ECG Patterns of Occlusion Myocardial Infarction: A Narrative Review.

The traditional management of acute coronary syndrome has relied on the identification of ST-segment elevation myocardial infarction (STEMI) as a proxy of acute coronary occlusion. This conflation of STEMI with acute coronary occlusion has historically overshadowed non-ST-segment elevation myocardial infarction (NSTEMI), despite evidence suggesting 25% to 34% of NSTEMI cases may also include acute coronary occlusion. Current limitations in the STEMI/NSTEMI binary framework underscore the need for a revised approach to chest pain and acute coronary syndrome management.

Anti-Amyloid Therapies for Alzheimer's Disease and Amyloid-Related Imaging Abnormalities: Implications for the Emergency Medicine Clinician.

Alzheimer's disease is the neurodegenerative disorder responsible for approximately 60% to 70% of all cases of dementia and is expected to affect 152 million by 2050. Recently, anti-amyloid therapies have been developed and approved by the Food and Drug Administration as disease-modifying treatments given as infusions every 2 to 5 weeks for Alzheimer's disease. Although this is an important milestone in mitigating Alzheimer's disease progression, it is critical for emergency medicine clinicians to understand what anti-amyloid therapies are and how they work to recognize, treat, and mitigate their adverse effects.

Age-Related Ventricular Tachycardia Substrate Characteristics for Repaired Tetralogy of Fallot Before Transcatheter Pulmonary Valve Placement.

Background: Ventricular tachycardia (VT) substrate characteristics before transcatheter pulmonary valve replacement (TPVR) in repaired tetralogy of Fallot (rTOF) are unknown.

Objectives: In this study, the authors sought to evaluate substrates for sustained monomorphic VT before TPVR in rTOF.

Methods: Retrospective (2017 to 2021) and prospective (commencing 2021) rTOF patients with native right ventricular outflow tract referred for electrophysiology study (EPS) before TPVR were included.

Percutaneous VT Ablation via RA-to-LV Access in Patients With Double Mechanical Valves: A Multicenter Registry.

Background: In patients with mechanical aortic and mitral valves requiring catheter ablation of ventricular tachycardia (VT), a technique for access from the right atrium (RA) to the left ventricle (LV) via puncture of the inferoseptal process of the LV was previously described in a single-center series.

Objectives: This study sought to report the multicenter experience of VT ablation using this novel LV access approach.

Methods: We assembled a multicenter registry of patients with double mechanical valves who underwent VT ablation with RA-to-LV access.

Left ventricular elastance with resting volumetric transthoracic echocardiography identifies different phenotypes in heart failure with preserved ejection fraction: A retrospective analysis of a multicenter prospective observational study.

Background: Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous entity including patients with different phenotypes of near normal, normal, and supernormal left ventricular (LV) function.

Objectives: To assess the value of resting LV elastance (also known as force) with transthoracic echocardiography (TTE) to identify HFpEF phenotypes.

Methods: In a prospective, observational, multicenter study, 2380 HFpEF patients were recruited from July 2016 to May 2024.

Dietary Inflammatory Score and Incident Heart Failure in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study.

Background: Inflammation plays a key role in the development of heart failure (HF), and diet is a known modifiable factor that modulates systemic inflammation. The dietary inflammatory score (DIS) is a tool to quantify the inflammatory components of diet. We sought to determine whether the DIS is associated with incident HF events.

Psychosocial impact associated with a multicancer early detection test (PATHFINDER): a prospective, multicentre, cohort study.

Background: PATHFINDER was a prospective cohort study of multicancer early detection (MCED) testing in an outpatient ambulatory population. The aim of this study is to report the patient-reported outcomes (PROs) collected as secondary and exploratory measures in the PATHFINDER study.

Methods: PATHFINDER is a prospective, multicentre, cohort study that enrolled existing healthy ambulatory outpatients at seven health networks in the USA, including hospitals, academic medical centres, and integrated health systems.

Estimation of the phase velocity dispersion curves for viscoelastic materials using Point Limited Shear Wave Elastography.

Ultrasound shear wave elastography (SWE) is widely used in clinical applications for non-invasive measurements of soft tissue viscoelasticity. The study of tissue viscoelasticity often involves the analysis of shear wave phase velocity dispersion curves, which show how the phase velocity varies with frequency or wavelength. In this study, we propose an alternative method to the two-dimensional Fourier transform (2D-FT) and Phase Gradient (PG) methods for shear wave phase velocity estimation.

Strategies for Influenza Outbreak Management in a US Residential Summer Camp Communal Housing: A Comparative Analysis of Targeted Antiviral Prophylaxis.

Background: Previous research has underscored the efficacy of individual control strategies in mitigating influenza spread within communal settings; however, the unique dynamics of residential summer camps-characterized by close contact and high social interaction-present distinct challenges for outbreak management.

Purpose: The purpose of this study was to evaluate and compare the effectiveness of two targeted antiviral prophylaxis protocols using oseltamivir in controlling influenza outbreaks within a residential youth camp, aiming to provide evidence-based insights for optimizing outbreak management in communal settings with high social interaction.

Design: This retrospective study analyzed the progression of influenza outbreaks in a residential youth camp using two antiviral prophylaxis protocols with oseltamivir.

Correlating autonomic physiology with symptoms of autonomic dysreflexia after spinal cord injury.

Background: Individuals with spinal cord injury (SCI) commonly have autonomic dysreflexia (AD) with increased sympathetic activity. After SCI, individuals have decreased baroreflex sensitivity and increased vascular responsiveness.

Objective: To evaluate the relationship between baroreflex and blood vessel sensitivity with AD symptoms.

The Dorsolateral Prefrontal Cortex: A High-level Hub for Allostatic Cardiovascular Control.

The dorsolateral prefrontal cortex (dlPFC) is increasingly targeted by various noninvasive transcranial magnetic stimulation or transcranial current stimulation protocols in a range of neuropsychiatric and other brain disorders. The rationale for this therapeutic modulation remains elusive. A model is proposed, and up-to-date evidence is discussed, suggesting that the dlPFC is a high-level cortical centre where uncertainty management, movement facilitation, and cardiovascular control processes are intertwined and integrated to deliver optimal behavioural responses in particular environmental or emotional contexts.

Reevaluating Anti-Inflammatory Therapy: Targeting Senescence to Balance Anti-Cancer Efficacy and Vascular Disease.

Modulating immune function is a critical strategy in cancer and atherosclerosis treatments. For cancer, boosting or maintaining the immune system is crucial to prevent tumor growth. However, in vascular disease, mitigating immune responses can decrease inflammation and slow atherosclerosis progression.

Outcomes of liposuction techniques for management of lipedema: a case series and narrative review.

Background And Objective: Lipedema is a commonly underdiagnosed chronic condition. This study aimed to evaluate liposuction techniques for lipedema by conducting a systematic review and presenting our experience. A case series study and a comprehensive review were conducted.

Artificial intelligence in clinical settings: a systematic review of its role in language translation and interpretation.

Background: Addressing language barriers through accurate interpretation is crucial for providing quality care and establishing trust. While the ability of artificial intelligence (AI) to translate medical documentation has been studied, its role for patient-provider communication is less explored. This review evaluates AI's effectiveness in clinical translation by assessing accuracy, usability, satisfaction, and feedback on its use.

Lessons Learned From the Liver About the Undergraduate to Graduate Medical Education Transition.

The burden of cirrhosis and chronic liver disease is growing, yet there is a projected worsening deficit in hepatology providers. As such, cirrhosis and liver disease have been important inclusions within the core curricula of Internal Medicine. Formal assessments of provider preparedness resulting from the curriculum are lacking though.

Population-Based Analysis of Late Outcomes of Mitral Valve Repair for Degenerative Mitral Valve Regurgitation.

Background: Population-based analyses may reduce uncertainty related to referral bias and/or incomplete follow-up.

Objectives: This study analyzed long-term mortality and durability of mitral valve repair in a geographically defined population with clinical and echocardiographic follow-up.

Methods: We used the Rochester Epidemiology Project to identify 153 Olmsted County patients who underwent mitral valve repair for degenerative regurgitation from 1993 to 2018.

Home-Based Cardiac Rehabilitation Among Attendees From a Large Health Care System During the Covid-19 Pandemic.

Background: Few studies have evaluated home-based cardiac rehabilitation (HBCR) during the pandemic, compared to prepandemic center-based CR (CBCR), with respect to patient characteristics, participation rates, and its efficacy on clinical metrics, health-related quality of life (QoL), and modifiable risk factors.

Objectives: We aimed to describe patient characteristics and participation rates for those attending HBCR compared to patients who attended CBCR and compare the effects of HBCR vs CBCR on clinical metrics, health-related QoL, and modifiable risk factors in CR patients pre vs during the COVID-19 pandemic.

Methods: A retrospective cohort study comparing 511 HBCR patients and 765 CBCR patients from the Mayo Clinic Health System.

Etiology and Phenotypes of Cardiomyopathy in Southern Africa: The IMHOTEP Multicenter Pilot Study.

Background: Cardiomyopathies are an important cause of heart failure in Africa yet there are limited data on etiology and clinical phenotypes.

Objectives: The IMHOTEP (African Cardiomyopathy and Myocarditis Registry Program) was designed to systematically collect data on individuals diagnosed with cardiomyopathy living in Africa.

Methods: In this multicenter pilot study, patients (age ≥13 years) were eligible for inclusion if they had a diagnosis of cardiomyopathy or myocarditis.

Promotion of Cardiovascular Health in Africa: The Alliance for Medical Research in Africa (AMedRA) Expert Panel.

This proposed scientific statement is focused on providing new insights regarding challenges and opportunities for cardiovascular health (CVH) promotion in Africa. The statement includes an overview of the current state of CVH in Africa, with a particular interest in the cardiometabolic risk factors and their evaluation through metrics. The statement also explains the main principles of primordial prevention, its relevance in reducing noncommunicable disease and the different strategies that have been effective worldwide.