Lundgreendickens1194
% respectively for 2D-LVGLS, and 2D-LVGLS values are only affected by vendor software.
Left ventricular (LV) extracellular remodeling is a critical process in aortic stenosis (AS), which is related to functional abnormalities. Data regarding the use of combined T1 mapping and feature tracking (FT) to assess LV extracellular remodeling in severe AS are scarce. This study aimed to investigate the ability of T1-derived and FT-derived parameters to identify and assess the changes in process of LV extracellular remodeling in patients with severe AS.
A total of 49 patients with severe AS and 20 healthy volunteers were prospectively recruited. Modified look-locker inversion-recovery T1 mapping and FT imaging were performed in all participants using 3.0-T cardiac magnetic resonance imaging. The degree of myocardial fibrosis was quantified using Masson trichrome stain in biopsy specimens obtained intraoperatively from 13 patients and expressed as collagen volume fraction (CVF). Patients were divided into subgroups according to preserved LV ejection fraction (LVEF) (LVEF ≥50%) or reduced LVEF (LVEF & best diagnostic performance as defined by the area of under the curve (-0.83), and GLS, ECV, and post-T1 were significant discriminators after regression analysis.
In the process of LV extracellular remodeling in severe AS, ECV is the structural marker of extracellular fibrosis burden, and GLS is the functional marker before the fibrosis burden intensifies.
In the process of LV extracellular remodeling in severe AS, ECV is the structural marker of extracellular fibrosis burden, and GLS is the functional marker before the fibrosis burden intensifies.
A triangular resection (TR)/suture of the posterior leaflet lesion is the most common technique in mitral valve repair procedures. However, posterior leaflet motion is restricted after surgical resection in echocardiogram analyses. Although several reports have compared the resection/suture technique and the artificial chorda technique, few reports have compared TR with folding repair (FR). We compared the effectiveness and short-term impact of the TR and non-resection-based FR procedures on patients undergoing mitral valve repair.
Mitral valve repair was conducted on 36 patients with moderate to severe mitral regurgitation (MR) through either TR (n=18) or FR (n=18). Echocardiographic data were collected pre- and post-operatively. Routine echocardiographic follow-ups were performed for each patient. Data were analyzed using t-test, Mann-Whitney U-test, chi-squared analysis, or Fisher's exact test. P values <0.05 were considered significant.
Operative time and length of stay within the intensive care etwork (study ID UMIN000039041).
The performance of published preoperative risk scores for acute type A aortic dissection (aTAAD) is suboptimal. So, the predictive power of these scores were externally validated in order to develop and validate a more reliable preoperative score for identification of patients at high risk of mortality.
Potential preoperative risk variables of consecutively admitted patients with aTAAD were prospectively collected. Seven published risk scores were validated with our dataset. For derivation and internal validation, the original population was divided at a ratio of 73. Logistic regression was used to identify variables for the new score. A 50-patient retrospective dataset was used for external validation. The predictive accuracy for post-operative mortality was evaluated using the area under the receiver operating characteristic (AUROC) curve.
During the study period, 225 patients with aTAAD were admitted preoperatively. https://www.selleckchem.com/products/plx5622.html Of these, 209 underwent surgical repair and 29 died postoperatively. The AUROCs of the seven published pre-operative risk scores for post-operative mortality ranged from 0.57 to 0.77. Four variables were derived for the new score system, i.e., Acute myocardial ischemia, Lactate, Iliac arteries involved, and CreatininE (the ALICE score). The AUROCs for post-operative mortality in the derivation, internal and external validation populations were 0.85, 0.88 and 0.83, respectively. At a cutoff value of 3, the ALICE score for post-operative mortality had a sensitivity of 71% to 88% and specificity of 78% to 86%.
The ALICE score comprising four components might help bedside clinicians in early detection of the most severe aTAAD patients.
The ALICE score comprising four components might help bedside clinicians in early detection of the most severe aTAAD patients.
Post-procedural conduction disorders following transcatheter aortic valve replacement (TAVR) still remain frequent, especially using the largest self-expandable device (Medtronic Corevalve Evolut R
, 34 mm, STHV-34). We, therefore, assessed previously described, predictive factors of permanent pacemaker (PPM) implantation in the context of the STHV-34, including calcification distribution, implantation depth and membranous septum length (MSL).
We performed a dual centre analysis of 130 of 182 consecutive patients treated with STHV-34, further stratified into subjects without post-procedural PPM (-PPM n=100, 76.9%) and those requiring post-procedural PPM (+PPM n=30, 23.1%). These events were further analyzed by univariate and multivariate analysis according to several underlying conditions.
Multivariate analysis only depicted previous right bundle branch block [RBBB; OR 11.52 (2.63-50.44), P=0.001] and eccentricity index of the left ventricular outflow tract (LVOT-EI) >0.3 [OR 3.07 (1.22-7.77), P=0.018] as highly predictive for PPM-need, being also confirmed by c-statistics [area under the curve (AUC) =0.68; 95% confidence interval (CI) 0.57-0.80; P=0.0025]. There was only moderate correlation of implantation depth over the MSL in terms of PPM prediction (r=0.23; P<0.0001).
This study offers new insights into potential PPM predictors using the STHV-34 previous RBBB and a pronounced LVOT-EI were independent predictors of PPM, while most of the previously reported determinants failed to predict PPM-need including MSL and implantation depth.
This study offers new insights into potential PPM predictors using the STHV-34 previous RBBB and a pronounced LVOT-EI were independent predictors of PPM, while most of the previously reported determinants failed to predict PPM-need including MSL and implantation depth.