bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 19508: Mid-term Results of the Ross Procedure in Children: A Reappraisal of the Subannular Implantation Technique
Authors: Torii Ryo , Cornejo Patricia , Tran Phan-Kiet , Tran-Lundmark Karin , Hsia Tain-Yen , Kostolny Martin , Hughes Marina , Tsang Victor 
Published: March 2022

Dilatation of the pulmonary autograft is an ongoing concern in the paediatric population. Unlike those of the aortic valve leaflets, those of the pulmonary valve are directly attached to the right ventricular muscular outflow tract, and therefore at the time of the Ross procedure the pulmonary root needs to be placed within the left ventricular outflow (LVOT) tract for support.
Between 1998 and 2012, 74 children were operated with the subannular technique with interrupted sutures, at the median age of 10.2 years (range 5 months to 18 years). Mean follow up time was 5.2 years (range 3 days to 13.2 years). There were no deaths, but 3 reinterventions on the autograft for regurgitation and 2 resections of LVOT obstruction. Mean freedom from autograft and LVOT reintervention time was 12.1 years (95% CI 11.0 - 13.2). There were no significant autograft stenosis, and freedom from moderate to severe autograft regurgitation was 95% and 87.5% at 5 and 10 years, respectively. Z-scores at latest follow-up were at the annulus 0.23 (range -2.9 to +3.2), sinus of Valsalva 2.6 (range -3.1 to +5.4), and the sinotubular junction 2.9 (range -1.2 to +6.0). As expected, the correlation between time after surgery and the increase in Z-score of the root structures were positive at the level of the sinus of Valsalva (r=+0.39, p=0.003) and at the sinotubular junction (r=+0.27, p=0.049), but was negative at the annulus (r=-0.26, p=0.054). Average rate of change in Z-score was significantly lower at the annulus compared to the sinus of Valsalva (0.19 vs 0.46 Z-score/year, p < 0.001).
Our data confirms the importance of subannular support of the pulmonary autograft in the LVOT with limited annular dilatation and autograft regurgitation, and delayed need for autograft reintervention.
Abstract 19675: Management of Pump Thrombosis in Heartware Hvad Patients
Authors: Krabatsch Thomas , Kaufmann Friedrich , Hörmandinger Christoph , Müller Markus , Kretzschmar Alexandra , Pergantis Panagiotis , Falk Volkmar , Potapov Evgenij V 
Published: March 2022

Introduction:
Implantable continuous-flow left ventricular assist device (LVAD) HeartWare HVAD has found broad acceptance, but a significant number of patients present with pump thrombosis (PT). We report our diagnostic and therapeutic strategy.

Methods:
We retrospectively analyzed pump thrombosis in 540 patients supported with the HeartWare HVAD in 8/2009-5/2015. Our anticoagulation protocol consisted of bridging with heparin until sufficient oral anticoagulation. Patients with clear evidence of pre- or post-device thrombus (n=5 and n=3) were excluded.

Suspected PT was defined as marked increase of LVAD power consumption, significant increase of hemolysis (according to Intermacs definitions) and/or positive signals in acoustic analysis. Confirmed PT was defined as either demonstration of thrombotic material in the explanted LVAD or complete disappearance of hemolysis and normalization of device parameters after thrombolytic therapy.

Results:
As median support in this group was 248 (range 0-2106) days the cohort represents 617 patient-years. Eighty-three episodes of PT were detected in 66 patients with 10 of these episodes successfully treated by thrombolysis (15%). PT occurred within 2-1521 days after primary implantation, median 349 days. Cumulative rate of all types of PT per patient-year (EPPY) was 0.13, with 0.11 for proven and 0.02 for suspected PT.

The decision to exchange the pump was triggered by marked hemolysis and/or high power consumption or failed thrombolysis, if initiated.
Fifty-five operative pump exchanges, including 5 after unsuccessful thrombolysis were necessary in 48 patients 5 patients experienced two and 1 patient three exchanges. Fifty pump exchanges were performed via lateral mini-thoracotomy and five through a median re-sternotomy.
Eight patients died before pump exchange. The hospital discharge rate was 62% after the first and 100% after the second and third pump exchange.

Conclusions:
Minority of pump thrombosis after HeartWare implantation could be cured medically. As most thrombosed devices can be exchanged through a lateral mini-thoracotomy with low postoperative mortality, the pump exchange should not be delayed and then even repeated thrombotic events can be handled successfully.
Abstract 9909: Selenium Supplementation Rescues Cardiac Function in Patients With Severe Heart Failure Who are Intractable to Renin-Angiotensin System Inhibitors and β-blockers
Authors: Hiraoka Yuji , Tanabe Masato , Yamazaki Taketoshi , Kihara Yasuki 
Published: March 2022

Introduction:
Increases in oxidative stress may be involved in the progression of heart diseases. Selenium (Se) is an integral part of the enzyme glutathione peroxidase (GSHPx), one of the central players of the heart’s antioxidant system. This study evaluated Se supplementation in patients with severe heart failure who were intractable to renin-angiotensin system (RAS) inhibitors and β-blockers.

Methods:
In order to confirm the activation of myocardial oxidative stress and the local deficiency of GSHPx, we examined immunohistochemical staining of endomyocardial biopsy specimens obtained from 24 dilated cardiomyopathy (DCM) patients and analyzed serum Se concentrations and GSHPx activities. We enrolled patients who had shown no functional improvements after RAS inhibitors and β -blockers (n = 11). The patients were supplied with 25 μg of Se chloride twice per day while their other medications remained unchanged.

Results:
Compared with patients with normal ventricular function (n = 30), the serum Se concentrations and GSHPx activities from the patients with DCM (n = 24) were decreased by 55% (0.167 μg/ml vs 0.076 μg/ml, p < 0.01), and by 33% (328 μmol/min/L vs 221 μmol/min/L, p < 0.01), respectively.

Myocardial biopsy from DCM patients, but not control patients, uniformly showed marked reduction of GSHPx stains (24/24 vs 0/3, respectively) that was accompanied by positive staining for both 4-hydroxy-2nonenal (20/24 vs 1/3) and 8-hydroxy-2`-deoxyguanosine (16/24 vs 0/3).
Left ventricular (LV) ejection fraction increased from 26% ± 8% to 34% ± 8%, 37% ± 12%, and 38% ± 11% at the 3-month follow-up, 6-month follow-up, and 12-month follow-up, respectively, and then maintained thereafter.

Conclusions:
Our study suggests that myocardial oxidative stress in chronic heart failure may be augmented at least in part by concomitant GSHPx deficiency, and that the administration of Se could rescue the exhaustion of this selenoprotein, resulting in improved LV function.
Abstract P044: Difference of Body Composition Between Urban and Rural Overweight Children in Taiwan - Reappraisals Using of BMI as the Criteria for Childhood Obesity
Authors: Chu Nain-Feng , Hsu Juy-Ting , Lin Fu-Hung 
Published: March 2022

To evaluate the prevalence of overweight among school children at urban and rural area and also examine the difference of body fat compositions of normal and overweight status children in Taiwan.
We conducted school-wide survey among junior-high school children at Taipei (as urban area) and Taitung (as rural area) in 2006 and 2012. Anthropometric variables of body height and weight were measured using standard scales and BMI was calculated as kg/m2. We measured body composition using the Tanita body composition analyzer (TBF-410GS). Total body fat (TBF) and percentage of body fat (%BF) were obtained for further analyses.
There are 1263 urban and 577 rural children included for this survey. The mean (SD) of BMI for boys was 21.6 (4.2) at urban and 21.0 (4.2) at rural area and for girls was 20.5 (3.5) and 20.3 (3.4) at urban and rural area (no statistical difference). But the percentage of body fat was 22.2 (7.9) and 18.9 (6.9) for urban and rural boys (p < 0.001), and was 26.2 (7.8) and 24.5 (7.1) for urban and rural girls (p< 0.01).
The overall prevalence of overweight was 38.3% in boys and 24.6% in girls for urban children and was 30.4% and 20.5% for rural children. The prevalence of overweight was 41.7, 37.1 and 35.8 for age 13, 14 and 15 yo urban boys and was 33.3, 33.7, and 25.2% for rural boys. For girls, the prevalence of overweight was 23.5, 25.8 and 24.6 for age 13, 14 and 15 yo at urban area was 28.1, 20.9, and 17.1% at rural area.
There is no statistical difference of mean BMI between urban and rural area (26.0 vs. 26.3 for boys and 25.4 vs. 25.4 for girls). However, the percentage of body fat was higher for urban overweight children when compared with rural overweight children (28.8 vs. 26.5 for boys, p<0.05 and 36.5 vs. 32.9 for girls, p<0.001).
Using BMI as cot-off points of overweight for children at urban and rural area may be biased (or underestimate for the urban children). Body fat composition may be more appropriate criteria for children or for children comparing with different areas or countries.
Abstract P116: Physical Fitness in Early Adulthood: A Modifiable Risk Factor for Neurological and Psychiatric Diseases
Authors: Nyberg Jenny , Åberg David , Margda Waern , Wallin Anders , Torén Kjell , Nilsson Michael , Åberg Maria A , Kuhn Georg 
Published: March 2022

Low cardiovascular fitness in mid- and late life represents a risk factor for several neurological diseases. However, the respective effect of aerobic cardiovascular and muscle fitness in early adulthood is largely unknown. Therefore, we analyzed these in young men with regard to long-term risk serious depression, bipolar disorders, stroke and dementia.
We performed population-based longitudinal cohort studies of Swedish male conscripts registered in 1968-2005 for mandatory military service (approx. 1,800,000 subjects), representing about 95 % of all Swedish males at age 18 during this time period. Data on cardiovascular fitness (determined by the cycle ergometric test), muscle strength (isometric contraction) and cognitive performance (IQ tests) were subdivided into low, medium, high fitness groups. Over a 40-year follow-up, risk of serious depression, bipolar disorder, stroke and dementia were calculated with Cox proportional hazards models controlling for potential confounders. To identify cases, we used the International Classification of Diseases (ICD) 8-10 in the Hospital Discharge Register and the Cause of Death Register.
Depression. Adjusted hazard ratios (HRs) with confidence interval (CI) show significant relationships between fitness and severe depression for low compared to high fitness: HR (CI) 1.80 (1.64-1.99) for cardiovascular fitness and 1.43 (1.32-1.55) for muscle strength. Bipolar disorders exhibited a lower, yet significant association with cardiovascular fitness and muscle strength (adjusted hazard ratios (HRs) with confidence interval (CI): 1.35 (1.12-1.63) and 1.22 (1.05-1.42), respectively.
Stroke. Adjusted HRs show inverse relationships between fitness and stroke for low compared to high fitness HR (CI) 1.70 (1.50-1.93) for cardiovascular fitness and 1.39 (1.27-1.53) for muscle strength. All three stroke types (subarachnoidal hemorrhage, intracerebral hemorrhage and ischemic stroke displayed similar associations. There were stronger associations for fatal stroke.
Dementia. Low compared to high cardiovascular fitness was significantly associated with an increased risk for diagnosis of dementia before age 60: HR (CI) 2.49 (1.87-3.32). Mild cognitive impairment (MCI) showed an even greater association: HR (CI) 3.57 (2.23-5.74). The combination of low cardiovascular fitness and poor cognitive performance in early adulthood was associated with a >8-fold increase in the risk of early-onset MCI and a >7-fold increased risk of early-onset dementia.
In summary, this study sheds light on physical fitness as an early-life risk factor for psychiatric and neurological conditions, and underlines the potential for lifestyle modification to reduce the risk of late-life CNS impairments.
Abstract P051: Association of Subclinical Hypoglycemia with Incident Cardiovascular Disease and All-cause Mortality: The Multi-Ethnic Study of Atherosclerosis
Authors: Mongraw-Chaffin Morgana , Bertoni Alain G , Golden Sherita Hill , Mathioudakis Nestoras , Sears Dorothy D , Szklo Moyses , Anderson Cheryl A 
Published: March 2022

Trials of intensive glucose control have not improved cardiovascular disease (CVD) risk in type 2 diabetes; however data are inconsistent about the effects of maintaining below normal glucose levels in the general population. Further, it has been suggested that fasting glucose and HbA1c in the lower ranges have a different relationship with CVD and mortality.
In 5992 participants from the Multi-Ethnic Study of Atherosclerosis, free of CVD at baseline, we used logistic regression to investigate the associations of low fasting glucose (<80mg/dL) and HbA1c (<5.0%), from baseline and averaged across follow-up over 13 years, with incident CVD and mortality. We used the normal range (80 to <100mg/dL and 5.0 to <5.7%) as reference. We excluded participants with diabetes at baseline from the low, normal, and impaired groups at baseline, and excluded participants with diabetes at any visit from those groups for averaged values. We matched covariates to the visit of glycemic data collection.
Participants with low fasting glucose were more likely to be younger, female, Asian, use glucose lowering medication, have lower BMI and be normotensive. Those with low HbA1c were more likely to be younger, Asian or Hispanic, and have higher income at baseline. Adjusted for age, sex, race/ethnicity, education, and income, glucose and HbA1c in the impaired (100 to <126mg/dL and 5.7 to <6.5%) and diabetic ranges (≥126mg/dL and ≥6.5%) at baseline were significantly associated with increased CVD and mortality. Low baseline glucose and low baseline HbA1c were positively, but not significantly, associated with mortality; while low average glucose and low average HbA1c were both strongly and significantly associated with increased risk of mortality (Figure).
The relationships between fasting glucose and HbA1c with mortality are J-shaped at baseline, but strongly and significantly U-shaped when average levels are used. Consistently low fasting glucose or HbA1c may be better markers for risk from subclinical hypoglycemia than a single low measurement.
Abstract P261: HIV-positive Individuals With Undetectable Viral Loads Have suPAR Levels Comparable to HIV-negative Individuals
Authors: Topel Matthew L , Hayek Salim H , Wadhwani Shikha , Moran Caitlin , Staloch Dustin A , Wei Changli , Reiser Jochen , Ofotokun Ighovwerha , Quyyumi Arshed A 
Published: March 2022

Introduction:
Individuals with poorly-controlled HIV have high levels of plasma soluble urokinase plasminogen activator receptor (suPAR), a marker of immune activation associated with all-cause mortality, incident myocardial infarction and HIV-associated nephropathy in HIV-positive individuals. Data is conflicting regarding the effect of viral suppression on suPAR levels in HIV-positive individuals, or how these levels compare to individuals without HIV.

Hypothesis:
HIV-positive individuals with undetectable viral loads (VLs) will have similar levels of suPAR compared to individuals without HIV.

Methods:
Plasma suPAR was measured by ELISA in 273HIV-positive (70% Black [n=167], age 42 ± 8 years, 86% female [n=240], 56% detectable viral load [n=150]) and 276 HIV-negative (63% Black [n=169], age 40 ± 9 years, 96% female [n=265]) outpatients. Demographics, medical history and laboratory samples were collected.

Results:
Compared to HIV-negative individuals, HIV-positive subjects were older (p=0.01), less likely to be female (p<0.001), had lower body mass index (28 ± 7 vs. 30 ± 8 kg/m
2
, p<0.001) and worse renal function (eGFR 92 ± 19 vs. 97 ± 20 mL/min/1.73 m
2
, p=0.004).

Median suPAR level was similar for HIV-negative and HIV-positive subjects with undetectable VLs (2436 [1908, 3380] vs. 2667 [1966, 4034] pg/mL, p=0.256), and both were significantly lower compared to HIV-positive subjects with detectable VLs (4252 [3099, 5369] pg/mL, p<0.001).
Within HIV-positive subjects, a detectable viral load was an independent predictor for high suPAR (OR 2.37 [95% CI 1.07-5.25], p=0.03) after controlling for age, race, sex, body mass, smoking history, hypertension, diabetes, eGFR and CD4+ count.

Conclusions:
In conclusion,HIV-positive individuals with undetectable VLs have similar levels of suPAR compared to those without HIV. Lower suPAR levels may account for the lower incidence of cardiovascular events and HIV nephropathy in patients with well-controlled HIV.
Abstract 21292: Total Laser Cycles - A Novel Measure of Transvenous Lead Extraction Difficulty
Authors: Elsaid Ossama , O'Sullivan David , Zweibel Steven , Cronin Edmond 
Published: March 2022

Background:
Several variables have been identified as predictors for difficult or complicated transvenous lead extraction (TLE), including age and number of implanted leads, as well as patient’s age; however, a standard measure of TLE difficulty has not been described.

Objective:
Total laser cycles (TLC) delivered during laser-assisted TLE is an objective variable that could reflect the difficulty of TLE. This study investigated whether TLC is correlated with known predictors of difficult TLE.

Methods:
In a retrospective study of TLE procedures using the laser sheath, we analyzed TLC delivered and compared it to established predictors of procedural failure and complications.

Results:
Of 166 patients undergoing TLE, the laser sheath (SLS II or Glidelight, Spectranetics Inc,) was used as the primary extraction sheath in 130 patients, and 100 patients had complete TLC data available. The mean age of the oldest lead (AOL) was 7.1 ± 3.2 years, and 1.6 ± 0.7 leads (range, 1-4) were extracted per procedure. Two-thirds of procedures involved ICD leads. Clinical success was 97.5%, with one patient (0.6%) experiencing a major complication. Median TLC delivered was 1165 (IQR, 567-2062; range, 49 - 9522) Hz. TLC was positively correlated with AOL (ρ=0.203, p=0.042), and the combined age of leads extracted (ρ=0.287, p=0.004) Fig 1. TLC was also positively correlated with number of leads extracted per procedure (ρ=0.240, p=0.016). There was negative and non-significant correlation between TLC and patient’s age (ρ=-0.114, p=0.257).

Conclusion:
TLC showed significant correlation with known predictors of difficulty during TLE using the laser sheath. TLC can hence be used as an objective method to report the difficulty of TLE.

Figures:
Figure1: Panel A showing the correlation between age of oldest lead (AOL) and total laser cycles (TLC); Panel B showing the correlation between combined age of leads (CAL) and total laser cycles (TLC)
Abstract 24043: Cytosolic RBFox1 in Cardiac Fibrosis Regulation
Authors: GAO Chen , Hsiao Yun-Hua Esther , Ren Shuxun , Xiao Xinshu (Grace) , Xing Yi , Wang Yibin 
Published: March 2022

RBFox1 is known to be an RNA splicing regulator with enriched expression in cardiac muscle. Loss of RBFox1 expression is a molecular hallmark associated with pathological hypertrophy and heart failure. However, much of our current knowledge about RBFox1 focuses on nuclear RBFox1 with a major impact on global alternative splicing changes in the diseased heart. Yet, RBFox1 gene also generates a cytosolic isoform through alternative splicing (RBFox1c), but the specific function of RBFox1c in heart has not been characterized.
RBFox1c expression is significantly repressed in the mouse failing heart and hypertrophic cardiomyocytes. We performed RNA-seq combined with GO and IPA analysis to determine the impact of RBFox1c expression in culture. Among the genes suppressed specifically by RBFox1c but not the nucleus RBFox1 are groups of pro-inflammatory genes. Both Motif enrichment analysis and de novo motif discovery identified significant enrichment of RBFox1 binding motif in the 3’UTRs of the RBFox1c regulated genes. Using CLIP analysis followed by RT-PCR, we observed RBFox1c, but not nuclear RBFox1 specifically interacted with targeted inflammatory gene 3’UTR. In the cardiac specific RBFox1 knockout mice, enhanced cardiac fibrosis was observed following TAC, associated with elevated expression of RBFox1c dependent inflammatory genes. In contrast, cardiac specific expression of RBFox1c significantly reduced cardiac fibrosis and inflammatory gene expression following TAC, associated with improved ejection fraction and reduced hypertrophic marker gene expression. Further, we tested the effect of RBFox1c expression on cardiac fibrosis response using NRVM conditioned media. We showed the conditioned media from the hypertrophic cardiomyocytes potently induce fibroblast proliferation. However, RBFox1c expression can suppress phenylephrine and isoproterenol induced fibroblasts proliferation.
RBFox1 regulates cardiac transcriptome reprogramming at two post-transcriptional steps. The RBFox1 nuclei isoform regulates global RNA splicing reprogramming in heart, while the RBFox1c regulates inflammatory gene expression and fibrotic remodeling potentially through potential interaction with their 3’UTR and targeted RNA degradation.
Left Atrial Volumetric/Mechanical Coupling Index
Authors: Benfari Giovanni , Essayagh Benjamin , Nistri Stefano , Maalouf Joseph , Rossi Andrea , Thapa Prabin , Michelena Hector I. , Enriquez-Sarano Maurice 
Published: March 2022

Background:
Left atrial assessment is complex, particularly in heart failure with reduced ejection fraction due to interactions with functional mitral regurgitation (FMR). Pilot data suggest that left atrial volumetric/mechanical coupling index (LACI) may be useful, but large outcome data are lacking.

Methods:
We enrolled a comprehensively characterized cohort of patients in sinus rhythm with heart failure with reduced ejection fraction diagnosis at Mayo Clinic from 2007 to 2011. Routinely measured left atrial volume index and tissue-doppler-imaging a’ allowed LACI calculation as (left atrial volume index)/(tissue-doppler-imaging a’). Survival was the outcome measured.

Results:

The cohort’s 4196 patients (69 [58–77] years, ejection fraction 40 [31–45]%) had mild FMR in 1505 and moderate-severe FMR in 1068. LACI was overall 5.06 (3.50–8.10) and increased with each FMR grade (3.86 [2.94–5.29] without FMR, 5.38 [3.80–8.02] with mild, 5.45 [1.49–8.07] with moderate/severe FMR;
P
<0.0001). At diagnosis, higher LACI was independently determined by more severe FMR and by higher left ventricular mass index, lower ejection fraction, higher E/e’, and lower glomerular filtration rate (all
P
<0.0001). During follow-up 1588 (38%) patients died. In spline modeling, excess mortality appeared around LACI=6 and steeply increased thereafter (5-year survival 72±1% with LACI<6 and 49±2% with LACI ≥6,
P
<0.0001). Multivariable comprehensive adjustment showed LACI strong association with excess mortality (adjusted hazard ratio, 1.41 [1.23–1.61],
P
<0.0001 for LACI ≥6). Independent link to mortality persistent across FMR grades (adjusted hazard ratio, 1.45 [1.13–1.86],
P
=0.004 without FMR, 1.42 [1.16–1.77],
P
=0.0008 with mild FMR, and 1.38 [1.01–1.66],
P
=0.04 with moderate/severe FMR) without interaction (
P
=0.3). LACI independent impact on outcome was incremental to that of left atrial volume index, tissue-doppler-imaging a’, or any other characteristic including the Meta-Analysis Global Group in Chronic-score (least significant
P
=0.02).

Conclusions:
In this large cohort, left atrial volumetric/mechanical coupling measured by LACI in routine practice integrates the influence of several morphological/hemodynamic determinants but displays progressive deterioration with increasing FMR severity in heart failure with reduced ejection fraction. About outcome, higher LACI is strongly, independently, and incrementally associated with excess mortality, irrespective of FMR grade and in all subsets. Hence, LACI is a novel and critical measure in heart failure with reduced ejection fraction, quantifiable in routine practice, which should be integrated in prognostication and decision-making.