bluuebunny/crossref_metadata_2025_split huggingface dataset:
The variability of juvenile dispersal in an opportunistic raptor
Authors: García-Macía Jorge , López-Poveda Gabriel , De La Puente Javier , Bermejo-Bermejo Ana , Galán Manuel , Álvarez Ernesto , Morollón Sara , Urios Vicente 
Published: May 2022

AbstractThe juvenile dispersal of raptors is a crucial stage that stretches from parental independence to the establishment of the first breeding area. Between 2012 and 2020, 44 juvenile red kites Milvus milvus from the Spanish breeding population were tagged using GPS telemetry to study their dispersal. Juveniles left the parental breeding area at the end of their first summer and performed wandering movements throughout the Iberian Peninsula, returning to the parental breeding area the following year, repeating the same pattern until they settled in their first breeding area. We analyzed the mean distance from the nest, the maximum reached distances, and the traveled distances (daily and hourly) during the first 2 years of dispersal and compared them. Despite the high individual variability, variables describing the dispersal movements of juveniles showed a decreasing trend during the second dispersal year: 80% of individuals reached a shorter maximum distance in the second year, 70% decreased their mean distance to the nest, 65% decreased their hourly traveled distances, and 50% decreased their daily traveled distances. On the other hand, the red kites usually combined wandering movements with the establishment of temporary settlement areas (TSA). The average duration of settlement in the TSAs was 75 ± 40 days (up to 182 days) and was located at 182 ± 168 km from the nest. In those areas, juveniles used 781.0 ± 1895.0 km2 (KDE 95%). Some of the TSAs were used by several individuals, which suggests that these areas might be good targets for conservation in future management plans
The way to a man’s heart is through his stomach? A unique case report of transient constrictive pericarditis secondary to infarction of herniated omentum following bariatric surgery
Authors: Singh Suhasini , Rowe M. , Hopkins G. , Dahiya A. 
Published: May 2022

Abstract

Background
Intrapericardial diaphragmatic hernias are a rare form of diaphragmatic hernia. The presentation is usually acute due to trauma or from iatrogenic causes. In some instances however, these patients can present years later. We describe an unusual case of transient constrictive pericarditis associated with herniation of omentum through a diaphgragmatic hernia extending into the pericardial space, which infarcted following recent bariatric surgery. A multi-disciplinary approach was required with surgical correction of the diaphragmatic defect and removal of omentum from the pericardial space.

Case summary
A 38-year-old gentleman with a history of a remote abdominal stab wound and recent laparoscopic gastric sleeve procedure presented with sharp central chest pain radiating to the shoulder. Chest imaging [echocardiography, computed tomography (CT), and cardiac magnetic resonance imaging (MRI)] revealed the presence of an intrapericardial diaphragmatic hernia and herniation of devascularized omentum into the pericardial space. Surgery was undertaken to remove the pericardial omentum. Echocardiography and cardiac MRI revealed changes of pericardial constriction which resolved with anti-inflammatories.

Discussion
A multi-disciplinary approach was required in this case with surgical correction of the diaphragmatic defect and removal of omentum from the pericardial space. Multi-modal imaging proved essential in the diagnosis of this rare condition, aiding in timely diagnosis, ongoing management decisions, and for assessing therapeutic response.
C7 WEARABLE CARDIOVERTER – DEFIBRILLATOR IN PATIENTS WITH HIGH RISK OF SUDDEN CARDIAC DEATH: IS IT USEFUL A PATIENT SELECTION?
Authors: Bolognesi M , Rossi L , Biagi A , Coccia M , Sticozzi C , Comastri G , Aschieri D 
Published: May 2022

Abstract

Background
The wearable cardioverter defibrillator (WCD) is considered in patients with increased risk of sudden cardiac death (SDC), in which implanted cardiac defibrillator (ICD) is temporary not definitively indicated. A few registry confirmed efficacy and safety of WCD and left ventricular ejection fraction recovery (LEVS)after wearing time.

Methods
We considered in our study 40 consecutively patients that used WCD in Piacenza and Castel San Giovanni Cardiology Department from August 2017 to September 2021 with recent acute myocardial infarction, newly diagnosed cardiomyopathy, primary arrhythmias syndrome awaiting diagnostic completation. They were followed by remore monitoring. The primary outcome were: the need of ICD implantation or not indication to ICD at the of the wearing time, We analyzed clinical variables related to primary outcome.

Results
Out of 40 patients, average age 66 years, average LEVS media 29%±12,5,88% were males, 32% suffered from diabetes mellitus, 35% renal failure, 55% acute and chronic heart failure, 10% previous ischemic stroke, 17% atrial fibrillation (AF), 12% cardiac arrest (ACC) after STEMI onset, 20% ventricular tachicardia (VT). 27% of these patients took amiodarone,92% beta blockers and 82% ACEi.The average wearing time of WCD was 51 days and 22,96 hours dailyAt the end of this period 48% of patients didn‘t receive ICD implantation for increasing LEVS.We evaluated clinical variables related to primary outcome with Chi Square test and Student’s t test.There weren’t significant difference regarding primary outcome between ischemic disease and other cardiophaties. The presence of AF, previous stroke, renal failure, hypertension, diabetes mellitus was more but not significant in ICD group. No significant age difference(66.8±14.1 vs 66.3±11.8, p = 0,6) neither FEVS (29.4±11.6 vs 29.5±12.7, p = 0,8) was in patients that received ICD versus not received .The clinical variables related to primary outcome only were: ACC after STEMI onset and amiodarone therapy.

Conclusions
In our study of patients with WCD, the percentage of LEVS increase is consistent with European registries. A few clinical variables may be related to ICD indication. Further studies can be useful to identify patients who need more of WCD for a lack of LEVS improvement.
C24 TWIDDLER SYNDROME AND HEART FAILURE: INTEGRATION OF REMOTE MONITORING AND CARDIOLOGY TELECONSULTATION FOR OPTIMAL MANAGEMENT
Authors: Gatto M , Dominici T , Rinaldi M , Rinaldi D , Percoco F , Tung M , Pontiroli C , Persi A , Ciccaglioni L , Kol A 
Published: May 2022

Abstract
The prevalence of heart failure in the population and the COVID pandemic have rendered increasingly necessary the integration of remote monitoring with cardiology teleconsultation. A patient with dilated cardimiopathy was subjected to ICD implantation (Boston Scientific Perciva DR) with remote monitoring (LatitudeTM). One month after implant, remote monitoring recorded an increase in the HeartLogicTM heart failure index, a decrease of right ventricular and atrial sensing, contextually to fluctuations of the impedance values of the two leads (Fig. 1). The patient reported having performed shoulder’s rehabilitation therapy with probable manipulation of the ICD pocket. Chest X–ray showed dislocation of both leads with distal end of right atrial catheter in superior vena cava and distal end of right ventricular catheter in right atrium (Fig. 2A) and kinking of proximal segments (Fig. 2B), a picture compatible with diagnosis of Twiddler‘s syndrome. Implant revision confirmed lead kinking in the subcutaneous pocket (Fig. 3A). The atrial catheter, given the amount of tissue deposited at its distal end (Fig.3B) which prevented its active fixation, was replaced. Following discharge, an increase in the HeartLogicTM Heart Failure Index was detected. The outpatient visit showed the presence of pleural effusion and medical therapy was therefore optimized. In order to avoid frequent ambulatory visits to the patient, a cardiology teleconsultation was planned, which enabled to verify the clinical benefit of therapy’s variation. Remote device monitoring confirmed HeartLogicTM Heart Failure Index normalization. In conclusion, the integration of remote monitoring with cardiology teleconsultation, enables to timely detect device malfunctions and prevent episodes of heart failure, avoiding further hospitalizations. This integration is even more useful and necessary in geographically disadvantaged areas, strengthening the link between the territory and the hospital, improving patients compliance and therapeutic adherence and thus allowing a progressive improvement of the symptoms and quality of life of heart failure patients.
C59 HEART RATE AT DISCHARGE AS INDEPENDENT LONG–TERM PREDICTOR OF ALL–CAUSE MORTALITY IN PATIENTS WITH ACS: INSIGHTS FROM THE APULIA PONTE ACS STUDY
Authors: Lisi F , Locuratolo N , Rutigliano D , Campanella C , Mancini L , Parisi G , De Gennaro L , Bonfantino V , Potenza A , Sasanelli P , Scicchitano P , Barletta A , Caldarola P 
Published: May 2022

Abstract

Background
Heart rate is able to impact on the prognosis if patients with cardiovascular diseases. The aim of this study was to evaluate the impact of heart rate at discharge of patients with ACS and/or coronary revascularization on long–term follow–up

Methods
This was a subanalysis of the PONTE ACS study. The PONTE ACS study is a prospective, longitudinal, cohort study which enrolled patients who were discharged from HUB centres of ASL BARI after coronary revascularization and/or ACS. They underwent clinical evaluation at 30 days, 3, 6 and 1 year–follow–up. The data were collected after including the data in the electronic medical record of the PONTE ACS study. Anthropometric, clinical and pharmacological parameters, instrumental and laboratory examinations were included. Data were computed in order to evaluate the major determinants of all–cause mortality at one–year follow–up.

Results
We finally enrolled 2476 patients (77.4% male, mean age: 67.2±12.0 years). Pharmacological treatments were optimized during the follow–up visits. Heart rate at discharge was 65.5 ± 11.3 bpm. At univariate regression analysis, age, systolic and diastolic arterial pressure, body mass index, smoke habit, diabetes, hypertension, high–density lipoprotein and total cholesterol, creatinine, haemoglobin, fasting glycemia, left ventricle ejection fraction, heart rate, use of ACEi/sartans, statins, dual/triple anti–thrombotics were all related to all–cause mortality. Nevertheless, at multivariate Cox regression analysis, age (β coefficient: 0.07117 ± 0.01942, p = 0.0002), history of hypertension (1.4823 ± 0.7476, p = 0.0474), and heart rate (0.04409 ± 0.01278, p = 0.0006) remained related to the primary endpoint.

Conclusions
Heart rate confirmed to act as a long–term predictor of all–cause death in patients with ACS.
C77 EFFECT OF SACUBITRIL/VALSARTAN ON BOTH METABOLIC PARAMETER AND INSULIN RESISTANCE IN NON OBESE NON DIABETIC PATIENTS WITH HEART FAILURE
Authors: Giofrè F , Ventura M , Sacchetta L , Arturi F , Clausi C , Pelle M , Zaffina I , Lucà S , Sciacqua A , De Rosa F , Arturi F , Cloro C 
Published: May 2022

Abstract

Background
Sacubitril/Valsartan has been shown to improve mortality and reduce hospitalizations in patients with heart failure with reduced ejection fraction (HFrEF). Moreover Sacubitril/Valsartan showed a significantly reduction in the HbA1c in diabetic patients. The effect of Sacubitril/Valsartan on metabolic parameter and insulin resistence in both, non obese and non diabetic patients, have not been previously described.

Aim
We evaluated the effects of the Sacubitril/Valsartan on both glycaemic and metabolic parameter, on HOMA–IR and on echocardiographic parameters in patients with HFrEF.

Methods
A total of 59 non obese and non diabetic patients with a diagnosis of HFrEF (EF &lt; 35%) have been enrolled. All the patients underwent a complete anthropometrical evaluation, laboratory determinations (including fasting glucose, fasting insulin, HbA1c) and echocardiogram evaluation. Data analysis was made after 24 weeks of treatment. The insulin resistance has been assessed by HOMA–IR.

Results
Data analysis demostrated a significant reduction in fasting plasma glucose (111.4 + 11.5 vs 106 + 10 mg/dl, P = 0.03), fasting plasma insulin (13.6 + 5.9 vs 10.5 + 4.4 µUI/ml), HbA1c value (6.14 + 0.5% vs 5.9 + 0.3%, P &lt; 0.01) and insulin resistance (HOMA–IR, 3.74 + 2.2 vs 2.7 + 2.1, P = 0.03). The echocardiogram evaluation showed a significant reduction of the end–diastolic left ventricular volume (168 + 44 vs 150 + 38 ml, P &lt; 0.05), a no significant reduction of the end–systolic left ventricular volume (98 + 26 vs 88 + 22 ml, P = 0.07), a significant reduction of E/e1 ratio and an average 7.8% increase in ejection fraction (EF), from a mean baseline of 32.3 + 2.4 to 40.1 + 3.8% (P &lt; 0.0001). No differences in interventricular septal (IVS) thickness, posterior wall (PW) thickness, A–wave, E–wave and E/A ratio have been observed. No differences in anthropometrical parameters (weight, body mass index, waist circumference) and blood pressure were observed.

Conclusions
Our data, even if preliminary, seem to indicate that sacubitril/valsartan might enhance glycaemic control and improve insulin resistance in non obese/non diabetic patients with HFrEF. Also, our data confirm that sacubitril/valsartan treatment is able to improve ejection fraction in HFrEF patients.
P14 PROCEDURAL SAFETY, SHORT AND LONG–TERM FOLLOW UP AFTER PACEMAKER IMPLANTATION IN NONAGENARIANS
Authors: Meynet I , Tricomi L , Ferraro A , Maggio R , Mazza A , Ceci R , Minniti D , Varbella F 
Published: May 2022

Abstract

Background
Permanent cardiac stimulation is increasingly necessary in very old patients, due to the augmented life expectancy. This raise concerns in physicians, patients and caregivers, because pacemaker (PM) implantation can be perceived as too invasive for frail patients with significant comorbidities. The aim of the present study is to provide data about peri–operative complications, short and long–term survival and their predictors in this specific setting.

Materials and Methods
All consecutive patients aged ≥ 90 years undergoing pacemaker implantation in our Centre from 2008 to 2020 were enrolled in the registry. Their baseline and follow up data were recorded in a specific database.

Results
Among the 2437 patients undergoing PM implantation in a 13–year period, 153 were nonagenarians (6.3%). Mean age was 92.7 ± 2.3 years. Most of the patients (66.7%) received a ventricular single chamber PM. High–degree atrio–ventricular block was the first indication for implant (59.5%), followed by sick sinus syndrome or atrial fibrillation with slow ventricular response (30.1%). 15.7% patients needed temporary pacing at presentation. 4 patients (2.6%) experienced acute complications: 3 pneumothorax, 1 ventricular lead displacement with need of repositioning. Mean follow up duration was 2.5 ± 2.0 years. 117 patients (78.5%) died during the follow up. Death occurred after a mean of 2.47 years after pacemaker implantation (range 1 – 3272 days). Survival rates were 70.0%, 35.3% and 10.0% at 1, 3 and 5 years respectively. No pacemaker–related long–term complication was recorded during the follow up. 2 patients underwent generator replacement due to battery end of life. Chronic kidney insufficiency (p = 0.030) and congestive heart failure (p = 0.021) but not age were predictors of precocious mortality (within 1 month). Age at implant and longer length of hospital stay before PM implantation were predictors of long–term death (p = 0.001 and p = 0.043 respectively).
P42 ASCENDING AORTIC DISEASE: IS CURRENT GENERAL PERCEPTION UPDATED TO CURRENT GUIDELINES ??
Authors: Totaro P , Sciortino A , Preda Z , Pelenghi S 
Published: May 2022

Abstract

Backgroud
Thoracic aorta diseases represent a frequent cause of hospitalization and up to 15% of workload of a modern Cardiac Surgery centre. To allow for an accurate monitoring of such activity a dedicated thoracic aorta diseases clinic was launched in January 2019 at our Division. Clinic was open for all new referrals (both by general pratictioner and different specialities clinic) as well as for follow–up of operated on patients. Here we report our analysis of new referrals during past 30 months.

Materials and Metods
237 overall patients were seen at clinic. 68 patients (29%) were new referrals; 23 patients (10%) were preoperative follow up and 145 (61%) were postoperative follow up. New referrals were divided in urgent referral (42 pts 62%) and scheduled referral (26 patients 38%). Out of 168 follow up, 22 (12%) were requested as urgent follow up. Majority of urgent new referral were from general pratictioner (21 pts 50%).

Results
Only 5 patients (2 urgent referral) had surgical indication at time of clinic assessment, according current guidelines. 23 patients (6 urgent referral) were in the so–called grey zone and required close follow–up). 40 patients (34 urgent referral) had no significant aortic diseases to require neither urgent specialist consultation or close follow–up. Out of 181 postoperative follow up, 12 patients required surgical re–intervention none of these were referred with matter of urgency. Despite 56% of new referral did not have recent CT scan evaluation, majority of new referral clearly showed moderate aortic dilatation especially in urgent referral (Fig 1). When considering indexed–dilatation, proportion of patient with moderate dilation raised even more (Fig 2).

Conclusions
Current perception of clinical severity of thoracic aorta diseases is still sub–optimal. Majority of patients are indeed referred as a matter of urgency despite non–significant aortic ectasia. On other hands, potentially dangerous situation are underestimated by the general practitioner and/or medical specialist. An accurate territorial policy of sensitization and updating about these pathologies is therefore essential to try to reduce the risks of acute aortic syndromes in our country.
P95 PERI–PROCEDURAL COMPLICATIONS AND LONG–TERM OUTCOMES IN ATRIAL FIBRILLATION PATIENTS STRATIFIED FOR CHRONIC KIDNEY DISEASE SEVERITY UNDERGOING LEFT ATRIAL APPENDAGE OCCLUSION: RESULTS FROM AN INTERNATIONAL, MULTICENTER REGISTRY
Authors: Magnocavallo M , Della Rocca D , Van Niekerk C , Gilhofer T , Ha G , D‘Ambrosio G , Galvin J , Urbanek L , Lavalle C , Schmidt B , Geller C , Lakkireddy D , Di Biase L , Price M , Mansour M , Saw J , Horton R , Gibson D , Natale A 
Published: May 2022

Abstract

Background
Atrial fibrillation (AF) and chronic kidney disease (CKD) often coexist and share an increased risk of thromboembolic events. CKD concomitantly contributes to several pathophysiological changes predisposing towards a pro–haemorrhagic state.

Objective
To evaluate the impact of kidney function on peri–procedural complications and clinical outcomes in AF patients undergoing left atrial appendage occlusion (LAAO) with a Watchman device.

Methods
2124 consecutive AF patients undergoing Watchman implantation at 8 different centers were categorized into CKD stage 1 + 2 (n = 1089), CKD stage 3 (n = 796), CKD stage 4 (n = 170), CKD stage 5 (n = 69) based on the estimated glomerular filtration rate at baseline. The primary efficacy endpoint included a composite of cardiovascular (CV) mortality, stroke, transient ischemic attack, peripheral thromboembolism (TE), and major bleeding.

Results
A non–significant higher incidence of major peri–procedural adverse events (1.7% vs. 2.3% vs. 4.1% vs. 4.3%) was observed with worsening baseline kidney function (p = 0.14). The mean follow–up period was 13 ± 7 months [2226 patient–years (PY)]. In comparison to CKD stage 1 + 2 as a reference, the incidence of the primary endpoint was significantly higher in CKD stage 3 (log–rank p–value= 0.04), CKD stage 4 (log–rank p–value= 0.01), and CKD stage 5 (log–rank p–value= 0.001) (Fig. 1A). A non–significant increase in event rates for stroke/TIA and clinically relevant bleeding was observed among the four groups. LAAO led to a TE risk reduction of 72%, 66%, 62%, and 41% in each group (Fig. 1B). The relative risk reduction in the incidence of major bleeding was 58%, 44%, 51%, and 52%, respectively (Fig. 1C).

Conclusion
Patients with moderate–to–severe CKD had a higher incidence of the primary composite endpoint. The relative risk reduction in the incidence of TE and major bleeding was consistent across CKD groups, irrespective of the very different risk profiles at baseline.
P151 RIGHT VENTRICULAR MECHANICS IN PATIENTS AFFECTED BY PULMONARY VALVE STENOSIS, BEFORE AND AFTER PERCUTANEOUS PULMONARY VALVULOPLASTY
Authors: Sirico D , Spigariol G , Mahmoud H. T , Basso A , Reffo E , Biffanti R , Sabatino J , Di Candia A , Castaldi B , Di Salvo G 
Published: May 2022

Abstract

Aim of the Study
To evaluate the mechanical changes of the right ventricle in patients undergoing balloon pulmonary valvuloplasty using transthstandard transthoracic echocardiography (TTE) and speckle–tracking echocardiography (STE) and to investigate the correlation between haemodynamic and echocardiographic parameters before and after treatment.

Materials and Methods
43 pediatric patients (19 males), mean age 3,2±4,9 years with severe pulmonary valve stenosis and indication for percutaneous balloon valvuloplasty were recruited. All patients underwent TTE and STE with analysis of right ventricle global longitudinal strain (RVGLS) one day before and after the procedure. For each patient were collected invasive parameters during balloon valvulopasty.

Results
After the procedure, there was an immediate reduction of both peak–to–peak transpulmonary gradient (Dp post) and ratio between the systolic pressure of right and left ventricle (RV/LV ratio) with a drop of 29,3±14,67mmHg and 0,43±0,03, respectively. Post–procedural echocardiography showed peak and mean transvalvar pressure gradient drop (50±32,23 and 31±17,97, respectively). The degree of pulmonary valve regurgitation was mild in 8% of patients before the procedure, following the intervention it reached 29% with a statistically significant increase (p = 0,007). However, moderate and severe regurgitation remained stable after the procedure. There was a significant improvement of Fractional Area Change (FAC) after the procedure (40,11% vs 44,42%, p = 0,01). TAPSE (p = 0,60) and longitudinal strain (p = 0,31), did not improve significantly after intervention. Finally, pre–procedural invasive RV/LV ratio showed good correlation to echocardiographic transvalvular peak and mean pressure gradient (R = 0,375, p = 0,019 and R = 0,40, p = 0,012, respectively), as well as with FAC (R = 0,31 p = 0,05), TAPSE (R = 0,62 p &lt; 0,001)and RVGLS (R = 0,46 p = 0,01)

Conclusions
Percutaneous balloon pulmonary valvuloplasty represents an efficient and safe procedure. Right ventricular global systolic function improved following afterload reduction, while longitudinal systolic function did not show improvement immediately after intervention. Finally, invasive preprocedural RV/LV ratio demonstrated better correlation with echocardiographic evaluation of stenosis degree and right ventricular function compared to invasive peak–to–peak pressure gradient. Therefore, RV/LV ratio should be preferred for the assessment of pulmonary valve stenosis.