bluuebunny/crossref_metadata_2025_split huggingface dataset:
Catheter ablation and thoracoscopic ablation in long persistent atrial fibrillation with large left atrium
Authors: Park Chan Soon , Choi Eue-Keun , Lee So-Ryoung , Ahn Hyo-Jeong , Kwon Soonil , Kim Sunhwa , Sohn Suk Ho , Choi Jae Woong , Hwang Ho Young , Oh Seil 
Published: September 2022

BackgroundPulmonary vein antrum isolation (PVAI) is the cornerstone of atrial fibrillation (AF) ablation, but the clinical outcomes of PVAI are unsatisfactory in patients with persistent AF and a large left atrium (LA).ObjectivesWe investigated the clinical outcomes following radiofrequency ablation (RFCA), cryoballoon ablation (CBA), and thoracoscopic maze in patients with persistent AF and a large LA.MethodsWe included patients with consecutive persistent AF who had a large LA (LA diameter &gt;50 mm) and underwent RFCA, CBA, or thoracoscopic maze surgery. In the RFCA group, additional linear ablation was performed at the physician’s discretion. The endpoint was 12 months without recurrence of an atrial arrhythmia, including AF, atrial flutter, and atrial tachycardia, following a 90-day blanking period.ResultsWe recruited 89 persistent AF patients with a large LA who underwent RFCA (n = 32), CBA (n = 38), or the thoracoscopic maze procedure (n = 19). During the 12-month follow-up, 48 (53.9%) cases of AF recurrence were observed. There was no prognostic difference between groups (50.0% in RFCA vs. 52.6% in CBA vs. 63.2% in thoracoscopic maze, all P &gt; 0.05). Early recurrence during the blanking period was a significant predictor of late recurrence for RFCA and CBA, but not for the thoracoscopic maze.ConclusionIn persistent AF patients with a large LA, we did not find a prognostic difference RFCA, CBA, or a thoracoscopic maze procedure in recurrence of atrial arrhythmia. Early recurrence predicted late recurrence in catheter ablation, but not in thoracoscopic maze.
Long-term outcomes of drug-coated balloons in patients with diffuse coronary lesions
Authors: Yang Xinyue , Lu Wenjie , Pan Liang , Han Zhanying , Pan Sancong , Wang Xi , Zhu Yongjian , Shan Yingguang , Peng Meng , Qin Peng , Zhang Peisheng , Qin Xiaofei , Sun Guoju , Qin Zhongsheng , Dong Jianzeng , Qiu Chunguang 
Published: September 2022

BackgroundDrug-coated balloons (DCB), alone or in combination with drug-eluting stents (DES), may be used to treat diffuse coronary lesions. We aimed to explore the efficacy and safety of DCB in patients with diffuse coronary lesions.MethodsConsecutive patients with diffuse coronary lesions (lesion length &gt; 25 mm) who underwent DCB and/or DES between January 2015 and December 2019 were included in this prospective, observational, multicenter study. The DCB group included 355 patients (360 lesions), of which 142 patients (143 lesions, 39.7%) received the DCB-only strategy and 213 patients (217 lesions, 60.3%) received the hybrid strategy (DCB combined with DES). The DES group included 672 patients (831 lesions) treated with DES alone. Target lesion revascularization (TLR) during 3-year follow-up was the primary outcome of interest. The secondary outcome was major adverse cardiac events (MACE), defined as a composite of all-cause death, non-fatal myocardial infarction, and target vessel revascularization.ResultsThe two groups had comparable baseline clinical and lesion characteristics. Lesion length was similar (43.52 ± 16.46 mm vs. 44.87 ± 15.80 mm, P = 0.181), but the stent length in the DCB group was significantly shorter (24.02 ± 23.62 mm vs. 51.89 ± 15.81 mm, P &lt; 0.001). Ten lesions (2.8%) in the DCB group received bailout stents. Over 3 years of follow-up, no significant difference in TLR incidence between the groups (7.3 vs. 8.3%, log-rank P = 0.636) was observed. Incidence of MACE also did not differ significantly (11.3 vs. 13.7%, log-rank P = 0.324). No thrombosis events occurred in the DCB group, while four patients (0.6%) in the DES group experienced stent thrombosis (log-rank P = 0.193). Moreover, similar TLR and MACE rates were observed between DCB-only and hybrid strategies (TLR: 6.4 vs. 8.0%, log-rank P = 0.651; MACE: 11.4 vs. 11.2%, log-rank P = 0.884).ConclusionLong-term outcomes show that the efficacy and safety of the DCB strategy (DCB alone or combined with DES) are similar to those of DES alone in diffuse coronary lesions. These findings suggest that this strategy is a promising alternative for select patients with diffuse coronary lesions.
A global case meta-analysis of three-dimensional speckle tracking for evaluating the cardiotoxicity of anthracycline chemotherapy in breast cancer
Authors: Zhang Li , Zhang Rui , Shuai Ping , Chen Jie , Yin Lixue 
Published: September 2022

BackgroundAnthracycline cardiotoxicity has become one of the most common complications of anthracycline therapy. Regular follow-up of chemotherapy patients with myocardial deformation parameters might be helpful for early diagnosis of myocardial damage and protective intervention. This study aimed to investigate the value of three-dimensional speckle tracking imaging (3D-STI) in diagnosing and predicting potential cardiotoxicity in breast cancer patients undergoing anthracycline therapy through meta-analysis based on global cases collection.MethodsRelevant case-control studies published prior to November 2021 were extracted to assess cardiotoxicity by 3D-STI in breast cancer patients undergoing chemotherapy. Weighted mean difference (WMD) and 95% confidence interval (CI) were used as pooled statistics. Meta regression and subgroup analysis were employed to identify sources of heterogeneity and publication bias was evaluated by Egger’s test and funnel plot.ResultsA total of 1,515 breast cancer patients from 14 studies were enrolled and followed up for 4 or 6 cycles of chemotherapy. Following chemotherapy, absolute values of Left ventricular ejection fraction (LVEF) WMD = –1.59, 95% CI (–1.99, –1.20); p &lt; 0.001; global longitudinal strain (GLS) WMD = 2.19, 95% CI (1.87, 2.51); p &lt; 0.001; global circumferential strain (GCS) WMD = 1.69, 95% CI (1.11, 2.26); p &lt; 0.001; global radial strain (GRS) WMD = –1.72,95% CI (–2.44, –1.00); p &lt; 0.001, and global area strain (GAS) WMD = 6.25, 95% CI (4.48, 8.02); p &lt; 0.001 were decreased. A medium degree of heterogeneity was shown for values of LVEF (I2 = 44.4%, p = 0.037) while values for GLS (I2 = 59.0%, p = 0.003), GCS (I2 = 81.3%, p &lt; 0.001) and GRS (I2 = 57.5%, P = 0.004) showed a large degree of heterogeneity. Egger’s test and funnel plot showed no significant publication bias in GLS, GCS and GAS data (all p &gt; 0.05).Conclusion3D-STI has utility for the non-invasive and objective evaluation of changes in left ventricular function in breast cancer patients undergoing chemotherapy with anthracyclines. The current findings have clinical potential for the early evaluation of myocardial injury caused by chemotherapy toxicity.
Analysis of diastolic left ventricular wall shear stress in normal people of different age groups
Authors: Dong Liping , Li Hairu , Xu Xiangli , Ren Min , Yu Weidong , Bai Wenkun , Sun Di , Tian Jiawei 
Published: September 2022

BackgroundDiastolic wall shear stress (WSS), assessed by using vector flow mapping (VFM), is the result of the interaction between the blood flow and the ventricular wall. This study aimed to evaluate the trend of left ventricular (LV) WSS in normal subjects.Methods and resultsA total of 371 healthy volunteers were recruited and divided into four age groups (group I: 18–30 years; group II: 31–43 years; group III: 44–56 years; group IV: 57–70 years). LV WSS of different age groups was measured at each diastolic phase (P1: isovolumic diastolic period, P2: rapid filling period, P3: slow filling period, and P4:atrial contraction period) to evaluate the change trend of LV WSS. In each age group, LV WSS coincided with a trend of increasing-decreasing-increasing during P1–P4 (P &lt; 0.05). Besides, among groups I, II, III, and IV, WSS of anterolateral, inferoseptal, and anteroseptal in P1 and WSS of inferolateral, inferoseptal, and anteroseptal in P4 all showed an increasing trend with age (P &lt; 0.05). Regarding sex differences, women had greater diastolic WSS compared to men (P &lt; 0.05).ConclusionLV WSS showed a regular variation and had specific age- and sex-related patterns in different diastolic phases.
Retrograde recanalization of radial artery occlusion via the distal transradial artery: A single-center experience
Authors: Lin Yaowang , Bei Weijie , Liu Huadong , Liu Qiyun , Yuan Jie , Wu Meishan , Sun Xin , Dong Shaohong 
Published: September 2022

BackgroundRadial artery occlusion (RAO) often occurs after catheterization when using a transradial artery approach.ObjectiveThis prospective study assessed the success and feasibility of accessing the distal transradial artery (dTRA) for retrograde recanalization of RAO.MethodsFrom June 2019 to December 2021, 44 consecutive patients who had undergone cardiac catheterization resulting in RAO were given retrograde recanalization via the dTRA. According to the result of the procedure (primary endpoint), patients' cases were analyzed as successful or failed. Rates of post-operative patency and adverse events were calculated up to 12 months.ResultsThe procedural success rate was 88.6%. Compared with the successful group, a significantly higher percentage of patients in the failed group were current smokers and/or suffered from diabetes mellitus (each, 80.0% cf. 33.3%, P = 0.046); had undergone at least 3 previous cardiac catheterizations (60.0% cf. 12.8%, P = 0.011), lower rate of anticoagulation (30.77% cf. 0%, P = 0.048) and exhibited chronic total occlusion (100.0% cf. 51.28%, P = 0.041). In each group, one patient each had minor bleeding at the access site and hematoma. The patency rates in the successful group at postoperative 3, 6, and 12 months were 48.7, 43.6, and 35.9%, respectively.ConclusionThe dTRA approach for retrograde recanalization of RAO showed a high procedural success rate, but with patency rates of &lt;50% at follow-up.
Impact of right atrial enlargement on clinical outcome in patients with atrial fibrillation
Authors: Ko Kyu-Yong , Jang Ji-Hun , Choi Seong-Huan , Baek Yong-Soo , Kwon Sung Woo , Park Sang-Don , Woo Seong-Ill , Kim Dae-Hyeok , Shin Sung-Hee 
Published: September 2022

BackgroundLeft atrial (LA) remodeling is associated with adverse cardiovascular events, including heart failure (HF) and stroke in patients with atrial fibrillation (AF). However, there are limited data on the value of right atrial (RA) remodeling in this population. We investigated the prognostic role of RA enlargement in patients with non-valvular AF.Methods and resultsWe analyzed 254 consecutive patients (age = 69 ± 12years, male:female = 165:89, mean left ventricular ejection fraction = 58.0 ± 7.2%) with non-valvular AF who underwent two-dimensional echocardiography from a single center. RA and LA volumes were measured from apical views and indexed to the body surface areas (right atrial volume index [RAVI] and left atrial volume index [LAVI]) and RAVI &gt; 30mL/m2 and LAVI &gt; 34mL/m2 were considered as enlarged. The relationship between RA enlargement and composite clinical outcome of hospitalization for HF (HHF), stroke, systemic embolism, or death from any cause was assessed. Right atrial (RA) enlargement was associated with older age and more frequent prevalence of persistent or permanent AF. During a median follow-up of 47.1 months, 77 patients (30%) had experienced primary composite outcome. In a multivariable model, RA enlargement, but not LA enlargement, was independently associated with adverse clinical outcomes even after adjusting for clinical and echocardiographic factors {adjusted hazard ratio [HR], 1.90 [95% confidence interval (CI), 1.14–3.18], p = 0.014 for primary composite outcome; adjusted HR, 2.70 [95% CI, 1.27–5.67], p = 0.001 for HHF or all cause death}.ConclusionRA enlargement was independently associated with an increased risk of HF, stroke, systemic embolization or death in patients with non-valvular AF, suggesting that RA volume can be helpful in assessing future cardiovascular risk in this population.
Calreticulin and PDIA3, two markers of endoplasmic reticulum stress, are associated with metabolic alterations and insulin resistance in pediatric obesity: A pilot study
Authors: Antoniotti Valentina , Bellone Simonetta , Gonçalves Correia Filipa Patricia , Peri Caterina , Tini Sabrina , Ricotti Roberta , Mancioppi Valentina , Gagliardi Mara , Spadaccini Daniele , Caputo Marina , Corazzari Marco , Prodam Flavia 
Published: September 2022

Our aim was to evaluate the markers of endoplasmic reticulum (ER) stress among children and adolescents with obesity in relation to metabolic alterations. Calreticulin (CALR) and PDIA3 circulating levels were assessed on 52 pediatric subjects—26 patients with obesity and 26 normal weight controls (4–18 years)—enrolled in a pilot study. Clinical and metabolic evaluations were performed (BMI-SDS, insulin, and glucose at fasting and during an oral glucose tolerance test, lipid profile, blood pressure), and metabolic syndrome was detected. PDIA3 was higher (p &lt; 0.02) and CALR slightly higher in children with obesity than in controls. PDIA3 was related positively to the Tanner stages. Both PDIA3 and CALR were positively associated with insulin resistance, cholesterol, and triglycerides and the number of criteria identifying metabolic syndrome and negatively with fasting and post-challenge insulin sensitivity. Our preliminary findings suggest the existence of a link between ER stress and metabolic changes behind obesity complications even at the pediatric age. CALR and PDIA3 could be early markers of insulin resistance and dyslipidemia-related ER stress useful to stratify patients at high risk of further complications.
Gut microbiota profiling revealed the regulating effects of salidroside on iron metabolism in diabetic mice
Authors: Shi Jing , Zhao Qin , Hao Dou Dou , Miao Hong Xia , Wan Sha , Zhou Chao Hua , Wang Si Yu , Chen Si Yuan , Shang Jin , Feng Tian Hang 
Published: September 2022

BackgroundDiabetes is a common metabolic disease that is associated with gut microbiota dysbiosis and iron metabolism. Salidroside (SAL) is the main ingredient of the traditional Chinese herb Rhodiola, previous studies have shown that SAL could reshape the gut microbiota and limit iron accumulation. Therefore, it is possible that SAL can act as an alternative therapy for diabetes, and its underlying mechanism is worth exploring.MethodsSAL was used to treat diabetic db/db mice. Serum glucose and iron levels and the histopathology of myocardial fibres were evaluated. The gut microbiota composition was determined by 16S rRNA Illumina sequencing technology.ResultsTreatment with SAL significantly reduced blood glucose and ameliorated diabetic cardiomyopathy in diabetic db/db mice, which was accompanied by inhibited ferroptosis and iron accumulation. Furthermore, the 16S rRNA sequencing results showed that SAL induced a change in the gut microbiota composition. Overall, SAL could increase the proportion of probiotic bacteria and decrease Lactobacillus to improve gut microbiota. Specifically, SAL increased the ratio of Bacteroidetes to Firmicutes in diabetic mice. The most significant biomarker was the genus Lactobacillus between the MD group and the SAL group. In addition, COG and KEGG analyses suggested that SAL mainly participated in nutrient metabolism, among them iron metabolism was associated with the abundance of Lactobacillus.ConclusionsSAL could reduce the glucose level and protect against diabetic cardiomyopathy in diabetic mice, which might be mediated by the change in the gut microbiota and the regulation of iron metabolism. The findings suggested that SAL was a promising complementary option for diabetes therapy.
Glucose-to-Lymphocyte Ratio (GLR) as a Predictor of Preoperative Central Lymph Node Metastasis in Papillary Thyroid Cancer Patients With Type 2 Diabetes Mellitus and Construction of the Nomogram
Authors: Jin Lingli , Zheng Danni , Mo Danni , Guan Yaoyao , Wen Jialiang , Zhang Xiaohua , Chen Chengze 
Published: September 2022

BackgroundDetection of metastasis of central lymph nodes in papillary thyroid cancer is difficult before surgery. The role of routine or preventive central lymph node dissection in the management of papillary thyroid cancer remains inconclusive. Moreover, glucose metabolism and systemic inflammation are related to the aggressiveness of several malignant tumors and the prognoses of these patients. This study aimed to construct a nomogram based on the readily available preoperative clinical features for predicting the occurrence of preoperative central lymph node metastasis in patients with papillary thyroid cancer and type 2 diabetes mellitus. The findings may underlie clinical implications for determining the appropriate treatment strategies for these patients.MethodsA total of 419 patients were enrolled. We used the receiver operating characteristic curves to determine the best cut-off value and converted the continuous into categorical variables. Next, a single-factor logistic analysis for the independent variables was performed, following which a multivariate regression analysis was conducted for the selected significant risk factors. Finally, the nomogram was constructed and verified using external data; the existing data were compared with the original model.ResultsAccording to the receiver operating characteristic curves, the best cut-off values ​​for glucose-to-lymphocyte ratio and tumor size were 4.23 cm and 0.95 cm, respectively. Findings from the multivariate logistic regression analysis suggested that age, bilateral tumors, maximum tumor size, and the ratio of glucose-to-lymphocytes were independent risk factors for preoperative central lymph node metastasis. The C-indexes in the training and the external validation data sets were 0.733 and 0.664, respectively. Both calibration curves and the Hosmer-Lemeshow tests indicated that the model was well-calibrated. Through decision curve analysis, the predictive model was estimated to have strong clinical applicability and greater benefits. To compare the performance of the new with that of the original model, we performed a net reclassification index and the integrated discrimination improvement analyses, both of which indicated that the new model had a better predictive ability.ConclusionIn patients with type 2 diabetes mellitus and papillary thyroid cancer, a high preoperative glucose-to-lymphocyte ratio was an independent predictor of the preoperative central lymph node metastasis. The nomogram so constructed could better predict the preoperative central lymph node metastasis in these patients.
Association between waist-hip ratio and subclinical myocardial injury in the general population: Insights from the NHANES
Authors: Wang Zhenwei , Huang Xu , Li Jingjie , Liu Naifeng , Wei Qin 
Published: September 2022

BackgroundAlthough studies have shown that higher waist-hip ratio (WHR) is closely related to higher risk of metabolism-related diseases, the relationship between WHR and subclinical myocardial injury (SC-MI) is unknown. This study was to evaluate the effect of WHR on SC-MI in the general population free from cardiovascular disease.MethodsThe cross-sectional study included 6253 participants without cardiovascular disease (CVD) from the third National Health and Nutrition Examination Survey (NHANES III) for further analysis. Restricted cubic spline, multivariable logistic regression models and subgroup analyses were performed to assess the association between WHR and SC-MI.ResultsThe multivariate logistic regression showed that after adjusting for potential confounding factors, participants in the higher quartiles had higher risk of developing SC-MI than those in the first quartile of WHR [Q3, OR (95% CI): 1.523 (1.159, 2.000), P = 0.002; Q4, OR (95% CI): 1.719 (1.279, 2.311), P &lt; 0.001], and this relationship was robust among the participants aged ≥ 50 years, with hypertension and without diabetes. Every 0.1 unit increase in WHR, as a continuous variable, increased the risk of SC-MI by more than 20% [OR (95% CI): 1.233 (1.092, 1.392), P = 0.001]. And restricted cubic spline analysis showed that there was a linear positive correlation between WHR and the risk of SC-MI.ConclusionsWHR may be an independent risk factor for SC-MI in the general population free from CVD.
Distinguishing between metastatic and benign adrenal masses in patients with extra-adrenal malignancies
Authors: Chen Jinchao , He Yedie , Zeng Xiaowei , Zhu Shaoxing , Li Fangyin 
Published: September 2022

Background and ObjectivesThe adrenal gland is a common organ involved in metastasis. This study aimed to compare adrenal metastases (AMs) and adrenal benign masses (ABMs) of patients with extra-adrenal malignancies during the staging or follow-up.MethodsWe retrospectively collected data from 120 patients with AMs and 87 patients with ABMs. The clinical characteristics, imaging features, pathology, and treatment regimes were analyzed.ResultsThe most common types of extra-adrenal malignancies in patients with ABMs included thyroid, kidney, and gynecological cancers. On the other hand, lung and kidney cancers and lymphoma were the most frequent primary cancers of AMs. The age and incidence of symptoms were significantly higher in patients with AM. Radiological analysis showed that AMs tended to have larger tumor sizes and higher attenuation values than ABMs on pre-contrast computed tomography (CT). The diagnostic accuracy of positron emission tomography-CT for AM was 94.1%. An adrenal biopsy had a diagnostic accuracy of 92.5%. A multivariate logistic regression model demonstrated that the origins of extra-adrenal malignancies, the enhancement pattern, and attenuation values in pre-contrast CT were independent predictors of AMs. The sensitivity and specificity of this predictive model of combination was 92.5% and 74.1%, respectively.ConclusionsThe differential diagnosis between AMs and ABMs is extremely important. The combination of origin of first malignancy, enhancement pattern and CT value in non-enhanced phase is a valuable model for predicting AMs.
HIL real-time simulator based 3D-space vector pulse width modulation for performance analysis of 3-phase matrix converter
Authors: Palanisamy R. , Shanmugasundaram V. , Lakshmi M. , Karthikeyan B. , Aboras Kareem M. , Bajaj Mohit , Alsharef Mohammad , Elattar Ehab E. , Kamel Salah 
Published: September 2022

In this paper, Three Dimensional Space Vector Pulse Width Modulation (3D-SVPWM) is developed to obtain the performance analysis of a 3-phase matrix converter (MC). MC is used to convert 3-phase fixed AC voltage to 3-phase variable AC voltage, which provides superior performance compared to conventional AC to AC converters. The 9-bidirectional power switches in a 3-phase matrix converter are controlled by appropriate gating pulses utilizing 3D-SVPWM. In conventional AC to AC power converters, the common mode voltage is induced across the load terminal, which causes bearing failure and EMI issues and so leads to increased total harmonic distortion (THD). Implementing the 3D-SVPWM approach with the nearest switching state vector (NSV) selection mechanism alleviates these problems. In proposed system, CMV is reduced to 37 V, which is equivalent to a Vdc/8 time of the supplied AC input voltage and THD of 3-phase to 3-phase MC is reduced to 1.12% for output voltage and 2.18% for output current. The output findings of the simulation and real-time simulator are verified using the Matlab Simulink model and the HIL real-time (OPAL-RT) simulator.