bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single-centre experience with the Impella CP, in patients with cardiogenic shock
Authors: Jimenez Rodriguez GM , Kraaijeveld AO , Voskuil M , Vlachojannis GJ , Rittersma ZH , Stella PR 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Short-term percutaneous mechanical circulatory support devices are increasingly used in cardiogenic shock. The choice between Impella or extra-corporeal membrane oxygenation (ECMO) is still a matter of concern. The purpose of this work was to identify the characteristics and clinical outcomes of Impella CP in patients with cardiogenic shock in a real world setting.

Methods
A retrospective single center study was performed on all cardiogenic shock patients that were treated with Impella CP from January 01th 2020 to April 30th 2021, the primary outcome was 30-day mortality. Secondary endpoint was the occurrence of device-related complications (limb ischemia, access site-related bleeding or dissection, access site-related infection).

Results
We identified 16 patients with cardiogenic shock who underwent placement of an Impella CP device. 8 patients (50%) underwent support in the setting of previously known chronic heart failure and acute decompensation, 5 patients (31.2%) for the assistance of a recent acute myocardial infarction, 2 (12.5%) for high-risk PCI and one case (6.25%) of hemodynamic support for an acute rejection following heart transplantation. In 10 cases (62.5%) the main indication was bridge to decision. The combination of Impella and ECMO (ECPELLA) as a unloading therapy was used in 7 patients (43.7%). The 30-day mortality was 37.5%. There were three vascular complications (18.7%) two dissections and one vascular occlusion, solved with good final results.

Conclusions
The application of the Impella CP is feasible in profound cardiogenic shock in multiple scenarios with an acceptable rate of complications. More data is needed to extend and standardize its use.
Diagnostic value of cardiac magnetic resonance functional parameters to predict the presence of microvascular damage in the setting of reperfusion injury in STEMI
Authors: Igual Munoz BIM , Ferre Vallverdu MFV , Berenguer Jofesa ABJ , Rumiz Gonzalez ERG , Fernandez Diaz CFD , Gradoli Palmero JGP , Sepulveda Sanchez PSS , Ridocci Soriano FRS , Perez Bosca JLPB , Paya Serrano RPS 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
Microvascular damage is a poor prognostic factor after STEMI and is a goal to improve its diagnosis and treatment. The aim of this work is to analyze the value of cardiac magnetic resonance (CMR) functional parameters to predict the presence of microvascular damage in the setting of reperfusion injury.

Methods
A cohort of patients with acute STEMI was prospectively included and systolic and diastolic blood pressure at catheterization laboratory during reperfusion procedures were assessed . All patients underwent cardiac MRI during the first week post reperfusion with a standardized protocol including functional evaluation with b-SSFP sequences and also 8-10 short axis slices in IR-FGRE sequences assessing the area of necrosis as area of signal hyper intensity&gt; 5 Sds relative to the remote myocardium and microvascular obstruction (MVO) as signal hypointensity in the infarct core . Functional derived parameters as left ventricle (LV) and right ventricle (RV) volumes, mass and ejection fraction (LVEF, RVE ) , biventricular stroke volumes (SV), systolic and diastolic relative LV parietal mass ) and end systolic and diastolic pressure /volume (P/V) ratio were calculated and assessed in this clinical setting.

Results
94 patients with reperfused STEMI were included. Forty nine of them (51%) have microvascular obstruction detected by CMR. Univariate analysis was performed showing that presence of MVO was significantly related to LV and RV ejection fraction, LVSV, end systolic biventricular volumes , systolic P / V ratio and systolic relative parietal mass. Area under ROC curve and statistic significance of analyzed data was shown in the picture. A multivariate regression model adjusted by LV ejection fraction was performed showing that LVSV (CI: 0.6-0.8 p=0.02) and systolic P / V ratio (p=0.01 CI: 0.8-0.9) as the most powerful functional predictors improving diagnostic accuracy of MVO in this clinical setting.

Conclusions
In addition to LV ejection fraction, LV stroke volume and systolic P / V ratio were the most powerful functional predictors associated to presence of microvascular damage in the setting of reperfused STEMI.
Endothelial function improvement associated with the new European Society of Cardiology LDL target levels in STEMI patients
Authors: Stepura AO , Parkhomenko AN , Lutai YAM , Bilyi DO , Dovhan OV 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
According to current guidelines, statin therapy is indicated for all ACS patients regardless of the initial cholesterol level. However, the effects of different lipid-lowering regimes on endothelial function in patients after STEMI have been insufficiently studied.

Methods
The study involved 135 STEMI patients admitted an average of 4.5 hours after symptoms onset and treated with primary PCI. Lipid-lowering treatment was prescribed immediately after admittance. Patients were randomly assigned to one of two patients groups – 50 pts with intermediate (atorvastatin 10 mg /ezetimibe 10 mg or atorvastatin 40 mg), and 85 pts with high intensity treatment (atorvastatin 40 mg/ ezetimibe 10 mg or atorvastatin 80 mg). Endothelial function assessment by flow-dependent vasodilation (FDV) was performed on the 1st, 10th days of the hospital period and within the 90th day of onset of the disease.

Results
The average level of low-density lipoprotein cholesterol (LDL) on the 90th day in patients was 1,66 ± 0.11 mmol /l. On that time frame the growth of the diameter of the brachial artery and FDV were increased by 66.2% in patients who reached LDL cholesterol &lt;1.8 mmol/l and 85% in patients with LDL cholesterol &lt;1.4 mmol/l versus 26.8% in patients with LDL cholesterol ≥1.8 mmol/l, p&lt;0.05. Growth in the diameter of the brachial artery according to the results of the test with FDV more than 10% was statistically significant and more frequently observed in patients who reached the level of LDL less than 1.4 mmol /l on the 90th day (Fig.1).

Conclusions
Patients with STEMI who achieved a reduction in LDL cholesterol &lt;1.4 mmol/l on the 90th day of follow-up were more likely to have a complete recovery of endothelial function. It may be dependent on early initiation of high intensity lipid-lowering treatment.
Association between serum potassium levels and short-term mortality in out-of-hospital cardiac arrest survivors
Authors: Byrne C , Krogager ML , Kragholm KH , Pareek M , Mohr GH , Ringgren KB , Wissenberg M , Folke F , Gislason G , Koeber L , Lippert F , Torp-Pedersen C , Lip GYH , Barcella CA 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): The Danish Heart Foundation
The Danish Foundation TrygFonden

Background
Serum potassium levels outside the normal range are associated with increased short-term mortality in patients with acute cardiovascular disease such as acute heart failure. In survivors of out-of-hospital cardiac arrest (OHCA), the initial serum potassium concentration is often outside the normal range. However, it is unknown whether there is an association between initial serum potassium level and short-term mortality in OHCA survivors.

Purpose
The aim of this study was to describe potential associations between serum potassium level and 30-day survival in patients surviving OHCA.

Methods
We identified 1630 patients who had return of spontaneous circulation (ROSC) at hospital arrival, and a registered post-OHCA serum-potassium value, using Danish nationwide registry data from 2001-2015. Thirty-day survival was analyzed according to the following seven predefined potassium levels: &lt;2.5, 2.5-2.9, 3.0-3.4, 3,5-4.6, 4.7-5.5, 5.5-6.0, &gt;6.0 mmol/L. Thirty-day survival was estimated using a multivariable Cox regression (reference normokalemia 3.5–4.6 mmol/L). The multivariable model included age, sex, Charlson comorbidity index, witnessed status, performance of CPR and first registered heart rhythm.

Results
During 30-day follow-up, survival in the seven strata was 29 (55.8%), 52 (61.9%), 167 (63.3%), 543 (58.7%), 66 (35.5%), 12 (28.6%), and 18 (23.4%), respectively. Standardized average risk ratios (ARR) of 30-day survival was significantly lower for all groups with hyperkalemia compared with normokalemia: 4.7-5.5 mmol/L: (ARR: 0.86, 95% confidence interval (95% CI): 0.74–0.96); 5.5-6.0 mmol/L: (ARR: 0.76, 95% CI: 0.52–0.98); &gt;6.0 mmol/L: (ARR: 0.64, 95% CI: 0.50–0.79). Survival did not differ significantly in patients with hypokalemia compared with normokalemia: &lt;2.5 mmol/L: (ARR: 0.87, 95% CI: 0.68–1.06); 2.5-2.9 mmol/L: (ARR: 1.06, 95% CI: 0.93–1.19); 3.0-3.4 mmol/L: (ARR: 1.01, 95% CI: 0.93–1.10).

Conclusions
In OHCA survivors, hyperkalemia was associated with reduced 30-day survival compared with normokalemia. This association was independent of age, sex, Charlson comorbidity index, witnessed status, performance of CPR and first registered heart rhythm. Conversely, hypokalemia was not associated with reduced 30-day survival in this patient population.
Impact of high admission glucose on LV function and in-hospital heart failure in patients with AMI
Authors: Luvsansuren B , Chimed S 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Patients with acute myocardial infarction (AMI) often had high admission glucose, regardless previous history of diabetes mellitus (DM). Previous studies demonstrated that hyperglycemia in patients AMI is associated with adverse outcomes. In this study, we aimed to reveal relationship between high admission gluocse and in-hospital heart failure (HF) in patients with AMI.

Material and methods
Patients with AMI who treated by primary PCI were prospectively selected. Plasma glucose level is measured on admission in all patients. Hyperglycemia was defined as admission plasma glucose ≥11.1 mmol/l. In-hospital HF was defined according to the Killip classification. Multiple logistic regression analysis was used to assess relationship between admission glucose level and in-hospital HF.

Results
A total of 428 patients (59±13, 84% male) were included in this study. 122 patients had high plasma glucose (≥11.1 mmol/l) on admission and classified as a hyperglycemia. 306 patients had normal plasma glucose (&lt;11.1mmol/l) on admission and classified as a normoglycemia. Left ventricular global longitudinal strain was significantly impaired in patients with hyperglycemia compared with patients with normoglycemia (-13.8±4.4% vs. -15.7±3.7%, p&lt;0.001). Occurrence of in-hospital HF was significantly higher in patients with hyperglycemia compared with normoglycemia (30% vs. 21%, p&lt;0.05). In multivariable logistic regression analysis was showed that admission glucose level is independently associated with in-hospital HF after adjustment of age, gender, hypertension, previous myocardial infarction, previous heart failure, previous coronary artery disease, chronic kidney disease, heart rate, multivessel disease, LAD culprit vessel and final TIMI flow grade in non-diabetic patients (OR 1.10, 95% CI 1.02-1.18, p&lt;0.01). Furthermore, univariable logistic regression analysis revealed that every 1 unit increase of admission glucose level is associated with 1.07 fold increased probability of in-hospital HF (OR 1.07, 95% CI 1.01-1.15, p&lt;0.05) in non-diabetic patients.

Conclusion
Our results suggest that admission glucose level was independent predictor of in-hospital HF in patients with AMI. However, this relationship is only evident for non-diabetic patients.
Non-invasive hemodynamic evaluation following TAVI for severe aortic stenosis
Authors: Grinberg T , Aviv Y , Perl L , Wiessman M , Kornowski R , Orvin K 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Various hemodynamic changes occur following Transcatheter aortic valve implantation (TAVI) that impact treatment decisions. NICaS, a noninvasive whole-body bio-impedance monitoring system to assess hemodynamics and fluid balance, was tested in patients with severe aortic stenosis (AS) before and after TAVI.

Methods
Between October 2019 and December 2020 all consecutive patients with severe AS undergoing TAVI were assessed by NICaS at several time points – 24 hours before (baseline) and after the procedure, at hospital discharge and at 30 days to 1 year follow-up. Excluded were patients undergoing TAVI due to reasons other than severe AS, patients under general anesthesia and those who died at the catheterization lab or immediately following the procedure.

Results
We performed hemodynamic analysis on 97 consecutive patients who underwent TAVI using either Medtronic Evolut R (54%), Edwards Sapien 3 (32%) or SYMETIS ACURATE neo (13%). Patients were more often women (54%) and had multiple comorbidities including hypertension (83%), dyslipidemia (79%), coronary artery disease (46%), and diabetes mellitus (37%). Compared to baseline NICaS measurements, we observed increases in systolic blood pressure (BP) and total peripheral resistance (TPR) within 24 hours following TAVI (systolic BP 132.5±22.3 mmHg at baseline versus 148.4±23.9 mmHg after TAVI, P&lt;0.001; TPR 1754±520 versus 2094±752 dynes*s/cm5, respectively, P&lt;0.001) while cardiac output (CO), cardiac index (CI) and stroke volume (SV) decreased (CO 4.2±1.2 versus 3.9±1.2 L/min, respectively, P=0.013; SV 62±15 versus 56±15.8 mL, P=0.002). However, opposite trends were demonstrated exclusively in patients with ejection fraction (EF) under 40%. At follow-up (median 59 days, IQR [39.5-91]) these hemodynamic measurements returned to values that were not statistically different from the baseline, despite a significant improvement in EF from baseline to follow-up (55.6±11.6 to 59.4±9.4%, P&lt;0.001).

Conclusion
A unique pattern of short and longer term adaptive hemodynamic changes was demonstrated using the NICaS system among patients undergoing TAVI. These findings require validation and further research to their underlying mechanism if NICaS is to be used as a bedside monitoring tool to guide treatment decisions.
C - reactive protein is a promising indicator of ventricular arrhythmias in pacemaker patients
Authors: Jirak P , Mirna M , Wernly B , Hinterbuchner L , Hauptmann L , Fejzic D , Topf A , Lichtenauer M , Hoppe U , Hoefer K , Schernthaner C , Motloch L 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Ventricular tachyarrhythmias are the main reason for sudden cardiac death to date. Accordingly, tools for risk stratification for ventricular arrhythmias are paramount. Non-sustained ventricular tachycardia (nsVT) represents a predictor of malignant rhythm disorders. Recently, low grade chronic inflammation was shown to predict ventricular arrhythmic events in high risk patients. This study aims to investigate, if inflammatory markers may predict higher arrhythmia burden in a low risk population.

Methods
We prospectively analyzed ventricular arrhythmia burden in pacemaker records of 166 patients (age 79.2 9.3; male 60.2%, 38 with coronary artery disease (CAD)) with preserved ejection fraction (left ventricular ejection fraction≥50%) during a annually pacemaker follow up in a single center. To evaluate potential predictive factors, associations of laboratory values including inflammatory markers (CRP and interleukin 6) with occurrence of nsVT was evaluated using logistic regression. Sensitivity analysis in patients with and without established CAD was performed.

Results
The cumulative incidence of nsVT was 12.7%. Concentrations of BNP (OR 1.00 95%CI 0.99-1.01; p=0.46), troponin (OR 0.98 95%CI 0.95-1.02; p=0.43) or interleukin-6 (OR 1.03 95%CI 0.99-1.07; p=0.16) were not associated with the occurrence of nsVTs. However, the concentration of CRP was associated with increased odds of nsVT (OR 1.26 95%CI 0.97-1.64; p=0.09) in trend. In sensitivity analysis in CAD patients, CRP was associated with increased likelihood of nsVT (OR 3.89 95%CI 1.14-13.29; p=0.03), whereas in patients without CAD there was no association between CRP and rates of nsVTs (OR 1.16 95%CI 0.88-1.54; p=0.30).

Conclusion
Our study shows that inflammatory markers like CRP may be promising predictors of rhythm disorders CAD patients. While CRP was associated with increased odds for nsVTs in pacemaker patients with CAD, IL-6 did not show a significant correlation. This might be based on a more volatile expression of IL-6 while CRP represents a more stable parameter for inflammation.
Safety of SARS-CoV-2 vaccination in people with a history of acute myocarditis
Authors: Abou Saleh I , Hayek A , Azar L , Tomasevic D , Falque H , Prieur C , Kochly F , Bonnefoy-Cudraz E , Mewton N , Bochaton T 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
SARS-CoV-2 is a global health issue. Rare cases of myocarditis following SARS-CoV-2 vaccination have been reported in the literature.

Purpose
There is a lack of data regarding the risk of myocarditis recurrence after SARS-CoV-2 vaccination in patients with a history of myocarditis. We hypothesized that SARS-CoV-2 vaccination did not increase the risk of myocarditis recurrence in patients with prior history of myocarditis.

Methods
We selected all the patients hospitalized in our hospital for the last five years (from January 2016 to June 2021) with a diagnosis of acute myocarditis. Patients were contacted with a phone call to answer a standardized questionnaire on their vaccination status and events related to the vaccination to assess the safety of SARS-CoV2 vaccination in this population. Data concerning their vital status was collected in their centralized medical file.

Results
We enrolled 142 patients with prior history of confirmed acute myocarditis. 16 patients refused vaccination, 12 of them had a fear of myocarditis recurrence. There were no serious adverse events in the vaccinated group.

Conclusion
We showed that SARS-CoV-2 vaccination in patients with prior history of acute myocarditis is not associated with a risk of myocarditis recurrence or serious side effects. These results provide reassuring data that may incite patients with prior history of myocarditis to get vaccinated against SARS-CoV-2.
Age influence on the results of the treatment of complex coronary bifurcated lesions using the mini-crush two-stent technique
Authors: Sanchez Perez I , Moron Alguacil A , Freites Esteves A , Lozano Ruiz Poveda F , Concepcion Suarez R , Martinez Del Rio J , Munoz Garcia M , Negreira Caamano M , Aguila Gordo D , Mateo Gomez C , Soto Perez M , Cubides Novoa AF , Gonzalvez Garcia A 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
There is limited evidence about the benefit of "double stenting" techniques over "provisional stenting" in percutaneous coronary intervention (PCI) of complex coronary bifurcation lesions. Elderly patients (&gt;75 years) represent an unfavourable high-risk subgroup that have typically been under-represented in cardiovascular clinical trials.

Purpose
The aim of this study was to evaluate the influence of age on the rate of major adverse cardiovascular events (MACE): cardiovascular mortality, non-fatal myocardial infarction, target lesion revascularization (TLR) and stent thrombosis after prolonged follow-up (median 32 months).

Methods
Observational study in wich were included 152 consecutive patients (mean age 69.5 years, 73.7% male) with 152 complex bifurcated coronary severe lesions that underwent PCI with "mini-crush" two-stent technique and in which were compared the subgroup of elder patients (&gt;75 years) from April 2014 to April 2020.

Results
The 53.3% of patients had stable coronary disease and 46.7% acute coronary syndrome (30.1% Non-STEMI and 16.6% STEMI). 35% of patients were &gt;75 years old. We observed a significantly higher proportion of nonsmokers (51.2%), diabetics (38.8%) and hypertensive patients (75.3%). Clinical presentation, basal featured characteristics and antiplatelet pretreatment was similar in both groups. Mean Syntax score was higher in the older group (33.9 ± 13.7 vs. 28.1 ± 12.7, p=0.035). Left main bifurcation was the most frequently coronary artery affected in both groups and circumflex was the most common side vessel. There were no differences in pre-dilation rate either in final kissing balloon post-dilation rate. There were also no differences in the length and diameter of stents implanted and zotarolimus stent was the most commonly used in both groups as well as in the main vessel and in side branch. MACE incidence was higher in the older group (19.3% vs 8.4%, p=0.05), due to higher cardiovascular mortality (10.5% vs 2.1%, p=0.024). There were no differences in the remaining components separately.

Conclusions
Elderly patients with complex bifurcation coronary severe lesions treated with "mini-crush" technique had higher cardiovascular mortality at long-term follow-up compared with younger patients. There were no differences in other lesion-related outcomes.
Comparative validation of the GRACE 2.0 and EUROSCORE II for 6-month mortality risk estimation of patients with acute coronary syndrome undergoing urgent bypass graft surgery
Authors: Szabo D , Magyar L , Szabo A , Merkely B , Hizoh I 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The research was supported by the Ministry of Innovation and Technology NRDI Office within the framework of the Artificial Intelligence National Laboratory Program.

Background
According to the current NSTE-ACS guidelines, the GRACE 2.0 score is used for predicting mortality risk of patients with acute coronary syndrome regardless of treatment modality. However, mortality risk of patients requiring acute bypass graft surgery is usually assessed by the EUROSCORE II model.

Purpose
We aimed to validate comparatively the predictive ability of the two models in NSTE-ACS patients undergoing urgent bypass surgery.

Methods
We analysed data of 99 complete cases of an unicentre registry who underwent acute CABG surgery between 2013 and 2021. Patients were followed-up by means of hospital records, follow-up visits, and records of the National Health Insurance Fund. Besides analysis of the bootstrapped c-statistics, we constructed univariate Cox regression models and compared model fit using Fine’s partial likelihood ratio test for non-nested models. Statistical analysis was performed using R.

Results
Of the ninety-nine cases, two patients were lost to follow-up at 180 days (2.02%). The mortality rate was 16/97 (16.49%) with a c-statistic of 0.82 (95% CI: 0.70 to 0.92) and 0.72 (95% CI: 0.57 to 0.86) for the GRACE 2.0 and EUROSCORE II models, respectively (p=0.11). Analysis of the fitted univariate Cox models revealed that the two models are highly ‘distinguishable’ (p=0.0004, variance test). Yet, with this small sample size, the difference in model fit did not reach statistical significance in the non-nested partial likelihood ratio test (p=0.08, that GRACE 2.0 fits better than EUROSCORE II).

Conclusion
The GRACE 2.0 score may have a good predictive power to estimate 180-day mortality risk of acute coronary syndrome patients undergoing acute bypass surgery. Our preliminary data may raise the possibility that it also may outperform the EUROSCORE II. Nevertheless, to test this hypothesis with adequate statistical power, larger, preferably multicentre data are needed.