Association Between FFR and Instantaneous Wave-Free Ratio (iFR) of Intermediate Lesions on Coronary Computed Tomography Angiography.

Background: New data suggests long term outcomes of coronary revascularization based on instantaneous wave free ratio (iFR) are equivalent to invasive fractional flow reserve (FFR). We aimed to evaluate the correlation between non-invasive FFR derived from cardiac CT (FFR) and iFR.

Methods: Data from 21 patients with 26 vessels, who underwent both FFR computation and invasive iFR measurement, were analysed.

The Vulnerable Plaque: Recent Advances in Computed Tomography Imaging to Identify the Vulnerable Patient.

Purpose Of Review: This review aims to summarize the role of coronary computed tomography plaque analysis in identifying high-risk patients and plaques.

Recent Findings: In this review, we will describe the histopathological features of a vulnerable plaque as well as the coronary computed tomography characteristics including spotty calcification, low-attenuation fatty core, positive remodeling, and thin fibrous cap. We will also review several studies that assessed features of a vulnerable plaque on non-invasive imaging and evaluated them as risk predictors of future acute coronary events.

Mitral regurgitation: a contemporary review of percutaneous mitral valve repair and role of periprocedural imaging.

Purpose Of Review: This article aims to review recent landmark clinical trials that have resulted in a paradigm shift in the management of patients with mitral regurgitation. This article additionally highlights the instrumental role that structural heart disease (SHD) imaging plays in evaluation of mitral regurgitation and determining candidacy for transcatheter mitral valve repair (TMVr), in addition to the procedural guidance and detection of complications.

Recent Findings: Edge-to-edge TMVr with the MitraClip device (Abbott Vascular, Santa Clara, California) was initially studied and subsequently approved by the US Food and Drug Administration (FDA) for treatment of primary mitral regurgitation in 2013.

Device Therapy for Sudden Cardiac Death Prophylaxis After Acute Coronary Syndrome: When and Why?

Implantable cardioverter-defibrillators (ICDs) are a powerful tool in preventing sudden cardiac death due to ventricular arrhythmias in ischemic cardiomyopathy. ICD indications and timing in acute coronary syndromes are unclear. PURPOSE OF REVIEW: We reviewed several trials that delineated the indications for a cardiac defibrillator in patients with coronary artery disease.

Simultaneous Transfemoral Mitral and Tricuspid Valve in Ring Implantation: First Case Report with Edwards Sapien 3 Valve.

Patients with advanced valvular disease may be at high or prohibitive risk for surgical management. We describe a patient with previous mitral and tricuspid valve repair and recurrent admissions for New York Heart Association Class IV heart failure symptoms due to severe mitral stenosis and severe tricuspid regurgitation. Due to her comorbidities and two previous sternotomies, the patient was at high risk for surgery.

Unplugging the Drain: Treatment of a Rare Late Complication of Cardiac Resynchronization Therapy.

Central vein thrombosis (CVT) is a rare cause of chylothorax. We report a patient with chylothorax secondary to CVT, despite being on anticoagulation, who was successfully treated with balloon angioplasty of the occluded vein. A 65-year-old male presented with shortness of breath of one-month duration.

Inflammation-associated microRNA changes in circulating exosomes of heart failure patients.

Objective: MiR-486 and miR-146a are cardiomyocyte-enriched microRNAs that control cell survival and self-regulation of inflammation. These microRNAs are released into circulation and are detected in plasma or in circulating exosomes. Little is known whether heart failure affects their release into circulation, which this study investigated.