tbuckley/cabot-search huggingface dataset:
Hypertension
Authors: Matthew R. Weir
Journal: Annals of Internal Medicine (2014)

This issue provides a clinical overview of Hypertension focusing on prevention, diagnosis, treatment, practice improvement, and patient information. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including ACP Smart Medicine and MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic from these primary sources in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of science writers and physician writers. Editorial consultants from ACP Smart Medicine and MKSAP provide expert review of the content. Readers who are interested in these primary resources for more detail can consult http://smartmedicine.acponline.org, http://mksap.acponline.org, and other resources referenced in each issue of In the Clinic.
Abstract 18540: Lifelong Exercise Training Results in a Dose Dependent, Upward Shift of the Frank-Starling Relationship in Healthy Seniors
Authors: Paul S Bhella, Jeffrey L Hastings, Naoki Fujimoto, Shigeki Shibata, Graeme C Carrick-Ranson, Nainesh K Gandhi, Benjamin D Levine
Journal: Circulation (2010)

Background: Masters' athletes, highly competitive seniors who train 6-7 sessions per week, benefit from an upward shift of the Frank-Starling relationship when compared to sedentary seniors (Circulation. 2004;110:1799-1805). However it is not clear how much training necessary to achieve this improvement in ventricular performance; defining this dose-response relationship was the focus of this study. Methods: Subjects (age > 65; n=86, 60 M, 26 F) were recruited from the Aerobics Center Longitudinal Study, a well validated cohort which has prospectively documented lifelong exercise training patterns in subjects for 25 years and regional race results. Subjects were stratified into four groups based on their history of exercise training: ‘Group 1' <2 sessions/wk (n=27); ‘Group 2' 2-3/wk (n=15); ‘Group 3' 4-5/wk (n=24); and ‘Group 4' 6-7/wk plus regular competitions (n=20). All subjects underwent right heart catheterization, echocardiography and cardiac output (Qc) measurement (foreign gas rebreathing). PCWP, ...
Abstract 62: Resuscitation with Actual Performance Integrated Debriefing (RAPID) Improves CPR Quality and Initial Patient Survival
Authors: Dana P Edelson, Barbara Litzinger, Vineet Arora, Salem Kim, Diane S Lauderdale, Terry L Vanden Hoek, Lance B Becker, Benjamin S Abella
Journal: Circulation (2007)

Introduction Recent investigations have documented poor cardiopulmonary resuscitation (CPR) performance in clinical practice. We hypothesized that a debriefing intervention using CPR quality data from actual cardiac arrests (Resuscitation with Actual Performance Integrated Debriefing, or RAPID) would improve CPR performance and initial patient survival. Methods Rescuers at a university teaching hospital underwent weekly RAPID sessions between March, 2006 and February, 2007. During the intervention period, facilitators led debriefing discussions using actual performance data, obtained from a CPR-sensing defibrillator with audiovisual feedback capability, and highlighted deficiencies in CPR quality and defibrillation. These data were compared to an historical control in which a similar defibrillator was used. The main outcomes were objective metrics of CPR performance and initial return of spontaneous circulation (ROSC). Results CPR quality and outcome data from 123 patients resuscitated during the intervention period were compared to 101 patients in the baseline cohort. Compared to the control period, CPR quality parameters and defibrillation accuracy were improved (table ). These were associated with a significant improvement in the unadjusted rate of ROSC (table ). After adjusting for shockable vs. non-shockable rhythm, time and location of arrest, and patient demographics, the RAPID intervention was associated with a significant increase in the adjusted odds of ROSC (OR 1.84 [1.06 –3.20]; p=0.03). Conclusions The combination of RAPID and real-time audiovisual feedback improved CPR quality over the use of feedback alone, and was associated with an increased rate of ROSC. CPR sensing and recording devices allow for methods of debriefing that were previously available only for simulation based education; such methods have the potential to fundamentally alter resuscitation training and improve patient outcomes. Resuscitation Performance and Patient Outcomes by Cohort
Prognostic impact of surgery and radiofrequency ablation on single nodular HCC ⩽5 cm: Cohort study based on serum HCC markers
Authors: Masaki Ueno, Shinya Hayami, Yoshinobu Shigekawa, Manabu Kawai, Seiko Hirono, Ken-ichi Okada, Hideyuki Tamai, Naoki Shingaki, Yoshiyuki Mori, Masao Ichinose, Hiroki Yamaue
Journal: Journal of Hepatology (2015)
Abstract 2939: Short Term Effects of Cardiac Resynchronisation Therapy on Right Ventricular Function
Authors: Maxime Cannesson, Erwan Donal, Helene Thibault, Sophie Thivolet, Laura Ernande, Martine Barthelet, Christophe Leclerq, Jean-Claude Daubert, Philippe Mato, Genevieve Derumeaux
Journal: Circulation (2006)
Ponatinib As Initial Therapy For Patients With Chronic Myeloid Leukemia In Chronic Phase (CML-CP)
Authors: Jorge E. Cortes, Gautam Borthakur, Naveen Pemmaraju, Naval Daver, Alfonso Quintas-Cardama, Farhad Ravandi, Evguenia Gachimova, Zeev Estrov, Elias Jabbour, Susan O'Brien, Hagop Kantarjian
Journal: Blood (2013)
Abstract 18292: Influence Of RV Diastolic Physiology On LV Diastolic Filling In Children After Tetralogy Of Fallot Repair. Restrictive RV Physiology Is Associated With Decreased LV Compliance
Authors: Nauman Ahmad, Paul Kantor, Lars Grosse-Wortmann, Mark K Friedberg, Luc Mertens
Journal: Circulation (2010)

Background: Restrictive RV physiology is a common finding after Tetralogy of Fallot repair. RV filling characteristics may influence LV filling via diastolic ventriculo-ventricular interactions. Th...
Abstract 2055: A Fingertip-Mounted Ultrasound Probe for Open-Chest Echocardiographic Imaging During Heart Surgery: Pilot Studies with a New Scanning Method
Authors: Ling Hui, Ronald W Schutz, Scott Corbett, Evan Dudik, Shelly Kinnune, David J Sahn
Journal: Circulation (2007)

Background: We report a newly developed fingertip-mounted ultrasound probe (SonicEye®), which has been applied to an open-chest intraoperative imaging study. This probe is small, flexible, and quickly detachable. Its intuitive positioning makes it easy to acquire images in standard as well as unique views including views from the diaphragmatic surface of the left ventricle and behind the left atrium with a “heads up” that can be easily viewed by the surgeon while looking at the heart and the probe. Methods: In an open-chest study of two 12–14 kg piglets, the finger-mounted (11 mm radius, 4 – 6 MHz) and a conventional phased array ultrasound probe (Siemens 7V3C, 4 – 6 MHz) were used for scanning on a Siemens Cypress system. Images were recorded and analyzed for quality of image offline. Results: The fingertip-mounted ultrasound probe had the same performance as the conventional ultrasound probe as regards to image quality and Doppler performance. Furthermore, the probe could provide unique views from behind the left atrium and/or under the diaphragmatic surface of the left ventricle that even TEE does not match. Conclusions: The fingertip-mounted probe was able to capture high quality images during our study. This probe is easy to wear and provides high resolution unique images which should be useful for intraoperative evaluation of cardiac repairs.
Abstract 1425: The Popeye Domain Containing 2 (Popdc2) Gene is Essential for Sinus Node Function
Authors: Thomas Brand, Alexander Froese, Stephanie S Breher, Jan Schlueter, Christoph Waldeyer, Bettina Kirchmaier, Juliane Kuhtz, Angela Torlopp, Franz Vauti, Thomas D Mueller, Christoph W Winkler, Thorsten Schwerte, Hans-Henning Arnold, Paulus Kirchhof, Larissa Fabritz
Journal: Circulation (2008)
A Prospective Randomized Trial of Everolimus-Eluting Stents Versus Bare-Metal Stents in Octogenarians
Authors: Adam de Belder, Jose M. de la Torre Hernandez, Ramon Lopez-Palop, Peter O'Kane, Felipe Hernandez Hernandez, Julian Strange, Federico Gimeno, James Cotton, Jose F. Diaz Fernandez, Pilar Carrillo Saez, Martyn Thomas, Eduardo Pinar, Nick Curzen, Jose A. Baz, Nina Cooter, Inigo Lozano, Nicola Skipper, Derek Robinson, David Hildick-Smith
Journal: Journal of the American College of Cardiology (2013)
Abstract 1874: Circumferential and Radial Left Ventricular Mechanics in Elderly Canines with Hypertensive Heart Disease
Authors: Josef Korinek, Brian P Shapiro, Carolyn S Lam, Donna M Meyer, Margaret M Redfield
Journal: Circulation (2007)

Introduction: Cross-sectional studies in patient with hypertensive heart disease (HHD) and heart failure with normal ejection fraction (HFnlEF) suggested impairment of longitudinal myocardial mechanics as assessed by tissue Doppler imaging. It has been suggested that enhanced circumferential, and/or radial LV mechanics or LV remodeling compensates for depression in longitudinal function and thus, preserves EF in HHD or HFnlEF. Hypothesis : We hypothesized that if longitudinal performance is depressed, whether due to increased afterload or to intrinsic myocardial dysfunction, circumferential and radial LV mechanics would also be effected. To test this hypothesis, we used an aged canine model of hypertension. Methods: Elderly dogs (n=22) underwent bilateral renal wrapping to induce hypertension. 2D echocardiography (mid-short axis views) was performed before and 8 weeks after renal wrapping; peak radial (PR) and peak circumferential (PC) regional strains were measured by speckle tracking averaging data from 6 segments. Ejection fraction (EF), LV mass index (LVMI), systolic blood pressure (SBP), and circumferential wall stress (CWS) were assessed as well. Results : See table . PR correlated with PC (r=0.65), EF (r=0.67), LWMI (r=0.71) and CWS (r=0.58) (p&lt;0.005 for all). PC correlated also with EF (r=0.60), LWMI (r=0.49) and CWS (r=0.48) (p&lt;0.01 for all). The relationship between EF and CWS (r 2 =0.64, p&lt;0.001) was modified by the addition of either PC (r 2 =0.74, p for PC =0.005) or PR strain(r 2 =0.69, p for PR =0.04). Conclusions : These data show that development of hypertension with LV hypertrophy does not enhance but impairs circumferential and radial LV mechanics as assessed with strain imaging, and that like EF, circumferential and radial strain are related to afterload (wall stress). However, both confer additional information regarding contractility. Conclusions regarding myocardial function based on strain imaging must account for its load dependence.
Optimal age for starting lipid lowering treatment
Authors: W. G Simpson
Journal: BMJ (2000)

<h3>Abstract</h3> Diet-induced obesity (DIO) leads to dysfunctional feeding behavior. But the precise molecular nodes that are dysregulated by DIO that alter satiety sensing and feeding motivation are not fully disentangled. The fruit fly is a simple genetic model system yet displays significant evolutionary conservation to mammalian nutrient sensing and energy balance. Using a longitudinal high sugar regime in <i>Drosophila</i>, we sought to address how lipid alteration in fat cells alters feeding motivation. We find that long-term exposure to an HSD increases baseline feeding in flies. However, prolonged exposure to HSD degrades the hunger-driven feeding (HDF) response. Lipidomics analysis reveals that longitudinal exposure to HSD significantly alters whole body phospholipid profiles. Then, performing a systematic screen for phospholipid enzymes, we identify a specific enzyme, PECT, a rate-limiting enzyme in the phosphatidylethanolamine (PE) biosynthesis pathway and the fly ortholog of human PCYT2, was critical to maintaining hunger-driven feeding motivation. We show that disrupting PECT only in the fat body causes insulin-resistant phenotypes and a loss of hunger-driven feeding. Excitingly, we find that overexpression of PECT restores HSD induced loss of hunger-driven feeding response. Strikingly human studies have noted a correlation between PCYT2/PECT levels and clinical obesity. Now, our unbiased studies in <i>Drosophila</i> provide specific genetic evidence for PECT in maintaining nutrient sensing during DIO. Our study provides novel insights on the role of phospholipids in interorgan communication of nutrient status.
Abstract 19032: Anatomic Isolation of Core Elements of Circuit Substrate with Ablation Eliminates Multiple Scar Based Ventricular Tachycardias
Authors: Wendy S Tzou, Timothy Hegeman, David S Frankel, William H Sauer, Francis E Marchlinski
Journal: Circulation (2014)

Introduction:  Radiofrequency ablation (RFA) of multiple or unmappable ventricular tachycardias (VT) remains a challenge with unclear endpoints. We present our experience with a new strategy isolating core elements of VT circuits.   Methods:  Patients with structural heart disease presenting for VT RFA at 2 centers were included. Strategy involved entrainment/activation mapping if VT was hemodynamically tolerated, and/or voltage mapping with electrogram analysis and pace mapping. Core isolation (CI) was performed incorporating putative isthmus and early exit site(s) based on standard criteria (panel A). If VT was noninducible, the dense scar (   Results:  44 patients undergoing CI were included (mean age 63, 95% male, 73% ischemic cardiomyopathy, mean LVEF 31%, 68% with multiple unstable VTs (mean 3+2)). CI area was 11+12 cm2, vs. 55+40 cm2 total scar area. Additional substrate modification was performed in 27 (61%), and epicardial RFA was performed in 4 (9%). CI was achieved in 37 (84%) and led to better VT free survival (log rank p=0.013), as well as added incremental benefit to acute VT noninducibility in improving long-term ablation success (panels B and C).   Conclusion:  “Core isolation” is a novel strategy with a discrete and measurable endpoint beyond VT inducibility to treat patients with multiple and/or unmappable VTs. The CI region can be selected based on standard characterization of suspected VT isthmus surrogates thus limiting ablation target size. Exit block within the isolated area is achievable in most and may further improve long-term success.
Abstract 638: A Novel Mutation In The <i>KCR1</i> Gene May Influence Susceptibility To The Acquired Long QT Syndrome
Authors: Kenshi Hayashi, Hidekazu Ino, Noboru Fujino, Katsuharu Uchiyama, Eiichi Masuta, Akira Funada, Yuichirou Sakamoto, Toshinari Tsubokawa, Toshihiko Yasuda, Honin Kanaya, Min Young Kim, Sabina Kupershmidt, Haruhiro Higashida, Masakazu Yamagishi
Journal: Circulation (2007)

Introduction : Acquired QT interval prolongation and torsade de pointes can be caused by exposure to certain drugs, electrolyte imbalance, and myocardial ischemia. Acquired LQTS is more prevalent than the congenital LQTS and represents a significant problem for public health. Previous reports showed that K + channel regulator 1 (KCR1), an α glucosyltransferase, diminishes HERG drug sensitivity , and that a KCR1 polymorphism, Ile447Val, is associated with protection against drug-induced LQTS in humans. However, few studies address the effects of genetic changes in KCR1 and we screened the coding region of KCR1 in Japanese patients with the acquired LQTS. Hypothesis : We hypothesized that mutations or polymorphisms in KCR1 may influence the development of acquired LQTS. Methods: The genomic DNA of 70 unrelated patients with congenital LQTS, 41 unrelated patients with acquired LQTS, and 130 unrelated control subjects was screened by PCR-SSCP, PCR-RFLP, and direct sequencing. Appropriate sequence changes were introduced into subcloned KCR1 cDNA using site-directed mutagenesis, and HERG plus WT or mutant KCR1 cDNA was transiently transfected into CHO-K1 cells. HERG current was recorded using whole cell patch-clamp techniques and drug block of HERG current was assessed. Results : We identified a novel mutation in KCR1 , Glu33Asp in a Japanese acquired LQTS patient. Similar to what we reported previously, WT KCR1 diminished the susceptibility of HERG current to dofetilide (50 nM). After 15 min of continuous pulsing, 74±7% current remained in the presence of WT KCR1 vs 54±5% in the absence of KCR1. In contrast, 48±6% of HERG current remained in the presence of Glu33Asp KCR1 which was comparable to that of HERG alone. Significantly, we found that unlike WT KCR1, Glu33Asp KCR1 is no longer able to complement the genetic defect in α glucosyltransferase activity in yeast strain YG649, suggesting that enzymatic function of Glu33Asp KCR1 is compromised. We found no evidence for the Ile447Val KCR1 in Japanese LQTS patients and control subjects, which is present at an allele frequency of 7% allele frequency in a control population of the United States. Conclusion: These data suggest that the Glu33Asp KCR1 genetic change may predispose to the development of acquired LQTS.
Running a Code in My Ice Skates, and Other Tales
Authors: David Alfandre
Journal: JAMA (2015)

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Abstract 5017: Osteoprotegerin and the Risk of Recurrent Events in Patients With Non-ST elevation Acute Coronary Syndromes (NSTE-ACS): Observations From MERLIN-TIMI 36
Authors: Marc Bonaca, Torbjorn Omland, Marc S Sabatine, Sabina A Murphy, Benjamin M Scirica, Lars M Rasmussen, Allan Flyvbjerg, David A Morrow
Journal: Circulation (2009)

Osteoprotegerin (OPG) inhibits bone resorption and may also play a role in mediating vascular calcification. Recent studies have suggested that high plasma OPG is a strong predictor of cardiovascular disease (CV) and mortality. We hypothesized that OPG would be useful for risk assessment in patients presenting with NSTE-ACS. METHODS: We measured OPG at baseline in 4,463 pts with NSTE-ACS randomized to ranolazine or placebo in the MERLIN-TIMI 36 trial. Patients were followed for an average of one year. Endpoints were adjudicated by a blinded CEC. RESULTS: OPG at presentation showed a significant graded association with higher rates of recurrent CV events (Figure ). OPG &gt; median (1632 pmol/L, IQR 1206–2242) was associated with a higher risk of CV death (HR 2.9; 95% CI 2.2 – 4.0), CV death or MI (HR 1.9; 95% CI 1.6 – 2.3), and CV death or CHF (HR 2.5; 95% CI 1.9 – 3.1). After adjustment for important covariates including age, gender, diabetes, smoking, HTN, index event, cTnI, CRP and BNP, OPG remained independently associated with the risk of death (adj HR 1.7; 95% CI 1.2 – 2.4), CVD or MI (adj HR 1.4; 95% CI 1.1 – 1.7) and CVD or CHF (adj HR 1.4; 95% CI 1.1 – 1.8). CONCLUSIONS: OPG was independently associated with long-term risk of recurrent CV events in patients with NSTE-ACS, adding to clinical predictors, cTnI, CRP and BNP. This finding in a large data set adds to the emerging evidence supporting OPG as a candidate prognostic marker in pts with ACS, and supports investigation of other therapies that might modify this risk. Event Rates at 1 Year by Quartile of OPG
Abstract 15308: Optimal Cutpoint for BNP as a Predictor of 1-year Heart Failure-Specific Re-Hospitalization
Authors: Robert G Zoble, Yao Djilan, Philip Foulis, Adam G Zoble, Robert J Hariman, Britta I Neugaard
Journal: Circulation (2011)

Background: Hospitalization for heart failure (HF) is a major cause of health care expenditures. It would useful to be able to identify HF patients at the time of initial HF hospitalization who are...
A multicenter study to determine the optimum duration of neoadjuvant letrozole on tumor regression to permit breast-conserving surgery: Final analyses.
Authors: R. Carpenter, J. C. Doughty, C. Cordiner, N. Moss, A. Gandhi, C. Wilson, C. Andrews, G. Gui, A. Skene
Journal: Journal of Clinical Oncology (2010)

670 Background: Neoadjuvant letrozole is currently approved in the UK for the treatment of early breast cancer, to allow breast conserving surgery (BCS) in postmenopausal women with ER-positive breast cancer previously considered suitable for mastectomy only. This approval was based on a study that included 4 months of letrozole treatment. Prospective studies have not investigated treatment duration beyond 6 months and retrospective studies suggest useful responses can occur after this period. The aim of this study was to determine the optimum preoperative duration of treatment with 2.5 mg daily letrozole to permit BCS in patients not suitable for BCS at study entry. Following interim analyses suggesting the percentage of patients who become eligible for BCS increases with duration of letrozole therapy (Carpenter et al., SABCS 2009 [abstract 1082]) we will present final analyses of this 12-month trial. The last patient is scheduled to leave the trial no later than March 2010. Methods: This was a phase 4c prospective, multicentre, longitudinal study, designed as a single-arm, open-label, noncomparative trial. Postmenopausal women with large (≥T2), estrogen receptor and/or progesterone receptor positive primary tumours will be treated with neoadjuvant letrozole for up to 12 months. The primary endpoint is the time at which a patient is considered eligible for BCS. Kaplan-Meier product limit methodology was used to calculate the survival function, and the proportion of patients achieving the primary endpoint at 2 month intervals from 2 to 12 months will be determined. Secondary endpoints include reduction in tumour volume, as measured by clinical and ultrasound examination. Responses were assessed until the criteria for BCS were met, patients were withdrawn from study (no response or evidence of progressive disease), or if 12 months of letrozole treatment had been completed. Mammography was undertaken at baseline and trial end.Final results, including median time to BSC, response rates at 2-month intervals and median changes in tumour volume from baseline will be presented. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Novartis AstraZeneca, Novartis, Pfizer, Roche Novartis Novartis, Pfizer, Roche Novartis, Roche