bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of coronary sinus in the risk stratification and the prognostic evaluation of idiopathic pulmonary arterial hypertension
Authors: Uygur B , Demir AR , Sancar K , Yildiz M , Erturk M 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Coronary sinus (CS) is a venous structure draining into the right atrium, therefore it can reflect the pressure and the volume load of the right heart chambers. Idiopathic pulmonary arterial hypertension (IPAH) is a progressive, life-threatening disease in which the risk assessment plays a critical role.

Purpose
We aimed to evaluate the correlation of CS diameter with the well-known risk assessment parameters in IPAH patients and to search the utility of CS diameter in the prediction of mortality and hospitalization.

Methods
A total of 25 IPAH patients were enrolled in our retrospective study. All patients underwent detailed echocardiographic examination, laboratory examination, 6 minutes walking test and cardiopulmonary exercise test at the same day. The patients were followed-up for a mean 16.8 ± 10.1 months. Primary endpoint was mortality or hospitalization. The relationship between CS diameter and well-known risk parameters and the prognosis were analyzed.

Results
Mean CS diameter was 9.9 ± 3.7 mm. CS diameter had moderate positive correlation with age (r:0.560, p:0.004), NT-proBNP (r:0.625, p:0.001) and weak positive correlation with functional class (r:0.483, p:0.017) and moderate negative correlation with 6 minutes walking distance (r:-0.553, p:0.005) and peak oxygen uptake (r:-0.506 p:0.038). Six (24%) patients were hospitalized, and three patients (12%) died during mean 16.8 ± 10.1 months follow-up. The CS diameter &gt; 9 mm predicted mortality and hospitalization with a sensitivity of 77.8%, specificity of 75.0% (Area under curve (AUC): 0.788; 95% CI: 0.580-0.996; P = 0.019).

Conclusion
CS which is a noninvasive, cheap and readily available echocardiographic parameter, might be used in the risk assessment and the evaluation of prognosis in IPAH patients. Abstract Figure. Coronary sinus measurement Abstract Figure. Basal features
Sacubitril-valsartan improves radial and longitudinal strain and ejection fraction in C57Bl/6 mice treated with doxorubicin through NLRP3 mediated pathways and reduction of cytokine storm
Authors: Quagliariello V , Buccolo S , Iovine M , Maurea C , Rea D , Barbieri A , Maurea N 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): Ricerca Corrente grant, Ministero della Salute (it)

Background
Doxorubicin-mediated adverse cardiovascular events are among the leading causes of morbidity and mortality in breast cancer patients. Sacubitril-valsartan (LCZ 696) is a combination drug, made up of neprilysin inhibitor sacubitril and angiotensin II receptor blocker valsartan, used for the treatment of heart failure in patients with a reduced ejection fraction.

Hypothesis
we hypothesized that LCZ 696, administered during doxorubicin, could improve cardiac functions in preclinical models

Methods
C57Bl/6 mice were untreated (Sham, n = 6) or treated for 10 days with doxorubicin i.p at 2.17 mg/kg (DOXO, n = 6), LCZ-696 at 60 mg/kg (LCZ, n = 6) or doxorubicin combined to LCZ-696 (DOXO-LCZ, n = 6). Before and after treatments, ejection fraction (EF) and radial and longitudinal strain were analyzed through transthoracic echocardiography (Vevo 2100). After treatment, mice were sacrificed and cardiac tissues were treated for determination of NLRP3 inflammasome, Myd88, NF-kB and cytokines involved in heart failure and arrhythmias (IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-10, IL-12, IL17-α, IL-18, IFN-γ, TNF-α, G-CSF, and GM-CSF).

Results
LCZ 696 improved significantly the EF and prevented the reduction of radial and longitudinal strain after 10 days of treatment with doxorubicin. No significant differences were observed for IVS;d-D, LVID;d-D, LVPW;d-D, LV Mass, LV Vol; d, LV Vol;s between the experimental groups. A reduced expression of NLRP3, MyD88 and NF-kB in cardiac tissues was seen in DOXO-LCZ group compared to DOXO mice (p &lt; 0.001). Cardiac expression of IL-1β, IL-6, TNF-α, G-CSF and GM-CSF were significantly reduced (p &lt; 0.001) after treatment with LCZ-696 indicating anti-inflammatory and cardioprotective properties.

Conclusion
LCZ-696 improves cardiac functions in mice treated with doxorubicin. Biochemically, these effects are mediated by the downregulation of NLRP3 inflammasome-related pathways and cytokines involved in doxorubicin-mediated heart failure and cardiomyopathies.
Weight reduction after bariatric surgery improves myocardial work indices and global longitudinal strain
Authors: Sinski M , Piechocki K , Styczynski G , Szmigielski CA , Bidiuk J , Lewandowski J 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Obesity is known to affect cardiovascular morphology, function and outcomes. Most parameters used to evaluate cardiac function, especially ejection fraction, but also strain are load dependent and the research focused on the effects of the weight loss on cardiac systolic function are inconsistent. Myocardial work is a novel cardiovascular parameter that characterizes cardiac systolic function and is less load dependent. However, there is lack of data how bariatric surgery affects parameters of the non-invasively calculated myocardial work indices obtained from pressure-strain loops obtained in patients referred with severe obesity.

Purpose
The purpose of the study was to analyze whether myocardial work indices change after bariatric surgery.

Methods
Out of 171 consecutive subjects that were referred to bariatric surgery and characterized elsewhere (1) 15 subjects, that had both, adequate visualization, and post- surgery transthoracic echo (TTE) performed, were taken into analysis. Echocardiographic examination was performed using GE Vivid 9 and analyzed with EchoPac 204 software.

Results
Global myocardial work (GWI), global constructive work (GCW) and global work efficiency (GWE) indexes increased, while global wasted work index (GWW) decreased significantly after bariatric surgery (Figure). GLS increased significantly after bariatric surgery (Figure). LV ejection fraction did not change significantly after surgery (60.2 ± 6.5% vs. 60.9 ± 7 %, p = 0.68). LV end-diastolic diameter (LVEDD) did not change (4.86 cm ± 0.35 vs. 4.89 cm ± 0.38, p = 0.55), while posterior wall thickness (PW) and relative wall thickness (RWT) decreased significantly (1.08 ± 0.13 vs. 0.99 ± 0.13, p = 0.001 and 0.45 ± 0.05 vs. 0.41 ± 0.06, p= 0.0003, respectively). Left atrial diameter (Figure) and left atrial area were lower after bariatric surgery (18.6 cm2 ± 2.5 vs. 16.7 cm2 ± 2.5, p = 0.027). Both systolic blood pressure and heart rate decreased after bariatric surgery (Figure). Mean time to post – surgery TTE was 400 days ± 151 and mean weight reduction was 38 kg ± 8.

Conclusion
Left ventricular systolic function evaluated using myocardial work indexes increased after bariatric surgery. After bariatric surgery, the myocardial work parameters returned to normal range, when based on the values recorded in the reference STAAB cohort study (2). Abstract Figure
Prognostic value of incidental finding of pulmonary hypertension detected by echocardiography in patients without known cardiovascular or pulmonary disease
Authors: Ashur A , Levy A , Liel-Cohen N , Michael T , Sergienko R , Kobal S 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Introduction
The estimated overall prevalence of pulmonary hypertension (PHT) is ∼1% in the global population, and up to 10% among patients older than 65 years. PHT is associated with a worst prognosis in patients with cardiovascular or pulmonary disease. However, the significance of PHT as an incidental finding among subjects who do not suffer from cardiac or pulmonary diseases is unknown. The aim of our study is to examine whether incidental diagnosis of PHT in patients without cardiovascular or pulmonary comorbidity is associated with long-term all-cause mortality.
Methods
This retrospective cohort study included 8296 patients (58% females, mean age, 63 ± 14 years), who performed a first echo study (echo 1) in the years 2006-2009 and a follow up study (echo 2) until 01/2020 in a large single center echo-lab. Patients were excluded if they had evidence of moderate or more left ventricular dysfunction (LVD), significant valvular disease or diagnosis of pulmonary disease at echo 1. The association between PHT and LV function degree (Ejection fraction above or below 55%) to all-cause mortality was examined between four groups [group 1 (G1)- normal LV function (NLV)+ no PTH (NPH), G2- LVD and NPH, G3- NLV and PHT, G4- LVD and PHT] using a Kaplan-Meier analysis and Cox proportional-hazards model, accounting for various covariates.
Results
Survival time of patients with or without PHT in echo 1 and LV function status at echo 2 was found significantly different among all groups (Pv &lt; 0.001 for all comparisons) (Figure 1). Patients in G1 had the longest mean survival time (141 ± 23 months) compared to any other group (G2-134 ± 30 months, G3-129 ± 32 months, G4-119 ± 38 months). In the multivariable analysis conducted (Table 1), PHT adjusted for various demographic factors and comorbidities was found to be an independent risk factor for long term all-cause mortality with increased risk of up to 34% (adjusted HR-1.34; 95% CI: 1.21-1.47, PV &lt; 0.001).

Conclusion
Incidental finding of PHT in patients without known cardiovascular or pulmonary disease is an independent risk factor for long term all-cause mortality. Future studies should be conducted to assess the impact of an early diagnosis on all-cause mortality, and the need for further diagnostic and therapeutic steps. Abstract Figure. Abstract Figure.
Prognostic value of left atrioventricular coupling index (LACI) in pre- and post-menopausal women : from the multi-ethnic study of atherosclerosis (MESA)
Authors: Pezel T , Michos E , Varadarajan V , Shabani M , Ambale Venkatesh B , Vaidya D , Kato Y , De Vasconcellos H , Heckbert S , Wu C , Post WENDY , Bluemke D , Allison M , Lima J 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

BACKGROUND
Although endogenous sex hormones influence both left atrial (LA) and left ventricular (LV) structure in peri-menopausal women, no study has ever evaluated the interaction between sex hormones levels and the left atrioventricular coupling.

PURPOSE
This study aimed to assess the prognostic value of a left atrioventricular coupling index (LACI) in pre- and post-menopausal women without history of CVD at baseline.

METHODS
In all women participating in the Multi-Ethnic Study of Atherosclerosis (MESA) with baseline cardiovascular magnetic resonance (CMR) study, LACI was measured as the ratio of the LA end-diastolic volume divided by the LV end-diastolic volume. Cox proportional hazard models were used to assess the association between LACI and the outcomes of atrial fibrillation (AF), heart failure (HF), coronary heart disease (CHD) death, and hard CVD defined by myocardial infarction, resuscitated cardiac arrest, stroke, or CHD death. In multivariable analyses, the associations between LACI and the time-to-event were evaluated, adjusting for demographics, traditional cardiovascular risk factors, menopausal status and sex hormone levels.

RESULTS
Among the 2,087 women (61.2 ± 10.1 years), 485 cardiovascular events were observed during mean follow-up period of 13.2 ± 3.3 years. Greater LACI was independently associated with AF (HR 1.70; 95% CI [1.51-1.90]), HF (HR 1.62; 95% CI [1.33-1.97]), CHD death (HR 1.36; 95% CI [1.10-1.68]), and hard CVD (1.30; 95% CI [1.13-1.51], all p &lt; 0.001). Adjusted models with LACI showed significant improvement in model discrimination and reclassification compared to currently used standard models to predict the incidences of AF (C-statistic: 0.82 vs. 0.79; NRI = 0.325; IDI = 0.036), HF (C-statistic: 0.84 vs. 0.81; NRI = 0.571; IDI = 0.023), CHD death (C-statistic: 0.87 vs. 0.85; NRI = 0.506; IDI = 0.012), and hard CVD (C-statistic: 0.78 vs. 0.76; NRI = 0.229; IDI = 0.012). The prognostic value of LACI was homogeneous in both pre- and post-menopausal women with a better discrimination and reclassification compared to individual LA or LV parameters.

CONCLUSIONS
In a multi-ethnic population of pre- and post-menopausal women, LACI is an independent predictor of HF, AF, CHD death and hard CVD. In both pre- and post-menopausal women, LACI has an incremental prognostic value to predict cardiovascular events over traditional risk factors and sex hormone levels.
ClinicalTrials.gov Identifier: NCT00005487 Abstract Figure. Kaplan-Meier curves by LACI terciles Abstract Figure. Kaplan-Meier curves by LACI and Menop.
Sex- and age- specific normal values with threshold-based trabeculae quantification
Authors: Grebur K , Gregor ZS , Kiss AR , Szabo LE , Toth A , Horvath M , Dohy ZS , Merkely B , Vago H , Szucs A 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): ÚNKP-19-3-II New National Excellence Program of the Ministry for Innovation and Technology National Research, Development and Innovation Office of Hungary (NKFIA; NVKP_16-1-2016-0017 National Heart Program) Thematic Excellence Program (Tématerületi Kiválósági Program 2020-4.1.1-TKP2020)
The threshold-based (TB) trabeculated and papillary muscle mass (TPM) quantification method for cardiac MRI (CMR) calculates different values than conventional contouring techniques.
We aimed to identify the sex- and age-related normal reference ranges for left ventricular (LV) myocardial mass values, volumetric and functional parameters and the correspondence of these parameters using the TB method.
Healthy European adults (n = 200, age: 39.4 ± 12 years, males: 100) were examined with CMR and evaluated with a TB postprocessing method. They were stratified by sex and age (Group A: 18-29, Group B: 30-39, Group C: 40-49, Group D: &gt;50 years). The calculated parameters were indexed to body surface area (i).
The normal reference ranges for the studied parameters were assessed in each age group. Significant biometric differences in LV parameters and mass-to-volume ratios were found between males and females, and the left ventricular compacted myocardial mass (LVCMi) and TPMi differences remained significant after stratification by age. Unlike other LV volumetric and functional parameters and mass-to-volume ratios, the TPMi, the LVCMi and the TPMi-to-LVCMi ratio did not differ among age groups in males or females. This finding was strengthened by the lack of correlation between TPMi and age.
Age- and sex-related normal reference ranges for LV volumetric and functional parameters and LVCMi and TPMi values were established using a TB postprocessing method. TPMi, LVCMi and their ratio did not change over time. The TPMi-to-LVCMi and the mass-to-volume ratios might have clinical utility in the differential diagnosis of conditions with LV hypertrabeculation.
Regression of left ventricular mass after transcatheter aortic valve implantation
Authors: Costa Mauricio AR , Goncalves S , Santiago H , Prata S , Santos L , Vaz R , Ribeiro F , Almeida A , Pinto F 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Regression of left ventricular mass (LVM) after transcatheter aortic valve implantation (TAVI) is an important parameter of left ventricular reverse remodeling and is associated with less hospitalizations 1year after TAVI. The association between LVM índex (LVMi) at 6 months and outcome 1 year after TAVI is unclear.

Purpose
Evaluate and compare LVMi, before TAVI and 6 months after, and determine the association between LVMi regression and clinical outcomes at 1-year follow-up.

Methods
Retrospective, comparative study in patients with symptomatic severe aortic stenosis with a high operative risk, after TAVI. All patients underwent echocardiographic study before TAVI and 6 months of follow-up, the LVMi (by the Devereux formula) was evaluated. Associations between LVMi regression (percent change between baseline and 6 months after TAVI), rehospitalization rate and death at 1 year of follow-up were examined.

Results
We studied 50 patients, 82% with moderade or severe LVMi before TAVI. Comparative analysis between ecocardiography study before and 6 months after TAVI, showed there was statistically significant decrease in LVMi (150,7 ± 38 g/m2 vs 132 ± 36 g/m2; p = 0.03). LVMi moderate or severe (between 130 and 154 g/m2) at 6 months was associated with biggest hospitalization rate (p = 0,03).Comparative analysis between regression of LVMi (before and 6 months after TAVI) and death, showed: decrease of 5% and 10% in LVMi was independently associated with death at 1 year (p = 0,77 vs p = 0,4).

Conclusions
Patients with severe symptomatic aortic stenosis treated with TAVI who had a significant decrease of LVMi after 6 months of follow-up had lower hospitalization rates, but decrease of LVMi is independently associated with death at 1 year of follow-up.
Cardio-vascular remodelling during sacubitril/valsartan therapy in patients with heart failure and reduced ejection fraction
Authors: Monosilio S , Filomena D , Luongo F , Neccia M , Sannino M , Birtolo IL , Cimino S , Tonti G , Pedrizzetti G , Benedetti G , Fedele F , Maestrini V , Agati L 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Sacubitril/valsartan (S/V) benefits in patients with heart failure and reduced ejection fraction (HFrEF) are partially related to cardiac reverse remodelling, in terms of volumes reduction and function improvement. Effects on vascular remodeling are less investigated.

Purpose
To evaluate cardiac and vascular remodelling in a cohort of patients with HFrEF after six months of therapy with S/V.

Methods
50 patients with HFrEF eligible to start a therapy with sacubitril/valsartan were enrolled. Clinical evaluation and standard and advanced echocardiography were performed at baseline and after six months of follow up (FU). Standard left ventricular dimension and function parameters, global longitudinal strain (GLS) were calculated. Non-invasive pressure-volume curves (P-V loop) estimation was assessed with an off-line dedicated software using ST-E derived time-resolved LV volumes and brachial pressure as input. The following hemodynamic parameters were calculated based on P-V loop curves: left ventricular elastance (Ees), arterial elastance (Ea) and ventricular-arterial coupling (VAC).

Results
At six months F/U, a reduction of NYHA class in the vast majority of patients was detected (NYHA Class ≥ II, baseline vs F/U = 100% vs 50%; p&lt; 0,001). Systolic and diastolic blood pressure were lower, in comparison with baseline values (119 ± 16 vs 126 ± 11 mmHg; p = 0,002 and 71 ± 8 vs 78 ± 8 mmHg; p = 0,001, respectively). At echocardiographic evaluation, left ventricular end-diastolic and end-systolic volumes decreased (p&lt; 0.001 and p&lt; 0,001, respectively) and ejection fraction and GLS significantly improved (p&lt; 0.001 and p &lt; 0.001, respectively). Moreover, a significant reduction of Ea and a significant improvement of Ees and VAC were observed (p = 0.008, p&lt; 0,001 and p&lt; 0,001, respectively).

Conclusion
Therapy with S/V in HFrEF patients determines both cardiac and vascular remodelling reflecting the complex mechanisms behind clinical improvement. Abstract Figure.
Additional value of CMR feature tracking parameters for the evaluation of the risk of complex ventricular arrhythmias and sudden cardiac death in patients with Mitral Valve Prolapse
Authors: Pavon A , Guglielmo M , Arangalage D , Bonanni M , Angelini G , Paiocchi V , Leo L , Valgimigli M , Pedrazzini G , Pontone G , Monney P , Faletra F 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Mitral valve prolapse (MVP) with mitro-annular disjunction (MAD) has been associated with complex ventricular arrhythmias (c-VA) and sudden cardiac death (SCD) but risk stratification in this subset of patients remains insufficiently characterized. The aim of this study was to investigate the association between deformation parameters assessed by feature tracking (FT) cardiac magnetic resonance (CMR) in patients with MVP and MAD (MVP-MAD) and c-VA and/or SCD.

Methods
We included 23 patients (47 ± 13 years; 43 % males) with MVP-MAD, of whom 17 (74 %) presented with c-VA and 6 (26%) with SCD, as well as 20 age- and sex-matched controls (50 ± 18 years; 57% males). All patients underwent CMR with assessment of MAD length, late gadolinium enhancement (LGE), extracellular volume (ECV), global and regional longitudinal (LS), and circumferential strain (CS). RATIO-CS was defined as the ratio between regional CS in the basal inferolateral and mid-inferolateral walls (fig.1).

Results
In MVP-MAD patients, non-ischemic LGE of the LV inferior and inferolateral wall was observed in 21 patients (50%). As compared to controls, MVP-MAD patients showed lower global LS (-18.7 ±4.1 vs -24.7 ± 5.7 p &lt; 0.001), higher native T1 relaxation time and ECV of the left ventricle (LV) inferolateral wall (1104 ± 63ms vs 1083 ± 66ms p &lt; 0.029 and 0.31 ± 0.03 vs 0.27 ± 0.04 p 0.003), lower CS and LS of the LV mid and inferolateral segments (p &lt; 0.005).
Logistic univariate regression analysis showed an increased risk of c-VA in case of LGE presence (OR: 9.52 [2.28-39.7] p = 0.002), a high number of LV segments with LGE (OR: 1.78 [1.21-2.63] p = 0.004), GLS (OR: 1.58 [1.21-2.07] p &lt; 0.001), decreased inferolateral mid ventricular wall CS (OR: 1.41 [1.16-1.72] p &lt; 0.001), decreased basal and mid-ventricular inferolateral wall LS (OR: 1.11 [1.00-1.23] p = 0.047 and OR: 1.62 [1.22-2.13] p &lt; 0.001 respectively), increased native T1 times (OR: 1.01 [1.00-1.02] p = 0.039), increased ECV of the basal infero-lateral wall (OR: 4.93e + 07 [1.22-1.98e + 15] p = 0.047) and decreased RATIO-CS (OR: 7.48 [1.87-30.00] p = 0.005) (table 1). In multivariate analysis the presence of a lower LS in the basal inferolateral wall remained an independent predictor of c-VA (OR: 1.62 [1.22-2.13.00] p = 0.0007) and RATIO-CS remained an independent predictor of SCD (OR: 7.73 [1.78-33.60] p = 0.006).

Conclusion
Lower inferolateral LS and RATIO CS are respectively associated with c-VA and SCD in MVP-MAD patients. FT may provide additional value for risk stratification on top of standard CMR parameters in this subset of patients. Abstract Figure. fig.1 Abstract table 1