MINOCA: A Pathophysiological Approach of Diagnosis and Treatment-A Narrative Review.

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a clinical entity characterized by the absence of significant coronary artery obstruction in epicardial arteries (<50%) on coronary angiography in the setting of acute myocardial infarction (AMI). This article aims to provide a narrative review of the pathophysiological mechanisms, diagnostic challenges, and prognosis associated with MINOCA based on pathophysiology regarding the atherosclerotic and non-atherosclerotic causes. Etiological factors, including thromboembolism, coronary artery spasm, spontaneous coronary artery dissection, coronary microvascular disease, and supply-demand mismatch, are addressed.

Dyspnea After Spinal Surgery and a Troubling X-Ray: A Case of Cement Embolism.

An older woman developed dyspnea after instrumented lumbar spinal fusion surgery. During clinical work-up, a chest radiography revealed a U-shaped object within the cardiac silhouette. Further imaging confirmed that the object was entrapped in the tricuspid subvalvular apparatus.

A More Targeted and Selective Use of Implantable Loop Recorders Improves the Effectiveness of Syncope Units: A Single-Center Experience.

Purpose: Syncope remains a common medical problem. Recently, the role of dedicated syncope units and implantable loop recorders has emerged in the investigation of unexplained syncope. This study aims to investigate the possibilities for a more rational and targeted use of various diagnostic tools.

Wireless Device Therapy in Hypertrophic Cardiomyopathy Using the Combination of a Leadless Pacemaker and a Subcutaneous Defibrillator: A Report with 2-year Follow-up of Two Patients.

Cardiac implantable electronic devices (CIEDs) are essential tools in cardiology for tackling rhythm disturbances and have come a long way over the last decades. Technology is shifting toward leadless devices that spare the complications and limitations of traditional intravascular CIEDs. Herein, we report the simultaneous implantation of a leadless pacemaker (LP) and a subcutaneous implantable cardioverter-defibrillator (S-ICD) in two patients with hypertrophic cardiomyopathy, as well as their 2-year follow-up results, while explaining the preventive measures taken to steer around unwanted device interaction.

Dynamics in Explicit Gradient Elasticity: Material Frame-Indifference, Boundary Conditions and Consistent Euler-Bernoulli Beam Theory.

The paper is concerned with the boundary conditions of explicit gradient elasticity of Mindlin's type in dynamics. It has been argued in an earlier paper that acceleration terms should not be present in the boundary tractions because of objectivity arguments. This is discussed in the present paper in more detail, and it is supplemented by assuming the validity of the principle of material frame indifference.

External chirality enhancing downconversion in a waveguide-coupled nonlinear plasmonic metasurface.

Metasurfaces, typically constructed from spatial arrangements of localized building blocks, can enhance light-matter interactions through local field enhancement or by coherent coupling to extended photonic modes. Recent works have explored how guided mode resonances influence the performance of nonlinear metasurfaces. Here we investigate the modal impact on difference-frequency generation in a waveguide-coupled metasurface platform.

Ischemia testing and revascularization in patients with monomorphic ventricular tachycardia: A relic of the past?

Testing for myocardial ischemia in patients presenting with sustained monomorphic Ventricular Tachycardia(VT) even without evidence of acute myocardial infarction is a tempting strategy that is frequently utilized in clinical practice. Monomorphic VT is mainly caused by re-entry around chronic myocardial scar and active ischemia has no role in its pathogenesis, thus making testing for ischemia futile, at least in theory. This systematic literature review sought to address the usefulness of ischemia testing (mainly coronary angiography) in patients presenting with monomorphic VT through 8 selected studies after evaluating a total of 130 published manuscripts.

Generating Angular-Varying Time Delays of THz Pulses via Direct Space-to-Time Mapping of Metasurface Structures.

We experimentally demonstrate the generation of double terahertz (THz) pulses with tailored angular-dependent time delays from a nonlinear metasurface excited by a near-infrared femtosecond pulse. The tailored temporal properties of the generated pulses emerge from a direct mapping of the nonlinear spatial response of the metasurface to the emitted THz temporal profile. We utilize the Pancharatnam-Berry phase to implement symmetric and antisymmetric metasurface configurations and show that the emitted patterns present spatiotemporal "X-shaped" profiles after collimation by a parabolic mirror, with angular-dependent pulse delays corresponding to the intended design.

Management of Patients With Unexplained Syncope: Derivation and Validation of a Simplified 2-Step Diagnostic Approach.

Background: The aim of this study was to develop a structured 2-step approach, based on noninvasive diagnostic criteria, that led to an electrophysiology study in patients with unexplained syncope.

Methods And Results: Two independent cohorts were used: the derivation cohort with 665 patients based on electronic health record data to develop our 2-step diagnostic approach, and the validation cohort based on 160 prospectively screened patients, presenting with unexplained syncope episodes. Noninvasive electrocardiographic and imaging markers and an electrophysiology study-based invasive assessment were combined.

Exercise and cardiac rehabilitation in hypertensive patients with heart failure with preserved ejection fraction: A position statement on behalf of the Working Group of Arterial Hypertension of the Hellenic Society of Cardiology.

Arterial hypertension is a major cause of cardiovascular morbidity and mortality and the most common cause of comorbidity in heart failure (HF) with preserved ejection fraction (HFpEF). As an adjunct to medication, healthy lifestyle modifications with emphasis on regular exercise are strongly recommended by both the hypertension and the HF guidelines of the European Society of Cardiology. Several long-term studies have shown that exercise is associated with a reduction in all-cause mortality, a favorable cardiac and metabolic risk profile, mental health, and other non-cardiovascular benefits, as well as an improvement in overall quality of life.

Holographic THz Beam Generation by Nonlinear Plasmonic Metasurface Emitters.

The advancement of terahertz (THz) technology hinges on the progress made in the development of efficient sources capable of generating and shaping the THz emission. However, the currently available THz sources provide limited control over the generated field. Here, we use near-field interactions in nonlinear Pancharatnam-Berry phase plasmonic metasurfaces to achieve deep subwavelength, precise, and continuous control over the local amplitude of the emitted field.

Angiotensin Regulation of Vascular Homeostasis: Exploring the Role of ROS and RAS Blockers.

Extensive research has been conducted to elucidate and substantiate the crucial role of the Renin-Angiotensin System (RAS) in the pathogenesis of hypertension, cardiovascular disorders, and renal diseases. Furthermore, the role of oxidative stress in maintaining vascular balance has been well established. It has been observed that many of the cellular effects induced by Angiotensin II (Ang II) are facilitated by reactive oxygen species (ROS) produced by nicotinamide adenine dinucleotide phosphate (NADPH) oxidase.

The imaging appearances of non-calcified ductal carcinoma in situ: A pictorial essay.

Non-calcified ductal carcinoma in situ (NCDCIS) presents as a heterogeneous entity on various imaging modalities, most frequently presenting symptomatically as a palpable lump. The combination of multiple modalities and knowledge of its potential radiological appearances are important in minimising misdiagnosis. Compared to conventional 2D mammography, both sonography and digital breast tomosynthesis show higher diagnostic accuracy in the detection of NCDCIS.

Tumor Volume on PSMA PET as a Prognostic Biomarker in Prostate Cancer Patients Treated With Cabazitaxel.

Purpose: The aim of this study was to evaluate the prognostic value of 68 Ga-labeled prostate-specific membrane antigen (PSMA) PET/CT in metastatic castration-resistant prostate cancer patients receiving second-line chemotherapy with cabazitaxel.

Methods: All patients with metastatic castration-resistant prostate cancer who underwent a PSMA PET/CT within 8 weeks before initiating the cabazitaxel treatment were retrospectively evaluated. The whole-body PSMA total tumor volume (PSMA-TV) was measured for each patient.

The Role of ECG Strain Pattern in Prognosis after TAVI: A Sub-Analysis of the DIRECT Trial.

Background: The presence of an electrocardiographic (ECG) strain pattern-among other ECG features-has been shown to be predictive of adverse cardiovascular outcomes in asymptomatic patients with aortic stenosis. However, data evaluating its impact on symptomatic patients undergoing TAVI are scarce. Therefore, we tried to investigate the prognostic impact of baseline ECG strain pattern on clinical outcomes after TAVI.

Enhancing THz emission from nonlinear metasurfaces by a Bragg perfect absorber.

Nonlinear plasmonic metasurfaces were demonstrated recently as ultracompact tetrahertz (THz) sources, emitting relatively strong single-cycle THz pulses after femtosecond laser illumination. There has been great progress in their ability to generate controlled THz wavepackets; however, their overall emission strength has not yet been optimized. Here we numerically show that by designing a Bragg assisted perfect absorber we can improve the coupling of the pumping laser to the nonlinear metasurface.

Cardiorenal multimorbidity in hospitalized cardiology patients: The Hellenic Cardiorenal Morbidity Snapshot (HECMOS) study.

Purpose: Cardiovascular disease is commonly accompanied by renal dysfunction. Multimorbidity in hospitalized patients impacts unfavorably on prognosis and hospital stay. We aimed to illustrate the contemporary burden of cardiorenal morbidity across inpatient cardiology care in Greece.