bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anabolic steroid misuse is an important reversible cause of cardiomyopathy: a case report
Authors: Milevski Stefan V , Sawyer Matthew , La Gerche Andre , Paratz Elizabeth 
Published: July 2022

Abstract

Background
Anabolic steroid misuse is very common and has been linked to the development of a severe cardiomyopathy, arrhythmias, and sudden death.

Case summary
A 46-year-old miner presented to hospital with subacute dyspnoea and palpitations. Investigations revealed atrial fibrillation and a severe dilated cardiomyopathy with left ventricular ejection fraction of 12%. The patient had a history of longstanding exogenous testosterone administration. Haematological investigations demonstrated a marked polycythaemia, with haematocrit of 0.60 L/L (normal 0.40–0.54 L/L). Hormonal investigations revealed an elevated testosterone level of 46.4 nmol/L (normal 8.0–30.0 nmol/L) and suppressed luteinizing and follicle-stimulating hormones, consistent with excess testosterone use. The patient was referred to the endocrinology specialty team for support with ceasing excess testosterone use, while commencing guideline-directed heart failure therapy. At 6 months of follow-up, the patient’s left ventricular ejection fraction had normalized and he was asymptomatic. Biochemical indicators of testosterone excess had also normalized.

Discussion
Anabolic steroids are widely misused, particularly among young and middle-aged males. Cardiovascular complications include a potentially reversible severe cardiomyopathy, accelerated coronary disease, dyslipidaemia, arrhythmias, and sudden death. It is important to identify a history of anabolic steroid misuse when investigating cardiomyopathy and be alert for indicators such as polycythaemia. Cessation of anabolic steroid misuse may lead to complete reversal of cardiomyopathy but should be undertaken in close partnership with the patient and endocrinologists.
A case report of pericardial constriction with coexisting severe left main coronary artery disease
Authors: Ostad Karampour Saman , Sedlak Tara L , Luong Christina L , Price Joel E , Brunner Nathan W 
Published: July 2022

Abstract

Background
Constrictive pericarditis (CP) is a rare condition in which the pericardium becomes progressively fibrotic and non-compliant leading to impaired ventricular filling and overt heart failure. While CP shares many clinical and haemodynamic similarities with restrictive cardiomyopathy, differentiation of these diseases is crucial as CP is potentially curative through pericardiectomy. Here, we present a case of proven pericardial constriction with atypical haemodynamics in a patient presenting with heart failure and severe left main coronary artery disease (CAD).

Case summary
A 69-year-old female with a history of hypertension and paroxysmal atrial fibrillation presented with persistent heart failure refractory to diuretics. Ischaemic and infiltrative work-up were found to be negative with magnetic resonance imaging demonstrating trace pericardial fluid and thickening of the pericardium. Echocardiogram and right-heart catheterization demonstrated atypical haemodynamics suggestive of but not conclusive for CP, with coronary angiogram demonstrating severe left main CAD. Ultimately, the patient underwent coronary artery bypass grafting along with pericardiectomy and pericardial biopsy demonstrating constrictive physiology.

Discussion
We suspect the inconclusive nature of the echocardiogram and cardiac catheterization was likely secondary to severe CAD impairing left ventricular relaxation and dampening ventricular interdependence. As such, clinicians should consider the possibility of coexistent severe CAD in patients with a clinical suspicion of CP, but inconclusive haemodynamics.
Sex-related differences in the management and outcomes of patients hospitalized with ST-elevation myocardial infarction: a comparison within four European myocardial infarction registries
Authors: Hellgren Tora , Blöndal Mai , Jortveit Jarle , Ferenci Tamas , Faxén Jonas , Lewinter Christian , Eha Jaan , Lõiveke Piret , Marandi Toomas , Ainla Tiia , Saar Aet , Veldre Gudrun , Andréka Péter , Halvorsen Sigrun , Jánosi András , Edfors Robert 
Published: July 2022

Abstract

Aims
Data on how differences in risk factors, treatments, and outcomes differ between sexes in European countries are scarce. We aimed to study sex-related differences regarding baseline characteristics, in-hospital managements, and mortality of ST-elevation myocardial infarction (STEMI) patients in different European countries.

Methods and results
Patients over the age of 18 with STEMI who were treated in hospitals in 2014–17 and registered in one of the national myocardial infarction registers in Estonia (n = 5817), Hungary (n = 30 787), Norway (n = 33 054), and Sweden (n = 49 533) were included. Cardiovascular risk factors, hospital treatment, and recommendation of discharge medications were obtained from the infarction registries. The primary outcome was mortality, in-hospital, after 30 days and after 1 year. Logistic and cox regression models were used to study the associations of sex and outcomes in the respective countries. Women were older than men (70–78 and 62–68 years, respectively) and received coronary angiography, percutaneous coronary intervention, left ventricular ejection fraction assessment, and evidence-based drugs to a lesser extent than men, in all countries. The crude mortality in-hospital rates (10.9–15.9 and 6.5–8.9%, respectively) at 30 days (13.0–19.9 and 8.2–10.9%, respectively) and at 1 year (20.3–28.1 and 12.4–17.2%, respectively) after hospitalization were higher in women than in men. In all countries, the sex-specific differences in mortality were attenuated in the adjusted analysis for 1-year mortality.

Conclusion
Despite improved awareness of the sex-specific inequalities on managing patients with acute myocardial infarction in Europe, country-level data from this study show that women still receive less guideline-recommended management.
Nurse follow-up visit after the atrial complex ablation: a cross-sectional descriptive study
Authors: Cano Valls A , Carro E , Niebla M , Hevia S , Domingo R , Carrasco M , Massanet L , Poza M , Marginet J , Duenas I , Lajara M A , Venturas M 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Atrial fibrillation (AF) and flutter are complex arrhythmias to ablation because their anatomical location. A navigation system is required to map the ablationable area and in addition, the patient are under general anesthesia. In our hospital, the expert nurse control these patients 10 days afters discharge.

Purpose
To identify the complications and recurrences of arrhythmia that the nurse has detected early and how it has been managed.

Methods
Cross-sectional descriptive study, from September 2020 to January 2022, all patients who underwent complex atrial ablation under total anaesthesia and who were assessed by a nurse 10 days later were included. In the event that any problem arises, the nurse is in charge of managing the network of referrals to specialist doctors.

Results
A total of 159 patients were included with a mean age of 62 years (SD 10.4) and 34% were women. Arrhythmias were 73.5% AF, 11.3% flutter, 14.5% re-do ablations mixed AF/Flutter. CHA2DS2-VASc scale mean 2 points (SD 1.2). Nine cardioversions were scheduled due to early AF recurrence documented. 35% (n=55) of the patients underwent a blood test to control risk factors such as cholesterol, diabetes, kidney failure or thyroid problems. 17.6% (n=28) were programmed for a polysomnography. Cardiologist was consulted in 6.3% (n=10) due to edema of the lower legs, ventricular extrasystoles, asthenia and bradycardia. Interconsultations were also made with endocrinology 1.2%, urology 0.6%, vascular surgery 6.2% and neurology 2.5%. Finally, 12% of patients were referred to their GP for minor controls.

Conclusion
There is little evidence to suggest that nursing consultation could be useful for the early detection of complications and the management of arrhythmia recurrences. More experimental studies are necessary to know the impact of nurse follow-up in the management of patients undergoing complex atrial ablation.
Development of videoconferencing group educational program for patients with heart failure: A Delphi study.
Authors: Alkouri O , Al Marzouqi A , Al-Bashaireh A , Khader Y , Jarrah M , Schultz T 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
During the COVID-19 outbreak, videoconference technology can help people avoid physical contact and minimise the exposure of healthcare providers to sick people as well as respiratory secretions. Videoconferencing can be beneficial for people with chronic conditions (such as heart failure) who have restricted mobility, live in remote and rural areas, or experience social loneliness. However, evidence for the effectiveness of using internet videoconferencing and its components accounted for the positive outcomes (such as knowledge, quality of life, self-care, healthcare utilization) is still lacking.

Purpose
To develop a feasible videoconferencing program for patients with heart failure that meets patients’ needs and preferences in Jordan.

Methods
The study involved two Delphi survey studies of three rounds each. The first Delphi survey involved 32 healthcare staff, with heart failure clinical experience, to obtain a consensus of opinion on a proposed group videoconferencing program for patients with heart failure. The second Delphi study involved seven staff of the information technology center, with experience in videoconferencing and using supporting applications, to obtain their consensus on the current capabilities, needs, barriers and facilitators of the healthcare system (providers) and patients (users) about information technology. For both Delphi studies, content analysis was used to analyze responses of participants in the first-Delphi round. Items resulting from the first-round analysis were summarized, listed, and rated (5-point Likert scale) in order to provide input and develop the second-round questionnaire. The percent agreement of participants was defined to be 80% or above to indicate their consensus.

Results
Healthcare providers prefer sessions to be led by the cardiologists and cardiac nurses, moving from simple to a complex topic, and the dose of information and frequency should be varied according to the needs and severity of heart failure. Videoconferencing strategy could improve patients’ satisfaction, knowledge and self-care, and adherence with their therapy plans. Jordan healthcare system has a capability to use videoconferencing strategy in Jordan.

Conclusion
This study addresses the equivocal evidence for the effectiveness of using internet videoconferencing between healthcare provider and patients. Establishing an effective videoconferencing program assists with meeting patients’ needs and preferences, accessing healthcare during COVID-19, reducing travel burden/costs as well as the risk of exposure to the virus, and ultimately improving clinical outcomes. This study will capture attention of healthcare providers to perform further studies targeting videoconferencing heart failure management programs
Influence of sacubitril/valsartan on hibernating myocardium in patients with chronic heart failure with reduced ejection fraction
Authors: Mukhamedova M , Narzullaeva D S , Uzokov J K 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Myocardial viability particularly hibernating myocardium is one of the critical parameters for the assessment of the long-term prognosis of patients with ischemic etiology heart disease. Purpose of the study was to evaluate the influence of angiotensin receptor neprilysin inhibitor - sacubitril/valsartan on hibernating myocardium in patients with ischemic etiology chronic heart failure with reduced ejection fraction.

Material and Methods
One hundred and twenty patients with chronic heart failure with reduced ejection fraction (EF&lt;40%) were enrolled in the study (mean age 58.2±14.6 years, male=53%). Patients were divided into two groups by sixty. Group I patients were assigned sacubitril/valsartan while Group II were assigned valsartan in addition to the standard treatment. Hibernating myocardium were assessed with echocardiography with dopamine test. All statistical analysis were assessed using STATA software.

Results
Ejection fraction and the wall motion score has been improved in both groups from baseline (P&lt;0.05), however when we compared two groups, sacubitril/valsartan group tended to have more positive effect on ejection fraction (from 32.2±8.2% to 43.6±12.4% vs. from 31.7±8.0% to 37.2±10.3%, P&lt;0.05) and the wall motion score (from 2.34±0.5 to 1.92±0.4 vs. 2.36±0.6 to 2.15±0.45, P&lt;0.05) compared to valsartan group. Diastolic and systolic wall thickness has been improved in both groups from baseline (P&lt;0.05), however there were not statistically significant changes between groups (P&gt;0.05). When we analyzed by gender there were not significant changes between male and female (P&lt;0.05).

Conclusion
Sacubitril/valsartan improves myocardial viability in patients with ischemic etiology chronic heart failure with reduced ejection fraction. Further studies with large amount of patients are required to clarify exact mechanisms.
Identifying if patient's living with heart failure retain knowledge better by gaining it through lived experience rather than through education.
Authors: Caples N , Regan A , Vijayamma Sadanandan D , Huish K 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Self-care is when a patient possesses a set of knowledge and skills that are used to process information to make correct health decisions. Self-care in heart failure (HF) includes monitoring symptoms for deterioration in HF and having an appropriate response time in contacting their health care provider. One of the main principles of a heart failure clinic is to provide a structured education programme for the patient regarding self-care. Patient education is the leading intervention to equip patients with the skills for symptom recognition. The education aims to ensure the patient can recall the knowledge from memory if required.

Purpose
The aim of this study was to evaluate patient knowledge, through testing memory, regarding symptom recognition in a single center HF clinic. To identify if there was a difference between attaining knowledge on symptom recognition gained through lived experience versus knowledge on symptom recognition gained through education.

Methods
50 patients were recruited for this study.
Average age was 72 years old.
38 male and 12 female.
All participants had previously experienced at least one symptom of HF.
All participants had a minimum of 2 education sessions in the HF clinic.
All patients had evidence from their weight logbook of daily weight monitoring. Question "a" tests knowledge acquired from education and question "b" tests knowledge acquired from lived experience.
All participants were asked two questions:
a) what is the amount of weight increase you are monitoring for?
b) name one symptom you are monitoring that would indicate possible deterioration in HF.

Results
single center prospective analysis
Question a: 35% answered correctly
Question b: 82% answered correctly

Conclusions
Processes of learning and the transfer of learning are central to understanding how people can achieve competency in self-care. In this study patients seem to remember information better from a lived experience rather than trying to recall taught information. It important to identify the patients’ individual factors and needs to successfully support their self-care management. Further evaluation of assessing the implementation of other supports available such as, mobile Apps and multimedia-based education, to address knowledge recall deficits is needed to determine if they aid the patient to achieve competency in self-care.
An intervention to improve caregiver self-efficacy and contribution to self-care does not affect caregiver anxiety, depression, quality of life and sleep. Secondary outcome analysis of MOTIVATE-HF RCT
Authors: Locatelli G , Rebora P , Occhino G , Ausili D , Riegel B , Vellone E , Alvaro R 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Center of Excellence for Nursing Scholarship (CECRI), Rome, Italy.

Background
Caregiver contribution (CC) to self-care can improve patient outcomes in heart failure (HF). However, caring for a person with HF can be a burdensome experience for caregivers. Experimental studies aimed at improving caregiver self-efficacy and CC to HF self-care are scarce. Moreover, it is underexplored if interventions aiming to improve caregiver self-efficacy and CC to HF self-care consequently affect caregiver anxiety, depression, quality of life and sleep.

Purpose
To evaluate if the delivery of a Motivational Interviewing intervention aimed at improving caregiver self-efficacy and CC to HF self-care affects caregiver anxiety, depression, quality of life, and sleep.

Methods
Secondary outcome analysis of the MOTIVATE-HF randomized controlled trial. Participants were recruited from three centers in Italy, and they were randomized into three arms: Arm 1 (Motivational Interview for patients), Arm 2 (Motivational Interview for patients and caregivers), Arm 3 (standard care). The intervention consisted in one face-to-face MI session, plus three telephone contacts within two months from enrollment with patients (Arm 1) or with patients and caregivers (Arm 2). Data were collected at baseline and after 3, 6, 9, 12 months. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale, quality of life was measured with the 12-Item Short-Form Health Survey, and sleep was evaluated with the Pittsburgh Sleep Quality Index.

Results
A total of 510 patient and caregiver dyads were enrolled. Caregiver median age ranged between 53 and 57, they were mainly female (76%), married (72%), spouses (37%), educated at high school or university level (55%), employed (73.5%), and living with the patient (60%). At baseline, anxiety, depression, quality of life and sleep scores were comparable among the three Arms. Over the year of follow-up, anxiety, depression, and sleep disturbances decreased, while quality of life slightly increased in all the three Arms. However, these changes were not significant in any of the study arms. When comparing these changes between Arm 2 and Arm 1 and 3, we did not observe any significant difference.

Conclusion
Delivering Motivational Interview to caregivers to improve their self-efficacy and contribution towards patient self-care did not increase caregivers’ own levels of anxiety and depression and did not decrease their quality of life and sleep. This may help tailoring future interventions for caregivers knowing that such an intervention does not worsen caregivers’ conditions and wellbeing.
Influence of sacubitril/valsartan on diastolic parameters in patients with chronic heart failure with reduced ejection fraction
Authors: Uzokov J , Mukhamedova M G , Narzullaeva D S , Nosirova G A , Orziev D Z , Majidov I 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Chronic heart failure (CHF) is one of the pressing issues of modern cardiology and is widely discussed lately. Chronic heart failure with reduced ejection fraction (HFrEF) is common and is concerned with poor outcomes. Not only systolic function, but also diastolic function is deteriorated in HFrEF. Thus, we hypothesized the efficacy of angiotensin converting enzyme-neprilysin inhibitors on the diastolic function of patients with HFrEF.

Objective
Aim of the study was to evaluate the efficacy of angiotensin converting enzyme-neprilysin inhibitor - sacubitril/valsartan on diastolic parameters in patients with CHFrEF.

Material and Methods
114 patients with diagnosed HFrEF with NYHA II-III functional class patients had been enrolled in the study. Mean age of the patients was 61.12±14.4 years, male was 53%. Patients randomly were divided into two groups by 57. Group I was provided with sacubitril/valsartan whereas Group II was provided with valsartan. All anthropometric, laboratory and instrumental methods including echocardiography with Doppler were performed at baseline and after the six months of the treatment. All statistical analysis were performed with STATA software.

Results
Diastolic function was significantly improved after the treatment of sacubitril/valsartan in six months compared to valsartan group (P&lt;0.05). E/e ratio was significantly improved in patients with sacubitril/valsartan compared to valsartan group (P&lt;0.01). Left atrial longitudinal strain was significantly lower in the first group patients than second one was (P&lt;0.001). Even though, isovolumic relaxation time and velocity time integral of the E-A complex have been improved in both groups during the treatment in six months, there have not been observed significant changes between groups (P&gt;0.05). During the follow-up period group I patients have been experienced less hospitalization than group II patients were (P&lt;0.05).

Conclusion
Sacubitril/valsartan significantly improved diastolic function compared to valsartan in patients with HFrEF. Further studies are required with large amount of patients.
The role of NT-proBNP in patients discharged after COVID-19 pneumonia
Authors: Shchudro O , Konopkina L , Pertseva T , Botvinikova L , Bielosludtseva K 
Published: July 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Aims
The long-term health effects after SARS-CoV-2 infection remain poorly understood. The aim of our study was to define the cardiac disorders in the early postCOVID period.

Methods and resuts
Was observed 85 patients (40 (47,1%) men, 45 (52,9%) women, average age – 44,2 (39,3; 47,1)) on 48,3 (45,0; 56,2) days after the onset of the first symptoms of COVID-19. The main group were divided into 3 subgroups: 1 – 39 patients after moderate COVID-19 pneumonia, 2 – 36 patients after severe COVID-19 pneumonia, 3 – 10 patients after critical COVID-19 pneumonia. The subgroups were comparable in gender and age. All patients before COVID-19 were virtually healthy and had no history of cardiovascular disease, including arrhythmias. All patients underwent general clinical methods of examination, determination of SpO2, echocardiography and measured NT-proBNP concentration in serum. In 100% patients was the level of SpO2 more than 95% (average 97,5 (96,3; 98,8)%) and preserved left ventricular ejection fraction (LVEF) (average 62,3 (60,2; 74,3)%). In patients after moderate COVID-19 pneumonia, the level of NT-proBNP was significantly lower (79,4 (59,9; 75,3) pg/ml) than in patients after severe (145,0 (66,9; 170,9) pg/ml) and critical (149,7 (79,3; 138,5) pg/ml) COVID-19 pneumonia (p &lt; 0,01). But concentration NT-proBNP in patients after severe and critical COVID-19 pneumonia didn’t differ significantly (p &gt; 0,05).

Conclusions
Patients after severe and critical COVID-19 pneumonia are at risk for developing cardiac disorders in the early postCOVID period. Determining the level of NT-proBNP, and not just performing echocardiography, after discharged in such patients will help to customize the most appropriate therapeutic strategies.