bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rhythm control in patients with atrial fibrillation admitted to outpatient clinic
Authors: Carvalho D , Carvalho P , Ferraz L , Pacheco A , Carvalho S , Ferreira R , Bastos JM , Neves AB 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. Patients are often symptomatic leading to a reduction in quality of life. Recent studies suggests that early rhythm control therapy have a clinical benefit in patients with recently diagnosed AF.

Purpose
This study aims to evaluate outpatient with AF referred to an outpatient clinic to electrical Cardioversion. Besides that, the study aims to evaluate if outpatient referred from the emergency room had spontaneously reverted to sinus rhythm.

Material and Methods
Retrospective observational study carried out through the analysis of the clinical process. Clinical data were collected from AF patients evaluated in an outpatient clinic during the year of 2020. Statistical analysis was made using R software and RStudio.

Results
This study included 92 patients evaluated in an outpatient clinic and referred because paroxysmal, persistent and long standing AF to electrical cardioversion. Average age was 67.3 ± 10.1 years. 78 patients had atrial fibrillation and 14 patients had atrial flutter. Hypertension was the most prevalent risk factor (n=83; 79,3%), followed by dislipidemia (n=66; 71.7%), overweight (n=43; 46,7%), diabetes mellitus (n=27; 29.3%) and smoke (n=20; 21.7%). 15 patients had paroxysmal AF, 67 patients had persistent AF and 10 patients had long standing AF. CHA2DS2VASC median were 2,78 ± 1.66 and HASBLED median was 1,14 ± 0.94. The heart rate control were most frequently made with betablocker (n=78; 84.7%). 4 patients (4,3%) were medicated with digoxin and 3 patients with calcium channel blockers. 69 patients were forwarded from external consultant and 23 patients from the emergency room (ER). We verified that 12 patients (52,2%) were in sinus rhythm in admission of outpatient clinic and had spontaneously reversion to sinus rhythm. Mostly patients with paroxysmal AF were from the ER (80% of all patients, p&lt;.001) and mostly patients with persistent and long standing AF were from external consultant (respectively 82% p&lt;0.01 and 85% p&lt;0,01). Symptoms improvement were evaluated by EHRA classification. Mostly patients had clinical improvement after electrical or spontaneously cardioversion (63%, p.0.02). The median EHRA score previous to CVE were "2" and after cardioversion were "1".

Conclusions
Risk factor control is the cornerstone of AF prevention. Control rhythm is important to improve clinical symptons related to AF. However, we can delay cardioversion in a recent acute episode in the emergency room. In our sample, it seems that AF with short natural story presents more in emergency room and the more chronic comes to our consultation.
Vascular retinopathy and relationship with long-term development of ischemic heart disease. Results of the RETICARD registry
Authors: Aguila Gordo D , Marina Breysse M , Piqueras Flores J , Mateo Gomez C , Negreira Caamano M , Cubides Novoa AF , Soto Perez M , Munoz Garcia M , Martinez Del Rio J , Moron Alguacil A , Arizon Munoz JM , Salas Bravo D , Blanco Lopez E , Soto Martin P 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Despite the undoubted relationship between retinopathy and cardiovascular pathology, its role as a predictor in the development of myocardial ischemia has not been sufficiently studied.

Methodology
Prospective study of a Spanish cohort of 107 patients who underwent diagnostic-therapeutic coronary angiography by medical indication. A fundus examination was also performed, determining the existence of retinopathy of vascular etiology (diabetic, hypertensive or atherosclerotic) and classifying it according to its degree. During follow-up, the appearance of myocardial perfusion defects was recorded by gated-SPECT.

Results
The median age was 67 years. 60.7% were men. The mean follow-up time was 111±19.7 months. Of the patients, 91.6% had some cardiovascular risk factor: 32.7% were diabetic, 78.5% had hypertension and 57% had dyslipidemia. 91.6% of the patients had some cardiovascular risk factor: 32.7% were diabetic, 78.5% had hypertension and 57% had dyslipidemia. 84.1% of the patients, had retinopathy of vascular etiology, 43.6% of whom had high-grade retinopathy. Significant coronary artery disease was present in 44.9%, with a mean SYNTAX score of 3.99±7.5 and 39.3% required percutaneous intervention. During follow-up, 15% presented inducible ischemia assessed by gated-SPECT. Subsequent coronary angiography was performed in 68.8% of these cases. Advanced vascular retinopathy, male sex, SYNTAX score and previous percutaneous coronary intervention were associated with a higher risk of myocardial perfusion defects. In logistic regression adjusted for these variables, vascular retinopathy presented an OR of 5.3 (95%CI 0.9-30.6; p=0.063) for the development of myocardial ischemia.

Conclusion
The presence of high-grade vascular retinopathy is an independent risk marker for the development of myocardial ischemia assessed by SPECT. Performing a funduscopic examination as part of the stratification of the cardiovascular patient could allow us to identify patients at higher risk.
Post-load glucose spike: a better predictor of post-MI prognosis than post-load glucose in patients without known diabetes
Authors: Chattopadhyay S , Soman B , George A , John J , Sathyapalan T 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
In non-diabetic population, number of deaths increase as the post-challenge glucose spike (PGS) i.e. difference between the fasting and 2h-PG increases in the DECODE study.

Purpose
To assess whether PGS is a better predictor of post-ACS prognosis in patients without known diabetes.

Methods
Retrospective cohort analysis of post-MI survivors (n=1056) without known diabetes undergoing pre-discharge oral glucose tolerance test. A standardised dataset was collected for the Myocardial Infarction National Audit Project. MACE (death or non-fatal re-infarction) over 5 (median 3.4) years was collected from notes review. Predictors of MACE were determined from Cox proportional hazard regression (stepwise) models adjusted for several variables (tested for collinearity) including GRACE score (GRS), fasting (FG) and 2-hour post-load glucose (2hG) and PGS as % of the 2hG (%PGS) (VIF=3.12). Incremental predictive value of PGS over 2hG was tested using probabilities of MACE calculated from logistic regression models using the same covariates and FG, 2hG and PGS individually and in combination applying c-statistics, continuous net reclassification improvement (cNRI) and integrated discrimination improvement (IDI).

Results
Of the patients 469 (44.4%) had normal glucose tolerance, 378(35.8%) preDM and 209 (19.8%) had new DM. In the whole cohort, MACE was predicted by %PGS (HR 1.02 (1.01-1.03), p&lt;0.0001), GRS (HR 1.01, (1.01-1.02), p&lt;0.0001), discharge with betablockers (HR 1.50 (1.14-1.98), p=0.0037), previous history of MI (HR 1.44 (1.02-2.03), p=0.039) but neither FG nor 2hG were included in the final model. MACE was predicted by %PGS (HR 1.04 (1.02-1.06), p&lt;0.0001) in the non-diabetic group but not in the new DM patients (HR 1.02 (0.99-1.05), p=0.296). Addition of PGS to models containing FG and 2hG improved reclassification by 22.6% for events and 5.0% for non-events (NRI&gt;0 0.275, p&lt;0.001) and discrimination (IDI 0.0076, p=0.033). However the c-statistics did not change significantly (ΔAUC 0.0094, p=0.099).

Conclusion
PGS is a better predictor of post-MI prognosis than FG or 2hG in patients without known diabetes.
Features of nutrition in women with arterial hypertension and abdominal obesity
Authors: Koval SERGEY , Rieznik LARYSA , Starchenko TG , Penkova MYU 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Aim
The study was aimed to investigate the nutritional characteristics of female patients (residents of Ukraine) with arterial hypertension and abdominal obesity.

Materials and methods
We examined 75 female patients (residents of Ukraine) with AH stage II, 2–3 degrees, aged from 40 to 59 years (40 women with AO (I–II degrees) and 35 women with normal body weight (NBW). All patients underwent a routine examination. The peculiarities of the nutrition of the patients were analyzed using the questionnaire "Diary of daily nutrition".

Results
The energy value of the daily ration was higher in the group of women with AH and AO (2782.4 [2214.6; 3118.4] kcal), than in women with AH and NBW (1823.2 [1516.5; 2368.5] kcal, р &lt; 0,05. In the group of women with AH and AO, the maximum energy value of the daily ration was for dinner in the most of the examined (73%), in women with AH and NBW - only in 43% (p &lt;0.05). The study of the macronutrient composition of the daily diet of patients showed a significant increase in fat intake (106.8 [87.9; 182.0] g / day) in the main group, in contrast to the comparison group (50.5 [38.5; 118.7] g/ day), p &lt;0.01. Intake of saturated fatty acids (p &lt;0.01) and trans-unsaturated fatty acids (p &lt;0.01) was also likely to be higher in the group of women with АН and AO than in the group of women with AH and NBW. Women with AH and AO probably consumed more carbohydrates than women with AH and NBW (375.1 [302.4; 447.3] g / day and 269.2 [211.7; 374.8] g / day respectively, p &lt;0.05. Daily protein intake in the group of women with AH in combination with AO and in the group of women with AH and NBW probably did not differ and amounted to 81.2 [57.4; 127.6] g / day and 74.5 [56.6; 132.7] g / day (p &lt;0.05). Women with AH and AO consumed an insufficient amount of dietary fiber - 28.8 [6.3; 38.4] g/day. At the same time, the consumption of dietary fiber in the group of women with AH and NBW was probably high - 39.2 [15.9; 52.5] g / day (p &lt;0.05) and corresponded to the European norms of healthy nutrition. The groups of women probably did not differ in the level of consumption of table salt (p = 0.082) and in the number of persons who "add salt to their food".

Conclusions
Significant violations of the healthy eating norms were found in women with AH, which were much more pronounced in women with AO that must be taken into account when developing optimal schemes for correcting the diet in these patients.
Alternations in markers of insulin resistance: HOMA-IR, HOMA-B, QUICKI, after dual therapy combination with delapril/manidipine in prediabetic hypertensive patients
Authors: Liontos A , Papathanasiou A , Biros D , Papagiannopoulos C , Tsourlos S , Athanasiou L , Kolios NG , Pappa C , Veliani C , Zarachi A , Christaki E , Liberopoulos E , Elisaf M , Milionis H , Liamis G 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Purpose
The administration of the 30mg hydrochloric delapril and 10mg hydrochloric manidipine formulation is indicated for patients with idiopathic hypertension whose arterial pressure cannot be sufficiently managed with monotherapy. The purpose of this study is to investigate the effect of the premade combination delapril/manidipine 30/10mg per day on the variation of HOMA-IR, HOMA-B and QUICKI values, in patients with stage 2 hypertension (systolic blood pressure (SBP) 160-180 mmHg and/or diastolic blood pressure (DBP) 100-110 mmHg) and with prediabetes (IFG/IGT) before and after the 3-month treatment with the fixed combination dual-therapy.

Methods
53 patients (30 male/23 female, from whom 12 smokers and 7 alcohol users) who visited our outpatient clinic for lipid metabolism disorders and fulfilled the study’s criteria joined the study’s sample. They were randomized in the delapril/manidipine group. The patients’ BMI was 28.73 [27.73-30.3] and the SBP and DBP values were: 156 [151-161] and 100 [88-101] mmHg respectively.

Results
The resulting variations of SBP and DBP levels, as well as the variations of glucose and insulin levels and HOMA-IR, HOMA-B and QUICKI are presented on Table 1.

Results
From the sampled patients it seems that the 3-month treatment with delapril/manidipine improved statistically significantly the levels of both SBP and DBP (reduction by -11.54% and -12% respectively, p&lt;0.001 for both values). Glucose levels witnessed a 1.55% decrease with statistical significance while a notable increase in insulin by 4.65% was also observed after the 3-month treatment, albeit without any statistical significance. Concerning HOMA-IR and QUICKI, there were no significant variance, while HOMA-B values showed a statistically significant increase (7%, p=0.006)
Physical activity is extremely low and should be encouraged in patients with severe aortic stenosis waiting for transcatheter aortic valve implantation
Authors: Van Erck D , Dolman CD , Scholte Op Reimer WJM , Henriques JP , Delewi R , Schoufour JD 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Amsterdam UMC - location AMC

Background
Physical activity is crucial to preserve muscle mass and muscle function, which is hard to regain at older age. Therefore, even short periods of physical inactivity can be harmful for older adults. Due to symptoms of aortic stenosis patients planned for an elective Transcatheter Aortic Valve Implantation (TAVI) treatment could be at risk of physical inactivity. Specifically, because many of these patients are already older and frail, this could be harmful for physical functioning and even mortality at the long-term.

Purpose
To determine physical activity in patients planned for TAVI, using a wearable.

Methods
Consecutive patients undergoing TAVI from January 2020 to September 2021 were included. All patients were asked to wear a Stepwatch activity monitor to objectively measure physical activity in the period before the TAVI. The Stepwatch is a valid tool to determine physical activity in frail and older adults, because it is able to detect slow or irregular movement. Patients were asked to wear the Stepwatch for seven consecutive days during every awake hour. By three complete days of at least 10 hours of wear time the data were included in the analysis. Two parameters were collected: the number of steps per day and activity time at moderate intensity. For number of steps per day patients were classified as extremely inactive (&lt;2500), inactive (&lt;7500) or active (&gt;7500). For time at moderate intensity, it was determined how many patients did meet the activity guidelines (&gt;150 min of moderate activity per week).

Results
In total 89 patients were included; mean age was 81 ± 5 years and 54% was male. Average number of steps per day were 6249 ± 2999. In total 19% (n=17) of the patients were extreme inactive, 67% (n=59) were inactive, and 15% (n=13) were active. Patients were moderate active for a median of 8 [IQR: 0 – 43] minutes per week. In total 6% (n=5) of the patients met the recommended guidelines of at least 150 minutes of moderate physical activity per week.

Conclusion
Older and frail patients with severe aortic stenosis planned for TAVI are mainly inactive. Most patients only moved at low intensity and a very small number of patients (6%) met the activity guidelines. The extremely low physical activity in patients waiting for TAVI, make them at high risk for muscle breakdown and adverse health outcomes at the longer term. (P)rehabilitation interventions should be developed to encourage patients with severe aortic stenosis to become more active during waiting time before TAVI.
Effects of concurrent training on cardiorespiratory fitness and body composition in adults with schizophrenia: CORTEX-SP study
Authors: Tous-Espelosin M , Iriarte-Yoller N , Sanchez P , Maldonado-Martin S 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Spanish Ministry of Economy and Competitiveness “Fondo de Investigación Sanitaria del Insti-tuto de Salud Carlos III”

Background
Concurrent training (i.e. a combination of aerobic and resistance exercise in the same session) is emerging as a time-efficient exercise strategy for improving cardiorespiratory fitness and controlling body composition parameters.

Purpose
The purpose of this study was to determine the effectiveness of a concurrent exercise program on cardiorespiratory fitness and body composition in adults with schizophrenia (SP).

Methods
Participants (n=98, 20.4% women, 41.4±10.1 yr old) with SP were randomly assigned into an attention control group (usual care) or a supervised exercise group (concurrent training, 3 days/week). All variables were assessed pre- and post-intervention (20 weeks). For the assessment of cardiorespiratory fitness, a peak cardiopulmonary exercise test on a cycle ergometer and the Modified Shuttle Walk Test (MSWT) were used.

Results
Following the intervention, in the control group, there was a significant (P &lt;0.05) increased in body mass (Δ = 2.54%), body mass index, BMI (Δ = 2.82%), waist circumference (Δ = 2.70%) and a decreased in MSWT (Δ = - 7.54%). However, in the exercise group, there was a significant (P&lt;0.001) increased in first ventilatory threshold, VT1 (Δ = 28.69%), peak oxygen uptake, V̇O2peak (L∙min-1) (Δ = 19.58%), V̇O2peak (mL∙kg.1∙min-1) (Δ = 21.52%) and MSWT-distance (Δ = 11.43%), with no significant changes in body composition (P&gt;0.05). When both groups were compared, body mass, and BMI was significantly (P&lt;0.05) more reduced, and VT1, V̇O2peak, and MSWT more increased in the exercise group.

Conclusion
A supervised concurrent exercise program in people with SP helps to maintain body composition values and leads to improvements in cardiorespiratory fitness levels. Exercise should be considered as a co-adjuvant program in the treatment of population with SP.
Awareness and knowledge of pneumococcal vaccination in cardiology outpatient clinics and impact of physicians' recommendation on vaccination rates
Authors: Ekin T , Kis M , Gungoren F , Atici A , Kunak AÜ , Mutlu D , Katkat F , Demir M , Sarac İ , Soydan E , Karaduman M , Bekar L , Boyuk F , Adiyaman MS , Zoghi M 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Although there is not enough data on pneumococcal vaccination status in patients with cardiovascular disease and or risk factors in our country, it is known that vaccination rates are quite low in the current data.

Purpose
We aimed to evaluate the awareness of pneumococcal vaccination (PCV13, PPSV23) in general cardiology outpatient clinics and impact of physician’s recommendation (with educational brochures) on vaccination rate.

Methods
Awareness of vaccination, before COVID-19 pandemic, was measured in patients admitting to cardiology outpatient clinics from 40 center of our country by a questionnaire contained 19 questions. The demographics (including gender, age, educational level, awareness vaccination level) and comorbidities were obtained. The vaccination rates were calculated within 3-months follow-up from the admitting of patient to cardiology clinics.

Results
The 403 (18.2%) of patients with previous pneumococcal vaccination were excluded from the study. The mean age of study population (n=1808) was 61.9±12.1 years and 55.4% were male. The 58.7% had coronary artery disease, hypertension (74.1%) was the most common risk factor and 32.7% of the patients had never been vaccinated although they had information about vaccination before. The 98.5% were referred to family medicine (n=1412, 78.1%) or vaccination outpatient clinics (n=370, 20.5%) and the vaccination rate was 62.1% during the follow-up period. The differences between vaccinated and not-vaccinated patients are presented in Table 1.
The physician’s recommendation was positively correlated with vaccination intention and behavior in our participants. Multivariate logistic regression analysis showed a significant between vaccination and female sex [OR=1.55 (95% CI=1.25–1.92), p&lt;0.001], higher education level [OR=1.49 (95% CI=1.15-1.92), p=0.002] patients’ knowledge [OR=1.93 (95% CI=1.56-2.40), p&lt;0.001], and their physician’s recommendation [OR=5.12 (95% CI=1.92-13.68), p=0.001].

Conclusion
To our knowledge this is the first report about the awareness pneumococcal vaccination rates and impact of physician’s recommendation in patients with cardiovascular disease by high study population. These findings suggest providing information on the benefits of vaccination by physician’s and educational advice was significantly associated with an increase vaccination rate and have a key role.
Implementing the ask-advice-connect method in a university hospital
Authors: De Frel DL , Janssen VR , Meijer E , Atsma DE 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Smoking cessation reduces the relative risk of morbidity and mortality.(1, 2) Healthcare professionals (HPs) can play a substantial role in smoking cessation counselling (SCC) but in practice often skip this task.(3, 4) A quick and effective method for HPs to assist is the Ask-Advise-Connect method in which the physician asks about smoking, advises to quit and offers to connect the patient to an external SCC program.(5)

Purpose
To evaluate an intervention aimed to implement the Ask-Advise-Connect (AAC) method in a University hospital.

Methods
This mixed methods pre-post interventional study was performed at the Cardiology department of a University hospital and consisted of 1) semi-structured interviews with 10 HPs to assess their attitudes towards AAC, 2) a blended intervention aimed to implement AAC, and 3) quantitative assessment of patient smoking registration and HP connection rates to external SCC which were collected from the Electronic Medical Record. In total, 48,321 patient consultations and 67 HPs were included. The blended intervention consisted of face-to-face and online AAC psychoeducation for HPs followed-up with motivational messages over a period of 6 weeks.

Results
Before the intervention, HPs assessed smoking status in 74.0% of patients and connected 9.3% of identified smokers with external SCC. The blended intervention did not increase these percentages at post-test (respectively 73.2%, p=0.20; and 10.9%, p&gt;0,05). Nonetheless, the vast majority of HPs feel it is important to discuss patient smoking, and view it as their duty to do so. Main barriers to AAC reported by HPs were forgetfulness and time pressure.

Conclusion
This study shows that this AAC intervention does not increase Asking after smoking status or Connection of patients to SCC. However, HPs hold positive attitudes towards AAC. A better understanding of the mechanisms required for changing HPs practice behavior is needed.