bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevention of metabolic syndrome implies prevention of severe and multivessel coronary artery disease
Authors: Papadopoulos A , Sdogkos E , Spahiu A , Konstantinou T , Georgakopoulos A , Theodosiou P , Pittas S , Vogiatzis I 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background and Purpose
Metabolic Syndrome (MS) is the result of metabolic, clinical, and hemodynamic disturbances caused by a group of cardiometabolic risk factors. The particular components of the syndrome are each individually also a predisposing factor for Coronary Artery Disease (CAD). The purpose of our study is to demonstrate the direct correlation of MS with the angiographic severity of CAD so that by affecting by prevention of one axis of this equation, a favorable effect is automatically achieved on its outcome as well.

Methods
We have studied 151 patients, 124 males - 27 females of mean age 63.56 ± 11.28 years, who were hospitalized for Acute Coronary Syndrome (ACS) and underwent coronary angiography. MS definition is according to the criteria set by the respective scientific companies. Thus, patients were classified into Group A with MS (46 patients - 35 males, 11 females - mean age 62.07 ± 11.35 years) and Group B without MS (105 patients - 89 males, 16 females – a mean age 65.06 ± 12.54 years). The correlation between MS, and the severity of CAD, has been estimated using the SYNTAX Score.

Results
Group A patients had a higher incidence of ST-elevation myocardial infarction (STEMI) than Group B patients, namely 32 patients (69.56%) versus 28 patients (26.67%), (p = 0.002), a higher incidence of multivessel disease, 20 patients (43.48%) versus 16 patients (16.8%), (p = 0.02), reduced Ejection Fraction (42.4% ± 9.6% vs. 53.5% ± 6.54% - p = 0.01) and higher SYNTAX Score (19.52 ± 7, 68 vs. 9.64 ± 5.32 - p = 0.01). In Group A with MS, lipid levels disorders were also observed (Total cholesterol, triglycerides, LDL, HDL - p = 0.01), higher values of fasting plasma glucose and HbA1c but also of mean platelet volume (MPV), which is considered a significant prognostic factor in patients with CAD (11.91 ± 1.93 femtolitres vs. 9.84 ± 1.06 femtolitres).

Conclusions
MS is associated with more severe clinically and angiographically CAD. Prevention and regulation of MS factors are significant for the avoidance of the occurrence of severe coronary syndrome.
The relationship between frailty and HRQoL in elderly cardiovascular patients in Phase II Cardiac Rehabilitation
Authors: Xu J , Yokoyama M , Shimada K , Fujiwara K , Abidan A , Kunimoto M , Nozawa Y , Kasuya H , Tabata M , Daida H , Minamino T 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
With an aging cardiovascular disease population, frailty is become an important prognostic factor in patients, which is associated with poor quality of life outcomes, such as fatigue, and decreased physical activity. However, the relationship between frailty and health-related quality of life (HRQOL) in elderly patients undergoing cardiac rehabilitation (CR) remains unclear.

Methods
In this study, 217 patients (mean age: 74.6 ± 5.8 years; male: 67%) were recruited who participated in early phase II CR at a university hospital between November 2015 and December 2016. As part of the CR processed, patients were asked to complete the Kihon Checklist (KCL) and 36-Item Short Form Survey (SF-36). We divided patients into three groups according to their KCL results: the frailty group (n = 81; 37%), the pre-frailty group (n = 71; 32%), and the non-frailty group (n = 65; 29%). The three groups were compared based on their basic characteristics and SF-36 scores.

Results
Among the three groups, sex, body mass index, 6-minute walking distance (6MWD), hemoglobin level, and low-density lipoprotein cholesterol level varied significantly (p&lt;0.05). The frailty group scored significantly lower than the other two groups on all items of the SF-36, the Physical Component Summary (PCS), and the Mental Health Component Summary (MCS) (p&lt; 0.05). In all groups, the PCS scores were below the standardized mean scores. Interestingly, MCS score in the frailty group was below the standardized mean scores. Additionally, the significant correlations were found between the PCS and 6MWD in the non-frailty group (p=0.006, r=0.38) and pre-frailty group (p=0.002, r=0.52), but no correlation was found in the frailty group (p=0.14, r=0.22). On the other hand, there was no significant correlation between MCS score and 6MWD in all groups.

Conclusions
HRQOL as well as physical and mental domains declined in frail elderly patients undergoing CR, which suggests that an intervention program considering social life and daily roles is necessary.
Impact of COVID-19 situation on non COVID myocardial infarction admissions
Authors: Del Castillo-Carnevali H , Alvarez J , Torres J , Magnani S , Morante M E , Sahuquillo A , Ripoll T , Peral V , Gamez J M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
COVID-19 outbreak nudged worldwide health systems to reallocate resources from from other areas to help fighting against this novel infectious disease. Consequently, accuracy and quality care of cardiovascular patients was partially compromised. Moreover, fear to get to hospital made patients to stay home despite the presence of symptoms that would have led them to search medical aid in other scenarios.

Aim
We aimed to demonstrate that non COVID myocardial infarction admissions after the outbreak were more complex in term of coding and length of stay (LOS) compared to those previous to pandemic situation.

Methods
We analyzed complexity coding weight (CW) parameters (according to current Spanish Coding manual CIE-10)obtained from local healthcare authorities of 903 admissions from Balearic Islands Region from January 2019 to December 2021. Admissions with higher coding value were considered more complex. We performed an interrupted time series using pre pandemic admissions as a control group.

Results
2020 showed a lower number of admissions (268/mean CW: 0,651), specially form March to June compared to 2019 (347/mean CW: 0,631) and 2021 (288/ mean CW: 0,627). CW values and LOS, trend and comparison are showed in figures.

Conclusions
Number of myocardial infarction admissions were reduced in 2020. Complexity trend to mildly increase in 2020. No significant variations in LOS where found. Further analysis with data from other regions would be useful to confirm this trend in the whole country.
Non-alcoholic steatohepatitis and hepatic fibrosis are strongly associated with estimated 10-years cardiovascular risk in people living with severe obesity
Authors: Lajeunesse-Trempe F , Dugas S , Maltais-Payette I , Piche M E , Dimitriadis G K , Biertho L , Tchernof A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Cardiometabolic health, diabetes and obesity research network IUCPQ Foundation.

Background
Obesity (Body Mass Index [BMI] over 30 kg/m2) is associated with metabolic disturbances that promote the development and progression of cardiovascular diseases (CVD). However, the association between anthropometric indices of obesity (BMI, Waist Circumference [WC], Waist-to-Hip ratio [WHR] or Neck Circumference [NC]) and CVD risk factors has not always been observed in people living with severe obesity (BMI &gt;35 kg/m2). Among obesity-related metabolic disorders, non-alcoholic ateatohepatitis (NASH) is associated with an increased risk of CVD and cardiac events. NASH has been shown to correlate with a degree of obesity, as defined by BMI or WC. The association between anthropometric parameters, NASH and CVD risk factors has not been explored yet in people living with severe obesity.

Purpose
The aim of this study was to explore the relationships between CVD risk score, anthropometric parameters and the presence of NASH (hepatic steatosis and fibrosis) in a population with severe obesity.

Method
A total of 2257 patients with severe obesity, who underwent bariatric surgery with concomitant liver biopsy were included. All biopsy specimens were classified according to the Brunt grading system. Pre-operative demographic and anthropometric data (age, sex, weight, height, BMI, WC, WHR, NC) were recorded. Comorbidities were assessed (type 2 diabetes, hypertension, dyslipidemia). The 10-year cardiovascular risk was calculated preoperatively in each patient using the Framingham risk score (FRS). Dependent variable FRS was compared using Kruskal Wallis H test and Chi2 exact test. Associations were tested using multivariate logistic regression analysis.

Results
In this specific population (mean age of 46.2 years old, mean BMI of 47.8 kg/m2, 69.1% female), FRS did not significantly increase with weight, BMI and WC, but was positively correlated with WHR and NC (p&lt;0.05). A total of 47.3 % of patients with a histopathological diagnosis of NASH had a moderate-to-high FRS. Among NASH patients with histopathological evidence of grade-4 fibrosis, 69.3% had a moderate-to-high FRS. Presence of NASH and fibrosis were more strongly correlated with a moderate-to-high FRS (OR of 1.61 and 1.37, respectively), compared to all other anthropometric parameters (p&lt;0.05), except WHR (OR of 1.99).

Conclusion
In people living with severe obesity, the presence of NASH and hepatic fibrosis is strongly associated with a high FRS but not more than WHR. Further research is needed to identify the best predictors of CVD and cardiac events in people living with NASH and severe obesity.
Factors influencing systemic coronary risk estimation 2 (SCORE 2)
Authors: Bielecka-Dabrowa A , Banach M , Sakowicz A , Sosnowska B , Adach W , Gryglewska K 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): statutory measures.

Purpose
The aim of the study was to identify factors correlating with estimated an individual’s 10-year risk of fatal and non-fatal CVD events (myocardial infarction, stroke) in apparently healthy people aged 40-69 years with risk factors that are untreated or have been stable for several years and independent predictors of high and very high CVD risk.

Methods
148 patients from high-risk country without established ASCVD, diabetes mellitus, CKD, Familial Hypercholesterolemia were included in the study. The clinical examination, laboratory results, chest x-ray, echocardiography using Vivid E95 - GE Healthcare, non-invasive body mass analysis using Body Composition Analyzer (Tanita Pro), spiroergometry using The MetaSoft® Studio application were performed. The subjects were divided into a low-risk group with low-to-moderate CVD risk in SCORE2 (70 pts) and a high risk group with high and very high CVD risk (78pts).

Results
Pts from high risk group had significantly more frequently s arrythmia (23 vs 2%; p&lt;0,001) and obesity (45 vs 10%; p&lt;0.001), they more often use too much amounts of alcohol (8 versus 0%; p=0.02) compared to low risk group. High risk pts had also significantly higher BMI (29 vs 24 kg; p&lt;o.001), fat (27 vs 19 kg; p&lt;0,001) and TBW (41 vs 38kg; p=0.03); higher LAVI (35 vs 27 ml/m2; p&lt;0.001), left ventricular mass index (86 vs 73 g/m2; p&lt;0,001); E/E’ (7,5 vs 6 cm/s; p=0,0002) but lower V02AT (13 vs 15 ml/min/kg; p=0,01), V02/kg (20 vs 22 ml/min/kg; p=0.008) compared to counterparts. High risk pts presented also higher values of hs of TnT (6,8 vs 3,2 pg/ml; p&lt;0,001 ) and NTproBNP (100 vs 5 pg/ml; p&lt;0,001) and lower level of eGFR (82 vs 98 ml/min/1,73m2). In a multiple logistic regression model the following variables were independently associated with high and very high CVD risk: : E/E’&gt;6,75 cm/s (OR 3.9 95% CI: 1.5-10.3; p=0.004) and hs TnT &gt;4.8 pg/ml (OR6.02, 95% CI: 2.3-15.8; p=0.0002) SCORE 2 (%) correlated positively with metabolic age (R Spearman= 0,79; p&lt;0.0001), hs TnT (R=0.6;p&lt;0.001), NT-proBNP (R=0,5;p&lt;0.001) and negatively with eGFR (R=-0,5; p&lt;0/001), VO2max (ml/min/kg) (R=-0,3; p=0.0008) -Figure 1.

Conclusions
Higher left ventricular filling pressure assessed by E/E’ and higher hsTnT level are independent predictors of high and very high risk in SCORE 2. The increasing 10-year cardiovascular disease risk correlates with higher metabolic age, higher level of NT-proBNP and hsTnT and lower level of eGFR.
Prevalence and significance of T-wave inversion on the electrocardiogram of patients with marfan syndrome
Authors: Ibrahim B , Poveda P , Kasiakogias A , Tojalsi L , De Frutos F , Potterton A , Sharma S , Papadakis M , Tome M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Cardiac risk in the young charity, and Robert Luff Foundation.

Background
The 12-lead ECG is used as a screening tool in healthy individuals and patient populations, and pathological T-wave inversion (TWI) warrant further investigation for heart disease. Marfan syndrome (MFS) can be associated with valvular disease and a cardiomyopathy-like phenotype but there are limited data on the ECG of this cohort.

Purpose
We aimed to characterize the ECG of MFS patients, with particular emphasis on the prevalence and significance of TWI.

Methods
The study population included consecutive MFS patients, aged ≥18 years old, free of cardiothoracic surgery, seen in our Aortopathy clinic between 2015 and 2019. We collected information on demographics, MFS systemic score, body habitus (height, weight and body mass index-BMI), medical treatment and echocardiographic data. Chest deformities were defined as presence of pectus excavatum (PE), pectus carinatum (PC) or chest wall asymmetry (CA). The ECG was systematically analysed based on established criteria. The presence of TWI and its localisation were recorded.

Results
116 MFS patients were included (mean age 39±15 years, females 60%, Caucasian 89%, BMI 25±6 Kg/m2). 44% of patients were on beta-blocker. Chest deformities were present in 42% of the patients (PE 18%, PC 22%, CW 2%) and scoliosis in 59% of them. Echocardiography revealed a mean aortic root was 38.1±4.8mm but no evidence of significant cardiomyopathy in any of the patients. Four individuals exhibited moderate mitral regurgitation. ECG abnormalities are summarised in Figure 1. Anterior TWI was present in 10.3%, inferior TWI in 4.3% and lateral in 3.4%. Age, ethnicity, BMI, scoliosis, or valvular pathology were not associated with TWI. However, anterior TWI was more common in females compared to males (14.5% versus 4.3%) and in patients with PE compared to those without (31.3% vs 8%, p=0.003).

Conclusion
Pathological TWI were present in almost a fifth of MFS patients. Anterior TWI were more frequently present in females and in patients with pectus excavatum and are likely to represent a benign trait. The exact significance of other TWI remains to be elucidated
Markers of imminent myocardial infarction
Authors: Sundstrom J , Lampa E , Jensevik Eriksson K , Ganna A , Svennblad B , Gustafsson S 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): AFA Insurance and the European Commission Seventh Framework Programme.

Background and Purpose
Myocardial infarction is a leading cause of death globally, but is notoriously difficult to predict. While most studies to date have considered long timeframes for etiological and prediction models, we aimed to identify biomarkers of an imminent first myocardial infarction and design relevant prediction models.

Methods
We used a novel case–cohort consortium of 2018 persons without prior cardiovascular disease (420 cases, 1598 subcohort representatives) from six European cohorts. We investigated associations of 817 proteins, 1025 metabolites, and 16 clinical variables at baseline with subsequent risk of a first myocardial infarction within 6 months after baseline. Associations in weighted, stratified Cox proportional hazards models that passed multiple testing bounds in the discovery sample were verified in an independent validation sample. We also developed a prediction model for clinical use.

Results
Forty-eight proteins, 43 metabolites, age, sex, and systolic blood pressure were associated with risk of an imminent first myocardial infarction in models adjusted for technical covariates only (Figure 1). Brain natriuretic peptide (BNP) was most consistently associated with imminent myocardial infarction risk, in models adjusting for additional covariates including age and sex. Using clinically readily available variables, we devised a prediction model (Figure 2) with good ability to discriminate between subsequent cases and non-cases (cross-validated C-index 0.78) to which the addition of BNP did not improve performance.

Conclusion
We found 94 biomarkers associated with risk of a first myocardial infarction within 6 months in persons without prior cardiovascular disease, and devised a prediction model with good discriminative ability for an imminent first myocardial infarction in the general population, with potential for motivating primary prevention efforts.
The association between circulating lipoprotein subfractions and lipid content in coronary atheromatous plaques assessed by near-infrared spectroscopy
Authors: Saether J , Vesterbekkmo E K , Gigante B , Giskeodegard G F , Bathen T F , Follestad T , Wiseth R , Madssen E , Bye A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Norwegian Health Association The Liaison Committee for education, research and innovation in Central Norway.

Background
Lipid content in coronary atheromatous plaques, measured by near-infrared spectroscopy (NIRS), can predict the risk of future coronary events. Biomarkers that reflect lipid content in coronary plaques may therefore improve coronary artery disease (CAD) risk assessment, and lipoprotein subfractions could potentially add value beyond traditional lipid measurements.

Purpose
We aimed to investigate the association between circulating lipoprotein subfractions and lipid content in coronary atheromatous plaques in statin-treated patients with stable CAD undergoing percutaneous coronary intervention.

Methods
56 patients with stable CAD underwent three vessel imaging with NIRS when feasible. The coronary artery segment with the highest lipid content, defined as the maximum lipid core burden index within any 4mm length across the entire lesion (maxLCBI4mm), was selected as target segment. Lipoprotein subfractions were analyzed in fasting serum samples by nuclear magnetic resonance spectroscopy. Penalized linear regression analyses (lasso) were used to identify the best predictors of maxLCBI4mm. The uncertainty of the lasso estimates was assessed as the percentage of the resampled datasets by bootstrapping.

Results
Only modest evidence was found for an association with lipoprotein subfractions and maxLCBI4mm. The lipoprotein subfractions with strongest potential as predictors according to the percentage presence in resampled datasets were lipoprotein a (Lp(a)) (reg.coeff = 57.0; 78.1 % presence) and free cholesterol in the smallest high-density lipoprotein (HDL) subfractions (reg.coeff = 36.5; 74.3 % presence). When including established cardiovascular risk factors in the regression model, none of the lipoprotein subfractions was considered potential predictors of maxLCBI4mm.

Conclusion
In this study, Lp(a) and free cholesterol in the smallest HDL subfractions in serum showed the strongest potential as predictors for lipid content in coronary atheromatous plaques. Although the evidence is modest, our study suggests that measurements lipoprotein subfractions may provide additional information with respect to coronary plaque composition compared to traditional lipid measurements, but not in addition to established risk factors. Future studies are needed to verify our findings, and to investigate the clinical implication of lipoprotein subfractions as meaningful biomarkers for lipid-rich plaques and enhanced risk prediction in CAD.
Community echocardiographic left ventricular hypertrophy and mortality in South Asians in the UK: E-ECHOES study
Authors: Shantsila E , Shantsila A , Williams N , Lip G Y H , Gill P S 
Published: May 2023

Abstract

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

Background
People of South-Asian origin have high cardiovascular morbidity, contributed by health inequalities. Hypertension is the key modifiable cardiovascular risk factor but is underdiagnosed, but its scale in South Asian communities is unknown. Left ventricular hypertrophy (LVH) on echocardiography is a measure of target organ damage related to uncontrolled hypertension. The study aims to assess prevalence of LVH in South Asian community and its impact on mortality. This study is based on the large prospective UK community Ethnic-Echocardiographic Heart of England Screening Study (E-ECHOES, age ≥45 years).

Methods
Left ventricular mass index (LVMI) was calculated using echocardiography. LVH was established as increased LVMI. Predictive value of LVH all-cause and cardiovascular mortality was assessed using Cox regression.

Results
The study included 3200 South Asians (age 59±10, 52% women, 45% had a history of hypertension). There were 182 deaths, including 64 cardiovascular deaths during a 5.8±1.0-year follow-up. LVH was found in 1568 (49%). In those with LVH, 705 (45%) did not have a diagnosis of hypertension. On Cox regression LVH was independently associated with all-cause mortality (hazard ratio [HR] 1.38, 95% confidence interval [CI] 1.01-1.88), cardiovascular mortality (HR 2.64, 95% CI 1.21-3.73). The projected overall hypertension prevalence was 82%.

Conclusion
South Asians in the UK have a very high prevalence of hypertension which is often underdiagnosed and poorly controlled, leading to LVH and excess in overall and cardiovascular mortality. The findings call for more effective screening and management of hypertension with lower BP targets.
Does right ventricular remodeling in elite athletes persist years after training cessation?
Authors: Prosperi S , Monosilio S , Ferrara R , Lemme E , Di Gioia G , Mango R , Gualdi G , Squeo M R , Maestrini V , Pelliccia A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Intense and prolonged exercise training induces morpho-functional cardiac changes, known as "athlete’s heart". The physiologic nature of this cardiac remodeling has been questioned and data on reversibility of cardiac remodeling, especially of the right ventricle (RV), after the suspension of high intensity training are scarce.

Purpose
To describe cardiac morpho-functional changes by echocardiography in a group of Olympic athletes prior the Olympic games (T1) and years after cessation of their competitive athletic career (T2).

Methods
Endurance athletes evaluated prior their participation to the Olympic games (edition 2004-2008-2012) and after cessation of their athletic career (&gt; 3 years of cessation of intensive exercise training) were invited to be evaluated at our Institute. 12-lead ECG, exercise ECG test and echocardiogram were performed. Echocardiogram parameters at T1 and T2 were compared including left ventricle (LV) and RV dimension, systolic and diastolic function.

Results
25 athletes were enrolled (mean age 47±2 years). The mean time from the end of their agonistic activity was 12 ± 7 years. No differences in terms of LV dimensions and function were observed (Table). Veterans showed a significant decrease in RV dimensions and improvement in function at T2 compared to T1.

Conclusion
After suspension of competitive training, Veteran athletes showed reverse remodeling of the right ventricle compared with the evaluation during the peak training by echocardiography.