tbuckley/cabot-search huggingface dataset:
Abstract 16493: Comparison of Left Ventricular Volumes and Ejection Fraction Measured by Non-contrast 2 Dimensional, Contrast 2 Dimensional and 3 Dimensional Transthoracic Echocardiography in Patients With Heart Failure During One Examination, to Measurements by Cardiovascular Magnetic Resonance Imaging
Authors: Allison Rosenthal, Katherine C Lee, Shaefali Padiyar, Bliss Uribe, Shizhen Liu, JD Cochran, Theresa Green, sara mobasseri, Peter Flueckiger, Vibhav Rangarajan, Hassan S Sayegh, Mani A Vannan
Journal: Circulation (2020)

Introduction: Non-contrast 2D TTE (2D NC TTE) is done in patients with HF to assess LV EDV and ESV and EF. 2D contrast and 3D TTE (2D C TTE, 3D TTE) are also done. Hypothesis: There are no distinct cut-offs for LV volumes for 2D C TTE or 3D TTE volumes. And, it is not known which of these measurements should be reported. The relative differences in these measurements, and their relative accuracy, compared to CMR is unknown. Methods: This is an observational, retrospective analysis of 239 HF patients who had 2D NC, 2D C, 3D TTE, and CMR. We measured bi-plane LV EDV and ESV, ml), and EF (%) in the 2D NC and C TTEs, and 3D LV EDV and ESV were measured in one TTE. Results: Data from 35 of the 239 patients are shown. 2D NC LV volumes were significantly smaller than 2D C volumes (EDV: 189±80 Vs. 227±86 and ESV: 133±68 Vs. 158±77, p&lt;0.001 for both). 2D NC TTE volumes were significantly smaller than 3D TTE volumes (EDV: 189±80 Vs. 206±85 and ESV: 133±68 Vs. 154±70). But, only 2D C EDV was significantly smaller than 3D TTE (227±86 Vs. 206±85, p&lt;0.01), ESV was not significantly different between the two. Compared to CMR, 2D C TTE did not show any significant differences in volumes because contrast was able to identify the compacted myocardial edge. In 3D TTE, only EDV was significantly smaller than CMR (p&lt;0.01) but not 3D TTE ESV, because there is a bigger separation of trabeculated and compacted myocardial edges in ED which is less so in systole. 2D NC TTE EDV and ESV were both significantly smaller (p&lt;0.001) than CMR because the trabeculated myocardial edge is used to measure these. There were no significant differences in EF between the three TTE methods. Figure 1 shows an example. Conclusions: In HF, 2D NC is smaller than 2D C TTE LV volumes, the latter being larger and comparable to CMR. Thus, there is a need to identify specific cut-offs for contrast TTE LV volumes to classify LV size. 3D TTE volumes are comparable to CMR, but smaller than 2D C TTE volumes. Contrast 3D TTE may prove to be most comparable to CMR when this becomes available.
Abstract P008: Ideal Cardiovascular Health And Hepatocyte Growth Factor In The Multi-ethnic Study Of Atherosclerosis
Authors: Olatokunbo Osibogun, Oluseye Ogunmoroti, Richard A Ferraro, Olumuyiwa A Esuruoso, Chiadi E Ndumele, Gregory Burke, Nicholas B Larson, Suzette J Bielinski, Erin Michos
Journal: Circulation (2021)

Background: Hepatocyte growth factor (HGF) is a cytokine released in response to vascular injury and a novel biomarker of cardiovascular disease (CVD) risk. However, the relationship between ideal cardiovascular health (CVH) and HGF is unknown. We examined whether ideal CVH is associated with lower HGF levels in a multi-ethnic cohort of adults free from clinical CVD at baseline. Methods: We analyzed data from the MESA study of 6,490 men and women aged 45-84 years. The independent variable was the CVH score derived from 7 metrics (smoking, body mass index, physical activity, diet, total cholesterol, blood pressure and blood glucose). Each metric was scored 0 points (poor), 1 point (intermediate) and 2 points (ideal). The total CVH score ranged from 0-14. An inadequate score was 0-8, average, 9-10 and optimal, 11-14. The number of ideal metrics was also counted. The dependent variable was logarithmically transformed HGF. We examined the association between the CVH score and HGF using linear regression models adjusted for age, sex, race/ethnicity, education, income, health insurance and study site. Results: The mean (SD) age of participants was 62 (10) years. Fifty-three percent were women. Participants with optimal CVH scores had the lowest HGF concentration [Median (IQR): 807 (678-962) pg/mL] compared to those with average [870 (740-1,036)] and inadequate scores [969 (821-1,159)]. A one-unit increment in the CVH score was significantly associated with a 3% lower HGF concentration (Table). Average and optimal CVH scores were also significantly associated with 8% and 12% lower HGF concentrations, respectively, compared to inadequate scores. Additionally, a greater number of ideal metrics was associated with lower HGF concentrations. Interactions by age, sex and race/ethnicity were not significant. Conclusion: In this ethnically diverse cohort, optimal CVH was significantly associated with lower HGF levels. Interventions aimed at promoting ideal CVH may reduce vascular injury as indicated by lower serum HGF levels.
Abstract 16043: Effectiveness and Safety of Switching From Warfarin to Apixaban in Advanced Chronic Kidney Disease Patients With Prevalent Atrial Fibrillation in the United States Between 2012 and 2016
Authors: Katherine Garlo, Thomas Mavrakanas, Elisabeth Burdick, Wei Wang, David Charytan
Journal: Circulation (2020)

Introduction: Apixaban is the preferred direct acting oral anticoagulant in patients with CKD and has advantages compared with warfarin. Data on effectiveness and safety outcomes after switching from warfarin to apixaban in patients with prevalent AF and CKD are limited. Methods: Individuals with advanced CKD not on dialysis and prevalent AF who receive ≥6 months of continuous warfarin prior to Jan 1, 2012 were identified from the United States Data Renal System (USRDS) database. Individuals were followed from Jan 1, 2012 - Dec 31, 2015 to identify switches from warfarin to apixaban. The primary efficacy outcome was combined all-cause stroke, transient ischemic attack, or systemic thromboembolism. The primary safety outcome was major bleeding. Outcomes were compared between patients switching from apixaban and those continuing warfarin. Individuals were censored at the time of the first event or anticoagulation discontinuation, discontinuous Medicare part D coverage, dialysis, kidney transplant, a 2 nd switch in anti-coagulant, or death. Results: 1762 individuals with advanced CKD not receiving dialysis with non valvular AF or flutter were on warfarin during the 6 months prior to Jan 1, 2012. Of these, 71 (4.0%; 57.8% male, mean age 78.2 years (SD ±6.6), 78.9% white) switched from warfarin to apixaban and 1691 (41.3%; 47.6% male, mean age 80.1 years (SD ±8.7), 87.9% white) continued warfarin from Jan 1, 2012 - Dec 31, 2015. Incidence of all cause stroke or systemic thromboembolism in the apixaban switch and warfarin continuation groups were 1 (1.4%) and 303 (17.8%) respectively. Incidence of major bleeding events in the two groups were 1 (1.4%) and 201 (11.9%). Conclusions: Among advanced CKD patients with AF in the US who switched from warfarin to apixaban the proportion of all cause stroke or systemic thromboembolism and major bleeding events were low. Data is limited by duration of apixaban market authorization and short follow up.
83P Axillary reverse mapping using near-infrared fluorescence imaging in invasive breast cancer (ARMONIC study)
Authors: A. Conversano, M. Abbaci, M. Karim, M.C. Mathieu, F. de leeuw, S. Michiels, C. Laplace-Builhé, C. Mazouni
Journal: Annals of Oncology (2021)
Abstract 16431: Outcomes of Left Heart Decompression in Children on Veno-Arterial Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-analysis
Authors: Siddharth Mahajan, Dierdre Lewis, James Schneider, Janice Lester, Kholwadwala Dipak, Shilpi M Epstein, Todd Sweberg, Aparna Kulkarni
Journal: Circulation (2020)

Introduction: Left heart decompression (LD) is performed in patients on veno-arterial extra-corporeal membrane oxygenation (ECMO) to decrease myocardial wall stress, enhance recovery and decrease complications. Data on outcomes following LD however, are unclear. We sought to evaluate outcomes of death(D) and hospital parameters with a systematic review and meta-analysis (SR-MA) in children without congenital heart disease (CHD) who underwent LD on ECMO. Methods: We included citations in non-CHD patients &lt;21 years age on ECMO, from a MESH search for ECMO, LD and D in CINAHL, CINAHL PLUS and MEDLINE, in English up to January 31, 2020. Case reports, systematic reviews, database duplicates and CHD outcomes were excluded. Cochrane ROBINS-I risk of bias (ROB) tool for non-randomized studies was used to assess ROB. Results: The search yielded 300 citations, reduced to 36 full text screening of which 7 met inclusion criteria. All were observational retrospective analysis (5 single centers, 2 registries). ROB was critical in 3 studies, and low in 2 (not assessed in 2 abstracts). Of 1,789 included pts, 1,575 were in registries. Median age on ECMO was 6 years and weight 18.7 (range 3-92) kgs. Main diagnoses consisted of myocarditis (n=636,36%) and dilated cardiomyopathy (n=919,52%). Overall, 659 pts died and 75 underwent heart transplantation. Time from ECMO to LD was 15.5 hours (0-113.7 hrs). Dynamic left atrial (LA) LD was performed in 239 pts(13%), static in 135(8%), LA drain in 150(8%) and atrial septal stent in 17(1%). Median LA pressure at the time of decompression was 21 mm Hg. Pts who underwent LD were found to have lower odds ratio for D compared to pts who did not (OR 0.73 [0.5-1.0],I 2 0%). There was inadequate data to assess outcomes of number of days on ECMO (1 study-LD 17+28 vs non-LD 6+4 days), mechanical ventilation (1 study- LD 32+49 vs non-LD 14+19 d), ICU stay (1 study-LD 52+55 vs non-LD 18+10 d) and total length of stay (1 study-LD 60+55 vs non-LD 27+33 d). Conclusions: Our systematic review and meta-analysis found that survival was better in non-CHD pts on ECMO who underwent LD compared to pts who did not. Further outcome analysis was limited by inadequate data. Larger registry level analysis is necessary to assess this further.
Abstract 16196: Nitric Oxide Delivery During Cardiopulmonary Bypass Reduces Acute Kidney Injury: Randomized Trial
Authors: Nikolay O Kamenshchikov, Yuriy K Podoksenov, Yana J Anfinogenova, Boris N Kozlov
Journal: Circulation (2020)

Introduction: Acute kidney injury (AKI) is a serious complication of cardiac surgery with cardiopulmonary bypass (CPB). Postoperative AKI develops in 30% to 52% of cardiac surgery patients and 2% to 5% of these patients require renal replacement therapy. Hypothesis: We hypothesized that nitric oxide treatment during cardiac surgery with CPB can decrease AKI incidence in adult patients. The aim of study was to evaluate the effects of nitric oxide supplementation to CPB circuit on the development of cardiac surgery-associated AKI. Methods: A prospective randomized controlled study included 96 patients with moderate risk of renal complications who underwent elective cardiac surgery with CPB. The study protocol was registered at www.clinicaltrials.gov (#NCT03527381). Patients were randomly assigned to either the nitric oxide supplementation to CPB circuit (NO-treatment group, n = 48) or the usual care (control group, n = 48). 40-ppm nitric oxide was administered in NO-treatment group during the entire CPB period. The primary outcome was AKI incidence. Results: Nitric oxide treatment was associated with a significant decrease in AKI incidence (10 (20.8%) versus 20 (41.6%); RR 0.5 (95% CI 0.26-0.95; p =0.023) and a higher urine output during CPB (2.6 [2.1;5.08] versus 1.7 [0.80;2.50] mL/kg/h; p = 0.0002). Urinary neutrophil gelatinase-associated lipocalin levels were significantly lower in NO-treatment group 4 h after surgery: 1.12 [0.75;5.8] versus 4.62 [2.02;34.55] ng/mL; p = 0.005. Concentrations of nitric oxide metabolites in NO-treatment group significantly increased at 5 min post-clamping, 5 min after declamping, and at the end of surgery. The concentrations of proinflammatory and anti-inflammatory mediators and free plasma hemoglobin did not significantly differ between groups. Conclusions: Nitric oxide administration to patients at moderate risk of renal complications undergoing elective cardiac surgery with CPB was associated with a decrease in AKI incidence. The implications of study for clinical practice expand the array of methods, which may be used for prevention of AKI in cardiac surgery patients.
Abstract 16415: Racial Differences in Incidence of Atrial Fibrillation After Cryptogenic Stroke
Authors: David B Laslett, Abdullah Haddad, Dianna Gaballa, Hardik Mangrolia, Olivia Follis, Chethan Gangireddy, Anuj Basil, Richard Greenberg, George Yesenosky, Edmond Cronin, Joshua M Cooper, Isaac R Whitman
Journal: Circulation (2020)

Introduction: The incidence of atrial fibrillation (AF) is lower among non-whites compared to whites, despite a higher burden of AF risk factors. Current knowledge of first detection of AF after cryptogenic stroke (CS) by an implantable cardiac monitor (ICM) is based on a predominantly white cohort. The incidence of new AF after CS among minorities is unknown. We hypothesized that the incidence of AF after CS would be lower in non-whites. Methods: We reviewed charts of all patients without a history of AF undergoing implantation of an ICM after CS at our hospital from July 2014 to December 2019. Incidence of AF was identified through review of ICM monitoring for each patient, including adjudication of AF episodes for accuracy. Kaplan Meier survival analysis was performed, and cumulative incidence of AF using adjusted Cox proportional hazards regression was compared by race. Results: We identified 417 patients who underwent ICM implant after CS during the study period, with a mean follow-up time of 1.5 ± 1.1 years. Mean age was 62 ± 12 years, and 46% (n=190) were male. The majority of patients were non-white (white, 15%, n=63; black, 59%, n=244; Hispanic, 26%, n=110). At baseline, blacks, Hispanics, and whites were of similar age (mean 62.2, 62.1, and 61.5 years, respectively), and blacks and Hispanics had more AF risk factors, including heart failure, hypertension, diabetes, chronic kidney disease, and higher BMI, than whites. Hispanics had more coronary artery disease than whites and blacks (25.5%, 17.5%, 9.1% respectively, p &lt; 0.001). Among blacks, the cumulative incidence of newly detected AF at one, two, and three years was 13.0%, 18.9%, and 23%, which was similar to Hispanics (12.9%, 18.2%, and 20.9%). By comparison, the incidence in whites was significantly higher (20.8%, 34.3%, 40.3%; blacks p=0.02; Hispanics p=0.01) Conclusion: In patients undergoing ICM after CS, the incidence of newly detected AF is approximately double in whites compared to both blacks and Hispanics.
Abstract 14867: Atrial Fibrillation is Associated With Risk of Incident Heart Failure and Its Subtypes
Authors: Charles D Nicoli, Wesley T O'Neal, Emily B Levitan, Matthew J Singleton, Suzanne E Judd, George Howard, Monika M Safford, Elsayed Z Soliman
Journal: Circulation (2020)

Background: Heart failure (HF) is an established risk factor for atrial fibrillation (AF). However, the extent to which AF is a risk factor for HF and its subtypes in a racially diverse population is unclear. Methods: This analysis included 25,787 participants free of baseline HF from the REasons for Geographic And Racial Differences in Stroke (REGARDS). AF at baseline was identified by electrocardiogram and self-reported physician diagnosis. HF events during follow-up were ascertained from medical records with subclassification by left ventricular ejection function (EF) at time of diagnosis as HF with reduced EF (HFrEF; EF&lt;40%), HF with preserved EF (HFpEF; EF≥50%), mid-range HF (EF 40-49%) and unclassified. Cox proportional-hazards regression was used to separately examine the association of baseline AF and incident overall HF, HFpEF, and HFrEF. The Lunn-McNeil method was used to test differences in the association of AF by HFrEF &amp; HFpEF. Consistency of the associations of AF with HF and its subtypes was examined in subgroups stratified by sex and race. Results: AF was detected in 1,924 (7.5%) participants at baseline (2003-2007). Over 10.1 years median follow-up, 1,109 HF events occurred (388 HFrEF, 356 HFpEF, 77 mid-range HF, and 288 unclassified). AF was associated with more than 2-fold increased risk of overall HF as well as its subtypes HFpEF and HFrEF in models adjusted for socio-demographics and cardiovascular risk factors. The strength of associations was slightly attenuated after adjustments for Warfarin, aspirin and statin. A stronger association of AF with HFrEF than HFpEF was observed, but the difference was not statistically significant. These associations were consistent among men, women, Black and White subgroups (Table). Conclusions: AF is strongly associated with both HFrEF and HFpEF. While further investigation of the underlying mechanisms is needed, our findings extend the sequelae of AF beyond stroke to include HF regardless of type.
Abstract 024: Effects Of Diet On 10-year Atherosclerotic Cardiovascular Disease Risk Using The Pooled Cohort Equations Risk Calculator: Results From The Dash Trial
Authors: Sun Young Jeong, Lara Kovell, Timothy B Plante, Christina C Wee, Edgar R Miller, Lawrence J Appel, Kenneth J Mukamal, Stephen P Juraschek
Journal: Circulation (2021)

Background: The Dietary Approaches to Stop Hypertension (DASH) diet is known to reduce cardiovascular disease (CVD) risk factors, but its effects on 10-year CVD risk based on the pooled cohort estimating equation has not been reported. Objective: To determine the effects of adopting the DASH diet on 10-year atherosclerotic cardiovascular disease (ASCVD) risk compared to a typical American (control) diet or a diet rich fruit and vegetables (F/V), but otherwise similar to control. Methods: The DASH trial was a 3-arm, parallel-group, randomized controlled feeding trial of 459 adults aged 22 to 75 years without CVD and not taking anti-hypertensive or diabetes medications. These participants were randomized to a control diet, a F/V diet, or the DASH diet for 8 weeks. Weight was kept constant. Blood pressure (BP) and lipids were measured at baseline and at 8-weeks to compare 10-year ASCVD risk scores across dietary assignments. Comparisons were performed via linear regression adjusted for baseline ASCVD risk score. Results: The mean age of participants was 45 years; 49% were women, 60% were black, and 10% were current smokers. Mean systolic BP was 131.3±10.8 mm Hg, mean LDL cholesterol was 121±32 mg/dL, and mean HDL cholesterol was 48±14 mg/dL. Both DASH and F/V diets shifted the distribution of ASCVD risk scores downward compared to the control diet ( Figure, Panel A ). Compared to the control diet, the DASH and F/V diets reduced 10-year ASCVD risk by 10.0% (95% CI: -17.7, -1.5; P = 0.02) and 11.7% (95% CI: -19.3, -3.3; P = 0.007) respectively ( Figure, Panel B ). There was no difference between the DASH and F/V diets (-1.9%; 95% CI: -10.3, 7.4; P = 0.68). Conclusions: Compared to the control diet, the DASH and F/V diets reduced 10-year ASCVD risk, while the DASH and F/V had similar effects.
Abstract 12937: Single-cell Transcriptomic Analysis Reveals Developmentally Impaired Endocardial Population in Hypoplastic Left Heart Syndrome
Authors: Yifei Miao, Lei Tian, Marcy Martin, Sharon Paige, Francisco X Galdos, Soah Lee, Paul D Grossfeld, Seema Mital, Joseph C Wu, Marlene RABINOVITCH, Timothy J Nelson, Shuyi Nie, Sean M Wu, Mingxia Gu
Journal: Circulation (2020)

Hypoplastic left heart syndrome (HLHS) is one of the most challenging forms of congenital heart diseases. Previous studies were mainly focused on intrinsic defects in myocardium. However, this does not sufficiently explain the abnormal development of the cardiac valve, septum, and vasculature, known to originate from the endocardium. Here, using single-cell transcriptomic profiling, induced pluripotent stem cells (iPSC) derived endocardial cells (iEECs), human fetal heart tissue with underdeveloped left ventricle, as well as a Xenopus model, we identified a developmentally impaired endocardial population in HLHS. The intrinsic endocardial deficits contributed to abnormal endothelial to mesenchymal transition, NOTCH signaling, and extracellular matrix organization, all of which are key factors in valve formation. Consequently, in an endocardium-myocardium co-culture system, we found that endocardial abnormalities conferred reduced proliferation and maturation of iPSC derived cardiomyocyte (iPSC-CMs) judged by Ki67 staining, contractility, sarcomere organization, and related gene expressions through a disrupted fibronectin (FN1)-integrin interaction. Several recently described HLHS de novo mutations such as ETS1 and CHD7 showed reduced binding to FN1 promoter and enhancer in HLHS vs. control iEECs based on ChIP-qPCR analysis. Additionally, we found that suppression of the ETS1 in Xenopus caused reduced endocardial FN1 expression and impaired heart development. Supplementation of FN1 or ETS1 over-expression in HLHS iEECs could rescue dysfunctions in both endocardium and myocardium in HLHS. Our studies reveal a critical role of endocardial abnormality in causing HLHS, and provide a rationale for improving endocardial function in future regenerative strategies. Schematic illustration of the endocardial and myocardial defects in HLHS.
The Canadian paediatric brain tumour consortium (CPBTC): A model of cooperation using teleconferencing services
Authors: Bouffet E, Carret As, Crooks B, Hukin J, Eisenstat D, Wilson B, Odame I, Zelcer S, Johnston D, Silva M, Mpofu C, Samson Y, Brossart J, Moghrabi A, Strother D
Journal: Neuro-Oncology (2007)
Do serum ALT and quantitative HBV DNA levels predict histologic activity in patients with decompensated cirrhosis?: Analysis in explanted Liver
Authors: Jin Dong Kim, Jong Young Choi, Si Hyun Bae, Se Hyun Cho, Seung Kew Yoon, Jin Mo Yang, Jun Yeol Han, Nam Lk Han, Sang Wook Choi, Young Sok Lee, Chang Don Lee, Eun Sun Jung
Journal: Clinical and Molecular Hepatology (2008)