tbuckley/cabot-search huggingface dataset:
Abstract 13868: Effects of Chronic Electronic Cigarette Vapor Exposures on the Cardiovascular Function in Rats
Authors: Wangde Dai, Jianru Shi, Juan Carreno, Lifu zhao, Michael T Kleinman, David A Herman, Rebecca M Johnson, Samantha Renusch, Irene Hasen, Amanda Ting, Robert A Kloner
Journal: Circulation (2020)

Background: We investigated the effects of chronic electronic cigarettes with nicotine (E-Cig) exposure on cardiovascular function in rats. Methods: Adult Sprague Dawley rats were exposed to either pure air (n=10) or E-Cig (n=14) for 12 weeks. After 12 weeks of exposure, flow-mediated vasodilation was measured in anesthetized rats with ultrasound to measure femoral artery diameter. Femoral artery flow velocity was measured before and 5 minutes after reperfusion of a 5-minute femoral artery occlusion. Cardiac function was assessed by echocardiogram. A Millar catheter was used to record systemic arterial and LV pressures. Cardiac output was measured using a themodilution catheter. Results: The femoral artery internal diameter and blood flow velocity were comparable between the 2 groups before and after artery occlusion. However, in the E-cig group, blood flow velocity significantly decreased from 55.5 ± 5.2 cm/s prior to occlusion to 41.3 ± 4.1 cm/s after reperfusion (p = 0.005); it remained similar prior to (47.8 ± 3.4 cm/s) and after (47.8 ± 5.5 cm/s) occlusion in the air group. There were no statistically significant differences in left ventricular diastolic and systolic dimensions, LV fractional shortening, heart rate or mean blood pressure (80 ± 3 mmHg in air and 79 ± 5 mmHg in E-cig group) , LV end-diastolic pressure (Ped), end-systolic pressure (Pes), peak -dP/dt, Tau, or cardiac output (48.3 ± 3.3 ml/min in air and 47.6 ± 3.9 ml/min in E-cig group) between the E-Cig and the pure air group. There was a trend toward a reduction in peak LV +dP /dt in the E-Cig group (5574 ± 341 mmHg/s) compared to the air group (6166 ± 238 mmHg/s). LV weight and wall thickness were similar between groups. Conclusions: Twelve weeks of E-Cig exposure did not affect heart rate or blood pressure; but did tend to reduce contractility. E-cigarette exposure slowed the flow-mediated blood flow velocity probably at a microvascular level, possibly by altering endothelial function.
Abstract 16617: Multimodality Imaging Approach in Delivery and Tracking of a Novel Imageable Hydrogel in a Chronic Porcine Infarct Model
Authors: Inga H Melvinsdottir, Shin-rong Lee, Ricardo Avendano, Dan Midgett, Yi-Hwa Liu, Stephanie Thorn, christi hawley, Marina Mamarian, Selen Uman, Jay D Humphrey, James Duncan, Jason A Burdick, Albert J Sinusas
Journal: Circulation (2020)

Introduction: Left ventricular (LV) remodeling is a known complication from myocardial infarction (MI). Intramyocardial hydrogel (HG) delivery can potentially prevent LV remodeling post MI. We evaluated the feasibility of using multimodality imaging approach to assess the delivery and response to an imageable HG in a chronic porcine MI model. Methods: Nine Yorkshire pigs subjected to 90 min balloon occlusion and reperfusion were randomized 5 days post MI to delivery of HG (n=5) or controls (n=4). 99m Tc-Tetrofosmin was injected during the occlusion to assess risk area (RA). The imageable HG (Hyaluronic Acid/Gelatin modified with Aldehydes and Hydrazides, with 100 mg/mL iohexol) was delivered intramyocardially in a 3x3 grid 5 days post-MI after assessing MI region with Hybrid 201 Tl SPECT/CT. Contrast cineCT angiography was performed at baseline, 5 days post MI and 1 hour and 1 week post thoracotomy to assess LV geometry, HG location and CT intensity expressed as Hounsfield units (HU). Results: The average RA was 16.7% LV with no difference between the groups (p=0.44). The HG was delivered to the MI region with guidance of SPECT/CT. The HG was visible with cineCT post-delivery within perfusion defect (MI: 154 ± 26 HU; remote 82 ± 20 HU, p&lt;0.0001), but it was not visible 1 week post-delivery (MI: 79 ± 12 HU; remote 80 ± 14 HU, p=0.94). The wall thickening of the MI region dropped by 33% in both groups (p=0.99) at 5 days post MI. After HG delivery wall thickening increased by 33% in the HG group but decreased by 31% in the control group (HG: 2.42 ± 0.33 mm; Control: 1.25 ± 0.31 mm, p=0.041). After similar increase in end diastolic volume (EDV) 5 days post MI (p=0.43), the EVD was significantly reduced post HG delivery in the HG group (6.0 ± 2.0 ml reduction) compared to the control group (6.3 ± 4.4 ml increase, p=0.042). Conclusions: Multimodality imaging is a feasible method to guide and track the delivery of a novel imageable HG. Intramyocardial HG delivery was associated with decreased LV remodeling.
Seroprevalence of SARS-CoV-2 in slums versus non-slums in Mumbai, India
Authors: Anup Malani, Daksha Shah, Gagandeep Kang, Gayatri Nair Lobo, Jayanthi Shastri, Manoj Mohanan, Rajesh Jain, Sachee Agrawal, Sandeep Juneja, Sofia Imad, Ullas Kolthur-Seetharam
Journal: The Lancet Global Health (2020)
Let Sleeping Patients Lie, avoiding unnecessary overnight vitals monitoring using a clinically based deep-learning model
Authors: Viktor Tóth, Marsha Meytlis, Douglas P. Barnaby, Kevin R. Bock, Michael I. Oppenheim, Yousef Al-Abed, Thomas McGinn, Karina W. Davidson, Lance B. Becker, Jamie S. Hirsch, Theodoros P. Zanos
Journal: npj Digital Medicine (2020)

Abstract Impaired sleep for hospital patients is an all too common reality. Sleep disruptions due to unnecessary overnight vital sign monitoring are associated with delirium, cognitive impairment, weakened immunity, hypertension, increased stress, and mortality. It is also one of the most common complaints of hospital patients while imposing additional burdens on healthcare providers. Previous efforts to forgo overnight vital sign measurements and improve patient sleep used providers’ subjective stability assessment or utilized an expanded, thus harder to retrieve, set of vitals and laboratory results to predict overnight clinical risk. Here, we present a model that incorporates past values of a small set of vital signs and predicts overnight stability for any given patient-night. Using data obtained from a multi-hospital health system between 2012 and 2019, a recurrent deep neural network was trained and evaluated using ~2.3 million admissions and 26 million vital sign assessments. The algorithm is agnostic to patient location, condition, and demographics, and relies only on sequences of five vital sign measurements, a calculated Modified Early Warning Score, and patient age. We achieved an area under the receiver operating characteristic curve of 0.966 (95% confidence interval [CI] 0.956–0.967) on the retrospective testing set, and 0.971 (95% CI 0.965–0.974) on the prospective set to predict overnight patient stability. The model enables safe avoidance of overnight monitoring for ~50% of patient-nights, while only misclassifying 2 out of 10,000 patient-nights as stable. Our approach is straightforward to deploy, only requires regularly obtained vital signs, and delivers easily actionable clinical predictions for a peaceful sleep in hospitals.
Call to Action: Structural Racism as a Fundamental Driver of Health Disparities: A Presidential Advisory From the American Heart Association
Authors: Keith Churchwell, Mitchell S.V. Elkind, Regina M. Benjamin, April P. Carson, Edward K. Chang, Willie Lawrence, Andrew Mills, Tanya M. Odom, Carlos J. Rodriguez, Fatima Rodriguez, Eduardo Sanchez, Anjail Z. Sharrief, Mario Sims, Olajide Williams
Journal: Circulation (2020)

Structural racism has been and remains a fundamental cause of persistent health disparities in the United States. The coronavirus disease 2019 (COVID-19) pandemic and the police killings of George Floyd, Breonna Taylor, and multiple others have been reminders that structural racism persists and restricts the opportunities for long, healthy lives of Black Americans and other historically disenfranchised groups. The American Heart Association has previously published statements addressing cardiovascular and cerebrovascular risk and disparities among racial and ethnic groups in the United States, but these statements have not adequately recognized structural racism as a fundamental cause of poor health and disparities in cardiovascular disease. This presidential advisory reviews the historical context, current state, and potential solutions to address structural racism in our country. Several principles emerge from our review: racism persists; racism is experienced; and the task of dismantling racism must belong to all of society. It cannot be accomplished by affected individuals alone. The path forward requires our commitment to transforming the conditions of historically marginalized communities, improving the quality of housing and neighborhood environments of these populations, advocating for policies that eliminate inequities in access to economic opportunities, quality education, and health care, and enhancing allyship among racial and ethnic groups. Future research on racism must be accelerated and should investigate the joint effects of multiple domains of racism (structural, interpersonal, cultural, anti-Black). The American Heart Association must look internally to correct its own shortcomings and advance antiracist policies and practices regarding science, public and professional education, and advocacy. With this advisory, the American Heart Association declares its unequivocal support of antiracist principles.
Marijuana Is Not the Only Cause of Drugged Driving—Reply
Authors: Mark R. Rosekind, Johnathon P. Ehsani, Jeffrey P. Michael
Journal: JAMA Internal Medicine (2020)

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Abstract 13535: Cardiopulmonary Exercise Testing in Pediatric Patients With Hypertrophic Cardiomyopathy
Authors: Jonathan B Edelson, Danielle Burstein, Helen Stanley, Maully Shah, Michael W McBride, Paul Stephens, Jungwon Min, Heather M Griffis, Carol Wittlieb-Weber, Matthew J O’Connor, Joseph W Rossano, Kimberly Y Lin, Stephen Paridon
Journal: Circulation (2020)

Introduction: Data from exercise stress tests (EST) offer novel information about cardiovascular (CV) health of pediatric hypertrophic cardiomyopathy (HCM) patients and may have prognostic utility. Methods: A retrospective single center analysis of all HCM patients &lt;21 years old who had EST from 1/1/2000-1/1/2019 was performed. Clinical and demographic characteristics, and exercise capacity data were analyzed. The primary composite endpoint included death/aborted cardiac death, transplant, or internal cardiac defibrillator (ICD) placement, with each patient limited to a single outcome. Outcomes analysis was performed using a multivariate analysis. Results: 142 patients (53% with a recognized genetic variant) were identified: 70% were white, and 79% male. No tests were aborted due to safety concerns. By echo, the mean ejection fraction was 68.2% (SD 8.7), mean max septal diameter (MSD) was 1.6 cm (SD 0.7) and average peak left ventricular outflow tract (LVOT) gradient at rest was 26.9 mmHg (SD 53.1). The mean age at EST was 15.3 y (SD 3.5). 90% of patients were tested using cycle ergonometry, and 48% of patients were on a beta-blocker. The mean peak oxygen consumption (V02) was 36.0 ml/kg/min (SD 9.5), 79.7% predicted, mean anaerobic threshold (AT) was 22.1 ml (SD 5.8), and mean peak power (P) was 2.4 watts/kg (SD 0.7), 71.5% predicted. 45.5% of patients had ectopy during exercise, and 9% had an abnormal blood pressure response to exercise (ABPR). The primary endpoint was reached in 32 patients (cardiac death/aborted cardiac death/transplant in 5 and ICD placement in 27). Adjusting for clinical and demographic factors, and beta blocker use, low P, MSD &gt; 1.8 cm, and LVOT gradient &gt; 50 mmhg, but not ABPR were independent predictors of the composite endpoint. Conclusion: Pediatric patients with HCM have impaired CV fitness as measured by EST. EST can be performed safely, and may provide valuable information in the risk stratification in children with HCM.
mTOR Restricts Chromatin Access and Genomic Activity to Maintain Hematopoietic Stem Cell Quiescence and Engraftment
Authors: Cuiqing Fan, Chuntao Zhao, Feng Zhang, Xiongwei Cai, Lingli Xu, Shan Lin, Xiaoyi Chen, Fukun Guo, Richard Q Lu, Weidong Tian, Yi Zheng
Journal: Blood (2017)
Trough levels of ipilimumab in serum as a potential biomarker of clinical outcomes for patients with advanced melanoma after treatment with ipilimumab
Authors: Yoshinobu Koguchi, Noriko Iwamoto, Takashi Shimada, Shu-Ching Chang, John Cha, Brendan D Curti, Walter J Urba, Brian D Piening, William L Redmond
Journal: Journal for ImmunoTherapy of Cancer (2021)

Background Immune checkpoint blockade (ICB) using anti-CTLA-4 and anti-PD-1/PD-L1 has revolutionized the treatment of advanced cancer. However, ICB is effective for only a small fraction of patients, and biomarkers such as expression of PD-L1 in tumor or serum levels of CXCL11 have suboptimal sensitivity and specificity. Exposure–response (E-R) relationships have been observed with other therapeutic monoclonal antibodies. There are many factors influencing E-R relationships, yet several studies have shown that trough levels of anti-PD-1/PD-L1 correlated with clinical outcomes. However, the potential utility of anti-CTLA-4 levels as a biomarker remains unknown. Methods Serum was obtained at trough levels at weeks 7 and 12 (after doses 2 and 4) from patients with advanced melanoma who received ipilimumab alone (3 mg/kg every 3 weeks for four treatments) via an expanded access program ( NCT00495066 ). We have successfully established a proteomics assay to measure the concentration of ipilimumab in serum using an liquid chromatography with tandem mass spectrometry-based nanosurface and molecular-orientation limited proteolysis (nSMOL) approach. Serum samples from 38 patients were assessed for trough levels of ipilimumab by the nSMOL assay. Results We found that trough levels of ipilimumab were higher in patients who developed immune-related adverse events but did not differ based on the presence or absence of disease progression. We found that patients with higher trough levels of ipilimumab had better overall survival when grouped based on ipilimumab trough levels. Trough levels of ipilimumab were inversely associated with pretreatment serum levels of CXCL11, a predictive biomarker we previously identified, and soluble CD25 (sCD25), a prognostic biomarker for advanced melanoma, as well as C reactive protein (CRP) and interleukin (IL)-6 levels at week 7. Conclusions Our results suggest that trough levels of ipilimumab may be a useful biomarker for the long-term survival of patients with advanced melanoma treated with ipilimumab. The association of ipilimumab trough levels with pretreatment serum levels of CXCL11 and sCD25 is suggestive of a baseline-driven E-R relationship, and the association of ipilimumab trough levels with on-treatment levels of CRP and IL-6 is suggestive of response-driven E-R relationship. Our findings highlight the potential utility of trough levels of ipilimumab as a biomarker. Trial registration number NCT00495066 .
Abstract 17284: Geographic Variation in Cardiovascular Health Among American Adults
Authors: Vibhu Parcha, Rajat Kalra, Sarabjeet Suri, Gargya Malla, Thomas J Wang, Garima Arora, Pankaj Arora
Journal: Circulation (2020)

Background: There are longstanding and pervasive geographic disparities in cardiovascular (CV) health in the US. We sought to evaluate the contemporary trends in CV risk factors by census regions from 2011-2017. The region-specific CV mortality for 2017 was evaluated to assess the geographic overlap between risk factors, CV mortality, and COVID-19 mortality. Methods: The age-adjusted prevalence (per 2010 US census proportions) of CV health index (CVHI) metrics (sum of ideal blood pressure, blood glucose, lipid levels, body mass index, smoking status, physical activity, and diet) (0-7 points), were estimated as both continuous and categorical (ideal, intermediate and poor CVHI) measures in the 2011-2017 BRFSS. Regional trends were evaluated with multivariable-adjusted logistic regression models. Age-adjusted CV mortality for 2017 was derived from the CDC WONDER database. COVID-19 crude mortality rates were ascertained from respective state public health departments. Results: Among 1,362,529 American adults, the CVHI score increased from 3.89±0.004 in 2011 to 3.96±0.01 in 2017 (P&lt;0.001), modestly improvements in all regions (P&lt;0.05 for all). Ideal CV health prevalence improved only in the northeastern (P=0.03) and southern regions (P=0.002). The CVHI score (3.81±0.01) and prevalence of ideal CV health [2017: 12.2% (95% CI: 11.7-12.7%)] was lowest in southern US. This corresponded with the distribution of CV mortality (per 100,000 persons), which was highest in southern region (233.0 [95% CI: 232.2-233.8]) and lowest in western region (197.5 [95% CI: 19.6-198.5]) ( Figure 1 ). State-level distribution of poor CV health did not track with COVID-19 mortality. Conclusion: Despite a modest improvement in CVHI, only one-in-six Americans have ideal CV health with significant regional and state-level differences that correlate with the geographical distribution of CV mortality but not COVID-19 mortality. These disparities may worsen after the COVID-19 pandemic.
Abstract 13750: Cardiac Magnetic Resonance to Predict Coronary Artery Compression in Patients Undergoing Transcatheter Pulmonary Valve Implantation Into Conduits
Authors: Ryan A Romans, Jimmy C Lu, Wendy Whiteside, Sunkyung Yu, Osamah Aldoss, Aimee K Armstrong, Brian Boe, David Balzer, Jason T Christensen, Thomas K Jones, Britton C Keeshan, Daniel McLennan, George T Nicholson, Neil Patel, Arash Salavitabar, Shabana Shahanavaz, Patrick M Sullivan, Mariel E Turner, Jeffrey D Zampi
Journal: Circulation (2020)

Introduction: Transcatheter pulmonary valve implantation (TPVi) is a widely available option to treat right ventricular outflow tract (RVOT) conduits, but coronary artery compression is an absolute contraindication. Cardiac magnetic resonance (CMR) may evaluate coronary anatomy, but its utility in predicting coronary compression is not well established. Hypothesis: CMR prior to TPVi can accurately predict coronary compression risk. Methods: We analyzed all patients with a recent CMR (≤ 12 months) and attempted TPVi in an RVOT conduit at 9 centers from 2007-2016. A core lab reviewed all CMRs for the shortest orthogonal distance from a coronary artery to the conduit, the shortest distance from a coronary artery to the most stenotic area of the conduit, and subjective assessment of coronary compression risk. Receiver operating characteristic curve was used to determine optimal predictive distances. Univariate and independent associations of the distances and qualitative assessment with coronary compression were examined using logistic regression. Results: Of 231 patients (62% male, median age 19.0 years), TPVi was successful in 198 (86%); in 24 (10%) balloon testing (documented coronary compression or high risk) precluded implantation. Distance to the RV to PA conduit ≤ 2.1 mm (area under the curve [AUC] 0.70) and distance to most stenotic area ≤ 13.1 mm (AUC 0.69) predicted coronary compression (Table). Subjective assessment had the highest AUC (0.78), with 96% negative predictive value. Both distances and qualitative assessment remained independently associated with coronary compression when controlling for abnormal coronary anatomy. Conclusions: CMR can predict the risk of coronary compression during TPVi in RVOT conduits but cannot completely exclude the risk of coronary compression. CMR may assist in patient selection and counselling families prior to TPVi, although balloon testing prior to TPVi remains essential.
Abstract 15038: Gender Differences Amongst Caucasians and African Americans in Rates of Arrhythmias, Implantable Cardiac Devices, and In-hospital Mortality in Sarcoidosis Patients With Cardiomyopathy
Authors: Chaitanya Rojulpote, Karthik Gonuguntla, Shivaraj Patil, Pranav Karambelkar, Tapan Buch, Abhijit Bhattaru, Kiranmayi Vuthaluru, Nikola Perosevic, Paco E Bravo
Journal: Circulation (2020)

Introduction: The prevalence of sarcoid cardiomyopathy (SCM) with female predominance is well known. However, gender differences amongst individual races remains poorly studied. Hypothesis: We sought to determine and compare within each gender and race, the rates of arrhythmias, implantable cardiac devices, and in-hospital mortality in patients with SCM after excluding those with a history of coronary artery disease. Methods: The Nationwide Inpatient Sample was queried from 2010 to 2014 using ICD-9 diagnosis code (135) for sarcoidosis among patients &gt;18 years old. We combined it with code (425.8) for cardiomyopathy in other diseases including sarcoid and sarcoid heart muscle disease. We excluded patients with a history of prior myocardial infarction, percutaneous coronary intervention and coronary artery bypass graft. Results: From 2010 to 2014, we identified 9,063 patients with SCM (mean age = 53.11 ± 11.28 years; men 51.8% and black 52.5%). Upon comparison of gender within races, event rates per 100 patients were (white male, white female, black male, black female; p-value): atrial fibrillation (20.7, 18.8, 18, 16.1; p=0.172), ventricular fibrillation (VF) (4.1, 1.7, 2.3, 2.1; p&lt;0.001), ventricular tachycardia (VT) (33.1, 19.3, 25.1, 21; p&lt;0.001), complete heart block (CHB) (9.1, 8.6, 3.4, 3.6; p=0.58), second degree Mobitz type II (0.3, 0.35, 0.8, 0.4; p=0.717), implantable cardioverter-defibrillator (ICD) (13.3, 9.3, 8.4, 9.2; p&lt;0.001), cardiac resynchronization therapy defibrillator (CRT-D) (5.5, 1.4, 3.4, 2.5; p&lt;0.001), permanent pacemaker (PPM) (2.2, 4.1, 1.1, 1.6; p&lt;0.001), sudden cardiac arrest (SCA) (1.3, 1.7, 1.3, 2.4; p=0.34), endomyocardial biopsy (EMB) (3.6, 2.1, 1.9, 2.3; p=0.011), cardiac MRI (CMR) (1.4, 0.3, 0.7, 1.3; p=0.002), cardiogenic shock (2.5, 1.4, 3, 3; p=0.027), orthotopic heart transplantation (OHT) (2.3, 1.4, 1.1, 0.2; p=0.05), catheter ablation (8.3, 4.5, 3.8, 1.9; p&lt;0.001), and in-hospital mortality (1.7, 3, 2.9, 2.6; p=0.008). Conclusion: White males had higher rates of VF, VT, CHB, but they also had a lower in-hospital mortality and SCA rates likely due to higher procedural rates such as EMB, ICD, CRT-D, catheter ablation and OHT as compared to others.