A standardised protocol for blood and cerebrospinal fluid collection and processing for biomarker research in ataxia.

The European Spinocerebellar Ataxia Type 3/Machado-Joseph Disease Initiative (ESMI) is a consortium established with the ambition to set up the largest European longitudinal trial-ready cohort of Spinocerebellar Ataxia Type 3/Machado-Joseph Disease (SCA3/MJD), the most common autosomal dominantly inherited ataxia worldwide. A major focus of ESMI has been the identification of SCA3/MJD biomarkers to enable future interventional studies. As biosample collection and processing variables significantly impact the outcomes of biomarkers studies, biosampling procedures standardisation was done previously to study visit initiation.

Differential Temporal Dynamics of Axial and Appendicular Ataxia in SCA3.

Background: Disease severity in spinocerebellar ataxia type 3 (SCA3) is commonly defined by the Scale for the Assessment and Rating of Ataxia (SARA) sum score, but little is known about the contributions and progression patterns of individual items.

Objectives: To investigate the temporal dynamics of SARA item scores in SCA3 patients and evaluate if clinical and demographic factors are differentially associated with evolution of axial and appendicular ataxia.

Methods: In a prospective, multinational cohort study involving 11 European and 2 US sites, SARA scores were determined longitudinally in 223 SCA3 patients with a follow-up assessment after 1 year.

BREAST-Q Translation and Linguistic Validation to European Portuguese.

Introduction: Evaluating the impact of surgical treatment on health-related quality of life of breast cancer patients has become increasingly relevant, particularly for reconstructive procedures. The BREAST-Q consists of a broadly used patient-reported outcome measure to assess the impact of breast surgery on the health-related quality of life of these patients. The aim of this study was to translate and linguistically validate the BREAST-Q reconstructive module to European Portuguese.

Methods to evaluate vascular function: a crucial approach towards predictive, preventive, and personalised medicine.

Endothelium, the gatekeeper of our blood vessels, is highly heterogeneous and a crucial physical barrier with the ability to produce vasoactive and protective mediators under physiological conditions. It regulates vascular tone, haemostasis, vascular inflammation, remodelling, and angiogenesis. Several cardio-, reno-, and cerebrovascular diseases begin with the dysfunction of endothelial cells, and more recently, COVID-19 was also associated with endothelial disease highlighting the need to monitor its function towards prevention and reduction of vascular dysfunction.

Dynamics of Soluble Factors and Double-Negative T Cells Associated with Response to Renal Denervation in Resistant Hypertension Patients.

The role of the immune system, and hence inflammation, in the pathophysiology of hypertensive patients is not clear. Until now, most clinical and biochemical parameters have failed to predict a positive response to renal denervation (RDN). Our aim was to evaluate the immune response in a cohort of patients treated by RDN, through the analysis of cytokine, chemokine, and growth factor behavior.

Lower urinary tract and bowel dysfunction in spinocerebellar ataxias.

Background: Little information is available in spinocerebellar ataxias (SCAs) regarding pelvic organ symptoms. The aim of this study was to characterize the lower urinary tract (LUT) and bowel dysfunction in autosomal dominant spinocerebellar ataxias.

Methods: Patients with confirmed SCAs attending a tertiary care service were approached about LUT and bowel complaints, and completed validated questionnaires: urinary symptom profile (USP), Qualiveen-Short form, International Prostate Symptom Score, and Neurogenic Bowel Dysfunction Score.

Activated double-negative T cells (CD3CD4CD8HLA-DR) define response to renal denervation for resistant hypertension.

Purpose: To explore the cellular immune response of patients with resistant hypertension treated with renal denervation (RDN).

Methods And Results: Twenty-three patients were included and blood samples were obtained in six timings, pre and post procedure. Response was evaluated at six-months and one year and was observed in 69.

Intravascular imaging, histopathological analysis, and catecholamine quantification following catheter-based renal denervation in a swine model: the impact of prebifurcation energy delivery.

The purpose of this study was to evaluate the impact of prebifurcation renal denervation in a swine model and assess its safety through optical coherence tomography (OCT). Prebifurcation renal denervation with a multi-electrode catheter was performed in one renal artery of 12 healthy pigs, with the contralateral artery and kidney being used as controls. Angiograms and OCT pullbacks were obtained peri-procedurally and 1 month post procedure.

Renal denervation in the era of HTN-3. Comprehensive review and glimpse into the future.

The pathophysiological role of sympathetic overactivity in conditions such as hypertension has been well documented. Catheter-based renal denervation (RDN) is a minimally invasive percutaneous procedure which aims to disrupt sympathetic nerve afferent and efferent activity through the application of radiofrequency energy directly within the renal artery wall. This technique has emerged as a very promising treatment with dramatic effects on refractory hypertension but also in other conditions in which a sympathetic influence is present.

Additional value of associating aortic valve calcification to coronary calcium as a gatekeeper for coronary tomography angiography.

Background: Aortic valve calcification shares risk factors with coronary artery disease. Coronary calcium has been used has a gatekeeper to performing coronary tomography angiography. The aim of this study was to evaluate aortic valve calcification as a predictor of obstructive coronary artery disease by computed tomography, and its possible usefulness, alongside with coronary calcium, to improve the decision of whether or not to proceed with computed tomography angiography.

Universal definition of myocardial infarction: clinical insights.

Aims: The universal definition of myocardial infarction (MI) classifies acute ischaemia into different classes according to lesion mechanism. Our aim was to perform a detailed comparison between these different types of MI in terms of baseline characteristics, management and prognosis.

Methods And Results: An observational retrospective single-centre cohort study was performed, including 1,000 consecutive patients admitted for type 1 (76.

Improving risk stratification in non-ST-segment elevation myocardial infarction with combined assessment of GRACE and CRUSADE risk scores.

Background: Risk assessment is fundamental in the management of acute coronary syndromes (ACS), enabling estimation of prognosis.

Aims: To evaluate whether the combined use of GRACE and CRUSADE risk stratification schemes in patients with myocardial infarction outperforms each of the scores individually in terms of mortality and haemorrhagic risk prediction.

Methods: Observational retrospective single-centre cohort study including 566 consecutive patients admitted for non-ST-segment elevation myocardial infarction.

Which method of left atrium size quantification is the most accurate to recognize thromboembolic risk in patients with non-valvular atrial fibrillation?

Background: Left atrial (LA) size is a predictor of cardiovascular outcomes in patients in sinus rhythm, whereas conflicting results have been found in atrial fibrillation (AF). This study aims to: (1) Evaluate the accuracy of LA size to identify surrogate markers of an increased thromboembolic risk in patients with AF; (2) Assess the best method to evaluate LA size in this setting.

Methods: Cross-sectional study enrolling 500 consecutive patients undergoing transthoracic and transesophageal echocardiography evaluation during a non-valvular AF episode.

Can cardiac computed tomography predict cardiovascular events in asymptomatic type-2 diabetics?: results of a long term follow-up.

Background: Doubts remain about atherosclerotic disease and risk stratification of asymptomatic type-2 diabetic patients (T2DP). This study aims to evaluate the usefulness of calcium score (CS) and coronary computed tomography (CT) angiography (CTA) to predict fatal and non fatal cardiovascular events (CVEV) in T2DP.

Methods: Eighty-five consecutive T2DP undergoing CT (Phillips Brilliance, 16-slice) with CS and CTA were prospectively enrolled in a transversal case-control study.

Mid-term Risk Stratification of Patients with a Myocardial Infarction and Atrial Fibrillation: Beyond GRACE and CHADS.

We hypothesize that the discriminative performance of GRACE, ACHTUNG-Rule, CHADS or CHADS-VASc may be lower in patients with a Myocardial Infarction (MI) and concurrent atrial fibrillation (AF), as none of these scores seem able to fully capture both atherothrombotic/thromboembolic risks. This study aims to evaluate the mid-term prognostic performance of these algorithms in patients with these two conditions and to analyze the utility of a score combining GRACE and CHADS-VASc. Observational retrospective single-centre cohort study including 1852 patients admitted with a MI.

Performance of the Cockcroft-Gault, MDRD and CKD-EPI Formulae in Non-Valvular Atrial Fibrillation: Which one Should be Used for Risk Stratification?

Renal dysfunction is a strong predictor of adverse events in patients with atrial fibrillation (AF). The Cokcroft-Gault, Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equations are available for estimating the glomerular filtration rate (GFR). No comparisons between these equations have yet been performed in patients with non-valvular AF concerning their mid-term prognostic performance.

Stroke prediction with an adjusted R-CHA2DS2VASc score in a cohort of patients with a Myocardial Infarction.

Introduction: A new risk stratification scheme incorporating the original CHADS2 score and renal function, entitled R(2)CHADS(2), was validated in the ROCKET-AF and ATRIA study cohorts.

Aims: Adjusting and validating a modified R-CHA2DS2VASc score as a predictor of ischaemic stroke and all-cause mortality in patients discharged following admission for a Myocardial Infarction (MI).

Materials And Methods: Observational retrospective single-centre cohort study including 1711 patients admitted with MI and discharged alive.

Surgery for Atrial Fibrillation: Selecting the Procedure for the Patient.

This manuscript aims to review the current knowledge in the field of surgical ablation of atrial fibrillation (AF), including a brief discussion regarding the standard Maze procedure, its variants, minimally invasive thoracoscopic procedures and hybrid treatments, which briefly summarizes the advantages and differences between each technique. The rationale for the surgical approach of the left atrial appendage, its different techniques and complications will also be briefly covered. To conclude, the current Expert Consensus recommendations will be reviewed and an algorithm for the surgical management of the patient with AF, suggesting which technique applies better to which patient, under specific settings, will also be proposed.

BLEED-Myocardial Infarction Score: Predicting mid-term post-discharge bleeding events.

Aim: To derive and validate a score for the prediction of mid-term bleeding events following discharge for myocardial infarction (MI).

Methods: One thousand and fifty patients admitted for MI and followed for 19.9 ± 6.

Early repolarization patterns and the role of additional proarrhythmic triggers.

The majority of individuals with early repolarization (ER) patterns have a benign prognosis. However, recent case-control series and population studies have established a significant association between ER and an increased risk of arrhythmic death. There is a common agreement that J-waves, particularly of large amplitude, dynamic, and present in multiple leads, are more prevalent in patients with idiopathic ventricular fibrillation, but the distinction between benign and malignant electrocardiographic variants of ER is still a controversial subject.

Overview of resistant hypertension: A glimpse of the cardiologist's current standpoint.

Hypertension is a major risk factor for cardiovascular disease, resulting in increased incidence of cerebrovascular events, ischaemic heart disease, heart failure, and renal impairment. Thus, it is one of the most important preventable causes of premature morbidity and mortality. Despite current knowledge on the management of hypertension and the availability of several effective antihypertensive medications, uncontrolled hypertension remains a common and challenging clinical problem.