bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 6: Early Telephone Follow-up Fails to Reduce Readmission Rates for CHF & AMI.
Authors: Lehman Elmer P , Granger Bradi B , Batten Hunter , Pura John , Lokhnygina Yuliya V , McCarver Catherine , Shah Bimal R 
Published: March 2022

Background:
To reduce readmissions rates for patients admitted with acute myocardial infarction (AMI) or congestive heart failure (CHF), Duke University Hospital piloted a program in which patients were contacted by telephone within 72 hours of discharge and asked a set of structured questions believed to identify gaps in care to reduce the risk of readmission.

Methods:
A cohort of 838 patients admitted between December 2012 and May 2013 with a primary diagnosis of AMI (n=374) or CHF (n=464) were identified by DRG for prospective telephone follow-up and analyzed retrospectively. For primary outcome analysis, readmission rates were compared between two groups: one that received the telephone intervention and one that did not. If successfully contacted, patients were asked about filling and complying with their prescriptions, knowledge of their follow-up appointment, and understanding their discharge instructions. A secondary outcome analysis evaluated readmission rates among the telephone-eligible subgroup.

Results:
Patient characteristics among those contacted vs. not contacted did not differ substantially for either AMI or CHF discharges.

Among AMI patients, there was no association between contact attempt and readmission within 30 days (p = 0.719) or 90 days (p=0.803). This finding persisted after adjusting for the effect of age at hospitalization, disease group, race, gender, and payor (OR = 1.28, 95% CI = 0.61 - 2.68, p = 0.512 at 30 days; OR = 1.24, 95% CI = 0.65 - 2.37, p = 0.510 at 90 days).
Among CHF patients, there was no association between contact attempt and readmission within 30 days (p = 0.156) or 90 days (p=0.904). This finding persisted after adjusting for the effect of age at hospitalization, disease group, race, gender, and payor (OR = 0.67, 95% CI = 0.35 - 1.25, p = 0.207 at 30 days; OR = 0.94, 95% CI = 0.56 - 1.55, p = 0.797 at 90 days).
There was no association between telephone-eligible patients and readmission rates at 30 or 90 days for either condition. Among patients successfully contacted, there was no association between answers pertaining to post-discharge behavior and readmission rates for CHF or AMI.

Conclusions:
Early telephone follow-up targeting post-discharge behaviors was not observed to impact 30- or 90-day readmission rates for patients admitted to an academic medical center with CHF or AMI.
Abstract 183: In Patients Evaluated for Chest Pain or Dyspnea, Right Bundle Branch Block and/or Right Ventricular Dysfunction Are Associated With Inferior Long Term Outcomes Independent of Stress Test Results
Authors: Yager Neil , Badr Salem , Zhang Lulu , Ramineni Tina , Torosoff Mikhail 
Published: March 2022

Background:
Association between right bundle branch block (RBBB) and/or right ventricular (RV) dysfunction or dilation and outcomes in patients evaluated with stress testing are not well investigated.

Methods:
Records of 404 consecutive patients referred for chest pain or dyspnea evaluation with stress echocardiogram at a single tertiary care center were reviewed. In 140 patients, baseline echocardiogram included assessment of RV dimensions and function. Demographic, clinical data, and outcomes were collected. ANOVA, chi-square, and logistic regression analyses were used. Mean follow up length was 76+/-18 months. Study was approved by the IRB.

Results:
Demographic data and co-morbidities, including DM, CAD, HTN and PVD, were similar in patients with RBBB and/or RV dilation or dysfunction.

Baseline, pre-stress RV dysfunction or dilatation were associated with an approximate fourfold increase in mortality during follow up, regardless of stress test outcome (44% vs. 11%, p=0.0052). Ischemia during stress test was also more likely in patients with RV dysfunction or dilatation (44% vs. 15%, p=0.019).
In patients with RV dilatation and/or dysfunction, RBBB on baseline ECG was noted in 33% vs. 8% in patients with normal RV size and function (p = 0.0159). However, baseline RBBB was not associated with increased mortality, ability to reach THR, or ischemia during stress test.

Conclusions:
RV dilation and/or dysfunction pre-stress testing was associated with increased mortality and ischemia on stress testing. Observed in 1/3 of our study patients RV dilatation and/or dysfunction, RBBB was not associated with worst outcomes. Additional studies investigating utility of pre-stress echocardiogram in assessment of RV dimensions and function are warranted.
Abstract 252: Use of a Chest Pain Score by Emergency Department and Hospitalist Physicians and Subsequent Utilization of Cardiac Imaging and Left Heart Catheterization at a Large Community Hospital
Authors: Manalac Raoul , Wascome Eric , Giarrusso Amy , Slataper Richard 
Published: March 2022

Background:
Chest pain is the chief complaint of approximately 10% of all Emergency Department (ED) admissions. Optimal care is difficult to achieve in the ED environment and often requires involvement of hospitalists physicians to aid in triage decisions.

Hypothesis:
Introduction of a web-based chest pain scoring system will result in decreased cardiac imaging and catheterizations.

Methods:
ED physicians and hospitalists of a large community hospital were provided web-based copies of the chest pain score. The basis of the score was previously validated scores found in the published literature for patients presenting to an ED with chest pain.

All hospitalist consultations from the ED with a chief complaint of “chest pain” from 10/8/2014 to 2/1/2015 were assigned a chest pain score by ED providers. STEMI, emergent non-cardiac, and surgical causes were excluded (e.g. pneumothorax, acute trauma, aortic dissection). A hospitalist then assessed each consultation and assigned his or her own score. These scores corresponded with pre-specified disposition and management plans. When there were discrepancies in scoring, ED and the hospitalist collaborated on further work-up and disposition.
Primary variables of interest were the number of imaging studies and left heart catheterization performed. Imaging and catheterization data were captured from hospitalist physician Computerized Physician Order Entry (CPOE) and Electronic Medical Record (EMR) data. Imaging data were compared approximately four months prior to (6/1/2014-10/7/2014) and after (10/9/2014-2/1/15) initiation of the study. Catheterization data were compared approximately two months prior to (8/1/14-10/8/14) and after (10/8/14-11/25/14) initiation of the study.

Results:
During the study period there was a decrease of 49% [(39-20)/39] in urgent catheterizations. Regarding imaging, there was a roughly 34% [(699-463)/699] decrease in all cardiac imaging and an approximately 46% [(585-317)/585] decrease in nuclear perfusion scanning. Notably there was a 28% [(146-114)/114] increase in the use of stress echo. These findings are summarized in Figure 1.

Conclusions:
The findings show a significant decrease in left heart catheterizations and total number of cardiac imaging studies with a concurrent increase in use of stress echo.
Abstract 261: The Impact of Exercise Training on Depression, Anxiety and Physical Capacity in Women After Myocardial Infarction
Authors: Korzeniowska-Kubacka Iwona , Piotrowska Dorota , Bilinska Maria , Piotrowicz Ryszard 
Published: March 2022

Introduction:
Anxiety and depression are commonly observed risk factors in CAD patients, especially in women, and are also strong predictors of mortality in patients after myocardial infarction (MI).

Objectives:
The aim of the study was to assess the effectiveness of exercise training on depression, anxiety and physical capacity in women after MI.

Methods:
The study comprised 30 women aged 59.2±8.1 after MI. All subjects underwent an 8-week training program (TP) consisted of 24 interval trainings. At the beginning of and after completing the TP, all pts underwent (1) a symptom limited exercise stress test (EST) during which the following parameters were analyzed: maximal workload (W), duration (min), double product- DP (mmHg/min) at rest and at peak effort; (2) depression intensity assessed with the Beck Depression Inventory (BDI); (3) anxiety assessed with State-Trait Anxiety Inventory (STAI).

Results:
The depression intensity decreased significantly after TP (14.8±8.7 vs 10.5±8.8; p< 0.01). The initial anxiety manifestation for state anxiety was found to be 45.7±9.8 and decreased to 40.8±7.8 (p< 0.01) after TP.

Physical capacity improved significantly after TP: max workload 92.2±22.2 vs 108.6±26.1 (p< 0.001), EST duration 4.4±1.2 vs 5.4±1.4 (p<0.001), DP at rest 8584.8±1416 vs 8031.0±1562 (p<0.001), DP at peak effort 19511.9±3092 vs 20848.9±3970 (p<0.001).

Conclusions:

1. Participating in a training program beneficially contributed to a decrease in depression and anxiety manifestation in post-MI women.
2. Physical capacity improved significantly after training program.
Abstract 326: Valvular Regurgitations May Increase Arrhythmias in Hypertensive Heart Failure in Blacks
Authors: Ajayi Adesuyi A , Akintomide Anthony O , Ajayi Olufemi E 
Published: March 2022

Hypertensive heart disease(HHD) in Nigerians, is associated with concentric LVH and a high frequency of early valvular regurgitations (VR). HHD is the commonest cause of sudden cardiac death (SCD) in that population, but the role of arrhythmias in these is not known. We therefore (a)investigated the relationship between VR and cardiac arrhythmias in normotensives, hypertensives, and hypertensive heart failure (HHF) in Nigerians and (b) examined the hypothesis that VR increases the prevalence and complexity of cardiac arrhythmias in HHF Nigerians. HHF patients (n=14), HHD patients (n= 23) and Normal controls (N) n=9 underwent 24 hr Holter EKG monitoring and 2D and Doppler Echocardiography, and the presence or absence of VR noted in each individual and groups. Each patient group was sub classified into those with VR or without VR (NVR). There were significant between patient group differences in SVT P<0.001ANOVA),mean and median VT frequency (p <0.02) and ventricular couplets (p= 0.0002 ANOVA). HHF with VR had more SVT (81/24HRS) than HHF with NVR (4/24HRS) p = 0.016, as well as more VT/Triplets(69/24HRS) than HHF-NVR (34/24HRS) p <0.02 . HHF with VR had more couplets 446/24HRS than HHF-NVR (58/24HRS) p _ 3 VALVES) had the greatest number of dangerous arrhythmias with VT 6/11 or 55%, but only 3/19 ( 19%) in NVR .
The number of regurgitant valves was positively correlated both to the frequency and the Lown class of arrhythmias (0-IVB)( r = 0.42 p=0.003, n=46), and to VT frequency/episodes ( r = 0.30, p=0.04 ANOVA , n=46). HHF with VR had lower EF but higher LVH compared to HHF NVR (p <0.05). These results support the role of valvular regurgitation in cardiac arrhythmogenesis and complex ventricular ectopy perhaps through connexin43 modification and LVH in HHD, and HHF.
Abstract 354: Cardiovascular Responses to Chronic Baroreflex Activation in Aldosterone Hypertension
Authors: Lohmeier Thomas , Liu Boshen , Georgakopoulos Dimitrios , Cates Adam , Irwin Eric 
Published: March 2022

Both suppression of sympathetic activity (SA) by chronic electrical activation of the carotid baroreflex (BA) and renal denervation (RDX) abolish obesity-induced hypertension (HT), which is mediated by increased SA. Evidence in support of a sympathetic component to aldosterone (Aldo) HT is equivocal. Therefore, at the same stimulation parameters in each dog, cardiovascular responses to 7 days of BA were determined in 9 dogs before (no HT) and after induction of HT by infusion of Aldo for 14 days (12μg/kg/day), which increased plasma levels ~ 10-fold (control= 4.3±0.4 ng/dL). 3 dogs with Aldo HT were subjected to RDX. Aldo HT was associated with increases in plasma osmolality (293±1 to 297±1 mOsm/kg) and [vasopressin] (AVP, Table), marked polydipsia (241± 90 to 2,380 ± 382 mL/day), hypokalemia (4.2±0.1 to 2.3±0.1 mmol/L), and suppression of plasma renin activity, but no significant changes in plasma [norepinephrine] (NE, Table). MAP (mmHg), NE (pg/mL), and AVP (pg/mL) responses to BA:
*P<0.05 vs Control
Plasma [NE] decreased with BA during both no HT and Aldo HT, indicating suppression of SA, but MAP lowering was appreciably diminished during Aldo HT. In contrast, there was no lowering of MAP after RDX. There were no significant changes in plasma osmolality, drinking, or [AVP] during BA. These findings indicate that classic renal mineralocorticoid mechanisms, not increased SA, account for the initial progression of HT produced by pathophysiological circulating levels of Aldo. Further, they show that chronic stimulation of baroreceptors afferents has differential central effects to suppress SA without altering control of plasma osmolality by suppressing thirst or AVP secretion.
Abstract 357: Role of Blood Pressure in Aldosterone-Mediated Cardiac Injury
Authors: Ball Jana P , Syed Maryam , Maranon Rodrigo O , Reckelhoff Jane F , Yanes Licy L , Romero Damian G 
Published: March 2022

Excess aldosterone (ALDO) causes hypertension (HTN), and cardiac hypertrophy, injury and dysfunction. The role of HTN in ALDO-mediated cardiac injury remains controversial. Whether cardiac injury is blood pressure (BP)-dependent, -independent or exacerbated by HTN is not fully understood. We aim to study the role of BP in ALDO-mediated cardiac hypertrophy, inflammation and fibrosis.
Eight-week old uninephrectomized male Sprague Dawley rats (N=6/grp) were randomly assigned to the following 3 groups: Control, ALDO/SALT, ALDO/SALT+3-AHT (Triple Anti-Hypertensive Therapy). ALDO (0.75 μg/h) or vehicle (PEG 300) was administered by osmotic minipumps. SALT (1.0 % NaCl + 0.3 % KCl) was administered in tap water. 3-AHT (240 mg/kg hydralazine, 75 mg/kg hydrochlorothiazide, 15 mg/kg reserpine) was administered in the food. Another set of animals (N=6/grp) was implanted with radiotelemetry probes for BP monitoring. Left ventricle (LV) gene expression (GE) was quantified by qRT-PCR.
3-AHT reduced MAP (126 ± 4 vs. 178 ± 3 mm Hg, p<0.05 vs. ALDO, controls: 108 ± 1). 3-AHT attenuated cardiac (3.8 ± 0.1 vs. 4.0 ± 0.1 HW/BW, p<0.05 vs. ALDO; controls: 3.5 ± 0.1) and LV (2.8 ± 0.1 vs. 3.0 ± 0.1 LVW/BW, p<0.05 vs. ALDO; controls: 2.4 ± 0.1) hypertrophy. 3-AHT abolished ALDO-mediated LV GE upregulation of fibrosis (collagen I, collagen III, fibronectin, Timp1, periostin) and inflammation (osteopontin, MCP-1, TGFβ, Hmox1) markers. A similar effect was observed with novel LV ALDO-target genes such as Reg3b, collagen VIII, Prss35, Ltbp2 or Pcp4. 3-AHT drug administration in the food caused no change in NaCl intake. However, to avoid the confounding effect of the natriuretic drug hydrochlorothiazide, a group of animals was treated with hydralazine and reserpine alone (2-AHT). 2-AHT treatment attenuated HTN (135 ± 4 vs. 178 ± 3 mm Hg, p<0.05 vs. ALDO) but did not modify ALDO-mediated cardiac or LV hypertrophy. However, 2-AHT also abolished ALDO-mediated GE upregulation of fibrosis and inflammation markers, as well as novel LV ALDO-target genes.
These results suggest that ALDO-mediated LV GE regulation in vivo is BP-dependent without excluding that ALDO may exacerbate the HTN-mediated cardiac injury. A stricter BP management may benefit patients with elevated ALDO levels.
Abstract 366: Midodrine is Associated With a Lower Risk of All-cause Hospitalizations Compared With Fludrocortisone in Patients With Orthostatic Hypotension and Heart Failure
Authors: Shibao Cyndya , Grijalva Carlos G , Lipsitz Lewis A , Biaggioni Italo , Griffin Marie R 
Published: March 2022

Orthostatic hypotension (OH) causes approximately 80,000 hospitalizations per year in the US. Current treatment for OH includes midodrine and fludrocortisone. Although these medications have been
used for decades for treatment of OH, their relative effectiveness and safety is unknown. We compared incidence rates of hospitalizations for all causes, for congestive heart failure (CHF, safety outcome) and for syncope (effectiveness outcome) among users of midodrine compared to users of fludrocortisone (reference) in a retrospective cohort study of Tennessee Medicaid enrollees (1996-2008). Adjusted rate ratios were
calculated using propensity scores. We studied 636 patients initiating midodrine and 1066 patients initiating fludrocortisone. Incidence rates of all-cause hospitalizations for midodrine and fludrocortisone users were 1398 and 1515 per 1,000 person-years, respectively (adjusted incidence-rate ratio (aIRR) 0.88, 95% CI (0.75-1.03). The respective rates of syncope-related hospitalization were 129 and 129 per 1,000 person-years (aIRR: 0.90, 95% CI:0.60-1.36). Among 452 (27%) patients with prevalent CHF, the rates of all-cause hospitalization were 1786 and 2413 per 1000 person-years (aIRR: 0.66, 95% CI:0.47-0.87) (Figure), and the respective rates of CHF exacerbation-related hospitalizations were 285 and 297 per 1,000 person-years (aIRR: 0.60, 95% CI:0.34-1.06). Compared with fludrocortisone, users of midodrine had similar rates of all-cause and syncope-related hospitalizations. However, among patients with CHF, midodrine use was associated with a lower risk of hospitalization.
Abstract 415: Identification of Intracellular Signaling Pathways in Human Endothelial Cells Stimulated by Angiotensin-(1-7)
Authors: Meinert Christian , Gembardt Florian , Greenberg Barry , Walther Thomas 
Published: March 2022

Despite many publications regarding the physiological actions of Ang-(1-7) and its beneficial effects under pathophysiological circumstances, the intracellular signaling initiated by Ang-(1-7) remains still elusive. It was the aim of our study to identify proteins regulated by Ang-(1-7) and to determine potential intracellular signaling cascades.

Human Umbilical Vein Endothelial Cells (HUVEC) were stimulated either with 10
-7
M Ang-(1-7) or the solvent for 1h, 3h, 6h, and 9h. Effects of Ang-(1-7) on intracellular signaling were assessed via protein microarray, containing antibodies against 725 proteins. Bioinformatics software was used to identify potential intracellular Ang-(1-7) signaling pathways. Protein microarray data has been verified by Western blot and Real-Time PCR.

The microarray identified 107 regulated proteins after 1h, 139 after 3h, 33 after 6h, and 77 after 9h. Regulated proteins could be associated with high significance to metabolic pathways like “Molecular Mechanism of Cancer” and “Chronic Myeloid Leukemia” signaling, the latter fitting our recent findings that Ang-(1-7) stimulates hematopoetic progenitor cells. The regulation of identified proteins fitted into the signaling cascades in a time dependent manner. Western blot results for PIAS2 (early protein) were in accordance to the protein microarray data and displayed a decrease by almost 45% after Ang-(1-7) stimulation for 1h and 3h. Additionally, we were able to verify the protein microarray results for FBI-1/Pokemon (late protein) after stimulation for 9h, but not after 6h. The Ang-(1-7) mediated decrease of PIAS2 was reproduced in other endothelial cell types like HDMEC and bEnd.3. Further experiments showed that PIAS2 protein was affected by Ang-(1-7) already after 30 min, whereby Real-Time PCR showed no influence of Ang-(1-7) on mRNA level.
Our experiments identified new proteins as the E3-type small ubiquitin-like modifier ligase PIAS2 and the proto-oncogene FBI-1/Pokemon in human endothelial cells, that are regulated in a time dependent manner by Ang-(1-7), and are mainly part of metabolic pathways related to cell death and cell survival, whereby PIAS2 is regulated through posttranslational modification after short-term stimulation with Ang-(1-7).
Abstract 425: Beneficial Effects of BIA 5-1058 in a Genetic Model of Salt-sensitive Hypertension and Heart Failure
Authors: Igreja Bruno , Pires Nuno M , Wright Lyndon C , Soares-da-Silva Patrício 
Published: March 2022

Hyperactivity of Sympathetic Nervous System (SNS) is implicated in numerous cardiovascular diseases. One strategy to slow down the SNS drive is to reduce the biosynthesis of norepinephrine (NE) via inhibition of dopamine-β-hydroxylase (DβH), the enzyme that catalyses the conversion of dopamine (DA) to NE in sympathetic nerves. BIA 5-1058 is a new DβH inhibitor that decreases NE and increases DA levels in peripheral sympathetically innervated tissues.
It was previously shown that BIA 5-1058 dose-dependently reduces blood pressure (BP) in spontaneously hypertensive rats. The Dahl salt-sensitive (Dahl/SS) rat is known to develop systemic hypertension, over 200 mmHg, due to combined pressure and volume overload, which results in compensated left ventricle (LV) hypertrophy after five to six weeks and cardiac failure with LV dilation and contractile dysfunction after 10 to 12 weeks of high-salt (HS) diet. The aim of the present study was to evaluate the effect of BIA 5-1058 in salt-induced hypertension and heart failure in the Dahl/SS rat.
To evaluate the effect of acute BIA 5-1058 treatment on hypertension, six Dahl/SS rats were implanted with telemetry device TA11PA-C40 (DSI) and fed a HS (8% NaCl) diet. Salt-induced hypertensive animals were used to evaluate two different doses (10 and 100 mg/Kg) of BIA 5-1058 on BP. Afterwards, a second cohort of rats were used to evaluate the effect of prolonged BIA 5-1058 treatment (30 mg/Kg/day) on the survival rate of Dahl/SS rats fed a HS diet.
The reduction in the sympathetic tone attained by DβH inhibition with BIA 5-1058 showed a dose- and time-dependent effect on systolic (SBP) and diastolic (DBP) blood pressure. The maximum reduction on SBP was -16.1 and -22.9 mmHg for 10 and 100 mg/Kg, respectively. Likewise, the maximum reduction on DBP was -18.8 and -23.3 mmHg for 10 and 100 mg/Kg, respectively. Survival rate of Dahl/SS rats fed a HS diet demonstrated that BIA 5-1058, beyond BP reduction, shows beneficial effects to the heart of Dahl/SS rats fed a HS diet with a significant 19-day increase in median survival.
In conclusion, the use of DβH inhibitors, like BIA 5-1058, is a promising approach to treat hypertension, heart failure and others cardiovascular diseases where a reduction in the sympathetic tone has beneficial effects.