bluuebunny/crossref_metadata_2025_split huggingface dataset:
What is the association between lifelong exercise volumes, valvular function and aortic diameters in subjects with a bicuspid aortic valve?
Authors: Schreurs BA , Hopman MTE , Van Kimmenade RRJ , Eijsvogels TMH 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Hartstichting and Stichting Hartekind

Background/Introduction
Subjects with bicuspid aortic valve disease (BAV) have a higher risk of developing valvular and aortic complications. There is debate if hemodynamic stress associated with long-term exercise training may accelerate the development of complications. Current exercise guidelines are rather restrictive and primarily based on expert opinion. Hence, more insight is needed into the association between exercise volumes and disease characteristics in BAV subjects, especially since exercise training is a powerful strategy to improve cardiovascular health.

Purpose
To assess the association between lifelong exercise volumes and disease characteristics in BAV subjects.

Methods
We enrolled BAV subjects ≥35 years old who have not undergone an aortic valve or aorta intervention. Lifelong physical activity was determined using a validated questionnaire and quantified as Metabolic Equivalent of Task minutes per week (MET-min/wk). Participants were classified as 1) insufficiently active, 2) active, or 3) highly active, based on their lifelong physical activity volumes (&lt;500, 500-1000 and &gt;1000 MET-min/wk, respectively). Disease characteristics were assessed from echocardiographic images that were obtained during the most recent visit to our outpatient clinic, whereas patient characteristics were extracted from electronic health records.

Results
152 participants (54±10 years, 55% male) were included of which n=59 insufficiently active, n=47 active and n=46 very active. Median lifelong physical activity volumes were 235 [108-387], 713 [653-828] and 1499 [1198-1875] MET-min/wk (p&lt;0.001), respectively. Subject characteristics did not differ across groups (Table 1). No difference was found in aortic valve dysfunction across exercise volume groups, measured as peak aortic valve velocity (1.8 [1.5-2.4] m/s vs. 1.7 [1.4-2.6] m/s vs. 1.8 [1.5-2.5] m/s, p = .52) and presence of moderate-severe aortic valve regurgitation (n=7 (12%) vs. n=7 (15%) vs. n=6 (13%), p=.89) Also, aortic diameters at the level of the sinus of Valsalva (36.0±4.9 mm vs 35.8±5.5 mm vs 36.7±6.1 mm, p=.69) and ascending aorta (36.5±6.3 mm vs 39.0±7.0 mm vs 37.5±7.0 mm, p=.18) did not significantly differ across groups.

Conclusion
Lifelong exercise volumes are not associated with characteristics of disease severity in BAV subjects who have not undergone an aortic valve or aorta intervention. These observations may support a less cautious approach for habitual physical activity and exercise training in BAV subjects, so they can profit from the cardiovascular health benefits of a physically active lifestyle.
Contrast induced nephropathy in interventional cardiology; identification of high-risk patients and its prevention
Authors: Shuka N , Kristo A , Gishto T , Simoni L , Hasimi E , Shirka E , Siqeca M , Lazaj J , Refatllari I , Xhafaj M , Seiti J , Mijo A , Petrela E , Goda A 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
CIN is a serious and potentially preventable complication of coronary angiography and/or percutaneous coronary interventions (PCI). The definition of CIN, its incidence and risk factors and therapeutic interventions are not well established .

Purpose
To study incidence and risk factors of CIN in patients undergoing coronary angiography and/or PCI, to investigate high-risk patients with CIN and to evaluate its preventive therapies (Hydration an Acetylcysteine).

Method
This was a prospective trial, in one center with patients undergoing coronary angiography and/or PCI, during 2010-2014. The renal function was evaluated through serum Creatinine (Cr) and GFR (Cockcroft –Gault formula ). CIN was defined as an increase in Creatinine by 25% and/or by 0.5 mg/dL at 48/72 h after the index procedures. Patients with CIN were considered high-risk when Creatinine increased more than 50% and/or by 2 mg/dL, or needing dialysis. We evaluated the major risk factors for CIN such as: Preexisting Renal Lesion (PRL), Age≥65 years, Heart Failure (HF), Diabetes Mellitus (DM), Anemia (Hb &lt; 12 g/dL) and the Quantity of Contrast used. We evaluated the role of hydration with intravenous saline and acetylcysteine (ACC) in the prevention of CIN.

Results
Out of the 1231 patients enrolled, 804 patients fulfilled the inclusion criteria. The incidence of CIN resulted 14.4%, higher in the group of patients with risk factors for CIN (15.3%) versus without risk factors (9.1%); p=0.05. Risk factors HF (OD: 4.63; CI95%: 2.10-10.05, p&lt;0.001), PRL (OD: 1.57; CI95%: 1.02-2.41, p=0.039) and Age ≥ 65 years (OD: 1.82; CI95%: 1.37-3.73, p=0.038 ) resulted independent risk factors, for CIN whereas Anemia (p=0.171), DM (p=0.502) and the Quantity of contrast used (p=0.479) did not result independent risk factors. Creatinine at 24 hours after the procedure resulted a predictive factor for the development of CIN. (sensitivity 64.7%, specificity 91.7%, positive predictive value 63.5%, negative predictive value 92.1% ). Creatinine &gt; 1.5 mg/dL before the procedure resulted an independent risk factor for CIN, with a higher specificity than eGFR &lt; 60 ml/min. The incidence of patients with CIN at high risk was 3.9% and HF resulted the only independent risk factor in this subgroup of patients (OD:4.49, CI 95%: 2.03-9.95). Intravenous hydration with saline resulted efficient in the prevention of the development of CIN (p=0.029), whereas ACC did not (p=0.485).

Conclusions
The frequency of CIN is higher in the group with risk factors. The HF, PRL, Age≥ 65 years resulted as independent risk factors for, and intravenous hydration with saline was a simple and efficient method for the prevention of CIN. Although our definition of CIN is widely used, the need for a universal definition for CIN is a contemporary need.
Non-invasive instrumental evaluation of coenzyme Q10 phytosome on endothelial reactivity in healthy non-smoking young volunteers: a double-blind, placebo-controlled cross-over clinical trial
Authors: Cicero A , Fogacci F , Di Micoli A , Veronesi M , Borghi C 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): University of Bologna

Background
Coenzyme Q10 (CoQ10) is a natural antioxidant compound that prevents the vascular damage induced by free radicals and the activation of inflammatory signaling pathways.
Supplementation with CoQ10 is safe though its bioavailability is generally low, as far as variable depending on the pharmaceutical form of preparation. Recently, the development of phytosome technology has improved the bioavailability of CoQ10 and definitely facilitated its effective use in clinical.

Purpose and Methods
The present double-blind, randomized, placebo-controlled, cross-over clinical study aimed to investigate the effect on endothelial reactivity and total antioxidant capacity (TAC) of either acute and chronic supplementation with CoQ10 phytosome in a sample of 20 healthy young not smoking subjects.

Results
The immediate acute effect of dietary supplementation with CoQ10 phytosome on pulse volume (PV) was sustained in the actively treated group in comparison with placebo and the baseline (p&lt; 0.05). Chronic supplementation of the tested pharmaceutical formulation of CoQ10 significantly improved mean arterial pressure and TAC compared to placebo and baseline values (p&lt; 0.05 for both comparisons). In the actively treated group, the effect on dietary supplementation with CoQ10 phytosome on PV was also sustained when compared to the baseline (P&lt;0.05).
Opportunistic screening for atrial fibrillation in hypertensive patients using a mobile application (prospective study of 160 cases)
Authors: El Adaoui A , Habbal R 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Atrial fibrillation (AF) is the most common cardiac arrhythmia,affecting between 1-4% of the general population and responsible for 10-20% of strokes.
New technologies are now available for screening for AF,but their implementation in real clinical settings has not yet been fully investigated.

Purpose
-evaluate the electrocardiogram recordings on smartphones intended for screening for AF using the KardiaMobile device, with a dedicated mobile application.
- Highlight the prevalence of AF in a moroccan hypertensive population
-Evaluate the effectiveness of computerized screening for AF in therapeutic management

Methods
Prospective screening for AF in patients aged 55 or over,known to be hypertensive for at least 5 years, was performed at the cardiology consultation services between June 2019-July 2020.A single lead ECG was acquired by placing the fingers of each hand on the electrodesThe diagnosis of the Kardia app was assessed by the consultation cardiologist,and a baseline ECG was performed for each suspected arrhythmia.CHA2DS2-VASc score was collected from each patient.

Results
A total of 160 ECGs were performed.The diagnosis of the Kardia app was provided in 93% of cases.A heart rhythm described as normal was detected in 120 consultants,AFwas suspected in 8.1% of the patients described by the device as ‘possible AF’,and confirmed by a baseline ECG in 7.5% of the patients screened.
Anti-coagulation was started in 6.2% of patients.

Conclusion
Mobile Device for screening for atrial fibrillation in a population at risk is a promising, inexpensive tool with significant prognostic benefit for the prevention of cardiovascular complications
The Kardia app is able to quickly filter and detect atial fibrillation with high sensitivity and specificity.
Prevalence of cardioprotective medication use in coronary heart disease patients in South America: systematic review and meta-analysis
Authors: Marza Florensa A , Drotos E , Gulayin P , Grobbee DE , Irazola V , Klipstein-Grobusch K , Vaartjes I 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Coronary heart disease (CHD) is the most common cause of death globally, and clinical guidelines recommend cardioprotective medications for patients with established CHD. Suboptimal use of these medications has been reported, but an overview from the South American region is lacking.

Purpose
Our aim is to summarize evidence on the prevalence of cardioprotective medication use for secondary prevention of CHD in South America. We also intend to explore time-trends, guideline compliance and factors associated with medication use.

Methods
We conducted a systematic review searching literature in PubMed, Embase, Cochrane, Lilacs and SciElo. We searched articles published from 2000 to 2021 that reported prevalence of secondary prevention medication use in South America. We pooled the prevalence estimates in a meta-analysis, described findings on guideline compliance, and used meta-regression models to analyse time-trends and identify factors associated with medication use.

Results
We identified 7388 publications, from which 73 were included in the review (Fig 1). Medication prevalence varied by class: beta-blockers 73.0%(95%CI 66.6%–79.1%), ACEI/ARBs 55.8% (95%CI 49.7%–61.8), antiplatelets 84.6% (95%CI 79.6%–88.5%), acetylsalicylic acid 85.1% (95%CI 79.7%–89.3%) and statins 78.5% (95%CI 70.7%–84.7%). Heterogeneity of the pooled estimates was high. Ten publications reported low medication use and nine reported adequate use. The use of beta-blockers, ACEI/ARBs and statins significantly increased from 1993 to 2020. Medication use was lower in community, public and rehabilitation settings compared to tertiary centres.

Conclusion
The use of most cardioprotective medication classes for secondary prevention of CHD in South America has increased over the last 20 years, but it could be further improved particularly in community settings.
Which subjective factors determine the self-rated negative occupational prognosis of patients in cardiac rehabilitation? A qualitative study
Authors: Brehmer N , Wolff L L , Voeller H , Salzwedel A 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
A negative self-rated occupational prognosis hinders the vocational reintegration of patients after cardiac rehabilitation (CR). Several studies reveal that these patients often show reduced physical performance as well as higher psychosocial burden. Although the current evidence indicates that self-rated (negative) occupational prognosis of the patients in CR is a multi-factorial issue, there are no studies on subjective factors determining that prognosis.

Purpose
The aim of this study was to understand what subjective factors determine a self-rated negative occupational prognosis of patients in CR.

Methods
A single-centre qualitative study using thematic analysis was conducted in the fourth quarter of 2021. Data was collected by two researchers using in-depth interviews with 20 patients with self-rated negative occupational prognosis and 5 patients with non-impaired prognosis. We interviewed working-age patients (range 18-60 years) who were admitted to a rehabilitation program usually within 14 days after an acute cardiac event. The participants were selected by theoretical sampling. All interviews were recorded, transcribed and coded. We concluded the codes in main themes.

Results
In our analysis of interview texts we extrapolated seven themes: 1) environmental factors (social support, requalification opportunities, industry-specific occupational risks); 2) personal factors (professional skills, knowledge about own impairments, attitude toward future); 3) factors that occurred before a cardiac event (previous illness, unhealthy lifestyle, familial predisposition to disease); 4) factors that occurred after a cardiac event (health stigma and discrimination, disabilities, changed personal priorities); 5) patient's health perception including physical capacity; 6) possibilities to change the working conditions; 7) heart-focused anxiety. The themes 1 to 4 can be considered as an umbrella term for multiple individual factors. However, the themes 5 to 7, which indicate specific determining subjective factors for self-rated occupational prognosis, appeared in most of the interviews.

Conclusion
We conclude that the self-rated occupational prognosis is determined by a complex set of individual factors. However, three themes – patient´s health perception, opportunity to adjust work place, and resilience towards heart-focused anxiety- were mentioned by the majority of patients regarding their self-accessed occupational prognosis. Affected patients are likely to require a multidisciplinary rehabilitation program, whereas these three themes might be addressed by social workers and psychologists.
Determinants of peak oxygen pulse in disorders of glucose metabolism
Authors: Karaduz B , Bozdemir-Ozel C , Calik Kutukcu E , Arikan H , Dagdelen S 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background/Introduction
Oxygen pulse reflects oxygen consumption per heart beat and it provides an information for stroke volume and peripheral oxygen extraction during exercise. Further this, oxygen pulse reported as prognostic for all-cause and cardiovascular mortality. Disorders of glucose metabolism (i.e., prediabetes and overt diabetes mellitus) are important risk factor for cardiovascular disease and might disrupt oxygenation.

Purpose
We aimed to investigate determinants of peak oxygen pulse in patients with prediabetes and overt diabetes mellitus.

Methods
Twenty-six patients with disorders of glucose metabolism (mean age: 48,62±7,08 years, HbA1c: 6,51±0,94) were included in the study. Laboratory parameters which very low density lipoprotein cholesterol (VLDL), low and high density lipoprotein (HDL, LDL) levels, HbA1c and C-reactive protein (CRP) levels of participiants were recorded. Patient performed a symptom limited maximal cardiopulmonary test (CPET).

Results
There was statistically significant negative correlation between oxygen pulse with VLDL (r=-512, p=0,018), CRP (r=-665, p&lt;0.001), waist circumference (r=-471, p=0,015). Based on linear regression analysis, we found that CRP and VLDL explained %40 of variance Oxygen pulse. (R=0.637, R2=0.406, F(2-26). 6.160, p=0.009, constant=0.133).

Conclusion(s)
CRP and very low density lipoprotein cholesterol levels is independent predictors of oxygen pulse. Management of VLDL levels and inflammation can improve peripheral oxygenization in prediabetes and overt diabetes mellitus.
Prevalence of abnormal electrocardiographic findings in a brazilian cohort of young football players: B-pro foot ECG pilot study
Authors: Stein R , Ferrari F , Helal L , Dilda GD , Emed LGM , Bassan F , Aleixo HC , Martins VM , Da Silveira AD 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Hospital de Clínicas de Porto Alegre Research and Event Incentive Fund (FIPE-HCPA)

Introduction
The 12-lead resting electrocardiogram is a useful tool for diagnosing pathological conditions in athletes. The prevalence of electrocardiographic abnormalities in Brazilian soccer players are unknown.

Purpose
To describe the prevalence of abnormal electrocardiographic findings in young Brazilian soccer players based on the "2017 International Criteria for Electrocardiographic Interpretation in Athletes".

Methods
Continuous variables were displayed as mean and standard deviation or median and interquartile range, while prevalence’s with 95% confidence intervals, and stratified by race. Intra-group differences were estimated by linear models or binomial and multinomial logistic regressions. Type I error was set to set a at 0.05. An additional margin of 0.025 was considered at the discretion of the statistician conditioned to the quality of the model. All analysis were running in Stata version 16.0.0.

Results
2,581 young Brazilian soccer players from 27 clubs (mainly first division), aged 15-35 years (median: 18 years) were evaluated. 1,268 (49.1%) were Caucasians, 796 (30.8%) Mixed-Race (MR) and 517 (20.1%) Afro-Brazilians (AB). T-wave inversion (TWI) in the inferior leads (3.0%), high lateral leads (DI/aVL) (0.6%), V5 (2.3%), V6 (1.8%), and V5-V6 (1.7%) were present. Six Caucasians (0.5%) presented TWI in V1-V4. Prolonged corrected QT interval (QTc) (0.5%), QRS ≥140 ms (0.2%), "pathological" anterior Q waves (0.2%), lateral ST-segment depression (0.07%), premature ventricular contractions (0.5%), Mobitz type II atrioventricular block (0.03%), and a Wolff-Parkinson-White pattern (0.04%) were also observed. There were no athletes with short QTc interval, epsilon waves, profound sinus bradycardia (&lt;30 beats per minute), complete left bundle branch block, third-degree atrioventricular block, or Brugada pattern (1, 2 or 3). Overall, 111/2,581 (4.3%) soccer players had electrocardiographic changes considered to be abnormal (4.4% in Caucasians, 4.5% in MR and 6.4% in AB). There was no difference between the abnormal findings among races, except for the prevalence of TWI in V6, which was higher in AB compared to Caucasians (3.1% versus 1.2%, respectively; P = 0.01).

Conclusion
To the best of our knowledge, this is the first large electrocardiographic cohort of Brazilian young soccer players to be described. In this sample, we evidence a prevalence &lt;5% of abnormal findings according to the "2017 International Criteria for Electrocardiographic Interpretation in Athletes". Additional evaluation in all these cases is indicated.
Cholesterol and the risk of acute coronary syndrome. Mendelian randomisation in the Czech population
Authors: Hubacek JA , Adamkova V , Dlouha D , Pitha J 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Health, Czech Republic

Introduction
Increased plasma cholesterol levels are considered as a risk factor for the development of cardiovascular diseases, including acute coronary syndrome (ACS). However, observational studies in recent years have often found no increased LDL-cholesterol values in ACS patients compared to controls. Final cholesterol levels are largely modified by genetic factors, so they can be used to demonstrate (based on Mendelian randomization) whether the link between plasma cholesterol and MI risk is still present.

Methods
In our study, we analysed LDL-R (rs6511720), CILP2/PBX4 (rs16996148), APOB (rs693) and SORT-1 (rs646776) variants in a total of 939 patients with ACS and 1,191 healthy controls (post-MONICA study). Only men aged 18-65 years were included in the study.

Results
Patients with ACS had significantly lower total cholesterol levels than controls (4.8 ± 1.1 vs. 5.7 ± 1.1 mmol / L; P &lt;0.001). Total and LDL-cholesterol were not higher in patients even after adjusting for age, BMI and dyslipidemic treatment. We confirmed a significant effect of all analysed variants on LDL-cholesterol levels (all P &lt;0.01). None of the four analysed variants significantly affected the risk of MI (P values between 0.10 and 0.58). Individuals with at least seven cholesterol-raising alleles had a slightly increased risk of ACS compared to others (OR, 95% CI; 1.26, 1.06-1.51; P = 0.01).

Conclusion
Variants within the genes for LDL-R, CILP2 / PBX4, APOB and SORT-1 are significant genetic determinants of LDL-cholesterol levels in the population of Czech men. After a population-wide reduction in cholesterol levels, these levels no longer seem to be a serious problem in determining ACS, and interventions to reduce other types of risk should be given more attention.