bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variables determining higher health care effectiveness in patients with cardiovascular disease
Authors: Kurpas D , Szlenk-Czyczerska E 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
The projected incidence of cardiovascular disease and the aging population (deaths from cardiovascular disease increase after age 50) are expected to increase in the coming years. It is therefore imperative to improve health care for patients with CVD in primary care.

Objective
The aim of this study was to analyze the variables that influence the efficiency of health care delivery, which is synonymous with high quality of life, intensification of health behaviors, and high satisfaction of needs in patients with chronic cardiovascular disease.

Methods
The study was conducted on 157 patients with chronic cardiovascular disease who came to a follow-up appointment with a general practitioner. The WHOQOL-BREF Quality of Life Questionnaire, the Health Behavior Inventory Questionnaire (HBI), the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS), and the Hospital Anxiety and Depression Scale-Modified Version (HADS-M) were used for the study. The Wilcoxon test and Fisher's exact test, as well as Spearman's rank correlation coefficient and logistic regression, were used for the analyzes.

Results
Analysis of patients revealed an association between home care effectiveness and the following variables (OR per unit): age (OR = 0.96, 95% CI: 0.92-0.99), educational level (OR = 1.45, 95% CI: 1.13-1.91), financial status (OR = 0.98, 95% CI: 0.20-0.89), assessment of physical well-being (OR = 2.60, 95% CI: 1.29-5.65), improvement in psychological well-being after a nurse visit (OR = 1.36, 95% CI: 0.00-0.17), and medication irregularity (OR = 0.30, 95% CI: 0.09-0.86). There was no association between effectiveness of care and duration of cardiovascular disease (p = 0.149), number of visits to a cardiology clinic (p = 0.414), number of visits to a PHC (p = 0.223), interventions by a family nurse practitioner (p = 0.075), and health care services provided by a physician such as ae.g., medical interview (p = 0.064), physical examination (p = 0.731), blood pressure measurement (p = 0.558).

Conclusions
Patients with CVD characterized by lower educational status, poorer financial status, poorer self-perception of physical well-being, expectation that the GP will provide information about disease progression, expectation that a social worker will provide information about the possibility of receiving social services, and the expectation that the family nurse would be more accessible when needed, as well as being characterized by irregular medication adherence and nonadherence to good eating habits, were much more likely to receive worse health care. Patients with cardiovascular disease can be well supported in primary care settings as long as the model of care is tailored to their specific needs. This includes care coordination within the health care team, home care, and support from general practice.
The kinocardiograph for assessment of fluid status in patients with acute decompensated heart failure
Authors: Herkert C , De Lathauwer I , Van Leunen M , Spee R F , Balali P , Migeotte P F , Hossein A , Yuan L , Kemps H M C 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Aims
To improve telemonitoring strategies in heart failure patients, there is a need for novel non-obtrusive sensors which monitor parameters closely related to intracardiac filling pressures. This proof-of-concept study aims to evaluate the responsiveness of cardiac kinetic energy (KE) measured with the Kinocardiograph (KCG), consisting of a seismocardiographic (SCG) sensor and a ballistocardiographic (BCG) sensor, during treatment of patients with acute decompensated heart failure (ADHF).

Methods
Eleven patients with ADHF who were hospitalized for treatment with intravenous diuretics, received daily KCG measurements. The KCG measurements were compared to the diameter of the inferior vena cava (IVC) and body weight. Follow-up stopped at discharge, i.e. in the recompensated state.

Results
Median (IQR) weight and IVC diameter decreased significantly after diuretic treatment (weight 74.5 (67.6–98.7) to 73.3 (66.7-95.6) kg, p=0.003; IVC diameter 2.47 (2.33–2.99) to 1.78 (1.65–2.47) cm, p=0.03). In contrast with BCG measurements, significant changes in median KE measured with SCG were observed during the passive filling phase of the diastole (0.48 (0.39–0.60) to 0.69 (0.56-0.84), p=0.026), the active filling phase of the diastole (0.38 (0.30–0.61) to 0.31 (0.09–0.47), p=0.016)) and the ratio between the passive and active filling phase (2.76 (1.68–5.30) to 5.02 (3.13–10.17), p=0.006). Systolic KE did not show significant changes.

Conclusion
KE measured with the KCG using SCG is highly responsive to changes in fluid status. Future research is needed to confirm its accuracy in a larger study population, and specifically its application for detection of clinical deterioration in the home-environment.
Variation in complexity weight values for heart failure admissions: the impact of COVID-19 situation
Authors: Del Castillo-Carnevali H , Sahuquillo A , Ripoll T , Torres J , Alvarez J , Cremer D , Coto B , Gamez J M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
COVID-19 outbreak nudged worldwide health systems to reallocate resources from from other areas to help fighting against this novel infectious disease. Consequently, accuracy and quality care of cardiovascular patients was partially compromised. Moreover, fear to get to hospital made patients to stay home despite the presence of symptoms that would have led them to search medical aid in other scenarios.

Aim
We aimed to demonstrate that heart failure admissions after the outbreak were more complex in term of coding compared to those previous to pandemic situation.

Methods
We analyzed complexity coding weight parameters (according to current Spanish Coding manual CIE-10)obtained from local healthcare authorities of 1479 admissions from Balearic Islands Region from January 2019 to December 2021. Admissions with higher coding value were considered more complex. We performed an interrupted time series using pre pandemic admissions as a control group.

Results
2020 showed a lower number of admissions (468), specially form March to June compared to 2019 (499) and 2021. Coding weight values, trend and comparison are showed in figures.

Conclusions
Number of heart failure admissions were reduced in 2020, being it complexity mildly higher compared to 2019 and 2021. Further analysis with data from other regions would be useful to confirm this trend in the whole country.
Maximal functional capacity in subjects with isolated left bundle branch block: a pilot study
Authors: Minguez S , Dominguez E , Mendez J , Iraola D , Albiach C , Gasull A , Lara R , Palau Sampio P 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Sociedad Española de Cardiología.

Background
Left bundle branch block (LBBB) has been commonly associated with adverse cardiovascular (CV) events, but the effect of an isolated LBBB on maximal functional capacity is not well characterized.

Purpose
To evaluate maximal functional capacity in adults with isolated LBBB and compare it to healthy population-derived predicted values (adjusted for sex, age, weight, and height).

Methods
This descriptive pilot study included subjects with isolated LBBB derived from outpatient clinics of two academic hospitals. All subjects underwent maximal cardiopulmonary exercise testing (CPET) and a Global Physical Activity Questionnaire (GPAQ). The primary endpoint was to evaluate maximal functional capacity according to population-derived predicted values of peak oxygen consumption (peakVO2): pp-peakVO2. The secondary endpoint was to evaluate adverse CV events (CV deaths or hospitalizations) at follow-up.

Results
A total of 27 (18 women and 9 men) participants were included. The median (interquartile range) age of the sample and time to screening from the first LBBB diagnosis were 62 (51-71) and 3.4 (1.1-8.4) years, respectively. The results of the GPAQ score showed that 19 patients were highly active, and 8 were moderately active. The median of peakVO2 and pp-peakVO2 were 19.3 (15-22.5) mL/kg/min and 88 (79.3-104.4) %, respectively. There were no adverse CV events at a median follow-up after CPET of 3.1 (2.7-3.4) years.

Conclusion
In this pilot study, adults with isolated LBBB showed reduced maximal functional capacity, despite the absence of cardiac disease and a baseline moderate to highly active lifestyle.
Diagnostic yield in national team football players
Authors: Abela M , Mckean D , Micallef Stafrace K , Zammit Montebello J , Cremona C 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Malta Football Association.

Introduction
Sudden cardiac death (SCD) is an important cause of morbidity in competitive athletes. Pre-participation evaluation (PPE) is mandatory for most sporting organisations. The ECG plays a very important diagnostic role and is included in most screening algorithms. PPE for athletes ≥14 years registered with the National Football Association is now mandatory.
Study objectives: The objective of this study was to assess the diagnostic yield of PPE in a group of elite Maltese football players competing at national level.

Methodology
Players selected at national level (years 2020-2022) underwent PPE (history, physical examination, and resting ECG). Senior team players also underwent echocardiography (biannually) as per regulations. Data was tabulated and analyzed in Microsoft Excel.

Results
300 athletes (69% male) were selected in this timeframe. 10.6% (n=32) required referral for secondary evaluation, equating to 1 in 11 athletes screened. Referrals were more frequent in male vs female athletes (22.1% vs 10.2%, p=0.005). Most referrals were from the men’s senior’s squad (22.5%), followed by the men’s U17 squad (21.7%) and 20% of the men’s U15 team.
The ECG was the commonest reason for referral to a sports cardiologist (n=23, 71.8%). The commonest abnormal ECG patterns included anterior TWI (n=9, 3.0%), inferior/lateral TWI (n=6, 2.0%) and WPW (n=2, 0.7%).
108 (36.0%) had echocardiography as a first line screening modality. This was abnormal in a fifth of those referred (n=7, 21.9%), 4 of these had a normal ECG.
3 (1.0%) athletes were diagnosed with a condition linked to SCD (n=2 WPW, n=1 HCM). Another 5 (1.7%) athletes were diagnosed with a cardiac disorder (n=1 left ventricular outflow tract ectopy, n=1 dilated aortic root, n=1 aortic regurgitation, n=1 atrial septal defect, n=1 mitral regurgitation). Echocardiography doubled the diagnostic yield (1.3% vs 2.7%), with 3 athletes having otherwise a normal history, physical examination and ECG. 1 in 38 athletes (2.7%) were given a cardiac diagnosis, 1 in 100 athletes (1.0%) were labelled with a condition linked to SCD.

Conclusion
The referral rate is comparable to that reported in international screening programs, higher in males. The ECG was the commonest reason for referral. The overall diagnostic yield equates to 2.7%, while 1.0% were given a diagnosis linked to SCD. The higher diagnostic yield in this population highlights the importance of raising awareness about heart disease and PPE in young athletes.
Association between dietary phytochemical index and cardiometabolic risk factors
Authors: Gamba M , Roa Diaz Z M , Raguindin P F , Glisic M , Bano A , Muka T , Franco O H , Marques-Vidal P 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Swiss National Science Foundation.

Background
Consuming plant-based diets have been associated with reduced cardiometabolic risk factors (CRFs), which might be partly mediated by their high phytochemical content and the synergistic action of these bioactive compounds. Nevertheless, dietary phytochemical content estimation is difficult. The dietary phytochemical index (DPI) has been proposed as a practical way to assess the total dietary phytochemical content from phytochemical-rich foods (PRFs).

Purpose
This study aimed to evaluate the association between DPI with CRFs.

Methods
Cross-sectional analysis within a population-based cohort study conducted between 2009-2012. The dietary intake was assessed via a validated food frequency questionnaire. DPI was calculated by dividing energy obtained from PRFs by total energy intake and multiplying by 100. Multivariable linear regressions were applied to establish the associations. CRFs included anthropometric measures, blood pressure, insulin resistance and diabetes markers, dyslipidemia markers, and cardiovascular/inflammatory markers.

Results
3879 participants (mean age 57.6±10.4 years, 53.5% women) were included. The median DPI value was 25.5 (interquartile range: 17.7–34.6). In multivariable-adjusted linear models, significant inverse associations were observed in the highest DPI quartile for body mass index -0.86 (-1.26,-0.46), waist circumference -2.91 (-3.99,-1.84), leptin -0.21 (-0.30,-0.12), insulin -0.09 (-0.14,-0.04), and high-sensitivity C-reactive protein -0.20 (-0.29,-0.11). No other associations were found CRFs.

Conclusions
A high DPI index representing a high intake of PRFs is associated with lower body mass index, waist circumference, leptin, insulin, and high-sensitivity C-reactive protein values.
Spatial analysis of 10-year predicted risk and incident cardiovascular atherosclerotic diseases in a swiss urban population
Authors: Jordan G , Ridder D , Guessous I , Joost S , Vollenweider P , Marques-Vidal P , Vaucher J 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Swiss National Science Foundation GlaxoSmithKline.

Introduction
Whether cardiovascular risk score geographically aggregates and informs on spatial development of atherosclerotic cardiovascular disease (ASCVD) remains unknown.

Aims
We first determined the spatial distribution of cardiovascular risk predicted in an urban population. Second, we compared risk maps with clustering of incident ASCVD over a 10-year follow-up. Sensitivity analyses were conducted to identify explanatory risk factors for both clusters of predicted risk and observed ASCVD.

Methods
Using data from a population-based cohort study, we computed the Systematic Coronary Risk Evaluation Score 2 (SCORE2 and SCORE2-OP) in participants free from ASCVD at baseline (2003-2006). Geographical distributions of predicted risk and incident ASCVD were determined using global and local spatial autocorrelation statistics. Different models were tested to identify explanatory variables (alcohol consumption, body mass index, socio-economic status, anxiety disorder, major depressive disorder, Mediterranean diet, sport activity, polygenic risk score, mean noise, concentration of PM2.5, normalized difference vegetation index, land surface temperature).

Results
6203 individuals (56% women, mean age 52.5 ± SD 10.7) with a median follow-up of 10 years (IQR, 6-10) were included in the analyses. Over the period, there was persistent geographical clustering of predicted risk and ASCVD (Figures 1 and 2). Predicted risk and incident ASCVD marginally overlapped spatially. Body-mass index (BMI) and alcohol consumption explained most of the spatial distribution of predicted risk, reducing high-risk clusters from 286 to 5 and low-risk clusters from 391 to 44. For ASCVD, high clusters either persisted or were reinforced depending upon locations, after adjustment for potential risk factors, with an increase from 100 to 118. Low clusters reduced from 293 to 76 after the adjustment. Incidence rate of ASCVD was 2.5% (IC95%, 3.7-2.4%]) in high-risk clusters compared to the rest of the population.

Conclusions
Using a population-based cohort, we showed that in an urban area there exists clusters of high and low incidence of ASCVD. Geographical distribution of clusters of high clinical risk score was not congruent with that of incident ASCVD, limiting the use of clinical risk scores in identifying areas where ASCVD may develop.
Interest of ergospirometry in the management of thoracic oncology surgery
Authors: Forton K , Lamotte M , Gillet A , Pennequin P , Vander Kuylen M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
A cardiopulmonary exercise testing (CPET) is recommended before a resection of a primary pulmonary nodule by surgical approach for patients at risk (with abnormal spirometry). The maximal oxygen consumption measurement (VO2max) evaluates the morbidity/mortality and allows to orient the surgical choice towards a lobectomy or a cuneiform resection. However, the VO2 max can be influenced by some parameters as patient’s motivation, overweight, ….

Purpose
The objective of this work is therefore to identify other complementary predictive factors of cardiopulmonary exercise test (CPET) in at-risk patients population with abnormal pulmonary function tests.

Methods
211 subjects who underwent thoracic surgery for non-small cell lung cancer (NSCLC) between 2016 and 2020 at Erasmus Hospital and performed a CPET were analyzed and divided into 2 groups (G1 At Risk: n = 159: 10 mL/min/kg &lt; VO2max &lt; 20 mL/min/kg; G2 Control: n = 52: VO2max ≥ 20 mL/min/kg). Anthropological, biometric, clinical, and intraoperative data were collected based on the medical record.

Results
The risk group (G1) had a reduced VO2max associated with a higher VE/VCO2 slope. However, the 30-day and 1-year mortality as well as the number of minor and major complications were comparable to the control group (G2) because of the screening and the operative choices.
All groups combined, VO2max was predictive of major complications (OR = 0.98, p = 0.04) and VE/VCO2 slope emerged as a predictor of total and minor postoperative complications (OR = 1.07, p = 0.0054 and respectively OR = 1.05, p = 0.046). Patients with a slope ≥ 34.5 had a higher incidence of total complications (OR = 3.16, p = 0.0004).
In a subgroup with medium operative risk (VO2max between 15 and 20 mL/min/kg), VE/VCO2 slope was predictive of total complications (OR = 1.09, p = 0.02) whereas VO2max was predictive of major complications (OR = 0.97, p = 0.04).
Aspirin and statin use in primary prevention after coronary artery calcium score
Authors: Parada Barcia J , Manuel Barreiro Perez M B P , Pablo Pazos Lopez P P L , Tatiana Matajira Chia T M C , Maria Sol Bravo Amaro M B A , Francisco Calvo Iglesias F C I , Inmaculada Gonzalez Bermudez I G B , Luis Dominguez Rodriguez L D R , Pablo Dominguez Erquicia P D E , Andrea Lizancos Castro A L C , Andres Iniguez Romo A I R 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
A coronary artery calcium (CAC) score of more than 100 places the 10-year cardiovascular risk above 7.5%, justifying the initiation of pharmacological measures in primary prevention.

Purpose
The present study explores the level of implementation of a primary prevention strategy after CAC score in patients without obstructive coronary disease.

Methods
The study cohort included all patients from the health area of our city (Galicia, Spain) who underwent a coronary computed tomography (CT) scan between July 2021 and February 2022. Subjects with obstructive coronary disease (CADRADS 3 or higher), atrial fibrillation patients and inconclusive studies were excluded. The final population of the study consisted of 209 patients. The sample was classified according to Agatston Score into three groups: no calcification (CAC=0), non-significant (CAC 1-100), and significant calcification (CAC &gt;101). Multinomial and binomial logistic regression were performed to identify the predictors associated with the prescription of statin and aspirin, respectively.

Results
41 patients (19.62%) had significant calcification (CAC &gt;101). Of those, 16 (39.02%) started aspirin and 21 (51.22%) started statin (Figure 1). The CAC score allowed to increase the percentage of patients who benefited from lipid-lowering treatment, from 31.70% to 82.92% (Figure 2). Significant differences were observed in the proportion of patients who initiated aspirin and statins according to the degree of coronary calcification (Chi2 18.76; p=0.000), (Chi2 48.42; p=0.000) respectively. After multivariate adjustment, a CAC score &gt;100 (OR 5.88 (2.29-15.07; p=0.000) and the presence of vulnerable plaque (OR 6.78 (1.01-47.46; p=0.050) were the only predictos which led clinicians to start antiplatelet therapy. Neither age, nor SIS (segment involvement score) were associated. Regarding to lipid-lowering therapy, CAC score 1-100 (OR 5.87 (1.68-20.51; p=0.006) and CAC score &gt;100 (OR 30.78 (5.08-186.47; p=0.000) were independently associated with statin prescription.

Conclusions
The use of coronary CT allows optimization of the therapeutic strategy in primary prevention, increasing the percentage of patients who may benefit from statins. In this setting, aspirin is little established in our cohort. Therefore, we should transmit to the clinician the possibility of starting antiplatelet therapy, individualizing the indication.
Evaluation of the eye findings of young male patients diagnosed with acute coronary syndrome compared to healthy individuals by optical coherence tomography angiography
Authors: Sahin A , Sertdemir A L , Icli A , Baloglu R , Satirtav Akdeniz G , Kesriklioglu S 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
It was aimed to evaluate retinal microvascular functions in optic coherence tomography - angiography (OCT-A) as a marker of atherosclerotic risk in young male patients followed up with Acute Coronary Syndrome (ACS).

Methods
This is a prospective study conducted in patients followed in our clinic with the diagnosis of ACS. Thirty male patients diagnosed with ACS and 30 healthy controls were included in the study. The patients in the ACS group underwent eye examination within the first 72 hours and selected parameters of the macular and circumpapillary vasculature, including macular vessel densities, foveal avascular zone, optic disc, were measured using OCT-A. The same measurements were made for those included in the similar age group in the control group and analyzed.

Results
In OCT-A measurements, the superficial and deep capillary plexus densities were found to be low in the ACS group, and the low superficial capillary plexus (SCP) density, especially in the perifoveal region, was noted (49.9-52.2, p:0.008). In addition, the foveal avascular zone was found to be higher in the ACS group (0.27-0.24, p:0.039). As expected, HDL values were lower and WBC and neutrophil values were higher in ACS patients (p&lt;0.001). In addition, left ventricular ejection fraction (LVEF) was significantly lower in the ACS group compared to the control group (LVEF: 49.7%-63.1%, p&lt;0.001, respectively).

Conclusions
Our results support the negative effects of atherosclerosis on retinal microvasculature in the newly diagnosed ACS group without known comorbidity and eye problems. Based on these findings, it was thought that the use of OCT-A in ophthalmic screening may be useful in predicting the atherosclerotic process.