tbuckley/cabot-search huggingface dataset:
Abstract 4129675: Effective Transcatheter Intracoronary Delivery of mRNA-Lipid Nanoparticle Targeting on The Heart
Authors: Kazuma Handa, Masashi Kawamura, Masao Sasai, Takashi Matsuzaki, Akima Harada, Kenji Miki, Lisa Fujimura, Shunsuke Saito, Ryo Tsuneda, Anri Fujishiro, Kunio Hirano, Shigeru Miyagawa
Journal: Circulation (2024)

Introduction: mRNA has great potential to provide new medical innovations in the treatment of heart failure. Lipid nanoparticles (LNPs) are an established and effective mRNA delivery system. However, effectively delivering LNPs to the heart remains a significant challenge. We evaluated the efficacy of transcatheter intracoronary (IC) administration compared to intravenous (IV) and intramyocardial (IM) administration as methods for delivering. Methods: Normal rabbits were used to examine each route of administration. Fluorescence (ATTO 700)-labeled LNP encapsulating Firefly Luciferase (FLuc) mRNA (25 ug/kg) were used to confirm the in vivo mRNA-LNP dynamics. The LNP accumulation and FLuc expression were verified using an in vivo imaging system (IVIS) 4 hours post-administration, followed by immunohistochemical analysis. The same experiments were conducted in an ischemia-reperfusion (I/R) model. Results: In the normal model, IVIS spectrum data showed that LNPs accumulated in the order of IM, IC and IV groups, with FLuc expression significantly higher in the IC group than in the IV group and comparable to the IM group (A). Histological analysis revealed that FLuc-expressing cells were mainly found in troponin T-positive cardiomyocytes at the injection site in the IM group and throughout the heart in the IC group (B). In the I/R model, LNP accumulation and FLuc expression were increased in the IV group compared to the normal model, whereas, in the IC and IM groups LNP accumulation and FLuc expression levels were similar to those in the normal model (C). Histological analysis revealed more FLuc-expressing cells in the infarcted area in all groups, but higher FLuc expression was observed in remote areas in the IC group (D). Conclusions: IC administration effectively delivered mRNA-LNPs not only to the damaged area but also to the remote area (non-damaged area) in the diseased heart, suggesting a safe and useful method for delivery to a wider range of cardiomyocytes in the heart.
Abstract 4131796: Non-Contact Biometric System for Early Detection of Hypertension and Diabetes Using AI and RGB Imaging
Authors: Ryoko Uchida, Ying Chen, Eriko Hasumi, Katsuhito Fujiu
Journal: Circulation (2024)

Introduction: In recent years, the development of wearable devices and bioinformation analysis applications utilizing smartphone sensors has seen significant advancements. Despite these technological strides, their adoption and sustained use remain limited to health-conscious individuals. The general populace, particularly those indifferent to health management, stands to miss out on the potential benefits of wearable technologies due to a lack of engagement. This disconnect underscores the necessity for more accessible health monitoring solutions. Research Questions and Goals: This study aims to bridge the gap in health monitoring accessibility by introducing a system capable of non-invasive, non-contact acquisition of biometric information. Such a system seeks to democratize the early detection and prevention of diseases across various demographics. Methods and Results: A prospective cohort clinical study was conducted in a hospital setting with approximately 200 consenting patients and healthy controls. Images of the subjects' faces and hands were captured with a high-speed camera, and blood pressure measurements were taken simultaneously for correlation. A machine learning algorithm was developed to analyze skin blood flow and spectral features from these images to identify potential diseases. The study specifically focused on early detection of hypertension and diabetes. Hypertension was categorized for individuals with systolic blood pressure ≥115 mmHg or diastolic blood pressure ≥75 mmHg. Diabetes was identified in subjects with HbA1c levels ≥6.5 or those previously diagnosed. The algorithm's performance in detecting hypertension showed a 94.2% in alignment with the AHA guidelines for stage1 hypertension, based on pulse wave features. For a subset including 40% early hypertension cases, accuracy rates were 86.2% for 30-second data segments and 80.9% for 5-second segments. For diabetes detection, the application of the algorithm to video data achieved a 75.3%, utilizing blood flow patterns as markers. Hypertension and diabetes were analyzed using different features. Conclusions: The integration of AI algorithms with video data analysis of skin and blood vessels demonstrates a promising avenue for the non-contact, early detection of hypertension and diabetes. This approach not only offers a viable non-contact monitoring technology, but also represents a significant leap towards inclusive, accessible health care prevention and management strategies.
Abstract 4131381: Comparison of Dietary Macronutrient Interventions for Weight and Cardiovascular Risk Factor Reduction: A Systematic Review and Network Meta-analysis of Randomized Controlled Trial
Authors: Eman Ali, Fakhar Latif, Kumail Mustafa Ali, Prinka Perswani, Hamza Janjua, Yusra Ansari, Sharath Vipparthy, Farman Ali, Tariq Jamal Siddiqi, Michael Hall
Journal: Circulation (2024)

Background: Dietary interventions play a crucial role in weight management and reducing cardiovascular risk factors. Our study aims to compare the effectiveness of four dietary macronutrient interventions on weight loss and cardiovascular (CV) risk factor reduction through a systematic review and network meta-analysis. Methods: We conducted a comprehensive literature search on PubMed, Scopus, Embase, and Cochrane Library up till May 2024 to identify randomized controlled trials (RCTs) comparing four macronutrient dietary interventions including Mediterranean Diet (MD), Keto, Dietary Approaches to Stop Hypertension (DASH), and Intermittent Fasting (IF) with study period ≥ 6 months or 24 weeks. The primary outcomes of interest were weight loss, systolic blood pressure (SBP), Diastolic blood pressure (DBP), Body Mass Index (BMI), High density lipoprotein (HDL), Low density Lipoprotein (LDL), cholesterol levels and C-reactive protein (CRP) levels. Outcomes were reported as standard mean difference (SMD). Results: Our analysis identified 50 studies enrolling 5368 patients (MD=3554; DASH=838; Keto=206; IF=770). Regarding BP outcome, MD and DASH had significant reduction in SBP and DBP respectively (MD [SBP]: -0.76 mmHg vs DASH [DBP]: -1.92 mmHg) respectively. In contrast, IF showed a significant rise in SBP (0.87). MD participants also had significant weight loss (-1.06 kg) and a moderate decrease in BMI (-0.79) when compared with other diets. Furthermore, IF, keto, and MD showed moderate increase in HDL levels (0.61, 0.77 and 0.33) respectively. In contrast, DASH resulted in a moderate decline in HDL levels (-0.92). IF and MD resulted in modest decline in LDL levels (-0.45 and -0.42) respectively. In contrast, Keto demonstrated non-significant rise in LDL (0.35). DASH showed a significant decrease in triglycerides (-3.02). Lastly, MD demonstrated a significant reduction in CRP (-0.89). Conclusions: MD and DASH were superior to other dietary interventions in terms of weight loss and CV risk factors. Further research is required to tailor specific types of dietary interventions and assess their long-term efficacy on weight loss and CV risk reduction.
Abstract 4129729: Relationship Between Inflammatory Biomarkers and Quality of Life in Black Adults Living with Heart Failure: A Pilot Study
Authors: Christopher Herring, Andrea Madariaga, Erica Davis, Melinda Higgins, Alanna Morris, Sandra Dunbar, Brittany Butts
Journal: Circulation (2024)

Introduction: Heart failure (HF) impacts quality of life considerably, with inflammatory biomarkers potentially playing a significant role in this relationship. The purpose of this study is to examine the relationship between NYHA Class, inflammatory biomarkers, and quality of life in Black adults living with HF. Methods: Black adults living with HF (N=41) were enrolled in this study. NYHA Class was extracted from the medical record. Health-related quality of life was measured using the Kansas City Cardiomyopathy Questionnaire (KCCQ), a 23-item questionnaire that quantifies physical function, symptoms, social function, and health-related quality of life in HF. Scores are transformed to a range of 0-100, with higher scores reflecting better health status. One-way ANOVA and correlation analyses were used to assess associations between NYHA class, inflammatory biomarkers (XO activity, IL-1β, IL-15, and CCL-19), and KCCQ scores. Results: Participants were 57±11 years of age and 66% female, with mean LVEF 33±14%. NYHA Class ranged from I (20%) to IV (12%), with the majority of participants in Class II (34%) and III (22%). Mean KCCQ Clinical Summary Score was 85± 21. NYHA Class I had significantly lower scores on the KCCQ Clinical Summary Score compared to Class III and IV (p &lt; .001, η 2 = 0.54), KCCQ Physical Limitation compared to Class II, III, and IV (p &lt; .001, η 2 = 0.53), and KCCQ Symptom Frequency compared to Class IV (p = .001, η 2 = 0.39). The KCCQ Clinical Summary Score was negatively associated with XO activity (r = -0.440, p = .046), IL-1β (r = -0.407, p = .043), IL-15 (r = -0.427, p = .033), and CCL-19 (r = -0.559, p = .004). Similar negative associations were observed for the KCCQ subscales. Conclusion: The negative association between XO activity and health-related quality of life (KCCQ) in individuals with HF highlights the potential impact of oxidative stress on these patients' subjective well-being and functional status. Understanding this relationship could underscore the importance of mitigating oxidative stress pathways to improve the overall quality of life and symptom burden experienced by individuals with HF. The KCCQ and subscales were also negatively associated with markers of inflammation, highlighting the potential impact of systemic inflammatory processes on subjective well-being and functional status in persons with HF. Targeting inflammatory pathways may improve quality of life and mitigate the burden of symptoms in HF.
Abstract 4129533: Phenotypes and clinical outcome of heart failure with preserved ejection fraction (HFpEF) patients in China: Findings from the Chinese Cardiovascular Association Database-Heart Failure Center Registry
Authors: Shuai Yuan, Zhonglei Xie, Xiaotong Cui, Jingmin Zhou, Junbo Ge
Journal: Circulation (2024)

Background: Heart failure with preserved ejection fraction (HFpEF) is a heterogenous syndrome with 5 phenotypes. We aimed to evaluate the clinical outcome of HFpEF patients with various phenotypes in China. Methods and Results: Data from the Chinese Cardiovascular Association (CCA) Database-HF Center Registry between January 2017 and December 2021 were analyzed, 51,466 hospitalized HFpEF patients with 1-year follow-up results were included in this analysis. The patients were categorized into five phenotypes based on published phenotyping method. Clinical characteristics and 1-year outcome and related risk factors of HFpEF patients with various phenotypes were explored. Results demonstrated significant differences in baseline characteristics and clinical outcomes among the phenotypes, patients with phenotype-3 (right heart and pulmonary-related HFpEF), phenotype-4 (valvular- and rhythm-related HFpEF) and phenotype-5 (extracardiac disease-related HFpEF) exhibited high incidence of adverse outcomes. Phenotype-3 and -4 exhibited high risk of heart failure rehospitalization, whereas phenotype-5 showed high cardiovascular mortality. The independent prognostic risk factors varied across different phenotypes as well. Conclusion: One-year outcome differs among HFpEF patients with various phenotyping. Future studies are warranted to validate if personalized treatment strategies based on HFpEF phenotypes could improve the individual outcome of HFpEF patients, especially for phenotype-3, -4 and -5 HFpEF patients. Keywords: Heart failure with preserved ejection fraction, phenotype, prognosis, population study, risk factors.
Abstract 4128352: Association Between G6PD Deficiency and Congenital Heart Disease Incidence and Hospital Outcomes
Authors: Alana Hendrickson, Natalie Caryl, Omar Meziab, Jennifer Andrews, brent barber, Michael Seckeler
Journal: Circulation (2024)

Background: G6PD deficiency classically presents with hemolytic anemia, but associations have been described with atherogenesis and coronary artery disease. There are limited data that also suggest a link between G6PD deficiency and the development of congenital heart disease (CHD). Hypothesis: We hypothesize a higher incidence of CHD among individuals with G6PD deficiency as well as worse hospital outcomes for those with CHD and G6PD deficiency. Methods: We reviewed the Vizient® Clinical Data Base (a national, administrative database) from 10/2019-3/2024 for admissions of individuals aged 0-25 years with ICD-10 codes for moderate to severe CHD with and without and G6PD deficiency (D55.0, D75.A) to calculate and compare CHD incidence. Additional data included: demographics, hospital outcomes and costs. Hospital outcomes were compared using t-tests for normally distributed data, Mann-Whitney U test for non-normally distributed data and χ 2 for categorical data. Results: There were 213,708 admissions of individuals with CHD and &lt;1% had G6PD deficiency; findings in Table 1. Of the 6,363 admissions with G6PD, 289 (4.5%) had CHD and of 11,179,670 without G6PD, 213,419 (1.9%) had CHD ( p &lt;0.001). Patients with CHD and G6PD deficiency had male predominance and more Blacks (consistent with known G6PD deficiency epidemiology), longer length of stay and higher hospital costs than those without G6PD deficiency (Table 1). Conclusions: This review of a national database shows a higher incidence of CHD in admissions with G6PD deficiency as well as worse hospital outcomes (longer length of stay, higher costs) for those with CHD and comorbid G6PD deficiency. There were demographic differences, but these reflect the typical inheritance of G6PD deficiency. While there may be potential interplay between race/ethnicity and these outcomes as well, further investigation is needed.
Abstract 4131488: Artificial Intelligence-Enhanced Electrocardiogram for the Diagnosis of Cardiac Amyloidosis: A Systemic Review and Meta-analysis
Authors: Laibah Khan, Isma Noor, Amber Siddique, Saad Shakil, Mahnoor Keen, Bayan Zafar, Maheera Farooqi, Nabeeha Essam, Muhammad Sami Khan, Tariq Jamal Siddiqi, Michael Hall
Journal: Circulation (2024)

Background: Diagnosis of cardiac amyloidosis (CA) is often delayed due to variability in clinical presentation. The electrocardiogram (ECG) is one of the most common and widely available tools for assessing cardiovascular diseases. Artificial intelligence (AI) models analyzing ECG have recently been developed to detect CA, but their pooled accuracy is yet to be evaluated. Aim: To meta-analyze the accuracy of AI-enhanced ECG in diagnosing CA. Methods: We searched the Scopus, MEDLINE, and Cochrane CENTRAL databases up until April 2024 for studies assessing AI-enhanced ECG diagnosis of CA. Studies reporting findings from derivation and validation cohorts were included. Studies combining other diagnostic modalities such as echocardiography were excluded. The outcome of interest was the area under the receiver operating characteristic curve (AUC) for overall CA and subtypes transthyretin amyloidosis (ATTR) and light chain amyloidosis (AL). Analysis was done using RevMan 5.4.1 general inverse variance random effects model, pooling data for AUC and 95% confidence intervals (CI). Results: 5 studies comprising 7 cohorts met the eligibility criteria. The total derivation and validation cohorts were 8,639 and 3,843 respectively. The AUC were 0.89 (95% CI, 0.86-0.91) for cardiac amyloidosis, 0.90 (95% CI, 0.86-0.95) for ATTR amyloidosis and 0.80 (95% CI, 0.80-0.93) for AL amyloidosis. The forest plots can be found in the Figure 1. Conclusion: AI-enhanced ECG models effectively detect CA and may provide a useful tool for the early detection and intervention of this disease.
Abstract 4131412: Effects of Angiotensin Converting Enzyme Inhibition And Afterload Reduction in Single Ventricle Patients Prior To Fontan: Not What You Might Think
Authors: Mark Fogel, Cassie Giner, Andrea Jones, Karen Ramirez Suarez, Maria Medina, Sara Partington, Danish Vaiyani, Matthew Harris, Kevin Whitehead, David Biko
Journal: Circulation (2024)

Introduction: Pts with single ventricle (SV) after bidirectional Glenn (BDG) are placed on angiotensin converting enzyme inhibitors (ACEI) to reduce afterload, improve ventricular performance and allow for decreased systemic to pulmonary collateral flow (APC). No large scale data exists to support ACEI use in BDG pts to accomplish this. We hypothesized that ACEI may not perform as predicted. Goals: To determine if ACEI use in BDG pts decreases APC and improves ventricular function. Methods: Single center retrospective study of all BDG pts who underwent cardiac magnetic resonance (CMR) from 2010 to present. Demographics, medication, ventricular function and flow data were collected. Pts included were &gt;1 year old and on ACEI for &gt;3 months prior to CMR. Wilcoxon and Fisher Exact tests were used. Significance P&lt;0.05 Results: Of the 320 BDG pts (median 2.8 years old) studied, 137 (43%) were treated with ACEI. See table for all data. There was no difference in age, sex, medications (except for ACEI) or body surface area (BSA) between both groups. APC as a % of aortic flow and APC/BSA were not different between those treated with ACEI compared to those who were not, whether right (RV) or left ventricle (LV) dominant. There was no correlation of APC with time on ACEI or ACEI dosage. Ejection fraction (EF) was lower and end-diastolic volume (EDV) was higher in BDG on ACEI for the entire group and RVs. Although LV EDV was higher with those on ACEI, LV EF was the same for those on ACEI and those who weren’t (graph). APC as a % of aortic flow and APC/BSA positively correlated with EDV (rho 0.25-0.34, P&lt;.001). There was no difference in atrioventricular valve regurgitation between those on ACEI and those who were not (median 5 vs 6% respectively). As a surrogate for cerebral blood flow (CBF), superior vena caval (SVC) flow was lower for those on ACEI compared to those who were not. Conclusion: BDG pts treated with ACEI did not demonstrate decreased APC or improved ventricular performance. There is a suggestion that ventricular performance may be worse on ACEI. CBF is decreased in BDG on ACEI using SVC flow as a surrogate. This suggests that ACEI use in SV pts at the BDG stage is not indicated and should be discouraged.
Abstract 4128549: Feasibility and Acceptability of a Combined Contingency Management and Problem-Solving Therapy Intervention to Enhance Alcohol Abstinence: A Pilot Single-Arm Mixed Methods Randomized Controlled Trial
Authors: HAGAR HALLI HAN, Sangeun Lee, Joy Shin, Ruth Adomah, Kathleen Rospenda
Journal: Circulation (2024)

Introduction/Background: It is crucial to develop and implement innovative behavior-change therapies that specifically target young adults with alcohol use disorder, as the prevalence of this issue is on the rise, and it has serious long-term health consequences. Research Questions/Hypothesis: How does the newly developed Contingency Management and Problem-Solving Therapy (CM-PST) intervention impact the levels of alcohol misuse or abstinence in young adults at follow-up compared to baseline.Young adults who receive the newly developed CM-PST will have lower levels of alcohol misuse or abstain from alcohol. Goals/Aims: We aimed to examine the feasibility, acceptability, and efficacy of an integrated behavior therapy of CM-PST for young adults with alcohol use disorder. Methods/Approach: This mixed methods study employed a single-arm design with post-intervention and 12-week follow-up assessments. Young adults aged 18-24 were recruited from July 2023 to May 2024. Participants underwent the newly developed integrated CM-PST intervention for 8 weeks. The assessment of feasibility was conducted by evaluating the rates of recruitment and retention, and adherence to the intervention. Acceptability was assessed by analyzing participants’ feedback and engagement data. Participants completed the Alcohol Use Disorders Identification Test (AUDIT) and the 90-day Timeline Follow back (TLFB) at baseline and 12 weeks after the intervention. Furthermore, they participated in a twice daily breathalyzer test, post-intervention interview and completed a client satisfaction scale questionnaire. Results: A total of 28 participants were recruited, with 71.43% (20/28) completing all the study procedures. Adherence to the CM-PST was 100%, indicating strong engagement. Participant feedback highlighted the influence of CM on behavior and decision-making and the efficacy of PST in addressing life challenges as well. Alcohol consumption at 12 weeks was significantly lower than those at baseline ( t =3.042, p =.007). Overall, the newly developed intervention was well-received, and 95% of participants indicated that the interventions were acceptable. Conclusions: This study showed that the integrated CM-PST intervention to promote alcohol abstinence and reduce alcohol related problems is both feasible and acceptable. Study findings indicated that the intervention has potential as a supplementary care for individuals seeking support in reducing alcohol consumption.
Abstract 4128519: Performance of a Popular Large Language Model in Answering Cardiovascular Related Queries: A Systematic Review and Pooled-Analysis
Authors: Joseph Kassab, Abdel Hadi El Hajjar, Elio Haroun, Mohamed Kanj, Ashish Sarraju, Luke Laffin, Samir Kapadia, Serge Harb
Journal: Circulation (2024)

Background: The integration of large language models (LLMs) such as ChatGPT into healthcare can have significant implications for patient education and clinical decision-making. Aims: This systematic review and pooled analysis aim to evaluate the accuracy of ChatGPT 3.5 and 4 in answering simple queries across cardiovascular (CV) medicine disciplines. Methods: Literature searches were conducted in PubMed, Embase, and Cochrane Central in May 2024. Keywords included “ChatGPT”, “LLMs”, and “Chat-based artificial intelligence models”. Cross-sectional, peer-reviewed studies published in 2023 and 2024 investigating ChatGPT’s performance in CV medicine-related queries (Table/Figure) were extracted and included. All queries were evaluated by expert physicians in the corresponding fields within each study (and not by our readjudication), and a standardized grading system was employed for pooled analysis using an "accurate" and "inaccurate" grading scale for each answer. Results: Out of 127 identified and screened peer-reviewed studies, fourteen studies involving 542 CV-related queries were included. Pooled analysis revealed an overall accuracy of 84.5% (458/542) (95% CI [81.5, 87.6]). Stratification by model (ChatGPT-4 vs. ChatGPT-3.5) did not show a significant difference in accuracy (p=0.32). Furthermore, no significant differences in accuracies were seen between answers in 2023 and 2024 (p=0.07). The accuracies across the various topics were statistically comparable, except in the field of cardio-oncology, which showed significantly lower accuracy at 68% (p=0.02). Detailed performances per topic are included in the table and figure. Conclusion: ChatGPT demonstrated consistently high accuracy in answering CV-related queries with no significant differences across model versions or years. These results support the potential use of online-chat based LLMs as an informational tool in cardiology.