bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case report: large left ventricular aneurysm with contained rupture and haemopericardium
Authors: Willett Aimee , Glenn Zachary , Rose-Malkamäki Madison , Arshi Arash 
Published: May 2023

Abstract

Background
Recent advancements in cardiology have significantly decreased the incidence of post-myocardial infarction mechanical complications. When these sequelae occur, they can have high morbidity and mortality and may require aggressive intervention.

Case summary
We describe a case of contained rupture of a large left ventricular aneurysm (LVA) presenting with syncope in a 60-year-old male with late presentation myocardial infarction (MI) 6 weeks prior on home triple antithrombotic therapy (TAT). Urgent pericardiocentesis along with imaging techniques including ultrasound, computed tomography angiography (CTA), and cardiac magnetic resonance imaging (MRI) were used for initial diagnosis. Definitive treatment was achieved with excision and repair of the LVA with return to prior functional status 1 month after intervention.

Discussion
Highlights of this report emphasize the importance of differential diagnosis consideration of LVA with contained rupture in patient populations with prior late presentation MI and TAT. High clinical suspicion and thorough diagnostic workup with appropriate imaging are important to guide appropriate treatment interventions.
Reflections on teaching Derek Walcott’s Omeros: slow reading approaches to the postcolonial epic
Authors: Sazzad Rehnuma 
Published: May 2023

Abstract
Through slow reading Walcott’s Omeros, this article contributes to three different discursive fields that illustrate various techniques associated with the slow reading: innovative pedagogical practice, Walcott scholarship, and postcolonial and diasporic writings. This article particularly focuses on how Walcott’s epic generates a tacit invitation for the serene acceptance of the stranger, since it is part of the postcolonial, diasporic, and historical reality of the contemporary world.
Modifiable cardiovascular risk factors and genetics for targeted prevention of dementia
Authors: Juul Rasmussen Ida , Frikke-Schmidt Ruth 
Published: May 2023

Abstract
Dementia is a major global challenge for health and social care in the 21st century. A third of individuals &gt;65 years of age die with dementia, and worldwide incidence numbers are projected to be higher than 150 million by 2050. Dementia is, however, not an inevitable consequence of old age; 40% of dementia may theoretically be preventable. Alzheimer’s disease (AD) accounts for approximately two-thirds of dementia cases and the major pathological hallmark of AD is accumulation of amyloid-β. Nevertheless, the exact pathological mechanisms of AD remain unknown. Cardiovascular disease and dementia share several risk factors and dementia often coexists with cerebrovascular disease. In a public health perspective, prevention is crucial, and it is suggested that a 10% reduction in prevalence of cardiovascular risk factors could prevent more than nine million dementia cases worldwide by 2050. Yet this assumes causality between cardiovascular risk factors and dementia and adherence to the interventions over decades for a large number of individuals. Using genome-wide association studies, the entire genome can be scanned for disease/trait associated loci in a hypothesis-free manner, and the compiled genetic information is not only useful for pinpointing novel pathogenic pathways but also for risk assessments. This enables identification of individuals at high risk, who likely will benefit the most from a targeted intervention. Further optimization of the risk stratification can be done by adding cardiovascular risk factors. Additional studies are, however, highly needed to elucidate dementia pathogenesis and potential shared causal risk factors between cardiovascular disease and dementia.
Prevalence of myocardial injury in patients after acute ischaemic stroke according to standard criteria
Authors: Mihalovic Michal , Mikulenka Petr , Línková Hana , Neuberg Marek , Štětkářová Ivana , Peisker Tomáš , Lauer David , Tousek Petr 
Published: May 2023

Abstract
This study examined the prevalence of acute and chronic myocardial injury according to standard criteria in patients after acute ischaemic stroke (AIS) and its relation to stroke severity and short-term prognosis. Between August 2020 and August 2022, 217 consecutive patients with AIS were enrolled. Plasma levels of high-sensitive cardiac troponin I (hs-cTnI) were measured in blood samples obtained at the time of admission and 24 and 48 h later. The patients were divided into three groups according to the Fourth Universal Definition of Myocardial Infarction: no injury, chronic injury, and acute injury. Twelve-lead ECGs were obtained at the time of admission, 24 and 48 h later, and on the day of hospital discharge. A standard echocardiographic examination was performed within the first 7 days of hospitalization in patients with suspected abnormalities of left ventricular function and regional wall motion. Demographic characteristics, clinical data, functional outcomes, and all-cause mortality were compared between the three groups. The National Institutes of Health Stroke Scale (NIHSS) at the time of admission and the modified Rankin Scale (mRS) 90 days following hospital discharge were used to assess stroke severity and outcome. Elevated hs-cTnI levels were measured in 59 patients (27.2%): 34 patients (15.7%) had acute myocardial injury and 25 patients (11.5%) had chronic myocardial injury within the acute phase after ischaemic stroke. An unfavourable outcome, evaluated based on the mRS at 90 days, was associated with both acute and chronic myocardial injury. Myocardial injury was also strongly associated with all-cause death, with the strongest association in patients with acute myocardial injury, at 30 days and at 90 days. Kaplan–Meier survival curves showed that all-cause mortality was significantly higher in patients with acute and chronic myocardial injury than in patients without myocardial injury (P &lt; 0.001). Stroke severity, evaluated with the NIHSS, was also associated with acute and chronic myocardial injury. A comparison of the ECG findings between patients with and without myocardial injury showed a higher occurrence in the former of T-wave inversion, ST segment depression, and QTc prolongation. In echocardiographic analysis, a new abnormality in regional wall motion of the left ventricle was identified in six patients. Chronic and acute myocardial injury with hs-cTnI elevation after AIS are associated with stroke severity, unfavourable functional outcome, and short-term mortality.
Triggers, characteristics, and hospital outcome of patients with Takotsubo syndrome: 10 years experience in a large university hospital centre
Authors: Polednikova Karolina , Kozel Martin , Linkova Hana , Novackova Marketa , Trinh Minh Duc , Tousek Petr 
Published: May 2023

Abstract
A unique clinical feature of Takotsubo syndrome (TTS) is the stress trigger factor. Different types of triggers exist, generally divided into emotional and physical stressor. The aim was to create long-term registry of all consecutive patients with TTS across all disciplines in our large university hospital. We enrolled patients on the basis of meeting the diagnostic criteria of the international InterTAK Registry. We aimed to determine type of triggers, clinical characteristics, and outcome of TTS patients during 10 years period. In our prospective, academic, single centre registry, we enrolled 155 consecutive patients with diagnoses of TTS between October 2013 and October 2022. The patients were divided into three groups, those having unknown (n = 32; 20.6%), emotional (n = 42; 27.1%), or physical (n = 81; 52.3%) triggers. Clinical characteristics, cardiac enzyme levels, echocardiographic findings, including ejection fraction, and TTS type did not differ among the groups. Chest pain was less common in the group of patients with a physical trigger. On the other hand, arrhythmogenic disorders such as prolonged QT intervals, cardiac arrest requiring defibrillation, and atrial fibrillation were more common among the TTS patients with unknown triggers compared with the other groups. The highest in-hospital mortality was observed between patients having physical trigger (16% vs. 3.1% in TTS with emotional trigger and 4.8% in TTS with unknown trigger; P = 0.060). Conclusion: More than half of the patients with TTS diagnosed in a large university hospital had a physical trigger as a stress factor. An essential part of caring for these types of patients is the correct identification of TTS in the context of severe other conditions and the absence of typical cardiac symptoms. Patients with physical trigger have a significantly higher risk of acute heart complications. Interdisciplinary cooperation is essential in the treatment of patients with this diagnosis.
Health promotion interventions in informal caregivers and their impact on health promoting behaviors in patients with cardiovascular disease
Authors: Kurpas D , Szlenk-Czyczerska E 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Health behaviors are considered a key element in the prevention of cardiovascular disease. Less than optimal self-care for cardiovascular disease is associated with adverse health outcomes and lower quality of life. Support from an informal caregiver is important for patients with cardiovascular disease. The caregiver, as the person who directly cares for the chronically ill patient, has the greatest influence on the development of the patient's attitude toward health.

Purpose
The purpose of this study was to analyze the factors that influence the intensity of health behaviors among informal caregivers of patients with cardiovascular disease and to evaluate the effects of health-promoting interventions among caregivers on the health behaviors of their charges.

Methods
The study was conducted with 193 patients with chronic cardiovascular disease and their 161 informal caregivers. The author interviewed them using a questionnaire and the Health Behavior Inventory (HBI). Spearman's rank correlation coefficient test and logistic regression were used for the analyzes.

Results
The strongest predictors influencing lower health behavior expression in informal caregivers were male gender (p &lt; 0.001), level of relationship with patient (p = 0.016), professional activity (p = 0.028), lack of expectations of the PHC physician (p = 0.028), family nurse practitioner (p = 0.003), and social worker (p = 0.008), and lower client health care efficiency (p = 0.036). Higher severity of caregiver health behaviors was associated with higher odds of better client health care efficiency (odds ratio (OR) 1.60 (1.06;2.56).

Conclusions
Comprehensive caregiver education using modern technologies (Internet) and advanced ICT systems to promote health behaviors and specifically for the above caregivers could provide innovative solutions to promote and sustain health behavior change in patients with cardiovascular disease. A breakthrough is now needed in health and social care, where digital health solutions show promise but have not yet been fully implemented.
Left atrial strain as an independent predictor of sinus rhythm maintenance after catheter ablation for paroxysmal atrial fibrillation in HFpEF patients
Authors: Katbeh A S I M , De Potter T , Geelen P , Van Camp G , Vanderheyden M , Bartunek J , Penicka M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The early AF treatment by radio-frequency catheter ablation is very important for improving clinical outcome in patients with history of atrial fibrillation (AF) and heart failure with preserved ejection fraction (HFpEF). Left atrial (LA) strain showed to be a useful index to monitor atrial function in AF and HFpEF states. However, the accuracy of LA strain to predict the long-term maintenance of sinus rhythm (SR) in HFpEF patients with paroxysmal AF undergoing catheter ablation is still under debate.

Aims
To define the best echocardiography derived parameters to predict the long-term maintenance of SR in paroxysmal AF patients with high probability of HFpEF undergoing catheter ablation.

Methods
We prospectively enrolled (between September 2017 and May 2019) 200 consecutive patients (62 ± 10 years, 58% males) with dyspnea (NYHA≥II), paroxysmal AF and preserved LV ejection fraction (≥50%). All patients had a H2FPEF score suggesting high probability of HFpEF. During sinus rhythm, all patients underwent comprehensive transthoracic echocardiography at baseline, including assessment of left ventricular (LV) global longitudinal strain (GLS), left atrial (LA) reservoir strain (LASr), LA conduit strain (LAScd) and LA contractile strain (LASct) using two-dimensional speckle tracking in apical views.

Results
After 42+/-8 months follow-up, a total of 34 (17%) patients had a documented recurrence of AF. Patients with AF recurrence had lower LASr (22.2% vs. 28.3%, p &lt; 0.001) and LASct (10.9% vs. 13.2%, p &lt; 0.01) compared to patients who keep on SR. Among speckle tracking derived LA phasic strain indices, LASr showed the largest area under the curve (AUC = 0.8, p &lt; 0.001) and the strongest independent predictive value (LASr &gt; 22%) of long-term maintenance of SR with sensitivity of 80% and specificity of 66% (Figure 1). Other parameters of LA function, LA diameter, maximum or minimum LA volume index, LV GLS or ejection fraction, and indices of LV diastolic function had lower area under the curve. Using multivariable logistic regression, only LASr (OR 0.89, 95% CI 0.81-0.97, p=0.013) was independently associated with long-term SR maintenance while other LA size and function indices were not.

Conclusion
In HFpEF patients with paroxysmal AF undergoing catheter ablation, LASr is more accurate predictor of SR maintenance than other standard echocardiographic parameters in long-term follow-up.
Figure 1: Receiver-operating characteristic curves of left atrial reservoir strain (LASr), LA conduit strain (LAScd) and LA contractile strain (LASct), LA emptying fraction (LAEF), LA expansion index (LAEI), LA end-systolic (LAES) and end-diastolic (LAED) volume index (VI) to predict long-term maintenance of sinus rhythm.
Impact of wearable devices with feedbacks for increasing daily walking activity and physical capacities in cardiovascular patients: a meta-analysis of randomized controlled trials
Authors: Heizmann A , Chapelle C , Laporte S , Roche F , Hupin D , Le Hello C 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Despite the known benefits of physical activity, patients with cardiovascular disease do not practice enough nor maintain a regular physical activity for their health [1-4] . Walking is one of the easiest ways to stay physically active and can be implemented easily in everyday life [5]. Wearable physical activity monitoring devices have the potential to help increase physical activity through self-monitoring and feedback.

Purpose
To review randomized controlled trials using wearable physical activity monitoring device as an intervention to increase daily walking activity and improve physical capacities in cardiovascular diseases (CVD) patients.

Methods
Design: Systematic review and meta-analysis of randomized controlled trials (RCTs).
Data Sources: PubMed, Embase, Web of Science.
Eligibility criteria: Randomized controlled studies including patients over 18 years of age with CVD comparing an intervention group using a wearable physical activity monitoring device with feedback to usual care or to a control group receiving no feedback on their physical activity and reporting a change in the daily number of steps and/or a change in the distance covered in the 6-minute walking test (6MWT) or a change in peak oxygen uptake (VO2 peak).
Outcomes: Primary outcome was daily number of steps, secondary ouctomes were distance covered in the 6-minute walking test (6MWT) and/or peak oxygen uptake (VO2 peak).

Results
Sixteen RCTs were included. The intervention of wearing a physical activity monitoring device with feedback significantly improved daily number of steps compared with controls (standardized mean difference ((SMD) 0.85; 95% CI [0.42; 1.27], p &lt; 0.01). The effect was greater when the duration of the intervention was less than 3 months (SMD 1.0; 95% CI [0.18; 1.82], p &lt; 0.01) than when the duration of the intervention was 3 months or longer (SMD 0.71; 95% CI [0.27; 1.16], p &lt; 0.01) but no significant interaction was found between subgroups (p = 0.55). Six MWT distance and VO2 peak showed only small effects (SMD 0.34 (95% CI [-0.11; 0.80], p = 0.02) and SMD 0.53 (95% CI [0.03; 1.03], p = 0.07), respectively).
Usefulness of impedanciometry for the assessment of obesity in a high risk dyslipidemia screening unit
Authors: Navarro Melero S , Duran Torralba C , Cortez Quiroga G A , Cubillas Quero A , Huertas Escribano M J , Rus Mansilla C 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Residual risk is related to future events in already treated patients. In addition, obesity increases cardiovascular risk. Body mass index (BMI) is the OMS-defined measure for the diagnosis of obesity, but not the only one, as body fat percentage (%BF) allows a more accurate estimation of visceral fat.

Objective
To identify the clinical utility of adding body fat percentage (%BF) measured by impedanciometry to the assessment of obesity, and to compare the residual lipid profile of obese versus non-obese patients according to the measurement methods.

Methods
Prospective observational study, which analysed 213 patients included in a High Risk Dyslipidemia Screening Unit. Three groups were classified: group A (BMI &lt;30 and %BF &lt;25%-35% according to gender; group B (BMI &lt;30 but %BF ≥25% -35%) and group C (BMI ≥30 and %BF ≥25-35%). Clinical characteristics, screening unit inclusion variables and residual lipid profile were analysed, as well as the association with early coronary heart disease and with the development of cardiovascular disease among the three groups.

Results
Of the 213 patients included, 91 belonged to Group A (non-obese patients), 80 belonged to Group C (obese according to BMI and %BF) and 42 patients belonged to Group B (classified as obese according to %BF but with BMI &lt;30). When comparing the three groups, it was observed that the patients in group B had a residual lipid profile more similar to that of group C patients. They had higher levels of TG, remnant cholesterol and VLDL; with lower levels of HDL (p&lt;0.05), with no statistically significant differences in the levels of Lp(a), ApoB, LDL and non-HDL in relation to those in group A. Fifty percent of group B patients developed coronary heart disease, compared to 56% of group C and 36% of group A patients (p= 0.029). There were no differences in the development of early coronary heart disease. There were 31.6% of patients with BMI&lt;30 who were reclassified as obese according to %BF. If we classified the obese according to BMI, 45.5% developed cardiovascular disease and 45.2% developed early coronary heart disease. If we reclassify the obese according to %BF, the percentage rises to 65.7% and 65.6% respectively. All data are shown in table 1.

Conclusion
Adding the % of BF by impedanciometry for the diagnosis of obesity in a high risk dyslipidemia screening unit allows the identification of an important percentage of patients with a higher cardiovascular risk and a worse residual lipid profile. BMI is insufficient as a single parameter for the assessment of obesity and for stratifying cardiovascular risk.
The impact of cardiac SPECT in risk stratification for women with suspected coronary artery disease in a very high cardiovascular risk country
Authors: Vitola B , Mintale I , Trusinskis K , Erglis A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Risk stratification has become increasingly important in the management of women with coronary artery disease (CAD). Population based cross-sectional study of cardiovascular risk (CVR) factors in Latvia revealed that women in age 25 -74 are in a very high CVR group: more than 60% of women have dyslipidemia, 30% have arterial hypertension (AH) and are overweight.

Purpose
To evaluate CVR factor profile in women with suspected CAD and performed cardiac single photon emission computed tomography (SPECT) and to prove the need of perfusion imaging for women in a very high cardiovascular risk population.

Methods
Cardiac SPECT for women with suspected CAD and positive or non-informative exercise test was performed in a single center from 2018 till 2022. The patients were analyzed by risk factors and perfusion test result, divided into 2 groups: normal myocardial perfusion or true myocardial perfusion defect.

Results
466 patients without known CAD were analyzed. The mean age of cohort patients was 59.3±10.9 years. 28 (6.0%) patients had no CVR factors, 90 (19.3%) women had only 1, but the rest of them (348, 74.7%) had 2 or more CVR factors. Dyslipidemia was present in 358 (76.8%), AH in 282 (60.5%) and type 2 Diabetes mellitus (T2DM) in 27 (5.8%) patients. More than half of patients (n=303, 65.0%) were overweight (BMI&gt;25.0 kg/m2). 65 (13.9%) women were current or ex-smokers.
True myocardial perfusion defect was detected in 96 patients (20.6%). There was no statistically significant difference between CVR risk factor count and cardiac SPECT result (p=0.229), although there were patients with significant perfusion defect without any risk factor present. However, significant correlation between risk factors and detection of obstructive coronary artery disease (CAD) after positive cardiac SPECT was found (p&lt;0.001).
Totally in study was detected 71 patients with suspected ischemia with non-obstructive CAD (INOCA), but further investigation with intracoronary physiology measurements – coronary flow reserve (CFR), index of microvascular resistance (IMR) and acetylcholine provocation test is required to define INOCA endotype.

Conclusions
The cardiac SPECT is an appropriate diagnostic method for women patients with suspected CAD. Even in patients with no CVR factors, but with positive or non-informative exercise test, the CAD is present, therefore they should be referred to cardiac SPECT in a very high CVR country. In patients with significant perfusion defect and absence of obstructive CAD, the performance of intracoronary physiology measurements is required.