bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term results of zero-fluoroscopy catheter ablation in pregnant patients with arrhythmias: a 2-year follow-up study
Authors: Abdrakhmanov A , Ainabekova B , Nuralinov O , Smagulova A 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Incidences of rhythm disturbance in pregnant are commonly seen. Catheter ablation of arrhythmias has been shown to be effective and safe. Data on perinatal outcomes and results of zero-fluoroscopy catheter ablation in pregnant patients is limited.

Purpose
the aim of our study is to observe long-term results and perinatal outcomes in pregnant women with arrhythmias, treated by zero-fluoroscopy catheter ablation method.

Methods
There were 48 pregnant women, who underwent zero-fluoroscopy catheter ablation (Mean age of pregnant was 25.7±4.3 years, mean gestation age 24.1 ±3.2 weeks). Procedure-related complications, perinatal outcomes and arrhythmia recurrence were documented during 24 months follow-up.

Results
The most common arrhythmias were atrioventricular nodal reentrant tachycardia (n=21; 43.75%). This was followed by Wolff–Parkinson–White syndrome (n=15; 31.25%). Combination of accessory pathways with slow conduction ways were found in 3 cases (6.25%). In six cases were ablation due to frequent premature ventricular contraction (12.5%). Ventricular tachycardia was rare during pregnancy (n=3; 6.25%). Zero-fluoroscopy catheter ablation was performed under the guidance of CARTO (n=21; 43.75%) and Ensite Precision systems (n=27; 56.25%). The median procedural time was 71±15 minutes. Interventions were effective in all cases (100%). Procedural complication was in one patient (2.1%), who developed an ileofemoral thrombosis. Pregnancy course after ablation procedure was benign in all patients. Perinatal outcomes: spontaneus vaginal delivery was in the majority of cases (n=36; 75%). Twelve pregnancies (25%) were delivered by cesarean section due to obstetric indicators. Intrapartum hemorrhage was 335.2±228.92 ml. Two women had placental abraption and preeclampsia (4.2%). Maternal adverse cardiac events were none declared. There were 48 live births (in all cases). Fetal birth weight was 3324.7±684.4 grams, 5 minute Apgar was 8.4±1.3. There were no maternal and fetal mortality. At 24 months there were no arrhythmia recurrence.

Conclusions
Zero-fluoroscopy catheter ablation method is safe and effective in pregnant women with arrhythmias. Pregnancy course and outcomes after this procedure is bening in the majority of cases.
Association between triglyceride and all-cause mortality and cardiovascular outcomes in heart failure patients: a territory-wide study in Hong Kong
Authors: Ren Q W , Tse Y K , Yiu K H 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Objectives
To determine the association between levels of triglyceride (TG) and all-cause mortality and cardiovascular outcomes. To evaluate the concentration of TG associated with the lower range and lowest risk of adverse outcomes in heart failure (HF) patients.

Methods
Using a previously validated territory-wide clinical information registry, all eligible patients with HF (N=147 396) from 1996 to 2020 were enrolled. Levels of time-weighted TG associated with risk of mortality were evaluated on a continuous scale using restricted cubic spline curves and by categories of TG with Cox proportional hazards regression model. The primary outcomes were all-cause mortality and cardiovascular death (CVD). Secondary outcomes include cause-specific mortality and incident cardiovascular events.

Results
Among 147 396 HF patients, the mean age was 70.0±12.5 years and 73 571 (49.9%) were male. The association between levels of time-weighted TG and the risk of all-cause mortality was J-shaped, with low and high levels associated with an increased risk of all-cause mortality, CVD and cause-specific mortality. Compared with individuals with levels of TG between 1.14 to 2.85 mmol/L, the multivariable-adjusted hazard ratio (HR) for all-cause mortality was 1.39 (95% confidence interval [CI] 1.35 to 1.44) for individuals with TG concentrations of less than 0.71 mmol/L and 1.97 (95% CI, 1.67 to 2.32) for TG concentrations of more than 5.60 mmol/L. The concentration of TG associated with the lowest risk of all-cause mortality was 1.84 mmol/L. Similar results were seen in males and females, in patients with or without lipid-lowering treatment, and for cardiovascular events.

Conclusion
In the HF population, low and high levels of TG were associated with an increased risk of all-cause mortality and cardiovascular outcomes. The lowest risk of all-cause mortality was found at a TG concentration of 1.84 mmol/L.
Factors Associated with Coronary Artery Calcification and Cardiovascular Outcome Among Pre-Dialysis Chronic Kidney Disease Patients in Phramongkutklao hospital
Authors: Anantawong V , Prasitdumrong H , Prasitdumrong H 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Cardiovascular disease is the leading cause of death in chronic kidney disease (CKD) patients. Calcified coronary artery is highly prevalent and more severe among these group. Coronary calcium score was used as a risk predictor for coronary heart disease in general population but data among CKD patients were less known.

Objective
To evaluate factors associated with coronary calcium score in pre-dialysis CKD patients.

Methods
Prospective cohort study was conducted in CKD patients who have intermediate risk for coronary heart disease between February 2021 and December 2021. Patients who had received dialysis or coronary revascularization were excluded. GFR was categorized into 4 groups including Group 1: GFR ≥ 60 ml/min/1.73m2, Group 2: GFR 45-59 ml/min/1.73m2, Group 3: GFR 30-44 ml/min/1.73m2 and Group 4: GFR &lt; 30 ml/min/1.73m2. Baseline geographical data and prespecified factors that might be correlated with coronary calcium score were collected and Agaston coronary calcium score was performed by 640-slice CT scanner with standard protocol. Primary outcome was evaluation of factors associated with coronary calcium score. Secondary outcome was incidence of composited cardiovascular events which defined as death, MI or heart failure within 6 months after enrollment.

Results
Total 53 males and 35 females were enrolled. Patients in Group 1, 2, 3 and 4 were 22, 24, 21 and 21 patients, respectively. Mean age, underlying hypertension, T2DM with target organ damage, PTH, ESR, Osteocalcin and coronary calcium score were significantly different between each group of GFR. Coronary calcium score showed inversely correlation with GFR level, p-value &lt; 0.001. Factors that significantly correlated with coronary calcium score were mean age (r=0.548, p-value &lt;0.001), underlying hypertension (r=0.466, p-value &lt;0.001), CAVI (r=0.436, p-value &lt;0.001) and Osteocalcin (r=0.83, p &lt;0.001). In multivariate analysis, Osteocalcin was significantly correlated with coronary calcium score, p-value &lt; 0.001. Increasing Osteocalcin 1 ng/ml correlated with increasing coronary calcium score 52, p-value &lt; 0.001. Composited cardiovascular events were found in 11 patients, 6 patients in Group 3, and was not demonstrated correlation with coronary calcium score.

Conclusions
Coronary calcium score showed inversely correlation with GFR level. Increasing Osteocalcin was significantly correlated with increasing coronary calcium score in pre-dialysis CKD patients.
Novel serum biomarkers for predicting prognosis in post cardiac arrest patients
Authors: Song H 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Objective
To determine the clinical feasibility of novel serum biomarkers by comparing them with conventional serum biomarkers in out-of-hospital cardiac arrest (OHCA) patients treated with target temperature management (TTM).

Methods
This study was a prospective observational study conducted on OHCA patients who underwent TTM. We measured serum biomarker Neuron‑Specific Enolase (NSE), S-100B (S100 calcium-binding protein), Tau protein, Glial Fibrillary Acidic Protein (GFAP), Neurofilament Light Chain (NFL), and Ubiquitin C-terminal hydrolase-L1 (UCH-L1) at 0, 24, 48, and 72 hours after return of spontaneous circulation (ROSC). Conventional biomarkers include NSE and S-100B. The primary outcome was good neurologic outcome at 6 months after OHCA.

Results
A total of 100 patients were included in this study from August 2018 to May 2020. Among the included patients, 46 patients had good neurologic outcomes. As for the biomarker's AUC value measured immediately after ROSC, GFAP had the highest value (0.850), and among the values measured 24 hours after ROSC, S100B showed the highest value (0.901). The AUC values of biomarkers measured after 48 hours and 72 hours after ROSC, were the highest in NFL (0.921, 0.946). AUC values measured after 72 hours of ROSC showed higher values in novel biomarkers than in conventional biomarkers.

Conclusion
After 72 hours of ROSC, the Novel biomarkers showed a higher AUC value than the conventional biomarkers. Among them, NFL showed the highest AUC values than other biomarkers at 48 and 72 hours of ROSC.
Different cellular landscape of four types of non-diseased cardiac valves contributes to their differences in susceptibility of pathological remodeling and disease
Authors: Shu S , Fu M , Chen X , Song J 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): National Natural Science Foundation of China

Background
Exploring the mechanisms of valvular heart disease (VHD) at the cellular level may be useful to identify new therapeutic targets; however, the comprehensive cellular landscape of non-diseased human cardiac valve leaflets remains unclear.

Methods
The cellular landscapes of non-diseased human cardiac valve leaflets (five aortic valves, five pulmonary valves, five tricuspid valves, and three mitral valves) from end-stage heart failure patients undergoing heart transplantation were explored using single-cell RNA sequencing (scRNA-seq). Bioinformatics was used to identify the cell types, describe the cell functions, and investigate cellular developmental trajectories and interactions. Differences among the four types of cardiac valve at the cellular level were summarized. Pathological staining was performed to validate the key findings of scRNA-seq. An integrative analysis of our single-cell data and published genome-wide association study-based and bulk RNA sequencing-based data provided insights into the cell-specific contributions to calcific aortic valve diseases.

Results
Six cell types were identified among 128,412 cells from non-diseased human cardiac valve leaflets. Valvular interstitial cells were the largest population, followed by myeloid cells, lymphocytes, valvular endothelial cells, mast cells, and myofibroblasts. The four types of cardiac valve had distinct cellular compositions. The intercellular communication analysis revealed that valvular interstitial cells were at the center of the communication network. The integrative analysis of our scRNA-seq data revealed key cellular subpopulations involved in the pathogenesis of calcific aortic valve diseases.

Conclusions
The cellular landscape differed among the four types of non-diseased cardiac valve, which might explain their differences in susceptibility to pathological remodeling and VHD.
A canadian retrospective multicenter experience with selexipag in a heterogeneous group of pediatric pulmonary hypertension patients
Authors: Youssef D , Richards S , Lague S , Sheppard C , Smith J , Vorihes E , Hosking M , Pietrosanu M , Bates A 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The introduction of the oral prostanoid selexipag for treating severe adult pulmonary arterial hypertension (PH) has contributed to reduced rates of death and secondary complications in PAH. Pediatric physicians have extrapolated from the adult literature to utilize this medication to treat severe pediatric pulmonary hypertension. However, longitudinal, multicenter data on the therapeutic benefits of selexipag for pediatric patients is lacking.

Materials and Methods
We performed a retrospective review describing the clinical outcomes of pediatric PH patients receiving selexipag for pulmonary hypertension (PH) therapy in addition to standard pulmonary vasodilator therapy across three North American pediatric PH centers between January 2005 and June 2021.

Results
Across three Canadian centers, 24 patients (15 female) with a mean age at diagnosis of 5.4 (0.9) years were included. Of this cohort, 19 (79.2%) had group 1 PAH, 4 (16.7%) had group 3 PH, and 1 (4.2%) had group 4 PH. Genetic syndromes were noted in 7 (29.2%) patients. Dosing was targeted to achieve 20–30 mcg/kg/dose orally every 12 hours; the mean dosage after 12 months was 31.2 (10.3) mcg/kg/dose. Twelve months following selexipag initiation, a median increase of 71.5 m (p = 0.44) in six-minute walk test distance was observed together with median decreases of 0.2 cm (p = 0.17) in tricuspid annular plane systolic excursion, 3.5 mmHg (p = 0.95) in right ventricle systolic pressure, and 6.1 mmHg (p = 0.09) in mean pulmonary artery pressure. 2 patients (8.3%) died, 1 (4.2%) was referred for a heart transplant, and 1 (4.2%) received an atrial flow regulator. One patient (4.2%) required admission to a pediatric intensive care unit during their treatment course this was related to profound desaturation, six (25.0%) had gastrointestinal symptoms, and two (8.3%) had facial flushing.

Conclusion
Selexipag appears to be a beneficial adjunctive therapy for selected pediatric PH patients and has a tolerable adverse effect profile aside from gastrointestinal disturbances. Further prospective studies of changes in hemodynamics and functional classification over a longer period and with a larger sample are needed.
Safety and efficacy of cerebral embolic protection devices in transcatheter aortic valve implantation: a meta-analysis
Authors: Tan N , Gao F , Mohammed R A , Lim S T , Abdul Aziz Z , Govindasamy S , Chao V T T , Ewe S H , Ho K W , Yap J 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Stroke during Transcatheter Aortic Valve implantation (TAVI) is not an uncommon complication with potential devastating consequences. With the extension of TAVI to the low-risk patient, stroke prevention takes on increasing importance. The use of cerebral embolic protection device (EPD) reveals conflicting data. This meta-analysis aims to evaluate the clinical efficacy and safety of EPDs.

Methods
A comprehensive literature search for all studies till May 2022 reporting clinical safety and efficacy outcomes of the only EPD approved for use by the Food and Drug Administration (FDA) was performed. Study outcomes were divided based on time period - overall (up to 30 days and in-hospital) and short (﻿≤7 days). Primary outcome was stroke - major and minor. Secondary outcomes included transient ischaemic attack (TIA), mortality, acute kidney injury (AKI), major vascular and bleeding complications.

Results
A total of 12 studies involving 288531 patients were analysed, which included 3 randomised controlled trials (RCTs), 7 propensity-matched and 2 cohort studies. Regarding overall outcomes, significant differences were noted for mortality (OR 0.59 [0.42-0.84], p=0.0036) and major stroke (OR 0.40 [0.18-0.91], p=0.028) (Fig 1). No significant differences were noted for all stroke (p=0.058), minor stroke (p=0.32), TIA (p=0.49), AKI (p=0.17), major vascular complications (p=0.40) and major bleeding complications (p=0.11). There was significant heterogeneity across the studies for mortality (p=0.032) and all stroke (p=0.009). In the subgroup analysis of studies reporting ﻿≤7 days outcomes (n=5), EPDs showed significantly lower rates of all stroke (0.33 [95% CI 0.19-0.56], p=&lt;0.0001), major stroke (0.19 [0.08-0.48], p=0.0004) and major bleeding complications (OR 0.29 [0.10-0.79], p=0.016), but no significant differences for mortality (p=0.67) and minor stroke (p=0.070). There was no significant heterogeneity across the studies (all p&gt;0.05)

Conclusions
In this meta-analysis including non-randomised studies, the use of EPDs was associated with lower mortality and major stroke rates, although significant heterogeneity was noted for the studies reporting mortality. Further ongoing larger scale RCTs will further clarify these results.
Understanding the management of hypertension in Asia: results of a literature search
Authors: Rahman A R , Magno J D A , Cai J , Han M , Lee H Y , Nair T , Narayan O , Panyapat J , Van Minh H , Khurana R 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Servier, France

Background
Hypertension poses a significant healthcare burden in Asia. Detection, treatment and control of hypertension are suboptimal, despite the existence of clear international guidelines and the availability of safe and effective treatments.

Purpose
To understand hypertension management in Asia, based on the analysis of national guidelines, treatment patterns and patient characteristics.

Methods
A PubMed search was performed using four search strings relating to 1) hypertension; 2) treatment/management/drug therapy; 3) guideline, consensus, real world evidence; and 4) Asian countries. The search was restricted to English language articles published since January 2008 to July 2022. Articles were filtered by relevance to the research question, study size, scope, methodology, and country/region to identify a target of 100 final references.

Results
The search yielded 2,436 articles, of which 92 were selected as being most relevant. Compared with Europeans, Asians appeared to have higher systolic blood pressure (BP), diastolic BP, and mean arterial pressure, with stronger association between BP and stroke. Rates of severe hypertension were also higher. Trends identified in the literature suggested that calcium channel blockers are the most common monotherapy used in Asian countries, with a high variability across the region. In the available publications focused on the studies with RAAS inhibitors, the majority of them compared the use of angiotensin receptor blockers as mono/combination therapy versus combination therapy with ACE inhibitors, calcium channel blockers or diuretics. Among treated patients, the observed control rates were only ~35–40% (~10% or less in the general population). There is a lack of focus on selecting the most appropriate treatment for each individual patient. Areas for improvement in delivering guideline-directed therapy for improved BP control also included facilitating access to health care and compliance with medication (including support mechanisms like community programmes, telemedicine, mobile phone apps and home BP monitoring), improving diet (reducing salt intake) and encouraging exercise.

Conclusions
Asian patients and European patients have different clinical profiles, with more severe hypertension in Asians. Rates of BP control across Asia are low. The management of hypertension requires a focused multimodal and supportive approach with implementation of public health measures, more effective screening initiatives and evidence-based goal-driven recommendations for appropriate pharmacotherapy augmented by lifestyle changes.
Association between non-alcoholic fatty liver disease and incidence of arrhythmia and other cardiovascular outcomes: a systematic review and meta-analysis
Authors: Jaiswal V I K A S H , Ang S O N G P , Hameed M A H A , Momi N K , Shah M A I T R I , Kanakannavar S S , Rajak K R I P A , Kalra K R I T I , Chia J I A E E , Wajid Z , Roy S , Agrawal V I B H O R , Sharma P R A C H I , Jaiswal A K A S H 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The association between non-alcoholic fatty liver disease (NAFLD) with cardiovascular and cerebrovascular outcomes, as well as their clinical impact, has yet to be established in the literature.

Objective
We aim to evaluate the association between NAFLD patients and the risk of atrial fibrillation (AF), heart failure (HF),stroke, cardiovascular mortality (CVM), and peripheral revascularization.

Method
We performed a systematic literature search using the PubMed, Embase, Scopus, and Cochrane libraries for relevant articles from inception until July 20th, 2022. Odds ratios (OR) were pooled using a random-effect model, and a p-value of &lt;0.05 was considered statistically significant.

Results
A total of 10 studies with 17886340 patients (2887214 NAFLD vs 14999126 non-NAFLD) were included in our analysis. The average age and percentage of males were comparable between groups, with a mean age of 55 years and 72.5% of males in the NAFLD group, whereas 52 years and 47.4% of males in the non-NAFLD group. The most common comorbidities among the NAFLD group included: hypertension (38% vs 24%), diabetes mellitus (14% vs 8%). The mean follow-up duration was 6.26 years. The likelihood of atrial fibrillation [OR, 1.42(95%CI: 1.18-1.70), P&lt;0.001], heart failure [OR, 1.48(95%CI: 1.27-1.73), P&lt;0.001], stroke (OR, 1.26(95%CI: 1.17-1.36), P&lt;0.001], and peripheral revascularization (OR, 3.95(95%CI: 1.60-9.73), P=0.003] was significantly higher in NAFLD patients when compared with non-NAFLD patients. In contrast, cardiovascular mortality was comparable between both the groups of patients [OR, 3.11(95%CI: 0.32-30.03), P=0.33] respectively.

Conclusion
Patients with NAFLD demonstrated increased incidence of cardiovascular and/or cerebrovascular outcomes; heart failure, stroke, and arrhythmia. Patients with associated comorbidities were at higher risk of cardiovascular disease, implying a greater need for screening and adoption of cardio-protective measures amongst NAFLD patients.
Prevalence of cardiovascular disease and thromboembolic events in a prospective cohort of patients with sickle cell disease
Authors: Natarajan N , Al-Mohammad A A , Robinson G R , Pillai R P , Tsitsikas D T , Ang R A 
Published: January 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Sickle cell disease (SCD) is an inherited disorder of globin chains that cause haemolysis, thrombosis and chronic organ damage. SCD affects multiple organs including the cardiovascular system. The two main subtypes of SCD are the homozygous HbSS and the heterozygous HbSC form. Here we describe and compare the prevalence of cardiovascular disease and thromboembolic events between HbSS and HbSC forms of SCD.

Methods
This is an observational study where a prospective database of SCD patients from a UK centre was retrospectively analysed.

Results
A total of 291 patients were included from the database with 183 (63%) HbSS patients. HbSS patients were younger (40.8±11 vs 48.1±14, p=0.03) with more males (49% v 35%, p=0.02) compared to the HbSC group.
As expected, HbSS patients had more severe form of the disease with higher rate of hospital admissions for sickle related crises, transfusion related iron overload, and are more likely to be on prophylactic phenoxymethylpenicillin as well as disease modifying treatments (Table 1).
Cardiovascular risk factors hypertension and hypercholesterolemia were less prevalent in HbSS compared to HbSC patients. Interestingly, the prevalence of ischaemic heart disease and vascular disease is similarly low in both groups at around 1%. However, the prevalence of thromboembolic events, pulmonary hypertension and stroke/TIA is higher at between 4 to 8% with no significant difference between the groups (Table 2).

Conclusion
The different prevalence of cardiovascular risk factors between HbSS and HbSC may be explained by the difference in age between the groups. SCD would appear to have a differential effect on the cerebral, cardiac, pulmonary and peripheral circulations.