Relationship of Structural Abnormalities of Papillary Muscles to the Site of Origin of Ventricular Arrhythmias.

Background: Arrhythmias originating from papillary muscles (PAPs) can be challenging when targeted with catheter ablation. The prevalence and impact of structural abnormalities on PAPs in patients with focal PAP arrhythmias is unknown.

Objectives: The purpose of this study was to analyze, in a consecutive patient series with focal PAP arrhythmias, the impact of structural abnormalities detected by multimodality imaging.

Low-Gradient Severe Aortic Stenosis: Insights From the CURRENT AS Registry-2.

Background: Low-gradient (LG) aortic stenosis (AS) has not been fully characterized compared with high-gradient (HG) AS in terms of cardiac damage, frailty, aortic valve calcification, and clinical outcomes.

Objectives: The aim of this study was to compare the clinical characteristics and outcomes between each hemodynamic type of LG AS and HG AS.

Methods: The current study included 3,363 patients in the CURRENT AS (Contemporary outcomes after sURgery and medical tREatmeNT in patients with severe Aortic Stenosis) Registry-2 after excluding patients without indexed stroke volume or left ventricular ejection fraction (LVEF) data.

Surgical management of a huge mediastinal mature teratoma in a 2-year-old girl: a case report.

Background: Mature teratomas are benign cystic tumors that are most commonly asymptomatic. However, in some cases, mediastinal teratomas rupture the lungs and mediastinum with potentially fatal outcomes. Herein, we report a case of a large mediastinal mature teratoma that expanded to the entire left hemithorax in a child with common cold-like symptoms.

Prognostic Value and Safety of Serial Exercise Echocardiography in Asymptomatic Severe Aortic Stenosis.

Background: The prognostic value of serial exercise echocardiography (EEC) in asymptomatic severe aortic stenosis is unknown. We sought to evaluate the safety and utility of monitoring patients with asymptomatic severe aortic stenosis by annual EECs to refer them to aortic valve replacement (AVR) or to keep them under follow-up.

Methods And Results: The cohort comprised 196 patients, with a normal screening EEC and a minimal follow-up of 18 months.

Interrelation of pericoronary adipose tissue texture and coronary artery disease of the left coronary artery in cardiac photon-counting computed tomography.

Aim: Recent research highlights the role of pericoronary adipose tissue (PCAT) in coronary artery disease (CAD) development. PCAT has been recognized as a metabolically active tissue involved in local inflammation and oxidative stress, potentially impacting CAD initiation and progression. Radiomics texture analysis shows promising results to better understand the link between PCAT quality and CAD risk.

The association between triglyceride to high-density-lipoprotein cholesterol ratio and calcific aortic valve disease: a retrospective study.

Background: The ratio of triglycerides to high-density-lipoprotein cholesterol (TG/HDL-C) is increasingly recognized as a practical marker for insulin resistance and cardiovascular risk assessment. This retrospective study investigates the potential of the TG/HDL-C ratio to predict the development of calcific aortic valve disease (CAVD), thereby extending its applicability in cardiovascular diagnostics.

Methods: Data from 400 individuals, comprising 200 patients with diagnosed CAVD and 200 matched healthy controls, were analyzed.

Elevated concentrations of cardiac troponin T are associated with thoracic aortic calcification in non-dialysis chronic kidney disease patients of stage G3 to G5.

Background: Vascular calcification (VC), especially coronary artery calcification (CAC), serves as a robust predictor of cardiovascular mortality in chronic kidney disease (CKD) patients. Recent studies have revealed that the presence of extra-coronary calcifications (ECCs) contributes to cardiovascular disease (CVD). Elevated myocardial injury markers predict mortality risk in CKD patients and are associated with CVD.

Extensive Myocardial Calcification Rapidly Progressing After Orthotopic Liver Transplantation.

Orthotopic liver transplantation has been rarely associated with myocardial calcification; no prior cases of asymptomatic calcification have been documented. We present the unique finding of asymptomatic myocardial calcification following orthotopic liver transplantation.

Native Valve and Native Neo-Sinus Remodeling Following Transcatheter Aortic Valve Replacement.

Background: Transcatheter aortic valve replacement (TAVR) pushes aside the diseased native aortic valve and creates a native neo-sinus bordered by the aortic root wall and the displaced native valve. There are limited data on the progression of native valve disease post-TAVR and no previous analysis of the native neo-sinus.

Methods: Native aortic valves and native neo-sinus explants obtained post-TAVR were evaluated histologically (hematoxylin and eosin, Movat pentachrome, and Martius Scarlet Blue stains) and by immunohistochemistry (TGF-β1 [transforming growth factor-beta 1], FAP [fibroblast activation protein], and ALP [alkaline phosphatase]) to assess disease mechanisms.

Balloon-assisted bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction with en face view for patients exhibiting severe calcified leaflet: a case report.

Background: Balloon-assisted bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction (BA-BASILICA) enables valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) in patients at risk of coronary artery obstruction. However, its efficacy in patients with severely calcified leaflets remains unclear.

Case Summary: We report a 78-year-old woman with a deteriorated 21 mm Carpentier-Edwards PERIMOUNT Magna valve.

[Cardiac myxoma: biological features, morphology, differential diagnosis].

Cardiac myxoma in its morphology is a typical benign tumor, meanwhile, the fact of its localization in the heart chamber, directly in the constant blood flow, largely determines the clinical behavior of this neoplasm, which is often manifested by the development of characteristics that formally determine the aggressive and even malignant nature of the course. Accordingly, the malignancy of cardiac myxoma is determined more by its clinical behavior (recurrence, multifocality of the lesion, the presence of mechanisms of spread similar to metastasis) rather than by its histological picture. In the structure of primary benign tumors of the heart, myxoma occupies a dominant position and its incidence is up to 85%.

A Novel Polymer Film to Develop Heart Valve Prostheses.

Polymer heart valves are a promising alternative to bioprostheses, the use of which is limited by the risks of calcific deterioration of devitalized preserved animal tissues. This is especially relevant in connection with the increasingly widespread use of transcatheter valves. Advances in modern organic chemistry provide a wide range of polymers that can replace biological material in the production of valve prostheses.

The Role of Dietary Magnesium in Cardiovascular Disease.

In the past 20 years, a large number of epidemiological studies, randomized controlled trials, and meta-analyses have found an inverse relationship between magnesium intake or serum magnesium and cardiovascular disease, indicating that low magnesium status is associated with hypertension, coronary artery calcification, stroke, ischemic heart disease, atrial fibrillation, heart failure, and cardiac mortality. Controlled metabolic unit human depletion-repletion experiments found that a mild or moderate magnesium deficiency can cause physiological and metabolic changes that respond to magnesium supplementation, which indicates that these types of deficiencies or chronic latent magnesium deficiency are contributing factors to the occurrence and severity of cardiovascular disease. Mechanisms through which a mild or moderate magnesium deficiency can contribute to this risk include inflammatory stress, oxidative stress, dyslipidemia and deranged lipid metabolism, endothelial dysfunction, and dysregulation of cellular ion channels, transporters, and signaling.

Effect of vitamin K1 supplementation on coronary calcifications in hemodialysis patients: a randomized controlled trial.

Background: Chronic kidney disease (CKD) is associated with several adverse cardiovascular outcomes, including coronary heart disease, heart failure, and arrhythmias. The severity of arterial calcifications predicts the risk of coronary heart disease and increases the risk of premature cardiovascular death. In experimental models, vitamin K1 supplementation appears to reduce coronary artery calcifications.

Tissue engineered decellularized bovine pericardium as prosthetic material in paediatric cardiac surgery.

Aim: To evaluate the short-term outcomes of Tissue Engineered Decellularized Bovine pericardium (Synkroscaff®) in congenital heart surgery as a prosthetic material.

Methodology: This is a prospective observational cohort study. SynkroScaff® was used as prosthetic material in cohort of successive patients under 18 years of age requiring cardiac surgery for congenital heart diseases.

Calcific Uremic Arteriolopathy (CUA) Among Malaysian Dialysis Patients: Clinical Characteristics, Treatment, and Outcomes.

Background Calcific uremic arteriolopathy (CUA) is a rare but debilitating disease affecting patients with kidney disease. Reported risk factors of CUA in the literature include female sex, obesity, diabetes mellitus, and vitamin K antagonists' (VKAs) usage. CUA prevalence in Malaysia is unknown and has not been reported before.

The effects of hemodialysis on the cardiovascular system.

Chronic kidney disease and dialysis-dependent end-stage renal disease are increasing in prevalence in the United States. The costs associated with end-stage renal disease management comprise approximately 1% of the federal government's annual budget. Chronic kidney disease and end-stage renal disease cause significant derangements of the cardiac and vascular system.

Systematic Coronary Risk Evaluation 2 for Older Persons (SCORE2-OP): 10 years risk validation, clinical utility and potential improvement.

Aims: European Systematic Coronary Risk Assessment 2 for Older Persons (SCORE2-OP) model has shown modest performance when externally validated in selected cohorts. We aim to investigate its predictive performance and clinical utility for 10-years cardiovascular (CV) risk in an unbiased and representative cohort of older people of a low CV risk country. Furthermore, we explore whether other clinical or echocardiographic features could improve its performance.

Calcific aortic stenosis: omics-based target discovery and therapy development.

Calcific aortic valve disease (CAVD) resulting in aortic stenosis (AS) is the most common form of valvular heart disease, affecting 2% of those over age 65. Those who develop symptomatic severe AS have an average further lifespan of <2 years without valve replacement, and three-quarters of these patients will develop heart failure, undergo valve replacement, or die within 5 years. There are no approved pharmaceutical therapies for AS, due primarily to a limited understanding of the molecular mechanisms that direct CAVD progression in the complex haemodynamic environment.

Global, Regional, and National Burden of Valvular Heart Disease, 1990 to 2021.

Background: Valvular heart disease poses an escalating global health challenge with an increasing impact on mortality and disability. This study aims to comprehensively analyze the global burden of valvular heart disease.

Methods And Results: Using the Global Burden of Disease 2021 data, we analyzed the prevalence and disability-adjusted life years, examining implications across demographics and geographic regions.

Incidental Coronary Artery Calcification and the Risk of Major Adverse Cardiovascular Outcomes.

Background Incidental findings of coronary artery calcifications (CACs) are not consistently reported, and the clinical significance relating to cardiovascular outcomes remains to be established. In this single-center cross-sectional study, we assessed the association between incidental coronary artery calcification documented on formal chest CT reports and the incidence of major adverse cardiovascular events (MACE). Methods A MACE was defined as the occurrence of stroke or transient ischemic attack or ST-segment elevation myocardial infarction, non-ST-elevation myocardial infarction, or undergoing coronary artery bypass grafting.

Characterising high-risk plaque on cardiac CT.

Coronary computed tomography angiography (CCTA) is a well-established and reliable non-invasive imaging modality that provides a comprehensive assessment of coronary artery anatomy and luminal stenosis due to atherosclerosis. Owing to advances in CCTA software and technology, the composition and morphology of coronary plaque can be accurately evaluated. Adverse features which identify plaque as being high-risk or 'vulnerable' can provide a personalised cardiovascular risk assessment over and above stenosis severity.

Rotational atherectomy with cutting balloon before stenting in severely calcified coronary lesions: a meta-analysis.

Background: Rotational atherectomy (RA) has been proven to treat coronary artery calcification (CAC) during percutaneous coronary intervention (PCI).

Purpose: This study evaluates the safety and efficacy of RA followed by cutting balloon angioplasty (ROTACUT) before stent placement in CAC.

Methods: A systematic review and meta-analysis of randomized controlled trials and observational studies was conducted.

Comprehensive Overview of Retrograde-Antegrade Connection Techniques Without Externalization in Chronic Total Occlusion PCI: The Portal Techniques.

Background: Advancing the retrograde microcatheter (MC) into the antegrade guide catheter during retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) can be challenging or impossible, preventing guidewire externalization.

Objectives: To detail and evaluate all the techniques focused on wiring to achieve intubation of the distal tip of a microcatheter, balloon, or stent with an antegrade or retrograde guidewire, aiming to reduce complications by minimizing tension on fragile collaterals during externalization and enabling rapid antegrade conversion in various clinical scenarios.

Methods: We describe the two main techniques, tip-in and rendezvous, and their derivatives such a facilitated tip-in, manual MC-tip modification, tip-in the balloon, tip-in the stent, deep dive rendezvous, catch-it and antegrade microcatheter probing.