and 0.2% decrease in hospitalisations, respectively.
There is geographical variation in the prevalence of AF and socioeconomic factors are an important determinant of this condition. In the working-age group, improvements in the economic situation are likely to have positive health effects, in contrast to those in the post-working age group, where increases in health sector expenditure have the greatest effect.
Extreme cardiac remodelling observed in elite endurance athletes: analysis of myocardial deformation and estimated hemodynamic forces
Authors: Monosilio S , Prosperi S , Ciuffreda A , Lemme E , Di Gioia G , Mango R , Pedrizzetti G , Tonti G , Gualdi G , Pelliccia A , Squeo M R , Maestrini V 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Athletes of endurance disciplines present the highest level of cardiac remodelling often generating concerns for differential diagnosis with cardiomyopathies. In addition to standard morpho-functional evaluation, left ventricle (LV) myocardial deformation (MD) and estimated intra-ventricular hemodynamic forces (HDFs) are emerging diagnostic tools, particularly in heart failure patients. In the athletic population MD data are scarce while HDFs are lacking.

Purpose
To describe MD and HDFs evaluated by CMR feature-tracking in a cohort of endurance Olympic athletes and to evaluate the possible relationship with LV geometry.

Methods
A group of endurance Olympic athletes evaluated prior the Olympic games and with unremarkable cardiac pre-participation screening tests was enrolled. All athletes underwent CMR without contrast administration. Cine images were post-processed to evaluate end-diastolic and end-systolic LV volumes, ejection fraction (LVEF), global longitudinal and circumferential strain (GLS and GCS) and estimated HDFs by a dedicated feature-tracking software. HDFs were measured in apex-base (AB) and latero-septal (LS) directions, over the entire cardiac cycle, in systole and diastole. LS/AB ratio was also derived to determine forces distribution. Athletes were divided in subgroups according to the 3D sphericity index (&lt; 40% or 40%). A group of sedentary subjects was enrolled as a control group.

Results
109 endurance Olympic athletes (62% male; mean age 26 ± 5 years) and 21 sedentary subjects were enrolled. Athletes with increased sphericity index (≥40%) were 61 (56%) and presented with greater EDV, ESV and lower LVEF compared to those without increased sphericity and controls (Table). No significant differences were found between athletes and controls regarding LV-GLS and GCS. HDFs distribution was not different between groups and even athletes with a more spherical LV shape showed an HDFs diastolic ratio comparable to those of athletes with lower sphericity index and control.

Conclusion
Although more than half of endurance athletes presented with altered geometry (increased sphericity index), strain parameters and hemodynamic forces were not different from sedentary controls and those athletes without increased sphericity. The use of advanced parameters to evaluate cardiac function could be used as a tool to confirm the benign nature of cardiac adaptation due to intense exercise training.
Characteristics and prognosis of patients with elevated triglycerides in acute myocardial infarction: observational data from a large database over a 17 years period
Authors: Zeller M , Chague F , Maza M , Bichat F , Cottin Y , Farnier M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Amarin Corp.

Background and aim
From a large database of a regional registry, we aimed to address the prevalence, characteristics and prognosis of patients with elevated triglycerides (TG) in patients hospitalized for an acute myocardial infarction (MI).

Methods
From the multicenter database (RICO survey), all consecutive patients hospitalized for an acute MI (2001-2017) and alive at discharge were included. Patients with TG &gt; 500 mg/dL, lost to follow-up (FU), or under chronic fibrate treatment were excluded. Patients with high TG (&gt; 200 mg/dL) on admission were compared to those with TG ≤ 200 mg/dL. Endpoints were recurrent ischemic events (i.e. recurrent MI, angina, unstable angina, stroke or urgent revascularization (PCI or CABG)) at 1-year FU.

Results
Among the 10667 patients included, 1886 (17.7%) had elevated TG. When compared with patients with TG £ 200 mg/dL, patients with high TG were younger (59 vs 69 y, p&lt;0.001), had a higher BMI (28 vs 26 kg/m², p&lt;0.001), were more frequently men (77 vs 68%, p&lt;0.001), diabetic (27 vs 21%, p&lt;0.001), and smokers (42 vs 28%, p&lt;0.001). The rate of statin therapy at discharge was similar for the 2 groups (79 vs 77%, p=0.285), as well as SYNTAX score and rate of multivessel disease (p=0.368 and p=0.791). In high TG group, LDL cholesterol was higher (130 vs 120 mg/dL, p&lt;0.001) and HDL-cholesterol was lower (37 vs 46 mg/dL). At 1-Y FU, recurrent ischemic events were more frequent in elevated TG patients (11.2 vs 9.1%, p=0.004). In multivariate logistic regression analysis, high TG (OR (95%CI): 1.356(1.095-1.679)) remains an independent estimate for recurrent ischemic event, even after adjustment for confounding (GRACE score, diabetes, obesity).

Conclusions
In our large population-based cohort, elevated TG are common in acute MI, and associated with residual risk of recurrent ischemic events, beyond traditional prognostic markers. Our data may help to identify candidates for targeted therapies to reduce recurrent ischemic risk after MI.
Cannabis use and risk of atherosclerosis cardiovascular disease: a two-sample mendelian randomization study
Authors: de La Harpe R , Schoeler T , Thorball C W , Thomas A , Kutalik Z , Vaucher J 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Whether cannabis use causally associates with atherosclerotic cardiovascular disease (ASCVD) remains unknown. A genetic approach, using Mendelian randomization principles, can help make inferences on the association between a risk factor and a disease outcome when a clinical trial is impracticable for ethical reasons.

Aims
To estimate the effect of genetically determined cannabis use on risk of ASCVD, including coronary artery disease (CAD) and acute ischemic stroke (AIS).

Methods
Using two-sample Mendelian Randomization (MR), 65 independent (R2&lt;0.2) genetic markers associating with "ever use of cannabis" in 184’765 European individuals were employed to estimate the causal association between cannabis use and risk of ASCVD. The genetic instruments were first used to test the causal association between cannabis use and CAD in 60’801 cases and 123’504 controls. Second, we explored the causal association between cannabis use and AIS in 34’217 cases and 406’111 controls. Genetic data for both outcomes predominantly comprised individuals from Caucasian origin. To triangulate genetic findings, we conducted a meta-analysis of observational studies reporting a link between cannabis use and ASCVD, CAD or AIS.

Results
Based on the genetic analysis, there was no evidence for a causal effect of cannabis use on the risk of CAD (OR=0.97, 95%CI 0.92-1.02, p-value=0.19) or AIS (OR=1.03, 95%CI 0.98-1.09, p-value=0.41). Sensitivity analyses, including MR-Egger, weighted median MR, Steiger filtering and multivariate MR analysis, yielded similar results, and no heterogeneity and directional pleiotropy were observed. Based on the meta-analysis of 6 observational studies for each outcome, ever use of cannabis was not associated with CAD (pooled OR=1.23, 95% CI 0.78-1.69), nor AIS (pooled OR=1.22, 95%CI 0.95-1.50).

Conclusion
Using a genetic approach recapitulating a clinical trial, we found no evidence in support of a causal effect between cannabis use and CAD or AIS.
Readability of the current preparticipation cardiovascular screening questionnaires: Are they suitable for athletes?
Authors: Riding N 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Pre-participation screening (PPS) is now implemented by the majority of the leading sporting organisations around the globe, where the presence of the personal symptoms and family history questionnaire has to date been constant among all. The leading cardiology and sporting bodies of the AHA, ESC, IOC and FIFA all however independently publish, and advocate altered variations of the form, which are not validated, and based on expert opinion alone.

Purpose
The National Institute of Health (NIH) recommend questionnaires be written at a reading age of between 11-14 years. To date the readability and suitability of commonly used PPS questionnaires has not been investigated; thus, it was our aim to assess the readability of several PPS questionnaires from the leading sporting and cardiology organisations.

Methods
Readability analysis was performed on the PPS questionnaires from the leading sporting and cardiology organisations 1) AHA; 2) The PPE monograph; 3) ESC; 4) FIFA; 5) IOC. To assess the readability of the questionnaires, several formulae were applied, using multiple regression equations to predict the reading ability needed to understand the given text. The readability formula used were the Flesch Kincaid, Flesch Reading Ease, New Dale-Chall, SMOG scale, FORCAST, Coleman-Liau, and the Gunning Fog scale.

Results
Readability analysis demonstrated that the PPS questionnaires had an average reading age of between 14 and 18 years, resulting in all falling outside the NIH recommended reading age. The best performing questionnaire in terms of readability was the IOC questionnaire (average 13.7 years). The questionnaire with the highest reading age was the AHA 14-step (18.4 years), where 34.3% of the total words within the questionnaire were considered difficult according to the New Dale-Chall list. Questions relating to symptoms were considered easier to comprehend than family history questions. This was also exemplified by percentage of "unfamiliar" words, with symptoms questions having an average of 19.4%, while family history questions having an average of 27.3%. Within the sub analysis of individual questions, chest pain, syncope and palpitations were questions documented by all organisations, however the wording of these showed notable variation, with an average 7.5-year difference in reading age between questionnaires.

Conclusion
The readability of the current PPS questionnaires exceed the NIH recommended reading age of 11-14 years. Readability is an integral part of health literacy, and should a question be too difficult for an athlete to comprehend, this misunderstanding may lead to them rejecting the questionnaire or providing an inaccurate response. The PPS questionnaire remains a mainstay within the screening process, yet more research needs to be conducted to establish athlete comprehension and tailor future questionnaires towards this, with the goal of improving specificity and sensitivity.
Coronary angiographic profile in non ST elevation acute coronary syndrome: risk stratification and management strategy
Authors: Dakhil Z A , Farhan H A S A N 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
It has been reported that risk scores like GRACE and TIMI scores in NSTE-ACS are associated with more complex coronary anatomy and predict worse outcomes. No data from Iraq regarding how these scores reflect severity of coronary obstruction.

Purpose
We aimed to investigate how obstructive coronary lesions are related to GRACE or TIMI risk class in NSTE-ACS.

Methods
Patients with NSTE-ACS were prospectively recruited and stratified according to TIMI and GRACE risk scores into high, intermediate and low classes. Their coronary angiography findings were recorded, and results classified accordingly into: Normal coronaries, non-critical coronary lesion&lt;70% and critical coronary lesion (obstruction≥70% of coronary artery).

Results
n=150, among whom 65.33% were referred for coronary catheterization. For patients catheterized within 2 hours: 20% have normal coronary angiography (all in lower risk category), 80 % have obstructive coronary lesions. Moreover, those who were catheterized within&gt;24 hours were 74 patients, among whom; 16.21 % had normal coronary angiography and 81.08% had obstructive (Critical) coronary lesions. However, there was no statistical significance for types of coronary lesions considering timing to intervention or risk category. In 29.59% of those who were referred for catheterization, they had PCI at same session and 29.59% had been referred for CABG. Patients with higher GRACE scores were more frequent to be referred for CABG. Conversely, on classifying patients according to TIMI score, those with intermediate TIMI scores were more to be referred for CABG.

Conclusions
Higher TIMI and GRACE scores were associated with more significant angiographic coronary lesions and with more referral for CABG than lower risk patients. This finding supports the importance of referring higher risk patients for catheterization according to guideline recommendation especially in resource-limited settings in Iraq where proper risk stratification is crucial to choose those who will benefit the most from invasive strategy.
Daytime napping and the risk of atrial fibrillation in the SUN cohort
Authors: Diaz-Gutierrez J , Baron-Esquivias G , Martinez-Gonzalez M A , Bazal P , Goni L , Barrio-Lopez M T , Bes-Rastrollo M , Amigo-Otero E , Ruiz-Canela M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): European Regional Development Fund (FEDER) and Spanish Ministry of Health.

Introduction
Previous research has identified a potential relationship between sleep patterns and atrial fibrillation (AF). Short daytime napping is a widespread healthy habit particularly in Mediterranean countries. However, as far as we know, daytime napping and the risk of developing AF has not been analysed before.

Purpose
Our objective was to assess the association between daytime napping and the incidence of AF in a Mediterranean cohort.

Methods
The SUN project is a dynamic, prospective cohort of Spanish university graduates. A total of 20,348 participants, free of AF at baseline, were followed-up for a median time of 13.8 years, with a retention proportion of 91%. Daytime napping was assessed at baseline and participants were categorised according to their average daily napping time. Incident cases of AF were confirmed by a cardiologist according to a prespecified protocol. Multivariable Cox regression models were used to estimate hazard ratios (HR) of AF according to daytime napping time.

Results
During follow-up, we identified 131 incident cases of AF. In comparison to participants with short daytime napping (&lt;30 minutes/day), those who slept ≥30 minutes/day exhibited a significant 90% higher relative risk of incident AF (adjusted HR= 1.90; 95% CI: 1.26, 2.86), whereas no significant risk was observed for participants who did not have nap (adjusted HR = 1.26; 95% CI: 0.82, 1.93). After excluding participants that reported not having nap, those with shorter daytime napping had a lower risk of developing AF, with the greatest risk reduction between 15-30 minutes/day (adjusted HR = 0.44; 95% CI: 0.27, 0.72), in comparison to sleeping &gt;30 minutes/day.

Conclusions
Daytime napping was significantly associated with the risk of developing AF. Sleeping a longer nap (≥30 minutes/day) was associated with an increased risk, while a shorter nap between 15-30 minutes/day was associated with a lower risk of incident AF. These findings suggest a potential novel healthy lifestyle habit in the primary prevention of AF.
The impact of the COVID-19 pandemic on the quality of centre-based cardiac rehabilitation
Authors: Jug B , Trsan J , Novakovic M , Tasic J , Krevel B , Fras Z , Lainscak M , Farkas Lainscak J 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Slovenian Research Agency Ministry of Health, Slovenia.

Background
The coronavirus-19 (COVID-19) pandemic has severely disrupted the provision of cardiac rehabilitation (CR), with responses ranging from outright closure of CR centres to adapting CR provision to the diversion of resources and changing public health guidance. Using interrupted time-series analysis, we sough to estimate the impact of the COVID-19 pandemic the quality centre-based CR.

Methods
Quality indicators for 1,268 patients undergoing centre-based CR after a myocardial infarction were extracted from the national CR registry, and summarized with a composite quality score (i.e., adjudicating one point for each: antithormbotic therapy, high-potency statin therapy, low-density lipoprotein cholesterol [LDL-C] &lt;1.4 mmol/L, systolic blood pressure &lt;130 mmHg, body mass index &lt;25 kg/m2, non-smoking status, &gt;20% improvement in exercise capacity from baseline). Composite quality scores were aggregated on monthly time units; an interrupted time series of 52 time points was constructed, with breakpoint defined on 1 March 2020. Using Prais-Winsten (autoregressiove order 1) segmented regression, change in level and time trend of the composite quality score were estimated, with 95% confidence intervals [95%CI].

Results
After the pandemic outbreak, waiting times for CR increased (from 56 [IQR 36-82] to 75 [IQR 58-102] days, p&lt;0.001), while duration of CR (from 100 [SD 58] to 90 [SD 67] days) and number of sessions (from 33 [SD 7] to 28 [SD 9]) decreased (p&lt;0.001 for both). The outbreak of COVID-19 was associated with a non-significant change in level (+0.370 [95%CI -0.207; 0.946] points, p=0.204) and a significant change in trend (-0.0438 [95%CI -0.0841; -0.0437] points/per month, p=0.034) of the composite quality score. Patterns for estimates did not change significantly after adjustment for number of sessions and/or duration of CR. See Figure 1.

Conclusons
The COVID-19 pandemic has affected the quality of centre-based CR, with a trainsient (non-significant) increase followed by a persistent (significant) trend of decreasing quality of CR provision. Our findings suggest the need for intensifying the quality of secondary prevetive care during CR in the forthcoming post-pandemic recovery.