bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unusual presentation of acute spinal cord injury with ischaemic electrocardiographic changes: a case report
Authors: Hussein Hossameldin , Ali Wessam 
Published: July 2023

Abstract

Background
Spinal cord injury (SCI) is a significant cause of morbidity and mortality with an incidence of 40–83/million/year. Sympathetic denervation in SCI leads to cardiovascular abnormalities including orthostatic hypotension, rhythm disturbance, and repolarization changes. Electrocardiographic (ECG) findings include bradyarrhythmias, ectopic beats, long QT interval, and ST-T changes that may be mistaken for myocardial ischaemia.

Case summary
A patient in their 40 s with free past medical history was referred to our centre with the diagnosis of non-ST elevation acute coronary syndrome. On presentation, chest pain was diffuse and radiating to the back. Twelve-lead ECG showed deep symmetrical T-wave inversion. Echocardiography and cardiac troponin were normal. The patient was scheduled for multi-slice computed tomography coronary angiography which was normal; however, a few hours after admission, the patient developed rapidly progressive motor weakness in both lower limbs with urine retention. Examination revealed motor power Grade 1 in both lower limbs. All sensations were diminished with a sensory level at T6. Urgent magnetic resonance imaging spine revealed neoplastic infiltration of the whole vertebrae with D5/D6 fracture exerting spinal cord compression. The patient was referred for urgent decompression surgery.

Conclusion
Electrocardiographic changes could be the earliest sign for ongoing SCI. ST-elevation is reported in higher levels of complete injury, while ST depression and inverted T waves can occur independent of lesion level or severity. Misinterpretation of these changes may cause a delay in reaching the correct diagnosis. We highlight the importance of considering neurological causes for ischaemic-like ECG changes, as early recognition could prevent irreversible functional loss.
The effect of SGLT2 inhibitors on the endothelium and the microcirculation: from bench to bedside and beyond
Authors: Dimitriadis Kyriakos , Adamopoulou Eleni , Pyrpyris Nikolaos , Sakalidis Athanasios , Leontsinis Ioannis , Manta Eleni , Mantzouranis Emmanouil , Beneki Eirini , Soulaidopoulos Stergios , Konstantinidis Dimitrios , Fragkoulis Christos , Aggeli Konstantina , Tsioufis Konstantinos 
Published: July 2023

Abstract

Aims
The beneficial cardiovascular effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors irrespective of the presence of diabetes mellitus are nowadays well established and they already constitute a significant pillar for the management of heart failure, irrespective of the ejection fraction. The exact underlying mechanisms accountable for these effects, however, remain largely unknown. The direct effect on endothelial function and microcirculation is one of the most well studied. The broad range of studies presented in this review aims to link all available data from the bench to bedside and highlight the existing gaps as well as the future directions in the investigations concerning the effects of SGLT2 inhibitors on the endothelium and the microcirculation.

Methods and results
An extensive search has been conducted using the MEDLINE/PubMed database in order to identify the relevant studies. Preclinical data suggest that SGLT2 inhibitors directly affect endothelial function independently of glucose and specifically via several interplaying molecular pathways, resulting in improved vasodilation, increased NO production, enhanced mitochondrial homeostasis, endothelial cell viability, and angiogenesis as well as attenuation of oxidative stress and inflammation. Clinical data systematically confirm this beneficial effect on the endothelium, whereas the evidence concerning the effect on the microcirculation is conflicting.

Conclusion
Preclinical and clinical studies indicate that SGLT2 inhibitors attenuate endothelial and microvascular dysfunction via a combination of mechanisms, which play a role in their beneficial cardiovascular effect.
Electrocardiography and Holter monitoring in patients with Cardiac AL Amyloidosis
Authors: Fingrova Z , Havranek S , Kuchynka P , Linhart A , Palecek T 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Aim
Cardiac amyloidosis (CA) reflects an infiltrative heart disease with poor prognosis. Aim of the study was to recognise differences between patients with and without CA in 12-lead electrocardiography (ECG) and 24hr Holter ECG monitoring and identify dependence of ECG and Holter ECG monitors on disease progression.

Methods
We prospectively analyzed clinical profile, echocardiographical pattern, ECG and 24hr Holter monitoring in 39 (66 (62; 71) years, 62% males) consecutive patients with AL amyloidosis screened to cardiac involvement.

Results
Out of all patients, CA was confirmed in 26 (67%) patients. All patients with cardiac AL amyloidosis manifested at least one pathology on ECG, what was contrast to low prevalence in patients without cardiac involvement (54%), p &lt; 0.001. Abnormal Holter ECG was seen in 77 % and 62 % of patients with and without cardiac involvement, respectively. Patients with cardiac involvement and E/A or E/E´ ratio above median manifested higher numbers of VPBs than rest of subjects (median 195 (IQR 31; 546) vs. 6 (3; 40); p = 0.02, and 195 (31; 274) vs. 14 (5; 54); p = 0.04, respectively). During follow-up 19 (7; 59) month, 19 (73%) of patients with cardiac AL amyloidosis died. The proportion of surviving patients was higher in subjects with QRS &lt; 100ms and QTc &lt; 450ms (both p &lt; 0.05).

Conclusion
Standard 12-lead ECG seems to be method with excellent negative predictive value for exclusion of CA. Advanced CA is associated with higher number of both premature atrial and ventricular beats. QRS and QTc duration seems to be a marker of earlier mortality of patients with CA.
Impact of clinical pharmacist led theory-based discharge counselling service on clinical outcomes of patients with acute coronary syndrome: preliminary results of a randomized controlled study
Authors: Demirci M Y , Okuyan B , Sancar M , Mutlu B 
Published: July 2023

Abstract
Funding Acknowledgements: Type of funding sources: None.
It is aimed to evaluate impact of clinical pharmacist-led theory-based discharge counselling service on hospital readmission and medication adherence of patients with acute coronary syndrome. In this prospective parallel randomized controlled study, adult patients who were hospitalized due to acute coronary syndrome in the cardiology clinic of tertiary university hospital was recruited between January 15 and June 15, 2021. The patients were assigned by permutated block randomization into the control group or study group that received clinical pharmacist-led theory-based discharge counselling service. The clinical pharmacist, within the scope of discharge counselling services, provided medication reconciliation, medication review, individually prepared patient medicine (pill) card, patient education (based on Health Belief Model by using written material and video, and counseling (based on Health Belief Model by using written material and video, and verbally [by using Teach back method especially for patients with low health literacy]) and counseling (using behavior change techniques based on The Capability, Opportunity, and Motivation Behavior [COM-B] model) and telephone follow-up within 12 months. The control group received usual care. According to preliminary results of this study, in the control group 30-day readmission rate was higher than study group (%5.7 vs %0.0, respectively; p = 0.06). In control group nonadherence rate (%10.3) was higher than study group (%1.2) within 30 days of discharge (p&lt;0.05). The early findings of our study demonstrated theory-based patient counselling service had positive impact on medication adherence and clinical outcomes in patients with acute coronary syndrome.
Increasing patient advocacy: The development of patient guidelines for cardio-oncology
Authors: Lee G , Lopez Fernandez T 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
As people live longer, many are living with two conditions- cardiovascular disease and cancer. With advancements in treatment in cancer including surgery and immunotherapy and, a relatively new specialty- cardio-oncology- has evolved. As patients can either have a pre-existing cardiovascular condition or present with a cardiac complication such as Acute Coronary Syndrome or Atrial Fibrillation during cancer treatment, there is a need for cardiovascular assessment prior to, during and after cancer treatment.
The first cardio-oncology guidelines were released in 2022 for use in clinical practice that is aimed at clinicians. Despite increased involvement of patients in the research process, the evidenced-based results are not always written in ‘patient’ friendly language. Often lay summaries and thus the practical aspects of the condition or treatment are not available to patients and their families.

Purpose
Given the need to be more inclusive and make research findings and guidelines more patient friendly, the aim was to develop patient guidelines for

Methods
The ESC clinical practice guidelines on cardio-oncology for patients were written by a multidisciplinary team of healthcare professionals, including doctors, nurses, scientists and patients, and are intended mainly for use in clinics and hospitals with the aim of ensuring the language was inclusive and non-technical.

Results
Guidelines are useful in making diagnoses and deciding on treatment using the most up-to-date medical and scientific evidence to ensure that patients receive the most appropriate care. The guidelines outline recommendations on (i) Being treated by a multidisciplinary cardio-oncology team, (ii) Looking after your heart health, during and after cancer treatment, (iii) Paying particular attention to your heart health if you have previously had a heart attack, a stroke, an arrhythmia (irregular heartbeat) or you have high blood pressure, diabetes or high cholesterol and (iv) Making appropriate healthy lifestyle choices. A final version was published in late 2022 and the plan is to translate thee guidelines into several languages so they can be widely used and disseminated.

Conclusion
These guidelines demonstrate how clinicians and patients can work collaboratively to develop patient-friendly guidelines that can be used in practice and potentially optimise the shared-decision making process between patients and their healthcare team.
Incidence of premature ventricular contractions in patients with cardiovascular diseases risk factors
Authors: Bielinskyi M , Vytryhovskiy A I , Seredyuk N M , Kulayets N M , Kiritsa N , Bielinska K V 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Aim of the study
To establish the incidence of premature ventricular contractions among individuals with high and very high risk of cardiovascular diseases.

Materials and methods
During the period between 2007-2013 a total of 4,214 individuals were examined, age ranged from 35 to 85 years. Each individual underwent 24-hour Holter monitoring. All participants of the study were divided into groups: 1-st - patients with coronary artery disease (mainly stable angina), but without accompanying risk factors for cardiovascular diseases, such as smoking and obesity (n=234); 2nd group - people who smoked 5 or more cigarettes per day for more than 2 years (n=144); 3rd group - obese people without concomitant coronary artery disease and arterial hypertension (n=197); 4th group - people with obesity and hypertension (n=187). The control group included 149 practically healthy people. The groups were statistically homogenic in age and gender. The incidence of premature ventricular contractions in was following according to V. Lown and M. Wolf classification: the 1st group – I - 16 (6,83%), II - 23 (9,82%), III - 2 (0,85%), IV - 13 (5,55%), V - 18 (7,69%); the 2nd group - 14 (9,72%), II – 10 (6,95%), III - 5 (3,47%), IV - 28 (19,44%), V - 13 (9,02%); the 3rd - I - 1 (7,61%), II - 6 (3,04%), III - 3 (1,52%), IV - 21 (10,65%), V - 13 (6,6%), the 4th - I - 22 (11,76%), II - 13 (6,95%), III - 2 (1,07%), IV - 24 (12,83%), V - 8 (4,27%). The lowest incidence of this arrhythmia was observed among patients with stable angina - 30,34%. This can be explained by patients being more thoroughly supervised by doctors and higher compliance for treatment. Another reason was that groups 2-4 included people with only risk factors, and group 1 - people with the coronary artery disease. Among obese people with and without hypertension, the incidence of this arrhythmia was almost the same – 35,1% and 36,7%, respectively, and was not significantly different from control group (33,6%). Therefore, analyzing the data presented above, we established that people who smoke tobacco have higher incidence of ventricular premature contractions than in healthy individuals and people with obesity and hypertension. There was observed no statistically significant difference in the incidence of ventricular premature contractions in individuals with isolated obesity or obesity concomitant with arterial hypertension.
Relationship of the occurrence of self-reported anxiety and depression symptoms and achievement of cardiovascular risk factors control
Authors: Pietrzykowski L , Michalski P , Kosobucka-Ozdoba A , Ratajczak J , Siodmiak J , Kasprzak M , Kubica A 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Nicolaus Copernicus University in Torun.

Introduction
Anxiety and depression influence lifestyle and therefore interfere with preventive measures aimed at eliminating or reducing the severity of modifiable risk factors for cardiovascular diseases (CVD).

Aim
The study aimed to evaluate the influence of self-reported anxiety and depression symptoms on achieving the control of cardiovascular (CV) risk factors in patients without a history of atherosclerotic coronary heart disease (CHD).

Methods
A total of 200 patients from the Polish arm of the EUROASPIRE V were included. The median age was 52.0 years (IQR 43.0-60.5). Patients were assessed regarding the control of major CV risk factors: blood pressure, BMI, waist circumference, physical activity, smoking, and the concentration of LDL cholesterol, triglycerides, and blood glucose. Risk factors were considered adequately controlled when the therapeutic target was achieved. The number of controlled CV risk factors was assessed for each individual, as well as the rate of patients who achieved the therapeutic target for particular risk factor was analyzed. Total CVD risk was analyzed with the SCORE scale. The level of anxiety and depression was evaluated based on the results of the Hospital Anxiety and Depression Scale (HADS), which consists of two subscales (HADS Anxiety and HADS Depression). For each subscale obtained score indicated normal, borderline, or abnormal level.

Results
The median score of anxiety (HADS Anxiety) and depression (HADS Depression) levels were 3.0 (IQR 2.0-6.0) and 3.0 (IQR 1.0-5.0), respectively. In the studied group the median of adequately controlled CV risk factors was 4.0 (IQR 3.0-5.0) and the median SCORE result was 2.0% (IQR 1.0-3.0%). No relationship between the level of anxiety or depression and the CVD risk measured by the SCORE sale was observed (Table 1.). Patients with self-reported anxiety or depression symptoms (borderline and abnormal level) had a significantly lower median number of adequately controlled CV risk factors (HADS Anxiety p = 0.0014; HADS Depression p = 0.0304) (Table 1.). A significantly lower rate of patients with adequate waist circumference (HADS Anxiety p = 0.0464; HADS Depression p = 0.0200) and with regular physical activity (HADS Anxiety p = 0.0431; HADS Depression p = 0.0055) was observed in groups with anxiety or depression symptoms (Table 2.). In patients with anxiety symptoms, a significantly lower rate of normal BMI (p = 0.0218) and adequate triglycerides concentration (p = 0.0278) was found (Table 2.).

Conclusion
The occurrence of anxiety and depression might influence the achievement of therapeutic targets regarding the control of CV risk factors in patients without a history of CHD.
Retrospective evaluation of the effect of nutritional status of patients with left ventricular assist device on clinical results in the postoperative period
Authors: Milaniak I , Wasilewski G , Gorkiewicz-Kot I , Wisniowska-Smialek S , Kaleta M , Krupa-Hubner A , Wierzbicki K 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Objective
Malnutrition in patients undergoing left ventricular assist device (LVAD) implantation has negative consequences, such as infection and limited functional capacity. The effects of nutritional status of patients with LVAD on their clinical outcomes were investigated.

Methods
116 records of patients with LVAD implantation were retrospectively analysed. For nutritional evaluation, nutrition risk score NRI score was calculated to divide the patients into two groups with and without malnutrition risk. Demographic and clinical data before LVAD, early postoperative adverse events after LVAD, prognostic data, and laboratory findings were analysed.

Results
116 patients (6 females, 110 man) had a mean age of 60.5±9,46 years; Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) scores were determined as 1 (n=11), 2 (n=36), 3 (n=65), and 4 (n=4). Forty four patients (44%) (19 mild, 6 moderate, 19 severe) had MR. The MR was higher in patients with preoperative INTERMACS score 1, low level of haemoglobin and albumin The incidence of adverse events was found to be significantly higher in patients with higher preoperative grade NRI (death during the pooperative period, bleeding).

Conclusion
In the early postoperative period, a MR of 44% was detected in patients who underwent LVAD. Total 72.2 % patients had any adverse events. We found that the presence of MR was effective in predicting postoperative adverse events according to NRI score before LVAD treatment.
Informal caregivers must open the door to information during heart surgery patients hospitalization. A qualitative study
Authors: Hojskov I E , Bjornnes A K , Tonnessen T , Halvorsen S , Blakoe M , Moller C H , Kaljusto M L , Parry M , Moons P , Lie I 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background/Introduction
Despite the possibility of invasive procedures, open heart surgery is still recommended in cases of severe ischemic heart disease and valvular heart disease. National health authorities recommend that health care professionals in hospital should offer informal caregivers necessary learning and support for burdensome caring duties. Follow-up of heart surgery patients after discharge from hospital can be an informal caregiver challenge. There is a lack of studies on the informal caregivers’ experiences with information from health care professionals from before and during hospitalization.

Purpose
This study explores the informal caregivers of heart surgery patients experiences of information and communication from health care professionals before and during hospitalization.

Methods
Qualitative in-depth interviews were conducted in informal caregivers to patients, who had undergone open heart surgery. A semi-structured interview guide was used during videotelephony (Facetime), phone or face-to-face onsite interview. The settings were university hospitals in Norway and Denmark respectively and were carried out between November 2022 – January 2023. Data analysis in NVivo software tool, following Braun and Clarke`s 6-step thematic analysis process.

Results
A total of 12 informal caregivers, married or partnered, two men, mean age 65 years, were interviewed two to four weeks after the patient had been discharged to home following open heart surgery. Two main themes were identified: i) lack of preoperative information and ii) responsibility to chase for in-hospital communication. Informal caregivers must invite themselves to gain access to information before admission. Informal caregivers experienced being a team with the patient before admission and then be separated in the health care system. The information and communication were targeted to the patient. Therefore, it was necessary for informal caregivers to be communicatively strong and thereby force doors open to get needed information for themselves. For some informal caregivers it was manageable while others felt lost and withdrew.

Conclusion(s)
Informal caregivers to patients undergoing open heart surgery want to be part of the information process before and during hospital admission. They want to be in a team with the patient, but it requires an active invitation from health care professionals.
The role of the icc coordinator within the NHS-SUD pilot project
Authors: Neculau G , Frampton K 
Published: July 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Inherited Cardiac Conditions services across the country provide excellent care to families affected by sudden unexpected death, with many Coroners and Pathologists facilitating appropriate referrals and retention of post mortem tissue samples for future genetic testing. However, service provision varies greatly resulting in missed opportunities for tissue retention, signposting to ICC services and disparities in clinical screening. To ensure this gap is closed, the seven NHS Genomic Medicine Service Alliance (GMSA) regions have partnered with the British Heart Foundation to recruit seven ICC coordinators, tasked with coordinating the delivery of a nationally standardised NHS - Coronial Sudden Unexpected Death (SUD) pilot pathway.

Methods
The ICC coordinator’s main role is to improve the processes and collaboration between the Coronial and their nearest ICC service, increase the number of affected families who are assessed in an NHS ICC service and facilitate genomic counselling and testing at the beginning of the pathway. ICC nurses and genetic counsellors have been recruited into these posts. Their unique skillsets and existing links with pathologists, coroners, coroner officers, families, nurses, geneticists, support groups and cardiologists maximises the deliverables for the duration of the pilot.

Results
30 cases of sudden unexplained deaths eligible for entry into the pilot have been signposted and 65 at risk family members have been identified by the seven sites. Some of the most notable results have been facilitation of family referrals, cardiac-genomic counselling, and timely results dissemination. Furthermore, ICC Coordinators have established relationships and delivered training to pathologists, coroner officers and local MDTs, ensuring consistent pathway delivery. Genomic samples are tracked and transferred to the regional genomic laboratory hubs in a standardised manner. Collaboration with external evaluators is ongoing and methods of data capture have been established.

Conclusion
To ensure national delivery and equitable access to genomic testing, the ICC coordinator role is vital to each ICC service and coronial network. We have highlighted some of the unique skills and relationships needed for a national rollout. Following the outcome of the project evaluation, this role can be expanded to other cardiac nurses and genetic counsellors in other regions.