5-Year Prognostic Value of Quantitative Versus Visual MPI in Subtle Perfusion Defects: Results From REFINE SPECT.

Objectives: This study compared the ability of automated myocardial perfusion imaging analysis to predict major adverse cardiac events (MACE) to that of visual analysis.

Background: Quantitative analysis has not been compared with clinical visual analysis in prognostic studies.

Methods: A total of 19,495 patients from the multicenter REFINE SPECT (REgistry of Fast Myocardial Perfusion Imaging with NExt generation SPECT) study (64 ± 12 years of age, 56% males) undergoing stress Tc-99m-labeled single-photon emission computed tomography (SPECT) myocardial perfusion imaging were followed for 4.

Upper reference limits of transient ischemic dilation ratio for different protocols on new-generation cadmium zinc telluride cameras: A report from REFINE SPECT registry.

Background: Upper reference limits for transient ischemic dilation (TID) have not been rigorously established for cadmium-zinc-telluride (CZT) camera systems. We aimed to derive TID limits for common myocardial perfusion imaging protocols utilizing a large, multicenter registry (REFINE SPECT).

Methods: One thousand six hundred and seventy-two patients with low likelihood of coronary artery disease with normal perfusion findings were identified.

Rationale and design of the REgistry of Fast Myocardial Perfusion Imaging with NExt generation SPECT (REFINE SPECT).

Background: We aim to establish a multicenter registry collecting clinical, imaging, and follow-up data for patients who undergo myocardial perfusion imaging (MPI) with the latest generation SPECT scanners.

Methods: REFINE SPECT (REgistry of Fast Myocardial Perfusion Imaging with NExt generation SPECT) uses a collaborative design with multicenter contribution of clinical data and images into a comprehensive clinical-imaging database. All images are processed by quantitative software.

Left Atrial Fibrosis and Risk of Cerebrovascular and Cardiovascular Events in Patients With Atrial Fibrillation.

Background: Severity of left atrial (LA) fibrosis is a strong predictor of atrial fibrillation (AF) ablation success and has been associated with a history of stroke, hypertension, and heart failure (HF). However, it is unclear whether more severe LA fibrosis independently increases the risk of major adverse cardiovascular and cerebrovascular events (MACCE) among those with AF.

Objectives: The goal of this study was to evaluate the occurrence and frequency of MACCE by strata of LA fibrosis severity in patients with AF.

Effect of reduced cardiac output on blood stasis on transcatheter aortic valve leaflets: implications for valve thrombosis.

Aims: There is an increasing awareness of leaflet thrombosis following transcatheter aortic valve implantation (TAVI) and valve-in-valve (ViV) procedures. Nevertheless, the predisposing factors affecting transcatheter aortic valve (TAV) thrombosis have remained unclear. This study aimed to quantify the effects of reduced cardiac output (CO) on blood stasis on the TAV leaflets as a permissive factor for valve thrombosis.

Blood Stasis on Transcatheter Valve Leaflets and Implications for Valve-in-Valve Leaflet Thrombosis.

Background: Leaflet thrombosis after valve-in-valve (ViV) procedure has been increasingly recognized. This study aimed to investigate the flow dynamics aspect of leaflet thrombosis by quantifying the blood stasis on the noncoronary and coronary leaflets of a surgical aortic valve (SAV) and a transcatheter aortic valve (TAV) in a ViV setting.

Methods: Two computational models, representing a SAV and a TAV in ViV setting, were developed in a patient-specific geometry.

Valve thrombosis following transcatheter aortic valve replacement: significance of blood stasis on the leaflets.

Objectives: Leaflet thrombosis following transcatheter aortic valve replacement (TAVR) and valve-in-valve (ViV) procedures has been increasingly recognized. However, the factors affecting the post-TAVR/ViV thrombosis are not fully understood. This study aimed to investigate the effect of the geometric confinement of transcatheter aortic valve (TAV) on blood residence time (BRT) on the TAV leaflets and in turn on the post-TAVR valve thrombosis.

Trainee inexperience is associated with longer procedure times but no increase in complications for cardiac device implantation.

Background: The "July phenomenon" describes poor patient outcomes in teaching hospitals at the beginning of a new academic year when trainees begin. Whether this phenomenon truly exists is unclear.

Objective: The purpose of this study was to identify whether trainee and attending inexperience is associated with cardiac electrophysiologic procedural outcomes including total procedure time, fluoroscopy time, and complications.

Risk factors and prognosis for clot formation on cardiac device leads.

Background: Clot formation on cardiac device leads is poorly understood. We sought to determine how often clot is seen on device leads by transthoracic echo (TTE), identify risk factors, and to describe the natural history of this phenomenon.

Methods: We reviewed 71,888 echocardiographic studies performed at the University of California, San Francisco from 2005 to 2011.

Asymptomatic Left Bundle Branch Block Predicts New-Onset Congestive Heart Failure and Death From Cardiovascular Diseases.

Background: Left bundle branch block (LBBB) has been proposed as a risk factor for cardiovascular morbidity and mortality. We sought to characterize the strength of these associations in a population without preexisting clinical heart disease.

Methods: The association between LBBB and new-onset congestive heart failure (CHF) or death from cardiovascular diseases was examined in 1,688 participants enrolled in the SPPARCS study who were free of known CHF or previous myocardial infarction.

Funding source and author affiliation in TASER research are strongly associated with a conclusion of device safety.

Background: Controversy exists regarding the safety of electrical stun guns (TASERs). Much of the research on TASERs is funded by the maker of the device and, therefore, could be biased. We sought to determine if funding source or author affiliation is associated with TASER research conclusions.

Predictors of axillary vein location for vascular access during pacemaker and defibrillator lead implantation.

Background: The axillary vein is a commonly used extrathoracic access site for cardiac rhythm device lead implantation. We sought to describe variation in axillary vein location and identify predictors of a more cranial or caudal radiographic location to facilitate blind venous cannulation.

Methods: This was a single-center, retrospective study of patients undergoing lead implantation between 2006 and 2010.

Frequency of atrial flutter after adult lung transplantation.

Lung transplantation, which involves an anastomosis of the graft to the native left atrium, may increase the risk of left-side atrial flutter (AFL). Our aim was to evaluate the incidence, predisposing conditions, and course of AFL after lung transplantation in adults. Two hundred sixty-nine consecutive patients who underwent lung transplantation were studied retrospectively.

The effect of angiotensin-converting enzyme inhibitor on hemodynamic instability in patients undergoing cardiopulmonary bypass: results of a dose-comparison study.

Background: Recently, hemodynamic instability including hypotension and its effect on the clinical outcome in patients treated with angiotensin-converting enzyme inhibitors (ACEIs) during coronary artery bypass graft (CABG) has been described. However, no analysis has examined the dose of ACEIs and its risk of hypotension. In this study, we tested the hypothesis that a higher dose of ACEIs could lead to increased episodes of hypotension.

The effect of dental overbite on eustachian tube dysfunction in Iranian children.

Objective: To investigate the association between deep dental overbite and eustachian tube dysfunction.

Methods: It was designed as a case-control study. Among hospitalized patients in otolaryngology department at Taleghani Hospital in Tehran, Iran, from January to December 2005, 132 patients between the ages of 2 and 6 years were recruited.