tbuckley/cabot-search huggingface dataset:
Abstract 16740: Glycemic Markers and Heart Failure Subtypes: The Multi-Ethnic Study of Atherosclerosis (mesa)
Authors: Justin B Echouffo Tcheugui, Oluseye Ogunmoroti, Sherita H Golden, Alain G Bertoni, Morgana Mongraw-chaffin, Ambarish Pandey, Chiadi E Ndumele, Erin D Michos
Journal: Circulation (2020)

Introduction: Markers of glucose dysregulation and insulin resistance (hemoglobin A 1C [HbA 1C ], fasting plasma glucose [FPG], homeostasis model assessment of insulin resistance [HOMA-IR], and fasting insulin) capture various metabolic pathways, and thus could be differentially associated with heart failure (HF) subtypes (HF with preserved ejection fraction [HFpEF] or HF with reduced ejection fraction [HFrEF]). There are limited data on such associations. Hypothesis: Glycemic markers differentially relate to HFpEF and HFrEF. Methods: We included 6,688 (39% white, 28% black, 12% Chinese, and 22% Hispanic) adults without prevalent cardiovascular disease who attended the first MESA visit (2000-2002). Participants were followed for incident hospitalized HF, adjudicated for HFpEF or HFrEF [EF ≥50% vs. &lt;50%]. Estimates of the association of each glycemic markers (HbA 1C , FPG, HOMA-IR, and fasting insulin) and glycemic status (normoglycemia, prediabetes, diabetes) with HF and each of its subtypes (HFpEF vs. HFrEF) were evaluated using adjusted Cox models. Results: The mean age of participants was 62 ± 10 years, with 53% women. There were 356 HF events (145 HFpEF, 173 HFrEF, and 38 indeterminate HF events) over a median follow-up of 15 years. Table shows the estimates of the associations of glycemic makers and HF subtypes. Diabetes status conferred higher risks of HFpEF and HFrEF of similar magnitude compared to normoglycemia (all P &lt;0.001). Similarly, higher levels of HbA 1C (≥6.5%) and FPG ( ≥ 126 mg/dL) were each associated with higher risks of HFpEF and HFrEF (all P &lt;0.001), to a comparable extent for each HF subtype. Prediabetic range HbA 1C (5.7-6.4%) or FPG (100-125 mg/dL), as well as HOMA-IR and fasting insulin were not-significantly associated with HFpEF or HFrEF. Conclusions: Among community-dwelling individuals, HbA 1C and FPG in the diabetes range were each positively associated with higher risks of HFpEF and HFrEF, with similar magnitudes of their associations.
Abstract 15403: New-onset Atrial Fibrillation is Infrequent in Acute COVID-19 but Maybe Associated With Worse Outcomes
Authors: Ruifang Yang, Sokol Kalaveshi, David Goldgrab, Jearim Craig, Stephen Mester, Christian Perzanowski
Journal: Circulation (2020)

Introduction: The COVID-19 has reached pandemic status with significant morbidity and mortality including cardiovascular complications. Systemic inflammation caused by the COVID-19 infection has been associated with an intense release of multiple cytokines which directly cause myocardial injury. New-onset atrial fibrillation (noAF) is a common consequence of systemic inflammation in bacterial pneumonia as well as influenza and has been shown to have independently poorer outcomes. Hypothesis: We sought to determine the incidence and significance of noAF in patients with confirmed COVID-19 infection. Methods: We prospectively studied patients with acute COVID-19 infection admitted to our referral center between March and May 2020. Data of demographics, clinical features, comorbidities and complications were collected. Cardiac rhythms were observed using 12-lead electrocardiogram and continuous telemetry. Results: Total 62 patients were followed. The end-point included incidence of any episode of AF, cardiovascular death and total mortality. Mean age was 66 ±17 years, 56% were males, 37 patients without history of cardiac disease, 25 patients with documented cardiac disease including 31% of coronary artery disease (CAD), 28% of congestive heart failure (CHF), 11% of history of prior atrial fibrillation (hoAF). Four (6.5%) patients manifested noAF during hospitalization (95% CI, 1.8, 16). There was a significant difference in mortality between patients with and without cardiac diseases (P = 0.02) (Table). All patients with noAF required ventilation support and had significantly higher mortality compared to patients without cardiac disease (P &lt; 0.05) (Figure). Conclusions: New-onset AF was infrequently observed, however was associated with a poorer prognosis for hospitalized patients with acute COVID-19 infection. Larger studies are needed to confirm these findings as well as identify measures of AF prevention in this population.
Abstract 13872: Cue Restricted Smoking Increases Quit Rates With Varenicline
Authors: Jaqueline Scholz, Tania O Abe, Patricia Gaya, Iana R Moraes, Bianca Bellini, Paulo R Tomaz, Juliana R Santos, Paulo C Santos, Serena Tonstad
Journal: Circulation (2020)

Introduction: Varenicline effectively helps smokers quit by reducing withdrawal symptoms and blocking the reward of smoking. However, most quitters return to smoking within 1 year. “Cue-restricted smoking” is a behavioral technique designed to increase quit rates by asking smokers attempting to quit to restrict smoking to the standing position, while alone, in an isolated area facing a wall, with the cigarette as the only stimulus. Hypothesis: We compared the effectiveness of cue-restricted smoking cessation advice versus standard target quit date advice from day 8 of initiating varenicline in smokers making a quit attempt at the Smoking Cessation Service at the Prevention Department of the Heart Institute, Sao Paulo, Brazil. Methods: Using retrospective clinic records we compared quit rates in 281 smokers (50% males) instructed in the cue-restricted smoking cessation method during 2016-18 to quit rates in 324 smokers (46% males) advised to completely stop smoking on the target quit date which we previously used during 2011-14. All were prescribed varenicline for 12 weeks alone, with the addition of bupropion if needed after 4 weeks. Follow-up consisted of behavioral support at 4-6 visits during active drug treatment and telephone counselling at 24 and 52 weeks. The smoking cessation rate was confirmed with expired carbon monoxide at the 12-week clinic visit and only by telephone at 52 weeks. Results: The mean age of smokers was 49 ±12 years both groups and the number of cigarettes smoked daily was similar (18/day in the cue-restricted versus 19/day in the target quit day group). The smoking cessation rate at 12 weeks was 75% in the cue-restricted versus 45% in the target quit day group (relative risk 1.8; 95% confidence interval 1.4-2.2; p&lt;0.001). At 52 weeks the quit rate was 65% vs 34% respectively (relative risk 1.9; 95% confidence interval 1.5-2.4; p&lt;0.001). Conclusion: Cue restricted smoking substantially increased the chance of quitting compared with standard advice during treatment with varenicline . These results should be further studied in a randomized controlled trial.
Abstract 13876: Squat-to-stand Provocation of Dynamic Left Ventricular Outflow Tract Obstruction in Hypertrophic Cardiomyopathy
Authors: Lillian Peng, Darrell B Newman, Jeffrey B Geske
Journal: Circulation (2020)

Background: Left ventricular outflow tract (LVOT) obstruction is an important determinant in management of hypertrophic cardiomyopathy (HCM). Valsalva maneuver and amyl nitrite are used in clinical practice during resting echocardiography to induce latent obstruction (LVOT gradient &lt;30 mmHg at rest, ≥30 mmHg with maneuver). With a nationwide shortage of amyl nitrite in 2019, we implemented a “repetitive squat-to-stand” maneuver to provoke LVOT obstruction during echocardiography. Methods: Patients with known or suspected HCM without resting obstruction who underwent repetitive squat-to-stand maneuver during echocardiography between February and September 2019 were included. Maximal instantaneous gradients were recorded. Provocable gradients were compared utilizing a two-sided t-test. Amyl nitrite was not available during the study period. Results: Squat-to-stand assessments were available in 125 patients without resting obstruction (age 58 ± 15 years, 67% male); 114 also performed Valsalva maneuver. 47 of 125 patients (37.6%) demonstrated provocable obstruction. 46 (36.8%) demonstrated latent obstruction provoked by squat-to-stand, which was severe (gradient ≥50 mmHg) in 29 (23.2%). Of the 46 patients, 19 demonstrated latent obstruction only with squat-to-stand but not with Valsalva, 13 of which demonstrated severe obstruction. Among patients with latent obstruction who performed both Valsalva and squat-to-stand maneuver (n=41), squat-to-stand resulted in a higher gradient than Valsalva maneuver (p&lt;0.0001, Figure). Conclusion: Repetitive squat-to-stand maneuver is a clinically useful adjunct to the traditional echocardiographic exam in HCM. This maneuver appears to be more sensitive than the Valsalva maneuver for identifying severe dynamic LVOT obstruction. Use of repetitive squat-to-stand warrants further study in comparison to amyl nitrite, particularly regarding cost savings and diagnostic performance.
Noninvasive Assessment of Coronary Artery Disease: Anatomy, Physiology, and Clinical Outcome⁎⁎Editorials published in JACC: Cardiovascular Imaging reflect the views of the authors and do not necessarily represent the views of JACC: Cardiovascular Imaging or the American College of Cardiology.
Authors: Paul Schoenhagen, Eike Nagel
Journal: JACC. Cardiovascular imaging (2011)
Abstract 13798: Influence of Advanced Pulmonary Vascular Remodeling on Accuracy of Echocardiographic Parameters of Left Ventricular Filling Pressure
Authors: Yasuyuki Chiba, Hiroyuki Iwano, Sanae Kaga, mio shinkawa, Michito Murayama, Hiroshi Ohira, Ko Motoi, Suguru Ishizaka, Shingo Tsujinaga, Shinobu Yokoyama, Masahiro Nakabachi, Hisao Nishino, Kazunori Okada, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai
Journal: Circulation (2020)

Introduction: Evaluation of left ventricular (LV) filling pressure (FP) plays an important role in the clinical management of pulmonary hypertension (PH). However, the accuracy of echocardiographic parameters for the estimation of LV FP in the presence of pulmonary vascular lesions has not been fully addressed. Methods: We investigated 87 patients diagnosed with PH due to pulmonary vascular lesions (non-cardiac PH; PH NC ) (PH NC group) and 117 patients with ischemic heart disease without reduced LV ejection fraction (&lt;40%) (control group). Mean pulmonary arterial wedge pressure (PAWP) and pulmonary vascular resistance (PVR) were obtained by right heart catheterization. As echocardiographic parameters of LV FP, the ratio of early- (E) to late-diastolic transmitral flow velocity (E/A), ratio of E to early-diastolic mitral annular velocity (E/e'), and left atrial volume index (LAVI) were measured. The PH NC group was subdivided into non-severe and severe groups according to median PVR (5.3 Wood units). Results: PAWP was 12±5 mmHg in controls, 9±4 mmHg in non-severe PH NC , and 8±3 mmHg in severe PH NC . In the control and non-severe PH NC groups, positive correlations were observed between PAWP and E/A (R=0.66 and R=0.41, respectively), E/e' (R=0.36 and R=0.33), and LAVI (R=0.38 and R=0.62). In contrast, in the severe PH NC group, PAWP was only correlated with LAVI (R=0.41, p=0.006). In the control group, PAWP determined E (β=0.45, p&lt;0.001) but PVR did not, whereas both PAWP and PVR were independent determinants of E (β=0.32, p=0.001; and β=-0.35, p&lt;0.001, respectively) in the PH NC group. Conclusions: In the presence of advanced pulmonary vascular lesions, conventional Doppler echocardiographic parameters may not accurately reflect LV FP. Importantly, elevated PVR would lower the E value, even when PAWP is elevated, resulting in blunting of these parameters for the detection of elevated LV FP. LAVI might be a reliable parameter for estimating LV FP in patients with severe non-cardiac PH.
CD38 ecto-enzyme in immune cells is induced during aging and regulates NAD+ and NMN levels
Authors: Claudia C. S. Chini, Thais R. Peclat, Gina M. Warner, Sonu Kashyap, Jair Machado Espindola-Netto, Guilherme C. de Oliveira, Lilian S. Gomez, Kelly A. Hogan, Mariana G. Tarragó, Amrutesh S. Puranik, Guillermo Agorrody, Katie L. Thompson, Kevin Dang, Starlynn Clarke, Bennett G. Childs, Karina S. Kanamori, Micaela A. Witte, Paola Vidal, Anna L. Kirkland, Marco De Cecco, Karthikeyani Chellappa, Melanie R. McReynolds, Connor Jankowski, Tamara Tchkonia, James L. Kirkland, John M. Sedivy, Jan M. van Deursen, Darren J. Baker, Wim van Schooten, Joshua D. Rabinowitz, Joseph A. Baur, Eduardo N. Chini
Journal: Nature Metabolism (2020)
2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: Executive Summary
Authors: Steve R. Ommen, Seema Mital, Michael A. Burke, Sharlene M. Day, Anita Deswal, Perry Elliott, Lauren L. Evanovich, Judy Hung, José A. Joglar, Paul Kantor, Carey Kimmelstiel, Michelle Kittleson, Mark S. Link, Martin S. Maron, Matthew W. Martinez, Christina Y. Miyake, Hartzell V. Schaff, Christopher Semsarian, Paul Sorajja
Journal: Journal of the American College of Cardiology (2020)
Abstract 15391: The Natural History of Asymptomatic and Mildly Symptomatic Obstructive Hypertrophic Cardiomyopathy: Insights From the Share Registry
Authors: Monica Ahluwalia, Larry Han, iacopo olivotto, Euan A Ashley, Michelle Michels, Jodie Ingles, Christopher Semsarian, Daniel L Jacoby, Steven Colan, Alexandre D Pereira, Rossano W Joseph, Sam Wittekind, James S Ware, Sara Saberi, Adam S Helms, Sharlene Day, Carolyn Ho, Neal K Lakdawala
Journal: Circulation (2020)

Background: Contemporary studies are needed to determine the natural history of asymptomatic and mildly symptomatic patients with obstructive hypertrophic cardiomyopathy (oHCM). Methods: Patients with HCM, peak left ventricular outflow tract (LVOT) gradient ≥30 mm Hg (at rest, post-Valsalva, or exercise) and baseline NYHA I-II symptoms were identified using the multicenter Sarcomeric Human Cardiomyopathy Registry (SHaRe). Patients with prior atrial fibrillation (AF) or septal reduction therapies (SRT) were excluded. Incident outcomes, including the composite of NYHA III-IV symptoms, AF or SRT, were related to LVOT using Kaplan-Meier analysis (LVOT tertiles) and Cox proportion hazard models, controlling for age, sex, race, proband status, sarcomere status, hypertension and left atrial diameter. Results: At baseline, the 1048 patients who met inclusion criteria were 52.0 ± 16.1 yrs, 48.9% female, 34.9% sarcomere mutation +, with mean LVOT gradient 72 ± 39mm Hg. Over 8.6 years follow up (IQR 2.3, 13.6), progression to the composite endpoint ocurred in 530 (50.6%) and 92 (8.8%) died. Patients in the highest tertile of LVOT gradient (&gt;84 mm Hg) were at increased risk of the composite endpoint (Figure). Every 10 mm Hg increase in LVOT gradient was associated with increased risk of incident NYHA III-IV HF (HR 1.04, 95% CI 1.00, 1.08, p=0.04), SRT (HR 1.07, 95% CI 1.04, 1.09, p&lt;0.001) and the composite endpoint (HR 1.03, 95% CI 1.01, 1.06, p=0.003), but not incident AF (HR 1.02, p=0.39) or death (HR 0.99, p=0.3). Older age (HR 1.01, 95% CI 1.00-1.03, p=0.03), black race (HR 1.73, 95% CI 1.11-2.69, p=0.02) and sarcomere mutations (HR 1.27, 95% CI 1.02-1.59, p=0.03) were also associated with increased risk of the composite endpoint. Conclusions: In oHCM patients with NYHA I-II symptoms, the LVOT gradient appears to predict worsening symptoms and need for SRT, but not AF or overall survival. These findings have implications for refining management strategies for oHCM.
Outcomes following liver transplantation from HCV-seropositive donors to HCV-seronegative recipients
Authors: Bashar Aqel, Karn Wijarnpreecha, Surakit Pungpapong, C. Burcin Taner, Kunam Reddy, Michael Leise, Lanyu Mi, Rolland C. Dickson
Journal: Journal of Hepatology (2020)
Abstract 333: A Prospective Study of the Incidence of Intracranial Hemorrhage in Survivors of Out of Hospital Cardiac Arrest
Authors: Jonathan Gelber, Martha E Montgomery, Amandeep Singh
Journal: Circulation (2020)

Introduction: Intracranial Hemorrhage (ICH) is an important cause of out-of-hospital cardiac arrest (OHCA), yet there are no United States (US), European, or Australian prospective studies examining its incidence. A single Japanese prospective study found a high incidence of ICH in survivors of OHCA (18.3% incidence), but that data is not generalizable to the US, which has a far lower overall rate of ICH. Aim: This study aims to identify the incidence of ICH in US patients with OHCA who obtain return of spontaneous circulation (ROSC). Methods: We prospectively analyzed all consecutive patients with OHCA who achieved ROSC at a single US hospital over a 15-month period from 2018-2020. A standardized order set, including non-contrast head computed-tomography (NCH-CT), was recommended as part of the initial management for all patients with ROSC after OHCA. Patient and cardiac arrest variables were recorded, as were NCH-CT findings. Results: During the study period, 194 patients presents to the emergency department with OHCA, and 95 patients achieved ROSC and survived to hospital admission. A NCH-CT was obtained in 85/95 patients (89.5%). Twenty-four of 85 patients (28.2%) survived to hospital discharge. Three of 85 patients with NCH-CT had ICH (3.5%). Survival with good neurologic outcome was seen in 14/82 (17.1%) patients without ICH and in 0/3 patients with ICH. Patients with ICH were significantly older than patients without ICH (86.7 years versus 64.4 years, p=0.01). Conclusions: In our US cohort, ICH was an uncommon finding in patients who sustained OHCA and survived to hospital admission. The incidence of ICH in survivors of OHCA was 3.5%, lower than previously reported retrospective data in the US, and much lower than reported in a prospective Japanese study. No patients with ICH survived with good neurologic outcome.
Abstract 15844: Predicting the Risk of Significant Coronary Artery Disease in Liver Transplant Patients: The CAD-LT Score
Authors: Rayan Jo Rachwan, Issa Kutkut, Lava R Timsina, Rody G Bou Chaaya, Edward El-Am, Mohamad Sabra, Fakilahyel S Mshelbwala, Mahmoud Rahal, Marco A Lacerda, Chandrashekhar A Kubal, Jonathan A Fridell, Marwan S Ghabril, Patrick V Bourdillon, Richard S Mangus
Journal: Circulation (2020)

Background: Patients with significant coronary artery disease (CAD) are more likely to develop post-liver transplant (LT) cardiac events. We developed the CAD-LT screening score and testing algorithm to predict the risk of significant CAD in LT candidates. Methods: Patients who underwent pre-LT evaluation at Indiana University (2010-2017) were studied retrospectively (n=1814). Stress tests (ST) (n=1677) and cardiac catheterization (CATH) reports (n=1300) were reviewed. CATH was performed in patients with predefined CAD risk factors. Significant CAD was defined as disease requiring percutaneous or surgical intervention. Multivariable estimates (Adjusted Odds Ratio i.e. AOR [95%CI]) with assessment of model performance using Receiver Operating Curve analysis were used to compute a point-based risk score and stratify patients. A 10-fold internal cross-validation (CV) model was done. Results: There were 950 LT and 864 no-LT patients. The risk-adjusted predictors of significant CAD were older age (AOR 1.06 [95%CI 1.03-1.09]), male gender (1.69 [1.13-2.50]), diabetes (1.44 [1.01-2.06]), hypertension (1.50 [1.05-2.15]), current smoking history (1.81 [1.16-2.82]), family history of CAD (1.76 [1.24-2.50]), and personal history of CAD (5.41 [3.48-8.43]). The CAD-LT score is shown in Table 1. Figure 1 is an algorithm for its use. The mean CV Area Under the Curve [95% CI] was 0.75 [0.71-0.79]. The algorithm detected 97% of the patients with significant CAD and would decrease the number of ST by 718 (43%; 671 in high-risk group and 47 in low-risk group) and CATH by 409 (30%). Conclusion: The CAD-LT score identifies LT candidates at high risk for significant CAD and guides pre-LT testing.
In-situ biotransformation of nitric oxide by functionalized surfaces of cardiovascular stents
Authors: Meng Qian, Qi Liu, Yan Wei, Zhikun Guo, Qiang Zhao
Journal: Bioactive Materials (2020)

Cardiovascular diseases (CVDs) are among the leading causes of mortality and morbidity worldwide. Nitric oxide (NO) is a signalling molecule that plays a vital role in protecting and regulating cardiovascular function and homeostasis. Despite several successful outcomes of exogenous supplementation of NO for cardiovascular disease therapy, a great challenge lies in controlled and long-term delivery due to the short half-life and instability of NO. Recently, increasing attention has been paid to the in situ conversion of endogenous NO donors catalysed by functional surfaces. Based on bioinspired and biomimicking strategies, a series of surface functionalization methods for cardiovascular stents has been successfully developed. By further combining NO catalysis with other biofunctionalities, improved endothelium healing and long-term patency can be anticipated.
Myeloma-Modified Adipocytes Exhibit Metabolic Dysfunction and a Senescence-Associated Secretory Phenotype
Authors: Heather Fairfield, Amel Dudakovic, Casper M. Khatib, Mariah Farrell, Samantha Costa, Carolyne Falank, Maja Hinge, Connor S. Murphy, Victoria DeMambro, Jessica A. Pettitt, Christine W. Lary, Heather E. Driscoll, Michelle M. McDonald, Moustapha Kassem, Clifford Rosen, Thomas L. Andersen, Andre J. van Wijnen, Abbas Jafari, Michaela R. Reagan
Journal: Cancer Research (2020)

Abstract Bone marrow adipocytes (BMAd) have recently been implicated in accelerating bone metastatic cancers, such as acute myelogenous leukemia and breast cancer. Importantly, bone marrow adipose tissue (BMAT) expands with aging and obesity, two key risk factors in multiple myeloma disease prevalence, suggesting that BMAds may influence and be influenced by myeloma cells in the marrow. Here, we provide evidence that reciprocal interactions and cross-regulation of myeloma cells and BMAds play a role in multiple myeloma pathogenesis and treatment response. Bone marrow biopsies from patients with multiple myeloma revealed significant loss of BMAT with myeloma cell infiltration of the marrow, whereas BMAT was restored after treatment for multiple myeloma. Myeloma cells reduced BMAT in different preclinical murine models of multiple myeloma and in vitro using myeloma cell-adipocyte cocultures. In addition, multiple myeloma cells altered adipocyte gene expression and cytokine secretory profiles, which were also associated with bioenergetic changes and induction of a senescent-like phenotype. In vivo, senescence markers were also increased in the bone marrow of tumor-burdened mice. BMAds, in turn, provided resistance to dexamethasone-induced cell-cycle arrest and apoptosis, illuminating a new possible driver of myeloma cell evolution in a drug-resistant clone. Our findings reveal that bidirectional interactions between BMAds and myeloma cells have significant implications for the pathogenesis and treatment of multiple myeloma. Targeting senescence in the BMAd or other bone marrow cells may represent a novel therapeutic approach for treatment of multiple myeloma. Significance: This study changes the foundational understanding of how cancer cells hijack the bone marrow microenvironment and demonstrates that tumor cells induce senescence and metabolic changes in adipocytes, potentially driving new therapeutic directions.