bluuebunny/crossref_metadata_2025_split huggingface dataset:
One year results on a Spanish cardiac rehabilitation center
Authors: Sanchez Gimenez R , Peiro O , Carrasquer A , Camprubi M , Torla R , San Segundo R , Bardaji A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Cardiac rehabilitation programs (CRP) after myocardial infarction have an I-A recommendation level, according to European clinical guidelines, but in real life their implementation is very low. To improve secondary prevention, post-infarction CRP needs to be implemented and made it accessible to the public Spanish Health-care services.

Purpose
The aim of this study is to analyze the results after one year of CPR program in a tertiary Spanish hospital.

Methods
An observational study was performed on cardiac rehabilitation patients from October 2021 to November 2022. Patients were included in an individualized exercise program consisting in 3-days-supervised workout, self-home workout, life-style and nutrition lessons and medical treatment optimization. Demographics and analytic data were collected on the first visit and the last visit before discharge.

Results
One hundred patients were included (73.7% male, median age 60.9 years (SD 8.69)). Principal cardiovascular risk factors were arterial hypertension (55.5%), diabetes (29.3%), dyslipidemia (62.9%) and smoking (37.4%). ST-elevation myocardial infarction was the main prior diagnosis (47.5%) followed by non-ST myocardial infarction (39.4) and unstable angina (10.1%). Patients improved weight control - 1.67 kg (SD 2.89), abdominal circumference -2.7 cm (SD 2.6), exercise capacity 1.84 METS (SD 2.3), diet (PREDIMET scale) 1.6 points (SD 2.3) and anxiety and depression scale -1.05 points (SD 2.07). 85,7% of patient give up smoking. LDL-cholesterol reduction was -60.3 mg/dl (SD 38.58), reaching the LDL-cholesterol target by 66.3% (levels&lt;55mg/dl) and on diabetic patients, glycated hemoglobin (HbA1c) achieves an 11.5% mean reduction from basal levels, reaching target levels (Hb A1c &lt; 7%) on 68.2%.

Conclusion
CRP programs are an essential in secondary prevention and their implementation should be extensive to the majority of hospitals and primary care centers to promote life-style hacks and control cardiovascular risk factors.
Eicosapentaenoic acid (EPA) reduced expression of neutrophil activation proteins in endothelial cells during challenge with angiotensin II (Ang II) and cytokines
Authors: Sherratt S C R , Libby P , Bhatt D L , Mason P 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Amarin Pharmaceutical, Inc. Elucida Research LLC.

Background
Neutrophil degranulation contributes to atherogenesis and tissue injury in response to cytokine release and activation of the renin-angiotensin system (RAS), along with its effector angiotensin II (Ang II). Mixed omega-3 fatty acid (n3-FA) formulations of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have not shown reduction in CV events compared to EPA-only formulations (REDUCE-IT), but the mechanisms of atheroprotection with EPA are not well understood.

Purpose
We measured the effects of EPA on expression of proteins related to neutrophil activation in vascular endothelial cells (ECs) under various inflammatory challenges, specifically exposure to Ang II and the cytokine IL-6 in vitro.

Methods
Human umbilical vein ECs (HUVECs) were challenged with the cytokine IL-6 at (12 ng/mL) and Ang II (100 nM) for 2 h, then treated with EPA (40 µM) for 24 h. Global proteomic analysis was performed using LC/MS to measure relative expression levels of over 2,500 proteins simultaneously. Only significant (p&lt;0.05) changes in expression between treatment groups &gt;1-fold (100%) were analyzed by differential enrichment analysis of proteomics data (DEP) and included in gene set enrichment analyses (GSEA).

Results
EPA significantly down/up-regulated expression of 507/505 and 544/472 proteins, respectively, compared with Ang II and IL-6 alone. The GSEA revealed EPA treatment significantly modulated expression of 88 and 80 proteins within the neutrophil degranulation pathway (Gene Ontology ID: 0043312), compared to Ang II and IL-6, respectively. Of these proteins, 20 were similarly modulated by EPA relative to each stimulus (13 decreased, 7 increased expression). This included a 110% decrease in expression of heat shock protein 90 (110%) and HSP 86 (110%) and a 140% and 110% increase in junction plakoglobin relative to Ang II and IL-6, respectively, which is also involved in endothelial cell-cell adhesion.

Conclusion
EPA modulated expression of multiple proteins linked to neutrophil degranulation following challenge with either Ang II or IL-6. The effects of EPA on neutrophil protein expression may lead to reduced inflammation and risk for patients with CV disease as demonstrated in outcome trials.
Motivational aspects of the cardiac rehabilitation programme
Authors: Coto Morales B , Del Castillo Carnevalli H , Basabe Velasco M E , Gomez Sanchez M I , Marti Sanchez D , Molinos A C , Rodriguez Biedma M F , Fuertes Pereiro J , Casanova Lopez L P , De Juan Bitria C , Delgado Cavia F A , Duarte Torres J , Biscotti Rodil M B , Rodriguez Gamero M A , Alvarez Anton A S 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction/Background
Cardiac rehabilitation programmes have proven to be effective in many ways in patients with cardiovascular disease. In fact, its implementation has acquired a relevant role in the European Clínical Practice Guidelines. The reasons why the programmes are successful are diverse, including motivating patients to improve their lifestyle. But, what specific aspects keep the patient motivated in the cardiac rehabilitation programme?.

Method
An anonymous survey was administered to patients who completed cardiac rehabilitation programme and who were considered by their physicians as successul in terms of lifestyle changes. A 13-question questionnaire was distributes (Table 1) including baseline characteristics. Patients were asked to rate from 1 to 5 (being 5 the highets rating) how important each of thes items had been in terms of motivation.

Results
170 questionnaires correct completed were analyzed. Mean age was 66+/- 12 y.o. and 43 women (25%). The mode of studies level was primary school. Mean Value of Question (Q) 5: 4,68, Q6: 4,25 Q7: 4,54 Q8: 4,67, Q9:4,58 Q10: 3,91 Q11:3,962 Q12: 4,58 Q13:4,53.

Conclusions
Although many items were valued similarly, the most popular items were the trust in the information given by healthcare professionals( Q5) and the importance of feeling better and improving self-esteem (Q8), being scored over 4,5. On the other hand, the last popular items were the posibility of having a relapse (Q11) and the impact on social life (Q10) . The population who fulfilled the survey considered the programme valuable in terms of making them improve their lifestyle, being Q13 scored over 4,5 (4,53).
Potential for optimizing management of overweight and obesity in patients with established atherosclerotic coronary artery disease
Authors: Burazor I , Djokic O , Peric M , Bilic T , Subic O , Rankovic-Nenezic T , Tasic N , Tasic D , Otasevic P , Micovic S , Vukovic P , Nikolic A , Ostojic M , Bojic M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.
Obesity and overweight play a key role in the development of cardiovascular disease or myocardial ischemia, particularly today, as does their relationship to traditional and non-traditional risk factors. Despite, diet and weight management are grossly under-met per desired body mass index (BMI) threshold goals among very high-risk patients with established atherosclerotic cardiovascular disease (ASCVD). Thus, we aimed to investigate the presence of overweight and obesity in patients with established atherosclerotic cardiovascular disease who were admitted to our center.
Patients and methods: Out of 790 patients admitted in our center between May and October 2021, we analyzed 341 patients who underwent isolated coronary artery by-pass surgery. Risk factors were noted as well as previous drug therapy, previous COVID 19 infection and vaccination. Anthropometric data were measured and BMI was determined. Obesity was defined as a BMI &gt;_30 kg/m2 and overweight as a BMI between 25 and 30 kg/m2 . Patients with a BMI &gt;_40 kg/m2 were considered morbidly obese. Early cardiac rehabilitation (phase 1) was performed by using personalized approach in all patients.

Results
Out of 341 patients (64.68±7.91 years of age), 275 were males (80.6%). The total of 97 (28.44%) had previous myocardial infarction. Blood pressure was well controlled. Majority of the patients reached the step 2 goals according to EAPC Guidelines on prevention (130.7±6.45/75.27±6.54mmHg), and were adherent to prescribed drugs. Mean heart rate was 65±5.65/minute. Only 27% of females and 22% of males had normal weight with BMI between 18.5 and 24.9.kg/m2. The mean BMI was 27.76 kg/m2. 50% of males and females were overweight. Obesity was noted in 23% of females and 27% of males (0.7% morbidly obese. Early cardiac rehabilitation was performed in all patients and they were all referred to participate the phase 2 programs.

Conclusions
Diet and body weight reduction in overweight and obese ASCVD patients should continue to be a priority given the impact on cardiovascular risk. There is a potential for optimizing management of overweight and obesity in patients. In addition to a better risk factor profile, weight loss also leads to a better quality of life. Cardiovascular prevention and rehabilitation programs should include weight loss intervention. Different forms of self-support and use of digital health might be used as a specific component of a comprehensive intervention to reduce total cardiovascular risk, extend life expectancy, and improve quality of life.
Causal associations of alcohol with ECG-derived cardiovascular phenotypes in chinese adults
Authors: Ho A , Im B , Clarke R , Turnbull I , Chen Z M , Millwood I 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Heavy alcohol consumption is associated with increased risk of stroke, but its role, especially moderate drinking, in other types of cardiovascular disease (CVD) remains inconclusive. Understanding how alcohol intake affects cardiac traits measured by electrocardiogram (ECG) can improve our understanding of the relationships between alcohol intake and risk of different types of CVD.

Purpose
This study aims to assess the causal associations of alcohol and ECG-derived cardiovascular phenotypes in Chinese adults, where two genetic variants which alter alcohol metabolism and greatly affect alcohol intake can be used in a Mendelian randomisation approach.

Methods
The prospective China Kadoorie Biobank recruited 512,715 adults from ten diverse regions in China between 2004-2008 and recorded baseline alcohol use and other characteristics. 151,035 participants were genotyped for two genetic variants that affected alcohol metabolism (ALDH2-rs671 and ADH1B-rs1229984), and 25,041 participants had ECG measurements taken at the 2013-2014 resurvey, broadly defined into phenotypes (ischaemia, left ventricular hypertrophy (LVH), arrhythmia) and continuous traits. Self-reported alcohol intake (conventional analysis) and genotype-predicted alcohol intake (genetic analysis) were related to the odds of ECG-derived cardiovascular phenotypes and the mean values of ECG continuous traits using multivariable logistic and linear regression models respectively.

Results
Among men, 35.0% drank alcohol regularly. There was a J-shaped association between ECG-defined ischaemia with self-reported alcohol intake, with a clear dose-response among current drinkers (OR 1.56, 95%CI 1.25-1.94 per 280g/week increase in alcohol intake (Figure 1)). However, there was no clear causal association in genetic analysis (1.02, 0.82-1.27 per 280g/week (Table 1)). There were no associations between alcohol intake and LVH or arrhythmia in conventional or genetic analysis. Among women, only 2.3% drank alcohol regularly, and there were no clear associations between alcohol intake and ECG measurements and derived phenotypes in either the conventional or genetic analyses. Genotype-predicted alcohol intake was associated with smaller P, QRS, and T-axis, and longer QRS and QTc duration in men, and marginally associated with ventricular rate in women.

Conclusion
This study found no clear causal associations of alcohol with ECG-derived cardiovascular phenotypes and continuous traits, and no evidence of a cardioprotective effect of moderate drinking on myocardial ischaemia.
Exercise and prevalence of cardiovascular disease in older female endurance athletes during 10 years follow-up
Authors: Johansen K , Sorensen E , Hylen Ranhoff A , Myrstad M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): PhD student Kristoffer Johansen is funded by the Northern Norway Regional Health Authority (grant number HNF1568-21). The Birkebeiner Ageing Study has been funded by the Kavli research center for ageing and dementia and the Norwegian ExtraFoundation.

Background
Although research suggests that the health benefits of endurance sport practice is larger in female compared to male athletes, women are underrepresented in sports cardiology research. Furthermore, previous studies on endurance sport practice in women have mostly included younger to middle aged athletes. Thus, prospective studies addressing endurance sport practice and health among older female endurance athletes is lacking.

Purpose
The purpose of this study was to characterise how older recreational female cross-country skiers maintained exercise and cardiovascular health during 10-years follow up.

Method
Forty-six women aged ≥65 years that completed the 54-km Birkebeiner cross country ski race in Norway in 2009/2010 were included. The Birkebeiner race includes about 1000 uphill altitude meters and is considered one of the world's most challenging ski races. Participants answered a questionnaire addressing exercise habits and health issues at baseline in 2009/10 and at follow-up in 2014 and 2020. Thirty-five (76%) participants attended follow-up in 2014 and 36 (78%) participants attended follow-up in 2020. Descriptive statistics are given as mean ± SD for continuous variables and as percentages for categorical variables.

Results
Skiers (age 67.5 ± 2.2 years at baseline) reported a cumulative exposure to regular endurance exercise of 26 ± 15 years. The proportion reporting moderate- to vigorous exercise during the past year was 86% at baseline and 61% at follow-up in 2020. One woman died during follow up. During 10-years follow-up the cumulative prevalence of atrial fibrillation (AF) was 15.6%, more than twice as high as for other cardiac diseases (7.1%) and stroke (7.1%).

Conclusion
Most female athletes sustained a physically active and healthy lifestyle with advancing age. Notably, the prevalence of AF was twice as high as for other cardiac diseases and stroke. Thus, although previous literature indicates that the risk of AF in female athletes is reduced, our findings suggest that additional research is needed to draw more firm conclusions. Future studies aiming to further clarify the female athlete and AF association would greatly benefit from including older athletes that has accumulated several decades of endurance sport practice. In conclusion, further research aiming to close the knowledge gap between female and male athletes are highly warranted.
Effect of the phaleria macrocarpa extract on proprotein convertase subtilisin/kexin type-9 levels in healthy population
Authors: Desandri D R , Witarsa T R , Sukmawan R 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Phaleria macrocarpa fruit extract was reported in decreasing the low-density lipoprotein cholesterol (LDL-C) level as well as increasing the high-density lipoprotein cholesterol (HDL-C) level in animal studies. Currently, proprotein convertase subtilisin/kexin type 9 (PCSK-9) has become a novel target for lipid modification, as it enhances the degradation of LDL-C receptors in hepatocytes. However, the effect of Phaleria macrocarpa fruit extract on PCSK-9 levels in humans remains unclear.

Purpose
To evaluate the effect of Phaleria macrocarpa fruit extract on PCSK9 levels in a healthy population.

Method
This is a randomised, double-blind, placebo-controlled clinical trial. A total of 40 healthy participants were included and randomised into two treatment groups, consisting of 2 x 500 mg of Phaleria macrocarpa extract (n = 20) and placebo (n = 20). Participants were followed for eight weeks. Clinical and laboratory parameters, including PCSK9 levels, were measured on the baseline and the eighth week. Intention-to-treat analysis was performed with a p-value of &lt;0.05 was considered statistically significant.

Results
There was no loss-to-follow-up in each treatment group and the analysis was conducted according to the original group. Compared to the placebo group, the baseline features in the Phaleria macrocarpa extract group were not significantly different, except for the PCSK9 levels (21.1 ± 2.5 ng/mL and 23.9 ± 1.0 ng/mL respectively, p=0.000). After eight weeks of administration of the treatment, Phaleria macrocarpa extract failed to show any remarkable effect on the PCSK9 concentration in humans, as the PCSK9 level was not significantly different at the final evaluation compared to the baseline (23.7 ± 1.3 ng/mL and 23.9 ± 1.0 ng/mL respectively, p=0.455).±.

Conclusion
Phaleria macrocarpa fruit extract did not affect PCSK9 levels in a healthy population after eight weeks of administration.
Evolution of smoking-attributable cardiovascular mortality in Germany 1992-2020
Authors: Mons U 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Marga and Walter Boll Foundation, Kerpen, Germany.

Background
Despite comparatively weak tobacco control, smoking has steadily declined in Germany over the last 30 years. At the same time, while cardiovascular mortality rates have generally been decreasing in recent decades, population ageing leads to increasing numbers of deaths.

Purpose
To explore the impact of smoking prevalence on cardiovascular mortality against the background of these different trends at a population level, this study sought to quantify trends in smoking-attributable cardiovascular mortality (SACVM) in Germany over the past three decades.

Methods
Smoking and mortality statistics from 1992 to 2020 were obtained from the German Statistical Office, from which absolute and relative SACVM was calculated separately for each cardiovascular cause of death causally associated with smoking. The impact of population ageing was explored by comparing crude and age-standardized SACVM, respectively. To estimate the impact of population ageing on future SACVM, a forward projection until 2035 was modelled assuming constant mortality rates and a continuation of smoking trends.

Results
Results show that total absolute SACVM strongly declined over time, from about 71,900 cases in 1992 to about 42,000 cases in 2020, with a stronger drop in men (from about 51,200 to 26,400 cases) than in women (from about 20,700 to 15,600 cases). Somewhat stronger declines were seen for age-adjusted SACVM, with differences between crude and age-standardized SACVM being somewhat more distinct in men. Relative SACVM decreased overall, from 17.3% in 1992 to 14.6% in 2020. Sex-specific relative SACVM however showed differing trends: a strong decrease in men (from 29.3% to 18.8%) and a slight increase in women (8.6% to 10.6%). The forward projection of SACVM indicates a slight decline among men and a marked increase in women.

Conclusions
Results indicate that SACVM has strongly declined over the past three decades, even though being partly compensated by opposing trends in population ageing. The marked decrease in absolute SACVM seems to be mostly due to the general drop in cardiovascular mortality rates, and only partly due to declining smoking rates, particularly in women, where relative SACVM has even slightly increased. Over the next 15 years, population ageing and the increasing trend in relative SACVM among women might halt the recent declining trend in absolute SACVM. Hence, there is tremendous potential to curb the smoking-associated public health burden by implementing a comprehensive set of evidence-based tobacco control polices. Additionally, given still significant smoking rates in middle and old age, smoking cessation programs should be intensified.
Prognosis of various atrial fibrillation patterns in the general population
Authors: Tilly M J , Lu Z , Geurts S , Stricker B H , Labrecque J A , Ikram M K , De Maat M P M , De Groot N M S , Kavousi M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Senior Scientist Grant from the Dutch Heart Foundation.

Aims
Due to their dependence on temporality, current atrial fibrillation (AF) classifications are inaccurate and impractical in large cohort studies, resulting in scarce evidence on prognostic differences between AF patterns in the general population. Using our recently developed AF classification, we investigated potential differences in cardiovascular prognosis among participants with various AF patterns and matched non-AF individuals from the general population.

Methods
1,111 individuals from the general population were classified as 'single-documented AF episode' (sAF), 198 as 'multiple-documented AF episodes' (mAF), and 52 as 'longstanding persistent AF' (lpAF). Each group was independently matched with non-AF participants through propensity score matching. Participants were followed for the development of coronary heart syndrome (CHD), stroke, heart failure (HF), and cardiovascular mortality. Cox proportional hazards regression analyses were performed to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for each AF pattern.

Results
Stroke risk was 1.01; 0.82-1.28 (HR; 95% CI) for sAF, 1.36; 0.87-2.11 for mAF, and 1.44; 0.79-3.54 for lpAF, as compared to their matched participants. HF risk was larger in all AF patterns, with the gradient corresponding to AF severity: 3.48; 1.61-7.55 for lpAF, 2.78; 1.94-3.98 for mAF, and 1.71; 1.44-2.03 for sAF. Compared to non-AF participants, cardiovascular mortality risk was larger in the sAF (1.56; 1.37-1.79) and mAF (1.53; 1.11-2.12) categories, but not for lpAF (0.85; 0.40-1.82).

Conclusion
More severe AF patterns in the general population carried a larger HF risk. We observed a trend regarding a larger stroke risk in more severe AF patterns, albeit statistically not significant. Our new AF classification method may benefit comorbidity and mortality risk stratification associated with AF in a general population.