tbuckley/cabot-search huggingface dataset:
Abstract 10222: Demographic and Clinical Characteristics of Patients Enrolled in a Non-Academic Multidisciplinary Cardio-Obstetrics Program
Authors: Kirsten Shaw, William Wagner MD, Abbey Sidebottom, Courtney Baechler, Joy Hayes, Gretchen A Benson, Brynn Okeson, Alena Guenther, Retu Saxena
Journal: Circulation (2021)

Introduction: Pregnancy in women with cardiovascular disease (CVD) is associated with significant morbidity and mortality. The CARPREG2 and the modified World Health Organization (mWHO) classification have been developed to predict cardiac complications. Most cardio-obstetric (CVOB) clinics are conducted through academic institutions; we describe the demographic and clinical characteristics of patients enrolled in a non-academic multidisciplinary CVOB specialty program after its inception in 2018/2019. We compared this with pregnant women seen in cardiology consultation in 2016/2017 prior to the program’s inception. Hypothesis: Women seen by the CVOB program will have higher risk scores compared to pre-program controls. Methods: A retrospective chart review was conducted of 113 patients who received care from the CVOB program in 2018/2019 as well as 338 pregnant women seen by cardiology in 2016/2017. Data on demographics, CVD risk and comorbidities were collected. Results: The CVOB patients had higher mWHO score ( &gt; II-III) at 57% vs.17% and higher CARPREG2 scores ( &gt; 2) 51% vs 28%. The CVOB patients were more racially diverse (34% nonwhite vs 24%). The CVOB group had higher rates of valvular heart disease (27% vs 8%) and hypertension (19% vs 12%). The use of antiplatelets and antihypertensives in the CVOB group was higher during pregnancy. Conclusions: Women in the CVOB program were at significantly increased CVD risk and were more racially diverse compared to pregnant women referred for cardiology consultation.
Anchoring of fully covered self-expandable metal stents: selected patients or all?
Authors: Yi-Jun Liao, Yen-Chun Peng
Journal: Endoscopy (2021)

See also: Efficacy of an internal anchoring plastic stent to prevent migration of a fully covered metal stent in malignant distal biliary strictures: a randomized controlled studyEndoscopy 2021; 53(06): 578-585DOI: 10.1055/a-1256-0571 See also: Reply to Drs. Liao and PengEndoscopy 2021; 53(12): 1291-1291DOI: 10.1055/a-1616-0869
Abstract 12989: Impact of Vasopressor Use on Brain Edema and Neurological Outcomes Among Resuscitated Cardiac Arrest Survivors
Authors: Abhishek Dutta, Nasir Majeed, Lawson McDonald, Youssef Masmoudi, John Azizian, Waqas Qureshi
Journal: Circulation (2021)

Introduction: Current guidelines in post cardiac arrest care recommend the use of vasopressors for hemodynamic optimization. The use of hypothermia can further challenge hemodynamics. The impact of vasopressors among cardiac arrest survivors on neurological outcomes is not well studied Hypothesis: We hypothesized that duration and use of vasopressor are not associated with poor neurological outcome and brain edema Methods: We enrolled cardiac arrest survivors from January 2012 - December 2016 that were able to survive for 24 hours or more. We examined associations of vasopressor use and duration with brain edema and poor neurological outcomes in adjusted logistic regression models (Fig 1). Poor neurological recovery was defined as cerebral performance score (CPC) of &gt;2 or modified Rankin score of &gt;3(unable to perform daily activities independently).Kaplan-Meier was used to depict relationship of brain edema with mortality. Results: Out of 981 cardiac arrest survivors (mean age 62.5±14.8 years, 39.3% female, 70.4% white, 34.7% shockable rhythm), 754 (76.6%) were treated with vasopressors. CT or MRI brain were performed among 931 (94.9%) of the patients and brain edema was present among 445 (47.8%) of the patients. Brian edema was independently associated with mortality (HR 2.50; 95% 2.06 - 3.04, p &lt;0.001). Vasopressor use was significantly associated with brain edema (OR 2.90; 95% CI 2.00 - 4.21, p &lt;0.001). Vasopressor duration was also an independent risk factor of brain edema (OR per hour of vasopressor use 1.031; 95% CI 1.002 - 1.061, p = 0.03). In addition to this, vasopressor use was associated with CPC &gt;2 (OR 1.04; 95% CI 1.01 - 1.07, p = 0.006) and with modified Rankin score &gt;3 (OR 1.04; 95% CI 1.01 - 1.07, p = 0.006). Conclusions: We observed that the duration and use of vasopressor were associated with poor neurological outcomes and brain edema among cardiac arrest survivors. Future studies should evaluate the mechanism of brain edema associated with vasopressor use.
Abstract 9606: Prognostic Significance of Interventricular and Mitral Calcification on Permanent Pacemaker Implantation Post Tavr. Is All That Glitters Gold?
Authors: Kirtivardhan Vashistha, Amel Tobaa, Mark Doyle, Susan Bartley, Stephen Bailey, Robert W Biederman
Journal: Circulation (2021)

Background: Despite growing demand, TAVR implantation is not free of complications, conduction defects being one of the major barriers to its widespread usage. We sought to evaluate the prognostic implications of interventricular (IVS) and mitral annular calcification (MAC) on post-TAVR conduction abnormalities. Methods: We performed a retospective chart review on patients who underwent TAVR at our center (Pittsburgh, PA) during the year 2016-2020 and identified two groups ranked via presence or absence of permanent pacemaker (PPM) implantation post-TAVR. These groups were compared based on baseline demographics, comorbidities, transthoracic echocardiogram (TTE) parameters, and evidence of IVS/MAC calcification via TTE. Results: Extracted from a database of &gt;2500 pts, an aged-matched cohort of 75 pts requiring a post-TAVR PPM were identified along with 53 patients undergoing TAVR with no post-procedure conduction defects that were utilized as the control group. In the former group, 66 patients had on-site echocardiographic imaging of which 36 had evidence of IVS calcification (54%). The latter group had 51 patients with imaging of which 22 had evidence of IVS calcification (43%); p=NS; Table 1). Although via a binary logistic model, association of post-TAVR PPM with IVS confirmed no relation with PPM, MAC was strongly associated with PPM with a sensitivity of 82% and specificity of 81%; area under the ROC curve of 0.91. The coefficients in the model are &lt;0.1 level; p&lt;0.001 (Fig 1). PPM placement was directly related to MAC presence and inversely related to LVEF. Conclusion: Inherently, IVS calcification should predict post-TAVR PPM given its' proximity to the conduction system. Unexpectedly, however, MAC was a very strong predictor of post-TAVR 30d PPM placement. Moreover, once MAC is present there is ~3-fold increase in PPM while for every 1% increase in LVEF, there is a 1.2% increase in PPM. This simple predictor may have relevance in prognostication even more than EKG.
Can ablation for atrial fibrillation be performed safely and effectively in the elderly
Authors: Yoshida Hiroshi, Yamane Teiichi, Tokuda Michifumi, Kanzaki Yasuko, Inada Keiichi, Shibayama Kenri, Matsuo Seiichiro, Miyanaga Satoru, Miyazaki Hidekazu, Date Taro, Sugimoto Kenichi, Yoshimura Michihiro
Journal: Circulation (2008)
Abstract 10823: Familial Hypercholesterolemia in the Brazilian Adult Population: Prevalence and Factors Associated According to the National Health Survey
Authors: Ana Carolina M Sa, Luisa C Brant, Crizian S Saar Gomes, Elton Junio Sady Prates, Deborah Malta
Journal: Circulation (2021)

Introduction: Familial Hypercholesterolemia (FH) is a genetic dyslipidemia associated with premature coronary artery disease (CAD) and stroke, however it is underdiagnosed. The World Health Organization recognizes FH as a public health priority and recommends early diagnosis and treatment. In Brazil, the prevalence of FH in population representative studies is lacking. Objective: To estimate the prevalence and investigate factors associated with FH in the Brazilian adult population. Methods: A total of 8,521 adults over 18 years old from the National Health Survey (NHS, 2014-2015) were included in this cross-sectional analysis. FH was defined by the Dutch Lipid Clinic Network criteria (Dutch MEDPED). Possible FH was defined in individuals who scored 3 to 5 points: premature CAD (2 points) and/or cerebral disease (1 point), and LDL-Cholesterol (mg/dL): 155-189 (1 point), 190-249 (3 points), 250-329 (5 points), ≥330 (8 points). The prevalence of FH was estimated according to sociodemographic, lifestyle, and health conditions variables and differences were evaluated using the chi-square test (p ≤ 0,05). Results: The prevalence of possible FH was 0.96% and it was higher in women (1.22%; p = 0.04), individuals of 45 to 59 years (1.74%; p = 0.004), white race (1.13%; p = 0.05), illiterate or with incomplete elementary school (1.55%; p = 0.002), in the presence of hypertension (1.75%; p = 0.002), diabetes (1.85%; p = 0.02), total cholesterol ≥310 mg/dL (53.94%; p &lt; 0.001), and poor/very poor health self-assessment (2.40%; p &lt; 0.001). Conclusions: FH was frequently present in the Brazilian adult general population (1:104 individuals). The early identification of FH may contribute to reducing the burden of premature CAD in the country.
Lenalidomide Dosing and Outcomes in Transplant-Ineligible Patients with Newly-Diagnosed Multiple Myeloma: A Multi-Institutional Report from the Canadian Myeloma Research Group (CMRG) Database
Authors: Hira S Mian, Richard Leblanc, Martha L Louzada, Esther Masih-Khan, Arleigh McCurdy, Christopher P. Venner, Julie Stakiw, Moustafa Kardjadj, Victor H Jimenez-Zepeda, Michael Sebag, Darrell J White, Muhammad Aslam, Kevin W Song, Anthony Reiman, Rami Kotb, Engin Gul, Donna E. Reece
Journal: Blood (2021)
Abstract 11040: Gender Imbalance in Heart Failure Treatment, Use of Implantable Left Ventricular Assist Systems, and Cardiac Transplantation
Authors: Fadi I Musfee, Randa Hamden, Mrinalini Buddha, Hayden Naizer, Alexandra Zingg Guzman, Ganduglia Cazaban M Cecilia, George V Letsou
Journal: Circulation (2021)

Introduction: Fewer women than men with heart failure (HF) progress to implantation of a left ventricular assist device (LVAD) or transplant. A comprehensive, large-database analysis of women with HF is lacking. Methods: From a commercial and a national Medicare database using OPTUM® Clinformatic® Data Mart and a Medicare National Sample comprising 57,585,519 US patients, we identified 346,345 adults treated for HF during 2014-2016. Comorbidities including diabetes, coronary artery disease, hypertension, and cardiomyopathy were recorded. Patients were monitored for stroke, mechanical ventilation, heart transplant, renal insufficiency, and death through 2019 or until they were no longer enrolled. Sex and age were discerned from enrollment information. Results: Approximately equal percentages of men (51%) and women (49%) had HF. Age at HF diagnosis was similar between men and women (60 vs 58 y). Diastolic HF was more common in women than in men prior to LVAD placement (64% vs 36%) . All patients who progressed to LVAD placement had combined systolic and diastolic heart failure. Similar numbers of men and women with HF died within the follow-up period. Women received only 24% of the implanted LVADs. Age at LVAD placement was similar between men and women (61 vs 59 y). More men than women with HF and implanted LVADs had coronary artery disease and ischemic cardiomyopathy. After LVAD implantation, intracerebral bleeding and stroke were more common in women. Conclusions: In the largest database analysis to date, HF incidence, age at diagnosis, and age at LVAD placement were similar between women and men. Fewer women progressed to LVAD placement or transplantation. The prevalence of diastolic HF was significantly higher in women prior to LVAD placement. Women’s outcomes after LVAD implantation were significantly worse than men’s, especially with regard to stroke and cerebral injury. These findings support those of smaller studies.
QOLP-19. FINANCIAL TOXICITY AND DISTRESS DURING THE COVID-19 PANDEMIC IN PEOPLE LIVING WITH PRIMARY BRAIN TUMORS
Authors: Heather Leeper, Elizabeth Vera, Alvina Acquaye, Nicole Briceno, Anna Choi, Alexa Christ, Ewa Grajkowska, Varna Jammula, Jason Levine, Matthew Lindsley, Jennifer Reyes, Kayla Roche, James Rogers, Michael Timmer, Lisa Boris, Eric Burton, Nicole Lollo, Marissa Panzer, Marta Penas-Prado, Valentina Pillai, Lily Polskin, Brett Theeler, Jing Wu, Mark Gilbert, Terri Armstrong
Journal: Neuro-Oncology (2021)

Abstract Primary brain tumor (PBT) patients experience high symptom burden and functional limitations, which may be impacted by the economic strain and mood disturbance during the COVID-19 pandemic. We assessed financial toxicity and associated patient reported outcomes (PROs) after one year of lockdown in a cohort of PBT patients. Patient and disease characteristics and PROs including FACIT-COST, MDASI-Brain Tumor, PROMIS-Anxiety/Depression short forms, and EQ-5D-3L were collected from 7/2020 to 5/2021 from participants in our Natural History Study. Descriptive statistics, Pearson correlations, and independent samples t-tests evaluated PRO relationships. The cohort included 112 PBT patients: 57% male, 87% white, mean age = 47 (range 25 – 80). Majority were married (65%), completed ≥ 4-year college degree (73%), earned annual family income ≥ $50,000 (68%) and living with a high-grade glioma (72%) complicated by recurrence (51%). Using FACIT-COST, 56% reported some financial hardship due to illness with a mean FACIT-COST of 28.3 (SD = 11.3, range: 0 - 44). Half of patients reported feeling moderately to extremely anxious or depressed. Non-Whites and Hispanics as well as those not currently working reported worse financial toxicity compared to White non-Hispanics and individuals currently working (21.4 vs 29.8 and 25.7 vs 30.4, respectively). Worse financial toxicity scores strongly correlated with worse overall symptom burden (r = -0.55) and interference (r = -0.42), worse anxiety (r = -0.39) and depression scores (r = -0.44), and worse overall HRQOL scores (r = –0.33)[all p&amp;lt; .01]. This is the first report of FACIT-COST in PBT patients to our knowledge and demonstrates that non-White individuals living with high grade glioma who are not currently working due to their tumor reported worse financial toxicity which was strongly correlated with higher symptom burden and interference with lower HRQOL. Future studies to assess financial toxicity longitudinally and post-pandemic using the FACIT-COST are needed.
Abstract 10579: Vascular Impairment by Trimethylamine N-Oxide (TMAO) Uptake and the First Description of a TMAO Transporter in Endothelial Cells
Authors: Sascha T Rittig, Lidia Gaal, Marie R Schubert, Jasmin M Kneuer, Karoline Elizabeth Kokot, Jana Hauke, Juergen G Okun, Ulrich Laufs, Jes-Niels Boeckel
Journal: Circulation (2021)

Introduction: Trimethylamine N-oxide (TMAO) derived from dietary sources has been linked to a higher risk of atherosclerotic disease. However, the underlying mechanisms are not fully understood. Impairment of endothelial cells (ECs) by chronic inflammation or metabolic cues can lead to a loss of EC phenotype and function towards a mesenchymal cell type, a process contributing to atherosclerosis termed endothelial-to-mesenchymal transition (EndMT). Here, we investigate the potential uptake of TMAO and its impact on endothelial inflammation and EndMT. Methods &amp; Results: Using tandem mass spectrometry, we found ECs to take up TMAO in a time-dependent manner (0.5 nmol/mg within 30 min rising to 5.8 nmol/mg TMAO/total protein after 24 h). The induction of ICAM1 (+26.5-fold) and E-Selectin (+77.7-fold, both p&lt;0.05) indicated an inflammatory activation of ECs after TMAO uptake. The prolonged treatment of ECs with TMAO for 3 days induced EndMT, as indicated by increase of the mesenchymal markers Calponin 1 (+11.9-fold) and SM22 (+8.6-fold) and by a concomitant downregulation of endothelial LYVE1 (-92%, all p&lt;0.05). Functionally, the EC barrier function was significantly impaired after prolonged TMAO treatment leading to an increase in vascular permeability (+2.36-fold). The multitude of known human solute carrier proteins were screened in ECs for identification of a potential TMAO transporter. Single-cell RNA-sequencing revealed the Endothelial TMAO Transporter 1 (ETT1) to be upregulated in inflammatory-activated ECs of the myocardium. Overexpression of ETT1 resulted in a 61.7% higher intracellular TMAO concentration in ECs after 30 min of treatment. Downregulation of ETT1 by siRNA prevented TMAO-induced inflammation (-112% induction of E-Selectin and -105% induction of ICAM1) and EndMT (-315% induction of SM22 and -533% induction of Calponin 1) and restored EC barrier function (-78% induction of permeability). Conclusions: In summary, our study identifies that TMAO uptake into human ECs causes increased inflammation and induces EndMT. The TMAO-mediated impairment of EC function is prevented by down-regulation of the newly identified TMAO transporter ETT1. Our findings may help to better understand the interaction of diet and atherosclerosis.
Comparing cord blood transplantation and matched related donor transplantation in non-remission acute myeloid leukemia
Authors: Yoshimitsu Shimomura, Tomotaka Sobue, Shigeki Hirabayashi, Tadakazu Kondo, Shohei Mizuno, Junya Kanda, Takahiro Fujino, Keisuke Kataoka, Naoyuki Uchida, Tetsuya Eto, Shigesaburo Miyakoshi, Masatsugu Tanaka, Toshiro Kawakita, Hisayuki Yokoyama, Noriko Doki, Kaito Harada, Atsushi Wake, Shuichi Ota, Satoru Takada, Satoshi Takahashi, Takafumi Kimura, Makoto Onizuka, Takahiro Fukuda, Yoshiko Atsuta, Masamitsu Yanada
Journal: Leukemia (2021)
Favorable Outcomes of Patients with Limited-Stage Ocular Adnexal DLBCL Treated in the Rituximab Era: Long-Term Follow-up of a Single Center Experience
Authors: David Qualls, Connie Lee Batlevi, Philip C Caron, Audrey Hamilton, Paul A. Hamlin, Steven M. Horwitz, Erel Joffe, Niloufer Khan, Anita Kumar, Matthew J. Matasar, Alison J. Moskowitz, Ariela Noy, Colette Owens, M. Lia Palomba, David J. Straus, Gottfried von Keudell, Andrew D. Zelenetz, Michelle Okwali, Joachim Yahalom, Heiko Schöder, Ahmet Dogan, Gilles Salles, Lorenzo Falchi
Journal: Blood (2021)
Abstract 11221: Counseling in the Time of COVID - Prenatal Diagnosis of Congenital Heart Disease During a Pandemic
Authors: Christina Ronai, Ethan Canty, Amanda Kim, Stephanie Dukhovny, Rachel Pilliod, Erin J Madriago
Journal: Circulation (2021)

Introduction: Comprehensive prenatal care of congenital heart disease (CHD) relies on a multi-disciplinary approach that includes timely prenatal counseling and individualized care plans for the pregnancy, delivery and neonatal period. With the COVID-19 pandemic our fetal therapy clinic (FTC) approach to patient care was altered to accommodate restrictions, including the use of telehealth visits. We investigated whether counseling and access to care for fetal patients with CHD was negatively impacted by COVID-19. Hypothesis: Fetuses with CHD would experience a delay in timing of diagnosis and referral; parents would receive a shorter counseling session during the COVID-19 pandemic. Methods: Retrospective chart review of all fetal cardiology patients seen in our multidisciplinary FTC both before (5/1/19-12/31-19) and during the COVID-19 pandemic (5/1/20-12/31/20). Data collected included gestational age (GA) at referral, GA at first fetal echo, use of telehealth, total time counseled, number of sub-specialty consults, and total number of fetal cardiology visits. Results: A comparable number of dyads were seen before and during the pandemic (Table 1). GA at initial diagnosis was similar, but GA at referral and first visit was earlier during the pandemic. Additionally, families seen during the pandemic had longer counselling across all disciplines with significant differences in pediatric cardiology and neonatology. There was no difference in total number of consults or access to care based on insurance. Conclusions: While prenatal counseling and referral to FTC is multifaceted, we demonstrated that COVID-19 and alterations in care delivery did not in fact lead to delays in referrals for patients across a large geographical catchment. Moreover, with telemedicine we were able to ensure our families continued to receive multidisciplinary care and families were able to spend more time with our care team developing comprehensive individualized plans.
Abstract P335: Nanoparticle-mediated Delivery Of TT-10 Promotes Myocardial Repair
Authors: Wangping Chen, Danielle Pretorius, Yang Zhou, Jianyi Zhang
Journal: Circulation Research (2021)

The pharmaceutical product TT-10 increases cardiomyocyte proliferation and survival by upregulating nuclear levels of Yes-associated protein (Yap) and the expression of Yap-targeted genes. When evaluated in a mouse model of myocardial infarction (MI), intraperitoneal TT-10 administration was associated with improvements in infarct size and cardiac function one week after treatment, but functional parameters progressively declined at later time points [1]. Here, we tested our hypothesis that the potency of TT-10 for myocardial repair could be increased by loading it into poly-lactic-co-glycolic acid nanoparticles (NPs) before intramyocardial administration. Mice were treated with injections of DPBS (n=9), empty nanoparticles (Empty-NPs, n=8), TT-10 solution (TT-10-sol, n=8), or TT-10-loaded NPs (TT-10-NPs, n=9) immediately after MI was induced via permanent ligation of the coronary artery. Cardiac function was assessed via transthoracic echocardiography, infarct size via histological Fast-Green staining, cardiac hypertrophy via measures of the heart-weight:bodyweight (HW:BW) ratio, cardiomyocyte proliferation via staining for Ki67 and phosphorylated histone 3 (PH3), and apoptosis via TUNEL. In vitro assessments confirmed that TT-10 was released from the TT-10-NPs for up to four weeks, and that the NPs were taken up by cultured cardiomyocytes. One and four weeks after MI induction and treatment, measures of left-ventricular (LV) ejection fraction (EF) and fractional shortening (FS) were significantly greater in TT-10-NP animals than in the TT-10-sol, Empty-NP, or DPBS groups; LV EF and FS also remained stable in the TT-10-NP group, while measurements in all other groups worsened (but not significantly) (LV EF at Week 4: TT-10-sol vs TT-10-NPs; 22.25 ± 1.474 vs 43.95 ± 1.884, p&lt;0.05), between the two time points. TT-10-NP treatment was also associated with significantly smaller (by ~20%, p&lt;0.05) infarcts and significantly lower HW:BW ratios at Week 4; with significantly greater proportions of Ki67 + , PH3 + , and nuclear-Yap + cardiomyocytes at Week 1; and with significant declines in TUNEL + cardiomyocytes 72 hours after MI and treatment. Thus, NP-mediated delivery of TT-10 results in the efficacy of both the magnitude and durability of the benefits associated with promotion of myocyte proliferation in a mouse MI model. [1] H. Hara, N. Takeda, M. Kondo, M. Kubota, T. Saito, J. Maruyama, et al., Discovery of a Small Molecule to Increase Cardiomyocytes and Protect the Heart After Ischemic Injury, JACC Basic Transl Sci, 3 (2018) 639-653.