bluuebunny/crossref_metadata_2025_split huggingface dataset:
From inoperable to back to life: a case report of successfully treated obstructive right ventricular primary cardiac lymphoma
Authors: Al Mawed Mohammad , Brockmeier Johannes , Haertel Dirk , Ellermeier Marc , Hartmann Frank , Gielen Stephan 
Published: February 2022

Abstract

Background
Cardiac masses include various tumourous and non-tumourous lesions. Primary cardiac tumours are very rare and most commonly benign. Primary cardiac lymphomas (PCL) account for 1–2% of malignant primary cardiac tumours. Only 197 cases of PCL have been reported between 1949 and 2009.

Case summary
We report a case of a 73-year-old patient who presented with atrial flutter. The diagnosis was a tumourous cardiac mass in the right atrium with signs of the infiltration of the tricuspid valve insertion and pericardium. There were no signs of extracardiac disease at the initial presentation. The patient was deemed to be inoperable by cardiac surgeons. Rapid tumour progression caused atrioventricular-block type Mobitz 2 with concomitant obstruction of the tricuspid valve and axillary lymph node metastasizing. Excision of the axillary lymph node revealed a diffuse large B-cell non-Hodgkin lymphoma. An epicardial right ventricle single lead pacemaker was sited, and chemotherapy was administered, resulting in complete remission.

Discussion
Cardiac masses are rare and challenging cases. Although current imaging procedures deliver extensive information, histological examination is still required in many cases. We encountered a tumourous mass with deep infiltration. After the patient was deemed inoperable, later lymph node invasion allowed histological examination, revealing PCL. Primary cardiac lymphomas are life-threatening tumours with rapid and aggressive growth. Treatment is based on chemotherapy consisting of anthracycline-containing regimens. This case report highlights the curative potential of chemotherapy, as we report a rapid regression of the tumour as well as the disappearance of arrhythmias and conduction disorders after treatment.
Endometriosis and cardiovascular disease
Authors: Marchandot Benjamin , Curtiaud Anais , Matsushita Kensuke , Trimaille Antonin , Host Aline , Faller Emilie , Garbin Olivier , Akladios Chérif , Jesel Laurence , Morel Olivier 
Published: February 2022

Abstract
Endometriosis is a chronic gynaecological disease affecting 1 in 10 reproductive-age women. It is defined as the presence of endometrium-like tissue outside the uterus. Beyond this placid anatomical definition, endometriosis is a complex, hormonal, inflammatory, and systemic condition that poses significant familial, psychological, and economic burden. The interaction between the cardiovascular system and endometriosis has become a field of interest as the underlying mutual mechanisms become better understood. On the basis of accumulating fundamental and clinical evidence, it is likely that there exists a close relationship between endometriosis and the cardiovascular system. Therefore, investigating the endometriosis—cardiovascular interaction is highly clinically significant. In this review, we highlight our current understanding of the pathophysiology of endometriosis with systemic hormonal, pro-inflammatory, pro-angiogenic, immunologic, and genetic processes beyond the peritoneal microenvironment. Additionally, we provide current clinical evidence about how endometriosis interacts with cardiovascular risk factors and cardiovascular disease (CVD). To date, only small associations between endometriosis and CVD have been reported in observational studies, inherently limited by the potential influence of unmeasured confounding. Cardiovascular disease in women with endometriosis remains understudied, under-recognized, and underdiagnosed. More detailed study of the cardiovascular-endometriosis interaction is needed to fully understand its clinical relevance, underlying pathophysiology, possible means of early diagnosis and prevention.
The evolution of the human healthcare system and implications for understanding our responses to COVID-19
Authors: Kessler Sharon E , Aunger Robert 
Published: February 2022

AbstractThe COVID-19 pandemic has revealed an urgent need for a comprehensive, multidisciplinary understanding of how healthcare systems respond successfully to infectious pathogens—and how they fail. This study contributes a novel perspective that focuses on the selective pressures that shape healthcare systems over evolutionary time. We use a comparative approach to trace the evolution of care-giving and disease control behaviours across species and then map their integration into the contemporary human healthcare system. Self-care and pro-health environmental modification are ubiquitous across animals, while derived behaviours like care for kin, for strangers, and group-level organizational responses have evolved via different selection pressures. We then apply this framework to our behavioural responses to COVID-19 and demonstrate that three types of conflicts are occurring: (1) conflicting selection pressures on individuals, (2) evolutionary mismatches between the context in which our healthcare behaviours evolved and our globalized world of today and (3) evolutionary displacements in which older forms of care are currently dispensed through more derived forms. We discuss the significance of understanding how healthcare systems evolve and change for thinking about the role of healthcare systems in society during and after the time of COVID-19—and for us as a species as we continue to face selection from infectious diseases.
Genetic Influences on Educational Achievement in Cross-National Perspective
Authors: Baier Tina , Lang Volker , Grätz Michael , Barclay Kieron J , Conley Dalton C , Dawes Christopher T , Laidley Thomas , Lyngstad Torkild H 
Published: February 2022

AbstractThere is a growing interest in how social conditions moderate genetic influences on education [gene–environment interactions (GxE)]. Previous research has focused on the family, specifically parents’ social background, and has neglected the institutional environment. To assess the impact of macro-level influences, we compare genetic influences on educational achievement and their social stratification across Germany, Norway, Sweden, and the United States. We combine well-established GxE-conceptualizations with the comparative stratification literature and propose that educational systems and welfare-state regimes affect the realization of genetic potential. We analyse population-representative survey data on twins (Germany and the United States) and twin registers (Norway and Sweden), and estimate genetically sensitive variance decomposition models. Our comparative design yields three main findings. First, Germany stands out with comparatively weak genetic influences on educational achievement suggesting that early tracking limits the realization thereof. Second, in the United States genetic influences are comparatively strong and similar in size compared to the Nordic countries. Third, in Sweden genetic influences are stronger among disadvantaged families supporting the expectation that challenging and uncertain circumstances promote genetic expression. This ideosyncratic finding must be related to features of Swedish social institutions or welfare-state arrangements that are not found in otherwise similar countries.
Invasive validation of the different echo parameters and cut-offs among the trilogy of left ventricular filling pressure assessment guidelines: EACVI/ASE 2016, ESC 2016, HFA 2019
Authors: Barakat A , Alsaadi A,R 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): Al-mouwasat University Hospital and University Heart Surgery Center in Damascus, Syrian Arab Republic.

Background
Left ventricular filling pressure assessment is a challenge. Three guidelines concerned about this are: EACVI/ASE 2016, ESC 2016 and the HFA 2019 guidelines. Echo assessment is a corner stone in their algorithms with different cutoffs and different parameters used depending on expert consensus that should be validated in an invasive manner as the authors stated.

Aims
This study validates and tests the accuracy of the different cutoffs and parameters used in echo LV filling pressure assessment in the three guidelines: EACVI/ASE 2016, ESC 2016 and HFA 2019 by direct measure in the catheterization lab.

Methods
82 patients with EF ≥ 50%, signs and symptoms of HF underwent transthoracic echocardiography immediately before catheterization. Av E/e", TR, LAVI, LVMI, RWT, LV wall thickness, Septal, lateral and mean e" were used to assess LV filling pressure with respect to EACVI/ASE 2016, ESC 2016 and HFA guidelines algorithms" different cutoffs and parameters used. This study used LV pre-A wave with a cutoff &gt;12mmhg defined high as a reference and then we compared the results.

Results
all the results of functional and structural echo parameters" diagnostic criteria (sensitivity, specificity, NPV, PPV and accuracy) are summarized in (Table:1 + 2).

Conclusion
From an echo view, each algorithm depends on modest to high specific but low to modest sensitive echo parameters. There is no single parameter makes a guidelines superior to others. Although that the fact of combining more echo indices make the diagnosis and eventually the algorithm more reliable as in HFA 2019, that was for the cost of simplicity and ease of application. Av E/e"&gt;13 was the best cutoff (ESC 2016). Orientation for the cause of use (sensitivity, specificity, NPV or PPV) should employ the echo indices and cutoffs in best benefit, as for mitral (e"), although that septal &lt; 7 and lateral e"&lt;10 (EACVI/ASE 2016 and HFA 2019) had an overall more accuracy than mean e"&lt;9 (ESC 2016), sub analysis showed that the first is better used for specificity and NPV but the latter better for sensitivity and PPV. Same idea for LVMI≥145/122 (m/f)+RWT &gt; 0.42 (HFA 2019 major criteria) which had more specificity than LVMI≥115/95 (m/F) cutoffs (HFA2019 minor criteria and ESC2016) but in the cost of lower sensitivity, furthermore, sub analysis showed this LVMI high cutoffs were more benefit in female than in men after taking the NPV, PPV and accuracy in consideration. Abstract Figure. Abstract Figure.
Identification of hemodynamically significant coronary artery disease with stress myocardial blood flow ratio by dynamic CT perfusion studies
Authors: Maqsood H , Ashraf T , Younus S , Rasool M W , Hameed A 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Coronary computed tomographic angiography (CTA) is an accepted noninvasive tool with high diagnostic accuracy for the evaluation of coronary artery disease (CAD). However, coronary CTA is limited in that it does not provide information on the hemodynamic relevance of coronary artery stenosis. Therefore, to determine the potential benefit of future coronary revascularization, a functional assessment is often required. A protocol combining coronary computed tomographic angiography (CTA) and CTP can provide a simultaneous assessment of both coronary artery ischemia and anatomy.

Purpose
This study sought to evaluate the diagnostic accuracy of stress myocardial blood flow ratio (SFR), a novel parameter derived from stress dynamic computed tomographic perfusion (CTP), for the detection of hemodynamically significant coronary stenosis.

Methods
A total of 98 patients (mean age 54.5 ± 10 years) with 128 vessels with either 1- or 2-vessel disease, scheduled for invasive angiography were included in this study. Stress dynamic CTP was performed followed by coronary CTA using a dual-source computed tomographic system. Fractional flow reserve was performed at subsequent invasive angiography to identify hemodynamically significant stenosis. Stress myocardial blood flow ratio (SFR) was defined as the ratio of hyperemic myocardial blood flow (MBF) in an artery with stenosis to hyperemic MBF in a non-diseased artery. The diagnostic accuracy of the SFR index was determined against the reference standard of invasive fractional flow reserve ≤0.80.

Results
58 (45.3%) vessels were deemed hemodynamically significant by fractional flow reserve (FFR) measurement. Hyperemic MBF and SFR were lower for vessels with hemodynamically significant lesions (95 ± 32.2 ml/100 ml/min vs. 140.5 ± 30.4 ml/100 ml/min; p &lt; 0.01 for both). When compared with ≥50% stenosis by CTA, the specificity for detecting ischemia by SFR increased from 44% to 92%, while the sensitivity decreased from 93% to 58%. The combination of stenosis ≥50% by CTA and SFR resulted in an area under the curve of 0.9, which was significantly higher compared with hyperemic MBF, area under the curve = 0.79 and p &lt; 0.01.

Conclusion
Our study concludes that the calculation of SFR by dynamic CTP provides a pioneering and accurate method to identify flow-limiting coronary stenosis. Abstract Figure.
Correlation of cardiac biomarkers with computed tomography severity score in COVID-19 patients
Authors: Rivera R , Cuenza L , Razon-Cuenza T 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

INTRODUCTION
A vast number of COVID-19 cases have been reported worldwide since the initial outbreak in China, and the disease has since become a global pandemic. Knowledge on this predominantly respiratory illness is evolving with studies suggesting myocardial injury reflected by elevated cardiac enzymes portending to more severe disease. CT scoring indices provide visual, semi-quantitative assessment of lung involvement and have aided in determining extent of COVID-19 pneumonia but, none have been validated for prognostication.

PURPOSE
Establishing a relationship between these non-invasive diagnostic parameters could provide timely identification and proper allocation of limited medical resources to patients in need of more aggressive therapy.

METHODS and RESULTS
A total of 50 COVID-19 patients were retrospectively enrolled and their clinical parameters collected from an electronic medical database. There was a total of 31 patients with troponin I-HS with chest CT scan done and another 42 patients for NT-proBNP and chest CT. The levels of both cardiac biomarkers in patients with clinically severe COVID pneumonia were higher than those with mild and moderate disease. Rank-order analysis showed that both troponin I-HS (moderate, p = 0.0003174) and NT-proBNP (moderate, p = 0.006255) correlated positively with CT severity scores. Furthermore, there is a significant relationship between mortality and septic shock with both Troponin I-HS (p &lt; 0.001; p = 0.002) and NT-proBNP (p = 0.004; p = 0.031).

CONCLUSION
The cardiac markers troponin I-HS and NT-proBNP increased significantly at more severe CT scores and more notably, these biomarkers predicted the development of septic shock and mortality in COVID-19 pneumonia.
Characterizing patients with newly diagnosed atrial fibrillation compared to those with established atrial fibrillation: data from the CODE-AF registry
Authors: Choi J M , Lee S R , Choi E K 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Korean Healthcare Technology R&D project funded by the Ministry of Health & Welfare

OnBehalf
CODE-AF investigator
Background/Introduction: The characteristic of atrial fibrillation (AF), such as the risk of complications, may differ depending on the time after diagnosis.

Purpose
This study aimed to compare the baseline characteristics according to the AF diagnosis duration using a large multicenter prospective registry: CODE-AF (COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation).

Methods
A total of 10,021 patients with AF were enrolled between May 2016 to March 2021. We defined patients into two groups: the newly diagnosed (AF duration less than 3 months before enrollment) and the established (AF duration more than 3 months before enrollment) AF groups. We compared the baseline characteristics and the incidence of the composite outcomes (stroke, all-bleeding, heart failure and all-cause death) during follow-up period between the two groups. The survival analysis was performed using Kaplan-Meier curve analysis with validation by log-rank test.

Results
Among the 10,021 patients with AF (age 67.0 ±14.5 years, female 35.7%), patients with newly diagnosed AF were 2181, and those with established AF were 7840. Two groups did not differ between sex, weight, height, and body mass index. The newly diagnosed AF group was younger with higher tobacco and alcohol consumption compared to the established AF group. The established AF group had more comorbidities at the time of enrollment. Also, CHA2DS2-VASc score (2.36 ±1.64 vs. 2.68 ±1.67, p &lt;0.001) and HAS-BLED score (1.55 ±1.02vs. 1.86 ±1.06 p &lt;0.001) were both higher in established AF. The newly diagnosed AF group had a lower proportion of oral anticoagulation prescription (68.6% vs. 73.0%, p &lt;0.001), whereas prescription of non-vitamin K antagonist oral anticoagulants was higher compared to those with established AF (75.7% vs. 68.9%, p &lt;0.001) (Table). There was no significant difference in the event-free survival during the overall follow-up period on the composite outcomes. However, the newly diagnosed AF group showed a significantly higher risk of the composite outcomes within 90 days of enrollment than the established AF group (hazard ratio 2.01, 95% confidence interval 1.48 to 2.72) (Figure).

Conclusion
The newly diagnosed AF group showed different characteristics compared to the established AF group. Also, the composite clinical outcomes, including stroke, bleeding, heart failure, and all-cause death, had occurred more frequently during the early period after diagnosis in the newly diagnosed AF group. For the better clinical outcome of patients with newly diagnosed AF, structured assessment and comprehensive management is needed, especially during the early period after diagnosis. Abstract Figure.
A multicentre survey of paediatric out-of-hospital cardiac arrest incidence, aetiology, and survival in New South Wales over an 11-year period
Authors: Youssef D , Singh A , Ayer J , Turner C , Christoff A , Bromage J , Balit C , Numa A , Skinner J R 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Out-of-hospital cardiac arrest (OOHCA) is commonly associated with pulseless ventricular tachycardia and ventricular fibrillation (VT/VF) and cardiac aetiologies. One New South Wales (NSW) ambulance registry reported(1) cardiac aetiologies with a prevalence of 31% among OOHCA cases. Multicentre OOHCA data and NSW’s well-developed services for cardiac genetic predisposition screening motivate us to consider the following study of paediatric OOHCA in this state.

Purpose
We present a multicentre, retrospective study summarizing the demographics, clinical characteristics, incidence, presenting rhythm, and survival-to-discharge status of paediatric OOHCA cases in NSW over an 11-year period. We also present and categorize diagnostic outcomes for patients presenting with VT/VF.

Methods
A retrospective case series of 298 patients admitted to one of three NSW PICUs (two in Sydney and one in Newcastle) under 18 years of age and presenting with OOHCA between January 2009 and December 2019.

Results
Out of 296 paediatric OOHCA patients that survived until PICU admission, 187 (63.2%) were male and 160 (54.1%) survived until hospital discharge. Of those surviving to discharge, 105 (65.6%) were male. Presenting rhythm was asystole or pulseless electrical activity in 240 patients (84.8%, aged 0–17 years, median age 2 years), VT/VF in 41 patients (14.5%, aged 0–16 years, median age 9 years), and complete heart block in 2 patients (0.7%, aged 4–4 years, median age 4 years). Survival was higher in the VT/VF group (82.9%) relative to the asystole and pulseless electrical activity group (50.0%). Of the 41 patients presenting with VT/VF, 13 (31.7%) had a predisposing cardiac condition (2 truncus arteriosus, 1 arrhythmogenic right ventricular cardiomyopathy, 1 double outlet right ventricle, 1 hypoplastic right ventricle, 1 left ventricular non-compaction, 2 asystolic syncope, 2 left ventricular intramyocardial fibroma, 1 familial dilated cardiomyopathy, and 2 undetermined cardiac conditions) and 20 (48.8%) had a genetic condition (9 catecholaminergic polymorphic ventricular tachycardia, 4 hypertrophic cardiomyopathies, 1 Nkx-2.5 mutation, 2 Long QT syndrome, 2 PPA2 mutation, 1 TANGO2 mutation, 1 supraventricular tachycardia). Toxins or trauma were involved in 4 (9.8%) cases, while no cause was determined in 4 (9.8%) other cases.

Conclusions
Overall, 54.1% of paediatric OOHCA patients admitted to PICU survived until hospital discharge, rising to 82.9% among those with VT/VF. Genetic conditions (48.8%), predominated by CPVT, were present in over one-third of VT/VF cases: this figure confirms the continued need for detailed cardiac/genetic assessment for paediatric OOHCA cases.
The first survey on patient needs for remote monitoring of cardiac implantable electronic device in South Korea
Authors: Hwang Y 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background/Aims: Studies showed that remote device monitoring reduced unnecessary outpatient visits and increased patient satisfaction. As there was no local research on remote monitoring (RM) in Korea, there was a lack of evidence for policy or insurance standards due to the lack of domestic data despite high demand by domestic arrhythmia experts. In order to establish the basis for patient satisfaction, economic efficiency, and safety of wireless monitoring, a survey-based study was planned.

Methods
This was a single-university hospital survey. The satisfaction index was evaluated using a questionnaire to investigate patient satisfaction in outpatient clinics, economic efficiency (measured as home-to-clinic time, waiting time, and actual clinic time), and demand for RM in patients with implantable cardiac devices. The questionnaire was adopted and modified from the Survey on Telehealth Patient Experience by Bas-Villalobos, 2006 (modified Korean version 2.0 by You Mi Hwang, 2020).

Results
Surveys were answered by 171 patients. The mean age of these patients was 71.2 ± 12.4 years. Based on the survey, home to clinic time was usually less than one h, mean waiting time in the hospital until clinic time ranged 42.6 ± 24.5 min, and mean clinic time ranged 3.1 ± 1.7 minutes. Based on the survey, patients favored RM over hospital visits with cardiac implantable electronic device follow-up mainly because of long travel times from home to clinic.

Conclusions
Based on the survey results, there is a clear need for RM in patients who have cardiac implantable electronic devices.