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Association between antihypertensive combinations and postoperative mortality and functional decline: a nationwide survey of Japanese adults undergoing major surgeries medRxiv. Cardiovasc. Med. Pub Date : 2024-03-16 Rena Suzukawa, Shintaro Mandai, Yuta Nakano, Shunsuke Inaba, Hisazumi Matsuki, Yutaro Mori, Fumiaki Ando, Takayasu Mori, Koichiro Susa, Soichiro Iimori, Shotaro Naito, Eisei Sohara, Tatemitsu Rai, Kiyohide Fushimi, Shinichi Uchida
Background: Considering the limited information available regarding the impact of antihypertensive classes on mortality and physical function during hospitalization, we aimed to clarify the impact of six antihypertensive classes, namely thiazide/thiazide-like diuretics (TH), calcium receptor blockers (CCBs), renin-angiotensin-aldosterone system inhibitors (RASis), mineral corticoid receptor antagonists
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Understanding the Utility of Endocardial Electrocardiographic Imaging in Epi-Endocardial Mapping of 3D Reentrant Circuits medRxiv. Cardiovasc. Med. Pub Date : 2024-03-16 Maryam Toloubidokhti, Omar Gharbia, Adityo Prakosa, Natalia Trayanova, Saman Nazarian, John Sapp, Linwei Wang
Background: Studies of VT mechanisms are largely based on a 2D portrait of reentrant circuits on one surface of the heart. This oversimplifies the 3D circuit that involves the depth of the myocardium. Simultaneous epicardial and endocardial (epi-endo) mapping was shown to facilitate a 3D delineation of VT circuits, which is however difficult via invasive mapping. Objective: This study investigates
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Declining Trend of Sudden Cardiac Death in Younger Individuals: A 20-Year Nationwide Study medRxiv. Cardiovasc. Med. Pub Date : 2024-03-16 Carl Johann Hansen, Jesper Svane, Peder Emil Warming, Thomas Hadberg Lynge, Rodrigue GARCIA, Carolina Malta Hansen, Christian Torp-Pedersen, Jytte Banner, Bo Gregers Winkel, Jacob Tfelt-Hansen
Background Declining all-cause and cardiovascular mortality rates have been well-documented, yet temporal trends of sudden cardiac death (SCD) in the young are unclear. We provide contemporary nationwide estimates of the incidence and temporal trends of SCD in the young aged 1-35 from 2000-2019 and evaluate these trends in relation to changes in out-of-hospital cardiac arrest (OHCA) patterns and implantable
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Large-scale plasma proteomics in the UK Biobank modestly improves prediction of major cardiovascular events in a population without previous cardiovascular disease medRxiv. Cardiovasc. Med. Pub Date : 2024-03-15 Patrick Royer, Elias Bjornson, Martin Adiels, Rebecca Josefsson, Eva Hagberg, Anders Gummesson, Goran Bergstrom
Background and Aims: Improved identification of individuals at high risk of developing cardiovascular disease would enable targeted interventions and potentially lead to reductions in mortality and morbidity. Our aim was to determine whether use of large-scale proteomics improves prediction of cardiovascular events beyond traditional risk factors (TRFs). Methods: Using proximity extension assays, 2919
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Artificial intelligence-guided detection of under-recognized cardiomyopathies on point-of-care cardiac ultrasound medRxiv. Cardiovasc. Med. Pub Date : 2024-03-15 Evangelos K Oikonomou, Gregory Holste, Andreas Coppi, Robert L. McNamara, Girish Nadkarni, Cristiana Baloescu, Harlan Krumholz, Zhangyang Wang, Rohan Khera
Background: Point-of-care ultrasonography (POCUS) enables access to cardiac imaging directly at the bedside but is limited by brief acquisition, variation in acquisition quality, and lack of advanced protocols. Objective: To develop and validate deep learning models for detecting underdiagnosed cardiomyopathies on cardiac POCUS, leveraging a novel acquisition quality-adapted modeling strategy. Methods:
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Molecular insights into mitoepigenetic stress response signaling in age-associated cardiovascular disease risk medRxiv. Cardiovasc. Med. Pub Date : 2024-03-15 Nikita Soni, Prasan Kaur, Vikas Gurjar, Rajnarayan Tiwari, Vinay Singh Raghuwanshi, Rupesh K. Srivastava, Pradyumna Kumar Mishra
Cardiovascular diseases (CVD) represent a major challenge for the elderly population and continue to be among the leading causes of mortality worldwide. The integrity of mitochondria in peripheral lymphocytes can indicate age-related degenerative disorders, revealing the balance between bioenergetics, inflammation, and senescence. The present study aims to investigate the impact of aging on mitochondrial-mediated
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Cardiovascular outcomes and fracture risk after the discontinuation of preventative medications in older patients with complex health needs: a self-controlled case series analysis medRxiv. Cardiovasc. Med. Pub Date : 2024-03-15 DANIEL PRIETO-ALHAMBRA, Francesco Dernie, Antonella Delmestri, Trishna Rathod-Mistry, Eng Hooi Tan, Annika M. Jodicke
Objective To assess the effect of stopping statins, antihypertensives, and bisphosphonates on the risk of cardiovascular events and fractures in older patients with complex health needs (CHN). Methods Patients aged >65 years, registered in CPRD GOLD for ≥1 year before study start (01/01/2010) and with CHN (non-elective hospitalisation/s, frailty or polypharmacy) were selected. Self-controlled case
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Sex disparities in in-hospital outcomes after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction and a history of coronary artery bypass grafting (CABG): A nationwide inpatient sample-matched analysis (2016–2019) medRxiv. Cardiovasc. Med. Pub Date : 2024-03-14 Rui Yan, Xueping Ma, Bo Shi, Congyan Ye, Shizhe Fu, Kairu Wang, Haohong Qi, Mingzhi Cui, Ru Yan, Shaobin Jia, Guangzhi Cong
Background The role of sex disparities in in-hospital outcomes after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in patients with a history of coronary artery bypass grafting (CABG) remains underexplored. This study aimed to identify sex disparities in in-hospital outcomes after PCI in patients with AMI and a history of CABG. Methods Using the National Inpatient Sample
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Advanced ECG heart age estimation applicable to both sinus and non-sinus rhythm associates with cardiovascular risk, cardiovascular morbidity, and survival medRxiv. Cardiovasc. Med. Pub Date : 2024-03-13 Zaidon Al-Falahi, Todd T Schlegel, Israel Lamela-Palencia, Annie Li, Erik B Schelbert, Louise Niklasson, Maren Maanja, Thomas Lindow, Martin Ugander
Background: An explainable advanced electrocardiography (A–ECG) heart age gap is the difference between A–ECG heart age and chronological age. This gap is an estimate of accelerated cardiovascular ageing expressed in years of healthy human aging, and can intuitively communicate cardiovascular risk to the general population. However, existing A–ECG heart age measures require discernible P waves on the
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Factors affecting Cost-Related Medication Non-Adherence among US population with Cardiovascular Risk Factors medRxiv. Cardiovasc. Med. Pub Date : 2024-03-13 Nikhila Gandrakota, Manju Ramakrishnan, Kavya Sudireddy, Megha K Shah
Abstract Introduction In the US, cardiovascular diseases (CVD) are the leading cause of death and disability. Cost-related non-adherence (CRMN) can have serious consequences and worsen CVD outcomes. We examined the relationship between CVD risk factors and CRMN among US adults. Methods CDC?s 2019-2021 National Health Interview Survey (NHIS) data was used to examine CRMN among adults, categorized into
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Burden and Determinants of Self-Reported High Blood Pressure Among Women of Reproductive Age In Tanzania: Evidence from 2022 Tanzania Demographic and Health Survey. medRxiv. Cardiovasc. Med. Pub Date : 2024-03-13 Nelson Musilanga, Hussein Nasib, Ambokile Mwakibolwa, Keneth Kijusya, Samson Henry, Given Jackson, Frank Shayo, Clarkson Nhanga, Mussa Luwumba, Joseph Keshi, Saleh Girukwigomba
Background: High blood pressure, commonly referred to as hypertension, remains a prevalent global health concern characterized by elevated arterial pressure. Its multifactorial etiology involves genetic predisposition, lifestyle factors, and comorbidities, posing significant risks such as cardiovascular diseases, stroke, and kidney diseases. Therefore, the aim of this study was to assess the burden
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Bicuspid Aortic Valve Disease With Early Onset Complications: Characteristics And Aortic Outcomes. medRxiv. Cardiovasc. Med. Pub Date : 2024-03-13 Maximilian A Selbst, Megan K Laughlin, Colin R Ward, Hector Michelena, Anna Sabate-Rotes, Lisa Bianco, Julie De Backer, Laura Muiño Mosquera, Anji T. Yetman, Malenka M Bissell, Maria Grazia Andreassi, Ilenia Foffa, Dawn S. Hui, Anthony Caffarelli, Yuli Y. Kim, Dongchuan Guo, Rodolfo Citro, Margot De Marco, Justin T. Tretter, Shaine A Morris, Kim L. McBride, Simon C Body, EBAV Investigators, Siddharth
Bicuspid aortic valve (BAV) is the most common congenital heart malformation in adults but can also cause childhood-onset complications. In multicenter study, we found that adults who experience significant complications of BAV disease before age 30 are distinguished from the majority of BAV cases that manifest after age 50 by a relatively severe clinical course, with higher rates of surgical interventions
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Effects of individual components of remote monitoring for implantable cardioverter defibrillators or cardiac resynchronisation therapy defibrillators: protocol for a systematic review and component network meta-analysis medRxiv. Cardiovasc. Med. Pub Date : 2024-03-09 Makiko Okazaki, Natsuko Sekiguchi, Yuki Sahashi, Hisashi Noma, Takahiro Mihara
Introduction Currently, the standard of care for patients with cardiac implantable electronic devices (CIEDs) such as implantable cardioverter-defibrillators (ICD) and cardiac resynchronisation therapy-defibrillators (CRT-D) involves a combination of in-person outpatient visits and remote monitoring (RM). RM consists of scheduled remote device interrogation and automated transmission of prespecified
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Effect of prior tuberculosis on cardiovascular status in perinatally HIV-1-infected adolescents. medRxiv. Cardiovasc. Med. Pub Date : 2024-03-12 Itai M Magodoro, Carlos E Guerrero-Chalela, Landon Myer, Jennifer Jao, Mpiko Ntsekhe, Katalin A Wilkinson, Robert J Wilkinson, Heather Zar, Ntobeko AB Ntusi
Whether, and how, co-occurring HIV-1 infection (HIV) and tuberculosis (TB) impact cardiovascular status, especially in adolescents with perinatally acquired HIV (APHIV), have not been examined. We hypothesized that APHIV with previous active TB have worse cardiac efficiency than APHIV without TB, which is mediated by increased inflammation. Arterial elastance (Ea) and ventricular end-systolic elastance
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Prolonged Water-only Fasting is a Safe and Feasible Treatment Option for Managing Stage 1 and 2 Hypertension medRxiv. Cardiovasc. Med. Pub Date : 2024-03-12 Evelyn Zeiler, Sahmla Gabriel, Mackson Ncube, Natasha Thompson, Eugene R Scharf, Alan C Goldhamer, Toshia R Myers
Prolonged water-only fasting appears to reduce high blood pressure but randomized controlled trials are needed. This single arm pre-post interventional trial (clinicaltrials.gov, NCT04515095) investigates the safety, feasibility, and effectiveness of prolonged water-only fasting in the treatment of stage 1 and 2 hypertension. Twenty-nine participants with stage 1 and 2 hypertension, who were pre-approved
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Intravenous iron therapy with ferric carboxymaltose results in a rapid and sustained rise in myocardial iron content through a non-canonical pathway: a translational study medRxiv. Cardiovasc. Med. Pub Date : 2024-03-11 Mayra Vera-Aviles, Syeeda Kabir, Akshay Shah, Paolo Polzella, Yee Lim, Poppy Buckley, Charlotte Ball, Dorine Swinkels, Hanke Matlung, Colin Blans, Philip Holdship, Jeremy Nugent, Edward Anderson, Michael Desborough, Stefan Piechnik, Vanessa Ferreira, Samira Lakhal-Littleton
Background and Aims: Intravenous iron therapies contain iron-carbohydrate complexes, designed to ensure iron becomes bioavailable via the intermediary of spleen and liver reticuloendothelial macrophages. How other tissues obtain and handle this iron remains unknown. This study addresses this question in the context of the heart. Methods: A prospective observational study was conducted in 12 patients
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Cardioprotective effects of antiretroviral treatment in adolescents with perinatal HIV infection are heterogeneous depending on age at treatment initiation. medRxiv. Cardiovasc. Med. Pub Date : 2024-03-10 Itai M Magodoro, Carlos Eduardo E Guerrero-Chalela, Brian Claggett, Stephen Jermy, Petronella Samuels, Landon Myer, Heather Zar, Jennifer Jao, Mpiko Ntsekhe, Mark J Siedner, Ntobeko AB Ntusi
The cardioprotective effects of antiretroviral treatment (ART) in adolescents with perinatal HIV infection (APHIV) may depend on age at ART initiation. We used cardiovascular magnetic resonance (CMR) to characterize and compare residual cardiac changes in apparently healthy APHIV with early and delayed ART initiation compared to sex- and age-similar HIV uninfected peers. We defined early and delayed
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A Multicenter Randomized Controlled Trial of Exercise in Aortic Dissection Survivors medRxiv. Cardiovasc. Med. Pub Date : 2024-03-10 Yasmin A Toy, Kayla N House, Leslie M Boyer, Jennifer L McNamara, Marion A Hoffman-Bowman, Kim A Eagle, Michelle S Lim, Alan C Braverman, Siddharth K Prakash
There are currently no evidence-based guidelines for exercise after thoracic aortic dissection (TAD), leading to highly variable recommendations that frequently lead patients to restrict their physical activities. This multicenter randomized controlled trial was intended to evaluate the safety and efficacy of a moderate intensity guided exercise program for TAD survivors. Participants were eligible
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Lipoprotein(a) testing in Patients with Atherosclerotic Cardiovascular Disease in Five Large U.S. Health Systems medRxiv. Cardiovasc. Med. Pub Date : 2024-03-09 Nishant P Shah, Hillary Mulder, Betsy Lydon, Karen Chiswell, Xingdi Hu, Zachary M Lampron, Lauren Cohen, Manesh R. Patel, Susan Taubes, Wenliang Song, Suresh R. Mulukutla, Anum Saeed, Daniel P Morin, Steven M Bradley, Adrian F. Hernandez, Neha J. Pagidipati
Introduction: Lipoprotein (a) [Lp(a)] is an independent, causal risk factor for atherosclerotic cardiovascular disease (ASCVD). However, testing patterns remain variable and it is unclear what patient level factors are associated with Lp(a) testing, and if testing changes clinical management. Methods: A retrospective study using electronic medical record data from five health systems in the CardioHealth
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Constipation is associated with an increased risk of major adverse cardiac events in a UK population medRxiv. Cardiovasc. Med. Pub Date : 2024-03-08 Tenghao Zheng, Leticia Camargo Tavares, Mauro D'Amato, Francine Z. Marques
Background: Traditional cardiovascular risk factors, including hypertension, only explain part of major adverse cardiac events (MACE). Understanding what other risk factors contribute to MACE is essential for prevention. Constipation shares common risk factors with hypertension and is associated with an increased risk of several cardiovascular diseases. We hypothesised that constipation is an under-appreciated
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Death Incidents Following Transcatheter Edge-to-Edge Repair (TEER) With the MitraClip Device: Analysis of 10-years Post-marketing Death Reports from the Manufacturer and User Facility Device Experience (MAUDE) Registry medRxiv. Cardiovasc. Med. Pub Date : 2024-03-07 Xing-He Sun, YI-FEI ZHAO, Yan Li
Background: The MitraClip device (Abbott), an FDA-approved transcatheter apparatus, is employed for the management of mitral regurgitation (MR) among patients deemed at high risk for surgical interventions. We analyzed reports in the FDA MAUDE database to evaluate the safety trend in fatal complications associated with MitraClip implantation in the last decade. Methods: We searched the publicly accessible
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Racial Disparities in the Utilization and Outcomes of concomitant Left Atrial Appendage Exclusion during Cardiac Surgery: A Nationwide Analysis medRxiv. Cardiovasc. Med. Pub Date : 2024-03-07 Izhan Hamza, Mahmoud Ismayl, Amer Abdulla, Patricia A. Pellikka, Khaled Chatila
Background: Concomitant left atrial appendage exclusion (LAAE) during cardiac surgery is an effective method of reducing stroke risk in patients with atrial fibrillation. Previous studies have documented racial disparities in the performance of multiple cardiac procedures. We sought to evaluate if there were any disparities in the utilization and outcomes of concomitant LAAE. Methods: We used the 2016-2020
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Outcomes of a Multidisciplinary Approach to Management of Mavacamten in Obstructive Hypertrophic Cardiomyopathy medRxiv. Cardiovasc. Med. Pub Date : 2024-03-07 Hanna Jensen, Zaid Yousif, Trina Huynh, Megan Kraushaar, Marcy Reed, Trista Boarman, Jorge Silva Enciso, Andrew Willeford
Background: Traditional treatments for obstructive hypertrophic cardiomyopathy (oHCM) include beta-blockers, calcium channel blockers, and disopyramide. Mavacamten, a novel cardiac myosin inhibitor, is a promising oHCM therapy but has practical challenges limiting its use. This study aimed to describe a clinic workflow for mavacamten management in a real-world setting, addressing challenges such as
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A meta-analysis approach to gene regulatory network inference identifies key regulators of cardiovascular diseases medRxiv. Cardiovasc. Med. Pub Date : 2024-03-07 Gerardo Pepe, Romina Appierdo, Gabriele Ausiello, Manuela Helmer-Citterich, Pier Federico Gherardini
Cardiovascular diseases (CVDs) represent a major concern for global health whose mechanistic understanding is complicated by a complex interplay between genetic predisposition and environmental factors. Specifically, heart failure (HF), encompassing dilated cardiomyopathy (DC), ischemic cardiomyopathy (ICM), and hypertrophic cardiomyopathy (HCM), is a topic of substantial interest in basic and clinical
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Pulmonary Vein Isolation Versus Left Atrial Posterior Wall Isolation with the Cryoballoon Using the Cross-Over Technique in Persistent Atrial Fibrillation medRxiv. Cardiovasc. Med. Pub Date : 2024-03-06 Fuminori Odagiri, Takashi Tokano, Tetsuro Miyazaki, Koji Hirabayashi, Kai Ishii, Hiroshi Abe, Sayaki Ishiwata, Midori Kakihara, Masaaki Maki, Hiroki Matsumoto, Ryosuke Shimai, Tadao Aikawa, Shintaro Takano, Yuki Kimura, Shunsuke Kuroda, Hiroyuki Isogai, Dai Ozaki, Tomoyuki Shiozawa, Yuki Yasuda, Kiyoshi Takasu, Kenichi Iijima, Kazuhisa Takamura, Tomomi Matsubara, Haruna Tabuchi, Hidemori Hayashi, Ken
Background The cryoballoon (CB) has recently been used for performing pulmonary vein isolation (PVI) with concomitant left atrial posterior wall isolation (LAPWI). However, successful LAPWI using only the CB is technically challenging. This study aimed to evaluate the feasibility, safety, and efficacy of the cross-over technique, wherein an overlapped ablation is performed by placing the CB from both
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Catheter Ablation Approach Targeting Epicardial Connections to the Right Pulmonary Vein Antrum Detected before Pulmonary Vein Isolation medRxiv. Cardiovasc. Med. Pub Date : 2024-03-06 Yosuke Nakatani, Yutaka Take, Shingo Yoshimura, Ryoya Takizawa, Koji Goto, Kenichi Kaseno, Yumiko Haraguchi, Koki Kimura, Takehito Sasaki, Yuko Miki, Kohki Nakamura, Shigeto Naito
Background: Epicardial connections from surrounding structures to the right pulmonary vein (PV) antrum impede the PV isolation. This study aimed to evaluate the efficacy of an ablation approach targeting epicardial connections for right PV isolations. Methods: We prospectively enrolled 124 atrial fibrillation patients who underwent initial PV isolations. We identified the activation breakthrough site
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Coronary Microvascular Function Following Severe Preeclampsia medRxiv. Cardiovasc. Med. Pub Date : 2024-03-05 Michael C. Honigberg, Katherine E. Economy, Maria A Pabon, Xiaowen Wang, Claire Castro, Jenifer M. Brown, Sanjay Divakaran, Brittany N. Weber, Leanne Barrett, Anna Perillo, Anina Y. Sun, Tajmara Antoine, Faranak Farrohi, Brenda Docktor, Emily S. Lau, Doreen DeFaria Yeh, Pradeep Natarajan, Amy A. Sarma, Robert M. Weisbrod, Naomi M Hamburg, Jennifer E. Ho, Jason D. Roh, Malissa J. Wood, Nandita S. Scott
Background: Preeclampsia is a pregnancy-specific hypertensive disorder associated with an imbalance in circulating pro- and anti-angiogenic proteins. Preclinical evidence implicates microvascular dysfunction as a potential mediator of preeclampsia-associated cardiovascular risk. Methods: Women with singleton pregnancies complicated by severe antepartum-onset preeclampsia and a comparator group with
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Changes in risk factor status and risk of future ASCVD events in primary prevention medRxiv. Cardiovasc. Med. Pub Date : 2024-03-05 In-Chang Hwang, Chee Hae Kim, JaeYoung Kim, Jiesuck Park, Hyejung Choi, Hong-Mi Choi, Yeonyee E Yoon, Goo-Yeong Cho
Primary cardiovascular prevention highlights the management of risk factors through lifestyle changes and therapeutic interventions. While most previous studies focused on the presence of risk factors assessed only at baseline, temporal changes in the risk factor status were not considered. We aimed to evaluate the prognostic impact of temporal changes in risk factor status in primary prevention settings
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RACIAL AND ETHNIC DIFFERENCES IN LONG-TERM CARDIOVASCULAR MORTALITY AMONG WOMEN AND MEN FROM THE CAC CONSORTIUM medRxiv. Cardiovasc. Med. Pub Date : 2024-03-04 Samuel Aryeh Rosenblatt, Michael J. Blaha, Ron Blankstein, Yvette Yeboah-Kordieh, Khurram Nasir, Fay Y Lin, Daniel S. Berman, Michael D. Miedema, Seamus P Whelton, John A. Rumberger, Mathew Buddoff, Matthew J. Budoff, Jonathon Leipsic, Leslee J. Shaw
Background: Despite an increasingly diverse population, knowledge regarding racial and ethnic disparities is limited among women and men undergoing atherosclerotic cardiovascular (ASCVD) screening. Our aim was to compare CV mortality by ASCVD risk and coronary artery calcium (CAC) scores among Black and Hispanic women and men compared to other participants. Design and Methods: From the CAC Consortium
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Associations of Physical Activity and Heart Rate Variability from a Two-Week ECG Monitor with Cognitive Function and Dementia: the ARIC Neurocognitive Study medRxiv. Cardiovasc. Med. Pub Date : 2024-03-04 Francesca R Marino, Hau-Tieng Wu, Lacey Etzkorn, Mary R Rooney, Elsayed Z. Soliman, Jennifer A Deal, Ciprian M Crainiceanu, Adam Spira, Amal A. Wanigatunga, Jennifer A. Schrack, Lin Yee Chen
BACKGROUND: Low physical activity (PA) measured from accelerometers and low heart rate variability (HRV) measured from short-term ECG recordings are associated with worse cognitive function. Wearable long-term ECG monitors are now widely used. These monitors can provide long-term HRV data and, if embedded with an accelerometer, they can also provide PA data. Whether PA or HRV measured from long-term
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Significance of Right Ventricular Myocardial Work for Clinical Improvement in Heart Failure with Reduced Ejection Fraction Patients after Transcatheter Edge-To-Edge Repair medRxiv. Cardiovasc. Med. Pub Date : 2024-03-04 Jie Zeng, Qinglan Shu, Yi Liu, Cong Lu, Yun Xu, Yi Zhou, Qingfeng Zhang, Luwei Ye, Qingguo Meng, Sijia Wang, Yuan Yao, Xinyi Lin, YI WANG
Aims: It remains uncertain which patients would benefit the most from transcatheter edge-to-edge repair (TEER). We aim to investigate the relationship between right ventricular function, as assessed by pressure-strain loops (PSL), and post-TEER clinical improvement. Methods and results: A total of 48 heart failure with reduced ejection fraction (HFrEF) patients (68±15 yrs) with moderate-to-severe or
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Blood pressure management in 1,000 patients with CureApp HT digital therapeutics for hypertension medRxiv. Cardiovasc. Med. Pub Date : 2024-03-04 Akihiro Nomura, Yusuke Takagi, Tomoyuki Tanigawa, Masayuki Takamura, Koichi Node, Kazuomi Kario
Background: Essential hypertension patients who utilized a new digital therapeutics (DTx) application for hypertension for up to 6 months achieved notable decreases in ambulatory, home, and office blood pressures, per the HERB-DH1 randomized controlled trial. Nevertheless, the extent of its effectiveness in clinical settings is not yet fully understood. This study seeks to evaluate blood pressure changes
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Evaluation of a Machine Learning-guided Strategy for Elevated Lipoprotein(a) Screening in Health Systems medRxiv. Cardiovasc. Med. Pub Date : 2024-03-04 Arya Aminorroaya, Lovedeep Singh Dhingra, Evangelos K Oikonomou, Rohan Khera
Background: While universal screening for Lp(a) is increasingly recommended, fewer than 0.5% of the patients undergo Lp(a) testing. Here, we assessed the feasibility of deploying Algorithmic Risk Inspection for Screening Elevated Lp(a) (ARISE), a validated machine learning tool, to health system EHRs to increase the yield of Lp(a) testing. Methods: We randomly sampled 100,000 patients from the Yale-New
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Age-related structural remodelling of the coronary microcirculation medRxiv. Cardiovasc. Med. Pub Date : 2024-03-04 Daniel Candeias Faria, Marco Lombardi, Nina W van der Hoeven, Alejandro Travieso, Julius Cornelis Heemelaar, Sukhjinder S Nijjer, Hernán Mejía-Rentería, Guus A. de Waard, Sayan Sen, Tim P van de Hoef, Ricardo Petraco, Mauro Echavarría-Pinto, Jan J Piek, Justin E Davies, Niels van Royen, Javier Escaned
Background: While it is broadly accepted that ageing is associated with impairment of coronary microvascular function, little is known on the underlying mechanisms. Diastolic microcirculatory conductance (DMVC) and the backward expansion wave (BEW) derived from wave intensity analysis (WIA) are two physiological indices derived from post-analysis of coronary pressure and flow that have been previously
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Cross-Sectional and Longitudinal Evaluation of Heart-to-Brachium Pulse Wave Velocity for Cardiovascular Disease Risk medRxiv. Cardiovasc. Med. Pub Date : 2024-03-04 Jun Sugawara, Hirofumi Tanaka, Akira Yamashina, Hirofumi Tomiyama
BACKGROUND: Heart-brachium pulse wave velocity (hbPWV) is a measure of proximal aortic stiffness and does not require the technical placement of transducers. To characterize age-associated changes and the clinical utilities of heart-brachium pulse wave velocity (hbPWV), we conducted both cross-sectional and longitudinal analyses and used brachial-ankle pulse wave velocity (baPWV) as a comparative measure
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A Multicenter Evaluation of the Impact of Procedural and Pharmacological Interventions on Deep Learning-based Electrocardiographic Markers of Hypertrophic Cardiomyopathy medRxiv. Cardiovasc. Med. Pub Date : 2024-03-03 Lovedeep Singh Dhingra, Veer Sangha, Arya Aminorroaya, Robyn Bryde, Andrew Gaballa, Adel H Ali, Nandini Mehra, Harlan Krumholz, Sounok Sen, Christopher M Kramer, Matthew W Martinez, Milind Y Desai, Evangelos K Oikonomou, Rohan Khera
Background Artificial intelligence–enhanced electrocardiography (AI–ECG) can identify hypertrophic cardiomyopathy (HCM) on 12–lead ECGs and offers a novel way to monitor treatment response. While the surgical or percutaneous reduction of the interventricular septum (SRT) represented initial HCM therapies, mavacamten offers an oral alternative. Objective To evaluate biological response to SRT and mavacamten
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Temporal Trends in Stroke Management and Outcomes between 2011 and 2020: Results from a Nationwide Multicenter Registry medRxiv. Cardiovasc. Med. Pub Date : 2024-03-02 Tai Hwan Park, Keun-Sik Hong, Yong-Jin Cho, Wi-Sun Ryu, Dong-Eog Kim, Man-Seok Park, Kang-Ho Choi, Joon-Tae Kim, Jihoon Kang, Beom Joon Kim, Moon-Ku Han, Jun Lee, Jae-Kwan Cha, Dae-Hyun Kim, Jae Guk Kim, Soo Joo Lee, Jee-Hyun Kwon, Wook-Joo Kim, Dong-Ick Shin, Kyu Sun Yum, Sung-Il Sohn, Jeong-Ho Hong, Jay Chol Choi, Byung-Chul Lee, Kyung-Ho Yu, Mi Sun Oh, Jong-Moo Park, Kyusik Kang, Kyungbok Lee, Sang-Hwa
Background: There have been significant advancements in the treatment of ischemic stroke including stent retrievers for endovascular thrombectomy, new oral anticoagulants for atrial fibrillation, dual antiplatelet therapy for stroke prevention, and statins for atherosclerotic stroke. This study aims to evaluate temporal trends of these treatments and related clinical outcomes through a decade-long
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Identifying Appropriate Height Exponents and the Impact on Diagnosis and Prognosis of Left Ventricular Hypertrophy: the REMODEL Study medRxiv. Cardiovasc. Med. Pub Date : 2024-03-02 Clement Lee, Ryan Chan, Desiree Faye Toh, Michelle Kui, Vivian Lee, Jennifer Bryant, Redha Bourbertakh, Chi-Hang Lee, Ping Chai, Thu-Thao Le, Calvin WL Chin
BACKGROUND Left ventricular hypertrophy (LVH) is a strong predictor of adverse outcomes. Although normalizing LV mass (LVM) to height exponents reduced variability from body size, specific recommendations for height exponents are lacking due to a scarcity of normal cohorts to define appropriate height exponents. We aimed to demonstrate the diagnostic and prognostic implications of establishing height
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Predicting Patient Weight from Intracardiac Electrograms: A Study in Electrophysiological Signal Analysis medRxiv. Cardiovasc. Med. Pub Date : 2024-03-02 Celal Alagoz
The analysis of electrophysiological signals from the human body has become increasingly crucial, especially given the widespread adoption of wearable technologies and the growing trend of remote and online monitoring. In situations where demographic patient data is unavailable, the evaluation of such information from electrophysiological signals becomes imperative for making well-informed diagnostic
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Sex-Specific Effect of MTSS1 Downregulation on Dilated Cardiomyopathy medRxiv. Cardiovasc. Med. Pub Date : 2024-03-01 Dongwook Choe, Megan Burke, Jeffrey A Brandimarto, Ingrid Marti-Pamies, Jaime Yob, Yifan Yang, Michael P Morely, Theodore G Drivas, Sharlene Day, Scott M Damrauer, Xiao Wang, Thomas P Cappola
MTSS1 (metastasis suppressor 1) is an I-BAR protein that regulates cytoskeleton dynamics through interactions with actin, Rac, and actin-associated proteins. In a prior study, we identified genetic variants in a cardiac-specific enhancer upstream of MTSS1 that reduce human left ventricular (LV) MTSS1 expression and associate with protection against dilated cardiomyopathy (DCM). We sought to probe these
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Eligibility to COAPT trial in the daily practice: a real-world experience at 4 years medRxiv. Cardiovasc. Med. Pub Date : 2024-02-29 Edoardo Zancanaro, Nicola Buzzatti, Paolo Denti, nicolo azzola guicciardi, Enrico Melillo, Fabrizio Monaco, Eustachio Agricola, Francesco Ancona, Ottavio Alfieri, Michele De Bonis, Francesco Maisano
Background: The COAPT Trial was the first ever to demonstrate a survival benefit in treating functional mitral regurgitation (FMR). That was achieved through transcatheter mitral repair in selected patient. The exact proportion of patients fulfilling COAPT selection criteria in the real-world is unknown. Objectives: to assess the applicability of COAPT criteria in real-world and its impact on patients'
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A Qualitative Descriptive Study Exploring Caregivers' Information Needs and Experience Caring for a Child with Chronic Heart Failure medRxiv. Cardiovasc. Med. Pub Date : 2024-02-29 Chentel Cunningham, Jennifer Conway, Ziad Zahoui, Mark J Haykowsky, Shannon D. Scott
Background: Chronic phenotypes of pediatric heart failure pose life-long burdensome symptoms for the healthcare system and families. Treatment involves complex medical therapies with few surgical options until more advanced, refractory stages. Caregivers must become proficient in providing care to these vulnerable children in the home environment, which imposes a high amount of stress. Despite caregiver
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Net Clinical Benefit of Edoxaban for 12 versus 3 Months in Cancer-associated Isolated Distal Deep Vein Thrombosis: ONCO DVT study medRxiv. Cardiovasc. Med. Pub Date : 2024-02-29 Yuji Nishimoto, ONCO DVT Study Investigators, Yugo Yamashita, Takeshi Morimoto, Nao Muraoka, Michihisa Umetsu, Takuma Takada, Yoshito Ogihara, Tatsuya Nishikawa, Nobutaka Ikeda, Kazunori Otsui, Daisuke Sueta, Yukari Tsubata, Masaaki Shoji, Ayumi Shikama, Yutaka Hosoi, Yasuhiro Tanabe, Ryuki Chatani, Kengo Tsukahara, Naohiko Nakanishi, Kitae Kim, Satoshi Ikeda, Yukihito Sato, Tetsuya Watanabe, Takahisa
Background: The ONCO DVT (Edoxaban for 12 Months Versus 3 Months in Patients With Cancer With Isolated Distal Deep Vein Thrombosis) study has revealed the superiority of a 12-month versus 3-month edoxaban treatment in terms of fewer thrombotic events for cancer-associated isolated distal deep vein thrombosis; however, concern for increased bleeding with longer anticoagulation remains. Methods: In this
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Associations between Monocyte-to-High Density Lipoprotein Ratio and abdominal aortic calcification: Results of a nationwide survey medRxiv. Cardiovasc. Med. Pub Date : 2024-02-29 wei ran
Background Abdominal aortic calcification (AAC), a critical marker for cardiovascular disease, is strongly correlated with metabolic disorders like diabetes and hypertension. Recent studies have highlighted the Monocyte-to-High Density Lipoprotein Ratio (MHR) as a potential biomarker for assessing the risk of atherosclerosis and cardiovascular diseases. Methods and Results This cross-sectional study
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A Multimodality Video-Based AI Biomarker For Aortic Stenosis Development And Progression medRxiv. Cardiovasc. Med. Pub Date : 2024-02-29 Evangelos K. Oikonomou, Gregory Holste, Neal Yuan, Andreas Coppi, Robert L. McNamara, Norrisa Haynes, Amit N. Vora, Eric J. Velazquez, Fan Li, Venu Menon, Samir R. Kapadia, Thomas M. Gill, Girish N. Nadkarni, Harlan M. Krumholz, Zhangyang Wang, David Ouyang, Rohan Khera
Importance: Aortic stenosis (AS) is a major public health challenge with a growing therapeutic landscape, but current biomarkers do not inform personalized screening and follow-up. Objective: A video-based artificial intelligence (AI) biomarker (Digital AS Severity index [DASSi]) can detect severe AS using single-view long-axis echocardiography without Doppler. Here, we deploy DASSi to patients with
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Integrating urinary and plasma omics to identify markers and therapeutic targets for cardiac disease medRxiv. Cardiovasc. Med. Pub Date : 2024-02-28 Sophie C. de Ruiter, Marion van Vugt, Chris Finan, Rui Providencia, Sandesh Chopade, Diederick E. Grobbee, Hester M. den Ruijter, Sanne A. E. Peters, A. Floriaan Schmidt
Introduction: Urinary metabolites, representing kidney regulated filtration of metabolism end products, contain cardiac disease biomarkers such as NT-proBNP. We set out to integrate plasma proteins with urinary metabolites to identify potentially druggable metabolic pathways for cardiac disease. Methods: Data was leveraged from a genome-wide association study (GWAS) on 954 urinary metabolites. Mendelian
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Acceptability of fixed-dose combination treatments for hypertension in Kenya: a qualitative study using the Theoretical Framework of Acceptability. medRxiv. Cardiovasc. Med. Pub Date : 2024-02-27 Daniel Mbuthia, Ruth Willis, Mary Gichagua, Jacinta Nzinga, Peter Mugo, Adrianna Murphy
Background Fixed-dose combinations (FDCs) – 2-3 anti-hypertensive medications in a single pill - have the potential to improve hypertension treatment and outcomes. Yet, they are not widely implemented. Factors undermining implementation remain unknown, particularly in sub–Saharan Africa, where hypertension is a major cause of disease burden and is poorly treated. Methods We used in-depth semi-structured
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Differential expression analyses on aortic tissue reveal novel genes and pathways associated with abdominal aortic aneurysm onset and progression medRxiv. Cardiovasc. Med. Pub Date : 2024-02-27 Gerard Temprano-Sagrera, Begoña Soto, Jaume Dilmé, Olga Peypoch, Laura Calsina-Juscafresa, David Davtian, Lluis Nieto, Andrew Brown, José-Román Escudero, Ana Viñuela, Mercedes Camacho, Maria Sabater-Lleal
Background: Abdominal aortic aneurysms (AAA) are focal dilatations of the abdominal aorta. They are normally asymptomatic and progressively expand, increasing their risk of rupture. Rupture of an AAA is associated with high mortality rates, but the mechanisms underlying the initiation, expansion and rupture of AAA are not yet fully understood. This study aims to characterize and identify new genes
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Correlates of non-dipping blood pressure in persons with and without hypertension medRxiv. Cardiovasc. Med. Pub Date : 2024-02-27 Situmbeko Liweleya, Benson M Hamooya, Obrain Mungalu, Sharon Zimba, Sepiso Masenga
Background Blood pressure (BP) is known to follow a circadian rhythm with 10% to 15% lower values during the night than daytime. Non-dipping BP refers to the absence of BP dipping and has been associated with the development of target organ damage. The general goal of this study was to determine the correlates of non-dipping BP in persons with and without hypertension. Methods This was a cross-sectional
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Standardized Data Elements for Patients with Acute Pulmonary Embolism: A Consensus Report from the Pulmonary Embolism Research Collaborative medRxiv. Cardiovasc. Med. Pub Date : 2024-02-23 Kenneth Rosenfield, Terry Bowers, Christopher Barnett, George Davis, Jay Giri, James Horowitz, Menno V. Huisman, Beverley J. Hunt, Brent Keeling, Jeffrey A Kline, Frederikus A. Klok, Stavros Konstantinides, Michelle Lanno, Robert Lookstein, John Moriarty, Fionnuala Ní Áinle, Jamie Reed, Rachel Rosovsky, Sara Royce, Eric A. Secemsky, Andrew SP Sharp, Akhilesh K. Sista, Roy E Smith, Phil Wells, Joanna
Recent advances in therapy and the promulgation of multidisciplinary pulmonary embolism teams (PERTs) show great promise to improve management and outcomes of acute pulmonary embolism (PE). However, the absence of randomized evidence and lack of consensus leads to tremendous variations in treatment and compromises the wide implementation of new innovations. Moreover, the changing landscape of healthcare
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18F-NaF Uptake on Vascular PET Imaging in Symptomatic versus Asymptomatic Atherosclerotic Disease: a Meta-Analysis medRxiv. Cardiovasc. Med. Pub Date : 2024-02-23 Shiv Bhakta, Mohammed M Chowdhury, Jason M Tarkin, James H.F. Rudd, Elizabeth A Warburton, Nicholas R Evans
Abstract Introduction 18F-sodium fluoride (NaF) positron-emission tomography (PET) is increasingly being used to measure microcalcification in atherosclerotic disease in vivo. Correlations have been drawn between sodium fluoride uptake and the presence of high-risk plaque features, as well as its association with clinical atherosclerotic sequelae. The aim of this review was to perform a meta-analysis
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Conduction system pacing is superior to reduce the new-onset atrial fibrillation risk compared with right ventricular pacing: insights from pooled clinical evidence medRxiv. Cardiovasc. Med. Pub Date : 2024-02-22 Feng Li, You Zhang, Si-Liang Peng, Meng-Chao Jin, Chi Geng, Venkatesh Ravi, Parikshit S Sharma, Pugazhendhi Vijayaraman, Hui Li
Background: Conduction system pacing (CSP) has been reported to improve clinical outcomes in comparison of right ventricular pacing (RVP). However, the performance between CSP and RVP on the risk of new-onset atrial fibrillation (AF) remains elusive. Methods: Four online databases were systematically searched up to December 1st 2023. Studies comprising the rate/risk of new-onset AF between CSP and
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Superior long-term patency of no-touch vein graft compared to conventional vein grafts in over 1500 consecutive patients medRxiv. Cardiovasc. Med. Pub Date : 2024-02-21 Gabriele Ferrari, Richard Loayza, Ava Azari, Håkan Geijer, Yang Cao, Roland Carlsson, Leif Bojö, Ninos Samano, Domingos Savio Souza
Objectives: To evaluate the long-term angiographic patency of saphenous vein grafts (SVG) harvested using the no-touch technique compared to the conventional technique. Methods: This was a single-center, retrospective, cohort study. The inclusion criteria were individuals who underwent a CABG (coronary artery bypass grafting) between January 1995 and July 2020, and who successively needed a clinically-driven
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Automated Estimation of Computed Tomography-Derived Left Ventricular Mass Using Sex-specific 12-Lead ECG-Based Temporal Convolutional Network medRxiv. Cardiovasc. Med. Pub Date : 2024-02-21 Heng-Yu Pan, Benny Wei-Yun Hsu, Chun-Ti Chou, Chih-Kuo Lee, Wen-Jeng Lee, Tai-Ming Ko, Tzung-Dau Wang, Vincent S. Tseng
Background Left ventricular hypertrophy (LVH) is characterized by increased left ventricular myocardial mass (LVM) and is associated with adverse cardiovascular outcomes. Traditional LVH diagnosis based on rule-based criteria using limited electrocardiogram (ECG) features lacks sensitivity. Accurate LVM evaluation requires imaging techniques such as magnetic resonance imaging or computed tomography
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Mapping echocardiogram reports to a structured ontology: a task for statistical machine learning or large language models? medRxiv. Cardiovasc. Med. Pub Date : 2024-02-21 Suganya Subramaniam, Sara Rizvi, Ramya Ramesh, Vibhor Sehgal, Brinda Gurusamy, Hikamtullah Arif, Jeffrey Tran, Ritu Thamman, Emeka Anyanwu, Ronald Mastouri, G Burkhard Mackensen, Rima Arnaout
Background: Big data has the potential to revolutionize echocardiography by enabling novel research and rigorous, scalable quality improvement. Text reports are a critical part of such analyses, and ontology is a key strategy for promoting interoperability of heterogeneous data through consistent tagging. Currently, echocardiogram reports include both structured and free text and vary across institutions
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Racial and Ethnic Disparities among Takotsubo Cardiomyopathy; A Nation-Wide Analysis medRxiv. Cardiovasc. Med. Pub Date : 2024-02-21 Jamal C Perry, Oluwasegun M Akinti, Henry A Becerra, Henry O Aiwuyo, Charles O Poluyi, Abdullah Khan
Background: Takotsubo cardiomyopathy (TSC) is a transient left ventricular dysfunction often precipitated by stress, with unclear mechanisms ranging from coronary artery spasm to microvascular dysfunction. Its true incidence remains uncertain, estimated at 1 to 2% among suspected acute coronary syndrome cases. This condition can have a favorable prognosis but is associated with fatal complications
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A Novel Truncating Variant in MYBPC3 Causes Hypertrophic Cardiomyopathy medRxiv. Cardiovasc. Med. Pub Date : 2024-02-21 Yuanyuan Zhang, Wenyan Gong, Yusheng Cong, Xingwei Zhang, Zhelan Zheng
Background Familial hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disease. Related mutations contributing to hypercontractility and poor relaxation in HCM have been incompletely understood. The purpose of this study was to explore and verify a novel variant in cardiac myosin-binding protein C3 (MYBPC3) in a HCM family. Methods Clinical information was collected and cardiac
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Cardiac remodeling in moderate aortic stenosis medRxiv. Cardiovasc. Med. Pub Date : 2024-02-21 Eylem Levelt, Marilena Giannoudi, Henry Procter, Sindhoora Kotha, Nicholas Jex, Amrit Chowdhary, Sharmaine Thirunavukarasu, Peter P. Swoboda, Sven Plein, Richard M Cubbon, Hui Xue, Ladislav Valkovic, Peter Kellman, Marc Dweck, John P. Greenwood
Background: Aortic stenosis (AS) accounts for substantial global morbidity and premature mortality even in moderate AS (Mod-AS). The mechanisms for this adverse prognosis in Mod-AS, however, remain poorly understood, although the myocardial remodeling response is thought to be critical. We aimed to prospectively assess myocardial remodeling, perfusion and energetics differences in Mod-AS and severe
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Efficacy of Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Disease Patients with Exercise Pulmonary Hypertension medRxiv. Cardiovasc. Med. Pub Date : 2024-02-21 Yutaro Naka, Takumi Inami, Kaori Takeuchi, Hanako Kikuchi, Ayumi Goda, Masaharu Kataoka, Takashi Kohno, Kyoko Soejima, Toru Satoh
Background The efficacy of balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary disease (CTEPD) with or mild pulmonary hypertension (PH) or without PH remains unknown. Exercise pulmonary hypertension (Ex-PH) is associated with impaired exercise capacity and ventilatory efficiency, even under normalized pulmonary hemodynamics at rest. We hypothesized that patients with Ex-PH and/or
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Impact of Calcium Cracks after Balloon Angioplasty in Patients with Complex Calcified Coronary Plaque The Results of the OCT-CALC Registry medRxiv. Cardiovasc. Med. Pub Date : 2024-02-20 Nobuhiko Maejima, Tsutomu Endo, Takashi Ashikaga, Taishi Yonetsu, Kazuhiro Ashida, Hiroshi Ohira, Takahiko Kiyooka, Tomohiko Shigemasa, Gaku Nakazawa, Yuji Ikari, Akihiro Hata, Tetsuya Tobaru, Itaru Takamisawa, Teruyasu Sugano, Ichiro Michishita, Kouji Yamamoto, Toshiro Shinke, Ken Kozuma, Yasuhiro Honda, Kiyoshi Hibi
Background: Target lesion calcification is known to influence the percutaneous coronary intervention (PCI) outcomes. This study aimed to assess the impact of calcium cracks after balloon angioplasty on the PCI results as well as the long-term clinical outcomes by multicenter optical coherence tomography (OCT)-guided PCI registry. Methods: We formed a prospective, multicenter registry that include 22