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Drug-target Mendelian randomization analysis supports lowering plasma ANGPTL3, ANGPTL4, and APOC3 levels as strategies for reducing cardiovascular disease risk medRxiv. Cardiovasc. Med. Pub Date : 2024-04-15 Fredrik Landfors, Peter Henneman, Elin Chorell, Stefan K. Nilsson, Sander Kersten
Background and Aims APOC3, ANGPTL3, and ANGPTL4 are circulating proteins that are actively pursued as pharmacological targets to treat dyslipidemia and reduce the risk of atherosclerotic cardiovascular disease. Here, we used human genetic data to compare the predicted therapeutic and adverse effects of APOC3, ANGPTL3, and ANGPTL4 inactivation.
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Transcatheter versus Surgical Interventions for Severe Aortic Stenosis: A Contemporary Evaluation against Conservative Management medRxiv. Cardiovasc. Med. Pub Date : 2024-04-15 Zhiyuan Ma, Shahrad Shadman, Yaniv Maddahi, Mahesh Krishnamurthy, Peter Puleo, Jamshid Shirani
Background Aortic valve replacement (AVR), through transcatheter (TAVR) or surgical (SAVR) means, serves as a pivotal therapeutic approach for severe aortic stenosis (AS). While both modalities show advantages over conservative management, the long-term mortality benefits post-AVR, especially when comparing TAVR with SAVR, remain uncertain.
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Premorbid predictors of a fatal initial presentation of coronary heart disease among post-menopausal women medRxiv. Cardiovasc. Med. Pub Date : 2024-04-14 Ming-Li Chen, Jin Li, Kruthika R. Iyer, Catherine Tcheandjieu, Shirin Jimenez, Elias Levy Itshak Salfati, Liana C. Del Gobbo, Marcia L Stefanick, Manisha Desai, Xiaonan Xue, Themistocles L Assimes
Background Premorbid health traits that predispose to a fatal initial presentation of coronary heart disease (CHD) remain poorly characterized.
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A Role For Electrocardiograms in Aortic Stenosis Screening: A Retrospective Trial medRxiv. Cardiovasc. Med. Pub Date : 2024-04-14 Matthew Pulaski, Aditi Newadkar, Iman Richie, Cole Urnes, Ivan Ho, Jubin Joseph, Ray Matthews, Junaid Zaman
Background Aortic stenosis affects 1 in 50 adults over age 65 and is associated with significant morbidity and mortality. Machine learning has identified an association between right-sided precordial U waves and moderate to severe aortic stenosis. No study has explored the role of ECG screening by primary care physicians for patients with unknown aortic stenosis status.
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Can Deep Learning Models Differentiate Atrial Fibrillation from Atrial Flutter? medRxiv. Cardiovasc. Med. Pub Date : 2024-04-15 Estela Ribeiro, Quenaz Bezerra Soares, Felipe Meneguitti Dias, Jose Eduardo Krieger, Marco Antonio Gutierrez
This study investigates the use of standard 12-lead ECG records from six largest PhysioNet CinC Challenge 2021 databases and a private database to differentiate Atrial Fibrillation from Atrial Flutter. Image-based and one-dimensional-based Deep Learning models were considered to perform the classification using different 1D and 2D Convolutional Neural Network architectures. For 1D CNNs, LiteVGG-11
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Machine learning model for predicting left atrial thrombus or spontaneous echo contrast in non-valvular atrial fibrillation patients based on multimodal echocardiographic parameters medRxiv. Cardiovasc. Med. Pub Date : 2024-04-12 Decai Zeng, Shuai Chang, Xiaofeng Zhang, Xiangling Cao, Yanfen Zhong, Yongzhi Cai, Tongtong Huang, Ji Wu
BACKGROUND Although clinical prediction models have been proposed to predict thrombosis risk in non-valvular atrial fibrillation (NVAF), machine learning (ML) based models to predict thrombotic risk were limited. This study aimed to develop a robust ML-based predictive model that integrates multimodal echocardiographic data and clinical risk factors to evaluate the risk of thrombosis in patients with
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Ablation STrategies for Repeat PrOcedures in Atrial Fibrillation Recurrences despite Durable Pulmonary Vein Isolation ASTRO - AF Trial medRxiv. Cardiovasc. Med. Pub Date : 2024-04-12 Boris Schmidt, Stefano Bordignon, Andreas Metzner, Philipp Sommer, Daniel Steven, Tilmann Dahme, Matthias Busch, Roland Richard Tilz, David Schaack, Andreas Rillig, Christian Sohns, Arian Sultan, Karolina Weinmann-Emhardt, Astrid Hummel, Julia Vogler, Thomas Fink, Jakob Lueker, Alexander Pott, Christian Heeger, KR Julian Chun
Background Ablation strategies for patients with symptomatic atrial fibrillation (AF) and isolated pulmonary veins (PV) vary and their impact on arrhythmia recurrence remains unclear. This prospective randomized German multi—center trial sought to compare two ablation strategies in this patient cohort.
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Clinical Outcomes, Management, Healthcare Resource Utilization, and Cost According to the CHA2DS2-VASc Scores in Asian Patients with Nonvalvular Atrial Fibrillation medRxiv. Cardiovasc. Med. Pub Date : 2024-04-12 Keye Fan, Yue Xiao, Aoming Xue, Jifang Zhou
Background The prognosis among non-valvular atrial fibrillation (NVAF) patients with different CHA2DS2-VASc scores in the contemporary Asian population remains unclear. Additionally, there is a lack of research examining the disparities in management patterns, healthcare resource utilization (HCRU), and cost among these patients. Therefore, this study aims to assess the incidence of clinical outcomes
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Reduced Continuity Index with Proactive Esophageal Cooling Compared to Luminal Temperature Monitoring During Radiofrequency Ablation medRxiv. Cardiovasc. Med. Pub Date : 2024-04-12 Catherine Lazarus, Jacob Sherman, Natalie Putzel, William Zagrodzky, Tiffany Sharkoski, Alex Ro, Jose Nazari, Westby Fisher, Erik Kulstad, Mark Metzl
Background Proactive esophageal cooling is FDA cleared to reduce the likelihood of esophageal injury during radiofrequency ablation for treatment of atrial fibrillation (AF). Long-term follow-up data have also shown improved freedom from arrhythmia with proactive esophageal cooling compared to luminal esophageal temperature (LET) monitoring during pulmonary vein isolation (PVI). One hypothesized mechanism
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Sleep-Disordered Breathing Destabilizes Ventricular Repolarization medRxiv. Cardiovasc. Med. Pub Date : 2024-04-12 Soroosh Solhjoo, Mark C. Haigney, Trishul Siddharthan, Abigail Koch, Naresh M. Punjabi
Rationale Sleep-disordered breathing (SDB) increases the risk of cardiac arrhythmias and sudden cardiac death.
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The association between HDL-C and stroke in people over 40 years of age: A NHANES cross-sectional study medRxiv. Cardiovasc. Med. Pub Date : 2024-04-10 Kevin Patel
Background Previously, studies have indicated that high-density cholesterol (HDL-C) levels are associated with lower risk of cardiovascular disease. However, this has been challenged in recent years.
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Evidence of aberrant anti-Epstein-Barr virus antibody response, though no viral reactivation, in people with post-stroke fatigue medRxiv. Cardiovasc. Med. Pub Date : 2024-04-10 Isobel C. Mouat, Judy Zhu, Alperen Aslan, Barry W. McColl, Stuart M. Allan, Craig J. Smith, Marion S. Buckwalter, Laura McCulloch
BACKGROUND Fatigue is a common complication of stroke that has a significant impact on quality of life. The biological mechanisms that underly post-stroke fatigue are currently unclear, however, reactivation of latent viruses and their impact on systemic immune function have been increasingly reported in other conditions where fatigue is a predominant symptom. Epstein-Barr virus (EBV) in particular
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Temporal Heart Rhythm Clusters and Physiomorphic Age Mapping: A Deep Learning Approach to Cardiovascular Risk Stratification medRxiv. Cardiovasc. Med. Pub Date : 2024-04-10 Gouthamaan Manimaran, Sadasivan Puthusserypady, Helena Dominguez, Jakob E. Bardram
Purpose Understanding the intricate relationships between sleep quality and cardiovascular outcomes can potentially offer new avenues in risk stratification for cardiovascular diseases (CVD). This study aimed to evaluate the significance of biological age predicted through the analysis of sleep stages and nocturnal heart rhythms as a marker for cardiovascular risk.
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Long-Term Mortality Prediction with Pooled Cohort Equations: Implications for Lipid-Lowering Therapy medRxiv. Cardiovasc. Med. Pub Date : 2024-04-09 Zhiyuan Ma, Lynn N. Moran, Jamshid Shirani
Background Current guidelines recommend primary prevention statin therapy based on 10-year risk of atherosclerotic cardiovascular disease (ASCVD) assessed by the pooled cohort equations (PCE), while assessing effectiveness through low-density lipoprotein cholesterol levels. It remains uncertain whether 10-year ASCVD risk can accurately predict the mortality impact of lipid-lowering therapy.
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EchoGPT: A Large Language Model for Echocardiography Report Summarization medRxiv. Cardiovasc. Med. Pub Date : 2024-04-09 Chieh-Ju Chao, Imon Banerjee, Reza Arsanjani, Chadi Ayoub, Andrew Tseng, Jean-Benoit Delbrouck, Garvan C. Kane, Francisco Lopez-Jimenez, Zachi Attia, Jae K Oh, Li Fei-Fei, Ehsan Adeli, Curtis Langlotz
Background The increasing need for diagnostic echocardiography (echo) tests presents challenges in preserving the quality and promptness of reports. While Large Language Models (LLMs) have proven effective in summarizing clinical texts, their application in echo remains underexplored. To address this, we proposed EchoGPT, a dedicated, domain specific LLM focused on echo report summarization.
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Prescription Trends of Initial Antihypertensive Medications among Treatment-Naïve Individuals in South Korea: A Retrospective Analysis medRxiv. Cardiovasc. Med. Pub Date : 2024-04-09 Hajung Joo, Seung Eun Chae, Yeong Rok Eom, Nam Kyung Je
Introduction Managing hypertension effectively is crucial for preventing cardiovascular complications. This study investigates the prescribing trends of initial antihypertensive treatments in South Korea, focusing on the shift towards combination therapies, especially fixed-dose combinations, as recommended by current guidelines.
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Immune system homeostasis in people with multiple long-term conditions determines susceptibility to organ injury and mortality following cardiac surgery medRxiv. Cardiovasc. Med. Pub Date : 2024-04-09 Florence Y Lai, Adewale S Adebayo, Sophia Sheikh, Marius Roman, Lathishia Joel-David, Hardeep Aujla, Tom Chad, Kristina Tomkova, Shameem Ladak, Gianluigi Condorelli, Mustafa Zakkar, Charles Solomon, Marcin J Woźniak, Gavin J Murphy
Background People with Multiple Long-Term Conditions (MLTC) experience higher rates of organ failure and death following cardiac surgery. The aim of this study was to identify disease processes in MLTC associated with increased susceptibility to organ injury post-surgery.
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Adaptive trials in stroke: Current use & future directions medRxiv. Cardiovasc. Med. Pub Date : 2024-04-05 Kathryn S Hayward, Emily J Dalton, Bruce CV Campbell, Pooja Khatri, Sean P Dukelow, Hannah Johns, Silke Walter, Vignan Yogendrakumar, Jeyaraj Pandian, Simona Sacco, Julie Bernhardt, Mark Parsons, Jeffrey L Saver, Leonid Churilov
Inclusion of adaptive design features in a clinical trial provides pre-planned flexibility to dynamically modify a trial during its conduct, while preserving validity and integrity. Adaptive trials are needed to accelerate the conduct of more efficient, informative, and ethical clinical research in the field of neurology as compared to traditional fixed designs. Stroke is a natural candidate for adoption
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A longitudinal analysis of incidence of hypertension and blood pressure measurements by age of migration among older Hispanic men and women medRxiv. Cardiovasc. Med. Pub Date : 2024-04-05 Brandon S. Walker, Norman J Waitzman, Evan V. Goldstein, Megan E. Vanneman, Alan Taylor Kelley, Fernando A. Wilson
Objective To conduct a longitudinal analysis of incidence of self-reported hypertension and blood pressure measurements among foreign-born Hispanics by age of migration, compared to US-born populations.
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Reference equations for peak oxygen uptake for treadmill cardiopulmonary exercise tests based on the NHANES lean body mass equations, a FRIEND registry study medRxiv. Cardiovasc. Med. Pub Date : 2024-04-05 Everton J. Santana, Daniel Seung Kim, Jeffrey W Christle, Nicholas Cauwenberghs, Bettia E. Celestin, Jason V. Tso, Matthew T Wheeler, Euan A Ashley, James E. Peterman, Ross Arena, Matthew Harber, Leonard A. Kaminsky, Tatiana Kuznetsova, Jonathan N. Myers, Francois Haddad
BACKGROUND Cardiorespiratory fitness (CRF), measured by peak oxygen uptake (VO2peak), is a strong predictor of mortality. Despite its widespread clinical use, current reference equations for VO2peak show distorted calibration in obese individuals. Using data from the Fitness Registry and the Importance of Exercise National Database (FRIEND), we sought to develop novel reference equations for VO2peak
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Ready-To-Use Investigational Stem Cells, MiSaver, in Patients with Recent Acute Myocardial Infarction, 1 year follow up from a Phase 1 Safety Study medRxiv. Cardiovasc. Med. Pub Date : 2024-04-04 KC Ueng, CF Tsai, CH Su, YT Chuang, JTK Liu
Objectives The aim of this study was to investigate the safety of MiSaver stem cells and their preliminary efficacy in improving left ventricular ejection function and functional activity in patients with acute myocardial infarction (AMI)
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The effect of transcutaneous auricular vagus nerve stimulation on cardiovascular function in subarachnoid hemorrhage patients: a safety study medRxiv. Cardiovasc. Med. Pub Date : 2024-04-03 Gansheng Tan, Anna L. Huguenard, Kara M. Donovan, Phillip Demarest, Xiaoxuan Liu, Ziwei Li, Markus Adamek, Kory Lavine, Ananth K. Vellimana, Terrance T. Kummer, Joshua W. Osbun, Gregory J. Zipfel, Peter Brunner, Eric C. Leuthardt
Objective Subarachnoid hemorrhage (SAH) is characterized by intense central inflammation, leading to substantial post-hemorrhagic complications such as vasospasm and delayed cerebral ischemia.2,6,7 Given the anti-inflammatory effect of transcutaneous auricular vagus nerve stimulation (taVNS) and its ability to promote brain plasticity, taVNS has emerged as a promising therapeutic option for SAH patients
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Scalable Risk Stratification for Heart Failure Using Artificial Intelligence applied to 12-lead Electrocardiographic Images: A Multinational Study medRxiv. Cardiovasc. Med. Pub Date : 2024-04-03 Lovedeep S Dhingra, Arya Aminorroaya, Veer Sangha, Aline Pedroso Camargos, Folkert W Asselbergs, Luisa CC Brant, Sandhi M Barreto, Antonio Luiz P Ribeiro, Harlan M Krumholz, Evangelos K Oikonomou, Rohan Khera
Background Current risk stratification strategies for heart failure (HF) risk require either specific blood-based biomarkers or comprehensive clinical evaluation. In this study, we evaluated the use of artificial intelligence (AI) applied to images of electrocardiograms (ECGs) to predict HF risk.
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Endovascular thrombectomy for acute ischemic stroke with a large infarct area: an updated systematic review and meta-analysis of randomized controlled trials medRxiv. Cardiovasc. Med. Pub Date : 2024-04-03 Shivani Ravipati, Ayesha Amjad, Komal Zulfiqar, Hannah Biju, Wajeeh Hassan, Haider Mumtaz Jafri, Ali Husnain, Ibrahim Tahir, Muaaz Aslam, Sharib Afzal, Muhammad Ehsan, Huzaifa Ahmad Cheema, Muhammad Ayyan, Wajeeh Ur Rehman, Sourbha S. Dani
Background Since the efficacy and safety of endovascular thrombectomy (EVT) in patients with acute ischemic stroke with a large infarct area is still inconclusive, we sought to compare functional and neurological outcomes with the use of endovascular thrombectomy versus medical care alone.
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Pacemaker implantation after cardiac surgery: a contemporary, nationwide perspective medRxiv. Cardiovasc. Med. Pub Date : 2024-04-02 Amar Taha, Alice David, Sigurdur Ragnarsson, Piotr Szamlewski, Shabbar Jamaly, J. Gustav Smith, Susanne J. Nielsen, Anders Jeppsson, Andreas Martinsson
Background Cardiac surgery entails an increased risk for brady-arrhythmias. Currently known rates for permanent pacemaker (PPM) implantation after cardiac surgery are derived from non-contemporary studies. This study aimed to explore the incidence and indications for PPM implantation at 30 days and one year after different cardiac surgical procedures in a modern cohort.
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Artificial Intelligence for Hemodynamic Monitoring with a Wearable Electrocardiogram Monitor medRxiv. Cardiovasc. Med. Pub Date : 2024-04-01 Daphne E. Schlesinger, Ridwan Alam, Roey Ringel, Eugene Pomerantsev, Srikanth Devireddy, Pinak Shah, Joseph Garasic, Collin M. Stultz
Background The ability to non-invasively measure left atrial pressure would facilitate the identification of patients at risk of pulmonary congestion and guide proactive heart failure care. Wearable cardiac monitors, which record single-lead electrocardiogram data, provide information that can be leveraged to infer left atrial pressures.
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Intensive Blood Pressure Lowering Improves Left Ventricular Geometry in Older Hypertensive Patients: The STEP Trial medRxiv. Cardiovasc. Med. Pub Date : 2024-04-01 Yue Deng, Juyan Zhang, Zhenzhen Chen, Jingjing Bai, Xiaomin Yang, Chunli Yu, Jing Yu, Jun Cai, STEP Study Group
Background The effect of intensive systolic blood pressure (SBP) lowering on left ventricular (LV) geometry remains unclear.
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COMPARING EFFICACY AND SAFETY OF LEFT ATRIAL APPENDAGE CLOSURE DEVICES: A NETWORK META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS medRxiv. Cardiovasc. Med. Pub Date : 2024-04-01 John W Davis, Steven L Mai, Wissam Harmouch, Jenna Reisler, Elizabeth Davis
Introduction Atrial fibrillation-related stroke is a leading cause of morbidity and mortality. Options for prevention include left atrial appendage closure devices or oral anticoagulation. However, it remains unclear which option may be superior overall.
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Mitral annular plane systolic excursion to left atrial volume ratio – a strainless relation with left ventricular filling pressures medRxiv. Cardiovasc. Med. Pub Date : 2024-03-31 Thomas Lindow, Hande Oktay Tureli, Charlotte Eklund Gustafsson, Daniel Manna, Björn Wieslander, Per Lindqvist, Ashwin Venkateshvaran
Purpose Left atrial reservoir strain (LASr) offers diagnostic and prognostic value in patients with heart failure. However, LASr may be technically challenging and is not available to all clinical echocardiographers. Since LASr is a consequence of left atrial (LA) stretch during apical descent of the mitral annulus, we hypothesized that a ratio between mitral annular plane systolic excursion (MAPSE)
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Cardiac Ultrasonic Tissue Characterization in Myocardial Infarction Based on Deep Transfer Learning and Radiomics Features medRxiv. Cardiovasc. Med. Pub Date : 2024-03-30 Ankush D. Jamthikar, Quincy A Hathaway, Kameswari Maganti, Yasmin Hamirani, Sabahat Bokhari, Naveena Yanamala, Partho P. Sengupta
Objective Acute myocardial infarction (MI) alters cardiomyocyte geometry and architecture, leading to changes in the acoustic properties of the myocardium. This study examines ultrasomics — a novel cardiac ultrasound-based radiomics technique to extract high-throughput pixel-level information from images—for identifying infarcted myocardium.
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SGLT2 inhibition reduces cardiac surgery-associated acute kidney injury: An open-label randomized study medRxiv. Cardiovasc. Med. Pub Date : 2024-03-28 Lars I.P. Snel, Maartina J.P. Oosterom-Eijmael, Elena Rampanelli, Yugeesh R. Lankadeva, Mark P. Plummer, Benedikt Preckel, Jeroen Hermanides, Daniel H Van Raalte, Abraham H. Hulst
Background Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common postoperative complication. Currently, no effective preventative strategies exist to mitigate CSA-AKI. Sodium-glucose transporter-2 (SGLT2) inhibitors reduced acute kidney injury (AKI) incidence in large, randomized placebo-controlled, cardiovascular and kidney outcome trials conducted in patients with chronic kidney disease
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Applying Deep Learning in Heart Failure: Hospital Readmission is Not Like Other Health Quality Metrics medRxiv. Cardiovasc. Med. Pub Date : 2024-03-28 Hailey Morgan Shepherd, Jeffrey Heaton, Theo Marghitu, Louisa Bai, Melanie Subramanian, Sophia Roberts, Martha McGilvray, Amit Pawale, Gregory A Ewald, Brian Cupps, Michael K Pasque, Randi Foraker
Background Early identification of heart failure patients at increased risk for near-term adverse outcomes would assist clinicians in efficient resource allocation and improved care. Deep learning can improve identification of these patients. Methods This retrospective study examined adult heart failure patients admitted to a tertiary care institution between January 2009 and December 2018. A deep
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Trends of heart failure associated mortality in premenopausal women in the United states 1999-2020 medRxiv. Cardiovasc. Med. Pub Date : 2024-03-28 Sarath Lal Mannumbeth Renjithlal, Mohamed Eid Magdi, Keerthi Mannumbeth Renjith, Nikhil Cordeiro, Hazel Lever, Jeffrey D Alexis, Sabu Thomas
Background: Heart Failure (HF)-related mortality has been showing an upward trend since 2012. In this study, we assessed nationwide trends in mortality related to HF among women and focused on women 15-55 years of age in the United States from 1999 to 2020. Methods: Trends in mortality related to HF were assessed through a cross-sectional analysis of the Centers for Disease Control and Prevention Wide-Ranging
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Optimal Pair Matching Combined with Machine Learning Predicts that Omega-3 Fatty Acid Supplementation Markedly Reduces the Risk of Myocardial Infarction in African Americans medRxiv. Cardiovasc. Med. Pub Date : 2024-03-28 Shudong Sun, Aki Hara, Laurel Johnstone, Brian Hallmark, Eric Lu, Joseph C. Watkins, Cynthia A. Thomson, Susan M. Schembre, Susan Sergeant, Jason Gari Umans, Guang Yao, Hao Helen Zhang, Floyd H. Chilton
Conflicting results from clinical trials have contributed to a lack of consensus about cardioprotective effects of omega-3 (n-3) highly unsaturated fatty acids (HUFA). Although the VITAL trial did not demonstrate an overall benefit of n-3 HUFA supplementation on composite cardiovascular disease (CVD) and cancer outcomes, the substantial enrollment of African Americans (AfAm) afforded a unique opportunity
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Estimating Ejection Fraction from the 12 Lead ECG among Patients with Acute Heart Failure medRxiv. Cardiovasc. Med. Pub Date : 2024-03-27 Sunita Pokhrel Bhattarai, Dillon J Dzikowicz, Ying Xue, Robert Charles Block, Rebecca G Tucker, Shilpa Bhandari, Victoria E Boulware, Breanne Stone, Mary G Carey
Background: Identifying patients with low left ventricular ejection fraction (LVEF) in the emergency department using an electrocardiogram (ECG) may optimize acute heart failure (AHF) management. We aimed to assess the efficacy of 527 automated 12-lead ECG features for estimating LVEF among patients with AHF. Method: Medical records of patients >18 years old and AHF-related ICD codes, demographics
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Heart failure admission characteristics in women with a history of sexual or physical abuse: a case-control study medRxiv. Cardiovasc. Med. Pub Date : 2024-03-27 Alicia Chan, Suzanne M Cosh, John D. Horowitz, Phillip J Tully
Introduction: An emerging body of epidemiological evidence links a history of exposure to sexual and physical abuse or assault with an increased risk of developing cardiovascular disease. Understanding adverse physical health outcomes including heart failure (HF) in persons exposed to sexual and physical abuse is of particular importance to help improve multidisciplinary approaches to mental and physical
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Genetic and phenotypic architecture of human myocardial trabeculation medRxiv. Cardiovasc. Med. Pub Date : 2024-03-27 Kathryn A McGurk, Mengyun Qiao, Sean L Zheng, Arunashis Sau, Albert Henry, Antonio Luiz Pinho Ribeiro, Antonio H Ribeiro, Fu Siong Ng, R Thomas Lumbers, Wenjia Bai, James S Ware, Declan P O'Regan
Cardiac trabeculae form a network of muscular strands that line the inner surfaces of the heart. Their development depends on multiscale morphogenetic processes and, while highly conserved across vertebrate evolution, their role in the pathophysiology of the mature heart is not fully understood. We report variant associations across the allele frequency spectrum for trabecular morphology in 47,803
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Ultrasonic Texture Analysis for Acute Myocardial Infarction Risk Stratification: A Pilot Study medRxiv. Cardiovasc. Med. Pub Date : 2024-03-27 Quincy A Hathaway, Ankush D. Jamthikar, Bernard R. Chaitman, Jeffrey L. Carson, Naveena Yanamala, Partho P. Sengupta
Background: Current risk stratification tools for acute myocardial infarction (AMI) have limitations, particularly in predicting mortality. This study utilizes cardiac ultrasound radiomics (i.e., ultrasomics) to risk stratify AMI patients when predicting all cause mortality. Methods: The study included 197 patients: a) retrospective internal cohort (n=155) of non ST elevation myocardial infarction
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In vivo inhibition of miR-125b modulates monocyte trafficking through the CCR7 receptor and attenuates atherosclerosis medRxiv. Cardiovasc. Med. Pub Date : 2024-03-26 Adrian Mallén, Cristian Varela, Noemí Rotllan, Valentina Paloschi, Lars Mäegdefessel, Joan Carles Escolà, Josep Maria Aran, Estanis Navarro, Miguel Hueso
Background Atherosclerosis (ATH) is a chronic systemic inflammatory disease affecting the vessel wall, wherein regulating non-coding RNAs play a crucial role. We previously demonstrated that miR-125b is upregulated in ATH and is a main regulator of cholesterol metabolism in macrophages. Herein we hypothesized that inhibiting miR-125b may attenuate ATH.
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Prevalence of Undiagnosed Hypertension Among Adult Displaced Individuals in Baidoa Camps, Somalia medRxiv. Cardiovasc. Med. Pub Date : 2024-03-26 Mohamed Jayte
Introduction Hypertension may be prevalent among internally displaced people who typically do not engage in sedentary activities throughout the day. However, the prevalence of hypertension in this population remains poorly understood. In this study, we aimed to determine the prevalence of undiagnosed hypertension and associated factors among adults living in internally displaced people (IDP) camps
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Diagnostic performance of the fragmented QRS complex on electrocardiogram for detecting myocardial scars assessed by 3.0 Tesla cardiac magnetic resonance imaging medRxiv. Cardiovasc. Med. Pub Date : 2024-03-26 Kasin Viriyanukulvong, Nonthikorn Theerasuwipakorn, Wanwarang Wongcharoen, Paisit Kosum, Ronpichai Chokesuwattanaskul
Background: Fragmented QRS complex (f-QRS) on a 12-lead electrocardiogram (EKG) with a 0.15-100 Hz low-pass filter correlates with ischemic myocardial scars. While cardiac magnetic resonance (CMR) imaging enhances scar assessment, f-QRS diagnostic values for non-ischemic scars and routine 0.15-40 Hz filter EKGs are unknown. This study evaluates f-QRS (from EKGs with 0.15-40 and 0.15-100 Hz filters)
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A Phase 1 Study of Novel Antiplatelet Agent to Overcome Pharmacogenomic Limitations of Clopidogrel medRxiv. Cardiovasc. Med. Pub Date : 2024-03-26 Anil Pareek, Nitin Chandurkar, Vivek Raut, Kumar Naidu
Background: Clopidogrel is the most commonly prescribed thienopyridine as part of dual antiplatelet therapy for the treatment of cardiovascular diseases. However, Clopidogrel responsiveness shows variability based on CYP2C19 polymorphism. Therefore, we planned a study with an objective of evaluating safety, tolerability, pharmacodynamics and pharmacokinetics of a novel thienopyridine antiplatelet agent
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Circulating Levels of Angiotensinogen, Sex, and Hormone Therapy - The Multi-Ethnic Study of Atherosclerosis (MESA) medRxiv. Cardiovasc. Med. Pub Date : 2024-03-24 Karita Claudia Freitas Lidani, Patrick J. Trainor, Robert Buscaglia, Kristoff Foster, Sophia Jaramillo, Kirolos Michael, Alexander Pete Landry, Erin D. Michos, Pamela Ouyang, Erin Morgan, Sotirios Tsimikas, Andrew P DeFilippis
Background: Angiotensinogen, the unique precursor of all angiotensin hormones of the Renin-Angiotensin-Aldosterone System (RAAS), is now a potential target in a novel pharmacological approach to hypertension. Investigating the factors that influence angiotensinogen levels, including sex hormones, may have important therapeutic implications. Methods: Plasma angiotensinogen and sex hormones levels were
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Large-scale Mendelian randomization identifies novel pathways as therapeutic targets for heart failure with reduced ejection fraction and with preserved ejection fraction medRxiv. Cardiovasc. Med. Pub Date : 2024-03-24 Danielle Rasooly, Claudia Giambartolomei, Gina M Peloso, Hesam Dashti, Brian R Ferolito, Daniel J Golden, Andrea R.V.R. Horimoto, Maik Pietzner, Eric H Farber-Eger, Quinn Stanton Wells, Giorgio Bini, Gabriele Proietti, Gian Gaetano Tartaglia, Nicole M Kosik, Peter W.F. Wilson, Lawrence S Phillips, Patricia B. Munroe, Steffen E Petersen, Kelly Cho, John Michael Gaziano, Andrew R Leach, VA Million Veteran
We used expression quantitative trait loci (eQTLs) and protein quantitative trait loci (pQTLs) to conduct genome-wide Mendelian randomization (MR) using 27,799 cases of heart failure (HF) with reduced ejection fraction (HFrEF), 27,579 cases of HF with preserved ejection fraction (HFpEF), and 367,267 control individuals from the Million Veteran Program (MVP). We identified 70 HFrEF and 10 HFpEF gene-hits
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Application of Artificial Intelligence of Machine learning in Assessing Stroke Among HIV Patients on Protease Inhibitors-ART: A Bayesian Network Approach medRxiv. Cardiovasc. Med. Pub Date : 2024-03-24 Brian Chanda Chiluba
Background: In our investigation, we aim to utilize Bayesian network models in the field of machine learning to assess the likelihood of CVD in adults who are HIV positive and receiving protease inhibitors-antiretroviral therapy (PIs-ART). It is imperative to comprehend the risk factors and prognosis of stroke in order to effectively manage individuals infected with HIV, particularly those who have
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Cardiac Stasis Imaging, Stroke and Silent Brain Infarcts in Patients with Non-Ischemic Dilated Cardiomyopathy medRxiv. Cardiovasc. Med. Pub Date : 2024-03-24 Elena Rodríguez-González, Pablo Martinez-Legazpi, Ana González-Mansilla, Maria Angeles Espinosa, Teresa Mombiela, Juan A. Guzmán De Villoria, Maria Guadalupe Borja, Fernando Díaz-Otero, Ruben Gómez de Antonio, Pilar Fernández-García, Ana I Fernández-Ávila, Cristina Pascual-Izquierdo, Juan Carlos del Alamo, Javier Bermejo
Background: Cardioembolic stroke is one of the most devastating complications of non-ischemic dilated cardiomyopathy (NIDCM). However, in clinical trials of primary prevention, the benefits of anticoagulation were hampered by the risk of bleeding. If indices of cardiac blood stasis account for the risk of stroke, they may be useful to individualize primary prevention treatments. Methods: We performed
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In-silico trials guide optimal stratification of atrial fibrillation patients to catheter ablation and pharmacological medication: the i-STRATIFICATION study medRxiv. Cardiovasc. Med. Pub Date : 2024-03-24 Albert Dasi, Claudia Nagel, Michael T.B. Pope, Rohan S. Wijesurendra, Timothy R. Betts, Rafael Sachetto, Axel Loewe, Alfonso Bueno-Orovio, Blanca Rodriguez
Background and Aims: Patients with persistent atrial fibrillation (AF) experience 50% recurrence despite pulmonary vein isolation (PVI), and no consensus is established for second treatments. The aim of our i-STRATIFICATION study is to provide evidence for stratifying patients with AF recurrence after PVI to optimal pharmacological and ablation therapies, through in-silico trials. Methods: A cohort
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Cardiovascular disease risk score derivation and validation in Abu Dhabi United Arab Emirates. Retrospective Cohort Study medRxiv. Cardiovasc. Med. Pub Date : 2024-03-24 Latifa Mohammad Baynouna Al Ketbi, Nico Nico Nagelkerke, Ahmed Humaid, Noura AlAlawi, Rudina AlKetbi, Hamda Aleissaee, Noura AlShamsi, Hanan Abdulbaqi, Toqa Fahmawee, Basil AlHashaikeh, Muna AlDobaee, Mariam AlShamsi, Nayla AlAhbabi, AlYazia AlAzeezi, Fatima Shuaib, Jawaher Alnuaimi, Esraa Mahmoud, Alreem AlDhaheri, Mohammed AlMansoori, Sanaa AlKalbani, Wesayef AlDerie, Ekram Saeed, Nouf AlMarzooqi
Cardiovascular disease (CVD) risk assessment is key to rational decision-making in primary prevention. The CVD risk depends on dynamic factors requiring continuous equation updates. Design: The Abu Dhabi Risk Study (ADRS ) is the first and longest-duration retrospective cohort study in Abu Dhabi and the United Arab Emirates (UAE), aiming to develop 10-year risk prediction equations for CAD, stroke
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Computational analysis of congenital heart disease associated SNPs: Unveiling their impact on the gene regulatory system medRxiv. Cardiovasc. Med. Pub Date : 2024-03-22 Shikha Vashisht, Costantino Parisi, Cecilia Lanny Winata
Congenital heart disease (CHD) is a prevalent condition characterized by defective heart development, causing premature death and stillbirths among infants. Genome-wide association studies (GWASs) have provided insights into the role of genetic variants in CHD pathogenesis through the identification of a comprehensive set of single-nucleotide polymorphisms (SNPs). Notably, 90-95% of these variants
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A rare ORAI1 missense variant associates with risk of vascular diseases in White British adults medRxiv. Cardiovasc. Med. Pub Date : 2024-03-22 Heba Shawer, Chew Weng Cheng, Karen E Hemmings, Abeer M Aldawsari, Gonzalo Revilla-González, Fabio Stocco, Jian Shi, David J Beech, Marc A Bailey
Background: Pathological remodelling of native vascular smooth muscle cells (VSMC) within the arterial wall is a key contributor to vascular disease. A driver of this remodelling is platelet-derived growth factor BB (PDGF-BB) and its signalling via activation of the calcium ion channel, ORAI1. Here, we investigated if there are associations of ORAI1 polymorphisms with human cardiovascular disease.
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Improved diagnosis of COVID-19 vaccine-associated myocarditis with cardiac scarring identified by cardiac magnetic resonance imaging. medRxiv. Cardiovasc. Med. Pub Date : 2024-03-22 Josephine Warren, Daryl Cheng, Nigel Crawford, Bryn Jones, Annette Alafaci, Dion Stub, Philip Lew, Andrew Taylor
Aims Myocarditis is a rare but potentially serious complication of COVID-19 vaccination. Cardiac magnetic resonance (CMR) late gadolinium enhancement (LGE) imaging can identify cardiac scar, which may improve diagnostic accuracy and prognostication. We sought to define the incidence of long-term LGE post COVID-19 vaccine-associated myocarditis (C-VAM) and to establish the additive role of CMR in the
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Decreased cerebral blood flow in a supine position in patients with a history of syncope and presyncope during the Tilt Table Test medRxiv. Cardiovasc. Med. Pub Date : 2024-03-22 Víctor Cano, Jesús Antonio González-Hermosillo, Chiharu Murata, Martín Martínez-Rosas, Guadalupe Hernández-Pacheco
Objective: To analyze the hemodynamic response, cerebral blood flow, and the sympathovagal balance between patients with structurally healthy hearts who have a history of syncope and presyncope that exhibited signs or symptoms of presyncope without progressing to syncope during the tilt-table test, and a healthy group. Methodology: A retrospective study was conducted on patients attending the dysautonomia
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Assessing the Performance of Zero-Shot Visual Question Answering in Multimodal Large Language Models for 12-Lead ECG Image Interpretation medRxiv. Cardiovasc. Med. Pub Date : 2024-03-22 Tomohisa Seki, Yoshimasa Kawazoe, Yu Akagi, Toru Takiguchi, Kazuhiko Ohe
Large Language Models (LLM) are increasingly multimodal, and Zero-Shot Visual Question Answering (VQA) shows promise for image interpretation. If zero-shot VQA can be applied to a 12-lead electrocardiogram (ECG), a prevalent diagnostic tool in the medical field, the potential benefits to the field would be substantial. This study evaluated the diagnostic performance of zero-shot VQA with multimodal
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Artificial Intelligence-Derived Extracellular Volume Fraction for Diagnosis and Prognostication in Patients with Light-Chain Cardiac Amyloidosis medRxiv. Cardiovasc. Med. Pub Date : 2024-03-22 In-Chang Hwang, Eun Ju Chun, Pan Ki Kim, Myeongju Kim, Jiesuck Park, Hong-Mi Choi, Yeonyee E. Yoon, Goo-Yeong Cho, Byoung Wook Choi
Aims: T1 mapping on cardiac magnetic resonance (CMR) imaging is useful for diagnosis and prognostication in patients with light-chain cardiac amyloidosis (AL–CA). We conducted this study to evaluate the performance of T1 mapping parameters for detection of cardiac amyloidosis (CA) in patients with left ventricular hypertrophy (LVH) and their prognostic values in patients with AL–CA, using a semi-automated
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The prognostic value of mean platelet volume in patients with coronary artery disease: a systematic review with meta-analyses medRxiv. Cardiovasc. Med. Pub Date : 2024-03-22 Akhmetzhan Galimzhanov, Han Naung Tun, Yersin Sabitov, Francesco Perone, Mustafa Tigen Kursat, Erhan Tenekecioglu, Mamas Andreas Mamas
Background: Mean platelet volume (MPV) is a widely available laboratory index, however its prognostic significance in patients with coronary artery disease (CAD) is still unclear. We intended to investigate and pool the evidence on the prognostic utility of admission MPV in predicting clinical outcomes in patients with CAD. Methods: PubMed, Web of Science, and Scopus were the major databases used for
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Association between oral anticoagulant adherence and serious clinical outcomes in patients with atrial fibrillation: A long-term retrospective cohort study medRxiv. Cardiovasc. Med. Pub Date : 2024-03-21 Abdollah Safari, Hamed Helisaz, Shahrzad Salmasi, Adenike Adelakun, Mary A De Vera, Jason G Andrade, Marc W Deyell, Peter S Loewen
Background Patients with atrial fibrillation (AF) are frequently nonadherent to oral anticoagulants (OACs) prescribed for stroke and systemic embolism (SSE) prevention. We quantified the relationship between OAC adherence and AF clinical outcomes using methods not previously applied to this problem. Methods Retrospective observational cohort study of incident cases of AF from population-based administrative
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Navigating stroke care during the COVID-19 pandemic: A scoping review medRxiv. Cardiovasc. Med. Pub Date : 2024-03-20 Alixe Ménard, Michelle Yang, Samantha Oostlander, Kanika Sarwal, Irfan Manji, Tracey O'Sullivan, Sarah Fraser
Background: Previous viral outbreaks have highlighted implications for the management of complex health conditions. This study delves into the repercussions of the COVID-19 pandemic on stroke care, by examining evidence of shifts in healthcare utilization, the enduring effects on post-stroke recovery, and the overall quality of life experienced by stroke survivors. Methods: A scoping review was conducted
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Relationship between body regional fat and cardiovascular disease in middle-aged and young adults: Results from NHANES 2011-2018 and Mendelian randomization meta-analysis medRxiv. Cardiovasc. Med. Pub Date : 2024-03-20 Zheng Liu, Wenqi Shu, Meisi Liu, Wei Chong
BACKGROUND: To assess the correlation between regional body fat and cardiovascular diseases in middle-aged and young adults. METHODS: Information on the regional body fat, including the mass and percentage of fat in the head, arms, trunk, and legs, was collected. Data for the observational study were derived from the National Health and Nutrition Examination Survey 2011?2018. The relationship between
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Machine Learning-Based Prediction of Coronary Care Unit Readmission: A Multi-Hospital Validation Study medRxiv. Cardiovasc. Med. Pub Date : 2024-03-20 Fei-Fei Flora Yau, I-Min Chiu, Kuan-Han Wu, Chi-Yung Cheng, Wei-Chieh Lee, Huang-Chung Chen, Cheng-I Cheng, Tien-Yu Chen
Readmission to the Coronary Care Unit (CCU) has significant implications for patient outcomes and healthcare expenditure, emphasizing the urgency to accurately identify patients at high readmission risk. This study aims to construct and externally validate a predictive model for CCU readmission using machine learning (ML) algorithms across multiple hospitals. Patient information, including demographics
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A Dynamic Time-Series Model of Oxygen Consumption during Paediatric Cardiopulmonary Bypass medRxiv. Cardiovasc. Med. Pub Date : 2024-03-19 Mansour Taghavi Azar Sharabiani, Richard W Issitt, Alireza S Mahani, Yadav Srinivasan, Serban Stoica
Background: During cardiopulmonary bypass (CPB), maintaining adequate oxygen consumption (VO2i) can only be achieved indirectly either by modifying oxygen delivery (DO2i) through its component parts or by modulating metabolic demand through altering body temperature. The body reacts to these actions by changing OER and consequently VO2i. Understanding the body's adaptive OER dynamics can elucidate