tbuckley/cabot-search huggingface dataset:
Abstract 264: Bystander-initiated Cardiopulmonary Resuscitation in an Asian Community: Does the Socioeconomic Status Matter?
Authors: Wen-Chu Chiang, Patrick Chow-In Ko, Anna Marie Chang, Wei-Ting Chen, Yu-Sheng Huang, Shey-Ying Chen, Bin-Chou Lee, Mei-Shu Lai, Matthew Huei-Ming Ma
Journal: Circulation (2013)

Objectives: To determine the association of neighborhood socioeconomic status (SES) with bystander-initiated cardiopulmonary resuscitation (CPR) and patient outcomes of out of hospital cardiac arrests (OHCAs) in an Asian Metropolitan area. Methods: We performed a retrospective study in a prospectively collected cohort from an Utstein registry of adult non-traumatic OHCAs in Taipei, Taiwan. Average real estate value was assessed as the first proxy of SES. Twelve administrative districts in Taipei City were categorized into low versus high SES areas to test the association. Primary outcome was bystander-initiated CPR, and secondary outcome was patient survival status. Factors associated with bystander-initiated CPR were adjusted for in multivariate analysis. The mean household income was assessed as the second proxy of SES to validate the association. Results: From Jan. 1, 2008 to Dec. 30, 2009, 3573 OHCAs received prehospital resuscitation in the community. Among them, 617 (17.3%) cases received bystander CPR. Proportions of bystander CPR in low SES vs. high SES areas were 14.5% vs. 19.6% (p&lt;0.01). Odds ratio (OR) of receiving bystander-initiated CPR were 0.72 (95% confidence interval (CI) 0.60-0.88) in low SES areas after adjusted by age, gender, witnessed status, public collapse, and unrecognized OHCA by online dispatcher. Survival to discharge rate was significantly lower in low SES areas vs. high SES areas (4.3% vs. 6.8%; p&lt;0.01). All results above remained consistent in analyses by mean household income. Conclusions: Patients who had an OHCA in low SES areas were less likely to receive bystander CPR, as well as worse survival outcomes.
Abstract 16646 : The Left Atrium Emptying Fraction Improves Diagnosis of Paroxysmal Atrial Fibrillation after Cryptogenic Ischemic Stroke: Results from The SURPRISE Study
Authors: Tor Biering-Sørensen, Louisa M. Christensen, Derk W. Krieger, Rasmus Mogelvang, Jan Skov Jensen, Søren Højberg, Nis Høst, Finn Michael Karlsen, Hanne Christensen
Journal: Circulation (2013)

Tor Biering- Sorensen, 2013 Finalist and Presenting Author
Abstract 9535: Image-Based Validation of Left Ventricular Mass and Stroke Volume in Fetal Sized Hearts Using 4D Nongated Echocardiography
Authors: Kevin Truong, Kaavya Mandi, Christine Kang, Meihua Zhu, Muhammad Ashraf, Cole Streiff, David J Sahn
Journal: Circulation (2013)

Background: The non-gated 4D echocardiogram is the most recently developed tool for visualizing cardiac mechanics without the requisite use of electrocardiogram (EKG) wires. This study was designed to determine the left ventricular (LV) stroke volume (SV) and mass (LVM) of fetal heart models using non-gated 4D echo. Methods: 4D volumes of fetal heart models (rabbit LVs) were acquired at five different stroke volumes (SV) between 1 and 5mL with an X6-1 matrix transducer interfaced with a Philips® iU22 ultrasound system. Data was collected at two different stroke rates (SR), 40 and 80 strokes per minute, for each SV and analyzed offline with QLab®. LVM and SV were calculated in QLab® according to stacked endocardial and epicardial ellipses and compared to displacement data. Results: We found no significant difference between the displacement and 4D echo-derived values for LVM (R 2 =0.98, p&lt;0.01) and SV (R 2 =0.92, p&lt;0.01). It was also determined that 97% of the data was contained within a 95% confidence interval (CI) in a Bland-Altman analysis. Conclusions: Thus, we determined that the new Philips® iU22 4D echocardiogram is an accurate way to measure the LV mass and SV of fetal hearts.
Abstract 9545: Airway Management and Outcomes After Out of Hospital Cardiac Arrest in the CARES Network
Authors: Jason T McMullan, Bryan McNally, Ryan Gerecht, Jordan Bonomo, Rachel Robb, Henry E Wang
Journal: Circulation (2013)

Introduction: While commonly performed during out of hospital cardiac arrest (OHCA) resuscitation, the optimal airway management strategy [endotracheal intubation (ETI), supraglottic airway (SGA), or no advanced airway device] remains unclear. Hypothesis: We tested the following hypotheses: 1) ETI and SGA result in similar rates of neurologically intact OHCA survival, and 2) compared with [ETI or SGA], the use of no advanced airway device results in similar rates of neurologically intact OHCA survival. Methods: We studied adult OHCA cases from 2011 with airway management information in the Cardiac Arrest Registry to Enhance Survival (CARES), a large multicenter North American OHCA registry. Primary exposures were: 1) ETI, 2) SGA, 3) no advanced airway. Primary outcomes were: 1) sustained ROSC, 2) ED survival, 3) survival to hospital discharge, 4) neurologically intact survival to hospital discharge (cerebral performance category 1-2). We defined propensity scores to characterize the probability of receiving ETI, SGA or no advanced airway. Using multivariable random effects regression to account for clustering by EMS agency, we compared outcomes between 1) ETI vs. SGA, and 2) [no advanced airway] vs. [ETI or SGA]. We adjusted for Utstein confounders (age, sex, race, witnessed arrest, use of AED initial rhythm, public location, response time) and propensity score. Results: Of 10,691 OHCA, there were 5591 (52.6%) ETI, 3110 (29.3%) SGA, and 1929 (18.2%) with no advanced airway. Unadjusted neurologically intact survival was: ETI 5.4%, SGA 5.2% and no advanced airway 18.6%. Compared with SGA, patients receiving ETI achieved higher sustained ROSC (OR 1.35; 95% CI 1.19-1.54), ED survival (1.36; 1.19-1.55), hospital survival (1.41; 1.14-1.76) and hospital discharge with good neurologic outcome (1.44; 1.10-1.88). Compared with [ETI or SGA], patients receiving no advanced airway attained higher ED survival (1.31; 1.16-1.49), hospital survival (2.96; 2.50-3.51) and hospital discharge with good neurologic outcome (4.24; 3.46-5.20). Conclusions: OHCA in the CARES network receiving no advanced airway exhibited superior outcomes than those receiving ETI or SGA. When an advanced airway was used, ETI was associated with improved outcomes compared to SGA.
Abstract 250: The Association of Advanced Age and Outcomes in Targeted Temperature Management After Out-of-hospital Cardiac Arrest
Authors: Raghu R Seethala, David P Yamane, Kathleen R Avery, Molly H O’Brien, Michael G Kyller, Karen M Griswold, Carol D Pierce, Paul Szumita, Peter H Stone, Anthony F Massaro, Galen V Henderson, David A Morrow, Benjamin M Scirica
Journal: Circulation (2013)

Background: Therapeutic hypothermia or targeted temperature management (TTM) is the only therapy shown to improve neurologically intact survival post cardiac arrest. One of the original randomized control trials evaluating TTM, excluded patients older than 75. Advanced age has been associated with poor outcomes following cardiac arrest. However, investigations have shown that elderly patients that actually survive cardiac arrest may go on to have good outcomes. Given these findings it is unclear whether TTM benefits elderly patients. Objectives: We hypothesized that in patients undergoing TTM, advanced age would be associated with decreased survival to discharge as well as decreased neurologically intact survival. Methods: We performed a retrospective single center study of 140 patients who underwent TTM after cardiac arrest over a four-year period. Patients were analyzed based on advanced age defined as age greater than or equal to 80. The primary outcomes were survival to discharge and neurologically intact survival defined as a CPC score of 1 or 2. We compared baseline characteristics including: initial lactate, witnessed arrest, down time, initial cardiac rhythm, bystander CPR and vasopressor use. Results: A total of 140 patients underwent TTM (12 patients with advanced age vs. 128). Fewer patients survived in the advanced age group (8.3% vs. 43% p =0.01), and fewer survived with good neurologic function (8.3% vs. 35.9% p = 0.03). Baseline characteristics were similar except for a lower proportion of VF/VT in the advanced age group (16.7% vs. 52.8% p=0.01). After adjusting for these characteristics, advanced age was still associated with decreased survival (p = 0.04), but not with decreased neurologically intact survival (p =0.15). When age greater than or equal to 75 years was chosen as the cut off for advanced age, survival to discharge was 17.4 % (4/23) with all survivors having good neurologic function. Conclusions: Age greater than 80 was associated with decreased survival to discharge but not with decreased neurologically intact survival. Additionally, all of the survivors 75 or older had good neurologic outcomes. Further study is needed to establish the benefits of TTM in the elderly.
Abstract 9820: Catheterization Diastolic Pressures Correlate With Diastolic Dyssynchrony in Patients With Single Right Ventricles
Authors: Corey Stiver, Janaki Gokhale, Nazia Husain, Lisa Nicholson, Joyce Cordier, Lindsey Van Lente, Ralf J Holzer, Clifford L Cua
Journal: Circulation (2013)

Introduction: Diastolic dyssynchrony is increasingly being recognized in both the adult and pediatric population. Increasing diastolic dyssynchrony has correlated with increased pulmonary capillary wedge pressures and worse clinical outcomes in patients with normal cardiac anatomy. No data exist in patients with single right ventricle (sRV) physiology. Goal of this study was to determine if diastolic dyssynchrony in patients with sRV physiology correlates with ventricular end-diastolic pressures (VEDP) obtained via cardiac catheterization. Methods: Tissue Doppler imaging (TDI) and strain rate (SR) analysis of sRV patients undergoing catheterization were performed. TDI analysis was performed at the level of the atrioventricular valve. Time interval from onset of QRS to peak TDI e’ wave of the respective walls was obtained. Differences in intervals were calculated: QRS(RV) - QRS(IVS) and QRS(RV) - QRS(LV). The sRV was separated into a six segment model for SR analysis. Time interval from onset of QRS to peak SR early diastolic wave (SRe) wave was obtained for the six segment model sRV. Standard deviation of the six SRe time intervals was calculated. VEDP was obtained from the catheterization report. Correlation of VEDP with timing intervals was analyzed via Pearson correlation. Results: Forty sRV patients were evaluated: 27 hypoplastic left heart syndrome, 9 double outlet right ventricles, 4 unbalanced atrioventricular septal defects. Age was 2.8 ± 3.5 years. Catheterization VEDP of the sRV was 9.3 ± 3.9 mmHg (median 8 mmHg range 4 - 24 mmHg). QRS(RV) - QRS(IVS) was 22.3 ± 18.1 msec and QRS(RV) - QRS(LV) was 23.7 ± 19.0 msec. SRe standard deviation of the sRV was 61.6 ± 23.9 msec. There was no significant correlation with VEDP and QRS(RV) - QRS(VS) (r = 0.1, p = NS) or with QRS(RV) - QRS(LV) (r = 0.2, p = NS). There was a significant correlation of VEDP with the SRe standard deviation value (r = 0.4, p &lt; 0.05). Conclusion: Diastolic dyssynchrony, measured via SR analysis, correlated with VEDP in patients with sRV physiology. Future studies are needed to determine if this measurement is beneficial for either monitoring or treatment purposes in this complex patient population.
Abstract 9468: Exploring the Missing Heritability of Complex Traits: Multiple Associated Variants Increase the Heritability Explained for Plasma Lipids and Coronary Artery Disease
Authors: Hayato Tada, Hong-Hee Won, Jian Yang, Gina M Peloso, Ron Do, Sekar Kathiresan
Journal: Circulation (2013)

Background: Plasma lipid levels as well as coronary artery disease (CAD) have been shown to be highly heritable-estimates range from 40%-60%. However, top variants detected by large-scale genome-wide association studies (GWAS) could explain only a fraction of the total variance in these phenotypes, raising the challenge for “missing heritability” to which multiple variants at a loci may contribute. Recently, a conditional and joint association analysis tool using summary-level statistics has been developed. Methods and Results: We performed a conditional and joint association analysis using GWAS summary-level statistics from two large consortiums: (1). the Global Lipids Genetics Consortium (GLGC) study, and (2). the CAD from the Coronary ARtery DIsease Genome-wide Replication and Meta-analysis (CARDIoGRAM) study. These studies included up to 100,184 individuals from 46 studies for lipids, and 22,233 cases and 64,762 controls from 14 studies for CAD, respectively. We detected a number of loci which represent multiple associated independent SNPs with lipid traits within a locus (12 at 33 loci for high-density lipoprotein cholesterol [HDL-C], 10 at 35 loci for low-density lipoprotein cholesterol [LDL-C], 13 at 44 loci for total cholesterol [TC], and 8 at 28 loci for triglycerides [TG]) with genome-wide significance (p &lt; 5x10 -8 ), nearly doubling the heritability explained by the previous GWAS results (3.6% to 7.6% for HDL-C, 4.9% to 8.8% for LDL-C, 5.4% to 8.8% for TC, and 5.7% to 8.5% for TG). Multiple SNPs were also associated with CAD (3 at 15 loci, 9.6% to 11.4% of increased heritability). Among them, 9 SNPs in the CETP locus could explain as much as 2.6% of variance explained in HDL-C, 9 SNPs in the APOE locus explained 2.1% of that in LDL-C, 6 SNPs in the APOE locus explained 1.1% of that in TC, 7 SNPs in the LPL locus explained 1.7% in that of TG, and 2 SNPs in the CDKN2A/CDKN2B locus explained 2.8% of that in CAD trait. The prediction analysis validated our results. Conclusions: A portion of the missing heritability for lipid traits and CAD could be explained by joint effects from multiple variants at each locus. There should be multiple causal variants within a single locus, providing deeper understanding for various complex heritable traits.
Abstract 258: The Effectiveness of Therapeutic Hypothermia in Patients Suffering From Asphyxia Cardiac Arrest
Authors: Jung Hee Wee, Jeong Ho Park, Chun Song Youn, Kyu Nam Park, Seung Pill Choi, Korean Hypothermia Network Investigators
Journal: Circulation (2013)

Introduction: Therapeutic hypothermia (TH) is recommended for comatose survivors of cardiac arrest; however, the effectiveness of TH provided to asphyxial cardiac arrest has not been studied. So, we aimed to describe the characteristics and outcome among patients with out-of-cardiac-arrest caused by asphyxia, who were treated with TH. Patients and methods: We performed a multicenter retrospective registry-based study of adult OHCA patients treated with TH presenting to 24 hospitals across South Korea during the period from January 2007 to December 2012. Comatose survivors who were treated with TH after asphyxial cardiac arrest were included, but hanging and gas intoxication were excluded. Results: Of a total of 930 OHCA patients entered in the registry, 111 patients were enrolled in this study. The mean age was 65.8±16.3 years and old age (≥65) was 68 cases (61.3%). Most cases (85, 76.6%) were witness cardiac arrest, but few were provided bystander CPR (26, 23.4%). First monitored rhythms were almost non-shockable (80, 72.1%), and 23 (20.7%) had previous lung disease. TH were started within 121.9 (±152.4) min after ROSC, target temperature were achieved in 168 (±173.3) min, and maintained 23.6 (±10.6) hr. Intravascular cooling technique was performed in 34 cases (30.6%). 52 patients (46.8%) were survived and good neurologic outcome (CPC 1, 2) was 6 cases (5.4%). Witnessed status, age, previous lung disease, bystander CPR and any time factor were not correlated with survival and good neurologic outcome except ROSC time from detection in favorable outcome (p=0.005). Conclusion: The effectiveness of TH in axphyxial cardiac arrest was low, but quick achievement of ROSC would increase the favorable neurologic outcome proportion. proportion.
Abstract 10093: Obesity paradox is not recognized in chronic heart failure patients with metabolic syndrome
Authors: Taro Narumi, Tetsu Watanabe, Shinpei Kadowaki, Yoichiro Otaki, Satoshi Nishiyama, Hiroki Takahashi, Takanori Arimoto, Tetsuro Shishido, Takehiko Miyashita, Takuya Miyamoto, Isao Kubota
Journal: Circulation (2013)

Taro Narumi, 2013 Finalist and Presenting Author
Abstract 9786: Wnt11 Regulates Angiogenesis Through a Non-canonical Wnt-PKC-JNK Pathway
Authors: Jingcai Wang, Bin Yu, Min Gong, Yi-Gang Wang, Ronald Millard, Muhammad Ashraf, Meifeng Xu
Journal: Circulation (2013)

Wnt11 has been implicated in stem cell proliferation and differentiation. However, its role in angiogenesis remains largely unknown. We investigated angiogenic role of Wnt11 on human vascular endothelial cells (HUVECs) and documented its related signaling pathways. HUVECs pre-labeled with PKH26 were seeded in BD Matrigel Matrix (growth factor reduced) at 1.5х10 4 /cm 2 and treated with recombinant Wnt11 proteins at 5μg/ml. Both the length and the number of capillary-like tubes (CLT) were measured after HUVECs were treated for 18 hours. Wnt11 significantly increased the number and length of CLT (Fig. A). The migration of HUVECs assessed with the BD Biocoat™ Angiogenesis System was also promoted by Wnt11 (Fig. B). Immunostaining (Fig. C) and Western blotting (Fig. D) results revealed upregulation of p-pan-PKC and p-JNK in HUVECs transfected with Wnt11 (H Wnt11 ) compared to control cells transduced with empty vector (H GFP ). Moreover, the effect of Wnt11 on CLT formation and HUVECs migration were abrogated when the JNK inhibitor SP600125 (SP) at 5 μM and the PKC inhibitor Calphostin-C (Cal-C) at 0.1 μM were added to the culture system (Fig. E and F). Our data suggested, for the first time, that Wnt11 promotes endothelial cell migration and capillary formation, which is related to the activation of the non-canonical Wnt-PKC-JNK pathways.
Abstract 9898: Aldosterone, Cardiorenal and Metabolic Disease in a General Community in Olmsted County, Minnesota: Biomarker and/or Mediator
Authors: Alessia Buglioni, Valentina Cannone, Alessandro Cataliotti, Denise M Heublein, Christopher G Scott, Kent R Bailey, Richard J Rodeheffer, Riccardo Sarzani, John C Burnett, Jr
Journal: Circulation (2013)

Introduction: Aldosterone (Aldo) increases sodium and water reabsorption and mediates inflammatory processes. Its relationship to co-morbidities has not been well defined in the general population. Hypothesis: We addressed the hypothesis that plasma aldosterone concentration (PAC) is associated with metabolic and cardiorenal diseases in the general community. Methods: We determined PAC in a general community-based cohort from Olmsted County, MN (n=1,674), and defined correlations with cardiorenal, metabolic diseases and myocardial function and structure. Results: PAC was detected in all subjects and ranged from 2.5 to 91 ng/dl (mean value 6.7 ng/dl, +/- SD 6.6). Multivariate analysis adjusted for age, gender, BMI, ANP and BNP showed highly significant correlations between PAC and hypertension (HTN) (p&lt;.0001, OR=2.28, CI:1.91-2.71), atrial fibrillation (p&lt;.01), chronic kidney disease (CKD) (p&lt;.0001, OR=1.64, CI:1.33-2.02), central obesity (p&lt;.0001, OR=1.61, CI:1.27-2.05), hypertriglyceridemia (p&lt;.003), prevalence of metabolic syndrome (MetS) (p&lt;.0007, OR=1.40, CI=1.15-1.71), obesity (p&lt;.0001, OR=1.48, CI:1.27-1.73), and concentric left ventricular hypertrophy (cLVH) (p=.01). Recognizing that ANP and BNP are known inhibitors of Aldo, we defined the relationship between these cardiac hormones (NTpro-ANP and NT-proBNP) and PAC and observed highly significant inverse relationships with NTpro-ANP (p=0.0009), NTpro-BNP (p=0.0003) in the general population. Conclusions: In conclusion, in the general community, PAC is strongly correlated with renal, metabolic and cardiovascular diseases as well as cardiac remodeling. Specifically, increasing PAC is strongly associated with HTN, CKD, obesity, MetS, cLVH, and lower levels of natriuretic peptides. Our data suggest a key role of Aldo as a possible biomarker and/or mediator of human cardiorenal and metabolic diseases even in the general adult population, prior to overt disease. This study also supports a possible counter regulatory relationship between cardiac natriuretic peptides and PAC. Further studies are warranted to evaluate possible therapeutic interventions targeting Aldo as a strategy to delay disease progression.
Abstract 9912: Global Intracoronary Infusion of Allogeneic Atrial Cardiosphere-Derived Cells (CDCs) Stimulates Myocyte Regeneration and Reverses LV Remodeling in Miniature Swine With Chronic Myocardial Infarction
Authors: Gen Suzuki, Brian R Weil, Merced M Leiker, John M Canty
Journal: Circulation (2013)

Background: Intracoronary infusion of autologous CDCs (icCDCs) into the infarct-related artery using the “stop flow” technique improves regional function in patients but global function remains unchanged. We tested the hypothesis that this reflects the inability to regress cellular hypertrophy and replace myocytes lost in remote remodeled regions that can be overcome by global intracoronary infusion of CDCs. Methods: Miniswine (n=10) were studied 8 weeks after chronic infarction was produced by LAD microembolization (1x10 6 microspheres, 45μm diameter). Ejection fraction decreased from 63 ± 2% at baseline to 31 ± 2% four weeks after infarction (p&lt;0.05 vs. baseline) and remained unchanged at 8 weeks (32 ± 2%, p-ns vs. 4 weeks). Allogeneic CDCs (20 x 10 6 CDCs, cyclosporine 100 mg/day) isolated from donor atrial biopsies were infused into the 3 major coronary distributions without interrupting flow. We assessed myocardial function (echo), myocyte proliferation (Ki67) and infarct size (TTC) in comparison to untreated controls. Regional myocyte regeneration was quantified by assessing myocyte nuclear density and size. Results: Infusing icCDCs into infarcted and remodeled remote myocardium increased regional function and ejection fraction (Table). icCDCs stimulated myocyte proliferation (Ki67) in LAD and remote regions by three-fold. As a result, myocyte number (nuclear density) increased by 35% and myocyte cell diameter decreased by 33% in both LAD and remote myocardium. The reduction in infarct volume after icCDCs was not significant. Conclusion: We conclude that global infusion of allogeneic icCDCs without “stop flow” 1.) stimulates myocyte proliferation throughout the LV and 2.) in a model of infarction, improves regional function with a substantial increase in left ventricular ejection fraction. Thus, allogeneic icCDCs may afford a widely available platform to reverse LV dysfunction in patients with chronic post infarction LV remodeling.