tbuckley/cabot-search huggingface dataset:
Abstract 17419: Gender Differences in Outcomes With Patients Undergoing Percutaneous Left Atrial Appendage Occlusion: Insights From the NCDR LAAO Registry
Authors: Douglas J Darden, Thao Duong, Mohamad B Munir, Frederick Han, Ryan Reeves, Chengan Du, Yongfei Wang, Karl E Minges, Jeptha P Curtis, James V Freeman, Jonathan C Hsu
Journal: Circulation (2020)

Introduction: Left atrial appendage occlusion (LAAO) has emerged as an alternative to anticoagulation in select patients with atrial fibrillation (AF), however women are underrepresented in trial data and sex-specific sub analyses are limited. Hypothesis: Women will be more likely than men to experience adverse events following left atrial appendage occlusion (LAAO) procedure. Methods: Using the National Cardiovascular Data Registry LAAO Registry, patients undergoing Watchman implantation between January 2016 and December 2018 were included. Unadjusted and multivariable adjusted logistic regression analyses were performed to assess the association between gender and in-hospital outcomes, including any complication, major adverse events (pericardial effusion, major bleeding, stroke, and device embolization), hospital stay &gt; 1 day, and mortality. Results: A total of 20,388 (41.3%) women and 28,969 (58.7%) men underwent Watchman implantation. Compared with male patients, women were older (76.5 vs 75.8 years, p&lt;0.001) with a higher CHA2DS2-VASc score (1.5 vs 1.4, p&lt;0.001), and higher prevalence of paroxysmal atrial fibrillation (59.0% vs 50.0%, p&lt;0.001), prior stroke (27.5% vs 26.7%, p=0.003) and uncontrolled hypertension (29.3% vs 26.7%, p&lt;0.001). Women had a lower prevalence of congestive heart failure (34.5% vs 39.7%, p&lt;0.001), diabetes (34.8 vs 39.7%, p&lt;0.001), and coronary artery disease (35% vs 55.7%, p&lt;0.001). There were no differences with increased thromboembolic risk or history of major bleed, while women were more likely to have a high fall risk (39.8% vs 33.5%, p&lt;0.001) and labile INR (9.1% vs 8.3%, p=0.003) as an indication for occlusion. After multivariable adjustment, women were more likely to have any complication (OR 1.62, 95% CI 1.62 - 1.77, p&lt;0.001), major adverse event (OR 1.81, 95% CI 1.61 - 2.04, p&lt;0.001), hospital stay &gt;1 day (OR 1.46, 95% CI 1.38 - 1.54, p&lt;0.001), and higher mortality (2.01, 95% CI 1.31 - 3.09, p=0.001). Conclusion: Women have a significantly higher risk than men of in-hospital adverse events and mortality following Watchman implantation. Further examination of the risk-benefit relationship of LAAO in women is warranted.
Heart Failure Association of the ESC, Heart Failure Society of America and Japanese Heart Failure Society Position statement on endomyocardial biopsy
Authors: Petar M. Seferović, Hiroyuki Tsutsui, Dennis M. McNamara, Arsen D. Ristić, Cristina Basso, Biykem Bozkurt, Leslie T. Cooper, Gerasimos Filippatos, Tomomi Ide, Takayuki Inomata, Karin Klingel, Aleš Linhart, Alexander R. Lyon, Mandeep R. Mehra, Marija Polovina, Ivan Milinković, Kazufumi Nakamura, Stefan D. Anker, Ivana Veljić, Tomohito Ohtani, Takahiro Okumura, Thomas Thum, Carsten Tschöpe, Giuseppe Rosano, Andrew J.S. Coats, Randall C. Starling
Journal: European Journal of Heart Failure (2021)
Abstract 048: Disparities In Gestational Diabetes Mellitus Among US- Vs. Foreign-born Women: An Analysis Of 2016-2017 National Health Interview Survey
Authors: Michelle Ogunwole, Ruth-Alma N Turkson-Ocran, Ellen Boakye, Wendy L Bennett, Lisa A Cooper, Andreea A Creanga, Garima Sharma, Xiaobin Wang, Yvonne Commodore-mensah
Journal: Circulation (2021)

Background: Gestational diabetes mellitus (GDM) is a common complication of pregnancy. Although GDM is associated with increased risk of cardiovascular disease it is unclear whether the associations between GDM prevalence and cardiometabolic risk factors differ between US- and foreign-born women and whether length of US residence influences these associations. Methods: We analyzed cross-sectional data from the 2016-2017 National Health Interview Survey among women currently living in the US who both reported ever being pregnant and responded to the survey question about GDM. Using generalized linear models with binomial distribution and logit link, we examined the prevalence of GDM by nativity status and length of US residence adjusting for potential confounders (Table). Results: Of 24,466 women, 14.3% were foreign-born. The crude prevalence of GDM was higher among foreign-born (9.0%) compared to US-born women (7.1%). Foreign-born women with ≥10 years of residence in the US had the highest age-standardized GDM prevalence (8.3%) compared to US-born (7.5%) and foreign-born women with &lt;10 years US residence (4.8%). Among women with a history of GDM, US-born women were more likely to be overweight/ obese, report a history of hypertension, be current smokers and alcohol drinkers than foreign-born women. Among foreign-born women, those with ≥10 years of US residence had higher prevalence of hypertension, smoking and alcohol use than those with &lt;10 years in the US. In the fully adjusted regression model, only foreign-born women with ≥10 years of residence in the US had a significantly higher prevalence of GDM than US-born women (PR=1.43; 95% CI:1.22-1.67). Conclusions: In this sample of women with self-reported GDM, greater length of US residence contributes to nativity-related disparities in GDM. Acculturation, including changing health-related behaviors, may have a larger impact on maternal health outcomes of foreign-born women, and should be a target of interventions to reduce GDM and future cardiovascular diseases.
Abstract P070: Longer Sleep Duration Is Associated With Less Myosteatosis In African Caribbean Adults
Authors: Adrianna I Acevedo-Fontanez, Ryan Cvejkus, Allison L Kuipers, Joseph Zmuda, Victor Wheeler, Iva Miljkovic
Journal: Circulation (2021)

Introduction: Skeletal muscle is the largest organ in the human body and vital to maintaining metabolic homeostasis. Increased skeletal muscle fat infiltration (i.e. myosteatosis) is now recognized as a major risk factor for cardio-metabolic diseases, independent of general obesity. Modifications in lifestyle, such as sleep, to reduce myosteatosis would be of great public health importance. However, studies of this relationship often use subjective data and are lacking in minority populations. The aim of this study was to examine the relation between objectively measured sleep duration and myosteatosis at the calf among African Caribbeans. Methods: Data were collected on men (n=393) and women (n=438) from the Tobago Health Study. Sleep duration and physical activity was collected using a SenseWear Pro Armband (BodyMedia, Inc.). Participants were instructed to wear the armband at all times, except in water, for 4-7 days. Measures of muscle density, intermuscular adipose tissue (IMAT), and area were obtained by peripheral QCT scans of the calf (Stratec XCT-2000). Model covariates included age, sex, BMI, diabetes, alcohol intake, smoking, and moderate to vigorous physical activity (MVPA). Linear regression was used to assess the relationship of sleep duration on skeletal muscle. Results: Mean sleep duration was 5.5 hours/day (Min 2.2, Max 11.6). Overall, participants were aged 58.7 years, had a BMI of 30.2 kg/m 2 , spent an average of 42 min/day in MVPA, and 18% were diabetic. In fully adjusted models, longer sleep duration was associated with smaller muscle area, but greater muscle density and less IMAT (all P&lt;0.03). There was no interaction of sleep and sex on muscle density, area and IMAT (p-value=0.5184; 0.2730; 0.0954). Conclusions: In African Caribbean men and women, longer sleep duration was associated with less myosteatosis, as well as, less muscle area at the calf. Further research is warranted to understand this relationship longitudinally in order to determine how it may inform lifestyle guidelines in the Caribbean.
Government should commit to making GP premises carbon neutral by 2030, say leaders
Authors: Gareth Iacobucci
Journal: BMJ (2021)

Local medical committees have urged the UK government to commit to making general practice premises carbon neutral by 2030 as part of wider efforts to tackle the climate crisis.

Representatives at the annual UK conference of local medical committees carried a motion to promote tackling climate change and the current ecological crisis in general practice, such as approving the use of active travel to …
Abstract 12570: Association Between Left Atrial Global Peak Longitudinal Strain and Tgfβ1 in Cardiovascular Surgery Patients
Authors: Hiroko Yazawa, Toshiaki Nakajima, Akiko Haruyama, Suguru Hirose, Shu Inami, Hiroyuki Kaneda, Hirohisa Amano, Fumiya Saito, Shoutarou Obi, Takuo Arikawa, Ikuko Shibasaki, Hirotsugu Fukuda, Shigeru Toyoda, Teruo Inoue
Journal: Circulation (2020)

Introduction: Atrial fibrosis plays an important role in atrial remodeling and the development of atrial fibrillation (AF). Transforming growth factor β1 (TGFβ1) is one of the major factors that accelerate atrial fibrosis. Left atrium global peak longitudinal strain (GPLS) measured by two-dimensional speckle tracking (2DS) method has been reported to be a useful method to predict the degree of atrial fibrosis. Hypothesis: To investigate the association between GPLS, Af and atrial fibrotic remodeling by analyzing fibrosis-relating gene expression including collagen type 1 (COL1A1), and TGFβ1 in cardiovascular surgery patients. Methods: Conventional echocardiography and 2DS method were performed in 117 patients (36 atrial fibrillation (Af) patients, 81 patients with sinus rhythm (SR), average age 69.7 years, 69 males) before cardiovascular surgery including cardiac valve replacement, and CABG. The fibrosis-relating gene expression such as collagen type 1 (COL1A1), COL4A1, TGFβ1, and connective tissue growth factor (CTGF) mRNA were analyzed by real-time reverse transcription polymerase chain reaction (RT-PCR) in 39 cases in which LA tissues were removed from the appendage during surgery. Results: GPLS was significantly negatively correlated with left atrial diameter (LAD), E/e‘, and left atrial volume index (LAVI). Expression of TGFβ1 in the atrium was positively correlated with expression level of Col1A1, Col4A1, and CTGF mRNA. GPLS was significantly negatively correlated with the expression of Col1A1 (r = -0.418, p = 0.015), TGFβ1 (r = -0.557, p = 0.000), and Col4A1 (r = -0.411, p = 0.013). However, no clear correlation was observed with LAD and LAVI. In multivariate analysis, unlike LAD and LAVI, GSLS was a clear predictor of Col1A1 expression, even when corrected with gender, age, brain natriuretic peptide (BNP), and type of heart rhythm (Af, sinus rhythm). On the other hand, TGFβ1 concentration in blood did not correlate with TGFβ1, Col1A1 and Col41A mRNA expression level in the atrium. Conclusions: Low LA GPLS exhibits increased atrial fibrosis reflected by collagen and TGFβ1 expression , irrespectively of heart rhythm (Af or sinus rhythm), and becomes an extremely useful marker for predicting LA fibrosis in cardiovascular surgery patients.
Abstract P037: Progression Of Coronary Artery Calcification And Risk Of Clinical Events In Chronic Kidney Disease
Authors: Joshua D Bundy, Ling Tian, Matthew J Budoff, Julia J Scialla, Rupal Mehta, Georges Saab, Bernard Jaar, Mirela A Dobre, Muredach P Reilly, Daniel J Rader, Raymond R Townsend, James Lash, Philip Greenland, Tamara Isakova
Journal: Circulation (2021)

Introduction: Patients with chronic kidney disease (CKD) are at high risk for cardiovascular disease (CVD) events. Coronary artery calcification (CAC) and progression of CAC are associated with higher risk of clinical events in the general population, but this has not been quantified among patients with CKD. Hypothesis: Progression of CAC is independently associated with CVD events and mortality among patients with CKD stages 2-4. Methods: We pooled individual-level data from 2 prospective longitudinal cohort studies (the Chronic Renal Insufficiency Cohort [CRIC] Study and the Multi-Ethnic Study of Atherosclerosis [MESA]). We included participants with CKD, defined as an estimated glomerular filtration rate &lt;60 mL/min/1.73m 2 or urinary albumin-to-creatine ratio ≥30 mg/g. In both cohorts, CAC was measured at baseline and a follow-up visit using electron beam or multidetector computed tomography. Multivariable-adjusted Cox proportional hazards regression models were used to assess the associations of CAC progression between visits with risks of adjudicated atherosclerotic CVD events (myocardial infarction, stroke) and all-cause mortality. Analyses were stratified by presence or absence of CAC at baseline. Results: 2111 participants with CKD were included (1314 with and 797 without CAC at baseline). Over an average of 3 years between CAC scans, 192 (24%) participants without baseline CAC developed CAC while 222 participants (17%) with baseline CAC increased ≥100 Agatston units per year. Over an average 9.4-year follow-up after the second CAC scan, we observed 272 atherosclerotic CVD events (178 myocardial infarction, 94 stroke) and 570 deaths. After multivariable adjustment, CAC progression was significantly associated with higher risk of atherosclerotic CVD and mortality, particularly among those with CAC at baseline (Table). Conclusions: Among adults with CKD stages 2-4, progression of CAC over approximately 3 years is significantly associated with atherosclerotic CVD and mortality.
An atlas of alternative polyadenylation quantitative trait loci contributing to complex trait and disease heritability
Authors: Lei Li, Kai-Lieh Huang, Yipeng Gao, Ya Cui, Gao Wang, Nathan D. Elrod, Yumei Li, Yiling Elaine Chen, Ping Ji, Fanglue Peng, William K. Russell, Eric J. Wagner, Wei Li
Journal: Nature Genetics (2021)
Inhibition of DNA-PK with AZD7648 Sensitizes Tumor Cells to Radiotherapy and Induces Type I IFN-Dependent Durable Tumor Control
Authors: Kyoko Nakamura, Ankur Karmokar, Paul M. Farrington, Neil H. James, Antonio Ramos-Montoya, Susan J. Bickerton, Gareth D. Hughes, Timothy M. Illidge, Elaine B. Cadogan, Barry R. Davies, Simon J. Dovedi, Viia Valge-Archer
Journal: Clinical Cancer Research (2021)

Combining radiotherapy (RT) with DNA damage response inhibitors may lead to increased tumor cell death through radiosensitization. DNA-dependent protein kinase (DNA-PK) plays an important role in DNA double-strand break repair via the nonhomologous end joining (NHEJ) pathway. We hypothesized that in addition to a radiosensitizing effect from the combination of RT with AZD7648, a potent and specific inhibitor of DNA-PK, combination therapy may also lead to modulation of an anticancer immune response.
Abstract 342: Serum Albumin Hydrogels Alter Excitation-Contraction Coupling in Neonatal Rat Myocytes and Human Induced Pluripotent Stem Cell Derived Cardiomyocytes
Authors: Eleanor J Humphrey, Manuel M Mazo, Nadav Amdursky, Nicholas S Peters, Molly M Stevens, Cesare M Terracciano
Journal: Circulation Research (2017)

Tissue engineering provides a promising method of introducing functional cardiomyocytes (CMs) to damaged myocardium after myocardial infarction; however, finding a biocompatible construct with the chemical and mechanical properties capable of supporting CM function is challenging. Serum albumin hydrogels are novel autogenic scaffolds with elastic properties that can be tailored to mimic the stiffness of native adult myocardium. We assessed the hypothesis that culturing immature CMs on these serum albumin hydrogels would affect CM gene expression and calcium handling. Neonatal cardiomyocyte (NRVM) viability was maintained for at least 14 days on the hydrogels, with clear sarcomeric striations. Cardiac gene expression was quantified using RT-qPCR and demonstrated an up regulation in many genes of cells cultured on hydrogels compared to glass (e.g. relative expression (log 2-ΔΔCt) of ryanodine receptor 2: glass= -2.3±0.5, hydrogel= -0.3±0.1,p&lt;0.01; connexin 43:glass= -1.7±0.5, hydrogel= 0.3±0.1,p&lt;0.01,n=4-6). Compared to glass, NRVMs on hydrogels have an increased time to peak of the calcium transients measured using Fluo-4AM and field stimulated at 1 Hz (tp glass=38±3 ms, tp hydrogel= 54±2 ms, p&lt;0.01,n=4-6). Compared to glass the hydrogels also have a reduced time 50% decay (t50 glass=108±13 ms, t50 hydrogel=78±6 ms, p&lt;0.05,n=4-6) and 80% decay (t80 glass=217±19 ms, t80 hydrogel= 152±10 ms,p&lt;0.05,n=4-6). Human induced pluripotent stem cell derived cardiomyocytes (iPSC-CMs) were cultured on the hydrogels for up to 28 days. Calcium handling was faster in the iPSC-CMs cultured on the hydrogels in comparison to glass with a reduced time to peak (tp glass=281±43 ms, tp hydrogel= 186±8 ms, p&lt;0.05, n=4) and time to 50% decay (t50 glass=269±15 ms, t50 hydrogel=204±10 ms,p&lt;0.01,n=4) and 90% decay (t90 glass=535±33 ms, t90 hydrogel=397±19 ms, p&lt;0.01,n=4). The serum albumin hydrogels are compatible with NRVM and iPSC-CM culture for at least 28 days. We demonstrate that the serum albumin hydrogels have significant effects on CM calcium cycling and have the potential for use in myocardial repair. Further study is required to determine the mechanisms involved in calcium handling alterations and then assess this engineered patch in vivo for cardiac repair.
Abstract 15360: Coronary Artery Dominance, Anatomical Variants and Anomalies in African American Population
Authors: Hilda M Gonzalez Bonilla, Nitheesha Ganta, Ahmad A Awan, Isaac Opoku Asare
Journal: Circulation (2020)

Introduction: Coronary arterial dominance is defined by the vessel which gives rise to the posterior descending artery (PDA). The prevalence of right dominance is 80- 85%, left dominance is 8% and codominance is 7% among the general population. The coronary dominance in African Americans is not well known. The aim of this study was to investigate the coronary dominance in African Americans. Previous studies showed that left dominance and codominance are associated with increased post-percutaneous coronary intervention (PCI) in-hospital mortality in patients with acute coronary syndrome (ACS). Methods: A retrospective analysis of coronary angiograms performed in our facility was done. A total of 556 cases were reviewed from 2018 to 2019. All the data was collected from the electronic medical records. Patients were categorized by race, gender, age, and comorbidities. Angiograms were reviewed and coronary dominance was determined by the vessel which supplied the PDA. Results: From the 556 charts reviewed, 430(77%) cases were performed in African Americans. Of the 430 patients, 220(51%) were male and 210(49%) were female. Mean age was 62.6 years. 370(86%) patients had hypertension, 171(39.7%) had diabetes, 28(6.5%) had peripheral vascular disease, 149(34.6%) had heart failure, 33(7.6%) had history of stroke. 28(6.5%) were on dialysis, 201(46.7%) had dyslipidemia, 14(3.2%) had HIV, 43 (10%) had atrial arrhythmias, 237(55.1%) had history of tobacco use and 21(4.8%) had history of cocaine use. In 390(90.7%) patients, left main coronary artery bifurcated into left anterior descending coronary artery (LAD) and left circumflex artery (LCX). In 40(9.3%) patients, left main coronary artery trifurcated into LAD, LCX and ramus intermedius artery. Among these patients, 303(70.4%) had right coronary dominance, 38(8.8%) had left coronary dominance and 89(20.7%) had codominance. 7 patients had ectasia of the coronary vessels and 8 patients had anomalous origin of coronary vessels. Conclusions: Our study showed that African Americans have higher prevalence of codominance compared to general population. It is important to identify it at the time of coronary angiogram since it has been associated with increased post PCI in-hospital mortality in patients with ACS.
Isotope tracing in adult zebrafish reveals alanine cycling between melanoma and liver
Authors: Fuad J. Naser, Madelyn M. Jackstadt, Ronald Fowle-Grider, Jonathan L. Spalding, Kevin Cho, Ethan Stancliffe, Steven R. Doonan, Eva T. Kramer, Lijun Yao, Bradley Krasnick, Li Ding, Ryan C. Fields, Charles K. Kaufman, Leah P. Shriver, Stephen L. Johnson, Gary J. Patti
Journal: Cell Metabolism (2021)
In vitro differentiation of CD34+ hematopoietic progenitor cells toward distinct dendritic cell subsets of the birbeck granule and MIIC- positive Langerhans cell and the interdigitating dendritic cell type
Authors: B Herbst, G Kohler, A Mackensen, H Veelken, P Kulmburg, FM Rosenthal, HE Schaefer, R Mertelsmann, P Fisch, A Lindemann
Journal: Blood (1996)
Abstract 17018: Left Ventricular Assist Device Failure With Total Artificial Heart Bridge to Heart Transplant
Authors: Zackary Tushak, Taylor Wood, Mohammed Quader, Keyur B Shah
Journal: Circulation (2020)

Mechanical support devices are used in cardiogenic shock as a bridge to heart transplantation (OHT) or as a destination treatment. The two long term variants are left ventricular assist devices (LVADs) and total artificial hearts (TAHs). Developed in tandem, LVADs have gained favor, but are not without limitations. Adverse events include thrombosis, bleeding, mechanical failures, ventricular arrhythmias (VAs), and right ventricular failure (RVF). When LVADs fail, often the only options becomes OHT or TAH implantation. This case series retrospectively follows ten patients requiring TAH implantation due to LVAD failure between 12/2009-09/2018 at VCU Health. On admission, all were in multiorgan failure with four requiring hemodialysis and two requiring intubation. Eight patients required extra support including pressors, inotropes, and additional mechanical support. The causes of failure included refractory infection, outflow graft mechanical compromise, right ventricular failure, VAs, and pump thrombosis. The mean time from admission to TAH was 13.5 days. Major adverse events included mediastinal hematoma with tamponade in three patients requiring surgical intervention and one patient with an acute cerebral vascular attack who died. One patient died from ongoing respiratory failure. Another patient died from multiorgan failure and hemorrhage. Of the seven surviving patients, all underwent successful OHT and were alive at one year follow-up. The patients who experience LVAD failure are extremely sick and have limited options. TAH implantation, while not without risk, can be a useful tool to bridge patients to transplant with favorable outcomes.