Transcatheter edge-to-edge repair in severe mitral regurgitation following acute myocardial infarction - aetiology-based analysis.

Aims: To evaluate the association between transcatheter edge-to-edge repair (TEER) and outcomes in patients with significant mitral regurgitation (MR) following acute myocardial infarction (MI), focusing on the aetiology of acute post-MI MR in high-risk surgical patients.

Methods And Results: The International Registry of MitraClip in Acute Mitral Regurgitation following Acute Myocardial Infarction (IREMMI) includes 187 patients with severe MR post-MI managed with TEER. Of these, 176 were included in the analysis, 23 (13%) patients had acute papillary muscle rupture (PMR) and 153 (87%) acute secondary MR.

Left Ventricular and Atrial Function Analysis Following Transcatheter Edge-to-Edge Mitral Valve Repair.

Conventional echocardiography used to assess volumes of the left ventricle (LV) and left atrium (LA) along with mitral regurgitation grade is routine in studies before and after transcatheter edge-to-edge mitral valve repair (Mitral TEER). Previous studies focus on LV parameter changes and comparison of the functions before and a few months following Mitral TEER implantation, as well as LA reverse remodeling, by assessing LV volumes. However, less is known regarding LA strain changes in the early phase after the procedure.

Clinical factors and pre-surgical depression scores predict pain intensity in cardiac surgery patients.

Background: Severe pain is prevalent in cardiac surgery patients and can increase cardiac complications, morbidity and mortality. The objectives of the study were to assess perioperative pain intensity and to assess predictors of pain post-cardiac surgery, including clinical characteristics and depression.

Methods: A total of 98 cardiac surgery patients were included in the study.

Relationships among norepinephrine levels, exercise capacity, and chronotropic responses in heart failure patients.

In heart failure (HF) patients, the pathophysiological mechanisms of severe exercise intolerance and impaired exercise capacity are related to both central and peripheral abnormalities. The central abnormalities in HF patients include impaired cardiac function and chronotropic incompetence (CI). Indeed, CI, the inability to adequately increase heart rate (HR) from rest to exercise often exhibited by HF patients, is related to activation of the sympathetic nervous system (SNS) yielding a rise in circulating norepinephrine (NE).

Acute Kidney Injury Following Transcatheter Aortic Valve Implantation: Association with Contrast Media Dosage and Contrast Media Based Risk Predication Models.

The effect of contrast media (CM), delivered prior to- and during transcatheter aortic valve implantation (TAVI), on kidney function, following the procedure, is debatable. Consequently, the performance of CM-based, acute kidney injury (AKI) risk prediction models is also questionable. We retrospectively studied 210 patients that underwent TAVI.

Immediate Post-Procedural and Discharge Assessment of Mitral Valve Function Following Transcatheter Edge-to-Edge Mitral Valve Repair: Correlation and Association with Outcomes.

The correlation between residual mitral regurgitation (rMR) grade or mitral valve pressure gradient (MVPG), at transcatheter edge-to-edge mitral valve repair (TEEMr) completion and at discharge, is unknown. Furthermore, there is disagreement regarding rMR grade or MVPG from which prognosis diverts. We retrospectively studied 82 patients that underwent TEEMr.

Use of MitraClip for mitral valve repair in patients with acute mitral regurgitation following acute myocardial infarction: Effect of cardiogenic shock on outcomes (IREMMI Registry).

Objectives: To assess outcomes in patients with acute mitral regurgitation (MR) following acute myocardial infarction (AMI) who received percutaneous mitral valve repair (PMVR) with the MitraClip device and to compare outcomes of patients who developed cardiogenic shock (CS) to those who did not (non-CS).

Background: Acute MR after AMI may lead to CS and is associated with high mortality.

Methods: This registry analyzed patients with MR after AMI who were treated with MitraClip at 18 centers within eight countries between January 2016 and February 2020.

Predictors of Mitral Regurgitation Severity Improvement in Patients With Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation.

Background: Mitral regurgitation (MR) is frequently associated with severe aortic stenosis (AS). Significant MR is associated with less favorable prognosis after transcatheter aortic valve implantation (TAVI), including higher early and late mortality rate. The severity of MR is improved in about half of patients undergoing TAVI.

Pre- and Post-Transcatheter Aortic Valve Replacement Serum Brain Natriuretic Peptide Levels and All-Cause Mortality.

Background: Risk stratification in patients post-transcatheter aortic valve replacement (TAVR) is limited to and is based on clinical judgment and surgical scoring systems. Serum natriuretic peptides are used for general risk stratification in patients with aortic stenosis, reflecting the increase in their afterload and thereby stressing the need for valve intervention. The objective of this study was to determine the predictive value of pre- and post-procedural serum brain natriuretic peptide (BNP) on 1-year all-cause mortality in patients who underwent TAVR.

The association between carotid calcium on dental panoramic radiographs and coronary calcium score on chest computerized tomography.

Objectives: Coronary artery calcium measured by CT predicts future coronary events. Similarly, carotid artery calcium on dental panoramic radiographs has been associated with increased cardiovascular events. Pre-procedural assessment of candidates for valve replacement in our institution includes panoramic radiographs and chest tomography.

Clinical, Surgical, and Sociopsychological Factors and Depression After Cardiothoracic Surgery.

Background: Depression is highly prevalent in cardiac surgical patients and is associated with mortality. The objectives of the study were to evaluate depression scores longitudinally pre- and postoperatively and to examine the association between postoperative depression scores and clinical, surgical, and sociopsychological factors.

Methods: Depression scores were assessed using the Center for Epidemiological Study of Depression (CES-D) in 100 cardiac surgical patients who underwent cardiac surgery preoperatively, during hospitalization, and at 2 and 6 week after discharge.

Dental screening prior to valve interventions: Should we prepare transcatheter aortic valve replacement candidates for "surgery"?

Background: 40% of cases of infective endocarditis (IE) are likely caused by oral bacteria. IE prevalence after transcatheter aortic valve replacement (TAVR) is comparable to IE following surgical prosthetic valve replacement (SVR). Current guidelines recommend pre-operative dental screening for SVR, without specific recommendations regarding TAVR.

Dark Energy from Quantum Gravity Discreteness.

We argue that discreteness at the Planck scale (naturally expected to arise from quantum gravity) might manifest in the form of minute violations of energy-momentum conservation of the matter degrees of freedom when described in terms of (idealized) smooth fields on a smooth spacetime. In the context of applications to cosmology, such "energy diffusion" from the low energy matter degrees of freedom to the discrete structures underlying spacetime would lead to the emergence of an effective dark energy term in Einstein's equations. We estimate this effect using a (relational) hypothesis about the materialization of discreteness in quantum gravity which is motivated by the strict observational constraints supporting the validity of Lorentz invariance at low energies.

Serum BNP levels are associated with malignant pericardial effusion.

Introduction: The development of malignant pericardial effusion indicates a poor prognosis and is the leading cause of cardiac tamponade. The objectives of the study were to examine the levels of BNP in traumatic, malignant and non-malignant pericardial effusion etiologies, and to assess the value of serum and pericardial fluid BNP levels in the prognosis of malignant pericardial effusion.

Methods: A of 56 patients with clinical and echocardiographic diagnosis of pre-tamponade or tamponade who required pericardiocentesis were included in the study.

Dark Energy from Violation of Energy Conservation.

In this Letter, we consider the possibility of reconciling metric theories of gravitation with a violation of the conservation of energy-momentum. Under some circumstances, this can be achieved in the context of unimodular gravity, and it leads to the emergence of an effective cosmological constant in Einstein's equation. We specifically investigate two potential sources of energy nonconservation-nonunitary modifications of quantum mechanics and phenomenological models motivated by quantum gravity theories with spacetime discreteness at the Planck scale-and show that such locally negligible phenomena can nevertheless become relevant at the cosmological scale.

Impact of Early Invasive Approach on Outcomes of Patients With Acute Coronary Syndrome and Baseline Anemia: Analysis From the ACSIS Registry.

Background: Anemia in patients with acute coronary syndromes (ACS) is strongly related to the increased risk of bleeding and mortality. Whether benefit of early invasive strategy exceeds the risk of bleeding in these patients is unknown.

Aim: To assess impact of early coronary angiography on outcomes of patients with ACS and baseline anemia.

The impact of industry representative's visits on utilization of coronary stents.

Background: The interaction between physicians and industry is complex and essential for improvement of medical care. However, conflict of interests may affect decision process. Our aim was to test if promotional visits by industry representatives affect treatment patterns and the use of various stents during percutaneous coronary interventions.

Contrast-induced nephropathy in interventional cardiology.

Development of contrast-induced nephropathy (CIN), ie, a rise in serum creatinine by either ≥0.5 mg/dL or by ≥25% from baseline within the first 2-3 days after contrast administration, is strongly associated with both increased inhospital and late morbidity and mortality after invasive cardiac procedures. The prevention of CIN is critical if long-term outcomes are to be optimized after percutaneous coronary intervention.

Troponin-positive, CK-MB-negative acute myocardial infarction: clinical, electrocardiographic and angiographic characteristics.

Objectives: We assessed the clinical, electrocardiographic (ECG) and angiographic characteristics of patients with acute coronary syndrome, increased troponin I (cTn-I) levels and normal creatine kinase levels.

Background: Cardiac troponins are part of the new definition of acute myocardial infarction by the European Society of Cardiology and the American College of Cardiology. However, there are limited data regarding the angiographic characteristics of these patients.