tbuckley/cabot-search huggingface dataset:
Abstract 15709: Antagonist of Growth Hormone-Releasing Hormone Receptor Protects Against Cardiopulmonary Injury Induced by rVSV-SARS-CoV-2-S Virus Through Rag2 Regulation
Authors: Jose Manuel Condor, Emely Robleto, Ali Kamiar, Tengjiao Cui, Ali Saad, Amanda Wong, Jason Villano, Andrew Pekosz, Mark J Ranek, Keith A Webster, Andrew Schally, Robert M Jackson, Lina A Shehadeh
Journal: Circulation (2023)

Background: SARS-CoV-2 (COVID-19) transmits a multi-systemic disease that can lead to acute respiratory distress syndrome. Growth hormone-releasing hormone receptor (GHRH-R) and its splice variant are expressed in murine and human lung and heart. GHRH-R antagonist, MIA-602, has been shown to regulate inflammation in animal models and immune cell responses to bleomycin lung injury. Using a BSL2-compatible recombinant VSV-eGFP-SARS-CoV-2-S virus (rVSV-SARS-CoV-2-S) which mimics native SARS-CoV-2 infection in K18 hACE2tg mice, we tested our hypothesis that MIA-602 attenuates COVID-19-induced cardiopulmonary injury by reducing inflammation. Methods: Male and female K18-hACE2tg mice were infected with SARS-CoV-2/USA-WA1/2020, rVSV-SARS-CoV-2-S, or PBS and lung viral load, weight-loss and histopathology were compared (N=8). Mice infected with rVSV-SARS-CoV-2-S were subject to daily subcutaneous injections of 10 μg MIA-602 or vehicle (control) starting at 24h post-infection. Pulmonary function was measured via whole-body plethysmography on day 0, day 3, and day 5 (n=7). Five days after viral infection mice were sacrificed, and blood and tissues collected for histopathological analyses, H&amp;E staining, RNA and protein work. Heart and lung tissues were used for RNASeq (n=3 per group). T-test or One-way ANOVA-test was used for statistical analysis. Results: SARS-CoV-2 and rVSV-SARS-CoV-2-S presented similar pathology for weight loss, infectivity (~60%) and histopathologic changes. Daily treatment with MIA-602 ameliorated weight loss, reduced lung inflammation, pneumonia and pulmonary dysfunction evidenced by rescued respiratory rate, expiratory parameters, and dysregulated airway parameters (p&lt;.05). MIA-602 normalized the high expression of the inflammatory protein ICAM-1 in heart and lung (p&lt;0.01), and master immune modulator Rag2 in lung (RNA:10-FC; Protein: 2-FC; p&lt;.001). Conclusions: The results indicate a possible role for pulmonary Rag2 in protecting against pulmonary dysfunction and heart/lung inflammation by peptide GHRH-R antagonist MIA-602 in a novel animal model of COVID-19 pneumonia.
Abstract 13931: Direct Oral Anticoagulants in Atrial Fibrillation Patients With Rheumatic Heart Disease After Mitral Valve Replacement With Bioprosthesis
Authors: Ayman R Fath, Amro Aglan, Abdullah S Eldaly, Mahmoud Kabbani, Hemal M Nayak, Ariel Vinas
Journal: Circulation (2023)

Background: We sought to investigate the outcomes of direct oral anticoagulants (DOACs) versus warfarin in patients with atrial fibrillation and bioprosthetic mitral valve replacement (bMVR) due to rheumatic heart disease. Methods: We performed a retrospective study using the TriNetX global database to identify patients with atrial fibrillation and bMVR due to rheumatic heart disease from 2010 to 2020. Patients who had mechanical mitral or aortic valve replacement were excluded. Patients were stratified into 2 groups: DOAC group and Warfarin group. 1:1 propensity-score matching to control for baseline differences between the two groups was performed. The primary endpoint was ischemic stroke and secondary endpoints were all-cause mortality, major bleeding, myocardial infarction, and all-cause hospitalization over a mean follow-up of 3 years. Results: A total of 2,011 patients were identified and 586 were included after propensity-score matching (293 patients in each group). Patients in the DOAC group, compared to the warfarin group aged 68.9 ± 11.2 vs 68.2 ± 11 years (P=0.41) and 63.4% vs 63.8% were females (P=0.93). There was no significant difference between the two groups in ischemic stroke, all-cause mortality, major bleeding, myocardial infarction, and all-cause hospitalization. (Table 1, figure 1). Conclusion: In patients with atrial fibrillation and bMVR due to rheumatic heart disease, DOACs use was associated with similar rates of ischemic stroke, mortality, major bleeding, myocardial infarction, or hospitalization compared to warfarin.
Abstract 18264: Associations of High-Sensitivity Troponin and Natriuretic Peptide Levels With Cognitive Outcomes in SPRINT
Authors: Devin Haney, James A de Lemos, Jarett D Berry, Djhenne Dalmacy, Simon Ascher
Journal: Circulation (2023)

Background: Subclinical elevations in high sensitivity cardiac troponin T (hsc-TnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) identifies a high-risk subgroup with reduction in cardiovascular disease in response to intensive systolic blood pressure (SBP) lowering. However, it remains unknown if these markers also identify subgroups with greater improvement in cognitive outcomes from intensive SBP lowering. Methods: We measured hs-cTnT and NT-proBNP at baseline in Systolic Blood Pressure Intervention Trial (SPRINT). Adjudicated cognitive outcomes were classified as probable dementia (PD) and mild cognitive impairment (MCI). Combined cardiac biomarker categories were defined as elevated, intermediate, and non-elevated. The association of combined biomarker categories with risk of cognitive outcomes was assessed using multivariable Cox proportional hazards models. Heterogeneity in the effect of intensive versus standard SBP lowering on the risk of cognitive outcomes across combined biomarker categories was determined. Results: Of 8,111 SPRINT participants with measured biomarkers and at least one follow-up cognitive assessment, 830 (10.2%) experienced the composite outcome of PD or MCI. After multivariable adjustment, elevated vs. non-elevated cardiac biomarker levels were independently associated with increased risk of composite outcome [HR 95% CI: 1.56 (1.26 - 1.92)]. The effect of intensive SBP lowering on the composite outcome was strongest among participants with non-elevated cardiac biomarkers (see Table). Conclusion: Elevated cardiac biomarkers were associated with higher risk for cognitive impairment. The effect of intensive SBP lowering on preventing cognitive impairment was strongest among patients with non-elevated cardiac biomarkers. This suggests that intensive SBP lowering may be more effective in preventing cognitive impairment in individuals with favorable cardiac biomarker profiles.
Abstract 13956: Trends in Cardiology Specialty Applicants and Match Rates: A Comparative Analysis From 2017 to 2021
Authors: Omar Obeidat, Saeed Abughazaleh, Mohammad Tarawneh
Journal: Circulation (2023)

Introduction: The demand for well-trained cardiologists is increasing, particularly in the US. Understanding trends in cardiology specialty applicants and match rates is crucial to address the demand-supply gap. Aim: Analyze the trends in cardiology specialty applicants and match rates between 2017 and 2021. Methods: Data from the NRMP and the ABIM websites were examined using chi-square tests to examine changes in match rates among different applicant types. Furthermore, we assessed the proportion of applicants matching at their first, second, third, or subsequent choices. Statistical analysis was conducted using IBM SPSS version 23. Results: There is a significant increase in the number of matched US MD applicants from 482 in 2017 to 549 in 2021 (p=0.0001). However, the match rate for US MD applicants experienced a decline from 89.8% in 2017 to 83.1% in 2021. The number of matched US DO applicants also significantly increased from 60 in 2017 to 103 in 2021 (p=0.0001), with the statistically significant change starting in 2020. We observed a decrease in an applicant's probability of matching at their first choice from 52.7% to 45.3% after the virtual interviews season (p=0.001). In contrast, the probability of matching at a program beyond the third choice increased over time, rising from 152 in 2017 to 288 in 2021. Conclusions: This study highlights the increasing competitiveness of the cardiology match process. The observed trends in match rates underscore the challenges faced by different applicant groups, particularly after the implementation of a virtual interview format. Further investigation into these factors is warranted to better understand and address the disparities.
Abstract 12798: Cardiovascular Function and Prognostic Relevance of Cardiac Cachexia in Patients With Cancer; a Systematic Review and Meta Analysis
Authors: Abhigan Babu B Shrestha, Nischal Mainali, Lukash Adhikari, Tungki Pratama Umar, Sajina Shrestha, Rishikesh Rijal, SHUMNEVA SHRESTHA, Ankush Asija, Yub Raj Sedhai, Pratima Thapa, Sabin KC, Vikash Jaiswal
Journal: Circulation (2023)

Introduction: Cardiac cachexia (CC), a severe muscle-wasting condition prevalent in advanced cancers, poses significant implications for heart health. Hypothesis: To evaluate the specific alterations in clinical and imaging parameters and assess their prognostic value. Methods: A systematic search was conducted on PubMed, Cochrane, and Embase, covering articles available until June 1, 2023. The outcomes were pooled using a random-effects model, and mean differences (MD) with 95% confidence intervals (CI). Results: Our analysis included a total of 873 patients (670 cancer patients and 203 controls) from five studies. Cancer patients exhibited a significant reduction in LV Ejection Fraction [MD, 2.61 (95% CI: 0.29 to 4.93), I2=82.05%, p=0.03], LV Mass [MD, 26.59 (95% CI: 13.57 to 39.61), I2=0.00%, p&lt;0.001], Left Ventricular Mass Index for height [MD, 8.028 (95%CI: 4.257-11.800), I2=0.00%, p&lt;0.001] and LV Mass Index for Body Surface Area [MD, 9.684 (95%CI: 4.233-15.135), I2=0.00%, p=0.0005] for cancer patients. However, no statistically significant differences were found in Right Ventricular Wall Thickness [MD, -0.065 (95%CI: -0.246 to 0.115), I2=9.88%, p=0.4770], LV Wall Thickness [MD, 0.511 (95% CI: -1.027 to 2.049), I2=78.48%, p=0.5150], Intraventricular Septal thickness [MD, 0.420 (95% CI: -0.804 to 1.644), I2=76.71%, p=0.50], and LV End-Diastolic Volume Index [MD, -0.186 (95% CI: -7.222 to 6.849), I2=74.09%, p=0.9586]. Qualitative analysis: CC causes remodeling and hence, alters cardiac parameters. It is associated with chemo- and radiotherapy, and tumor progression. Furthermore, it is also linked to increased all-cause mortality. Conclusions: The presence of CC is associated with notable changes in various parameters, detectable through routine imaging techniques. Screening for these alterations may hold clinical importance in guiding the selection of appropriate cancer regimens for affected patients.
Abstract 13954: The Canadian Tia Score as a Predictor of Ischemic Lesion on Magnetic Resonance Imaging in Transient Ischemic Attack or Minor Stroke Following a Negative Computed Tomography Scan
Authors: Matthieu Robitaille, Mukul Sharma, Marcel Emond, Ariane Mackey, Pierre-Gilles Blanchard, Marie-Joe Nemnom, Marco Sivilotti, Ian STIELL, Grant Stotts, Jacques Lee, Andrew Worster, Judy Morris, Ka Wai Cheung, Albert Jin, Wieslaw J Oczkowski, Demetrios Sahlas, Heather Murray, Steve Verreault, Marie-Christine Camden, Samuel Yip, Philip A Teal, David J GLADSTONE, Mark Boulos, Nicholas Chagnon, Elizabeth Shouldice, Clare Atzema, Tarik Slaoui, Jeanne S Teitelbaum, George A Wells, Jeffrey J Perry
Journal: Circulation (2023)

Introduction: Patients with a diagnosis of transient ischemic attack (TIA) or minor stroke with an acute infarction on brain imaging are at higher risk of subsequent stroke. Our goal was to establish if the Canadian TIA Score (CTS) could predict infarction on magnetic resonance imaging (MRI) when a computed tomography (CT) scan was negative for stroke and aimed to identify clinical factors predictive of a positive MRI. Methods: Patients were selected from the prospective cohort used for the validation of the CTS in 13 centers. Patients with negative CT scans who underwent MRI within 7 days were analyzed. The main outcome was cerebral infarction defined as MRI diffusion-weighted imaging (DWI) positivity. Associations between confirmed stroke and demographic characteristics, clinical features, laboratory findings, and medications were determined using a multivariate logistic regression model. Subsequent stroke rate at 7, 30, and 90 days was analyzed. Results: From 11,507 patients, 1,048 met inclusion criteria. MRI positivity was 15.4%, 30.4%, and 50.0% for the low, medium, and high-risk CTS groups, respectively. Subsequent stroke/TIA rates were higher with confirmed ischemic lesions on MRI at 90 days: twice (10.0%) in the low-risk group, 51 (22.3%) in the medium-risk group, and 20 (24.7%) in high-risk patients. 1.7% of DWI negative patients had a subsequent stroke. Predictive factors in multivariable models for DWI positivity in the medium-risk group were male (OR=1.53; 95% CI 1.11-2.12), hypertension (OR=1.63; 95% CI 1.17-2.27), clinical history of unilateral weakness (OR=2.09; 95% CI 1.50-2.91), language disturbance (OR=1.43; 95% CI 1.03-1.97), and the presence of pronator drift on examination (OR=2.18; 95% CI 1.37-3.47). Conclusion: The CTS helps predict MRI findings and confirmed ischemic lesion is a predictor of the recurrence risk of stroke. The low-risk group showed few positive MRIs and had a lower recurrence rate justifying less urgent MRI. In the medium-risk group, we highlighted findings that should raise the suspicion of an ischemic lesion and these patients should be prioritize for rapid investigation of stroke etiology. In the high-risk group, patients are at risk for stroke despite negative imaging and MRI should not delay management.
Abstract 17103: The Proteomic Fingerprint in Patients With Single Ventricle Disease in the Interstage Period: Evidence of Chronic Inflammation and Widespread Activation of Biological Networks
Authors: Lindsay M Thomson, Christopher A Mancuso, Kelly R Wolfe, Ludmila Khailova, Eiman Ali, Michael DiMaria, Max B Mitchell, Mark Twite, Gareth J Morgan, Benjamin Frank, Jesse Davidson
Journal: Circulation (2023)

Introduction: Children with single ventricle heart disease (SVHD) experience significant morbidity across systems and time: (AKI 70%, neurodevelopmental impairment 33%, growth failure 14%, NEC 5.5%). Proteomics is a novel method to identify new biomarkers and mechanisms of injury in complex physiologic states. Hypothesis: Does the proteome of patients with SVHD differ from healthy children, and which biological systems are activated or repressed? Methods: Infants with SVHD in the interstage period were compared to similar-age healthy controls. Serum samples were collected, stored at -80C, and run on a panel of 1500 proteins in single batch analysis (Somalogic Inc., CO). Partial Least Squares-Discriminant Analysis (PLS-DA) was used to compare the proteomic profile of cases and controls and t-tests to detect differences in individual proteins (FDR &lt; 0.05). Protein network analysis with functional enrichment was performed in STRING and Cytoscape. Results: PLS-DA readily discriminated between cases (n=33) and controls (n=24) based on their proteomic pattern alone (Accuracy=0.96, R2=0.97, Q2=0.80) (Fig 1a). 568 proteins differed between groups (FDR &lt; 0.05). The 15 proteins with the greatest effect on the proteomic phenotype between the groups are shown (Fig 1b). We identified 25 up-regulated functional clusters and 13 down-regulated (5 clusters highlighted in Fig 1c). Active biological systems fell into six key groups: angiogenesis and cell proliferation/turnover, immune system activation and inflammation, altered metabolism, neuronal development, gastrointestinal system, and cardiac development. Conclusions: We report a clear differentiation in the circulating proteome of patients with SVHD and healthy controls with &gt;500 circulating proteins distinguishing the groups. This proteomic data identifies various dysregulated protein networks across multiple organ systems with promising biological plausibility as drivers of SVHD morbidity.
Abstract 14919: Speckle Tracking Based Echocardiographic Evaluation of COVID-19 Recovered Patients: A One Year Follow-Up Study
Authors: Shekhar Kunal, Md Faiz, Girish Palleda, Vishal Batra, ANKIT BANSAL, Mohit Gupta
Journal: Circulation (2023)

Introduction: The occurrence of myocardial injury during acute COVID-19 is well known however, its persistence and impact over a longer period of time is unclear. Hypothesis: We assessed left ventricle (LV) global longitudinal strain (GLS) and right ventricle (RV) longitudinal and free wall strain using speckle tracking echocardiography (STE) in COVID-19 recovered patients. Methods: A total of 189 subjects following recovery from COVID-19 infection and with a normal LV ejection fraction were enrolled. Routine blood investigations, inflammatory markers and detailed echocardiographic evaluation including STE were done for all. All these patients were followed-up for a period of one year with repeat echocardiography done at six months and one-year. Results: Of the 189 subjects, 176 (93.1%) were symptomatic and categorized as mild [n = 91 (51.8%)], moderate [n = 65 (36.9%)] or severe [n = 20 (11.3%)] illness. Subclinical LV and right ventricle (RV) dysfunction were seen in 58 (30.7%) and 25 (13.2%) patients respectively. LVGLS was significantly lower in patients recovered from severe illness (mild: -21.4 ± 3.1 %; moderate: -18.8 ± 4.8%; severe: -16.3 ± 2.7%; P &lt; 0.0001). RV longitudinal strain was significantly lower in patients recovered from severe COVID (mild: -22.9 ± 1.7, moderate: -21.8 ± 1.5, severe: -17.9 ± 1.6; P &lt; 0.0001). There was a significant improvement in LVGLS (baseline: -19.1± 5.7, one-year: -19.9±4.6; P &lt; 0.0001) and RVFWS (baseline: -23.5±6.3; one-year: -23.7 ± 5.8; P=0.03) however, RVLS improved though not significant (baseline: -21.4±5.7; one-year: -21.6 ± 5.2; P=.156) over a one-year follow-up period. Of the 58 subjects with baseline reduced LVGLS, over a one-year follow-up, 22 (11.6%) had persistently reduced LVGLS. Conclusions: Subclinical LV dysfunction was seen in one third of recovered COVID-19 patients which improved over a one-year follow-up. A fraction of subjects had persistently reduced LVGLS even at one year which suggests need for closer follow-up among them to elucidate long-term cardiovascular outcomes.
Abstract 17786: Transcatheter Atrial Septal Defect With Deficient Retro-Aortic Rim Closure Success Rate and Complication is Similar to Other Anatomical Variants: Meta-Analysis
Authors: Kahtan Fadah, Michael Brockman, Nihar Chandupatla, Bryan Nguyen, Chanwit Roongsritong, Tariq Siddiqui
Journal: Circulation (2023)

Introduction: Atrial septal defect (ASD) is a common congenital cardiac malformation resulting from incomplete fusion of one of the multiple embryological structures. Though surgical repair when indicated had been the norm, technological advances over the years have led to the current availability of transcatheter closure of the ASD. This alternative approach has been associated with lower complications and mortality but the procedural success and outcome are variable dependent upon anatomical features. Hypothesis: Several reports have linked deficiency of retro-aortic rim to higher complications, particularly aortic erosion in patients undergoing transcatheter ASD closure. Recent retrospective studies have however suggested otherwise. We herein performed meta-analysis of existing data on the success rate and adverse events following transcatheter closure of ASDs in patients with deficient retro-aortic rims (DRAR) in an attempt to provide general recommendations on the optimal approach for this common anatomic variant. Methods: Twelve relevant studies of ASD with DRAR were identified utilizing PubMed. Each of the twelve studies was closely reviewed for major adverse events including cardiovascular mortality, mortality from non-cardiovascular causes, device erosions, device embolization, residual shunting post-ASD repair, and other complications. The incident of each major adverse events was subsequently tabulated. Five of these reports directly compared the failure rates of ASD closure between patients with and without DRAR. A Mantel-Haenszel random effect meta-analysis was performed on these five publications. Results: Of the total 4,621 transcatheter-based approach ASD closures included, the rate of major adverse events was 5.14%. There was no significant difference in the procedural failure rate between those with and without DRAR ( relative risk =1.14, 95% CI[0.39 3.35], p=0.811 ), (heterogeneity, I 2 =74.75%). Conclusions: Our meta-analysis suggests that transcatheter ASD closure could be performed in patients with deficient retro-aortic rim ASD with expected similar rates of adverse events and success rates as in other anatomical variants.
Abstract 14478: Electrocardiographic Predictors of Response to Sacubitril/Valsartan Therapy in Heart Failure With Reduced Ejection Fraction: A Retrospective Cohort Study
Authors: Jonathan Shpigelman, Ciara Blaine, Carol-Ann Nugent, Louise Kiernan, Caitriona Cahir, Benjamin Mac Curtain, Amir Bachari, Wadeed Irfan, Patrick O'Boyle, James O'Neill, Michael Daly
Journal: Circulation (2023)

Introduction: Sacubitril/valsartan (SV) therapy is currently recommended as first-line therapy in patients with heart failure and reduced ejection fraction (HFrEF) due to its significant clinical and prognostic benefit; however, not all patients respond to therapy and predictors of clinical response to SV remain under-studied. Hypothesis: Certain electrocardiographic (ECG) parameters may predict response to SV therapy in HFrEF patients. Methods: Retrospective analysis of a hospital heart failure registry was undertaken. Consecutive HFrEF patients (NHYA class II - III) on maximal-dose SV were studied. Response to SV was defined as ≥10% relative improvement in left ventricular ejection fraction (LVEF) at 3-months post-therapy. Pre-therapy ECGs were retrospectively analyzed for axes and standard wave and interval durations. Logistic regression was used to estimate odds ratios and 95% confidence intervals for associations between predictors and therapeutic response. For P-wave duration (PWD), the reference level was set to &lt;100ms; for the remaining variables, reference levels were set as: (a) the normal range for ECG variables; (b) absence for bundle branch blocks; and (c) the other category for binary variables. Calibration and discriminative performance of the models were also assessed. Results: In the 102 patients studied, PWD 100 - 120ms, PWD &gt;120ms, and QTc &gt;460ms were independently associated with response to SV therapy: OR 18.00 (4.45 - 122.90), 5.00 (1.47 - 20.42), and 3.10 (1.18 - 9.22) respectively. A multivariate logistic regression model including these predictors, and adjusting for pre-therapy LVEF, was both highly selective (area under the ROC curve = .840) and well-calibrated (Hosmer-Lemeshow p = .973). Conclusions: Prolongation of both PWD and QTc interval on baseline ECG in HFrEF patients is predictive of therapeutic response to maximal-dose SV therapy and may indicate early cardiac remodeling that is highly amenable to reversal.