An Approach to Non-left Main Bifurcation Lesions: A Contemporary Review.

Bifurcated anatomical locations in the arterial tree, such as coronary artery bifurcations, are prone to develop obstructive atherosclerotic lesions due to the pro-atherogenic low wall shear stress. The percutaneous treatment of bifurcation lesions is among the most challenging complex coronary interventions, including different multistep stenting strategies. Even though provisional side branch (SB) stenting is recommended as the primary approach in most cases, the debate continues between provisional SB and upfront two-stent strategies, particularly in complex bifurcations consisting of a significantly diseased SB that supplies a crucial myocardial territory.

Is there a relationship between heart rate recovery and blood pressure in white coat hypertension?

Aim    Increasing evidence suggests that autonomic dysfunction may be involved in the etiology of white coat hypertension (WCH). The aim of this study was to evaluate cardiac autonomic function by using heart rate recovery (HRR) indices in patients with WCH classified according to their circadian rhythm type of blood pressure (BP).Material and methods    This cross-sectional study included 120 participants over the age of 18 yrs, including 50 patients diagnosed with WCH and 70 healthy controls with normal in- and out-of-office BP and without any known disease.

Higher levels of TWEAK and matrix metalloproteinase-3 during the acute phase of myocardial infarction are associated with adverse left ventricular remodeling.

Introduction: It is known that the levels of tumor necrosis factor-like weak inducer of apoptosis (TWEAK/TNFSF12) increase after myocardial infarction (MI) and that it interacts with sCD163. It has also been argued that TWEAK can induce matrix metalloproteinases (MMPs) in macrophages.

Aim: To investigate the roles of TWEAK, sCD163, and MMPs in left ventricular (LV) adverse remodeling (AR) in the early post-MI period.

Noninvasive Investigation of the Presence and Extent of Coronary Artery Disease by the Evaluation of Fingertip-Reactive Hyperemia.

Objective: Fingertip-reactive hyperemia-peripheral artery tonometry (RH-PAT) is an emerging novel noninvasive method for evaluating endothelial function. We aimed to evaluate endothelial function with fingertip-reactive hyperemia by RH-PAT in symptomatic patients undergoing elective coronary angiography and to assess the relationship between the degree of endothelial dysfunction (ED) and the presence and the severity of coronary artery disease (CAD).

Subjects And Methods: We assessed 92 patients.

Association of changes in the infarct and remote zone myocardial tissue with cardiac remodeling after myocardial infarction: a T1 and T2 mapping study.

Tissue structure in the infarct and remote zone myocardium post-acute myocardial infarction (MI) may offer prognostic information concerning left ventricular remodeling. We aimed to identify or establish a relationship between adverse remodeling (AR) and changes (Δ) in T1, T2 mapping and extracellular volume (ECV) in post MI periods. Fifty-four MI patients underwent 3 Tesla CMR performed 2 weeks (acute phase) and 6 months post-MI.

Vascular Complications in TAVR: Incidence, Clinical Impact, and Management.

Transcatheter aortic valve replacement (TAVR) has replaced surgical aortic valve replacement as the new gold standard in elderly patients with severe aortic valve stenosis. However, alongside this novel approach, new complications emerged that require swift diagnosis and adequate management. Vascular access marks the first step in a TAVR procedure.

Current Recommendations on Atrial Fibrillation: A Comparison of the Recent European and Canadian Guidelines.

Background: Guidelines for the diagnosis and management of atrial fibrillation (AF) are frequently published and updated, reflecting the rapid evolution in AF pathogenesis and treatment modalities.

Summary: Recently, 2 important guidelines for the diagnosis and management of atrial AF have been published by the European Society of Cardiology (ESC), and Canadian Cardiovascular Society (CCS). Although the evidence-based recommendations and statements are quite similar, there are some important differences between the ESC and CCS guidelines for AF.

Physiologic Assessment of Coronary Stenosis: Current Status and Future Directions.

Purpose Of Review: Percutaneous coronary intervention (PCI) is a commonly used treatment option in coronary artery disease (CAD). Reduced major adverse cardiovascular events (MACE) in those randomized to PCI compared to optimal medical therapy have been demonstrated only if it is performed for physiologically significant coronary lesions. Despite data demonstrating improved outcomes primarily in stable CAD and then acute settings, physiology-guided PCI remains underutilized.

Cerebral embolic protection devices during transcatheter aortic valve implantation, the current state of the art.

Stroke after transcatheter aortic valve (TAVI) is a devastating adverse event. The majority of these occur in the acute phase following TAVI where cerebral embolic events are frequent. Cerebral embolic protection devices (CEPD) have been developed to minimise the risk of peri-procedural ischaemic stroke during TAVI.

High Eosinophil Rates in Patients With Right-to-Left Shunts: An Expected Role, or an Unexpected Risk?

Background and objective Eosinophils are associated with thromboembolic events. Since eosinophils are eliminated in the pulmonary vasculature, right-to-left shunt (RLS) through patent foramen ovale may increase eosinophils in the peripheral blood. In this report, we evaluated the eosinophils of patients with regard to the presence of RLS and its quantity.

A systematic review on durability and structural valve deterioration in TAVR and surgical AVR.

Mechanical valves and bioprosthetic heart valves are widely used for aortic valve replacement (AVR). Mechanical valves are associated with risk of bleeding because of oral anticoagulation, while the durability and structural valve deterioration (SVD) represent the main limitation of the bioprosthetic heart valves. The implantation of bioprosthetic heart valves is increasing precipitously due aging population, and the widespread use of transcatheter aortic valve replacement (TAVR).

Echocardiographic assessment in cardiogenic shock.

Echocardiography is the most helpful diagnostic modality in cardiogenic shock, the management of which still remains challenging despite advances in therapeutic options. The presence of cardiogenic shock portends high mortality rates. Therefore, rapid recognition, identification of the underlying cause, and evaluation of the severity of hemodynamic dysfunction are vital for correct management.

The Issue of Subclinical Leaflet Thrombosis After Transcatheter Aortic Valve Implantation.

Transcatheter aortic valve implantation (TAVI) has been considered an important therapy for the treatment of symptomatic severe aortic stenosis. Although the devices and the techniques have been improved some complications may occur and several issues still need to be addressed. The issue of subclinical leaflet thrombosis (SLT) has been recognized as a complication after TAVI, and its incidence ranges from 0% to 40%.

Evaluation of Effectiveness and Safety of Transcatheter Mitral Valve Repair Under Moderate Conscious Sedation.

Background: Transcatheter mitral valve repair (TMVR) using the MitraClip system (Abbott Vascular) has become a world-wide, well-established therapeutic alternative to symptomatic patients with severe mitral regurgitation (MR) and prohibitive surgical risk. Currently, TMVRs are performed under general anesthesia. Herein, we aimed to present the effectiveness and safety of TMVR under moderate conscious sedation (MCS).

Perspectives by a position statement on atrial fibrillation in acute heart failure a: Mechanisms and therapeutic approaches.

The co-existence of atrial fibrillation (AF) and acute heart failure (AHF) is frequently reported and can exacerbate either or both of them. Their combination leads to increased morbidity and mortality. Although there has been a lack of studies on the prevalence and significance, as well as the treatment, of AF in patients with AHF, a position statement from the Acute Cardiovascular Care Association and European Heart Rhythm Association has recently reviewed the latest evidence on AF in the setting of AHF.

Atrial fibrillation in acute heart failure: A position statement from the Acute Cardiovascular Care Association and European Heart Rhythm Association of the European Society of Cardiology.

Atrial fibrillation and acute heart failure frequently co-exist and can exacerbate each other. Their combination leads to increased morbidity and mortality. However, the prevalence and significance, as well as the treatment, of atrial fibrillation in acute heart failure are not well studied.

Effects of angiotensin receptor neprilysin inhibition on P-wave dispersion in heart failure with reduced ejection fraction.

Background: Angiotensin receptor neprilysin inhibitors (ARNI; sacubitril/valsartan combination) decrease morbidity and mortality in heart failure with reduced ejection fraction (HFrEF). Increased P‑wave duration and P‑wave dispersion (P) reflect prolongation of atrial conduction and correlate with atrial fibrillation. Here, we aimed to assess the effects of switching from valsartan to ARNI treatment on the basis of P‑wave indices.

Review of the 2019 European Society of Cardiology Guidelines for the management of patients with supraventricular tachycardia: What is new, and what has changed?

Supraventricular arrhythmias are frequent, and symptomatic patients often need medical therapy or catheter ablation. The recently published 2019 European Society of Cardiology (ESC) Guidelines for the management of patients with supraventricular tachycardia (SVT) give a comprehensive overview of current developments in the field and provides recommendations for the management of adults with SVT. In this paper, we briefly summarized major new recommendations and significant changes from the former ESC guideline published 16 years ago.

Assessment of Vascular Patency and Inflammation with Intravascular Optical Coherence Tomography in Patients with Superficial Femoral Artery Disease Treated with Zilver PTX Stents.

Purpose: Zilver PTX nitinol self-expanding drug-eluting stent with paclitaxel coating is effective for treatment of superficial femoral artery (SFA) disease. However, as with any stent, it induces a measure of vascular inflammatory response. The current clinical trial (NCT02734836) aimed to assess vascular patency, remodeling, and inflammatory markers with intravascular optical coherence tomography (OCT) in patients with SFA disease treated with Zilver PTX stents.

Association of Serum Copeptin Levels with Patency of Infarct-Related Arteries in Patients with ST-Segment Elevation Myocardial Infarction.

Background: Copeptin is widely used as a predictor of an adverse prognosis in many clinical conditions. Reduced antegrade coronary flow in an infarct-related artery (IRA) is associated with adverse clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to investigate whether copeptin level on admission was associated with IRA patency in STEMI patients.

Mitral Paravalvular Leak Closure: Transcatheter and Surgical Solutions.

Paravalvular leak (PVL) is an important complication after surgical valve replacement and might lead to serious clinical results, including heart failure and/or hemolytic anemia. PVLs are the result of an incomplete seal between the sewing ring and annulus. It frequently affects surgical valves in the mitral position, occurring in 5% to 15% of valve replacements.

Successful WATCHMAN Device Implantation in a Patient with IVC Filter Thrombosis and Iliac Vein Occlusions.

Percutaneous left atrial appendage occlusion has been shown to be a safe and cost-effective treatment for stroke prevention in patients with nonvalvular atrial fibrillation with increased stroke and bleeding risk. Venous system might be occluded from prior procedures or have structural abnormalities. Herein, we present a successful WATCHMAN device implantation in a patient with inferior vena cava filter thrombosis and iliac vein occlusions.