Feasibility of a No-Implant Approach to Interatrial Shunts: Preclinical and Early Clinical Studies.

Background: Heart failure with preserved ejection fraction represents a major unmet clinical need with limited treatment options. Recent device therapies under investigation have focused on decompression of the left atrium through an implantable interatrial shunt. Although these devices have shown favorable safety and efficacy signals, an implant is required to maintain shunt patency, which may increase the patient risk profile and complicate subsequent interventions requiring transseptal access.

No-Implant Interatrial Shunt for HFpEF: 6-Month Outcomes From Multicenter Pilot Feasibility Studies.

Background: Most approaches to the creation of an interatrial shunt require placement of a permanent implant to maintain patency.

Objectives: The goal of this study was to investigate the safety and efficacy of a no-implant interatrial shunt for patients with heart failure with preserved ejection fraction (HFpEF) and heart failure with mildly reduced ejection fraction (HFmrEF).

Methods: This was a multicenter, uncontrolled study of patients with HFpEF/HFmrEF and NYHA functional class ≥II, ejection fraction >40%, and pulmonary capillary wedge pressure (PCWP) during supine exercise ≥25 mm Hg with PCWP-to-right atrial gradient ≥5 mm Hg.

Reducing cardiac tamponade caused by temporary pacemaker perforation in transcatheter aortic valve replacement.

Background: Cardiac tamponade caused by temporary right ventricular (RV) pacemaker perforation is a rare but serious complication in transcatheter aortic valve replacement (TAVR).

Aims: To study the incidence of temporary pacemaker related cardiac tamponade in TAVR, and the relation to the type of pacemaker lead used in periprocedural temporary transvenous pacing.

Methods: A single center registry of transfemoral TAVRs in 2014-2020.

A Novel Model to Predict 1-Year Mortality in Elective Transfemoral Aortic Valve Replacement: The TAVR-Risk Score.

Objectives: We aimed to develop and validate an effective prediction model for 1-year mortality risk in elective transfemoral transcatheter aortic valve replacement (TAVR), ie, the TAVR-Risk (TARI) model.

Background: TAVR is the primary treatment for patients with symptomatic severe aortic valve stenosis; however, risk assessment tools for longer-term outcomes after TAVR remain scarce.

Methods: This retrospective cohort study used logistic regression to test univariate and multivariate associations.

Preoperative heart disease and risk for postoperative complications after pancreatoduodenectomy.

Background: Comorbidities increase the risk for postoperative complications after pancreatoduodenectomy. The importance of different categories of heart disease on postoperative outcomes has not been thoroughly studied.

Methods: Patients aged ≥18 years undergoing pancreatoduodenectomy between 2008 and 2019 at Karolinska University Hospital, Sweden were included.

Percutaneous plug-based vascular closure device in 1000 consecutive transfemoral transcatheter aortic valve implantations.

Background: Arterial access-site related complications constitute a large proportion of adverse events related to cardiac interventions requiring large-bore devices and have significant implications on morbidity, mortality and hospital cost.

Aims: To evaluate the safety and effectiveness of a novel percutaneous plug-based vascular closure device (VCD) in 1000 consecutive patients undergoing transfemoral transcatheter aortic valve implantation (TAVI).

Methods: A single-center observational study evaluating a plug-based VCD (MANTA, Teleflex/Essential Medical Inc.

Left Ventricular Outflow Tract Obstruction Following Transcatheter Mitral Valve Replacement Resolved by Chordal Rupture.

Transcatheter mitral valve replacement carries a risk of left ventricular outflow tract obstruction associated with mortality. We present a case of left ventricular outflow tract obstruction that resolved spontaneously when chords to the anterior mitral leaflet were found to have ruptured. ().

Change in mitral regurgitation severity impacts survival after transcatheter aortic valve replacement.

Background: The impact of a change in mitral regurgitation (MR) following TAVR is unknown. We studied the impact of baseline MR and early post-procedural change in MR on survival following TAVR.

Methods: The SWEDEHEART registry included all TAVRs performed in Sweden.

The obesity paradox: An analysis of pre-procedure weight trajectory on survival outcomes in patients undergoing transcatheter aortic valve implantation.

Introduction: Increased mortality has been observed in those with cardiovascular diseases who are of normal body mass index (BMI) compared to the overweight and the obese. A similar association has been demonstrated in patients undergoing transcatheter aortic valve (TAVI) implantation. However, it still remains unclear whether low or normal BMI itself is unfavourable or whether this is merely a reflection of cardiac cachexia due to severe aortic stenosis.

A Path to Avoid during Transcatheter Aortic Valve Implantation: Case Report.

Collateral pathways in vascular disease are important natural "bypass" conduits that protect against ischemia. Endovascular diagnostic and therapeutic procedures via peripheral access sites are performed frequently. This case report underlines the importance of being aware of collateral circulation in patients with chronic aortoiliac occlusive disease undergoing subclavian transcatheter aortic valve implantation to avoid acute limb ischemia.

A missed penalty kick triggered coronary death in the husband and broken heart syndrome in the wife.

Events that induce emotional stress and frustration in a large number of subjects under specific circumstances, such as earthquakes, war conditions, and sporting occasions, may increase the incidence of cardiovascular events, such as acute myocardial infarction, arrhythmias, and sudden cardiac death. This report describes a married couple who expressed an apparently passionate interest in football with hazardous consequences after a tense football match during the FIFA 2014 World Championships. A series of emotional stressors initiated by defeat in this football game lead to cardiac arrest in a 58-year-old man caused by a thrombotic occlusion of the left anterior descending artery and ending in the death of the patient.

Adrenalin, noradrenalin and heart rate responses to psychosocial stress in young adults born preterm at very low birthweight.

Objective: Adults born preterm at very low birthweight (VLBW; ≤ 1500 g) have high levels of cardiovascular risk factors and altered responses to psychosocial stress including higher blood pressure and lower cortisol. Our aim was to investigate adrenalin (A), noradrenalin (NA) and heart rate (HR) responses to psychosocial stress in adults born preterm at VLBW.

Design And Participants: We studied 50 young adults, aged 19-27 years, born at VLBW and 39 term-born controls, group-matched for age, sex and birth hospital.

Sleep problems and cardiovascular function in children.

Objective: To assess the associations of sleep problems with 24-hour ambulatory blood pressure and cardiovascular reactivity in children.

Methods: Sleep problems in 285 term-born, healthy 8-year-olds (mean [standard deviation] = 8.1 [0.

Blunted hypothalamic-pituitary-adrenal axis and insulin response to psychosocial stress in young adults born preterm at very low birth weight.

Background: Young adults born preterm at very low birth weight (VLBW, ≤1500 g) have higher levels of cardiovascular risk factors, including impaired glucose regulation, than their term-born peers. This could be mediated through altered hypothalamic-pituitary-adrenal axis (HPAA) response to stress.

Objective: To compare HPAA, glucose and insulin responses provoked by psychosocial stress in VLBW subjects versus a comparison group of term-born controls.

Pain and hospice care in nursing home residents with dementia and terminal cancer.

Aim: One condition associated with severe end-of-life pain that can lead to a poor quality of death is cancer. Cancer pain in people with dementia is of particular concern because of communication problems that occur with worsening disease. The aim of the current pilot study was to examine the association between hospice enrolment, dementia severity and pain among nursing home residents who died from advanced cancer.

Higher levels of physical activity are associated with lower hypothalamic-pituitary-adrenocortical axis reactivity to psychosocial stress in children.

Context: Children who undertake more physical activity (PA) not only have more optimal physical health but also enjoy better mental health. However, the pathways by which PA affects well-being remain unclear.

Objective: To address this question, we examined whether objectively measured daytime PA was associated with diurnal hypothalamic-pituitary-adrenocortical axis (HPAA) activity and HPAA responses to psychosocial stress.

Characteristics and underlying meaning of hoarding behavior in elders with Alzheimer's dementia: caregivers' perspective.

Background: Dementia and its associated problem behaviors remain bothersome to family and professional caregivers. Exploring characteristics and the underlying meaning of disruptive behaviors in elders with Alzheimer's dementia can be a first step to pursuing patient-centered care. Although hoarding is relatively harmless, unattended excessive hoarding can create health and safety issues for both patients and caregivers.

Assessing advanced cancer pain in older adults with dementia at the end-of-life.

Aim: To assess advanced cancer pain in older adults with dementia at the end-of-life.

Background: Self-report is the gold standard for pain assessment; however, people with Alzheimer's disease may lose the ability to report pain. Biochemical and neuropathological changes occur in Alzheimer's disease that impairs the affective, sensory, and motor pain processing regions of the brain.

Washington State Death with Dignity Act: implications for long-term care.

The Washington Death with Dignity Act (DWDA) allows competent, terminally ill adults to request a lethal dose of medication from a physician. The purpose of this study was to explore knowledge of Directors of Nursing (DONs) in long-term care (LTC) and assisted living facilities regarding the DWDA. Findings of the survey provide insight into DONs' understanding of the law and whether they have provided staff education regarding how to respond to resident requests.

Poor sleep and cardiovascular function in children.

We investigated whether sleep quantity and quality were related to 24-hour ambulatory blood pressure and cardiovascular reactivity in children. We studied term-born, healthy 8.0-year olds (SD: 1.

Body size at birth and cardiovascular response to and recovery from mental stress in children.

Cardiovascular (CV) response to mental stress, a predictor of CV disease risk, may be determined already in utero. However, the underlying mechanisms remain unclear, and previous studies have used adult subjects and neglected CV recovery. We investigated 147 girls and 136 boys aged 8 years who underwent the Trier Social Stress Test for children to determine whether body size at birth is associated with CV activity.

Maternal prenatal licorice consumption alters hypothalamic-pituitary-adrenocortical axis function in children.

Overexposure to glucocorticoids has been proposed as a mechanism by which prenatal adversity 'programs' the function of the hypothalamic-pituitary-adrenocortical axis (HPAA), thereby increasing the risk of adult diseases. Glycyrrhizin, a natural constituent of licorice, potently inhibits 11β-hydroxysteroid dehydrogenase type 2, the feto-placental barrier to the higher maternal cortisol levels. We studied if maternal consumption of glycyrrhizin in licorice associates with HPAA function in children.

The effects of a web-based intervention on psychosocial well-being among adults aged 60 and older with diabetes: a randomized trial.

Purpose: The purpose of this study is to investigate the impact of a 6-month Web-based intervention on the psychosocial well-being of older adults with diabetes.

Methods: This study was a randomized controlled trial (N - 62) comparing the effects of a 6-month Web-based intervention plus usual care with usual care alone among adults aged 60 years or older with diabetes. The outcomes included quality of life, depression, social support, and self-efficacy.

Poor sleep and altered hypothalamic-pituitary-adrenocortical and sympatho-adrenal-medullary system activity in children.

Context: Neuroendocrine alterations, with well-known links with health, may offer insight into why poor sleep is associated with poor health. Yet, studies testing associations between sleep and neuroendocrine activity in children are scarce.

Objective: The aim of this study was to determine whether actigraphy-based sleep pattern is associated with hypothalamic-pituitary-adrenocortical axis and sympatho-adrenal-medullary system activity in children.