tbuckley/cabot-search huggingface dataset:
Abstract 14301: Effects of Septal Reduction Therapy on Acute Cardiovascular Events and All-cause Mortality in Patients With Obstructive Hypertrophic Cardiomyopathy: Propensity Score-matched Study
Authors: Sae Morita, Yanling Zhao, Kohei Hasegawa, Muredach P Reilly, Mathew S Maurer, Hiroo Takayama, Yuichi J Shimada
Journal: Circulation (2020)

Introduction: Septal reduction therapy (SRT) - i.e., septal myectomy and alcohol septal ablation - has been used to treat medically-refractory obstructive hypertrophic cardiomyopathy (HOCM) for a few decades. However, the effects of SRT on the risk of acute cardiovascular (CV) events and all-cause mortality are largely unknown. Hypothesis: SRT is associated with a long-term decrease in acute CV events and a short-term increase in all-cause mortality in patients with HOCM. Methods: We performed a propensity score (PS)-matched study using all-payer databases that capture all hospitalizations and outpatient visits in New York State. We identified patients with HOCM who underwent SRT between January 1, 2007 and December 31, 2014 (i.e., the SRT group) and those who have never had SRT but had at least one hospitalization for HOCM during the same period (i.e., the control group). We performed 1:1 PS matching using age, sex, race/ethnicity, source of payment, season and year of starting event follow-up (i.e., the day of SRT or the index hospitalization), and Elixhauser comorbidity measures. The primary outcomes were (1) acute CV event (i.e., emergency department visit or unplanned hospitalization for CV disease) during 1-360 days and 361-720 days and (2) 7-, 15-, 30-, 180-, and 360-day all-cause mortality. We compared the risk of the outcome event using logistic regression models. Results: The analytic cohort consisted of 690 patients with HOCM (i.e., 345 PS-matched pairs). The SRT group had a lower risk of acute CV event during 361-720 days (OR 0.44; 95% CI, 0.20-0.97; P=0.04) but a higher risk of 7-day mortality (11 vs. 2 in the control group; P=0.03). The SRT group had a non-significant trend towards lower all-cause mortality in longer terms ( Figure ). Conclusion: In this population-based PS-matched study of patients with HOCM, SRT was associated with a reduced risk of acute CV events in the second post-procedure year at the sacrifice of a short-term increase in all-cause mortality.
Sexual behavior and sexual health of transgender women and men before treatment: Similarities and differences
Authors: María Dolores Gil-Llario, Beatriz Gil-Juliá, Cristina Giménez-García, Trinidad Bergero-Miguel, Rafael Ballester-Arnal
Journal: International Journal of Transgender Health (2020)

There is a lack of research on the sexual health of transgender individuals, as well as a paucity of data about overall sexual health indexes before treatment.This study aims to analyze the main issues involved in transgender individuals' sexual behavior (with and without a partner), overall sexual health indexes, and potential predictors of sexual health, comparing trans men and trans women on all the variables assessed.260 trans people were recruited at a transgender health clinic in Spain. Participants completed the Sexual Behavior Questionnaire for transgender people before receiving any treatment.Overall results show that trans women have a more ego-dystonic and problematic experience of their sexuality. Regarding masturbation, there are no differences in its frequency between trans women and trans men, although there are differences in the reasons they do not masturbate. Regarding sexual behavior with a partner, trans women experience more difficulties than trans men, with significant differences in several areas (e.g., the percentage of transgender individuals who never allow their partners to touch their genitals). Regarding sexual health, we found differences between groups, with lower sexual desire, sexual arousal without orgasm, and overall sexual health in trans women. Likewise, different variables such as pain during sex, fantasies, and time with a steady partner seem to be associated with the different sexual health indexes.Our results show a clear difference between trans women and trans men in most of the sexual aspects assessed, revealing greater gender dysphoria in trans women. We would recommend taking these data into account, as well as variables that may be associated with different sexual health indexes, when designing interventions for transgender people.
Persistence and Evolution of SARS-CoV-2 in an Immunocompromised Host
Authors: Bina Choi, Manish C Choudhary, James Regan, Jeffrey A Sparks, Robert F Padera, Xueting Qiu, Isaac H Solomon, Hsiao-Hsuan Kuo, Julie Boucau, Kathryn Bowman, U Das Adhikari, Marisa L Winkler, Alisa A Mueller, Tiffany Y-T Hsu, Michaël Desjardins, Lindsey R Baden, Brian T Chan, Bruce D Walker, Mathias Lichterfeld, Manfred Brigl, Douglas S Kwon, Sanjat Kanjilal, Eugene T Richardson, A Helena Jonsson, Galit Alter, Amy K Barczak, William P Hanage, Xu G Yu, Gaurav D Gaiha, Michael S Seaman, Manuela Cernadas, Jonathan Z Li
Journal: New England Journal of Medicine (2020)

SARS-CoV-2 in an Immunocompromised Host This letter describes an immunocompromised patient who had persistent infection with SARS-CoV-2 over a period of months, despite several courses of remdesivi...
PD-1 and TIGIT coexpression identifies a circulating CD8 T cell subset predictive of response to anti-PD-1 therapy
Authors: Sylvain Simon, Valentin Voillet, Virginie Vignard, Zhong Wu, Camille Dabrowski, Nicolas Jouand, Tiffany Beauvais, Amir Khammari, Cécile Braudeau, Régis Josien, Olivier Adotevi, Caroline Laheurte, François Aubin, Charles Nardin, Samuel Rulli, Raphael Gottardo, Nirasha Ramchurren, Martin Cheever, Steven P Fling, Candice D Church, Paul Nghiem, Brigitte Dreno, Stanley R Riddell, Nathalie Labarriere
Journal: Journal for ImmunoTherapy of Cancer (2020)

Background Clinical benefit from programmed cell death 1 receptor (PD-1) inhibitors relies on reinvigoration of endogenous antitumor immunity. Nonetheless, robust immunological markers, based on circulating immune cell subsets associated with therapeutic efficacy are yet to be validated. Methods We isolated peripheral blood mononuclear cell from three independent cohorts of melanoma and Merkel cell carcinoma patients treated with PD-1 inhibitor, at baseline and longitudinally after therapy. Using multiparameter flow cytometry and cell sorting, we isolated four subsets of CD8 + T cells, based on PD-1 and TIGIT expression profiles. We performed phenotypic characterization, T cell receptor sequencing, targeted transcriptomic analysis and antitumor reactivity assays to thoroughly characterize each of these subsets. Results We documented that the frequency of circulating PD-1 + TIGIT + (DPOS) CD8 + T-cells after 1 month of anti-PD-1 therapy was associated with clinical response and overall survival. This DPOS T-cell population was enriched in highly activated T-cells, tumor-specific and emerging T-cell clonotypes and T lymphocytes overexpressing CXCR5, a key marker of the CD8 cytotoxic follicular T cell population. Additionally, transcriptomic profiling defined a specific gene signature for this population as well as the overexpression of specific pathways associated with the therapeutic response. Conclusions Our results provide a convincing rationale for monitoring this PD-1 + TIGIT + circulating population as an early cellular-based marker of therapeutic response to anti-PD-1 therapy.
Abstract 13533: Acute Post-operative Renal Failure and Mortality Risk Following Norwood Surgical Palliation: A Secondary Analysis of the Pediatric Heart Network Single Ventricle Reconstruction Trial Public Use Database
Authors: Reid C Chamberlain, Nicholas D Andersen, Andrew W McCrary, Christoph P Hornik, Kevin D Hill
Journal: Circulation (2020)

Introduction: The Single Ventricle Reconstruction (SVR) trial randomized neonates with a single morphologic right ventricle undergoing Norwood to a modified Blalock-Taussig shunt (mBTS) or a right ventricle-to-pulmonary artery shunt at 15 centers. The trial demonstrated increased risk of death or heart transplant at one-year post-Norwood in subjects randomized to a mBTS. Using SVR public data, we evaluated incidence and risk factors for post-op renal failure after Norwood, and evaluated the relationship between renal failure, shunt type and one-year post-Norwood mortality. Methods: Post-op renal failure was defined a-priori as a 3-fold rise in creatinine from baseline, or dialysis use within 7 days of Norwood. We used multivariate logistic regression to evaluate risk factors for post-op renal failure and Cox hazard regression to determine the association between post-op renal failure and one-year post-Norwood mortality. Results: Overall 46/544 (8.4%) SVR trial subjects developed post-op renal failure, the majority (32/46, 69.6%) by post-op day 3. In multivariate analysis, risk factors for post-op renal failure included receipt of a mBTS (aOR 3.3, p=0.02), center volume &lt;15 cases/year (aOR 2.7, p=0.005), presence of ≥ 2 pre-op complications (aOR 4.0, p&lt;0.001), low birth weight (aOR 3.2, p=0.002), post-op heart block (aOR 8.5, p=0.001), and delayed sternal closure (aOR 5.3, p=0.026). Renal failure was an independent risk factor for one-year post-Norwood mortality (aHR 1.9, CI 1.1-3.2, p=0.019). When renal failure and shunt type were included as model covariates, there was interaction (p=0.049) with renal failure attenuating the mortality risk associated with receipt of a mBTS (p=0.24), Figure. Conclusions: In the SVR trial, post-op renal failure was relatively common but with modifiable risk factors including receipt of a mBTS. Our findings suggest that post-op renal failure accounts for some of the increased mortality risk associated with the mBTS.
Abstract 13545: Atlas of Exosomal Microrna Secreted From Human Ipsc-derived Cardiac Cell Types
Authors: Mark Chandy, June Rhee, Mehmet O Ozen, Damon Williams, Lejla Pepic, Chun Liu, Hao Zhang, Jessica Malisa, Edward Lau, Utkan Demirci, Joseph C Wu
Journal: Circulation (2020)

Exosomes are small particles secreted from cells through an endosomal sorting complexes required for transport (ESCRT)-mediated pathway that releases vesicles into the extracellular matrix following fusion of the endosomal multivesicular body to the plasma membrane. Initially thought to be a waste disposal system for the cell, exosomes are now recognized as important mediators in cellular communication, transporting nucleic acid, protein and lipid. We hypothesize that microRNA (miRNA) transcriptomic profiles isolated from exosomes are distinct for each cardiovascular lineage in healthy control patients. Using induced pluripotent stem cells (iPSC), established differentiation protocols and a high-yield mechanical-sorting device (ExoTIC), we characterized the transcriptomic profiles of exosomal secretions derived from cardiomyocytes (CM), cardiac fibroblasts (CF) and endothelial cells (EC). We identified 120 miRNAs from 94 miRNA genes to be secreted at appreciable levels. We discovered 1) let-7 miRNA precursors are depleted in iPSC secretomes; 2) only a subset of total cellular miRNAs are present; 3) a common core of miRNAs are secreted by all three cardiac cell types; and 4) distinct enrichment or depletion of different mature miRNAs in each exosome type. The exosomal transcriptomic profiles of each lineage was compared to a published atlas of miRNA from seventeen tissue types from the human body. miR-302c known to be specific to pluripotent cells and is enriched in iPSC exosomes and found in bone, reflecting hematopoietic stem cells. miR-1, critical for cardiac development and pathology, is secreted by iPSC-CM and enriched in striated muscle and myocardium. miR-151 is secreted by iPSC-CF and is expressed ubiquitously. The relative enrichment of miRNAs in different cardiac tissues could be used to quantifying the cellular content of heterogenous mixtures of iPSC-derived cardiac lineages. We developed a ratiometric cell purity assay that can sensitively detect iPSC contamination in iPSC-CM differentiations.
Calcified Adrenal Metastasis of High-Grade Osteosarcoma on FDG PET/CT
Authors: Nuh Filizoglu, Ceren Ozge Engur, Huseyin Kemal Turkoz, Tunc Ones, Tanju Yusuf Erdil
Journal: Clinical Nuclear Medicine (2020)

Classic type of high-grade osteosarcoma is the most common type of skeletal malignancy in children and adolescents. Metastasis of osteosarcoma frequently occurs in the lung. Adrenal metastasis of osteosarcoma is extremely rare, with only few reported case in the literature. Herein, we present the case of a 13-year-old boy with adrenal metastasis of high-grade osteosarcoma, which was seen as a solitary calcified hypermetabolic adrenal lesion on FDG PET/CT.
Abstract 14598: Multiple Arterial Coronary Bypass Grafting is Associated With Improved Survival in Females
Authors: Derrick Tam, Rodolfo Rocha, Jiming Fang, Maral Ouzounian, Joanna Chikwe, Jennifer S Lawton, Dennis T Ko, Peter Austin, Mario F Gaudino, Stephen E Fremes
Journal: Circulation (2020)

Introduction: Multiple arterial grafting (MAG) in coronary artery bypass grafting (CABG) is associated with improved survival and freedom from major adverse cardiac and cerebrovascular events (MACCE) in observational studies of mostly males. It is not known whether the MAG is beneficial in females. Herein, we compared the late clinical outcomes of MAG versus single arterial grafting (SAG) in females undergoing CABG for multivessel coronary artery disease (CAD) Methods: Clinical and administrative databases for Ontario, Canada, were linked to obtain all female patients with angiographic evidence of left main, triple, or double vessel disease undergoing isolated non-emergent primary CABG from 2008-2019. Baseline characteristics were compared and 1:1 propensity score matching was performed to account for differences. 30-day mortality was compared in the matched groups. Late mortality and MACCE ( composite of stroke, myocardial infarction, repeat revascularization, and death) was compared between the matched groups with a stratified log rank test and Cox-proportional hazard model. Results: In total 2,961 and 7,954 females underwent CABG with MAG and SAG respectively for multivessel CAD. Prior to propensity-score matching, compared to SAG, those that underwent MAG were younger (66.0 vs. 68.9 years) and had less comorbidities. After propensity-score matching, 2,446 well-matched pairs were formed. In matched patients, there was no significant difference in 30-day mortality (1.6% vs 1.8%, P=0.43) between MAG and SAG. The median and maximum follow-up was 5.0 and 11.0 years respectively. Over the entire follow-up, MAG was associated with improved survival (Figure, hazard ratio (HR): 0.85, 95% confidence interval (CI): 0.75-0.98) and freedom from MACCE (HR: 0.85, 95%CI: 0.76-0.95). Conclusions: MAG was associated with improved survival and freedom from MACCE and should be considered for female patients with good life expectancy requiring CABG.
Abstract 13663: Long-Term Outcome of Cook Formula Stents in Patients With Congenital Heart Disease
Authors: Ramya Ramachandra, carlos sisniega, Tharak Yarrabolu
Journal: Circulation (2020)

Introduction: Cook Formula stents are widely used in pediatric cardiology owing to their low profile and availability in a variety of sizes. Literature regarding the long-term outcome of these stents is limited. Methods: A single center retrospective cohort study was conducted to investigate the long-term outcome of Cook Formula stents. Demographic and catheterization data were collected for all patients who underwent stent implantation between January 2014 and March 2020. Patients with stents at sites other than the aorta and pulmonary arteries were excluded. Generalized Estimating Equation model was used to determine predictors of expansibility of stents. Results: 48 patients with 70 stents were included in the study. Of these, 36 stents had no subsequent balloon dilation while 34 stents had one or more balloon dilations during a median follow-up time of 33.3 months. No stent related mortality or stent fractures were seen. 2 stents embolized to a distal location. No decline in median narrowest vessel diameter was noted between any two subsequent catheterizations. Age (OR 1.0, 95% CI 0.13 - 1.0003), sex (OR 0.45, 95% CI 0.08 - 2.5), stent diameter of 5, 6, 7 mm compared to 4 mm (OR 2.6, 95% CI 0.13 - 55.1; OR 1.3, 95% CI 0.13 - 14.4; OR 3.0, 95% CI 0.33 - 27.4 respectively) and initial narrowest vessel diameter (OR 1.5, 95% CI 0.81 - 2.8) were not found to have any significant predictive impact on the ability of stents to reach a target diameter of 10 mm. Conclusions: Cook Formula stents are safe in neonates, infants and children. They have a low rate of in-stent stenosis. They are easily expandable to diameters greater than 10 mm irrespective of age, sex and initial stent or vessel diameter.
Abstract 14287: Iron Deficiency is Associated With More Severe Pulmonary Vascular Disease in Pulmonary Hypertension Due to Chronic Lung Disease
Authors: Jasmine Tatah, Marc R Pritzker, Thenappan Thenappan, Kurt W Prins
Journal: Circulation (2020)

Background: Iron deficiency promotes pulmonary vascular remodeling in pre-clinical models, and is associated with worse outcomes in pulmonary arterial hypertension. However, the consequences of iron deficiency in patients with pulmonary hypertension due to chronic lung disease (Group 3 PH) are unexplored. Methods: We studied 122 consecutive Group 3 PH patients from the University of Minnesota Pulmonary Hypertension Repository. Serum soluble transferrin receptor (sTR) levels quantified iron deficiency. We evaluated the relationship between iron deficiency and pulmonary vascular disease, right ventricular (RV) function, exercise capacity, and survival. Results: The iron deficient group (&lt;4.8mg/L sTR) had significantly higher mean pulmonary arterial pressure (40±9 mmHg, n=59 vs. 44±13 mmHg, n=61; p =.02) and lower pulmonary arterial compliance (2.2±1.2 mL/mmHg, n=52 vs. 1.7±0.8 mL/mmHg, n=55; p =.01), but there was no difference in pulmonary vascular resistance. Moreover, there were trends for higher right atrial pressure (7±4 mmHg, n=58 vs. 9±6 mmHg, n=61; p =0.08) in iron deficient patients. However, iron deficiency did not significantly alter RV function by echocardiography, 6-minute walk distance, or survival. Conclusions: Iron deficiency in Group 3 PH is associated with worse pulmonary vascular disease. This suggests iron deficiency could contribute to pulmonary vascular disease in Group 3 PH, and future studies are needed to determine if iron replacement could be a therapy for this deadly type of PH.
Abstract 135: Telephone-assisted Cardiopulmonary Resuscitation May Overcome Ethnic and Age Variation Observed in Bystander CPR
Authors: Audrey L Blewer, Nur Shahidah Binte Ahmad, Benjamin Sieu-Hon Leong, Pin Pin Pek, Yih Yng Ng, Anjni Joiner, Shalini Arulanandam, Marcus E Ong
Journal: Circulation (2020)

Introduction: Ethnicity, female gender, and older age are associated with lower rates of receipt of bystander cardiopulmonary resuscitation (B-CPR). Increasing telephone-assisted CPR (T-CPR), or provision of CPR instructions when individuals call 9-1-1, may improve B-CPR rates. It is unknown whether provision of T-CPR may overcome ethnic, gender and age variation seen in B-CPR. Objectives: We sought to assess whether provision of T-CPR may overcome ethnic, gender, and age variation seen in B-CPR. We hypothesized that the provision of T-CPR will improve B-CPR and reduce differences associated with ethnicity. Methods: We conducted a retrospective study of adult, non-traumatic out-of-hospital cardiac arrests (OHCA) from the Singapore registry (4/2010-12/2016). We assessed variation in B-CPR by ethnicity, female gender, and increased older age, stratified by receipt of T-CPR. We examined the differences using descriptive statistics and multivariable logistic regression accounting for confounding. Results: From 2010-2016, the Singapore registry contained 12,546 OHCA events. Excluding traumatic, EMS witnessed, and healthcare facility arrests, 7,997 events were analyzed. Of these, mean age was 66±19 and 65% were male. B-CPR was administered in 53% of the events, while T-CPR was provided in 30% of the events. In a univariate analysis, female gender was associated with variation in B-CPR if T-CPR was not provided (F: 29% vs M: 35%, p&lt;0.01) and provision of T-CPR reduced this variation (p=0.17), but this association was not observed in the multivariable logistic regression. When adjusting for confounding, ethnicity was associated with variation in B-CPR if T-CPR was not provided (p&lt;0.01), while provision of T-CPR reduced this variation (p=0.50). Additionally, increased older age was associated with a decreased likelihood of receipt of B-CPR if T-CPR was not provided (OR: 0.99 (0.98-0.99), p&lt;0.01), while this variation was not observed with provision of T-CPR (p=0.50). Conclusion: T-CPR modified the known B-CPR differences seen in ethnicity and increased older age, but did not modify differences seen in gender when controlling for other covariates. These findings may help inform public policy and methods to decrease variation and increase B-CPR.
Abstract 15358: Cardiac Remodeling in Adults Following Percutaneous Patent Ductus Arteriosus Closure: A Meta-analysis
Authors: Sarah Blissett, Harsh Agrawal, Ahmed Kheiwa, Hope Caughron, Ian Harris, Anushree Agarwal, Elyse Foster, Indika Mallawaarachchi, Vaikom Mahadevan
Journal: Circulation (2020)

Introduction: Patent ductus arteriosus (PDA) is often recognized and treated with percutaneous closure in adults. However, the impact on cardiac reverse remodeling following PDA closure in adults is not clear. We performed a meta-analysis to characterize the extent of cardiac remodeling following percutaneous PDA closure in adults. Methods: MEDLINE and EMBASE were systematically searched for original studies that reported echocardiographic variables at baseline, immediately post-procedure (within 24 hours), and at follow-up (&gt;1 month) in adults undergoing percutaneous PDA closure. Additionally, we included echocardiographic data from a cohort of patients &gt;18 years of age that underwent percutaneous PDA closure between 01/2015 and 12/2019 at our centre. For parameters with sufficient data for pooling, weighted averages were calculated, and pooled differences were presented as weighted mean differences. Heterogeneity was assessed using the I 2 statistic. Results: After screening 278 abstracts, 5 studies were identified. When combined with our own cohort of 13 patients, our meta-analysis encompassed 244 patients. The weighted mean age of all patients was 33 years with all studies predominantly comprised of female patients and the median follow-up was 12 months (ranging from 1 month- 5 years across the studies). When compared to baseline, left ventricular ejection fraction (LVEF) decreased significantly immediately post-procedure and all parameters significantly decreased at follow-up (Table 1). Conclusions: As demonstrated by the decreases in the left ventricular and left atrial sizes, reverse remodeling was observed in adults who underwent percutaneous PDA closure. The significantly lower LVEF immediately post-procedure could reflect withdrawal of chronic volume overload or increased afterload. The clinical significance of the statistically significant lower LVEF on follow-up testing is unclear and requires further evaluation.