bluuebunny/crossref_metadata_2025_split huggingface dataset:
Therapeutic uncertainties: first finding of atrial fibrillation in acute coronary syndrome
Authors: Greco Antonio , Capodanno Davide 
Published: November 2022

Abstract
Atrial fibrillation (AF) and coronary artery disease share several risk factors and their simultaneous presentation in the same patient, sometimes in the course of acute coronary syndrome (ACS), is not a rare occurrence. Patients with AF and ACS represent an important clinical challenge in terms of diagnosis, prognosis and therapy. From a diagnostic point of view, AF may be new onset as a complication of ACS, or a pre-existing asymptomatic AF that is occasionally diagnosed during ACS. Regarding the prognosis, AF, whether new onset or already known, has been shown to exert a negative prognostic impact during ACS. Finally, the main therapeutic dilemma concerns the selection of the optimal antithrombotic therapy, which, at least in the first period following ACS, would require the combination of anticoagulant and antiplatelet drugs, with a consequent increase in the risk of bleeding complications. Several randomized studies have evaluated the therapeutic options in patients with AF and coronary artery disease, overall showing the advantage of a dual therapy with an antiplatelet and an anticoagulant compared with a long-term triple therapy with dual antiplatelet and anticoagulant therapy; the analyses of the ACS subgroups of these randomized studies confirmed such results also in the acute setting.
The many NOs to the use of Class IC antiarrhythmics: weren’t the guidelines too strict?
Authors: Turturiello Dario , Cappato Riccardo 
Published: November 2022

Abstract
Class IC antiarrhythmic drugs (AADs) currently represent a cornerstone in the therapy of atrial fibrillation, both for the restoration of sinus rhythm and for the prophylaxis of long-term relapses. They also play an important role in the treatment of idiopathic ventricular arrhythmias. Following the results of the Cardiac Arrhythmia Suppression Trial study, flecainide and by extension the other Class IC AADs were contraindicated in patients with ischaemic and structural heart disease, due to their pro-arrhythmic effect and the consequent increase in mortality observed in the study. Recent studies carried out on patients with chronic coronary heart disease without previous heart attacks and/or residual ischaemia have shown a good safety profile for this class of drugs. In addition, other studies have shown excellent efficacy in the absence of pro-arrhythmic effects of Class IC AADs in patients with structural heart disease such as arrhythmogenic right ventricular cardiomyopathy (ARVC) and tachy-cardiomyopathy. The purpose of this review is to evaluate the appropriate use of Class IC AADs in the different patient subgroups, in the light of the evidence and new diagnostic and therapeutic tools available.
Clinical implications of cardiac magnetic resonance imaging fibrosis
Authors: Guglielmo Marco , Pontone Gianluca 
Published: November 2022

AbstractCardiac magnetic resonance (CMR) is a non-invasive imaging method that allows to characterize myocardial tissue. In particular, using the late gadolinium enhancement technique, it is possible to identify areas of focal fibrosis. Specific distribution patterns of this fibrosis allow us to distinguish ischaemic cardiomyopathy (iCMP) from non-ischaemic cardiomyopathy (nCMP) and sometimes to identify the aetiology of the latter. Diffuse fibrosis can also be identified using the parametric T1 mapping sequences. For this purpose, the native T1 of the tissue is measured before the administration of the contrast agent (c.a.) or the extracellular volume is calculated after c.a. Both focal and diffuse fibrosis evaluated with CMR appear to be strong prognostic predictors for the identification of threatening ventricular arrhythmias and sudden cardiac death. These evidence open the doors to a possible role of CMR in the selection of the patient to be sent to a defibrillator implant in primary prevention. In this review, we will briefly review the techniques used in CMR for the evaluation of fibrosis. We will then focus on the clinical role of myocardial tissue fibrosis detection in iCMP and nCMP.
When to set anticoagulant therapy in asymptomatic AF? looking for a cut-off duration
Authors: Rossini Roberta , Peirone Andrea 
Published: November 2022

Abstract
The incidence of atrial fibrillation (AF) is progressively increasing, in line with the aging of the population and with the increase in chronic diseases. The care burden of the disease and above all to its consequences (i.e. ischaemic stroke and heart failure) significantly impacts the various health systems with forecasts of exponential increase in the near future. Clinical forms of AF, i.e. those diagnosed with electrocardiogram, have a clear correlation with systemic embolic events and also with a reduction in survival. Thromboembolic prophylaxis in these patients, with anticoagulant drugs, has in fact been shown to greatly reduce the incidence of ischaemic stroke and improve survival. In recent decades, the widespread use of therapeutic intra-cardiac devices, which allow constant and continuous monitoring of myocardial electrical activity, is bringing to light a large number of atrial high rate episodes (AHREs), which are not associated with clinical manifestation. The incidence of these findings grows linearly with the duration of the observation. More independent studies have shown that AHREs are associated with a risk of stroke that is higher (about double) than controls but significantly lower than in patients with manifest AF. However, taking into consideration patients with ischaemic stroke and wearers of implantable devices, no temporal correlation emerged between the incidence of the ischaemic episode and arrhythmia. The presence of AHRE is associated with an approximately six-fold increase in the incidence of clinical AF but only a minority of these patients meet the criteria for prescribing anticoagulation. Pending the publication of the studies still in progress, the European Society of Cardiology guidelines for the treatment of AF recommend considering the initiation of anticoagulant therapy in patients with long-lasting AHRE (&gt; 24 h) associated with a high embolic risk. In patients with episodes of shorter duration (1–24 h), especially if with high burden, anticoagulant therapy can be considered in case of very high embolic risk (e.g. secondary prevention, CHADVASc ≥ 3).
Selection of patients eligible for implantable cardioverter defibrillator: beyond left ventricular ejection fraction
Authors: Rizzello Vittoria 
Published: November 2022

Abstract
The selection of patients eligible for implantable cardioverter defibrillator (ICD), in primary prevention, is a critical moment in the management of the patients with cardiomyopathies as it needs a right balance of the patients’ arrhythmic risk and the risks related to the implantation, as well as the device costs. Several data indicate that left ventricular ejection fraction alone is not a sufficient criterion for a proper identification of patients who could benefit most from ICD. Numerous findings show that genetic analysis and characterization of myocardial fibrosis with magnetic resonance imaging allow an important improvement of this process.
The enigma of resistant hypertension: from lifestyle changes and pharmacological treatment to renal denervation
Authors: Volpe Massimo , Gallo Giovanna 
Published: November 2022

Abstract
Resistant hypertension consists in the failure to achieve effective control of blood pressure despite the use of at least three drugs, including a diuretic, at the maximum tolerated dosage. Despite the progress made in terms of improving awareness and effectiveness of the available therapeutic strategies, the percentage of patients with resistant hypertension represents up to 18% of the entire hypertensive population. The management of resistant hypertension includes the combination of different strategies from lifestyle changes to complex interventional procedures. Lifestyle interventions include reducing salt intake, weight loss, quitting smoking and alcohol consumption, and performing aerobic physical activity. With regard to drug therapy, international guidelines recommend the introduction of a mineralocorticoid receptor antagonist or, if not tolerated, of a loop diuretic, or of the beta-blocker bisoprolol, or of the alpha-blocker doxazosin. In the last few years, promising results have been obtained from studies that have evaluated the efficacy and safety of the denervation of the renal arteries by ablation. This procedure may constitute an increasingly widespread option for those patients suffering from resistant hypertension despite the use of different drug classes, or who are intolerant or poorly adherent to medical therapy.
Surgical approach to combined mitral and tricuspid valve disease: good neighbourhood rules
Authors: Ascione Guido , Carino Davide , Alfieri Ottavio 
Published: November 2022

Abstract
Tricuspid regurgitation afflicts more than one-third of patients with mitral valve disease during their clinical history, and negatively affects their outcomes, increasing mortality and hospitalizations for heart failure and reducing the quality of life. A renewed interest in the ‘neglected valve’ has increased the frequency of the combined treatment of these two diseases. Undoubtedly necessary in patients with degenerative mitral valve disease in the presence of two severe valve defects, tricuspid annuloplasty has proven to be safe and effective even if performed prophylactically, when tricuspid annular dilation coexists with primary mitral dysfunction. In the absence of survival benefits, however, this additional surgical procedure increases the risk of high-grade atrio-ventricular blocks and the need for a definitive pacemaker. On the other hand, the role of surgery has been scaled down in patients with functional mitral and tricuspid regurgitation. In this context, a multidisciplinary approach is needed and transcatheter alternatives are increasingly the chosen treatment option. A new therapeutic algorithm is therefore looming on the horizon. In the future, the treatment of tricuspid and mitral valve disease may be considered two potentially distinct and successive phases of an integrated heart failure patients care process.
Transcatheter mitral valve replacement: there is still work to be done
Authors: Bartorelli Antonio L , Monizzi Giovanni , Mastrangelo Angelo , Grancini Luca , Fabbiocchi Franco , Conte Edoardo , Moltrasio Marco , Andreini Daniele 
Published: November 2022

Abstract
Transcatheter mitral valve replacement (TMVR) is a novel therapeutic option for patients with severe mitral regurgitation (MR) at high or prohibitive surgical risk. Most TMVR technologies under investigation use either a trans-apical or a trans-septal approach via dedicated multistep anchoring systems. Transcatheter mitral valve replacement offers several potential advantages over transcatheter repair, notably a greater and more sustained MR reduction. At the same time, significant engineering challenges and potential disadvantages must be acknowledged. Preclinical and clinical studies have shown promising results, demonstrating TMVR feasibility. Nevertheless, further development, testing, and trials are needed before considering TMVR as a definitive therapeutic option for MR in a wide range of anatomical scenarios.
Why can primary angioplastics be ineffective despite the precocity of the intervention?
Authors: Patti Giuseppe , Ghiglieno Chiara 
Published: November 2022

Abstract
Early coronary revascularization is a first choice therapeutic strategy in the case of acute myocardial infarction (MI). Despite an early coronary angioplasty, however, in some cases, there is a lower efficacy of revascularization, with less favourable clinical outcome in the short and long terms. Various elements participate in the distant prognosis after primary coronary angioplasty (PCI). Among the clinical risk factors that predispose to a recurrence of ischaemic cardiovascular events are advanced age, diabetes mellitus, chronic renal failure, peripheral vascular disease, atrial fibrillation and the multiplicity of cardiovascular risk factors, which identify a higher baseline risk profile. The risk factors associated with the percutaneous interventional procedure include the presence of diffuse or complex coronary lesions, the use of small diameter stents or a suboptimal post procedural thrombolysis in MI flow. The occurrence of procedural complications, such as no-reflow, is in fact associated with an increase in the infarct area and a worse prognosis, as it favours negative ventricular remodelling. The presence of concomitant right ventricular dysfunction, the high ventricular arrhythmic burden in the acute phase, the presence of risk factors for thrombosis or intra-stent restenosis also affect the outcome after primary PCI.
The point on the electronic cigarette more than 10 years after its introduction
Authors: Spoladore Roberto , Daus Francesca , Pezzini Sara , Milani Martina , Limonta Antonella , Savonitto Stefano 
Published: November 2022

Abstract
Electronic cigarettes (e-cigarettes) are battery-powered devices containing a liquid based on propylene glycol or vegetable glycerin, compounds which, when vaporized, act as a vehicle for nicotine, flavours, and other chemical components. These devices have been marketed without clear evidence of risks, long-term safety, and efficacy as a means of traditional smoking cessation. Recent clinical studies have shown how the use of the e-cigarette, combined with adequate psychological support, can be effective in reducing traditional smoking but not nicotine addiction. However, meta-analyses of observational studies have not confirmed this efficacy. Several studies have also highlighted an increase in sympathetic tone, vascular stiffness, and endothelial dysfunction, all factors associated with an increased cardiovascular risk. Clinicians, therefore, should carefully monitor the possible risks to public health deriving from the use of e-cigarettes and should discourage non-smokers and adolescents from using such devices. Finally, particular attention should be paid to smokers so that the combined use of electronic and traditional cigarettes can be limited as much as possible.
Cardiology of the future: xenotransplantation with porcine heart
Authors: Sinagra Gianfranco , Pagura Linda , Radesich Cinzia , Gagno Giulia , Cannata’ Antonio , Barbisan Davide , Cittar Marco , Paldino Alessia , Perotto Maria , Mase’ Marco , Dal Ferro Matteo , Mazzaro Enzo , Merlo Marco 
Published: November 2022

Abstract
The reduced availability of human donor hearts compared with the needs of patients with advanced heart failure refractory to medical therapy has promoted the search for therapeutic alternatives to cardiac allografts. Porcine heart xenotransplantation represents one of the most promising frontiers in this field today. From the first researches in the 1960s to today, the numerous advances achieved in the field of surgical techniques, genetic engineering and immunosuppression have made it possible at the beginning of 2022 to carry out the first swine-to-human heart transplant, attaining a survival of 2 months after surgery. The main intellectual and experimental stages that have marked the history of xenotransplantation, the latest acquisitions in terms of genetic editing, as well as the improvement of immunosuppressive therapy are discussed analytically in this article in order to illustrate the underlying complexity of this therapeutic model.
Non-invasive localization of post-infarct ventricular tachycardia exit sites to guide ablation planning: a computational deep learning platform utilizing the 12-lead electrocardiogram and intracardiac electrograms from implanted devices
Authors: Monaci Sofia , Qian Shuang , Gillette Karli , Puyol-Antón Esther , Mukherjee Rahul , Elliott Mark K , Whitaker John , Rajani Ronak , O’Neill Mark , Rinaldi Christopher A , Plank Gernot , King Andrew P , Bishop Martin J 
Published: November 2022

AbstractAimsExisting strategies that identify post-infarct ventricular tachycardia (VT) ablation target either employ invasive electrophysiological (EP) mapping or non-invasive modalities utilizing the electrocardiogram (ECG). Their success relies on localizing sites critical to the maintenance of the clinical arrhythmia, not always recorded on the 12-lead ECG. Targeting the clinical VT by utilizing electrograms (EGM) recordings stored in implanted devices may aid ablation planning, enhancing safety and speed and potentially reducing the need of VT induction. In this context, we aim to develop a non-invasive computational-deep learning (DL) platform to localize VT exit sites from surface ECGs and implanted device intracardiac EGMs.Methods and resultsA library of ECGs and EGMs from simulated paced beats and representative post-infarct VTs was generated across five torso models. Traces were used to train DL algorithms to localize VT sites of earliest systolic activation; first tested on simulated data and then on a clinically induced VT to show applicability of our platform in clinical settings. Localization performance was estimated via localization errors (LEs) against known VT exit sites from simulations or clinical ablation targets. Surface ECGs successfully localized post-infarct VTs from simulated data with mean LE = 9.61 ± 2.61 mm across torsos. VT localization was successfully achieved from implanted device intracardiac EGMs with mean LE = 13.10 ± 2.36 mm. Finally, the clinically induced VT localization was in agreement with the clinical ablation volume.ConclusionThe proposed framework may be utilized for direct localization of post-infarct VTs from surface ECGs and/or implanted device EGMs, or in conjunction with efficient, patient-specific modelling, enhancing safety and speed of ablation planning.
Mitochondrial Dysfunction and Intrinsic Capacity: Insights From a Narrative Review
Authors: Aragoni da Silva Jaqueline , Rolland Yves , Martinez Laurent O , de Souto Barreto Philipe 
Published: November 2022

Abstract
Mitochondrial dysfunction occurs during aging and may play a role, by distinct mechanisms, in the loss of intrinsic capacity (IC), operationalized through 5 domains: locomotion, psychological, cognition, vitality/nutrition, and sensory (hearing, vision). The objective of this review is to provide an overview of the associations between mitochondrial function and IC domains. This study is a narrative review of original investigations (any study design) on the relationship of mitochondrial function in humans with locomotion (eg, gait speed), psychological (eg, depressive symptoms), cognition (eg, global cognitive function), vitality (eg, handgrip strength), and/or sensory (hearing and vision acuity) domains. The IC domains were considered from the perspective of the Integrated Care for Older People (ICOPE), according to the World Health Organization guidelines. The results show that there is still limited evidence regarding the associations between mitochondrial function and IC domains. Most studies were cross-sectional and involved small samples. The tissues/cells most often investigated in the original studies were skeletal muscle and peripheral blood mononuclear cells. The available evidence, although limited, indicates that mitochondrial function, in particular, the mitochondrial DNA copy number, is associated with all IC domains. The evidence is more robust for locomotion and less abundant for hearing. In conclusion, this review supports the notion that mitochondrial function is correlated with IC domains by distinct mechanisms. Future studies are needed to confirm whether mitochondria play a role in maintaining optimal function and preventing/delaying the onset of disability during aging, which could ultimately contribute to healthy aging.
Effects of misreporting landings, discards, and Catch Per Unit of Effort index in state-space production models: the case of black hake in northwest Africa
Authors: Soto María , Fernández-Peralta Lourdes , Pennino Maria Grazia , Kokkalis Alexandros , Rey Javier , Salmerón Francisca , Liébana María , Meissa Beyah , Kell Laurie 
Published: November 2022

Abstract
Recently, various state-space implementations of surplus production models (SPMs) have been developed for data-limited stocks. Often, catches and fishing effort are underestimated and discards are ignored. This results in biased estimates of stock status and reference points. Therefore, we conduct a sensitivity analysis for different under-reporting scenarios (due to non-declared landings, by-catch, and discards) on model estimates and thus advice for the black hake species in northwest Africa. Two modelling frameworks were used, namely a stochastic SPM in continuous time (SPiCT) and Just Another Bayesian Biomass Assessment (JABBA). A common set of diagnostics was developed to allow comparison across modelling frameworks. Scenarios correspond to hypotheses about misreporting and assumptions and priors that were kept consistent. The ratio of current fishing mortality over the fishing pressure that gives the maximum sustainable yield, F/FMSY, is most affected by under-reporting. Results are sensitive to the prior assumed for the initial depletion level, B0/K, and research is needed. If the misreporting is changing over time, relative quantities (e.g. F/FMSY) and trends are biased, while if misreporting (or at least a part of misreporting) is constant, relative quantities are unbiased. Therefore, the nature of any trend in misreporting should be investigated.
Smooth Points of the Space of Plane Foliations with a Center
Authors: Gavrilov Lubomir , Movasati Hossein 
Published: November 2022

Abstract
We prove that a logarithmic foliation corresponding to a generic line arrangement of $d+1 \geq 3$ lines in the complex plane, with pairwise natural and co-prime residues, is a smooth point of the center set of plane foliations (vector fields) of degree $d$.
EQUAL CPA Score 2022: a tool to measure guideline adherence for chronic pulmonary aspergillosis
Authors: Sprute Rosanne , Van Braeckel Eva , Flick Holger , Hoenigl Martin , Kosmidis Chris , Agarwal Ritesh , Davidsen Jesper R , Laursen Christian B , Cornely Oliver A , Seidel Danila 
Published: November 2022

Abstract

Background
Chronic pulmonary aspergillosis (CPA) can complicate underlying pulmonary diseases, and clinical management of CPA is challenging. Guidelines support clinicians but due to the complexity of the disease they can be difficult to adhere to.

Objectives
To map current guideline recommendations for the clinical management of CPA into a scoring tool to facilitate and quantify guideline adherence in clinical practice.

Methods
Recommendations for diagnosis, treatment and follow-up of CPA presented in the current ESCMID/ERS/ECMM and CPAnet guidance documents were assembled and weighed on the basis of their strength of recommendation and level of evidence.

Results
Twenty-seven recommendations were identified, resulting in a total maximum EQUAL CPA Score of 51. For diagnostics (ScoreMax = 27), a strong emphasis on expert consultation, culture, direct microscopy, histopathology, serology and imaging was reflected in respective points, whereas molecular techniques and susceptibility testing count into the diagnostics score to a lesser extent.
Ten treatment recommendations (ScoreMax = 14), including antifungal therapy, therapeutic drug monitoring and treatment duration, were identified. Surgery, where indicated, adds three points. For refractory disease or intolerance of first-line antifungal treatment, optimal second-line treatment added another two points.
During follow-up (ScoreMax = 10), response assessment via imaging gave three points, while culture and serology added two points each to the ScoreMax.

Conclusion
The EQUAL CPA Score intents to be used as a comprehensive tool for measuring guideline adherence. If adherence to current guidelines is associated with clinical outcome, this will be assessed in future studies.