bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poster No. 110 History of venous thromboembolic disease: a prognostic risk marker following STEMI? Insights of the French SCALIM registry
Authors: Chenard Pierre , Dousset Benjamin , Boukhris Marouane , Virot Patrice , Aboyans Victor 
Published: October 2022

Abstract

Background
Venous and arterial thrombosis are two different entities. However, they share common risk factors and a continuum between arterial and venous thrombosis has been suggested. The purpose of our study was to determine whether a history venous thromboembolic disease (VTE) is associated with poorer outcome in patients with ST-elevation myocardial infarction (STEMI).

Methods
All consecutive STEMI patients between 2011 and 2019 were included in our regional SCALIM registry. Clinical history of VTE was collected at baseline. The primary outcome was cardiovascular mortality and recurrent non-fatal arterial events (including non-fatal-myocardial infarction, ischemic stroke and peripheral ischemic event) at 5-year follow-up. The secondary outcome was total mortality.

Results
A total of 1924 patients (64.7 ± 14.1 years; 75.1% men) were included, among whom 2.8% with history of VTE. The latter were older than those without VTE (respectively 72.8 ± 14.1 vs. 64.4 ± 14.0 years; P &lt; 0.001) and had more often hypertension, history of stroke and cancer. We found no statistical difference between the two groups regarding the 5-year cardiovascular mortality (11.3% vs. 7.1%, P = 0.231) and recurrent non-fatal arterial events (17.0% vs. 14.9%, P = 0.754). Five-year all-cause mortality was significantly higher in patients with history of VTE (33.3% vs. 14.6%, P = 0.001).
In a nested case-control study adjusted for age, no difference was found in primary and secondary outcomes according to VTE history.

Conclusion
We found no impact of history of VTE on 5-year cardiovascular outcome in who had STEMI patients. Higher mortality in these patients are related to older age and comorbidities.
Oral Presentation No. 121 Aortic stiffness descriptors by cardiac magnetic resonance are correlated with mechanical testing of ex-vivo aortic aneurysms specimens
Authors: Muñoz Aroa Ruiz , Guala Andrea , Cilla Myriam , Martínez Miguel , Dux-Santoy Lydia , Teixidó-Turà Gisela , Garrido-Oliver Juan , Galian Laura , Sao-Aviles Augusto , Evangelista Arturo , Ferreira-Gonzalez Ignacio , Peña Estefania , Rodriguez-Palomares Jose 
Published: October 2022

Abstract

Background
Aortic stiffness independently predicts mayor adverse cardiovascular events and mortality in the general population. Cardiovascular magnetic resonance (CMR) permits the assessment of a number of parameters theoretically linked to aortic stiffness, such as distensibility (AD), pulse wave velocity (PWV) and proximal aorta longitudinal strain. However, no previous study validates these parameters as descriptors of aortic wall stiffness against ex-vivo mechanical testing.

Materials and methods
Ascending aorta (AAo) specimens were collected from 20 patients undergoing AAo replacement for aneurysms. Patients underwent a CMR protocol in the days leading to the surgery, including 4D flow CMR. Two 15×5 mm specimens (one oriented in the circumferential and the other in the longitudinal aortic direction) were extracted during surgery, and later tested controlling for extension force. Elongation was measured by laser video extensometer and the tangent of the stress-strain curve at diastolic pressure was extracted. AAo PWV and the Eh product (E being Young modulus and h wall thickness) were measured from 4D flow CMR while AD and AAo longitudinal were quantified from cine images.

Results and conclusions
Marked correlations were found between circumferential elastic modulus and AAo AD (R = −0.502), PWV(R = 0.652) and Eh (R = 0.602). Similarly, strong correlation was identified between AAo longitudinal strain and longitudinal elastic modulus(R = −0.513). In conclusion, PWV and the Eh product are positively related to aortic wall stiffness while aortic distensibility and strain show negative relationships. Thus, these biomarkers are a reliable expression of aortic wall stiffness.

Funding
PI17/00381,SEC/FEC-INV-CLI20/015,LCF/BQ/PR22/11920008.
Oral Presentation No. 126 NOACs safety and efficacy in Adult Congenital Heart Disease
Authors: Pinto Ricardo Jorge Reis Alves , Carvalho Miguel Martins , Proença Tânia , Costa Catarina , Amador Ana Filipa , Calvão João , Marques Catarina , Cabrita André , Santos Luís , Oliveira Cátia , Pinho Ana , Cruz Cristina , Macedo Filipe 
Published: October 2022

Abstract

Introduction
Adult Congenital Heart Disease(ACHD) patients are an increasing population with known high risk for thromboembolic events.Validated scores are uncertain in this population. Although apparently safe, data is scarce about the use of NOAC.

Purpose
To evaluate all patients on-NOAC followed in an ACHD outpatients clinic and observe its safety and efficacy during a median follow-up of 34 months (IQR 7–60 months). Major bleeding was defined according to types 3 to 5 in BARC scale. Adverse event was defined as ≥ 1 of the follows: death, stroke, myocardial infarction, systemic embolism or major bleeding.

Results
A total of 65 patients were included, with a mean age of 52 ± 14 year-old, 66% female. Most frequent ACHD were atrial septal defect (22%) and tetralogy of Fallot (22%), followed by atrioventricular septal defect (17%) and transposition of great arteries (9%). Most patients had preserved biventricular function, 20% presented systemic ventricle systolic dysfunction and 12% subpulmonic ventricle systolic dysfunction. Atrial fibrillation or atrial flutter (AF/AFL) were the major reasons for anticoagulation (94%); the remaining were on NOAC due to previous ischaemic stroke, intra-cardiac thrombus or deep venous thrombosis. At the time of NOAC initiation, 49% had a CHA2DS2-VASc score ≥ 2 (median 1, IQR 1-3) and median HAS-BLED score was 0 (IQR 0-2);43% were medicated with apixaban, 29% with rivaroxaban,22% with edoxaban and 6% with dabigatran.During a median follow-up of 34 months, none had ischaemic complications or major bleeding and one patient died after pulmonic prothesis dysfunction surgery. Concerning time-to- adverse-event analysis, all patients kept uneventful after 2 years and more than 95% continued event-free after 8 years on-NOAC.
Poster No. 127 Intravenous statin administration during myocardial infarction mitigates cardiac damage and preserves cardiac function in diabetic cardiomyopathy rats
Authors: Alcover Sebastian , López Sergi , Badimon Lina , Vilahur Gemma 
Published: October 2022

Abstract

Introduction
Diabetic patients may develop diabetic cardiomyopathy (DCM) and are at increased risk of myocardial infarction (MI). Yet, cardioprotection remains a challenge in the presence of comorbidities.

Objectives
We examined whether intravenous administration of atorvastatin during ongoing myocardial ischemia prevents against the deleterious effects of MI in DCM rats.

Methods
DCM was induced by streptozotocin (65 mg/kg) in Sprague Dawley rats (n = 14). 5 weeks thereafter animals exhibited a DCM phenotype associated with a significant diastolic (IVRT + 15.64 ± 5.49ms P &lt; 0.05 vs. baseline) and systolic (LVEF, −8.63 ± 6.71% P &lt; 0.05 vs. baseline) ventricular dysfunction. AMI was then induced by coronary ligation of the LAD for 45minutes. Early after ischemia (15minutes) DCM-rats received either i.v atorvastatin or vehicle. Animals were reperfused and sacrificed at 24h for infarct size assessment and molecular analysis. Cardiac function was monitored by echocardiography.

Results
No differences were detected as per the area-at-risk between both animal groups. Atorvastatin significantly reduced infarct size expansion (35% relative reduction) as compared to vehicle (15.3 ± 1.03% vs. 23.7 ± 4.3% IS/AAR; P &lt; 0.05). LVEF, shortening fraction, and stroke volume were better preserved in atorvastatin-treated DCM rats as compared to vehicle (4.62 ± 2.55% vs. 12.4 ± 3.16%; 5.77 ± 3.74% vs. 15.9 ± 4.9%; and 58.93 ± 28.79μl vs. 101.73 ± 31.58 μl, respectively; P &lt; 0.05). At a molecular level, atorvastatin administration was associated with a lower expression of Phosphorylated-p53 (apoptosis) and higher P-AMPK/AMP ratio (cardiac metabolism); P &lt; 0.05 vs. vehicle).

Conclusion
Intravenous administration of atorvastatin during MI limits infarct size and preserves cardiac function post-MI in rats with manifest DCM supporting the cardioprotective potential of this therapeutic approach despite comorbid conditions.
Clinical Case 01—Cardioembolic stroke with a twist: a case of left ventricular thrombus
Authors: Vazão Adriana , Gonçalves Carolina Miguel , Ribeiro Rui Filipe , Domingues Ana Catarina , Cerqueira Margarida , Carvalho João Filipe , de Jesus Banz Maria , Morais João 
Published: October 2022

Abstract

Presentation and diagnosis
A 62-years old male was brought to the emergency department after being found unconscious, lying on his left side. He was last seen 1 week before. Past medical history revealed ischemic cardiomyopathy with reduced ejection fraction of 35% after ST-segment elevation myocardial infarction 3 months before, subject to coronary angioplasty of 2 vessels (left anterior descending artery with drug-eluting stent and circumflex artery with balloon angioplasty). He had poor therapeutic compliance with missing cardiology appointments. On examination, he was hypothermic and hemodynamically unstable with signs of hypoperfusion. He was admitted for septic shock with origin in a decubitus ulcer on his left-hand dorsum. Head CT-scan revealed sub-acute ischemic stroke in the right middle cerebral artery territory. He started fluid therapy, vasopressors and large spectrum antibiotics with favorable clinical evolution and no heart failure symptoms but remained febrile. Meanwhile, Proteus hauseri had grown in blood cultures. An echocardiography was performed excluding infectious endocarditis and revealing a large apical thrombus on the left ventricle.

Management
Therapeutic anticoagulation with enoxaparin was initiated and antibiotic was de-escalated according to the antibiogram. Later on, anticoagulation was switched to warfarin (target INR∼2.0–3.0). When clinically stable, was discharged home with anticoagulation and clopidogrel, with an echocardiography scheduled after 3 months.

Learning points
Left ventricular thrombus is a rare complication of ischemic cardiomyopathy with high risk of adverse outcomes, including ischemic stroke and death. Vitamin K antagonists are usually preferred to direct oral anticoagulants in the management of these patients, but further research is needed.
Clinical Case 10—An unusual case of thrombocytopenia following transfemoral aortic valve implantation
Authors: Câmara de Sá Ana Débora , Antunes André , Santos M Raquel , Temtem Margarida , Sousa João Adriano , Silva Bruno 
Published: October 2022

Abstract
Clinical Case: An 85-year-old female patient with diabetes, hypertension, obesity, chronic kidney disease and severe aortic stenosis was submitted to transcatheter aortic valve implantation (TAVI). During procedure unfractionated heparin was administered. Intervention was performed without complications and she was discharged with platelet count of 116,000/μL.
Fifteen days after (day 0), she was readmitted with dyspnea. Arterial blood gas showed hypoxemia and lactate levels of 5,8mmol/L. The ECG showed new-onset atrial fibrillation (AFib) with a rapid ventricular rate. Blood tests showed platelet count of 45,000/μL, D-dimers 2790ng/mL, worsening kidney function and high inflammation markers. An echocardiogram showed normofunctioning transcatheter aortic valve.
Pulmonary embolism (PE) or respiratory infection with new-onset AFib were admitted. The patient started enoxaparin and an antibiotic.
On day 4 the patient was oliguric needing dialysis. A CT Angiography was performed that excluded PE but showed several thrombus on the right atrium and appendix, right ventricle and on the abdominal aorta. Blood results showed hemolytic anemia. On day 8, the platelet count reached the nadir of 11 000/μL.
At that time, differential diagnoses included thrombotic thrombocytopenic purpura (TTP), heparin-induced thrombocytopenia and sepsis-induced disseminated intravascular coagulation (DIC). Laboratory evaluation showed a near-normal coagulation profile and a PF4+ antibody. Enoxaparin was stopped; fondaparinux and plasma therapy were started.
Platelet count took weeks to reach previous levels. The patient was discharged with a DOAC.
It is usual to have some degree of thrombocytopenia after TAVI. In this case we have a complex and challenging scenario, properly handled, and with a good outcome.
Clinical Case 12—Thrombus on apical left ventricle: when the clinical suspicion is high
Authors: Duarte Fabiana Silva , dos Santos Inês Coutinho , Barradas Maria Inês , Oliveira Luís , Machado Carina , Dourado Raquel , Martins Dinis 
Published: October 2022

Abstract

Introduction
Left ventricular thrombi may develop as a complication of myocardial infarction. Transthoracic echocardiography (TTE) has a low sensitivity for thrombus detection and other imaging methods are usually required.

Case report
A 32-years-old man with a past medical history of smoking habits, obesity and a ST-segment elevation myocardial infarction (STEMI) diagnosed on December 2017. Primary angioplasty was performed with stent implantation in the anterior descending coronary artery. TTE revealed severe systolic dysfunction (SD) and an apical aneurysm with thrombus formation. Six months after anticoagulation with warfarin, a cardiac magnetic resonance revealed thrombus resolution and it was decided to stop warfarin. On September 2021, the patient presented to the Emergency Department referring sudden chest pain. The electrocardiogram showed an anterior STEMI and in the Cath Lab a late stent thrombosis was evident. TTE revealed a severe SD and akinesia of apical segments (poor acoustic window).
On the 3rd day of hospital stay, the patient developed backache and Murphy´s punch sign.
Imaging workup was suggestive of right renal infarction. At this time, the suspicion of embolic source arises, and the patient underwent contrast echocardiography demonstrating a filling defect suggestive of an apical thrombus. Therapy with warfin was reinitiated concomitantly with dual antiplatelet therapy.

Conclusion
This is a particular case of an apical thrombus formation occurring twice in a young patient. There is a lack of evidence about the adequate screening methods and therapeutic approach. More cases need to be reported to understand the best approach in each case to minimize complications.
Clinical Case 21—An unusual cause for hypoxemia and breathlessness
Authors: de Figueiredo Margarida Gancho , Paula Sofia , Almeida Samuel , Gomes Francisco , Ferreira Filipa , Luz João , Cunha Diogo , Baltazar Oliveira , Almeida Lurdes 
Published: October 2022

Abstract
75-year-old woman with past medical history of ischemic stroke in 2019, when complementary diagnostic tests were performed and it was found that the patient had a patent foramen ovale (PFO). Current hospitalization due to COVID-19 pneumonia, which was complicated by bacterial co-infection and intermediate-low risk right main pulmonary artery thromboembolism. The patient was successfully treated, with improvement of the clinical condition and evident imaging resolution of pulmonary cavitations and recanalization of the right pulmonary artery. However, something intriguing was observed: the patient presented dyspnea in the upright position and a decline in transcutaneous oxygen saturation from 96% in the supine position to 85% in orthostatism, with reversal of these findings with the recumbency. This led to the suspicion of platypnea-orthodeoxia syndrome. A transesophageal echocardiogram with bubble test was then performed, revealing an atrial shunt in the supine position without Valsalva maneuver. With these evidences, the diagnosis of platypnea-orthodeoxia syndrome was made. Even though the patient was &gt;60 years, due to important right-to-left shunt, the history of stroke and the current platypnea-orthodeoxia, it was decided to close the PFO. The day after the procedure, the patient was placed in the upright position, maintaining an oxygen saturation of 96%.
This case is an example that the decision of closing PFO must be individualized, not focusing only on patient's age, but also on his medical history and current situation, as indicated in the 2022 Guidelines for the Management of Patent Foramen Ovale. Figure 1Transesophageal echocardiogram showing interatrial communication.
Clinical Case 23—Adult-onset recurrent Kawasaki disease complicated by coronary aneurysms and recurrent acute myocardial infarction
Authors: Carvalho Mariana Margarida Ferreira , Gonçalves Carolina , Cabral Margarida , Fernandes Sara Lopes , Carvalho Rita Ribeiro , Guardado Jorge , Morais João 
Published: October 2022

Abstract
Summary of case: A 67-year-old man presented to the emergency department (ED) with acute chest pain. He had the previous diagnosis of Kawasaki disease (KD) made when he was 51 years-old in a event of a acute myocardial infarction. Upon admission, his blood pressure was 100/70 mm Hg, heart rate was 55 beats/min, apyretic. Clinical examination was unremarkable. Electrocardiogram showed a synus rhythm without any ST-T alterations. An echocardiogram showed mildly decreased left ventricular function (LVEF) of 44% by the biplane Simpson method, with hypokinesia of anterolateral and inferolateral wall, and enlargement of the ascendent aorta and aorta root. Cardiac enzymes were elevated, troponin-I 10.5 ng/mL and NTproBNP of 832 ng/mL. The diagnosis of acute myocardial infarction without ST segment elevation was made. Cardiac catheterization revealed diffuse aneurysmal dilation of the left anterior descendent artery and right coronary artery. Circunflex artery was occluded in the mid segment. Thrombotic aspiration was made and a drug-eluting stent was implanted. The patient showed clinical improvement and was discharged 4 days later with ticagrelor and aspirin.
This case illustrates the importance to recognize adult-onset KD as part of the differential diagnosis of chest pain with ST-segment elevation in a adult, even if uncommon. Early recognition is fundamental, permitting correct treatment and prevention of potentially fatal coronary complications.
Shared Patterns of Gene Expression and Protein Evolution Associated with Adaptation to Desert Environments in Rodents
Authors: Bittner Noëlle K J , Mack Katya L , Nachman Michael W 
Published: October 2022

AbstractDesert specialization has arisen multiple times across rodents and is often associated with a suite of convergent phenotypes, including modification of the kidneys to mitigate water loss. However, the extent to which phenotypic convergence in desert rodents is mirrored at the molecular level is unknown. Here, we sequenced kidney mRNA and assembled transcriptomes for three pairs of rodent species to search for shared differences in gene expression and amino acid sequence associated with adaptation to deserts. We conducted phylogenetically independent comparisons between a desert specialist and a non-desert relative in three families representing ∼70 million years of evolution. Overall, patterns of gene expression faithfully recapitulated the phylogeny of these six taxa providing a strong evolutionary signal in levels of mRNA abundance. We also found that 8.6% of all genes showed shared patterns of expression divergence between desert and non-desert taxa, much of which likely reflects convergent evolution, and representing more than expected by chance under a model of independent gene evolution. In addition to these shared changes, we observed many species-pair-specific changes in gene expression indicating that instances of adaptation to deserts include a combination of unique and shared changes. Patterns of protein evolution revealed a small number of genes showing evidence of positive selection, the majority of which did not show shared changes in gene expression. Overall, our results suggest that convergent changes in gene regulation play an important role in the complex trait of desert adaptation in rodents.
Extensions of the d’Alembert formulae to the half line and the finite interval obtained via the unified transform
Authors: Fokas A S , Kalimeris K 
Published: October 2022

Abstract
We derive the solution of the one-dimensional wave equation for the Dirichlet and Robin initial-boundary value problems (IBVPs) formulated on the half line and the finite interval, with non-homogeneous boundary conditions. Although explicit formulas already exist for these problems, the unified transform method provides a convenient framework for deriving different representations of the solutions for these and other types of IBVPs. Specifically, it provides solution formulas in the Fourier space or solutions which constitute the extension of the classical formula of d’Alembert of the initial value problem on the full line. We also derive the solution of the forced wave equation on the half line.
Fallacies of Democratic State-Building
Authors: Trantidis Aris 
Published: October 2022

AbstractThis paper criticizes the epistemic foundations of democratic state-building, which are derived from a model of political transitions according to which liberal democratic institutions will transform a hitherto authoritarian and troubled country into a more prosperous and stable society and, therefore, foreign interventions to establish these institutions are realistic and worthy investments, provided they are properly planned based on knowledge of what has worked elsewhere. This expectation is based upon two epistemological premises. The first premise, linearity, is that social and institutional change exhibits identifiable input–output relations connecting socioeconomic conditions and outcomes. The second premise, ergodicity, is that these relations, inferred from past samples, provide reliable probabilistic projections about future outcomes, which can guide the focus of policy interventions. Drawing from the study of complex systems, the paper indicates why these two premises offer a flawed conception of political transitions and why radical and large-scale interventions, such as state-building, will tend to generate unintended consequences rather than the planned effect.
nudt7 gene depletion causes transcriptomic change in early development of zebrafish
Authors: Bhandari Sushil , Hong KwangHeum , Miyawaki-Kuwakado Atsuko , Tomimatsu Kosuke , Kim Yong-Il , Nam In-Koo , Sagerström Charles G , Nakamura Mako , Choe Seong-Kyu 
Published: October 2022

Abstract
The Nudt family has been identified as enzymes performing Coenzyme A to 3′5′-ADP + 4′-phospho pantetheine catalysis. The members of this family have been shown to be particularly involved in lipid metabolism, while their involvement in gene regulation through regulating transcription or mRNA metabolism has also been suggested. Here, we focused on peroxisomal NUDT7, possessing enzymatic activity similar to that of its paralog, peroxisomal NUDT19, which is involved in mRNA degradation. No reports have been published about the Nudt family in zebrafish.
Our transcriptomic data showed that the Nudt family members are highly expressed around zygotic gene activation (ZGA) in developing zebrafish embryos. Therefore, we confirmed the computational prediction that the products of the nudt7 gene in zebrafish were localized in the peroxisome and highly expressed in early embryogenesis. The depletion of nudt7 genes by the CRISPR/Cas9 system did not affect development; however, it decreased the rate of transcription in ZGA. In addition, H3K27ac ChIP-seq analysis demonstrated that this decrease in transcription was correlated with the genome-wide decrease of H3K27ac level. This study suggests that peroxisomal Nudt7 functions in regulating transcription in ZGA via formation of the H3K27ac domain in active chromatin.