bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pulmonary hypertension in mitral stenosis patients submitted to percutaneous balloon mitral valvuloplasty: an innocent bystander?
Authors: Ferreira V , Rodrigues I , Almeida Morais L , Bernardes L , Cacela D , Patricio L , Galrinho A , Reis JP , Grazina A , Castelo A , Cruz Ferreira R 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Percutaneous balloon mitral valvuloplasty (PBMV) is the cornerstone of the treatment of rheumatic mitral stenosis (MS) in suitable patients. Pulmonary hypertension (PH) is a common coexisting finding and an indication for intervention. We sought to assess the influence of PH in PBMV immediate results and in very longterm outcome.

Methods
Between 1991 and June 2021, 202 consecutive patients underwent PBMV in a single tertiary centre. Clinical data, echocardiographic parameters, and MACE (cardiovascular mortality, need for percutaneous or surgical mitral reintervention) were analysed.

Results
Mean age was 47.3 ± 13.6 years and 89.6% were women. A previous commissurotomy or PBMV was found in 10.4% and mean Wilkins score was 7.6 ± 1.4. PH, defined as pulmonary artery systolic pressure (PASP) ≥45mmHg, was present in 32.7% of patients. A successful procedure was achieved in 89.1% of total population. Mean mitral valve (MV) gradient decreased from 13.1 to 5.0 mmHg (p &lt; 0.001) and MV area increased from 1.1 to 1.8 cm2 (p &lt; 0.001). A significant reduction also occurred in left atrium diameter (48.8 to 46.8 mm, p &lt; 0.001) and PASP (50.5 to 38.5 mmHg, p &lt; 0.001). During a mean follow-up of 12.0 ± 8.8 years, 7 cardiovascular deaths occurred (3.5%) and 33.2% of patients needed MV reintervention. Baseline PH did not impact immediate success and was not related with MACE in the follow-up. However, PH persistence after PBMV was correlated with unsuccessful procedure (p = 0.023) and with the occurrence of MACE during FU (HR 3.3, CI 95% 1.1-9.6, p = 0.028 and Kaplan-Meier analysis, log-rank 0.020).

Conclusions
PBMV in patients with MS and PH is a safe and effective intervention, achieving a significant decrease in PASP after procedure. Baseline PH was not associated with success or MACE. However, PH persistence after PBMV, correlated with worse prognosis in longterm follow up. Special attention and further investigation for this subgroup is needed. Abstract Figure.
Diversity in the european association of cardiovascular imaging (EACVI) research and training grants: gender, geographic and economic perspectives
Authors: Dakhil ZA 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Training and research grants are crucial for professional and academic advancement especially in a rapidly evolving specialty like cardiac imaging. Equity, inclusion and diversity in funding research and training are fundamental in achieving research and training excellence. No prior data evaluated the diversity in the research and training grants awarded by international cardiovascular societies.

Purpose
Current analysis aimed to evaluate the distribution of awarded EACVI grants according to the country and gender of the grantsˈ winners.

Methods
Official ESC website was searched for names of EACVI research and training grantsˈ winners, gender, and affiliating country as well as hosting country of the awardee were documented. If any of this data was missed in the ESC website, then the awardeesˈ gender and affiliation were searched via google scholar, ResearchGate and LinkedIn platforms. The countries of the awardees were classified according to the continent and World Bank Economic classification [High income (HIC), middle (MIC) and low income (LIC) countries].

Results
A total of 57 EACVI grants[36 research grants (from 2009 to 2021) and 21 training grants (from 2015 to 2021)] were analysed. Women won 54.38% of total grants [55.56% of research grants and 52.38% of training grants]. Winners of research grants were from HIC and MIC in 63.89% and 36.11% respectively, while winners of training grants were from HIC and MIC in 66.67% and 33.33% respectively. Winners of research grants were from Europe in 80.55%, and Asia in 16.66%, while winners of training grants were from Europe in 66.67% and Asia in 19.04%. The most common EACVI research grant hosting countries were Belgium (27.77%), UK (22.22%), Netherlands and Italy (16.66% for each), while the most common EACVI training grant hosting countries were UK (52.38%), Italy (23.8%) and Belgium (9.52%).

Conclusions
Women were well represented in EACVI research and training grants. Yet, both low-income countries and non-European countries were remarkably under-represented in EACVI grants. Considering the high burden of cardiovascular diseases in LIC and MIC, every effort should be made to increasingly include cardiologists from these countries in research and training opportunities to achieve the main ESC mission of decreasing the cardiovascular disease burden worldwide beyond the limits of geography. Abstract Figure. Abstract Figure.
Echocardiographic characteristics of patients admitted with acute heart failure with a previous history of cancer: a single-centre observational study
Authors: Todd F , Wong C , Mohamed A , Hewitson L , Doolub G , Gogola L , Skyrme-Jones A , Aziz S , Ghosh A , Sammut E , Dastidar A 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background
Cancer and heart failure frequently co-exist, with cancer and chemotherapy exerting a number of pathological effects on the myocardium. Despite this, our understanding of the clinical impact of previous history of cancer in acute heart failure remains unclear. We therefore performed a retrospective cohort study to identify the echocardiographic characteristics in patients admitted with acute heart failure with and without a diagnosis of solid organ cancer.

Methods
Consecutive patients with signs and/or symptoms of acute heart failure admitted over a period of 33 weeks (7th January – 28th August 2020) were identified. Discharge summaries, electronic notes and shared care networks were manually searched to determine baseline demographics, admission bloods, comorbidities, cancer diagnoses, imaging and echocardiography. Univariate and multivariate Cox regression analysis was performed to identify clinical and biochemical predictors of mortality.
Results
In total, 478 patients were admitted with acute heart failure over the study period (mean age 80 ± 11 years, 53.6% were male and mean NT pro-BNP was 9106). 386 had echocardiography available for review. Of these, 64 (16.6%) had a past or current history of solid organ cancer.
Patients with a past or current history of solid organ cancer had a significantly higher ejection fraction (48% (±9%) vs 44% (±11%), p = 0.003), higher incidence of heart failure with preserved ejection fraction (57.8% vs 33.5%, p &lt; 0.001) and lower incidence of right ventricular impairment (defined using both visual inspection and TAPSE measurements) (25.0% vs 47.8%, p &lt; 0.001).
There were no significant differences in any valvular pathologies between groups (overall prevalence 71.9% vs 71.7%, p = 0.982) No difference was observed between the rate of prior myocardial infarction (28.1% vs 26.0%, p = 0.727) or lung disease (34.4% vs 37.0%, p = 0.692).
Overall, mortality at six months follow up was significantly higher in the group with a current or previous cancer diagnosis (43.4% vs 32.0%, p = 0.046) compared to the group without.

Conclusion
Patients admitted with acute heart failure and a past or current history of cancer have a significantly higher ejection fraction and lower prevalence of right ventricular impairment. Despite the higher ejection fraction their prognosis is worse. Further work is needed to determine potential mechanisms for this, as well as its clinical implications. Abstract Figure. Six Month Survival Kaplan Meier Graph Abstract Figure. Echocardiogrpahic Features
Association of COVID-19 with impaired endothelial glycocalyx, coronary flow and longitudinal strain four months after infection
Authors: Ikonomidis I , Katogiannis K , Mitrakou A , Kountouri A , Thymis J , Korakas E , Varlamos C , Andreadou I , Tsoumani M , Bamias A , Kazakou P , Grigoropoulou S , Kavatha D , Dimopoulos MA , Lambadiari V 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Aims
SARS-CoV-2 infection may lead to endothelial and vascular dysfunction. We
investigated alterations of arterial stiffness, endothelial coronary and myocardial
function markers four months after COVID-19 infection.

Methods
In a case-control prospective study, we included 100 patients four months after COVID-19 infection, 50 age- and sex-matched healthy individuals. We measured a) perfused boundary region (PBR) of the sublingual arterial microvessels (increased PBR indicates reduced endothelial glycocalyx thickness), b) flow-mediated dilation (FMD), c) coronary Flow Reserve (CFR) by Doppler echocardiography d) pulse wave velocity (PWV) e) global left (LV) and right (RV) ventricular longitudinal strain (GLS), f) malondialdehyde (MDA), an oxidative stress marker, von-Willenbrand factor and thrombomodulin as endothelial biomarkers.

Results
COVID-19 patients had lower CFR and FMD values than controls (2.39 ± 0.39 vs 3.31 ± 0.59, p = 0.0122, 5.12 ± 2.95% vs 8.12 ± 2.23%, p = 0.006 respectively). Compared to controls, COVID-19 had greater PBR5-25 (2.11 ± 0.14μm vs 1.87 ± 0.16μm, p = 0.002), higher PWV (PWVc-f 12.32 ± 2.44 vs 10.11 ± 1.85 m/sec, p = 0.033) and impaired LV and RV GLS (-19.11 ± 2.14% vs -20.41 ± 1.61%, p = 0.001 and -16.45 ± 3.33% vs -20.11 ± 2.48%, p &lt; 0.001). MDA and thrombomodulin were higher in COVID-19 patients than controls (10.55 ± 2.45 vs 1.01 ± 0.50 nmole/L, p = 0.001 and 3716.63 ± 188.36 vs 2590.02 ± 156.51pg/ml, p &lt; 0.001). Residual cardiovascular symptoms at 4 months were associated with oxidative stress and endothelial dysfunction markers.

Conclusions
SARS-CoV-2 may cause endothelial and vascular dysfunction linked to
impaired cardiac performance four months after infection.
Long term non-invasive endothelial function assessment in patients with paediatric inflammatory multisystem syndrome temporarily associated with Covid 19 (PIMS TS)
Authors: Spanaki A , Miller O , Wong J , Pushparajah K , Theocharis P 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Patients with PIMS-TS present with features of vasculitis (bright coronary arteries and diffuse coronary ectasia on transthoracic echocardiography) and prothrombotic features (e.g. elevated D Dimers) indicating involvement of the endothelial layer in the inflammatory process. Impairment in endothelial function may contribute to the acute but also to possible long-term consequences in patients with PIMS-TS. The aim of this pilot study is to assess non-invasively the endothelial (dys)function using reactive hyperemic peripheral arterial tonometry (RH-PAT) 6 months after the acute inflammatory phase.

Methods
Ten patients with previous diagnosis of PIMS-TS were compared to age-matched controls. The endothelial function was assessed using the EndoPAT device which provides the reactive hyperemic index (RHI) of endothelial function in a 15-min test. Cardiac function indices by means of LV fractional shortening (FS) was also assessed.

Results
There were no significant differences regarding age (11.2 ± 3.0 vs 13.6 ± 2.4, p = 0.063), height, weight and body surface area, (BSA: 1.49 ± 0.36 vs 1.52 ± 0.25, p = 0.856) in patients with previous diagnosis of PIMS-TS and controls respectively. The two groups also had similar LV systolic function assessed by FS (36.3 ± 9.1% vs 36.7 ± 7.1%, p = 0.922). The RHI in the PIMS TS group was similar to the control group (1.65 ± 0.43 vs 1.81 ± 0.60, p = 0.533 respectively).
Conclusions. Patients with PIMS-TS who may present with features of vasculitis during the acute phase, do not show evidence of endothelial dysfunction during the long term follow-up, suggesting resolution. Further studies are required to accurately determine the endothelial (dys)function during the acute phase of the inflammatory syndrome and course.
Left ventricle structure and function relations with the levels of plasma markers of fibrosis in hypertensive patients with NonSTEMI
Authors: Krestjyaninov M , Gimaev RH , Buharaeva AI , Bakshutova AA , Mirina MP 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Introduction. The myocardial fibrosis lies in the basis of left ventricle remodelling in patients with hypertension. Cardiomyocites hypertrophy, fibroblasts proliferation, enlargement of interstitial collagen volume and their ratio disorders may increase severity of stroke and myocardial infarction.
Purpose. The purpose of the study is to evaluate relations between the plasma levels of myocardium fibrosis markers and left ventricle remodelling, systolic and diastolic function in hypertensive patients with NonSTEMI.
Methods. Were examined 138 hypertensive patients (both men and women) with NonSTEMI.
The mean age of patients was 51.2 (11.2) years. Patients with arrhythmias and conduction abnormalities, diabetes mellitus and autoimmune diseases were excluded form the study.

In all patients was performed
ECG in 12 standard leads; EchoCG (according to ASE/EACVI 2015 recommendations); evaluation plasma levels of tissue inhibitor of metalloproteinases-1 (TIMP-1) and insulin-like growth factor 1 (IGF-1). HF NYHA functional class was determined by performing 6MWT.
Statistical significance was defined at the level of methods for p &lt; 0,05.
Results. The averaged levels for plasma markers of myocardium fibrosis were: TIMP-1 - 322.0 (250.0; 483.5) ng/mL; IGF-1 - 160.0 (141.0; 175.0) ng/mL.
Results of correlative analysis revealed relations between IGF-1 and ILV mass (R=-0.59; p &lt; 0.001), and weak correlation between IGF-1 and E/e" averaged (R=-0.19; p = 0.027) (Picture 1). These negative correlations may be explained by the growth in both fibroblasts and collagen production in myocardium. Also there were positive correlations between TIMP-1 and ILV mass (R = 0.63; p &lt; 0.001) and TIMP-1 and E/e" average (R = 0.37; p &lt; 0.001) (Picture 1) which may be due to an increase of myocardial stiffness as the result of fibrosis activity.
The results of the comparison of TIMP-1 and ICF-1 plasma levels, structural and functional parameters of the LV in groups of patients with different types of LV geometry can be seen in Table 1.
Conclusion. Thus, the results of the study show that plasma markers of fibrosis was significantly higher in patients with concentric and eccentric LV hypertrophy which may reflects the higher levels of myocardium stiffness. Abstract Table 1. Abstract Figure. Picture 1.
Left ventricular systolic function parameters are increased in patients with primary biliary cholangitis without cirrhosis
Authors: Bidiuk J , Styczynski G , Szmigielski CA , Lewandowski J , Sinski M 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Primary biliary cholangitis (PBC) is a chronic, autoimmune liver disease causing destruction of the small intralobular bile ducts in the liver. PBC patients can also develop extrahepatic manifestations, mostly related to skin, nervous system and laboratory abnormalities. Cardiac involvement is inconsistent in PBC studies despite high levels of serum lipids. Cardiac abnormalities are especially important because with the treatment many patients with early-stage PBC may have a normal life expectancy and therefore the cardiovascular complications can develop. Additionally, in recent years new echocardiographic modalities emerged letting for more precise analysis of cardiac morphology and function.

Purpose
The purpose of the study was to compare novel and classic echocardiographic indices in patients with confirmed PBC without cirrhosis and in control subjects.

Methods
22 female patients with PBC and without cirrhosis and 44 healthy females, matched for age, (53.3 ± 9 years and 50.9 ± 8 years respectively, p = 0.065) were investigated. TTE study was performed and analysis of left ventricular (LV) global longitudinal strain (GLS) and myocardial work was performed.

Results
Systolic blood pressure (SBP) differed between PBC and control group (128 ± 17 mmHg and 116 ± 11 mmHg respectively, p = 0.006), while diastolic blood pressure (DBP) (78 ± 10 mmHg and 76 ± 10 mmHg, p = 0.2) and heart rate (HR) (73 ± 12 bpm and 70 ± 8 bpm , p = 0.32) did not. PBC group had increased diameter of cardiac chambers when adjusted for body surface area (BSA), including left atrium (LA/BSA) and right ventricle (RV/BSA), as well as left ventricular mass (LWMI) and relative wall thickness (RWT) (Table) with no difference in left ventricular end diastolic diameter (LVEDD/BSA). LV ejection fraction (EF) measured by Simpson method was increased in PBC group (Table). LV diastolic function parameters (E/A, E/e’) were impaired in patients with PBC when compared with controls (Table 1). LV GLS indices (GLSAVG, GLSLAX, GLS4C, GLS2C) were significantly higher in PBC group, as well as global myocardial work indexes : global myocardial work (GWI) and global constructive work (GCW). Global work efficiency (GWE) and global wasted work (GWW) indexes were not different (Table).

Conclusion
Our study shows that in patients with PBC without cirrhosis LV systolic function is increased. That implies hyperkinetic circulation in that group of patients even before the development of cirrhosis. Abstract Table
Echocardiographic assessment of pulse wave velocity in psoriatic patients with and without psoriatic arthritis
Authors: Wierzbowska-Drabik K , Gruchala-Cislak A , Skibinska M , Lesiak A , Niedzwiedz M , Kasprzak JD , Narbutt J 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Psoriasis (PSO) is an inflammatory disorder which in its more severe form affects cardiovascular system (CVS) leading to more rapid atherosclerosis progression. Moreover, some data suggested that the presence of psoriatic arthritis (PSA) may further increase CVS deterioration.

Purpose
Our aim was to compare the pulse wave velocity (PWV) between psoriatic patients without and with psoriatic arthritis (PSA 0 and 1 group, respectively).

Methods
We examined 31 consecutive patients (20 males and 11 females) with moderate to severe PSO taking systemic anti-inflammatory medications (TNF-alpha inhibitor, IL-17 inhibitor, IL-23 inhibitor or IL12/23 inhibitor) with transthoracic echocardiography with the evaluation of PWV

The group was divided into two
17 patients without PSA (PSA 0) and 14 with concomitant PSA (PSA 1). To achieve PWV value the time from R wave in ECG to the onset of arterial flow was measured respectively in carotid (T1) and femoral artery (T2) with further calculation of time difference (delta T). The distance between supraclavicular area and groin was measured during physical examination of patient. PVW was expressed as the ratio between assessed distance (in meters) and time difference (in seconds).

Results
Patients with psoriatic arthritis (PSA 1) had more frequently hypertension and higher BMI but did not differ significantly from the group without joints involvement regarding other demographics, risk factors and basic echocardiographic data. They also showed similar PSO severity as assessed with PASI score, see Table. The PWV assessment was feasible in all patients and the respective mean values achieved 9.2 ± 3.7 m/s in PSA 0 vs 10 ± 2.8 m/s in PSA 1 group, p = ns.
Both T1 and T2 correlated significantly with duration of PSO, see Figure, and even better with patient’s age r = -0.61, p = 0.0003 for T1 and r = -0.77, p &lt; 0.0001 for T2, whereas PWV correlated significantly only with patient’s age.
In the model of 12 variables only older age was the independent predictor of PWV &gt;10 m/s in multivariate logistic analysis, OR 1.08 95% CI 1.003- 1.165.

Conclusions
Patients with PSA showed tendency to the higher prevalence of obesity and hypertension when compared with patients with skin PSO only. Measurement of PWV during echocardiography or even more simple times to flow spectrum onset in carotid or femoral arteries provided quantitative parameters reflecting cardiovascular impairment in PSO and PSA. Abstract Table. Group comparison. Abstract Figure. PSO duration, T1, T2 and PVW.
Echocardiographic evaluation of patients with diastolic dysfunction of the left ventricle treated with external counterpulsation
Authors: Alakbarov R , Jahangirov T , Dadashova G 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The influence of the external counterpulsation (ECP, EECP) on patients with diastolic dysfunction of the left ventricle (LV) is unclear. We aim to determine whether external counterpulsation therapy improves echocardiographic parameters in these patients.

Methods
We studied 57 patients with stable coronary artery disease undergoing one course of external counterpulsation therapy. The average age of the patients was 63.07 ± 7.44 years (there were 43 (75.4%) male and 14 (24.6%) women). All patients divided into two groups: patients with diastolic dysfunction of the left ventricle (E/e" ratio &gt; 14, total 15 patients, main group) and control group (E/e"&lt; =14, total 42 patients). The mean age of the patients included in the main and control groups was 64.20 ± 5.93 and 62.67 ± 7.93 years (p = 0.36). All patients treated with one course of ECP (EECP) treatment (33,26 ± 3,60 and 32,85 ± 4,56 sessions, p = 0,38). Results from echocardiographic examinations after the treatment in these groups were compared. Echocardiographic assessment included evaluation of the chamber size, chamber volume, ejection fraction of the left ventricle (LV) by 2D and Doppler measurements.

Results
Echocardiographic parameters for main and control groups before treatment: the diastolic diameter of the LV (cm): 5,65 ± 0,97 and 5,20 ± 0,62 (p = 0,0913); the end-diastolic volume of the LV (ml): 93.53 ± 28.38 and 75.45 ± 25.13 (p = 0.0163); LV stroke volume (ml): 48,57 ± 11,47 and 43,02 ± 10,64 (p = 0,1471); LV ejection fraction (%): 52.83 ± 10.12 and 59.11 ± 9.53 (p = 0.0340); the volume of the left atrium (ml): 73.25 ± 22.79 and 57.86 ± 20.60 (p = 0.0229); tissue Doppler velocity of the mitral annulus (e ", cm/s): 5,89 ± 1,18 and 7,43 ± 1,50 (p = 0,0006); E/e" ratio: 18,85 ± 3,40 and 9,69 ± 1,95 (p &lt; 0,0001). Echocardiographic parameters for the main and control groups after treatment: the diastolic diameter of the LV (cm): 5.53 ± 0.85 and 5.15 ± 0.57 (p = 0.1879); the end diastolic volume of the LV (ml): 92.91 ± 31.29 and 75.15 ± 22.78 (p = 0.0536); LV stroke volume (ml): 50,77 ± 11,49 and 47,01 ± 11,24 (p = 0,2612); LV ejection fraction (%): 56.81 ± 10.50 and 64.06 ± 7.67 (p = 0.0088); the volume of the left atrium (ml): 60.84 ± 16.20 and 55.77 ± 17.53 (p = 0.2388); tissue Doppler velocity of the mitral annulus (e", cm/s): 6,15 ± 1,11 and 7,73 ± 1,90 (p = 0,0037); E/e" ratio: 15.97 ± 5.39 and 10.08 ± 2.81 (p &lt; 0.0001). Statistically significant changes between two groups noted for the left atrium volume: decrease in 12,41 ± 16,33 ml and 2,09 ± 13,72 ml (p = 0,0124) in both groups, and for E/e" ratio: decrease in -2,87 ± 3,94 in the main group and increase in 0,39 ± 2,12 in the control group (p = 0,0003).

Conclusion
ECP treatment was associated with a decrease in the left atrium volume and E/e’ ratio in patients with diastolic dysfunction of the left ventricle.