Risultati per: Long COVID: principali risultati, meccanismi e raccomandazioni

Circulation, Volume 150, Issue Suppl_1, Page A4113573-A4113573, November 12, 2024. Introduction/Background:Cardiovascular and neurological diseases develop in a significant proportion of COVID-19 patients. Minimally invasive tools to predict outcome after SARS-CoV-2 infection would enable personalized healthcare, potentially easing the disease burden. We showed that blood levels of the long noncoding RNA lymphoid enhancer-binding factor-1 antisense 1 (LEF1-AS1) predict COVID-19 in-hospital mortality.Hypothesis:LEF1-AS1 is associated with long-term clinical outcomes of COVID-19.Aim:Test the capacity of LEF1-AS1 to predict neuro-cardio-vascular outcomes post-SARS-CoV-2 infection.Methods/Approach:We enrolled 104 primo-infected COVID-19 patients aged 18+ recruited from April to December 2020 in the PrediCOVID national cohort for which 12-month follow-up data were available (Ethics Committee approvals 202003/07 and 202310/02-SU-202003/07). Whole blood samples were collected at baseline and expression levels of LEF1-AS1 were assessed by quantitative PCR.Results/Data:Of the 104 patients, 35 had at least one neurological symptom and one cardiovascular symptom at month 12. Levels of LEF1-AS1 at baseline were lower (p=0.019) in patients who developed neurological and cardiovascular symptoms as compared to patients who did not. Lower LEF1-AS1 was associated with symptoms development with an odds ratio of 0.48 (95% CI 0.28-0.83) from logistic regression model adjusted for age, sex, comorbidities and disease severity at baseline. Addition of LEF1-AS1 to a clinical model including age, sex, comorbidities and baseline severity yielded an incremental predictive value as attested by an increased AUC from 0.79 to 0.83 (likelihood ratio test p=0.005), a net reclassification index of 0.54 (p=0.007) and an integrated discrimination improvement of 0.08 (p=0.009).Conclusion:Blood levels of LEF1-AS1 predict 12-month neurological and cardiovascular outcomes of COVID-19 patients. This needs to be validated in larger populations.

Circulation, Volume 150, Issue Suppl_1, Page A4139306-A4139306, November 12, 2024. Introduction:Although home-based diagnostics have dramatically reshaped care delivery, greater patient activation could affect compliance. For home enrollment and activation (HE) of long-term continuous ambulatory cardiac monitoring (LTCM) devices, patients must receive the device by mail, self-apply the patch, wear it for up to 14 days, and return by mail for ECG interpretation. We developed two direct-to-patient digital interventions and evaluated association of use of these to compliance outcomes after US-wide implementation.Methods:MyZio® is an optional smartphone app (iOS&Android) for patients for use with Zio® LTCM (iRhythm Technologies, Inc; San Francisco, CA) that tracks shipping status, enables registration, provides educational content and instruction on application/activation/wear, notifies users of remaining wear time and gives return reminders. Patients with a mobile number may also opt-in to short messages services (SMS) text notifications. Opt-in patients receive texts regarding delivery, application/wear, billing information, device return and prompts to download MyZio.We evaluated patient compliance (activation, wear, and device return) in all patients shipped Zio LTCM with HE between Oct 1 and Apr 3, 2024; the period after launch of MyZio version 2.0. We calculated return rates, stratified by use of one or both digital interventions. Odds ratios were calculated and the Chi Square test was used to report associated p-values compared to the reference (no intervention).Results:The distribution of the use of digital tools and compliance outcomes in 169,131 patients are shown in Table 1. Compliance was lowest (74.6%) when both the app and text messaging were not used. App use was associated with the highest gains in compliance, largely irrespective of concomitant text messaging. Opting into SMS text was associated with compliance improvement but was inferior to app use.Conclusion:In patch-based ECG LTCM, a dedicated patient app and SMS texting were associated with improved device return rates, although the app had a stronger effect. These data support the use of patient digital health interventions in home-based diagnostics and underscore the importance of post-implementation evaluation of outcomes.

Circulation, Volume 150, Issue Suppl_1, Page A4140910-A4140910, November 12, 2024. Background:Patients with type 2 diabetes mellitus (T2DM) often develop atrial fibrillation. Nevertheless, its incidence and long-term cardiovascular outcomes in newly diagnosed atrial fibrillation in patients with T2DM are still unclear.Hypothesis:We aim to investigate the association between new-onset AF and the risks of atherosclerotic cardiovascular disease (ASCVD); heart failure (HF), stroke, and all-cause mortality among patients with T2DM.Methods:A systematic search was conducted using multiple electronic databases from inception until March 2024 using the appropriate Mesh terms, “atrial fibrillation,” “diabetes mellitus,” “stroke,” “heart failure,” and “all-cause mortality.” We used the random effect model to calculate the pooled relative risk and their corresponding confidence interval. A p-value of

Circulation, Volume 150, Issue Suppl_1, Page A4145299-A4145299, November 12, 2024. Background:COVID-19 can present with a wide spectrum of clinical manifestations ranging from asymptomatic to life-threatening. It is often thought of as a primarily pulmonary infection and different systemic presentations are sometimes overlooked. We present a case of COVID-19 induced myocarditis leading to hemodynamic instability and end-organ dysfunction.Case presentation:A 77-year-old male with a history of CKD, paroxysmal atrial fibrillation, and COPD was transferred to our hospital for a higher level of care due to worsening cardiogenic shock. He was cold and wet (Forrester class IV) with a High Sensitivity troponin of 331 and a BNP level of 21,503. EKG showed atrial fibrillation with RVR but no evidence of acute ischemic changes. A TTE was done which revealed an EF of 30-35% and diffuse hypokinesis with regional variation, a significant reduction from an EF of 50-55% just 4 weeks prior. The patient exhibited end-organ dysfunction, as evidenced by deranged liver function tests and a rise in creatinine from a baseline of 2 to 4.6, indicating congestive hepatopathy and cardiorenal syndrome respectively. The patient’s hemodynamics necessitated milrinone and norepinephrine infusions and efforts to wean them off were unsuccessful due to repeated failed fluid bolus challenges. Considering the patient’s clinical picture, there was a strong suspicion of viral-induced cardiomyopathy, and a COVID-19 infection was confirmed by PCR testing; his last COVID-19 booster dose was in 2021. The patient was promptly started on remdesivir and IV steroids. Unfortunately, the patient’s condition continued to deteriorate, and he succumbed to his illness.Discussion:A myriad of cardiovascular manifestations have been implicated with COVID-19, including ACS, myocarditis, and heart failure. Although the exact underlying mechanisms for each of these conditions are unclear, a complex interplay between direct viral injury, systemic inflammation, and cytokine storm has been hypothesized. Our case illustrates the quick progression of heart failure into cardiogenic shock requiring pressor support, with subsequent rapid decompensation rendering CMR, cardiac catheterization, and biopsy timely impractical. It serves as a reminder to explore COVID-19 as a potential cause of biventricular failure in individuals with no evident reason and rapid clinical deterioration, particularly as early initiation of antiviral therapy could improve prognoses.

Circulation, Volume 150, Issue Suppl_1, Page A4142129-A4142129, November 12, 2024. Background:The clinical impact of neutrophil to lymphocyte ratio (NLR) and right ventricular (RV) dysfunction on clinical outcomes in COVID-19 have not been studied in the often-underrepresented Indonesian population.Aim:To investigate the role of NLR and RV dysfunction in Indonesian patients hospitalized for COVID-19.Methods:A retrospective cohort study was conducted at a COVID-19 referral hospital in Indonesia. We included all adult patients hospitalized with COVID-19 between April 2020 – April 2021 who had transthoracic echocardiography (TTE) during admission. Clinical data were extracted from electronic medical records. TTE variables were defined according to the American Society of Echocardiography criteria. All statistical analyses were conducted using the SPSS software. This study was approved by the IRB at Universitas Indonesia (#2022-01-135).Results:A total of 488 patients were included – 29 with and 459 without RV dysfunction. The mean age of the population was 54.8 (SD ± 13.5), and 42% were females. Receiver operating curve analysis and Youden’s J statistics were used to determine the optimal NLR cut-off (Figure 1). An NLR > 4.79 was considered elevated, and had a sensitivity of 70.6% and a specificity of 80.6% in predicting severe – critical COVID-19. A high NLR (OR: 3.38, P = 0.02) and LV systolic dysfunction (OR: 9.76, P < 0.01) were independently associated with RV dysfunction. In multivariate cox regression analysis, older age (HR: 1.02, P = 0.01), obesity (HR: 1.85, P < 0.01), chronic kidney disease (HR: 1.69, P = 0.01), high NLR (HR: 2.75, P < 0.01), and RV dysfunction (HR: 2.07, P = 0.02) increased the risk of 30-day mortality.Conclusions:In Indonesian patients hospitalized with COVID-19, A high NLR is predictive of severe – critical COVID-19 and is associated with RV dysfunction. A high NLR at admission and RV dysfunction independently increase the risk of 30-day mortality in hospitalized Indonesian adults with COVID-19.

Circulation, Volume 150, Issue Suppl_1, Page A4140003-A4140003, November 12, 2024. Background:Hypertension is a major preventable risk factor for cardiovascular (CV) disease. Emerging evidence suggests that in addition to blood pressure (BP) levels, controlling the consistency of BP is a key determinant of clinical outcomes. We aimed to assess the effects of consistency of BP control on adverse CV and renal outcomes using two metrics: long-term variability of systolic BP (LT-BPV) and the degree at which BP control is achieved, known as cumulative systolic BP load (CBPL).Methods:We collected clinic systolic BP (SBP) measurements from UK Biobank primary care records in those diagnosed with hypertension (N=39,816), chronic kidney disease (CKD, N=8,062), and neither of these (N=17,702), including a per-participant mean of 21 SBP values over 6 years. Instances of the primary outcome, 4-point major adverse cardiovascular events (MACE; stroke, acute myocardial infarction, heart failure hospitalization, and cardiovascular-related death), were collected from hospital records. Per-standard deviation (SD) and per-quartile hazard ratios (HR) were used to estimate LT-BPV, CBPL, and mean SBP separately using adjusted Cox regression. Sensitivity analyses were used to determine the independence of BP consistency effects from mean BP levels.Results:In those with hypertension, each per-SD increase in LT-BPV was associated with increased risk for MACE (HR=1.12, p=4.4E-11), specifically CV-related death, stroke, and HF hospitalization. LT-BPV effect estimates were strongest in those with controlled SBP and the strongest predictors for all events in those without high-risk comorbidities (coronary artery disease, CKD, peripheral vascular disease, and diabetes). CBPL was similarly associated with MACE (HR=1.13, p=8.1E-13), specifically stroke and acute myocardial infarction, but not with fatal events or HF. In those with CKD, both LT-BPV and CBPL were associated with progression to renal failure (HR=1.31-1.33, p

Circulation, Volume 150, Issue Suppl_1, Page A4141048-A4141048, November 12, 2024. Background:α1-antichymotrypsin (SERPINA3), high sensitivity C-reactive proten (hsCRP) and Pentraxin 3 (PTX3) are acute phase proteins triggered by inflammation. Hepatocytes are a primary source of SERPINA3 and CRP, while PTX3 is produced by a variety of tissues including endothelial cells. These inflammatory markers are upregulated after an acute myocardial infarction (AMI). Comparisons of their long-term prognostic value in acute coronary syndrome (ACS) patients by gender are scarce. We aimed to assess their long-term prognostic utility in females and males, respectively, hospitalized for chest pain of suspected coronary origin.Methods:A total of 871 consecutive patients (39.0% females) with a median age of 72.6 years (females 77.3, males 69.1) were admitted in the study. Of these, 386 were diagnosed with an acute MI based on Troponin-T (TnT) levels >50 ng/L. Stepwise Cox regression models, applying normalized continuous loge/SD values, were fitted for the biomarkers with total mortality within 7 years as the dependent variable.Results:At 7-year follow-up, 332 patients had died; 44.1 % females vs. 34.1 % males (χ2(1) = 9.368; p = 0.0022). Blood samples were available for analysis of SERPINA3, hsCRT and PTX3 in 847, 868 and 795 patients, respectively. There was no significant differences between the means of the sexes for SERPINA3 (p = 0.20), hsCRT (p = 0.84) and PTX3 (p = 0.068), respectively.None of the biomarkers predicted long-term outcome in females after multivariable adjustment (p=0.92, p=0.40 and p=0.57, respectively), but were good predictors in males [SERPINA3: HR 1.34 (95%CI 1.16-1.56), p=0.00001. hsCRP: HR 1.19 (95%CI 1.02-1.38), p=0.027. PTX3: HR 1.22 (95%CI 1.04-1.44), p=0.018]. Furthermore, the p-values for interaction would suggest a gender difference in the prognostic weighting, favoring SERPINA3 (p=0.015) and to a lesser degree hsCRP (p=0.074) and PTX3 (p=0.14).Conclusion:SERPINA3, hsCRT and PTX3 are good predictors of long-term all-cause mortality in males admitted with chest pain of suspected coronary origin, but were not shown to predict outcome among females of that population. The prognostic utility of the studied inflammatory biomarkers may essentially be related to males.

Circulation, Volume 150, Issue Suppl_1, Page A4113411-A4113411, November 12, 2024. Background:Long term follow-up data on elevated blood pressure (BP) or antihypertensive drugs in young adults are scarce. The effect of hypertension (HTN) and antihypertensive medications on the cardiovascular disease incidence in young healthy adults (20~45 years) was analyzed using a large-scale population medical use database in Korea.Methods:In total, 4,590,597 young Korean adults without comorbidities who underwent regular health examination were included in this study. They were stratified into four groups according to their BP (optimal BP, normal BP, high normal BP, and HTN). The primary outcome was a composite of the incidence of myocardial infarction and ischemic and hemorrhagic stroke, obtained by tracking the medical use data of the first-ever ICD-10 codes. Subgroup analysis was conducted by categorizing the HTN group into two subgroups according to the prescription ratios of the antihypertensive drugs during the follow-up period.Results:The average age was 33.8 years and median follow-up duration was 15.9 years. HTN elevated the incidence risk of major cardiovascular disease by 2.16 times compared to that of the optimal BP group. Dyslipidemia and HTN were the most dominant risk factors for myocardial infarction and stroke, respectively. In the subgroup analysis, antihypertensive medications decreased the incidence of cardiovascular disease by 70% in all diseases.Conclusions:Cardiovascular risk factors, including HTN, contribute to major cardiovascular disease incidence in young adults. The antihypertensive medications decreased the major cardiovascular disease incidence estimates.

Circulation, Volume 150, Issue Suppl_1, Page A4144490-A4144490, November 12, 2024. Background:Conduction disturbances (CD) following transcatheter aortic valve implantation (TAVI) are well known as one of the important predictors of poor post-TAVI prognosis. Although persistent CD are evidently associated with poor prognosis, data on transient CD are limited. The aim of this study was to investigate the prognostic impact of transient CD on long-term clinical outcomes after TAVI.Methods:Patients with severe aortic stenosis (AS) undergoing TAVI between February 2017 and October 2022 were retrospectively enrolled. CD were defined as any of the following: 2nd- or 3rd-degree atrioventricular block, right or left bundle branch block, and intraventricular CD with QRS duration ≥120 ms. Transient CD were defined as CD that appeared after TAVI but improved either before discharge or within 7 days. Persistent CD were defined as CD that appeared after TAVI and presented at hospital discharge or >7 days after TAVI. The primary endpoint was cardiovascular adverse events (CAE) after discharge, defined as a composite of cardiovascular death, heart failure hospitalization, and new pacemaker implantation.Results:Of 412 enrolled patients, transient CD occurred in 81 patients (19.7%), persistent CD in 72 patients (17.5%), and no CD in 259 patients (62.9%). In comparison between the transient and no CD groups, membranous septum length was significantly shorter in the transient CD group (5.0 mm vs. 6.1 mm, p=0.005). For a maximum of 2,000 days follow-up (the median follow-up period was 569 days), the transient CD group showed a significantly higher incidence of CAE compared with the no CD group (18.5% vs. 9.3%, p=0.012) (Figure). Although there was no significant difference in cardiovascular mortality (11.1% vs. 8.5%, p=0.48), the incidence of heart failure hospitalization tended to be higher in the transient CD group (6.2% vs. 2.3%, p=0.091), and new pacemaker implantation was more frequent in the transient CD group (4.9% vs. 0.0%, p

Circulation, Volume 150, Issue Suppl_1, Page A4148117-A4148117, November 12, 2024. Background:Tricuspid regurgitation (TR) is a prevalent disease in the population and is usually progressive. Most patients are treated with conservative management due to the risk involving transcatheter tricuspid valve replacement (TTVR) and surgical tricuspid valve replacement (STVR). The TRI-SCORE was developed to evaluate the severity of patients with TR and their risk of undergoing a correction procedure. However, there is still controversy regarding the cutoff value of the score. Therefore, we aim to perform a systematic review and meta-analysis comparing the cutoffs ≥6 with =6 with

Circulation, Volume 150, Issue Suppl_1, Page A4141717-A4141717, November 12, 2024. Introduction:Although 14-day patch-based long-term continuous ambulatory ECG monitoring (LTCM) has shown greater diagnostic yield and lower retest rates compared to other rhythm monitoring modalities, wear can still be limited by factors related to patient comfort and acceptance. Rather than data from small, non-generalizable focus groups, patient survey data at point of care offered to all patients may be valuable in collecting quality improvement data on product experience and satisfaction. We assessed the feasibility of this approach to compare patient satisfaction associated with the prior generation LTCM to that of a new generation, FDA-cleared LTCM product designed with patient-centered features, including a more breathable adhesive, waterproof housing, thinner profile, and lighter weight.Methods:Starting in March 2018, we implemented a survey provided to all patients prescribed Zio® XT LTCM (iRhythm Technologies, San Francisco, CA) to complete and return at end of wear. The survey was completed via paper card or digitally via a web address printed on the card. The survey included questions regarding ease of use, comfort, ability for normal activity, and willingness to wear the device again. Scores of 4 or 5 (i.e., Agree or Strongly Agree) on a Likert scale were considered affirmative responses. Beginning in April 2022, the new Zio® Monitor device was launched for use and the same survey method was used. We compared survey responses for Monitor and XT between Jan 1 and Dec 31, 2023.Results:Among 334,054 respondents, the new LTCM was associated with a greater proportion of affirmative responses across all survey categories (Table 1), with the largest gains in comfort of wear (79.1% vs. 64.7%; p

Circulation, Volume 150, Issue Suppl_1, Page A4146266-A4146266, November 12, 2024. Background:Cardiac allograft vasculopathy (CAV) is one of the leading causes of graft failure and death after heart transplantation (HTx). Conventionally, CAV is characterized by concentric intimal thickening, however the long-term progression patterns of plaque morphology are not yet well understood.Research Question:This study aimed to assess the plaque morphology, including histology and eccentricity, in a temporal manner post-HTx using virtual histology intravascular ultrasonography (VH-IVUS).Methods:We included 50 patients who underwent serial VH-IVUS assessment at three assessment points (A1:0-1 year, A2:3-5 years, A3:7-10 years) after HTx. Differences in VH-IVUS findings between timepoints A1 to A2 (early period) and A2 to A3 (late period) were investigated. Plaque volume index was defined as (plaque volume/vessel volume) × 100%. Eccentricity index (EI) was defined as (maximum intimal thickness – minimum intimal thickness)/maximum intimal thickness and was evaluated in 39 patients with significant plaque (maximal intimal thickness >0.50 mm at the A3) at each timepoint. The serial changes of EI and relationship between EI and other VH-IVUS findings were investigated.Results:Of 50 patients, mean age was 51±13 years, 36 (72%) were males. In both early and late periods, the plaque volume (PV) index showed a significant increase, however, the rate of progression was significantly slower in late period. (5.8% [0.9, 13.2] vs 2.4% [-0.2, 7.4], p=0.015). The EI showed a trend of decrease in the early period, compared to increases in the late period (-0.040 [-0.103, 0.004] vs 0.003 [-0.030, 0.052], p=0.036). Patients with EI change in late period higher than median value had significantly lower proportion of fibrous plaque (70.8% [67.2, 75.1] vs 62.7 [55.5, 66.9], p=0.002) and higher dense calcium (1.1% [0.9, 1.9], 4.5% [1.8, 6.9], p=0.022) at A3.Conclusion:In heart transplant patients, coronary artery plaque progression in the late period showed more eccentric progression with lower fibrous plaque composition, a pattern commonly observed in typical and conventional coronary atherosclerosis. These findings may provide a novel mechanism and therapeutic insight into the temporal patterns in CAV progression during long term follow up.

Circulation, Volume 150, Issue Suppl_1, Page A4144744-A4144744, November 12, 2024. Importance:Prosthesis-Patients Mismatch (PPM) is associated with multiple adverse event after aortic valve replacement (AVR), especially increased long-term mortality. Despite women are more likely to have PPM, sex-differences in PPM outcomes remain poorly explored.Objectives:To evaluate PPM incidence and sex-differences in PPM impact in a large cohort of patients underwent surgical aortic valve replacement.Design, Setting and Participants:We included 7,319 patients who underwent Surgical AVR between 2000 and 2021. PPM was defined accordingly to Valve-Academic-Research-Consortium-3 criteria, adopting correction for Body Surface Area >30 kg/m2 and retrieving the predicted effective orifice area of the aortic valve prosthesis. The cohort was followed up prospectively from Surgical AVR until November 2023.Main Outcomes and Measures:Primary endpoint was defined as long-term mortality and secondary endpoint as long-term cardiovascular (CV) mortality. Mortality was established and Cardiovascular mortality adjudicated by Quebec national database.Results.Severe PPM incidence was rare (1.1%), more prevalent in women (2.5%) than in men (0.5%, p

Circulation, Volume 150, Issue Suppl_1, Page A4141571-A4141571, November 12, 2024. Background:Although ambient air pollution exposure has been linked with increased mortality in many cardiovascular or pulmonary diseases, its relationship with pulmonary arterial hypertension (PAH) is still unknown. The present study aims to investigate the association of ambient particulate matter (PM) exposure with pulmonary hemodynamics and long-term survival in patients with PAH in China.Methods:This retrospective multi-center cohort study included 1511 participants who underwent invasive right heart catheterization and were eventually diagnosed with PAH from January 2014 to December 2020. The primary outcome was transplant-free survival from the time of diagnosis. The association of PM2.5and PM10with all-cause death or lung transplantation was assessed by fitting Cox proportional risk models. Generalized linear models were used to examine the relationship between PM exposure and pulmonary hemodynamic severity at baseline. Restricted cubic splines were used to describe exposure-response curves. Mediation analysis with bootstrap method was used to explore whether potential variables mediated the associations.Results:During a median follow-up of 36.7 months, all-cause death or lung transplantation occurred in 149 patients. Per 10 µg/m3increase of PM2.5and PM10were associated with 14.5% and 7.9% increased risk of primary outcomes adjusting for potential confounding variables, respectively. PM2.5and PM10were associated with European Society of Cardiology risk stratification and with pulmonary hemodynamics at baseline, in particular pulmonary vascular resistance (PVR), mean pulmonary artery pressure (mPAP), cardiac index, and mixed venous oxygen saturation (SVO2). Effect of PM may be mediated in part by impaired glucolipid metabolism and inflammation-associated lymphocyte.Conclusions:Particulate matter exposure was associated with disease severity and pulmonary hemodynamics at baseline in patients with PAH, and higher chronic exposure to PM2.5and PM10independently predicted shorter transplant-free survival.

Circulation, Volume 150, Issue Suppl_1, Page A4142099-A4142099, November 12, 2024. Introduction:Aortic compliance is crucial for maintaining diastolic blood pressure and systemic perfusion throughout the cardiac cycle. Echocardiography is widely used for cardiovascular imaging but has limited precision in clinical phenotyping of aortic compliance.Hypothesis:We hypothesized that a deep learning approach can quantify aortic compliance by precision characterization of the aortic root in parasternal long-axis echocardiogram videos and that this deep learning measured aortic compliance would correlate with aspects of thoracic aortic repair.Aims:Develop a high precision deep learning model for quantifying aortic compliance from echocardiogram videos and explore associations with surgical repair.Methods:We used 51730 PLAX echocardiogram videos from Cedars-Sinai Medical Center, divided into training (46188), validation (5035), and test (507) cohorts. The DeepLabv3 architecture with a 50-layer residual network backbone was used for frame-level segmentation of the aortic root. Strain was obtained by dividing the change in root diameter by the minimum diameter during each cardiac cycle. Evaluation of measurements was performed on a separate cohort of 33 patients who underwent endovascular repair of the thoracic aorta.Results:The model accurately measured aortic root diameter with a mean absolute error (MAE) of 2.5mm comparing favorably with clinical inter-observer variability (MAE of 2.9mm, p=0.010). Exploratory data analysis showed increasing aortic root strain after endovascular repair (n=12, p=0.084) but no clear trends after combined endovascular and open repair (n=21, p=0.852). Aortic strain was lower in patients with prior abdominal surgery (n=12, p=0.001) and dissection that underwent repair (n=14, p=0.099), and postoperative aortic strains were lower in patients requiring surgery within 30 days (n=7, p=0.024).Conclusion:A deep learning workflow can measure aortic root diameter and identify changes in aortic compliance with higher precision than human assessment. Trends in preoperative and postoperative aortic strain in patients undergoing endovascular repair suggest utility of aortic strain phenotyping for prognosticating clinical outcomes.

Circulation, Volume 150, Issue Suppl_1, Page A4121104-A4121104, November 12, 2024. Introduction:Epidemiological studies and clinical trials have revealed cardiometabolic benefits associated with dietary fish oil-derived omega-3 polyunsaturated fatty acids, particularly EPA and DHA. Omega-3 very-long-chain polyunsaturated fatty acids (VLCPUFA), synthesizedin vivoby very-long-chain fatty acid elongase (ELOVL), e.g. ELOVL2 and 4, have recently garnered interest for their role in eye and cardiometabolic diseases. In our previous study, aging mice fed a VLCPUFA-rich diet for 8 weeks exhibited lowered plasma lipid levels, and repeated gavage of VLCPUFA in young mice resulted in improved retinal function. However, it is largely not known if VLCPUFA intake for a short term in aged mice would also improve retinal function and have beneficial effects in cardiometabolic risk factors.Hypothesis:We hypothesized that VLCPUFA may delay or rescue age-related vision loss by supplementing the products of ELOVL2, which decrease in quantity with age. We also hypothesize that short-term VLCPUFA intake may also confer favorable cardiometabolic benefits.Aims:We aimed to evaluate the effects of exogenous VLCPUFA on visual function and lipoprotein profiles in aged mice.Methods:Sixteen-month-old mice received a daily oral gavage of C24-28-rich VLCPUFA-oil (80 mg/kg BW) or an Intralipid vehicle for 15 consecutive days (n=8). The electroretinogram (ERG) instrument used was a UTAS E-3000 with gold corneal and stainless-steel scalp electrodes. Fast Protein Liquid Chromatography was performed using pooled plasma.Results:Consumption of VLCPUFA for 15 days increased scotopic a- (p < 0.05 at −5, 0, 5, 10, and 15 dB) and b-wave (p < 0.05 at 0 and 5 dB, p = 0.08 at 10 dB) amplitudes on ERG in both male and female mice compared with control. Although photopic ERG results did not exhibit statistically significant differences, likely due to low sample size, the overall results were consistent with those in our previous studies in young mice. We report no statistically significant difference in the composition of pro-atherogenic VLDL and LDL fractions due to VLCPUFA gavage. Increasing the duration and samples size in future gavage studies may be critical to determine the effects of VLCPUFA on eye and cardiovascular risk factors.Conclusions:This study revealed that a short-term oral administration of VLCPUFA was effective in improving ERG response overall, but not lipoprotein profiles.