bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unexplained exercise-related dyspnea in type 2 diabetes predicts pulmonary arterial hypertension during exercise
Authors: Gojevic T , Van Ryckeghem L , Jogani S , Frederix I , Bakelants E , Petit T , Stroobants S , Dendale P , Bito V , Hansen D , Verwerft J 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Purpose
To evaluate whether type 2 diabetes mellitus (T2DM) patients who suffer from unexplained exercise-induced dyspnea display cardiac dysfunction during exercise.

Background
Patients with type 2 diabetes mellitus (T2DM) frequently suffer from unexplained dyspnea. It is not fully understood whether these patients have a worse exercise capacity and cardiac dysfunction than non-dyspneic patients. If so, it would be clinically relevant to evaluate cardiac function in T2DM patients with unexplained dyspnea and initiate treatment accordingly.

Methods
47 T2DM patients with unexplained dyspnea and 50 asymptomatic T2DM patients underwent echocardiography with simultaneous cardiopulmonary exercise testing (CPETecho). Left ventricular (LV) function (cardiac output, LV ejection fraction, stroke volume), estimated LV filling pressures (E/e’) and mean pulmonary artery pressures (mPAP) were assessed at rest, low- and high-intensity exercise by using colloid contrast. Breath-by-breath analyses were used to monitor exercise intensity and evaluate exercise capacity (V̇O2peak).

Results
The groups had similar characteristics and glycemic control (p&gt;0.05). LV function and E/e’ were similar between groups during all stages of exercise (p&gt;0.05). However, mPAP increased disproportionally (mPAP/CO &gt; 3) during exercise in 62% of the patients with dyspnea. The mPAP/CO slope was significantly steeper in the patients with, as opposed to without dyspnea (Pinteraction=0.013). Moreover, a steeper mPAP/cardiac output slope (β= -1.86, 95% CI -2.75, -0.98) was an independent predictor of lower V̇O2peak (multivariate model R²:0.54).

Conclusion
In T2DM patients with unexplained exertional dyspnea, simultaneous cardiopulmonary exercise testing and echocardiography frequently reveal a reduced exercise capacity associated with exercise-induced pulmonary arterial hypertension. Dyspneic T2DM patients possibly have early left atrial and LV diastolic dysfunction. Timely preventive and therapeutic interventions may improve clinical outcomes in these patients.
High fibrinogen-to-albumin ratio with type 2 diabetes mellitus is associated with poor prognosis in patients undergoing percutaneous coronary intervention: 5-year findings from a large cohort
Authors: Wang P , Yuan D , Yuan J 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): the National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences

Background
Inflammation plays a crucial role in coronary atherosclerosis progression, and growing evidence has demonstrated that the fibrinogen-to-albumin ratio index (FAR) is associated with the severity of coronary artery disease (CAD). However, the long-term risk of cardiovascular events remains indistinct in patients with different level of FAR and different glycemic metabolism status. This study was to access 5-year clinical outcomes of diabetic and non-diabetic patients who underwent percutaneous coronary intervention (PCI) with different level of FAR.

Methods
We consecutively enrolled 10,724 patients with CAD hospitalized for PCI and followed up for major adverse cardiac and cerebrovascular events (MACCE) covering all-cause mortality, non-fatal myocardial infarction, non-fatal ischemic stroke and unplanned coronary revascularization. FAR was computed using the following formula: Fibrinogen (mg/dL) / Albumin (g/L). According to the optimal cut-off value of FAR, which was determined by the surv_cutpoint function of the R package survminer via RStudio software (version 2021.09.0), patients were divided into higher level of FAR (FAR-H) and lower level of (FAR-L) subgroups, and were further categorized into for groups as FAR-H with DM and non-DM, and FAR-L with DM and non-DM.

Results
5,298 patients (58.36 ± 10.36 years, 77.7% male) were ultimately enrolled in the present study. A total of 1,099 (20.7%) MACCEs were documented during the 5-year follow-up. The optimal cut-off value of FAR was 0.0783 by the surv_cutpoint function. Compared to ones with FAR-H and DM, patients with FAR-L and non-DM, FAR-H and non-DM, FAR-L and DM had decreased risk of MACCEs [adjusted hazard ratio (HR): 0.75, 95% confidence interval (CI) 0.64-0.89, p = 0.001; HR: 0.006, 95% CI 0.66-0.93, p = 0.006; HR: 0.81, 95% CI 0.68-0.97, p = 0.019]. Notably, non-diabetic patients with lower level of FAR also had lower all-cause mortality risk than those in the FAR-H/DM group (HR: 0.41, 95% CI 0.27-0.63, p &lt; 0.001). Multivariate Cox proportional hazards regression analysis also indicated the highest risk of MACCEs in patients with FAR-H and DM than others (p for trend = 0.005). In addition, subgroup analysis revealed consistent effects on 5-year MACCE across various subgroups.

Conclusion
Diabetic patients with higher level of FAR had the worse 5-year outcomes compared with patients in other three groups. The level of FAR may help to identify high-risk individuals in this specific population.
Physical activity and psychological status of hypertensive and healthy individuals: in the era of COVID-19
Authors: Karaduz B , Sener YZ , Vardar Yagli N , Calik Kutukcu E , Tokgozoglu L 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background/Introduction
Hypertension is an important and common reason of cardiovascular diseases. Hypertension can prevent, delay and/or manage with lifestyle modifications like regular physical activity participiation, stress management. During COVID-19 pandemic physical inactivity, increased stress and anxiety levels impair disease management of hypertensive individuals and becomes a serious risk factor for healthy individuals.

Purpose
We aimed to investigate and compare physical activity, anxiety and depression level of hypertensive and healthy individuals.

Methods
Forty hypertensive and forty healthy individuals were included in the study (Mean age: 51,15±6,96 years and 49,75±8,41 years, respectively). Patients informed about the study and invited during their cardiology visit and called by a physiotherapist in lockdown periods. In phone call, working status, quarantina compliance, sociodemographic status were asked. Physical activity levels were assessed with International Physical Activity Questionnnaire-Long Version (IPAQ), anxiety and depression levels were examined with Hospital Anxiety and Depression Scale (HAD). Patients categorized as inactive, minimally active and active according to METs results of IPAQ and classified as increased depression and/or anxiety according to HAD results.

Results
Working status, quarantina compliance and gender were similar between groups (p&gt;0,05). Anxiety and depression scores were similar but number of people who had increased depression were higher in hypertensive group. Considering physical activity, transport, vigorous domestic activities, leisure time vigorous activities and total physical activity levels were statistically different between groups (p&lt;0,01, p=0,002, p=0,002,respectively) and hypertensive individuals were less active. When we compared physical activity categorization, in hypertensive group 12,5% were active, 47,5% were minimally active and 40% were sedentary and in healthy group 32,5% were active, 50% were minimally active and 17,5% were sedentary and physical activity status were statistically significant (p=0,029).

Conclusion(s)
According to our results, hypertensives were more inactive and deprressed than healthy controls. Quarantine periods become very inactive periods for all populations but this is very crucial for especially risky populations. To prevent upcoming cardiovascular diseases and complications of hypertension physical activity and psychosocial support can implement by healthcare providers.
Use of traditional medicine and control of hypertension in 12 Sub-Saharan African countries: the EIGHT cross-sectional study
Authors: Lassale C , Gaye B , Diop IB , Azizi M , N'guetta L , Antignac M , Jouven X 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Camille Lassale is supported by a fellowship from “La Caixa” Foundation (ID 100010434). The fellowship code is LCF/BQ/PR21/11840003

Background
Use of traditional medicine (TM), is widespread in Sub-Saharan Africa as treatment option for a wide range of disease. We aimed to describe the profile of TM users and estimate the association with blood pressure (BP) and control of hypertension among hypertensive patients in a pan-African study.

Methods
We included 2128 participants in the cross-sectional EIGHT study, who attended an outpatient consultation in the cardiology departments of 12 Sub-Saharan African countries (Benin, Cameroon, Congo, Democratic Republic of the Congo, Gabon, Guinea, Côte d’Ivoire, Mauritania, Mozambique, Niger, Senegal, Togo). We describe patients’ characteristics according to TM use. We modelled the odds of uncontrolled hypertension, severe hypertension, and complications of hypertension by multivariable mixed logistic regression, and the linear association with systolic and diastolic BP by linear regression, all adjusted for age, sex, individual wealth index, adherence to hypertension conventional treatment, and country.

Results
A total of 512 (24%) of participants reported using TM, and this percentage varied drastically across countries from 10% in the Congo to 48% in Guinea. TM users were more likely to be male, with poor treatment adherence, reporting missing treatment because it is too expensive, and presenting any complication of hypertension. TM use was associated with greater odds of hypertension (OR=1.30; 95% confidence interval: 0.99, 1.70), severe hypertension (OR=1.34; 1.04, 1.74) and of any complication of hypertension (OR=1.27; 1.01, 1.60), driven by renal complication (OR=1.57; 1.07, 2.29). Use of TM was associated with a 3.87 mmHg higher systolic BP and 1.75 mm Hg higher diastolic BP compared to no use.

Conclusions
In this cross-sectional study of patients with hypertension in 12 Sub-Saharan African countries, we identified that the use of traditional medicine was associated with a poorer control of hypertension and more complications.
Determination of hypertriglyceridemic gene score in patients with familial dysbetalipoproteinemia
Authors: Satny MS , Vrablik MV , Altschmiedova TA , Todorovova VT , Hubacek JH , Kyselak OK , Soska VS 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): The study was supported by the Charles University, project GA UK No. 70220.

Introduction
Familial dysbetalipoproteinemia (FD also known as hyperlipopproteinemia type III) is an AR inherited disease associated with APOE polymorphism. The typical genotype of FD is APOE2/2 and the phenotype is mixed DLP arising in the context of other unknown metabolic or genetic factors. The aim of this work was to determine the hypertriglyceridemic (HTG) score in patients with FD, as a possible determinant of FD development.

Methods
A total of 13 single-nucleotide polymorphisms (SNPs), which are related to the development of HTG in the Czech population, were analyzed in 101 patients with FD and 90 controls with the APOE2/2 genotype (from a large biobank post-MONICA and HAPIEE studies). Genetic analyzes of SNPs were performed using RFLP or real-time PCR. The data were processed by descriptive statistics methods.

Results
A total of 8 SNPs out of 13 examined were associated with the development of DLP, resp. HTG in patients with FD compared to controls (strongest SNPs in APOE and APOA5 genes; P &lt;0.005). Unweighted gene scores (sum of risk alleles) were different between the two groups (P &lt;0.01).

Conclusion
Cumulation of risk genetic variants, assessed by an unweighted score, can distinguish between individuals with the APOE2/2 genotype and those at risk of developing FD.
Unmasking the prevalence of cardiac amyloidosis in the real world: first insights from the phase 2 of the AC-TIVE study, an italian nationwide survey
Authors: Porcari A , Merlo M , Pagura L , Rapezzi C , Sinagra G 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Pfizer

Introduction
Clinicians need to identify patients with cardiac amyloidosis (CA) at an early stage, due to the availability of disease modifying therapies. Some echocardiographic findings may rise the suspicion of CA, also in patients with mild or no symptoms, orienting second level diagnostic tests.

Purpose
To investigate the prevalence of CA in consecutive patients ≥55 years undergoing clinically indicated, routine transthoracic echocardiogram (TTE) in Italy with echocardiographic signs suggestive of CA.

Methods
This is a prospective multicentric study conducted in Italy. It comprises two phases: 1) an observational phase consisting in a national survey on prevalence of possible echocardiographic red flags of CA in consecutive patients ≥55 years undergoing routine TTE (1), and 2) a CA diagnostic phase. Preliminary results of phase 2 are herein presented. Patients who presented a CA-suggestive TTE (i.e. at least one red flag of CA in hypertrophic, non-dilated left ventricles) in the phase 1 were further evaluated (1). Those who consented to proceed in the study, underwent clinical evaluation, electrocardiography, blood and urine tests and scintigraphy with bone tracer. Diagnosis of transthyretin related-CA (ATTR-CA) was made in presence of grade 2 -3 Perugini uptake at scintigraphy and absence of monoclonal protein. The study was registered at ClinicalTrials.gov.

Results
Of the 5315 screened echocardiograms, 381 exams (7.2%) were classified as CA-suggestive (1). Two-hundred-twelve of the 381 patients with a CA-suggestive TTE proceeded to the phase 2 of the study. The main reasons for the 169 non-entering patients into the phase 2 were death [n=53] and refusal to participate [n=85]. Sixty-five of these 212 patients (31%; 17% considering also the 169 non-entering patients into the phase 2 and assuming they did not have CA) had a circumstantiated diagnosis of CA. In detail, ATTR-CA was diagnosed in 53 (25%) and AL-CA in 12 (5.7%) patients.

Conclusion
Among a cohort of consecutive unselected patients ≥55 years with echocardiographic findings suggestive of CA, the real prevalence of disease ranged from 17% up to 31%. Although ATTR-CA was predominant, AL-CA was diagnosed in a significant amount of cases. TTE has a fundamental role in screening patients, raising the suspicion of disease and orienting diagnostic work-up for CA.
Effect of one-day intermittent fasting on 24-hour blood pressure profile in hypertensive and normotensive patients with overweight and obesity
Authors: Isayeva ANNA , Matiashova LOLITA 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): National Academy of Medical Science of Ukraine

Background
The modification of eating behavior is an integral part of cardiovascular disease prevention. Intermittent fasting is a modern approach towards diet correction. However, insufficient data exists on its effect and safety on daily blood pressure and lipids.
The aim of this paper was to assess the response of blood pressure, blood lipids and creatinine to acute intermittent fasting (IF) in hypertensive and normotensive patients with overweight and obesity.

Methods
A cohort of 65 hypertensive patients and 45 young normotensive patients with overweight and obesity included. All patients were monitored for 24 hours by Ambulatory Blood Pressure monitoring by ABMP50 Machine. All hypertensive patients were on stable antihypertensive therapy for at least 3 months and had met target office blood pressure levels. Fasting glucose (FG), blood lipids, creatinine, uric acid and high sensitive C-reactive protein (hCRP) were measured before and after fasting. All patients were asked to fast (F) for 16 hours for the first time in their lives. At the end of the fasting period, all participants in the study rated their subjective state from 1 to 10. Statistical analyses were conducted by IBM SPSS Statistics 22.

Results
The reaction of blood pressure on intermitted fasting was similar in both groups. Decrease of day systolic blood pressure (SBP) as well as increase of night diastolic blood pressure (DPB) was observed in both groups (TABLE 1). No significant changes of daily BP were observed in normotensive patients. Daily heart rate increased in 1st group by 1,5% (p=0.003) and decreased in 2nd group by 4,2% (p=0,002). At the same time daily SBP decreased in the group of hypertensive patients. The hypertension group (65 patients) rated their subjective state higher than 5 points and expressed that fasting was easy for them, age median 57 (51:61) years old. The normotensive group rated themselves below 5 points and expressed the difficulty of fasting and low quality of sleep, age median 26 (25:45) years old. The median BMI in 1st group 32,1 (30:35) in 2nd group 27,4 (25:30) kg/m2. The mean FG before fasting in the 1st group was 5,45(±0,61) mmol/l in the 2nd group was 4,75 (±0,55) mmol/l and after IF in the 1st group 5,36 (±0,73) mmol/l in the 2nd group 4,58 (±0,64) mmol/l (p&gt;0.05). In hypertension group the mean of hCRP decreased from 9.95±8.02 to 4.68±2.88 (p=0.04). The level of blood creatinine and GFR had not significant changes.

Conclusion
One-day intermittent fasting leads to a change in blood pressure, does not cause hypotension, and is tolerated favorably in obese patients with hypertension on stable antihypertensive therapy.
Fear of movement (kinesiophobia) after cardiac hospitalization: predictors and impact on participation in cardiac rehabilitation
Authors: Keessen P , Visser B , Van Duijvenbode ICD , Latour CHM , Jorstad HT , Scholte Op Reimer WJM 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Dutch Research Council (NWO) RAAK-PRO grant

Background
Fear of movement (kinesiophobia) after cardiac hospitalization is associated with low physical activity levels and reduced quality of life. Participation in cardiac rehabilitation (CR) improves psychological wellbeing and relieves kinesiophobia. However, little is known about the predictors of kinesiophobia and the impact of kinesiophobia on participation in CR.

Purpose
To identify predictors of kinesiophobia after (acute) cardiac hospitalization and to assess the impact of kinesiophobia on participation in CR.

Methods
We performed a longitudinal study in patients with coronary artery disease, acute heart failure or atrial fibrillation. At hospital discharge we collected demographic variables, cardiac disease history and administered questionnaires about kinesiophobia, cardiac anxiety, depression and psychological complexity (severity of psychological problems). Kinesiophobia was measured with the Tampa Scale for Kinesiophobia (TSK), scores &gt;28 are considered `high levels of kinesiophobia’. At 3 months patients were followed up to evaluate participation in CR. We investigated (1) predictors of kinesiophobia at hospital discharge and (2) the impact of kinesiophobia on participation in CR at 3-months follow up, using two multivariable logistic regression models with backward elimination to identify predictors.

Results
In 149 patients (22% women), mean age 64.1 (±10.1) high levels of kinesiophobia were measured in 61 patients (40,9%). Higher age decreased the odds for kinesiophobia: OR: 0.95 (95%CI:0.89 – 0.99). Two variables increased the odds for kinesiophobia: higher levels of psychological complexity: OR: 1.27 (95%CI 1.01- 1.60) and cardiac anxiety: OR: 1.10 (95%CI: 1.02 – 1.19). The odds for participating in CR were decreased by kinesiophobia: OR: 0.91 (95%CI: 0.84 – 0.99) and higher age: OR: 0.92 (95%CI:0.86-0.98).

Conclusion(s)
Kinesiophobia at hospital discharge is associated with psychological complexity and negatively impacts participation in CR. This study emphasizes the need for early screening to identify those who are at risk of developing kinesiophobia which in turn can lead to non-adherence to CR.
How well can wearables in children and adolescents with congenital heart disease represent their exercise capacity?
Authors: Hock J , Willinger LW , Hager AH , Ewert PE , Mueller JM 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Stiftung KinderHerz

Background
Wearables enjoy great popularity in children and adolescents. They suggest objectively measuring subjects’ physical activity (PA) or at least give a hint of how it is. But is there a correlation between step-count, moderate to vigorous physical activity (MVPA), and peak oxygen uptake (peakV’O2)?

Purpose
This study investigates this question in children with various congenital heart diseases (CHD).

Methods
From September 2017 to September 2021 sixty-six patients (13 ± 3 years, 20 girls) measured their daily step-count and MVPA via Garmin fit jr. over one week and underwent a cardiopulmonary exercise test (CPET) to quantify their peakV’O2. CHD severity was complex in 50%, moderate in 39%, and simple in 11%. The distribution consisted of 18% with a left heart defect, 50% with a right heart defect, 5% with a Fontan circulation, 9% with an isolated shunt, and 18% with transposition of the great arteries. The correlation was performed via first Spearman’s correlation and secondly partial correlation, adjusted for age, sex height, and weight. Results are presented in median [IQR25;IQR75].

Results
Median steps on a weekly average were 7,576 [6,100;10,888] and MVPA 68 [52;95] minutes. PeakV’O2 was 33 [28;39] ml/min/kg, represented as 77 [68;91] % of predicted, which corresponds to slight impairment. Step-counts slightly correlates with peakV’O2 (r=0.277, p=0.024). However, correlation vanished after adjusting for anthropometrics (step-count: r=0.244, p=0.056). MVPA and peakV’O2 did not correlate at all.

Conclusions
Objectively measured PA and exercise capacity are poorly associated. Since both are independent constructs, it is necessary to assess both in a clinical setting - PA in the context of cardiovascular prevention and peakV’O2 as the strongest predictor for morbidity and mortality.