tbuckley/cabot-search huggingface dataset:
Abstract 17451: Use of Intracardiac Echocardiography to Predict Follow-Up Hemodynamic Changes After Transcatheter Pulmonary Valve Implantation
Authors: Salvador Alberto J Rodriguez Franco, Salvador Alberto A Rodriguez Franco, Ryan A Leahy, Jess T Randall, Jenny E Zablah, Gareth Morgan
Journal: Circulation (2020)

Objective: Evaluate the correlation between intracardiac echocardiography (ICE) gradients and next-day and one-month transthoracic echocardiography (TTE) gradients, after percutaneous pulmonary valve implantation (PPVI) Background: Post-procedure Doppler-derived gradients have gained popularity as acceptable parameters to evaluate valve function after PPVI, but they have no proven correlation with the invasive gradient measured during the procedure, indeed a large disparity between these two measurements has been described. Interestingly, ICE gradients, which are also an invasive assessment, have been suggested to present a strong correlation with post-procedure echocardiographic evaluations, and their application could allow a more accurate and predictable evaluation of valve function, establishing a typical pattern of short-term hemodynamic progression in these patients. Methods: We performed a retrospective chart review of 84 patients who underwent PPVI between January 2018 and December 2019 and selected 51 patients in whom ICE was performed after valve implantation. We evaluated the correlation between ICE and RV-PA gradients with post-procedural Doppler-derived gradients. Among the parameters assessed, the one which demonstrated the strongest correlation was used to create a predictive model to estimate the expected gradients after PPVI. Results: All the assessed correlation models between Doppler-derived parameters during ICE evaluation and post-procedure TTE evaluations were statistically significant, and presented moderate to strong linear relationships. The strongest correlation was found between ICE Doppler mean gradient and post-procedural Doppler mean gradient. The derived predictive equation was distributed by the size of the device implanted and body mass index. We found this model was capable of predicting post-procedural evaluations (mean Doppler-derived gradients at 1 day and 1 month) within a range of ±5 mmHg from the observed value in more than 80% of cases. Conclusions: There is a strong correlation between ICE and post-procedure TTE. This allowed us to derive a predictive equation, distributed by body size and device size that defines expected echo Doppler-derived hemodynamic pathways after PPVI.
Randomized phase II trial of lymphodepletion plus adoptive cell transfer of tumor-infiltrating lymphocytes, with or without dendritic cell vaccination, in patients with metastatic melanoma
Authors: Chantal Saberian, Rodabe N. Amaria, Amer M. Najjar, Laszlo G. Radvanyi, Cara L. Haymaker, Marie-Andrée Forget, Roland L. Bassett, Silvana C. Faria, Isabella C. Glitza, Enrique Alvarez, Sapna Parshottam, Victor Prieto, Gregory Lizée, Michael K. Wong, Jennifer L. McQuade, Adi Diab, Cassian Yee, Hussein A. Tawbi, Sapna Patel, Elizabeth J. Shpall, Michael A. Davies, Patrick Hwu, Chantale Bernatchez
Journal: Journal for ImmunoTherapy of Cancer (2021)

Background The adoptive transfer of tumor-infiltrating lymphocytes (TIL) has demonstrated robust efficacy in metastatic melanoma patients. Tumor antigen–loaded dendritic cells (DCs) are believed to optimally activate antigen-specific T lymphocytes. We hypothesized that the combined transfer of TIL, containing a melanoma antigen recognized by T cells 1 (MART-1) specific population, with MART-1-pulsed DC will result in enhanced proliferation and prolonged survival of transferred MART-1 specific T cells in vivo ultimately leading to improved clinical responses. Design We tested the combination of TIL and DC in a phase II clinical trial of patients with advanced stage IV melanoma. HLA-A0201 patients whose early TIL cultures demonstrated reactivity to MART-1 peptide were randomly assigned to receive TIL alone or TIL +DC pulsed with MART-1 peptide. The primary endpoint was to evaluate the persistence of MART-1 TIL in the two arms. Secondary endpoints were to evaluate clinical response and survival. Results Ten patients were given TIL alone while eight patients received TIL+DC vaccine. Infused MART-1 reactive CD8 + TIL were tracked in the blood over time by flow cytometry and results show good persistence in both arms, with no difference in the persistence of MART-1 between the two arms. The objective response rate was 30% (3/10) in the TIL arm and 50% (4/8) in the TIL+DC arm. All treatments were well tolerated. Conclusions The combination of TIL +DC showed no difference in the persistence of MART-1 TIL compared with TIL therapy alone. Although more patients showed a clinical response to TIL+DC therapy, this study was not powered to resolve differences between groups. Trial registration number NCT00338377 .
An Unusual Cause of Macroscopic T-Wave Alternans in a Patient With Acute Promyelocytic Leukemia
Authors: Zhen-Hua Liang, Yun-Tao Zhao, Yi-Chang Zhou
Journal: JAMA Internal Medicine (2021)

This case study presents the electrocardiographic findings in a man in his 50s with a history of acute promyelocytic leukemia treated with arsenic trioxide who was hospitalized with recurrent loss of consciousness.
Hypertension optimal treatment (HOT) trial (multiple letters) [1]
Authors: A. Simon, J. Levenson, F. Avanzini, R. Marchioli, C. Alli, G. Tognoni, E. Grossman, U. Goldbourt, F. Gueyffier, J. P. Boissel, T. Senderovitz, J. P. Kampmann, M. E. Safar, J. Blacher, J. A. Staessen, J. M. Cruickshank, H. H. Parving, L. Hansson, A. Zanchetti
Journal: The Lancet (1998)
Abstract 15146: Reverse Right Heart Chambers Remodeling and Decrease in Tricuspid Regurgitation Severity After Restoration of Sinus Rhythm in Patients With Atrial Fibrillation: A Mid-term 3d Echocardiographic Study
Authors: Iris Benhamou Tarallo, Laurie SOULAT-DUFOUR, Sylvie Lang, Stephane Ederhy, Saroumadi Adavane-Scheuble, Marion Chauvet-Droit, Pascal Nhan, Marie-Liesse Jean, Rim Ben Said, Pauline Issaurat, Franck Boccara, Ariel A Cohen
Journal: Circulation (2020)

Introduction: The natural history of tricuspid regurgitation (TR) and right heart chambers remodeling in patients with atrial fibrillation (AF) according to the cardiac rhythm at mid-term follow-up has been poorly assessed. Hypothesis: Restoration of sinus rhythm in AF patients is beneficial to the remodeling of right heart chambers and decrease in TR severity. Methods: We prospectively and serially evaluated 24 consecutive patients hospitalized for AF using three dimensional (3D) transthoracic echocardiography (TTE) at admission (M0) and every 6 months during a 2 years-follow-up (FU, M6, M12, M18, M24) (120 TTE exams). Patients were divided into two groups according to their cardiac rhythm at M24: restoration to SR (SR group, n=14) and persistence of AF (AF group, n=10). TR grade severity was divided into 4 grades using an integrated approach (0: none or trace; 1: mild; 2: moderate; 3: severe TR). 3D indexed volumes (3D Vi) of the right atrium (RA) and right ventricle (RV) as well as 3D tricuspid annulus (TA) area were analyzed in end systole (ES) and end diastole (ED). Results: Beyond 6 months of FU, the SR group had overall significantly lower 3D ES RA Vi, 3D ED RA Vi, 3D TA ES area and TR severity in comparison with AF group (Figure). There were no significant differences between the 2 groups with regard to 3D RV Volumes and 3D ED TA area. Conclusions: According to our results on both TR evolution and right heart cavities reverse remodeling, strategies aiming at SR restoration in patients with AF and TR should be broadly discussed.
Biodiversity conservation as a promising frontier for behavioural science
Authors: Kristian Steensen Nielsen, Theresa M. Marteau, Jan M. Bauer, Richard B. Bradbury, Steven Broad, Gayle Burgess, Mark Burgman, Hilary Byerly, Susan Clayton, Dulce Espelosin, Paul J. Ferraro, Brendan Fisher, Emma E. Garnett, Julia P. G. Jones, Mark Otieno, Stephen Polasky, Taylor H. Ricketts, Rosie Trevelyan, Sander van der Linden, Diogo Veríssimo, Andrew Balmford
Journal: Nature Human Behaviour (2021)
Abstract 15364: Radiation Exposure of the Base of the Heart Accelerates Coronary Atherosclerosis
Authors: Prerna Ramesh Nepali, Karen Gabriels, Mickael Mathieu, James Russell, Johannes A te Poele, Sarah Kitz, Sebastien Monette, Sylvia Heeneman, Fiona A Stewart, Edgar A JAIMES, Adriana Haimovitz-Friedman
Journal: Circulation (2020)

Introduction: Radiation therapy (RT) is used in the treatment of approximately 50% of cancer patients. Thoracic RT is commonly used in breast cancer, Hodgkin’s lymphoma, head and neck and lung cancers among others. Unfortunately, the benefits of RT are often out-weighed by the by-stander cardiovascular risks and associated non-relapse mortality in cancer survivors. Hence, the development of cardiovascular disease (CVD) in patients receiving RT remains an important clinical problem. The base of the heart has been shown to be dose-sensitive wherein basal irradiation is associated with lower patient survival in lung-cancer patients treated with curative-intent RT. Although the mechanisms for RT-induced CVD are poorly understood, direct injury to the coronary arteries endothelium has been implicated. Hypothesis and Results: We hypothesized that irradiation harms heart tissue differentially depending upon the specific region that receives radiation. In order to test this hypothesis, we irradiated different regions of the heart and measured the development of atherosclerotic plaques as compared to control unirradiated mice. Apolipoprotein E knockout (ApoE -/- ) mice were irradiated with 16Gy to the base, apex or to the whole heart. Our results demonstrate that the base of the heart has significantly greater sensitivity to irradiation as compared to the apex, and develops atherosclerotic lesions that are equivalent to those produced by whole heart irradiation at 20 weeks post-RT. In addition, a greater number of plaques are present in the base of the heart after whole heart and basal irradiation compared to unirradiated controls at 40 weeks post-RT. Atherosclerotic plaques with subendothelial macrophage foam cell accumulation and fibrin deposits were also observed at 20 and 40 weeks post basal or whole heart RT. Ongoing studies are testing the effect of high-fat diet on the development of differential RT-induced atherosclerotic plaques in ApoE -/- mice and their correlation with heart function. Conclusion: Our studies strengthen the argument for advanced RT techniques to shield the base of the heart from radiation exposure to minimize RT-induced CVD and improve the quality of life and survival of cancer patients receiving RT.
Abstract 17491: Abstract
Authors: Tariq Azam, Hanna Berlin, Husam Shadid, Michael Pan, Elizabeth Anderson, Chelsea Meloche, Rafey Feroze, Jeff Leya, Patrick O'Hayer, Rayan Kaakati, abbas bitar, Kishan Padalia, Daniel Perry, Pennelope Blakely, Peiyao Zhao, Lili Zhao, Salim Hayek
Journal: Circulation (2020)

Introduction: Mortality and demographic data during the COVID-19 pandemic demonstrate a disproportionate prevalence and mortality among patients identifying as Black and Native American. Hypothesis: We hypothesized minority patients would have worse COVID-19 outcomes and be less likely to receive COVID-19 specific therapies compared to Caucasian patients. Methods: We used the Michigan Medicine COVID-19 Cohort to extract treatment and outcome data on adult patients with COVID-19 who had been discharged or died by June 17 th , 2020. We calculated crude rates of COVID-19 specific treatments and outcomes between patients identifying in different racial groups using Caucasian patients as a baseline. Results: Of 553 patients analyzed, 486 patients were included, 213 (43.8%) identified as Caucasian, 232 (47.7%) identified as Black, 33 (6.8%) identified as Asian, 6 (1.2%) had an unknown racial group, and 1 identified as more than one race and 1 identified as Native American. Given this distribution, analysis was focused on Black and Caucasian patients. Black patients were less likely to receive remdesivir (3.9% vs 12.2%, P-value = 0.001) or be enrolled in COVID-19 clinical trials (10.3% vs 19.7%, P-value = 0.005). Black patients were more likely than Caucasian patients to have acute kidney injury (63.8% vs 45.5%, P-value = &amp;lt;0.001) and need renal replacement therapy (20.3% vs 9.9%, P-value = 0.002). No significant differences were noted in mortality, ARDS, need for renal replacement therapy at discharge, or length of stay. Conclusions: Racial disparities exist in both treatment and outcomes in COVID-19. We report a stark difference in the rate of receipt of remdesivir between Black and Caucasian patients and lower Black patient enrollment in clinical trials, matching trends in other areas of medicine. Further study is needed to determine if these differences in treatment are associated with the differential renal outcomes seen, and how comorbidities impact outcomes.
Colorectal Cancer Screening Starting at Age 45 Years—Ensuring Benefits Are Realized by All
Authors: Shivan J. Mehta, Arden M. Morris, Sonia S. Kupfer
Journal: JAMA Network Open (2021)

US Preventive Services Task Force; Karina W. Davidson, PhD, MASc; Michael J. Barry, MD; Carol M. Mangione, MD, MSPH; Michael Cabana, MD, MA, MPH; Aaron B. Caughey, MD, PhD; Esa M. Davis, MD, MPH; Katrina E. Donahue, MD, MPH; Chyke A. Doubeni, MD, MPH; Alex H. Krist, MD, MPH; Martha Kubik, PhD, RN; Li Li, MD, PhD, MPH; Gbenga Ogedegbe, MD, MPH; Douglas K. Owens, MD, MS; Lori Pbert, PhD; Michael Silverstein, MD, MPH; James Stevermer, MD, MSPH; Chien-Wen Tseng, MD, MPH, MSEE; John B. Wong, MD
Abstract 16231: Long-term Outcomes of Coronary Artery Bypass Grafting versus Percutaneous Coronary Intervention in Patients With Non-st Elevation Acute Coronary Syndrome
Authors: Kiro Barssoum, Ashish Kumar, Devesh Rai, Adnan Kharsa, Medhat Chowdhury, Ahmed Elkaryoni, Samarthkumar J Thakkar, Muhammad Waqas Tahir, Mohan Rao
Journal: Circulation (2020)

Background: Long term outcomes of culprit multi-vessel and left main patients who presented with Non-ST Elevation Acute Coronary Syndrome (NSTE-ACS) and underwent either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) are not well defined. Randomized trials comparing the two modalities constituted mainly of patients with stable coronary artery disease (SCAD). We performed a meta-analysis of studies that compared the long term outcomes of CABG vs. PCI in NSTE-ACS. Methods: Medline, EmCare, CINAHL, Cochrane databases were queried for relevant articles. Studies that included patients with SCAD and ST-elevation myocardial infarction were excluded. Our primary outcome was major adverse cardiac events (MACE) at 3-5 years, defined as a composite of all-cause mortality, stroke, re-infarction and repeat revascularization. The secondary outcome was re-infarction at 3 to 5 years. We used the Paule-Mandel method with Hartung-Knapp-Sidik-Jonkman adjustment to estimate risk ratio (RR) with 95% confidence interval (CI). Heterogeneity was assessed using Higgin’s I 2 statistics. All statistical analysis was carried out using R version 3.6.2 Results: Four observational studies met our inclusion criteria with a total number of 6695 patients. At 3 to 5 years, the PCI group was associated with a higher risk of MACE as compared to CABG, (RR): 1.52, 95% CI: 1.28 to 1.81, I 2 =0% (PANEL A). The PCI group also had a higher risk of re-infarctions during the period of follow up, RR: 1.88, 95% CI 1.49 to 2.38, I 2 =0% (PANEL B). Conclusion: In this meta-analysis, CABG was associated with a lower risk of MACE and re-infarctions as compared to PCI during 3 to 5 years follow up period.
Abstract 13575: Lack of Both Mitochondrial Proteins Sirt3 and Ucp2 in Mice Recapitulates Many Critical Features of Human Pulmonary Arterial Hypertension (PAH), Including Inflammatory Plexogenic Lesions, Supporting the Metabolic Theory of PAH
Authors: Yongneng Zhang, Sotirios D Zervopoulos, Aristeidis E Boukouris, Bruno Saleme, Yongsheng Liu, Alois Haromy, Linda Webster, Seyed Amirhossein Tabatabaei Dakhili, John R Ussher, Gopinath Sutendra, Evangelos D Michelakis
Journal: Circulation (2020)

Loss-of function SNPs for Sirt3 (a mitochondrial deacetylase) and Ucp2 (an atypical uncoupling protein enabling mitochondrial calcium entry) have been associated with insulin resistance and obesity in humans; and patients with PAH have insulin resistance without being obese. In a cohort of PAH patients (n=60) we found these SNPs often both in the same patient in a homozygous or heterozygous manner and their presence correlated positively with the degree of PAH upon referral, the presence of type II diabetes and outcomes (death, transplantation). We generated and studied double KO mice for Sirt3 and Ucp2 using closed-chest right heart catheterization and echocardiography and found increasing severity of pulmonary hypertension (PHT) in Sirt3 +/- -Ucp2 +/ - , Sirt3 -/- -Ucp2 +/ - , Sirt3 +/- -Ucp2 -/- and Sirt3 -/- -Ucp2 -/- , associated with decreasing cardiac output and increasing right ventricular hypertrophy, dilatation and dysfunction (TAPSE), compared to wild-type (WT) mice. The LVEDP in all mice was normal. There was increasing severity of vascular remodeling with increasing levels of CD4 + cell infiltration, while Sirt3 -/- -Ucp2 +/- , Sirt3 +/- -Ucp2 -/- and Sirt3 -/- -Ucp2 -/- mice also developed frequent plexogenic lesions. In vivo and in vitro pulmonary artery smooth muscle cells (PASMC) expressed higher levels of Ki67, compared to WT mice. In vitro, the Sirt3 -/- -Ucp2 +/- , Sirt3 +/- -Ucp2 -/- and Sirt3 -/- -Ucp2 -/- PASMC exhibited more apoptosis-resistance, expressed higher nuclear levels of proliferative transcription factors (HIF1, NFATc2), exhibited decreased respiration and higher levels of glycolysis, similarly to previous reports of animal and human PAH PASMC. The Sirt3 -/- -Ucp2 -/- , but not the WT mice, also developed in vivo evidence of insulin resistance. Our work supports the metabolic theory of PAH and shows that these mice exhibit spontaneous severe PHT (without environmental or chemical triggers) in a gene dose-response dependent manner that mimics human PAH. No other mouse model of PHT has shown frequent and predictable plexogenic lesions. Our study is relevant to the PAH patients that carry loss-of-function SNPs of mitochondrial proteins and offers a new mouse model of PAH, with more features of human PAH than previous mice models.
Abstract MP07: Metabolic Signature Improves Heart Failure Risk Prediction In Older Adults
Authors: Guning Liu, Quynh Nguyen, Sunil K Agarwal, David Aguilar, Eric Boerwinkle, Patricia Chang, Brian Claggett, Laura R Loehr, Kunihiro Matsushita, Carlos Rodriguez, Joseph Rossi, Stuart D Russell, Brandon Stacey, Gerardo M Heiss, Amil Shah, Bing Yu
Journal: Circulation (2021)

Introduction: Circulating metabolome profiling holds promise in predicting HF risk, but its prediction performance among older adults is not well established. Hypothesis: We hypothesize that metabolic signatures are associated with the risk of HF and its subtypes (HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF)), and they can improve HF risk prediction beyond established risk factors. Methods: We measured 828 serum metabolites among 4,030 African and European Americans free of HF from the Atherosclerosis Risk in Communities (ARIC) study visit 5 (2011-2013). We regressed incident HF on each metabolite using Cox proportional hazards models. A metabolite risk score (MRS) was derived by summing individual metabolite levels weighted by beta coefficients estimated from least absolute shrinkage and selection operator (LASSO) regularized regressions. We regressed incident HF, HFpEF and HFrEF on the MRS. Harrell’s C-statistics were calculated to evaluate risk discrimination. We replicated the association between MRS and HF in 3,697 independent ARIC participants with metabolite measured at visit 1 (1987-1989). Results: Among 4,030 participants, the mean (SD) age was 76 (5) years. Adjusting for HF risk factors, 302 metabolites were associated with incident HF (false discovery rate &lt; 0.05). One SD increase of the MRS, constructed from 51 metabolites selected by LASSO, was associated with two to three-fold high risk of HF, HFpEF and HFrEF in the fully adjusted models ( Table ). Five-year risk prediction analysis showed that C statistics improved from 0.850 to 0.884 by adding MRS over ARIC HF risk factors, kidney function and NT-proBNP (ΔC (95%CI) = 0.034 (0.017,0.052)). In the replication analysis, a more parsimonious MRS constructed using 15 metabolites, was associated with incident HF ( Table ). Conclusions: We identified a metabolic signature that was associated with the risk of HF and improved HF risk prediction. Our findings may shed light on pathways in HF development and at-risk populations.
Abstract 13123: Early Mobilization of Older Adults in the Cardiac Intensive Care Unit
Authors: Michael Goldfarb, Koorosh Semsar-kazerooni, Jose Morais, Diana Dima
Journal: Circulation (2020)

Background: Early mobilization (EM) is beneficial in general critical care units and in older hospitalized patients, but little is known about EM in older adults with acute cardiovascular disease. Methods: Consecutive admissions of adults ≥ 80 years old to a cardiac ICU at an academic tertiary care centre before (January to December 2017) and after (February 2018 to June 2019) implementation of a structured nurse-driven EM program. Mobility was measured using the validated Level of Function (LOF) Mobility Scale, which ranges from 0 (bed immobile) to 5 (able to walk &gt; 50 feet). The primary outcome was discharge home. Results: There were 412 patients included (N=234, intervention; N=178, preintervention). There was no difference in mean age between groups (overall mean age 86.3±4.8 years old) or sex (overall female N=215, 52.2%). In the intervention group, functional impairment was present in 89 patients (38.0%) prior to hospitalization and in 209 patients (89.3%) on admission. Nearly half of patients undergoing EM (N=107; 45.7%) improved their LOF by ≥1 during cardiac ICU stay. Mobilization occurred during nearly all opportunities (838/850; 98.6%) and most mobility activities were completed (2,207/2,553; 86.4%). Adverse events were rare (5/2,207 activities [0.2%]) and transient (N=5). There were no falls, line dislodgements, or healthcare team injuries). Patients in the intervention group were more likely than patients in the preintervention group to be discharged home (74.4% vs. 65.7%, P=0.047, respectively) and had a lower rate of in-hospital death (6.4% vs. 14.6%, P=0.006, respectively). There was no difference in length of hospital stay or re-admission. In the multivariable analysis, predictors of discharge home were younger age, heart failure, and higher prehospital LOF. Outcomes were similar in adults ≥ age 90. Conclusion: EM is safe in older adults in the cardiac ICU and is associated with reduced discharge to healthcare facility and in-hospital mortality.