Stellate Ganglion Block and Bilateral Sympathectomy for Recurrent Coronary Vasospasm Secondary to Severe Eosinophilic Asthma.

A 42-year-old man experienced recurrent coronary artery spasm (CAS) secondary to eosinophilic asthma despite being on multiple medications. He underwent a successful unilateral stellate ganglion block followed by bilateral thoracoscopic sympathectomy, with no subsequent recurrence of CAS. These invasive therapies offer a potential treatment option for refractory CAS.

Estimating wastewater emissions and environmental levels of typical organic contaminants based on regionalized modelling.

Organic contaminants (OCs) are released into the environment through effluent discharges from wastewater treatment plants (WWTP), posing risks to environment health. However, emissions from various source, particularly large-scale investigations across different industries, remain poorly understood. Based on both sampling and statistical data, this study estimates the emissions of 10 OCs, including perfluorooctane acid (PFOA), perfluorooctane sulfonate (PFOS), 4-nonylphenol (4-NP), 4-tert-octylphenol (4-t-OP), dibutyl phthalate (DBP), di-iso-butyl phthalate (DIBP), dimethyl phthalate (DMP), butyl benzyl phthalate (BBP), di(2-ethylhexyl) phthalate (DEHP), and bisphenol A (BPA), from the effluents of 160 factories across 8 industries, 541 municipal wastewater treatment plants (MWWTPs), and 8 waste treatment plants (WTPs) in the upper Yangtze River Basin.

Elevated Troponin T in Immune-Checkpoint Inhibitor Myositis: A Case of Mistaken Myocarditis.

A patient with metastatic renal cell carcinoma on axitinib and pembrolizumab had elevated high-sensitivity cardiac troponin T and normal high-sensitivity cardiac troponin I with unremarkable cardiac investigations. A noncardiac cause (myositis) was the likely cause for cardiac troponin T elevation. Cardiac troponin I may be a more appropriate marker to support a myocarditis diagnosis with concurrent myositis.

Sex differences in post-operative outcomes following non-cardiac surgery.

It is uncertain whether sex is an independent risk factor for poor outcomes after non-cardiac surgery. We examined sex differences in short- and long-term mortality and morbidity in patients undergoing non-cardiac surgery in Alberta, Canada. Using linked administrative databases, we identified patients undergoing one of 45 different non-cardiac surgeries who were hospitalized between 2008 and 2019.

Does cardiac imaging surveillance strategy influence outcomes in patients with early breast cancer?

Background: Many patients with breast cancer receive therapies with the potential to cause cardiotoxicity. Echocardiography and multiple-gated acquisition (MUGA) scans are the most used modalities to assess cardiac function during treatment in high-risk patients; however, the optimal imaging strategy and the impact on outcome are unknown.

Methods: Consecutive patients with stage 0-3 breast cancer undergoing pre-treatment echocardiography or MUGA were identified from a tertiary care cancer center from 2010-2019.

Aurantio-obtusin ameliorates obesity by activating PPARα-dependent mitochondrial thermogenesis in brown adipose tissues.

Obesity contributes to the progression of various chronic diseases, and shortens life expectancy. With abundant mitochondria, brown adipose tissue (BAT) dissipates energy through heat to limit weight gain and metabolic dysfunction in obesity. Our previous studies have shown that aurantio-obtusin (AO), a bioactive ingredient in Chinese traditional medicine Cassiae semen significantly improves hepatic lipid metabolism in a steatotic mouse model.

Association of Frailty, Age, Socioeconomic Status, and Type of Surgery With Perioperative Outcomes in Patients Undergoing Noncardiac Surgery.

This cohort study examines the association of Hospital Frailty Risk Score classification, demographic characteristics, and type of surgery with risk of mortality among patients undergoing noncardiac surgery.

Metabolic activity of the left and right atria are differentially altered in patients with atrial fibrillation and LV dysfunction.

Background: Alterations in atrial metabolism may play a role in the perpetuation of atrial fibrillation (AF). This study sought to compare F-fluorodeoxyglucose (FDG) uptake on PET, in patients with LV dysfunction versus those without AF.

Methods: Seventy-two patients who underwent myocardial viability assessment were evaluated.

An Unusual Case of Obstructive Shock.

A 54-year-old man presented in profound obstructive shock. Investigations revealed a right atrial mass causing severe right ventricular inflow obstruction and compromised cardiac output. The patient was treated with emergency balloon catheter intervention to relieve the obstruction, with resulting hemodynamic stability.

Internal validation of myocardial flow reserve PET imaging using stress/rest myocardial activity ratios with Rb-82 and N-13-ammonia.

Background: Myocardial flow reserve (MFR) measurement provides incremental diagnostic and prognostic information. The objective of the current study was to investigate the application of a simplified model for the estimation of MFR using only the stress/rest myocardial activity ratio (MAR) in patients undergoing rest-stress cardiac PET MPI.

Methods And Results: Rest and dipyridamole stress dynamic PET imaging was performed in consecutive patients using Rb or NH (n = 250 each).

Reliable quantification of myocardial sympathetic innervation and regional denervation using [C]meta-hydroxyephedrine PET.

Purpose: Cardiac sympathetic nervous system (SNS) dysfunction is associated with poor prognosis in chronic heart failure patients. This study characterized the reproducibility and repeatability of [C]meta-hydroxyephedrine (HED) positron emission tomography (PET) quantification of cardiac SNS innervation, regional denervation, and myocardial blood flow (MBF).

Methods: Dynamic HED PET-CT scans were performed 47 ± 22 days apart in 20 patients with stable heart failure and reduced ejection fraction.

Differential association of diabetes mellitus and female sex with impaired myocardial flow reserve across the spectrum of epicardial coronary disease.

Aims: Diabetes mellitus (DM) affects the macro- and microvasculature, leading to impairment in coronary vascular reactivity. Microvascular dysfunction is more prevalent in females compared to males, leading to increased cardiovascular risk in women. The purpose of this study was to quantify the association between diabetes and female sex on myocardial flow reserve (MFR) across the spectrum of epicardial coronary artery disease (CAD).

Is Immigrant Status Associated With Cervical Cancer Screening Among Women in Canada? Results From a Cross-Sectional Study.

Objective: Cervical cancer accounts for the highest mortality rate from cancer in women worldwide. Despite widespread availability of cervical cancer screening programs in Canada, immigrant women are largely underscreened. The most recently published Canadian-wide study evaluated screening uptake from 2001 to 2002.

Reproducible quantification of cardiac sympathetic innervation using graphical modeling of carbon-11-meta-hydroxyephedrine kinetics with dynamic PET-CT imaging.

Background: Graphical methods of radiotracer kinetic modeling in PET are ideal for parametric imaging and data quality assurance but can suffer from noise bias. This study compared the Logan and Multilinear Analysis-1 (MA1) graphical models to the standard one-tissue-compartment (1TC) model, including correction for partial-volume effects, in dynamic PET-CT studies of myocardial sympathetic innervation in the left ventricle (LV) using [C]HED.

Methods: Test and retest [C]HED PET imaging (47 ± 22 days apart) was performed in 18 subjects with heart failure symptoms.

Saline-push improves rubidium-82 PET image quality.

Introduction: Rubidium-82 (Rb) PET is used widely for myocardial perfusion imaging. The purpose of this study was to investigate if an additional saline-push following the Rb elution improves PET image quality.

Methods: Rb PET scans were acquired with and without 26 mL saline-push in six patients as part of a clinical quality improvement program.

Repeatable and reproducible measurements of myocardial oxidative metabolism, blood flow and external efficiency using C-acetate PET.

Background: Non-invasive approaches to investigate myocardial efficiency can help track the progression of heart failure (HF). This study evaluates the repeatability and reproducibility of C-acetate positron emission tomography (PET) imaging of oxidative metabolism.

Methods And Results: Dynamic C-acetate PET scans were performed at baseline and followup (47 ± 22 days apart) in 20 patients with stable HF with reduced ejection fraction.