bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of combined hyperbaric oxygenation and erythropoietin therapy in treatment of heart failure
Authors: Mitrovic P , Tepic S 
Published: October 2022

Abstract

It well known that hyperbaric oxygenation (HBO) and erythropoietin (EP) are growth factors. Because of that, it is logical to apply them together as a therapeutic procedure in the regeneration and recovery of the heart muscle. Hyperbaric oxygen therapy has increased the amount of oxygen which “presents” to cardiac muscle, while the use of EP is reduced the intensity of apoptosis of heart muscle. The aim of this study was to analyze if combined therapy of HBO and EP can be usefulness in patients (pts) with heart failure (HF), especially in chronic type of HF.

Material and methods
The study was designed as a cross-sectional study in the field of new procedures of HF treatment. From January 2017 to January 2019, there were analyzed 92 patients (pts) with chronic HF. There were more men (69.6%). All pts were divided in two groups: Group I – 72 pts (78.3%) with ischemic HF and Group II – 20 pts (21.7%) with non-ischemic HF. Hyperbaric oxygen therapy protocol was defined as protocol for pts with sever cardiac diseases (total of 15 treatment, once daily, on pO2 1.3–1.7 ATA). Recombined EP was administered deeply subcutaneous, every second day 2000 IU, until dose of 18000 IU. In all pts, on admission and one month after therapy, next procedures were arranged: hemoglobin level, distribution of NYHA class, 6-minutes walking test and EF (by radionuclide ventriculography).

Results
There were no differences between two groups in gender (p=0.0170) and hemoglobin level before and after therapy (p=0.4400). There were significant changes in distribution of NYHA class in both group of pts, from NYHA class III to NYHA class I and II (p=0.0179) one month after therapy, as well as in 6-minutes walking test one month after therapy (p=0.0148), too. Ejection fraction was significantly better in both groups of pts, one month after therapy (p=0.0040).

Conclusion
The results of this study open up completely new aspects of the combined use of comparative therapeutic procedures with significant final positive effect in the treatment of chronic HF, ischemic, as well as in non-ischemic type of HF.

Funding Acknowledgement
Type of funding sources: None.
Device-based remote monitoring strategies for guided management of patients with heart failure: a systematic review and meta-analysis
Authors: Zito A , Princi G , Romiti G F , Basili S , Liuzzo G , Sanna T , Restivo A , Ciliberti G , Trani C , Burzotta F , Cesario A , Savarese G , Crea F , D'Amario D 
Published: October 2022

Abstract

Background
Preclinical predictors of worsening heart failure can be monitored by implanted devices and may support the management of patients with heart failure. However, clinical results of such an approach are controversial.

Purpose
We aimed to assess if guided heart failure management according to device-based remote monitoring strategies is more effective than standard therapy.

Methods
A comprehensive literature research for randomized controlled trials (RCTs) comparing a strategy of guided heart failure management versus standard therapy was performed on PubMed, Embase, and CENTRAL databases. Incidence rate ratios (IRRs) and associated 95% confidence intervals (CIs) were calculated using the Poisson regression model with random study effects. The primary outcome was a composite of all-cause death and hospitalizations for heart failure. Secondary endpoints included the individual components of the primary outcome.

Results
A total of 9216 patients from 14 RCTs were included. The average follow-up duration was of 16 months. Compared with standard therapy, guided heart failure management reduced the risk of the composite of all-cause death and hospitalizations for heart failure (IRR 0.86, 95% CI 0.79–0.94, p&lt;0.001), driven by a reduction in both all-cause death (IRR 0.88, 95% CI 0.77–1.00, p=0.049) and hospitalizations for heart failure (IRR 0.83, 95% CI 0.75–0.92, p&lt;0.001). Findings varied according to the type of parameters monitored, with haemodynamic-guided and multiparameter-guided strategies yielding favorable effects, while impedance-guided strategy was not able to provide significant benefits.

Conclusion
Device-based remote monitoring systems as a tool to guide the management of patients with heart failure were associated with a valuable reduction in the risks of death, hospitalizations for heart failure, and the composite of both, supporting their routine use in clinical practice.

Funding Acknowledgement
Type of funding sources: None.
Coffee consumption and cardiovascular health in the general population
Authors: Wenzel J , Senftinger J , Borof K , Ojeda F , Aarabi G , Beikler T , Mayer C , Behrendt C , Walther C , Zyriax B C , Twerenbold R , Blankenberg S , Nikorowitsch J 
Published: October 2022

Abstract

Background
Coffee, next to water the most widespread beverage, is attributed both harmful and protective characteristics concerning cardiovascular health. This study aimed to evaluate associations of coffee consumption with cardiac biomarkers, echocardiographic, and electrocardiographic parameters as well as major cardiovascular diseases.

Methods and results
We performed a cross-sectional analysis of 9,009 participants a large German population-based cohort study, enrolled between 2016 and 2018 median age 63 [IQR: 55; 69] years. Coffee consumption was classified into three groups: &lt;3 cups/day (low), 3–4 cups/day (moderate), &gt;4 cups/day (high). In linear regression analyses adjusted for age, sex, body mass index, diabetes, hypertension, and smoking, moderate and high coffee consumption were associated with LDL-cholesterol (β=2.08; 95% CI: 0.14, 4.03, p=0.036; β=5.69; 95% CI: 2.91, 8.47; p&lt;0.001). Moderate and high coffee consumption were negatively associated with systolic (β=−1.6; 95% CI: −2.66, −0.54; p=0.003; β=−2.63; 95% CI: −4.15, −1.12; p=0.001) and diastolic blood pressure (β=−0.8; 95% CI: −1.38, −0.22; p=0.007; β=1.28; 95% CI: −2.11, −0.45; p=0.002). Different levels of coffee consumption did neither correlate with any investigated electrocardiographic or echocardiographic parameter nor with prevalent major cardiovascular diseases, including prior myocardial infarction and heart failure.

Conclusions
In this cross-sectional analysis, moderate and high coffee consumption was positively associated with LDL-cholesterol and negatively associated with systolic and diastolic blood pressure. However, major cardiovascular diseases including heart failure and its diagnostic precursors were not associated with coffee consumption, connoting a neutral role of coffee in the context of cardiovascular health.

Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Deutsche Forschungsgemeinschaft [Grant Number TH1106/5-1; AA93/2-1]The Foundation Leducq [Grant Number 16 CVD 03]
Sodium glucose co-transporter 2 inhibition prevents muscle energy metabolism changes in infarcted rats
Authors: Souza L M , Brandao B B , Pagan L U , Gatto M , Rodrigues E A , Borim P A , Murata G M , Zornoff L A M , Okoshi K , Okoshi M P 
Published: October 2022

Abstract

Introduction
Skeletal muscle energy metabolism is commonly altered in heart failure patients, with a metabolic shift from oxidative to glycolytic muscle fiber. These changes contribute to reduced functional capacity. Sodium glucose co-transporter type 2 (SGLT2) inhibitors improve cardiovascular outcomes in both diabetic and non-diabetic patients, as well as those with and without heart failure. However, the effects of SGLT2 inhibitors on skeletal muscle during heart failure have not been established. The aim of this study was to assess the metabolic effect of empagliflozin (EMPA) on skeletal muscle of rats with myocardial infarction (MI)-induced heart failure.

Methods
One week after MI induction or simulated surgery, male Wistar rats were divided into four groups: Sham (n=10), Sham+Empa (n=12), MI (n=10), and MI+Empa (n=09). EMPA was added to rat chow (5 mg/kg/day). Rats were supplied with ad libitum water and chow for 12 weeks. Infarct size was measured by histological analysis. Metabolic enzyme activity in the soleus muscle was assessed by spectrophotometry. Statistical analysis: ANOVA and Tukey, and Student's t tests.

Results
Only rats with infarction size greater than 35% of total left ventricle area were included in this study. Infarction size did not differ between infarcted groups (MI 41.8±4.2; MI+Empa 40.7±5.7 of total left ventricle area). In the MI soleus muscle, metabolic enzyme activity of glucose-6-phosphate-dehydrogenase, citrate synthase and beta-hydroxy-acyl-dehydrogenase was higher than the Sham group. These changes were not observed in the MI+Empa group. MI+Empa had lower hexokinase, phosfructokinase, and pyruvate kinase activity (glycolytic metabolism enzymes), and lower citrate synthase and glucose-6-phosphate-dehydrogenase activity than MI.

Conclusion
Chronic treatment with SGLT2 inhibitor empagliflozin prevents metabolic abnormalities in skeletal muscle in infarcted rats.

Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): CAPES, CNPq, FAPESP
The I4RON-HF study, Intravenous Iron Isomaltoside for Inpatients veRsus Outpatient Asians with Heart Failure
Authors: Lee T , Teh K C , Sundram R , Ariff A , Roslan A , Sundarajoo M , Low M Y , Ong C S H , Goay S E , Palaniappan G , Norasiah N , Syamira N , Fatini N , Ghazi A 
Published: October 2022

Abstract

Background and purpose
Iron deficiency (ID) impacts ∼50% of heart failure (HF) patients [1] and is a risk factor and strong predictor for death and mortality with or without anaemia [2]. Oral iron appears to be ineffective whilst intravenous iron (IV-iron) has proven to be efficacious however data is primarily from a Caucasian population [3] despite ID being more prevalent amongst Asians. The I4RON-HF study assesses efficacy of high-dose IV-iron versus oral iron in stable outpatients and inpatients amongst an Asian population recovering from episodes of decompensated HF.

Methods
This is a single-centre randomized controlled study, where patients who had symptomatic heart failure (Ejection Fraction &lt;50% and New York Heart Association class 2–3) were randomized into two groups. The intervention arm received anywhere from 500mg to 1500mg of IV Iron Isomaltoside as a single infusion, whereas the control arm received routine iron supplements.
The primary study endpoint was the percentage of patients achieving iron repletion at 4,8 and 12 months after enrolment. Secondary endpoints included clinical parameters (6-minute walk test, NYHA status and 2D-Echocardiogram), and biochemical parameters (Serum NTproBNP, Cardiac Troponin-T and hemogloblin) at 4,8 and 12 months.

Results
A total of 65 patients were enrolled (male 55%), 33 in the interventional arm and 32 in the control arm. There were no patients lost to follow up. 96.9% of patients in the IV Iron arm achieved the primary endpoint at 4 months, compared to 68.7% in the control group. These findings we consistent at 8 months (90.9% vs 65.6%) and 12 months (90.9% vs 56.2%). Looking at the secondary endpoints, the IV Iron cohort recorded a 11.14% increase in Hemogloblin levels versus the control arm which recorded a reduction of 16.23%. There was also lower NTproBNP levels in the IV iron group (81.6% reduction) versus the control group (66.3% reduction). Clinically, the patients who received IV iron had a 42.98% increase in their 6-minute walk test from baseline, compared to an increase of 8.61% in the control arm. There were no significant echocardiographic changes.

Conclusion
These findings in our single-centre study support the efficacy of IV iron over oral supplements in the treatment of iron deficiency amongst Asian heart failure patients. The secondary endpoints also indicate better clinical and biochemical outcomes when iron stores are successfully repleted. Lastly, this study demonstrates the feasibility and safety of outpatient administration of high-dose IV-iron. Results from large-scale clinical studies looking at hard endpoints (mortality, HF hospitalization) are expected to further advance understandings.

Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): National Heart Institute (Institut Jantung Negara) FoundationCompai Pharma
Critical roles of Parkin and PINK1 in antiviral immunity and protection from cell death in Enterovirus-induced viral myocarditis
Authors: Jin U , Park S J , Park S M 
Published: October 2022

Abstract

Background
Myocarditis is an inflammatory disease of the heart muscle often resulting in cardiac dysfunction and death. One of the most common causes is a cardiac infection with viruses, especially with enteroviruses of the Coxsackievirus B (CVB) family. CVB3-induced viral myocarditis is a well-established model to elucidate viral myocarditis in mice. It is assumed that mitochondrial damage control and mitochondria-associated innate immunity is essential for defence against viral infection of the heart muscle. And Parkinson's disease genes Parkin and PINK1 are well known for their critical function in mitochondrial homeostasis and damage control. We investigated the roles of Parkin and PINK1 in CVB3-induced viral myocarditis mouse model.

Material and methods
Male C57BL/6J WT, Parkin KO and PINK1 KO mice were used in an age of 8 to 12 weeks. The animals were injected intraperitoneally with 1x104 plaque forming units of CVB3 diluted in phosphate-buffered saline. Control and survived virus-infected mice were sacrificed for tissue sampling at day 7 to investigate imaging and molecular workup.

Result
After virus inoculation, the Parkin KO and PINK1 KO groups showed a significantly lower 28-day survival rate compared with the WT group (p&lt;0.001 in Parkin KO; p&lt;0.001 in PINK1 KO). Evans-Blue Dye (EBD) staining image of day 7 after virus-infection showed that the hearts of Parkin KO and PINK1 KO mice were more severely damaged than the hearts of WT mice (3.2-fold, p&lt;0.01 in Parkin KO; 2.6-fold, p&lt;0.05 in PINK1 KO). H&E staining showed that severe inflammatory reaction occurred in the hearts of WT mice, although the inflammatory reaction was much lower compared to WT in the hearts of Parkin KO and PINK1 KO mice (p&lt;0.001 in Parkin KO; p&lt;0.001 in PINK1 KO). In immunohistochemistry, EBD staining positive area colocalized well with CVB3 in Parkin KO and PINK1 KO mice hearts, although EBD staining positive area was rare and didn't colocalized well CVB3 in WT mice hearts. mRNA levels of cell markers (CD3, natural cytotoxicity receptors, F4/80), inflammatory cytokines (IL-1β, IL-6, TNF-α), type II interferon, macrophage-derived protective factors, and CXCL10 family cytokines were lower in virus-infected Parkin/PINK1 KO mice than WT mice. Western blots showed that phospho-p65 increased less than WT in the heart of Parkin KO (0.7-fold, p&lt;0.05) and PINK1 KO mice (0.58-fold, p&lt;0.05).

Conclusion
The Parkin KO and PINK1 KO mice showed a higher mortality rate and more severe cardiomyocyte damage than the WT mice in the viral myocarditis mouse model. Parkin and PINK1 is critical to the type II IFN pathway that inhibits virus replication. And Parkin and PINK1 play an important role in the recruitment of IFN-γ-producing lymphocytes through NF-κB pathway and CXCL10 family chemokines.

Funding Acknowledgement
Type of funding sources: None.
Intracardiac echocardiography-guided left atrial appendage occlusion: descriptive analysis
Authors: Grazina A , Cardoso I , Viegas J M , Albuquerque F , Ferreira A , Santos A R , Teixeira B , Ferreira V , Fiarresga A , Ramos R , Cacela D , Moura Branco L , Galrinho A , Cruz Ferreira R 
Published: October 2022

Abstract

Introduction
Oral anticoagulants are the standard treatment for prevention of stroke in patients with atrial fibrillation (AF). However, some patients still have stroke despite anticoagulation or have contraindications to anticoagulation. The left atrial appendage occlusion (LAAO) is an option for those patients. The use of intracardiac echocardiography (ICE) instead of Transesophageal echocardiography guiding LAAO procedures has increased, allowing to reduce the use of general anesthesia.

Objectives
The aim of this study is to describe data regarding safety and efficacy in patients submitted to ICE-guided LAAO.

Methods
In a tertiary center, patients submitted to ICE-guided LAAO were identified. Information regarding baseline characteristics, procedure technical success, complications, hospitalization and follow-up data was noted retrospectively. The registered stroke and bleeding rates were compared with predicted rates using CHA2DS2-VASc and HAS-BLED scores, respectively.

Results
45 patients underwent ICE-guided LAAO, mean age 75.5±9.6 years old, 71.1% male (detailed characteristics in table 1). Permanent AF was present in 68.9% (n=31), with average CHA2DS2-VASc and HAS-BLED scores of 4.0±1.4 and 3.6±1.1, respectively (predicting a stroke risk of 4.0% per year and a major bleeding risk of 8.7% per year). The LAAO indication was previous major bleeding in 64.4% (n=29), high bleeding risk in 24.4% (n=11) and embolic events despite therapeutic anticoagulation in 11.1% (n=5). The LAAO devices were implanted successfully in 96% of the patients (n=43). It was noted a complication rate of 8.8% (n=4), perforation in 4.4% (n=2), device embolization in 4.4% (n=2, one of them leading to cardiac arrest and death) and no major vascular complications occurred. No other procedure-related deaths occurred. The average duration of hospitalization after the procedure was 5.7 days. All patients were followed-up for a mean period of 19.0 months. During that period, another death (2.2%) occurred with a non-cardiac cause and the re-hospitalization rate was 26.7% (n=12), 11.1% (n=5) for cardiac causes. During the same period, 1 stroke (2.2%) and 6 major bleeding (13.3%) occurred – yearly rates of 1.4% and 8.4%, respectively. The stroke rate is markedly inferior to predicted by the score and the major bleeding is slightly inferior to predicted.

Conclusions
This study provides data about the safety and mainly about the efficacy of the LAAO guided by ICE in a cohort of patients with high hemorrhagic and embolic risk.

Funding Acknowledgement
Type of funding sources: None.
In-hospital glycemic variability and all-cause mortality in patients hospitalized with acute heart failure: analysis of the KorAHF registry
Authors: Chun K H , Oh J , Lee C J , Kang S M 
Published: October 2022

Abstract

Introduction
Glycemic variability (GV) is known to be a poor prognostic marker in various diseases including cardiovascular disease.

Purpose
We investigated the association of GV with all-cause mortality in patients with acute heart failure (HF).

Methods
The Korean Acute Heart Failure registry enrolled patients hospitalized for acute HF from 2011 to 2014. Among survivors of the index hospitalization, we analyzed those who had ≥3 blood glucose measurements before discharge. Patients were divided into two groups based on their coefficient of variation (%CV) as an indicator of GV. We investigated all-cause mortality at 6 month and 1 year after discharge.

Results
The study analyzed 2,617 patients (median age 72 years, 53% male). During the median follow-up period of 11 months, 583 (22%) patients died. Compared to alive patients, patients who died had a significantly higher diabetes prevalence (46% vs. 41%, P=0.035) and higher %CV (31.0% vs. 27.5%, P&lt;0.001). Kaplan-Meier curve analysis revealed that a high GV (%CV &gt;21%) was associated with lower cumulative survival to all-cause death compared with a low GV (%CV ≤21%) (log-rank P&lt;0.001). Multivariate Cox proportional analysis showed that a high GV was associated with an increased risk of 6-month mortality (hazard ratio [HR] 2.02, 95% CI 1.58–2.59, P&lt;0.001) and one-year mortality (HR 1.57, 95% CI 1.29–1.91, P&lt;0.001). The risk of high GV for one-year mortality was significant in non-diabetic patients (HR 1.98, 95% CI 1.55–2.53, P&lt;0.001), but not in diabetic patients (HR 1.24, 95% CI 0.91–1.69, P=0.176; P-for-interaction=0.030).

Conclusion
A high GV (%CV &gt;21%) before discharge was associated with all-cause mortality within 1 year, especially in non-diabetic acute HF patients.

Funding Acknowledgement
Type of funding sources: None.
Derivation and validation of a machine learning-based risk prediction model for in-hospital mortality in patients with acute heart failure
Authors: Misumi K , Matsue Y , Nogi K , Kitai T , Oishi S , Suzuki S , Yamamoto M , Kida T , Okumura T , Nogi M , Ishihara S , Ueda T , Kawakami R , Saito Y , Minamino T 
Published: October 2022

Abstract

Background
Although risk stratification is important in patients with acute heart failure (AHF) to predict patient prognosis, pre-existing risk models have not often been used due to its complexity. Recently, machine learning methods have been presented as an alternative approach to analyzing the predictive probability of large clinical datasets.

Purpose
The aim of this study is to develop a user-friendly risk score developed by one of machine learning methods and compare the performance of the new risk score to the existing conventional risk models.

Methods
A machine-learning-based risk model was developed using least absolute shrinkage and selection operator (LASSO) regression by identifying predictors of in-hospital mortality in the derivation cohort (REALITY-AHF) and externally validating and comparing its performance with two pre-existing risk models: the Get With The Guidelines risk score incorporating brain natriuretic peptide and hypochloremia (GWTG-BNP-Cl-RS) and the acute decompensated heart failure national registry (ADHERE) risk model.

Results
In-hospital deaths in the derivation and validation (NARA-HF) cohorts were 76 (5.1%) and 61 (4.9%), respectively. The risk score comprised four variables (systolic blood pressure, blood urea nitrogen, serum chloride, and C-reactive protein) and was developed according to the results of the LASSO regression weighting the coefficient for selected variables using a logistic regression model (4V-RS). Even though 4V-RS comprised fewer variables, In the validation cohort, it showed a higher area under the receiver operating characteristic curve (AUC) than the ADHERE risk model (AUC, 0.783 vs. 0.740; P=0.059) and a significant improvement in net reclassification (0.359; 95% CI, 0.10–0.67; p=0.006). 4V-RS performed similarly to GWTG-BNP-Cl-RS in terms of discrimination (AUC, 0.783 vs. 0.759; p=0.426) and net reclassification (0.176; 95% CI, −0.08–0.43; p=0.178).

Conclusions
The 4V-RS model comprising only four readily available data points at the time of admission performed similarly to the more complex pre-existing risk model in patients with AHF.

Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Cardiovascular Research Fund