tbuckley/cabot-search huggingface dataset:
Abstract 13677: Usefulness of 2-year Iodine-123 Metaiodobenzylguanidine-based Risk Model for the Post-discharge Risk Stratification in Acute Decompensated Heart Failure Patients With Preserved Left Ventricular Ejection Fraction
Authors: Shunsuke Tamaki, Takahisa Yamada, Tetsuya Watanabe, Takashi Morita, Yoshio Furukawa, Masatake Fukunami, Yoshio Yasumura, Akito Nakagawa, Yusuke Nakagawa, Masamichi Yano, Takaharu Hayashi, Shungo Hikoso, Daisaku Nakatani, Yasushi Sakata
Journal: Circulation (2020)

Background: A four-parameter risk model including cardiac iodine-123 metaiodobenzylguanidine (MIBG) imaging and readily available clinical parameters has been recently developed for the prediction of 2-year cardiac mortality risk in patients with chronic heart failure (CHF) using a Japanese CHF database consisting of 1322 patients. However, there is no information available on the usefulness of 2-year MIBG-based cardiac mortality risk score for the prediction of post-discharge prognosis in patients with heart failure with preserved LVEF (HFpEF) who are admitted with acute decompensated heart failure (ADHF). Methods and Results: Patients' data were extracted from The Prospective mUlticenteR obServational stUdy of patIenTs with Heart Failure with Preserved Ejection Fraction (PURSUIT-HFpEF) study, which is a prospective multicenter observational registry for ADHF patients with LVEF ≥50% in Osaka. We studied 239 patients who survived to discharge. Cardiac MIBG imaging was performed just before discharge. The 2-year cardiac mortality risk score was calculated using four parameters, including age, LVEF, NYHA functional class, and the cardiac MIBG heart-to-mediastinum ratio on delayed image. The patients were stratified into three groups based on the 2-year cardiac mortality risk score: low- (&lt;4%), intermediate- (4-12%), and high-risk (&gt;12%) groups. The endpoint was all-cause death. During a follow-up period of 1.6±0.8 years, 33 patients had all-cause death. Multivariate Cox analysis showed that 2-year MIBG-based cardiac mortality risk score was an independent predictor of all-cause death (p=0.0009). There was significant difference in the rate of all-cause death among the three groups stratified by 2-year cardiac mortality risk score (Figure). Conclusions: In this multicenter study, the 2-year MIBG-based cardiac mortality risk score was shown to be useful for the prediction of post-discharge clinical outcome in HFpEF patients admitted for ADHF.
Extensive Postchemotherapy Calcinosis Cutis in a Non-Hodgkin Lymphoma Patient With Spontaneous Resolution
Authors: Vineet Mishra, Lokeshwaran Madurai Kalimuthu, Prakash Singh, Manish Ora, Sanjay Gambhir
Journal: Clinical Nuclear Medicine (2020)

Abstract We report the case of a 30-year-old woman with stage IV, non-Hodgkin lymphoma. Baseline 18 F-FDG PET/CT scan revealed lymphadenopathy with breasts and skeletal involvement. She received 3 cycles of R-CHOP (rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone) chemotherapy without significant adverse effects. Biochemical examinations before and after chemotherapies were unremarkable. Interim 18 F-FDG PET/CT showed a partial treatment response. However, there was an appearance of FDG-avid coarse calcification in breasts. Cutaneous and subcutaneous regions of elbows, pelvis, and thighs showed similar calcifications. Posttherapy PET/CT showed a significant resolution of calcinosis cutis. This case presents a postchemotherapy idiopathic calcinosis cutis with rapid spontaneous resolution.
Abstract 15941: Derivation of Risk-Scores That Stratify Risk of Hospitalization and Death in SARS-CoV-2 Positive Patients
Authors: Kirk U Knowlton, Heidi T May, Stacey Knight, Tami L Bair, Viet T Le, Joseph B Muhlestein, Benjamin D Horne, Jeffrey L Anderson
Journal: Circulation (2020)

Introduction: It is well-documented that COVID-19 patients with pre-existing cardiovascular-related disorders are at higher risk of a complicated course. It would be valuable to integrate individual risk factors into overall risk scores for hospitalization and death from COVID-19. Methods: The Intermountain Healthcare medical record database was searched for all individuals tested for SARS-CoV-2 infection up to June 8, 2020. Data from test-positive patients (pts) was analyzed to determine the characteristics of pts requiring hospitalization. From these data, 2 risk scores for hospitalization were derived using multi-variable modeling: of only demographic and risk-factor data, or also including concurrent medications. The risk scores were also applied to predict the risk of dying from COVID-19. Results: Of 104,018 people tested at Intermountain Healthcare for SARS-CoV-2, 5505 (5.3%) were positive. Of test-positive pts, 451 (8.2%) were hospitalized, and 37 (0.7%) died. Using a demographic/risk factor only score, 1.4, 7.0, and 36.6% of low-, moderate-, and high-risk groups, respectively, were hospitalized (AUC=0.826). Using demographic risk-factors and medications, 1.4, 5.6, and 40.3% of low-, moderate-, and high-risk patients were hospitalized (AUC=0.854, Table 1). The demographic/risk factor-score was also predictive of the risk of dying, with 0%, 0.9% and 4.5% in low-, moderate-, and high-risk groups dying (AUC=0.918). Adding medications to the risk-factors model further improved the prediction of death with 0.1, 0.04, and 4.9% in the low-, moderate-, and high-risk groups dying (AUC=0.942, Table 2). Conclusions: We demonstrate the derivation of highly predictive risk scores for COVD-19 patients at low, moderate, and high risks of hospitalization or death. Pending appropriate validation in another cohort, application of these risk-scores may allow healthcare systems to risk-stratify COVID-19 patients requiring variable intensity of care.
Christopher Hayles Cameron
Authors: K Nesbitt
Journal: BMJ (2020)

Christopher Hayles Cameron (“Chris”) had a remarkable career: as a youth he spent much time on a sheep farm in the Lammermuir Hills, where his parents had a summer cottage, to such effect that the farmer, having no heirs, offered him the 800 acre farm as a legacy.

He turned it down and entered the arts faculty of Edinburgh University to study languages, but after a year changed to follow his father into medicine (his father, Ernest Cameron, had been a distinguished ophthalmologist in the city): having no relevant school science background, he found the …
Abstract 15472: The Utility of Isoproterenol Testing in Pediatric Patients Following Atrioventricular Nodal Reentry Ablation
Authors: Tahmina Samad, Eric S Silver, Leonardo Liberman
Journal: Circulation (2020)

Intro: AVNRT is a common mechanism of SVT in pediatric patients. Catecholamines such as isoproterenol (ISO) are routinely given during post ablation (ABL) testing to confirm acute success. In light of its recent significant cost increase, the aim of our study was to determine if ISO is necessary in all pediatric patients after AVNRT ablation to ensure acute procedural success. Method: Retrospective study of patients &lt;21 years with AVNRT from 1/06-12/18 who had undergone catheter ablation. We excluded patients with congenital heart disease (CHD), prior ABL, without inducible tachycardia (presumed AVNRT), unsuccessful ABL and those who required ISO to induce tachycardia (TACHY) prior to ABL lesions. All patients were tested after ABL without ISO and if AVNRT was not induced they were retested while on ISO. Result: We identified 232 patients with AVNRT of whom 65 (28%) met the study criteria; 123 (53%) were excluded for requiring ISO to induce AVNRT prior to ABL, 23 (10%) for CHD, 12 (5%) with presumed AVNRT and 9 (4%) with an unsuccessful ABL. The average age was 14.4 yrs (±3.5) and 54% were female. All patients received anesthesia, 40/65 were intubated (62%). Evidence of slow pathway conduction (Spath) (AH jump with atrial extrastimulus testing, presence of AV nodal echo beats or PR&gt;RR) was seen in 35/65 patients (54%). Patients were divided into 2 groups: group 1 (n= 57, 88%) consisted of patients without inducible TACHY post ABL while receiving ISO, group 2 (n = 8, 12%) of patients in whom TACHY was inducible with ISO thus required further ABL. There was no difference between the groups with regards to sex, age, intubation status, prior use of antiarrhythmic meds, or in the incidence of Spath (31/57, 54% vs. 4/8, 50%, p=1). Four of the 8 patients in group 2 with no evidence of Spath had inducible TACHY with ISO. Conclusion: We found that 12% of pediatric patients who did not require ISO to induce AVNRT prior to ABL had inducible TACHY only with ISO after AVNRT ABL. Presence of dual AV nodal physiology after ABL lesions did not predict inducibility of AVNRT on ISO, and 50% of the patients with no evidence of slow pathway conduction by conventional testing had inducible AVNRT with ISO. ISO testing is useful in all pediatric patients to test for inducibility following catheter ablation of AVNRT.
FRI0041 Improvements in functional status due to anakinra therapy in patients with rheumatoid arthritis who are not using dmards
Authors: P Emery, JM Woolley, WW Chan
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> <h3>Objectives</h3> To evaluate the effect of anakinra on the functional status of subjects with rheumatoid arthritis who were not using DMARDs. <h3>Methods</h3> In a 24-week, multicenter, randomised, double-blind clinical trial conducted in Europe, 473 subjects received either one of three doses of anakinra (30 mg, 75 mg, or 150 mg) or placebo SC QD. Subjects were excluded if they used DMARDs within six weeks of entry, or if they had failed therapy with more than three DMARDs. Functional status was measured by the HAQ, which was administered at baseline and at weeks 12 and 24. The mean change in HAQ score was compared between subjects receiving anakinra (all doses combined) and those on placebo. All subjects who completed at least one post-baseline assessment were included (n = 452) and the last-observation was carried forward in the case of missing data. <h3>Results</h3> As shown in the Table 1, functional status improved for subjects on anakinra as their mean HAQ scores decreased by an average of 0.24. This improvement was both statistically significant, clinically important, and superior to the mean change in subjects receiving placebo. This result was true for each dose of anakinra, as compared to placebo (data not shown). <h3>Conclusion</h3> Subjects receiving anakinra experienced statistically significant improvements in their HAQ scores that exceeded those for subjects on placebo. These improvements were of a magnitude considered clinically important. In subjects with rheumatoid arthritis who are not receiving DMARD therapy, anakinra leads to improvements in functional status.
Abstract 12812: The Use of Hemodynamics Does Not Aide in Correctly Identifying the Etiology of Cardiomyopathy in Patients Receiving Advanced Therapy
Authors: Norman Aiad, Navneet Narula, Claudia G Gidea, Stuart D Katz, Shaline Rao, Alex Reyentovich, Tajinderpal S Saraon, Deane Smith, Nader Moazami, Stephen Pan
Journal: Circulation (2020)

Introduction: There is limited evidence demonstrating the benefit of hemodynamics in diagnosing the etiology of cardiomyopathy in patients referred for advanced therapies such as left ventricular assist device (LVAD) or orthotropic heart transplantation (OHT). Hypothesis: In patients with end stage heart failure, invasive hemodynamic measures differ between patients with different etiologies of cardiomyopathy. Methods: Hemodynamic and echocardiography data from 119 patients undergoing LVAD (n=85, Male 76%, Age 63 ± 12 years) or OHT (n=34, Male 70%, Age 60 ± 11 years) at a single center was reviewed. The follow invasive hemodynamic measurements were recorded and compared (central venous pressure (CVP), Pulmonary Artery Pulsatility Index (PAPI), peripheral vascular resistance (PVR), transpulmonary gradient, mean pulmonary artery pressure, cardiac index, and pulmonary diastolic pressure decoupling) were compared between groups. Results: Between patients with dilated cardiomyopathy (DCM), ischemic cardiomyopathy (ICM), and those with missed diagnosis, there were no significant differences between CVP, PAPI, PVR, transpulmonary gradient, mean PA pressure, cardiac index, or decoupling (Table 1). Left ventricular end diastolic diameter (LVEDD) on echocardiography was significantly larger in patients with DCM when compared to those with ischemic cardiomyopathy as well as infiltrative cardiomyopathies (6.65±1.04mm, 6.24±0.77mm, and 5.14±1.25mm, respectively p&lt;0.0001). Conclusions: Hemodynamic measures in patients with stage D cardiomyopathy did not differ according to the etiology of the underlying cardiomyopathy. . The similarity in hemodynamic profiles amongst different cardiomyopathy subtypes likely reflects end stage disease. LVEDD performed better than hemodynamics to help differentiate cardiomyopathy etiologies, and in addition were helpful in identifying cases where the diagnosis was incorrect.
Abstract 15820: Differential Myocardial Gene Expression of Glucose Transporters in Heart Transplant Recipients With and Without Diabetes Mellitus
Authors: Marc Vanderheyden, Leen Delrue, Sofie Verstreken, Riet Dierckx, Ward Heggermont, Jozef Bartunek
Journal: Circulation (2020)

Introduction: The Sodium Glucose cotransporter (SGLT) and glucose transporters(GLUTs) play a crucial role in cellular glucose transport. Although experimental data have shown differential regulation of GLUT4 and SGLT in diabetic cardiomyopathy, the impact of diabetes mellitus (DM) upon myocardial glucose transporters in humans remains undetermined. Aim: To better understand the impact of elevated glucose levels upon myocardial expression of glucose transporters, the endomyocardial gene expression of GLUT1, GLUT4 and SGLT1 was investigated in heart transplant(HTx) recipients, with and without DM, who received a heart from a DM- donor. Methods: At baseline(BL), immediately after HTx and 12 ± 2 months(FU) later, serial endomyocardial biopsies were procured in 26 Htx pts, free of clinical or histological rejection, at time of routine surveillance biopsy. Patients were categorized in DM+ (n = 13pts) and DM- (n = 13 pts), according to the presence of diabetes mellitus (DM) at FU. Results: Despite similar hemodynamics and HbA1c levels at BL, DM+ pts had higher HbA1c levels (46,00 ± 13,79 vs 38,33 ± 4,88; p &lt; 0,05) at FU. No differences were noted in BL GLUT1, GLUT4 and SGLT gene expression between both groups. In DM- pts SGLT1(0,081 ± 0,080 vs 0,188 ± 0,108; p = 0,0036) , GLUT4(0,076 ± 0,068 vs 0,137 ± 0,065; p = 0,0011 )and GLUT1(0,020 ± 0,021 vs 0,022 ± 0,009; p = 0,043) increased significantly at FU whereas no change was observed in DM+ pts. Conclusion: Similar to experimental data, differential endomyocardial regulation in SGLT1 and GLUT4 was noted between DM+ and DM-pts with a blunted upregulation of glucose transporters at 1 year in DM+ HTx pts. These observations are in line with experimental data and suggest that myocardial glucose uptake is differentially regulated in DM+ HTx pts.
SAT0076 Patients with osteoarthritis (oa) report more severe pain than age- and gender matched rheumatoid arthritis (ra) patients
Authors: B Slatkowsky-Christensen, N Bellamy, TK Kvien
Journal: Annals of the Rheumatic Diseases (2001)

<h3>Background</h3> Patients with RA generally receive more attention by rheumatologists than patients with widespread OA. We wanted to examine if this difference in level of care is based on differences in severity of health status. <h3>Objectives</h3> To compare age- and sex matched OA and RA patients regarding levels health status. <h3>Methods</h3> Fifty-one patients between 50 and 70 years of age with generalised osteoarthritis (OA) including hand OA, previously referred to a rheumatology outpatient department, underwent a comprehensive clinical examination including completion of several self-reported health status questionnaires. Among these were AIMS2, SF-36, MHAQ, pain and fatigue on VAS. These OA patients were compared with 51 RA patients matched for age and gender. The RA patients were recruited from the Oslo RA register and had previously completed identical questionnaires. Groups were compared with the McNemar tests (categorical variables) and paired analyses (continuous variables). <h3>Results</h3> Mean (SD) age was 66.1 (4.4) years, 4(8%) were males. Pain measures were numerically higher in OA than RA with statically significant difference for 2 (AIMS2 and SF-36) out of 3 measures (Table 1). No statistically significant differences were found within the dimensions of physical and mental health, social functioning and self-efficacy. <h3>Conclusion</h3> OA patients report more severe pain than RA patients matched for age and gender, whereas other dimensions of health status appear to be similar, with a tendency of worse physical health in RA and worse mental health in OA patients.
Do proton pump inhibitors influence SARS-CoV-2 related outcomes? A meta-analysis
Authors: Guo-Fu Li, Xiao-Xiao An, Yichao Yu, Li-Rong Jiao, Daniele Canarutto, Guo Yu, Guangji Wang, Dan-Na Wu, Yin Xiao
Journal: Gut (2020)

The article by Lee et al 1 showed that the current use of proton pump inhibitors (PPIs) increased the risk of severe clinical outcomes of COVID-19 rather than the susceptibility to SARS-CoV-2 infection in a Korean nationwide cohort. Instead, a significant association between susceptibility to SARS-CoV-2 infection and current use of PPIs, either one time or two times a day, was found by another recent study2 based on US nationwide data. The conflicting results of these two large-scale observational studies may be due to regional epidemiological differences or considerable between-study variance and might compromise clinical decision-making. As the impact of PPI use on SARS-CoV-2 infection has very relevant clinical implications, we performed a meta-analysis to address the aforementioned discrepancies, which could lead to better informed clinical decision-making on PPI use during the ongoing pandemic.

We scrutinised 3413 records retrieved from a comprehensive search using the COVID-19 Research Articles Downloadable Database maintained by the US CDC (https://www.cdc.gov/library/researchguides/2019novelcoronavirus/researcharticles.html) and ultimately included 16 studies1–16 from 10 countries or regions reporting comparative data on PPI use and clinical outcomes of COVID-19 (online supplemental figure 1 and table). We pooled the …
Abstract 13636: Evolocumab Shows No Significant Cost-effectiveness for Myocardial Infarction in China
Authors: Zhe Liang, Qi Chen, Quanming Zhao
Journal: Circulation (2020)

Introduction: The proprotein convertase subtilisin/kexin type 9 inhibitor evolocumab has been demonstrated to reduce the incidence of cardiovascular events. This study sought to evaluate the value of evolocumab in the healthcare perspective by conducting a long-term cost-effectiveness analysis in Chinese patients with myocardial infarction (MI). Hypothesis: We assessed the hypothesis that evolocumab was inefficient for the secondary prevention of MI. Methods: A Markov cohort state-transition model was developed in decision analysis software. The model subjects could have non-fatal MI and/or stroke events, as well as die from cardiovascular disease or other causes. We integrated Chinese population specific demographics and event rates with the risk reduction of evolocumab based on large trials and meta-analysis. Age-related change, event costs and utilities were included from published sources. The model had 1-year cycle and the time horizon was 25 years. The primary outcome was the incremental cost-effectiveness ratio (ICER), defined as cost per quality-adjusted life-year (QALY) saved. Results: At its current list price (33,748 CNY annually per person), the ICER was 927,713 CNY per QALY gained. In one-way deterministic sensitivity analyses, the ICER was closely associated with the utility of cardiovascular disease event free and the cost of cardiovascular death. Probabilistic sensitivity analyses demonstrated that the probability of the cost-effectiveness of evolocumab was 1.96% at the present willingness-to-pay threshold of 212,676 CNY per QALY gained. To achieve the cost-effectiveness threshold, a net value-based price of 10,255 CNY annually would be required, which is 70% lower than the present price. Alternative scenarios analyses of treatment benefit showed in MI patients with poorly controlled familial hypercholesterolemia (FH), the ICER for evolocumab was 187,736 CNY per QALY gained, which achieved the accepted cost-effectiveness threshold. Conclusions: In conclusion, the cost-effectiveness ratio of evolocumab is less favorable in MI; However, it showed good cost-effectiveness in MI patients with poorly controlled FH in China.
Psychotic Depression: Diagnosis, Differential Diagnosis, and Treatment
Authors: Steven L. Dubovsky, Biswarup M. Ghosh, Jordan C. Serotte, Victoria Cranwell
Journal: Psychotherapy and Psychosomatics (2020)

Psychotic depression was initially considered to be at one end of a continuum of severity of major depression. Subsequent experience demonstrated that psychosis is an independent trait that may accompany mood disorders of varying severity. While much has been learned about the impact of severe mood congruent delusions and hallucinations on the course and treatment response of depression, less is known about fleeting or mild psychosis, mood incongruent features, or psychotic symptoms that reflect traumatic experiences. Acute treatment of psychotic unipolar depression generally involves the combination of an antidepressant and an antipsychotic drug or electroconvulsive therapy. There is inadequate information about maintenance treatment of unipolar psychotic depression and acute and chronic treatment of psychotic bipolar disorder. Decision-making therefore still must rely in part on clinical experience.
Abstract 14246: Automated Detection of Arrhythmogenic VT Substrate: Performance of a 2019 HRS VT Consensus Document Recommended Strategy
Authors: Abhishek Baskaran, Einat Shapira, Ahmed Niri, Stéphane Massé, Andrew Ha, Meir Bartal, Tal Baron, Gal Hayam, Kumaraswamy Nanthakumar
Journal: Circulation (2020)

Background: During ventricular tachycardia (VT) ablation, clinical VT is often non-inducible or hemodynamically unstable. Hence, a substrate-based approach is often necessary. Although many strategies have been proposed, none have been automated nor incorporated into current day electro-anatomical mapping (EAM) systems. One strategy, recommended in 2019 HRS guideline, is Decrement Evoked Potential (DeEP) mapping for identification of critical VT substrate. We have developed an automated method to identify critical DeEP VT substrate in an EAM system (CARTO ® 3). Objective: The performance of this novel automated algorithm was retrospectively evaluated in patients who underwent substrate-based VT ablation. Methods: Entire VT ablation using DeEP mapping was performed and recorded in 12 consecutive patients. CARTO ® 3 case data was downloaded and analyzed by a novel automated algorithm for DeEP detection. A blinded electrophysiologist verified the automated electrogram DeEP annotations and assessed its performance in a dichotomous fashion. The effect of bipolar voltage threshold (0.01, 0.02, 0.05, 0.075, 0.1, 0.20, 0.25 and 0.30 mV) on algorithm performance was evaluated. Sensitivity, specificity and ROC curve of the algorithms were calculated. Finally, results from the analysis were merged with voltage map to produce DeEP maps. Results: Results from the ROC curve shows that a bipolar threshold of 0.075mV optimizes specificity and sensitivity. At that threshold the algorithm found 848 true positive and 626 true negatives out of a total of 1975 EGMS being analyzed. Sensitivity and specificity were found to be 65.8% and 82.3% respectively. Conclusions: We have developed an automatic detection algorithm that identifies and locates critical VT substrates. The performance characteristics have been evaluated for a multimodal VT substrate map to provide clinicians mechanistic substrate map in CARTO 3 ® for VT ablation.