tbuckley/cabot-search huggingface dataset:
Abstract 12063: Impact of Atrial Fibrillation on Outcomes in Hospitalized Cardiac Amyloidosis Patients
Authors: Temitope Ajibawo, Oluwatimilehin Okunowo, Adeniyi S Okunade
Journal: Circulation (2021)

Background and Objectives: Atrial fibrillation (AF) is associated with significant mortality and morbidity. However, the impact of AF on outcomes in patients hospitalized for cardiac amyloidosis (CA) is not well-defined. The main aim of the study is to assess the impact of AF on in-hospital mortality, and in-hospital outcomes including utilization of procedures in CA patients Methods: Patients (age ≥ 18 years) with a primary diagnosis of CA were identified using ICD-9 diagnostic codes from the National Inpatient Sample (2007 to 2014). Then, we compared in-hospital outcomes between the AF group and propensity score-matched group without AF. Results: AF occurred in 671(20.6%) of the CA patients. In comparison to those without AF, AF with CA did not experience any statistically significant difference in terms of in-hospital mortality (11.0% vs 12.1%; OR 0.89 95% CI 0.84-1.25,p=0.5008), acute kidney injury (30.8 % vs 29.1%; OR 1.09 95% CI 0.86-1.37 p=0.4849), sepsis (4.3% vs 6.0%; OR 0.71 95% CI 0.45-1.12 p= 0.1370), stroke (11.8% vs 12.2 %; OR 0.97 95% CI 0.69 -1.36 p= 0.8651), acute DVT/PE (2.5% vs 4.2 %; OR 0.59 95% CI 0.31-1.14 p=0.1149), and respiratory complications (10.2% vs 10.6%; OR 0.96 95% CI 0.66-1.38 p=0.8059). There was also no difference with regards to length of stay (6 days vs 5 days; p=0.5329) and median total hospital costs (42833 vs $38346; p=0.1785). Cardiac biopsies were performed in more AF with CA patients (11.5% vs 7.7; OR 1.55 95% CI 1.03-2.32) compared to without AF Conclusion: AF was not associated with a higher risk of in-hospital mortality and complications in CA hospitalization patients. However, there was higher rate of in-hospital cardiac biopsies in AF
RBIO-03. INITIAL RESULT OF DEVELOP ROBUST DEEP LEARNING MODEL FOR DETECTING GENOMIC STATUS IN GLIOMAS AGAINST IMAGE DIFFERENCES AMONG FACILITIES
Authors: Satoshi Takahashi, Masamichi Takahashi, Manabu Kinoshita, Mototaka Miyake, Jun Sese, Kazuma Kobayashi, Koichi Ichimura, Yoshitaka Narita, Ryuji Hamamoto, Consortium of Molecular Diagnosis of glioma
Journal: Neuro-Oncology (2021)

Abstract BACKGROUND The importance of detecting the genomic status of gliomas is increasingly recognized and IDH (isocitrate dehydrogenase) mutation and TERT (telomerase reverse transcriptase) promoter mutation have a significant impact on treatment decisions. Noninvasive prediction of these genomic statuses in gliomas is a challenging problem; however, a deep learning model using magnetic resonance imaging (MRI) can be a solution. The image differences among facilities causing performance degradation, called domain shift, have also been reported in other tasks such as brain tumor segmentation. We investigated whether a deep learning model could predict the gene status, and if so, to what extent it would be affected by domain shift. METHOD We used the Multimodal Brain Tumor Segmentation Challenge (BraTS) data and the Japanese cohort (JC) dataset consisted of brain tumor images collected from 544 patients in 10 facilities in Japan. We focused on IDH mutation and TERT promoter mutation. The deep learning models to predict the statuses of these genes were trained by the BraTS dataset or the training portion of the JC dataset, and the test portion of the JC dataset evaluated the accuracy of the models. RESULTS The IDH mutation predicting model trained by the BraTS dataset showed 80.0% accuracy for the validation portion of the BraTS dataset; however, only 67.3% for the test portion of the JC dataset. The TERT promoter mutation predicting model trained by the training portion of the JC dataset showed only 49% accuracy for the test portion of the JC dataset. CONCLUSION IDH mutation can be predicted by deep learning models using MRI, but the performance degeneration by domain shift was significant. On the other hand, TERT promoter mutation could not be predicted accurately enough by current deep learning techniques. In both mutations, further studies are needed.
Abstract 11803: Area Deprivation and COVID-19 Outcomes in Patients With and Without Cardiovascular Disease: The Curator Registry of Houston Methodist
Authors: Kobina Hagan, Zulqarnain Javed, Miguel Cainzos-Achirica, Javier Valero Elizondo, Charlie Nicolas, Tamer Yahya, Isaac Acquah, Ron Blankstein, Adnan Hyder, Elias Mossialos, Farhaan S Vahidy, Khurram Nasir
Journal: Circulation (2021)

Introduction: Individuals with CVD are at higher risk of COVID-19 complications. However, the impact of social disadvantage on COVID-19 outcomes has not been fully evaluated in people with CVD. We assessed Area Deprivation Index (ADI) associations with COVID-19 positivity, severity, and in-hospital mortality among patients with and without CVD. Methods: We used the Houston Methodist COVID-19 Surveillance and Outcomes Registry (CURATOR) of 152,850 consecutive adults tested for COVID-19 between March 6 and October 31, 2020. CVD status was obtained from electronic health records. We matched ZIP codes of patients’ residences to state-level ADI using the Neighborhood Atlas and Census Block information from the American Community Survey 2018. ADI was categorized into quintiles of increasingly higher social disadvantage. For reference, we also analyzed the data of patients without CVD. Results: The median ADI ranking of the total sample (mean age 51.3 years; 60% women) was 4 (IQR 1-6). Overall, 37,468 (24.5%) patients had CVD and their median ADI was higher than those without CVD. Of the total sample, 11.9% tested positive for COVID-19 (no CVD: 12.7%; CVD: 9.4%). COVID-19 patients with CVD (v. no CVD) were more likely to be hospitalized (68.4% v. 27.1%), receive intensive care (34.9% v. 16.4%), and die (16.2% v. 4.0%) during admission. Adjusting for demographics and comorbidities, the odds of COVID-19 positivity and hospitalization were at least 50% higher in the most (compared to the least) deprived groups, irrespective of CVD status (Figure). In contrast, associations were null between ADI, need for intensive care, and in-hospital mortality. Conclusions: Individuals from the most deprived neighborhoods were more likely to test positive and be hospitalized for COVID-19, irrespective of CVD status. However, once hospitalized, individuals from disadvantaged areas were not at increased risk of requiring intensive care or dying during admission.
Abstract 9587: Combined Aortic Regurgitation and Stenosis of the Bicuspid Aortic Valve Increases Ascending Aortic Wall Shear Stress and Left Ventricle Energy Burden
Authors: Koichi Sughimoto, Takumi Harada, Takashi Fujiwara, Alex J Barker, Masashi Kabasawa, Hao Liu
Journal: Circulation (2021)

Introduction: The bicuspid aortic valve (BAV) opening pattern and the degree of aortic stenosis (AS) are reportedly associated with the aneurysmal formation in the ascending aorta. Although AS is often accompanied by aortic regurgitation (AR), the combined effect of AR and AS on the wall of the ascending aorta and energy loss of the blood flow are not well understood. Hypothesis: We hypothesize that AR along with AS can increase the wall shear stress (WSS) to develop the aneurysm in the ascending aorta and increase the load on the left ventricle (LV). Methods: The effects of AR along with AS BAV on the hemodynamic features were assessed using an image-based subject-specific LV-aorta integrated computational model. The computational model was constructed based on an MRI dataset of a 72-year-old healthy volunteer. Four different types of stenosed (52% stenosis) BAV models were created: Type 0, RL fused, RN fused, and LN fused. Then, physiological boundary conditions were given based on a parameter-adjusted 0-1D cardiovascular model of the AS BAV with no AR, mild AR (17% regurgitant fraction (RF)), and severe AR (48% RF) to assess hemodynamic indices such as time-average of WSS in the ascending aorta and pulsatile energy loss index (PELI), an index to estimate energy loss in the aorta. Results: Averaged WSS was highest in the severe AR with AS BAV in 4.1±0.2 Pa, followed by the mild AR with AS BAV in 3.1±0.21 Pa, and no AR with AS BAV in 2.7±0.3 Pa. The intra-ventricular flow (LV) showed more disturbed flow in mid-diastole in severe AR with AS BAV. PELI was augmented in mild AR with AS BAV in 0.34±0.05 and severe AR with AS BAV in 0.25±0.06, compared to no AR with AS BAV in 0.19±0.16. Conclusions: AR along with AS in BAV has a great impact on increasing the WSS in the ascending aorta and increasing the energy loss of the flow in the aorta. These features imply that advanced AR along with AS in BAV may raise the risk of the development of aortic aneurysm as well as heart failure due to the increased workload on the LV.
Abstract 9591: Minority Stress and Incident Hypertension in Sexual Minority Women
Authors: Billy A Caceres, Yashika Sharma, Alina Levine, Melanie M Wall, Tonda Hughes
Journal: Circulation (2021)

Introduction: Sexual minority women (SMW; e.g., lesbian, bisexual) are at higher risk of hypertension than heterosexual women. Minority stressors (defined as unique psychosocial stressors attributed to sexual minority identity) are hypothesized to contribute to hypertension risk in SMW. However, research has yet to formally test the association of minority stressors with hypertension. We sought to examine the association between several key minority stressors and self-reported incident hypertension among SMW. Hypothesis: Minority stressors will be positively associated with incident hypertension in SMW. Methods: We conducted a secondary analysis of data from Chicago Health and Life Experiences of Women study, a 21-year longitudinal study of SMW’s health. Using two waves of data we examined the associations of minority stressors (i.e., experiences of discrimination, stigma consciousness, and internalized homophobia) with incident hypertension. We ran mutually adjusted logistic regression models to estimate the odds ratios of the associations between minority stressors and incident hypertension, after adjusting for demographics, insurance status, body mass index, and smoking status. Results: The analytic sample included 348 SMW; mean age 38.4 (±12.8) years. More than half were women of color (56.6%). Approximately 60% had completed a bachelor’s degree and most had healthcare insurance (73.6%). Mean follow-up was 7.0 (±0.6) years; during which 12.6% were diagnosed with hypertension. After covariate adjustment, we found that a 1-standard deviation increase in internalized homophobia scores was associated with higher odds of incident hypertension (AOR 1.50, 95% Cl = 1.05-2.10). Stigma consciousness (AOR 0.80, 95% CI = 0.52-1.23) and experiences of discrimination (AOR 1.13, 95% CI = 0.76-1.61) were not associated with incident hypertension. Conclusions: This is the first study to document that internalized homophobia is associated with incident hypertension in SMW. Future research is needed that examines the associations of minority stressors with objective measures of hypertension. Findings highlight there is a need for psychosocial interventions to reduce internalized homophobia and hypertension risk in SMW across the lifespan.
Abstract 11728: Common Primary Medical Conditions Associated With Secondary Takotsubo Cardiomyopathy
Authors: Pengyang Li, Chenlin Li, Peng Cai, Xiaojia Lu, xin wei, Qi Liu, Su Pan, Richard A Dixon, Bin Wang
Journal: Circulation (2021)

Introduction: Secondary Takotsubo cardiomyopathy (TCM) is considered a complication of the patient’s primary medical condition, such as medical, surgical or psychiatric conditions. More than one-third of TCM patients have primary medical conditions and tend to have a worse prognosis. However, there is no comprehensive study on the causes of TCM. Aim: We studied the common primary medical conditions in secondary TCM patients and their prognosis. Methods: We performed a retrospective analysis using the ICD-10-CM codes for a secondary diagnosis of TCM from the National Inpatient Sample database (2016-2018). We identified the primary medical condition represented by the ICD-10-CM diagnosis codes of secondary TCM patients and aggregated similar codes into clinically meaningful categories using the Clinical Classifications Software Refined. We then compared the mortality rate associated with each condition. Results: Of 14,816 patients admitted with secondary TCM, the common primary medical conditions included ‘Sepsis, unspecified organism’ (A419, 13.6%), ‘Chronic obstructive pulmonary disease with (acute) exacerbation’ (J441, 3.6%), ‘Acute respiratory failure with hypoxia’ (J9601, 2.8%), and ‘Pneumonia, unspecified organism’ (J189, 1.8%). After aggregating the individual codes into clinical categories, the common primary medical conditions included septicemia (19.1%), respiratory failure (6.4%), COPD and bronchiectasis (4.6%), hypertension with complications and secondary hypertension (4.2%), and cerebral infarction (3.1%). Primary medical conditions that yielded a higher mortality rate than the overall rate (8.5%) were septicemia (16.5%, P&lt;0.001), respiratory failure (10.7%, P=0.019), cerebral infarction (13.1%, P&lt;0.001), and acute hemorrhagic cerebrovascular disease (26.8%, P&lt;0.001). Conclusions: Sepsis is the most common primary medical condition of secondary TCM in admitted patients. Secondary TCM patients with a primary condition of acute hemorrhagic cerebrovascular disease, sepsis, respiratory failure, or cerebral infarction have higher in-hospital mortality than those with other primary medical conditions.
CTNI-44. DOSIMETRIC IMPACT OF TUMOR TREATING FIELDS ON CONCURRENT RADIATION THERAPY FOR PEDIATRIC BRAIN TUMORS
Authors: Enzhuo Quan, Eun Han, Christine Chung, Tina Briere, Zsila Sadighi, Susan McGovern
Journal: Neuro-Oncology (2021)

Abstract INTRODUCTION Early results suggest that tumor treating fields (TTF) concurrent with radiotherapy (RT) for glioblastoma yields acceptable dosimetry in adults; the impact on RT dose distribution in children is unknown. This study was undertaken to evaluate the dosimetric impact of TTF on concurrent photon RT for children with brain tumors. METHODS CT scans of an anthropomorphic pediatric head phantom (approximately 15-year-old) and an infant-head-sized spherical phantom were acquired with and without TTF attached. For each phantom, simulated supratentorial tumor targets were initially contoured on CT datasets acquired without TTF attached. Treatment plans using volumetric modulated arc therapy were created to deliver 60Gy and 50Gy to the gross tumor volume (GTV) and clinical tumor volume (CTV), respectively, in 30 fractions. The dose distributions of the same treatment plans were then re-computed with TTF attached. Target coverage metrics were compared between dose distributions with and without TTF. To measure skin dose, treatment plans were delivered with thermoluminescent dosimeters placed on the phantoms at various locations, with and without TTF attached. RESULTS The presence of TTF slightly reduced target coverage. For the two phantoms studied, D95 of the CTV was reduced by 0.65% and 1.03%, and D95 of the GTV was reduced by 0.7% and 1.05%, respectively. Electrodes under the direct beam path increased skin dose by an average of 43.3% (0.3Gy – 20.7Gy), but all skin dose measurements stayed within tolerances. TTF electrodes out of the RT field did not cause an increase in measured dose. CONCLUSIONS The dosimetric impact of TTF on pediatric head phantoms receiving concurrent RT resembles that reported in adult studies. Although the tumor dose is not significantly affected, the skin dose notably increases due to the bolus effect from the TTF electrodes, which may be mitigated by skin-sparing planning and shifting of the device during RT.
Abstract 16340: Effectiveness of Tricuspid Valve Repair Performed Concurrent With LVAD Implantation
Authors: Yaron Barac, Muath Bishawi, Jacob Schroder, Mani Daneshmand, Alina Nicoara, Nazish Hashmi, Eric Velazquez, Joseph Rogers, Chetan Patel, Carmelo Milano
Journal: Circulation (2018)

Pre-implant significant TR, in patients who come to surgery for durable LVAD, has been associated with increased right heart failure (RHF) after implantation. The benefit of concurrent tricuspid va...
Abstract 11256: Longitudinal Changes of Left Ventricular Hemodynamics and Geometry After Myocardial Infarction in a Chronic Swine Model with Functional Mitral Regurgitation
Authors: Daisuke Onohara, Michael Silverman, Daniella Corporan, Dongyang Xu, Kirthana Sreerangathama Suresh, Muralidhar Padala
Journal: Circulation (2021)

Introduction: Ischemic mitral regurgitation (IMR) is a frequent complication of left ventricular (LV) pathological remodeling after myocardial infarction (MI), which doubles morbidity and mortality. Longitudinal LV remodeling after an MI is not fully understood, therefore large animal studies are needed. In this study, we developed a chronic swine model with IMR and investigated temporal changes of LV remodeling with transesophageal echo (TEE) and pressure-volume (PV) loops. Methods: Yorkshire swine (n=14) underwent induction of a lateral MI through ethanol injection percutaneously into the left circumflex artery (LCX) distal to the first obtuse marginal branch. The animals were survived for 3 months with monthly follow-up TEE. PV loops were performed at baseline, immediately after MI induction, and 3 months post-MI ( Fig.A ). Results: 12 animals survived the MI procedure and developed IMR (average MR grade was 2.6±1.0). LCX occlusion was confirmed with coronary angiogram at 3 months post-MI. EDV and ESV were significantly increased at 3months compared to baseline (156.5±53.0 vs 63.3±7.2ml, p&lt;0.0001, and 83.2±31.4 vs 25.5±5.1ml, p&lt;0.0001, respectively). EF decreased 39.7±7.2% just after infarction compared to 59.4±4.3% at baseline (p=0.0001) and increased at 1 and 2 months, then decreased again at 3 months (53.6±8.1, 55.9±6.3, and 46.7±7.6%, respectively) ( Fig.B ). In invasive hemodynamics, end-systolic elastance, preload adjusted dP/dt max , and end-diastolic pressure-volume relationship significantly decreased at 3 months indicating both systolic and diastolic dysfunction. Arterial elastance at 3 months was significantly lower than baseline indicating a reduction of afterload due to MR ( Fig.C ). Conclusions: A lateral MI resulted in an acute reduction in EF, followed by development of IMR, chronic LV dilation, and decreased systolic and diastolic function over 3 months. Temporary improvement of EF after MI may indicate reduced afterload due to MR.
Abstract 9804: Overexpression of Pericyte Hif2a Exacerbates Hypoxia Induced Pulmonary Hypertension and Right Ventricular Hypertrophy
Authors: Hyunbum Kim, Timothy Klouda, Jiwon Kim, Cheng-Jun Hu, Wen Tian, Xinguo Jiang, Kurt R Stenmark, Mark Nicolls, Vinicio De Jesus Perez, Ke Yuan
Journal: Circulation (2021)

Introduction: Pulmonary arterial hypertension (PAH) is a life-threatening disease characterized by abnormally elevated pulmonary pressures and right-sided heart failure. Excessive accumulation of mural cells including pericytes surrounding the pulmonary vascular wall is one of the key pathological features seen in PAH. Whether pericytes contribute to other mural cell lineage and the underlying mechanisms responsible for their behavior are still elusive. Hypothesis: To evaluate the novel role of HIF2α signaling in pericytes in the pathogenesis of PAH. Methods and Results: NG2-Cre-ER mice are used to generate pericyte selective HIF2α overexpression (HIF2α NG2-OE ) and HIF2α NG2-OE reporter mice (HIF2α NG2-OE tdT) via tamoxifen injection for cell lineage identification. Compared to control, HIF2α NG2-OE mice in chronic hypoxia have significantly higher right ventricular systolic pressure and right ventricular hypertrophy along with increased muscularization and a greater abundance of NG2 + cells surrounding microvessels. Cellular lineage staining on HIF2α NG2-OE tdT reporter mice in chronic hypoxia show that tdT + cells accumulate in muscularized arterioles and exhibit significantly high levels of HIF2α protein, which initiates vascular cell proliferation and recruitment of inflammatory cells. Moreover, HIF2a over-expressed human pericytes exhibit greater contractility, impaired capacity to establish endothelial-pericyte communications, and loss of vascular integrity. Importantly, the HIF2a-targeted inhibitor attenuates hypoxia-induced pulmonary hypertension. Conclusions: HIF2α signaling in pericytes is a key mediator that contributes to abnormal vascular remodeling. Targeting HIF2α could potentially decrease pericyte migration as well as reducing vascular remodeling, therefore, serve as a potential treatment for certain forms of PH.
A Novel Autochthonous Mouse Model Serves As a Preclinical Evaluation Platform and Explores Dual BTK and BCL2 Inhibition for Activated B Cell-like Diffuse Large B Cell Lymphoma
Authors: Ruth Flümann, Pascal Nieper, Tim Lohmann, Ilmars Kisis, Martin Peifer, Nima Abedpour, Roman Thomas, Moritz Kochanek, Benedikt Pelzer, Filippo Beleggia, Reinhard Buettner, Philipp Lohneis, Thorsten Persigehl, Michael Hallek, Dinis Pedro Calado, Laura Pasqualucci, Bastian von Tresckow, Björn Chapuy, Ron Jachimowicz, Christian Reinhardt, Gero Knittel
Journal: Blood (2021)
CTIM-31. A PHASE II, OPEN-LABEL, SINGLE ARM TRIAL OF PEMBROLIZUMAB FOR REFRACTORY ATYPICAL AND ANAPLASTIC MENINGIOMA AND HEMANGIOPERICYTOMA
Authors: Shlomit Yust-Katz, Alexandra Amiel, Shlomit Yust-Katz, Dror Limon
Journal: Neuro-Oncology (2021)

Abstract BACKGROUND Grade II and III meningiomas are invasive tumors which tend to recur following initial treatment and are associated with shorter survival (relative to grade I). Hemangiopericytoma (HPC) is a dural based tumor that originates in the pericytes. Treatment options for these tumors include surgical resection and radiation. There are no defined standard treatments after failure these modalities, and effective systemic treatments are lacking. This trial concept was developed following previous reports of high PD-L1 levels in anaplastic meningioma. We currently report our initial experience with pembrolizumab for refractory atypical/anaplastic meningioma (RAM) and HPC patients. METHODS This is a single arm, single institute, phase 2 trial. Inclusion criteria included patients with RAM or HPC whose all previous lines of treatment were exhausted. All patients were treated with pembrolizumab (200mg every 3 weeks) until disease progression. Primary endpoint was 6- and 12-months progression free survival (PFS). The study was planned for 25 patients and we report here preliminary results. RESULTS Through February 2021, 12 patients were enrolled to this study (two with HPC, 10 with RAM). After a median follow up of 18.5 months, the 6 and 12 months PFS were 25% and 16.7% respectively, with a median PFS of 2.75 months. Two patients had a partial response while all others progressed, making the overall response rate 16.7%. One of the responders had HPC and has been stable for 30 months, while the second had atypical meningioma and was stable for 13 months. Median survival has not been reached yet; 1 year survival rate was 82.5%. Grade 3 toxicities included hyperglycemia, elevated liver enzymes and fatigue, with no grade 4 or 5 toxicities. CONCLUSIONS Pembrolizumab induced a low response rate for RAM and HPC. However, a subset of patients might benefit from this treatment with a prolonged response period.