tbuckley/cabot-search huggingface dataset:
Abstract 12767: Accuracy of Trans-Thoracic Echocardiography vs. Cardiac Magnetic Resonance for Assessment of Ventricular Aneurysms in Patients With Chagas Disease
Authors: Ramon Medina, Frida T Manrique, Diana Vargas Vergara, Lorena González Russi, Julian Forero, Jorge Fajardo, Juan José Diaztagle, Josep Brugada, Alejandro Olaya, Andrés Díaz, Hector M. Medina
Journal: Circulation (2021)

Introduction: Chagas disease is highly prevalent in Latin America and, due to migration, this condition is being diagnosed more frequently in developed countries. Trans-thoracic echocardiogram (TTE) is routinely used to evaluate these patients, in whom ventricular aneurysms (VA) are common. We aim to compare the accuracy of TTE vs. cardiac magnetic resonance imaging (CMR) as the gold standard for diagnosing VA. Methods: We performed TTE and CMR the same day in a prospective cohort of Chagas disease patients and no history of coronary artery disease. We classified VA′s according to their location and the apical ones were subclassified as follows: Microaneurysms (limited to the segment AHA-17), macroaneurysms (with extension to all apical segments), and giant aneurysms (with extension to midventricular segments). Results: A total of 79 patients were included. Of these, 57% were women with a median age of 60 years old (IQR 51-69) and a prevalence of VA of 24%. TTE had an overall sensitivity for VA of 47% (95% CI: 24 - 69%), specificity of 98% (95% CI: 95 -100%), positive predictive value of 90% (95% CI: 71 - 100%) and negative predictive value of 86% (95% CI: 77 - 93%) compared to CMR. Of notice, the TTE sensitivity for giant aneurysms was 100% (95% CI: 100 - 100%), for macroaneurysms was 54% (95% CI: 25 - 83%), and 0% (95% CI: 0 - 0%) for microaneurysms. Conclusions: The TTE sensitivity for VA in Chagas disease patients is limited and proportional to the size of the defect. Of notice, the specificity and positive predictive values are high. In patients with Chagas disease, CMR may be needed during the course of disease for optimal left ventricular wall characterization.
Abstract 11274: All-Cause Mortality Association of Right Ventricular Free Wall Longitudinal Strain and Strain Rate in Acute Pulmonary Embolism Patients
Authors: Vaibhav Jain, Juan Quintero-Martinez, Sandra C Madera, Danielle Vlazny, Waldemar E Wysokinski, Damon Houghton, Hector R Villarraga
Journal: Circulation (2021)

Introduction: Right ventricle (RV) dysfunction linked with acute Pulmonary embolism (PE) is associated with significant mortality. Several studies have documented use of RV free wall strain (RVS) for assessing mortality, but RV free wall systolic (RVSRs) and early diastolic strain rate (RVSRe) have not been explored. Hypothesis: The study aims to assess the RV function in longitudinal domain of contractility using 2 D speckle tracking echocardiography and evaluate if it was able to predict all-cause mortality at 30 days. Methods: This is a single center prospective study done between November 2012 to June 2020. 293 adult patients with acute PE having echocardiogram performed within 24 hours were enrolled and baseline comorbidities were recorded. 2 D Speckle tracking echocardiography was performed offline. Multiple logistic regression analyses and ROC were performed to evaluate if RV Strain (RVS) and strain rate (systolic-SRs, early diastolic-SRe) were able to predict all-cause mortality at 30 days. Results: Mean age was 65 ± 15 years, 60.7 % males and 41% had coronary artery disease, 29% had cancer and 11% had COPD. Mean free wall (FW) RVS was -19.7±7.7%, FW RV SRs was -0.9±0.4 s -1 , FW RV SRe was 0.8±0.3 s -1 . (Figure A) All-cause mortality was present in 11 patients (3.8%) at 30 days, 17 (5.8%) at 3 months and 29 (9.9%) at 6 months. In the Univariate analysis, FW RVS and FW RVSRs were significantly associated with 30 days all-cause, but after adjusting for age, cancer, and COPD, only FW RVSRs remains significant (p=0.02) with an AUC to predict 30-day all-cause mortality of 0.73 (95% CI 0.54-0.88) a cut-off value of -0.7 had a sensitivity of 73% and specificity of 64% (Figure B) Conclusions: The study demonstrated that RV Free wall SRs measured by 2 D STE is a good prognostic indicator for 30 days all-cause mortality in patients with acute PE. This novel modality could be used for risk stratification in the setting of acute PE.
Abstract 9935: Culprit Plaque Morphology in Young versus Elder Acute Coronary Syndrome Patients: An Optical Coherence Tomography Study
Authors: prachi sharma, Gaurav Chaudhary, Vikash Jaiswal, Basant Kumar Gupta, Abhishek Singh, Ayush Shukla, Monika Bhandari, Akhil Kumar Sharma, Pravesh Vishwakarma, Akshyaya Pradhan, Sharad Chandra, rishi sethi, Sudhanshu Dwivedi
Journal: Circulation (2021)

Objective: Culprit plaque morphology in young acute coronary syndrome (ACS) patients differs from that of elder patients. The underlying mechanisms responsible for ACS in younger compared to elder patients are yet to be explored with optical coherence tomography. Methods: This was a prospective, single-center, investigational study. Patients were divided into groups according to age, ≤35 (N=43) and &gt;35 years (N=50) and further subdivided according to the underlying mechanism i.e. plaque rupture (PR) and plaque erosion (PE). Results: A total of 93 patients were included in this analysis. Thin-cap fibroatheroma (TCFA) was significantly higher among elder than younger patients for both PR (80.0% vs. 31.8%, p=0.002) and PE (66.7% vs. 6.3%, p&lt;0.001) groups. Microchannels were also significantly more prevalent among elder than younger patients for both PR (65.0% vs. 18.2%, p=0.004) and PE groups (55.6% vs.12.5%, p=0.013). Macrophages were significantly higher in elder than younger patients for both PR (25.0% vs. 0%, p=0.018) and PE (44.4% vs. 0%, p=0.003) groups. In contrast, fibrous cap thickness was greater in younger than elder patients for both PR (105.71±48.02 μm vs. 58.00±15.76 μm, p&lt;0.001) and PE (126.67±48.22 μm vs. 54.38±24.21 μm, p&lt;0.001) groups. Intimal thickness was greater in elder than younger patients for both PR (728.00±313.92 mm 2 vs. 342.27±142.02 mm 2 , p&lt;0.001) and PE (672.78±334.57 mm 2 vs. 295.00±99.60 mm 2 , p&lt;0.001) groups. Plaque type, thrombus formation, and minimal luminal diameter did not differ significantly according to age. Conclusion: We conclude that the high resolution of OCT is able to define the detailed microstructure of the culprit lesion and allows a greater understanding of the mechanisms of coronary artery disease. The frequency of TCFA, microchannels, macrophages, and intimal thickness was significantly higher in elder ACS patients compared to younger patients. However, fibrous cap thickness was significantly greater in younger ACS patients compared to elder patients.
Abstract 11039: Platelets Contribute to Disease Severity in Covid-19
Authors: Tessa Barrett, Seda Bilaloglu, Macintosh Cornwell, Hannah Burgess, Vitor W De Moura Virginio, Kamelia Drenkova, Homam Ibrahim, Eugene Yuriditsky, Yindalon Aphinyanaphongs, Mark Lifshitz, Feng Xia Liang, Julie Alejo, Grace Smith, Stefania Pittaluga, Amy Rapkiewicz, Jun Wang, Camelia Iancu-Rubin, Ian Mohr, Kelly Ruggles, Kenneth Stapleford, Judith S Hochman, Jeffrey S Berger
Journal: Circulation (2021)

Objective: Heightened inflammation, dysregulated immunity, and thrombotic events are characteristic of hospitalized COVID-19 patients. Platelets are key regulators of thrombosis, inflammation, immunity and are prime candidates for a role in the pathogenesis of COVID-19. The objective of this study was to analyze the platelet phenotype in COVID-19. Approach and Results: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is detected in human megakaryocytes and platelets in COVID-19 patients and following incubation with the virus in vitro . We show a direct interaction between SARS-CoV-2 and megakaryocytes that alters the platelet transcriptome and platelet activity. COVID-19 platelets are hyperreactive and have a distinct transcriptomic profile characteristic of prothrombotic large and immature platelets. We find transcriptomic changes mediated by SARS-CoV-2 do not occur following exposure of megakaryocytes with a coronavirus responsible for the common cold, CoV-OC43. In a cohort of 3,915 hospitalized COVID-19 patients, we analyzed blood platelet indices collected at hospital admission. Following adjustment for demographics, clinical risk factors, medication use, and biomarkers of inflammation and thrombosis, platelet count, size, and immaturity are each associated with increased critical illness and all-cause mortality. Conclusions: Our findings demonstrate that SARS-CoV-2 virions invade megakaryocytes and platelets, inducing alterations to the platelet transcriptome and activation profile, which correlate with critical illness and mortality in hospitalized COVID-19 patients.
CD22 low/Bcl-2 high Expression Identifies Poor Response to Inotuzumab in Relapsed/ Refractory Acute Lymphoblastic Leukemia
Authors: Ernesto Diaz-Flores, Astrid Wintering, Kenichi Ishiyama, Stanley Tamaki, Courtney Tamaki, Josh Fandel, Lingyun Ji, Brent Wood, Constance M. Yuan, Nirali N. Shah, Maureen M. O'Brien, Mignon L. Loh
Journal: Blood (2021)
Acute injury care: the oft-forgotten prequel to rehabilitation and return to sport
Authors: Stephen Mutch, Rebecca Knight, Philip Glasgow
Journal: British Journal of Sports Medicine (2021)

Physiotherapists working in sport are expected to manage injuries from the moment they occur. When witnessing live sport, the physiotherapist watches for signs of trauma, overstretching or other unusual patterns of movement that can guide decision-making in a way that is of greatest help to the athlete. Regular training ensures that physiotherapists work as part of an inter-disciplinary team to provide treatment and timely removal from a field of play when necessary. Recognising important clues such as the degree of distress and injury mechanism can help shape the initial assessment and management based on training, experience and pattern recognition.

This BJSM edition focuses on Acute Management, rather than Rehabilitation or Return to Sport that more frequently headline conferences and symposia, or are commonly found within journal pages, blogs and across social media. Acute management and athlete assessment are discussed in an assortment of varied contexts. Dr Charles Pedlar discusses medical encounters in recreational running events, such as the popular and global Parkrun ( see page 1420 ), while Yuri Hosokawa and colleagues present expert recommendations for …
DDRE-10. SCREENING OF EPIGENETIC COMPOUNDS IN GLIOMA AND GLIOBLASTOMA IDENTIFIES NOVEL THERAPEUTICS FOR THEIR POTENTIAL TREATMENT
Authors: Philip Tatman, Tadeusz Wroblewski, Anthony Fringuello, Sam Scherer, William Foreman, Denise Damek, Samy Youssef, Kevin Lillehei, David Ormond, Michael Graner
Journal: Neuro-Oncology (2021)

Abstract BACKGROUND 28% of primary central nervous system tumors are glioma and glioblastoma. These tumors are responsible for 80% of malignant brain neoplasms and most brain tumor related deaths. Despite modern therapies, patients with grade II gliomas have an average survival of 8-15 years, while patients with grade III tumors have an average survival of 3-5 years, and patients with glioblastoma have an average survival of 12-15 months. The lack of a curative treatment for this group of tumors supports additional research and novel approaches to identify more effective therapies. METHODS In this study, we developed a high-throughput drug screen and culture system to identify epigenetic inhibitor compounds with the potential to reduce glioma and glioblastoma viability. RESULTS We screened 33 tumors: 18 glioblastoma, 8 oligodendroglioma, and 7 astrocytoma. The top three most effective compounds across the full glioma cohort were all HDAC inhibitors; in order from most effective: panobinostat (average tumor viability = 52.5% +/-14.1SD; p=2.16x10-61), LAQ824 (average tumor viability = 58.1% +/-18SD; p=1.48x10-45), and HC Toxin (average tumor viability = 64% +/-21.1SD; p= 1.16x10-33). Additionally, HDAC inhibition was also the most effective across each histopathological glioma type: astrocytoma, oligodendroglioma, and glioblastoma. UNC0631(G9a inhibitor) and JIB-04(KDM inhibitor) were the most effective compounds in the six recurrent tumors, though HDAC inhibition was still significantly effective in this group. We also evaluated drug sensitivity with respect to tumor grade, prior treatment, de novo vs progressive etiology, EGFR amplification, IDH mutation, MGMT methylation, and patient gender. CONCLUSIONS After screening a large glioma cohort against a panel of epigenetic inhibitors, we found HDAC inhibition most effectively reduced tumor viability across all histopathological types and grades. These findings require further in vivo validation.
Safety and Efficacy of Thrombopoietin Analogs in the Treatment of Chronic Thrombocytopenic Purpura in Children: A Systematic Review
Authors: Usman Ali Akbar, Vivek Soorya Sathya Moorthy, Sudeep Yadav, Saman Bahram, Adnan Mehboob Qureshi, Sheref A Elseidy, Syed Adeel Hassan, Atif Irfan Khan, Faiz Anwer
Journal: Blood (2021)
Abstract 10813: Impact of Multidisciplinary Rounds in Cardiac Patients
Authors: Pranati Sreepathy, Zaneta Ahuja, Noreen T Nazir
Journal: Circulation (2021)

Introduction: A multidisciplinary care approach is the cornerstone of cardiac patient care. Multidisciplinary rounds (MDR) consisting of social workers, nutritionists, pharmacists, physical therapists, nursing and physicians systematically addressing the multifaceted components of hospital care of the cardiac patient have been implemented at many hospitals recently as an effort to increase collaboration throughout the care team and address care gaps. At this time there is little research into the impact of MDR on clinical outcomes. Hypothesis: Implementing MDR will decrease mortality, clinical complications, and length of stay (LOS) while also improving communication between ancillary staff and decreasing readmissions. Method: A single center case control study was conducted comparing Mortality Index, LOS, Clinical Complications (defined as adverse events documented during hospital stay), 30 day readmissions, and number of ancillary staff consults prior to implementation of MDR and after in patients admitted to the cardiology inpatient service at our major metropolitan academic medical center. Study duration was 34 months total with 2,695 unique hospital encounters studied. Results: Mortality Index after MDR implementation decreased from 1.179 to 0.648 and was statistically significant (p-value 0.06, CI -1.087,0.025). Average number of complications decreased by 27% (3.15 to 2.29) in response to MDR and average ancillary consults (Physical Therapy and Nutritional/Dietitian Consults) increased by 39.7% (19.75 to 27.6) and 182% (2.8 to 7.9) respectively. No significant change was observed in 30 day readmissions or LOS. Conclusion: MDR had statistically significant decrease on mortality index on cardiac patients admitted. MDR positively impacted resource utilization with appropriate consultations for ancillary services increasing. Continuation of MDR may impact LOS and readmissions over time.
Abstract 11064: Intentional Weight Loss as a Novel Treatment for Heart Failure with Preserved Ejection Fraction
Authors: Moritz J Hundertmark, Matthew Burrage, Jack Miller, William Watson, Mark Peterzan, Jennifer Rayner, Stefan Neubauer, Ladislav Valkovic, Andrew J Lewis, Oliver J Rider
Journal: Circulation (2021)

Introduction: Heart failure with preserved ejection fraction (HFpEF) is frequent in obesity and both conditions are projected to increase in prevalence. We sought to investigate if weight loss is an effective treatment for patients with HFpEF and obesity. Hypothesis: Intentional weight loss improves symptoms, serum markers and imaging markers in patients with HFpEF and obesity. Methods: 12 obese HFpEF patients (BMI 33.5±5 kg/m 2 ; NYHA I-III) were assessed before and after a very low energy diet (VLED; 800 calories per day) for 10 weeks and compared to 10 weight-matched, obese controls (BMI 31.8±1.5 kg/m 2 ). We evaluated cardiac function using cardiovascular magnetic resonance (CMR) imaging, diastolic function with echocardiography and cardiac energetics (PCr/ATP) using 31 P-spectroscopy. Serum samples were drawn to measure N-terminal pro-brain natriuretic peptide (NTpro-BNP). Results: After 10 weeks of VLED, there was a highly significant reduction in body weight (BMI -2.7kg/m 2 ± 0.38, p&lt;0.001) paralleled by a significant drop in NTpro-BNP (-239pg/mL ± 149, p&lt;0.05) and heart failure symptoms (NYHA median pre II vs. I post). Echocardiography revealed a significantly lower left atrial volume (-29mL ± 28, p&lt;0.05) and a trend towards improved diastolic function (lateral E/E’ -0.68 ± 0.5, p=0.08). CMR demonstrated a significantly lower LV mass (-9g ± 2.9, p&lt;0.05) but no changes in PCr/ATP at rest (Δ0.015±0.1, p=ns) or during dobutamine stress (Δ0.087±0.06, p=ns). Except NTpro-BNP, all parameters returned to comparative levels of obese weight-matched patients without HFpEF. Conclusions: In obese HFpEF, intentional weight loss improves prognostic serum markers for HF, decreases symptom severity, reduces atrial size and LV mass, and improves diastolic function. These findings underscore the potential for weight loss as an effective treatment for HFpEF and the need for larger trials.
Dynamics and Management of CAR-T Cells Associated Cytopenias: A Single-Center Experience
Authors: Reyes María Martín-Rojas, Rebeca Bailen, Gillen Oarbeascoa, Mariana Bastos Oreiro, Ignacio Gómez-Centurión, Jon Badiola, Cristina Muñoz, Santiago Sabell, Javier Anguita, Jose L. Diez-Martin, Mi Kwon
Journal: Blood (2021)
Abstract 13072: Association Between Baseline Lipoprotein(a) and Five-Year Outcomes in Patients Underwent Coronary Artery Bypass Grafting: A Post-Hoc Analysis of DACAB Trial
Authors: Qixiang Yu, Yanzai Zhou, Wei Zhang, Qiang Zhao, Yunpeng Zhu
Journal: Circulation (2021)

Introduction: Serum lipoprotein(a) [Lp(a)] is genetically determined and has been proposed to be associated with coronary artery lesion severity and clinical outcomes in coronary artery disease (CAD). But some researches suggested heterogeneous effects and marked variations of Lp(a) level between ethnic groups. The aim of this study was to investigate the impact of baseline Lp(a) on five-year clinical outcomes in Chinese population who underwent coronary artery bypass grafting (CABG). Methods: We performed a post-hoc analysis of the DACAB trial (NCT02201771), in which patients aged 18 to 80 years, male or female, underwent primary, isolated and elective CABG, were randomly assigned to receive different antiplatelet treatments. Serum Lp(a) was obtained and analyzed in 270/272 patients of one single center. The primary outcome was major adverse cardiovascular events (MACE). MACE-5 included all-cause death, myocardial infarction, stroke, repeated revascularization and rehospitalization for unstable angina, and MACE-3 included cardiovascular death, myocardial infarction, and stroke. The mean follow-up reached 59.4±9.4 months. Results: The baseline characteristics were generally comparable. High Lp(a) level was identified in 71 (26.3%) (cut-off ≥30mg/dL) and 33 (12.2%) (cut-off ≥50mg/dL) patients, respectively. During 5-year follow-up, MACE-5 reported in high and low Lp(a) group were 34.2% vs 28.8% when the cut-off value was 30mg/dL (hazard ratio [HR], 1.11; 95% CI, 0.69-1.78, p=0.66). While the cut-off value was 50mg/dL, MACE-5 reported in high and low Lp(a) group were 39.4% vs 28.9% (HR, 1.32; 95% CI, 0.73-2.38, p=0.36). Similar results were observed in MACE-3 (Cut-off value 30mg/dL: 24.2% vs 21.9%, HR 1.08, p=0.78; Cut-off value 50mg/dL: 27.3% vs 21.8%, HR 1.24, p=0.56). No statistical significant difference was achieved between the two groups. Conclusions: In this single center post-hoc analysis, baseline Lp(a) level ≥30mg/dL or ≥50mg/dL had no statistical significant association with 5-year MACE in post-CABG Chinese population. But higher baseline Lp(a) levels seem to be associated with more MACE in longer follow-up. Larger sample size from multicenter are needed to confirm our findings.
Abstract 12299: Molecular Imaging of Active Vascular Microcalcification in the Lower Extremities of Patients With Diabetes and Peripheral Arterial Disease
Authors: Ting-heng Chou, Susan N Eisert, Laila Ettefagh, Timur P Sarac, Said A Atway, Michael R Go, Mitchel R Stacy
Journal: Circulation (2021)

Introduction: Patients with diabetes mellitus (DM) have accelerated progression of peripheral arterial disease (PAD) with higher prevalence of arterial calcification, which can limit and make options for endovascular revascularization more challenging, contribute to worse treatment outcomes, and result in higher rates of amputation. Positron emission tomography (PET) imaging with fluorine-18 ( 18 F)-sodium fluoride (NaF) has shown utility for detecting active microcalcification of coronary arteries but remains relatively understudied in patients with PAD. We hypothesized that 18 F-NaF PET/CT imaging could be used to quantify DM-induced active microcalcification of lower extremity arteries. Methods: 18 F-NaF PET/CT imaging was performed in PAD patients with type 2 DM (n=11), PAD patients without DM (n=8), and healthy controls (n=6). Regions of interest were manually drawn bilaterally on each axial slice of CT images for the femoral, popliteal, anterior tibial, tibioperoneal trunk, posterior tibial, and peroneal arteries to quantify 18 F-NaF uptake. The maximum target-to-background ratio (TBR max ) was calculated for each artery of interest. Results: 18 F-NaF PET/CT imaging non-invasively detected significantly higher active microcalcification of the femoral-popliteal, anterior tibial, tibioperoneal trunk, and posterior tibial arteries in patients with DM and PAD compared to healthy controls ( Fig. 1 ). A noticeable trend (not significant) in increasing arterial retention of 18 F-NaF was found with increasing disease status (i.e., healthy, PAD only, PAD with DM) ( Fig. 1 ). Conclusions: 18 F-NaF PET/CT quantifies vessel-specific active calcification of above- and below-the-knee arteries in patients with DM and PAD. PET/CT may offer insight into early pathophysiology of peripheral disease in patients with DM, thereby improving personalized therapeutic approaches for a population that suffers from significant morbidity and mortality.