The Dicrotic Notch: Mechanisms, Characteristics, and Clinical Correlations.

Purpose Of Review: The dicrotic notch (DN) has long been considered a marker of arterial stiffness and compliance. Herein, we explored the recent developments in vascular medicine research in an attempt to assess the DN utility in clinical cardiovascular medicine.

Recent Findings: Since its discovery, several studies have attempted to measure the changes in different parameters of the DN in physiological and pathological states.

Renal Outcomes Following Transcatheter Mitral Valve Repair - Analysis of COAPT Trial Data.

The prevalence of valvular heart disease in the United States has been estimated at 4.2-to-5.6 million, with mitral regurgitation (MR) being the most common lesion.

Three-Year Outcomes of Balloon-Expandable Transcatheter Aortic Valve Implantation According to Annular Size.

Data on the association between annular size and transcatheter aortic valve implantation (TAVI) outcomes beyond 1 year are limited. The present study assessed the association between the aortic annulus size and TAVI clinical and hemodynamic outcomes at 3 years of follow-up. Patients were classified according to the aortic annulus size as having small, intermediate, and large annuli (size <400, 400 to 574, and ≥575 mm, respectively).

Utility of Multidetector Computed Tomographic Angiography as an Alternative to Transesophageal Echocardiogram for Preoperative Transcatheter Mitral Valve Repair Planning.

Background: Three-dimensional (3D) transesophageal echocardiogram (TEE) is the gold standard for the diagnosis of degenerative mitral regurgitation (dMR) and preoperative planning for transcatheter mitral valve repair (TMVr). TEE is an invasive modality requiring anesthesia and esophageal intubation. The severe acute respiratory syndrome coronavirus 2 pandemic has limited the number of elective invasive procedures.

Is Periodontitis a Risk Factor for Lung Cancer? A Meta-Analysis and Detailed Review of Mechanisms of Association.

Background: Numerous studies have explored the correlation of periodontal disease (PD) with the risk of lung cancers, but the findings were inconsistent. Therefore, we did a meta-analysis to ascertain the correlation of PD with the risk of incident lung cancer.

Methods: The authors searched relevant studies in databases (PubMed, Web of Science, Scopus, Embase, and MEDLINE) till November 2020.

Association between haematological parameters and outcomes following transcatheter aortic valve implantation at mid-term follow-up.

Background: Patients undergoing transcatheter aortic valve implantation (TAVI) often have multiple comorbidities, such as anaemia and chronic inflammatory disorders. We sought to investigate the association between preoperative and postoperative haematological parameters and clinical outcomes in TAVI patients at mid-term follow-up.

Methods: In the present study, consecutive patients (N=908) who underwent TAVI at the Cleveland Clinic between 2017 and 2019 with available complete blood counts were studied.

Tell-a provider about tele: Reducing overuse of telemetry across 10 hospitals in a safety net system.

Background: Telemetry is often a scarce resource at hospitals and is important for arrhythmia and myocardial ischemia detection. Overuse of telemetry monitoring leads to alarm fatigue resulting in failure to respond to arrhythmias, patient harm, and possible unnecessary testing.

Methods: This quality improvement initiative was implemented across NYC Health and Hospitals, an 11-hospital urban safety net system.

Network Meta-analysis of Trials Comparing Intravascular Ultrasound, Optical Coherence Tomography, and Angiography-Guided Technique for Drug-Eluting Stent Implantation.

Background: The current advances in coronary imaging with the introduction of intravascular ultrasound (IVUS), and more recently, optical coherence tomography (OCT) have overcome the limitations of coronary angiography.

Objective: This study aimed to conduct a comprehensive network meta-analysis of randomized clinical trials to report clinical outcomes among patients undergoing drug-eluting stent (DES) implantation either by IVUS- or OCT-guided technique or angiography alone.

Methods: PubMed/MEDLINE and EMBASE databases were searched systematically for all relevant published randomized clinical trials from the inception of the respective database to October 15th, 2021.

Utilization and outcomes of aortic valve replacements (from the United States readmissions database).

Study Objective: Assess the utilization of aortic valve replacements (AVR).

Design: Retrospective analysis of the Nationwide Readmissions Database (2016-2018).

Setting: Nationwide.

Right ventricular systolic pressure - Non-invasive bedside predictor of mortality and readmission in heart failure with reduced and preserved ejection fraction hospitalization.

Objective: To study the prognostic role of right ventricular systolic pressure (RVSP) in patients with heart failure (HF).

Background: Although RVSP is a readily available echocardiographic parameter, it is often underused. Its prognostic role in patients with heart failure is not well established compared with pulmonary artery pressure measured by right heart catheterization.

Absolute lymphocyte count as a predictor of mortality and readmission in heart failure hospitalization.

Background: There is renewed interest in pursuing frugal and readily available laboratory markers to predict mortality and readmission in heart failure. We aim to determine the relationship between absolute lymphocyte count (ALC) and clinical outcomes in patients with heart failure hospitalization.

Methods: This was a retrospective cohort study of patients with heart failure.

Tolvaptan add-on therapy and its effects on efficacy parameters and outcomes in patients hospitalized with heart failure.

Introduction: Even with the adequate use of diuretics and vasodilators, volume overload and congestion are the major causes of morbidity and mortality in patients hospitalized with acute heart failure (HF). We aim to evaluate the additive effect of tolvaptan on efficacy parameters as well as outcomes in hospitalized patients with HF.

Methods: We searched PubMed, EMBASE, Cochrane library, and Web of Science databases for randomized controlled trials that studied the effects of tolvaptan versus placebo in hospitalized patients with HF.

Transient Left Bundle Branch Block in the Setting of Hyperkalemia.

Hyperkalemia is a potentially life-threatening condition that can lead to sudden cardiac death. We report a case of transient left bundle branch block (LBBB) pattern on an electrocardiogram (EKG) secondary to hyperkalemia in a patient with a history of end-stage renal disease. A 48-year-old female presented to the emergency department (ED) with chief complaints of weakness and shortness of breath after a missed hemodialysis session.

Mitral regurgitation following PASCAL mitral valve repair system: A single arm meta-analysis.

Major consequences of untreated severe mitral regurgitation (MR) includes heart failure, ventricular remodeling and pulmonary hypertension leading to significant morbidity and mortality. MitraClip is the most widely used device for treatment of severe MR. To overcome some of the shortcomings of MitraClip, novel devices like PASCAL mitral valve repair system are developed.

Intestinal Tuberculosis: A Diagnostic Challenge.

Diagnosing intestinal tuberculosis (TB) with uncommon clinical manifestations is often challenging. Here, we report a case of an alcoholic patient who presented with vague symptoms and was later diagnosed with intestinal TB. This patient experienced multiorgan failure causing hemodynamic instability requiring ionotropic support; acute hypoxic respiratory failure managed with non-invasive positive pressure ventilation, hepatic failure, transudative peritoneal effusion, and transudative pleural effusion.

Infective Endocarditis and Intravenous Drug Users: Never Was and Never Will Be Taken Lightly.

Infective endocarditis (IE) is the infection of the endocardial surface (innermost layer - valves, chordae tendineae, and papillary muscles) of the heart. It usually refers to infection of one or more of the heart valves which may be native or prosthetic. The definition also includes infection on indwelling cardiac devices.

comparative evaluation of efficiency of XP-endo shaper, XP-endo finisher, and XP-endo finisher-R files in terms of residual root filling material, preservation of root dentin, and time during retreatment procedures in oval canals - A cone-beam computed tomography analysis.

Background: In an oval-shaped canal, no single instrumentation systems were effective in absolute removing obturation.

Aim: The aim of the study was to evaluate the performance of ProTaper Universal Retreatment (PTUR) system, XP-endo Shaper (XPS), XP-endo Finisher (XPF), and XP-endo Finisher-R (XPF-R) in removing root-canal filling material and preservation of sound dentin during retreatment procedure.

Methodology: Root-canal preparation was performed on 60 mandibular premolars with oval-shaped canals using the ProTaper Gold file system.

Problems with interpreting troponins in chronic kidney disease patients for ruling out acute coronary syndrome.

Chest pain is one of the most common reasons for emergency department visits worldwide, and troponins play a central role in diagnosing acute coronary syndrome (ACS) in these patients. Hence, the tests for these molecules are imperative in triage for ACS. Presently, multiple high-sensitivity troponin tests are available, including those for troponin T and I.

Meta-Analysis of Early Intervention Versus Conservative Management for Asymptomatic Severe Aortic Stenosis.

The main objective was to determine the optimal strategy for managing asymptomatic severe aortic stenosis between early intervention versus conservative management. We performed a systematic electronic search of the PubMed and Cochrane databases from the inception of the database to May 31, 2020. The Mantel Haenszel method with the Paule-Mandel estimator of Tau and Hartung-Knapp adjustment were used to calculate relative risk (RR) with a 95% confidence interval (CI) and 95% prediction interval.

Left Bundle Branch Block: A Reversible Pernicious Effect of Lacosamide.

A 95-year-old male with a medical history of focal epilepsy presented with transient ischemic attack (TIA)/pre-syncope like symptoms. He was on lacosamide (LCM) and levetiracetam. On evaluation, he was found to have left bundle branch block (LBBB), sinus pause of three seconds, and 1st degree atrioventricular (AV) block.

Efficacy of corticosteroids in non-intensive care unit patients with COVID-19 pneumonia from the New York Metropolitan region.

Introduction: The role of systemic corticosteroid as a therapeutic agent for patients with COVID-19 pneumonia is controversial.

Objective: The purpose of this study was to evaluate the effect of corticosteroids in non-intensive care unit (ICU) patients with COVID-19 pneumonia complicated by acute hypoxemic respiratory failure (AHRF).

Methods: This was a single-center retrospective cohort study, from 16th March, 2020 to 30th April, 2020; final follow-up on 10th May, 2020.

Comparison of Management and Outcomes of Acute Heart Failure Hospitalization in Medicaid Beneficiaries Versus Privately Insured Individuals.

Medicaid expansion in terms of its eligibility and federal funding has led to improved healthcare access in previously uninsured individuals. However, proposed lower Medicaid rates have unintentionally led to lower utilization of substantial life-saving therapies and poor outcomes compared with private insurance. We examined heart failure (HF) management, in-hospital mortality, and resource utilization in Medicaid and privately insured individuals hospitalized with HF.

A Case of Life-threatening Actinomyces turicensis Bacteremia.

() are normal commensals of the oral, gut, vagina, and skin flora. Infection with these organisms is usually benign, and bacteremia is rare. Here, we describe a case of an otherwise healthy female patient presenting with renal calculi and life-threatening bacteremia.

Rare Association of Takotsubo Cardiomyopathy with Right Bundle Branch Block in the Dual Setting of Asthma Exacerbation and Psychiatric Illness.

BACKGROUND Takotsubo cardiomyopathy is characterized by a transient left ventricular dysfunction without obstructive coronary artery disease that mimics an acute myocardial infarction. The electrocardiogram findings of Takotsubo cardiomyopathy usually present with ST-segment elevation or depression, T-wave inversion, left bundle branch block or high-grade atrioventricular block. CASE REPORT This is a report of a case of a 58-year-old male diagnosed with Takotsubo cardiomyopathy that occurred in the setting of an acute asthma exacerbation and psychiatric exacerbation with novel electrocardiogram findings of right bundle branch block.