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Circulation, Volume 150, Issue Suppl_1, Page A4144168-A4144168, November 12, 2024. Introduction:Many patients with amyloidosis can have advanced cardiac involvement, that drives mortality. Due to lack of definitive therapies that can reverse cardiac infiltration, cardiac replacement is the only hope for these patients. Durable left ventricular assist devices are not a good option; hence heart transplant remains mainstay. We present here long-term outcomes from a single center.Methods:Using EPIC Electronic Health Records’ database Clarity and UNOS center-specific report builder, we abstracted clinical information of patients who underwent a heart transplantation for cardiac amyloidosis at our center from 2004 to 2023.Results:Fifty-one patients underwent heart transplant for cardiac amyloidosis: 32 for Amyloid Light chain (AL) and 19 for Amyloidosis Transthyretin (TTR). Majority were males (Table 1). Of the AL transplants, 6 received concomitant kidney, 2 liver and 2 lung transplantation and of the TTR, 1 received concomitant kidney and 16 concomitant liver transplantation. There were more multi-organs in TTR compared to AL cardiac transplants (17 vs 10, p

Circulation, Volume 150, Issue Suppl_1, Page AOr110-AOr110, November 12, 2024. Introduction:Lactic acidosis and impaired oxygen extraction due to mitochondrial dysfunction are common post-arrest. Thiamine, a cofactor for pyruvate dehydrogenase, is necessary for aerobic metabolism. In two randomized controlled trials (RCTs) testing the effect of thiamine vs. placebo in out-of-hospital and in-hospital post-arrest patients (NCT03450707 and NCT02974257), no relationship was found between thiamine treatment and the primary outcome of change in lactate over 24 hours. Cellular oxygen consumption rates (OCRs) were measured in a subset of patients at baseline. Maximal and spare OCRs measure the capacity of mitochondria to increase cellular respiration from their basal state when stimulated, and may identify patients likely to benefit from thiamine. We conducted a post-hoc analysis of the two RCTs to evaluate the primary outcome in subgroups defined by baseline OCRs.Hypothesis:Patients with higher maximal and spare OCRs at baseline are more likely to benefit from thiamine treatment, as indicated by lower lactate levels.Methods:Basal, maximal and spare OCRs, collected at enrollment, were measured in peripheral blood mononuclear cells using an XFe96 Extracellular Flux Analyzer and XF Cell Mito Stress Test Kit (Seahorse Bioscience). Lactates (at 6, 12, and 24 hours) were log-transformed and analyzed using a linear mixed model controlling for baseline lactate. In patients who expired

Circulation, Volume 150, Issue Suppl_1, Page A4143906-A4143906, November 12, 2024. Background:Atrial Fibrillation (AF) is the most diagnosed cardiac arrhythmia in clinical practice. Catheter ablation (ABLA) is a method used to manage AF by cauterizing the left atrium (LA) to isolate arrhythmogenic areas. However, ABLA is paradoxically associated with atrial inflammation and AF recurrence, with 10% of patients experiencing recurrence within 30 days and over 50% after 12 months. Studies suggest that AF prevalence is generally lower in women than in men, but females with AF are more prone to severe complications. Colchicine has been proposed for its anti-inflammatory and cardioprotective effects.Hypothesis:Early colchicine treatment prevents ABLA-triggered atrial fibrosis, inflammation, and arrhythmogenic substrates.Methods:Male and female Wistar rats (225-275g) were randomly assigned to four groups: Sham or ABLA, with or without colchicine treatment (1 mg/kg/day; intraperitoneally) starting 2 hours before surgery. Sham animals underwent surgery without ABLA.In vivoelectrophysiological studies and echocardiography were performed on days 1 (D1) and 3 (D3) post-ABLA. On D3,ex-vivooptical mapping was conducted on Langendorff-perfused hearts, and atrial fibrosis, gene, and protein expression were assessed using Masson’s trichrome staining, qPCR, and immunoblotting, respectively.Results:ABLA animals displayed a significantly higher susceptibility to atrial arrhythmias compared to Sham animals, and among ABLA rats, females were 20% less vulnerable to AF than males at D3 post-ABLA. The LA from ABLA rats exhibited significantly slowed conduction velocity, increased fibrosis areas, and enhanced levels of inflammatory markers compared to Sham. Colchicine significantly reduced the incidence of AF post-ABLA with more efficacy in females than males. Moreover, colchicine normalized LA conduction, fibrosis, and inflammation in LA ABLA compared to Sham. Consistent with contemporary knowledge about male and female differences in AF incidence, our data suggest that endogenous female sex hormones combined with colchicine administration may contribute to significantly reducing AF incidence.Conclusion:Initiating Colchicine treatment prior to ABLA may lower post-ABLA-induced LA inflammation and AF occurrence. Delving into the variances in male and female responses to colchicine intervention could offer new insights into addressing post-ABLA AF incidence.Bas du formulaire

Circulation, Volume 150, Issue Suppl_1, Page A4144055-A4144055, November 12, 2024. Background:Maternal cardiovascular health is a critical concern, particularly during and following pregnancy. Previous studies have highlighted the influence of social determinants on health outcomes, but the specific impact of adverse Physical Environment, Housing, and Economic Conditions on maternal cardiovascular health remains underexplored.Methods:Using the TriNetX global health research network within the US Collaborative Network, we explored how adverse Physical Environment, Housing, and Economic Conditions (ICD10CM: Z58 and ICD10CM: Z59) impact maternal cardiovascular health during pregnancy and within one year postpartum. Using, propensity score matching (PSM) analysis, our study compared two cohorts: women aged 15 to 60 who experienced issues related to Physical Environment, Housing, and Economic Conditions during or after pregnancy from 2008 to 2023, and women in the same age range who did not face such issues, thus representing a favorable physical environment, housing, and economic conditions.Results:Challenges related to the physical environment, housing, and economic conditions significantly increased the risk of all-cause mortality (OR: 3.237, 95% CI: 2.064 to 5.075, p

Circulation, Volume 150, Issue Suppl_1, Page A4144388-A4144388, November 12, 2024. Background:Atrial fibrillation (AF) is associated with adverse remodeling of the left atrium (LA). The impact of the extent of atrial myopathy and post-ablation remodeling on quality-of-life (QoL) outcomes have not been studied.Objective:The aim of our study was to investigate the association between atrial myopathy and post-ablation remodeling on quality-of-life outcomes in patients with persistent AF.Methods:We conducted an analysis of DECAAF II participants who underwent late-gadolinium enhancement MRI (LGE-MRI) before and after AF ablation. We assessed atrial myopathy and post-ablation atrial remodeling, scar formation, and fibrosis coverage with ablation. QoL metrics were assessed using the Short Form Survey (SF-36) and Atrial Fibrillation Severity Scale (AFSS). Uni- and multivariable regression models were developed for this analysis.Results:613 patients with persistent AF were included in our analyses. At baseline, AFSS burden and total AFSS score were 18.94±7.35 and 12.24±8.17, respectively. Following ablation, all QoL and AFSS metrics improved in both the pulmonary vein isolation (PVI) and MRI-guided fibrosis ablation groups. On average, one unit of post-ablation reduction in left atrial volume index (LAVI) was associated with an improvement of 0.085 in total AFSS score (p=0.001), 0.01 in shortness of breath with activity (p

Circulation, Volume 150, Issue Suppl_1, Page A4147291-A4147291, November 12, 2024. Background:RNA-seq provides a powerful tool to dissect cellular heterogeneity in diseased hearts. It generates reads from both mature RNA and pre-mRNA. Traditionally, only mature RNA transcripts are considered for analysis, but studying both species of transcripts from single-cell RNA-seq of cardiomyocytes in post-infarcted hearts can reveal novel insights into the dynamic transcriptional changes and regulatory mechanisms that occur during heart repair and regenerationResearch question:Do nascent transcriptional events from pre-mRNA forecast the biological processes in failing hearts better than the mRNA and unravel the complexity of cardiomyocyte diversity?Aim:Execute an exon-intron analysis on cardiomyocyte single-cell RNAseq data obtained from post-infarcted mouse heartsMethods:Cardiomyocytes from mice (n=4) post-LAD ligation were isolated and single-cell RNAseq was performed using MegaKit v.2 (Parse Biosciences) on a NovaSeq 6000. Data was analyzed via theParsepipeline andSeurat v5. Pre-mRNA reference was built withAGAT. Gene set enrichment was done usingfgsea. Sham mice without ligation (n=4) served as controlsResults: We analyzed at least 70K cells for each transcript type and compared their enrichment profiles for post-infarcted hearts to sham. Infarction resulted in enrichment for biological processes predominantly for development and fatty acid metabolism, especially from pre-mRNA mapping (mRNA vs pre-mRNA;p=4.2 x 10-18vs 4.8 x 10-32). At the level of individual clusters, cardiomyocyte heterogeneity was revealed with cells enriched for distinct processes. Common to both types of transcripts were terms enriched for cell death (mRNA vs pre-mRNA;p=7.6 x 10-3vs 4.2 x 10-3), tissue remodeling (p=4.3 x 10-4vs 9.6 x 10-4), and respiratory&metabolic activity (p=8.9 x 10-5vs 7.2 x 10-8).However, compared to mRNA, the pre-mRNA had more cell clusters enriched for terms related to increased protein production activity (p=7 x 10-4), activation of key signaling pathways (p=8.5 x 10-4), and defense response (p=2.1 x 10-6). These additional processes show adaptive mechanisms that promisingly forecast cardiomyocyte repair and could be visualized by mapping pre-mRNAConclusion:Examining pre-mRNA offers a realistic view of stressed cardiomyocytes’ transcriptional dynamics. This study could identify new biomarkers to predict the onset of heart failure. Further insights into transitioning cells could aid in developing therapies for regeneration

Circulation, Volume 150, Issue Suppl_1, Page A4125157-A4125157, November 12, 2024. Background:Recent evidence suggests that sodium-glucose cotransporter-2 inhibitors (SGLT2-i) may improve outcomes in patients with coronary artery disease (CAD) through various physiological pathways. However, their impact on patients who have undergone percutaneous coronary intervention (PCI) is not well established. This meta-analysis aims to evaluate the effectiveness of additive SGLT2 inhibitors versus standard therapy alone in patients with CAD after PCI.Methods:A systematic search was conducted across the Medline, Embase, and Cochrane Library databases for randomized controlled trials (RCTs) and observational studies that compared the addition of SGLT2 inhibitors to standard therapy versus standard therapy alone in patients post-PCI. The outcomes analyzed were Major Adverse Cardiovascular Events (MACE), all-cause death, cardiovascular death, recurrent acute myocardial infarction (AMI), nonfatal stroke, revascularization, and hospitalization for heart failure (HF).Results:A total of 7 studies met the inclusion criteria, encompassing a total of 11,800 individuals (5,004 on SGLT2-i and 6,796 non-SGLT2-i; mean age of 62.7 years; 28% women; 95% diabetic patients). SGLT2 inhibitors significantly reduced the risk of all-cause mortality (RR 0.6, 95% CI: 0.5-0.72, p

Circulation, Volume 150, Issue Suppl_1, Page A4146198-A4146198, November 12, 2024. Introduction:Lung cancer is divided broadly into two main types: Small cell lung cancer (SCLC) and non-small cell lung cancer-NSCLC. Approximately 70% of SCLC cases have metastasized to other parts of the body including lymph nodes, bone, liver, adrenal glands, and brain [1]. SCLS metastasis to cardiac tissue is rare. Primary cardiac tumors are as rare with a reported prevalence of 0.028% [2]. Here we present a 59-year-old female (59F) with recurrent SCLC metastasis with evidence of a newly diagnosed primary cardiac tumor.Case Presentation:59F with a past medical history of SCLC status-post chemotherapy and radiation presented for evaluation of worsening left upper extremity pain, paresthesia, motor weakness, and neck pain. During the hospital admission, an echocardiogram demonstrated extensive thrombus from the Superior Vena Cava (SVC) into the right atrium (RA) and an irregular echogenic 37 mm x 26 mm mass partially attached to the posterior leaflet of the tricuspid valve. The RA mass was successfully removed by mechanical thrombectomy. Pathological results of the RA mass revealed significant malignant epithelioid and spindled neoplasm with myxoid stroma– concerning for myoepithelial disease.Discussion:Cardiac tumors, although uncommon, should be included in the list of possible diagnoses when observing any abnormal mass detected through cardiovascular or thoracic imaging techniques. Cardiac tumors are likely due to metastatic origins as metastatic cardiac tumors occur 20 times more frequently than primary cardiac tumors[3].When metastatic cardiac tumors are suspected, malignant melanoma and leukemia are the most frequent origins[4]. Rarely does SCLC metastasize to cardiac tissue. Primary cardiac tumors are typically benign (90%), with primary malignant tumors being very rare[5]. Patients may be asymptomatic, or present with nonspecific symptoms such as exertional dyspnea, fevers, arthralgias, or life-threatening cardiac tamponade[6]. For right atrial tumors, treatment strategies are usually dependent on symptomatology, in which removal via aspiration or surgical resection has demonstrated a favorable prognosis[7].Conclusion:Given the rarity of primary cardiac tumors in the setting of metastatic SCLC, there exist no evidence-based guidelines for optimal management of right atrial tumors. In our patient, mechanical aspiration was performed without complications and prevented potential adverse cardiopulmonary events from occurring.

Circulation, Volume 150, Issue Suppl_1, Page A4141173-A4141173, November 12, 2024. Background:Heart transplantation remains definitive therapy for children with heart failure, but the burden of acute graft rejection remains. While adult data has shown cardiac magnetic resonance (CMR) offers reliable, non-invasive identification of graft rejection1-3, endo-myocardial biopsy (EMB) continues to be the gold-standard in children.Hypothesis:CMR can establish the presence/absence of rejection, guiding need for EMB and rejection therapy.Aims:To assess the (1) strength of CMR parametric mapping in discriminating presence of rejection (defined as need for new therapy), and (2) the ability of CMR to identify patients without rejection, negating the need for EMB.Methods:Pediatric heart transplant patients referred for EMB underwent concurrent noncontrast CMR with volumetry, flows, MOLLI T1 and T2 parametric mapping at 1.5T. Average and peak segmental native T1 and T2 were measured in 6 slices, and regions of sub-segmental ‘hotspot’ elevation (3 continuous voxels T1 >1050 ms or T2 >60 ms) were identified. Rejection treatment was per institutional protocol, blinded to CMR results, categorized as (A)new IV therapy, (B)oral augmentation of maintenance, or (C) no change. Sensitivity, specificity and ROC analyses were performed.Results:95 encounters in 34 patients (median age 13.1y (IQR 7.5-16.3), BSA 1.37 m2 (1.1-1.6), 47% female) were completed, with treatment groups A 13%, B 5%, and C 82%. Significantly higher T1 and T2 values were found in the rejection groups. ROC curve analysis identified elevated peak T1 levels as the strongest predictor of rejection (AUC = 0.848, 95% CI: 0.746, 0.950, p1099 ms. Subsegmental hotspots were present in all encounters with rejection requiring new therapy (100% sensitivity), however the type/ number of hotspots did not correlate with rejection. New rejection therapy was not initiated in any patient encounter without hotspots (NPV 100%).Conclusions:Elevated segmental T1 CMR values can identify children with graft rejection, and absence of subsegmental hotspot elevations can reliably identify patients without rejection. CMR is a promising non-invasive test to aid in graft surveillance and direct invasive testing and therapy.

Circulation, Volume 150, Issue Suppl_1, Page AOr109-AOr109, November 12, 2024. Background:Nicotinamide mononucleotide (NMN), a precursor of nicotinamide adenine dinucleotide (NAD+), has been shown to increase NAD+levels, reduce inflammation, and improve short-term survival in a rodent model of hemorrhagic shock. NAD+levels decrease after cardiac arrest (CA), but the effect of NMN on outcomes after CA remains undefined.Hypothesis:NMN administration increases NAD+content in the brain, reduces systemic inflammation, and improves outcomes after CA.Aims:This study aimed to investigate the effects of systemic NMN administration on neurological function, survival, and systemic inflammation after CA.Methods:In a murine model of CA, asystole was induced using potassium chloride. After 10 minutes of CA, mice were resuscitated with continuous epinephrine injections. Mice were randomly assigned to the NMN group (60 mg/kg body weight i.p.) or the control group (normal saline i.p.) 1.5 minutes after the return of spontaneous circulation (ROSC). The same treatment was repeated at 24 and 48 hours after CA. Neurological function score (on a scale from 0 to 12) at 48 hours post-CA and 7-day survival were compared between the NMN and control groups. Brain NAD+levels were measured 30 minutes post-ROSC. Plasma cytokine levels (IL-6 and TNF-α) were measured 2 hours post-ROSC.Results:Brain NAD+levels significantly increased 30 minutes post-ROSC in the NMN group compared to the control group (186 ± 15 pg/mg tissue and 131 ± 14 pg/mg tissue, respectively; P=0.02). NMN significantly improved neurological function score at 48 hours post-CA (NMN group median 12 [9–12] vs. control group 8 [4–11]; P=0.03). Moreover, NMN improved survival rate up to 7 days post-CA (NMN group 61.1% [11/18] vs. control group 22.2% [4/18]; P=0.03). Mean arterial pressure tended to be higher in the NMN group, although the difference was not significant (NMN group 113.8 ± 2.1 mmHg vs. control group 107.8 ± 2.9 mmHg; P=0.08). NMN showed a trend toward decreased IL-6 (NMN group 52.7 ± 14.3 pg/ml vs. control group 114.6 ± 33.3 pg/ml; P=0.15) and TNF-α (NMN group 6.9 ± 1.2 pg/ml vs. control group 11.7 ± 2.3 pg/ml; P=0.12).Conclusions:Systemic administration of NMN post-CA increased brain NAD+levels and improved neurological function and survival. NMN also showed a trend toward reduced systemic inflammation. NMN is a promising approach to improve outcomes after CA.

Circulation, Volume 150, Issue Suppl_1, Page A4140703-A4140703, November 12, 2024. Background:The mRNA vaccines against COVID-19 are highly effective but have been associated with a rare non-infective form of myocarditis, particularly in young males after receiving the second dose. Understanding the mediators of this adverse effect is crucial to enhance the safety of future mRNA vaccines.Hypothesis:Myocardial injury following COVID-19 mRNA vaccination is mediated by overproduced cytokines, and estrogens have a protective effect on this adverse effect.Approach:Candidate cytokine mediators were identified through analysis of proteomics data from plasma samples of vaccinated individuals. Human iPSC-derived macrophages and cardiomyocytes were used to model cytokine-induced effects. An in vivo mouse model of cytokine-induced myocardial injury was employed to assess the impact of the cytokine cocktail and estrogens.Results:CXCL10 and IFN-γ were consistently upregulated in vaccinated individuals on day 1 and further elevated in patients with myocarditis following mRNA vaccination. Consistently, iPSC-derived macrophages exposed to COVID-19 mRNA vaccines produced these cytokines. Next, iPSC-derived cardiomyocytes exposed to these cytokines showed impaired contractility, arrhythmogenicity, and pro-inflammatory gene expression. The phytoestrogen genistein mitigated these effects in vitro, reducing cytokine-induced proteasomal degradation of cardiac proteins and preserving contractile function. In vivo, genistein significantly decreased cardiac injury markers and immune cell infiltration in a mouse model of cytokine-induced myocardial injury.Conclusion:CXCL10 and IFN-γ are key mediators of myocardial injury post-mRNA vaccination. Genistein shows potential as a therapeutic agent to mitigate associated cardiovascular risks.

Circulation, Volume 150, Issue Suppl_1, Page ASu1203-ASu1203, November 12, 2024. Background:A goal of post-resuscitation care among patients successfully resuscitated from in-hospital cardiac arrest (IHCA) is avoidance of fever. However, the incidence of post-resuscitation fever after the initial therapeutic hypothermia trials in 2002 and after the recent Targeted Temperature Management (TTM) trial in 2013 is unknown.Objective:Examine temporal trends in fever during the first 24 hours after return of spontaneous circulation (ROSC) from IHCA during 2005-2013 (after the initial hypothermia trials) and then during 2014-2022 (after the TTM trial).Methods:Within the Get With The Guidelines-Resuscitation registry for IHCA in the U.S., we identified adult patients with ROSC after an index IHCA from 127 hospitals that submitted data on IHCA during both time periods between 2005 and 2022. Patients with sepsis and COVID-19 infection were excluded. We evaluated temporal trends in post-resuscitation fever (defined as >100 °F) during 2005-2013 after the initial hypothermia trials, and then between 2014-2022 after the TTM trial.Results:Among 41,155 patients with ROSC after IHCA, the mean age was 64.8 years (±15.0); 60.0% were male, and 68.6% were of White race. Overall, 11,745 (28.5%) developed post-resuscitation fever (Figure 1). Following the therapeutic hypothermia trials in late 2002, the incidence of fever decreased from 39.1% in 2005 to 29.0% in 2013 (Pfor trend < 0.001) (Figure 2). After the publication of the TTM trial in late 2013, post-resuscitation fever in the years 2014-2022 did not go up but declined more modestly (Pfor trend = 0.003).Conclusions:Between 2005 and 2013, the incidence of post-resuscitation fever after IHCA decreased substantially. Since the publication of the TTM trial in late 2013, fever incidence has not increased; rather, it has remained relatively stable, even as reported use of therapeutic hypothermia has declined.

Circulation, Volume 150, Issue Suppl_1, Page A4142259-A4142259, November 12, 2024. Background:A reduction or delay in myocardial flow and perfusion, despite recanalization of the epicardial coronary arteries, is a well-known phenomenon. However, the association between microvascular resistance and troponin levels following elective percutaneous coronary intervention (PCI) is not well established.Objective:The present study aimed to assess the angiographic-derived index of microcirculatory resistance (AMR) in patients undergoing elective PCI and its relationship with high-sensitivity troponin (hsT) values post-procedure.Methods:Between June 2021 and December 2023, patients who underwent elective PCI were considered for inclusion. Patients with successful PCI outcomes were selected for the IMR analysis using AngioPlus Core (Shanghai Pulse Medical Technology Inc); individuals with branch occlusion were excluded. All patients had hsT collected at least twice in the first 24 hours after PCI.Results:A total of 330 patients were included into the analysis. Compared with baseline, there was an increase in AMR in 89.6% of the patients, from 174.9 pre-PCI to 256.2 post-PCI (p< 0.001, Figures 1A-C). The higher the hsT peak after PCI, the greater the delta IMR (p = 0.004, Figure 1D) and the post-PCI IMR (p < 0.001, Figure 1E). There was a positive and significant correlation between the absolute values of hsT peak and delta IMR (p < 0.001, Figure 1F).Conclusion:In patients who underwent elective successful PCI, the increase in hsT is closely related to increase in the index of microcirculatory resistance during the procedure.

Circulation, Volume 150, Issue Suppl_1, Page ASu1002-ASu1002, November 12, 2024. Introduction:There is a lack of evidence on the optimal mechanical ventilation (MV) settings after pediatric cardiac arrest. The purpose of this study is to investigate the impact of MV settings on survival to hospital discharge (SHD) with favorable neurologic outcome (FNO) in the early post cardiac arrest period.Methods:We conducted a retrospective cohort study of children admitted to a single center pediatric CICU from 9/2016 – 4/2023. We divided our cohort into two groups: patients who did and did not utilize extracorporeal membrane oxygenation (ECMO)during the 48 hours after ROC. We evaluated the association of average values of various MV settings in the 48 hours post-ROSC/ROC: tidal volume (TV, defined as exhaled tidal volume per kg of body weight), peak inspiratory pressure (PIP), peak end expiratory pressure (PEEP), mean airway pressure (MAP), and fraction of inspired oxygen (FiO2) with the association of our primary outcome, SHD with FNO. We defined SHD with FNO as Pediatric Cerebral Performance Category (PCPC) of 1,2, or 3 or no change from admission to discharge. Unfavorable outcome was defined as death or SHD with PCPC of 4,5, or 6. We conducted univariate and multivariate logistic regression analyses, controlling for CPR duration and maximum lactate in the 6 hours post ROSC/ROC.Results:There were 102 index events during the study period. Patients with SHD with FNO compared to those without had lower CPR duration (6.0 [3.0, 18.0] vs. 22.0 [5.0, 43.0] minutes, p=0.0003), incidence of ECPR use (19/57 (33.33%) vs. 24/45 (53.33%), p=0.04), and epinephrine doses used (2.0 [1.0, 6.0] vs. 6.0 [2.0, 8.0], p=0.001). Table 1 shows the MV settings of patients with and without SHD with FNO by PCPC. We found no associations between TV, PIP, PEEP, MAP, and FiO2 with our primary outcome in both ECMO and non-ECMO cohorts. In patients who utilized ECMO, higher TV was associated with lower chances of SHD with FNO. (See Table 2)Conclusions:In this retrospective cohort study of a single center pediatric CICU, early post-arrest TV was associated with SHD with FNO amongst patient supported with ECMO, but not in those who did not utilize ECMO. We did not find an association of PIP, PEEP, MAP, or FiO2 with any outcomes. Future investigations should focus on whether there is a threshold of TV of MV settings that is associated with better outcomes in ECMO patients.

Circulation, Volume 150, Issue Suppl_1, Page A4138486-A4138486, November 12, 2024. Introduction:Acute myocardial infarction (MI) is a leading cause of morbidity and mortality worldwide. Despite advances in treatment, readmissions within 30 days remain a significant concern, impacting both patient outcomes and healthcare costs. This study aims to analyze trends in 30-day readmission rates (30-dr) for patients discharged after an acute MI.Methods:We analyzed the 2016-2020 Nationwide Readmission Database for patients aged ≥ 18 years with initial admission of acute MI and were readmitted within 30 days. Variables were identified using ICD-10 codes. The primary outcome was trends in 30-dr; secondary outcomes included trends in complications, mortality rate, length of stay (LOS), and healthcare costs. Multivariate and descriptive bivariate analyses were conducted, with p-values

Circulation, Volume 150, Issue Suppl_1, Page A4146872-A4146872, November 12, 2024. Introduction:Increased prevalence and incidence of heart failure has resulted in a significant rise in the number of patients progressing to advanced heart failure (AHF). Heart transplant improves morbidity and mortality in patients with heart failure refractory to medical therapy. We examined resource utilization as measured in 30-day readmission in a contemporary population utilizing the NRD database.Aim:We conducted a thorough analysis to identify trends in 30-day readmissions of HTs and analyze the associated costs.Methods:Using the National Readmission Database from 2010 to 2021, the study focused on new HT recipients. We evaluated various parameters, including readmission rates and the costs associated with 30-day readmissions. Patients aged