tbuckley/cabot-search huggingface dataset:
Abstract 12353: Unveiling the Hidden Insights: Cardiac Magnetic Resonance Radiomics Signature of the Myocardial Disease in Non-Ischemic Dilated Cardiomyopathy
Authors: Amine Amyar, Shiro Nakamori, Long H Ngo, Masaki Ishida, Satoshi Nakamura, Taku Omori, Keishi Moriwaki, Naoki Fujimoto, Kyoko Imanaka-Yoshida, Hajime Sakuma, Kaoru Dohi, Warren J Manning, Reza Nezafat
Journal: Circulation (2023)

Background: There is a growing interest in CMR radiomic signatures as novel imaging biomarkers of cardiac diseases. The relationship between CMR radiomic signatures and myocardial tissue composition is unknown. Goal: To investigate the association of CMR myocardial radiomic signatures to histological features in non-ischemic dilated cardiomyopathy (DCM). Methods: CMR images from 132 DCM patients (71% male; 54±15 years) who underwent CMR and endomyocardial biopsy within 6 [2-15] days were used to investigate the association between myocardial radiomic signatures measured from native T 1 , extra-cellular volume (ECV), LGE and histological features. Radiomic first-order and textural features were computed for each sequence from the mid-septal myocardium near the biopsy region (1023 features). We applied consensus clustering to identify distinct radiomic clusters. A single representative feature, the medoid, was identified within each cluster based on its minimal dissimilarity from other features. We built logistic regression models using one medoid per model to assess the association between each medoid and histological features. Results: Clustering analysis unveiled three radiomic clusters for each sequence. For native T 1 , the medoids were textural features, with medoids 1 and 2 exhibiting associations with fibrosis and myocyte hypertrophy (AUC of 0.71/0.74 and 0.78/0.69, respectively). ECV medoids included first-order and textural features. The first-order medoid was associated with myocyte hypertrophy (AUC=0.75), while medoid 3 (texture) was associated with fat replacement (AUC=0.81). LGE medoid 1 (first-order) was associated with inflammation (AUC=0.61) and vacuolization (AUC=0.76), while medoid 3 (texture), associated with fibrosis (AUC=0.69) and fat replacement (AUC=0.67) ( Figure 1 ). Conclusions: In DCM patients, CMR radiomic features were associated with myocardial tissue composition, as assessed by invasive biopsy.
Abstract 12256: The High FIB-4 Index is Independently Associated With an Increased Myocardial Extracellular Volume Fraction Quantified by Contrast-Enhanced Cardiac Magnetic Resonance Imaging
Authors: Hiroyuki Miura, Masahiro Koseki, Seiko Ide, kazuhiro nakao, Yasuhide Asaumi, Yoshiaki Morita, Yasutoshi Ohta, Tetsuya Fukuda, Katsunao Tanaka, Takashi Omatsu, Takeshi Okada, Teruo Noguchi, Yasushi Sakata
Journal: Circulation (2023)

Introduction: Liver fibrosis is associated with heart failure and left ventricular diastolic dysfunction. The fibrosis 4 (FIB-4) index is calculated from transaminases, age, and platelet count and can be used to screen patients with liver fibrosis. The myocardial extracellular volume fraction (ECVf) can be evaluated using contrast-enhanced cardiac magnetic resonance imaging (CMR). Hypothesis: ECVf is increased in patients with high FIB-4 index. AIMS: This study aimed to clarify the association between FIB-4 index and ECVf. Methods: A retrospective analysis was performed on patients aged ≥ 45 years with left ventricular ejection fraction (LVEF) &gt; 40 % who underwent CMR at two Japanese institutions. Patients were divided into 3 groups according to the FIB-4 index: Low: FIB-4 index &lt; 1.3; Intermediate: 1.3 ≤ FIB-4 index &lt; 2.67; High: 2.67 ≤ FIB-4 index. The association between the FIB-4 index and ECVf was evaluated using multiple regression analysis, with the FIB-4 index treated as a continuous and nominal variable. Results: A total of 244 patients were included in the analysis, 136 of whom underwent contrast-enhanced CMR and could be evaluated for ECVf. The ECVf of the high FIB-4 index group was significantly higher than that of the other two groups (High: 31.0 ± 4.3 %; Intermediate: 27.9 ± 3.4 %; Low: 27.6 ± 3.7 %. High vs. Intermediate, p = 0.014; High vs. Low, p = 0.008; Intermediate vs. Low, p = 0.65). Multivariate analysis showed that both the FIB-4 index (continuous variable) and high FIB-4 index (nominal variable) were associated with higher ECVf (continuous variable, p = 0.043; nominal variable, p = 0.016). Conclusions: The high FIB-4 index was independently associated with increased ECVf. In contrast, patients with the intermediate FIB-4 index did not have increased ECVf. These suggested the usefulness of FIB-4 index as a cardiac fibrotic parameter.
Abstract 13799: A Systems Approach to Target Discovery Identifies the Novel Role of lncRNA-SPANXA2-OT1 in Macrophage Chemotaxis
Authors: Prabhash K Jha, Lucas Y Itto, Aatira Vijay, Adrien Lupieri, Sarvesh Chelvanambi, Yuto Nakamura, Miguel C Barbeiro, Thanh-Dat Le, Taku Kasai, Dakota Becker-Greene, Abhijeet Sonawane, Sasha A Singh, Elena Aikawa, Shizuka Uchida, Masanori Aikawa
Journal: Circulation (2023)

Background: Coronary artery disease (CAD) remains the leading cause of mortality worldwide. Macrophages play a crucial role in recruiting immune cells and regulating the inflammatory milieu through the release of a diverse array of cytokines and chemokines in CAD. Long noncoding RNAs (lncRNAs) interact with DNA, RNA, miRNA, and proteins which makes them attractive therapeutic targets. We hypothesized that the lncRNA, SPANXA2-OT1 , regulates macrophage chemotaxis in CAD. Methods and Results: Gene-expression meta-analysis and weighted gene co-expression network analysis (WGCNA) of human CAD datasets identified 26 lncRNA-mRNA co-expression modules (Fig A). Network prioritization of top co-expression modules identified the SPANXA2-OT1 as a potential key candidate. The conservation analysis revealed that SPANXA2-OT1 is conserved only in primates. We validated the candidate coding-noncoding RNA regulatory triad in primary macrophages derived from healthy human PBMCs (n= 3-10). Loss-of-function experiments using antisense oligonucleotide (ASO) against SPANXA2-OT1 demonstrated decreased monocyte chemotaxis signature (Figure B and D), as recorded by unbiased global proteomics and RNA expression (IL8, CCL19 and CCL23) data. The expression of S PANXA2-OT1 was stimulated by IL1β (Fig C) and RNA in situ hybridization demonstrated it to be highly expressed in cytoplasm (Fig E) of macrophages. Luciferase assay established that SPANXA2-OT1 binds to miR-338 through its miRNA response elements (Fig F). Gain-of-function ( miR-338 mimic) and loss-of-function ( SPANXA2-OT1 ASO) experiments revealed that SPANXA2-OT1 : miR-338 axis regulates the expression of monocyte chemotactic genes (e.g., IL-8 ) that may contribute to the pathophysiology of CAD (Fig G and H). Conclusion: Our results indicate that the lncRNA SPANXA2-OT1 regulates chemokine signature in macrophages and may provide a molecular basis for the identification of novel therapeutic targets for CAD.
Abstract 12354: Patient-Reported Discordances in Atrial Fibrillation Care: Results From a Nationwide Survey Across Diverse Patient Populations
Authors: Larry R Jackson, Michelle Zhao, David Cappel, Jeffrey Carter, Cherilyn Heggen
Journal: Circulation (2023)

Background: Adverse outcomes associated with atrial fibrillation (AF) including increased rates of stroke and mortality have been documented in Black patients compared to White patients. Research Question: What are key factors that contribute to racial and ethnic disparities in AF outcomes? Methods: This project aimed to identify underlying drivers of health disparities in AF management through patient surveys. Between February-March 2022, PRIME Education conducted a nationwide online survey in patients with AF through a collaboration with StopAfib.org. Results: Of the participants who completed the survey, 878 self-identified as non-Hispanic White and 37 as Black. Compared to White patients, Black patients had increased prevalence of co-morbidities (hypertension, 76% vs. 52%, P = 0.006 ; diabetes, 27% vs 8%; P &lt; 0.001 ), increased hospitalizations due to AF-related causes (heart failure, 14% vs. 3%; P = 0.006 ), and more frequently experienced financial hardship affecting access to medical care (41% vs 17%, P = 0.001 ). Black patients were more likely to utilize primary care clinicians to manage AF compared to White patients (27% vs 5%, P &lt; 0.05 ) and were less likely to have undergone procedural rhythm control strategies (catheter ablation, 19% vs. 45%, P = 0.002 ; electrical cardioversion, 14% vs. 39%, P = 0.002 ) (Fig. 1). Conclusion: Findings from this patient survey highlight several intervenable factors including improved treatment of co morbid medical conditions, economic stability, and healthcare utilization that may contribute to disparities in AF management between Black and White patients with AF.
Abstract 13760: Systematic Review and Meta-Analysis of Clinical Outcomes in Cardiac Sarcoidosis: A Comprehensive Review
Authors: Jiyoung Seo, Daming Shao, Shaunak Mangeshkar, Natalia Nazarenko, Stepan Esagian, Sanjana Nagraj, Amrin Kharawala, Hansol Choi, Leonidas Palaiodimos, Damianos Kokkinidis
Journal: Circulation (2023)

Introduction: Cardiac sarcoidosis (CS), often overlooked due to its myriad and non-specific presentation, is mainly understood through small studies. Hypothesis: What comprehensive evidence exists regarding the cumulative clinical outcomes in CS patients? Methods: A literature search in PubMed and EMBASE was conducted until September 8, 2022. Data from Kaplan-Meier curves were reconstructed using WebPlotDigitizer, with subsequent analysis was conducted via Cox proportional hazards models and non-parametric methods. Results: We reviewed 183 studies with 29,830 CS-diagnosed patients, and CS predominantly affected middle-aged, White, and Black individuals, with data primarily derived from Europe, North America, and Japan. The prevalent arrhythmias were ventricular arrhythmias (25%) and conduction block (low-degree, 21%; high-degree, 15%). Steroids were the primary treatment, with implantable cardioverter-defibrillators (ICD) used in 20% of cases (Image 1) . Survival meta-analysis showed that immunosuppressants significantly lower mortality risk in CS patients (HR: 0.52, 95% CI: 0.38-0.7, p &lt; 0.0001) compared with the general CS population. ICD implanted for primary prevention in CS patients was associated with lower risk of inappropriate ICD therapy compared with ICD for secondary prevention (HR: 0.29, 95% CI: 0.19-0.44, p &lt; 0.0001). Post-transplant survival was superior in CS patients than non-CS patients (HR: 0.58, 95% CI: 0.46-0.72, p &lt; 0.0001) (Image 2) . Conclusions: This study is the first to provide comprehensive outcomes in CS patients. We encourage global research efforts to include underrepresented population in order to better understand CS.
Abstract 11590: Body Mass-Corrected Estimated Plasma Volume at Discharge Predicts Mortality of Heart Failure Patients With Non-Normal and Normal Left Ventricular Ejection Fraction
Authors: Kazuhiro Kuroda, Masamichi Tanaka, Akihisa Yumoto, Soichiro Fuke
Journal: Circulation (2023)

Introduction: Estimated plasma volume(ePV) is a parameter of body fluid volume and an indicator for residual congestion. Even in the era of novel cardioprotective drugs, achieving adequate body fluid volume with heart failure is sometimes challenging. We investigated the prognosis of heart failure patients with a one-time evaluation of ePV at discharge corrected by body mass index (BMI). Since current heart failure treatment algorithms follow different paths with left ventricular ejection fraction (LVEF), we also examined whether these groups have a difference in prognosis prediction. Methods: This is a single-center, prospective observational study. A total of 1427 consecutive heart failure hospitalizations, excluding acute coronary syndromes, were included from January 2018 to June 2022. We evaluated 858 patients, excluding repeat hospitalizations of the same patient, in-hospital deaths, transfers for cardiac surgery and forced discharges, and missing data. A prognosis investigation was conducted for all patients. BMI and ePV (ml, Hakim's formula) was calculated from height, weight, and hematocrit at discharge. Survival analysis was performed with ePV divided by BMI (ePV/BMI). The primary endpoint was all-cause death. Results: Median of 527 days of post-discharge observation, 286 deaths occurred. BMI and ePV at discharge show a positive significant correlation in both normal (≧50%) and non-normal LVEF (&lt;50%) groups. Among the mortality group during follow-up, ePV/BMI at discharge was significantly higher than the non-mortality group. Survival analysis with Kaplan-Meier curve by ePV/BMI three tertiles (Low, Medium, High) in normal (66.8% vs 50.1% vs 44.0%, Logrank P&lt;0.001), non-normal LVEF (72.2% vs 69.3% vs 49.6%, Logrank P&lt;0.001) and overall (70.6% vs 55.5% vs 47.4%, Logrank P&lt;0.001) population had a significantly worse three-year prognosis in the high ePV/BMI group. Multivariable Cox proportional hazard model with covariant univariable predictive factors shows higher ePV/BMI tertile, as well as a continuous variable of ePV/BMI, was predictive factor of death in normal, non-normal LVEF and overall population. Conclusions: Even after therapeutic intervention, ePV/BMI at discharge is a useful predictor of heart failure prognosis.
Abstract 12720: A Nationwide Multi Center Study From China, Comparing Long-Term and Standard Cardiopulmonary Resuscitation: Epidemiology, Risk Factors, and Outcomes
Authors: kui jin, Jun Xu, Yue G Wang, Wen w Wang, Yuan Yuan
Journal: Circulation (2023)

Introduction: The association between the duration of cardiopulmonary resuscitation (CPR) and patient outcomes remains largely unknown. Hypothesis: long-term CPR (LCPR) may benefit certain group of patients. Methods: In this retrospective cohort study, data from the Chinese Emergency Triage Assessment and Treatment database 1.0 (CETAT 1.0) were utilized. The study included CA patients admitted to 14 teaching hospitals in 7 provinces between July 2015 and July 2020. Patients were categorized into SCPR and LCPR groups based on the duration of resuscitation, where SCPR referred to CPR duration less than 60 mins, and LCPR referred to CPR duration equal to or more than 60 mins. The primary outcome measured was ROSC rates between the two groups, while the secondary and tertiary outcomes was 24-hour and 7-day survival rates. A multivariate logistic regression model was employed to analyze the factors influencing ROSC between groups. Results: A total of 529 patients were enrolled in the study, with 372 in the SCPR group and 157 in the LCPR group. Among them, 126 (33.9%) patients in the SCPR group and 56 (35.7%) in the LCPR group achieved ROSC without statistically difference between groups. Furthermore, 31 patients (8.3%) in the SCPR group and 7 patients (4.5%) in the LCPR group survived at 24 hours, while 13 patients (3.5%) in SCPR and 4 patients (2.5%) in LCPR group survived at 7 days, both without statistical difference. Factors associated with SCPR operation included Lower BMI, previous hypertension, daytime admission, hands-only compression, and ventilation. SpO2 and P ET CO2 were independent factors associated with ROSC, Moreover, in both groups higher SpO2 and P ET CO2 levels were associated with a higher rate of ROSC, suggesting that for this specific patient cohort, longer duration of CPR should be considered. Conclusions: Longer duration of CPR may need to be emphasize for certain group of patients, particularly those with high SpO2 and PET CO2 during CPR.
Abstract 11451: Development and Validation of the CANHEART Population-Based Laboratory Prediction Models for Atherosclerotic Cardiovascular Disease
Authors: Maneesh Sud, Atul Sivaswamy, Peter Austin, Robert J Hester, David Naimark, Michael E Farkouh, Douglas Lee, Idan Roifman, George Thanassoulis, Karen Tu, Jacob A Udell, Harindra C Wijeysundera, Dennis T Ko
Journal: Circulation (2023)

Background: The use of atherosclerotic cardiovascular disease (ASCVD) prediction models is suboptimal in clinical practice partly because of the need to gather history, physical and laboratory measures. Automation of risk assessment using only demographic and laboratory results may overcome this limitation. Our objective was to develop and validate sex-specific prediction models for ASCVD using age and routine laboratory tests and compare their performance to the Pooled Cohort Equations (PCEs). Methods: Models were derived and internally validated in Ontario residents aged 40 to 75 years without cardiovascular disease who had outpatient laboratory testing from April 1, 2009 to December 31, 2015. Estimates of the 5-year risk of ASCVD (myocardial infarction, stroke, death from ischemic heart or cerebrovascular disease) were obtained from Fine-Gray models that included age, total cholesterol, high-density lipoprotein cholesterol, triglycerides, hemoglobin, mean corpuscular volume, platelets, leukocytes, estimated glomerular filtration rate, and glucose as predictors. Models were externally validated in a primary care cohort assembled from electronic medical record data and compared with the PCEs. Results: Sex-specific models were developed and internally validated in 2,160,497 women and 1,833,147 men. They were well calibrated with less than 2% relative difference between mean predicted and observed risk. The C-statistic was 0.77 in women and 0.72 in men. External validation in 31,697 primary care patients demonstrated less than 15% relative and less than 0.3% absolute difference in mean predicted and observed risks ( Figure ). The C-statistics for the lab models were 0.72 for both sexes and were not significantly different from the C-statistics for the PCEs in women (p=0.18 for difference) or men (p=0.35). Conclusions: We developed and validated the CANHEART Lab Models that predict ASCVD with similar accuracy to more complex models such as the PCEs.
Abstract 11592: The Great Imitator: A Case of Lyme Carditis Mimicking ST Elevation Myocardial Infarction
Authors: Sacide S Ozgur, Muhammad Adil Afzal, Dhruv Patel, Nida Ansari, Arielle Aiken, Yezin Shamoon, Rachel Abboud, fayez shamoon
Journal: Circulation (2023)

Background: In the US, approximately 476,000 patients are diagnosed with Lyme disease annually. 1 to 5 % of patients with Lyme disease have cardiac involvement, predominantly conduction system abnormalities, less frequently endocarditis, valvular heart disease, and myopericarditis. We present a case of acute Lyme carditis mimicking ST-segment elevation myocardial infarction (STEMI). Case Presentation: A 31-year-old female with no past medical history presented to the hospital with chest pain, fatigue and chills for one day. She had a blood pressure of 101/61 mmHg, a heart rate of 88/minute, was afebrile, and saturating 99% on room air. Labs revealed elevated troponin of 8712 pg/ml and elevated C-reactive protein of 30 mg/l. EKG showed sinus rhythm with HR of 84, normal axis with ST elevation in leads II, III, AVF, and reciprocal ST segment depression in leads I and AVL. Decision Making: STEMI code was activated, patient's cardiac catheterization did not show any occlusion or left ventricle apical ballooning. Transthoracic echocardiogram was normal with left ventricular ejection fraction of 55 to 60% without wall motion abnormalities. Myopericarditis workup revealed ELISA Lyme Immunoglobulin (Ig)M antibodies with a negative IgG antibodies. Western blot test was positive for IgM, suggesting acute Lyme carditis. Patient's chest pain resolved with Celecoxib and Colchicine and treated with intravenous antibiotics. Conclusion: Lyme carditis mimicking acute coronary syndrome is rarely described in the literature. Lyme carditis should be considered in differential diagnoses in patients presenting with signs of myocardial ischemia with normal cardiac catheterization.
Abstract 12714: Superior Longitudinal Aortic Strain and Ventriculoarterial Coupling in Older Women is Independent of Body Size, Blood Pressure, and Moderately Correlated With Framingham 10-year Risk
Authors: JIE JUN WONG, Hongzhou Zhang, Fei Gao, Shuang Leng, Ru-San Tan, XIAODAN ZHAO, Kieran Tan, Liang Zhong, Angela Su-Mei Koh
Journal: Circulation (2023)

Background: Traditional risk factors are less helpful in predicting cardiovascular (CV) risk in women (1, 2). We used a novel cardiac MRI (CMR) method to determine sex differences in aortic global longitudinal strain (AoGLS), pulse wave velocity (AAPWV), and ventriculoarterial coupling (VAC) and correlated to Framingham Risk Scores (FRS). Methods: Community adults without CV disease underwent CMR. AoGLS was the maximal absolute Lagrangian strain tracking the phasic distance between brachiocephalic artery origin and aortic annulus. VAC was calculated as AAPWV divided by LVGLS. Sex-specific simplified FRS 10-year risk (TYR) and Heart/Vascular Age (HVA) were derived from pooled cohort equations (3). Results: These n=202 subjects (46% female) were similar in age (69.7 vs. 70.7, p=0.433). Women had better AAPWV (8.4m/s vs. 9.1m/s, p=0.020), AoGLS (6.2% vs. 5.2%, p=0.030), LVGLS (-21.9% vs. -20.1%, p=0.021), RVGLS (-32.8% vs. -29.9%, p=0.020), VAC (-0.39m/s·% vs. -0.47m/s·%, p=0.006), and smaller cardiac volumes (Table A). Female sex was associated with better AoGLS (β=0.838, p=0.030; R 2 =0.103) and VAC (β=-0.93, p=0.006; R 2 =0.113) independent of smoking, DBP, and BSA. Age only weakly correlated with AoGLS (β=-0.128 p&lt;0.001; R 2 =0.277). AoGLS correlated moderately with FRS in women (TYR r=-0.400 p=&lt;0.001; HVA r=-0.621 p&lt;0.001) and weakly in men (TYR r=-0.354 p=&lt;0.001; HVA r=-0.365 p=&lt;0.001). VAC was associated with adverse TYR (β=-6.915, p=0.017; R 2 =0.145) and HVA (β=-14.948, p=0.001; R 2 =0.084); VAC correlated moderately with FRS in women (TYR r=-0.233 p=0.024; HVA r=-0.364 p&lt;0.001) but not in men (TYR r=-0.175 p=0.068; HVA r=-0.183 p=0.056). Conclusion: Novel CMR-derived aortic strain identified sex differences in aortic age correlating with 10-year CV risk. Women had better aorto-ventricular strain and coupling independent of DBP and BSA. Chronological age was not useful in estimating aortic age. Advanced aortic imaging may augment CV risk assessment in women.