tbuckley/cabot-search huggingface dataset:
Abstract 078: Total Brachial Artery Reactivity And Incident Heart Failure And Heart Failure Sub-types: Multi-ethnic Study Of Atherosclerosis
Authors: Daniela Charry
Journal: Circulation (2021)

Introduction: Endothelial dysfunction may be a phenotypic expression of heart failure (HF). Total brachial artery reactivity (TBAR) is a non-invasive measurement of endothelial function that has been associated with increased risk of cardiovascular outcomes. Limited information is currently available on the impact of TBAR on incident HF and its subtypes. The aim of this study was to evaluate whether TBAR is associated with incident HF, HF with reduced ejection fraction (HFrEF), or HF with preserved ejection fraction (HFpEF) in a community-based study. Hypothesis: We hypothesized that TBAR would be inversely related with incident HF and both HF subtypes. Methods: Sample included 5,499 participants (45-84 years of age) from the Multi-Ethnic Study of Atherosclerosis who were free of cardiovascular disease at baseline. Brachial artery ultrasound was performed after five minutes of cuff occlusion at the right forearm. TBAR was calculated as the difference between maximum and minimum brachial artery diameters following cuff release, divided by the minimum diameter multiplied by 100%. A dichotomous TBAR variable was created based on the median value (below or above 7.9%). Participants with EF ≤ 40% were considered HFrEF and those with EF ≥ 50% were considered HFpEF. Cox proportional hazards regression models were used to calculate hazard ratios and 95% confidence intervals. Results: Over a mean follow-up period of 12.5 years, incident HF was diagnosed in 250 participants; 106 classified as HFpEF, 98 as HFrEF, and 46 with unknown or borderline EF (41-49%). Crude analysis revealed that those with TBAR below the median have significantly higher risk of HF (HR 1.46; 95% CI 1.13-1.88, p&lt;0.01) and HFrEF (HR 1.61; 95% CI 1.07-2.43, p&lt;0.05). Following adjustment for known HF risk factors (e.g. age, gender, race, blood pressure, others), these relationships were no longer statistically significant. Borderline significant results were revealed in those with HFpEF (HR 1.43; 95% CI 0.97-2.12, p=0.06). Kaplan-Meier curves suggest significantly lower risks of developing HF and HFrEF in those with TBAR above the median (log-rank p&lt;0.05 for both). When examined as a continuous variable, with a cut point of 50% for EF, every 1-standard deviation (9.7%) increase in TBAR resulted in a 19% and 29% decrease in risk of HF (p&lt;0.05) and HFrEF (p=0.05), respectively. Conclusions: Lower TBAR values were associated with higher rates of incident HF and HFrEF, suggesting a possible role of endothelial dysfunction in HF pathogenesis. The impact of other known HF risk factors may mediate this relationship, thus further research is warranted.
Abstract 15171: Predictive Value of the Wellens’ Sign in an Ethnically Diverse Urban Population
Authors: Samiullah Arshad, Neal J Ferrick, Scott Monrad, John D Fisher, andrew krumerman, Kevin J Ferrick
Journal: Circulation (2020)

Introduction: Wellens’ sign is a characteristic finding on ECG, often found to be indicative of severe proximal Left anterior descending artery (LAD) stenosis. Our study sought to identify the prevalence of the Wellens’ sign in the ethnically diverse population of the Bronx, NY and elucidate its relationship to the presence of significant CAD. Methods: We retrospectively analyzed an ECG database at Montefiore Medical Center of over 1.7 million ECGs, using six diagnostic codes for anterior ischemia to identify ECGs that resemble the Wellens’ sign. Of the six diagnostic codes, the ECGs of the two highest yielding codes, were identified, then manually reviewed by an electrophysiologist. Patient’s charts and demographics were reviewed and Chi Square test was used to test statistical significance of the data. Results: Of the 1,756,742 ECGs done on 433,218 patients between 2012-2019, 26,624 ECGs were isolated. Subsequently, 2186 of these ECGs were manually reviewed. Wellens’ sign was identified in 448 (0.1%) patients, of which, 229 patients underwent cardiac catheterization, while 219 patients were managed medically. There was no statistical difference seen in the prevalence of Wellens’ Type A and B pattern across various ethnic groups (P = 0.213). Significant LAD stenosis was seen in 80 (35%) patients of whom 22 (10%) had proximal, 40 (17%) had mid, 4 (1%) had distal stenosis, while 14 (6%) patients had diffuse LAD disease. Two-vessel disease was seen in 46 (20%) of the patients, and triple-vessel disease was seen in 23 (10%) of the patients. Most common indication for cardiac catheterization was NSTEMI. Takotsubo cardiomyopathy was diagnosed in 19 (8%) patients who had either no or non-obstructive CAD. Among patients with the Wellens’ sign on the ECG but did not undergo cardiac catheterization, majority had a non-ACS presentation. Conclusions: No statistical difference in the prevalence of Wellens’ sign was seen among the various ethnic groups. In our study population, Wellens’ sign was a rare ECG pattern with a prevalence of 0.1%. When seen in conjunction with a clinical setting suggestive of angina there is a high probability of underlying CAD. Although significant LAD stenosis is the known most common underlying pathology, multivessel CAD may also occur.
Abstract 15598: Population Characteristics and Outcomes of Patients With Constrictive Pericarditis Undergoing Pericardiectomy in the Contemporary Era: A Systematic Review and Metaanalysis
Authors: Aspasia Tzani, Ilias P Doulamis, Andreas Tzoumas, Dimitrios V Avgerinos, Polydoros Kampaktsis
Journal: Circulation (2020)

Introduction: Studies have described the changing landscape of patients with constrictive pericarditis (CP) in the modern era, however no systematic review or meta-analysis has been performed. Methods: We systematically searched the MEDLINE, Embase and Cochrane databases from their inception to April 1, 2020 for studies assessing the characteristics and outcomes patients with CP undergoing pericardiectomy. A meta-analysis was performed to assess the impact of CP etiology on outcomes. Results: We analyzed 27 eligible studies and 2114 patients. Etiology was most commonly idiopathic (50.2%), post-cardiac surgery (26.2%) and radiation (6.9%)(Figure 1A-B). Patients were mostly men (76%), with a mean age of 58 years and with advanced symptoms (NYHA III/IV 70.1%). Total pericardiectomy was preferred (85.8%) (Figure 1C-D) and concomitant cardiac surgery was relatively common (23.8%). Operative mortality was 6.9% and 5-year mortality was 32.7% (Table 1). Radiation and post-cardiac surgery patients had higher long-term risk for mortality respectively compared to idiopathic pericarditis (HR: 2.15; 95% CI: 1.21-1.36, p=.01 and HR: 3.21; 95% CI: 1.56-6.50, p&lt;.01, respectively). Thirty percent of included studies had more than low bias. A sensitivity analysis did not result in changes in the results. Conclusions: Pericardiectomy is performed mostly in middle-aged men with advanced symptoms and low comorbidity burden and still carries a significant operative mortality. Radiation and post-cardiac surgery patients have a significantly higher risk compared to idiopathic. Several methodological issues and significant heterogeneity limit the generalization of these data.
Selective androgen receptor modulators activate the canonical prostate cancer androgen receptor program and repress cancer growth
Authors: Michael D. Nyquist, Lisa S. Ang, Alexandra Corella, Ilsa M. Coleman, Michael P. Meers, Anthony J. Christiani, Cordell Pierce, Derek H. Janssens, Hannah E. Meade, Arnab Bose, Lauren Brady, Timothy Howard, Navonil De Sarkar, Sander B. Frank, Ruth F. Dumpit, James T. Dalton, Eva Corey, Stephen R. Plymate, Michael C. Haffner, Elahe A. Mostaghel, Peter S. Nelson
Journal: Journal of Clinical Investigation (2021)

Prostate cancer (PC) is driven by androgen receptor (AR) activity, a master regulator of prostate development and homeostasis. Frontline therapies for metastatic PC deprive the AR of the activating ligands testosterone (T) and dihydrotestosterone (DHT) by limiting their biosynthesis or blocking AR binding. Notably, AR signaling is dichotomous, inducing growth at lower activity levels, while suppressing growth at higher levels. Recent clinical studies have exploited this effect by administration of supraphysiological concentrations of T, resulting in clinical responses and improvements in quality of life. However, the use of T as a therapeutic agent in oncology is limited by poor drug-like properties as well as rapid and variable metabolism. Here, we investigated the antitumor effects of selective AR modulators (SARMs), which are small-molecule nonsteroidal AR agonists developed to treat muscle wasting and cachexia. Several orally administered SARMs activated the AR program in PC models. AR cistromes regulated by steroidal androgens and SARMs were superimposable. Coregulatory proteins including HOXB13 and GRHL2 comprised AR complexes assembled by both androgens and SARMs. At bioavailable concentrations, SARMs repressed MYC oncoprotein expression and inhibited the growth of castration-sensitive and castration-resistant PC in vitro and in vivo. These results support further clinical investigation of SARMs for treating advanced PC.
Covid-19: FDA authorises Pfizer vaccine for children 12-15
Authors: Janice Hopkins Tanne
Journal: BMJ (2021)

US public health experts are to meet this week to decide how to use the Pfizer BioNTech vaccine in adolescents after the Food and Drug Administration (FDA) granted it emergency use authorisation (EUA) for children aged 12-15.1

The Pfizer BioNTech vaccine, like Moderna’s, already has EUA for administration to people over the age of 16. Both Moderna and Johnson & Johnson, which make the other two vaccines approved in the US, are testing their vaccines in children.

About 1.5 million young people aged 11 to 17 have had covid-19 in the past year and 300 people under 18 have died, according …
Impact of Major Residual Lesions on Outcomes After Surgery for Congenital Heart Disease
Authors: Meena Nathan, Jami C Levine, Maria I Van Rompay, Linda M Lambert, Felicia L Trachtenberg, Steven D Colan, Iki Adachi, Brett R Anderson, Emile A Bacha, Aaron Eckhauser, J William Gaynor, Eric M Graham, Benjamin Goot, Jeffrey P Jacobs, Rija John, Jonathan R Kaltman, Kirk R Kanter, Carlos M Mery, L LuAnn Minich, Richard Ohye, David Overman, Christian Pizarro, Geetha Raghuveer, Marcus S Schamberger, Steven M Schwartz, Shanthi L Narasimhan, Michael D Taylor, Ke Wang, Jane W Newburger
Journal: Journal of the American College of Cardiology (2021)
Abstract 16849: Extracellular Vesicles Derived From Mesenchymal Stem Cells Protects Mice From Monocrotaline-Induced Pulmonary Hypertension and Improve Echocardiographic Parameters
Authors: Giana Blume Corssac, Rayane Teixeira, Catherine Karbasiafshar, Olin D Liang, Ruhul Abid
Journal: Circulation (2020)

Introduction: Pulmonary hypertension (PH) is a currently incurable disease with high morbidity and mortality. Treatment with extracellular vesicles derived from mesenchymal stem cells (MSC-EVs) appeared to be effective and promising. Objective: We aimed at evaluating whether MSC-EVs could improve right ventricle (RV) and pulmonary artery (PA) functions in mice with PAH induced by monocrotaline (MCT). Methods: FVB mice (M/F – 6 weeks) received MCT injections 1x/week for 4 weeks (60mg/kg sc.) and were treated with MSCs-EVs 24 hours after each MCT injection (3x10 6 cells in 100μL PBS 1x, iv.). The experimental groups were: Control (vehicle-vehicle; n=9); MCT (MCT-vehicle; n=10); Control EVs (vehicle-EVs; n=8); MCT EVs (MCT-EVs; n=10); PA acceleration time (PAT), PA ejection time (PET) and tricuspid annular plane systolic excursion (TAPSE) were assessed by echocardiography 28 days after first MCT injection; Fulton index was used to calculate RV hypertrophy, and pulmonary vascular remodeling (WT/D) was assessed by histology. Results: PAT and PAT/PET were decreased by 22.6±5.7% and 15.6±4.9%, respectively, in MCT group compared to Control (p&lt;0.01 and p&lt;0.02). PAT was increased in Control EVs and MCT EVs groups when compared with MCT group (by 28.2±7.6%, p&lt;0.01 and 20±6.9%, p&lt;0.04, respectively). TAPSE (figure 1) was decreased in the MCT group compared with Control (42.9±6.7%, p&lt;0.0001) and increased in both Control EVs (62.8±12.2%, p&lt;0.0001) and MCT EVs (52.7±11.1%, p&lt;0.0005) groups compared with MCT group. In addition, MCT group presented RV hypertrophy 49.4±16.5% higher than Control (p&lt;0.03), and 29.1±10.4% higher than MCT EVs group (p&lt;0.05). The WT/D was increased in MCT compared to Control (63.7±7.6%, p&lt;0.0001), but decreased in Control EVs (44.9±4.6%, p&lt;0.0001) and MCT EVs (44.3±5.4%, p&lt;0.0001) in relation to MCT group. Conclusion: Treatment with MSC-EVs protects against the development of PH and improves PA and the RV function in MCT-treated mice.
Ten-Year All-Cause Death According to Completeness of Revascularization in Patients With Three-Vessel Disease or Left Main Coronary Artery Disease: Insights From the SYNTAX Extended Survival Study
Authors: Kuniaki Takahashi, Patrick W. Serruys, Chao Gao, Masafumi Ono, Rutao Wang, Daniel J.F.M. Thuijs, Michael J. Mack, Nick Curzen, Friedrich-Wilhelm Mohr, Piroze Davierwala, Milan Milojevic, Joanna J. Wykrzykowska, Robbert J. de Winter, Faisal Sharif, Yoshinobu Onuma, Stuart J. Head, Arie Pieter Kappetein, Marie-Claude Morice, David R. Holmes
Journal: Circulation (2021)

Ten-year all-cause death according to incomplete (IR) versus complete revascularization (CR) has not been fully investigated in patients with 3-vessel disease and left main coronary artery disease undergoing percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG).The SYNTAX Extended Survival study (Synergy Between PCI With TAXUS and Cardiac Surgery: SYNTAX Extended Survival [SYNTAXES]) evaluated vital status up to 10 years in patients who were originally enrolled in the SYNTAX trial. In the present substudy, outcomes of the CABG CR group were compared with the CABG IR, PCI CR, and PCI IR groups. In addition, in the PCI cohort, the residual SYNTAX score (rSS) was used to quantify the extent of IR and to assess its association with fatal late outcome. The rSS of 0 suggests CR, whereas a rSS>0 identifies the degree of IR.IR was more frequently observed in patients with PCI versus CABG (56.6% versus 36.8%) and more common in those with 3-vessel disease than left main coronary artery disease in both the PCI arm (58.5% versus 53.8%) and the CABG arm (42.8% versus 27.5%). Patients undergoing PCI with CR had no significant difference in 10-year all-cause death compared with those undergoing CABG (22.2% for PCI with CR versus 24.3% for CABG with IR versus 23.8% for CABG with CR). In contrast, those with PCI and IR had a significantly higher risk of all-cause death at 10 years compared with CABG and CR (33.5% versus 23.7%; adjusted hazard ratio, 1.48 [95% CI, 1.15-1.91]). When patients with PCI were stratified according to the rSS, those with a rSS≤8 had no significant difference in all-cause death at 10 years as the other terciles (22.2% for rSS=0 versus 23.9% for rSS>0-4 versus 28.9% for rSS>4-8), whereas a rSS>8 had a significantly higher risk of 10-year all-cause death than those undergoing PCI with CR (50.1% versus 22.2%; adjusted hazard ratio, 3.40 [95% CI, 2.13-5.43]).IR is common after PCI, and the degree of incompleteness was associated with 10-year mortality. If it is unlikely that complete (or nearly complete; rSS<8) revascularization can be achieved with PCI in patients with 3-vessel disease, CABG should be considered. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT00114972. URL: https://www.clinicaltrials.gov; Unique identifier: NCT03417050.
Epidemiology, evolution and cryptic susceptibility of methicillin-resistant Staphylococcus aureus in China: a whole-genome-based survey
Authors: Yan Chen, Lu Sun, Xiaoliang Ba, Shengnan Jiang, Hemu Zhuang, Feiteng Zhu, Haiping Wang, Peng Lan, Qiucheng Shi, Zhengan Wang, Yiyi Chen, Keren Shi, Shujuan Ji, Yan Jiang, Mark A. Holmes, Yunsong Yu
Journal: Clinical Microbiology and Infection (2021)
サルコリピンの心臓特異性過剰発現はマウスの筋小胞体Ca 2+ ATPアーゼ(SERCA2a)を阻害し,心機能を低下させる
Authors: Asahi M, Otsu K, Takeda T, Nakayama H, Hikosoh S, Kusakari Y, Hirano S, Hongo K, Maclennan D H
Journal: Circulation (2004)
SARS-CoV-2 seroprevalence in a strictly-Orthodox Jewish community in the UK: A retrospective cohort study
Authors: Katherine M Gaskell, Marina Johnson, Victoria Gould, Adam Hunt, Neil RH Stone, William Waites, Ben Kasstan, Tracey Chantler, Sham Lal, Chrissy H. Roberts, David Goldblatt, Rosalind M Eggo, Michael Marks
Journal: The Lancet Regional Health - Europe (2021)
PSYCHOLOGICAL DISTRESS AND RISK OF ADVERSE CARDIOVASCULAR OUTCOMES IN YOUNG AND MIDDLE-AGED SURVIVORS OF MYOCARDIAL INFARCTION
Authors: Mariana Garcia, An Young, Zakaria Almuwaqqat, Samaah Sullivan, Kasra Moazzami, Bruno Lima, Tene Lewis, Muhammad Hammadah, Oleksiy Levantsevych, Ernest Garcia, Douglas Bremner, Paolo Raggi, Amit Shah, Arshed Quyyumi, Viola Vaccarino
Journal: Journal of the American College of Cardiology (2021)
Abstract 13060: Calcified Left Atrium: A Therapeutic Challenge for Atrial Fibrillation
Authors: Roshni V Khatiwala, patricia applegate, Uma N Srivatsa, Dali Fan, Nayereh Pezeshkian, Adam Oesterle
Journal: Circulation (2020)

Background: Myocardial calcium deposits are common in patients with end stage renal disease (ESRD) but present a challenge in patients with atrial fibrillation (AF) and may limit ablation success with currently available energy sources, while increasing stroke risk during ablation. Obective: We describe a challenging case of symptomatic AF management in a patient with a calcified (coconut) left atrium (LA). Methods: N/A Results: A fifty year old woman with ESRD, seen for longstanding symptomatic paroxysmal AF and AF induced hypotension during hemodialysis (HD). She had cardioverted with calcium channel blockers and amiodarone previously and was maintained on metoprolol and amiodarone. She was admitted for symptomatic atrial flutter and underwent an attempted ablation. Trans-esophogeal echocardiogram (TEE) before ablation demonstrated a dilated and severely calcified/coconut LA (figure). Despite extensive radiofrequency ablation, bi-directional block could not be achieved across the cavo-tricuspid isthmus even with disappearance of the local electrograms and non-induciblity at the end of the case. She continues to have symptomatic AF on amiodarone and hypotension at HD and AF ablation is considered unlikely to be successful with an increased complication rate. Conclusion: Porcelain LA has been reported in literature in patients with AF and ESRD. There is no contemporary data on AF management or ablation in these challenging patients and further clinical investigation is needed to determine the feasibility and safety of ablation. Performing pre-operative TEEs in all patients with ESRD is reasonable to assess for LA calcification prior to trans-septal puncture and LA ablation.
Abstract 15197: Lipopolysaccharide-Nuclear Factor-kappa B Pathway and Lipoprotein Apheresis Effects in Patients With Familial Hypercholesterolemia and Coronary Artery Disease
Authors: Huihui Liu, Cheng-Gang Zhu, Chuan-Jue Cui, Yexuan Cao, Jinglu Jin, Na-Qiong Wu, Yuan-Lin Guo, Ying Gao, Jing Sun, Qian Dong, Jian-Jun Li
Journal: Circulation (2020)

Introduction: Inflammation may play an important role in atherosclerosis in familial hypercholesterolemia (FH). Lipopolysaccharide (LPS)-nuclear factor-kappa B (NF-κB) pathway is a routine signal process activated in inflammatory status. Hypothesis: We assessed the hypothesis that LPS-NF-κB axis is markedly activated and lipoprotein apheresis has an inhibitory effect on this pathway in patients with FH and coronary artery disease (CAD). Methods: In this matched case-control study a genetically diagnosed FH cohort who presented stable CAD (n=63) was compared with 63 non-FH CAD and 63 non-FH non-CAD controls matched by sex and age. Plasma LPS levels and NF-κB activity were compared among the three groups. In addition, we studied in vitro LPS-induced interleukin-6 production by mononuclear cells from 16 FH cases without previous statin use and compared them with their respective matched control groups. Subsequently, these 16 FH patients underwent lipoprotein apheresis. Blood samples were taken immediately before and regularly after apheresis for measuring LPS and NF-κB. Results: FH plus CAD had higher LPS levels and NF-κB activity than CAD and non-CAD controls (all p &lt;0.01). LPS-induced interleukin-6 production by mononuclear cells of FH plus CAD was also much higher compared with CAD and non-CAD controls (both p &lt;0.01). Moreover, plasma LPS levels ( p &lt;0.001) and NF-κB activity ( p &lt;0.01) were dramatically reduced after apheresis in FH patients. Conclusions: In conclusion, genetically confirmed FH patients with CAD had a marked activation of LPS-NF-κB axis, while lipoprotein apheresis significantly attenuated this key inflammatory pathway, suggesting that inflammation may be an important therapeutic target for FH patients.
Abstract 15300: Epidemiology and Risk of Anxiety and Depression Among Patients With Lown-Ganong-Levine Syndrome
Authors: Mohammad Zmaili, Jafar Alzubi, Anas Alameh, Walid I Saliba, Oussama M Wazni, Ayman Hussein
Journal: Circulation (2020)

Introduction: Lown-Ganong-Levine (LGL) syndrome is a rare congenital pre-excitation syndrome with a perinodal accessory pathway. Arrhythmic events may lead to, or be influenced by, a myriad of psychological conditions such as anxiety and depressive disorders. There is no epidemiological data on the co-occurrence of these conditions in patients with LGL syndrome. We sought to describe the epidemiology and risk association of anxiety and depression in LGL syndrome. Methods: A multi-institutional database (Explorys Inc, Cleveland, OH, USA), with an aggregate of electronic health record data from 26 major integrated US healthcare systems, was surveyed. A cohort of patients with a Systematized Nomenclature of Medicine—Clinical Terms (SNOMED-CT) diagnosis of “Lown-Ganong-Levine syndrome” between 1999 and 2020 was identified. Demographic characteristics along with relevant clinical and social information were obtained. Results: Of 73,044,190 individuals in the database (1999-2020), 1,180 were given the diagnosis of LGL. Compared to subjects without LGL, patients with LGL syndrome were more likely to have anxiety (OR=5.9, p&lt;0.001) and depression (OR=5.2, p&lt;0.001). Within the anxiety and depression cohorts, LGL patients were more likely to be females, and had a higher association with smoking, alcohol and substance abuse. Anxiety but not depression was more common in young adults (18-65 years old). No difference in supraventricular arrhythmias was found between LGL patients carrying these psychiatric diagnoses with those who don’t. Conclusion: This is the largest study to date demonstrating the significant association between LGL and common psychiatric conditions. Care should be taken in identifying and managing such conditions as they, along with their pharmacologic therapies, may mimic or exacerbate the symptoms of LGL syndrome.