bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enlarged dimensions of cardiac chambers and the root of the aorta as a significant cardiovascular impact of pandemic COVID-19: a population-based study
Authors: Chlabicz M , Dubatowka M , Jamiolkowski J , Szum-Jakubowska A , Solomacha S , Zieleniewska N , Sowa P , Lawicki S , Szpakowicz A , Ptaszynska-Kopczynska K , Moniuszko-Malinowska A M , Kaminski K A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): National Centre of Science.

Background
The long-term complications in the cardiovascular (CV) system that the acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may cause are not fully understood. The aim of the study was to assess the impact of a coronavirus disease of 2019 (COVID-19) pandemic on echocardiographic (ECHO) and electrocardiographic (ECG) parameters.

Methods
This was single-center prospective cohort study. The study population consisted of 2 groups: the group before the COVID-19 pandemic (713 probands tested from 18. March 2018 to 17. March 2020) compared to the group during the COVID-19 pandemic (425 probands tested from 14. July 2020 to 02. March 2022). The comprehensive assessment was performed including laboratory parameters, ECHO and ECG.

Results
The studied populations did not differ by sex, age, body mass index and systolic blood pressure (BPs), while diastolic BP (BPd) was significantly lower in the group during the COVID-19 pandemic (p&lt;0.001). In the group during COVID-19 the dimensions of all cardiac chambers, i.e., left atrial dimension (p&lt;0.001), left atrial volume index (LAVI) (p&lt;0.001), right atrial volume (p&lt;0.001), left ventricular dimension (p=0.013), right ventricular dimension (p=0.046) and aortic root dimension (p=0.001) were larger compared to the pre-pandemic population. The ECG showed longer P-wave (p=0.022), PQ segment (&lt;0.001) and QRS complex durations (p=0.042) in the pandemic population compared to the pre-pandemic population. In contrast, there was no significant statistical difference between the analyzed groups in terms of left ventricular hypertrophy (LVH) assessed by ECHO or ECG criteria. In addition, N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations was significantly higher in the population during COVID-19 (p=0.011).

Conclusion
SARS-CoV-2 has had an impact on the cardiovascular system by increasing the size of all heart chambers and the root of the aorta which may have deleterious effects in the future. Careful monitoring of long-term effects is needed.
Sleep quality and sleep disorders in patients with acute coronary syndrome
Authors: Sanchez Sanchez C , Mora Robles J , Larrubia Valle J I , Moncada Ventura A M , Urbano Carrillo C A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Sleep disorders have been considered risk factors for cardiovascular diseases, and poor sleep quality has become a common complaint in patients with coronary artery disease. Despite being a very common problem in these patients, it is not yet routinary studied and reflected in the clinical practice guidelines.

Purpose
To study the prevalence and type of sleep disorders in patients with acute coronary syndrome (ACS).

Methods
This study was a quantitative, descriptive, cross-sectional investigation. We included patients admitted for ACS (unstable angina, STEMI, NSTEMI, MINOCA,...) during the period from June to October 2022. The patients were interviewed, collecting the following information: Demographic variables (age, sex, marital status), classic cardiovascular risk factors (hypertension, diabetes mellitus, dyslipidemia), presence or absence of a diagnosis of Obstructive Sleep Apnoea (OSA), as well as treatment or not with CPAP, toxic habits (tobacco, alcohol, other drugs), need for sleep medication and sleep quality using the Pittsburgh Sleep Quality Index (PSQI), which is a validated self-rated questionnaire that assesses sleep quality and sleeps disturbance over the past month.

Results
We included 46 patients in our study. The mean age was 68,85 years (SD 11,88), 69,56% were male and 60,87% were married. The main reason for admission was NSTEMI. The distribution of risk factors was: High blood pressure 78,26%, Diabetes Mellitus 36,96%, dyslipidemia 63,04%, smoking 21,74%, drinking alcohol habitually 19,57%, and other drugs abuse 4,35%. The prevalence of OSA was 17,39%. Overall, the mean PSQI score of all participants was 8,98 (SD 4,73). The most affected sleep component was ‘Sleep disturbance’ (mean score 1,76/3), followed by ‘Sleep latency’ (1,5/3) and ‘Sleep duration’ (1,48/3). 34,78 % referred use of sleep medication and 41,30% had daytime dysfunction. Table 1 shows the results in PSQI related to the reason for hospitalization.

Conclusions
Sleep disorders and poor sleep quality are remarkably prevalent in our cohort of ACS patients, which could be considered as a possible added cardiovascular risk factor or risk modifier. We consider the proactive investigation of sleep disorders useful in clinical practice as we can develop strategies to improve sleep and reduce residual cardiovascular risk and quality of life.
Risk factor clustering in men and women with CHD in the Southern Cone of Latin America
Authors: Marza Florensa A , Gutierrez L , Gulayin P , Vaartjes I , Grobbee D E , Klipstein-Grobusch K , Irazola V 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): This work was supported by the National Heart, Lung, and Blood Institute (NHLBI) grant number HHSN268200900029C.

Background
Presence of multiple risk factors (RF) increases the risk for cardiovascular morbidity and mortality, and this is especially important in patients with coronary heart disease (CHD).

Purpose
The current study investigates sex differences in the presence of multiple cardiovascular RF in subjects with established CHD in the southern Cone of Latin America.

Methods
We analyzed cross-sectional data from the 634 participants aged 35-74 with CHD from the community-based CESCAS Study. We calculated the prevalence for counts of cardiometabolic (hypertension, dyslipidemia, obesity, diabetes) and lifestyle (current smoking, unhealthy diet, low physical activity, excessive alcohol consumption) RF. Differences in RF number between men and women were tested with age-adjusted Poisson regression. We identified the most common RF combinations among participants with ≥ 4 RF. We performed a subgroup analysis by educational level.

Results
The prevalence of cardiometabolic RF ranged from 76.3% (hypertension) to 26.8% (diabetes), and the prevalence of lifestyle RF from 81.9% (unhealthy diet) to 4.3% (excessive alcohol consumption). Obesity, central obesity, diabetes and low physical activity were more common in women, while excessive alcohol consumption and unhealthy diet were more common in men. Close to 85% of women and 81.5% of men presented with ≥ 4 RF. Women presented with a higher number of overall (relative risk (RR) 1.05, 95% CI 1.02-1.08) and cardiometabolic RF (1.17, 1.09-1.25). These sex differences were found in participants with primary education (RR women overall RF 1.08, 1.00-1.15, cardiometabolic RF 1.23, 1.09-1.39), but were diluted in those with higher educational attainment. The most common RF combination was hypertension/dyslipidemia/obesity/unhealthy diet.

Conclusion
Women in the CESCAS study showed a higher burden of multiple cardiovascular RF. Sex differences persisted in participants with low educational attainment, and women with low educational level had the highest RF burden.
Medication use by insurance coverage in subjects with coronary heart disease in the Southern Cone of Latin America
Authors: Marza Florensa A , Gutierrez L , Gulayin P , Klipstein-Grobusch K , Grobbee D E , Vaartjes I , Irazola V 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): This work was supported by the National Heart, Lung, and Blood Institute (NHLBI) grant number HHSN268200900029C.

Background
Clinical guidelines recommend cardioprotective medication use in coronary heart disease (CHD) patients. Underuse of these drugs is common among patients of low resources, which may be explained by insufficient access in the public sector.

Aim
We aim to assess medication use and barriers to care by insurance coverage in subjects with CHD in the Southern Cone of Latin America.

Methods
We analysed cross-sectional data from 593 participants with CHD residing in Argentina, Chile and Uruguay, within the CESCAS community-based cohort study. Participants were categorized as covered by public insurance only or having additional coverage (social security or private insurance).
We calculated the prevalence of recommended medications use, mean number of medications, use of ≥ 1 and ≥ 2 drugs, and reported barriers to needed care in insured and uninsured participants. Differences between coverage groups were assessed with univariable and multivariable analysis (logistic and Poisson regression) adjusted by age, sex, previous revascularization, educational level and barriers.

Results
Medication use ranged from 39.8% (lipid-lowering) to 84.1% (antihypertensives). Mean number of medications was 1.8 (SE 0.1), 95.4% used ≥ 1 drugs, and 59.8% used ≥ 2 drugs. There were no significant differences by coverage in medication use, except for higher ACE-inhibitor and nitrate use among participants in the public sector (35.8% vs. 53.2%, p=0.001; and 1.5% vs. 5.2%, p=0.047 respectively). In the multivariable analysis, having public coverage only was not significantly associated with medication use, but it was with reporting barriers to care (OR 2.06, 95% CI 1.21-3.52).

Conclusion
Insurance coverage was not associated with the use of most medications in CHD patients in the Southern Cone of Latin America, possibly due to public health programs providing them free of charge. Uninsured participants more often face barriers to access medical care, and future studies should address these healthcare inequalities.
Dysrhythmic profile of inotropic therapy in patients with acute coronary syndrome
Authors: Rocha De Almeida A , Carias De Sousa M , Congo K , Trinca M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Patients with acute coronary syndrome (ACS) may develop ventricular dysfunction and need to use drugs with a positive inotropic effect, during the acute phase. Despite the hemodynamic benefit of the use of these drugs, positive inotropic drugs may have several side effects, including ventricular tachycardia (VT)and atrial fibrillation (AF).
AF can complicate the management of patients with ACS, since these patients need intense antiplatelet therapy, and in the case of AF, it may have to be associated with anticoagulant therapy, thereby increasing the bleeding risk. The clinical significance of AF during an acute event remains to be ascertained.

Purpose
This study aims to assess the frequency of occurrence of dysrhythmic complications with the use of positive inotropic drugs in patients hospitalized for ACS.

Methods
We performed a 6-year retrospective, observational, multicenter study. We included patients with ACS who used positive or not inotropic drugs during hospitalization, dividing the sample into two groups respectively (Group 1 and Group 2). Between the two groups we compared the occurrence of ventricular tachycardia and atrial fibrillation. In addition, we performed an analysis for the use of levosimendan.

Results
We analyzed a sample of 5860 patients. Of these, 70.3% were male. In Group 1 we included 377 patients and in Group 2 5329 patients. The occurrence of VT in Group 1 was higher than in Group 2 (15.5% vs 1.6%; p&lt;0.001; OR: 11.472; 95% CI [8.212;16.027]). The rate of occurrence of AF in Group 1 was higher than in Group 2 (19.3% vs 5.1%; p&lt;0.001; OR:4.413; 95% CI [3.388;5.749]). Regarding the use of levosimendan, 50 patients were analyzed. VT was more frequent with the use of this drug than without it (18.0% vs 2.5%; p&lt;0.001; OR: 8.576 95% CI [4.092;17.976]). Atrial fibrillation was more frequent with levosimendan use than with no use (34.0% vs 6.0%; p&gt;0.001; OR: 8.137; 95% CI [4.487;14.754]).

Conclusion
Arrhythmic complications were much more frequent in the group that used positive inotropic drugs, namely VT and AF. Levosimendan stands out, related to the increase in the occurrence of AF and the remaining inotropes with an increased risk of VT. These arrhythmic complications pose a challenge in the management of these patients, as in patients with ACS, the use of Levosimendan is associated with more episodes of AF, and might complicate the antithrombotic therapy strategy choice.
Cardiopreventive effect of Klotho protein on oxidative stress, inflammation and apoptosis during cardiac ischemia/reperfusion injury
Authors: Olejnik A , Kaminska M , Radajewska A , Krzywonos-Zawadzka A , Bil-Lula I 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Science Centre, Poland.

Background
The injury of the myocardium during ischemia/reperfusion (IRI) involves metabolic, morphological and contractile disorders [1]. Klotho is a membrane or soluble anti-aging protein. Recent studies have proven the correlation of Klotho deficiency and the occurrence and development of cardiovascular diseases [2].

Purpose
This study aimed to evaluate the effect of Klotho protein supply on oxidative stress, inflammation and apoptosis in hearts subjected to IRI.

Methods
Isolated Wistar rat hearts perfused with the Langendorff method were subjected to ischemia, followed by reperfusion, in the presence or absence of Klotho protein. Hemodynamic parameters, and the levels of nitrate/nitrite (NOX)-, glutathione peroxidase (GPx), superoxide dismutase (SOD), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-Κb), nuclear factor of activated T-cells, cytoplasmic 1 (NFATc1), interleukin-6 (IL-6), matrix metalloproteinase 2 (MMP-2), cytochrome c (cyt c) and caspase-9 were evaluated.

Results
Infusion supply of Klotho during IRI resulted in a recovery of contractile function (p=0.031) and heart rate (p=0.02). Klotho protein contributed to increase in the production of GPx (p=0.045) and SOD (p=0.006). The levels of (NOX)- (p=0.022), NF-Κb (p=0.006), NFATc1 (p=0.027), IL-6 (p=0.002), MMP-2 (p=0.008), cyt c (p=0.0002) and caspase-9 (p=0.009) were decreased in the IRI+Klotho group, as compared to the IRI group.

Conclusions
Klotho protein preserved heart mechanical function, enhanced antioxidant capacity, and reduced inflammation and apoptosis in the injured heart. Thus, Klotho can be recognized as a novel cardiopreventive/cardioprotective agent in ischemic damage.
Cardiac rehabilitation in older populations - never too late to rehabilitate
Authors: Gregorio C , Aguiar-Ricardo I , Alves Da Silva P , Cunha N , Martins A M , Abrantes A , Rodrigues M C , Afonso G , Araujo G , Miguel Correia S , Pinto F J , Abreu A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Age is one of the most determinant cardiovascular risk factors and the prevalence of cardiovascular disease is higher after 70 years old. Referral to cardiac rehabilitation programs for elder individuals is often overlooked since such patients are deemed as frail, high risk and may show lack of competence when attending these programs.

Purpose
To assess differences in clinical characteristics and outcomes between pts &gt;70 years old with younger ones.

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. We analysed prevalence of risk factors, lab echocardiographic and CPET data in women who were enrolled in the program. Statistical analysis was performed with Chi-square and Wilcoxon tests.

Results
From a pool of 349 patients, only 74 (21%) were 70 or more years old. In this group most of pts were male (90,5%), mean age of 75,2 +- 4,34 year-old. 90% pts had arterial hypertension (n=67), 76% had dyslipidemia, 34% were diabetic and 57,5% were smokers or past smokers. Most patients were in NYHA II (64,2%) and the remainder in NYHA I (29,9%) and III (6%). Mean ejection fraction was 52 +- 14%. NTproBNP in first evaluation 1335 pg/mL, LDL-c 80,4mg/dL and HDL 46,8%. Both groups (&lt;70 and &gt;70years) were relatively homogeneous, except for differences in sex (male sex mor prevalent (p=0.019) and hypertension (p=0.006). Interestingly there were no significant differences in both groups regarding hospital admissions, rate of reinfarction and cardiovascular death. In both groups we noted a significant improvement in echo and CPET, reaching statistical significance in ejection fraction variation (p=0.01), duration of CPET (p=0.048) workload peak; however, in contrast to younger patients, VO2 peak improvement was non significative.

Conclusions
Although there is a higher prevalence in cardiovascular disease among older people, CR referral is far lower. As we can see, such interventions are safe and effective also in older pts and thus we should identify factors going against their inclusion in CR programs and prioritize risk stratification.
Cardiac Rehabilitation in Covid Era: was it equally effective?
Authors: Abrantes A , Aguiar-Ricardo I , Alves Da Silva P , Martins A M , Gregorio C , Sousa P , Fiuza S , Caldeira E , Belo A , Rodrigues M C , Pinto F J , Abreu A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Cardiac rehabilitation is currently described as a mainstay when it comes to treatment of cardiac patients (pts), mainly ischemic heart disease. Despite this, referral and implementation suffered a decrease amidst covid outbreak.

Purpose
To describe, in a cardiac rehabilitation center, the real life data regarding programme effects during covid pandemic and after the release of most sanitary measures.

Methods
Prospective cohort study which included consecutive pts who were participating in a center-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 psychologist and educational sessions. Lab tests, echocardiogram and CPET were done before and after completion of the program.

Results
We analyzed 349 patients, mean age 60 ± 11,14 years, 83% male, most of them referred because of ischemic heart disease (83,6%), followed by valvular heart disease (7,0%). Mean ejection fraction was 48,4 ± 12,8 and most patients were in NYHA class II (65,1%). After program completion we noticed a clear benefit regarding functional class (NYHA before and after CRP: NYHA I 25,7% vs 63,7%; NYHA II 65,1% vs 34,5%; NYHA III 9,2% vs 1,9%; p&lt;0.05), although differences in weight and body mass index were non significant. Laboratorial data also showed a favourable and significant improvement: NTproBNP 1068±752 pg/mL vs 498±764 (p&lt;0.001); LDL-c 84±35,4 vs 70,6±30,2 (p=0.001); HDL-c 44,7±12,1mg/dL vs 46,8±10,4mg/dL (p=0.001); Triglycerides 126,9±66,6mg/dL vs 116,9±51,8mg/dL (p=0.34); HbA1c 6,07 vs 6,06 % (p=0.89). The significant differences in cholesterol were seen even after adjusting for statin dosage.

Conclusions
Despite constraints in CR programs during the pandemic, the long term data shows that maintaining such programs has an important effect when it comes to risk factor control and clinical improvement.
Klotho and FGF23 proteins levels and occurrence of myocardial infarction in patients with acute coronary syndrome
Authors: Olejnik A , Plonka J , Gierlotka M , Bil-Lula I 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Wroclaw Medical University, Poland.

Background
Klotho is a transmembrane and secretory protein, and acts as a co-receptor for fibroblast growth factor 23 (FGF23). Recent studies have underlined the importance of Klotho in renal disorders, where Klotho deficiency served as an early biomarker and therapeutic target [1]. Disrupted levels of Klotho and FGF23 were associated with cardiovascular disease [2].

Purpose
This study aimed to analyze the level and role of Klotho and FGF23 proteins in patients during an episode of myocardial infarction (MI).

Methods
This study consisted of 159 patients admitted by the Department of Cardiology between 2013 and 2021. The study group comprised 129 patients diagnosed with acute coronary syndrome (ACS), who were referred for further invasive diagnosis (MI group). Blood samples were collected immediately after invasive diagnostic (t0) and between 24-48 h post-procedure (t1). The criteria for the control subjects (n=30) were no declaration of past MI and no ACS based on the examination conducted on admission (no MI group).

Results
The level of Klotho protein in the MI group was increased at t0 (median=622.3 pg/ml; p=0.029), and then normalized at t1 (median=510.3 pg/ml; p=0.893), as compared to no MI patients (median=502.3 pg/ml). The level of FGF23 protein in the MI group was higher at t0 (median=384.6 pg/ml; p=0.03), and continued to increase at t1 (median=825.8 pg/ml; p&lt;0.0001), as compared to no MI patients (median=158.3 pg/ml). ROC analysis showed moderate accuracy for Klotho at t0 (AUC=0.633; p=0.043) and FGF23 at t0 (AUC=0.651; p=0.03), and high accuracy for FGF23 at t1 (AUC=0.866; p&lt;0.0001).

Conclusions
The level of Klotho and FGF23 proteins are higher in patients with MI compared to the healthy population. Thus, Klotho and FGF23 can be recognized as potential biomarkers for MI in patients with ACS. The high diagnostic power of FGF23 level 24-48 h post-MI creates a great diagnostic and clinical usefulness of this parameter.