bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symptomatology, prognosis and clinical findings of myocarditis as an adverse event of COVID-19 mRNA vaccine: a systematic review
Authors: Jaiswal VIKASH , Jaiswal AKASH , Batra NITYA , Mukherjee D , Ruchika R , Ishak ANGELA , Maskey U , Hitawala GAZALA , Song DAVID , Sattar YASAR 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Myocarditis, an inflammation of the myocardium in the absence of ischemic injury, may be caused by viruses, drugs, and vaccines. The Myocarditis following COVID-19 vaccinations is most commonly seen in young adult males and commonly after the second dose of the mRNA vaccine. It usually presents with chest pain, dyspnoea, palpitations but has a diverse clinical presentation and varied therapeutic response. We aim to systematically collate the symptomatology, prognosis, and clinical findings of COVID-19 vaccine adverse events causing Myocarditis.

Method
Following the PRISMA statement 2020, a systematic search was conducted to isolate confirmed cases of COVID-19 vaccine-induced Myocarditis. By applying the BOOLEAN logic, the following keywords were used: COVID-19, SARS-CoV-2, Myocarditis, Mortality. Four databases were searched from January 2021 through August 2021: PubMed, Science Direct, Google Scholar, and Cochrane Library; the reference lists of screened studies were searched as well (umbrella methodology).

Results
In total, 12 case reports, 10 case series and 1 cohort study with a total of 107 patients were included in the final analysis. A total of 101 male patients were recorded, and 6 were female showing male dominance. The mean age of all participants was 24.73 years(SD = 13.18), ranging from 14 to 70. The most common presenting symptoms were chest pain (47.66%), fever (35.51%), and myalgia (25.23%). Lab findings showed elevated Troponin I, CRP, and ESR levels in the majority of patients.
ECG was abnormal in most of the patients, which include sinus rhythm (24%), ST-elevation (42.05%) and T wave inversion (13.08%). Echo findings include decreased Ejection fraction in 19.62% of patients while 13.08% of patients having a hypokinetic left ventricular wall. Further, CMR finding suggestive of confirmed myocarditis cases in 36% patients while rest are suspected one. Overall mortality(1.86%) was low among patients.

Conclusion
There is increasing evidence for Myocarditis as a rare adverse event of COVID-19 mRNA vaccination in young adults. This evidence is strongest amongst young male patients. The majority of the patients complain of chest pain and fever. In lab findings Troponin I, CRP and ESR are usually increased and ST elevation is common in the ECG. This entity is mainly treated with nonsteroidal anti-inflammatory drugs, Colchicine, Beta-blockers, ACE inhibitors, Steroids. However, prognosis and outcomes are favourable with a very low mortality rate.
The association of preoperative dialysis with troponin trends and short term outcomes among advanced kidney disease patients undergoing coronary artery bypass grafting
Authors: Manla Y , Hogan M , Bhatnagar G , Khan N , Alsindi F , Aljabery Y , Sanger S , Gobolos L 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Coronary artery disease continues to be the leading cause of death in patients with stage IV-V chronic kidney disease (CKD IV-V). However, the prognosis and early outcomes for advanced CKD patients undergoing coronary artery bypass grafting (CAB) worsen as the estimated glomerular filtration rate (eGFR) deteriorates. Therefore, we compared postoperative clinical outcomes and troponin trends in patients having advanced CKD according to preoperative dialysis status in a single centre experience.

Methods
A total of 51 patients with CKD IV and V who underwent CAB between 2016-2021 were included in the study. Data on patient characteristics and postoperative outcomes were collected retrospectively, and independently for our Society of Thoracic Surgeons database. Characteristics were compared between patients having CKD IV vs. CKD V. The differences in postoperative cardiac troponin trends and outcomes were evaluated between patients who did vs. did not undergo preoperative dialysis. The statistical analysis was conducted applying appropriate parametric or non-parametric (for skewed variables) testing methods, and a p value &lt; 0.05 was considered to be statistically significant.

Results
47% (24) of subjects had CKD IV, while the rest featured CKD V. Patients with CKD IV tended to be older (61.8 ± 9.2 vs. 56.3 ± 11.5 years, p = 0.07), more obese (BMI: 31.4 ± 6.8, 27.4 ± 4.9 kg/m2, p = 0.02) and had significantly higher preoperative GFR (23 ± 4.9 vs. 9 ± 3.3 mL/min, p &lt; 0.001) (Table.1). When comparing patients who underwent preoperative dialysis vs. those who did not, troponin levels were the highest at 18h postoperative in both groups, however, troponin levels were comparable between both groups at all time points (Table.2). Although, there was no difference in hospital length of stay and mortality between these groups, patients who did not undergo preoperative dialysis had longer intensive care unit length of stay (ICU LOS).

Conclusion
In this single centre experience preoperative dialysis was not associated with a significant difference in trends of postoperative cardiac enzymes. Although preoperative dialysis was associated with shorter ICU LOS, complex pre-procedural surgical risk assessment remains paramount in reducing complications and mortality in this high-risk population. Abstract Figure. Abstract Figure.
Sex-specific differences in mortality after first time, isolated coronary artery bypass graft surgery: a systematic review and meta-analysis of randomized controlled trials
Authors: Matthews S , O"neil A , Sanders J , Buttery A , Maraosco S , Fredericks S , Martorella G , Keenan N , Ganes A , Wynne R 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

BACKGROUND
Evidence quantifying sex-specific differences in cardiac surgical outcomes is scant.

PURPOSE
The purpose of this review was to determine whether contemporary evidence indicates Coronary Artery Bypass Graft Surgery (CABGS) is differentially efficacious than alternative procedures by sex on mortality outcomes.

METHODS
EMBASE, CINAHL, Medline and Cochrane Library databases were searched (January 2010-April 2020). English language, randomized controlled trials, comparing isolated CABGS to an alternative revascularization strategy in adults, with analyses comparing sex-specific differences in mortality were included. Analyses of incidence data was performed using Mantel-Haenszel fixed-effects modelling, Cochrane RoB2 tool and CONSORT checklist. PROSPERO Registration ID: CRD42020181673.

RESULTS
The search yielded 4459 citations, with 29 articles for full-text review revealing 9 eligible studies with variability in time to follow-up. In contrast to men, mortality risk for women was lower in pooled analyses (RR 0.95, 95% CI 0.85-1.05, p = 0.33) but higher in sensitivity analyses excluding ‘high-risk’ patients (RR 1.18, 95% CI 0.99-1.40, p = 0.07). At 30-days and 10 years, women had an 18% (RR 0.82, 95% CI 0.66-1.02, p = 0.08) and 19% (RR 0.81, 95% CI 0.69-0.95, p = 0.01) mortality risk reduction. At 1-2 years women had a 7% (RR 1.07, 95% CI 0.69-1.64, p = 0.77), and at 2-5 years a 25% increase in risk of mortality compared to men (RR 1.25, 95% CI 1.03-1.53, p = 0.03). Women were increasingly under represented (23.2%) over time, comprising 29% (30-days) to 16% (10 years) of the pooled population.

CONCLUSION
Trials with sex-specific stratification are required to ensure appropriate treatment options for coronary revascularization.
Impact of the anti-hypertensive diets virtual education towards knowledge, attitude, practice, and reduction of blood pressure during covid-19 pandemic
Authors: Andrianto A , Ardiana M , Yutha A , Khrisna B P D , Nugraha R A , Putra T S , Shahab A R , Andrianto H , Kikuko I H , Puspitasari A N , Hajjrin M R 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Universitas Airlangga Project Grants for Community Empowerment

OnBehalf
Universitas Airlangga
Background. One of the efforts to reduce hypertension rates in the community is through dietary changes that refer to the Dietary Approach to Stop Hypertension guidelines or abbreviated as DASH. However, in the COVID-19 pandemic, there is a significant obstacle regarding the most effective way to transfer knowledge, skill, and attitude towards society.
Aims. Department of Cardiology and Vascular Medicine created a virtual education series about dietary guideline that refers to DASH by adapting the local wisdom of the Surabaya community. We aimed to evaluate the impact of Airlangga Comprehensive Anti-Hypertensive Diets Virtual Education Series towards knowledge, attitude, practice, and reduction of blood pressure in the primary care setting during COVID-19 pandemic.
Methods. This type of online action research is quantitative with a quasi-experimental design that designs using one group pretest-posttest, when this study was conducted in October-December 2020. The population in this study were all patients with hypertension who were treated in Mojo primary health care setting. A purposive sampling technique were done to receive 110 participants using online questionnaire.
Results. A total of 110 participants were included in the analysis, 55 in the intervention group and 55 in the control group. Following the Airlangga Comprehensive Anti-Hypertensive Diets Virtual Education Series implementation, the only parameter that showed significant improvement were knowledge and attitude (p &lt; 0 .001). There is no significant change in the skill parameters (p = 0.131) and blood pressure parameters (p = 0.433) .
Conclusion. Airlangga Comprehensive Anti-Hypertensive Diets Virtual Education Series implementation in our study population seems to be effective to improve knowledge and attitude of participants, however, this program seems to be ineffective to improve skill and blood pressure reduction in participants. Future study with longer durations and more comprehensive programme needs to be done to scrutinize the clinical impact of this program nationwide.
Homocysteine predicts vascular target organ damage in hypertension and may serve as guidance for first-line antihypertensive therapy
Authors: Carnagarin R , Schlaich MARKUS 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): the primary author is supported by the Australian National Heart Foundation post docctoral fellowship

OnBehalf
Dobney Hypertension Centre

Background
Homocysteine is an independent risk factor for cardiovascular and cerebrovascular disease and has been proposed to contribute to vascular dysfunction. We sought to determine in a real-world clinical setting whether homocysteine levels were associated with hypertension mediated organ damage (HMOD) and could guide treatment choices in hypertension.

Methods
We performed a cross-sectional analysis of prospectively collected data in 145 hypertensive patients referred to our tertiary hypertension clinic at our Hospital and analysed the association of homocysteine with HMOD, renin-angiotensin-aldosterone signaling (RAAS) and blockade.

Results
The average age of participants was 56 ± 17 years and there was a greater proportion of males than females (89vs56). Regression analysis showed that homocysteine was significantly associated with PWV (β=1.99; 95% CI 0.99-3.0; p &lt; 0.001), albumin creatinine ratio (β=1.14; 95% CI 0.47,1.8; p &lt; 0.001), 24 hr urinary protein excretion (β=0.7; 95% CI 0.48, 0.92; p &lt; 0.001) and estimated glomerular filtration rate (β=-29.4; 95% CI -36.35, -22.4; p &lt; 0.001), which persisted after adjusting for potential confounders such as age, sex, 24 hr BP, inflammation, smoking, diabetes mellitus, renal insufficiency and dyslipidaemia. A positive predictive relationship was observed between plasma homocysteine levels and PWV, with every 1.0 µmol/L increase in homocysteine associated with a 0.1 m/s increase in PWV. Homocysteine was significantly associated with elevated aldosterone concentration (β=0.26; p &lt; 0.001), thereby possible RAAS activation, an effect better resisted by angiotensin receptor blockers than ACE-inhibitors in higher physiological ranges of homocysteine.

Conclusions
Our results indicate that homocysteine is associated with hypertension mediated vascular damage and could potentially serve to guide first-line antihypertensive therapy.
Impact of perioperative interruption of antithrombotic therapy on thrombotic and bleeding events in non-cardiac surgery
Authors: Saito K , Saito Y , Muramatsu T , Kitahara H , Fujimoto Y , Isono S , Kobayashi Y 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Antithrombotic therapy including antiplatelet agents and anticoagulants are prescribed for secondary prevention in patients with established cardiovascular disease. Although antithrombotic therapy is often interrupted before non-cardiac surgery with or without perioperative bridging anticoagulation, the impact on thrombotic and bleeding events remains uncertain.

Purpose
The aim of this study was to clarify the impact of perioperative interruption of anticoagulants on thrombotic and bleeding events in patients with established CVD undergoing elective non-cardiac surgery.

Methods
A total of 330 patients chronically treated with antithrombotic therapy for secondary prevention underwent elective non-cardiac surgery under general anesthesia, with the complete interruption of antithrombotic agents. The study endpoints included all-cause death, thrombotic events, and major bleeding complications after surgical procedures.

Results
Of 330 patients, 171 (51.8%) and 159 (48.2%) received antiplatelet agents and anticoagulants perioperatively. Atrial fibrillation (31.8%) and coronary artery disease (20.3%) were the major indications for antithrombotic regimens. Antithrombotic therapy was interrupted from 5 [2, 7] days before the surgery to 4 [2, 7] days postoperatively. Perioperative bridging therapy with unfractionated heparin was employed in 99 (30.0%) patients. During the hospitalization, 3 (0.9%) patients died due to non-cardiovascular causes. Thrombotic events and major bleeding occurred in 2 (0.6%) and 9 (2.7%) patients. Bridging therapy with heparin was non-significantly associated with an increased risk of bleeding events (5.1% vs. 1.7%, p = 0.09). In univariable and multivariable analyses, pre-operative hemoglobin level and operative duration were significantly associated with bleeding complications.

Conclusions
In the present study, complete interruption of antithrombotic therapy resulted in a few thrombotic events with a numerically higher rate of bleeding events in patients undergoing elective non-cardiac surgery. Pre-operative hemoglobin level and operative duration were significantly associated with post-operative bleeding complications.
A four year experience of peripartum cardiomyopathy in a rural public hospital in south india
Authors: Kanakasabapathy R A , Annamalai N 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Peripartum cardiomyopathy (PPCM), as defined by the study group on PPCM of Heart Failure Association of the European Society of Cardiology (ESC), is an idiopathic Cardiomyopathy with systolic heart failure occurring towards the end of pregnancy or in the months following delivery, in previously healthy women. The current diagnostic criteria are:
- heart failure in the last month of pregnancy or in the first 5 postpartum months
- absence of other causes of heart failure
- absence of known heart disease predating the development of heart failure.
- reduced Left Ventricular Ejection Faction (LVEF) of &lt; 45% or Fractional Shortening &lt; 30%
The global incidence of PPCM is variable, the least reported in Japan and the most in Nigeria. The estimates of the incidence in India need more scrutiny because of the difficulties in diagnosing the condition. The current incidence in literature is 1 in 1374 live births. We conducted the study to characterize PPCM among women delivered at a resource-limited setting in South India.

Aim
To estimate the incidence of PPCM
To describe the risk factors and Feto-maternal outcomes and associated mortality
To estimate the recovery of cardiac function at the end of one year.

Materials and Methods
This was a prospective longitudinal study conducted in a rural public hospital in South India, from 2017 to 2020.
PPCM was diagnosed in pregnant and puerperal women, in concurrence with global standards.
Data included were Age, Parity, Gestational age, Risk factors, Medical Management, Pregnancy outcome and Echocardiography data on diagnosis and at 1-year follow-up.

Results
- 32 out of 14505 women in the 4-year study period were diagnosed with PPCM.
- The incidence of PPCM was 1 in 453 live births.
- The mean age was 23.2 years.
- 46.8% were primigravidae.
- 21.8% had pre-eclampsia.
- 100% had breathlessness at presentation (62.5% were in New York Heart Association – Class III).
- The mean LVEF on diagnosis was 24.5%.
- The Fractional Shortening was 16%.
- The Left Ventricular End Diastolic Dimension was 5.8cm.
- 18.75% of women were diagnosed antenatally, 75% in the early puerperium and 6.25% in the late puerperium.
- 81.3% were delivered by caesarean section.
- At 1-year follow up, complete recovery of cardiac function was observed in 65.6% of the women.
- There was no maternal mortality or adverse perinatal outcomes.

Conclusion
Although rare, PPCM is an important cause for Maternal Mortality. Being a diagnosis of exclusion, a high index of suspicion and involvement of a multi-disciplinary team will aid to optimize the Feto-maternal outcomes. Setting up a National PPCM registry will help in establishing the clinical epidemiology, risk factor assessment, screening strategies, diagnostic criteria and management options for mothers suffering from the condition.
Prognostic indicators for the onset of ischaemic versus haemorrhagic stroke in stable coronary artery disease
Authors: Wang W T 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background
The incidence of stroke may be increased in patients with coronary artery disease (CAD). We aimed to investigate the specific risk factors for the development of ischaemic and haemorrhagic stroke in stable CAD patients.

Methods
Patients with stable CAD were prospectively enrolled for future cardiovascular events in Taiwan. All the patients had received coronary interventions and were stable for least 1 month before enrolment. The incidence of ischaemic stroke was identified and confirmed by telephone and hospital records. Baseline characteristics, including demographic data, lipid profiles, medications, and biomarkers for potential inflammatory and atherosclerosis, were analysed.

Results
In total, 1428 patients (age, 63.07 ± 11.4 years; 1207 males) were under standard medical treatment and regularly followed-up for at least 4 years. Multivariate logistic regression analysis showed that baseline serum myeloperoxidase (MPO) level (HR: 1.89, 95% CI: 1.16-3.10, p = 0.01) and statin use (HR: 0.37; 95% CI: 0.17-0.79, p = 0.01) were independently associated with the onset of ischaemic stroke. Age (HR: 1.07, 95% CI: 1.00-1.14, p = 0.04) and angiotensin receptor blocker (ARB) use (HR: 0.37, 95% CI: 0.17-0.79, p = 0.01) were independently associated with future onset of intracranial haemorrhage (ICH), implying the different mechanisms of ischaemic stroke and ICH.
Conclusion Age and ARB use were related to ICH onset. Baseline MPO level and statin use were independently associated with longer and shorter future ischaemic stroke onset in stable CAD patients, respectively. Further studies are indicated to confirm the potential mechanisms and advance individual risk stratification for the onset of different types of stroke in clinical CAD.
The effect of high intensity interval training on patients with heart transplantation: a systematic review
Authors: Rajandekar T , John G 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

BACKGROUND
Exercise rehabilitation after heart transplant is of major importance in order to improve physical capacity and prognosis.High-intensity interval training (HIIT) has repeatedly proven to be a highly efficient form of exercise for improving the physical capacity of both normal subjects and patients with coronary artery diseases (CAD) and heart failure. In contrast to the chronotropic response of a normal heart to exercise, a newly transplanted heart is denervated, which causes higher resting heart rate (HR) and reduced heart response (chronotropic incompetence). The HR response during exercise is mainly controlled by catecholamine’s from the adrenal glands, resulting in a significantly slower increase of the HR at onset of exercise, a reduced peak HR, and a delayed return towards resting values after cessation of exercise. A study conducted in 2013 concluded that high-intensity, aerobic training, especially interval-based training, is a favourable type of exercise that yields improvements in both peripheral and central factors.The review was conducted to determine the effect of HIIT on heart transplant patients.I

PURPOSE
Heart transplant patients have benefitted from aerobic exercises, but the protocol is mostly focussed on moderate intensity exercises. Chronotropic incompetence and safety have been two issues while considering high intensity exercises in heart transplant patients.HIIT has been proved to be effective in coronary artery disease and heart failure patients.
METHODOLOGY

Criteria for considering these studies for the review
PRISMA guidelines of systematic review used. Physiotherapy Evidence Database scale used for assessing risk of bias. GRADE System of evaluation used for data extraction and quality assessment. "Mesh" terms used to search the article. Various databases like PubMed, Scopus, Google scholar, Cochrane screened. Inclusion and exclusion criteria stated. Studies done between 2010-2020 taken.Out of all the studies screened, which 3 studies fulfilled the full text eligibility and were included in the systematic review.

RESULTS
The heart transplant patients demonstrated a great improvement in VO2 peak, anaerobic threshold, peak expiratory flow, extensor muscle capacity, general health, systolic blood pressure and endothelial function post HIIT. One of the screened studies compared HIIT with moderate intensity exercises in heart transplant patients and found out that patients receiving HIIT demonstrated better improvement that moderate intensity exercises.The studies also emphasised that long term and community based HIIT is effective in improving the overall quality of life of the patients.

CONCLUSION
According to the three studies reviewed in this article, HIIT proved to be effective as exercise intervention on heart transplant patients. Abstract Figure. Forms of HIIT Abstract Figure. Heart transplant