bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of anticoagulation risk scores for predicting ischaemic stroke in dialysis patients with atrial fibrillation
Authors: Liao Y W L , Wang TKMW 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Risk models such as the CHADS₂ and revised CHA₂DS₂-VASc scores are recommended for anticoagulation decision-making in atrial fibrillation (AF) patients. Despite this, their prognostic utilities in dialysis patients with AF are not well established. We evaluated the performance of conventional anticoagulation risk scores at predicting adverse outcomes in dialysis patients with AF.

Methods
Pubmed database was searched until 3/20/2021 for studies reporting the area under receiver-operative characteristics curve (AUC) and/or hazards ratios (HR) of anticoagulation scores for adverse outcomes in dialysis patients with AF. Data was pooled using the random-effects DerSimonian-Laird method and OpenMetaAnalyst software.

Results
Amongst 260 studies screened, 34 full-text articles were reviewed and 7 eligible studies totalling 13,693 patients were analysed. Pooled AUCs (95% confidence intervals) for discriminating ischemic stroke were 0.705 (0.574-0.836) in 4 studies for the CHADS₂ score, and 0.719 (0.606-0.832) in 3 studies for the CHA₂DS₂-VASc score. Pooled HRs (95% confidence intervals) for stroke were 1.66 (1.26-2.18) in 4 studies for the CHADS₂ score, and 1.40 (1.17-1.67) in 3 studies for the CHA₂DS₂-VASc score. There were significant heterogeneity in all analyses (I2 inconsistency statistic 80.5-93.1%, P &lt; 0.001-0.006). Only one study reported either AUC or HR for predicting other outcomes such as bleeding and deaths in these patients, insufficient for pooled analyses.

Conclusion
The CHADS₂ and CHA₂DS₂-VASc scores had moderate discriminative ability for ischemic stroke during follow-up, comparing similarly to general AF populations. Further studies are required to assess if these scores can also guide selection for anticoagulation in this challenging to manage high-risk cohort.
J waves reaching to equal or more than 2 of 3 LV inferior wall leads may predict the presence of organized myocardial fibrotic or fat change in survivors of ventricular fibrillation
Authors: Funabashi N , Kobayashi Y 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The distribution of J waves and the presence of organized left ventricular (LV) myocardial damage may be related in survivors of ventricular fibrillation (VF).

Purpose
To predict the presence of organized myocardial damage such as fibrotic or fat change on cardiac computed tomography (CT) using the distribution of J waves in survivors of VF.

Methods
We conducted a retrospective analysis of 21 survivors of VF (17 males; mean age, 61 ± 14 years) that were implanted with a cardioverter defibrillator and underwent cardiac CT.

Results
On ECG, 4 patients had atrial fibrillation and 15 had J waves. On CT, 13 patients had organized LV myocardial fibrotic and/or fat change in myocardium. The mean corrected QT interval was 453 ± 30 and 429 ± 48 msec in patients with and without myocardial fibrotic and/or fat change, respectively (P = 0.182). The distribution of J waves was as follows: 5 had J waves in II, III and aVF leads (one had myocardial fibrotic and/or fat change) and 2 had J waves in III lead (one had myocardial fibrotic and/or fat change). One patient each had J waves in V1 lead; V1,2 leads; II, III, aVF and V1-3 leads; I, III, aVF and V1 leads; II, III, aVF, aVL and V1-6 leads; II, III, aVF and V4,5 leads; II, III, aVF and V2-5 leads; and III and aVF leads. The first one did not have myocardial fibrotic and/or fat change and the remaining 6 had myocardial fibrotic and/or fat change. If the J waves reached to ≥1 of 3 LV inferior wall leads (II, III, aVF leads) (N = 13), 10 (77%) had LV myocardial fibrotic and/or fat change. If not (N = 8), 3(38%) had LV myocardial fibrotic and/or fat change (P = 0.071). If the J waves reached ≥2 of 3 LV inferior wall leads (N = 11), 9 (82%) had LV myocardial fibrotic and/or fat change. If not (N = 10), 4 (40%) had LV myocardial fibrotic and/or fat change (P = 0.049). If the J waves reached all three LV inferior wall leads (N = 10), 8 (80%) had LV myocardial fibrotic and/or fat change. If not (N = 11), 5 (46%) had LV myocardial fibrotic and/or fat change (P = 0.104).

Conclusions
In survivors of VF, if the J waves reached ≥2 of 3LV inferior wall leads, the frequency of organized LV myocardial fibrotic and/or fat change was significantly higher than those without. Furthermore, the distribution of J waves and the presence of myocardial fibrotic and/or fat change on CT may predict VF. Abstract Figure. CT fibrosis in VF survivors with HCM
Echinacoside inhibited cardiomyocyte apoptosis and improved heart function in heart failure rats induced by isoproterenol via suppressing nadph/ros/atf6/chop associated endoplasmic reticulum stress
Authors: Ni Y J , Gao L , Zhu W J 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): Shaanxi Provincial Key Research and Development Projects (2019SF-218)

Background
Endoplasmic reticulum (ER) stress played an essential role in the development and progression of HF due to it could induce cardiomyocyte apoptosis, ATF6/CHOP was regulated by NADPH and ROS and was the crucial pathway to link ER stress and apoptosis in HF. Our previous study indicated that ECH reversed cardiac remodeling and improves heart function, but the underlying mechanisms are still unclear.

Objectives
To investigate the effect of ECH on cardiomyocyte apoptosis and endoplasmic reticulum stress and the underlying mechanisms.

Methods
In vitro, we cultured AC-16 cells and induced cell damage and ER stress by ISO, treated by ECH, the cell apoptosis and biomarkers of ER stress (GRP78, ATF6α, IRE1α, PERK) were detected. In vivo, we induced HF rat model by ISO and treated by ECH, indexes of heart function, cardiomyocyte apoptosis, biomarkers of ER stress and NADPH/ROS/ATF6/CHOP pathway were measured.

Results
In vitro, we confirmed that ECH inhibited ER stress and apoptosis. In vivo, we demonstrated that ECH inhibited cardiomyocyte apoptosis and improved heart function, it significantly decreased GRP78, ATF6α, IRE1α, PERK, and down-regulated NADPH/ROS/ATF6/CHOP pathway.

Conclusions
ECH inhibited cardiomyocyte apoptosis and improved heart function via suppressing NADPH/ROS/ATF6/CHOP pathway associated ER stress.
Cardiac resynchronization therapy in patients with true left bundle branch block : a systematic review and meta-analysis
Authors: Cheng C 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background Cardiac resynchronization therapy has been shown to improve clinical outcomes of heart failure. Still, about 30% of the patients had no response to CRT. A stricter LBBB criteria emphasizing notched or slurred R waves was newly proposed by Strauss to select patients for CRT.
Purpose To evaluate whether true left bundle branch block defined by Strauss criteria predicts a better clinical and instrumental response to CRT.
Methods A systematic review and meta-analysis was performed. Cohort studies including CRT patients with true left bundle branch block (LBBB) and non-true LBBB patients were identified. Non-true LBBB patients were defined as the patients who have conventional LBBB QRS morphology but not fulfilling Strauss criteria according to the ECG characteristic. Outcomes included death, heart failure(HF) hospitalization, CRT nonresponse, changes in QRS duration and left ventricular ejection fraction(LVEF).
Results Eight studies characterizing 1697 patients were identified. Pooled analysis of random effrct model demonstrated that true LBBB patients, as compared to non-true LBBB patients, had noticeable reduction in HF hospitalization or mortality (HR 0.49 , 95%CI 0.40,0.59; p &lt; 0.001), mortality alone (HR 0.55 , 95%CI 0.46, 0.66; p &lt; 0.001) , and HF hospitalization alone (HR 0.45 , 95%CI 0.22,0.93; p = 0.031). For other CRT response parameters, true LBBB patients had a significantly greater improvement of LVEF (SMD 7.30, 95%CI 0.57,14.03; p &lt; 0.001) .And the pooled value of the reduction in QRS duration was higher in the true LBBB patients (WMD -11.56, 95% CI -25.58, 2.45, P &lt; 0.001). Overall, there were more responders in the true LBBB patients than non-true LBBB patients (OR 8.16, 95% CI 1.64, 40.46, P &lt; 0.001).
Conclusions True left bundle branch block patients benefits more than non-true LBBB patients. Therefore, Strauss criteria of true LBBB is strong predictor of lower mortality, HF hospitalization and better response to CRT. (PROSPERO number : CRD42021242318)
Impact of angiotensin-receptor neprilysin inhibitor on reverse cardiac remodeling in patients with heart failure with reduced ejection fraction (hfref)
Authors: Atan N , Loch ALEX , Hadi FIRDAU 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Cardiac remodeling is a detrimental consequence of heart failure. The angiotensin-receptor neprilysin inhibitor (ARNI) sacubitril/valsartan has been shown to reverse cardiac remodeling and to improve systolic function in observational studies. There is a lack of local data regarding the effects of ARNI on cardiac remodeling in Asian populations. To determine the impact of ARNI on reverse cardiac remodeling.
The study was conducted at our University Medical Centre as a retrospective cohort study. Data was collected for the period from January 2017 until December 2020. Patients were included if they fulfilled the following criteria: i) age &gt;18 years, ii) recent diagnosis of HFrEF (EF &lt; 40%), iii) baseline Echocardiography was performed not more than 18 months prior to initiation of ARNI or Perindopril, iv) Echocardiography reassessment was performed not earlier than 6 months and not later than 18 months post initiation of ARNI or Perindopril, v) the HFrEF must have been diagnosed not more than 1 year prior to initiation of therapy. Echocardiographic parameters analyzed included Left Ventricular Ejection Fraction (LVEF), Left Ventricular End Diastolic Volume (LVEDV), and Left Ventricular End Systolic Volume (LVESV). 40 patients with complete echocardiographic sets treated with ARNI were identified. Another 40 patients treated with Perindopril and matching clinical characteristics were identified accordingly. Patients receiving ARNI recorded an increase in the LVEF from 24.9% ± 8.0% (mean ± standard deviation) to 36.4% ±12.3% (p &lt;0.001) and improvement in LVESV by 17% from the baseline (p = 0.003). Patients treated with Perindopril demonstrated a similar improvement in the LVEF from 28.7% ± 7.4% to 40.5%±15.9% (p &lt;0.001) with improvement in LVESV by 12.7% from the baseline (p = 0.093). The changes in LVEDV were less significant in both group (5.8% volume reduction in ARNI group and 2.6% in Perindopril group; p value 0.224 and 0.584 respectively). Treatment of recently diagnosed HFrEF patients with both ARNI and Perindopril resulted in significant improvement in the LVEF within 18 months after initiation of therapy.
The results of the study must be interpreted with caution as for the small sample size, the retrospective character of the study, and the relatively short follow-up period.
Association of Body mass index and clinical outcomes in patient with coronary artery disease undergoing percutaneous coronary intervention
Authors: Lin T Y , Leu H B 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background
Most of the world"s population lives in countries in which overweight status and obesity issues cause more morbidity and mortality than underweight status. Mortality increased as BMI increased above 25 kg/m², and the lowest mortality existed in a population with ideal body weight. Recently, the BMI or obesity paradox was widely discussed. The lower future risk was observed in these overweight subjects, not normal weight or lower BMI population, in patients with cardiovascular disease.
Purpose
The association of body weight and adverse outcomes in patients with coronary artery disease, undergoing percutaneous coronary intervention (PCI), has not yet been clearly established. The purpose of our study was to investigate the outcome of patients undergoing PCI, stratified by body mass index (BMI).
Methods
Moreover, 5,427 patients with established coronary artery disease (CAD) were enrolled while undergoing successful PCI from 2005 to 2015. The primary outcome, or total cardiovascular (CV) events, was the composite of cardiac death, nonfatal myocardial infarction, stroke, and hospitalization for congestive heart failure (CHF).
Results
During an average 65.06 ± 32.1 month follow-up, there were 573 total cardiovascular (CV) events (18.95%), 315 major adverse cardiovascular events (MACEs) (10.42%), 105 cardiac deaths (3.47%), 169 acute myocardial infarction (MI) (5.59%), 69 ischemic strokes (CVAs) (2.28%), 314 heart failure hospitalizations (10.39%) recorded. There was a "J-shape" curve association between BMI and future adverse events. Being overweight (BMI = 25-29.9 kg/m²) was associated with significantly lower risk of future total CV events (HR: 084, 95% CI:0.72-0.98), MACEs (0.76, 95% CI:0.63-0.93), acute MIs (0.76, 95%CI:0.58-1.00), and CVAs (HR:0.61, 95%CI:0.39-0.95).

Conclusion
A J-shape relationship exists between baseline BMI and future adverse events in CAD patients undergoing PCI, with the overweight (BMI = 25-29.9 kg/m²) group associated with the lowest risk of total CV events.
The value of microRNA-122 in the diagnosis of coronary heart disease
Authors: Marchenko O , Rudenko N , Kyriachenko Y , Dzobak A , Krasnienkov D 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. Patients with ischemic heart diseases form the majority group of cardiac diseases. Studies on the roles and mechanisms of microRNAs taking part in cardiac pathophysiology have become the focus of research worldwide.
Purpose. To elucidate whether microRNAs could be markers of atherosclerotic lesions, and further explore the mechanism of microRNAs in ischemic heart diseases.
Methods. In general, 40 patients were investigated in our Clinic. Blood tests, echocardiography (with two-dimensional speckle tracking echocardiography), ECG, coronary angiograms, microRNA detection were conducted. The patients were divided into two groups, i.e., a control group (Group A) without atherosclerotic lesion and a group with proven coronary artery disease (Group В). The data were analyzed using SPSS Statistics 20.0
Results. According to the level of circulating microRNA, a significant association between miR-122 and coronary artery lesion was identified (р=0.033). The results are shown in Figure 1. Besides, the positive moderate correlation was also revealed (r= 0.337, р=0.036). These data show miR-122 as a robust biomarker for predicting atherosclerosis lesions, and it plays certain role in pathogenesis of atherosclerosis.
Conclusion. Particularly, microRNA-122 fulfils the criteria of good biomarkers due to their key-role in severity assessment. The correlation between obtained coronary artery lesion results and epigenetic markers was found. The circulating microRNA has also improved the predictive power for diagnostics of ischemic heart disease, which is crucially important for patients and possible biochemical markers for control of treatment. Abstract Figure.
Analysis of clinical features and coronary angiography in 10 patients with de winter syndrome
Authors: Ni N I 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

OnBehalf
Guohua Ni

Objective
To investigate the clinical characteristics and electrocardiogram (ECG) changes of patients with de winter syndrome, so as to enhancing the awareness of de Winter ECG pattern and conducting early emergency interventional therapy for the patients.

Methods
The clinical data of 10 cases of patients with de winter syndrome admitted to a Medical University Hospital from January 2015 to May 2019 were retrospectively analyzed, to summarize the clinical characteristics, de Winter ECG pattern, timing of emergency interventional therapy, prognosis and other factors.

Results
Among the 10 patients with de winter syndrome, 9 males and 1 female, 3 cases of acute extensive anterior wall myocardial infarction (MI), 3 cases of non-ST -segment elevation MI (NSTEMI), 2 cases of acute anterior wall MI, and 2 cases of acute anterior septal MI. All the cases were in line with de winter ECG pattern, and they all had dynamic evolution characteristics. Of these, 7 patients developed ST-segment elevation MI (STEMI) and 3 patients developed NSTEMI. All cases were performed coronary angiography (CAG) and 9 patients were performed percutaneous coronary intervention(PCI). CAG showed that there were 6 cases of multi-vessel coronary disease, 4 cases of proximal occlusion of left anterior descending artery, 2 cases of subtotal occlusion, 1 case of 95% stenosis in proximal middle segment of stent. There was 1 case of middle occlusion of anterior descending branch and 1 case of subtotal occlusion, all the above 9 cases were performed PCI. One case had 95% stenosis in the middle segment of anterior descending branch, and no interventional therapy was performed due to hematuria.

Conclusion
de winter ECG pattern should be regarded as an STEMI equivalent, prompt recognition of the de winter ECG pattern and a timely diagnosis is of the utmost importance, in order to perform early emergency medical and interventional therapy.
Clinical Implications *
My study will enable cardiovascular clinicians to enhancing the awareness of de Winter ECG pattern and conducting early emergency interventional therapy for the patients, so as to improve the outcome and prognosis of the de winter syndrome. Abstract Figure.
Clinical implications of troponin-T elevations following TAVR
Authors: Imamura T , Oshima A , Onoda H , Tanaka S , Ushijima R , Sobajima M , Fukuda N , Ueno H , Kinugawa K 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Baseline and post-procedural elevations in serum troponin-T levels are associated with increased morbidity and mortality following transcatheter aortic valve replacement (TAVR). However, the prognostic impact of change in serum troponin-T level following TAVR remains unknown.

Methods
Among the patients with severe aortic stenosis who underwent TAVR, those with baseline serum troponin-T level ≥51.5 ng/L were excluded. The impact of increases in serum troponin-T level to an abnormally high range (≥51.5 ng/L) following TAVR on 2-year cardiovascular death or heart failure readmissions was investigated.

Results
Among 189 included patients (median 86 years old, 28% men), serum troponin-T level increased in 79 patients following TAVR. An increase in serum troponin-T was associated with a higher rate of 30-day adverse events, predominantly due to pacemaker implantation for complete atrio-ventricular block, and a higher 2-year cumulative incidence of the primary endpoint (hazard ratio 3.97, 95% confidence interval 1.51-10.4, p = 0.005) adjusted for the use of balloon-expandable valve and post-TAVR pacemaker implantation (Figure 1).

Conclusion
Post-procedural increase in serum troponin-T level was associated with adverse clinical outcomes following TAVR. Abstract Figure. Cumulative incidence of endpoint
Single center experience of transcatheter aortic valve implantation in severe aortic stenosis: study of mid-term clinical outcome
Authors: Tey Y S , Aris F A , Jalaluddin M S , Wan Rahimi Shah W F , Ashari A , Kolanthai Velu J , Ganesan K G , Dillon J J , Kadiman S , Sulong M A , Yahaya S A 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

BACKGROUND
Transcatheter Aortic Valve Implantation (TAVI) had revolutionized the treatment and outcome of symptomatic severe aortic stenosis (AS) since its introduction. In 2009, our center performed the first TAVI in Malaysia and since then it has provided an alternative treatment for severe AS patients. The objective of the study is to evaluate the clinical outcome of severe AS patients who had undergone TAVI in our center.
METHODS
A retrospective observational study was conducted. All TAVIs performed in our center between 01 Jan 2009 and 31 December 2020 were included. Patients’ baseline characteristic, clinical outcomes post procedure at 1-year and 3-year mortality were studied. Data were collected by using case report form and reviewing patient’s case note.
RESULTS
A total of 107 patients had TAVI performed during this period of time. The mean age (±SD) was 77.4 ± 5 (range 61-90 years). 50.5% of the patients were male (n = 54) and 45.8% were Malay ethnicity (n = 49). Majority of the patients had hypertension (86.9%, n = 93), dyslipidaemia (84.1%, n = 90) and ischemic heart disease (60.7%, n = 65). 26.2% of patients (n = 28) had previous coronary artery bypass surgery and 2.8% of patients (n = 3) had previous valvular operation. 85.9% of patient was in NYHA II – IV (n = 92). Mean EuroScore II and STS score were 4.82 and 4.564 respectively. Average hospitalization stay was 5 days. Total of 60 (56.1%) CoreValve were deployed followed by 46 Edwards Sapien (43%) and 1 MyVal (0.9%). 89.7% of procedure was performed via transfemoral access (n = 96) followed by transapical (6.5%, n = 7), transaortic (2.8%, n = 3) and subclavian (0.9%, n = 1). 98.1% (n = 105) procedure was successfully performed. There were 6 in-hospital mortality (5.6%) during indexed TAVI admission, of which 5 out of 6 were TAVI related. Kaplan Meier analysis of predicted survival rate with freedom from all-causes mortality at 1 year was 86.9% and 73.7% at 3 years.
CONCLUSIONS
Untreated severe AS was associated with poor outcome. High success rate of TAVI had provided another option of treatment to severe AS patient who are not the suitable candidate for surgical intervention.