bluuebunny/crossref_metadata_2025_split huggingface dataset:
1123 DIAGNOSTIC ACCURACY OF SMART GADGETS/WEREABLE DEVICES IN ATRIAL FIBRILLATION DETECTION: A METANALYSIS
Authors: Vetta Giampaolo , Parlavecchio Antonio , Gianni Carola , Cipolletta Laura , Polselli Marco , Vuono Francesco De , Pannone Luigi , Mohanty Sanghamitra , Cauti Fillippo Maria , Caminiti Rodolfo , Miraglia Vincenzo , Monaco Cinzia , Chierchia Gian Battista , Rossi Pietro , Biase Luigi Di , Bianchi Stefano , De Asmundis Carlo , Natale Andrea , Della Rocca Domenico Giovanni 
Published: December 2022

Abstract

Introduction
Atrial fibrillation (AF) is the most common sustained arrhythmia and an important risk factor for stroke and heart. Recent technology advances have allowed for heart rhythm monitoring using smart gadgets/wearable devices which can be used for early AF diagnosis.

Hypothesis
We performed a systemic review and meta-analysis to assess the accuracy of AF diagnosis by smart gadgets/wearable devices.

Methods
We systematically searched Medline, Embase and Cochrane electronic databases up to April 15th, 2022 for observational studies of the diagnostic accuracy of smartphone application, wrist-worn wearables and external devices in detecting AF. We calculated the area under the curve (AUC) of the summary receiver operating characteristic curves (SROC) and pooled sensitivities and specificities.

Results
A total of 79 studies were included enrolling 36903 patients, 66.3% male with average age of 68.3±8 years. In the overall analysis of all devices, the AUC was 0.99 (95% CI: 0.98-1.00), the sensitivity 95%(95% CI: 94–96%), the specificity 96%(95% CI: 96–97%). Wrist-worn wearables had AUC of 0.99 (95% CI: 0.98-1.00), the sensitivity 95%(9% CI: 92–97%), the specificity 97%(95% CI: 96–98%)(Figure 1A). Smartphone applications had AUC of 0.98 (95% CI: 0.96-0.99), the sensitivity 96%(9% CI: 94–97%), the specificity 96%(95% CI: 93–98%)(Figure 1B). External devices had AUC of 0.99 (95% CI: 0.98-1.00), the sensitivity 95%(9% CI: 93–97%), the specificity 96%(95% CI: 95–97%)(Figure 1C). Single-lead ECG had AUC of 0.99 (95% CI: 0.98- 1.00), the sensitivity 95%(9% CI: 92–96%), the specificity 96%(95% CI: 95–97%). PPG had AUC of 0.99 (95% CI: 0.98-1.00), the sensitivity 96%(9% CI: 95–97%), the specificity 97%(95% CI: 95–98%).

Conclusions
Smartphone application, wrist-worn devices and external devices with PPG and single-lead ECG have excellent diagnostic accuracy in atrial fibrillation diagnosis.
Figure 1. Summary Receiver Operating Characteristic curves and Areas Under The Curve of Wrist-worn wearables (A), Smartphone applications (B) and External devices (C).
284 EFFECTS OF TWO DIFFERENT COMBINATIONS OF POLICOSANOLS IN LIPID LOWERING AND ENDOTHELIAL FUNCTION
Authors: Cersosimo Angelica , Amore Ludovica , Cimino Giuliana , Calvi Emiliano , Arabia Gianmarco , Raddino Riccardo 
Published: December 2022

Abstract

Aims
Current guidelines recommend the use of lipid lowering agents based on the patient's cardiovascular risk. In the last years, a great interest was driven towards the cathegory of "very low risk" patients, in which a single cardiovascular risk factor is sufficient to make them been considered at "relatively higher" risk.
For the last category of patients nutraceutical acquired importance in the last years.
The present study aims to evaluate the efficacy and safety of a combination of monacolin K 2.9 mg, (fermented yest rice), coenzyme Q10 30 mg (Formulation A) versus monacolin K 10 mg, and coenzyme Q10 10 mg (Formulation B) on lipidic profile and on the vascular function evaluated as endothelial function and arterial stiffness.

Methods
The present is a single-center, open-label randomized controlled parallel group study to compare efficacy and safety of two different type of nutraceutical compounds (Formulation A or Formulation B).
Patients enrolled were with low cardiovascular risk, in primary prevention, in order to evaluate the evolution of the lipidic profile of these patients and the impact of a nutraceutical-based treatment strategy.
Patients eligible for the study were randomized 1:1 to receive either a pill day of Formulation A or B.

Results
Both treatments with Formulation A or B were tolerated; no patients reported side effects or withdrew from the study. The two groups were balanced with respect clinical and biochemical variables. After 24 weeks of treatment we demonstrated a statistically significant reduction in total cholesterol (p 0.010) and LDL (p 0.002).
We observed also an improvement in endothelial function (p 0.292) and a reduction of arterial stiffness (p 0.209) evaluated through the non-invasive methods of EndoPAT and SphygmoCOR. Data obtained suggest monacolin K 2.9 mg, coenzyme Q10 30 mg and rice policosanols 20 mg (Formulation A), was non inferiority to monacolin K 10 mg, coenzyme Q10 10 mg (Formulation B) in endothelial function improvement and serum lipids lowering.

Conclusions
The new combination of natural nutraceuticals, have a protective cardiovascular effect, not also through reduction of plasma lipids but also in endothelial function and arterial stiffness, despite the reduction of monacolin K.
101 LIPOPROTEIN ASSOCIATED PHOSPHOLIPASE A2 IN STEMI VS NSTE-ACS PATIENTS: A MARKER OF CARDIOVASCULAR ATHEROSCLEROTIC RISK RATHER THAN THROMBOSIS
Authors: Verdoia Monica , Gioscia Rocco , Rognoni Andrea , Luca Giuseppe De 
Published: December 2022

Abstract

Background
The precise role of Lipoprotein associated phospholipase A2 (Lp-PlA2) in the pathogenesis of acute coronary syndromes (ACS) and in the prediction of future cardiovascular events is still debated. So far, few data exist on the variations of Lp-PlA2 activity in ACS and especially in NSTE-ACS vs STEMI patients, where thrombotic and atherosclerotic mechanisms could play a differential role. The aim of the present study was, then, to compare Lp-PlA2 activity according to the type of ACS presentation.

Methods
A consecutive cohort of patients undergoing coronary angiography for acute coronary syndrome (ACS) were included and divided according to presentation for non ST-segment elevation-ACS or ST-segment elevation Myocardial Infarction (STEMI). Lp-PLA2 activity was assessed on blood samples drawn at admission using the Diazyme Lp-PlA2 Activity Assay.

Results
We included in our study 117 patients, of whom 31 (26.5%) presented with STEMI. STEMI patients were significantly younger (p=0.05), displayed a lower rate of hypertension (p=0.002), previous MI (p=0.001) and PCI (p=0.01) and used less frequently statins (p=0.01) and clopidogrel (p=0.02). White blood cells and admission glycemia were increased in STEMI (p=0.001, respectively). The prevalence and severity of CAD was not different according to ACS types, but for a higher prevalence of thrombus (p&lt;0.001) and lower TIMI flow (p=0.002) in STEMI. The levels of Lp-PlA2 were significantly lower in STEMI as compared to NSTE-ACS patients, (132±41.1 vs 154.6 ±40.9 nmol/min/mL, p=0.01). In fact, the rate of patients with Lp-PlA2 above the median (148 nmol/min/mL) was significantly lower in STEMI patients as compared to NSTE-ACS (32.3% vs 57%, p=0.02, adjusted OR[95% CI]=0.20[0.06-0.68], p=0.010). Moreover, a direct linear relationship was observed between Lp-PlA2 and LDL-C (r=0.47, p&lt;0.001), but not with inflammatory biomarkers.

Conclusion
The present study shows that among ACS patients, the levels of Lp-PlA2 are inversely associated with STEMI presentation and thrombotic coronary occlusion, being instead increased in NSTE-ACS patients, and with recurrent cardiovascular events, therefore potentially representing a marker of a more aggressive atherosclerotic disease and higher cardiovascular burden and risk.
697 SGLT2-INHIBITORS PREVENT LEFT VENTRICULAR DISFUNCTION INDUCED BY ANTHRACYCLINE CHEMOTERAPY IN MOUSE MODEL: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Faggiano Andrea , Gherbesi Elisa , Carugo Stefano 
Published: December 2022

Abstract

Background
No human studies evaluating the efficacy of sodium glucose cotransporter 2 inhibitors (SGLT2-i) in preventing left ventricular dysfunction induced by anthracycline chemotherapy are available. Current evidence on this topic is based on few studies conducted on mouse models.

Objective
We investigated this issue through a meta-analysis of echocardiography studies that reported data on difference in left ventricular function between animals assuming SGLT2-i and controls in mouse models of anthracycline-induced cardiomyopathy.

Methods
The PubMed, OVID-MEDLINE and Cochrane library databases were systematically analysed to search English-language articles published from inception to 31 July 2022. Studies were identified by using Me-SH terms and crossing the following terms: “ sodium glucose cotransporter 2 inhibitors”, “gliflozin”, “anthracycline”, “cardiotoxicity”, “systolic dysfunction” and “echocardiography”.

Results
The meta-analysis included a total of 106 mice (Sprague Dawley and C57Bl/6 species) with anthracycline-induced cardiomyopathy from 7 studies, 60 mice assuming a SGLT2-i (Empagliflozin:4 studies, Dapagliflozin:2, Canagliflozin:1) and 46 controls. Compared with controls, left ventricle systolic function was significantly better in the pooled SGLT2-i group. Precisely, both fractional shortening (FS: 44,7±3,7 vs 32,6±3,3) and left ventricle ejection fraction (LVEF: 78,2±3,4 vs 64,2±4,9) were higher in the pooled SGLT2-i group than in the controls group, with standard mean difference (SMD) respectively being 2,42±0,56 for FS (CI: 1,326-3,510, p value &lt;0.001) and 2,46±0,61 for LVEF (CI: 1,267-3,656, p value &lt;0.001). Figure 1.

Conclusions
Our study shows a favourable effect of SGLT2-i in the prevention of left ventricular dysfunction induced by anthracycline chemotherapy in mouse models, suggesting that this pharmacological strategy should also be tested in clinical studies involving human subjects.
367 LEFT VENTRICULAR MALIGNANT PERIPHERAL NERVE SHEATH TUMOR, A RARE PRIMARY CARDIAC NEOPLASM
Authors: Lapolla Davide , Fileti Luca , Campo Gianluca Calogero , Guardigli Gabriele , Tonet Elisabetta 
Published: December 2022

Abstract
This is a case of a 71 year-old man, symptomatic for heart failure (NYHA II class), with recent weight loss and occurrence of arthralgia. In the last month episodes of non sustained ventricular tachycardia were observed.
Transthoracic echocardiography showed a dilated left ventricle with reduced ejection fraction (30%) and the presence of an apical left ventricular cyst (dimensions 33×36 mm), with no doppler signal inside. No relevant valvular diseases were found. The first hypothesis was a cystic echinococcosis with left ventricle localization, but the serological testing resulted negative.
In order to obtain a better characterization of the apical lesion a Cardiac Magnetic Resonance (CMR) was performed: it confirmed the apical mass with thin wall, high T2 and T1 signal and no contrast enhancement. CMR findings raised the suspicion of cardiac tumor.
The case was discussed in the local heart team, and the patient was scheduled for cardiac surgery with mass removal. The histological examination showed a malignant mesenchymal neoplasm related to a primary cardiac schwannoma.
Follow up outpatient visit showed a decrease of the arrhythmic burden and a progressive improvement in patient's symptoms. Echocardiography reported little improvement in EF (38%) and no suspicious lesions.
MPNST (malignant peripheral nerve sheath tumor) is a type of cancer extremely rare and not fully considered in literature with a poor prognosis. CMR and echocardiography could help to early diagnose this neoplasms when dimension and localization are not prohibitive for operating.
411 AN UNEXPECTED (AND UNDESIRED) ECHOCARDIOGRAPHIC FINDING IN A PATIENT WITH RIGHT-SIDED CHEST PAIN
Authors: Radesich Cinzia , Pezzato Andrea , Saro Riccardo , Luca Antonio De , Ferro Matteo Dal , Dore Franca , Sinagra Gianfranco 
Published: December 2022

Abstract
A 71-year-old man, former smoker, without other cardiovascular risk factors nor previously known cardiological history, was admitted to our emergency department for nonproductive cough and right-sided chest pain, worsened by inspiration. ECG documented reduced peripheral QRS voltages. Echocardiography was performed, revealing the presence of an inhomogeneous, hyperechoic neoformation involving the lateral wall of the right ventricle (RV), dislocating the right coronary artery, protruding into the cavity towards the intraventricular septum and reaching the sub-valvular apparatus of the tricuspid valve, without any hemodynamic interference. Pericardial effusion was also documented (maximum 20 mm around the atrioventricular groove), without signs of cardiac tamponade. For better mass characterization, a computed tomography (CT) scan and a cardiac magnetic resonance (CMR) were performed, confirming the presence of a solid neoformation involving the RV and pericardial effusion, also showing right pleural effusion. Furthermore, right hilar and subcarinal lymphadenomegaly with compression of the bronchi was observed. A positron emission tomography (PET) scan showed areas of increased 18-fluorodeoxyglucose (18FDG) uptake in supra- and infra diaphragmatic lymph nodes, adrenal glands, bones, and lungs. Due to the clinical suspicion of a lymphoproliferative neoplasm, corticosteroid therapy was started.
Before a diagnostic lymph node biopsy could be performed, the patient had a syncopal episode due to cardiac tamponade, requiring pericardiocentesis. During hospitalization, continuous heart monitoring revealed intermittent third-degree atrioventricular block, so a permanent pacemaker was implanted. Finally, an excisional lymph node biopsy was obtained, and a diagnosis of diffuse large B-cell lymphoma was established. Treatment with Prednisone, Cyclophosphamide, Vincristine, nonpegylated liposomal Doxorubicin, and Rituximab (R-COMP) was promptly started. Seven months later, after five cycles of chemotherapy, complete remission was documented by PET scan, and the cardiac mass was no longer evident at echocardiography.
Metastatic involvement of the heart is a relatively frequent event in oncologic patients, with an estimated prevalence of 8% at autopsy. Lymphoproliferive neoplasms have a not negligible rate of heart mestastatization (9,4%). Neoplastic invasion secondary to lymphoma tends to infiltrate the myocardium, typically causing arrhythmias and conduction disturbances.
Diagnostic evaluation relies upon echocardiography, CT and CMR. PET/TC is of paramount importance to assess the malignant nature of the mass, to stage the disease and to evaluate the response to chemotherapy. Metastatic cardiac involvement typically occurs as a late manifestation of disseminated lymphoma and the prognosis is usually poor; however, survival is increasing thanks to new chemo-immunotherapy strategies.
608 PEAK ATRIAL SYSTOLIC LONGITUDINAL STRAIN (PALS) AS AN EARLY PARAMETER OF CANCER THERAPY-RELATED CARDIAC DYSFUNCTION
Authors: Minnucci Ilaria , Bergamini Corinna , Niro Lorenzo , Springhetti Paolo , Trento Laura , Benfari Giovanni , Rossi Andrea , Tafciu Elvin , Maffeis Caterina , Fiorio Elena , Luciano Ribichini Flavio 
Published: December 2022

Abstract

Background
Trastuzumab (TZ) is widely used for his key role in HER2 positive breast cancer. However, the most concerning cardiovascular complication is cardiotoxicity. Many studies have highlighted the importance of screening for subclinical myocardial dysfunction using left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS). However, there are only few studies investigating a possible atrial damage.

Purpose
Aim of this study was to analyze the modification peak atrial systolic longitudinal strain (PALS) in patients undergoing therapy with TZ in a follow-up period of 12 months. The fluctuation of left atrial function parameters under chemotherapy was evaluated focusing the attention on those patients who developed cancer therapy–related cardiac dysfunction (CTRCD).

Methods
116 women affected by breast cancer treated with TZ were enrolled. Each patient underwent a complete echocardiography at baseline and every 3 months.
Exclusion criteria were poor quality imaging and lack of a complete follow up with consequent missing data.
CTRCD was defined as a decrease in the left ventricular ejection fraction of &gt;10 percentage points to a value &lt;53% at any time of follow-up. 2D-Speckle tracking analysis was performed at baseline and at each examination using Tomtec software to analyze both atrial and left ventricular function. Trends of GLS, and PALS during 12 months-follow up periods were analyzed. Additionally, we explored if diabetes and renal impairment were associated with more prevalent atrial subclinical disfunction as demonstrated in previous studies.

Results
A total of 10 patients (9%) developed cancer therapy–related cardiac dysfunction. A significant reduction in GLS compared to the baseline was observed during the whole follow-up (p=0.05), starting in the first six months of treatment (-21 ± 2% vs -17 ± 2%, p= 0.021). Interestingly, PALS showed a similar trend with a significant decrease during the whole 12 months-follow up (p=0.012), starting in the first 3 months (45 ± 9% vs 35 ± 8%, p=0.001).
6 patients presented a diagnosis of diabetes at baseline, and presented lower PALS compared to the non-diabetic counterpart (38± 10% vs 49 ± 12% p=0.03).
2 patients presented a significant renal impairment (eGFR ≤30 ml/min). Similarly, these patients presented a lower PALS at baseline (32 ± 7% and 48 ± 7%; p=0.055).

Conclusions
In patients treated with Trastuzumab the development of left atrial impairment is frequent and PALS modifications seem to precede GLS variations in patients with CTRCD, suggesting a possible cardiotoxic effect of such therapy on both atrial and left ventricular myocardium and physiology.
847 CONCENTRATIONS OF GROWTH DIFFERENTIATION FACTOR 15 AND LEFT VENTRICULAR FUNCTION IN SURVIVORS FROM HODGKIN LYMPHOMA TREATED WITH ANTHRACYCLINE-CONTAINING CHEMOTHERAPY
Authors: Perna Valentina , Bertero Edoardo , Sirello Davide , Sarocchi Matteo , Porto Italo , Spallarossa Paolo , Ameri Pietro 
Published: December 2022

Abstract

Background
Recent studies have shown that the concentrations of growth differentiation factor 15 (GDF-15) increase after anthracycline administration and may be associated with cardiotoxicity during or shortly after treatment. The relation of GDF-15 with late-onset cardiotoxicity has far less been studied.

Methods
We examined GDF-15 levels across the spectrum of left ventricular (LV) function in a single-center cohort of adult patients who had received curative chemotherapy for Hodgkin lymphoma and underwent comprehensive cardiologic assessment including transthoracic echocardiography (TTE) as part of long-term follow-up. Plasma GDF-15 was measured by enzyme-linked immunosorbent assay, and the concentrations between TTE phenotypes were compared by unpaired Student's t test. The correlation between GDF-15 values and echocardiographic parameters was investigated by linear regression.

Results
35 (18 males, 51%) patients were evaluated a median of 47 months (IQR 24-67) after doxorubicin-containing chemotherapy. The median age at the end of treatment and at the time of TTE was 35 years (IQR 28-50) and 40 years (IQR 32-56), respectively. All subjects had received ABVD with or without rituximab as a first-line treatment; 2 (6%) had also received mediastinal irradiation, 6 (17.4%) a second-line therapy, 2 (8.7%) a third-line treatment, and 8 (17.4%) had ultimately undergone bone marrow transplantation. None had a history of heart disease or atrial fibrillation, nor NYHA class ≥II. Body mass index was 24 ± 5 Kg/m2. Seven (20%) patients had hypertension, 9 dyslipidemia (26%), and 2 (6%) diabetes; 28 (80%) were prior or current smoker. Mean GDF-15 was 1132,9 ± 485,0 pg/mL. LV ejection fraction (LVEF) was always &gt;50%; 3 (9%) subjects had global longitudinal strain (GLS) &lt; -18%. Moreover, 7 (20%) had mild or moderate diastolic dysfunction, as defined by E/A ratio &lt;1 or a pseudonormal mitral inflow pattern, respectively. There was no significant relation between GDF-15 and LVEF or GLS values. By contrast, GDF-15 levels were higher in patients with diastolic dysfunction than in those without. Moreover, GDF-15 concentrations correlated with E/A and E/e’ ratios, estimated pulmonary capillary wedge pressure, and estimated systolic pulmonary artery pressure (Figure).

Conclusions
Our results suggest that GDF-15 tracks with LV diastolic, rather than systolic, dysfunction years after anthracycline chemotherapy.
545 INVESTIGATING THE RISK OF CARDIAC FIBROSIS IN RESPONSE TO HEAT-NOT-BURN CIGARETTES THROUGH HUMAN CARDIAC STROMAL CELLS
Authors: Picchio Vittorio , Pagano Francesca , Carnevale Roberto , D´amico Alessandra , Cozzolino Claudia , Floris Erica , Bordin Antonella , Schirone Leonardo , Saade Wael , Miraldi Fabio , De Falco Elena , Sciarretta Sebastiano , Peruzzi Mariangela , Biondi-zoccai Giuseppe , Frati Giacomo , Chimenti Isotta 
Published: December 2022

Abstract

Background
The use of alternative smoking devices, such as heat-not-burn cigarettes (HNBC), is increasing on a global scale, and their impact on health is still uncertain.

Objective
To investigate the effects of circulating molecules in HNBC chronic smokers on the fibrotic specification and paracrine function of cardiac stromal cells (CSCs).

Methods
Resident CSCs were isolated from the atrial tissue of non-smokers patients with cardiovascular diseases, and exposed to the serum pools derived from 60 young healthy subjects, stratified in exclusive HNBC smokers, traditional combustion cigarette (TCC) smokers, or non-smokers (NS) as reference.

Results
CSCs treated with TCC serum versus NS displayed impaired 3D growth (NS 568±24 vs. TCC 442±27 spheroids/well, p≤0,01) and reduced migration after 6h (NS 0,62±0,04 vs. TCC 0,80±0,03 normalized scratch area versus t0, p≤0,01) and 10h (NS 0,49±0,03 vs. TCC 0,36±0,03 normalized scratch area versus t0, p≤0,05), as well as significantly increased expression (IL-6, IL-8) and/or release of pro-inflammatory (e.g CRP, PAI-1, CD40L, CXCL4) and pro-fibrotic cytokines (PDGFA, MMP1). CSCs cultured with HNBC serum showed significantly increased mRNA levels of pro-fibrotic genes (PDGFA, THY1, COL1A1, p&lt;0,01), and significantly reduced expression of the gap junction protein CX43 (p&lt;0,05). Nonetheless, both TCC and HNBC sera reduced the release of angiogenic and protective factors (e.g. VEGF, Adiponectin, CHI3L1) from CSCs, as assessed by protein arrays and ELISA. In fact, their paracrine support to tube-formation by endothelial cells (NS 63,29±4,72 vs. TCC 41,43±6,64 vs. HNBC 37,29±5,67 mesh number per well, p≤0,05) and to preserved cell viability of neonatal rat cardiomyocytes (NS 0,60±0,04 vs. TCC 0,40±0,01 vs. HNBC 0,47±0,01 OD490 normalized OD versus t0, p≤0,001) were significantly impaired. Treatment with the sera of both types of smokers also increased the expression of NOX isoforms and the release of H2O2 (NS 1,76±0,09 vs. TCC 3,84±0,25 vs. HNBC 2,90±0,35 µM, p≤0,05) and significantly reduced the release of NO (NS 6,98±0,43 vs. TCC 4,65±0,07 vs. HNBC 5,06±0,13 µM, p≤0,01) by CSCs.

Conclusion
The circulating molecules in the serum of chronic HNBC smokers induce fibrotic specification in CSCs. They also reduce the beneficial paracrine effects of stromal cells on endothelial cells and cardiomyocytes, albeit to a reduced extent for some features. These results point to a potential risk for atrial fibrosis development triggered by chronic HNBC use.