tbuckley/cabot-search huggingface dataset:
Abstract 497: Relationship of Extrapericardial Fat With Coronary Atherosclerosis on Multi-row Detector Cardiac Computed Tomography
Authors: Jigar Kadakia, Yasmin S Hamirani, Khurram Nasir, Hussain Isma'eel, Matthew J Budoff
Journal: Circulation (2009)

Background: Prior studies have suggested that the proximity of fat surrounding the heart was responsible for the deposition of plaque into the coronary arteries. In this study, we looked at the ass...
Abstract 15551: Age-Related and Blood Pressure-Related Changes in Echocardiographic Indices of Cardiac Remodeling
Authors: Kazumasa Harada, Taro Kariya, Aya Tanaka, Ayumi Toba, Yasuko Imai, Rie Aoyama, Masamitsu Sugie, Hajime Yokota, Taizo Ishiyama, Tsuboko Tusuke, Hajime Fujimoto, Kazuhiro Takeda
Journal: Circulation (2011)

Background: Diastolic Heart failure increases with advancing ages. Age-related cardiac remodeling has been suggested, but changes in echocardiographic indices in advancing ages remain to be investi...
Modulation of Gene Expression in Key Survival Pathways During Daily Torpor in the Gray Mouse Lemur, Microcebus murinus
Authors: Kyle K. Biggar, Cheng-Wei Wu, Shannon N. Tessier, Jing Zhang, Fabien Pifferi, Martine Perret, Kenneth B. Storey
Journal: Genomics Proteomics & Bioinformatics (2015)

A variety of mammals employ torpor as an energy-saving strategy in environments of marginal or severe stress either on a daily basis during their inactive period or on a seasonal basis during prolonged multi-day hibernation. Recently, a few Madagascar lemur species have been identified as the only primates that exhibit torpor; one of these is the gray mouse lemur (Microcebus murinus). To explore the regulatory mechanisms that underlie daily torpor in a primate, we analyzed the expression of 28 selected genes that represent crucial survival pathways known to be involved in squirrel and bat hibernation. Array-based real-time PCR was used to compare gene expression in control (aroused) versus torpid lemurs in five tissues including the liver, kidney, skeletal muscle, heart, and brown adipose tissue. Significant differences in gene expression during torpor were revealed among genes involved in glycolysis, fatty acid metabolism, antioxidant defense, apoptosis, hypoxia signaling, and protein protection. The results showed upregulation of select genes primarily in liver and brown adipose tissue. For instance, both tissues showed elevated gene expression of peroxisome proliferator activated receptor gamma (ppargc), ferritin (fth1), and protein chaperones during torpor. Overall, the data show that the expression of only a few genes changed during lemur daily torpor, as compared with the broader expression changes reported for hibernation in ground squirrels. These results provide an indication that the alterations in gene expression required for torpor in lemurs are not as extensive as those needed for winter hibernation in squirrel models. However, identification of crucial genes with altered expression that support lemur torpor provides key targets to be explored and manipulated toward a goal of translational applications of inducible torpor as a treatment option in human biomedicine.
Abstract 25307: Treating Obesity in Primary Care Practice: A Two-Year Randomized Controlled Trial
Authors: Thomas Wadden, Sheri Volger, David B Sarwer, Marion L Vetter, Adam G Tsai, Robert I Berkowitz, Shiriki Kumanyika, Kathryn H Schmitz, Ronald Barg, Jesse Chittams, Renee Moore
Journal: Circulation (2011)

Background: Primary care providers (PCPs) are encouraged to screen adults for obesity and to offer lifestyle counseling for weight loss. This study assessed three lifestyle interventions of varying intensities, all provided by PCPs, working with medical assistant (MAs) in their practices. Method: A total of 311 women and 79 men (mean age=51.5±11.5 yr, BMI=38.5±4.7 kg/m2) were recruited at 6 primary care practices, owned by a university health system. Participants were randomized to: 1) Usual Care, consisting of quarterly PCP visits at which weight management was briefly (5-7 min) reviewed using handouts from NHLBI; 2) Brief Lifestyle Coaching (LC), which included the same PCPs visits, combined with monthly 10-15 min visits with MAs, who presented abbreviated lessons from the Diabetes Prevention Program; or 3) Enhanced LC, which provided the same visits as Brief LC, combined with the use of either meal replacements or weight loss medication (sibutramine or orlistat), selected by participants in consultation with PCPs. The study, sponsored by NHLBI, had 80% power to detect a 2.75 kg difference in weight loss between Usual Care and each of the LC interventions. (Sibutramine was removed from the U.S. market in October 2010 because of its association with CVD events.) Results: Study retention at Month 24 was approximately 85% in all three groups. At this time, participants in Usual Care, Brief LC, and Enhanced LC lost 1.7±0.7, 2.9±0.7, and 4.6±0.7 kg, respectively. Enhanced LC was superior (p&lt;0.003) to Usual Care, with no other differences between groups. Forty percent of Enhanced LC participants lost ≥5% of weight vs 26% for Usual Care (p&lt;0.027) and 30% for Brief LC (ns). A secondary analysis, eliminating the 44 participants exposed to sibutramine, revealed a 4.3±0.8 kg loss for Enhanced LC, superior to Usual Care (p&lt;0.015). Conclusions: PCPs, by collaborating with MAs and prescribing meal replacements/medications, helped obese patients in their practices achieve clinically meaningful weight loss. Questions remain whether lifestyle counseling should be offered in primary care or could be provided more efficiently and at lower cost using Internet, smart phone, or call-center platforms.
Abstract 1695: Percutaneous Aortic Valve Replacement for Severe Aortic Stenosis by CoreValve Bioprosthesis: A Single-Center Experience
Authors: Axel Linke, Thomas Walther, Sven Möbius-Winkler, Michael Woinke, Jens Fassl, Friedrich W Mohr, Gerhard C Schuler
Journal: Circulation (2007)

Treatment of aortic stenosis remains challenging in older individuals, since their perioperative mortality for conventional aortic valve replacement increases due to co-morbidities. Therefore, it was aim of the present study to elucidate whether retrograde, percutaneous aortic valve replacement (PAVR) using the CoreValve system in older patients (pts) with co-morbidities is safe, feasible and associated with an improvement in hemodynamics. Methods: Pts with symptomatic aortic stenosis (valve surface area &lt; 0.8 cm 2 ), aged ≥ 75 years and/or a Logistic EuroSCORE ≥ 15 % were considered for enrollment. Using a retrograde approach, valvuloplasty was performed either under local or general anesthesia followed by CoreValve implantation. The CoreValve revalving system carries a porcine pericardial bioprosthesis in a self-expandable nitinol frame. Clinical events were recorded at 30 days after PAVR. Transthoracic echocardiography was performed before and at 10 days after CoreValve implantation to evaluate instantaneous changes in hemodynamics and short term follow-up of the prosthesis. Results: A total of 30 pts with a mean age of 83±1 years and a Logistic EuroSCORE of 22±3 % were enrolled. The CoreValve prosthesis was successfully implanted in 28 patients (93%), in two patients a conversion to conventional surgery was necessary due to valve misplacement. The mean gradient across the aortic valve markedly declined from 43±3 mmHg before to 10±2 mmHg at 10 days after PAVR. The valve surface area increased from 0.6±0.1 cm 2 before to 1.6±0.2 cm 2 after CoreValve implantation. Twenty-two pts had grade 0 or 1 aortic regurgitation (AR) after PAVR and 6 patients AR up to grade 2+. Three patients died after successful PAVR, two from sepsis and one from cardiac failure resulting in a 30-day-mortality for the entire study population of 10 %. Three patients (10 %) experienced a periprocedural stroke. Among 25 patients surviving to discharge after successful PAVR, no adverse events occurred within 30 days after leaving the hospital. Conclusion: These early results suggest that PAVR with the CoreValve prosthesis is feasible, safe, improves hemodynamics and, therefore, might be an alternative in very high-risk patients for conventional aortic valve replacement.
Abstract 1436: Gene Dosage of the Common Variant 9p21 Predicts Severity of Coronary Atheromatous Burden
Authors: Sonny Dandona, Alexandre F Stewart, Li Chen, Kathryn Williams, Derek So, Edward O’Brien, Christopher Glover, Michel LeMay, Lan Vo, Yan Q Wang, Marino Labinaz, George A Wells, Ruth McPherson, Robert Roberts
Journal: Circulation (2008)

Background: The first common genetic risk variant for coronary artery disease (CAD), 9p21, was recently identified and shown to occur in 75% of Caucasian and Asian populations. However, 9p21 does not contain a protein coding gene and its function is unknown. Given the phenotypes of atherosclerosis and thrombosis, pursuit of the molecular mechanisms mediating 9p21 risk requires elucidation of the 9p21 phenotype. Accordingly, we tested the hypothesis that 9p21 is directly related to coronary atherosclerosis. Methods: We studied 709 patients who were prospectively enrolled from the coronary catheterization laboratory at the University of Ottawa Heart institute from April 15 th 2006 to 4 th January 2008. Each subject was genotyped for the single nucleotide polymorphism rs1333049 (risk allele located at 9p21). Patients were designated AA (risk/risk), AB (risk/non-risk) and BB (non-risk/non-risk). Angiograms were reviewed by two independent parties blinded to genotype. Lesions with 50% or more stenosis were considered significant for the purposes of this study. Odds ratios were generated for proportion of patients with 3VD, significant left main disease and CABG relative to the non-risk genotype, BB. Results: We demonstrated a strong direct association between 9p21 gene dosage and 3VD (Fig. 1A ). Conversely, a strong inverse association between 9p21 gene dosage and 1VD was observed (Fig. 1B ). A strong direct association between gene dosage and LM disease (Fig. 1C ) and CABG (Fig. 1D ) was seen. Conclusions: The 9p21 variant risk is mediated through deposition of coronary atheroma. Therefore, elucidating 9p21 function should target atherogenesis.
Abstract 3657: Mortality after Coronary Artery Bypass Surgery and Psychosocial Factors: A PreCIS Database Study
Authors: Leopoldo Pozuelo, Gordon Blackburn, Charles Walters, Micheal Crawford, Cindy Stevenson, Danielle Brennan, Brian Hoar, Jianping Zhang, George Tesar, Kathleen Franco, Leslie Cho, Byron Hoogwerf
Journal: Circulation (2007)
Abstract MP54: Extent of Subclinical Atherosclerosis and Associations with Cardiovascular Disease Risk Factors Vary by Race/Ethnicity in Late Midlife Women: The Study of Women’s Health Across the Nation
Authors: Emma Barinas-Mitchell, Kim Sutton-Tyrrell, Lina Bai, Samar R El Khoudary, Julius Asubonteng, Rebecca C Thurston, Carol A Derby
Journal: Circulation (2013)

Subclinical atherosclerosis indices, such as carotid intima-media thickness (IMT) and plaque, have been linked to future CHD, MI and stroke events, are more prevalent in postmenopausal women and va...
Abstract 6255: Adiponectin Deficiency Profoundly Exacerbates Sepsis-Related Mortality through Endothelial Activation: A Novel Mechanistic Link between Adiposity and Sepsis
Authors: Hwee Teoh, Adrian Quan, K W Bang, Guilin Wang, Fina Lovren, Vivian Vu, Jack J Haitsma, Paul E Szmitko, Chao H Wang, Lee Errett, Milan Gupta, Haibo Zhang, Lawrence Chan, John Freedman, Gary Sweeney, Subodh Verma
Journal: Circulation (2008)

INTRODUCTION: Sepsis is a multifactorial, and often fatal disorder, characterized by widespread inflammation with resultant endothelial activation. Adiposity and diabetes are strong negative predictors of sepsis related cardiovascular dysregulation and mortality, however, the mechanisms remain unclear. We postulated that alterations in adipokine biology, particularly adiponectin, are essential modulators of survival and endothelial activation in sepsis. METHODS AND RESULTS: We evaluated both loss-of-function (adiponectin gene-deficient mice) and subsequent gain-of-function (recombinant adiponectin reconstitution) strategies in two well-established inflammatory models, cecal ligation perforation (CLP) and thioglyocollate-induced peritonitis. Adipoq −/− mice, subjected to CLP, exhibited a profound (~8 fold) reduction in survival compared to their wild-type Adipoq −/− littermates after 48 hours. Furthermore, compared to wild-type controls, thioglycollate challenge resulted in a markedly greater influx of peritoneal neutrophils in Adipoq −/− mice accompanied by an excess production of key chemoattractant cytokines (IL-12p70, TNFalpha, MCP-1 and IL-6) and upregulation of aortic endothelial adhesion molecule expression, VCAM-1 and ICAM-1. Importantly, all of these effects were blunted by recombinant total adiponectin administration given three days prior to thioglycollate challenge. The protective effects of adiponectin were largely ascribed to higher order adiponectin oligomers, since administration of recombinant trimeric adiponectin did not attenuate endothelial adhesion molecule expression in thioglycollate-challenged Adipoq −/− mice. CONCLUSIONS: These data suggest a critical role of adiponectin as a modulator of survival and endothelial inflammation in experimental sepsis and suggest one of the first mechanistic links between adiposity and sepsis related death.
Abstract 15857: High-on Thienopyridine Platelet Reactivity in Elderly Coronary Patients
Authors: Johanne Silvain, Guillaume Cayla, Jean-Sebastien Hulot, Jonhatan Finzi, Mathieu Kerneis, Anne Bellemain-Appaix, Stephen O'Connor, Jean-Philippe Collet, Gilles Montalescot
Journal: Circulation (2011)

OBJECTIVES: The aim of this study was to compare on-treatment platelet reactivity of elderly patients (>75 yrs) treated by thienopyridines in comparison with younger patients (< 75yrs). BACKGROUND:...
Abstract 12136: Relation between Oscillatory Ventilation and Cardiopulmonary Function during Exercise
Authors: Jo Kato, Akira Koike, Masayo Iwamoto-Hoshimoto, Osamu Nagayama, Koji Sakurada, Takeshi Yamashita, Karlman Wasserman, Kazutaka Aonuma
Journal: Circulation (2012)

Background: Oscillatory breathing, alternating between hyperpnea and hypopnea, has been recognized in cardiac patients, especially in those with heart failure. We evaluated whether the cycle length and amplitude of oscillatory breathing correlate with the impaired cardiopulmonary function during exercise. Methods: We analyzed respiratory gas data during cardiopulmonary exercise testing (CPX) in 17 cardiac patients (68±12 years) who showed clear oscillatory ventilation during CPX. The cycle length (time from peak to peak) and the amplitude (difference between peak and nadir) for both the oscillating ventilation (VE) and oscillating O2 uptake (VO2) were calculated from several consecutive oscillations noted at rest before the start of exercise, and compared with indices of CPX. Results: Oscillating VO2 preceded oscillating VE in 16 out of 17 patients. Peak VO2 (10.3±3.1 mL/min/kg) correlated significantly negatively with the cycle length of the VE oscillation (r=-0.60, p=0.010), and of the VO2 oscillation (...
Stage migration and the Kattan nomogram
Authors: L. Horvath, R. Thanigasalam, K. Rasiah, P. Stricker, A. Earnest, A. Haynes, S. Sutherland, R. Sutherland, S. Henshall
Journal: Journal of Clinical Oncology (2008)

5162 Background: In North America and Europe widespread prostate specific antigen (PSA) testing has resulted in prostate cancer (PC) stage migration, questioning the utility of prognostic nomograms in this setting. We investigated the effect of PSA testing on stage migration in an Australian population and its consequences on the accuracy of the Kattan post radical prostatectomy (RP) nomogram. Methods: 1,008 men who underwent consecutive open RP for localized PC between 1991 and 2001 at a single institution were divided into two cohorts: 1991–1996 representing the early PSA era and 1997–2001 representing the contemporary PSA era. Differences in clinicopathological features between the two groups were analyzed by chi-squared testing. Prognostic markers were identified using the Cox Proportional hazards model with biochemical relapse as the endpoint. Individual patient data was entered into the Kattan post RP Nomogram (2007 version) and prognostic accuracy assessed using receiver-operating characteristic curve analysis. Results: Patients in the contemporary PSA group had lower pathological stage disease (p = 0.01) and less cancers with Gleason score ≥8 (P < 0.0001) compared to the early PSA cohort. Multivariate analysis identified pre-operative PSA level (early PSA: HR 1.6, range 1.1–2.1, p=0.005 vs contemporary PSA: HR 1.9, range 1.3–2.7, p=0.001) and Gleason score (early PSA: HR 3.3, range 2.2–4.8, p<0.0001 vs contemporary PSA: HR 4.3, range 2.3–7.8, p<0.0001) as strong independent predictors of biochemical relapse in both time periods. In the contemporary PSA cohort, pathological stage was not significant (HR 1.4, range 0.9–2.1, p=0.1), but margin involvement became highly significant (early PSA: HR 1.1, range 0.8–1.6, p=0.5 vs contemporary PSA: HR 1.8, range 1.2–2.6, p=0.004). There was no significant difference in the predictive accuracy of the post RP nomogram at 5 years between the two time points (early PSA: AUC 0.77, 95%CI 0.70–0.82 vs contemporary PSA: AUC 0.72, 95%CI 0.67–0.77; p=0.25). Conclusions: The findings demonstrate a downward stage migration towards organ-confined disease after the introduction of widespread PSA testing in an Australian cohort. Despite this, the Kattan post RP nomogram remains a robust prognostic tool in clinical practice. No significant financial relationships to disclose.
Abstract 10903: What is the Benefit of Glycoprotein IIb/IIIa Inhibitors During Percutaneous Coronary Intervention? A Meta-Analysis of Randomized Clinical Trials Performed in the Era of Stents and Thienopyridines
Authors: David E Winchester, Xuerong Wen, William D Brearley, Ki E Park, R D Anderson, Anthony A Bavry
Journal: Circulation (2010)

Background: Glycoprotein IIb/IIIa inhibitors (GPI) are potent antiplatelet medications that are frequently used during percutaneous coronary intervention (PCI) to reduce thrombotic complications an...
Abstract 2870: Peripheral Vascular Intervention in the Elderly: Is It Safe?
Authors: Paul M Grossman, Khan Munir, Noah J Jones, Stanley J Chetcuti, James B Froehlich, Hitinder S Gurm, Ann E Luciano, Arthur L Riba, Elias Kassab, Chaman Sohal, Martha Massender, Milind Karve, Maggie Bishop, Dennis Dunning, Michael F Knox, M A Mansour, Ann Schaefer, Mauro Moscucci
Journal: Circulation (2006)
Abstract P266: Physical Activity Intensity Is Associated With Visceral Fat Accumulation In A Multi-ethnic Cohort
Authors: Iris A Lesser, Ann C Yew, Scott A Lear
Journal: Circulation (2012)

Introduction: Excess accumulation of visceral adipose tissue (VAT) has been found to increase the risk of cardiometabolic disease. We have previously reported that Chinese and South Asians have higher amounts of VAT for a given body size compared to Europeans. Exercise has been shown to preferentially reduce VAT in a dose-response relationship with the intensity of physical activity (PA). The purpose of this study is to examine how the intensity of PA is associated with the amount of VAT in men and women of Chinese, European and South Asian origin. Methods/Results: The study population were 603 apparently healthy males and females between 30 and 65 years of age of Chinese (n = 207), European (n = 200), and South Asian (n = 196) origin who were part of the Multi-cultural Health Assessment Trial. PA was assessed using the Modifiable PA Questionnaire. Metabolic equivalents (METs) of reported activities were determined from the Ainsworth Compendium and were categorized into moderate (3–6 METs) and vigorous (&gt;6 METs) intensities and reported as METs per week. Analysis of variance was used to determine differences in VAT and PA measures between ethnic groups. Linear regression analyses were used to explore the relationship between visceral fat and PA intensity. Moderate (p&lt;0.001), vigorous (p&lt;0.01) and total PA (p&lt;0.01) differed significantly between all groups. Chinese and South Asians had greater amounts of VAT than Europeans adjusted for age, sex, BMI and income. Both moderate and vigorous PA were negatively associated with VAT after adjustment for confounders. When both moderate and vigorous PA were added to the model, the difference in VAT between Chinese and Europeans was no longer apparent (p=0.114). However, South Asians still had a significantly greater amount of VAT (p&lt;0.001). Conclusion: Both PA and VAT differed among the ethnic groups. After consideration for differences in PA, there was no longer any difference in VAT between Chinese and Europeans suggesting that the higher amount of VAT observed in the Chinese population is a consequence of low PA levels. Consideration of PA did not affect differences in VAT in the South Asians and may indicate that other factors (whether dietary or genetic) play a role in the higher VAT amounts in South Asians.
New money should be divided equally amongst all GPs
Authors: C D A Fabre
Journal: BMJ (1995)

EDITOR,--Who is meant to benefit from the out of hours arrangements for general practitioners, including the allocation of pounds sterling45m, recently agreed with the government?1 Is it meant to be our patients or us as doctors? Or both?

Most patients would prefer to have their own doctor call on them for out of hours emergencies, so the arrangements are clearly not meant …
Abstract 3241: Quantitation of Mitral Annular Structure and Function in Organic Mitral Regurgitation: Effect of Valve Repair and Comparison of the Modified Carpentier Method With a New "American Correction"
Authors: Sagit Ben Zekry, Roberto M Lang, Lissa Sugeng, Marti L McCulloch, Lynn Weinert, Jai Raman, Stephen H Little, Gerald M Lawrie, William A Zoghbi
Journal: Circulation (2009)