Background: In a significant proportion of patients with left-sided heart failure (HF), left ventricular filling pressure (LVFP) may not be estimated using echocardiography, so filling pressure status may remain indeterminate. In these patients, mean right atrial pressure (mRAP) has been suggested as a surrogate of LVFP. The aim of this study was to determine whether high mRAP has prognostic value in patients with HF with indeterminate pressure (IP) and whether mRAP-based reclassification of patients with IP has an impact on outcomes.
Methods: A cohort of 465 patients hospitalized with HF was retrospectively studied and divided into groups with normal pressure (n = 102), high pressure (n = 265), and IP (n = 98). A composite end point of all-cause mortality and HF rehospitalization was evaluated after a median follow-up duration of 2.5 years.
Results: There were 282 events in the entire population (53 in the normal pressure group, 173 in the high pressure group, and 56 in the IP group; P = .047). High mRAP was independently associated with outcome only in patients with IP (hazard ratio, 2.72; 95% CI, 1.25-5.9; P = .012). Evaluation of LVFP after mRAP-based reclassification of patients with IP resulted in higher risk stratification capability than current recommendations alone (log-rank χ = 15.057 vs 8.148).
Conclusions: In patients with inconclusive determination of LVFP, echocardiographic estimation of mRAP is associated with outcomes. This finding corroborates previous observation of mRAP as a surrogate marker of elevated LVFP in left-sided HF and suggests its use in clinical practice.
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http://dx.doi.org/10.1016/j.echo.2020.05.027 | DOI Listing |
Sci Rep
January 2025
Mechanical Engineering, Stanford University, Stanford, CA, 94305, USA.
Triply periodic minimal surface (TPMS) metamaterials show promise for thermal management systems but are challenging to integrate into existing packaging with strict mechanical requirements. Composite TPMS lattices may offer more control over thermal and mechanical properties through material and geometric tuning. Here, we fabricate copper-plated, 3D-printed triply periodic minimal surface primitive lattices and evaluate their suitability for battery thermal management systems.
View Article and Find Full Text PDFEur Heart J Cardiovasc Imaging
January 2025
University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania.
J Clin Med
January 2025
Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
The management of multiple intracranial aneurysms presents significant clinical challenges, particularly when complicated by underlying conditions such as cerebral atherosclerosis. This case report highlights the successful treatment of a 66-year-old female diagnosed with three intracranial aneurysms located in the right middle cerebral artery (MCA), pericallosal artery, and M2 segment. The patient also had a history of systemic atherosclerosis and right-sided breast cancer, factors that increased the complexity of surgical intervention.
View Article and Find Full Text PDFJ Phys Condens Matter
January 2025
Chinese Academy of Sciences, 19 jia, Yuquan Road, Shijingshan District, Beijing, Beijing, 100049, CHINA.
Previous studies of the transition metal chalcogenide Ta2NiSe5 has identified two phase transitions occurring between 0-10GPa, involving the excitonic insulator-to-semiconductor transition at 1GPa and the semiconductor-to-semimetal transition at 3GPa. However, there is still a lack of in-depth research on the changes in its physical properties changes above 10GPa. In this study, Ta2NiSe5 were investigated under high-pressure conditions using high-pressure X-ray diffraction and high-pressure X-ray absorption experiments.
View Article and Find Full Text PDFEur J Heart Fail
January 2025
School of Cardiovascular and Metabolic Health, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
Aims: A cardiovascular magnetic resonance (CMR) approach to non-invasively estimate left ventricular (LV) filling pressure was recently developed and shown to correlate with invasively measured pulmonary capillary wedge pressure (PCWP). We examined the association between CMR-estimated PCWP (CMR-PCWP) and other imaging and biomarker measures of congestion, and the effect of empagliflozin on these, in the SUGAR-DM-HF trial (NCT03485092).
Methods And Results: SUGAR-DM-HF enrolled 105 patients with heart failure with reduced ejection fraction (HFrEF) and pre-diabetes or type 2 diabetes who were randomly assigned to empagliflozin 10 mg or placebo once daily for 36 weeks.
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