bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stricter blood pressure control reduces rate of left ventricular hypertrophy and diastolic dysfunction in ethnic minority groups in the UK:E-ECHOES study
Authors: Shantsila A , Shantsila E , Lip G Y H , Gill P S 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): British Heart Foundation (PG/05/036) Primary Care Research Network-Central England.

Background
Blood pressure (BP, mmHg) targets have been mainly determined based on the white ethnic group. Optimal BP levels have been less established in people of South Asian and African Caribbean origin. There is less data on how different office BP values influence the presence of cardiac target organ damage, left ventricular hypertrophy (LVH) and diastolic dysfunction (DD).

Methods
This study is based on the large prospective UK community Ethnic-Echocardiographic Heart of England Screening Study (E-ECHOES, South Asian and African-Caribbean origin, age ≥45 years). Echocardiography was used to diagnose LVH and DD following British Echocardiographic Society criteria. Optimal receiver operator curves (ROC) cut-off values for predicting LVH and DD were determined using the Leu method. Multivariable logistic regression, adjusted for age and sex, was used to determine the effects of different BP values for LVH and DD, using SBP 130-&lt;140 and DBP 80-&lt;90 as comparators (STATA 13).

Results
The study included 3200 South Asians (age 59±10, 52% women), of whom 1568 (49%) had LVH, and 1497 (47%) had diastolic dysfunction. Of people with LVH, 869 (55%) had SBP &gt;140, and 372 (24%) had DBP &gt;90. The optimal BP cut-off for ROC analysis was 139/80.5 for LVH and 139/80.5 for diastolic dysfunction. SBP &lt;130 and DBP &lt;80 were both associated with a 31% reduction in diastolic dysfunction (Table). BP ≥140/90 was strongly predictive of LVH and DD.
The study included 1922 African Caribbeans (62±12 age, 55% women), of whom 1186 (62%) had LVH and 1124 (58%) had DD. Of people with LVH, 778 (66%) had SBP &gt;140, and 333 (28%) had DBP &gt;90. The optimal BP cut-off for ROC analysis were 139/81.5 for LVH and 138/80.5 for DD. DBP &lt;80 mmHg 27% reduction in LVH and 24% in DD (Table). BP ≥140/90 was strongly predictive of LVH and DD.

Conclusions
People of South Asian origin may benefit from stricter SBP (&lt;130) control, and both ethnic groups may benefit from stricter DBP (&lt;80) control.
Results of a new scale for the assessment of exercise intensity in cardiac rehabilitation programs
Authors: Gomez Sanchez M I , Fuertes Pereiro J , Basabe Velasco M E , Delgado Calva F A , Marschall A F , Duarte Torres J , Biscotti Rodil M B , Dejuan Bitria C , Tapia Martinez M , Ramos Alejos-Pita C , Casanova Lopez M A , Molinos Laita A C , Rodriguez Biezma M F , Alvarez Anton S A , Coto Morales B M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The intensity of exercise that patients perceive is difficult to measure objectively. In most Cardiac Rehabilitation Units (CRH) they use the Borg scale to try to objectify the intensity of the exercise session perceived by the patients. However, in most cases, patients find it difficult to qualify the intensity with a numerical value, and the values they provide are not usually high.

Purpose
To make a new scale to assess whether it could be more adapted to the intensity perceived by the patients.

Methods
The CRH team of the Gomez Ulla Central Defense Hospital developed a new scale (image 1) and it was used in a random sample of 26 patients, performing a descriptive analysis of the scores obtained in the initial training session, session 6, session 12, session 18, session 24 and final session. These results were compared with another group of 27 people who had completed the cardiac rehabilitation program and in which the modified Borg scale had been used.

Results
A total of 53 patients were included and they were subdivided into two groups, one group with 26 patients in which the new scale was used and another with 27 patients who used the modified Borg scale. The mean age in both groups was similar, 65 ± 10 in the first group and 64 ± 10 in the second, as was the percentage of the males (70% and 68%, respectively). In 73.5% of the cases, ischemic heart disease was the main reason for inclusion.
In both cases, the initial METS in ergometry (7.5 ± 2.5 in the first group and 6.3 ± 1.9 in the second) and the final METS (8.9 ± 3 and 8.4 ± 2.5, respectively) were similar. However, the exercise intensity assessment scores offered by the group of patients with the new scale in sessions 6, 12, 18, 24 and final, were significantly higher (image 2).

Conclusions
In cardiac rehabilitation, the intensity of exercise perceived by the patients is an important assessment to evaluate the quality of physical training. Providing patients with scales that are easier to understand and use helps us in the training planning and in their self-knowledge. With the elaboration of this scale we try to help them identify the intensity in a more objective way.
Adding parenteral anticoagulation in STEMI undergoing PCI: safety and efficacy?
Authors: Carias M , Almeida A , Paralta M , Claudio F , Rocha R , Bento A , Trinca M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Antithrombotic therapy is the cornerstone treatment for acute coronary syndromes. Often, parenteral anticoagulation (AC) is added to the dual antiplatelet treatment, till primary percutaneous coronary intervention (PCI). This strategy is recommended by latest guidelines, due to large experience, however, there has been no placebo-controlled trial evaluating the efficacy or safety of AC in primary PCI.

Purpose
This study aims to evaluate the efficacy and safety of treatment with parenteral AC, either with UFH or with low molecular weight heparin (LMWH), in ST segment elevation myocardial infarction (STEMI), undergoing PCI.

Methods
Retrospective, multicenter, cohort of 1052 STEMI patients, admitted to primary PCI was divided in two groups: one undergoing parenteral AC and one with no AC. We did a sub analyze comparing the group treated with UFH and LMWH, against placebo. The primary efficacy endpoints were in-hospital and one year follow-up mortality, major adverse cardiovascular events (MACE) during hospitalization (re-infarction, mechanical complication, sudden cardiac death averted, ventricular arrhythmia, heart failure, stroke, and cardiogenic shock) and glycoprotein IIaIIIb inhibitor bailout strategy (GPIIaIIIb). The safety endpoints were TIMI major bleeding and decrease of hemoglobin (Hb) value greater than 3g/dL.

Results
Of the total of 1052 patients: 564 (54%) were treated with parenteral anticoagulation and 488 were not. In the anticoagulation sample, 207 patients were treated with UFH (37%), and 357 patients were treated with LMWH (63%). There were no statistically significant differences in both groups, in terms of age and sex distribution, with a 18-26% of women and mean age of 62,8-66,2±0,9 years old.
AC, and LMWH, had a statistically significant association with lower in-hospital mortality (p&lt;0,01), with odds ratio (OR) 0,3 and 0,28 respectively. UFH did not have a statistically significant association with lower mortality (p=0,8). In terms of follow-up mortality, there was no statistically significant association in either group. In terms of MACE and GPIIaIIIb, AC, LMWH and UFH had a statistically significant association with lower MACE and GPIIaIIIB (p&lt;0,01), with a OR 0,9, OR 0,56 and OR 0,77 respectively, on MACE, and with OR 0,1, OR 0,3 and OR 0,2, on GPIIaIIIB.
Regarding safety, neither AC, nor LMWH or UFH, had a statistically significant association with TIMI major bleeding (p=0,24, p=0,2, and p=0,8). LMWH had a statistically significant association with Hb value decrease greater than 3g/dL (p=0,03 RR 6%), that was not verified in AC or UFH samples (p=0,1), against placebo.

Conclusion
Adding AC, in STEMI patients admitted to primary PCI, to the antithrombotic therapy strategy is associated with lower in-hospital mortality, MACE and GPIIaIIIB bailout strategy, without increasing rates of TIMI major bleeding or Hb value decrease greater than 3g/dL.
Impact of telemedicine on treatment of diabetes mellites in patients with cardiovascular Disease during SARS-Cov-2 pandemic
Authors: Nakauchi R , Nishio N , Nishio N , Fujii Y , Fujii Y , Takahashi A , Takahashi A , Yamada T , Taniguchi N , Hata T , Nakajima S , Takahashi Y 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
In 2020, the Japanese government issued a new policy to facilitate telemedicine to prevent spread of SARS-Cov-2 infection in outpatient of medical facilities. This policy included consultation via telephone or web and issuing prescriptions directly to pharmacies. However, the patients with diabetes mellites usually have few symptoms. Accordingly, evaluation of control status and medical feedback is difficult on telemedicine basis. We sought to evaluate the impact of telemedicine on the treatment of DM in patients with cardiovascular disease during SARS-Cov-2 Pandemic period.

Method
Between April and Oct 2020, 165 patients with cardiovascular disease having diabetes mellites utilized telemedicine. We retrospectively analyzed indices of patients’ condition and compared them before and after telemedicine. These indices included serum blood sugar, hemoglobin A1c, HDL, LDL cholesterol and triglyceride.

Result
Mean age of the patients was 74.0 ± 9.6 years. Average interval of telemedicine was 6.6 ± 3.4 months. The value of HbA1c before and after telemedicine period was 6.7 ± 0.9 and 7.0 ± 1.2 % respectively (p=0.006). No statistical difference was observed in systolic/diastolic blood pressure, HDL LDL cholesterol and triglyceride during same period.

Conclusion
In telemedicine for the patients with cardiovascular disease, additional caution is needed when patients had concomitant diabetes mellites.
Large health disparities in the performance of the SCORE2 cardiovascular risk prediction model in an ethnic and socioeconomic diverse population
Authors: Kist J , Vos R C , Mairuhu A T A , Struijs J , Peet Van P G , Vos H M M , Os Van H J A , Beishuizen E D , Sijpkens Y W J , Faiq A , Numans M E , Groenwold R H H 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Leiden University Medical Centre University Leiden.

Background/introduction
There is much evidence on cardiovascular health disparities in different ethnic and socioeconomic subgroups in (European) populations. Whether ethnicity and socioeconomic status should explicitly be taken into account as predictors in European risk prediction models, on top of traditional risk factors (blood pressure, cholesterol, age and gender), is still considered as a gap in evidence by the 2021 ESC Guideline on cardiovascular disease prevention.

Purpose
To assess the performance of the cardiovascular SCORE2 risk prediction model in ethnic and socioeconomic subgroups.

Methods
External validation of the SCORE2 risk model in a population-based study stratified by ethnicity (country of origin), and socioeconomic status (disposable household income).

Results
In total 6966 cardiovascular disease (CVD) events were observed versus 5495 events predicted by the SCORE2 model. Relative underprediction was the same in men and women (observed/mean predicted (OE-ratio) 1.3 and 1.2 in men and women, respectively). Underprediction was largest in the Surinamese subgroup (OE-ratio 1.9, in both men and women), particularly in the low socioeconomic Surinamese subgroups (OE-ratio 2,5 and 2.1 in men and women, respectively). In Dutch and the combined "other ethnicities", underprediction was observed in low socioeconomic subgroups too: OE-ratio 1.5 and 1.7 in men and women, respectively. Discrimination showed moderate performance in all subgroups, with C-statistics between 0.65 and 0.72, which is similar to discrimination of the SCORE2 model in the development study.

Conclusions
The SCORE 2 CVD risk model for low-risk countries (as the Netherlands are) was found to under predict CVD risk, particularly in low socioeconomic and Surinamese ethnic subgroups. Taking both socioeconomic status and ethnicity into account as predictors in CVD risk models is desirable for adequate CVD risk prediction and counselling.
Gender differences in cardiovascular health over adolescence using the novel Life's Essential 8 score
Authors: Martinez-Gomez J , Fernandez-Alvira J M , De Cos-Gandoy A , Bodega P , De Miguel M , Santos-Beneit G , Beneito-Dura M , Tresserra-Rimbau A , Laveriano-Santos E P , Casas R , Sacanella E , Estruch R , Lamuela-Raventos R M , Fernandez-Jimenez R 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): 1. Fondo de Investigación Sanitaria - Instituto de Salud Carlos III 2. SHE Foundation and “la Caixa” Foundation.

Background/Introduction
The evidence for gender differences in overall cardiovascular health (CVH) score and individual health metrics over adolescence is conflicting.

Purpose
To study gender differences in overall CVH status and its individual metrics in a large cohort of adolescents aged 12 to 16 years in Spain.

Methods
This study collected longitudinal data from 1324 adolescents at baseline (48.4% girls; 12.5 (0.4) years), 1211 (47.9% girls; 13.9 (0.4) years) at first follow-up and 1095 at second follow-up (48.2% girls; 15.8 (0.4) years) attending 24 secondary schools enrolled in the SI! Program for Secondary Schools trial in Spain. Eight individual metrics (nicotine exposure, diet, physical activity (PA), sleep health, body mass index (BMI), blood glucose, non-high-density lipoprotein cholesterol, and blood pressure (BP)) were measured and scored from 0 to 100 points according to the Life’s Essential 8 (LE8) criteria established by the American Heart Association. An overall CVH score was constructed summing the metrics described above, ranging from 0 to 100 points. Low, moderate, or high overall CVH score was defined as 0-49, 50-79, or 80-100 points, respectively. Differences in CVH over time were analyzed in individuals with CVH score available at three time-points (n=1077) using generalized linear mixed adjusted models.

Results
At approximately 12 years of age, most individuals had a moderate or high LE8 CVH score and CVH was slightly higher (healthier) in girls than boys (77.2 vs. 76.0 points) (Figure 1). LE8 CVH score increased significantly in boys and girls between 12 and 14 years of age (1.78 and 1.95 points, respectively), without gender differences (Figure 2). LE8 CVH score decreased significantly in boys and girls between 14 and 16 years of age; however, this decline was higher in boys than in girls (-3.17 versus -1.62 points, p value=0.007). Regarding individual metrics, mean scores were lowest for the diet, and sleep health and highest for BP. The highest declines over time were observed in PA, especially in boys, and nicotine exposure, especially in girls.

Conclusions
Most adolescents had a moderate or high overall CVH status, although boys showed slightly unhealthier scores and greater decline over time. Gender differences in individual CVH metrics were also found. This information is helpful for tailoring health promotion programs in adolescence.
Left ventricular Myocardial Work assessment in patients after coronary artery bypass graft during cardiac rehabilitation
Authors: Perone F , Di Stasio F , Caterino L , La Gambina V , Del Villano V , Comenale Pinto S 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Myocardial work (MW) is a new tool in the echocardiographic assessment of the left ventricle (LV) performance. Specifically, this method evaluates LV function by incorporating myocardial strain and non-invasive blood pressure. Despite its added value in clinical application, it has not been studied in cardiac rehabilitation setting.

Purpose
The aim of this study is to investigate the change in left ventricle function, through MW, in patients undergoing coronary artery bypass grafting (CABG) before and after cardiac rehabilitation (CR).

Methods
Observational and prospective study that included patients undergoing CABG with indication for a CR program. All patients underwent a baseline evaluation and a transthoracic echocardiography before and after CR. In addition, a six-minute walking test and a Borg scale were also performed.

Results
Forty-one patients were included in the study. Baseline characteristics are shown in Table 1. At baseline, the left ventricle ejection fraction was 55,45%, the global work index was 1502,35 mmHg%, and the six-minute walking test was 57,07 meters. All parameters improved after a CR program at least two weeks. Indeed, the left ventricle ejection fraction was 59,41% (p = 0,025), the global work index was 1855,74 mmHg% (p = 0,0005), and the six-minute walking test was 447,92 meters (p = &lt; 0,0001).

Conclusion
In patients undergoing coronary artery bypass grafting, the CR improves the left ventricle performance and global work index, associated with increased functional capacity.
Left atrium volume is the predominant cardiac dimension related to new-onset atrial fibrillation in the general population
Authors: Lu Z , Tilly M , Van Oortmerssen J , Leening M , Van Walsum T , De Groot N , Bos D , Kavousi M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide, with significant sex differences in its epidemiology and etiology. Yet, sex-specific evidence comprehensively assessing the impact of cardiac volumes on AF development is sparse.

Purpose
To examine the association between cardiac volumes with new-onset AF among men and women.

Methods
From the population-based Rotterdam Study, 1021 men and 1179 women (mean age 69 years), free of AF, underwent non-contrast cardiac CT (2003 to 2006) to quantitatively assess cardiac structures in volumes (ml), except for aortic root diameter (expressed in mm). Sex-specific Cox proportional hazards regression models were used to assess the association between CT-assessed cardiac measures and risk of new-onset AF. Cardiac volumes were indexed to body surface area (BSA) and standardized to enable direct comparisons.

Results
After a median follow-up time of 9.1 years, 116 (11.0%) men and 81 (6.9%) women experienced new-onset AF. After adjustments for traditional cardiovascular risk factors, all assessed BSA-indexed cardiac volumes significantly associated with larger risk of AF among both men and women. Adjusted hazard ratios (HRs) per 1-standard deviation (SD) larger BSA-indexed volumes ranged from 1.20 [95% confidence interval (CI): 1.00-1.44] for right atrium to 1.66 (95% CI: 1.40-1.98) for left atrium in men; and ranged from 1.27 (95% CI: 1.01-1.61) for aortic root to 1.88 (95% CI: 1.56-2.27) for left atrium in women. A stronger association was found between right atrium and AF among women (HR; 95% CI: 1.59; 1.29-1.96), compared to men (p&lt;0.01 for interaction). After further adjustment for left atrium, the association of all other cardiac volumes with AF, among both men and women, were no longer significant.

Conclusions
We observed significant associations between various cardiac volumes and increased AF risk, most evidently among women. Findings underscored the predominant role of left atrium size on AF development.
Cardiac Rehabilitation - tackling ventricular remodeling and improving functional capacity
Authors: Martins A , Aguiar-Ricardo I , Alves Da Silva P , Cunha N , Abrantes A , Jordao A , Santos L , Rodrigues M C , Pinto F J , Abreu A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Exercise-based cardiac rehabilitation (CR) is part of the management of patients with established cardiovascular disease. Echocardiography and CPET are used to evaluate cardiac function and cardiorespiratory fitness improvement after such interventions.

Purpose
To analyze the cardiovascular impact of an exercise based CR program on ventricular remodeling and functional capacity.

Methods
Prospective cohort study which included consecutive pts who were participating in a centre-based CR program lasting 8-12 weeks from 2019 to 2021. The CR program included initial evaluation by cardiologist and rehabilitation specialist with collection of clinical characteristics, three times weekly supervised exercise sessions, appointment with rehabilitation nurse, nutritionist and psycologist and educational sessions. Lab tests, echocardiogram and CPET were done before and after completion of the program.

Results
We analysed 349 patients (82% male, mean age 60 ±11,4 years) most of which referred by ischemic heart disease (83%) followed by valvular heart disease (7%). After program completion there was a significant improvement in echo ejection fraction (48,4 ± 12,8% vs 52,07 ± 12,8% Z=-5,036 p&lt;0.001), although other parameters didn’t show the same trend namely left atrial volume and TAPSE. Regarding CPET data, there was a significant improvement in test duration (496,6 ± 158 seconds vs 542,9 ± 147 seconds, p&lt;0.001), in workload (66,2 ± 41,6W vs 123,6 ± 48W, p&lt;0.001), peak VO2 (15,8 ± 4,72mL/(kg.min) vs 16,75 ± 5,17mL/(kg.min) p=0.004) and O2 pulse (11,1 ± 2,8 vs 11,8 ± 2,9; p&lt;0.001). Similar improvements were also seen when analysing pts with reduced ejection fraction regarding ejection fraction, duration of test and workload (p&lt;0.005) but not on peak VO2 (14,4 +- 4,3mL/(kg.min) vs 15,2 +- 4,7mL/(kg.min), p=0.11) or pulse O2.

Conclusions
Exercise based cardiac rehabilitation has a very favorable impact in terms of cardiorespiratory fitness evaluated by several CPET parameters and such impact is also present in high risk individuals with reduced ejection fraction. Advocating for increasing referral of these patients is key to better improve cardiorespiratory capacity.