A Novel Protocol for Contrast-Free Transcatheter Aortic Valve Replacement Evaluation and Implantation.

Background: We aimed to develop a transcatheter aortic valve replacement (TAVR) sizing algorithm and implantation method to facilitate safe and effective TAVR without contrast use in patients with severe chronic kidney disease (CKD) who do not yet require renal replacement therapy. Patients with CKD are a challenging patient subset to treat using standard TAVR care pathways which most usually require the use of iodinated contrast media both during gated computed tomography (CT) angiography sizing, and valve deployment. Iodinated contrast exposure may worsen kidney function in a dose-dependent fashion, and may result in a need for renal replacement therapy.

Transcatheter Myotomy for Hypertrophic Obstructive Cardiomyopathy.

Purpose Of Review: To describe the emerging role of transcatheter septal myotomy in the treatment of hypertrophic obstructive cardiomyopathy.

Recent Findings: Transcatheter septal myotomy was developed to address risk of LVOT obstruction during TMVR, however it has been performed in patients with LVOT obstruction related to hypertrophic cardiomyopathy, in whom it improves symptoms, reduces LVOT gradients, and is associated with low incidence of procedural complications. Transcatheter myotomy is a novel approach to address LVOT obstruction related to hypertrophic cardiomyopathy in patients who are not favorable surgical candidates.

Federated learning for multi-omics: A performance evaluation in Parkinson's disease.

While machine learning (ML) research has recently grown more in popularity, its application in the omics domain is constrained by access to sufficiently large, high-quality datasets needed to train ML models. Federated learning (FL) represents an opportunity to enable collaborative curation of such datasets among participating institutions. We compare the simulated performance of several models trained using FL against classically trained ML models on the task of multi-omics Parkinson's disease prediction.

Long-term outcomes and reverse remodelling in recently diagnosed unexplained left ventricular systolic dysfunction.

Aims: In patients with recently diagnosed non-ischaemic LV systolic dysfunction, left ventricular reverse remodelling (LVRR) and favourable prognosis has been documented in studies with short-term follow-up. The aim of our study was to assess the long-term clinical course and stability of LVRR in these patients.

Methods And Results: We prospectively studied 133 patients (37 women; 55 [interquartile range 46, 61] years) with recently diagnosed unexplained LV systolic dysfunction, with heart failure symptoms lasting <6 months and LV ejection fraction <40% persisting after at least 1 week of therapy.

Federated Learning for multi-omics: a performance evaluation in Parkinson's disease.

While machine learning (ML) research has recently grown more in popularity, its application in the omics domain is constrained by access to sufficiently large, high-quality datasets needed to train ML models. Federated Learning (FL) represents an opportunity to enable collaborative curation of such datasets among participating institutions. We compare the simulated performance of several models trained using FL against classically trained ML models on the task of multi-omics Parkinson's Disease prediction.

Clinically significant myocardial bridging.

Myocardial bridging is a common anatomical variant in which a major epicardial coronary artery takes an intramyocardial course, leading to dynamic systolic compression. Because coronary perfusion occurs primarily during diastole, most patients with this anatomical variant have no associated perfusion abnormalities or symptoms. Despite this, there is a subset of patients with myocardial bridging who experience ischaemic symptoms.

The contemporary role of protamine in the cardiac catheterization laboratory.

Access to the arterial circulation and full anticoagulation carries a risk of serious bleeding during and after percutaneous coronary intervention. Important sources of bleeding include the arterial access site and coronary artery perforation. Prompt and effective management of hemorrhagic complications is an essential interventional skill.

Intraretinal Cysts as a Manifestation of Retinal Angiomatous Proliferation in Optical Coherence Tomography Angiography.

Background and Objectives: Intraretinal cysts are common pathology observed inspectral domain optical coherence tomography (SDOCT) in patients with neovascular form of age-related macular degeneration (AMD). The aim of the study was to determine if the presence of intraretinal cysts is positively correlated with diagnosis of retinal angiomatous proliferation (RAP) in optical coherence tomography angiography (OCTA). Material and Methods: A total of 21 eyes with intraretinal cysts in SDOCT exam (Group1) and 21 eyes with subretinal fluid(Group 2) were enrolled into the study.

A Randomized Controlled Trial of Prasugrel for Prevention of Early Saphenous Vein Graft Thrombosis.

Objectives: To test whether administration of prasugrel after coronary artery bypass grafting (CABG) reduces saphenous vein graft (SVG) thrombosis. Use of aspirin after CABG improves graft patency, but administration of other antiplatelet agents has yielded equivocal results.

Methods: We performed a double-blind trial randomizing patients to prasugrel or placebo after CABG at four United States centers.

Temporal Trends in Chronic Total Occlusion Percutaneous Coronary Interventions: Insights From the PROGRESS-CTO Registry.

Background: Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has significantly evolved in recent years.

Methods: We compared the clinical, angiographic, and technical characteristics, as well as procedural outcomes of CTO-PCIs in a multicenter registry between the "early era" (2012-2016) and the "current era" (2017-2019).

Results: Current era patients more often had stage III or IV angina compared with early era patients (71% vs 66%, respectively; P=.

Spontaneous tumor lysis syndrome in T-cell malignancy: two case reports.

Tumor lysis syndrome (TLS) refers to a constellation of metabolic abnormalities that result from release of intracellular solutes (potassium, phosphate, and nucleic acid metabolites) from rapidly dying tumor cells. While TLS most commonly occurs following chemotherapy, spontaneous TLS can rarely occur in rapidly dividing liquid or solid malignancies. Here, we report the cases of two patients who presented with non-specific symptoms and were found to have spontaneous TLS.

Comparison of routine contrast‑enhanced computed tomography with late gadolinium enhancement cardiac magnetic resonance imaging in the detection of myocardial pathology.

Unlabelled: Bacground: Cardiac magnetic resonance imaging (MRI) represents the gold standard in noninvasive evaluation of myocardial tissue. However, some patients are unable to undergo cardiac MRI due to a variety of reasons.

Aims: We sought to determine the diagnostic accuracy of routinely performed contrast‑enhanced computed tomography (CECT) compared with cardiac MRI in the evaluation of myocardial tissue.

Plasma osteopontin levels, but not its myocardial expression, reflect heart failure severity in recently diagnosed dilated cardiomyopathy.

Background: Elevated levels of the extracellular matrix glycoprotein osteopontin (OPN) may be detected in both myocardium and plasma under various pathological conditions affecting the heart. Several studies demonstrated increased plasma OPN levels in patients with heart failure due to dilated cardiomyopathy (DCM), while other studies showed high OPN expression levels in the myocardium of such patients. However, very little is known about OPN levels in both plasma and myocardium of the same individual with DCM.

Frequency and Outcomes of Ad Hoc Versus Planned Chronic Total Occlusion Percutaneous Coronary Intervention: Multicenter Experience.

Background: For patients needing coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI), a planned, staged intervention has been recommended by experts. Ad hoc CTO-PCI, however, occurs in practice.

Methods: Observational, contemporary, multicenter, international registry.

In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention in Patients With Chronic Kidney Disease.

Objectives: The effect of chronic kidney disease (CKD) on in-hospital outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study.

Methods: We evaluated the prevalence of CKD and its impact on CTO-PCI outcomes in 1979 patients who underwent 2040 procedures between 2012 and 2017 at 18 centers. CKD was defined as preprocedural estimated glomerular filtration rate (eGFR) <60 mL/min/1.

Radiation Safety in the Catheterization Laboratory: Current Perspectives and Practices.

Background: There is great variability in radiation safety practices in cardiac catheterization laboratories around the world.

Methods: We performed an international online survey on radiation safety including interventional cardiologists, electrophysiologists, interventional radiologists, and vascular surgeons.

Results: A total of 570 responses were received from various geographic locations, including the United States (77.

Diverse perspectives and training paths in cardiology: An analysis of authorship in the Journal of the American College of Cardiology.

Background: The role of women and foreign medical graduates (FMGs) in cardiology research published in the United States has received limited study.

Methods: We examined the characteristics of the first and last authors of all original contributions and review articles published in the Journal of the American College of Cardiology from October 1, 2015, to October 1, 2016.

Results: A total of 345 articles were identified, with 687 first and last authors originating from ≥50 different countries.

Contemporary Use of Laser During Percutaneous Coronary Interventions: Insights from the Laser Veterans Affairs (LAVA) Multicenter Registry.

Background: The contemporary use and outcomes of excimer laser coronary atherectomy (ELCA) in percutaneous coronary intervention (PCI) are not well described.

Methods: We examined the baseline clinical and angiographic characteristics and procedural outcomes of 130 target lesions in 121 consecutive PCIs (n = 116 patients) in which ELCA was performed at three United States Department of Veterans Affairs (VA) medical centers between 2008 and 2016.

Results: Mean age was 68.

Mechanical Circulatory Support in Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Multicenter U.S. Registry.

Objective: To study outcomes with use of percutaneous mechanical circulatory support (MCS) devices in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).

Methods: We examined characteristics and outcomes of 1598 CTO-PCIs performed from 2012-2017 at 12 high-volume centers.

Results: Patient age was 66 ± 10 years; 86% were men.

Randomized Comparison of a CrossBoss First Versus Standard Wire Escalation Strategy for Crossing Coronary Chronic Total Occlusions: The CrossBoss First Trial.

Objectives: The authors performed a multicenter, randomized-controlled, clinical trial comparing upfront use of the CrossBoss catheter versus antegrade wire escalation for antegrade crossing of coronary chronic total occlusions.

Background: There is equipoise about the optimal initial strategy for crossing coronary chronic total occlusions.

Methods: The primary endpoints were the time required to cross the chronic total occlusion or abort the procedure and the frequency of procedural major adverse cardiovascular events.

Prevalence, Presentation and Treatment of 'Balloon Undilatable' Chronic Total Occlusions: Insights from a Multicenter US Registry.

Background: The prevalence, treatment and outcomes of balloon undilatable chronic total occlusions (CTOs) have received limited study.

Methods: We examined the prevalence, clinical and angiographic characteristics, and procedural outcomes of percutaneous coronary interventions (PCIs) for balloon undilatable CTOs in a contemporary multicenter US registry.

Results: Between 2012 and 2017 data on balloon undilatable lesions were available for 425 consecutive CTO PCIs in 415 patients in whom guidewire crossing was successful: 52 of 425 CTOs were balloon undilatable (12%).

Mid-term outcomes of chronic total occlusion percutaneous coronary intervention with subadventitial vs. intraplaque crossing: A systematic review and meta-analysis.

Background: Some reports have demonstrated increased risk with subadventitial chronic total occlusion (CTO) crossing, whereas others suggest equipoise between subadventitial and intraplaque crossing techniques. We sought to clarify the effect of subadventitial lesion crossing on mid-term outcomes of CTO percutaneous coronary intervention (PCI).

Methods: We conducted a systematic review and meta-analysis of studies reporting post-discharge outcomes after CTO PCI performed via subadventitial vs.

Effect of PCSK9 Inhibitors on Clinical Outcomes in Patients With Hypercholesterolemia: A Meta-Analysis of 35 Randomized Controlled Trials.

Background: We sought to examine the efficacy and safety of 2 PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors: alirocumab and evolocumab.

Methods And Results: We performed a systematic review and meta-analysis of randomized controlled trials comparing treatment with and without PCSK9 inhibitors; 35 randomized controlled trials comprising 45 539 patients (mean follow-up: 85.5 weeks) were included.