tbuckley/cabot-search huggingface dataset:
Abstract 15099: Limitations of Predicting Postoperative Left Atrioventricular Valve Regurgitation by Transesophageal Echocardiography
Authors: Chalani D Ellepola, Benita Lin, Benjamin H Goot, William Johnson, Ronald K Woods
Journal: Circulation (2020)

Introduction: After atrioventricular septal defect (AVSD) repair, the degree of post-repair left atrioventricular valve regurgitation (LAVVR) at discharge is associated with need for re-intervention. Knowledge of the relationship between post-repair transesophageal echocardiogram (TEE) and discharge transthoracic echocardiogram (TTE) LAVVR could influence intraoperative decision-making. At present, this relationship has not been well-defined and to assess it, we undertook a retrospective study of a large cohort of AVSD patients. Methods: Between 11/2012-12/2018, 96 AVSD patients underwent surgical repair. Data included patient demographics, clinical characteristics, preoperative LAVV anomalies, surgical procedure and outcomes. LAVVR was graded as less than moderate or moderate and greater with statistical blinding techniques employed. Cohen’s kappa statistics were calculated to measure interobserver variability. Association between parameters was tested using univariate analysis. Results: Median age and weight at surgery for complete AVSD patients (68%) was 5 months and 5.6 kg respectively; for partial AVSD (32%), median age and weight was 27 months and 11.9 kg respectively. The median interval between echo studies was 6 days (IQR 4-12 days) with median length of stay of 8 days (IQR 5-16 days). There were no deaths. Post-repair TEE revealed less than moderate LAVVR in 86 patients (90%) and moderate or greater in 10 (10%). Overall, there was a discrepancy in LAVVR seen at discharge in 25 patients (26%) with 23/25 (92%) demonstrating a higher grade of LAVVR. Two patients underwent reoperation before discharge due to severe LAVVR. In univariate analysis, significant predictors for LAVVR discrepancy were younger age (p=0.032) and lower weight (p=0.032) at repair; preoperative LAVVR grade was a significant predictor for worsening LAVVR (p=0.038). Conclusions: Discrepancy between LAVVR grade on post-repair TEE and discharge TTE was present in 26% of AVSD patients with the vast majority changing to a higher grade. This important finding with implications for intraoperative decision-making should prompt further investigations into preoperative LAVV anomalies, surgical technique and postoperative factors influencing valvar function.
Abstract 15421: Effect of Sex and Age-group on Pulmonary Artery to Aorta Ratio in Healthy Aging: The Framingham Heart Study
Authors: Mawa Mohmand, Philimon N Gona, Carol J Salton, Connie W Tsao, Christopher J O'Donnell, Warren J Manning, Michael L Chuang
Journal: Circulation (2020)

Introduction: An increased ratio of main pulmonary artery (MPA) to ascending aorta (AAo) diameters is associated with excess morbidity and mortality in COPD and pulmonary hypertension. We sought to determine: 1) whether MPA to AAo ratio (MPA:AAo) varies with sex and age in healthy adults; 2) normal upper 90 th percentile (P90) values for MPA:AAo; 3) effect of age on MPA:AAo in the general population. Methods: 1794 adults from the Framingham Heart Study Offspring cohort (65±9 y, 47% men) underwent ECG-gated T2-weighted black blood aortic CMR at 1.5T. MPA and AAo diameters were measured at MPA bifurcation level or the adjacent slice. A referent group free of hypertension, LV focal wall motion abnormality, any history of smoking, asthma, COPD, DVT and obesity was identified and stratified by sex and age group (&lt;55, 55-64, 65-74, ≥75 y). Data are summarized as mean±SD. P90 values were determined from referent participants. We tested for sex differences by 2-sample t test and for within-sex trend across age groups using linear regression. Results: Of the 1794 Offspring, 370 met referent group criteria, among whom men had greater MPA (23.4±2.9 vs 21.3±3.1 mm, p&lt;0.0001) and AAo (31.1±2.9 vs 28.5±3.1 mm, p&lt; 0.0001) diameters than women, but height-indexed AAo/HT (p=0.60) and MPA/HT (p=0.33) were not different between sexes. MPA:AAo did not differ between sexes, men=0.76±0.10, women: 0.75±0.15, p=0.97. P90 values for MPA:AAo were 0.88 (men) and 0.87 (women). MPA:AAo significantly decreased with age in both sexes (see Table) due to increasing AAo; MPA did not vary with age. In the overall population MPA:AAo also decreased with greater age, but here both AAo and MPA tended to increase with advancing age. Conclusions: Among healthy adults free of hypertension, obesity, and common pulmonary risk factors, MPA:AAo ratio does not differ between sexes. In healthy aging MPA:AAo decreases with age in both sexes, due to increased AAo diameters. These patterns are consistent in the general population.
Abstract 13465: Prognostic Value of Vasodilator Stress Perfusion Cardiovascular Magnetic Resonance in Patients With Known Myocardial Infarction
Authors: Theo Pezel, Philippe Garot, Marine Kinnel, Thomas Hovasse, Solenn Toupin, Thierry Unterseeh, Marie Claude Morice, Stéphane Champagne, Yves Louvard, Francesca Sanguineti, Jerome Garot
Journal: Circulation (2020)

Introduction: Several studies have demonstrated the consistently high prognostic value of stress perfusion cardiovascular magnetic resonance (CMR). This prognostic value in patients with known myocardial infarction (MI) is poorly described. Hypothesis: To assess the prognostic value of vasodilator stress perfusion CMR in patients with known MI. Methods: We prospectively included consecutive patients with known MI referred for vasodilator stress CMR with dipyridamole. They were followed for the occurrence of major adverse cardiovascular events (MACE) defined as cardiac death or recurrent non-fatal myocardial infarction (MI). Results: Of 1602 patients with known MI (68 ± 17 years, 78% men), 1556 (97%) completed the CMR protocol, and among those 1401 (90%) completed the follow-up (median follow-up 5.7 (3.9-7.6) years). Reasons for failure to complete CMR included ECG-gating problems (n=13), intolerance to stress agent (n=12), renal failure (n=12), declining participation (n=4) and claustrophobia (n=5). Stress CMR was well tolerated without occurrence of death or severe adverse event. Patients without inducible ischemia experienced a substantially lower annual event rate of MACE (3.1%) than those with 1 or 2 segments of ischemia (4.5%), than those with 3 to 5 segments of ischemia (21.5%), than those with 6 or more segments of ischemia (45.7%, for all p&lt;0.01). Using Kaplan-Meier analysis, the presence of myocardial ischemia identified the occurrence of MACE (hazard ratio HR 3.52; 95% confidence interval CI: 2.67 - 4.65; p &lt;0.001). In a multivariable stepwise Cox regression including clinical characteristics and CMR indexes, the presence of inducible ischemia was an independent predictor of a higher incidence of MACE (HR 2.84; 95% CI: 2.14 to 3.78; p &lt;0.001). Conclusions: Stress CMR is technically feasible and has a good discriminative prognostic value to predict the occurrence of MACE in patients with known MI.
A pitfall for machine learning methods aiming to predict across cell types
Authors: Jacob Schreiber, Ritambhara Singh, Jeffrey Bilmes, William Stafford Noble
Journal: Genome biology (2020)

Abstract Machine learning models that predict genomic activity are most useful when they make accurate predictions across cell types. Here, we show that when the training and test sets contain the same genomic loci, the resulting model may falsely appear to perform well by effectively memorizing the average activity associated with each locus across the training cell types. We demonstrate this phenomenon in the context of predicting gene expression and chromatin domain boundaries, and we suggest methods to diagnose and avoid the pitfall. We anticipate that, as more data becomes available, future projects will increasingly risk suffering from this issue.
Abstract 14094: Gender Difference in Covid-19 Test Status and Disease Outcomes in Heart Failure Patients
Authors: Arlet V Nedeltcheva, Rami Doukky
Journal: Circulation (2020)

Introduction: Heart failure is a common health problem in older patients. As part of quality improvement study we analyzed the data of Heart failure patients admitted for COVID-19 infection in Cook County Health, Stroger Academic Hospital between March 19 and May 27, 2020. Hypothesis: 1. To test if all patient admitted for Covid-19 will test positive. 2. To test if there is gender difference in the Heart failure patients affected by Covid-19 pandemic. Methods: Quality improvement clinical research. Results: For the period stated 74 patients with Heart failure were admitted for treatment of Covid-19 viral infection (31% female vs. 69% male), ages 29 to 88 (Mean 61+/-12). From all Heart failure patients admitted for COVID-19 only 42% tested Covid-19 positive (19% female vs. 81% male).Table:1 From all Heart failure patients admitted (74) there were 3 deaths and they were in patients who tested positive for Covid-19. Their medical condition was complicated by severe comorbidity as HIV, multi-organ metastatic cancer, one patient had DNR/DNI status. From the Heart failure patients admitted for Covid-19 symptoms 96% went home with improved health. Conclusions: Our analysis indicates that there is gender difference in magnitude Covid-19 virus affects Heart Failure patients and in their health outcome. This data may be used as base for individualized health care approach.
Effects of Omega-3 Fatty Acids on Major Adverse Cardiovascular Events
Authors: Garima Sharma, Seth S. Martin, Roger S. Blumenthal
Journal: JAMA (2020)

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Abstract 13834: Low Coronary Microvascular Vasodilator Capacity Relative to Myocardial Mass Predicts Cardiovascular Risk in Hypertensive Heart Disease
Authors: Jenifer Brown, Wunan Zhou, Brittany Weber, Sanjay Divakaran, Jon Hainer, Courtney Bibbo, Viviany R Taqueti, Sharmila Dorbala, Ron Blankstein, MARCELO DI CARLI
Journal: Circulation (2020)

Introduction: Increased left ventricular (LV) mass and coronary microvascular disease (CMD) have been independently associated with risk of heart failure (HF) and mortality in hypertensive heart disease. Inability to match increased LV mass and corresponding metabolic demand with adequate perfusion may be important in the development of HF. Hypothesis: PET-derived coronary microvascular vasodilator capacity indexed to LV mass (stress P/M) is associated with LV structure (end-diastolic volume index, EDVi, and end-systolic volume index, ESVi), LV function (LVEF) and identifies patients at elevated risk for HF hospitalization and death. Methods: We studied a retrospective cohort of consecutive symptomatic patients with hypertension presenting for rest/stress myocardial perfusion PET with LVEF ≥ 40%, normal perfusion (summed stress score &lt; 3), and no prior CAD, cardiomyopathy, or HF. Stress P/M was defined as stress myocardial blood flow (MBF) divided by LV mass. CMD was defined by myocardial flow reserve (MFR = stress/rest MBF) ≤ 1.8. Associations between stress P/M and LV structure and function were assessed, and prognostic value for HF hospitalization and all-cause mortality was evaluated. Results: We studied 358 patients: mean age 62.7±12.3y, 72.4% female. Global stress MBF was negatively associated with LV mass (β=-0.023, P&lt;0.001). Lower stress P/M was independently associated with greater EDVi (β=-0.557, p&lt;0.001), greater ESVi (β=-0.943, p&lt;0.001), and lower LVEF (β=0.819, p&lt;0.001). A below-median stress P/M conferred increased risk of mortality or incident HF hospitalization (adjusted HR=1.73 [95% CI: 1.10-2.73], p=0.02) (Figure 1A) and conferred comparable risk to CMD in those with preserved MFR (Figure 1B). Conclusions: Coronary microvascular vasodilator capacity relative to myocardial mass integrates microvascular physiology with LV structure and function and refines risk of HF and all-cause death in hypertensive heart disease.
Abstract 17146: Late Gestation Fetal Growth in Infants Undergoing Stage 1 Palliation for Single Ventricle Heart Disease
Authors: Kristin Schneider, Elisa Marcuccio, James F Cnota, Haleh Heydarian, Philip R Khoury, Garick D Hill
Journal: Circulation (2020)

Introduction: Ideal timing for elective delivery of infants with single ventricle heart disease, balancing benefits of fetal growth with risk of fetal demise, remains unclear. Improved understanding of fetal growth in late gestation and postnatal outcomes related to gestational age (GA) may improve insight. Hypothesis: Patients with single ventricle heart disease and aortic hypoplasia have decreased fetal growth velocity in late gestation, but longer gestation results in improved outcomes. Methods: This was a retrospective cohort analysis of patients in phase 2 of the National Pediatric Cardiology Quality Improvement Collaborative database from 2016-2019 who were anticipated to need stage 1 palliation (S1P) and had a GA of &gt; 36 weeks. Birth weight (BW) and BW z-scores were compared across GA to normative values. Outcome measures of survival to stage 2 palliation (S2P), post-S1P length of stay, and duration of mechanical ventilation were compared by GA. Results: The cohort included 1290 infants. There was an increase in mean BW with increasing GA (2.83 kg at 36-37 weeks, 3.15 kg at 38 weeks, 3.33 kg at 39 weeks, 3.40 kg at &gt; 40 weeks; p &lt;.0001). BW z-scores were below zero at all points in late gestation (-0.29 at 36-37 weeks, -0.17 at 38 weeks, -0.20 at 39 weeks, -0.52 at &gt; 40 weeks; p &lt;.0001), with a slower rate of growth beyond 39 weeks GA. Of 1216 patients with available mechanical ventilation data, patients born at later GA had shorter durations of ventilation (11.3 days at 36-37 weeks GA, 9.2 days at 38 weeks, 7.6 days at 39 weeks, 6.6 days at &gt; 40 weeks; p=0.0001). Among 1083 survivors to discharge or S2P if not discharged, there was no difference in post S1P length of hospitalization across GA (p=0.19). Infants who reached S2P readiness milestones were more likely to undergo S2P if born after longer gestation (p=0.0001). Conclusions: Infants with single ventricle heart disease and aortic hypoplasia have decreased growth velocity in late gestation, but growth continues. Infants born after longer gestation have improved outcomes with shorter duration of ventilation and greater likelihood of undergoing S2P.
Abstract 15913: Two-year Results of the Getting to an Improved Understanding of Low-density Lipoprotein Cholesterol and Dyslipidemia Management (GOULD) Registry of Patients With Atherosclerotic Cardiovascular Disease (ASCVD)
Authors: Christopher P Cannon, James A De Lemos, Christie M Ballantyne, Robert S Rosenson, Shushama Alam, Katie Mues, Qi Gao, Deepak L Bhatt, Mikhail N Kosiborod
Journal: Circulation (2020)

Background: Atherosclerotic cardiovascular disease (ASCVD) treatment guidelines recommend intensive statin therapy and adding non-statin therapy if LDL-C ≥70 mg/dL. Methods: We designed the GOULD registry to assess lipid-lowering therapy (LLT) over time: At 120 U.S. centers, 5006 ASCVD patients on any (LLT) were enrolled in 1 of 3 cohorts: 1) currently on PCSK9 inhibitor (PCSK9i), 2) no PCSK9i and LDL-C ≥100 mg/dL, and 3) no PCSK9i and LDL-C 70-99 mg/dL. Results: Over the two years, only 16.8% had some type of LLT intensification, In the cohorts of patients with baseline LDL-C ≥ 100 and 70-99 mg/dL, LLT intensification was present in 21.9% and 14.3% respectively: statin dose was intensified in 6.1% and 6.1%, ezetimibe was added in 6.8% and 4.3% and PCSK9i was added in 6.3% and 2.2% respectively. Conversely, out of the total population, statins were discontinued in 246/4275 (5.8%), ezetimibe in 81/535 (15.1%), and PCSK9i in 47/544 (8.6%). At 24 months, 83.7% were on statin (43.4% high-intensity), with 14.2% on ezetimibe. Lipid panels were measured in 73% by 1 year and 84% by 2 years. Among Pts in the LDL-C ≥100 and 70-99 mg/dL cohorts, 18.6% and 30.4% achieved an LDL-C &lt;70 mg/dL by 1 year, with little further change by 2 years: 21.3% and 33.5% respectively. In the PCSK9 cohort, 53.2% had LDL-C&lt;70 mg/dl. Overall, only 31.7% had LDL-C &lt;70 mg/dL at 2 years (an increase from 6.7% at baseline), while 25.0% had LDL-C &gt;100 mg/dL. Conclusion: Of ASCVD patients with suboptimal LDL-C at baseline, even after 2 years of follow up, strikingly only 16% had LLT intensification, and thus most remained uncontrolled. Further intensive efforts are needed to achieve optimal LDL management in patients with ASCVD.
Abstract 17423: Impact of Hypertriglyceridemia on ST-Elevation Myocardial Infarction Outcomes
Authors: Mehmet Yildiz, Christian Schmidt, Santiago Garcia, Ross Garberich, Larissa I Stanberry, Scott W Sharkey, Frank V Aguirre, Mark Tannenbaum, Daniel Shivapour, Roberto Coronado-Pacheco, Timothy Smith, Jenny Chambers, Heather Rohm, Teresa Coulson, Timothy D Henry
Journal: Circulation (2020)

Introduction: There has been conflicting data regarding the impact of hypertriglyceridemia (HTG) on STEMI outcomes, including reports of a “lipid paradox” defined as lower event rates in patients with HTG. Therefore, the association between HTG and outcomes in STEMI deserves further investigation especially given the results of REDUCE-IT trial. Methods: A prospective, multicenter database of the Midwest STEMI Consortium was examined. The Midwest STEMI Consortium is a unique association of 4 large STEMI systems of care: Iowa Heart Center, Minneapolis Heart Institute Foundation, Prairie Cardiovascular, and The Christ Hospital. We included all consecutive STEMI patients between age of 40 and 75. Those with missing TG levels were excluded (23%). We compared 3 groups of TG levels: normal (&lt;150 mg/dl), moderate (150 to 499 mg/dl), and severe (&gt;500 mg/dl) for MACE (death, MI, or stroke) and all-cause mortality. Results: Of 6492 consecutive STEMI patients from 03/2003 to 01/2020, 3760 (58%) met inclusion criteria. The mean (SD) age was 59.1 ± 9.2 and male gender was predominant (76%). A little over one-third of the study participants had moderate HTG (35%). Patients with higher TG levels had lower HDL levels and increased rates of history of premature CAD, DM, and HTN (Table). Moderate HTG was not a risk factor for MACE or all-cause mortality. Severe HTG was significantly associated with increased in-hospital (p=0.016) but not 1-year all-cause mortality (p=0.21) (Figure). Conclusions: In STEMI patients, higher TG levels were associated with increased in-hospital but not 1-year all-cause mortality.
An analysis of the accuracy of the P300 BCI
Authors: Nitzan S. Artzi, Oren Shriki
Journal: Brain-Computer Interfaces (2018)

The P300 Brain-Computer Interface (BCI) is a well-established communication channel for severely disabled people. The P300 event-related potential is mostly characterized by its amplitude or its area, which correlate with the spelling accuracy of the P300 speller. Here, we introduce a novel approach for estimating the efficiency of this BCI by considering the P300 signal-to-noise ratio (SNR), a parameter that estimates the spatial and temporal noise levels and has a significantly stronger correlation with spelling accuracy. Furthermore, we suggest a Gaussian noise model, which utilizes the P300 event-related potential SNR to predict spelling accuracy under various conditions for LDA-based classification. We demonstrate the utility of this analysis using real data and discuss its potential applications, such as speeding up the process of electrode selection.
Abstract 13285: Short-term Low-saturated Fat Diet Compared to High-saturated Fat Diet Improves Monocyte Phenotypes in Subjects With Hypertriglyceridemia
Authors: zeqin lian, Xiaoyuan Perrard, Antu Antony, Lu Xu, Jing Ni, Bingqian Zhang, Xueying Peng, Veronica O'Brien, Anum Saeed, Xiaoming Jia, Aliza Hussain, Ron C Hoogeveen, Christie M Ballantyne, Huaizhu Wu
Journal: Circulation (2020)

Introduction: Clinical trials suggest that low-saturated fat diet (LSFD) may reduce the risk of atherosclerotic cardiovascular disease (ASCVD) in subjects with hypertriglyceridemia (HTG). Monocytes play crucial roles in atherogenesis. Hypothesis: LSFD vs high-saturated fat diet (HSFD) improves monocyte phenotypes, thereby reducing ASCVD risk, in subjects with HTG. Methods: Subjects with HTG and metabolic syndrome (MetS, n=19) received isocaloric LSFD (~25% of calories from fat, 5% from saturated fat) and HSFD (~52% of calories from fat, 25% from saturated fat) in randomized order for 4 days (days 1-4) plus a breakfast on day 5, separated by a 4- to 6-week washout period. Blood was drawn on day 1 fasting before the diets and 3 times on day 5 (fasting before the breakfast and 4 and 6 hours postprandial) for measurement of lipid profile and analyses of monocyte phenotypes by flow cytometry and monocyte adhesion by a lab-on-a-chip microfluidic assay. Results: On day 5, LSFD, compared to HSFD, induced lower plasma levels of postprandial total triglyceride and LDL-triglyceride and fasting and postprandial total cholesterol, LDL-cholesterol, and small dense LDL-cholesterol. Compared to HSFD, LSFD reduced fasting and postprandial intracellular lipid accumulation in classical and intermediate monocytes examined by nile red staining and indicated by side scatter value of flow cytometric analysis. LSFD versus HSFD also reduced ex vivo uptake of oxidized LDL by classical monocytes at 4 hours postprandially and by intermediate monocytes in fasting state. Surface levels of molecules involved in monocyte adhesion/migration, including CD11c, CD81, and CCR2, were lower on monocytes with LSFD than with HSFD. Consistently, LSFD compared to HSFD reduced monocyte adhesion to VCAM-1. Intracellular levels of cytokines such as IL-1β, TNFα, and IL-6 in monocytes showed no difference between the two diets. Conclusions: In subjects with HTG and MetS, short-term LSFD compared to HSFD reduces monocyte intracellular lipid accumulation and improves monocyte phenotypes with reductions in monocyte adhesion and oxidized LDL uptake. These findings highlight the importance of diet composition in monocyte phenotypes and possibly atherosclerosis risks in patients with HTG and MetS.