tbuckley/cabot-search huggingface dataset:
Abstract 8: Remote Ischemic Preconditioning Mitigates Myocardial and Neurological Dysfunction via KATP Channel Activation in a Rat Model of Hemorrhagic Shock
Authors: Xianwen Hu, Jiefeng Xu, Zhengfei Yang, Min Yang, Jie Qian, Jena Cahoon, Shijie Sun, Wanchun Tang
Journal: Circulation (2013)

Introduction: We investigated whether remote ischemic pre-conditioning (RIPC) would reduce myocardial and cerebral ischemia and reperfusion injuries during and following hemorrhagic shock. Hypothesis: RIPC mitigates myocardial and neurological dysfunction as the result of K ATP channel activation. Methods: Twenty-one male Sprague Dawley rats were randomized into three groups:1) RIPC; 2) RIPC with K ATP channel blocker (RIPC+blocker); 3) Control. RIPC was induced by four cycles of 5 mins of limb ischemia followed by reperfusion for 5 mins. Hemorrhagic shock was induced by removing 50% of the estimated total blood volume over an interval of 1 hour, 30 mins after bleeding, the animals were reinfused with shed blood during the ensuing 30 mins. All animals were monitored and observed for an additional 72 hours. Myocardial function was measured by echocardiography at baseline, 1 hour after bleeding, 30 mins after shock, 30 mins after reinfusion and at hourly intervals after reinfusion. The survival and neurological function were evaluated daily for a total of 72 hours. Results: At 2 hours after reinfusion, ejection fraction was restored to near-baseline levels and was significantly better than the Control group. Myocardial performance index was significantly decreased than the Control group. In addition, all animals survived for 72 hours in the RIPC group. The duration of survival was significantly longer than the Control group. Neurological deficit score was significantly better in the RIPC group than the control animals. However, pre-treatment of the K ATP channel blocker completely abolished the myocardial and cerebral protection effects of RIPC (Table). Conclusions: In a rat model of severe hemorrhagic shock, RIPC mitigated myocardial and neurological dysfunction with improved survival by activation of the K ATP channel.
Abstract 363: Dantrolene Decreases Susceptibility to Refibrillations by Restoring Vf Dependent Cardiac Calcium Handling Dysfunction
Authors: Nima Zamiri, Marjan Kusha, Stephane Massé, Mohammad Ali Azam, Patrick Lai, Chris Meyer, Paul Dorian, Kumaraswamy Nanthakumar
Journal: Circulation (2013)

Background: Ventricular refibrillation frequently occurs after successful defibrillation of Ventricular Fibrillation (VF) and negatively affects outcomes. Diastolic elevation in cytosolic calcium and dysfunction in calcium handling is proposed to underlie post-shock arrhythmias. Ryanodine Receptor 2 (RyR2) is the major calcium handling protein in cardiomyocytes. its dysfunction causes diastolic calcium leak from sarcoplasmic reticulum and calcium transient amplitude alternans (Ca-Alt), which can lead to arrhythmias. We hypothesized Dantrolene protects against refibrillations by restoring cardiac calcium handling and stabilizing RyR2 after VF. Methods and Results: Hearts from 14 healthy New-Zealand rabbits were excised and perfused using Langendorff method; VF(+ISO) was induced by burst pacing and left untreated for 4 min. Hearts received either Dantrolene (20μM) or saline during VF. Upon defibrillation, 4 more VF episodes were attempted. Sustainability (VF≥60 sec) and inducibility of refibrillations (VF≥10 sec) was evaluated. Calcium mapping using RhoD-2 was performed to assess Ca-Alt and diastolic Spontaneous Calcium Elevation (SCaE). Ca-Alt was defined as ≥10% variability in Calcium transient amplitudes. SCaE amplitude was measured during diastolic pause after termination of pacing. In total, 83.33% of attempts to induce refibrillation in controls were successful compared to 41.18% in Dantrolene-treated hearts. (P=0.007) Dantrolene (20μM) significantly decreased SCaE amplitude post VF. (Table 1) Ca-Alt emerged at shorter PCL in Dantrolene-treated hearts with 10% decrease from 195±9.5ms at baseline to 173±6.7ms post-VF compared to 11% increase in controls from 215±20ms to 235±8ms. (P=0.05) Conclusion: Dantrolene ameliorated arrhythmogenic diastolic SCaE caused by VF and increased calcium alternans threshold and may be the basis for the decreased susceptibility of treated hearts to refibrillations.
Abstract 15538: Serial Measurements of Neuron-specific Enolase and Prediction of Poor Neurological Outcome in Comatose Patients After Out-of-hospital Cardiac Arrest - A TTM Substudy
Authors: Sebastian Wiberg, David Erlinge, Jesper Kjaergaard, Michael Wanscher, Yvan Devaux, Pascal Stammet, Michael Kuiper, Niklas Nielsen, Hans Friberg, Christian Hassager
Journal: Circulation (2015)

Purpose: Neuron-specific enolase (NSE) has been established as a predictor of poor neurological outcome after out-of-hospital cardiac arrest (OHCA). The optimal strategy for evaluation of serial NSE measurements remains unknown. Methods: The Target Temperature Management (TTM) trial biobank holds serial blood samples of OHCA patients, drawn at 24 hours, 48 hours and 72 hours after randomization to targeted temperature of either 33°C or 36°C. We included all patients being comatose at day 3 and investigated the value of NSE to predict poor neurological outcome and death (i.e. cerebral performance category 3-5) at 180 days follow-up. Multiple logistical regression and C-statistics models were used to establish the optimal use of the NSE-values. Results: A total of 550 comatose OHCA patients were included in the study (mean age 65 years, 80% men). At 180-day follow-up 333 (61%) of the patients had a CPC-score of 3 to 5. C-statistics revealed that the strongest predictor for poor CPC-score was the NSE value at 72 hours (AUC=0.85, see table). In a multiple logistic regression model adjusted for sex, age, time to return of spontaneous circulation, shock-able rhythm and lactate-levels at admission the area under the NSE-curve from 24 to 72 hours had the highest odds ratio (OR=4.2, p&lt;.0001). Conclusions: In patients being comatose at day three after OHCA the biomarker NSE is a strong predictor for poor neurological function and death (CPC 3-5) at 180-day follow-up. Adjustment for pre-hospital factors associated with a poor prognosis suggests that the area under the NSE-curve from 24 to 72 hours is a strong independent predictor.
Abstract 77: CPC 1-2 and Modified Rankin &lt;3 Scoring at Discharge Underestimates the Prevalence and Severity of Cognitive Deficits Seen in Cardiac Arrest Survivors at 3 Months
Authors: Laura K Artman, Mary Ann Peberdy, Joseph P Ornato, Michelle R Gossip, Kathryn P Wilder Schaaf, Jeffrey S Kreutzer
Journal: Circulation (2013)

Background: Cerebral performance category (CPC) and Modified Rankin (MRS) scoring are used commonly to document neurocognitive (NC) function after cardiac arrest (CA) with CPC1-2 or MRS &lt;3 representing "good" neurological outcomes. This non-focused testing may be insensitive for deficits resulting from injury to brain areas most susceptible to global ischemia see in CA. Hypothesis: CPC 1-2 and MRS &lt;3 at discharge does not adequately identify important NC deficits in survivors of CA. Methods: One hundred forty-four consecutive CA patients (pts) underwent bundled post arrest care including therapeutic hypothermia (TH) from 2-1-11 through 1-15-13. Fifty-three percent survived to discharge. Three months post discharge, 27 pts underwent a battery of neuropsychological assessments focused on multiple domains known to be sensitive to NC impairment. Reasons for not testing were: unable to perform test due to deficits(17); coma (12); refused (11); no-show (10). Individual pt results were normed for age and education level. Impairment for memory is reported as binomial (impaired vs. not). Impairment in other domains is reported as severely impaired (below the 10th percentile) and mildly impaired (below expectations). Results: The study population is 24 of the 27 pts who underwent testing at 3 months and were CPC 1-2 and MRS &lt;3 at discharge. Pts were 75% male; mean age 51 (95%CI;45, 57) years; 92% VF; 92% witnessed; 79% bystander CPR; total ischemic time 18.5 (95%CI;17.1, 32.3)min; initial pH 7.19 (95%CI; 7.13, 7.24); initial lactate 8.5 (95%CI; 4.3, 12.6). The most commonly impaired cognitive domains are represented in the table. Conclusions: NC impairment is common after CA in pts treated with TH and a comprehensive post arrest program. Despite "good" neurologic outcome on traditional measures, CPC and MRS scoring significantly underestimates the prevalence and severity of these deficits at 3 months post discharge.
Abstract 16076: Anti-angiogenic actions of VEGF-A165b, a novel isoform of VEGF-A, in human obesity
Authors: Doan TM Ngo, Melissa G. Farb, Shakun Karki, Stephanie Tiwari, Sherman Bigornia, Naomi M. Hamburg, Joseph A. Vita, Donald T. Hess, Kenneth Walsh, Noyan Gokce
Journal: Circulation (2013)

Doan Ngo, 2013 Finalist and Presenting Author
Abstract 9391: Cyclic Variation of Heart Rate Score by Holter ECG for screening Sleep Disordered Breathing in Heart Failure Patients
Authors: Takeshi Shimizu, Akiomi Yoshihsa, Shoji Iwaya, Makiko Miyata, Satoshi Abe, Takamasa Sato, Satoshi Suzuki, Koichi Sugimoto, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Hitoshi Suzuki, Shu-ichi Saitoh, Yasuchika Takeishi
Journal: Circulation (2013)

Background: Sleep disordered breathing (SDB) has a critical association with cardiovascular mortality and morbidity, especially in patients with heart failure (HF). However, because of the complexity to refer the polysomnography, the majority of SDB patients remain undiagnosed. On the other hand, the abnormality of heart rate variability has been reported in patients with SDB. To explore an efficient ECG-based screening tool for SDB, we examined the usefulness of cyclic variation of heart rate score (CVHRS) by Holter ECG in HF patients. Methods and Results: In this study, 110 patients with HF (mean age 58.6 years, body mass index 23.6, left ventricular ejection fraction 45.5%) were enrolled. The exclusion criteria were the presence of atrial fibrillation and receiving implantable pacemaker device therapy. We simultaneously performed Holter ECG and polysomnography in night time, and measured apnea-hypopnea index (AHI) and CVHRS. We determined the temporal position of the individual dips comprising the CVHRS, using time-domain methods. CVHRS was measured as cyclic and auto correlated dips in smoothed interbeat interval time series. There were 77 patients with mild to moderate SDB (5≤AHI&lt;30/h) and 26 patients with severe SDB (AHI ≥30/h). There was a significant positive correlation between CVHRS and AHI (R=0.60, P&lt;0.001). From the ROC analysis, CVHRS (a cut off value of 30) identified severe SDB with sensitivity 82%, specificity 77%, positive predictive value (PPV) 78%, negative predictive value (NPV) 81% and area under the curve (AUC) 0.83. Conclusions: CVHRS determined by Holter ECG is a useful screening index for severe SDB in HF patients.
Abstract 9314: Clinical Impact of Heterozygous Carrier of ATP-binding Cassette Sub-family G Member 5 Gene on Asymptomatic Normolipidemic Patients: Evidence From Familial Gene Analysis
Authors: Hayato Tada, Masa-aki Kawashiri, Chiaki Nakanishi, Tetsuo Konno, Kenji Sakata, Kenshi Hayashi, Tsuyoshi Yoshimuta, Atsushi Nohara, Akihiro Inazu, Hiroshi Mabuchi, Masakazu Yamagishi
Journal: Circulation (2013)

Background: Sitosterolemia is a rare recessive form of inherited disease characterized by increased levels of plant sterols such as sitosterol, the cause of which is ATP-binding cassette (ABC) sub-family G member 5 (ABCG5) or ABCG8 gene mutations. However, few data exist regarding the clinical features and significance of heterozygous sitosterolemic carrier due to the rarity of this disease. The aim of our study was to determine the clinical impact of heterozygous mutation carriers of ABCG5 or ABCG8 gene. Methods and Results: We performed genetic analyses of ABCG5 and ABCG8 genes for the 15 family members of patients with homozygous sitosterolemia from different 3 families, and investigated their serum sitosterol levels as well as their lipid levels. We identified 12 heterozygous carriers (male=6, mean age=40) which exhibit single mutation in ABCG5 gene among these families (c.130C&gt;T, c.1306G&gt;A, c.1813_1817delCTTTT) as well as 3 normal family members (male=1, mean age=48). Although there were no significant differences in TC, TG, HDL-C, and LDL-C levels between heterozygous carriers and normal family members, serum sitosterol level of heterozygous carriers was significantly higher than that of normal family members (10.8±4.3 vs 2.7±0.5 μg/ml, p&lt;0.05). Interestingly, heterozygous carriers showed neither xanthomas nor any coronary artery diseases. Conclusions: These results demonstrate that heterozygous ABCG5 gene mutation carriers which are somewhat difficult to be identified by the conventional methods may exist among the common normolipidemic patients without significant clinical manifestations. We suggest that the functional analysis of ABCG5 or ABCG8 may facilitate identifying hyper sitosterolemic carriers.
Abstract 17536: Abnormal Cardiac Formation In Hypertrophic Cardiomyopathy - Fractal Analysis Of Trabeculae Detects Pre-Phenotypic Gene Expression
Authors: Gabriella Captur, Luis Lopes, Vimal Patel, Chunming Li, Paul Bassett, Daniel Sado, Michael Baldini, Sarah Anderson, Viviana Maestrini, William J McKenna, Vivek Muthurangu, Perry M Elliott, James C Moon
Journal: Circulation (2013)

Gabriella Captur, 2013 Finalist and Presenting Author
Abstract 9324: Safety and Efficacy of Device Closure for Patent Foramen Ovale for Secondary Prevention of Neurological events. Meta-analysis of Randomized Controlled Trials
Authors: Abdul Hakeem, Konstantinos Marmagkiolis, Yalcin Hacioglu, Barry F F Uretsky, Betul Gundogdu, Massoud Leesar,, Steven R Bailey, Mehmet Cilingiroglu
Journal: Circulation (2013)

Background: While the prevalence of patent foramen ovale (PFO) is significantly higher in patients with cryptogenic stroke, considerable controversy persists regarding the best management of such patients. We performed a meta-analysis of randomized controlled trials comparing PFO closure with medical therapy. Methods: A prospective protocol (Protocol registration # CRD42013004197) was developed and registered using the following data sources: PubMed, Cochrane Register of Controlled Trials, conference proceedings, and internet-based resources of clinical trials. Primary analyses were performed using the intention-to-treat method as reported in the respective trials Results: Three randomized trials comparing percutaneous PFO closure vs. medical therapy for secondary prevention of embolic neurological events involving 2303 participants (1153 medical therapy, 1150 PFO closure) formed the data set. Two trials (RESPECT and PC) used the Amplatzer PFO occluder whereas the Starflex closure device was used in the CLOSURE 1 trial. Baseline characteristics were similar. Mean age was 46 years. The prevalence of atrial septal aneurysm was similar (approximately 34% in both groups). During long-term follow-up , the pooled incidence of the primary endpoint (composite of stroke, death, or fatal stroke) was 3.4 % in the PFO closure arm and 4.8% in the medical therapy group [risk reduction (RR) 0.71 (0.48-1.06); p=0.09] The incidence of recurrent neurological events (secondary endpoint) was 1.7% for PFO closure and 2.7% for medical therapy[ RR 0.66 (0.35,1.24), p=0.19]. There was no difference in terms of death or adverse events between the two groups. After transcatheter closure, recurrent neurological events did not seem to be related to pre-treatment shunt size or atrial septal aneurysm. Reduction in primary event rate with closure strategy (in comparison to medical therapy) almost reached statistical significance (P=0.05) in male patients. Conclusions: While this meta-analysis of randomized clinical trials demonstrated no statistical significance in comparison to medical therapy, there was a strong trend towards overall improvement in outcomes in the PFO closure group.
Abstract 15058: RhoG Regulates GPVI/FcRγ-Mediated Platelet Activation and Thrombus Formation
Authors: Soochong Kim, Carol Dangelmaier, Dheeraj Bhavanasi, Shu Meng, Hong Wang, Lawrence E. Goldfinger, Satya P. Kunapuli
Journal: Circulation (2013)

Soochong Kim, 2013 Finalist and Presenting Author
Abstract 10981: Morphine Decreases Clopidogrel Concentration and Effects: A Randomized, Double Blind, Placebo-Controlled Trial
Authors: Eva-Luise Hobl, Thomas Stimpfl, Raute Sunder-Plassmann, Petra Jilma Stohlawetz, Christian Schoergenhofer, Ulla Derhaschnig, Josef Ebner, Bernd Jilma
Journal: Circulation (2013)

Eva- Luise Hobl, 2013 Finalist and Presenting Author
Abstract 15536: Cardiopulmonary resuscitation with chest compressions during sustained inflations: A new technique of Neonatal Resuscitation that improves recovery and survival in a neonatal porcine model
Authors: G.M. Schmölzer, M. O'Reilly, J. LaBossiere, T.F. Lee TF, S. Cowan, S. Qin, D.L. Bigam, P.H.Y. Cheung
Journal: Circulation (2013)

Georg Schmölzer, 2013 Finalist and Presenting Author
Abstract 350: Remote Ischemic Pre-Conditioning Reduce Myocardial Ischemic Injury During and Following Hemorrhage Shock in a Rat Model
Authors: Zhengfei Yang, Jiefeng Xu, Xianwen Hu, Jie Qian, Min Yang, Jena Cahoon, Shijie Sun, Wanchun Tang
Journal: Circulation (2013)

Introduction: Myocardial ischemic injury following severe hemorrhage shock is often represented by acute changes of ST-segment and fractional shortening (FS). In this study, we investigated whether remote ischemic pre-conditioning (RIPC) reduces myocardial ischemic injury by measuring changes in ST-segment and fractional shortening during and following severe hemorrhage shock in a rat model. Hypothesis: RIPC reduces myocardial ischemic injury during and following severe hemorrhage shock as measured by changes of ST-segment and FS. Methods: Fourteen male Sprague-Dawley rats were randomized to receive RIPC, or sham control. RIPC was induced by four cycles of 5 mins of limb ischemia, followed by 5 mins of reperfusion. Fifty percent of estimated blood volume was then removed over an interval of 1 hour. Thirty mins after bleeding was completed, the animals were resuscitated by reinfusion of shed blood within 30 mins. Electrocardiographic tracings, and haemodynamics were continuously recorded for up to 2 hours. FS was measured by echocardiography at baseline, bleeding 60 mins, 30 mins before and after reinfusion and 1 and 2 hours after resuscitation. Results: Depression of ST-segment was observed during hemorrhage and followed with elevation of ST-segment after infusion in all animals. However, depression of ST-segment during hemorrhage and subsequent elevation after resuscitation were significantly better in the RIPC group than in the Control group. The compensative capacity of FS was significantly greater in the RIPC group than the Control group during and following hemorrhage (Table). Conclusion: RIPC reduces myocardial ischemic injury during and following severe hemorrhage shock.
Abstract 292: Time Course of Epinephrine Administration During Cardiac Arrest Shows Transient Increase in Aortic Pressure at the Cost of Persistent Decrease in Carotid Flow
Authors: Andrew Ramadeen, Xudong Hu, Albert K Tsui, Gregory M Hare, Paul Dorian
Journal: Circulation (2013)

Epinephrine is routinely used during treatment of cardiac arrest. Administration may improve immediate resuscitation at the cost of long term survival. We hypothesized that epinephrine transiently increases aortic pressure, but decreases blood flow to the brain during cardiopulmonary resuscitation (CPR). Methods: Six anesthetized Yorkshire pigs (31±4 kg) underwent 1 minute of untreated ventricular fibrillation (VF), followed by 9 minutes of guideline based CPR with mechanical compressions, then defibrillation. Epinephrine (1 mg IV) was administered 1-3 times per pig (median 2.5) at ≥3 minute intervals. Hemodynamic parameters were measured continuously with a micromanometer in the abdominal aorta and a perivascular flow probe around the carotid artery. Results: After 10 minutes of VF, 5 of 6 pigs were successfully defibrillated, but all 5 became asystolic or lacked pulsatile aortic pressure 30 minutes after defibrillation. During CPR prior to epinephrine injection, aortic systolic and diastolic pressures were 72±26 and 17±3 mmHg respectively, coronary perfusion pressure was 15±5 mmHg and antegrade carotid blood flow was 141±77 mL/min. Epinephrine produced a repeatable, transient effect on both aortic pressure and carotid blood flow (see Table). Aortic systolic and diastolic pressures increased above pre-injection values with peak pressures reached approximately 80 seconds after injection and stabilizing after 180 seconds. Carotid flow decreased below pre-injection values with nadir flow reached approximately 80 seconds after injection, and remained below baseline for 100 additional seconds or longer. Conclusions: The effect of epinephrine on hemodynamics during CPR is not consistent over time. Epinephrine produces differential effects on aortic pressure and carotid flow. Although epinephrine may transiently improve coronary perfusion, it may do so at the cost of brain perfusion.
Abstract 359: Clinical Decision Rule to Activate the Massive Transfusion Protocol for Severe Trauma Patients
Authors: Takayuki Ogura, Minoru Nakano, Mitsunobu Nakamura, Kenji Fujizuka
Journal: Circulation (2013)

Background: There is no clear activation criteria of the Massive Transfusion (MT) Protocol for severe trauma patients. Objective: To create the Clinical Decision Rule (CDR) of MT Protocol activation, using Traumatic Bleeding Severity Score (TBSS). Method: Single center retrospective study was performed. Severe trauma patients (Injury Severity Score &gt;/= 16), who admitted to our center between 2010 and 2012 were enrolled. Initial TBSS and MT rate in each score of TBSS was calculated, and the area under the receiver operating characteristic curve (AUC) for MT were calculated. Those patients who were simple traumatic head injury or cardiopulmonary arrest on arrive were excluded. Result: There were 264 patients in this study. AUC for MT was 0.947. When TBSS was 12 pts or less, MT rate was 3.7% (3/162). When TBSS was from 13 pts to 16pts, MT rate was 36.7% (11/30). When TBSS was 17 pts or more, MT rate was 94.4% (68/72). When TBSS was 19 pts or more, all patients received MT. Discussion: It was reported that TBSS was superior to TASH Score or ABC Score (AHA ReSS 2012, ECTES 2103). According to the result of this study, the Low Risk Group for MT was patients whose TBSS was 12 pts or less, the Moderate Risk for MT was patients whose TBSS was from 13 pts to 16pts, and the High Risk Group for MT was patients whose TBSS was 17 pts or more. In reference to these risk classification, we propose the following CDR to activate the MT Protocol. 1: Activate the MT Protocol in the High Risk Group 2. DO NOT activate the MT Protocol in the Low Risk Group 3. In the Moderate Risk, repeatedly assess the TBSS and prepare for MT enough Conclusion: We propose the CDR to activate the MT Protocol that we should carry out MT for the trauma patients whose TBSS is 17 pts or more.&lt;!--EndFragment--&gt;