Using Augmented Mean Arterial Pressure to Identify High Mortality Risk Patients With Moderate Aortic Stenosis.

Objective: To study the usefulness of a novel echocardiographic marker, augmented mean arterial pressure (AugMAP = [(mean aortic valve gradient + systolic blood pressure) + (2 × diastolic blood pressure)] / 3), in identifying high-risk patients with moderate aortic stenosis (AS).

Patients And Methods: Adults with moderate AS (aortic valve area, 1.0-1.

Transcatheter Aortic Valve Replacement Prognostication with Augmented Mean Arterial Pressure.

Background: Post-transcatheter aortic valve replacement (TAVR) patient outcome is an important research topic. To accurately assess post-TAVR mortality, we examined a family of new echo parameters (augmented systolic blood pressure (AugSBP) and arterial mean pressure (AugMAP)) derived from blood pressure and aortic valve gradients.

Methods: Patients in the Mayo Clinic National Cardiovascular Diseases Registry-TAVR database who underwent TAVR between 1 January 2012 and 30 June 2017 were identified to retrieve baseline clinical, echocardiographic and mortality data.

Environmental contamination and risk factors for geohelminth transmission in three informal settlements in Durban metropole, South Africa.

Informal settlements/slums are characterised by a lack of adequate sanitation and safe drinking water. Contaminated soil and water sources combined with poor hygiene and environmental conditions results in the transmission of soil transmitted helminths to humans. The aim of the present study was to assess environmental contamination and risk factors for geohelminth transmission in three informal settlements in Durban, South Africa.

Impact of community piped water coverage on re-infection with urogenital schistosomiasis in rural South Africa.

Previously, we demonstrated that coverage of piped water in the seven years preceding a parasitological survey was strongly predictive of infection in a nested cohort of 1976 primary school children (Tanser, 2018). Here, we report on the prospective follow up of infected members of this nested cohort (N = 333) for two successive rounds following treatment. Using a negative binomial regression fitted to egg count data, we found that every percentage point increase in piped water coverage was associated with 4.

Predictors of Trypanosoma lewisi in Rattus norvegicus from Durban, South Africa.

This study investigated associations between Trypanosoma lewisi and Xenopsylla cheopis, a common cyclical vector of T. lewisi; Polyplax spinulosa, a reported mechanical vector; and Laelaps echidnina and Laelaps lamborni, 2 rodent mites of Rattus norvegicus in Durban, South Africa. In total, 379 R.

Impact of the scale-up of piped water on urogenital schistosomiasis infection in rural South Africa.

Recent work has estimated that sub-Saharan Africa could lose US$3.5 billion of economic productivity every year as a result of schistosomiasis and soil-transmitted helminthiasis. One of the main interventions to control schistosomiasis is the provision of safe water to limit the contact with infected water bodies and break the cycle of transmission.

Effects of Pectus Excavatum Repair on Right and Left Ventricular Strain.

Background: The cardiopulmonary benefits of pectus excavatum repair have been debated. Echocardiographic speckle-tracking strain and strain rate have been used to evaluate and detect subclinical myocardial dysfunction in patients receiving cardiotoxic chemotherapy, and patients with valvular heart disease. This technology was applied to evaluate the effects of pectus excavatum surgery on left ventricular (LV) and right ventricular (RV) function.

Cardiac Tamponade.

Cardiac tamponade is caused by an abnormal increase in fluid accumulation in the pericardial sac, which, by raising intracardiac pressures, impedes normal cardiac filling and reduces cardiac output, sometimes dramatically so. This article outlines the pathophysiology, clinical features, and treatment of this important clinical condition highlighting the important role played by echocardiography in diagnosis and management.

The Incremental Value of Magnetic Resonance Imaging for Identification of Apical Pouch in Patients with Apical Variant of Hypertrophic Cardiomyopathy.

Background: The development of a left ventricular (LV) apical pouch in patients with apical hypertrophic cardiomyopathy (aHCM) has been thought to be the transition point that can become an apical aneurysm, which is linked to higher risk of adverse events. In our study, we sought to compare the ability of transthoracic echocardiography (echo) and cardiac magnetic resonance imaging (cMRI) to accurately identify the presence of an apical pouch or aneurysm in patients with aHCM.

Methods: We retrospectively reviewed the charts of all consecutive patients that had features of aHCM on imaging.

Surgical repair of pectus excavatum relieves right heart chamber compression and improves cardiac output in adult patients--an intraoperative transesophageal echocardiographic study.

Background: Cardiac compression in pectus excavatum (PE) deformity and effect of PE surgery on cardiac function in adults have been debated. We examined the effect of PE correction on right heart size and cardiac output.

Methods: A retrospective evaluation was performed of 168 adult patients who underwent a modified Nuss PE repair with intraoperative transesophageal echocardiography from 2011 to 2014.

Two cases of apical ballooning syndrome masking apical hypertrophic cardiomyopathy.

Apical akinesis and dilation in the absence of obstructive coronary artery disease is a typical feature of stress-induced (takotsubo) cardiomyopathy, whereas apical hypertrophy is seen in apical-variant hypertrophic cardiomyopathy. We report the cases of 2 patients who presented with takotsubo cardiomyopathy and were subsequently found to have apical-variant hypertrophic cardiomyopathy, after the apical ballooning from the takotsubo cardiomyopathy had resolved. The first patient, a 43-year-old woman with a history of alcohol abuse, presented with shortness of breath, electrocardiographic and echocardiographic features consistent with takotsubo cardiomyopathy, and no significant coronary artery disease.

It begins with the right supervisor: importance of mentorship and clinician-investigator trainee satisfaction levels in Canada.

Purpose: Clinician Investigator Trainee Association of Canada/ Association des cliniciens-chercheurs en formation du Canada (CITAC/ACCFC) represents the interests of clinician-investigator (CI) trainees across Canada. To better advocate for the successful training of CI trainees in Canada, CITAC/ACCFC conducted a survey to assess satisfaction with their training and to find what factors were most associated with satisfaction level.

Methods: A nominal scale-based psychometric survey was conducted online in 2009 on CI trainees in Canada (including MD/MSc, MD/PhD, or CIP/SSP).

Chest pain and diarrhea: a case of Campylobacter jejuni-associated myocarditis.

Background: Diarrhea and chest pain are common symptoms in patients presenting to the emergency department (ED). However, rarely is a relationship between these two symptoms established in a single patient.

Objective: Describe a case of Campylobacter-associated myocarditis.

Population structure of an invasive parthenogenetic gastropod in coastal lakes and estuaries of northern KwaZulu-Natal, South Africa.

Background: Estuaries and coastal lakes receive little attention despite being heavily invaded by non-indigenous invasive species (NIS). In these situations, studies of population dynamics in invaded habitats can provide valuable insights into how NIS interact with new environments. Tarebia granifera is a prosobranch gastropod from south-east Asia which has invaded other sub-tropical parts of the world.

Usefulness of two-dimensional and speckle tracking echocardiography in "Gray Zone" left ventricular hypertrophy to differentiate professional football player's heart from hypertrophic cardiomyopathy.

Distinguishing the pathologic hypertrophy of hypertrophic cardiomyopathy (HC) from the physiologic hypertrophy of professional football players (PFP) can be challenging when septal wall thickness falls within a "gray zone" between 12 and 16 mm. It was hypothesized that 2-dimensional and speckle-tracking strain (ε) echocardiography could differentiate the hearts of PFPs from those of patients with HC with similar wall thicknesses. Sixty-six subjects, including 28 professional American football players and 21 patients with HC, with septal wall thicknesses of 12 to 16 mm, along with 17 normal controls, were studied using 2-dimensional echocardiography.

Coronary artery plaque burden does not affect left ventricular diastolic function in asymptomatic adults with normal ejection fraction.

Background: Coronary artery disease (CAD) is commonly cited as a mechanism underlying diastolic dysfunction. However, the association of CAD without ischemia and left ventricular (LV) diastolic dysfunction has not been convincingly demonstrated in asymptomatic patients. The objective of this study was to determine if such a relation exists using coronary artery calcium score (CACS) as a surrogate for coronary atherosclerosis burden.

Effect of positional changes on inferior vena cava size.

Aim: To study the effect of positional change on inferior vena cava (IVC) diameter. The influence of positional change on IVC size is not well studied. Although the American Society of Echocardiography guidelines for chamber quantification recommend imaging the IVC in the left lateral position, many labs routinely image the IVC from the supine position.

Short-term cardiac and noncardiac mortality following liver transplantation.

Objectives. To determine the importance of acute cardiac events as a cause of mortality compared to non-cardiac events in the four month period following liver transplantation (LT) using current preoperative cardiac screening strategies. Patients and Methods.

Carotid ultrasound identifies high risk subclinical atherosclerosis in adults with low framingham risk scores.

Background: Worldwide, cardiovascular (CV) disease remains the most common cause of morbidity and mortality. Although effective in predicting CV risk in select populations, the Framingham risk score (FRS) fails to identify many young individuals who experience premature CV events. Accordingly, the aim of this study was to determine the prevalence of high-risk carotid intima-media thickness (CIMT) or plaque, a marker of atherosclerosis and predictor of CV events, in young asymptomatic individuals with low and intermediate FRS (<2% annualized event rate) using the carotid ultrasound protocol recommended by the American Society of Echocardiography and the Society of Vascular Medicine.

Multimodality imaging showing complete cardiovascular involvement by Erdheim-Chester disease.

Erdheim-Chester disease (ECD) is a multisystem non-Langerhans form of cell histiocytosis. Histiocytic infiltration leads to xanthogranulomatous infiltrates of multiple organ systems. Erdheim-Chester disease was first reported in 1930, only 320 cases reported in the literature.