bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pregnancy and delivery after percutaneous embolization with a combination of microvascular plugs and hydrogel-coated coils for unilateral diffuse pulmonary arteriovenous malformations: a case report
Authors: Ogino Kayo , Hayashi Tomohiro , Waki Kenji , Ohya Masanobu 
Published: September 2023

Abstract

Background
Pulmonary arteriovenous malformations (PAVMs) are abnormal communications between the pulmonary arteries and veins; right-to-left shunts can cause hypoxaemia, emboli to systemic circulation, and brain abscesses. Cyanosis during pregnancy may increase the probability of premature birth or spontaneous abortion and may increase maternal cardiac complications.

Case summary
We describe a case of a 24-year-old woman with diffuse multiple PAVMs localized to the left inferior lobe and chronic cyanosis. She had increased exertional fatigue and chronic headaches and was New York Heart Association class II, although her rest sitting peripheral oxygen saturation (SpO2) had remained unchanged at 83% over the past 20 years. She underwent percutaneous embolization with microvascular plugs and hydrogel-coated coils. A microvascular plug was placed as an anchor near the venous sac, followed by hydrogel-coated coil embolization of the proximal pulmonary artery. A total of six sessions of catheter intervention were performed. The embolization was successful, her hypoxaemia was relieved, and she was able to conceive and deliver. Three years have passed since the last session, and SpO2 97% has been maintained.

Discussion
In the treatment of complex PAVMs, the combination of microvascular plugs and hydrogel-coated coils resulted in shorter procedure time, lower risk of migration of the embolus to the pulmonary veins, and less recanalization and revascularization. Percutaneous embolization of PAVMs resulted in safe delivery for the mother and child.
A long-term follow-up of necrobiotic xanthogranuloma with concomitant large-vessel vasculitis and heart failure with reduced ejection fraction: a case report
Authors: Setoguchi Naoto , Nakayama Yukiteru , Amiya Eisuke , Takeda Norifumi , Komuro Issei 
Published: September 2023

Abstract

Background
Necrobiotic xanthogranuloma (NXG) is a non-Langerhans cell histiocytosis and multisystem disorder. Low level of HDL cholesterol associated with a systemic inflammatory profile, which may result from the interaction of monoclonal immunoglobulin and lipoproteins, is a characteristic feature. There is no evidence of NXG-associated large-vessel vasculitis, nor are there any established treatments, although chemotherapy for comorbid multiple myeloma is most often administered.

Case summary
We describe a case of a 53-year-old male with a first history of heart failure with impaired systolic function. He presented with orbital xanthomas and multiple subcutaneous nodules, and laboratory examination showed elevated levels of C-reactive protein, low HDL, and paraproteinemia. A constellation of these clinical features and pathological findings of skin biopsy led to the diagnosis of NXG. 18F-Fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) confirmed increased uptake in the aorta and bilateral common carotid arteries. He began prednisolone treatment with reference to treatment for large-vessel vasculitis. After the treatment, C-reactive protein immediately decreased with markedly increased levels of apolipoprotein A1 (Apo-A1) and HDL. Systolic dysfunction was restored at 6-month follow-up. The patient has not experienced heart failure for 5 years after treatment, and the follow-up PET/CT demonstrated resolution of vascular inflammation.

Discussion
This is the first report of NXG-associated large-vessel vasculitis. Low-dose prednisolone may benefit for NXG-associated vasculitis and cardiomyopathy. HDL, Apo-A1, and C-reactive protein levels may be useful for monitoring the activity of NXG, and PET/CT was a valuable diagnostic tool for NXG-associated vasculitis.
Mitochondrial function and coronary flow reserve improvement after autologous myoblast patch transplantation for ischaemic cardiomyopathy: a case report
Authors: Ito Yoshito , Kawamura Takuji , Chimura Misato , Miyagawa Shigeru 
Published: September 2023

Abstract

Background
Autologous myoblast patch (AMP) transplantation has resulted in good clinical outcomes for end-stage ischaemic cardiomyopathy, but the mechanisms behind them are unclear. Herein, we report the relationship between mitochondrial function and coronary flow reserve (CFR) before and after AMP transplantation.

Case summary
The patient was a 73-year-old man who underwent coronary artery bypass grafting (CABG). At that time, the left ventricular ejection fraction (LVEF) was 53%, but it declined to 25% after 6 years. He was diagnosed with ischaemic cardiomyopathy (ICM). Coronary flow reserve in NH3-positron emission tomography (NH3-PET) was impaired to 1.69. In Tc-99m MIBI scintigraphy, the washout rate (WR) was 17%, suggestive of impaired mitochondrial function. He was not a candidate for heart transplantation, and we performed AMP transplantation 6 years after CABG. One year after AMP transplantation, LVEF, CFR, and Tc-99m MIBI WR improved to 36%, 2.07, and 7%, respectively. The Tc-99m MIBI WR improved especially in the anterolateral region, and the CFR increased in almost all segments.

Discussion
In this case, AMP transplantation for ICM improved cardiac function, CFR, and mitochondrial function. The mitochondrial transfer from the transplanted myoblasts to the damaged myocardium may have contributed to the mitochondrial function improvement. This probably induced myocardial energy metabolism recovery and decreased oxygen demand. AMP transplantation also has the potential to improve microvascular dysfunction, due to angiogenesis induction. These effects can lead to improved prognoses of ICM after AMP transplantation, highlighting its potential to cure refractory heart failure.
Intima-media thickness at the near or far wall of the common carotid artery in cardiovascular risk assessment
Authors: Seekircher Lisa , Tschiderer Lena , Lind Lars , Safarova Maya S , Kavousi Maryam , Ikram M Arfan , Lonn Eva , Yusuf Salim , Grobbee Diederick E , Kastelein John J P , Visseren Frank L J , Walters Matthew , Dawson Jesse , Higgins Peter , Agewall Stefan , Catapano Alberico , de Groot Eric , Espeland Mark A , Klingenschmid Gerhard , Magliano Dianna , Olsen Michael H , Preiss David , Sander Dirk , Skilton Michael , Zozulińska-Ziółkiewicz Dorota A , Grooteman Muriel P C , Blankestijn Peter J , Kitagawa Kazuo , Okazaki Shuhei , Manzi Maria V , Mancusi Costantino , Izzo Raffaele , Desvarieux Moise , Rundek Tatjana , Gerstein Hertzel C , Bots Michiel L , Sweeting Michael J , Lorenz Matthias W , Willeit Peter 
Published: September 2023

Abstract

Aims
Current guidelines recommend measuring carotid intima-media thickness (IMT) at the far wall of the common carotid artery (CCA). We aimed to precisely quantify associations of near vs. far wall CCA-IMT with the risk for atherosclerotic cardiovascular disease (CVD, defined as coronary heart disease or stroke) and their added predictive values.

Methods and results
We analysed individual records of 41 941 participants from 16 prospective studies in the Proof-ATHERO consortium {mean age 61 years [standard deviation (SD) = 11]; 53% female; 16% prior CVD}. Mean baseline values of near and far wall CCA-IMT were 0.83 (SD = 0.28) and 0.82 (SD = 0.27) mm, differed by a mean of 0.02 mm (95% limits of agreement: −0.40 to 0.43), and were moderately correlated [r = 0.44; 95% confidence interval (CI): 0.39–0.49). Over a median follow-up of 9.3 years, we recorded 10 423 CVD events. We pooled study-specific hazard ratios for CVD using random-effects meta-analysis. Near and far wall CCA-IMT values were approximately linearly associated with CVD risk. The respective hazard ratios per SD higher value were 1.18 (95% CI: 1.14–1.22; I² = 30.7%) and 1.20 (1.18–1.23; I² = 5.3%) when adjusted for age, sex, and prior CVD and 1.09 (1.07–1.12; I² = 8.4%) and 1.14 (1.12–1.16; I²=1.3%) upon multivariable adjustment (all P &lt; 0.001). Assessing CCA-IMT at both walls provided a greater C-index improvement than assessing CCA-IMT at one wall only [+0.0046 vs. +0.0023 for near (P &lt; 0.001), +0.0037 for far wall (P = 0.006)].

Conclusions
The associations of near and far wall CCA-IMT with incident CVD were positive, approximately linear, and similarly strong. Improvement in risk discrimination was highest when CCA-IMT was measured at both walls.
Prognosis prediction in cardiac amyloidosis by cardiac magnetic resonance imaging: a systematic review with meta-analysis
Authors: Boretto Paolo , Patel Neal Hitesh , Patel Keval , Rana Mannat , Saglietto Andrea , Soni Manas , Ahmad Mahmood , Sin Ying Ho Jamie , De Filippo Ovidio , Providencia Rui Andre , Hyett Bray Jonathan James , D’Ascenzo Fabrizio 
Published: September 2023

Abstract
Cardiac involvement is the foremost determinant of the clinical progression of amyloidosis. The diagnostic role of cardiac magnetic resonance (CMR) imaging in cardiac amyloidosis has been established, but the prognostic role of various right and left CMR tissue characterization and functional parameters, including global longitudinal strain (GLS), late gadolinium enhancement (LGE), and parametric mapping, is yet to be delineated. We searched EMBASE, PubMed, and MEDLINE for studies analysing the prognostic use of CMR imaging in patients with light chain amyloidosis or transthyretin amyloidosis cardiac amyloidosis. The primary endpoint was all-cause mortality. A random effects model was used to calculate a pooled odds ratio using inverse-variance weighting. Nineteen studies with 2199 patients [66% males, median age 59.7 years, interquartile range (IQR) 58–67] were included. Median follow-up was 24 months (IQR 20–32), during which 40.8% of patients died. Both tissue characterization left heart parameters such as elevated extracellular volume [hazard ratio (HR) 3.95, 95% confidence interval (CI) 3.01–5.17], extension of left ventricular (LV) LGE (HR 2.69, 95% CI 2.07–3.49) elevated native T1 (HR 2.19, 95% CI 1.12–4.28), and functional parameters such as reduced LV GLS (HR 1.91, 95% CI 1.52–2.41) and reduced LV ejection fraction (EF; HR 1.20, 95% CI 1.17–1.23) were associated with increased all-cause mortality. Unlike the presence of right ventricular (RV) LGE (HR 3.40, 95% CI 0.51–22.54), parameters such as RV GLS (HR 2.08, 95% CI 1.6–2.69), RVEF (HR 1.13, 95% CI 1.05–1.22), and tricuspid annular systolic excursion (TAPSE) (HR 1.11, 95% CI 1.02–1.21) were also associated with mortality. In this large meta-analysis of patients with cardiac amyloidosis, CMR parameters assessing RV and LV function and tissue characterization were associated with an increased risk of mortality.
Catholic Intellectuals and Transnational Anti-Communism: Pax Romana from the Spanish Civil War to the post-1945 World Order
Authors: Richards Michael 
Published: September 2023

Abstract
This article analyses the conditions and ideas motivating cross-border connectivity among young Roman Catholic intellectuals during the trans-war era of the 1930s and 1940s. It examines Pax Romana, the Swiss-based international association of Catholic students and graduates, as it navigated between fascism and resistance in the aftermath of the Spanish Civil War and during the global conflict of 1939–45. The organisation was headed successively by two young activists from Spain, Joaquín Ruiz-Giménez, a legal scholar from Madrid who fought for Franco, and Ramon Sugranyes de Franch, a Catalan literary specialist who went into exile in 1936. Comparison of their parallel careers forms the central narrative cord of the article, illuminating the complex relationship of national to global Catholic fractures between conservative nation-statists and political and social pluralists. The Pax Romana congress held in Spain in 1946 was pivotal in accounting for the transnational legacy of that country’s civil war. The wartime ‘humanist’ critique of Franco’s ‘crusade’ made by key Catholic public thinkers was both disseminated and challenged and its relevance to Europe’s future assessed. Ruiz-Giménez, as its president, used the organisation from Spain to legitimate the country’s regime, aided by sympathetic foreign nation-statists. Sugranyes, in contrast, gravitated in the early 1940s to Fribourg in Switzerland, Pax Romana’s headquarters—via Geneva, Paris and southern France—encountering and allying with progressive Catholic exiles from Italy and Spain and French anti-fascist resisters. Although taking different routes, both men ultimately transcended their nationally rooted religious and political assumptions through dialogue across boundaries.
Birth weight influences cardiac structure, function, and disease risk: evidence of a causal association
Authors: Ardissino Maddalena , Morley Alec P , Slob Eric A W , Schuermans Art , Rayes Bilal , Raisi-Estabragh Zahra , de Marvao Antonio , Burgess Stephen , Rogne Tormod , Honigberg Michael C , Ng Fu Siong 
Published: September 2023

Abstract

Background and Aims
Low birth weight is a common pregnancy complication, which has been associated with higher risk of cardiometabolic disease in later life. Prior Mendelian randomization (MR) studies exploring this question do not distinguish the mechanistic contributions of variants that directly influence birth weight through the foetal genome (direct foetal effects), vs. variants influencing birth weight indirectly by causing an adverse intrauterine environment (indirect maternal effects). In this study, MR was used to assess whether birth weight, independent of intrauterine influences, is associated with cardiovascular disease risk and measures of adverse cardiac structure and function.

Methods
Uncorrelated (r2 &lt; .001), genome-wide significant (P &lt; 5 × 10−8) single nucleotide polymorphisms were extracted from genome-wide association studies summary statistics for birth weight overall, and after isolating direct foetal effects only. Inverse-variance weighted MR was utilized for analyses on outcomes of atrial fibrillation, coronary artery disease, heart failure, ischaemic stroke, and 16 measures of cardiac structure and function. Multiple comparisons were accounted for by Benjamini–Hochberg correction.

Results
Lower genetically-predicted birth weight, isolating direct foetal effects only, was associated with an increased risk of coronary artery disease (odds ratio 1.21, 95% confidence interval 1.06–1.37; P = .031), smaller chamber volumes, and lower stroke volume, but higher contractility.

Conclusions
The results of this study support a causal role of low birth weight in cardiovascular disease, even after accounting for the influence of the intrauterine environment. This suggests that individuals with a low birth weight may benefit from early targeted cardiovascular disease prevention strategies, independent of whether this was linked to an adverse intrauterine environment during gestation.
A novel polygenic risk score improves prognostic prediction of heart failure with preserved ejection fraction in the Chinese Han population
Authors: Han Yi , Lu Jiapeng , Chen Bowang , Li Xi , Dai Hao , Zhang Lihua , Yan Xiaofang , Liu Jiamin , Zhang Haibo , Fu Xin , Yu Qin , Ren Jie , Cui Hanbin , Gao Yan , Li Jing 
Published: September 2023

Abstract

Aims
Mortality risk assessment in patients with heart failure (HF) with preserved ejection fraction (HFpEF) presents a major challenge. We sought to construct a polygenic risk score (PRS) to accurately predict the mortality risk of HFpEF.

Methods and results
We first carried out a microarray analysis of 50 HFpEF patients who died and 50 matched controls who survived during 1-year follow-up for candidate gene selection. The HF-PRS was developed using the independent common (MAF &gt; 0.05) genetic variants that showed significant associations with 1-year all-cause death (P &lt; 0.05) in 1442 HFpEF patients. Internal cross-validation and subgroup analyses were performed to evaluate the discrimination ability of the HF-PRS. In 209 genes identified by microarray analysis, 69 independent variants (r &lt; 0.1) were selected to develop the HF-PRS model. This model yielded the best discrimination capability for 1-year all-cause mortality with an area under the curve (AUC) of 0.852 (95% CI 0.827–0.877), which outperformed the clinical risk score consisting of 10 significant traditional risk factors for 1-year all-cause mortality (AUC 0.696, 95% CI 0.658–0.734, P = 4 × 10−11), with net reclassification improvement (NRI) of 0.741 (95% CI 0.605–0.877; P &lt; 0.001) and integrated discrimination improvement (IDI) of 0.181 (95% CI 0.145–0.218; P &lt; 0.001). Individuals in the medium and the highest tertile of the HF-PRS had nearly a five-fold (HR = 5.3, 95% CI 2.4–11.9; P = 5.6 × 10−5) and 30-fold (HR = 29.8, 95% CI 14.0–63.5; P = 1.4 × 10−18) increased risk of mortality compared to those in the lowest tertile, respectively. The discrimination ability of the HF-PRS was excellent in cross validation and throughout the subgroups regardless of comorbidities, gender, and patients with or without a history of heart failure.

Conclusion
The HF-PRS comprising 69 genetic variants provided an improvement of prognostic power over the contemporary risk scores and NT-proBNP in HFpEF patients.
A systematic review and cluster analysis approach of 103 studies of high-intensity interval training on cardiorespiratory fitness
Authors: Cadenas-Sanchez Cristina , Fernández-Rodríguez Rubén , Martínez-Vizcaíno Vicente , de los Reyes González Nicolás , Lavie Carl J , Galán-Mercant Alejandro , Jiménez-Pavón David 
Published: September 2023

Abstract

Aims
This study aims to systematically review the systematic reviews and meta-analyses examining the effect of high-intensity interval training (HIIT) protocols on improving cardiorespiratory fitness (CRF) and to characterize the main patterns of HIIT modalities using clustering statistical procedures to examine their potential differences on improving CRF. Finally, we aimed to develop a comprehensive guideline for reporting HIIT protocols.

Methods and results
A systematic review was conducted on PubMed and Web of Science from their inception to 31 October 2022 for systematic reviews and meta-analysis aimed at assessing the effect of HIIT on CRF in the entire study population. The Assessment of Multiple Systematic Reviews 2 tool was used to evaluate the risk of bias of each review. Additionally, a principal component analysis testing the data adequacy for the factor solution through the Kaiser–Meyer–Olkin procedure test was conducted. Once the number of factors was identified, in order to identify data patterns according to the main characteristics of the HIIT protocols, a two-step cluster analysis was conducted. Nineteen systematic reviews and/or meta-analyses comprising 103 studies were included. Clustering of systematic reviews and meta-analyses identified three HIIT modalities (‘HIIT-normal mixed’, ‘HIIT-long running’, and ‘HIIT-short cycling’) underlying the interventions across the included studies. Similar effectiveness in increasing CRF among the three HIIT modalities was observed. Subgroup analyses showed no significant differences in CRF by sex, weight status, study design, and baseline physical activity level (P &gt; 0.05), but differences were observed by age group, and exercise intensity indicator was used in the HIIT programmes (P &lt; 0.05).

Conclusion
All three HIIT modalities produced significant improvements of CRF, although some modalities showed greater changes for some specific age groups or intensity indicators.
Stellate ganglion ablation by conventional radiofrequency in patients with electrical storm
Authors: Rao B Hygriv , Lokre Avinash , Patnala Nagalaxmi , Padmanabhan T N C 
Published: September 2023

Abstract

Aims
We report a series of patients with Electrical Storm (ES) who underwent bilateral stellate ganglion ablation by using conventional radio frequency (RFA).

Methods and results
The procedure was done with fluoroscopic guidance using the COSMAN™ 1A RF Generator and a 22G RF needle (5 cm length and 5 mm active tip). Six patients, four male and two female (mean age 55 ± 7 years and mean LVEF—42 ± 21%) with ES underwent the procedure under fluoroscopic guidance. All patients experienced recurrent ICD shocks or required multiple external defibrillation shocks. There were no procedural complications. All patients survived free of ES at discharge. At a mean follow—up of 22 ± 8months, all were alive free of ES but two patients received appropriate shocks for VT and one patient had VT terminated by ATP.

Conclusion
This small series of cases is a proof of concept that neuromodulation by conventional RFA targeting bilateral stellate ganglia appears safe, feasible, and effective in treating selected unstable patients with ES.
A paradox of bacterial persistence and antibiotic resistance: chloramphenicol acetyl transferase as a double barrel shot gun
Authors: Alves da Silva Ana , Silva Inês Jesus , Arraiano Cecília Maria 
Published: September 2023

Abstract
The problematic microbial resistance to antibiotics has led to an increasing interest in bacterial persistence and its impact on infection. Nonetheless, these two mechanisms are often assessed in independent studies, and there is a lack of knowledge about their relation or possible interactions, both at cellular and population levels. This work shows evidence that the insertion of the resistance gene Chloramphenicol Acetyl Transferase (cat) together with its cognate antibiotic chloramphenicol (CAM), is capable to modulate Salmonella Typhimurium persistence to several antibiotics and decrease its survival. This effect is independent of the antibiotics’ mechanisms of action or the locus of cat. RelA [p(ppGpp) syntetase] has been shown to be involved in persistence. It was recently proposed that RelA [(p)ppGpp synthetase], binds to uncharged tRNAs, forming RelA.tRNA complexes. These complexes bind to vacant A-sites in the ribosome, and this mechanism is essential for the activation of RelA. In this study, we propose that the antibiotic chloramphenicol blocks the A-site of the ribosome, hindering the binding of RelA.tRNA complexes to the ribosome thus preventing the activation of RelA and (p)ppGpp synthesis, with a consequent decrease in the level of persistence of the population. Our discovery that the concomitant use of chloramphenicol and other antibiotics in chloramphenicol resistant bacteria can decrease the persister levels can be the basis of novel therapeutics aiming to decrease the persisters and recalcitrant infections.