tbuckley/cabot-search huggingface dataset:
Abstract 14723: Autoreactive T Lymphocytes Activate Cardiac Endothelium Independently of Tnf-α and Cause Endothelial Dysfunction Through Exosomes in Experimental Autoimmune Myocarditis
Authors: Filip Rolski, Marcin Czepiel, Kazimierz Weglarczyk, Maciej Siedlar, Gabriela Kania, Przemysław Błyszczuk
Journal: Circulation (2020)

Background: Inflammatory heart diseases represent an important clinical problem, nonetheless data regarding activation of cardiac microvascular endothelial cells (MVECs) are limited. Aim: To examine influence of TNF-α and exosomes produced by heart-reactive CD4+ T lymphocytes on activation of cardiac MVECs. Methods: Experimental autoimmune myocarditis (EAM) was induced in wild-type (WT) and TNF-α-deficient (TNF-KO) mice. CD4+ T lymphocytes were isolated from EAM mice at day 21 and activated in vitro to produce conditioned medium and exosomes. Activation of MVECs was assessed by specific assays and leukocyte-to-endothelial adhesion was analysed under shear flow condition using the BioFlux microfluidic system. Results: TNF-KO mice showed lower prevalence of myocarditis when compared to WT mice (50% vs. 90%). Stimulation of MVECs with secretome of antigen-activated autoreactive T cells resulted in upregulation of adhesion molecules (ICAM-1, VCAM-1 and P-selectin), increased ROS and decreased NO production. Addition of anti-TNF-α neutralizing antibodies effectively blocked adhesion of leukocytes to MVECs activated with the conditioned medium. Endothelial activation and dysfunction induced by the conditioned medium were independent of TNF-α produced by T cells. Stimulation of MVECs with T cell-derived exosomes increased ROS and decreased levels of NO and eNOS activation, but exosomes neither increased expression of adhesion molecules in MVECs nor induced their ability to bind leukocytes. Conclusions: TNF-α promotes MVEC activation and EAM development. In this model, autoreactive T cells activate MVECs, and TNF-a produced by MVECs rather than T cells is essential in this process. On the other hand, endothelial dysfunction caused by T cells seems to be mediated mainly by exosomes.
Publisher Correction: Mitochondrial pyruvate carriers are required for myocardial stress adaptation
Authors: Yuan Zhang, Paul V. Taufalele, Jesse D. Cochran, Isabelle Robillard-Frayne, Jonas Maximilian Marx, Jamie Soto, Adam J. Rauckhorst, Fariba Tayyari, Alvin D. Pewa, Lawrence R. Gray, Lynn M. Teesch, Patrycja Puchalska, Trevor R. Funari, Rose McGlauflin, Kathy Zimmerman, William J. Kutschke, Thomas Cassier, Shannon Hitchcock, Kevin Lin, Kevin M. Kato, Jennifer L. Stueve, Lauren Haff, Robert M. Weiss, James E. Cox, Jared Rutter, Eric B. Taylor, Peter A. Crawford, E. Douglas Lewandowski, Christine Des Rosiers, E. Dale Abel
Journal: Nature Metabolism (2020)
Breast Tissue Engineering
Authors: Charles W. Patrick
Journal: Annual Review of Biomedical Engineering (2004)

▪ Abstract Tissue engineering has the potential to redefine rehabilitation for the breast cancer patient by providing a translatable strategy that restores the postmastectomy breast mound while concomitantly obviating limitations realized with contemporary reconstructive surgery procedures. The engineering design goal is to provide a sufficient volume of viable fat tissue based on a patient's own cells such that deficits in breast volume can be abrogated. To be sure, adipose tissue engineering is in its infancy, but tremendous strides have been made. Numerous studies attest to the feasibility of adipose tissue engineering. The field is now poised to challenge barriers to clinical translation that are germane to most tissue engineering applications, namely scale-up, large animal model development, and vascularization. The innovative and rapid progress of adipose engineering to date, as well as opportunities for its future growth, is presented.
Abstract 249: Association of Diastolic Blood Pressure and Myocardial Perfusion Pressure with Survival During Pediatric Cardiopulmonary Resuscitation
Authors: Jill L Sorcher, Donald H Shaffner, Caitlin OBrien
Journal: Circulation (2020)

Introduction: Myocardial perfusion pressure (MPP), defined as the aortic diastolic pressure minus the central venous diastolic pressure, is an important determinant of return of spontaneous circulation (ROSC) in cardiac arrest. However, measuring MPP requires both arterial and venous catheters and is often not possible. When only invasive arterial monitoring is available, diastolic blood pressure (DBP) is suggested as a surrogate for MPP during resuscitation and is also associated with survival after cardiac arrest. Hypothesis: We hypothesized that DBP measured during chest compression delivery would mirror MPP during resuscitation and both would be associated with survival. Methods: We performed a retrospective, secondary analysis of 102 swine resuscitations. Pediatric swine underwent asphyxial cardiac arrest and were resuscitated with predefined periods of basic and advanced life support (BLS and ALS). MPP and DBP were recorded every 30 s during chest compression delivery. Results: For both survivors and non-survivors, DBP mirrored MPP throughout resuscitation ( Figure 1A, B ). During BLS, both MPP and DBP were significantly greater in survivors (MPP: 8.5 0.6 vs. 1.1 0.5 mmHg; p &lt; 0.0001; DBP 17.3 0.6 vs. 8.7 0.5 mmHg; p &lt; 0.0001). During ALS, MPP and DBP were greater in survivors than non-survivors (MPP: 20.5 1.0 vs. 0.7 0.3 mmHg; p &lt; 0.0001; DBP 32.3 0.9 vs. 8.8 0.2 mmHg; p &lt; 0.0001). During ALS, the magnitude of change in both MPP and DBP after the first epinephrine administration in survivors was greater than in non-survivors (MPP: 24.4 3.3 vs. 4.8 0.9 mmHg; p &lt; 0.0001; DBP: 24.5 3.1 vs. 5.4 0.8 mmHg; p &lt; 0.0001). Conclusion: These observations confirm that both DBP and MPP are associated with survival in cardiac arrest and validate the use of DBP as a surrogate for MPP. Figure 1: Myocardial perfusion pressure (MPP) and diastolic blood pressure (DBP) during BLS and ALS in survivors (A) and non-survivors (B). Arrows indicate administration of epinephrine during ALS.
Immune responses and residual SARS-CoV-2 in two critically ill COVID-19 patients before and after lung transplantation
Authors: Yan Yan, Xiufeng Jiang, Juanjuan Fu, Jiehui Huang, Yuanwang Qiu, Difei Ding, Lina Ge, Hao Zhang, Lihua Huang, Xiaojie Lu, Qinxue Hu
Journal: Journal of Infection (2020)
Abstract 15240: Evaluation of the Performance and Safety of Wideband Cardiac MRI in Patients With a Cardiac Implantable Electronic Device (CIED)
Authors: Sarah M Schwartz, Ashitha Pathrose, Ali Serhal, Ryan Avery, Ann Ragin, Jessica Charron, Bradley P Knight, Rod S Passman, Daniel Kim
Journal: Circulation (2020)

Introduction: Wideband late gadolinium enhancement (LGE) CMR is capable of suppressing image artifacts induced by cardiac implanted electronic devices (CIEDs). We implemented our own wideband segmented (seg) breath-hold and wideband single-shot (SS) free-breathing LGE pulse sequences and used them clinically since 2016. The purpose of this study was to evaluate image quality and CMR safety of wideband LGE compared to standard LGE. Methods: We retrospectively identified 54 consecutive patients (mean age: 61±15 years; 31% females) with CIED (33 t-ICD, 4 s-ICD, 15 pacemaker, 1 CRT-D, 1 CRT-P) who underwent CMR at 1.5T (Avanto, Siemens). Standard seg, wideband seg, and wideband SS LGE used standard imaging parameters. 16 myocardial segments were scored for scar/myocardial conspicuity and presence of any visual artifact on a 5-point Likert scale (1:worst; 3:acceptable; 5:best). Distance between center of the heart and CIED (CXR D) was measured on chest X-ray. Whole-body specific absorption rate (SAR) was read from DICOM metadata. Device changes were calculated from pre- and post- device interrogation measurements. Results: Both wideband seg and SS LGE consistently produced better image quality than standard LGE (Figure 1A). Median conspicuity and artifact scores were significantly better for wideband seg (F=20.6, p&lt;0.001) and wideband SS (F=24.2, p&lt;0.001) LGE compared to standard LGE. There was a trend in conspicuity and artifact scores with CIED distance for standard LGE (rho=0.476, p=0.02), but not wideband LGE scans (Figure 1B, 1C). Whole-body SAR averaged for both wideband scans (0.15±0.04 W/kg) was one order of magnitude below the 2.0 W/kg FDA limit. Device parameters (sensing, impedance, threshold, battery level) did not differ before and after CMR including wideband LGE. Conclusions: Both wideband seg and SS LGE scans produced improved image quality compared to standard LGE while maintaining CMR safety. *The first two authors (SS and AP) contributed equally
Abstract 15932: Clinical Significance of Coronavirus Disease 2019 in Hospitalized Patients With Myocardial Injury
Authors: Michael Briscoe, Robert A Sykes, Thomas Krysztofiak, Oliver H Peck, Kenneth Mangion, Colin Berry
Journal: Circulation (2020)

Introduction: Coronavirus disease 2019 (COVID-19) is a novel cause of myocardial injury. We investigated the clinical significance of COVID-19 in a population of hospitalized patients with myocardial injury. Methods: This was a prospective, longitudinal cohort study of hospitalized patients admitted to an urban academic medical center (catchment population 650,000) from March 1 - April 15, 2020. Consecutive patients with myocardial injury were identified using laboratory records by occurrence of ≥1 high-sensitivity troponin-I (hsTnI) result (Abbott ARCHITECT assay) &gt;99 th percentile sex-specific upper reference limit (URL; male: &gt;34 ng/L; female: &gt;16 ng/L). Cardiac endotypes were defined according to the Fourth Universal Definition of Myocardial Infarction (MI) and laboratory data used to determine presence of COVID-19 infection by PCR. Outcomes of patients with myocardial injury with and without COVID-19 were assessed. Results: Of 390 hospitalized patients with elevated hsTnI, 346 were eligible for inclusion; 44 were excluded ( Duplicate: 2; Missing data: 41; Research patient: 1 ). 35 (10.1%) had laboratory-confirmed COVID-19 (COVID-19, yes vs no: median age [IQR]; 65 [59-74] vs 74 [63-83] years); 64.8% vs 43.7% male). Distribution of cardiac endotypes by COVID-19 status (yes vs no) were: Type 1 MI (0 [0%] vs 115 [100%]; p&lt;0.0005), Type 2 MI (13 [16.5%] vs 66 [83.5%]; p=0.045), and non-ischemic myocardial injury (cardiac: 4 [5.8%] vs 65 [94.2%]; p=0.191, non-cardiac:19 [22.9%] vs 64 [77.%]; p&lt;0.0005). Among all patients, those with COVID-19 had lower comorbidity burden (Charlson Comorbidity Index: 3.6 vs 5.1; p=0.002), similar average hsTnI concentrations (initial: 282 vs 316; p=0.853, peak: 560 vs 527ng/L; p=0.911), longer hospital stay (median [IQR]: 16 [20] vs 4 [9] days; p&lt;0.0005) and higher inpatient mortality (66.7% vs 10.3%; OR=17.5; 95% CI: 8.00, 38.3). Respiratory failure requiring invasive ventilation occurred in 24 (68.6%) patients with COVID-19, whilst 18 (51.4%) and 21 (60%) required renal and/or circulatory support, respectively. Conclusion: Presence of both myocardial injury and COVID-19 is associated with high in-hospital mortality. Systemic consequences may be associated with higher mortality risk in this patient group.
Abstract 337: Trends and Outcomes with Early Left Heart Catheterization in Post-Out-of-hospital Cardiac Arrest
Authors: Brian J O'Neil, Shobi Mathew, Robert B Dunne, Joseph B Miller, Howard Klausner, Bryan McNally, James H Paxton, Robert D Welch
Journal: Circulation (2020)

Background: Left heart catheterization (LHC) and TTM are proven beneficial after OHCA. Detroit CARES data found a strong, though insignificant, trend for LHC rate and survival (p = 0.1). In 2018, the rate of patients with LHC and good CPC nearly doubled, despite an overall decrease in LHC rate. Therefore, we hypothesize LHC is performed later (after second day of hospitalization) nationwide and a good CPC is likely associated with selection of patients expected to survive. Methods: We analyzed the national CARES registry (2013 - 2018) to investigate whether delayed LHC after OHCA was occurring nationally. Included were patients 18 or older, non-skilled care facility patients and surviving to admission. The primary outcome was the CPC dichotomized into good (1 or 2) and poor (3 - 5). A propensity score was derived to predict early LHC that incorporated factors associated with LHC and outcome. A multi-level logistic regression analyses was fit using inverse weighted propensity scores. The primary predictor of interest was early LHC relative to no or late LHC. Also examined were TTM, year of cardiac arrest, and other predictors. Results reported are odds ratios (OR) and the corresponding 95% confidence intervals (95% CI). Results: 62,195 individual cases were identified; the median age was 61, (IQR-16), 62% male, 32% unwitnessed, 37% bystander CPR, and 35% initial shockable rhythm. 29% had good outcome and 22% received early LHC, 6% late LHC and 72% no LHC. 13% of patients receiving early LHC and 23% with no or late LHC had a good outcome. OR and 95% CI for good outcome were: 2.4 (2.2-2.7) for early LHC, 3.6 (3.3-3.8) for shockable rhythm, 1.9 (1.7-2.0) for public location and 2.0 (1.8-2.2) for witnessed arrest. Over the five-year period, no change in the total LHC occurred and a slight decrease in early LHC, (25%-23%), (Fig 1). Conclusion: Early LHC was associated with good outcome (CPC) at hospital discharge. The overall LHC rate is unchanged from 2013-18 with a slight decrease in early LHC.
Structural and Functional Correlates of Gradient-Area Patterns in Severe Aortic Stenosis and Normal Ejection Fraction
Authors: Alisson Slimani, Clotilde Roy, Christophe de Meester, Caroline Bouzin, Agnès Pasquet, Anne-Catherine Pouleur, David Vancraeynest, Philippe Noirhomme, Gebrine El Khoury, Bernhard L. Gerber, Jean-Louis Vanoverschelde
Journal: JACC. Cardiovascular imaging (2020)
Abstract 16274: Risk of Bleeding in Patients With Non-Valvular Atrial Fibrillation Exposed to Apixaban With or Without Selective Serotonin Reuptake Inhibitors (SSRIs) or Serotonin-norepinephrine Reuptake Inhibitors (SNRIs)
Authors: Sophie W Shen, Jenny Jiang, Ankit Priyadarshi, Guoqiang Zhang
Journal: Circulation (2020)

Background: Patients with NVAF treated with direct oral anticoagulants (DOACs) are often also treated with SSRI/SNRI for co-existing conditions. Whether the concomitant use of SSRI/SNRI with DOAC such as apixaban would impart additional bleeding risk over that of apixaban alone has not been well studied. Objective: To assess the risk of major bleeding (MB) in patients with NVAF treated with apixaban alone and in concomitant with SSRI/SNRI in a real-world setting. Methods: We identified patients with NVAF, and newly prescribed with apixaban or co-administered with SSRI/SNRI (Apix+SSRI/SNRI) in a large US administrative claims database (1JAN2013-31DEC2017). Patients treated with Apix+SSRI/SNRI were matched by propensity score (PSM) with those treated with apixaban only. Cox model was used to estimate the hazard ratios (HRs) of overall and individual MB (GI bleeding, intracranial hemorrhage [ICH], or other bleeding requiring hospitalization) across matched cohorts. Additionally, we applied inverse probability treatment weighting (IPTW) and covariates balancing PS (CBPS) methods to adjust for unbalanced covariates despite matching on PS. Results: We identified 32,225 and 6,101 patients with NVAF newly prescribed with apixaban and co-administered with Apix+SSRI/SNRI. Before PSM, Apix+SSRI/SNRI patients were older, had higher baseline CHA 2 DS 2 -VASc and HAS-BLED scores, more comorbidities, and received a lower dosage of apixaban. PS matched 6,035 patients in each group. The adjusted HR (95% CI) of overall MB, with Apix+SSRI/SNRI relative to apixaban alone was 1.42 (0.94-2.15). For GI bleeding HR was 1.26 (0.74-2.15), 3.94 (0.78-19.77) for ICH, and 1.39 (0.66-2.93) for other bleeding leading to hospitalization. The estimated associations between co-administration of apixaban with SSRI/SNRI and MB were less strong with IPTW and CBPS analyses. None of the HR point estimates was statistically significant. Conclusion: In this real-world study of patients with NVAF, patients co-administered with apix+SSRI/SNRI did not show significant increased risks of MB compared with those on apixaban alone. The findings do not suggest apixaban used concomitantly with SSRI/SNRI would impart additional risk of MB over that of apixaban alone in patients with NVAF.
Schistosomiasis and climate change
Authors: Giulio A De Leo, Anna-Sofie Stensgaard, Susanne H Sokolow, Eliézer K N’Goran, Andrew J Chamberlin, Guo-Jing Yang, Jürg Utzinger
Journal: BMJ (2020)

In 2014, a group of German and French tourists with no history of travel to tropical or subtropical countries were diagnosed with urogenital schistosomiasis, a debilitating parasitic disease that affects more than 200 million people in South America, Asia, and particularly sub-Saharan Africa.The European Centre for Disease Prevention and Control eventually tracked 120 cases of Schistosoma infection that were acquired in summer 2013 (and seven more, between 2015 and 2016) by people swimming in the Cavu River in Corsica.This French Mediterranean island is a popular summer destination for tourists from all over Europe.Until then, Corsica had been considered outside the geographic range of schistosomiasis transmission because of the near freezing temperatures of inland waters in the winter.
CLINICAL OUTCOMES IN HOSPITALIZED COVID-19 PATIENTS WITH CHRONIC LIVER DISEASE AND CIRRHOSIS
Authors: Suraj Suresh, Mohammad Siddiqui, Mouhanna Abu Ghanimeh, Faisal M Nimri, Megan Karrick, Maher Musleh, Vivek Mendiratta, Sarah Russell, Jessica Jou, Stephen Simmer, Mustafa Al-Shammari, Duyen Dang, Tobias Zuchelli
Journal: Hepatology (2020)

Background: There is increasing evidence suggesting that liver dysfunction is a risk factor for severe COVID-19 illness However, due to the low prevalence of liver disease and cirrhosis in the general population, larger studies looking at the impact of these conditions have utilized data from international registries which do not necessarily reflect the US population  Our study aims to assess the association between chronic liver disease and COVID-19 clinical outcomes across a single large inpatient cohort Methods: We performed a retrospective single-center study at a large tertiary care hospital All index admissions of adult patients with confirmed COVID-19 between 3/1/2020 and 4/30/2020 were included A manual chart review was performed to collect data on baseline patient characteristics, medical comorbidities, and clinical outcomes Patients with chronic liver disease (CLD) and cirrhosis were compared to the control group, who had no known underlying liver disease SAS 9 4 was used for analysis Results: A total of 1935 patients met our inclusion criteria of which 1869 (96 6%) had no underlying liver disease, 66 (3 4%) had CLD, and 21 (1 1%) had cirrhosis Table 1 shows baseline patient characteristics There were a higher proportion of males in the CLD and cirrhosis cohorts compared to the control group (67% and 76% vs 50%;p=0 0105) Patients with cirrhosis and chronic liver disease also had a significantly lower average BMI compared to the control group (25 8 and 27 3 vs 31 8;p=0 002) There was no difference in comorbidities between all three cohorts  Patients with cirrhosis had a significantly higher mortality (RR 2 1 [95% CI 1 33-3 62;p=0 0022]) compared to non-cirrhotics There was also a trend towards increased 30-day readmission in the cirrhotic cohort (RR 2 35 [95% CI 0 86-6 42];p=0 0950) however no difference in rate of ICU admission or intubation Patients with CLD did not have an increase in mortality, ICU admission, intubation, or 30-day re-admission compared to the control group Conclusion: Our study demonstrates that cirrhosis is associated with increased mortality in COVID-19 while chronic liver disease in the absence of cirrhosis does not confer the same degree of clinical risk Future studies performed on a larger scale should evaluate how decompensated disease and MELD score may impact this risk profile (Table Presented)
Haemodynamic characteristics of <scp>COVID</scp>‐19 patients with acute respiratory distress syndrome requiring mechanical ventilation. An invasive assessment using right heart catheterization
Authors: Sergio Caravita, Claudia Baratto, Fabiano Di Marco, Alice Calabrese, Giulio Balestrieri, Filippo Russo, Andrea Faini, Davide Soranna, Giovanni Battista Perego, Luigi P. Badano, Lorenzo Grazioli, Ferdinando Luca Lorini, Gianfranco Parati, Michele Senni
Journal: European Journal of Heart Failure (2020)
Abstract 14689: Optimal Prenatal Care Coordination is Associated With Fewer Pre-operative Risk Factors in Babies With a Prenatal Diagnosis of HLHS
Authors: David N Schidlow, Kimberlee Gauvreau, Emily M Bucholz, Amy Bennett, Terra Lafranchi, Jay Pruetz, christina ronai, Jeffrey Vergales, David W BROWN
Journal: Circulation (2020)

Introduction: Prenatal diagnosis (PD) of congenital heart disease permits coordination of care to optimize postnatal outcomes. Using phase II registry data from the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC), we sought to identify associations between prenatal care coordination (PNC) and pre-operative status among infants with HLHS and variants intended for Stage I Norwood or hybrid palliation. Hypothesis: We hypothesized that suboptimal PNC would be associated with worse pre-operative status. Methods: The NPC-QIC database was queried for all instances of prenatally diagnosed HLHS and variants intended for Stage 1 Norwood or hybrid palliation from 2016 through 2019. Demographic and clinical data pertaining to the prenatal period through the first birthday were obtained. Optimal PNC was defined as (1) a completed interdisciplinary case conference prior to delivery and (2) a note in the medical record documenting closed-loop communication between the OB and cardiology teams. Associations between PNC and outcomes were identified. Results: Among 1441 registry patients with HLHS and variants, 1242 (86%) had PD. Among patients with PD, optimal PNC was achieved in 68%. Preoperatively, infants without optimal PNC were more likely to have any adverse event (50% vs 40%, p&lt;0.001), receive inotropes (19% vs 13%, p=0.007), require mechanical ventilation (22% vs 16%, p=0.016), and were less likely to feed enterally (53% vs 67%, p &lt;0.001). Lower socio-economic status (SES) was associated with a lower likelihood of PD (p&lt;0.001), and African-American race was associated with a lower likelihood of optimal PNC (p=0.006). Conclusions: Among prenatally diagnosed infants with HLHS and variants, optimal PNC was associated with fewer preoperative risk factors. There also appear to be disparities in PD related to SES and in PNC related to race. Additional study is required to understand the complex interplay between PNC and clinical outcomes, as well as identify and address barriers to PD and optimal PNC.