tbuckley/cabot-search huggingface dataset:
Abstract 9463: Septal Myocardial Function is reduced in Carriers of Lamin A/C mutations and related to Atrioventricular Block, Ventricular Tachycardia and Septal Fibrosis
Authors: Nina E Hasselberg, Thor Edvardsen, Helle Petri, Knut E Berge, Trond P Leren, Henning Bundgaard, Kristina H Haugaa
Journal: Circulation (2012)

Background: Mutations in the Lamin A/C gene may cause dilated cardiomyopathy accompanied by atrioventricular (AV) block, atrial fibrillation and ventricular tachycardia (VT). VTs are frequent and commonly occur before development of dilated cardiomyopathy. Mechanisms of AV block and VT in these patients are not fully understood. Methods: We included 41 Lamin A/C mutation carriers with LV (left ventricular) EF 55±13%. PR interval from resting ECG and occurrence of VT by Holter monitoring and ICDs were recorded. Global and LV septal myocardial function were assessed by echocardiographic speckle tracking strain analysis. Nine patients were eligible for magnetic resonance imaging (MRI) with late gadolinium enhancement (LGE) to assess presence and distribution of myocardial fibrosis. Results: VT was documented in 21 patients (51%). Prolonged PR interval (p&lt;0.001), presence of AV block (p&lt;0.001) and reduced global longitudinal strain (p=0.01) were markers of VT, while LVEF was not (p=0.55). LV septal function was markedly reduced compared to function in the rest of the left ventricle (strain -16.7% vs. -18.7%, p=0.001). Prolonged PR interval correlated with reduced LV septal function (R=0.41, p=0.03). By LGE MRI, 4/5 patients (80%) with documented VT showed LV septal fibrosis while no fibrosis was detected in 4/4 (100%) patients without VT (p=0.05). Fibrosis by MRI was located exclusively in the LV septum. PR interval was longer in patients with LV septal fibrosis compared to those without (320±26 vs. 172±66ms, p=0.002). Conclusion: In Lamin A/C mutation carriers, myocardial function was most decreased in the LV septum and correlated to prolonged PR interval. Prolonged PR interval was a marker of VT. Myocardial LV septal fibrosis was associated with prolonged PR interval and VT. Localized fibrosis in the LV septum may be the mechanism behind AV block, VT and reduced LV septal function in Lamin A/C mutation carriers.
Abstract 9507: Noise vs. Signal: The Clinical Implications of A High Sensitivity Troponin Assay in the Evaluation of Possible Acute Coronary Syndrome
Authors: Sarah Y Wolf, Ramanjit Kaur, William Patrick McKeown, Helen Chan, Allen Dang, Trevor Kuston, Waihin Leung, John Purakal, Brian J O'Neil, Kim A Williams, Phillip D Levy
Journal: Circulation (2012)

Objectives: To evaluate the real-world impact of a switch from conventional troponin I (cTnI) measurement to a high-sensitivity (hsTnI) assay in patients with acute coronary syndromes (ACS). Methods: This was a retrospective analysis of ACS cases from a single hospital system in the 3 months before and after a troponin assay switch. Outcomes included admitting diagnosis, initial treatment and diagnostic testing, need for coronary artery intervention (i.e., stent placement), in-hospital events, and final discharge diagnosis. Descriptive statistics and univariate comparisons by assay group were performed. Results: 783 ACS cases (mean age 60.9 yrs; 52.9% male; 77.7% black) were identified, 330 (42.1%) before and 453 (57.9%) after the assay change with no difference in demographics by assay period. An admitting diagnosis of NSTEMI was more common after the assay change (43.0% vs. 70.4%; p &lt; 0.001) as was the proportion with a positive troponin (32.1% vs. 71.3%; p &lt; 0.001). While aspirin (92.4% vs. 91.4%; p = 0.79), beta-blocker (76.1% vs. 80.8%; p = 0.09) and clopidogrel (50.9% vs. 46.6%; p = 0.25) use was similar, anticoagulants were used more often after the assay change (45.8% vs. 56.3%; p = 0.004). Echocardiography was also more common (39.7% vs. 47.0%; p = 0.05), but cardiac catheterization was less frequent (53.6% vs. 41.7%; p = 0.003) with no difference in the proportion who underwent stent placement (52.4% vs. 50.0%; p = 0.72). In-hospital event rates (Table) were equivalent. At discharge, diagnosis of NSTEMI was more likely post-assay change (27.9% vs. 36.6%; p = 0.011). Conclusions: After the switch to a hsTnI assay, more ACS patients had a positive test result and a greater proportion were diagnosed with NSTEMI at admission. Despite this, cardiac catheterization was used less frequently and coronary artery intervention as well as in-hospital event rates were flat, highlighting the uncertainty that surrounds a positive troponin in an era of high-sensitivity assays.
Abstract 9451: Determinant Factors of Elevated Plasma B-type Natriuretic Peptide Level in Severe Aortic Stenosis
Authors: Masao Daimon, Takayuki Kawata, Sakiko Miyazaki, Ryoko Ichikawa, Kuniaki Hirose, Masaki Maruyama, Hiromasa Suzuki, Haruka Makinae, Shuo-Ju Chiang, Katsumi Miyauchi, Hiroyuki Daida
Journal: Circulation (2012)

Background: Elevated plasma B-type natriuretic peptide (BNP) level reflects left ventricular (LV) dysfunction and is associated with poor outcome in aortic stenosis (AS). We aimed to determine the echocardiographic and clinical factors that are associated with elevated plasma BNP level in patients with severe AS. Methods: We performed echocardiography in 142 patients (age 72±10 years) with severe AS (aortic valve area (AVA) &lt; 1.0cm 2 ). We excluded patients with chronic renal failure and other significant valvular disease. We used multivariate linear regression analysis to evaluate factors that are associated with the plasma BNP levels in these patients. Results: Mean AVA was 0.77±0.16cm 2 . The factors associated with plasma BNP levels were left ventricular (LV) ejection fraction, E/A, E/e’, left atrial diameter, estimated systolic pulmonary artery pressure (SPAP), AVA, LV mass index, e’, systolic systemic blood pressure and the presence of atrial fibrillation (Table). In multivariate stepwise linear regression analysis, LV ejection fraction was the strongest independent determinants of plasma BNP level. In addition, estimated SPAP, and E/e’, and AVA were also found to be independently associated with plasma BNP level. Conclusions: In patients with severe AS, plasma BNP levels mainly correlates with LV systolic dysfunction. However, LV diastolic dysfunction, elevated pulmonary hypertension, and AS severity are also independently associated with elevated plasma BNP levels in severe AS.
Committee on Scientific Sessions Program
Journal: Circulation (2011)

The American Heart Association is grateful to members of the Committee on Scientific Sessions Program for their dedication and leadership throughout the year in planning the program. Elliott Antman, MD, FAHA; Chair Robert A. Harrington, MD, FACC, FAHA; Vice-Chair Representatives Eric R Bates, MD, FAHA, FACC Clinical Cardiology Lance B. Becker, MD FAHA Resuscitation Science Symposium Eliot A. Brinton, MD, FAHA Nutrition, Physical Activity and Metabolism David A. Calhoun, MD, FAHA High Blood Pressure Research Mercedes R. Carnethon, PhD, FAHA Member-at-Large William M. Chilian, PhD, FAHA Arteriosclerosis, Thrombosis and Vascular Biology Mario Delmar MD PhD Member-at-Large Adrian F. Hernandez, MD, MHS Member-at-Large Alan T. Hirsch, MD Peripheral Vascular Disease Vincent B. Ho, MD, MBA, FAHA Cardiovascular Radiology and Intervention Carlos S. Ince, MD Member-at-Large Julie A. Johnson, Pharm.D Functional Genomics and Translational Biology Mikhail Kosiborod, MD Quality Care and Outcomes Research Donald M. Lloyd-Jones, MD, ScM, FACC, FAHA Epidemiology and Prevention Christine Maric, PhD, FAHA Kidney in Cardiovascular Disease Evangelos Michelakis, MD Cardiopulmonary, Critical Care, Perioperative and Resuscitation Wolfgang A. Radtke, MD, FAHA Cardiovascular Disease in the Young Cathy A. Sila, MD Stroke Yibin Wang, PhD Basic Cardiovascular Sciences Debra Wiegand, RN, PhD, FAAN Cardiovascular Nursing Y. Joseph Woo, MD, FAHA Cardiovascular Surgery and Anesthesia American Heart Association : Gordon F. Tomaselli, MD, FAHA, President ; Donna Arnett, PhD, FAHA, President-Elect; Rose Marie Robertson, MD, FAHA, Chief Science Officer
Abstract 9512: Postconditioning With Lactate-Enriched Blood Potentiates the Protective Effect of Postconditioning Alone in Patients With Acute Myocardial Infarction
Authors: Takashi Koyama, Akiyasu Baba, Masaru Shibata, Kazunori Moritani, Megumi Shimada, Makoto Akaishi
Journal: Circulation (2012)

Objective: The infarct-limiting effect of postconditioning (PC) could not be shown in recent clinical trials. We tested the hypothesis that modification of the original protocol to increase the delay in recovery from intracellular acidosis would potentiate the protective effect of PC. Methods: Consecutive 7 patients with acute MI in various stages of the condition underwent primary PCI by using the modified PC protocol in which the duration of each brief reperfusion was prolonged from 10 s to 60 s in a stepwise manner. Lactated Ringer’s solution (20-30 mL) containing 28 mM lactate was injected directly into the culprit coronary artery at the end of each brief reperfusion and the balloon was quickly inflated at the site of the lesion, whereby lactate could be trapped inside the ischemic myocardium. Each brief ischemic period lasted 60 s. After 7 cycles of balloon inflation and deflation, full reperfusion was performed. The aim of this protocol was to achieve controlled reperfusion with tissue oxygenation and minimal lactate washout. After these procedures, stenting was performed. Results: All patients were successfully reperfused and experienced neither worsening of chest pain nor worsening of ST deviation during reperfusion. Reperfusion arrhythmia, including bradycardia, was not evoked by reperfusion in any of the 7 patients. TIMI grade flow III was achieved in all patients. Moreover, marked myocardial staining with contrast medium (area surrounded by white arrows) and/or early visualization of venous drainage (black arrows) were observed in all patients, indicating unimpaired microcirculation. The peak CK value (1074±1082 IU/L) was lower than expected in each situation. Radioisotope imaging revealed well-preserved myocardial viability in all patients. Conclusion: PC with lactate-enriched blood consistently suppresses the various detrimental effects of reperfusion and potentiates the protective effect of postconditioning alone in patients with acute MI.
Abstract 9600: Coronary Artery Disease Patients with Normal Body Mass Index but Central Obesity Have the Worst Long-Term Survival When Compared to Other Patterns of Adiposity
Authors: Thais Coutinho, Kashish Goel, Daniel Correa de Sa, Charlotte Kragelund, Alka Kanaya, Marianne Zeller, Jong Seon Park, Lars Kober, Christian Torp-Pedersen, Yves Cottin, Luc Lorgis, Sang-Hee Lee, Young-Jo Kim, Randal Thomas, Veronique Roger, Virend Somers, Francisco Lopez-Jimenez
Journal: Circulation (2011)

Thais Coutinho, 2011 Finalist and Presenting Author
Abstract 9607: Development of Microporous Covered Stents for Treating Cerebral Aneurysms with Maintenance of Branching Flow
Authors: Yasuhide Nakayama, Shogo Nishi, Hatsue Ishibashi-Ueda
Journal: Circulation (2012)

Objective: Treatment of large (diameter: 12~25 mm) or giant (diameter: over 25 mm) cerebral aneurysms with broad neck in the cranio-cervical area is extremely difficult or carries high risks, even with clinical available surgical method or endovascular one using coils with the assistance of bare stents. In this study, we developed a novel balloon-expandable, microporous covered stent for treating such intractable cerebral aneurysms with high safety and reliability. Methods and Results: The covered stents were prepared using the specially designed balloon-expandable stents with open cell structure (CoCr, Japan Stent Technology; 3 mm x 20 mm). The stents had thin polyurethane cover membrane (thickness: 20 μ m), in which strut was completely impregnated, with a larger amount of micropores (diameter: 100~300 μ m, opening ratio: 10~30%). The experimental aneurysms (10~15 mm) were created at rabbit brachiocephalic arteries (3 mm) by distal ligation and intraluminal elastase incubation at right common carotid arteries. Upon placing the covered stents at the neck of the aneurysms all aneurysms were occluded immediately (n=15), whereas remaining of the aneurysms was occurred by bare stents even after 6 months (n=5). All the parent arteries were patent after implantation up to 12 months. At 3 months of implantation inner space of the aneurysms was filled completely with granulomatous tissue and luminal surface was covered with extremely thin neointima (n=5, thickness; 68 ± 22 μ m). The branching flow through the cover membrane was maintained in all cases. Conclusion: The newly developed covered stents performed well in terms of creating less intimal hyperplasia with maximum embolization effect without disturbing branching flow.
Abstract 9966: Right Ventricular Myocardial Strain Evaluated by Two-Dimensional Echocardiographic Speckle Tracking is Strongly Associated with Right Ventricular Contractile Function by Magnetic Resonance Imaging
Authors: Shingo Kato, Yuka Kusakawa, Nao Ishii, Kazuhiro Muto, Tatsuya Nakachi, Yasuo Okusu, Tsuyoshi Nakagawa, Kazuki Fukui, Kazuaki Uchino, Kazuo Kimura, Satoshi Umemura
Journal: Circulation (2011)

Purpose: Although the evaluation of right ventricular (RV) function is clinically important in patients with cardiovascular disease, accurate assessment is difficult due to the complexity of anatomy. Two-dimensional speckle tracking echocardiography (2D-STE) permits non-invasive measurement of regional and global RV myocardial strain. The purposes of this study were to investigate the relationship between RV myocardial strain by 2D-STE and RV ejection fraction (RVEF) by magnetic resonance imaging (MRI), and to determine whether RV strain measurement by 2D-STE can detect patients with pulmonary hypertension (PH). Methods: Fifty-two patients (mean age: 66 ± 10) with cardiovascular disease (ischemic heart disease, n= 10, cardiomyopathy, n= 7, valvular heart disease, n= 19, idiopathic pulmonary hypertension, n= 5, others, n= 11) were studied. RV free wall (RVFW) was divided into three segments on four chamber view (base, mid and apex). Regional and global longitudinal strain of RVFW was measured by using 2D-STE. Cine MRI was acquired in 23 patients by using 1.5T MR scanner, and RVEF was calculated by tracing endocardial border of RV on short axis slices. Right heart catheterization (RHC) was performed in 35 patients, and PH was defined as mean pulmonary arterial pressure (PAP) ≥25mmHg. Results: The global longitudinal strain of RVFW showed the strongest negative relation with RVEF by cine MRI (r = -0.82, P&lt;0.001). Both regional and global RV longitudinal strains were significantly decreased in patients with PH in comparison to those without (base:-24.1 ± 7.7 vs -17.9 ± 7.3, p=0.02; mid: -22.7 ± 6.0 vs -14.7 ± 6.3, p&lt;0.001; apex: -22.7 ± 5.4 vs -15.7 ± 7.2, p=0.002; global: -22.8 ± 5.5 vs -17.1 ± 6.5, p=0.009). RV longitudinal strain at mid level demonstrates highest correlation with mean PAP by RHC (r=0.71, p&lt;0.001). The area under the ROC curve (AUC) of RV longitudinal strain at mid for the detection of patients with PH was 0.83 (95%CI; 0.69 to 0.98). Conclusions: RV global longitudinal strain measured by 2D-STE correlates well with RVEF assessed by cine MRI. RV longitudinal strain at mid can detect patients with PH with AUC of 0.83. 2D-STE allows for non-invasive assessment of myocardial strain of RVFW, which is closely related to RV contractile function and PAP.
Abstract 9506: Clinical Correlates and Reference Intervals for Transmitral Doppler Early Filling Velocity to Tissue Doppler Early Diastolic Velocity Ratio from Infancy to Adolescence
Authors: Kenji Harada, Yukiko Harada
Journal: Circulation (2012)

Background: Transmitral Doppler early filling velocity to tissue Doppler early diastolic velocity (E/E’) ratio is an index for left ventricular (LV) filling pressure, but data on the factors affecting E/E’ ratio are limited in children. The purpose of this study is to investigate the relationships between E/E’ ratio and age, BMI z-score, LV geometry, and LV function from infancy to adolescence. Methods: Echocardiography with tissue Doppler imaging was performed in 1049 normal subjects aged 4 months to 20 years. LV end-diastolic volume, LV mass, mass to volume ratio, ejection fraction (EF), isovolumic relaxation time (IRT) and tissue Doppler-derived myocardial performance index (MPI) were assessed. Results: Median E/E’ ratio was 7.21 (5th to 95th percentile, 5.37 to 9.73). The E/E’ ratio in younger children (&lt; 5 years) was significantly higher than that in older children (≥ 5 years) and decreased significantly with age (r = -0.43, p &lt; 0.01) (Fig A). E/E’ ratio decreased significantly with BMI (r = -0.23, p &lt; 0.01) (Fig B), however, no significant relationship between E/E’ ratio and BMI z-score was observed. There were weak but significant relationships between E/E’ ratio and heart rate (r =0.36, p &lt; 0.01), systolic blood pressure (r =-0.20, p &lt; 0.01), EF (r = 0.14, p &lt; 0.01), IRT(r =-0.29, p &lt; 0.01), and MPI(r =-0.21, p &lt; 0.01). E/E’ ratio did not correlate with LV mass to volume ratio. Multiple regression analysis revealed that independent predictor of E/E’ ratio was age. Conclusions: We provide the first evidence of age-related decrease in E/E’ ratio from infancy to adolescence. Age-specific reference values should be considered in the interpretation of diastolic function during childhood.
Abstract 9989: Integration of Genetics with Metabolomics Identifies a Novel Gene Associated with Risk of Incident Cardiovascular Events: <i>TRAF3IP2</i>
Authors: Asad A Shah, Damian M Craig, Carol Haynes, James Bain, Robert Stevens, G C Hughes, L K Newby, Elizabeth R Hauser, William E Kraus, Christopher B Newgard, Simon G Gregory, Svati H Shah
Journal: Circulation (2011)

Background: Despite strong heritability, the genetic architecture of cardiovascular (CV) disease remains incompletely characterized. Plasma metabolite concentrations are heritable and have been associated with risk of CV events. We sought to identify novel genes for CV event risk using metabolic profiles as intermediate phenotypes. Methods: From a genome-wide association study of multiple metabolites performed in the KORA population, we selected a single nucleotide polymorphism (SNP; rs174399 , located in the intronic region of TRAF3IP2) strongly associated with short-chain dicarboxylacylcarnitine levels (metabolites that predict CV events). We genotyped this SNP in 3404 patients presenting for cardiac catheterization who also had quantification of 60 metabolites using mass-spectroscopy. Association between the SNP and short-chain dicarboxylacylcarnitine levels was tested using linear regression. Its association with CV events (death/MI) over a median of 5.4 years follow-up was tested using multivariable Cox proportional hazards regression adjusted for 11 clinical variables. Results: The association of rs174399 (T/C) with levels of the short-chain dicarboxylacylcarnitine C5-DC validated in our cohort (dominant P=0.01; additive P=0.03), but the association with C6-DC was not (dominant P=0.11; additive P=0.19). Rs174399 was also associated with values of a principal components analysis-derived metabolic factor consisting of multiple short-chain dicarboxylacylcarnitines (dominant P=0.01; additive P=0.08). The minor allele, C, was associated with higher concentrations of both C5-DC and values of the short-chain dicarboxylacylcarnitine factor. It was also associated with greater risk of death or MI (HR 1.17, [1.05-1.31], P=0.006) and death alone (HR 1.15 [1.02-1.30], P=0.03). Conclusions: Integrating genetics with metabolomics in a large CV study, we have identified a novel gene that predicts risk of CV events. This gene which encodes TRAF3 interacting protein 2, a protein involved in regulating responses to cytokines by members of the Rel/NF-kappaB transcription factor family, may serve as a good biological candidate to mediate CV risk through a metabolic pathway reported on by short-chain dicarboxylacylcarnitines.
Abstract 9472: Pretreatment with Novel Angiotensin type I Receptor Antagonist, Fimasartan, Prevents Doxorubicin-Induced Cardiac Toxicity and Improves Survival
Authors: Sung-A Chang, Byung Kwan Lim, Yoo-Jung Lee, Mi-Kyung Hong, Eun Sun Ju, Jin-Oh Choi, Eun-Seok Jeon
Journal: Circulation (2012)

Background: Cardiac toxicity are important complications of Doxorubicin-based chemotherapy. Protective effect of angiotensin receptor blockers (ARBs) in heart failure been established; however efficacy of ARB on prevention of doxorubicin induced cardiomyopathy and the survivals were not been investigated. We performed a preclinical study to evaluate the preventive effect of a novel ARB, fimasartan, in doxorubicin-induced cardiomyopathy. Method: All animals (n=63) were randomly assigned into 3 groups; daily treated with vehicle (Dox-only), 5mg/Kg (Low-fima), and 10mg/Kg of fimasartan (High-fima). Doxorubicin (3mg/kg) was injected intravenously once a week for 6 weeks. Fimasartan were administered daily for 8 weeks via gastric gavage. Echocardiography was performed in baseline, 6th and 8th week. Hemodynamic assessment was performed at 9th week using the miniaturized conductance catheter system. Result: 8-wk survival rate in High-Fima was higher (100%), than those in Low-fima (75%), and in Dox-only group (50%, p&lt;0.05). Echocardiography showed preserved LV systolic function in in High-Fima after 8weeks of treatment (LV EF=72±7%), but not in Dox-only group (54.6±8.4%, p=0.002). LV end-systolic and end-diastolic dimension increased progressively in Dox-only group; however remodeling was attenuated in Low-fima and High-fima group. Hemodynamic study showed higher positive (5931±1354 mmHg/sec) and negative dP/dt (-5410.3±1338.2) in High-fima group, than Dox-only group. (3425±947, -3123±1127 mmHg/sec, p&lt;0.001). Animals in Dox-only group looked very sick and showed severe anorexia, rat shedding, eye discharge and ascites compared to Low- and High-fima group. Conclusion: A novel ARB, fimasartan, prevents doxorubicin-induced cardiomyopathy and improves survivals in dose-dependent manner in doxorubin-induced cardiomyopathy. It shows possibility of fimasartan as a treatment option to prevent doxorubicin-induced cardiomyopathy.